PyChimera: use UCSF Chimera modules in any Python 2.7 project.

PubMed

Rodríguez-Guerra Pedregal, Jaime; Maréchal, Jean-Didier

2018-05-15

UCSF Chimera is a powerful visualization tool remarkably present in the computational chemistry and structural biology communities. Built on a C++ core wrapped under a Python 2.7 environment, one could expect to easily import UCSF Chimera's arsenal of resources in custom scripts or software projects. Nonetheless, this is not readily possible if the script is not executed within UCSF Chimera due to the isolation of the platform. UCSF ChimeraX, successor to the original Chimera, partially solves the problem but yet major upgrades need to be undergone so that this updated version can offer all UCSF Chimera features. PyChimera has been developed to overcome these limitations and provide access to the UCSF Chimera codebase from any Python 2.7 interpreter, including interactive programming with tools like IPython and Jupyter Notebooks, making it easier to use with additional third-party software. PyChimera is LGPL-licensed and available at https://github.com/insilichem/pychimera. jaime.rodriguezguerra@uab.cat or jeandidier.marechal@uab.cat. Supplementary data are available at Bioinformatics online.

UCSF Small Molecule Discovery Center: innovation, collaboration and chemical biology in the Bay Area.

PubMed

Arkin, Michelle R; Ang, Kenny K H; Chen, Steven; Davies, Julia; Merron, Connie; Tang, Yinyan; Wilson, Christopher G M; Renslo, Adam R

2014-05-01

The Small Molecule Discovery Center (SMDC) at the University of California, San Francisco, works collaboratively with the scientific community to solve challenging problems in chemical biology and drug discovery. The SMDC includes a high throughput screening facility, medicinal chemistry, and research labs focused on fundamental problems in biochemistry and targeted drug delivery. Here, we outline our HTS program and provide examples of chemical tools developed through SMDC collaborations. We have an active research program in developing quantitative cell-based screens for primary cells and whole organisms; here, we describe whole-organism screens to find drugs against parasites that cause neglected tropical diseases. We are also very interested in target-based approaches for so-called "undruggable", protein classes and fragment-based lead discovery. This expertise has led to several pharmaceutical collaborations; additionally, the SMDC works with start-up companies to enable their early-stage research. The SMDC, located in the biotech-focused Mission Bay neighborhood in San Francisco, is a hub for innovative small-molecule discovery research at UCSF.

Impact of UCSF criteria according to pre- and post-OLT tumor features: analysis of 479 patients listed for HCC with a short waiting time.

PubMed

Decaens, Thomas; Roudot-Thoraval, Françoise; Hadni-Bresson, Solange; Meyer, Carole; Gugenheim, Jean; Durand, Francois; Bernard, Pierre-Henri; Boillot, Olivier; Sulpice, Laurent; Calmus, Yvon; Hardwigsen, Jean; Ducerf, Christian; Pageaux, Georges-Philippe; Dharancy, Sebastien; Chazouilleres, Olivier; Cherqui, Daniel; Duvoux, Christophe

2006-12-01

Orthotopic liver transplantation (OLT) indication for hepatocellular carcinoma (HCC) is currently based on the Milan criteria. The University of California, San Francisco (UCSF) recently proposed an expansion of the selection criteria according to tumors characteristics on the explanted liver. This study: 1) assessed the validity of these criteria in an independent large series and 2) tested for the usefulness of these criteria when applied to pre-OLT tumor evaluation. Between 1985 and 1998, 479 patients were listed for liver transplantation (LT) for HCC and 467 were transplanted. According to pre-OLT (imaging at date of listing) or post-OLT (explanted liver) tumor characteristics, patients were retrospectively classified according to both the Milan and UCSF criteria. The 5-yr survival statistics were assessed by the Kaplan-Meier method and compared by the log-rank test. Pre-OLT UCSF criteria were analyzed according to an intention-to-treat principle. Based on the pre-OLT evaluation, 279 patients were Milan+, 44 patients were UCSF+ but Milan- (subgroup of patients that might benefit from the expansion), and 145 patients were UCSF- and Milan-. With a short median waiting time of 4 months, 5-yr survival was 60.1 +/- 3.0%, 45.6 +/- 7.8%, and 34.7 +/- 4.0%, respectively (P < 0.001). The 5-yr survival was arithmetically lower in UCSF+ Milan- patients compared to Milan+ but this difference was not significant (P = 0.10). Based on pathological features of the explanted liver, 5-yr survival was 70.4 +/- 3.4%, 63.6 +/- 7.8%, and 34.1 +/- 3.1%, in Milan+ patients (n = 184), UCSF+ Milan- patients (n = 39), and UCSF- Milan- patients (n = 238), respectively (P < 0.001). However, the 5-yr survival did not differ between Milan+ and UCSF+ Milan- patients (P = 0.33). In conclusion, these results show that when applied to pre-OLT evaluation, the UCSF criteria are associated with a 5-yr survival below 50%. Their applicability is therefore limited, despite similar survival rates compared to the Milan criteria, when the explanted liver is taken into account.

Surveillance Tools Emerging From Search Engines and Social Media Data for Determining Eye Disease Patterns

PubMed Central

Deiner, Michael S.; Lietman, Thomas M.; McLeod, Stephen D.; Chodosh, James; Porco, Travis C.

2016-01-01

IMPORTANCE Internet-based search engine and social media data may provide a novel complementary source for better understanding the epidemiologic factors of infectious eye diseases, which could better inform eye health care and disease prevention. OBJECTIVE To assess whether data from internet-based social media and search engines are associated with objective clinic-based diagnoses of conjunctivitis. DESIGN, SETTING, AND PARTICIPANTS Data from encounters of 4143 patients diagnosed with conjunctivitis from June 3, 2012, to April 26, 2014, at the University of California San Francisco (UCSF) Medical Center, were analyzed using Spearman rank correlation of each weekly observation to compare demographics and seasonality of nonallergic conjunctivitis with allergic conjunctivitis. Data for patient encounters with diagnoses for glaucoma and influenza were also obtained for the same period and compared with conjunctivitis. Temporal patterns of Twitter and Google web search data, geolocated to the United States and associated with these clinical diagnoses, were compared with the clinical encounters. The a priori hypothesis was that weekly internet-based searches and social media posts about conjunctivitis may reflect the true weekly clinical occurrence of conjunctivitis. MAIN OUTCOMES AND MEASURES Weekly total clinical diagnoses at UCSF of nonallergic conjunctivitis, allergic conjunctivitis, glaucoma, and influenza were compared using Spearman rank correlation with equivalent weekly data on Tweets related to disease or disease-related keyword searches obtained from Google Trends. RESULTS Seasonality of clinical diagnoses of nonallergic conjunctivitis among the 4143 patients (2364 females [57.1%] and 1776 males [42.9%]) with 5816 conjunctivitis encounters at UCSF correlated strongly with results of Google searches in the United States for the term pink eye (ρ, 0.68 [95%CI, 0.52 to 0.78]; P < .001) and correlated moderately with Twitter results about pink eye (ρ, 0.38 [95%CI, 0.16 to 0.56]; P < .001) and with clinical diagnosis of influenza (ρ, 0.33 [95%CI, 0.12 to 0.49]; P < .001), but did not significantly correlate with seasonality of clinical diagnoses of allergic conjunctivitis diagnosis at UCSF (ρ, 0.21 [95%CI, −0.02 to 0.42]; P = .06) or with results of Google searches in the United States for the term eye allergy (ρ, 0.13 [95%CI, −0.06 to 0.32]; P = .19). Seasonality of clinical diagnoses of allergic conjunctivitis at UCSF correlated strongly with results of Google searches in the United States for the term eye allergy (ρ, 0.44 [95%CI, 0.24 to 0.60]; P < .001) and eye drops (ρ, 0.47 [95%CI, 0.27 to 0.62]; P < .001). CONCLUSIONS AND RELEVANCE Internet-based search engine and social media data may reflect the occurrence of clinically diagnosed conjunctivitis, suggesting that these data sources can be leveraged to better understand the epidemiologic factors of conjunctivitis. PMID:27416554

$10M Gift Supports "Data Recycling" at UCSF.

PubMed

2017-10-01

The University of California, San Francisco's Institute for Computational Health Sciences has received a $10 million gift to support "data recycling" investigations. The approach to medical research involves mining existing data to potentially uncover new uses for existing drugs and help improve clinical care. ©2017 American Association for Cancer Research.

Multicentre validation of a sepsis prediction algorithm using only vital sign data in the emergency department, general ward and ICU.

PubMed

Mao, Qingqing; Jay, Melissa; Hoffman, Jana L; Calvert, Jacob; Barton, Christopher; Shimabukuro, David; Shieh, Lisa; Chettipally, Uli; Fletcher, Grant; Kerem, Yaniv; Zhou, Yifan; Das, Ritankar

2018-01-26

We validate a machine learning-based sepsis-prediction algorithm ( InSight ) for the detection and prediction of three sepsis-related gold standards, using only six vital signs. We evaluate robustness to missing data, customisation to site-specific data using transfer learning and generalisability to new settings. A machine-learning algorithm with gradient tree boosting. Features for prediction were created from combinations of six vital sign measurements and their changes over time. A mixed-ward retrospective dataset from the University of California, San Francisco (UCSF) Medical Center (San Francisco, California, USA) as the primary source, an intensive care unit dataset from the Beth Israel Deaconess Medical Center (Boston, Massachusetts, USA) as a transfer-learning source and four additional institutions' datasets to evaluate generalisability. 684 443 total encounters, with 90 353 encounters from June 2011 to March 2016 at UCSF. None. Area under the receiver operating characteristic (AUROC) curve for detection and prediction of sepsis, severe sepsis and septic shock. For detection of sepsis and severe sepsis, InSight achieves an AUROC curve of 0.92 (95% CI 0.90 to 0.93) and 0.87 (95% CI 0.86 to 0.88), respectively. Four hours before onset, InSight predicts septic shock with an AUROC of 0.96 (95% CI 0.94 to 0.98) and severe sepsis with an AUROC of 0.85 (95% CI 0.79 to 0.91). InSight outperforms existing sepsis scoring systems in identifying and predicting sepsis, severe sepsis and septic shock. This is the first sepsis screening system to exceed an AUROC of 0.90 using only vital sign inputs. InSight is robust to missing data, can be customised to novel hospital data using a small fraction of site data and retains strong discrimination across all institutions. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

McCormick to Aid Frederick National Laboratory in Developing RAS Cancer Genetics Initiative | Frederick National Laboratory for Cancer Research

Cancer.gov

Frank McCormick, Ph.D., director of the Helen Diller Family Comprehensive Cancer Center at the University of California, San Francisco, and associate dean of the UCSF School of Medicine, has signed a consulting agreement with SAIC-Frederick Inc. to w

Can we direct organ allocation based on predicted outcome? Hepatocellular carcinoma outside of UCSF criteria or retransplant?

PubMed

Rochon, Caroline; Sheiner, Patricia; Mahadevappa, Basant; Gunasekaran, Ganesh; Sharma, Joyti; Wolf, David C; Facciuto, Marcelo

2012-06-01

In this study, we ask between patients with graft failure listed for retransplant and patients with hepatocellular carcinoma (HCC) outside of UCSF criteria, who has the greater survival benefit with transplantation? This is a retrospective analysis, of liver transplant (LT) patients, done between February 2002 and December 2009 at our center. Patients were included in the "extended HCC" group if their tumor was pathologically beyond UCSF criteria at LT and in the "redo" group if they underwent LT for graft failure occurring more than 3 months after the initial LT. Extended criteria donors (ECDs) were defined as donors above 70 years old, DCD, serology positive for HCV, and split grafts. There were 25 redos and 37 extended HCC patients. Use of ECDs or high donor risk index organs was associated with poor outcome in both groups (P = 0.005). Overall, the extended HCC population had a much better survival than redos, both at 1 and 3 years. These two very different but high risk patient populations have very different survival rates. At a time where regulatory agencies demand more and more with regards to transplant outcomes, we think the transplant community has to reflect on whether allocation justice and fair access to transplant are respected if we start allocating organs based on outcomes.

Use of Age and Medical Comorbidity to Assess Long-term Other-cause Mortality Risk in a Cohort of Men Undergoing Prostate Biopsy at an Academic Medical Center.

PubMed

Kominsky, Hal D; Bashline, Michael; Eun, Daniel; Pontari, Michel A; Mydlo, Jack H; Reese, Adam C

2017-02-01

To assess life expectancy and biopsy outcomes in men undergoing prostate biopsy at an academic medical center. We analyzed men who underwent prostate biopsy at our medical center between July 2012 and June 2014. Long-term other-cause mortality risk was determined using survival tables. Indications for biopsy and biopsy outcomes were assessed, and compared among men with varying mortality risks. A total of 417 men underwent prostate biopsy, in whom 14-year other-cause mortality risk ranged from 9% to 74%. One hundred ninety-three men (46.3%) were considered low-mortality risk (<40% risk of 14-year mortality), 131 (31.4%) intermediate risk (41%-55% 14-year mortality), and 93 (22.3%) high risk (>55% 14-year mortality). Of the 417 patients who underwent biopsy, 149 (35.7%) were found to have prostate cancer. There was no significant difference in the rate of positive biopsies (P = .72), distribution of Gleason scores (P = .60), or percentage of positive biopsy cores (P = .74) between mortality risk groups. However, by UCSF Cancer of the Prostate Risk Assessment score, there was significant trend toward higher-risk prostate cancer in men with intermediate and high-mortality risk (P = .04). In this analysis, a large number of men with limited life expectancies underwent prostate biopsy. The majority of these men had negative biopsies or low-risk cancers, suggesting that they were unlikely to benefit from biopsy. To avoid potentially unnecessary prostate biopsies, the practitioner must give serious consideration to a patient's age and medical comorbidities before making a recommendation as to whether biopsy should be performed. Copyright © 2016 Elsevier Inc. All rights reserved.

Role of collaborative academic partnerships in surgical training, education, and provision.

PubMed

Riviello, Robert; Ozgediz, Doruk; Hsia, Renee Y; Azzie, Georges; Newton, Mark; Tarpley, John

2010-03-01

The global disparities in both surgical disease burden and access to delivery of surgical care are gaining prominence in the medical literature and media. Concurrently, there is an unprecedented groundswell in idealism and interest in global health among North American medical students and trainees in anesthesia and surgical disciplines. Many academic medical centers (AMCs) are seeking to respond by creating partnerships with teaching hospitals overseas. In this article we describe six such partnerships, as follows: (1) University of California San Francisco (UCSF) with the Bellagio Essential Surgery Group; (2) USCF with Makerere University, Uganda; (3) Vanderbilt with Baptist Medical Center, Ogbomoso, Nigeria; (4) Vanderbilt with Kijabe Hospital, Kenya; (5) University of Toronto, Hospital for Sick Children with the Ministry of Health in Botswana; and (6) Harvard (Brigham and Women's Hospital and Children's Hospital Boston) with Partners in Health in Haiti and Rwanda. Reflection on these experiences offers valuable lessons, and we make recommendations of critical components leading to success. These include the importance of relationships, emphasis on mutual learning, the need for "champions," affirming that local training needs to supersede expatriate training needs, the value of collaboration in research, adapting the mission to locally expressed needs, the need for a multidisciplinary approach, and the need to measure outcomes. We conclude that this is an era of cautious optimism and that AMCs have a critical opportunity to both shape future leaders in global surgery and address the current global disparities.

Can living donor liver transplantation offer similar outcomes to deceased donor liver transplantation using expanded selection criteria for hepatocellular carcinoma?

PubMed Central

Chen, Li-Ping; Li, Chuan; Wen, Tian-Fu; Yan, Lu-Nan; Li, Bo; Yang, Jia-Yin

2015-01-01

Objective: To compare the outcomes of living donor liver transplantation (LDLT) versus deceased donor liver transplantation (DDLT) for patients with hepatocellular carcinoma (HCC) in different selection criteria. Methods: Data of patients with HCC who underwent liver transplantation between 2005 and 2013 at our center were reviewed. Clinical data of LDLT recipients and DDLT recipients were compared. The postoperative recurrence-free survival (RFS) rate and overall survival (OS) rate after LDLT versus DDLT were compared in the Milan recipients, the University of California, San Francisco (UCSF) recipients, the up-to-seven recipients, the Hangzhou recipients and the Chengdu recipients. Results: Data of 255 patients were retrospectively reviewed in this study. Seventeen DDLT recipient and 9 LDLT recipients died during the perioperative period. Among the remaining 229 recipients (NLDLT=66, NDDLT=163), 96 patients met the Milan criteria, 123 recipients met the UCSF criteria, 135 patients met the up-to-seven criteria, 216 patients met the Hangzhou criteria, and 229 recipients met the Chengdu criteria. The overall RFS and OS rates of the Milan recipients, the UCSF recipients, the up-to-seven recipients, the Hangzhou recipients and the Chengdu recipients after LDLT and DDLT were all similar. Conclusion: Using well-studied selection criteria, LDLT offers similar outcomes to DDLT for patient with HCC, even using expanded selection criteria. PMID:26430399

Can living donor liver transplantation offer similar outcomes to deceased donor liver transplantation using expanded selection criteria for hepatocellular carcinoma?

PubMed

Chen, Li-Ping; Li, Chuan; Wen, Tian-Fu; Yan, Lu-Nan; Li, Bo; Yang, Jia-Yin

2015-01-01

To compare the outcomes of living donor liver transplantation (LDLT) versus deceased donor liver transplantation (DDLT) for patients with hepatocellular carcinoma (HCC) in different selection criteria. Data of patients with HCC who underwent liver transplantation between 2005 and 2013 at our center were reviewed. Clinical data of LDLT recipients and DDLT recipients were compared. The postoperative recurrence-free survival (RFS) rate and overall survival (OS) rate after LDLT versus DDLT were compared in the Milan recipients, the University of California, San Francisco (UCSF) recipients, the up-to-seven recipients, the Hangzhou recipients and the Chengdu recipients. Data of 255 patients were retrospectively reviewed in this study. Seventeen DDLT recipient and 9 LDLT recipients died during the perioperative period. Among the remaining 229 recipients (NLDLT=66, NDDLT=163), 96 patients met the Milan criteria, 123 recipients met the UCSF criteria, 135 patients met the up-to-seven criteria, 216 patients met the Hangzhou criteria, and 229 recipients met the Chengdu criteria. The overall RFS and OS rates of the Milan recipients, the UCSF recipients, the up-to-seven recipients, the Hangzhou recipients and the Chengdu recipients after LDLT and DDLT were all similar. Using well-studied selection criteria, LDLT offers similar outcomes to DDLT for patient with HCC, even using expanded selection criteria.

Enhancing UCSF Chimera through web services

PubMed Central

Huang, Conrad C.; Meng, Elaine C.; Morris, John H.; Pettersen, Eric F.; Ferrin, Thomas E.

2014-01-01

Integrating access to web services with desktop applications allows for an expanded set of application features, including performing computationally intensive tasks and convenient searches of databases. We describe how we have enhanced UCSF Chimera (http://www.rbvi.ucsf.edu/chimera/), a program for the interactive visualization and analysis of molecular structures and related data, through the addition of several web services (http://www.rbvi.ucsf.edu/chimera/docs/webservices.html). By streamlining access to web services, including the entire job submission, monitoring and retrieval process, Chimera makes it simpler for users to focus on their science projects rather than data manipulation. Chimera uses Opal, a toolkit for wrapping scientific applications as web services, to provide scalable and transparent access to several popular software packages. We illustrate Chimera's use of web services with an example workflow that interleaves use of these services with interactive manipulation of molecular sequences and structures, and we provide an example Python program to demonstrate how easily Opal-based web services can be accessed from within an application. Web server availability: http://webservices.rbvi.ucsf.edu/opal2/dashboard?command=serviceList. PMID:24861624

The impact of intramural grants on educators' careers and on medical education innovation.

PubMed

Adler, Shelley R; Chang, Anna; Loeser, Helen; Cooke, Molly; Wang, Jason; Teherani, Arianne

2015-06-01

The University of California, San Francisco (UCSF), Haile T. Debas Academy of Medical Educators Innovations Funding program awards competitive grants to create novel curricula and faculty development programs, compare pedagogical approaches, and design learner assessment methods. The authors examined the principal investigators' (PIs') perceptions of the impact of these intramural grants on their careers and on medical education innovation. At 12 months (project completion) and 24 months (follow-up), PIs submit a progress report describing the impact of their grant on their careers, work with collaborators, subsequent funding, project dissemination, and the UCSF curriculum. The authors analyzed these reports using qualitative thematic analysis and achieved consensus in coding and interpretation through discussion. From 2001 to 2012, the program funded 77 PIs to lead 103 projects, awarding over $2.2 million. The authors analyzed reports from 88 grants (85.4%) awarded to 68 PIs (88.3%). PIs noted that the funding led to accelerated promotion, expanded networking opportunities, enhanced knowledge and skills, more scholarly publications and presentations, extramural funding, and local and national recognition. They also reported that the funding improved their status in their departments, enhanced their careers as medical educators, laid the foundation for subsequent projects, and engaged an array of stakeholders, including trainees and junior faculty. These modest intramural education grants not only created innovative, enduring programs but also promoted educators' professional identity formation, fostered collaborations, supported junior faculty in finding their desired career paths, provided advancement opportunities, and raised the local and national profiles of recipients.

Policy Options for University of California Budgeting. Research & Occasional Paper Series: CSHE.5.11

ERIC Educational Resources Information Center

Young, Charles E.

2011-01-01

Within a quarter century after the end of World War II (1945-1970), largely because of the support and investment it received from the State, the University of California had changed from two modest-size general campuses (Berkeley and Los Angeles) and the medical campus in San Francisco (UCSF), to a system of eight general campuses. California was…

Does Research Training During Residency Promote Scholarship and Influence Career Choice? A Cross-Sectional Analysis of a 10-Year Cohort of the UCSF-PRIME Internal Medicine Residency Program.

PubMed

Kohlwes, Jeffrey; O'Brien, Bridget; Stanley, Marion; Grant, Ross; Shunk, Rebecca; Connor, Denise; Cornett, Patricia; Hollander, Harry

2016-01-01

The Association of Program Directors in Internal Medicine, the Accreditation Council for Graduate Medical Education, the Alliance for Academic Internal Medicine, and the Carnegie Foundation report on medical education recommend creating individualized learning pathways during medical training so that learners can experience broader professional roles beyond patient care. Little data exist to support the success of these specialized pathways in graduate medical education. We present the 10-year experience of the Primary Care Medicine Education (PRIME) track, a clinical-outcomes research pathway for internal medicine residents at the University of California San Francisco (UCSF). We hypothesized that participation in an individualized learning track, PRIME, would lead to a greater likelihood of publishing research from residency and accessing adequate career mentorship and would be influential on subsequent alumni careers. We performed a cross-sectional survey of internal medicine residency alumni from UCSF who graduated in 2001 through 2010. We compared responses of PRIME and non-PRIME categorical alumni. We used Pearson's chi-square and Student's t test to compare PRIME and non-PRIME alumni on categorical and continuous variables. Sixty-six percent (211/319) of alumni responded to the survey. A higher percentage of PRIME alumni published residency research projects compared to non-PRIME alumni (64% vs. 40%; p = .002). The number of PRIME alumni identifying research as their primary career role was not significantly different from non-PRIME internal medicine residency graduates (35% of PRIME vs. 29% non-PRIME). Process measures that could explain these findings include adequate access to mentors (M 4.4 for PRIME vs. 3.6 for non-PRIME alumni, p < .001, on a 5-point Likert scale) and agreeing that mentoring relationships affected career choice (M 4.2 for PRIME vs. 3.7 for categorical alumni, p = .001). Finally, 63% of PRIME alumni agreed that their research experience during residency influenced their subsequent career choice versus 46% of non-PRIME alumni (p = .023). Our results support the concept that providing residents with an individualized learning pathway focusing on clinical outcomes research during residency enables them to successfully publish manuscripts and access mentorship, and may influence subsequent career choice. Implementation of individualized residency program tracks that nurture academic interests along with clinical skills can support career development within medicine residency programs.

Enhancing UCSF Chimera through web services.

PubMed

Huang, Conrad C; Meng, Elaine C; Morris, John H; Pettersen, Eric F; Ferrin, Thomas E

2014-07-01

Integrating access to web services with desktop applications allows for an expanded set of application features, including performing computationally intensive tasks and convenient searches of databases. We describe how we have enhanced UCSF Chimera (http://www.rbvi.ucsf.edu/chimera/), a program for the interactive visualization and analysis of molecular structures and related data, through the addition of several web services (http://www.rbvi.ucsf.edu/chimera/docs/webservices.html). By streamlining access to web services, including the entire job submission, monitoring and retrieval process, Chimera makes it simpler for users to focus on their science projects rather than data manipulation. Chimera uses Opal, a toolkit for wrapping scientific applications as web services, to provide scalable and transparent access to several popular software packages. We illustrate Chimera's use of web services with an example workflow that interleaves use of these services with interactive manipulation of molecular sequences and structures, and we provide an example Python program to demonstrate how easily Opal-based web services can be accessed from within an application. Web server availability: http://webservices.rbvi.ucsf.edu/opal2/dashboard?command=serviceList. © The Author(s) 2014. Published by Oxford University Press on behalf of Nucleic Acids Research.

What's in It for Me? Maintenance of Certification as an Incentive for Faculty Supervision of Resident Quality Improvement Projects.

PubMed

Rosenbluth, Glenn; Tabas, Jeffrey A; Baron, Robert B

2016-01-01

Residents are required to engage in quality improvement (QI) activities, which requires faculty engagement. Because of increasing program requirements and clinical demands, faculty may be resistant to taking on additional teaching and supervisory responsibilities without incentives. The authors sought to create an authentic benefit for University of California, San Francisco (UCSF) Pediatrics Residency Training Program faculty who supervise pediatrics residents' QI projects by offering maintenance of certification (MOC) Part 4 (Performance in Practice) credit. The authors identified MOC as an ideal framework to both more actively engage faculty who were supervising QI projects and provide incentives for doing so. To this end, in 2011, the authors designed an MOC portfolio program which included faculty development, active supervision of residents, and QI projects designed to improve patient care. The UCSF Pediatrics Residency Training Program's Portfolio Sponsor application was approved by the American Board of Pediatrics (ABP) in 2012, and faculty whose projects were included in the application were granted MOC Part 4 credit. As of December 2013, six faculty had received MOC Part 4 credit for their supervision of residents' QI projects. Based largely on the success of this program, UCSF has transitioned to the MOC portfolio program administered through the American Board of Medical Specialties, which allows the organization to offer MOC Part 4 credit from multiple specialty boards including the ABP. This may require refinements to screening, over sight, and reporting structures to ensure the MOC standards are met. Ongoing faculty development will be essential.

Digital Tools for Cancer Prevention: Extending Reach and Engagement

Cancer.gov

Judith (Jodi) Prochaska, PhD, MPH, is Associate Professor of Medicine with the Stanford Prevention Research Center and a member of the Stanford Cancer Institute. Dr. Prochaska is a Principal Investigator on multiple research awards from the National Institutes of Health and the State of California Tobacco-Related Disease Research Program. Her research program is leveraging technology (e.g., web, text, social media) to bring tobacco cessation treatment into novel settings and to populations with high smoking prevalence. With attention to medical education and clinical practice, Dr. Prochaska has disseminated tobacco treatment curricula as part of Rx for Change (http://rxforchange.ucsf.edu). She has authored 175 peer-reviewed publications, serves on the Editorial Board of JAMA Internal Medicine, and is on the advisory board for Optum’s Quit for Life Tobacco Quitline. Dr. Prochaska is President of the Society for Research on Nicotine and Tobacco (SRNT), the international scientific society aimed at stimulating the generation and dissemination of new knowledge concerning nicotine and tobacco from bench to bedside and through to health policy.

Multiparametric MRI of the prostate: diagnostic performance and interreader agreement of two scoring systems.

PubMed

Lin, Wei-Ching; Muglia, Valdair F; Silva, Gyl E B; Chodraui Filho, Salomão; Reis, Rodolfo B; Westphalen, Antonio C

2016-06-01

To compare the diagnostic accuracies and interreader agreements of the Prostate Imaging Reporting and Data System (PI-RADS) v. 2 and University of California San Francisco (UCSF) multiparametric prostate MRI scale for diagnosing clinically significant prostate cancer. This institutional review board-approved retrospective study included 49 males who had 1.5 T endorectal MRI and prostatectomy. Two radiologists scored suspicious lesions on MRI using PI-RADS v. 2 and the UCSF scale. Percent agreement, 2 × 2 tables and the area under the receiver operating characteristic curves (Az) were used to assess and compare the individual and overall scores of these scales. Interreader agreements were estimated with kappa statistics. Reader 1 (R1) detected 78 lesions, and Reader 2 (R2) detected 80 lesions. Both identified 52 of 65 significant cancers. The Az for PI-RADS v. 2 and UCSF scale for R1 were 0.68 and 0.69 [T2 weighted imaging (T2WI)], 0.75 and 0.68 [diffusion-weighted imaging (DWI)] and 0.64 and 0.72 (overall score), respectively, and were 0.72 and 0.75 (T2WI), 0.73 and 0.67 (DWI) and 0.66 and 0.75 (overall score) for R2. The dynamic contrast-enhanced percent agreements between scales were 100% (R1) and 95% (R2). PI-RADS v. 2 DWI of R1 performed better than UCSF DWI (Az = 0.75 vs Az = 0.68; p = 0.05); no other differences were found. The interreader agreements were higher for PI-RADS v. 2 (T2WI: 0.56 vs 0.42; DWI: 0.60 vs 0.46; overall: 0.61 vs 0.42). The UCSF approach to derive the overall PI-RADS v. 2 scores increased the Az for the identification of significant cancer (R1 to 0.76, p < 0.05; R2 to 0.71, p = 0.35). Although PI-RADS v. 2 DWI score may have a higher discriminatory performance than the UCSF scale counterpart to diagnose clinically significant cancer, the utilization of the UCSF scale weighing system for the integration of PI-RADS v. 2 individual parameter scores improved the accuracy its overall score. PI-RADS v. 2 is moderately accurate for the identification of clinically significant prostate cancer, but the utilization of alternative approaches to derive the overall PI-RADS v. 2 score, including the one used by the UCSF system, may improve its diagnostic accuracy.

Caring Wisely: A Program to Support Frontline Clinicians and Staff in Improving Healthcare Delivery and Reducing Costs.

PubMed

Gonzales, Ralph; Moriates, Christopher; Lau, Catherine; Valencia, Victoria; Imershein, Sarah; Rajkomar, Alvin; Prasad, Priya; Boscardin, Christy; Grady, Deborah; Johnston, S

2017-08-01

We describe a program called "Caring Wisely"®, developed by the University of California, San Francisco's (UCSF), Center for Healthcare Value, to increase the value of services provided at UCSF Health. The overarching goal of the Caring Wisely® program is to catalyze and advance delivery system redesign and innovations that reduce costs, enhance healthcare quality, and improve health outcomes. The program is designed to engage frontline clinicians and staff-aided by experienced implementation scientists-to develop and implement interventions specifically designed to address overuse, underuse, or misuse of services. Financial savings of the program are intended to cover the program costs. The theoretical underpinnings for the design of the Caring Wisely® program emphasize the importance of stakeholder engagement, behavior change theory, market (target audience) segmentation, and process measurement and feedback. The Caring Wisely® program provides an institutional model for using crowdsourcing to identify "hot spot" areas of low-value care, inefficiency and waste, and for implementing robust interventions to address these areas. © 2017 Society of Hospital Medicine.

Aspm, a Key Element in Medulloblastoma Pathogenesis and a Novel Target for Treatment

DTIC Science & Technology

2013-10-01

pathogenesis ( Wechsler -Reya and Scott, 1999; Kenney and Rowitch, 2000; Zurawel et al., 2000; Ellison et al., 2011; Hatten and Roussel, 2011; Roussel...Laboratories, Bar Harbor, ME, USA) to generate Aspm floxed (Aspmf/+) mice. Math-1 cre mice were generously shared by David Rowitch, MD, PhD, UCSF and...Robert Wechsler -Reya, PhD, 10 Sanford-Burnham Medical Research Institute, La Jolla, CA and have been previously described (Matei et al., 2005

THE EFFECT OF PRE-OPERATIVE NUTRITIONAL STATUS ON POST-OPERATIVE OUTCOMES IN CHILDREN UNDERGOING SURGERY FOR CONGENITAL HEART DEFECTS IN SAN FRANCISCO (UCSF) AND GUATEMALA CITY (UNICAR)

PubMed Central

Radman, Monique; Mack, Ricardo; Barnoya, Joaquin; Castañeda, Aldo; Rosales, Monica; Azakie, Anthony; Mehta, Nilesh; Keller, Roberta; Datar, Sanjeev; Oishi, Peter; Fineman, Jeffrey

2013-01-01

Objective To determine the association between preoperative nutritional status and postoperative outcomes in children undergoing surgery for congenital heart defects (CHD). Methods Seventy-one patients with CHD were enrolled in a prospective, two-center cohort study. We adjusted for baseline risk differences using a standardized risk adjustment score for surgery for CHD. We assigned a World Health Organization Z-score for each subjects’ preoperative triceps skinfold measurement, an assessment of total body fat mass. We obtained preoperative plasma concentrations of markers of nutritional status (prealbumin, albumin) and myocardial stress (B-type natriuretic peptide, BNP). Associations between indices of preoperative nutritional status and clinical outcomes were sought. Results Subjects had a median (IQR) age of 10.2 (33) months. In the UCSF cohort, duration of mechanical ventilation (median 19 hours, IQR 29), length of ICU stay (median 5 days, IQR 5), duration of any continuous inotropic infusion (median 66 hours, IQR 72) and preoperative BNP levels (median 30 pg/mL, IQR 75) were associated with a lower preoperative triceps skinfold Z-score (p<0.05). Longer duration of any continuous inotropic infusion and higher preoperative BNP levels were also associated with lower preoperative prealbumin (12.1 ± 0.5 mg/dL) and albumin (3.2 ± 0.1) (p<0.05). Conclusions Lower total body fat mass and acute and chronic malnourishment are associated with worse clinical outcomes in children undergoing surgery for CHD at UCSF, a resource-abundant institution. There is an inverse correlation between total body fat mass and BNP levels. Duration of inotropic support and BNP increase concomitantly as measures of nutritional status decrease, supporting the hypothesis that malnourishment is associated with decreased myocardial function. PMID:23583172

Cross-calibration of liquid and solid QCT calibration standards: corrections to the UCSF normative data

NASA Technical Reports Server (NTRS)

Faulkner, K. G.; Gluer, C. C.; Grampp, S.; Genant, H. K.

1993-01-01

Quantitative computed tomography (QCT) has been shown to be a precise and sensitive method for evaluating spinal bone mineral density (BMD) and skeletal response to aging and therapy. Precise and accurate determination of BMD using QCT requires a calibration standard to compensate for and reduce the effects of beam-hardening artifacts and scanner drift. The first standards were based on dipotassium hydrogen phosphate (K2HPO4) solutions. Recently, several manufacturers have developed stable solid calibration standards based on calcium hydroxyapatite (CHA) in water-equivalent plastic. Due to differences in attenuating properties of the liquid and solid standards, the calibrated BMD values obtained with each system do not agree. In order to compare and interpret the results obtained on both systems, cross-calibration measurements were performed in phantoms and patients using the University of California San Francisco (UCSF) liquid standard and the Image Analysis (IA) solid standard on the UCSF GE 9800 CT scanner. From the phantom measurements, a highly linear relationship was found between the liquid- and solid-calibrated BMD values. No influence on the cross-calibration due to simulated variations in body size or vertebral fat content was seen, though a significant difference in the cross-calibration was observed between scans acquired at 80 and 140 kVp. From the patient measurements, a linear relationship between the liquid (UCSF) and solid (IA) calibrated values was derived for GE 9800 CT scanners at 80 kVp (IA = [1.15 x UCSF] - 7.32).(ABSTRACT TRUNCATED AT 250 WORDS).

Medical workstation design: enhancing graphical interface with 3D anatomical atlas

NASA Astrophysics Data System (ADS)

Hoo, Kent S., Jr.; Wong, Stephen T. C.; Grant, Ellen

1997-05-01

The huge data archive of the UCSF Hospital Integrated Picture Archiving and Communication System gives healthcare providers access to diverse kinds of images and text for diagnosis and patient management. Given the mass of information accessible, however, conventional graphical user interface (GUI) approach overwhelms the user with forms, menus, fields, lists, and other widgets and causes 'information overloading.' This article describes a new approach that complements the conventional GUI with 3D anatomical atlases and presents the usefulness of this approach with a clinical neuroimaging application.

Targeting BRCAness in Gastric Cancer

DTIC Science & Technology

2017-10-01

inhibitors. We also generated a modified CRISPR system using dCas9-KRAB expressing variants of these cells, and validated them for CRISPRi screening...Figure 2. Validation of CRISPR activity following transduction with sgRNAs targeting CD55 and FACS staining with the anti-CD55 antibody. Data shown...interpretation of CRISPR experiments Morgan Diolaiti Specialist UCSF PH.D. Experimental planning and reporting Jefferson Woods SRA UCSF B.S. Perform drug

University of California San Francisco (UCSF-1): Construction of Directional Regulatory Networks Using Orthogonal CRISPR/Cas Screens | Office of Cancer Genomics

Cancer.gov

UCSF investigators developed an orthogonal CRISPR/Cas system which can be used to quantify gene regulation and construct directional regulatory networks. They combined two orthogonal Cas9 proteins from Streptococcus pyogenes and Staphylococcus aureus to carry out a dual screen in which one gene is activated while a second gene is deleted in the same cell. Read the abstract.

The effect of preoperative nutritional status on postoperative outcomes in children undergoing surgery for congenital heart defects in San Francisco (UCSF) and Guatemala City (UNICAR).

PubMed

Radman, Monique; Mack, Ricardo; Barnoya, Joaquin; Castañeda, Aldo; Rosales, Monica; Azakie, Anthony; Mehta, Nilesh; Keller, Roberta; Datar, Sanjeev; Oishi, Peter; Fineman, Jeffrey

2014-01-01

The objective of this study was to determine the association between preoperative nutritional status and postoperative outcomes in children undergoing surgery for congenital heart defects (CHD). Seventy-one patients with CHD were enrolled in a prospective, 2-center cohort study. We adjusted for baseline risk differences using a standardized risk adjustment score for surgery for CHD. We assigned a World Health Organization z score for each subject's preoperative triceps skin-fold measurement, an assessment of total body fat mass. We obtained preoperative plasma concentrations of markers of nutritional status (prealbumin, albumin) and myocardial stress (B-type natriuretic peptide [BNP]). Associations between indices of preoperative nutritional status and clinical outcomes were sought. Subjects had a median (interquartile range [IQR]) age of 10.2 (33) months. In the University of California at San Francisco (UCSF) cohort, duration of mechanical ventilation (median, 19 hours; IQR, 29 hours), length of intensive care unit stay (median, 5 days; IQR 5 days), duration of any continuous inotropic infusion (median, 66 hours; IQR 72 hours), and preoperative BNP levels (median, 30 pg/mL; IQR, 75 pg/mL) were associated with a lower preoperative triceps skin-fold z score (P < .05). Longer duration of any continuous inotropic infusion and higher preoperative BNP levels were also associated with lower preoperative prealbumin (12.1 ± 0.5 mg/dL) and albumin (3.2 ± 0.1; P < .05) levels. Lower total body fat mass and acute and chronic malnourishment are associated with worse clinical outcomes in children undergoing surgery for CHD at UCSF, a resource-abundant institution. There is an inverse correlation between total body fat mass and BNP levels. Duration of inotropic support and BNP increase concomitantly as measures of nutritional status decrease, supporting the hypothesis that malnourishment is associated with decreased myocardial function. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

Special Issue on Global Health Disparities Focus on Cancer.

PubMed

Lee, Haeok

2016-01-01

Haeok Lee, PhD, RN, FAAN who is a Korean-American nurse scientist, received her doctor al degree from the Nursing Physiology Department, College of Nursing, University of California, San Francisco (UCSF), in 1993, and her post doctor al training from College of Medicine, UCSF. Dr. Lee worked at Case Western Reserve University and University of Colorado Health Sciences Center. She has worked at the UMass Boston since 2008. Dr. Lee has established a long-term commitment to minority health, especially Asian American Pacific Islanders, as a community leader, community health educator, and community researcher, and all these services have become a foundation for her community-based participatory research. Dr. Lee's research addresses current health problems framed in the context of social, political, and economic settings, and her studies have improved racial and ethnic data and developed national health policies to address health disparities in hepatitis B virus (HBV) infections and liver cancer among minorities. Dr. Lee's research, which is noteworthy for its theoretical base, is clearly filling the gap. Especially, Dr. Lee's research is beginning to have a favorable impact on national and international health policies and continuing education programs directed toward the global elimination of cervical and liver cancer-related health disparities in underserved and understudied populations.

Results of Liver Transplantation for Hepatocellular Carcinoma in a Multicenter Latin American Cohort Study.

PubMed

Piñero, Federico; Costa, Paulo; Boteon, Yuri L; Duque, Sergio Hoyos; Marciano, Sebastian; Anders, Margarita; Varón, Adriana; Zerega, Alina; Poniachik, Jaime; Soza, Alejandro; Machaca, Martín Padilla; Menéndez, Josemaría; Zapata, Rodrigo; Vilatoba, Mario; Muñoz, Linda; Maraschio, Martín; Fauda, Martín; McCormack, Lucas; Gadano, Adrian; Boin, Ilka Sf; García, Jose H Parente; Silva, Marcelo

2018-03-01

Heterogeneous data has been reported regarding liver transplantation (LT) for hepatocellular carcinoma (HCC) in Latin America. We aimed to describe treatment during waiting list, survival and recurrence of HCC after LT in a multicenter study from Latin America. Patients with HCC diagnosed prior to transplant (cHCC) and incidentally found in the explanted liver (iHCC) were included. Imaging-explanted features were compared in cHCC (non-discordant if pre and post-LT were within Milan, discordant if pre-LT was within and post-LT exceeding Milan). Overall, 435 patients with cHCC and 92 with iHCC were included. At listing, 81% and 91% of cHCC patients were within Milan and San Francisco criteria (UCSF), respectively. Five-year survival and recurrence rates for cHCC within Milan, exceeding Milan/within UCSF and beyond UCSF were 71% and 16%; 66% and 26%; 46% and 55%, respectively. Locoregional treatment prior to LT was performed in 39% of cHCC within Milan, in 53% beyond Milan/within UCSF and in 83% exceeding UCSF (p < 0.0001). This treatment difference was not observed according to AFP values (≤100, 44%; 101-1,000, 39%, and > 1,000 ng/mL 64%; p = 0.12). Discordant imaging-explanted data was observed in 29% of cHCC, showing lower survival HR 2.02 (CI 1.29; 3.15) and higher recurrence rates HR 2.34 when compared to AFP <100 ng/mL. Serum AFP > 1,000 ng/mL at listing was independently associated with a higher 5-year recurrence rate and a HR of 3.24 when compared to AFP <100 ng/mL. Although overall results are comparable to other regions worldwide, pre-LT treatment not only considering imaging data but also AFP values should be contemplated during the next years.

Structural Characterization and Determinants of Specificity of Single- Chain Antibody Inhibitors of Membrane-Type Serine Protease 1

DTIC Science & Technology

2007-03-01

inset) defined the on rate as k1 =1.2×10 8 M−1s−1. The KIUN CO RR E Figure 1. Progress curves of MT-SP1 inhibition by scFv inhibitors reveal multiple...Farady 5d. PROJECT NUMBER 5e. TASK NUMBER E -Mail: christopher.farady@ucsf.edu 5f. WORK UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND...library; pNA pAB, p-aminobenzamidine; ESI, elec E -mail address of the correspondi craik@cgl.ucsf.edu 0022-2836/$ - see front matter © 2007 P Please

Role of radiation therapy in the management of ocular reticulum cell sarcoma. [Efficacy and complications

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

Margolis, L.; Fraser, R.; Lichter, A.

Nine patients with ocular lymphomas were seen in the Department of Ophthalmology and the Division of Radiation Oncology at UCSF and Ralph K. Davies Medical Center, San Francisco, from 1968 through 1974. Six of the 9 patients had visual symptoms as the first manifestation of their disease. Eight of the 9 patients developed intracranial lymphoma at some time during the course of the disease. Despite lymphoma work-up including bone marrow biopsies and lymphangiogram, only 1 patient was found to have documented systemic involvement. The diagnosis of ocular lymphoma was based on pathologic material from the eye in 5 cases ormore » from central nervous system biopsy in 4 patients in association with tumor cell infiltrates in the retina and vitreous clouding. Radiation therapy to the eyes improved vision in 10 of 13 eyes treated in 8 patients. The usual dose was in the range of 3500 to 4500 rads given over 4 to 5 weeks. In addition, 7 patients received central nervous system irradiation. Review of the literature reinforced the findings of this series showing the frequent association of ocular lymphoma with intracranial lymphoma and the rare systemic dissemination. This disease process has previously been referred to as ocular reticulum cell sarcoma.« less

University of California San Francisco (UCSF-2): Gene Expression Profiling of Normal Mouse Skin, Hras WT and Hras -/- | Office of Cancer Genomics

Cancer.gov

University of California San Francisco (UCSF-2): Gene Expression Profiling of Normal Mouse Skin, Hras WT and Hras -/- This data set contains the transcriptional profiles of 20 dorsal skin samples from eight-week-old mice. Mice were generated by crossing FVB/N to Mus spretus mice to generate F1 mice, and then crossing F1 mice back to the FVB/N strain. 10  FVB/N mice lacking Hras1 (aka HrasKO, Hras-/-) and 10  FVB/N mice with wild-type Hras1 were generated. Read the abstract.

The UCSF screening exam effectively screens cognitive and behavioral impairment in patients with ALS.

PubMed

Murphy, Jennifer; Ahmed, Fizaa; Lomen-Hoerth, Catherine

2015-03-01

The University of California San Francisco (UCSF) Screening Battery provides clinicians with a uniquely tailored tool to measure ALS patients' cognitive and behavioral changes, adjusting for dysarthria and hand weakness. The battery consists of the ALS-CBS ( 1 ), Written Fluency Test ( 2 ), and a new revision of the Frontal Behavior Inventory (FBI-ALS) ( 3 ). The validity of each component was tested by comparing results with a gold standard neuropsychological exam (GNE). Consensus criteria-based GNE diagnoses ( 4 ) were assigned (n = 24) and concurrent validity was tested for each screening exam component. Results showed that each of the four cognitive and behavioral screening test components were significantly associated with diagnoses confirmed by GNE. GNE diagnoses were significantly associated with FBI-ALS negative score, written S-words score, and ALS-CBS cognitive score. The total FBI-ALS score and C-words tests were less predictive of GNE-diagnosed impairment. In conclusion, the UCSF Cognitive Screening Battery demonstrates good external validity compared with GNE in this modest sample, encouraging its use in larger investigations. These data suggest that this battery may provide an effective screen to identify ALS patients who will then benefit from a full examination to confirm their diagnosis.

Cigarette smoking and risk of pancreatic cancer: a clinic-based case-control study in the San Francisco Bay Area.

PubMed

Lea, C Suzanne; Holly, Elizabeth A; Bracci, Paige M

2015-11-01

Cigarette smoking is an established risk factor for pancreatic cancer (PC). We examined the association between cigarette smoking and PC in a San Francisco Bay Area clinic-based, case-control study. A total of 536 cases and sex and age frequency-matched controls (n = 869) were recruited predominately from the University of California San Francisco (UCSF) medical clinics between 2006 and 2011. Participants were interviewed in-person using structured questionnaires. Adjusted odds ratios (ORs) were computed. Forty-eight percent of cases and controls reported never having smoked cigarettes; 39% of cases and 40% of controls were former smokers; 13% of cases and 12% of controls were current smokers. No association was found for either former (OR = 0.85, 95% confidence interval [CI] = 0.66-1.1) or current cigarette smoking (men: OR = 1.0, 95% CI = 0.60-1.7; women: OR = 1.2, 95% CI = 0.73-2.1). No dose-response relationships were detected with number of cigarettes/day, smoking intensity, duration, or years since last smoked. Comparisons with a 1995-1999 population-based UCSF study demonstrated a significantly increased proportion of never smokers in this study (P < .001). This study revealed no significant associations between cigarette smoking and PC in the San Francisco Bay Area during 2006-2011. Data suggest a reduction in the duration of smoking within the referral population. Copyright © 2015 Elsevier Inc. All rights reserved.

Clinical management of chronic hepatitis B infection: results from a registry at a German tertiary referral center.

PubMed

Demir, M; Nigemeier, J; Kütting, F; Bowe, A; Schramm, C; Hoffmann, V; Waldschmidt, D; Goeser, T; Steffen, H-M

2015-04-01

We studied a cohort of adult patients with chronic hepatitis B (CHB) infection, followed at a tertiary referral liver center in Germany over 12.5 years to analyze the clinical features and impact of management on disease progression and survival of CHB patients in general and of those with CHB and HCC in particular. We retrospectively evaluated the medical records of 242 adult (age ≥ 18 years) patients. CHB was defined as positive hepatitis B surface antigen (HBsAg) and/or HBV-DNA levels >10 IU/mL for at least 6 months. Patient demographics, HBV markers, antiviral treatment, laboratory parameters, liver imaging and histology were recorded for each visit. HCC patients were divided into two groups and separately analyzed (group 1: n = 24, HCC at first visit and group 2: n = 11, HCC during surveillance). The mean age was 44 years in CHB patients without HCC (63% male) and about 59 years in patients with HCC (77% male). Antiviral therapy was given to 59% of patients without HCC compared to only 25% in group 1 and 18% in group 2 with comparable median HBV DNA levels of approximately 36,000 IU/mL. There was no statistically significant difference concerning the HCC stages (Milan, UCSF, BCLC) at first diagnosis. Five-year survival was 19% in group 1 vs. 64% in group 2 (p = 0.019), with LTx performed in 12 vs. 45%, respectively. Surveillance of CHB patients did not result in early stage detection of HCC but in a higher likelihood to receive potentially curative treatments.

Partial knee replacement

MedlinePlus

... guideline: surgical management of osteoarthritis of the knee: evidence-based guideline. J Am Acad Orthop ... UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, ...

DBMap: a TreeMap-based framework for data navigation and visualization of brain research registry

NASA Astrophysics Data System (ADS)

Zhang, Ming; Zhang, Hong; Tjandra, Donny; Wong, Stephen T. C.

2003-05-01

The purpose of this study is to investigate and apply a new, intuitive and space-conscious visualization framework to facilitate efficient data presentation and exploration of large-scale data warehouses. We have implemented the DBMap framework for the UCSF Brain Research Registry. Such a novel utility would facilitate medical specialists and clinical researchers in better exploring and evaluating a number of attributes organized in the brain research registry. The current UCSF Brain Research Registry consists of a federation of disease-oriented database modules, including Epilepsy, Brain Tumor, Intracerebral Hemorrphage, and CJD (Creuzfeld-Jacob disease). These database modules organize large volumes of imaging and non-imaging data to support Web-based clinical research. While the data warehouse supports general information retrieval and analysis, there lacks an effective way to visualize and present the voluminous and complex data stored. This study investigates whether the TreeMap algorithm can be adapted to display and navigate categorical biomedical data warehouse or registry. TreeMap is a space constrained graphical representation of large hierarchical data sets, mapped to a matrix of rectangles, whose size and color represent interested database fields. It allows the display of a large amount of numerical and categorical information in limited real estate of computer screen with an intuitive user interface. The paper will describe, DBMap, the proposed new data visualization framework for large biomedical databases. Built upon XML, Java and JDBC technologies, the prototype system includes a set of software modules that reside in the application server tier and provide interface to backend database tier and front-end Web tier of the brain registry.

Otosclerosis

MedlinePlus

... Updated by: Sumana Jothi, MD, specialist in laryngology, Assistant Clinical Professor, UCSF Otolaryngology, NCHCS VA, SFVA, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, ...

Cholesteatoma

MedlinePlus

... Updated by: Sumana Jothi, MD, specialist in laryngology, Assistant Clinical Professor, UCSF Otolaryngology, NCHCS VA, SFVA, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, ...

Mastoiditis

MedlinePlus

... Updated by: Sumana Jothi, MD, specialist in laryngology, Assistant Clinical Professor, UCSF Otolaryngology, NCHCS VA, SFVA, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, ...

Recurrent hepatocellular carcinoma after liver transplant: identifying the high-risk patient

PubMed Central

Nissen, Nicholas N; Menon, Vijay; Bresee, Catherine; Tran, Tram T; Annamalai, Alagappan; Poordad, Fred; Fair, Jeffrey H; Klein, Andrew S; Boland, Brendan; Colquhoun, Steven D

2011-01-01

Background Recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT) is rarely curable. However, in view of the advent of new treatments, it is critical that patients at high risk for recurrence are identified. Methods Patients undergoing LT for HCC at a single centre between 2002 and 2010 were reviewed and data on clinical parameters and explant pathology were analysed to determine factors associated with HCC recurrence. All necrotic and viable tumour nodules were included in explant staging. All patients underwent LT according to the United Network for Organ Sharing (UNOS) Model for End-stage Liver Disease (MELD) tumour exception policies. Results Liver transplantation was performed in 122 patients with HCC during this period. Rates of recurrence-free survival in the entire cohort at 1 year and 3 years were 95% and 89%, respectively. Thirteen patients developed HCC recurrence at a median of 14 months post-LT. In univariate analysis the factors associated with HCC recurrence were bilobar tumours, vascular invasion, and stage exceeding either Milan or University of California San Francisco (UCSF) Criteria. Multivariate analysis showed pathology outside UCSF Criteria was the major predictor of recurrence; when pathology outside UCSF Criteria was found in combination with vascular invasion, the predicted 3-year recurrence-free survival was only 26%. Conclusions Explant pathology can be used to predict the risk for recurrent HCC after LT, which may allow for improved adjuvant and management strategies. PMID:21843263

Palatal myoclonus

MedlinePlus

... Updated by: Sumana Jothi MD, specialist in laryngology, Assistant Clinical Professor, UCSF Otolaryngology, NCHCS VA, SFVA, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, ...

Infectious myringitis

MedlinePlus

... Updated by: Sumana Jothi, MD, specialist in laryngology, Assistant Clinical Professor, UCSF Otolaryngology, NCHCS VA, SFVA, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, ...

Aural polyps

MedlinePlus

... Updated by: Sumana Jothi, MD, specialist in laryngology, Assistant Clinical Professor, UCSF Otolaryngology, NCHCS VA, SFVA, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, ...

Headache

MedlinePlus

... ed. Philadelphia, PA: Elsevier Mosby; 2014:chap 30. Review Date 11/22/2017 Updated by: Luc Jasmin, ... of Maxillofacial Surgery at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by ...

Malignant otitis externa

MedlinePlus

... Updated by: Sumana Jothi, MD, specialist in laryngology, Assistant Clinical Professor, UCSF Otolaryngology, NCHCS VA, SFVA, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, ...

Cluster headache

MedlinePlus

... ed. Philadelphia, PA: Elsevier Mosby; 2014:chap 30. Review Date 11/22/2017 Updated by: Luc Jasmin, ... of Maxillofacial Surgery at UCSF, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by ...

BAER - brainstem auditory evoked response

MedlinePlus

... Updated by: Sumana Jothi, MD, specialist in laryngology, Assistant Clinical Professor, UCSF Otolaryngology, NCHCS VA, SFVA, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, ...

Benign ear cyst or tumor

MedlinePlus

... Updated by: Sumana Jothi, MD, specialist in laryngology, Assistant Clinical Professor, UCSF Otolaryngology, NCHCS VA, SFVA, San Francisco, CA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, ...

Osteotomy of the knee

MedlinePlus

... joint. A tibial osteotomy may make you look "knock-kneed." A femoral osteotomy may make you look " ... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic ...

Progranulin levels in blood in Alzheimer's disease and mild cognitive impairment.

PubMed

Cooper, Yonatan A; Nachun, Daniel; Dokuru, Deepika; Yang, Zhongan; Karydas, Anna M; Serrero, Ginette; Yue, Binbin; Boxer, Adam L; Miller, Bruce L; Coppola, Giovanni

2018-05-01

Changes in progranulin ( GRN ) expression have been hypothesized to alter risk for Alzheimer's disease (AD). We investigated the relationship between GRN expression in peripheral blood and clinical diagnosis of AD and mild cognitive impairment (MCI). Peripheral blood progranulin gene expression was measured, using microarrays from Alzheimer's ( n = 186), MCI ( n = 118), and control ( n = 204) subjects from the University of California San Francisco Memory and Aging Center (UCSF-MAC) and two independent published series (AddNeuroMed and ADNI). GRN gene expression was correlated with clinical, demographic, and genetic data, including APOE haplotype and the GRN rs5848 single-nucleotide polymorphism. Finally, we assessed progranulin protein levels, using enzyme-linked immunosorbent assay, and methylation status using methylation microarrays. We observed an increase in blood progranulin gene expression and a decrease in GRN promoter methylation in males ( P = 0.007). Progranulin expression was 13% higher in AD and MCI patients compared with controls in the UCSF-MAC cohort ( F 2,505 = 10.41, P = 3.72*10 -5 ). This finding was replicated in the AddNeuroMed ( F 2,271 = 17.9, P = 4.83*10 -8 ) but not the ADNI series. The rs5848 SNP (T-allele) predicted decreased blood progranulin gene expression ( P = 0.03). The APOE4 haplotype was positively associated with progranulin expression independent of diagnosis ( P = 0.04). Finally, we did not identify differences in plasma progranulin protein levels or gene methylation between diagnostic categories. Progranulin mRNA is elevated in peripheral blood of patients with AD and MCI and its expression is associated with numerous genetic and demographic factors. These data suggest a role in the pathogenesis of neurodegenerative dementias besides frontotemporal dementia.

Elbow sprain -- aftercare

MedlinePlus

... MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine: Principles and Practice . 4th ed. Philadelphia, PA: Elsevier ... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, ...

Achilles tendon repair

MedlinePlus

... MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine: Principles and Practice . 4th ed. Philadelphia, PA: Elsevier ... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, ...

Crutches and children - stairs

MedlinePlus

... Put the good foot on the step and push up. Push down hard on the crutches to help lift ... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic ...

Using a Curricular Vision to Define Entrustable Professional Activities for Medical Student Assessment.

PubMed

Hauer, Karen E; Boscardin, Christy; Fulton, Tracy B; Lucey, Catherine; Oza, Sandra; Teherani, Arianne

2015-09-01

The new UCSF Bridges Curriculum aims to prepare students to succeed in today's health care system while simultaneously improving it. Curriculum redesign requires assessment strategies that ensure that graduates achieve competence in enduring and emerging skills for clinical practice. To design entrustable professional activities (EPAs) for assessment in a new curriculum and gather evidence of content validity. University of California, San Francisco, School of Medicine. Nineteen medical educators participated; 14 completed both rounds of a Delphi survey. Authors describe 5 steps for defining EPAs that encompass a curricular vision including refining the vision, defining draft EPAs, developing EPAs and assessment strategies, defining competencies and milestones, and mapping milestones to EPAs. A Q-sort activity and Delphi survey involving local medical educators created consensus and prioritization for milestones for each EPA. For 4 EPAs, most milestones had content validity indices (CVIs) of at least 78 %. For 2 EPAs, 2 to 4 milestones did not achieve CVIs of 78 %. We demonstrate a stepwise procedure for developing EPAs that capture essential physician work activities defined by a curricular vision. Structured procedures for soliciting faculty feedback and mapping milestones to EPAs provide content validity.

Lifting and bending the right way

MedlinePlus

... MD, Thompson SR, eds. DeLee and Drez's Orthopaedic Sports Medicine . 4th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap ... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, ...

Improving Graduate Education to Support a Branching Career Pipeline: Recommendations Based on a Survey of Doctoral Students in the Basic Biomedical Sciences

PubMed Central

Fuhrmann, C. N.; Halme, D. G.; O’Sullivan, P. S.; Lindstaedt, B.

2011-01-01

Today's doctoral programs continue to prepare students for a traditional academic career path despite the inadequate supply of research-focused faculty positions. We advocate for a broader doctoral curriculum that prepares trainees for a wide range of science-related career paths. In support of this argument, we describe data from our survey of doctoral students in the basic biomedical sciences at University of California, San Francisco (UCSF). Midway through graduate training, UCSF students are already considering a broad range of career options, with one-third intending to pursue a non–research career path. To better support this branching career pipeline, we recommend that national standards for training and mentoring include emphasis on career planning and professional skills development to ensure the success of PhD-level scientists as they contribute to a broadly defined global scientific enterprise. PMID:21885820

From Hahnemann's hand to your computer screen: building a digital homeopathy collection

PubMed Central

Mix, Lisa A; Cameron, Kathleen

2011-01-01

The University of California, San Francisco (UCSF), Library holds the unique manuscript of the sixth edition of Samuel Hahnemann's Organon der Heilkunst, the primary text of homeopathy. The manuscript volume is Hahnemann's own copy of the fifth edition of the Organon with his notes for the sixth edition, handwritten throughout the volume. There is a high level of interest in the Organon manuscript, particularly among homeopaths. This led to the decision to present a digital surrogate on the web to make it accessible to a wider audience. Digitizing Hahnemann's manuscript and determining the best method of presentation on the web posed several challenges. Lessons learned in the course of this project will inform future digital projects. This article discusses the historical significance of the sixth edition of Hahnemann's Organon, its context in UCSF's homeopathy collections, and the specifics of developing the online homeopathy collection. PMID:21243055

Improving graduate education to support a branching career pipeline: recommendations based on a survey of doctoral students in the basic biomedical sciences.

PubMed

Fuhrmann, C N; Halme, D G; O'Sullivan, P S; Lindstaedt, B

2011-01-01

Today's doctoral programs continue to prepare students for a traditional academic career path despite the inadequate supply of research-focused faculty positions. We advocate for a broader doctoral curriculum that prepares trainees for a wide range of science-related career paths. In support of this argument, we describe data from our survey of doctoral students in the basic biomedical sciences at University of California, San Francisco (UCSF). Midway through graduate training, UCSF students are already considering a broad range of career options, with one-third intending to pursue a non-research career path. To better support this branching career pipeline, we recommend that national standards for training and mentoring include emphasis on career planning and professional skills development to ensure the success of PhD-level scientists as they contribute to a broadly defined global scientific enterprise.

Analysis of the UCSF Symptom Management Theory: Implications for Pediatric Oncology Nursing

PubMed Central

Linder, Lauri

2015-01-01

Symptom management research is a priority for both children and adults with cancer. The UCSF Symptom Management Theory (SMT) is a middle range theory depicting symptom management as a multidimensional process. A theory analysis using the process described by Walker and Avant evaluated the SMT with attention to application in research involving children with cancer. Application of the SMT in studies involving children has been limited to descriptive studies testing only portions of the theory. Findings of these studies have provided empiric support for the relationships proposed within the SMT. Considerations for future research involving children include attention to measurement of symptoms and clarity regarding the location of the parents and family within the model. With additional testing and refinement, the SMT has the potential to guide nursing research and practice to improve symptoms for children with cancer. PMID:20639345

An interview with Margaret A Liu: the future of gene-based vaccines and immunotherapies, and other musings.

PubMed

Liu, Margaret A; Rees, Jenaid

2015-02-01

Interview by Jenaid Rees, commissioning editor. Margaret A Liu is best known for her pioneering work in the area of DNA vaccines. A world renowned scientist, Liu was named one of 'The 50 Most Important Women Scientists' by Discover magazine in 2002. Liu obtained her M.D. from Harvard Medical School, and has held positions at numerous institutions including Harvard Medical School, Massachusetts Institute of Technology, University of Pennsylvania, UCSF, and the Karolinska Institutet in Stockholm. In her career she has served as Senior Advisor in Vaccinology at the Bill & Melinda Gates Foundation and Executive Vice-Chair of the International Vaccine Institute in Seoul, Korea and worked for companies including Merck, Transgène and Chiron Corporation. Her research achievements have led to her receipt of honorary lectureships, and she has held many board positions throughout her career. Liu currently consults in the fields of vaccines and immunotherapy for companies, universities, and non-governmental and governmental scientific organizations, and is a Foreign Adjunct Professor at the Karolinska Institutet in Stockholm, and an Adjunct Professor at the University of California, San Francisco.

English language proficiency, health literacy, and trust in physician are associated with shared decision-making in rheumatoid arthritis

PubMed Central

Barton, Jennifer L.; Trupin, Laura; Tonner, Chris; Imboden, John; Katz, Patricia; Schillinger, Dean; Yelin, Edward H.

2014-01-01

Objective Treat to Target guidelines promote shared decision-making (SDM) in rheumatoid arthritis (RA). Also, due to high cost and potential toxicity of therapies, SDM is central to patient safety. Our objective was to examine patterns of perceived communication around decision-making in two cohorts of adults with RA. Methods Data were derived from patients enrolled in one of two longitudinal, observational cohorts (UCSF RA Cohort and RA Panel). Subjects completed a telephone interview in their preferred language that included a measure of patient-provider communication, including items about decision-making. Measures of trust in physician, education, and language proficiency were also asked. Logistic regression was performed to identify correlates of suboptimal SDM communication. Analyses were performed on each sample separately. Results Of 509 patients across two cohorts, 30% and 32% reported suboptimal SDM communication. Low trust in physician was independently associated with suboptimal SDM communication in both cohorts. Older age and limited English proficiency were independently associated with suboptimal SDM in the UCSF RA Cohort, as was limited health literacy in the RA Panel. Conclusions This study of over 500 adults with RA from two demographically distinct cohorts found that nearly one-third of subjects report suboptimal SDM communication with their clinicians, regardless of cohort. Lower trust in physician was independently associated with suboptimal SDM communication in both cohorts, as was limited English language proficiency and older age in the UCSF RA Cohort and limited health literacy in the Panel. These findings underscore the need to examine the impact of SDM on health outcomes in RA. PMID:24931952

Treatment of Infants Identified by Newborn Screening for Severe Combined Immunodeficiency

PubMed Central

Dorsey, Morna J.; Dvorak, Christopher C.; Cowan, Morton J.; Puck, Jennifer M.

2017-01-01

Background Severe combined immunodeficiency (SCID) is characterized by severely impaired T cell development and is fatal without treatment. Newborn screening (NBS) for SCID permits identification of affected infants before development of opportunistic infections and other complications. Substantial variation exists between treatment centers with regard to pre-transplant care and transplant protocols for NBS identified SCID infants, as well as for infants with other T lymphopenic disorders detected by NBS. Methods We developed approaches to management based on the study of infants identified by SCID NBS who received care at UCSF. Results From August 2010 through October 2016, 32 NBS SCID and leaky SCID cases from California and other states were treated and 42 NBS identified non-SCID T cell lymphopenia (TCL) cases were followed. Conclusions Our center’s approach supports successful outcomes; systematic review of our practice provides a framework for diagnosis and management, recognizing that more data will continue to shape best practices. PMID:28270365

Trigger finger

MedlinePlus

... by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Related MedlinePlus Health Topics Finger Injuries and Disorders ...

Metatarsal fracture (acute) - aftercare

MedlinePlus

... Krettek C, Anderson PA, eds. Skeletal Trauma: Basic Science, Management, and Reconstruction . 5th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 67. Review Date 11/27/2016 Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic ...

Taking narcotics for back pain

MedlinePlus

... Turk DC, Argoff CE, Hurley RW, eds. Practical Management of Pain . 5th ed. Philadelphia, PA: Elsevier Mosby; 2014:chap 12. Review Date 9/7/2017 Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic ...

Synovial biopsy

MedlinePlus

... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Autoimmune Diseases Read more Biopsy Read more Fungal ...

Carpal tunnel biopsy

MedlinePlus

... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Amyloidosis Read more Biopsy Read more Carpal Tunnel ...

Metatarsus adductus

MedlinePlus

... 2016 Updated by: C. Benjamin Ma, MD, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Foot Injuries and Disorders Read more NIH MedlinePlus ...

Tendon repair

MedlinePlus

... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Sprains and Strains Read more NIH MedlinePlus Magazine ...

Compartment syndrome

MedlinePlus

... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Muscle Disorders Read more NIH MedlinePlus Magazine Read ...

Kyphosis

MedlinePlus

... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Spine Injuries and Disorders Read more NIH MedlinePlus ...

Tenosynovitis

MedlinePlus

... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Tendinitis Read more NIH MedlinePlus Magazine Read more ...

Bunion removal

MedlinePlus

... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Toe Injuries and Disorders Read more NIH MedlinePlus ...

Hammer toe

MedlinePlus

... by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Toe Injuries and Disorders Read more NIH MedlinePlus ...

Replantation of digits

MedlinePlus

... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Finger Injuries and Disorders Read more Toe Injuries ...

Does mentoring matter: results from a survey of faculty mentees at a large health sciences university

PubMed Central

Feldman, Mitchell D.; Arean, Patricia A.; Marshall, Sally J.; Lovett, Mark; O'Sullivan, Patricia

2010-01-01

Background To determine the characteristics associated with having a mentor, the association of mentoring with self-efficacy, and the content of mentor–mentee interactions at the University of California, San Francisco (UCSF), we conducted a baseline assessment prior to implementing a comprehensive faculty mentoring program. Method We surveyed all prospective junior faculty mentees at UCSF. Mentees completed a web-based, 38-item survey including an assessment of self-efficacy and a needs assessment. We used descriptive and inferential statistics to determine the association between having a mentor and gender, ethnicity, faculty series, and self-efficacy. Results Our respondents (n=464, 56%) were 53% female, 62% white, and 7% from underrepresented minority groups. More than half of respondents (n=319) reported having a mentor. There were no differences in having a mentor based on gender or ethnicity (p≥0.05). Clinician educator faculty with more teaching and patient care responsibilities were statistically significantly less likely to have a mentor compared with faculty in research intensive series (p<0.001). Having a mentor was associated with greater satisfaction with time allocation at work (p<0.05) and with higher academic self-efficacy scores, 6.07 (sd = 1.36) compared with those without a mentor, 5.33 (sd = 1.35, p<0.001). Mentees reported that they most often discussed funding with the mentors, but rated highest requiring mentoring assistance with issues of promotion and tenure. Conclusion Findings from the UCSF faculty mentoring program may assist other health science institutions plan similar programs. Mentoring needs for junior faculty with greater teaching and patient care responsibilities must be addressed. PMID:20431710

Bursitis of the heel

MedlinePlus

... by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Bursitis Read more Heel Injuries and Disorders Read ...

Limited range of motion

MedlinePlus

... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Joint Disorders Read more NIH MedlinePlus Magazine Read ...

Heritability of MMPI-2 scales in the UCSF Family Alcoholism Study

PubMed Central

Gizer, Ian R.; Seaton-Smith, Kimberley L.; Ehlers, Cindy L.; Vietan, Cassandra; Wilhelmsen, Kirk C.

2009-01-01

The present study evaluated the heritability of personality traits and psychopathology symptoms assessed by the Minnesota Multiphasic Personality Interview 2nd edition (MMPI-2) in a family-based sample selected for alcohol dependence. Participants included 950 probands and 1204 first-degree relatives recruited for the UCSF Family Alcoholism Study. Heritability estimates (h2) for MMPI-2 scales ranged from .25–.49. When alcohol dependence was used as a covariate, heritability estimates remained significant but generally declined. However, when the MMPI-2 scales were used as covariates to estimate the heritability of alcohol dependence, scales measuring antisocial behavior (ASP), depressive symptoms (DEP), and addictive behavior (MAC-R) led to moderate increases in the heritability of alcohol dependence. This suggests that the ASP, DEP, and MAC-R scales may explain some of the non-genetic variance in the alcohol dependence diagnosis in this population when utilized as covariates, and thus may serve to produce a more homogeneous and heritable alcohol dependence phenotype. PMID:20390702

Repair of webbed fingers or toes

MedlinePlus

... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Finger Injuries and Disorders Read more Toe Injuries ...

Mentorship through advisory colleges.

PubMed

Murr, Andrew H; Miller, Carol; Papadakis, Maxine

2002-11-01

Medical students face pressures ranging from the need to create a social network to learning vast amounts of scientific material. Students often feel isolated in this system and lack mentorship. In order to counteract feelings of bureaucratic anonymity and isolation, the University of California San Francisco has created an advisory college to foster the professional and personal growth and well being of students. UCSF has developed a formal structure to advise medical students. A selection committee, chaired by the associate dean of student affairs, appointed five faculty mentors to head advisory colleges. These five colleges serve as the advising and well-being infrastructure for the students. Mentors were chosen from a balanced range of clinical disciplines, both primary and specialty. The disciplines are obstetrics-gynecology, otolaryngology/head and neck surgery, medicine, pediatrics, and psychiatry. The mentors have demonstrated excellence in advising and counseling of students. Mentors meet individually at the beginning of the academic year with incoming first-year and second-year students. They then have bimonthly meetings with eight to ten students within each college throughout the academic year. Curricula for these group sessions include well-being discussions and coping techniques, sessions on the hidden and informal curriculum of professionalism, and discussions on career choices and strategies. For third-year students, advisory college meetings are scheduled during intersessions, which are weeklong courses that occur between the eight-week clerkship blocks. Mentors are available throughout the year to meet with students on an as-needed basis, and advisory colleges may hold group social activities. The dean's office supports each mentor with 20% salary and provides administrative support for the group college activities. Historically, UCSF students feel they receive an excellent education and appropriate job opportunities, but they do not feel they receive adequate advising and mentoring. This may have as its root cause the financial, clinical, and research pressures placed upon a faculty who are also responsible for mentoring residents and fellows. The advisory colleges begin by providing an infrastructure for developing a relationship for the student with a single faculty member. The advisory college system is incorporated into the academic schedule rather than relying on ad-hoc activities from well-meaning but inconsistently available faculty. In the early part of medical school, the advisory college relationship concentrates on assimilation into the new environment and provides the student with advice pertaining to mastering academic material. The college also serves as a sounding board for problems that can then be relayed to course directors to improve the educational experience. For students encountering academic difficulty, the college advisor can provide discreet advice about tutoring resources and can direct the student to a separately staffed Student Well-being Program. As time progresses, the mentors can direct students to key people in different fields of interest such as program directors and keep the students on track to make career decisions in a timely manner. The college system can help transform an anonymous medical school experience into a supportive, rich environment.

A Changing Health Care Environment: Its Impact on UCSF Graduates' Practice Patterns and Perceptions.

ERIC Educational Resources Information Center

Sauer, Barbara L.; Koda-Kimble, Mary Anne

1998-01-01

A survey of 754 University of California at San Francisco doctoral pharmacy graduates from 1980 to 1994 investigated how managed care affected practice patterns and perceptions of the profession. Graduates generally remained satisfied with their education and were optimistic about the profession. Although managed care has created a stressful…

Recruitment of Chinese American Elders into Dementia Research: The UCSF ADRC Experience

ERIC Educational Resources Information Center

Chao, Steven Z.; Lai, Ngan B.; Tse, Marian M.; Ho, Rachel J.; Kong, Joanne P.; Matthews, Brandy R.; Miller, Bruce L.; Rosen, Howard J.

2011-01-01

Purpose: To describe the results of efforts to recruit Asian Americans into longitudinal research on cognitive decline in aging. Design and Methods: Recruitment strategies include clinics for assessment of cognitive impairment at the University of California, San Francisco campus and San Francisco's Chinatown, lectures to local health care…

Standardization and Optimization of Computed Tomography Protocols to Achieve Low-Dose

PubMed Central

Chin, Cynthia; Cody, Dianna D.; Gupta, Rajiv; Hess, Christopher P.; Kalra, Mannudeep K.; Kofler, James M.; Krishnam, Mayil S.; Einstein, Andrew J.

2014-01-01

The increase in radiation exposure due to CT scans has been of growing concern in recent years. CT scanners differ in their capabilities and various indications require unique protocols, but there remains room for standardization and optimization. In this paper we summarize approaches to reduce dose, as discussed in lectures comprising the first session of the 2013 UCSF Virtual Symposium on Radiation Safety in Computed Tomography. The experience of scanning at low dose in different body regions, for both diagnostic and interventional CT procedures, is addressed. An essential primary step is justifying the medical need for each scan. General guiding principles for reducing dose include tailoring a scan to a patient, minimizing scan length, use of tube current modulation and minimizing tube current, minimizing-tube potential, iterative reconstruction, and periodic review of CT studies. Organized efforts for standardization have been spearheaded by professional societies such as the American Association of Physicists in Medicine. Finally, all team members should demonstrate an awareness of the importance of minimizing dose. PMID:24589403

'Addressed to you not as a smoker… but as a doctor': doctor-targeted cigarette advertisements in JAMA.

PubMed

Jackler, Robert K; Ayoub, Noel F

2018-07-01

During the mid-20th century tobacco companies placed advertisements in medical journals to entice physicians to smoke their brand and, more importantly, to recommend it to their patients. They have been little studied, in part because advertising sections in medical journals are almost universally discarded before binding. This study aimed to define the themes and techniques used in doctor-targeted tobacco advertisements that appeared in American medical journals in the mid-20th century and determine the motivations and tactics of the tobacco industry in engaging the medical profession in this way. Doctor-targeted tobacco advertisements from JAMA and the New York State Medical Journal appearing between 1936 and 1953 were studied. These were obtained from the New York Academy of Medicine and the UCSF Truth database of tobacco industry documents. Content analysis of advertising slogans and imagery was conducted. Using internal tobacco industry documents, we examined the relationship between tobacco advertisers and medical journals. Among the 519 doctor-targeted advertisements, 13 brands were represented, with two (Philip Morris and Camel) accounting for 84%. Correspondence between tobacco advertisers and medical journal editors reveals the potent influence of revenue to the sponsoring society and personal compensation derived from consulting arrangements. Content analysis of the advertisements revealed much flattery of doctors and arguments professing the harmlessness of the company's brand. Analysis of doctor-targeted tobacco advertisements in American medical journals from 1936 to 1953 suggest that tobacco companies targeted physicians as a potential sales force to assuage the public's fear of health risks and to recruit them as allies against negative publicity. Tobacco companies also appeared to try, through the substantial advertising revenue passed by journals to their parent medical societies, to temper any possible opposition by organized medicine. © 2018 Society for the Study of Addiction.

Internship Experiences Contribute to Confident Career Decision Making for Doctoral Students in the Life Sciences

ERIC Educational Resources Information Center

Schnoes, Alexandra M.; Caliendo, Anne; Morand, Janice; Dillinger, Teresa; Naffziger-Hirsch, Michelle; Moses, Bruce; Gibeling, Jeffery C.; Yamamoto, Keith R.; Lindstaedt, Bill; McGee, Richard; O'Brien, Theresa C.

2018-01-01

The Graduate Student Internships for Career Exploration (GSICE) program at the University of California, San Francisco (UCSF), offers structured training and hands-on experience through internships for a broad range of PhD-level careers. The GSICE program model was successfully replicated at the University of California, Davis (UC Davis). Here, we…

Engaging a University in Self-Assessment and Strategic Planning to Build Partnership Capacity: The UCSF Experience

ERIC Educational Resources Information Center

Wortis, Naomi; Goldstein, Ellen; Vargas, Roberto Ariel; Grumbach, Kevin

2006-01-01

In an effort to better fulfill its public service mission, the University of California, San Francisco, has undertaken an intensive assessment and strategic planning process to build institutional capacity for civic engagement and community partnership. The first stage was a qualitative assessment focused primarily on three local communities,…

Targeting BRCAness in Gastric Cancer

DTIC Science & Technology

2017-10-01

modified CRISPR system using dCas9-KRAB expressing variants of these cells, and validated them for CRISPRi screening. These reagents will next be used...OE19 Adherent Stable Oesophagus/ gastric cardia - - - OE33 Adherent Stable Esophageal adenocarcinoma - - - Figure 2. Validation of CRISPR ...project planning and reporting Patrick O’Leary Postdoctoral Fellow UCSF PH.D. Design, execution, and interpretation of CRISPR experiments

78 FR 77289 - Endangered and Threatened Wildlife and Plants; Designation of Critical Habitat for Arctostaphylos...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-20

... request, and we removed the existing off-leash dog play area from Corona Heights (Unit 6) and eliminated... in Corona Heights is fenced off and modified with wood chips. We visited Bernal Heights on November...; Bayview Hill; UCSF, Laurel Hill Campus; Buena Vista Park; Corona Heights Park; Starr King Open Space; and...

Cloning of the poly(ADP-ribose) Gene from Rat Liver.

DTIC Science & Technology

1986-09-24

Levinson, Ph.D. (Cetus Corp., Berkeley). 5. Amino acid analysis done in UCSF Bioanal. Lab. TABLE OF CONTENTS Page METHOD I...TABLE I ............. ............................... ... 12 Proteolytic degradation, isolation of peptide and amino acid sequences...technique developed for enzyme quantitation in biological materials. The amino- acid sequence of the enzyme has so far been determined because the amino

The UCSF AIDS Health Project Guide to Counseling: Perspectives on Psychotherapy, Prevention, and Therapeutic Practice.

ERIC Educational Resources Information Center

Dilley, James W., Ed.; Marks, Robert, Ed.

The University of California San Francisco AIDS Health Project has more than 15 years' experience in working with thousands of people with AIDS. This guide, developed by the Project, provides practical, state-of-the-art resources in the field. Part 1, "Risk and Behavior: Helping Clients Remain Uninfected," covers the following topics:…

Targeting BRCAness in Gastric Cancer

DTIC Science & Technology

2017-10-01

generated a modified CRISPR system using dCas9-KRAB expressing variants of these cells, and validated them for CRISPRi screening. These reagents will...adenocarcinoma - - - Figure 2. Validation of CRISPR activity following transduction with sgRNAs targeting CD55 and FACS staining with the anti...execution, and interpretation of CRISPR experiments Morgan Diolaiti Specialist UCSF PH.D. Experimental planning and reporting Jefferson Woods SRA

Expediting Clinician Adoption of Safety Practices: The UCSF Venous Access Patient Safety Interdisciplinary Education Project

DTIC Science & Technology

2005-01-01

knowledge in the digital age. New York: McGraw- Hill; 2001. p. 11. 37. Sackett D, Straus S, Richardson W, et al. Evidence - based medicine . 2nd ed. New...249. 46. Evidence - Based Medicine Working Group. Evidence - based medicine . A new approach to teaching the practice of medicine. JAMA 1992;268(17):2420

Targeting BRCAness in Gastric Cancer

DTIC Science & Technology

2017-10-01

modified CRISPR system using dCas9-KRAB expressing variants of these cells, and validated them for CRISPRi screening. These reagents will next be... CRISPR activity following transduction with sgRNAs targeting CD55 and FACS staining with the anti-CD55 antibody. Data shown for MKN7 and KATOIII...Oversight, project planning and reporting Patrick O’Leary Postdoctoral Fellow UCSF PH.D. Design, execution, and interpretation of CRISPR experiments

Targeting BRCAness in Gastric Cancer

DTIC Science & Technology

2017-10-01

a modified CRISPR system using dCas9-KRAB expressing variants of these cells, and validated them for CRISPRi screening. These reagents will next be... CRISPR activity following transduction with sgRNAs targeting CD55 and FACS staining with the anti-CD55 antibody. Data shown for MKN7 and KATOIII...Oversight, project planning and reporting Patrick O’Leary Postdoctoral Fellow UCSF PH.D. Design, execution, and interpretation of CRISPR

The virulence of human pathogenic fungi: notes from the South of France.

PubMed

Reedy, Jennifer L; Bastidas, Robert J; Heitman, Joseph

2007-08-16

The Second FEBS Advanced Lecture Course on Human Fungal Pathogens: Molecular Mechanisms of Host-Pathogen Interactions and Virulence, organized by Christophe d'Enfert (Institut Pasteur, France), Anita Sil (UCSF, USA), and Steffen Rupp (Fraunhofer, IGB, Germany), occurred May 2007 in La Colle sur Loup, France. Here we review the advances presented and the current state of knowledge in key areas of fungal pathogenesis.

Rate of tumor growth predicts recurrence of hepatocellular carcinoma after liver transplantation in patients beyond Milan or UCSF criteria.

PubMed

Hanouneh, I A; Macaron, C; Lopez, R; Aucejo, F; Zein, N N

2011-12-01

It is likely that some patients whose tumor burdens exceed the current transplant criteria have favorable tumor biology, and that these patients would have low risk of tumor recurrence after liver transplantation (LT). To assess the rate of tumor growth as selection criteria for LT in patients with hepatocellular carcinoma (HCC). We identified all patients who underwent LT for HCC in our institution from 2002 to 2008. Total tumor volume (TTV) was calculated as the sum of the volumes of all tumors on pretransplantation imaging [(4/3)πr3, where r is the maximum radius of each HCC]. The rate of tumor growth was calculated as per-month change in TTV on sequential pretransplantation imaging before any locoregional therapy. A Kaplan-Meier plot was constructed and Cox regression analysis performed. Ninety-two patients were included in the study. The median follow-up was 19.5 (range 10.7-30.7) months during which 12 patients (13%) experienced recurrence of HCC. Twenty-four patients (26%) had HCC beyond the Milan criteria, and the overall survival rate of the entire group was 72%. Higher pre-LT alpha-fetoprotein (hazard ratio [HR] 1.01; P=.001), poorly differentiated tumors (HR 13; P=.039), the presence of microvascular invasion (HR 7.9; P=.001), higher TTV (HR 1.03; P<.001), and faster tumor growth (HR 1.09; P<.001) were significantly associated with the risk of recurrence. A cutoff value of tumor growth of 1.61 cm3/mo was chosen on the basis of the risk of recurrence with the use of a receiver operating characteristic curve. Patients beyond the Milan criteria with tumor growth<1.61 cm3/mo experienced less recurrence (11% vs 58%; P=.023) than those beyond the Milan criteria with tumor growth>1.61 cm3/mo. Similarly, rate of tumor growth predicted HCC recurrence in those beyond the University of California of San Francisco (UCSF) criteria. Patients with slowly growing tumor who would be currently excluded from LT because tumor burden exceeds traditional Milan and UCSF criteria may have a favorable posttransplantation outcome. Copyright © 2011. Published by Elsevier Inc.

Quality of Life for Adults with Asthma in a Military Setting

DTIC Science & Technology

1998-05-01

Tilley, Havstead, & Zoratti, 1997). More recently, van der Molen , et al. (1997) conducted a study comparing discriminative aspects of two generic...Symptom Management Faculty Group, UCSF. (1994). IMAGE: Journal of Nursing Scholarship, 26(4), 272-276. van der Molen , T., Postma, D., Schreuers, A...the most important (Earwood, 1996, Rutten- Van Molken, Van Doorslaer, & Rutten, 1992). Purpose of the Study When patients clarify their perceptions of

[Neuroethics].

PubMed

Ramiro, H Manuel

2015-01-01

Neuroethics emerged as a discipline in 2012 after a World Congress organized by the Stanford University, the University of California at San Francisco (UCSF), and sponsored by the Dana Foundation. It has emerged with great force and an important interdisciplinary approach between science and philosophy. Its most relevant lines of action are the study of the ethical consequences of neuroscience research and clinical interventions; as well as the biological factors of human behavior or conduct.

Training the next generation of research mentors: the University of California, San Francisco, Clinical & Translational Science Institute Mentor Development Program.

PubMed

Feldman, Mitchell D; Huang, Laurence; Guglielmo, B Joseph; Jordan, Richard; Kahn, James; Creasman, Jennifer M; Wiener-Kronish, Jeanine P; Lee, Kathryn A; Tehrani, Ariane; Yaffe, Kristine; Brown, Jeanette S

2009-06-01

Mentoring is a critical component of career development and success for clinical translational science research faculty. Yet few programs train faculty in mentoring skills. We describe outcomes from the first two faculty cohorts who completed a Mentor Development Program (MDP) at UCSF. Eligibility includes having dedicated research time, expertise in a scientific area and a desire to be a lead research mentor. A post-MDP survey measured the program's impact on enhancement of five key mentoring skills, change in the Mentors-in-Training (MIT) self-rated importance of being a mentor to their career satisfaction, and overall confidence in their mentoring skills. Since 2007, 29 MITs participated in and 26 completed the MDP. Only 15% of the MITs reported any previous mentor training. Overall, 96% of MITs felt that participation in the MDP helped them to become better mentors. A majority reported a significant increase in confidence in mentoring skills and most reported an increased understanding of important mentoring issues at UCSF. MITs reported increased confidence in overall and specific mentoring skills after completion of the MDP. The MDP can serve as a model for other institutions to develop the next generation of clinical-translational research mentors.

A mentor development program for clinical translational science faculty leads to sustained, improved confidence in mentoring skills.

PubMed

Feldman, Mitchell D; Steinauer, Jody E; Khalili, Mandana; Huang, Laurence; Kahn, James S; Lee, Kathryn A; Creasman, Jennifer; Brown, Jeanette S

2012-08-01

Mentorship is crucial for academic productivity and advancement for clinical and translational (CT) science faculty. However, little is known about the long-term effects of mentor training programs. The University of California, San Francisco (UCSF), Clinical and Translational Science Institute launched a Mentor Development Program (MDP) in 2007 for CT faculty. We report on an evaluation of the first three cohorts of graduates from the MDP. In 2010, all Mentors in Training (MITs) who completed the MDP from 2007 to 2009 (n= 38) were asked to complete an evaluation of their mentoring skills and knowledge; all MITs (100%) completed the evaluation. Two-thirds of MDP graduates reported that they often apply knowledge, attitudes, or skills obtained in the MDP to their mentoring. Nearly all graduates (97%) considered being a mentor important to their career satisfaction. Graduates were also asked about the MDP's impact on specific mentoring skills; 95% agreed that the MDP helped them to become a better mentor and to focus their mentoring goals. We also describe a number of new initiatives to support mentoring at UCSF that have evolved from the MDP. To our knowledge, this is the first evaluation of the long-term impact of a mentor training program for CT researchers. © 2012 Wiley Periodicals, Inc.

Predicting Prostate Cancer Progression at Time of Diagnosis

DTIC Science & Technology

2015-06-01

shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number...the UCSF specimens given an unexpected finding of different mean scores between the two cohorts and the Canary (Aim 2) specimens. The repeat analysis...PCA3 in an Active Surveillance Cohort: Results from a Baseline Analysis in the Canary Prostate Active Surveillance Study” (Lin DW et al, Clin Cancer

A Controlled Trial of Topiramate Treatment for Alcohol Dependence in Veterans with PTSD

DTIC Science & Technology

2015-10-01

Dieter J. Meyerhoff, Dr.rer.nat., UCSF Rationale and Content: Civilian and military personnel with posttraumatic stress disorder (PTSD) frequently...patients with PTSD, and for some patients alcohol use may be an attempt to “self-medicate” or cope or to respond to symptoms such as insomnia , anxiety...model of stress -enhanced fear learning which mimics several PTSD features, including increased voluntary alcohol intake, and set it in context to other

Improved Ribosome-Footprint and mRNA Measurements Provide Insights into Dynamics and Regulation of Yeast Translation

DTIC Science & Technology

2016-02-11

the White- head Genome Technology Core for sequencing . This work was supported by the UCSF Program for Breakthrough Biomedical Research (funded in...landscape of the yeast genome defined by RNA sequencing . Science 320, 1344–1349. Nedialkova, D.D., and Leidel, S.A. (2015). Optimization of Codon Translation... the CC BY license (http://creativecommons.org/licenses/by/4.0/). SUMMARY Ribosome-footprint profiling provides genome -wide snapshots of translation

Investigating Genomic Mechanisms of Treatment Resistance in Castration Resistant Prostate Cancer

DTIC Science & Technology

2015-05-01

and genomically profiled. Figure 3 shows data from a series of cell- line experiments showing that PC3 prostate cancer cells are recoverable and...coursework until the second-half of the grant period. I am enrolled in the UCSF Biomedical Sciences Graduate Program class BMS 255: Genetics : Basic... Genetics and Genomics. This class is set to start in January 2016. Given a large number of clinical, teaching, and research duties I will plan to enroll

A Mentor Development Program for Clinical Translational Science Faculty Leads to Sustained, Improved Confidence in Mentoring Skills

PubMed Central

Feldman, Mitchell D.; Steinauer, Jody E.; Khalili, Mandana; Huang, Laurence; Kahn, James S.; Lee, Kathryn A.; Creasman, Jennifer; Brown, Jeanette S.

2012-01-01

Abstract Mentorship is crucial for academic productivity and advancement for clinical and translational (CT) science faculty. However, little is known about the long‐term effects of mentor training programs. The University of California, San Francisco (UCSF), Clinical and Translational Science Institute launched a Mentor Development Program (MDP) in 2007 for CT faculty. We report on an evaluation of the first three cohorts of graduates from the MDP. In 2010, all Mentors in Training (MITs) who completed the MDP from 2007 to 2009 (n= 38) were asked to complete an evaluation of their mentoring skills and knowledge; all MITs (100%) completed the evaluation. Two‐thirds of MDP graduates reported that they often apply knowledge, attitudes, or skills obtained in the MDP to their mentoring. Nearly all graduates (97%) considered being a mentor important to their career satisfaction. Graduates were also asked about the MDP's impact on specific mentoring skills; 95% agreed that the MDP helped them to become a better mentor and to focus their mentoring goals. We also describe a number of new initiatives to support mentoring at UCSF that have evolved from the MDP. To our knowledge, this is the first evaluation of the long‐term impact of a mentor training program for CT researchers. Clin Trans Sci 2012; Volume 5: 362–367 PMID:22883616

Validation of Clinical Testing for Warfarin Sensitivity

PubMed Central

Langley, Michael R.; Booker, Jessica K.; Evans, James P.; McLeod, Howard L.; Weck, Karen E.

2009-01-01

Responses to warfarin (Coumadin) anticoagulation therapy are affected by genetic variability in both the CYP2C9 and VKORC1 genes. Validation of pharmacogenetic testing for warfarin responses includes demonstration of analytical validity of testing platforms and of the clinical validity of testing. We compared four platforms for determining the relevant single nucleotide polymorphisms (SNPs) in both CYP2C9 and VKORC1 that are associated with warfarin sensitivity (Third Wave Invader Plus, ParagonDx/Cepheid Smart Cycler, Idaho Technology LightCycler, and AutoGenomics Infiniti). Each method was examined for accuracy, cost, and turnaround time. All genotyping methods demonstrated greater than 95% accuracy for identifying the relevant SNPs (CYP2C9 *2 and *3; VKORC1 −1639 or 1173). The ParagonDx and Idaho Technology assays had the shortest turnaround and hands-on times. The Third Wave assay was readily scalable to higher test volumes but had the longest hands-on time. The AutoGenomics assay interrogated the largest number of SNPs but had the longest turnaround time. Four published warfarin-dosing algorithms (Washington University, UCSF, Louisville, and Newcastle) were compared for accuracy for predicting warfarin dose in a retrospective analysis of a local patient population on long-term, stable warfarin therapy. The predicted doses from both the Washington University and UCSF algorithms demonstrated the best correlation with actual warfarin doses. PMID:19324988

Validation of clinical testing for warfarin sensitivity: comparison of CYP2C9-VKORC1 genotyping assays and warfarin-dosing algorithms.

PubMed

Langley, Michael R; Booker, Jessica K; Evans, James P; McLeod, Howard L; Weck, Karen E

2009-05-01

Responses to warfarin (Coumadin) anticoagulation therapy are affected by genetic variability in both the CYP2C9 and VKORC1 genes. Validation of pharmacogenetic testing for warfarin responses includes demonstration of analytical validity of testing platforms and of the clinical validity of testing. We compared four platforms for determining the relevant single nucleotide polymorphisms (SNPs) in both CYP2C9 and VKORC1 that are associated with warfarin sensitivity (Third Wave Invader Plus, ParagonDx/Cepheid Smart Cycler, Idaho Technology LightCycler, and AutoGenomics Infiniti). Each method was examined for accuracy, cost, and turnaround time. All genotyping methods demonstrated greater than 95% accuracy for identifying the relevant SNPs (CYP2C9 *2 and *3; VKORC1 -1639 or 1173). The ParagonDx and Idaho Technology assays had the shortest turnaround and hands-on times. The Third Wave assay was readily scalable to higher test volumes but had the longest hands-on time. The AutoGenomics assay interrogated the largest number of SNPs but had the longest turnaround time. Four published warfarin-dosing algorithms (Washington University, UCSF, Louisville, and Newcastle) were compared for accuracy for predicting warfarin dose in a retrospective analysis of a local patient population on long-term, stable warfarin therapy. The predicted doses from both the Washington University and UCSF algorithms demonstrated the best correlation with actual warfarin doses.

The 'indirect costs' of underfunding foreign partners in global health research: A case study.

PubMed

Crane, Johanna T; Andia Biraro, Irene; Fouad, Tamer M; Boum, Yap; R Bangsberg, David

2017-09-16

This study of a global health research partnership assesses how U.S. fiscal administrative policies impact capacity building at foreign partner institutions. We conducted a case study of a research collaboration between Mbarara University of Science and Technology (MUST) in Mbarara, Uganda, and originally the University of California San Francisco (UCSF), but now Massachusetts General Hospital (MGH). Our case study is based on three of the authors' experiences directing and working with this partnership from its inception in 2003 through 2015. The collaboration established an independent Ugandan non-profit to act as a local fiscal agent and grants administrator and to assure compliance with the Ugandan labour and tax law. This structure, combined with low indirect cost reimbursements from U.S. federal grants, failed to strengthen institutional capacity at MUST. In response to problems with this model, the collaboration established a contracts and grants office at MUST. This office has built administrative capacity at MUST but has also generated new risks and expenses for MGH. We argue that U.S. fiscal administrative practices may drain rather than build capacity at African universities by underfunding the administrative costs of global health research, circumventing host country institutions, and externalising legal and financial risks associated with international work. MGH: Massachusetts General Hospital; MUST: Mbarara University of Science and Technology; NIH: National Institutes of Health; UCSF: University of California San Francisco; URI: Uganda Research Institute.

Multicenter validation of a bedside antisaccade task as a measure of executive function

PubMed Central

Hellmuth, J.; Mirsky, J.; Heuer, H.W.; Matlin, A.; Jafari, A.; Garbutt, S.; Widmeyer, M.; Berhel, A.; Sinha, L.; Miller, B.L.; Kramer, J.H.

2012-01-01

Objective: To create and validate a simple, standardized version of the antisaccade (AS) task that requires no specialized equipment for use as a measure of executive function in multicenter clinical studies. Methods: The bedside AS (BAS) task consisted of 40 pseudorandomized AS trials presented on a laptop computer. BAS performance was compared with AS performance measured using an infrared eye tracker in normal elders (NE) and individuals with mild cognitive impairment (MCI) or dementia (n = 33). The neuropsychological domain specificity of the BAS was then determined in a cohort of NE, MCI, and dementia (n = 103) at UCSF, and the BAS was validated as a measure of executive function in a 6-center cohort (n = 397) of normal adults and patients with a variety of brain diseases. Results: Performance on the BAS and laboratory AS task was strongly correlated and BAS performance was most strongly associated with neuropsychological measures of executive function. Even after controlling for disease severity and processing speed, BAS performance was associated with multiple assessments of executive function, most strongly the informant-based Frontal Systems Behavior Scale. Conclusions: The BAS is a simple, valid measure of executive function in aging and neurologic disease. PMID:22573640

If Medicare Were to Negotiate Drug Prices, How Would it Determine a ‘Fair’ Price for a Cancer Treatment?

Cancer.gov

Steven D. Pearson, MD, MSc, FRCP, is the Founder and President of the Institute for Clinical and Economic Review (ICER). ICER is a leader in bringing stakeholders together to collaborate in the evaluation of the comparative effectiveness of medical interventions. The Institute also helps translate comparative effectiveness information into distinctive formats for patients, clinicians, and policy makers to enable them to make better use of evidence throughout the health care system. Dr. Pearson is also a Lecturer in the Department of Population Medicine at Harvard Medical School, as well as serving as Visiting Scientist in the Department of Bioethics at the National Institutes of Health. He attended UCSF School of Medicine, completed his residency in internal medicine at Brigham and Women’s Hospital in Boston, and obtained a Master of Science Degree in Health Policy and Management at the Harvard School of Public Health. An internist, health services researcher, and ethicist, Dr. Pearson has served in many advisory and leadership roles in academia and government. He was awarded an Atlantic Fellowship from the British Government in 2004 and chose to serve as Senior Fellow at the National Institute for Health and Clinical Excellence (NICE). Returning to the United States in 2005, he was asked to serve for one year as Special Advisor, Technology and Coverage Policy, within the Coverage and Analysis Group at the Centers for Medicare and Medicaid Services. He has also served as Senior Fellow at America’s Health Insurance Plans, as the Vice Chair of the Medicare Evidence Development and Coverage Advisory Committee (MedCAC), and as a Member of the Board of Directors of Health Technology Assessment International (HTAi). Dr. Pearson’s ongoing academic work combines efforts in comparative effectiveness research, health policy, and bioethics. His published work includes numerous articles and commentaries on the role of evidence in the health care system, and the book No Margin, No Mission: Health Care Organizations and the Quest for Ethical Excellence. If you are a person with a disability and require an assistive device, services or other reasonable accommodations to participate in this activity, please contact the Cancer Prevention Fellowship Program at (240) 276-5626 at least one week in advance of the lecture date to discuss your accommodation needs.

Novel Adult Stem Cells for Peripheral Nerve Regeneration

DTIC Science & Technology

2012-09-01

were also positive for MSC surface marker CD29 and CD44 (Fig. 1F-G). However, CD29 and CD44 are also expressed in SMCs, so we will not use these non...tubulin. In addition, MVSCs were negative for perivascular MSC marker CD146 (Fig. 1H) and SMC progenitor marker Sca-1 (Fig. 1I). MVSCs were also...University of California, Berkeley, California 94720, USA. 2 UC Berkeley-UCSF Graduate Program in Bioengineering, Berkeley, California 94720, USA. 3

Symposium KK: Structure-Property Relationships in Biomineralized and Bio-mimetic Composites

DTIC Science & Technology

2010-04-06

Preventive and Restorative Dental Sciences, UCSF, San Francisco, California. 4:45 PM KK2.8 Damage and Crack Evolution in Mammalian Enamel James Jin...Technology, Graz, Austria. 9:45AMKK6.S AFM and PFM measurements of Enamel in order to Determine the Crack Tip Toughness and Cohesive Zone of Enamel Gerold...11:00 AM KK9.7 Enamel Matrix Guided Growth of Apatite Vuk Uskokovic1. Li Zhu2, Wu Li2 and Stefan Habelitz1; ’Department of Preventive and

University of California San Francisco (UCSF-2): Gene Expression Profiling of Normal Mouse Skin, Hras WT and Hras -/- | Office of Cancer Genomics

Cancer.gov

This data set contains the transcriptional profiles of 20 dorsal skin samples from eight-week-old mice. Mice were generated by crossing FVB/N to Mus spretus mice to generate F1 mice, and then crossing F1 mice back to the FVB/N strain. 10  FVB/N mice lacking Hras1 (aka HrasKO, Hras-/-) and 10  FVB/N mice with wild-type Hras1 were generated. Read the abstract.

UCSF Protocol for Caries Arrest Using Silver Diamine Fluoride: Rationale, Indications, and Consent

PubMed Central

Horst, Jeremy A; Ellenikiotis, Hellene; Milgrom, Peter M

2016-01-01

The Food and Drug Administration recently cleared silver diamine fluoride for reducing tooth sensitivity. Clinical trials document arrest and prevention of dental caries by silver diamine fluoride; this off-label use is now permissible and appropriate under U.S. law. A CDT code was approved for caries arresting medicaments for 2016 to facilitate documentation and billing. We present a systematic review, clinical indications, clinical protocol, and consent procedure to guide application for caries arrest treatment. PMID:26897901

Matrix Metalloproteinases as a Therapeutic Target to Improve Neurologic Recovery After Spinal Cord Injury

DTIC Science & Technology

2013-10-01

the BMS scale where a score of 0 indicates hindlimb paralysis and a score of 9 reflects normal hindlimb locomotor function. The more mildly injured...graded levels of injury severity based upon the BMS scale . Urologic status shows injury severity-dependent changes with UICs being most pronounced...BMS scale . Exclusion criteria were as follows: any animal showing an average score of > 0.5 at 8 hours post- injury or morbidity as defined in UCSF

The Institute for Global Orthopedics and Traumatology: A Model for Academic Collaboration in Orthopedic Surgery.

PubMed

Conway, Devin James; Coughlin, Richard; Caldwell, Amber; Shearer, David

2017-01-01

In 2006, surgeons at the University of California, San Francisco (UCSF) established the Institute for Global Orthopedics and Traumatology (IGOT), an initiative within the department of orthopedic surgery. The principal aim of IGOT is to create long-term, sustainable solutions to the growing burden of musculoskeletal injury in low- and middle-income countries (LMICs) through academic partnership. IGOT currently has relationships with teaching hospitals in Ghana, Malawi, Tanzania, Nicaragua, and Nepal. The organizational structure of IGOT is built on four pillars: Global Surgical Education (GSE), Global Knowledge Exchange (GKE), Global Research Initiative (GRI), and Global Leadership and Advocacy. GSE focuses on increasing surgical knowledge and technical proficiency through hands-on educational courses. The GKE facilitates the mutual exchange of surgeons and trainees among IGOT and its partners. This includes a global resident elective that allows UCSF residents to complete an international rotation at one of IGOT's partner sites. The GRI strives to build research capacity and sponsor high-quality clinical research projects that address questions relevant to local partners. The fourth pillar, Global Leadership and Advocacy aims to increase awareness of the global impact of musculoskeletal injury through national and international courses and events, such as the Bay Area Global Health Film Festival. At the core of each tenet is the collaboration among IGOT and its international partners. Over the last decade, IGOT has experienced tremendous growth and maturation in its partnership model based on cumulative experience and the needs of its partners.

The Institute for Global Orthopedics and Traumatology: A Model for Academic Collaboration in Orthopedic Surgery

PubMed Central

Conway, Devin James; Coughlin, Richard; Caldwell, Amber; Shearer, David

2017-01-01

In 2006, surgeons at the University of California, San Francisco (UCSF) established the Institute for Global Orthopedics and Traumatology (IGOT), an initiative within the department of orthopedic surgery. The principal aim of IGOT is to create long-term, sustainable solutions to the growing burden of musculoskeletal injury in low- and middle-income countries (LMICs) through academic partnership. IGOT currently has relationships with teaching hospitals in Ghana, Malawi, Tanzania, Nicaragua, and Nepal. The organizational structure of IGOT is built on four pillars: Global Surgical Education (GSE), Global Knowledge Exchange (GKE), Global Research Initiative (GRI), and Global Leadership and Advocacy. GSE focuses on increasing surgical knowledge and technical proficiency through hands-on educational courses. The GKE facilitates the mutual exchange of surgeons and trainees among IGOT and its partners. This includes a global resident elective that allows UCSF residents to complete an international rotation at one of IGOT’s partner sites. The GRI strives to build research capacity and sponsor high-quality clinical research projects that address questions relevant to local partners. The fourth pillar, Global Leadership and Advocacy aims to increase awareness of the global impact of musculoskeletal injury through national and international courses and events, such as the Bay Area Global Health Film Festival. At the core of each tenet is the collaboration among IGOT and its international partners. Over the last decade, IGOT has experienced tremendous growth and maturation in its partnership model based on cumulative experience and the needs of its partners. PMID:28713803

Evaluation of the Program in Medical Education for the Urban Underserved (PRIME-US) at the UC Berkeley-UCSF Joint Medical Program (JMP): The First 4 Years.

PubMed

Sokal-Gutierrez, Karen; Ivey, Susan L; Garcia, Roxanna M; Azzam, Amin

2015-01-01

Medical educators, clinicians, and health policy experts widely acknowledge the need to increase the diversity of our healthcare workforce and build our capacity to care for medically underserved populations and reduce health disparities. The Program in Medical Education for the Urban Underserved (PRIME-US) is part of a family of programs across the University of California (UC) medical schools aiming to recruit and train physicians to care for underserved populations, expand the healthcare workforce to serve diverse populations, and promote health equity. PRIME-US selects medical students from diverse backgrounds who are committed to caring for underserved populations and provides a 5-year curriculum including a summer orientation, a longitudinal seminar series with community engagement and leadership-development activities, preclerkship clinical immersion in an underserved setting, a master's degree, and a capstone rotation in the final year of medical school. This is a mixed-methods evaluation of the first 4 years of the PRIME-US at the UC Berkeley-UC San Francisco Joint Medical Program (JMP). From 2006 to 2010, focus groups were conducted each year with classes of JMP PRIME-US students, for a total of 11 focus groups; major themes were identified using content analysis. In addition, 4 yearly anonymous, online surveys of all JMP students, faculty and staff were conducted and analyzed. Most PRIME-US students came from socioeconomically disadvantaged backgrounds and ethnic backgrounds underrepresented in medicine, and all were committed to caring for underserved populations. The PRIME-US students experienced many program benefits including peer support, professional role models and mentorship, and curricular enrichment activities that developed their knowledge, skills, and sustained commitment to care for underserved populations. Non-PRIME students, faculty, and staff also benefited from participating in PRIME-sponsored seminars and community-based activities. Challenges noted by PRIME-US students and non-PRIME students, faculty, and staff included the stress of additional workload, perceived inequities in student educational opportunities, and some negative comments from physicians in other specialties regarding primary care careers. Over the first 4 years of the program, PRIME-US students and non-PRIME students, faculty, and staff experienced educational benefits consistent with the intended program goals. Long-term evaluation is needed to examine the participants' medical careers and impacts on California's healthcare workforce and patient outcomes. Attention should also be paid to the challenges of implementing new medical education enrichment programs.

Using the structure-function linkage database to characterize functional domains in enzymes.

PubMed

Brown, Shoshana; Babbitt, Patricia

2014-12-12

The Structure-Function Linkage Database (SFLD; http://sfld.rbvi.ucsf.edu/) is a Web-accessible database designed to link enzyme sequence, structure, and functional information. This unit describes the protocols by which a user may query the database to predict the function of uncharacterized enzymes and to correct misannotated functional assignments. The information in this unit is especially useful in helping a user discriminate functional capabilities of a sequence that is only distantly related to characterized sequences in publicly available databases. Copyright © 2014 John Wiley & Sons, Inc.

Development of virtual environments for training skills and reducing errors in laparoscopic surgery

NASA Astrophysics Data System (ADS)

Tendick, Frank; Downes, Michael S.; Cavusoglu, Murat C.; Gantert, Walter A.; Way, Lawrence W.

1998-06-01

In every surgical procedure there are key steps and skills that, if performed incorrectly, can lead to complications. In conjunction with efforts, based on task and error analysis, in the Videoscopic Training Center at UCSF to identify these key elements in laparoscopic surgical procedures, the authors are developing virtual environments and modeling methods to train the elements. Laparoscopic surgery is particularly demanding of the surgeon's spatial skills, requiring the ability to create 3D mental models and plans while viewing a 2D image. For example, operating a laparoscope with the objective lens angled from the scope axis is a skill that some surgeons have difficulty mastering, even after using the instrument in many procedures. Virtual environments are a promising medium for teaching spatial skills. A kinematically accurate model of an angled laparoscope in an environment of simple targets is being tested in courses for novice and experienced surgeons. Errors in surgery are often due to a misinterpretation of local anatomy compounded with inadequate procedural knowledge. Methods to avoid bile duct injuries in cholecystectomy are being integrated into a deformable environment consisting of the liver, gallbladder, and biliary tree. Novel deformable tissue modeling algorithms based on finite element methods will be used to improve the response of the anatomical models.

DoD-GEIS - DoD Global Emerging Infections Surveillance and Response System, Fiscal Year 2007

DTIC Science & Technology

2007-01-01

Weaver SC. Endemic eastern equine encephalitis in the Amazon Region of Peru . Am J Trop Med Hyg, 76:293-8, 2007. 3. Alibayeva G, Todd CS, Khakimov...Naval Medical Center Naval Health Research Center Naval Medical Research Center Naval Medical Research Center Detachment (Lima, Peru ) Naval Medical...Medical Research Center Detachment (Lima, Peru ) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .60

Measuring the efficiency of dental departments in medical centers: a nonparametric analysis approach.

PubMed

Wang, Su-Chen; Tsai, Chi-Cheng; Huang, Shun-Te; Hong, Yu-Jue

2002-12-01

Data envelopment analysis (DEA), a cross-sectional study design based on secondary data analysis, was used to evaluate the relative operational efficiency of 16 dental departments in medical centers in Taiwan in 1999. The results indicated that 68.7% of all dental departments in medical centers had poor performance in terms of overall efficiency and scale efficiency. All relatively efficient dental departments were in private medical centers. Half of these dental departments were unable to fully utilize available medical resources. 75.0% of public medical centers did not take full advantage of medical resources at their disposal. In the returns to scale, 56.3% of dental departments in medical centers exhibited increasing returns to scale, due to the insufficient scale influencing overall hospital operational efficiency. Public medical centers accounted for 77.8% of the institutions affected. The scale of dental departments in private medical centers was more appropriate than those in public medical centers. In the sensitivity analysis, the numbers of residents, interns, and published papers were used to assess teaching and research. Greater emphasis on teaching and research in medical centers has a large effect on the relative inefficiency of hospital operation. Dental departments in private medical centers had a higher mean overall efficiency score than those in public medical centers, and the overall efficiency of dental departments in non-university hospitals was greater than those in university hospitals. There was no information to evaluate the long-term efficiency of each dental department in all hospitals. A different combination of input and output variables, using common multipliers for efficiency value measurements in DEA, may help establish different pioneering dental departments in hospitals.

Opportunity for Collaboration Between Radiation Injury Treatment Network Centers and Medical Toxicology Specialists.

PubMed

Davlantes, Elizabeth; Shartar, Samuel; Venero, Jennifer; Steck, Alaina; Langston, Amelia; Kazzi, Ziad N

2017-08-01

The Radiation Injury Treatment Network (RITN) comprises >50 centers across the United States that are poised to care for victims of a radiation emergency. The network is organized around bone marrow transplant centers because these facilities excel in both radiation medicine and the care of patients with severe bone marrow depression. A radiation emergency may cause not only irradiation from an external source but also internal contamination with radioactive material. Because medical toxicologists are trained in radiation injury management and have expertise in the management of internal contamination, RITN centers may benefit from partnerships with medical toxicology resources, which may be located at academic medical centers, hospital inpatient clinical services, outpatient clinics, or poison control centers. We determined the locations of existing RITN centers and assessed their proximity to various medical toxicology resources, including medical toxicology fellowship programs, inpatient toxicology services, outpatient toxicology clinics, and poison control centers. Data were derived from publicly available Internet sources in March 2015. The majority of RITN centers do not have a medical toxicology fellowship, an inpatient toxicology service, or an outpatient toxicology clinic within the same institution. Fifty-seven percent of RITN centers have at least one of these resources located in the same city, however, and 73% of centers have at least one of these resources or a poison control center within the same city. Ninety-five percent of RITN centers have at least one medical toxicology resource within the state. Most RITN centers are located in the same city as at least one medical toxicology resource. Establishing relationships between RITN centers and medical toxicologists needs to be explored further.

The state of research funding from the National Institutes of Health for criminal justice health research

PubMed Central

Ahalt, Cyrus; Bolano, Marielle; Wang, Emily A.; Williams, Brie

2015-01-01

Background Over 20 million Americans are currently incarcerated or have been in the past. Most are from medically underserved populations; one in three African American men and one in six Latino men born in 2001 are projected to go to prison during their lifetimes. The amount of funding from the National Institutes of Health (NIH) to understand and improve the health of criminal justice-involved persons is unknown. Objective Describe NIH funding for research addressing the health and healthcare needs of criminal justice-involved individuals. Design Review of NIH grants (from 2008 through 2012) in the RePORT (Research Portfolio Online Reporting Tools) database. Setting The NIH RePORT database. Patients Criminal justice involved individuals participating in NIH-funded clinical research. Measurements NIH research and training grants awarded by number, type, research area, institute or center, and dollar amount. Results Of more than 250,000 NIH funded grants, 180 (less than 0.1%) focused on criminal justice health research. The three most common foci of criminal justice health research grants were substance use and/or HIV (64%), mental health (11%), and juvenile health (8%). Two institutes, the National Institute on Drug Abuse and the National Institute of Mental Health, funded 78% of all grants. In 2012, the NIH invested $40.9 million in criminal justice health research, or 1.5% of the $2.7 billion health disparities budget for that year. Limitations NIH-supported research that did not explicitly include current or former prisoners but may have relevance to criminal justice health was not included. Conclusions Federal funding for research focused on understanding and improving the health of criminal justice-involved persons is small, even when compared to the NIH’s overall investment in health disparities research. The NIH is well-positioned to transform the care of current and former prisoners by investing in this critical yet overlooked research area. Primary Funding Source One author received funding support from the National Institute on Aging at the National Institutes of Health and Tideswell at UCSF. PMID:25732276

Analysis of 22q11.2 deletions by FISH in a series of velocardiofacial syndrome patients

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

Ravnan, J.B.; Golabi, M.; Lebo, R.V.

Deletions in chromosome 22 band q11.2 have been associated with velocardiofacial (VCF or Shprintzen) syndrome and the DiGeorge anomaly. A study of VCF patients evaluated at the UCSF Medical Center was undertaken to correlate disease phenotype with presence or absence of a deletion. Patients referred for this study had at least two of the following: dysmorphic facial features, frequent ear infections or hearing loss, palate abnormalities, thymic hypoplasia, hypocalcemia, congenital heart defect, hypotonia, and growth or language delay. Fluorescence in situ hybridization (FISH) using the DiGeorge critical region probe N25 was used to classify patients according to the presence ormore » absence of a deletion in 22q11.2, and the results were compared to clinical characteristics. We have completed studies on 58 patients with features of VCF. Twenty-one patients (36%) were found to have a deletion in 22q11.2 by FISH. A retrospective study of archived slides from 14 patients originally studied only by prometaphase GTG banding found six patients had a deletion detected by FISH; of these, only two had a microscopically visible chromosome deletion. Our study of 11 sets of parents of children with the deletion found two clinically affected mothers with the deletion, including one with three of three children clinically affected. A few patients who did not fit the classical VCF description had a 22q11.2 deletion detected by FISH. These included one patient with both cleft lip and palate, and another with developmental delay and typical facial features but no cardiac or palate abnormalities. Both patients with the DiGeorge anomaly as part of VCF had the deletion. On the other hand, a number of patients diagnosed clinically with classical VCF did not have a detectable deletion. This raises the question whether they represent a subset of patients with a defect of 22q11.2 not detected by the N25 probe, or whether they represent a phenocopy of VCF.« less

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.

U.S. academic medical centers under the managed health care environment.

PubMed

Guo, K

1999-06-01

This research investigates the impact of managed health care on academic medical centers in the United States. Academic medical centers hold a unique position in the U.S. health care system through their missions of conducting cutting-edge biomedical research, pursuing clinical and technological innovations, providing state-of-the-art medical care and producing highly qualified health professionals. However, policies to control costs through the use of managed care and limiting resources are detrimental to academic medical centers and impede the advancement of medical science. To survive the threats of managed care in the health care environment, academic medical centers must rely on their upper level managers to derive successful strategies. The methods used in this study include qualitative approaches in the form of key informants and case studies. In addition, a survey questionnaire was sent to 108 CEOs in all the academic medical centers in the U.S. The findings revealed that managers who perform the liaison, monitor, entrepreneur and resource allocator roles are crucial to ensure the survival of academic medical centers, so that academic medical centers can continue their missions to serve the general public and promote their well-being.

Living donor liver transplantation for hepatocellular carcinoma achieves better outcomes.

PubMed

Lin, Chih-Che; Chen, Chao-Long

2016-10-01

Liver transplantation (LT) for hepatocellular carcinoma (HCC) at Kaohsiung Chang Gung Memorial Hospital mainly relies on live donor LT (LDLT). Owing to taking the risk of LD, we are obligated to adopt strict selection criteria for HCC patients and optimize the pre-transplant conditions to ensure a high disease-free survival similar to those without HCC, even better than deceased donor LT (DDLT). Better outcomes are attributed to excellent surgical results and optimal patient selection. The hospital mortality of primary and salvage LDLT are lower than 2% in our center. Although Taiwan Health Insurance Policy extended the Milan to University of California, San Francisco (UCSF) criteria in 2006, selection criteria will not be consolidated to take into account only by the morphologic size/number of tumors but also by their biology. The criteria are divided into modifiable image morphology, alpha fetoprotein (AFP), and positron emission tomography (PET) scan with standard uptake value (SUV) and unmodifiable unfavorable pathology such as HCC combined with cholangiocarcinoma (CC), sarcomatoid type, and poor differentiation. Downstaging therapy is necessary for HCC patients beyond criteria to fit all modifiable standards. The upper limit of downstaging treatment seems to be extended by more effective drug eluting transarterial chemoembolization in cases without absolute contraindications. In contrast, the pitfall of unmodifiable tumor pathology should be excluded by the findings of pretransplant core biopsy/resection if possible. More recently, achieving complete tumor necrosis in explanted liver could almost predict no recurrence after transplant. Necrotizing therapy is advised if possible before transplant even the tumor status within criteria to minimize the possibility of tumor recurrence. LDLT with low surgical mortality in experienced centers provides the opportunities of optimizing the pre-transplant tumor conditions and timing of transplant to achieve better outcomes.

Increased mitochondrial DNA deletions and copy number in transfusion-dependent thalassemia

PubMed Central

Calloway, Cassandra

2016-01-01

BACKGROUND. Iron overload is the primary cause of morbidity in transfusion-dependent thalassemia. Increase in iron causes mitochondrial dysfunction under experimental conditions, but the occurrence and significance of mitochondrial damage is not understood in patients with thalassemia. METHODS. Mitochondrial DNA (mtDNA) to nuclear DNA copy number (Mt/N) and frequency of the common 4977-bp mitochondrial deletion (ΔmtDNA4977) were quantified using a quantitative PCR assay on whole blood samples from 38 subjects with thalassemia who were receiving regular transfusions. RESULTS. Compared with healthy controls, Mt/N and ΔmtDNA4977 frequency were elevated in thalassemia (P = 0.038 and P < 0.001, respectively). ΔmtDNA4977 was increased in the presence of either liver iron concentration > 15 mg/g dry-weight or splenectomy, with the highest levels observed in subjects who had both risk factors (P = 0.003). Myocardial iron (MRI T2* < 20 ms) was present in 0%, 22%, and 46% of subjects with ΔmtDNA4977 frequency < 20, 20–40, and > 40/1 × 107 mtDNA, respectively (P = 0.025). Subjects with Mt/N values below the group median had significantly lower Matsuda insulin sensitivity index (5.76 ± 0.53) compared with the high Mt/N group (9.11 ± 0.95, P = 0.008). CONCLUSION. Individuals with transfusion-dependent thalassemia demonstrate age-related increase in mtDNA damage in leukocytes. These changes are markedly amplified by splenectomy and are associated with extrahepatic iron deposition. Elevated mtDNA damage in blood cells may predict the risk of iron-associated organ damage in thalassemia. FUNDING. This project was supported by Children’s Hospital & Research Center Oakland Institutional Research Award and by the National Center for Advancing Translational Sciences, NIH, through UCSF-CTSI grant UL1 TR000004. PMID:27583305

A library for the fifteenth through the twenty-first centuries.

PubMed Central

Cooper, R S

1991-01-01

The University of California, San Francisco (UCSF), began developing a program for a new library in 1977, started the design in 1985, began construction in 1988, and opened the library in September 1990. The primary objectives were to design and build a facility that would house print collections under optimal conditions, allow for ten years' growth, be flexible enough to permit future reconfiguration, support present and future technologies, and provide beautiful spaces in which to study. The planning process is summarized, planning concepts are outlined, and considerations for the electronic library are briefly reviewed. Images PMID:2039900

A Hospital Local Area Communication Network—The First Year's Experience

PubMed Central

Simborg, D. W.; Chadwick, M.; Whiting-O'Keefe, Q. E.; Tolchin, S. G.; Stewart, R. L.; Kahn, S. A.; Bergan, E. S.; Gafke, G. P.

1982-01-01

A local area communications network has been implemented at the University of California, San Francisco Hospital to integrate major components of the hospital's information system. This microprocessor-based network technology was developed by The Applied Physics Laboratory of the Johns Hopkins University. The first year's experience has demonstrated the basic feasibility of this technology in simplifying the integration of diverse hardware and software systems. Four minicomputer-based UCSF systems now use the network to synchronize key patient identification and registration information among the systems. Clinical uses of the network will begin during the second year of the project.

Medical student socio-demographic characteristics and attitudes toward patient centered care: do race, socioeconomic status and gender matter? A report from the Medical Student CHANGES study.

PubMed

Hardeman, Rachel R; Burgess, Diana; Phelan, Sean; Yeazel, Mark; Nelson, David; van Ryn, Michelle

2015-03-01

To determine whether attitudes toward patient-centered care differed by socio-demographic characteristics (race, gender, socioeconomic status) among a cohort of 3191 first year Black and White medical students attending a stratified random sample of US medical schools. This study used baseline data from Medical Student CHANGES, a large national longitudinal cohort study of medical students. Multiple logistic regression was used to assess the association of race, gender and SES with attitudes toward patient-centered care. Female gender and low SES were significant predictors of positive attitudes toward patient-centered care. Age was also a significant predictor of positive attitudes toward patient-centered care such that students older than the average age of US medical students had more positive attitudes. Black versus white race was not associated with attitudes toward patient-centered care. New medical students' attitudes toward patient-centered care may shape their response to curricula and the quality and style of care that they provide as physicians. Some students may be predisposed to attitudes that lead to both greater receptivity to curricula and the provision of higher-quality, more patient-centered care. Medical school curricula with targeted messages about the benefits and value of patient-centered care, framed in ways that are consistent with the beliefs and world-view of medical students and the recruitment of a socioeconomically diverse sample of students into medical schools are vital for improved care. Published by Elsevier Ireland Ltd.

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

Patient-centered priorities for improving medication management and adherence.

PubMed

McMullen, Carmit K; Safford, Monika M; Bosworth, Hayden B; Phansalkar, Shobha; Leong, Amye; Fagan, Maureen B; Trontell, Anne; Rumptz, Maureen; Vandermeer, Meredith L; Brinkman, William B; Burkholder, Rebecca; Frank, Lori; Hommel, Kevin; Mathews, Robin; Hornbrook, Mark C; Seid, Michael; Fordis, Michael; Lambert, Bruce; McElwee, Newell; Singh, Jasvinder A

2015-01-01

The Centers for Education and Research on Therapeutics convened a workshop to examine the scientific evidence on medication adherence interventions from the patient-centered perspective and to explore the potential of patient-centered medication management to improve chronic disease treatment. Patients, providers, researchers, and other stakeholders (N = 28) identified and prioritized ideas for future research and practice. We analyzed stakeholder voting on priorities and reviewed themes in workshop discussions. Ten priority areas emerged. Three areas were highly rated by all stakeholder groups: creating tools and systems to facilitate and evaluate patient-centered medication management plans; developing training on patient-centered prescribing for providers; and increasing patients' knowledge about medication management. However, priorities differed across stakeholder groups. Notably, patients prioritized using peer support to improve medication management while researchers did not. Engaging multiple stakeholders in setting a patient-centered research agenda and broadening the scope of adherence interventions to include other aspects of medication management resulted in priorities outside the traditional scope of adherence research. Workshop participants recognized the potential benefits of patient-centered medication management but also identified many challenges to implementation that require additional research and innovation. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

High-intensity focused ultrasound ablation: an effective bridging therapy for hepatocellular carcinoma patients.

PubMed

Cheung, Tan To; Fan, Sheung Tat; Chan, See Ching; Chok, Kenneth S H; Chu, Ferdinand S K; Jenkins, Caroline R; Lo, Regina C L; Fung, James Y Y; Chan, Albert C Y; Sharr, William W; Tsang, Simon H Y; Dai, Wing Chiu; Poon, Ronnie T P; Lo, Chung Mau

2013-05-28

To analyze whether high-intensity focused ultrasound (HIFU) ablation is an effective bridging therapy for patients with hepatocellular carcinoma (HCC). From January 2007 to December 2010, 49 consecutive HCC patients were listed for liver transplantation (UCSF criteria). The median waiting time for transplantation was 9.5 mo. Twenty-nine patients received transarterial chemoembolization (TACE) as a bringing therapy and 16 patients received no treatment before transplantation. Five patients received HIFU ablation as a bridging therapy. Another five patients with the same tumor staging (within the UCSF criteria) who received HIFU ablation but not on the transplant list were included for comparison. Patients were comparable in terms of Child-Pugh and model for end-stage liver disease scores, tumor size and number, and cause of cirrhosis. The HIFU group and TACE group showed no difference in terms of tumor size and tumor number. One patient in the HIFU group and no patient in the TACE group had gross ascites. The median hospital stay was 1 d (range, 1-21 d) in the TACE group and two days (range, 1-9 d) in the HIFU group (P < 0.000). No HIFU-related complication occurred. In the HIFU group, nine patients (90%) had complete response and one patient (10%) had partial response to the treatment. In the TACE group, only one patient (3%) had response to the treatment while 14 patients (48%) had stable disease and 14 patients (48%) had progressive disease (P = 0.00). Seven patients in the TACE group and no patient in the HIFU group dropped out from the transplant waiting list (P = 0.559). HIFU ablation is safe and effective in the treatment of HCC for patients with advanced cirrhosis. It may reduce the drop-out rate of liver transplant candidate.

[Response of the tobacco industry to the creation of smoke-free environments in Brazil].

PubMed

Bialous, Stella Aguinaga; Presman, Sabrina; Gigliotti, Analice; Muggli, Monique; Hurt, Richard

2010-04-01

To document the response of the tobacco industry to the regulation of smoking in public places in Brazil starting in 1996. The Legacy Tobacco Documents Library (legacy.library.ucsf.edu/) and the British American Tobacco (BAT) Company Documents (bat.library.ucsf.edu/) were searched. The following key words were used: Brasil/Brazil; Souza Cruz; fumo passivo, tabagismo passivo/passive smoking; fumo de segunda mão/secondhand smoking; convivência em harmonia/courtesy of choice; along with the names of institutions, politicians, and individuals associated with tobacco control. We also searched the websites of cigarette manufacturers and hospitality industry organizations and businesses, news websites, and online newspapers and magazines. The search was limited to the period from 1995 to 2005. The text of the first law restricting smoking in Brazil (no. 9 294, of 1996) benefited the industry by stating that smokers and nonsmokers could share the same space provided that specific areas were designated as smoking and nonsmoking. As in other countries, the tobacco industry established partnerships with hotel, bar, and restaurant associations to prevent the passing of laws creating 100% smoke-free environments, as recommended by the World Health Organization. However, local state and city laws in major cities and states (such as Rio de Janeiro and São Paulo) have been successful in ensuring the creation of 100% smoke-free places. It is essential that Brazil recognize the damage caused by smoking and revise its federal law regulating smoking in closed environments. The knowledge concerning the strategies employed by the industry may be useful for politicians and health care professionals to prepare arguments opposing measures that can be detrimental to public health.

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.

Tobacco industry sponsorship of a book and conflict of interest.

PubMed

Hong, Mi-Kyung; Bero, Lisa A

2006-08-01

The tobacco industry has hidden its involvement in the design, conduct and publication of scientific research articles and has used the articles to argue against tobacco regulation. The objective of this study is to examine tobacco industry involvement in the development of scientific books. Qualitative analysis of previously secret internal tobacco industry documents retrieved from the Legacy Tobacco Documents Library (http://legacy.library.ucsf.edu). Information from the documents was supplemented with material from Internet searches, the National Center for Biotechnology Information Pubmed database and interviews with individuals involved in book publication. Between 1997 and 1999 the tobacco industry sponsored a monograph, entitled 'Analytical Determination of Nicotine and Related Compounds and their Metabolites', that examined the measurement and metabolism of nicotine. The tobacco industry recruited Elsevier Science to publish the monograph. Tobacco industry executives, lawyers and scientists reviewed the chapters. One use of the monograph was to stimulate collaborative efforts between academic and tobacco industry scientists. Another was to provide the book to a government regulatory agency reviewing the teratogenic effects of nicotine. Our findings show the breadth of tobacco industry engagement in scientific knowledge production and dissemination, and its motives for sponsoring scientific literature. The industry's effort to gain credibility through collaboration with academic scientists raises questions regarding the ethics of accepting tobacco industry funding for publication. Scientists who collaborate on publications sponsored by the tobacco industry must consider the full implications of these joint efforts.

Telephone-Based Cognitive-Behavioral Screening for Frontotemporal Changes in Patients with Amyotrophic Lateral Sclerosis (ALS)

PubMed Central

Christodoulou, Georgia; Gennings, Chris; Hupf, Jonathan; Factor-Litvak, Pam; Murphy, Jennifer; Goetz, Raymond R.; Mitsumoto, Hiroshi

2017-01-01

Objective To establish a valid and reliable battery of measures to evaluate frontotemporal dementia (FTD) in patients with ALS over the phone. Methods Thirty-one subjects were administered either in-person or telephone-based screening followed by the opposite mode of testing two weeks later, using a modified version of the UCSF Cognitive Screening Battery. Results Equivalence testing was performed for in-person and telephone-based tests. The standard ALS Cognitive Behavioral Screen (ALS-CBS) showed statistical equivalence at the 5% significance level when compared to a revised phone-version of the ALS-CBS. In addition, the Controlled Oral Word Association Test (COWAT) and Center for Neurologic Study-Lability Scale (CNS-LS) were also found to be equivalent at the 5% and 10% significance level respectively. Similarly, the Mini-Mental State Examination (MMSE) and the well-established Telephone Interview for Cognitive Status (TICS) were also statistically equivalent. Equivalence could not be claimed for the ALS-Frontal Behavioral Inventory (ALS-FBI) caregiver interview and the Written Verbal Fluency Index (WVFI). Conclusions Our study suggests that telephone-based versions of the ALS-CBS, COWAT, and CNS-LS may offer clinicians valid tools to detect frontotemporal changes in the ALS population. Development of telephone-based cognitive testing for ALS could become an integral resource for population-based research in the future. PMID:27121545

Telephone based cognitive-behavioral screening for frontotemporal changes in patients with amyotrophic lateral sclerosis (ALS).

PubMed

Christodoulou, Georgia; Gennings, Chris; Hupf, Jonathan; Factor-Litvak, Pam; Murphy, Jennifer; Goetz, Raymond R; Mitsumoto, Hiroshi

Our objective was to establish a valid and reliable battery of measures to evaluate frontotemporal dementia (FTD) in patients with ALS over the telephone. Thirty-one subjects were administered either in-person or by telephone-based screening followed by the opposite mode of testing two weeks later, using a modified version of the UCSF Cognitive Screening Battery. Equivalence testing was performed for in-person and telephone based tests. The standard ALS Cognitive Behavioral Screen (ALS-CBS) showed statistical equivalence at the 5% significance level compared to a revised phone version of the ALS-CBS. In addition, the Controlled Oral Word Association Test (COWAT) and Center for Neurologic Study-Lability Scale (CNS-LS) were also found to be equivalent at the 5% and 10% significance level, respectively. Similarly, the Mini-Mental State Examination (MMSE) and the well-established Telephone Interview for Cognitive Status (TICS) were also statistically equivalent. Equivalence could not be claimed for the ALS-Frontal Behavioral Inventory (ALS-FBI) caregiver interview and the Written Verbal Fluency Index (WVFI). In conclusion, our study suggests that telephone-based versions of the ALS-CBS, COWAT, and CNS-LS may offer clinicians valid tools to detect frontotemporal changes in the ALS population. Development of telephone based cognitive testing for ALS could become an integral resource for population based research in the future.

Delinquent Medical Service Accounts at Naval Medical Center Portsmouth Need Additional Management Oversight

DTIC Science & Technology

2015-03-04

H 4 , 2 0 1 5 Delinquent Medical Service Accounts at Naval Medical Center Portsmouth Need Additional Management Oversight Report No. DODIG-2015...04 MAR 2015 2. REPORT TYPE 3. DATES COVERED 00-00-2015 to 00-00-2015 4. TITLE AND SUBTITLE Delinquent Medical Service Accounts at Naval...i Results in Brief Delinquent Medical Service Accounts at Naval Medical Center Portsmouth Need Additional Management Oversight Visit us at

Kennedy Space Center Medical Operations and Medical Kit

NASA Technical Reports Server (NTRS)

Scarpa, Philip

2011-01-01

This slide presentation reviews the emergency medical operations at Kennedy Space center, the KSC launch and landing contingency modes, the triage site, the medical kit, and the medications available.

2. OVERALL VIEW OF THE MEDICAL CENTER (ESPECIALLY BUILDING 1) ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

2. OVERALL VIEW OF THE MEDICAL CENTER (ESPECIALLY BUILDING 1) FROM THE 'CAMPUS' GROUNDS; LOOKING SW. (Harms) - Veterans Administration Medical Center, Old State Route 13 West, Marion, Williamson County, IL

Public Health Potential of Farmers’ Markets on Medical Center Campuses: A Case Study From Penn State Milton S. Hershey Medical Center

PubMed Central

Kraschnewski, Jennifer L.; Rovniak, Liza S.

2011-01-01

There are currently 7175 farmers’ markets in the United States, and these organizations are increasingly viewed as one facet of the solution to national health problems. There has been a recent trend toward establishing markets on medical center campuses, and such partnerships can augment a medical center's ability to serve community health. However, to our knowledge no studies have described the emergence of a market at a medical center, the barriers and challenges such an initiative has faced, or the nature of programming it may foster. We provide a qualitative description of the process of starting a seasonal, once-a-week, producers-only market at the Pennsylvania State Hershey Medical Center, and we call for greater public health attention to these emerging community spaces. PMID:22021298

Public health potential of farmers' markets on medical center campuses: a case study from Penn State Milton S. Hershey Medical Center.

PubMed

George, Daniel R; Kraschnewski, Jennifer L; Rovniak, Liza S

2011-12-01

There are currently 7175 farmers' markets in the United States, and these organizations are increasingly viewed as one facet of the solution to national health problems. There has been a recent trend toward establishing markets on medical center campuses, and such partnerships can augment a medical center's ability to serve community health. However, to our knowledge no studies have described the emergence of a market at a medical center, the barriers and challenges such an initiative has faced, or the nature of programming it may foster. We provide a qualitative description of the process of starting a seasonal, once-a-week, producers-only market at the Pennsylvania State Hershey Medical Center, and we call for greater public health attention to these emerging community spaces.

4. OVERALL VIEW OF THE MEDICAL CENTER (ESPECIALLY BUILDING 2 ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

4. OVERALL VIEW OF THE MEDICAL CENTER (ESPECIALLY BUILDING 2 & BUILDING 1) FROM THE 'CAMPUS' GROUNDS; LOOKING NE. (Harms) - Veterans Administration Medical Center, Old State Route 13 West, Marion, Williamson County, IL

3. OVERALL VIEW OF THE MEDICAL CENTER (ESPECIALLY BUILDING 2 ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

3. OVERALL VIEW OF THE MEDICAL CENTER (ESPECIALLY BUILDING 2 & BUILDING 1) FROM THE 'CAMPUS' GROUNDS; LOOKING NW. (Harms) - Veterans Administration Medical Center, Old State Route 13 West, Marion, Williamson County, IL

ENTRANCE TO CEMETERY FROM VA MEDICAL CENTER CAMPUS, WITH ADMINISTRATION ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

ENTRANCE TO CEMETERY FROM VA MEDICAL CENTER CAMPUS, WITH ADMINISTRATION BUILDING IN BACKGROUND. VIEW TO NORTH. - Bath National Cemetery, Department of Veterans Affairs Medical Center, San Juan Avenue, Bath, Steuben County, NY

Delinquent Medical Service Accounts at Brooke Army Medical Center Need Additional Management Oversight

DTIC Science & Technology

2014-08-13

No. DODIG-2014-101 A U G U S T 1 3 , 2 0 1 4 Delinquent Medical Service Accounts at Brooke Army Medical Center Need Additional Management...13 AUG 2014 2. REPORT TYPE 3. DATES COVERED 00-00-2014 to 00-00-2014 4. TITLE AND SUBTITLE Delinquent Medical Service Accounts at Brooke Army...Results in Brief Delinquent Medical Service Accounts at Brooke Army Medical Center Need Additional Management Oversight Visit us at www.dodig.mil

MicroRNAs to Pathways in Prostate Cancer Progression

DTIC Science & Technology

2015-12-01

PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER Dr. Robert Blelloch and Dr. Cassandra Belair email: Robert.Blelloch@ucsf.edu 5e. TASK...Budget period of: 09/30/2013-09/29/2014: Name  Robert Blelloch  Project  Role  PI  Research Identifier Nearest person month  1.2  Contribution to... Project :  Dr. Blelloch was responsible for overall  coordination of this  project .  He was involved in  the design, interpretation and publication of all

The University of Tennessee Medical Center at Knoxville.

PubMed

Goldman, Mitchell H

2012-09-01

The University of Tennessee Medical Center at Knoxville hosts the University Health Services and the University of Tennessee Graduate School of Medicine. Founded in 1956, the center along with the Department of Surgery has grown in size and in academic stature to become an outstanding tertiary clinical, medical education, and research center.

Improving Medication Knowledge among Older Adults with Heart Failure: A Patient-Centered Approach to Instruction Design

ERIC Educational Resources Information Center

Morrow, Daniel G.; Weiner, Michael; Young, James; Steinley, Douglas; Deer, Melissa; Murray, Michael D.

2005-01-01

Purpose: We investigated whether patient-centered instructions for chronic heart failure medications increase comprehension and memory for medication information in older adults diagnosed with chronic heart failure. Design and Methods: Patient-centered instructions for familiar and unfamiliar medications were compared with instructions for the…

Trend of knowledge production of research centers in the field of medical sciences in iran.

PubMed

Falahat, K; Eftekhari, Mb; Habibi, E; Djalalinia, Sh; Peykari, N; Owlia, P; Malekafzali, H; Ghanei, M; Mojarrab, Sh

2013-01-01

Establishment of medical research centers at universities and health-related organizations and annually evaluation of their research activities was one of the strategic policies which followed by governmental organization in last decade in order to strengthening the connections between health research system and health system. The aim of this study is to scrutinize the role of medical research centers in medical science production in Iran. This study is a cross sectional which has been performed based on existing reports on national scientometrics and evaluation results of research performance of medical research centers between years 2001 to 2010. During last decade number of medical research centers increased from 53 in 2001 to 359 in 2010. Simultaneous scientific output of medical research centers has been increased especially articles indexed in ISI (web of science). Proper policy implementation in the field of health research system during last decades led to improving capacity building and growth knowledge production of medical science in recent years in Iran. The process embedding research into the health systems requires planning up until research products improves health outcomes and health equity in country.

Delinquent Medical Service Accounts at David Grant Air Force Medical Center Need Additional Management Oversight

DTIC Science & Technology

2015-09-24

No. DODIG-2015-179 S E P T E M B E R 2 4 , 2 0 1 5 Delinquent Medical Service Accounts at David Grant Air Force Medical Center Need Additional...us at www.dodig.mil Results in Brief Delinquent Medical Service Accounts at David Grant Air Force...Force Medical Center (DGMC) properly managed delinquent accounts over 180 days by effectively transferring the debt to the appropriate debt collection

Commercial Crew Medical Ops

NASA Technical Reports Server (NTRS)

Heinbaugh, Randall; Cole, Richard

2016-01-01

Provide commercial partners with: center insight into NASA spaceflight medical experience center; information relative to both nominal and emergency care of the astronaut crew at landing site center; a basis for developing and sharing expertise in space medical factors associated with returning crew.

1. AERIAL VIEW, LOOKING WEST OF 'THE BIRMINGHAM MEDICAL CENTER,' ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. AERIAL VIEW, LOOKING WEST OF 'THE BIRMINGHAM MEDICAL CENTER,' WITH HILLMAN HOSPITAL, THE FIVE-STORY BUILDING (CENTER RIGHT AT 20TH STREET AND SIXTH AVENUE SOUTH), JEFFERSON TOWER (CENTER LEFT AT 20TH STREET AND SEVENTH AVENUE SOUTH, AND THE MANY HOSPITALS AND TEACHING FACILITIES OF THE UNIVERSITY OF ALABAMA AT BIRMINGHAM MEDICAL CENTER. - Hillman Hospital, 600 Block Westside Twentieth Street South, Birmingham, Jefferson County, AL

Clinical outcome in patients with hepatocellular carcinoma after living-donor liver transplantation

PubMed Central

Choi, Ho Joong; Kim, Dong Goo; Na, Gun Hyung; Han, Jae Hyun; Hong, Tae Ho; You, Young Kyoung

2013-01-01

AIM: To investigate risk factors for hepatocellular carcinoma (HCC) recurrence after living donor liver transplantation (LDLT) and efficacy of various criteria. METHODS: From October 2000 to November 2011, 233 adult patients underwent LDLT for HCC at our institution. After excluding nine postoperative mortality cases, we analyzed retrospectively 224 patients. To identify risk factors for recurrence, we evaluated recurrence, disease-free survival (DFS) rate, survival rate, and various other factors which are based on the characteristics of both the patient and tumor. Additionally, we developed our own criteria based on our data. Next, we compared our selection criteria with various tumor-grading scales, such as the Milan criteria, University of California, San Francisco (UCSF) criteria, TNM stage, Barcelona Clinic Liver Cancer (BCLC) stage and Cancer of the Liver Italian Program (CLIP) scoring system. The median follow up was 68 (6-139) mo. RESULTS: In 224 patients who received LDLT for HCC, 37 (16.5%) experienced tumor recurrence during the follow-up period. The 5-year DFS and overall survival rates after LDLT in all patients with HCC were 80.9% and 76.4%, respectively. On multivariate analysis, the tumor diameter {5 cm; P < 0.001; exponentiation of the B coefficient [Exp(B)], 11.89; 95%CI: 3.784-37.368} and alpha fetoprotein level [AFP, 100 ng/mL; P = 0.021; Exp(B), 2.892; 95%CI: 1.172-7.132] had significant influences on HCC recurrence after LDLT. Therefore, these two factors were included in our criteria. Based on these data, we set our selection criteria as a tumor diameter ≤ 5 cm and AFP ≤ 100 ng/mL. Within our new criteria (140/214, 65.4%), the 5-year DFS and overall survival rates were 88.6% and 81.8%, respectively. Our criteria (P = 0.001), Milan criteria (P = 0.009), and UCSF criteria (P = 0.001) showed a significant difference in DFS rate. And our criteria (P = 0.006) and UCSF criteria (P = 0.009) showed a significant difference in overall survival rate. But Milan criteria did not show significant difference in overall survival rate (P = 0.137). Among stages 0, A, B and C of BCLC, stage C had a significantly higher recurrence rate (P = 0.001), lower DFS (P = 0.001), and overall survival rate (P = 0.005) compared with the other stages. Using the CLIP scoring system, the group with a score of 4 to 5 showed a high recurrence rate (P = 0.023) and lower DFS (P = 0.011); however, the overall survival rate did not differ from that of the lower scoring group. The TNM system showed a trend of increased recurrence rate, decreased DFS, or survival rate according to T stage, albeit without statistical significance. CONCLUSION: LDLT is considered the preferred therapeutic option in patients with an AFP level less than 100 ng/mL and a tumor diameter of less than 5 cm. PMID:23922471

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

Publication and reporting of clinical trial results: cross sectional analysis across academic medical centers.

PubMed

Chen, Ruijun; Desai, Nihar R; Ross, Joseph S; Zhang, Weiwei; Chau, Katherine H; Wayda, Brian; Murugiah, Karthik; Lu, Daniel Y; Mittal, Amit; Krumholz, Harlan M

2016-02-17

To determine rates of publication and reporting of results within two years for all completed clinical trials registered in ClinicalTrials.gov across leading academic medical centers in the United States. Cross sectional analysis. Academic medical centers in the United States. Academic medical centers with 40 or more completed interventional trials registered on ClinicalTrials.gov. Using the Aggregate Analysis of ClinicalTrials.gov database and manual review, we identified all interventional clinical trials registered on ClinicalTrials.gov with a primary completion date between October 2007 and September 2010 and with a lead investigator affiliated with an academic medical center. The proportion of trials that disseminated results, defined as publication or reporting of results on ClinicalTrials.gov, overall and within 24 months of study completion. We identified 4347 interventional clinical trials across 51 academic medical centers. Among the trials, 1005 (23%) enrolled more than 100 patients, 1216 (28%) were double blind, and 2169 (50%) were phase II through IV. Overall, academic medical centers disseminated results for 2892 (66%) trials, with 1560 (35.9%) achieving this within 24 months of study completion. The proportion of clinical trials with results disseminated within 24 months of study completion ranged from 16.2% (6/37) to 55.3% (57/103) across academic medical centers. The proportion of clinical trials published within 24 months of study completion ranged from 10.8% (4/37) to 40.3% (31/77) across academic medical centers, whereas results reporting on ClinicalTrials.gov ranged from 1.6% (2/122) to 40.7% (72/177). Despite the ethical mandate and expressed values and mission of academic institutions, there is poor performance and noticeable variation in the dissemination of clinical trial results across leading academic medical centers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

The Patient-Centered Medical Home Neighbor: A Critical Concept for a Redesigned Healthcare Delivery System

DTIC Science & Technology

2011-01-25

Sharing Knowledge: Achieving Breakthrough Performance 2010 Military Health System Conference The Patient -Centered Medical Home Neighbor: A Critical...DATE 25 JAN 2011 2. REPORT TYPE 3. DATES COVERED 00-00-2011 to 00-00-2011 4. TITLE AND SUBTITLE The Patient -Centered Medical Home Neighbor: A...Conference What is the Patient -Centered Medical Home?  …a vision of health care as it should be  …a framework for organizing systems of care at both the

A Study to Determine Patient Waiting Time at the Outpatient Pharmacy at Wilford Hall USAF Medical Center

DTIC Science & Technology

1988-06-01

at Wilford Hall USAF Medical Center significantly reduced the patient wait time at the main outpatient pharmacy. Satellite pharmacies have been ).’l...PRESENTING TO WINDOW 1, 19 MAR 88. 47 C:. A’.’E-:A: -ESCRIRTIONS PER PATIENT ...........48 H. WILFORD HALL MEDICAL CENTER OUTPATIENT QUESTIONNAIRE...that wait times at tne outpatient pharmacy were excessive. It was this concern that motivated the Medical Center Administrator to request that patient

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

The Center for Healthy Weight: an academic medical center response to childhood obesity

PubMed Central

Robinson, T N; Kemby, K M

2012-01-01

Childhood obesity represents a worldwide medical and public health challenge. Academic medical centers cannot avoid the effects of the obesity epidemic, and must adopt strategies for their academic, clinical and public policy responses to childhood obesity. The Center for Healthy Weight at Stanford University and Lucile Packard Children's Hospital at Stanford provides an example and model of one such strategy. The design provides both breadth and depth through six cores: Research, Patient Care, Community Programs, Advocating for Public Policy Change, Training and Professional Education, and the Healthy Hospital Initiative. The Center and its cores are designed to facilitate interdisciplinary collaboration across the university, medical school, children's hospital and surrounding community. The foci of these cores are likely to be relevant to almost any academic medical center's mission and functions. PMID:25089192

["AGAINST ALL ODDS" - PROMOTING RESEARCH, CLINICAL DEVELOPMENT AND MEDICAL SERVICES OF THE CONFLICT IN THE GALILEE MEDICAL CENTER].

PubMed

Bornstein, Jacob

2017-05-01

The Galilee Medical Center (GMC) is unique in several aspects. Firstly, in the clinical aspect: In recent years, led by the Director of Medical Center, Dr. Masad Barhoum, a considerable momentum of development has taken place to reduce health discrepancies between the center and the periphery. Despite the under- financing of the health system in the Galilee, the GMC opened new clinical departments, introduced advanced medical technology and key staff members were added. This approach is depicted in publications presented in the current issue. Secondly, the aspect of medicine standoff: The GMC is the nearest hospital to the border with neighboring countries. It is also a tertiary center for trauma, due to the establishment of the Department of Neurosurgery, Department of Oral and Maxillofacial Surgery and the Departments of Orthopedic Surgery, general invasive radiology and invasive radiology of the brain. In recent years, the medical center treated hundreds of victims of the civil war in Syria, a third of them - women and children. The injured patients presented unique medical problems that are described in the papers in this issue. Thirdly, the research aspect: The medical center is the main teaching facility of medical students of the Faculty of Medicine in the Galilee of Bar-Ilan University. The Faculty of Medicine, led by the Dean, Prof. Ran Tur-Kaspa, promotes research and teaching in the medical center. Even before the establishment of the Faculty of Medicine, former hospital director, Prof. Shaul Shasha, not only extolled the importance of research, but established a research laboratory years ago. The laboratory continues to pursue translational research by the physicians of the medical center, led by Dr. Shifra Sela and Prof. Batya Kristal, and supported by the current medical center director, Dr. Masad Barhoum. Several studies conducted in this research laboratory are published herewith. With these unique aspects and despite the discrimination in funding for Galilee compared to the center of the country, the GMC has not remained stagnant. On the contrary, it established and promoted departments, technologies and research laboratories. This activity is expressed as aforesaid in the studies published in the current issue of "Harefuah" that you hold in your hands. The authors of the papers belong to the GMC and to the Faculty of Medicine of the University of Bar-Ilan University.

Naval Medical R and D News. March 2017, Volume 9, Issue 3

DTIC Science & Technology

2017-03-01

Medical Research Center (Feature) Military Medicine Provides World-Class Solutions for Combat Casualties From Naval Medical Research Center Public... Researchers from the Naval Surface Warfare Center Panama City Division and the Naval Postgraduate School spent the voyage conducting experiments to...interruptions, motion sickness incidence, and Sopite syndrome on surgical procedures while in a shipboard environment.... From Naval Medical Research

78 FR 53154 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-28

... Logistics Branch, Division of Extramural Activities, National Cancer Institute, NIH, 9609 Medical Center... Logistics Branch, Division of Extramural Activities, National Cancer Institute, NIH, 9609 Medical Center... applications. Place: National Cancer Institute Shady Grove, 9609 Medical Center Drive, Room 7W034, Rockville...

78 FR 74163 - Harrison Medical Center, a Subsidiary of Franciscan Health System Bremerton, Washington; Notice...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-10

... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-83,070] Harrison Medical Center, a Subsidiary of Franciscan Health System Bremerton, Washington; Notice of Negative Determination... workers of Harrison Medical Center, a subsidiary of Franciscan Health System, Bremerton, Washington...

Lessons learned: mobile device encryption in the academic medical center.

PubMed

Kusche, Kristopher P

2009-01-01

The academic medical center is faced with the unique challenge of meeting the multi-faceted needs of both a modern healthcare organization and an academic institution, The need for security to protect patient information must be balanced by the academic freedoms expected in the college setting. The Albany Medical Center, consisting of the Albany Medical College and the Albany Medical Center Hospital, was challenged with implementing a solution that would preserve the availability, integrity and confidentiality of business, patient and research data stored on mobile devices. To solve this problem, Albany Medical Center implemented a mobile encryption suite across the enterprise. Such an implementation comes with complexities, from performance across multiple generations of computers and operating systems, to diversity of application use mode and end user adoption, all of which requires thoughtful policy and standards creation, understanding of regulations, and a willingness and ability to work through such diverse needs.

Identifying and collecting pertinent medical records for centralized abstraction in a multi-center randomized clinical trial: the model used by the American College of Radiology arm of the National Lung Screening Trial.

PubMed

Gareen, Ilana F; Sicks, JoRean D; Jain, Amanda Adams; Moline, Denise; Coffman-Kadish, Nancy

2013-01-01

In clinical trials and epidemiologic studies, information on medical care utilization and health outcomes is often obtained from medical records. For multi-center studies, this information may be gathered by personnel at individual sites or by staff at a central coordinating center. We describe the process used to develop a HIPAA-compliant centralized process to collect medical record information for a large multi-center cancer screening trial. The framework used to select, request, and track medical records incorporated a participant questionnaire with unique identifiers for each medical provider. De-identified information from the questionnaires was sent to the coordinating center indexed by these identifiers. The central coordinating center selected specific medical providers for abstraction and notified sites using these identifiers. The site personnel then linked the identifiers with medical provider information. Staff at the sites collected medical records and provided them for central abstraction. Medical records were successfully obtained and abstracted to ascertain information on outcomes and health care utilization in a study with over 18,000 study participants. Collection of records required for outcomes related to positive screening examinations and lung cancer diagnosis exceeded 90%. Collection of records for all aims was 87.32%. We designed a successful centralized medical record abstraction process that may be generalized to other research settings, including observational studies. The coordinating center received no identifying data. The process satisfied requirements imposed by the Health Insurance Portability and Accountability Act and concerns of site institutional review boards with respect to protected health information. Copyright © 2012 Elsevier Inc. All rights reserved.

Identifying and collecting pertinent medical records for centralized abstraction in a multi-center randomized clinical trial: The model used by the American College of Radiology arm of the National Lung Screening Trial

PubMed Central

Gareen, Ilana F.; Sicks, JoRean; Adams, Amanda; Moline, Denise; Coffman-Kadish, Nancy

2012-01-01

Background In clinical trials and epidemiologic studies, information on medical care utilization and health outcomes is often obtained from medical records. For multi-center studies, this information may be gathered by personnel at individual sites or by staff at a central coordinating center. We describe the process used to develop a HIPAA-compliant centralized process to collect medical record information for a large multi-center cancer screening trial. Methods The framework used to select, request, and track medical records incorporated a participant questionnaire with unique identifiers for each medical provider. De-identified information from the questionnaires was sent to the coordinating center indexed by these identifiers. The central coordinating center selected specific medical providers for abstraction and notified sites using these identifiers. The site personnel then linked the identifiers with medical provider information. Staff at the sites collected medical records and provided them for central abstraction. Results Medical records were successfully obtained and abstracted to ascertain information on outcomes and health care utilization in a study with over 18,000 study participants. Collection of records required for outcomes related to positive screening examinations and lung cancer diagnosis exceeded 90%. Collection of records for all aims was 87.32%. Conclusions We designed a successful centralized medical record abstraction process that may be generalized to other research settings, including observational studies. The coordinating center received no identifying data. The process satisfied requirements imposed by the Health Insurance Portability and Accountability Act and concerns of site institutional review boards with respect to protected health information. PMID:22982342

Johnson Space Center Health and Medical Technical Authority

NASA Technical Reports Server (NTRS)

Fogarty, Jennifer A.

2010-01-01

1.HMTA responsibilities: a) Assure program/project compliance with Agency health and medical requirements at identified key decision points. b) Certify that programs/projects comply with Agency health and medical requirements prior to spaceflight missions. c) Assure technical excellence. 2. Designation of applicable NASA Centers for HMTA implementation and Chief Medical Officer (CMO) appointment. 3. Center CMO responsible for HMTA implementation for programs and projects at the center. JSC HMTA captured in "JSC HMTA Implementation Plan". 4. Establishes specifics of dissenting opinion process consistent with NASA procedural requirements.

Patient-centered medical homes: will health care reform provide new options for rural communities and providers?

PubMed

Bolin, Jane N; Gamm, Larry; Vest, Joshua R; Edwardson, Nick; Miller, Thomas R

2011-01-01

Many are calling for the expansion of the patient-centered medical home model into rural and underserved populations as a transformative strategy to address issues of access, efficiency, quality, and sustainability in the delivery of health care. Patient-centered medical homes have been touted as a promising cost-saving model for comprehensive management of persons with chronic diseases and disabilities, but it is unclear how rural practitioners in medically underserved areas will implement the patient-centered medical home. This article examines how the Patient Protection & Affordable Care Act of 2010 will enhance rural providers' ability to provide patient-centered care and services contemplated under the Act in a comprehensive, coordinated, cost-effective way despite leaner budgets and health workforce shortages.

Finding Low-Cost Medical Care (For Teens)

MedlinePlus

... your insurance company before you go to one. Teaching Hospitals and Medical Centers Teaching hospitals and medical centers are the final step ... mentioned may offer specialist care at set times. Teaching hospitals and medical schools usually have clinics for ...

Utilization of a multimedia PACS workstation for surgical planning of epilepsy

NASA Astrophysics Data System (ADS)

Soo Hoo, Kent; Wong, Stephen T.; Hawkins, Randall A.; Knowlton, Robert C.; Laxer, Kenneth D.; Rowley, Howard A.

1997-05-01

Surgical treatment of temporal lobe epilepsy requires the localization of the epileptogenic zone for surgical resection. Currently, clinicians utilize electroencephalography, various neuroimaging modalities, and psychological tests together to determine the location of this zone. We investigate how a multimedia neuroimaging workstation built on top of the UCSF Picture Archiving and Communication System can be used to aid surgical planning of epilepsy and related brain diseases. This usage demonstrates the ability of the workstation to retrieve image and textural data from PACS and other image sources, register multimodality images, visualize and render 3D data sets, analyze images, generate new image and text data from the analysis, and organize all data in a relational database management system.

LS-SNP/PDB: annotated non-synonymous SNPs mapped to Protein Data Bank structures.

PubMed

Ryan, Michael; Diekhans, Mark; Lien, Stephanie; Liu, Yun; Karchin, Rachel

2009-06-01

LS-SNP/PDB is a new WWW resource for genome-wide annotation of human non-synonymous (amino acid changing) SNPs. It serves high-quality protein graphics rendered with UCSF Chimera molecular visualization software. The system is kept up-to-date by an automated, high-throughput build pipeline that systematically maps human nsSNPs onto Protein Data Bank structures and annotates several biologically relevant features. LS-SNP/PDB is available at (http://ls-snp.icm.jhu.edu/ls-snp-pdb) and via links from protein data bank (PDB) biology and chemistry tabs, UCSC Genome Browser Gene Details and SNP Details pages and PharmGKB Gene Variants Downloads/Cross-References pages.

[The current situation of the internationalization of the Naikan therapy].

PubMed

Kawahara, Ryuzo

2003-01-01

In Japan, there are 27 Naikan medical institutions in which are included 5 clinics, 5 general hospitals and 17 mental hospitals. As for Naikan meditation center, there are 32 places. Generally, Naikan medical institutions and Naikan meditation center coexist in Japan. It is rare to see institutions for Naikan therapy in more north than Kanto area. Around Nara prefecture, which is Naikan therapy cradle, fairly numbers of Naikan meditation center are located. Surprisingly, no Naikan medical institutions are located. Naikan medical institutions and Naikan meditation center are distributed over the world. Total Naikan medical institutions are 32 and it only located in Japan and China. Total Naikan meditation center are 38 and 32 in Japan, 3 in Austria, 2 in Germany, and 1 in U.S.A. I would like to make suggestions as follows. At first, it is important to make cooperating with Naikan medical institution and Naikan meditation center. Also, it is necessary to enhance the technique ability of Naikan therapy. Secondary, we should guide medical workers to make understand useful of Naikan therapy as many as possible. Third, in order to do so, it is desirable to establish international Naikan Medical Association. Fourthly, it is necessary to systematize theory of the disease, therapeutic theory and therapeutic mechanism in Naikan therapy.

Impact of patient-centered medical home assignment on emergency room visits among uninsured patients in a county health system.

PubMed

Roby, Dylan H; Pourat, Nadereh; Pirritano, Matthew J; Vrungos, Shelley M; Dajee, Himmet; Castillo, Dan; Kominski, Gerald F

2010-08-01

The Medical Services Initiative program--a safety net-based system of care--in Orange County included assignment of uninsured, low-income residents to a patient-centered medical home. The medical home provided case management, a team-based approach for treating disease, and increased access to primary and specialty care among other elements of a patient-centered medical home. Providers were paid an enhanced fee and pay-for-performance incentives to ensure delivery of comprehensive treatment. Medical Services Initiative enrollees who were assigned to a medical home for longer time periods were less likely to have any emergency room (ER) visits or multiple ER visits. Switching medical homes three or more times was associated with enrollees being more likely to have any ER visits or multiple ER visits. The findings provide evidence that successful implementation of the patient-centered medical home model in a county-based safety net system is possible and can reduce unnecessary ER use.

Hospital CIO Explains Blockchain Potential: An Interview with Beth Israel Deaconess Medical Center's John Halamka.

PubMed

Mertz, Leslie

2018-01-01

Work is already underway to bring blockchain technology to the healthcare industry, and hospital administrators are trying to figure out what it can do for them, their clinicians, and their patients. That includes administrators at Beth Israel Deaconess Medical Center, a leading academic medical center located in Boston.

Topical Application of Tranexamic Acid to Reduce Blood Loss during Complex Combat-Related Spine Trauma Surgery

DTIC Science & Technology

2016-10-01

UNIT NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) Washington University St . Louis, MO 63110-1010 Columbia University Medical Center...the Thomas Jefferson University Medical Center and Washington University in St . Louis Medical Center IRB for review and approval, to be completed by

The Stanford University Medical Center and the Federal Government.

ERIC Educational Resources Information Center

Rosenzweig, Robert M.; And Others

The Stanford University Medical Center consists of three main units: a medical school, a set of outpatient clinics, and a hospital. Financing of the center's functions cannot be carried out without federal support, and a network of relationships with government agencies has emerged. The impact of these relationships was discussed with key…

Assessing the Academic Medical Center as a Supportive Learning Community

ERIC Educational Resources Information Center

Gannon, Sam C.

2011-01-01

Academic medical centers are well-known for their emphasis on teaching, research and public service; however, like most large, bureaucratic organizations, they oftentimes suffer from an inability to learn as an organization. The role of the research administrator in the academic medical center has grown over time as the profession itself has…

Defense.gov Special Report: Travels With Hagel

Science.gov Websites

Thanks Warriors, Staff at Medical Center Defense Secretary Chuck Hagel made his first official visit to Brooke Army Medical Center Wednesday. Hagel was welcomed by BAMC Commander Col. Kyle Campbell and Command Sgt. Maj. Mark Pumphrey at San Antonio Military Medical Center followed by a meet-and-greet with

ACHP | News | Native Hawaiian Federal Interagency Working Group Created

Science.gov Websites

Search skip specific nav links Home arrow News arrow Walla Walla Veterans Administration Medical Center Gets New Use Walla Walla Veterans Administration Medical Center Gets New Use Recently a historic preservation effort at the Walla Walla Veterans Administration Medical Center came to larger light through a

Development of an Asset Map of Medical Education Research Activity

ERIC Educational Resources Information Center

Christiaanse, Mary E.; Russell, Eleanor L.; Crandall, Sonia J.; Lambros, Ann; Manuel, Janeen C.; Kirk, Julienne K.

2008-01-01

Introduction: Medical education research is gaining recognition as scholarship within academic medical centers. This survey was conducted at a medium-sized academic medical center in the United States. The purpose of the study was to learn faculty interest in research in medical education, so assets could be used to develop educational scholarship…

Medical waste management in Jordan: A study at the King Hussein Medical Center

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

Oweis, Rami; Al-Widyan, Mohamad; Al-Limoon, Ohood

2005-07-01

As in many other developing countries, the generation of regulated medical waste (RMW) in Jordan has increased significantly over the last few decades. Despite the serious impacts of RMW on humans and the environment, only minor attention has been directed to its proper handling and disposal. This study was conducted in the form of a case study at one of Jordan's leading medical centers, namely, the King Hussein Medical Center (KHMC). Its purpose was to report on the current status of medical waste management at KHMC and propose possible measures to improve it. In general, it was found that themore » center's administration was reasonably aware of the importance of medical waste management and practiced some of the measures to adequately handle waste generated at the center. However, it was also found that significant voids were present that need to be addressed in the future including efficient segregation, the use of coded and colored bags, better handling and transfer means, and better monitoring and tracking techniques, as well as the need for training and awareness programs for the personnel.« less

78 FR 77471 - Clinical Center; Notice of Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-23

... organizational initiatives. Place: National Institutes of Health, Building 10, 10 Center Drive, CRC Medical Board... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Clinical Center; Notice of.... Place: National Institutes of Health, Building 10, 10 Center Drive, CRC Medical Board Room (4-2551...

Medical service plans in academic medical centers.

PubMed

Siegel, B

1978-10-01

Medical service plans are of major importance to academic medical centers and are becoming increasingly so each year as evidenced by growing dependence of medical schools on resulting funds. How these funds are generated and used varies among schools. The procedures may affect the governance of the institution, modifying the authority of the central administration or the clinical departments. Recent developments in federal legislation, such as health maintenance organizations and amendments (Section 227) to the Social Security Act, and the future development of national health insurance will certainly have an effect on how academic medical centers organize their clinical activities. How successfully various medical schools deal with the dynamic problem may well determine their future survival.

Living Donor Liver Transplantation for Combined Hepatocellular Carcinoma and Cholangiocarcinoma: Experience of a Single Center.

PubMed

Chang, Cheng-Chih; Chen, Ying-Ju; Huang, Tzu-Hao; Chen, Chun-Han; Kuo, Fang-Ying; Eng, Hock-Liew; Yong, Chee-Chien; Liu, Yueh-Wei; Lin, Ting-Lung; Li, Wei-Feng; Lin, Yu-Hung; Lin, Chih-Che; Wang, Chih-Chi; Chen, Chao-Long

2017-02-28

BACKGROUND Because the outcome of liver transplantation for cholangiocarcinoma is often poor, cholangiocarcinoma is a contraindication for liver transplantation in most centers. Combined hepatocellular carcinoma and cholangiocarcinoma is a rare type of primary hepatic malignancy containing features of hepatocellular carcinoma and cholangiocarcinoma. Diagnosing combined hepatocellular carcinoma and cholangiocarcinoma pre-operatively is difficult. Because of sparse research presentations worldwide, we report our experience with living donor liver transplantation for combined hepatocellular carcinoma and cholangiocarcinoma. MATERIAL AND METHODS A total of 710 patients underwent living donor liver transplantation at our institution from April 2006 to June 2014; 377 of them received transplantation because of hepatocellular carcinoma with University of California San Francisco (UCSF) staging criteria fulfilled pre-operatively. Eleven patients (2.92%) were diagnosed with combined hepatocellular carcinoma and cholangiocarcinoma confirmed pathologically from explant livers; we reviewed these cases retrospectively. Long-term survival was compared between patients diagnosed with combined hepatocellular carcinoma and cholangiocarcinoma and patients diagnosed with hepatocellular carcinoma. RESULTS The mean age of the patients in our series was 60.2 years, and the median follow-up period was 23.9 months. Four patients were diagnosed with a recurrence during the follow-up period, including one intra-hepatic and three extra-hepatic recurrences. Four patients died due to tumor recurrence. Except for patients with advanced-stage cancer, disease-free survival of patients with combined hepatocellular carcinoma and cholangiocarcinoma compared with that of patients with hepatocellular carcinoma was 80% versus 97.2% in 1 year, and 46.7% versus 92.5% in 3 years (p<0.001), and overall survival was 90% versus 97.2% in 1 year, and 61.7% versus 95.1% in 3 years (p<0.001). CONCLUSIONS Outcomes of liver transplantation for patients with combined hepatocellular carcinoma and cholangiocarcinoma were worse than those for patients with hepatocellular carcinoma in this study. Combined hepatocellular carcinoma and cholangiocarcinoma are presumed to be a relative contraindication for liver transplantation.

Medical Waste Management in Community Health Centers.

PubMed

Tabrizi, Jafar Sadegh; Rezapour, Ramin; Saadati, Mohammad; Seifi, Samira; Amini, Behnam; Varmazyar, Farahnaz

2018-02-01

Non-standard management of medical waste leads to irreparable side effects. This issue is of double importance in health care centers in a city which are the most extensive system for providing Primary Health Care (PHC) across Iran cities. This study investigated the medical waste management standards observation in Tabriz community health care centers, northwestern Iran. In this triangulated cross-sectional study (qualitative-quantitative), data collecting tool was a valid checklist of waste management process developed based on Iranian medical waste management standards. The data were collected in 2015 through process observation and interviews with the health center's staff. The average rate of waste management standards observance in Tabriz community health centers, Tabriz, Iran was 29.8%. This case was 22.8% in dimension of management and training, 27.3% in separating and collecting, 31.2% in transport and temporary storage, and 42.9% in sterilization and disposal. Lack of principal separation of wastes, inappropriate collecting and disposal cycle of waste and disregarding safety tips (fertilizer device performance monitoring, microbial cultures and so on) were among the observed defects in health care centers supported by quantitative data. Medical waste management was not in a desirable situation in Tabriz community health centers. The expansion of community health centers in different regions and non-observance of standards could predispose to incidence the risks resulted from medical wastes. So it is necessary to adopt appropriate policies to promote waste management situation.

Patient-centered interventions to improve medication management and adherence: a qualitative review of research findings

PubMed Central

Kuntz, Jennifer L.; Safford, Monika M.; Singh, Jasvinder A.; Phansalkar, Shobha; Slight, Sarah P.; Her, Qoua Liang; Lapointe, Nancy Allen; Mathews, Robin; O’Brien, Emily; Brinkman, William B.; Hommel, Kevin; Farmer, Kevin C.; Klinger, Elissa; Maniam, Nivethietha; Sobko, Heather J.; Bailey, Stacy C.; Cho, Insook; Rumptz, Maureen H.; Vandermeer, Meredith L.; Hornbrook, Mark C.

2018-01-01

Objective Patient-centered approaches to improving medication adherence hold promise, but evidence of their effectiveness is unclear. This review reports the current state of scientific research around interventions to improve medication management through four patient-centered domains: shared decision-making, methods to enhance effective prescribing, systems for eliciting and acting on patient feedback about medication use and treatment goals, and medication-taking behavior. Methods We reviewed literature on interventions that fell into these domains and were published between January 2007 and May 2013. Two reviewers abstracted information and categorized studies by intervention type. Results We identified 60 studies, of which 40% focused on patient education. Other intervention types included augmented pharmacy services, decision aids, shared decision-making, and clinical review of patient adherence. Medication adherence was an outcome in most (70%) of the studies, although 50% also examined patient-centered outcomes. Conclusions We identified a large number of medication management interventions that incorporated patient-centered care and improved patient outcomes. We were unable to determine whether these interventions are more effective than traditional medication adherence interventions. Practice Implications Additional research is needed to identify effective and feasible approaches to incorporate patient-centeredness into the medication management processes of the current health care system, if appropriate. PMID:25264309

Quantitative Analysis of Contributing Factors Affecting Patient Satisfaction in Family Medicine Service Clinics at Brooke Army Medical Center

DTIC Science & Technology

2008-06-06

Predictors of patient satisfaction for Brooke Army Medical Center Family Medicine Service primary care clinics was performed. Data was obtained from...Factors Affecting Patient Satisfaction in Family Medicine Service Clinics at Brooke Army Medical Center Presented to MAJ Eric Schmacker, Ph.D. In...study. All patients ’ medical information was protected at all times and under no circumstances will be discussed or released to any outside agency

75 FR 14170 - Medical Device Epidemiology Network: Developing Partnership Between the Center for Devices and...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-24

... methods for medical device comparative analyses, best practices and best design and analysis methods. II... the performance of medical devices (including comparative effectiveness studies). The centers...

DOE Center of Excellence in Medical Laser Applications. Final report

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

Jacques, S.L.

1998-01-01

An engineering network of collaborating medical laser laboratories are developing laser and optical technologies for medical diagnosis and therapy and are translating the engineering into medical centers in Portland, OR, Houston, TX, and Galveston, TX. The Center includes the University of Texas M.D. Anderson Cancer Center, the University of Texas-Austin, Texas A and M University, Rice University, the University Texas Medical Branch-Galveston, Oregon Medical Laser Center (Providence St. Vincent Medical Center, Oregon Health Sciences University, and Oregon Graduate Institute, Portland, OR), and the University of Oregon. Diagnostics include reflectance, fluorescence, Raman IR, laser photoacoustics, optical coherence tomography, and several newmore » video techniques for spectroscopy and imaging. Therapies include photocoagulation therapy, laser welding, pulsed laser ablation, and light-activated chemotherapy of cancer (photodynamic therapy, or PDT). Medical applications reaching the clinic include optical monitoring of hyperbilirubinemia in newborns, fluorescence detection of cervical dysplasia, laser thrombolysis of blood clots in heart attack and brain stroke, photothermal coagulation of benign prostate hyperplasia, and PDT for both veterinary and human cancer. New technologies include laser optoacoustic imaging of breast tumors and hemorrhage in head trauma and brain stroke, quality control monitoring of dosimetry during PDT for esophageal and lung cancer, polarization video reflectometry of skin cancer, laser welding of artificial tissue replacements, and feedback control of laser welding.« less

DOE Center of Excellence in Medical Laser Applications. Final report, December 1, 1994--November 30, 1997

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

Jacques, S.L.

1998-01-01

An engineering network of collaborating medical laser laboratories are developing laser and optical technologies for medical diagnosis and therapy and are translating the engineering into medical centers in Portland OR, Houston TX, and Galveston TX. The Center includes the University of Texas M.D. Anderson Cancer Center, the University of Texas-Austin, Texas A and M University, Rice University, the University Texas Medical Branch-Galveston, Oregon Medical Laser Center (Providence St. Vincent Medical Center, Oregon Health Sciences University, and Oregon Graduate Institute, Portland, OR), and the University of Oregon. Diagnostics include reflectance, fluorescence, Raman IR, laser photoacoustics, optical coherence tomography, and several newmore » video techniques for spectroscopy and imaging. Therapies include photocoagulation therapy, laser welding, pulsed laser ablation, and light-activated chemotherapy of cancer (photodynamic therapy, or PDT). Medical applications reaching the clinic include optical monitoring of hyperbilirubinemia in newborns, fluorescence detection of cervical dysplasia, laser thrombolysis of blood clots in heart attack and brain stroke, photothermal coagulant of benign prostate hyperplasia, and PDT for both veterinary and human cancer. New technologies include laser optoacoustic imaging of breast tumors and hemorrhage in head trauma and brain stroke, quality control monitoring of dosimetry during PDT for esophageal and lung cancer, polarization video reflectometry of skin cancer, laser welding of artificial tissue replacements, and feedback control of laser welding.« less

Understanding health care provider barriers to hospital affiliated medical fitness center facility referral: a questionnaire survey and semi structured interviews.

PubMed

Smock, Carissa; Alemagno, Sonia

2017-08-03

The purpose of this study is to understand health care provider barriers to referring patients to Medical Fitness Center Facilities within an affiliated teaching hospital system using referral of diabetic services as an example. The aims of this study include: (1) to assess health care providers' awareness and use of facilities, (2) to determine barriers to referring patients to facilities, (3) identify current and needed resources and/or changes to increase referral to facilities. A 20-item electronic survey and requests for semi-structured interviews were administered to hospital system directors and managers (n = 51). Directors and managers instructed physicians and staff to complete the survey and interviews as applicable. Perceived barriers, knowledge, utilization, and referral of patients to Medical Fitness Center Facilities were collected and examined. Descriptive statistics were generated regarding practice characteristics, provider characteristics, and referral. Of the health care providers surveyed and interviewed (n = 25) 40% indicated verbally suggesting use of facilities, 24% provided a flyer about the facilities. No respondents indicated that they directly referred patients to the facilities. However, 16% referred patients to other locations for physical activity - including their own department's management and prevention services. 20% do not refer to Medical Fitness Center Facilities or any other lifestyle programs/locations. Lack of time (92%) and lack of standard guidelines and operating procedures (88%) are barriers to referral. All respondents indicated a strong ability to refer patients to Medical Fitness Center Facilities if given education about referral programs available as well as standard clinical guidelines and protocol for delivery. The results of this study indicate that, although few healthcare providers are currently referring patients to Medical Fitness Center Facilities, health care providers with an affiliated Medical Fitness Center Facility not only want clinical standard guidelines, protocol, and training to refer patients to Medical Fitness Center Facilities, but believe they have the ability to increase referral if given these tools. The Medical Fitness Association has a unique opportunity to bridge health care providers to Medical Fitness Center Facilities by developing clinical practice guidelines in cooperation with the American Diabetes Association.

Continuing quality improvement procedures for a clinical PACS.

PubMed

Andriole, K P; Gould, R G; Avrin, D E; Bazzill, T M; Yin, L; Arenson, R L

1998-08-01

The University of California at San Francisco (USCF) Department of Radiology currently has a clinically operational picture archiving and communication system (PACS) that is thirty-five percent filmless, with the goal of becoming seventy-five percent filmless within the year. The design and implementation of the clinical PACS has been a collaborative effort between an academic research laboratory and a commercial vendor partner. Images are digitally acquired from three computed radiography (CR) scanners, five computed tomography (CT) scanners, five magnetic resonance (MR) imagers, three digital fluoroscopic rooms, an ultrasound mini-PACS and a nuclear medicine mini-PACS. The DICOM (Digital Imaging and Communications in Medicine) standard communications protocol and image format is adhered to throughout the PACS. Images are archived in hierarchical staged fashion, on a RAID (redundant array of inexpensive disks) and on magneto-optical disk jukeboxes. The clinical PACS uses an object-oriented Oracle SQL (systems query language) database, and interfaces to the Radiology Information System using the HL7 (Health Languages 7) standard. Components are networked using a combination of switched and fast ethernet, and ATM (asynchronous transfer mode), all over fiber optics. The wide area network links six UCSF sites in San Francisco. A combination of high and medium resolution dual-monitor display stations have been placed throughout the Department of Radiology, the Emergency Department (ED) and Intensive Care Units (ICU). A continuing quality improvement (CQI) committee has been formed to facilitate the PACS installation and training, workflow modifications, quality assurance and clinical acceptance. This committee includes radiologists at all levels (resident, fellow, attending), radiology technologists, film library personnel, ED and ICU clinician end-users, and PACS team members. The CQI committee has proved vital in the creation of new management procedures, providing a means for user feedback and education, and contributing to the overall acceptance of, and user satisfaction with the system. Well developed CQI procedures have been essential to the successful clinical operation of the PACS as UCSF Radiology moves toward a filmless department.

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…

Research centers and institutes in U.S. medical schools: a descriptive analysis.

PubMed

Mallon, William T; Bunton, Sarah A

2005-11-01

Research centers and institutes are a common mechanism to organize and facilitate biomedical research at medical schools and universities. The authors report the results of a study on the size, scope, and range of activities of 604 research centers and institutes at research-intensive U.S. medical schools and their parent universities. Centers and institutes with primary missions of patient care, education, or outreach were not included. The findings indicate that, in addition to research, centers and institutes are involved in a range of activities, including education, service, and technology transfer. The centers and institutes the authors studied were more interdisciplinary than those included in previous studies on this topic. Most research centers and institutes did not have authority comparable to academic departments. Only 22% of centers directly appointed faculty members, and most center directors reported to a medical school dean or a department chair. A small group of centers and institutes ("power centers"), however, reported to a university president or provost, and may have considerable power and influence in academic decision making and resource allocation. Two main types of centers and institutes emerge from this research. The first type, which includes the vast of majority of centers, is modest in its scope and marginal in its influence. The second type--with greater amounts of funding, larger staffs, and direct access to institutional decisionmakers--may have a more significant role in the organization and governance of the medical school and university and in the ways that researchers interact within and across academic divisions.

Adapting an Effective Counseling Model from Patient-centered Care to Improve Motivation in Clinical Training Programs.

PubMed

Hamada, Hisayuki; Martin, Dawn; Batty, Helen P

2006-12-01

The value of establishing a patient-centered relationship within the context of the clinical encounter is well documented. The learner-centered method of medical education parallels the patient-centered clinical method; therefore, it should be explored as a method for teaching in the context of the learning encounter. In Japan and other Asian countries, rotations through services not related to the learner's chosen medical specialty are mandatory parts of the medical internship. Participation and effort in these rotations are often met with resistance from learners and are a common problem for medical educators. We adapted the counseling method for patients based on patient-centered methods such as motivational interviewing and solution-focused therapy to address this common problem. We show one case of a medical resident who lost his motivation to learn during his training. A resident has many kinds of mental and physical stress. One such problem arises from the gap between what they want to do and what they have to do. Strategies from motivational interviewing and solution-focused therapy were adapted to successfully resolve a common teaching problem in Japan. A physician teacher (preceptor) helped this resident solve the issue for himself instead of arguing in favor of change. The positive aspects of the counseling method were based on patient-centered medicine and proved useful and effective in counseling for medical residents. We may take the lessons learned from using patient-centered counseling methods to further develop a clear and systematic process of counseling methods for residents to conduct learner-centered medical education.

A Study to Evaluate the Organization and the Operating Procedures of the Patient Assistance Function at Brooke Army Medical Center, Fort Sam Houston, Texas

DTIC Science & Technology

1979-08-01

15 March 1979. 59Interview with Wendy L. Farace , Head Nurse, Obstetrics/Gynecology Clinic, Brooke Army Medical Center, Fort Sam Houston, Texas, 8...6 February 1979. Farace , Wendy L. Head Nurse, Obstetrica/Gynecology Clinic, Brooke Army Medical Center, Fort Sam Houston, Texas. Interview, 8 January

The Effects of Corporatization on Academic Medical Centers. How Will the Corporatization of Health Care Influence Health Professions Education?

ERIC Educational Resources Information Center

Dunn, Marvin R.

Areas of agreement/conflict between academic medical centers and investor owned corporations are considered. Academic medical centers are part of the university system, which is responsible for education, research, and the related public good (e.g., nurturing of professions). Major areas for a potential confluence of interest between the academic…

Qualitative and Political Issues Impacting Academic Medical Center Strategic Planning--A Methodological Approach. AIR Forum 1982 Paper.

ERIC Educational Resources Information Center

Kutina, Kenneth L.; And Others

A simulation model of an academic medical center that was developed to aid in strategic planning and policy analysis is described. The model, designated MCM for Medical Center Model, was implemented at the School of Medicine, University Hospitals of Cleveland, and the private practices of the faculty in the clinical departments at University…

76 FR 31340 - Medicare Program; Notification of Closure of St. Vincent's Medical Center

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-31

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-1587-N... & Medicaid Services (CMS), HHS. ACTION: Notice. SUMMARY: This notice announces the closure of St. Vincent's Medical Center and the initiation of an application process for hospitals to apply to the Centers for...

76 FR 14028 - Center for Devices and Radiological Health 510(k) Implementation: Online Repository of Medical...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-15

...] Center for Devices and Radiological Health 510(k) Implementation: Online Repository of Medical Device... public meeting entitled ``510(k) Implementation: Discussion of an Online Repository of Medical Device... establish an online public repository of medical device labeling and strategies for displaying device...

The Role of the Academic Medical Center in the PSRO Program

ERIC Educational Resources Information Center

Jessee, William F.; Goran, Michael J.

1976-01-01

The author contends that the professional standards review organization (PSRO), a national effort to assure high quality medical care, offers a challenge and an opportunity to the academic medical center. He discusses potential impact on role definition, criteria development, continuing medical education, curriculum evaluation, and attitudinal and…

The financial management of research centers and institutes at U.S. medical schools: findings from six institutions.

PubMed

Mallon, William T

2006-06-01

To explore three questions surrounding the financial management of research centers and institutes at U.S. medical schools: How do medical schools allocate institutional funds to centers and institutes? How and by whom are those decisions made? What are the implications of these decision-making models on the future of the academic biomedical research enterprise? Using a qualitative research design, the author and associates interviewed over 150 faculty members and administrators at six medical schools and their parent universities in 2004. Interview data were transcribed, coded, and analyzed using a grounded theory approach. This methodology generated rich descriptions and explanations of the six medical schools, which can produce extrapolations to, but not necessarily generalizable findings to, other institutions and settings. An examination of four dimensions of financial decision-making-funding timing, process, structure, and culture-produces two essential models of how medical schools approach the financial management of research centers. In the first, a "charity" model, center directors make hat-in-hand appeals directly to the dean, the result of which may depend on individual negotiation skills and personal relationships. In the second, a "planned-giving" model, the process for obtaining and renewing funds is institutionalized, agreed upon, and monitored. The ways in which deans, administrators, department chairs, and center directors attend to, decide upon, and carry out financial decisions can influence how people throughout the medical school think about interdisciplinary and collaborative activities marshalled though centers and institutes.

[Certified medical centers--A measurable benefit to patients?!].

PubMed

Eberlein-Gonska, Maria; Schellong, Sebastian; Baumann, Michael

2007-01-01

The establishment of medical centers should meet the high requirements of the healthcare system. They should provide innovative solutions for a number of problems, e.g. the interdisciplinary collaboration of various health departments with due regard to their autonomy. This is reminiscent of the implementation and advancement of a quality management system required by law where a clear idea of how to manage the organizational and procedural structures as an integral part of the management concept implemented is missing. The genuine efforts to implement and advance interdisciplinary medical centers are up against "bogus models" created out of sheer marketing interests. The term "medical center" has so far not been protected under trademark law, leaving patients, relatives or even the referring physicians unsure about how to judge a medical center's actual performance. The same is true of certified centers. Their numbers are growing, but not so the transparency about the amount of measurable, traceable and understandable benefits that a certified center provides to the patient. Therefore clear demands need to be placed on certified centers, especially with regard to the implementation of a concept that provides interdisciplinarity and process-oriented transparent structures and defines quality ratios and quality objectives. This includes providing resources for the continuous collection and evaluation of hard and soft data as well as deriving improvement measures. The three centers of the University Hospital Dresden--the University Cancer Center, the University Vascular Center and the University Pain Center--fulfil this high demand. They have created fundamentals for measurable improvement of patient care and are able to present first results.

Patient-centered medical homes in Louisiana had minimal impact on Medicaid population's use of acute care and costs.

PubMed

Cole, Evan S; Campbell, Claudia; Diana, Mark L; Webber, Larry; Culbertson, Richard

2015-01-01

The patient-centered medical home model of primary care has received considerable attention for its potential to improve outcomes and reduce health care costs. Yet little information exists about the model's ability to achieve these goals for Medicaid patients. We sought to evaluate the effect of patient-centered medical home certification of Louisiana primary care clinics on the quality and cost of care over time for a Medicaid population. We used a quasi-experimental pre-post design with a matched control group to assess the effect of medical home certification on outcomes. We found no impact on acute care use and modest support for reduced costs and primary care use among medical homes serving higher proportions of chronically ill patients. These findings provide preliminary results related to the ability of the patient-centered medical home model to improve outcomes for Medicaid beneficiaries. The findings support a case-mix-adjusted payment policy for medical homes going forward. Project HOPE—The People-to-People Health Foundation, Inc.

Integration of medical imaging into a multi-institutional hospital information system structure.

PubMed

Dayhoff, R E

1995-01-01

The Department of Veterans Affairs (VA) is providing integrated text and image data to its clinical users at its Washington and Baltimore medical centers and, soon, at nine other medical centers. The DHCP Imaging System records clinically significant diagnostic images selected by medical specialists in a variety of departments, including cardiology, gastroenterology, pathology, dermatology, surgery, radiology, podiatry, dentistry, and emergency medicine. These images, which include color and gray scale images, and electrocardiogram waveforms, are displayed on workstations located throughout the medical centers. Integration of clinical images with the VA's electronic mail system allows transfer of data from one medical center to another. The ability to incorporate transmitted text and image data into on-line patient records at the collaborating sites is an important aspect of professional consultation. In order to achieve the maximum benefits from an integrated patient record system, a critical mass of information must be available for clinicians. When there is also seamless support for administration, it becomes possible to re-engineer the processes involved in providing medical care.

76 FR 55917 - Medicare Program; Notification of Closure of St. Vincent's Medical Center; Extension of the...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-09

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-1587-N2... Submission of Applications AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. ACTION: Notice of... hospitals to apply to the Centers for Medicare & Medicaid Services (CMS) to receive St. Vincent's Medical...

Family-centered Care in the Outpatient General Psychiatry Clinic.

PubMed

Heru, Alison M

2015-09-01

Although family research supports family-centered care for all medical specialties, the benefit of family-centered care has not been fully realized in outpatient practice. Physicians, including psychiatrists, are not routinely taught how to work with families and may not be aware of the evidence-base for family interventions. However, some medical specialties, such as family medicine and palliative care, have a clinical practice that routinely includes the family. Clinicians working in medical clinics, such as diabetes clinics, know that successful management of chronic illness requires family involvement. Psychiatric clinics, such as The Family Center for Bipolar Disorder at Beth Israel Medical Center in New York City, also have a family-centered practice and show improved patient outcomes. This article provides guidelines, including clinical interview questions, to help psychiatrists practice family-centered care, either in a private office or in a general psychiatric outpatient clinic. The guidelines include questions that identify when to seek an in-depth family assessment or consultation. Family-centered care will become more useful when health care reimbursement focuses on patient outcome.

[Regional network for patients with dementia--carrying out Kumamoto model for dementia].

PubMed

Ikeda, Manabu

2014-01-01

The Japanese government has tried to establish 150 Medical Centers for Dementia (MCDs) since 2008 to overcome the dementia medical service shortage. MCDs are required to provide special medical services for dementia and connect with other community resources in order to contribute to building a comprehensive support network for demented patients. The main specific needs are as follows: 1) special medical consultation; 2) differential diagnosis and early intervention; 3) medical treatment for the acute stage of BPSD; 4) corresponding to serious physical complications of dementia; 5) education for general physicians (GPs) and other community professionals. According to the population rate, two dementia medical centers were planned in Kumamoto Prefecture. However, it seemed to be too few to cover the vast Kumamoto area. Therefore, the local government and I proposed to the Japanese government that we build up networks that consist of one core MCD in our university hospital and several regional MCDs in local mental hospitals. The local government selected seven (nine at present) centers according to the area balance and condition of equipment. The Japanese government has recommended and funded such networks between core and regional centers since 2010. The main roles of the core centers are as follows: 1) early diagnosis such as Mild cognitive impairment, very mild Alzheimer's disease, Dementia with Lewy bodies, and Frontotemporal lobar degeneration using comprehensive neuropsychological batteries and neuroimagings, such as MRI and SPECT scans; 2) education for GPs; 3) training for young consultants. The core center opens case conferences at least every one or two months for all staff of regional centers to maintain the quality of all centers and give training opportunities for standardized international assessment scales. While the main roles of the regional centers are differential diagnosis, intervention for BPSD, and management of general medical problems using local networks with general hospitals and GPs, and organizing local networks for dementia with GPs and care staff In short, the regional centers take responsibility for ordinal clinical work for dementia. To construct a more extensive network, each regional center must hold regional case conferences and lectures on dementia for care staff and GPs sharing knowledge and skills acquired from case conferences by the core center.

Creating a Clinical Video-Conferencing Facility in a Security-Constrained Environment Using Open-Source AccessGrid Software and Consumer Hardware

PubMed Central

Terrazas, Enrique; Hamill, Timothy R.; Wang, Ye; Channing Rodgers, R. P.

2007-01-01

The Department of Laboratory Medicine at the University of California, San Francisco (UCSF) has been split into widely separated facilities, leading to much time being spent traveling between facilities for meetings. We installed an open-source AccessGrid multi-media-conferencing system using (largely) consumer-grade equipment, connecting 6 sites at 5 separate facilities. The system was accepted rapidly and enthusiastically, and was inexpensive compared to alternative approaches. Security was addressed by aspects of the AG software and by local network administrative practices. The chief obstacles to deployment arose from security restrictions imposed by multiple independent network administration regimes, requiring a drastically reduced list of network ports employed by AG components. PMID:18693930

Creating a clinical video-conferencing facility in a security-constrained environment using open-source AccessGrid software and consumer hardware.

PubMed

Terrazas, Enrique; Hamill, Timothy R; Wang, Ye; Channing Rodgers, R P

2007-10-11

The Department of Laboratory Medicine at the University of California, San Francisco (UCSF) has been split into widely separated facilities, leading to much time being spent traveling between facilities for meetings. We installed an open-source AccessGrid multi-media-conferencing system using (largely) consumer-grade equipment, connecting 6 sites at 5 separate facilities. The system was accepted rapidly and enthusiastically, and was inexpensive compared to alternative approaches. Security was addressed by aspects of the AG software and by local network administrative practices. The chief obstacles to deployment arose from security restrictions imposed by multiple independent network administration regimes, requiring a drastically reduced list of network ports employed by AG components.

Tandem Repeated Irritation Test (TRIT) Studies and Clinical Relevance: Post 2006.

PubMed

Reddy, Rasika; Maibach, Howard

2018-06-11

Single or multiple applications of irritants can lead to occupational contact dermatitis, and most commonly irritant contact dermatitis (ICD). Tandem irritation, the sequential application of two irritants to a target skin area, has been studied using the Tandem Repeated Irritation Test (TRIT) to provide a more accurate representation of skin irritation. Here we present an update to Kartono's review on tandem irritation studies since 2006 [1]. We surveyed the literature available on PubMed, Embase, Google Scholar, and the UCSF Dermatology library databases since 2006. The studies included discuss the tandem effects of common chemical irritants, organic solvents, occlusion as well as clinical relevance - and enlarge our ability to discern whether multiple chemical exposures are more or less likely to enhance irritation.

Outpatient prescription practices in rural township health centers in Sichuan Province, China

PubMed Central

2012-01-01

Background Sichuan Province is an agricultural and economically developing province in western China. To understand practices of prescribing medications for outpatients in rural township health centers is important for the development of the rural medical and health services in this province and western China. Methods This is an observational study based on data from the 4th National Health Services Survey of China. A total of 3,059 prescriptions from 30 township health centers in Sichuan Province were collected and analyzed. Seven indicators were employed in the analyses to characterize the prescription practices. They are disease distribution, average cost per encounter, number of medications per encounter, percentage of encounters with antibiotics, percentage of encounters with glucocorticoids, percentage of encounters with combined glucocorticoids and antibiotics, and percentage of encounters with injections. Results The average medication cost per encounter was 16.30 Yuan ($2.59). About 60% of the prescriptions contained Chinese patent medicine (CPM), and almost all prescriptions (98.07%) contained western medicine. 85.18% of the prescriptions contained antibiotics, of which, 24.98% contained two or more types of antibiotics; the percentage of prescriptions with glucocorticoids was 19.99%; the percentage of prescriptions with both glucocorticoids and antibiotics was 16.67%; 51.40% of the prescriptions included injections, of which, 39.90% included two or more injections. Conclusions The findings from this study demonstrated irrational medication uses of antibiotics, glucocorticoids and injections prescribed for outpatients in the rural township health centers in Sichuan Province. The reasons for irrational medication uses are not only solely due to the pursuit of maximizing benefits in the township health centers, but also more likely attributable to the lack of medical knowledge of rational medication uses among rural doctors and the lack of medical devices for disease diagnosis in those township health centers. The policy implication from this study is to enhance professional training in rational medication uses for rural doctors, improve hardware facilities for township health centers, promote health education to rural residents and establish a public reporting system to monitor prescription practices in rural township health centers, etc. PMID:22988946

Medical Center Staff Attitudes about Spanking

PubMed Central

Gershoff, Elizabeth T.; Font, Sarah A.; Taylor, Catherine A.; Foster, Rebecca H.; Garza, Ann Budzak; Olson-Dorff, Denyse; Terreros, Amy; Nielsen-Parker, Monica; Spector, Lisa

2016-01-01

Several medical professional organizations, including the American Academy of Pediatrics, recommend that parents avoid hitting children for disciplinary purposes (e.g., spanking) and that medical professionals advise parents to use alternative methods. The extent to which medical professionals continue to endorse spanking is unknown. This study is the first to examine attitudes about spanking among staff throughout medical settings, including non-direct care staff. A total of 2,580 staff at a large general medical center and 733 staff at a children’s hospital completed an online survey; respondents were roughly divided between staff who provide direct care to patients (e.g., physicians, nurses) and staff who do not (e.g., receptionists, lab technicians). Less than half (44% and 46%) of staff at each medical center agreed that spanking is harmful to children, although almost all (85% and 88%) acknowledged that spanking can lead to injury. Men, staff who report being religious, and staff who held non-direct care positions at the medical center reported stronger endorsement of spanking and perceived their co-workers to be more strongly in favor of spanking. Non-direct care staff were more supportive of spanking compared with direct care staff on every item assessed. All staff underestimated the extent to which their co-workers held negative views of spanking. If medical centers and other medical settings are to lead the charge in informing the community about the harms of spanking, comprehensive staff education about spanking is indicated. PMID:27744218

Medical center staff attitudes about spanking.

PubMed

Gershoff, Elizabeth T; Font, Sarah A; Taylor, Catherine A; Foster, Rebecca H; Garza, Ann Budzak; Olson-Dorff, Denyse; Terreros, Amy; Nielsen-Parker, Monica; Spector, Lisa

2016-11-01

Several medical professional organizations, including the American Academy of Pediatrics, recommend that parents avoid hitting children for disciplinary purposes (e.g., spanking) and that medical professionals advise parents to use alternative methods. The extent to which medical professionals continue to endorse spanking is unknown. This study is the first to examine attitudes about spanking among staff throughout medical settings, including non-direct care staff. A total of 2580 staff at a large general medical center and 733 staff at a children's hospital completed an online survey; respondents were roughly divided between staff who provide direct care to patients (e.g., physicians, nurses) and staff who do not (e.g., receptionists, lab technicians). Less than half (44% and 46%) of staff at each medical center agreed that spanking is harmful to children, although almost all (85% and 88%) acknowledged that spanking can lead to injury. Men, staff who report being religious, and staff who held non-direct care positions at the medical center reported stronger endorsement of spanking and perceived their co-workers to be more strongly in favor of spanking. Non-direct care staff were more supportive of spanking compared with direct care staff on every item assessed. All staff underestimated the extent to which their co-workers held negative views of spanking. If medical centers and other medical settings are to lead the charge in informing the community about the harms of spanking, comprehensive staff education about spanking is indicated. Copyright © 2016 Elsevier Ltd. All rights reserved.

A Novel Anti-Beta2-Microglobulin Antibody Inhibition of Androgen Receptor Expression, Survival, and Progression in Prostate Cancer Cells

DTIC Science & Technology

2010-05-01

Uro -Oncology Research Pro- gram, Dept. of Medicine, Cedars-Sinai Medical Center, 8750 Beverly Blvd., Atrium 103, Los Angeles, CA 90048. Tel.: 310...ORGANIZATION: Cedars-Sinai Medical Center Los Angeles, California 90048 REPORT DATE: May...Cedars-Sinai Medical Center Los Angeles, California 90048 9. SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR/MONITOR’S ACRONYM

5 strategies for improving performance of academic medical centers.

PubMed

Valletta, Robert M; Harkness, Alicia

2013-06-01

Academic medical centers should consider five strategies for becoming more cost-efficient and profitable as reforms are implemented: Make faculty responsible for cost and quality. Explore opportunities to collaborate with community hospitals. Extend care and education beyond the walls of the organization, employing technology and innovative teaching practices. Maximize healthcare IT investment by sharing data-rich patient records with other medical centers and research institutes. Align research with business strategy.

Biostatistical and medical statistics graduate education

PubMed Central

2014-01-01

The development of graduate education in biostatistics and medical statistics is discussed in the context of training within a medical center setting. The need for medical researchers to employ a wide variety of statistical designs in clinical, genetic, basic science and translational settings justifies the ongoing integration of biostatistical training into medical center educational settings and informs its content. The integration of large data issues are a challenge. PMID:24472088

An academic medical center under prolonged rocket attack--organizational, medical, and financial considerations.

PubMed

Bar-El, Yaron; Michaelson, Moshe; Hyames, Gila; Skorecki, Karl; Reisner, Shimon A; Beyar, Rafael

2009-09-01

The Rambam Medical Center, the major academic health center in northern Israel, serving a population of two million and providing specialized tertiary care, was exposed to an unprecedented experience during the Second Lebanon War in the summer of 2006. For more than one month, it was subjected to continuous rocket attacks, but it continued to provide emergency and routine medical services to the civilian population and also served the military personnel who were evacuated from the battlefront. To accomplish the goals of serving the population while itself being under fire, the Rambam Medical Center had to undertake major organizational decisions, which included maximizing safety within the hospital by shifting patients and departments, ensuring that the hospital was properly fortified, managing the health professional teams' work schedules, and providing needed services for the families of employees. The Rambam Medical Center's Level I trauma center expertise included multidisciplinary teams and extensive collaborations; modern imaging modalities usually reserved for peacetime medical practice were frequently used. The function of the hospital teams during the war was efficient and smooth, based on the long-term actions taken to prepare for disasters and wartime conditions. Routine hospital services continued, although at 60% of normal occupancy. Financial losses incurred were primarily due to the decrease in revenue-generating activity. The two most important components of managing the hospital under these conditions are (1) the ability to arrive at prompt and meaningful decisions with respect to the organizational and medical hospital operations and (2) the leadership and management of the professional staff and teams.

Comparing antibiotic self-medication in two socio-economic groups in Guatemala City: a descriptive cross-sectional study.

PubMed

Ramay, Brooke M; Lambour, Paola; Cerón, Alejandro

2015-04-27

Self-medication with antibiotics may result in antimicrobial resistance and its high prevalence is of particular concern in Low to Middle Income Countries (LMIC) like Guatemala. A better understanding of self-medication with antibiotics may represent an opportunity to develop interventions guiding the rational use of antibiotics. We aimed to compare the magnitude of antibiotic self-medication and the characteristics of those who self-medicate in two pharmacies serving disparate socio-economic communities in Guatemala City. We conducted a descriptive, cross-sectional study in one Suburban pharmacy and one City Center pharmacy in Guatemala City. We used a questionnaire to gather information about frequency of self-medication, income and education of those who self-medicate. We compared proportions between the two pharmacies, using two-sample z-test as appropriate. Four hundred and eighteen respondents completed the survey (221 in the Suburban pharmacy and 197 in the City Center pharmacy). Most respondents in both pharmacies were female (70%). The reported monthly income in the suburban pharmacy was between $1,250.00-$2,500.00, the city-center pharmacy reported a monthly income between $125.00- $625.00 (p < 0.01). Twenty three percent of Suburban pharmacy respondents and 3% in the City Center pharmacy completed high school (p < 0.01). Proportion of self-medication was 79% in the Suburban pharmacy and 77% in City Center pharmacy. In both settings, amoxicillin was reported as the antibiotic most commonly used. High proportions of self-medication with antibiotics were reported in two pharmacies serving disparate socio-economic groups in Guatemala City. Additionally, self-medicating respondents were most often women and most commonly self-medicated with amoxicillin. Our findings support future public health interventions centered on the regulation of antibiotic sales and on the potential role of the pharmacist in guiding prescription with antibiotics in Guatemala.

Hospitals prepare plans, drill staff to ensure that potential Ebola patients are identified, isolated, and managed safely.

PubMed

2014-12-01

Hospitals around the country have stepped up their efforts to train staff and implement procedures to ensure the safe identification and management of any patients with signs of Ebola virus disease (EVD). Ronald Reagan UCLA Medical Center in Los Angeles, CA, held an "Ebola preparedness exercise" to give staff an opportunity to walk through the hospital's protocol for handling a simulated patient with EVD. The University of Alabama at Birmingham (UAB) Medical Center has held similar exercises, and is now holding twice-weekly meetings of its leadership team to make sure that all new developments in the Ebola outbreak are communicated. UCLA Medical Center has prepared PPE kits based on the practices developed at Emory University Hospital, which has thus far had the most experience in this country in caring for patients with EVD. The UCLA Health System has adjusted its medical record system so that a red flag is placed on the electronic medical record [EMR] of any patient who has recently traveled to a high-risk area. UAB Medical Center has incorporated what had been a paper-and-pencil screening tool for EVD into its electronic medical record. Training on PPE as well as EVD screening is being provided to first-responders and 911 call center dispatchers in the UAB system.

Innovations in Teaching on Aging: Integrative and Interactive Approaches.

ERIC Educational Resources Information Center

Timiras, Paola S.

1981-01-01

Presents summaries of current programs on aging and gerontology at these five institutions: University of Texas Health Science Center (San Antonio), Michigan State University (East Lansing), University of California (Berkeley), University of Colorado Medical Center (Denver), and University of Kentucky Medical Center (Lexington). (CS)

Scaffold Attachment Factor B1: A Novel Chromatin Regulator of Prostate Cancer Metabolism

DTIC Science & Technology

2016-10-01

INVESTIGATOR: SUNGYONG YOU PhD CONTRACTING ORGANIZATION: Cedars-Sinai Medical Center Los Angeles, CA 90048 REPORT DATE: October 2016 TYPE OF REPORT...NUMBER CEDARS-SINAI MEDICAL CENTER 8700 BEVERLY BLVD LOS ANGELES CA 90048-1804 9. SPONSORING / MONITORING AGENCY NAME(S) AND ADDRESS(ES) 10. SPONSOR...Bioinformatics. The Urologic Oncology Program, held in Cedars- Sinai Medical Center, Los Angeles, California, March 10, 2015. Oral Presentation: 1. You S

A Business Case Analysis: Establishment of a Sub-Acute Ward for Tripler Army Medical Center

DTIC Science & Technology

2007-03-31

7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) S. PERFORMING ORGANIZATION REPORT Tripler Army Medical Center I Jarrett White Road TAMC, Hawaii ...Reichenberg, CHES Tripler Army Medical Center, Hawaii Date Complete: 31 March 2007 Date Submitted: 31 March 2007 Running Heading: Establishment of a Sub... Hawaii for his personal insight. Running Heading: Establishment of a Sub-Acute Ward 4 Abstract This business case examines the likely costs and

Consumerism: forcing medical practices toward patient-centered care.

PubMed

Ozmon, Jeff

2007-01-01

Consumerism has been apart of many industries over the years; now consumerism may change the way many medical practices deliver healthcare. With the advent of consumer-driven healthcare, employers are shifting the decision-making power to their employees. Benefits strategies like health savings accounts and high-deductible insurance plans now allow the patients to control how and where they spend their money on medical care. Practices that seek to attract the more affluent and informed consumers are beginning to institute patient-centered systems designs that invite patients to actively participate in their healthcare. This article will outline the changes in the healthcare delivery system facing medical practices, the importance of patient-centered care, and six strategies to implement to change toward more patient-centered care.

Advertising by academic medical centers.

PubMed

Larson, Robin J; Schwartz, Lisa M; Woloshin, Steven; Welch, H Gilbert

2005-03-28

Many academic medical centers have increased their use of advertising to attract patients. While the content of direct-to-consumer pharmaceutical advertisements (ads) has been studied, to our knowledge, advertising by academic medical centers has not. We aimed to characterize advertising by the nation's top academic medical centers. We contacted all 17 medical centers named to the US News & World Report 2002 honor roll of "America's Best Hospitals" for a semistructured interview regarding their advertising practices. In addition, we obtained and systematically analyzed all non-research-related print ads placed by these institutions in their 5 most widely circulating local newspapers during 2002. Of the 17 institutions, 16 reported advertising to attract patients; 1 stated, "We're just word of mouth." While all 17 centers confirmed the presence of an institutional review board process for approving advertising to attract research subjects, none reported a comparable process for advertising to attract patients. We identified 127 unique non-research-related print ads for the 17 institutions during 2002 (mean, 7.5; range, 0-39). Three ads promoted community events with institution sponsorship, 2 announced genuine public services, and 122 were aimed at attracting patients. Of the latter group, 36 ads (29.5%) promoted the medical center as a whole, while 65 (53.3%) promoted specific clinical departments and 21 (17.2%) promoted single therapeutic interventions or diagnostic tests. The most commonly used marketing strategies included appealing to emotions (61.5%), highlighting institution prestige (60.7%), mentioning a symptom or disease (53.3%), and promoting introductory lectures or special offers likely to lead to further business (47.5%). Of the 21 ads for single interventions, most were for unproved (38.1%) or cosmetic (28.6%) procedures. While more than half of these ads presented benefits, none quantified their positive claims and just 1 mentioned potential harms. Advertising to attract patients is common among top academic medical centers but is not subjected to the oversight standard for clinical research. Many of the ads seemed to place the interests of the medical center before the interests of the patients.

Payment and Care for Hematopoietic Cell Transplantation Patients: Toward a Specialized Medical Home for Complex Care Patients.

PubMed

Gajewski, James L; McClellan, Mark B; Majhail, Navneet S; Hari, Parameswaran N; Bredeson, Christopher N; Maziarz, Richard T; LeMaistre, Charles F; Lill, Michael C; Farnia, Stephanie H; Komanduri, Krishna V; Boo, Michael J

2018-01-01

Patient-centered medical home models are fundamental to the advanced alternative payment models defined in the Medicare Access and Children's Health Insurance Plan Reauthorization Act (MACRA). The patient-centered medical home is a model of healthcare delivery supported by alternative payment mechanisms and designed to promote coordinated medical care that is simultaneously patient-centric and population-oriented. This transformative care model requires shifting reimbursement to include a per-patient payment intended to cover services not previously reimbursed such as disease management over time. Payment is linked to quality measures, including proportion of care delivered according to predefined pathways and demonstrated impact on outcomes. Some medical homes also include opportunities for shared savings by reducing overall costs of care. Recent proposals have suggested expanding the medical home model to specialized populations with complex needs because primary care teams may not have the facilities or the requisite expertise for their unique needs. An example of a successful care model that may provide valuable lessons for those creating specialty medical home models already exists in many hematopoietic cell transplantation (HCT) centers that deliver multidisciplinary, coordinated, and highly specialized care. The integration of care delivery in HCT centers has been driven by the specialty care their patients require and by the payment methodology preferred by the commercial payers, which has included bundling of both inpatient and outpatient care in the peritransplant interval. Commercial payers identify qualified HCT centers based on accreditation status and comparative performance, enabled in part by center-level comparative performance data available within a national outcomes database mandated by the Stem Cell Therapeutic and Research Act of 2005. Standardization across centers has been facilitated via voluntary accreditation implemented by Foundation for the Accreditation of Cell Therapy. Payers have built on these community-established programs and use public outcomes and program accreditation as standards necessary for inclusion in specialty care networks and contracts. Although HCT centers have not been described as medical homes, most HCT providers have already developed the structures that address critical requirements of MACRA for medical homes. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

Initial Benchmarking of the Quality of Medical Care in Childhood-Onset Systemic Lupus Erythematosus.

PubMed

Mina, Rina; Harris, Julia G; Klein-Gitelman, Marisa S; Appenzeller, Simone; Centeville, Maraisa; Eskra, Diane; Huggins, Jennifer L; Johnson, Anne L; Khubchandani, Raju; Khandekar, Prachi; Lee, Jiha; Liu, Hai Mei; Pendl, Joshua D; Silva, Clovis A; Silva, Marco F; Zaal, Ahmad I; DeWitt, Esi Morgan; Ardoin, Stacy P; Brunner, Hermine I

2016-02-01

To assess the quality of medical care in childhood-onset systemic lupus erythematosus (SLE) at tertiary pediatric rheumatology centers as measured by observance of SLE quality indicators (SLE-QIs). International consensus has been achieved for childhood-onset SLE-QIs capturing medical care provision in 9 domains: diagnostic testing, education of cardiovascular (CV) risk and lifestyles, lupus nephritis (LN), medication management, bone health, ophthalmologic surveillance, transition, pregnancy, and vaccination. Using medical record information, the level of performance of these childhood-onset SLE-QIs was assessed in childhood-onset SLE populations treated at 4 tertiary pediatric rheumatology centers in the US, 2 in Brazil, and 1 center in India. A total of 483 childhood-onset SLE patients were assessed. Care for the 310 US patients differed markedly for childhood-onset SLE-QIs addressing LN, bone health, vaccinations, education on CV risk, and transition planning. Performance of safety blood testing for medications was high at all centers. Despite often similar performance on the childhood-onset SLE-QI, access to kidney biopsies was lower in Brazil than in the US. Irrespective of the country of practice, larger centers tended to meet the childhood-onset SLE-QIs more often than smaller centers. The childhood-onset SLE-QIs, evidence-based minimum standards of medical care, are not consistently met in the US or some other countries outside the US. This has the potential to contribute to suboptimal childhood-onset SLE outcomes. © 2016, American College of Rheumatology.

Initial Benchmarking of the Quality of Medical Care of Childhood-Onset Systemic Lupus Erythematosus

PubMed Central

Mina, Rina; Harris, Julia G.; Klein-Gitelman, Marisa S.; Appenzeller, Simone; Centeville, Maraisa; Eskra, Diane; Huggins, Jennifer L.; Johnson, Anne L.; Khubchandani, Raju; Khandekar, Prachi; Lee, Jiha; Liu, HaiMei; Pendl, Joshua D.; Silva, Clovis A.; Silva, Marco F.; Zaal, Ahmad I.; DeWitt, Esi Morgan; Ardoin, Stacy P.; Brunner, Hermine I.

2015-01-01

Objective To assess the quality of medical care in childhood-onset systemic lupus erythematosus (cSLE) at tertiary pediatric rheumatology centers as measured by observance cSLE quality indicators (cSLE-QI). Methods International consensus has been achieved for cSLE-QI (Hollander et al. Arthritis Care & Research, 2013) capturing medical care provision in nine domains: diagnostic testing, education of cardiovascular (CV) risk and lifestyles, lupus nephritis (LN), medication management, bone health, ophthalmological surveillance, transition, pregnancy and vaccination. Using medical record information, the level of performance these cSLE-QI was assessed in cSLE populations treated at four tertiary pediatric rheumatology centers in the U.S, two in Brazil, and one center in India. Results A total of 483 cSLE patients were assessed. Care for the 310 U.S. patients differed markedly for cSLE-QI addressing LN, bone health, vaccinations, education on CV risk, and transition planning. Performance of safety blood testing for medications was high at all centers. Despite often similar performance on the cSLE-QI, access to kidney biopsies was lower in Brazil than in the U.S. Irrespective of country of practice, larger centers tended to meet the cSLE-QI more often than smaller centers. Conclusions The cSLE-QI, evidence based minimum standards of medical care, are not consistently met in the U.S. or some other countries outside the U.S. This has the potential to contribute to suboptimal cSLE outcomes. PMID:26219749

[RABIN MEDICAL CENTER - A TERTIARY CENTER OF EXCELLENCE IN SERVICE, TEACHING AND RESEARCH].

PubMed

Niv, Yaron; Halpern, Eyran

2017-04-01

Rabin Medical Center (RMC) belongs to Clalit Health Services and is a tertiary, academic medical center with all the facilities of modern and advanced medicine. Annually in the RMC, 650,000 patients are treated in the outpatient clinics, and 100,000 patients are hospitalized in the hospital departments. All these patients are treated by 4500 devoted staff members, including 1000 physicians and 2000 nurses. RMC is one of the largest, centrally located medical centers for medical and nursing students' education in Israel, taking place in clinical departments, as well as in basic sciences courses. We also have a nursing school attached to the hospital. Our vision supports excellence in research. We have a special Research Department that supports RMC researchers, with research coordinators, and all the relevant facilities to assist in clinical and basic science studies. We also promote collaboration efforts with many academic centers in Israel and abroad. The scope of RMC research is broad, including 700 new studies every year and 1500 active studies currently. This issue of Harefuah is dedicated to the clinical and basic science research conducted at RMC with original papers presenting research performed by our departments and laboratories.

Characteristics of medical teachers using student-centered teaching methods.

PubMed

Kim, Kyong-Jee; Hwang, Jee-Young

2017-09-01

This study investigated characteristics of medical teachers who have adopted student-centered teaching methods into their teaching. A 24-item questionnaire consisted of respondent backgrounds, his or her use of student-centered teaching methods, and awareness of the school's educational objectives and curricular principles was administered of faculty members at a private medical school in Korea. Descriptive statistics and chi-square analysis were conducted to compare faculty use of student-centered approaches across different backgrounds and awareness of curricular principles. Overall response rate was 70% (N=140/200), approximately 25% (n=34) of whom were using student-centered teaching methods. Distributions in the faculty use of student-centered teaching methods were significantly higher among basic sciences faculty (versus clinical sciences faculty), with teaching experiences of over 10 years (versus less than 10 years), and who were aware of the school's educational objectives and curricular principles. Our study indicates differences in medical faculty's practice of student-centered teaching across disciplines, teaching experiences, and their understanding of the school's educational objectives curricular principles. These findings have implications for faculty development and institutional support to better promote faculty use of student-centered teaching approaches.

Planetree health information services: public access to the health information people want.

PubMed Central

Cosgrove, T L

1994-01-01

In July 1981, the Planetree Health Resource Center opened on the San Francisco campus of California Pacific Medical Center (Pacific Presbyterian Medical Center). Planetree was founded on the belief that access to information can empower people and help them face health and medical challenges. The Health Resource Center was created to provide medical library and health information resources to the general public. Over the last twelve years, Planetree has tried to develop a consumer health library collection and information service that is responsive to the needs and interests of a diverse public. In an effort to increase accessibility to the medical literature, a consumer health library classification scheme was created for the organization of library materials. The scheme combines the specificity and sophistication of the National Library of Medicine classification scheme with the simplicity of common lay terminology. PMID:8136762

Use of a computerized medication shared decision making tool in community mental health settings: impact on psychotropic medication adherence.

PubMed

Stein, Bradley D; Kogan, Jane N; Mihalyo, Mark J; Schuster, James; Deegan, Patricia E; Sorbero, Mark J; Drake, Robert E

2013-04-01

Healthcare reform emphasizes patient-centered care and shared decision-making. This study examined the impact on psychotropic adherence of a decision support center and computerized tool designed to empower and activate consumers prior to an outpatient medication management visit. Administrative data were used to identify 1,122 Medicaid-enrolled adults receiving psychotropic medication from community mental health centers over a two-year period from community mental health centers. Multivariate linear regression models were used to examine if tool users had higher rates of 180-day medication adherence than non-users. Older clients, Caucasian clients, those without recent hospitalizations, and those who were Medicaid-eligible due to disability had higher rates of 180-day medication adherence. After controlling for sociodemographics, clinical characteristics, baseline adherence, and secular changes over time, using the computerized tool did not affect adherence to psychotropic medications. The computerized decision tool did not affect medication adherence among clients in outpatient mental health clinics. Additional research should clarify the impact of decision-making tools on other important outcomes such as engagement, patient-prescriber communication, quality of care, self-management, and long-term clinical and functional outcomes.

Medical Simulation Practices 2010 Survey Results

NASA Technical Reports Server (NTRS)

McCrindle, Jeffrey J.

2011-01-01

Medical Simulation Centers are an essential component of our learning infrastructure to prepare doctors and nurses for their careers. Unlike the military and aerospace simulation industry, very little has been published regarding the best practices currently in use within medical simulation centers. This survey attempts to provide insight into the current simulation practices at medical schools, hospitals, university nursing programs and community college nursing programs. Students within the MBA program at Saint Joseph's University conducted a survey of medical simulation practices during the summer 2010 semester. A total of 115 institutions responded to the survey. The survey resus discuss overall effectiveness of current simulation centers as well as the tools and techniques used to conduct the simulation activity

Lincoln County Primary Care Center Is a Model for Good Health.

ERIC Educational Resources Information Center

Casto, James E.

1992-01-01

Describes a rural West Virginia health-care center as a successful model program for integration between the clinic and community. Describes center facilities, funding sources, community cooperation, and cooperative residency program with regional medical school. Discusses implications for other medical-education programs. Describes differences…

76 FR 30948 - Agency Information Collection Activities: Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-05-27

... Act of 1995: Proposed Project: Reconciliation Tool for the Teaching Health Center Graduate Medical Education Program--[NEW] The Teaching Health Center Graduate Medical Education (THCGME) program, Section... statute provides that eligible teaching health centers receive payments for both direct and indirect costs...

A Study to Identify Functions Which Inhibit or Facilitate the Health Care Delivery Process on Ward 51 at Walter Reed Army Medical Center, Washington, D.C.

DTIC Science & Technology

1980-08-01

PROCESS ON WARD 51 AT WALTER REED ARMY MEDICAL CENTER, WASHINGTON, D.C. A Problem-Solving Project D TIC Submitted to the Faculty of ELECTE- Baylor...HEALTH CARN DELIVERY PROCESS ON WARD 51 AT WALTER RIED ARM1Y MEDICAL CENTER, WASHINGTON, D.C. 12. PERSONAL AUTHOR(S) LTC Ella L. Fletcher 130. TYPE OF...functions which Inhibit or acqpiir’o delivery- process on Ward 51 at Walter Reed Army M6edical Center. The interaction among ps physicians, nurses

Demographics of emergency medical care at the Indianapolis 500 mile race (1983-1990).

PubMed

Bock, H C; Cordell, W H; Hawk, A C; Bowdish, G E

1992-10-01

The Indianapolis 500 Mile Race, the largest single-day, single-venue sporting event in the world, is attended by an estimated 400,000 people. Major illness and injury are treated at the Hanna Emergency Medical Center, the track hospital. Minor illness is treated at ten outlying aid stations. We describe the demographics of emergency medical care at the Hanna Emergency Medical Center. Descriptive. Patient care data for patients treated at the medical center are first recorded on paper charts and then coded and transferred to computer. Data regarding patients treated at the medical center during eight consecutive races (1983-1990) were analyzed. Frequency of treatment and medical cardiac arrest rates were calculated. Aid station data and medical center records from nonrace days were not analyzed. The average number of patients treated per year at the track hospital was 139. The total number treated over the eight-year period was 1,113, yielding a frequency of treatment of 0.35 per 1,000. Analysis showed 16.2% of the proprietary treatment codes involved intoxication; 15.4%, lacerations (other than feet); 11.0%, pre-existing conditions; and 8.5%, heat illness. During the eight years, there were four medical cardiac arrests (incidence of 0.0125 per 10,000 spectators), all resulting in death. A fifth spectator died after being struck by a wheel from a race car. There were no driver deaths on race day. Descriptive data regarding medical care of crowds may be useful to emergency specialists who must staff, order supplies, and plan treatment facilities for similar mass gatherings. It is evident from this and other mass-gathering studies that there is a need for consistency in nomenclature and data collection. This will allow more accurate comparisons of emergency medical care between venues.

The Performance of Trauma Research Centers of Iran during the Past 10 Years; A Science Monitor Survey.

PubMed

Yadollahi, Mahnaz; Shamsedini, Narges; Shayan, Leila; Rezaianzadeh, Abbas; Bolandparvaz, Shahram

2014-01-01

To compare and evaluation of scores of trauma research center of Shiraz University of Medical Sciences in Iran with other trauma research centers in Iran. The assessment scores of each center were gathered from Iran medical research and Ministry of Health and Medical Education website. Each score is recorded in helical year which is defined from the 21th of March of every year until the 20th of March of the next. They are ranked and scored by knowledge production, capacity development, and research projects. The total evaluation scores of the trauma research center of Iran's Universities of Medical Sciences have increased from establishment. The highest increase in assessment scores was related to Tehran Trauma Research Center. An upward trend was observed in the total indicators of knowledge production index of all the trauma research centers from 2001/2002 to 2011/2012. An ascending trend was showed in the published articles score of Shiraz and Kashan Trauma Research Centers through the recent years. The increasing trend in scores of trauma research centers in Iran indicated a significant role in the knowledge production but it is need to find barriers of research and doing interventional projects to promote trauma care and prevention.

The Performance of Trauma Research Centers of Iran during the Past 10 Years; A Science Monitor Survey

PubMed Central

Yadollahi, Mahnaz; Shamsedini, Narges; Shayan, Leila; Rezaianzadeh, Abbas; Bolandparvaz, Shahram

2014-01-01

Objective: To compare and evaluation of scores of trauma research center of Shiraz University of Medical Sciences in Iran with other trauma research centers in Iran. Methods: The assessment scores of each center were gathered from Iran medical research and Ministry of Health and Medical Education website. Each score is recorded in helical year which is defined from the 21th of March of every year until the 20th of March of the next. They are ranked and scored by knowledge production, capacity development, and research projects. Results: The total evaluation scores of the trauma research center of Iran's Universities of Medical Sciences have increased from establishment. The highest increase in assessment scores was related to Tehran Trauma Research Center. An upward trend was observed in the total indicators of knowledge production index of all the trauma research centers from 2001/2002 to 2011/2012. An ascending trend was showed in the published articles score of Shiraz and Kashan Trauma Research Centers through the recent years. Conclusion: The increasing trend in scores of trauma research centers in Iran indicated a significant role in the knowledge production but it is need to find barriers of research and doing interventional projects to promote trauma care and prevention. PMID:27162863

Developing physician leaders in academic medical centers.

PubMed

Bachrach, D J

1997-01-01

While physicians have historically held positions of leadership in academic medical centers, there is an increasing trend that physicians will not only guide the clinical, curriculum and scientific direction of the institution, but its business direction as well. Physicians are assuming a greater role in business decision making and are found at the negotiating table with leaders from business, insurance and other integrated health care delivery systems. Physicians who lead "strategic business units" within the academic medical center are expected to acquire and demonstrate enhanced business acumen. There is an increasing demand for formal and informal training programs for physicians in academic medical centers in order to better prepare them for their evolving roles and responsibilities. These may include the pursuit of a second degree in business or health care management; intramurally conducted courses in leadership skill development, management, business and finance; or involvement in extramurally prepared and delivered training programs specifically geared toward physicians as conducted at major universities, often in their schools of business or public health. While part one of this series, which appeared in Volume 43, No. 6 of Medical Group Management Journal addressed, "The changing role of physician leaders at academic medical centers," part 2 will examine as a case study the faculty leadership development program at the University of Texas M.D. Anderson Cancer Center. These two articles were prepared by the author from his research into, and the presentation of a thesis entitled. "The importance of leadership training and development for physicians in academic medical centers in an increasingly complex health care environment," prepared for the Credentials Committee of the American College of Healthcare Executives in partial fulfillment of the requirements for Fellowship in this College.*

Platelet-Derived Growth Factor-BB Stimulates Fibronectin Gene Expression in Fibroblasts Isolated from Rat Thoracic Aorta

DTIC Science & Technology

1994-06-13

MARYLAND 20814-4799 TEACHING HOSPITALS WALTER REED ARMY MEDtCA L CENTER APPROVAL SHEET NAVAL HOSPITAL. BETHESDA MALCOLM GROW AIR FORCE MEDICAL ...CENTER WILFORD HALL "IR FORCE MEDICAL CENTER Title of Dissertation: "Platelet-derived growth factor-BB stimulates fibronectin gene expression in...fascinating world of basic medical science. His dedication and pursuit of excellence in all facets of his work are standards by which I will guide my own

Implementation of medical monitor system based on networks

NASA Astrophysics Data System (ADS)

Yu, Hui; Cao, Yuzhen; Zhang, Lixin; Ding, Mingshi

2006-11-01

In this paper, the development trend of medical monitor system is analyzed and portable trend and network function become more and more popular among all kinds of medical monitor devices. The architecture of medical network monitor system solution is provided and design and implementation details of medical monitor terminal, monitor center software, distributed medical database and two kind of medical information terminal are especially discussed. Rabbit3000 system is used in medical monitor terminal to implement security administration of data transfer on network, human-machine interface, power management and DSP interface while DSP chip TMS5402 is used in signal analysis and data compression. Distributed medical database is designed for hospital center according to DICOM information model and HL7 standard. Pocket medical information terminal based on ARM9 embedded platform is also developed to interactive with center database on networks. Two kernels based on WINCE are customized and corresponding terminal software are developed for nurse's routine care and doctor's auxiliary diagnosis. Now invention patent of the monitor terminal is approved and manufacture and clinic test plans are scheduled. Applications for invention patent are also arranged for two medical information terminals.

Prime Contractors | Division of Cancer Prevention

Cancer.gov

2015-2018 Efficacy and Intermediate Endpoint Biomarkers: The Research Institute of Fox Chase Cancer Center SRI International IIT Research Institute University of Texas MD Anderson Cancer Center University of Alabama at Birmingham Medical College of Wisconsin University of Oklahoma Health Sciences Center Weill Medical College of Cornell University Toxicology and Pharmacology

A Podiatric Medical Residency Program in an Academic Health Science Center

ERIC Educational Resources Information Center

Bogy, Louis T.; And Others

1977-01-01

The podiatric medical residency program in the Health Science Center at San Antonio provides an intensive exposure for the newly graduated podiatrist to practice in a multidisciplinary environment. Residents become more familiar with general medical and surgical diseases and disorders as well as podiatric pathology. (LBH)

Research Plan for the National Center for Medical Rehabilitation Research.

ERIC Educational Resources Information Center

National Inst. of Child Health and Human Development (NIH), Bethesda, MD.

This research plan describes a framework for defining and developing the field of rehabilitation sciences and research opportunities for the National Center for Medical Rehabilitation Research (NCMRR) and other agencies funding medical rehabilitation research. The plan addresses the needs of both persons who are involved in habilitation and in…

42 CFR 482.90 - Condition of participation: Patient and living donor selection.

Code of Federal Regulations, 2011 CFR

2011-10-01

... principles of medical ethics. Transplant centers must: (1) Ensure that a prospective living donor receives a... candidate on its waiting list, the candidate's medical record must contain documentation that the candidate... selected to receive a transplant, the center must document in the patient's medical record the patient...

Design for Medical Education. The Development and Planning of a Medical College and Care Center.

ERIC Educational Resources Information Center

Peery, Thomas M.; Green, Alan C.

Planning and design procedures which one medical education center employed in translating its educational objectives, philosophy and techniques into laboratory, classroom and clinic facilities are described. Basic planning considerations included--(1) determination of the curriculum, (2) facility utilization rate, (3) housing of research…

Defense.gov Special Report: Traumatic Brain Injury

Science.gov Websites

Excellence TBI Resources Brainline Military The Michael E. DeBakey VA Medical Center Congressionally Directed Medical Research Program NIH: National Institute of Neurological Disorders NIH: Traumatic Brain Injury Research CDC: Give Brain Injury a Voice Center for Medical Excellence for Multimedia Brainline.org - Brain

Medical Device Plug-and-Play Interoperability Standards and Technology Leadership

DTIC Science & Technology

2014-10-01

downloads/AboutFDA/CentersOffices/OfficeofMedicalProductsandTobacco/ CDRH /CDRHReports/UCM391521.pdf. Dr. Goldman spoke in multiple panels at this workshop...downloads/AboutFDA/CentersOffices/OfficeofMedicalProductsandTo bacco/ CDRH /CDRHReports/UCM391521.pdf  Arney D, Plourde J, Schrenker R, Mattegunta P

ASTRONAUT CONRAD, CHARLES (PETE), JR. - X-RAYS - MEDICAL TEAM MEMBERS - CAPE

NASA Image and Video Library

1965-08-17

S65-28699 (17 Aug. 1965) --- Astronaut Charles Conrad Jr. (dark shirt), pilot for the Gemini-5 spaceflight, discusses x-rays with members of the medical team at Cape Kennedy. Left to right are Dr. Eugene Tubbs; astronaut Conrad; Dr. Charles A. Berry, chief, Center Medical Programs, Manned Spacecraft Center; and Dr. Robert Moser (seated), Medical Monitor with the U.S. Army.

Introduction to Medical Terminology for Claretian Medical Center Worker Education Program of Northeastern Illinois University's Chicago Teachers' Center in Partnership with the Union of Needletrades, Industrial, Textile Employers (UNITE).

ERIC Educational Resources Information Center

Essex Community Coll., MD.

This manual consists of glossaries and descriptions of medical terminology for use in a workplace literacy program for hospital workers. The sections are as follows: hospital patient care areas; hospital departments; medical specialists; word elements (root, prefix, suffix, combining vowel, compound word); surgical procedures; diseases and…

Reducing length of stay provides key to improvement in Veterans Administration Medical Center.

PubMed

Huebler, L A; Christian, J A; Marcella, L W

1980-02-01

Concerted resolve and coordinated planning on the part of both administrative and patient care staff at the medical center made it possible to treat more patients in fewer beds than ever before and to improve the core staffing ratio at the same time. Staffing was enhanced and new programs were developed using available resources. Reduction of the average LOS for patients throughout the medical center was a primary factor in these achievements. In addition, formal quality assurance activities were strengthened; with careful planning and increased funding, the renovation of facilities and purchase of new equipment was also possible, thus making the improvement project comprehensive. These changes have had a major, beneficial impact on the delivery of health care a the Dublin Veterans Administration Medical Center.

Relating calls to US poison centers for potential exposures to medications to Centers for Disease Control and Prevention reporting of influenza-like illness.

PubMed

Beauchamp, Gillian A; McKeown, Nathanael J; Rodriguez, Sergio; Spyker, Daniel A

2016-03-01

The Centers for Disease Control (CDC) monitors influenza like illness (ILI) and the National Poison Data System (NPDS) warehouses call data uploaded by US poison centers regarding reported exposures to medication. We examined the relationship between calls to poison centers regarding reported exposures to medications commonly used to treat ILI and weekly reports of ILI. The CDC reports ILI, by age group, for each of 10 Health and Human Services (HHS) regions. We examined NPDS summary data from calls reported to poison centers regarding reported exposures to acetaminophen, cough/cold medications, and promethazine, for the same weeks, age groups, and HHS regions for influenza seasons 2000-2013. ILI and NPDS exposures were examined using graphical plots, descriptive statistics, stepwise regression analysis, and Geographic Information Systems (GIS). About 5,101,841 influenza-like illness cases were reported to the CDC, and 2,122,940 calls regarding reported exposures to medications commonly used to treat ILI, were reported by poison centers to the NPDS over the 13 flu seasons. Analysis of stepwise models of the linear untransformed data involving 24 NPDS data groups and for 60 ILI measures, over the 13 influenza seasons, demonstrated that reported exposures to medications used to treat ILI correlated with reported cases of ILI with a median R(2 )=( )0.489 (min R(2 )=( )0.248, max R(2 )=( )0.717), with mean ± SD of R(2 )=( )0.494 ± 0.121. Median number of parameters used (degrees of freedom - 1) was 7. NPDS data regarding poison center calls for selected ILI medication exposures were highly correlated with CDC ILI data. Since NPDS data are available in real time, it provides complimentary ILI monitoring. This approach may provide public health value in predicting other illnesses which are not currently as thoroughly monitored.

Teleradiology network system and computer-aided diagnosis workstation using the web medical image conference system with a new information security solution

NASA Astrophysics Data System (ADS)

Satoh, Hitoshi; Niki, Noboru; Eguchi, Kenji; Ohmatsu, Hironobu; Kaneko, Masahiro; Kakinuma, Ryutaru; Moriyama, Noriyuki

2011-03-01

We have developed the teleradiology network system with a new information security solution that provided with web medical image conference system. In the teleradiology network system, the security of information network is very important subjects. We are studying the secret sharing scheme as a method safely to store or to transmit the confidential medical information used with the teleradiology network system. The confidential medical information is exposed to the risk of the damage and intercept. Secret sharing scheme is a method of dividing the confidential medical information into two or more tallies. Individual medical information cannot be decoded by using one tally at all. Our method has the function of RAID. With RAID technology, if there is a failure in a single tally, there is redundant data already copied to other tally. Confidential information is preserved at an individual Data Center connected through internet because individual medical information cannot be decoded by using one tally at all. Therefore, even if one of the Data Centers is struck and information is damaged, the confidential medical information can be decoded by using the tallies preserved at the data center to which it escapes damage. We can safely share the screen of workstation to which the medical image of Data Center is displayed from two or more web conference terminals at the same time. Moreover, Real time biometric face authentication system is connected with Data Center. Real time biometric face authentication system analyzes the feature of the face image of which it takes a picture in 20 seconds with the camera and defends the safety of the medical information. We propose a new information transmission method and a new information storage method with a new information security solution.

Golden opportunity or sudden death threats.

PubMed

Beltran, Robert A

2005-11-01

King/Drew Medical Center is the only minority academic medical center west of the Mississippi River. As a result of the McCone Commission investigation into the Watts Riots of 1965, it was initially established as the Martin Luther King Hospital. Upon the establishment of Drew University in the mid-70s, the name change was made to recognize the existence of the College of Medicine at Drew University and its affiliated hospital. The medical school and hospital are known as the King/Drew Medical Complex. Referenced are the issues and challenges faced by the institution that have resulted in the current crisis. Restoration and rehabilitation of the academic medical center can be achieved by identifying the uncommon common goals of stakeholders in a collaborative and integrated process.

AL-Amyloidosis Presenting with Negative Congo Red Staining in the Setting of High Clinical Suspicion: A Case Report

DTIC Science & Technology

2012-01-01

1Department of Internal Medicine, William Beaumont Army Medical Center, 5005 N Piedras Street, Building 7777, 9th floor East, El Paso, TX 79920, USA...2Department of Nephrology, William Beaumont Army Medical Center, 5005 N Piedras Street, Building 7777, 12th floor, El Paso, TX 79920, USA 3Propath...NUMBER 7. PERFORMING ORGANIZATION NAME(S) AND ADDRESS(ES) William Beaumont Army Medical Center,Department of Nephrology,5005 N Piedras Street,Building

How to develop a low cost, in-house distance learning center for continuing medical education. Part II.

PubMed

Lanza, Vincenzo

2002-12-01

The first part of this paper discussed the advantages and communication tools needed to create a Distance Learning Center for continuing medical education by using an Intranet or the Internet. This part continues with an explanation of the hardware, software (largely free) and human resources needed for videoconferencing as well as the costs. Suitable even for small hospitals Distance Learning Centers can be of higher quality than traditional methods of continuing medical education.

Cardiac transplantation. Organ procurement to patient discharge.

PubMed

Rudolphi, D M; Nagy, K M; Verne, D J

1987-01-01

The care of the cardiac transplant patient is complex, yet rewarding. During the hospital stay, the patients, families, and nurses develop close-knit relationships that last after discharge. The cardiac transplant patients at Hershey Medical Center have formed a support group. To promote organ donation, they wear T-shirts, hats, and coats with the logo, "I got my heart at HMC," (Hershey Medical Center). This not only increases awareness of the need for organ donation, but also gives Hershey Medical Center recognition for its cardiac transplantation program.

Clinical case management and navigation for colonoscopy screening in an academic medical center.

PubMed

Cavanagh, Mary F; Lane, Dorothy S; Messina, Catherine R; Anderson, Joseph C

2013-08-01

One of 5 nationally funded Centers for Disease Control and Prevention Colorectal Cancer (CRC) Screening Demonstration Programs, Project SCOPE, was conducted at an academic medical center and provided colonoscopy screening at no cost to underserved minority patients from local community health centers. Established barriers to CRC screening (eg, financial, language, transportation) among the target population were addressed through clinical coordination of care by key project staff. The use of a clinician with a patient navigator allowed for the performance of precolonoscopy "telephone visits" instead of office visits to the gastroenterologist in virtually all patients. The clinician elicited information relevant to making screening decisions (eg, past medical and surgical history, focused review of systems, medication/supplement use, CRC screening history). The patient navigator reduced barriers, including, but not limited to, scheduling, transportation, and physical navigation of the medical center on the day of colonoscopy. Preprogram preparation was vital in laying groundwork for the project, yet enhancements to the program were ongoing throughout the screening period. Detailed referral forms from primary care physicians, coupled with information obtained during telephone interviews, facilitated high colonoscopy completion rates and excellent patient satisfaction. Similarly valuable was the employment of a bilingual patient navigator, who provided practical and emotional patient support. Academic medical centers can be efficient models for providing CRC screening to disadvantaged populations. Coordination of care by a preventive medicine department, directing the recruitment, scheduling, prescreening education, and the evaluation and preparation of target populations had an overall positive effect on CRC screening with colonoscopy among patients from a community health center. © 2013 American Cancer Society.

[HIGH VELOCITY PENETRATING HEAD AND NECK INJURIES OF SYRIAN CIVIL WAR CASUALTIES TREATED IN THE GALILEE MEDICAL CENTER].

PubMed

Ronen, Ohad; Assadi, Nidal; Sela, Eyal

2017-05-01

For two years the State of Israel has been treating casualties from the Syrian civil war. The Galilee Medical Center in Nahariya is the main hospital for this humanitarian mission. Objectives: To evaluate the demographic and clinical characteristics of the casualties that were treated in our department. Information from medical records of all Syrian casualties evacuated to the Galilee Medical Center were evaluated. Between March 2013 and December 2014, 450 casualties were evacuated to the Galilee Medical Center. Of those, 45 were treated in the Department of Otolaryngology - Head and Neck Surgery. Of the 45 cases, 43 were male (95.5%) and the mean age was 30.4 years (range 1-79 years). There was a significant difference in terms of gender (p <0.0001). The majority of cases (42.1%) were aged 21-27 years. The most common cause of injury was a gunshot wound. Thirty five patients (77.7%) suffered from multiple trauma, and complex injuries of the maxillofacial bones and upper respiratory tract. Eight (18%) of the cases arrived at the medical center with a tracheotomy. The average length of hospital stay was 15 days (range: 1-141). Of the 450 cases, 97.3% were discharged back to Syria, and 12 died. Of all Syrian injured treated in the ENT department, the vast majority were young men. The main cause of injury was gunshot wounds. It is likely that the lack of protective gear that exist in western armies is a factor in the complex injuries treated at the Galilee Medical Center.

A midwifery-led in-hospital birth center within an academic medical center: successes and challenges.

PubMed

Perdion, Karen; Lesser, Rebecca; Hirsch, Jennifer; Barger, Mary; Kelly, Thomas F; Moore, Thomas R; Lacoursiere, D Yvette

2013-01-01

The University of California San Diego Community Women's Health Program (CWHP) has emerged as a successful and sustainable coexistence model of women's healthcare. The cornerstone of this midwifery practice is California's only in-hospital birth center. Located within the medical center, this unique and physically separate birth center has been the site for more than 4000 births. With 10% cesarean delivery and 98% breast-feeding rates, it is an exceptional example of low-intervention care. Integrating this previously freestanding birth center into an academic center has brought trials of mistrust and ineffectual communication. Education, consistent leadership, and development of multidisciplinary guidelines aided in overcoming these challenges. This collaborative model provides a structure in which residents learn to be respectful consultants and appreciate differences in medical practice. The CWHP and its Birth Center illustrates that through persistence and flexibility a collaborative model of maternity services can flourish and not only positively influence new families but also future generations of providers.

Breast Reference Set Application: Chris Li-FHCRC (2015) — EDRN Public Portal

Cancer.gov

We propose to evaluate nine candidate biomarkers for ER+ breast cancer in samples from the EDRN Breast Cancer Reference Set. These biomarkers have been preliminarily validated in preclinical samples. The intended clinical applications of these markers are to: 1. Inform timing of a subsequent mammogram in women with a negative screening mammogram; 2. Inform continuation of mammographic screening among women 75-79 years; 3. Prioritize women who should be screened with mammography in areas with limited resources. Testing the reference samples would further expedite addressing these intended clinical applications by providing further validation data to support requests for samples from other sources for further Phase 3 evaluation (e.g., WHI, PLCO, and samples collected at the time of mammographic screening from the University of Toronto and UCSF).

Stories from Haiti: a comparison of three approaches.

PubMed

Baumann, Steven L; Bellefleur, Carmelle

2014-04-01

Two stories from Haiti are considered from three different perspectives. The first story is about a boy named Joseph Alvyns, whose mother died from cholera in 2011. His story is told in a short film titled Baseball in the time of Cholera. The second story is about Mme. Yolande Marie Nazaire, who was the Director of the Haiti National School of Nursing in Port-au-Prince on the morning of January 12, 2010, when an earthquake killed 90 students and faculty. The three perspectives discussed here are: (a) Critical Reflective in health professional education as used by the University of California at San Francisco (UCSF) School of Medicine; (b) The Capacities of Stories, which is part of a socio-narratology methodology; and(c) Story Theory with implications for global health nursing.

Mental health issues among college students: who gets referred for psychopharmacology evaluation?

PubMed

Kirsch, Daniel J; Doerfler, Leonard A; Truong, Debbie

2015-01-01

To describe diagnostic and psychotropic medication prescription characteristics among college students referred by college counseling centers for psychopharmacologic evaluation. Participants were 540 college students referred by 6 college counseling centers in Massachusetts between November 2005 and May 2011. Students completed self-report measures of depression, anxiety, suicidal ideation and attempts, and substance use. Information regarding DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th edition) diagnosis, previous history of medication prescription, and current psychotropic medication(s) prescribed by the consulting psychiatrist was obtained from medical records. Depression, anxiety, and attention-deficit/hyperactivity disorder (ADHD) were the most common psychiatric problems identified in students. Half of these students had been prescribed mediation prior to evaluation. Antidepressant medication was the most frequently prescribed medication. A large proportion of students reported previous thoughts of suicide, and 12% had made at least 1 suicide attempt. Depression, anxiety, and ADHD are common among students referred by college counseling centers for medication evaluation and treatment.

Roles of Medical Record and Statistic Staff on Research at the Tawanchai Center.

PubMed

Pattaranit, Rumpan; Chantachum, Vasana; Lekboonyasin, Orathai; Pradubwong, Suteera

2015-08-01

The medical record and statistic staffs play a crucial role behind the achievements of treatment and research of physicians, nurses and other health care professionals. The medical record and statistic staff are in charge of keeping patient medical records; creating databases; presenting information; sorting patient's information; providing patient medical records and related information for various medical teams and researchers; Besides, the medical record and statistic staff have collaboration with the Center of Cleft Lip-Palate, Khon Kaen University in association with the Tawanchai Project. The Tawanchai Center is an organization, involving multidisciplinary team which aims to continuing provide care for patients with cleft lip and palate and craniofacial deformities who need a long term of treatment since newborns until the age of 19 years. With support and encouragement from the Tawanchai team, the medical record and statistic staff have involved in research under the Tawanchai Centre since then and produced a number of publications locally and internationally.

Public Use of Mobile Medical Applications: A Case Study on Cloud-Based Medical Service of Taiwan.

PubMed

Lu, Chen-Luan; Yan, Yu-Hua

2016-01-01

The use of smart mobile devices has been getting increasingly popular. The focus of this study is an attempt to explore the development of mobile medical App by medical centers and regional hospitals of Taiwan and the function of the App for comparison. The results show indicated that many hospitals developed Apps for the public for mobile medical service, of which 26 medical centers (100%) and 72 regional hospitals (84.7%) availed appointment making service via Apps. The result indicated variance at significant level (p < 0.01). There are 23 medical centers (88.5%) and 74 regional hospitals (87.1%) availed Apps for checking service progress. The result indicated insignificant variance level (p > 0.01). We can see that mobile medical service is gradually emerging as a vital issue. Yet, this is a new domain in medical service. With the mushrooming of medical applications in smart mobile devices, the medical service system is expected to be installed in these devices to enhance interactive mode of operation and inquiry services, such as medication and inquiries into physical examination results. By then, people can learn the status of their health with this system.

Integrated care management: aligning medical call centers and nurse triage services.

PubMed

Kastens, J M

1998-01-01

Successful integrated delivery systems must aggressively design new approaches to managing patient care. Implementing a comprehensive care management model to coordinate patient care across the continuum is essential to improving patient care and reducing costs. The practice of telephone nursing and the need for experienced registered nurses to staff medical call centers, nurse triage centers, and outbound telemanagement is expanding as the penetration of full-risk capitated managed care contracts are signed. As health systems design their new care delivery approaches and care management models, medical call centers will be an integral approach to managing demand for services, chronic illnesses, and prevention strategies.

School-Based Health Centers and the Patient-Centered Medical Home. Position Statement

ERIC Educational Resources Information Center

National Assembly on School-Based Health Care, 2010

2010-01-01

The patient-centered medical home (PCMH) is an innovative care delivery model designed to provide comprehensive primary care services to people of all ages by fostering partnerships between patients, families, health care providers and the community. National Assembly on School-Based Health Care (NASBHC) recommends practices and policies that…

78 FR 52605 - Announcing the Twenty First Public Meeting of the Crash Injury Research and Engineering Network...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-23

... First Public Meeting of the Crash Injury Research and Engineering Network (CIREN) AGENCY: National... announces the Twenty First Public Meeting of members of the Crash Injury Research and Engineering Network... of centers, medical and engineering. Medical centers are based at Level I Trauma Centers that admit...

76 FR 46359 - Announcing the Nineteenth Public Meeting of the Crash Injury Research and Engineering Network...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-02

... Nineteenth Public Meeting of the Crash Injury Research and Engineering Network (CIREN) AGENCY: National... announces the Nineteenth Public Meeting of members of the Crash Injury Research and Engineering Network... of centers, medical and engineering. Medical centers are based at Level I Trauma Centers that admit...

77 FR 46154 - Announcing the Twentieth Public Meeting of the Crash Injury Research and Engineering Network (CIREN)

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-02

... Twentieth Public Meeting of the Crash Injury Research and Engineering Network (CIREN) AGENCY: National... announces the Twentieth Public Meeting of members of the Crash Injury Research and Engineering Network... of centers, medical and engineering. Medical centers are based at Level I Trauma Centers that admit...

Press releases by academic medical centers: not so academic?

PubMed

Woloshin, Steven; Schwartz, Lisa M; Casella, Samuel L; Kennedy, Abigail T; Larson, Robin J

2009-05-05

The news media are often criticized for exaggerated coverage of weak science. Press releases, a source of information for many journalists, might be a source of those exaggerations. To characterize research press releases from academic medical centers. Content analysis. Press releases from 10 medical centers at each extreme of U.S. News & World Report's rankings for medical research. Press release quality. Academic medical centers issued a mean of 49 press releases annually. Among 200 randomly selected releases analyzed in detail, 87 (44%) promoted animal or laboratory research, of which 64 (74%) explicitly claimed relevance to human health. Among 95 releases about primary human research, 22 (23%) omitted study size and 32 (34%) failed to quantify results. Among all 113 releases about human research, few (17%) promoted studies with the strongest designs (randomized trials or meta-analyses). Forty percent reported on the most limited human studies--those with uncontrolled interventions, small samples (<30 participants), surrogate primary outcomes, or unpublished data--yet 58% lacked the relevant cautions. The effects of press release quality on media coverage were not directly assessed. Press releases from academic medical centers often promote research that has uncertain relevance to human health and do not provide key facts or acknowledge important limitations. National Cancer Institute.

Can Japanese students embrace learner-centered methods for teaching medical interviewing skills? Focus groups.

PubMed

Saiki, Takuya; Mukohara, Kei; Otani, Takashi; Ban, Nobutaro

2011-01-01

Students' perceptions of learner-centered methods for teaching medical interviewing skills have not been fully explored. To explore Japanese students' perceptions of learner-centered methods for teaching medical interviewing skills such as role play with student-created scenarios, peer-assisted video reviews, and student-led small group debriefing. We conducted three focus groups with a total of 15 students who participated in the learner-centered seminars on medical interviewing skills at the Nagoya University School of Medicine. The transcripts were analyzed by two authors independently. Keywords and concepts were identified and a thematic framework was developed. Overall, students valued the experience of writing their own scenarios for role play, but some questioned their realism. Many students commented that peer-assisted video reviews provided them with more objective perspectives on their performance. However, some students expressed concerns about competitiveness during the video reviews. While students appreciated teachers' minimum involvement in the group debriefing, some criticized that teachers did not explain the objectives of the seminar clearly. Many students had difficulties in exchanging constructive feedback. We were able to gain new insights into positive and negative perceptions of students about learner-centered methods for teaching medical interviewing skills at one medical school in Japan.

76 FR 60059 - National Institute of General Medical Sciences; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-09-28

... General Medical Sciences; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Sciences Special Emphasis Panel, Research Centers in Wound Healing. Date: October 19, 2011. Time: 12 p.m... General Medical Sciences, National Institutes of Health, 45 Center Drive, Room 3AN18, Bethesda, MD 20892...

The Volume and Mix of Inpatient Services Provided by Academic Medical Centers.

ERIC Educational Resources Information Center

Moy, Ernest; And Others

1996-01-01

A study examined trends in the volume and type of inpatient clinical diagnoses, common medical services, and specialized services in academic medical centers (AMCs)--integrated and independent, other teaching hospitals, and nonteaching hospitals. Results indicate that despite rapid change in the health care environment, little change has occurred…

PROJECT HEAD START MEDICAL--A GUIDE FOR DIRECTION OF CHILD DEVELOPMENT CENTERS.

ERIC Educational Resources Information Center

Office of Economic Opportunity, Washington, DC.

HEALTH SERVICES OF PROJECT HEAD START CHILD DEVELOPMENT CENTERS PROVIDE--A MEDICAL EVALUATION OF EACH CHILD INCLUDING MEDICAL HISTORY, DEVELOPMENTAL ASSESSMENT, AND PHYSICAL EXAMINATION, SCREENING TESTS FOR VISION, HEARING, SPEECH, AND TUBERCULOSIS, LABORATORY TESTS OF URINE FOR ALBUMIN AND TESTS OF SUGAR AND BLOOD FOR ANEMIA, DENTAL ASSESSMENT,…

75 FR 61861 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2010-10-06

... and other research facilities approved by the Chief Medical Director to obtain data from those... research purposes determined to be necessary and proper by the Chief Medical Director. 5. The name(s) of a...) regional offices, VA Medical Centers, the VA Records Management Center, St. Louis, Missouri, and at the...

Repurposing With Purpose: Creating a Collaborative Learning Space to Support Institutional Interprofessional Initiatives.

PubMed

Young, Lauren M; Machado, Connie K; Clark, Susan B

2015-01-01

When the University of Mississippi Medical Center embraced a didactic shift to patient-centered, interprofessional education of its medical, dental, nursing, pharmacy, and allied health students, the Rowland Medical Library repurposed space to support the cause and created a collaborative learning space designated for campus-wide utility.

Medical Training Aid

NASA Technical Reports Server (NTRS)

1992-01-01

Dr. Steven S. Saliterman developed his Dynacath Critical Care Patient Simulator as a training system for medical personnel involved in critical care management and hemodynamic monitoring. The system incorporates NASA simulation technology and allows hospitals and medical manufacturers to conduct training away from the patient's bedside. Dr. Saliterman was formerly employed by Ames Research Center and Johnson Space Center.

42 CFR 411.355 - General exceptions to the referral prohibition related to both ownership/investment and...

Code of Federal Regulations, 2013 CFR

2013-10-01

... medical center means an affiliated medical school, faculty practice plan, hospital, teaching facility... whose primary purpose is supporting the teaching mission of the academic medical center.) The components... § 411.355(e)(3)); and (D) Provides either substantial academic services or substantial clinical teaching...

42 CFR 411.355 - General exceptions to the referral prohibition related to both ownership/investment and...

Code of Federal Regulations, 2010 CFR

2010-10-01

... medical center means an affiliated medical school, faculty practice plan, hospital, teaching facility... whose primary purpose is supporting the teaching mission of the academic medical center.) The components... § 411.355(e)(3)); and (D) Provides either substantial academic services or substantial clinical teaching...

42 CFR 411.355 - General exceptions to the referral prohibition related to both ownership/investment and...

Code of Federal Regulations, 2011 CFR

2011-10-01

... medical center means an affiliated medical school, faculty practice plan, hospital, teaching facility... whose primary purpose is supporting the teaching mission of the academic medical center.) The components... § 411.355(e)(3)); and (D) Provides either substantial academic services or substantial clinical teaching...

42 CFR 411.355 - General exceptions to the referral prohibition related to both ownership/investment and...

Code of Federal Regulations, 2014 CFR

2014-10-01

... medical center means an affiliated medical school, faculty practice plan, hospital, teaching facility... whose primary purpose is supporting the teaching mission of the academic medical center.) The components... § 411.355(e)(3)); and (D) Provides either substantial academic services or substantial clinical teaching...

42 CFR 411.355 - General exceptions to the referral prohibition related to both ownership/investment and...

Code of Federal Regulations, 2012 CFR

2012-10-01

... medical center means an affiliated medical school, faculty practice plan, hospital, teaching facility... whose primary purpose is supporting the teaching mission of the academic medical center.) The components... § 411.355(e)(3)); and (D) Provides either substantial academic services or substantial clinical teaching...

Medication Adherence among Adolescents in a School-Based Health Center

ERIC Educational Resources Information Center

Mears, Cynthia J.; Charlebois, Nicole M.; Holl, Jane L.

2006-01-01

School-based health centers are an integral part of the health care delivery system for low-income children. Medication adherence for these patients may be challenging because the student is often responsible for bringing home the prescription and receiving the instructions. This study assesses medication fill, initiation, and adherence rates…

Rebuilding the Trust: Independent Review Group Report on Rehabilitative Care and Administrative Processes at Walter Reed Army Medical Center and National Naval Medical Center

DTIC Science & Technology

2007-04-11

conditions and administrative hurdles and failed to place proper priority on solutions. • A smooth integration is lacking for transition into a joint Walter...accounts the evolution of rapid joint battlefield medical response, rapid evacuation with intensive care, quality air transportation, and unsurpassed...and increased survival is the result of more efficient joint medical response on the battlefield and medical tactics, techniques and procedures that

U.S. Army Medical Department Journal, April-June 2008

DTIC Science & Technology

2008-06-01

IGR), against dengue vector mosquitoes. In the Peruvian Amazon community at Iquitos, Stancil42 (Naval Medical Research Center Detachment, Peru ...Research Unit- Kenya, Nairobi; Naval Medical Research Center Detachment, Lima, Peru ; Naval Medical Research Unit-2, Jakarta, Indonesia; and the Naval...These projects have revealed that sand flies often emerge from the soil beneath tents and camps. In an effort to prevent sand flies breeding in rodent

Using Technology, Clinical Workflow Redesign, and Team Solutions to Achieve the Patient Centered Medical Home

DTIC Science & Technology

2011-01-01

The Quadruple Aim: Working Together, Achieving Success 2011 Military Health System Conference TMA and Services Using Technology, Clinical Workflow...Redesign, and Team Solutions to Achieve the Patient Centered Medical Home LTC Nicole Kerkenbush, MHA, MN Army Medical Department, Office of the...Surgeon General Chief Medical Information Officer 1 Military Health System Conference Report Documentation Page Form ApprovedOMB No. 0704-0188 Public

[The development of organization of medical social care of adolescents].

PubMed

Chicherin, L P; Nagaev, R Ia

2014-01-01

The model of the subject of the Russian Federation is used to consider means of development of health protection and health promotion in adolescents including implementation of the National strategy of activities in interest of children for 2012-2017 approved by decree No761 of the President of Russia in June 1 2012. The analysis is carried out concerning organization of medical social care to this group of population in medical institutions and organizations of different type in the Republic of Bashkortostan. Nowadays, in 29 territories medical social departments and rooms, 5 specialized health centers for children, 6 clinics friendly to youth are organized. The analysis of manpower support demonstrates that in spite of increasing of number of rooms and departments of medical social care for children and adolescents decreasing of staff jobs both of medical personnel and psychologists and social workers occurs. The differences in priorities of functioning of departments and rooms of medical social care under children polyclinics, health centers for children and clinics friendly to youth are established. The questionnaire survey of pediatricians and adolescents concerning perspectives of development of adolescent service established significant need in development of specialized complex center. At the basis of such center problems of medical, pedagogical, social, psychological, legal profile related to specific characteristics of development and medical social needs of adolescents can be resolved. The article demonstrates organizational form of unification on the functional basis of the department of medical social care of children polyclinic and clinic friendly to youth. During three years, number of visits of adolescents to specialists of the center increases and this testifies awareness of adolescents and youth about activities of department of medical social care. The most percentage of visits of adolescents to specialists was made with prevention purpose. Among physicians about 93% approved the given model of development of medical social service for adolescents.

What do clinicians want? Interest in integrative health services at a North Carolina academic medical center

PubMed Central

Kemper, Kathi J; Dirkse, Deborah; Eadie, Dee; Pennington, Melissa

2007-01-01

Background Use of complementary medicine is common, consumer driven and usually outpatient focused. We wished to determine interest among the medical staff at a North Carolina academic medical center in integrating diverse therapies and services into comprehensive care. Methods We conducted a cross sectional on-line survey of physicians, nurse practitioners and physician assistants at a tertiary care medical center in 2006. The survey contained questions on referrals and recommendations in the past year and interest in therapies or services if they were to be provided at the medical center in the future. Results Responses were received from 173 clinicians in 26 different departments, programs and centers. There was strong interest in offering several specific therapies: therapeutic exercise (77%), expert consultation about herbs and dietary supplements (69%), and massage (66%); there was even stronger interest in offering comprehensive treatment programs such as multidisciplinary pain management (84%), comprehensive nutritional assessment and advice (84%), obesity/healthy lifestyle promotion (80%), fit for life (exercise and lifestyle program, 76%), diabetes healthy lifestyle promotion (73%); and comprehensive psychological services for stress management, including hypnosis and biofeedback (73%). Conclusion There is strong interest among medical staff at an academic health center in comprehensive, integrated services for pain, obesity, and diabetes and in specific services in fitness, nutrition and stress management. Future studies will need to assess the cost-effectiveness of such services, as well as their financial sustainability and impact on patient satisfaction, health and quality of life. PMID:17291340

Tufts academic health information network: concept and scenario.

PubMed

Stearns, N S

1986-04-01

Tufts University School of Medicine's new health sciences education building, the Arthur M. Sackler Center for Health Communications, will house a modern medical library and computer center, classrooms, auditoria, and media facilities. The building will also serve as the center for an information and communication network linking the medical school and adjacent New England Medical Center, Tufts' primary teaching hospital, with Tufts Associated Teaching Hospitals throughout New England. Ultimately, the Tufts network will join other gateway networks, information resource facilities, health care institutions, and medical schools throughout the world. The center and the network are intended to facilitate and improve the education of health professionals, the delivery of health care to patients, the conduct of research, and the implementation of administrative management approaches that should provide more efficient utilization of resources and save dollars. A model and scenario show how health care delivery and health care education are integrated through better use of information transfer technologies by health information specialists, practitioners, and educators.

Tufts academic health information network: concept and scenario.

PubMed Central

Stearns, N S

1986-01-01

Tufts University School of Medicine's new health sciences education building, the Arthur M. Sackler Center for Health Communications, will house a modern medical library and computer center, classrooms, auditoria, and media facilities. The building will also serve as the center for an information and communication network linking the medical school and adjacent New England Medical Center, Tufts' primary teaching hospital, with Tufts Associated Teaching Hospitals throughout New England. Ultimately, the Tufts network will join other gateway networks, information resource facilities, health care institutions, and medical schools throughout the world. The center and the network are intended to facilitate and improve the education of health professionals, the delivery of health care to patients, the conduct of research, and the implementation of administrative management approaches that should provide more efficient utilization of resources and save dollars. A model and scenario show how health care delivery and health care education are integrated through better use of information transfer technologies by health information specialists, practitioners, and educators. PMID:3708191

Medical student and medical school teaching faculty perceptions of conflict of interest.

PubMed

Andresen, Nicholas S; Olson, Tyler S; Krasowski, Matthew D

2017-07-11

Attitudes towards conflict of interest (COI) and COI policy are shaped during medical school and influence both the education of medical students and their future medical practice. Understanding the current attitudes of medical students and medical school teaching faculty may provide insight into what is taught about COI and COI policy within the 'hidden' medical curriculum. Differences between medical student and medical school teaching faculty perceptions of COI and COI policy have not been compared in detail. The authors surveyed first year medical students and medical school teaching faculty at one academic medical center. The response rate was 98.7% (150/152) for students and 34.2% (69/202) for faculty. Students were less likely than faculty to agree that lecturers should disclose COI to any learners (4.06 vs. 4.31, p = 0.01), but more likely to agree that COI disclosure decreases the presentation of biased material (3.80 vs. 3.21, p < 0.001). Student and faculty responses for all other questions were not different. Many of these responses suggest student and faculty support for stronger COI policy at academic medical centers. Students and faculty perceptions regarding COI and COI policy are largely similar, but differ in terms of the perceived effectiveness of COI disclosure. This study also suggests that medical students and medical school teaching faculty support for stronger COI policy at academic medical centers.

Laughing through this pain: medical clowning during examination of sexually abused children: an innovative approach.

PubMed

Tener, Dafna; Lev-Wiesel, Rachel; Franco, Nessia Lang; Ofir, Shoshi

2010-03-01

This study examined the role of medical clowns during medical examinations of children who were sexually abused. Three case studies are described, illustrating diverse interactions among the victimized child, the medical clown, and the medical forensical examiner during medical forensic examinations held at the Tene Center for Sexually Abused Children, Poria-Pade Medical Center, Israel. The results indicated that medical clowns play a unique role both in lowering anxiety and fear among children before and during the unpleasant forensic examination as well as in mitigating potential retraumatization of the sexual abuse event resulting from the medical examination. The medical clown was found to assist in creating a pleasant and calm atmosphere, thus improving the child's cooperation during the examination.

Interdisciplinary collaboration: what private practice can learn from the health center experience.

PubMed

Hilton, Irene V

2014-01-01

Ideas on what medical-dental integration can look like on a practical level can be gained from studying efforts made in Federally Qualified Health Centers (Health Centers). Over the last 15 years, Health Centers have embarked on several initiatives that incorporated the development of infrastructure for medical-dental integration. This paper reviews these efforts and highlights successes, challenges and best practices that can bolster efforts in all dental practice settings.

76 FR 51403 - Lyle E. Craker, PhD; Order Regarding Officially Noticed Evidence and Motion for Reconsideration

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-18

... studies of marijuana, which were sponsored by the California Center for Medical Cannabis Research (CMCR...), every one of the 17 CMCR [California Center for Medical Cannabis Research]-sponsored pre- clinical or.... Id. (The program is also referred to as the ``Center for Medicinal Cannabis Research'' (CMCR). Tr...

The Vital Role of Patient Feedback in the Critical Assessment of a Patient-Centered Care Objective Structured Clinical Examination

ERIC Educational Resources Information Center

Rentfro, Allison Carothers

2011-01-01

Priorities in medical education have increasingly emphasized teaching skills and fostering attitudes related to patient-centered care (Beckman & Frankel, 2003; Haidet & Paterniti, 2003). The challenge for academic medical centers is to implement these competencies into their curriculum and assess the outcomes. Using a qualitative single…

Network of fully integrated multispecialty hospital imaging systems

NASA Astrophysics Data System (ADS)

Dayhoff, Ruth E.; Kuzmak, Peter M.

1994-05-01

The Department of Veterans Affairs (VA) DHCP Imaging System records clinically significant diagnostic images selected by medical specialists in a variety of departments, including radiology, cardiology, gastroenterology, pathology, dermatology, hematology, surgery, podiatry, dental clinic, and emergency room. These images are displayed on workstations located throughout a medical center. All images are managed by the VA's hospital information system, allowing integrated displays of text and image data across medical specialties. Clinicians can view screens of `thumbnail' images for all studies or procedures performed on a selected patient. Two VA medical centers currently have DHCP Imaging Systems installed, and others are planned. All VA medical centers and other VA facilities are connected by a wide area packet-switched network. The VA's electronic mail software has been modified to allow inclusion of binary data such as images in addition to the traditional text data. Testing of this multimedia electronic mail system is underway for medical teleconsultation.

76 FR 10911 - National Institute of General Medical Sciences; Notice of Closed Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-28

... General Medical Sciences; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... Sciences Special Emphasis Panel; Research Centers in Wound Healing. Date: March 22, 2011. Time: 1 p.m. to 4... General Medical Sciences, National Institutes of Health, 45 Center Drive, Room 3AN18, Bethesda, MD 20892...

Quality of Care Assessment: The Role of Faculty at Academic Medical Centers.

ERIC Educational Resources Information Center

Brook, Robert H.

Currently, there is not a single university medical center in which an acceptable routine system to assure quality of care has been established. This may result from reliance on the structure of the medical education process as a proxy measure to assure that physicians perform appropriately in their role. Several studies have been conducted to…

Defense.gov Special Report: Travels With Panetta - February 2012

Science.gov Websites

medical professionals here today. Story U.S. Defense Secretary Outlines 'State of DOD' to Troops U.S conference to visit with U.S. troops at Ramstein Air Base and Landstuhl Regional Medical Center in Germany E. Panetta's troop visit at Landstuhl Regional Medical Center, Germany Town Hall Meeting with U.S

Buffalo's Center for Immunology: A New Answer to an Old Dilemma

ERIC Educational Resources Information Center

Rose, Noel R.; Bogazzi, Pierluigi E.

1972-01-01

The Center for Immunology at the University of Buffalo provides a viable resource for educating medical students in immunology until a department of immunology can be developed within the medical school. (HS)

NPDES Permit Walter Reed Army Medical Center

EPA Pesticide Factsheets

Under National Pollutant Discharge Elimination System permit number DC0000361, the Department of the Army is authorized to discharge from a facility located at Walter Reed Army Medical Center into receiving waters named Rock Creek.

76 FR 13192 - Mark E. Van Wormer: Debarment Order

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-10

...: The Food and Drug Administration (FDA) is issuing an order under the Federal Food, Drug, and Cosmetic... Medical Center, also known as the Union County Medical, Diagnostic Imaging and Laser Surgery Center, PC...

Application and preventive maintenance of neurology medical equipment in isfahan alzahra hospital.

PubMed

Alikhani, Parivash; Vesal, Sahar; Kashefi, Parviz; Pour, Ramin Etamadi; Khorvash, Fariborz; Askari, Gholamreza; Meamar, Rokhsareh

2013-05-01

Nowadays Medical equipment plays an important role in the treatment and in the medical education. Using outdated preventive maintenance (PM) system may cause problems in the cutting edge medical equipment, Nervous system disease's equipment (In diagnosis and treatment) which are crucial for every medical center. Based on above facts we focused on nervous system treat units' equipment and informed the supervisors and their colleagues about the latest equipment maintenance status and promoted methodical and correct method to be used for medical equipment maintenance. This research is an analytical descriptive and has been done on the base information from a particular time to past. We gathered our required information of 2009 from Alzahra Medical Center. We divided this research info 2 main phases. In the first phase, we picked out Neurosurgery and Neourology diseases medical equipment (diagnosis and therapy equipment) and in the second phase, we need to implement a methodical PM for every equipment. Research has shown that there are 19nervous system equipment in Alzahra Medical center, categorized in diagnostic (13 pcs), therapeutic (4 pcs) and diagnostic-therapeutic (2 pcs). As we declare in methods part of this research, we categorized medical equipment in Food and Drug Administration (FDA) segmentation. Capital-scarce equipment: Magnetic resonance imaging, Eco Doppler, Kamalaarak ultrasonic surgical aspirator, Stereotactic, computed tomography-scan, euroendoscope/vital-scarce equipment: Coblation, Sonoco, vaterjet/scarce equipment: Transcranial color Doppler, electroencephalogram, electromyography, surgical microscope. Survey of application and preventive maintenance of neurology medical equipment in Isfahan Alzahra hospital show there is no P.M system. Implementing a complete P.M system for this medical center is crucial to preventing cause problems for these medical equipment and decreasing maintenance costs and gaining uptime. Researchers of this article have tried to provide PM, use of texts, web and experts.

Surgeon leadership in the coding, billing, and contractual negotiations for fenestrated endovascular aortic aneurysm repair increases medical center contribution margin and physician reimbursement.

PubMed

Aiello, Francesco; Durgin, Jonathan; Daniel, Vijaya; Messina, Louis; Doucet, Danielle; Simons, Jessica; Jenkins, James; Schanzer, Andres

2017-10-01

Fenestrated endovascular aneurysm repair (FEVAR) allows endovascular treatment of thoracoabdominal and juxtarenal aneurysms previously outside the indications of use for standard devices. However, because of considerable device costs and increased procedure time, FEVAR is thought to result in financial losses for medical centers and physicians. We hypothesized that surgeon leadership in the coding, billing, and contractual negotiations for FEVAR procedures will increase medical center contribution margin (CM) and physician reimbursement. At the UMass Memorial Center for Complex Aortic Disease, a vascular surgeon with experience in medical finances is supported to manage the billing and coding of FEVAR procedures for medical center and physician reimbursement. A comprehensive financial analysis was performed for all FEVAR procedures (2011-2015), independent of insurance status, patient presentation, or type of device used. Medical center CM (actual reimbursement minus direct costs) was determined for each index FEVAR procedure and for all related subsequent procedures, inpatient or outpatient, 3 months before and 1 year subsequent to the index FEVAR procedure. Medical center CM for outpatient clinic visits, radiology examinations, vascular laboratory studies, and cardiology and pulmonary evaluations related to FEVAR were also determined. Surgeon reimbursement for index FEVAR procedure, related adjunct procedures, and assistant surgeon reimbursement were also calculated. All financial analyses were performed and adjudicated by the UMass Department of Finance. The index hospitalization for 63 FEVAR procedures incurred $2,776,726 of direct costs and generated $3,027,887 in reimbursement, resulting in a positive CM of $251,160. Subsequent related hospital procedures (n = 26) generated a CM of $144,473. Outpatient clinic visits, radiologic examinations, and vascular laboratory studies generated an additional CM of $96,888. Direct cost analysis revealed that grafts accounted for the largest proportion of costs (55%), followed by supplies (12%), bed (12%), and operating room (10%). Total medical center CM for all FEVAR services was $492,521. Average surgeon reimbursements per FEVAR from 2011 to 2015 increased from $1601 to $2480 while the surgeon payment denial rate declined from 50% to 0%. Surgeon-led negotiations with the Centers for Medicare & Medicaid Services during 2015 resulted in a 27% increase in physician reimbursement for the remainder of 2015 ($2480 vs $3068/case) and a 91% increase in reimbursement from 2011 ($1601 vs $3068). Assistant surgeon reimbursement also increased ($266 vs $764). Concomitant FEVAR-related procedures generated an additional $27,347 in surgeon reimbursement. Physician leadership in the coding, billing, and contractual negotiations for FEVAR results in a positive medical center CM and increased physician reimbursement. Copyright © 2017 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

St. Mary cooks up awareness with heart-healthy booklet, television.

PubMed

Botvin, Judith D

2003-01-01

St. Mary Medical Center, Langhorne, Pa., distributed a half-million copies of its copyrighted booklet, "Heart Healthy Living" as the first of a larger, long-term marketing initiative to raise awareness of the suburban medical center. In addition to the medical center and physicians' offices, St. Mary had the booklet distributed by regional food markets and Fleet Bank. These partnerships and those with food products manufacturers helped reduce expenses. St. Mary physicians appeared on a cable television cooking show as well as in selected grocery markets.

Abortion misinformation from crisis pregnancy centers in North Carolina.

PubMed

Bryant, Amy G; Levi, Erika E

2012-12-01

This study assessed the accuracy of medical information provided by crisis pregnancy centers in North Carolina. We performed a secondary data analysis of a "secret shopper survey" performed by a nonprofit organization. Reports from phone calls and visits to crisis pregnancy centers were analyzed for quality and content of medical information provided. Web sites of crisis pregnancy centers in the state were also reviewed. Thirty-two crisis pregnancy centers were contacted. Nineteen of these were visited. Fourteen centers (44%) offered that they "provide counseling on abortion and its risks." Inaccurate information provided included a link between abortion and breast cancer (16%), infertility (26%) and mental health problems (26%). Of the 36 Web sites identified, 31 (86%) provided false or misleading information, including 26 sites (72%) linking abortion to "post-abortion stress." Many crisis pregnancy centers give inaccurate medical information regarding the risks of abortion. Overstating risks stigmatizes abortion, seeks to intimidate women and is unethical. Copyright © 2012 Elsevier Inc. All rights reserved.

Physician Payment Methods and the Patient-Centered Medical Home: Comment on "A Troubled Asset Relief Program for the Patient-Centered Medical Home".

PubMed

Quinn, Kevin

This commentary analyzes the patient-centered medical home (PCMH) model within a framework of the 8 basic payment methods in health care. PCMHs are firmly within the fee-for-service tradition. Changes to the process and structure of the Resource Based Relative Value Scale, which underlies almost all physician fee schedules, could make PCMHs more financially viable. Of the alternative payment methods being considered, shared savings models are unlikely to transform medical practice whereas capitation models place unrealistic expectations on providers to accept epidemiological risk. Episode payment may strike a feasible balance for PCMHs, with newly available episode definitions presenting opportunities not previously available.

A novel approach for effective integration of new faculty leadership

PubMed Central

Hastings, Natalie B; Centore, Linda S; Gansky, Stuart A; Finzen, Frederick C; White, Joel M; Wong, Eric; Marshall, Grayson W; Chung, Lisa; Kalenderian, Elsbeth

2017-01-01

Purpose We report on an accelerated and effective way of assimilating a new leader into a team at a large academic dental school department. Methods At University of California, San Francisco (UCSF), a new Chair was recruited through a national search to lead its largest department in the School of Dentistry. Two months after arrival, the new Chair embarked on a process of leadership assimilation among her executive team, facilitated by a professional consultant. Within four weeks, team members participated in one-on-one interviews with the professional facilitator consultant and then completed the leadership assimilation questionnaire and returned it electronically to the facilitator. The facilitator then summarized all answers into themes and met with the team members without the Chair to debrief. Thereafter, the facilitator met with the Chair to discuss the major themes. Next, the Chair met with the team members in a facilitated session to discuss the results and negotiate a path forward. Results Approximately half of the feedback described the “how” of leadership: comments on communication, building relationships, building trust, and understanding UCSF history. The remaining half described the “what”: comments on vision, strategy, and operations. Team members indicated that the first debriefing session was helpful to alleviate initial anxiety and to start building team spirit. The session with the Chair was perceived as open and fruitful in which team members were able to express their concerns and hopes for the Department, while the Chair showed commitment to the team and the communication process. Conclusion Leader assimilation allows teams to share their expectations and anxieties with the new leader early in the relationship in an open way, before new habits and beliefs are formed. Conversely, for the leader, it effectively and efficiently allows a window into the team members’ thinking at a critical time period when otherwise first impressions occur. With a safe space created for open communication, the process allowed siloed individual division leaders to move toward a cohesive group while at the same time solidifying a commitment to the success of the new leader. PMID:29720883

A novel approach for effective integration of new faculty leadership.

PubMed

Hastings, Natalie B; Centore, Linda S; Gansky, Stuart A; Finzen, Frederick C; White, Joel M; Wong, Eric; Marshall, Grayson W; Chung, Lisa; Kalenderian, Elsbeth

2017-01-01

We report on an accelerated and effective way of assimilating a new leader into a team at a large academic dental school department. At University of California, San Francisco (UCSF), a new Chair was recruited through a national search to lead its largest department in the School of Dentistry. Two months after arrival, the new Chair embarked on a process of leadership assimilation among her executive team, facilitated by a professional consultant. Within four weeks, team members participated in one-on-one interviews with the professional facilitator consultant and then completed the leadership assimilation questionnaire and returned it electronically to the facilitator. The facilitator then summarized all answers into themes and met with the team members without the Chair to debrief. Thereafter, the facilitator met with the Chair to discuss the major themes. Next, the Chair met with the team members in a facilitated session to discuss the results and negotiate a path forward. Approximately half of the feedback described the "how" of leadership: comments on communication, building relationships, building trust, and understanding UCSF history. The remaining half described the "what": comments on vision, strategy, and operations. Team members indicated that the first debriefing session was helpful to alleviate initial anxiety and to start building team spirit. The session with the Chair was perceived as open and fruitful in which team members were able to express their concerns and hopes for the Department, while the Chair showed commitment to the team and the communication process. Leader assimilation allows teams to share their expectations and anxieties with the new leader early in the relationship in an open way, before new habits and beliefs are formed. Conversely, for the leader, it effectively and efficiently allows a window into the team members' thinking at a critical time period when otherwise first impressions occur. With a safe space created for open communication, the process allowed siloed individual division leaders to move toward a cohesive group while at the same time solidifying a commitment to the success of the new leader.

Compliance of child care centers in Pennsylvania with national health and safety performance standards for emergency and disaster preparedness.

PubMed

Olympia, Robert P; Brady, Jodi; Kapoor, Shawn; Mahmood, Qasim; Way, Emily; Avner, Jeffrey R

2010-04-01

To determine the preparedness of child care centers in Pennsylvania to respond to emergencies and disasters based on compliance with National Health and Safety Performance Standards for Out-of-Home Child Care Programs. A questionnaire focusing on the presence of a written evacuation plan, the presence of a written plan for urgent medical care, the immediate availability of equipment and supplies, and the training of staff in first aid/cardiopulmonary resuscitation (CPR) as delineated in Caring for Our Children: National Health and Safety Performance Standards for Out-of-Home Child Care Programs, 2nd Edition, was mailed to 1000 randomly selected child care center administrators located in Pennsylvania. Of the 1000 questionnaires sent, 496 questionnaires were available for analysis (54% usable response rate). Approximately 99% (95% confidence interval [CI], 99%-100%) of child care centers surveyed were compliant with recommendations to have a comprehensive written emergency plan (WEP) for urgent medical care and evacuation, and 85% (95% CI, 82%-88%) practice their WEP periodically throughout the year. More than 20% of centers did not have specific written procedures for floods, earthquakes, hurricanes, blizzards, or bomb threats, and approximately half of the centers did not have specific written procedures for urgent medical emergencies such as severe bleeding, unresponsiveness, poisoning, shock/heart or circulation failure, seizures, head injuries, anaphylaxis or allergic reactions, or severe dehydration. A minority of centers reported having medications available to treat an acute asthma attack or anaphylaxis. Also, 77% (95% CI, 73%-80%) of child care centers require first aid training for each one of its staff members, and 33% (95% CI, 29%-37%) require CPR training. Although many of the child care centers we surveyed are in compliance with the recommendations for emergency and disaster preparedness, specific areas for improvement include increasing the frequency of practice of the WEP, establishing specific written procedures for external disasters and urgent medical emergencies, maintaining the immediate availability of potentially life-saving medications, and ensuring that all child care center staff are trained in first aid and CPR.

Performance Support Tools for Space Medical Operations

NASA Technical Reports Server (NTRS)

Byrne, Vicky; Schmid, Josef; Barshi, Immanuel

2010-01-01

Early Constellation space missions are expected to have medical capabilities similar to those currently on board the Space Shuttle and International Space Station (ISS). Flight surgeons on the ground in Mission Control will direct the Crew Medical Officer (CMO) during medical situations. If the crew is unable to communicate with the ground, the CMO will carry out medical procedures without the aid of a flight surgeon. In these situations, use of performance support tools can reduce errors and time to perform emergency medical tasks. The research presented here is part of the Human Factors in Training Directed Research Project of the Space Human Factors Engineering Project under the Space Human Factors and Habitability Element of the Human Research Program. This is a joint project consisting of human factors teams from the Johnson Space Center (JSC) and the Ames Research Center (ARC). Work on medical training has been conducted in collaboration with the Medical Training Group at JSC and with Wyle that provides medical training to crew members, biomedical engineers (BMEs), and flight surgeons under the Bioastronautics contract. Human factors personnel at Johnson Space Center have investigated medical performance support tools for CMOs and flight surgeons.

2016 Federal Green Challenge Award Winners in the New England Region

EPA Pesticide Factsheets

In the New England region, the 2016 Federal Green Challenge award winners are the Manchester Veterans Affairs (VA) Medical Center, West Haven VA Medical Campus, and the U.S. Naval Undersea Warfare Center..

Precision Diagnosis Of Melanoma And Other Skin Lesions From Digital Images.

PubMed

Bhattacharya, Abhishek; Young, Albert; Wong, Andrew; Stalling, Simone; Wei, Maria; Hadley, Dexter

2017-01-01

Melanoma will affect an estimated 73,000 new cases this year and result in 9,000 deaths, yet precise diagnosis remains a serious problem. Without early detection and preventative care, melanoma can quickly spread to become fatal (Stage IV 5-year survival rate is 20-10%) from a once localized skin lesion (Stage IA 5- year survival rate is 97%). There is no biomarker for melanoma in clinical use, and the current diagnostic criteria for skin lesions remains subjective and imprecise. Accurate diagnosis of melanoma relies on a histopathologic gold standard; thus, aggressive excision of melanocytic skin lesions has been the mainstay of treatment. It is estimated that 36 biopsies are performed for every melanoma confirmed by pathology among excised lesions. There is significant morbidity in misdiagnosing melanoma such as progression of the disease for a false negative prediction vs the risks of unnecessary surgery for a false positive prediction. Every year, poor diagnostic precision adds an estimated $673 million in overall cost to manage the disease. Currently, manual dermatoscopic imaging is the standard of care in selecting atypical skin lesions for biopsy, and at best it achieves 90% sensitivity but only 59% specificity when performed by an expert dermatologist. Many computer vision (CV) algorithms perform better than dermatologists in classifying skin lesions although not significantly so in clinical practice. Meanwhile, open source deep learning (DL) techniques in CV have been gaining dominance since 2012 for image classification, and today DL can outperform humans in classifying millions of digital images with less than 5% error rates. Moreover, DL algorithms are readily run on commoditized hardware and have a strong online community of developers supporting their rapid adoption. In this work, we performed a successful pilot study to show proof of concept to DL skin pathology from images. However, DL algorithms must be trained on very large labelled datasets of images to achieve high accuracy. Here, we begin to assemble a large imageset of skin lesions from the UCSF and the San Francisco Veterans Affairs Medical Center (VAMC) dermatology clinics that are well characterized by their underlying pathology, on which to train DL algorithms. If trained on sufficient data, we hypothesize that our approach will significantly outperform general dermatologists in predicting skin lesion pathology. We posit that our work will allow for precision diagnosis of melanoma from widely available digital photography, which may optimize the management of the disease by decreasing unnecessary office visits and the significant morbidity and cost of melanoma misdiagnosis.

Challenges and opportunities in the care of international patients: clinical and health services issues for academic medical centers.

PubMed

Martin, Don R

2006-02-01

International visitors who travel to the United States for the express purpose of receiving medical care constitute a small, but unique and important, subset of patients in this country. These visitors have traditionally sought care at what are widely regarded as the premier U.S. academic medical centers. Their care may prove challenging due to logistical, medical, language, and cross-cultural issues, and has the potential to distract from the educational and research missions of these medical centers. The author reflects on how one academic medical center, the Johns Hopkins Medical Institutions, has experienced and responded to these challenges. Specific issues include scheduling and evaluation challenges, language and cultural differences, and arranging continuity care. The author concludes that when an institution invests the resources necessary to address these issues, and enlists physicians stimulated by this challenging group of patients, the arrangement is mutually beneficial to the international patients and the institution. Scholarly evaluation of this phenomenon has been virtually nonexistent, due to both the unique niche occupied by these programs and institutional competition for this group of patients. However, collaborative evaluation of international patient programs will provide the opportunity to assess similarities, differences, and effectiveness, benefiting both those providing and those receiving care by improving the appropriateness and quality of care.

Regulation, Privacy and Security: Chairman's Opening Remarks

PubMed Central

Gabrieli, E.R.

1979-01-01

Medical privacy is a keystone of a free democratic society. To conserve the right of the patient to medical privacy, computerization of the medical data must be regulated. This paper enumerates some steps to be taken urgently for the protection of computerized sensitive medical data. A computer-oriented medical lexicon is urgently needed for accurate coding. Health industry standards should be drafted. The goals of various data centers must be sharply defined to avoid conflicts of interest. Medical privacy should be studied further, and medical data centers should consider cost-effectiveness. State boards for medical privacy should be created to monitor data security procedures. There is a need for purposeful decentralization. A national medical information policy should be drafted, and a national clinical information board should implement the nation's medical information policy.

Factors that influence the choice to work in rural township health centers among 4,669 clinical medical students from five medical universities in Guangxi, China.

PubMed

Qing, Yunbo; Hu, Guijie; Chen, Qingyun; Peng, Hailun; Li, Kailan; Wei, Jinling; Yi, Yanhua

2015-01-01

To produce competent undergraduate-level medical doctors for rural township health centers (THCs), the Chinese government mandated that medical colleges in Central and Western China recruit rural-oriented, tuition-waived medical students (RTMSs) starting in 2010. This study aimed to identify and assess factors that influence the choice to work in rural township health centers among both RTMSs and other students from five medical universities in Guangxi, China. An internet-based self-administered questionnaire survey was conducted with medical students in Guangxi province. Multinomial logistic regression was used to identify factors related to the attitudes toward work in a rural township health center. Among 4,669 medical students, 1,523 (33%) had a positive attitude and 2,574 (55%) had a neutral attitude toward working in THCs. Demographic characteristics, personal job concerns, and knowledge of THCs were associated with the choice of a career in THCs. The factors related to a positive attitude included the following: three-year program, a rural-oriented medical program, being male, an expectation of working in a county or township, a focus on medical career development, some perceived difficulty of getting a job, having family support, sufficient knowledge of THCs, optimism toward THC development, seeking lower working pressure, and a lower expected monthly salary. Male students in a three-year program or a rural-oriented tuition-waived medical education program were more likely to work in THCs. Selecting medical students through interviews to identify their family support and intentions to work in THCs would increase recruitment and retention. Establishing favorable policies and financial incentives to improve living conditions and the social status of rural physicians is necessary.

Gemini 4 prime crew with Official medical nurse for Astronaut crew members

NASA Technical Reports Server (NTRS)

1965-01-01

Gemini 4 prime crew, Astronauts Edward H. White II, (left), and James A. McDivitt (right) are shown with Lt. Dolores (Dee) O'Hare, US Air Force, Center Medical Office, Flight Medicine Branch, Manned Spaceflight Center (MSC). Lieutenant O'Hare has served during several space flights as Official medical nurse for the astronaut crew members on the missions.

Travels with Gates - May 3-4, 2007 - U.S. Department of Defense Official

Science.gov Websites

dozens of wounded warriors for their service and sacrifice during a visit to Brooke Army Medical Center with each servicemember, most times bedside, asking about their medical care, hometowns and future Staff Sgt. Randal C. Young at Brooke Army Medical Center on Fort Sam Houston, Texas, May 4, 2007. U.S

Utilization of rapid response resources and outcomes in a comprehensive cancer center*.

PubMed

Austin, Charles A; Hanzaker, Chris; Stafford, Renae; Mayer, Celeste; Culp, Loc; Lin, Feng-Chang; Chang, Lydia

2014-04-01

To compare the differences in characteristics and outcomes of cancer center patients with other subspecialty medical patients reviewed by rapid response teams. A retrospective cohort study of hospitalized general medicine patients, subspecialty medicine patients, and oncology patients requiring rapid response team activation over a 2-year period from September 2009 to August 2011. Five hundred fifty-seven subspecialty medical patients required rapid response team intervention. A single academic medical center in the southeastern United States (800+ bed) with a dedicated 50-bed inpatient comprehensive cancer care center. Data abstraction from computerized medical records and a hospital quality improvement rapid response database. Of the 557 patients, 135 were cancer center patients. Cancer center patients had a significantly higher Charlson Comorbidity Score (4.4 vs 2.9, < 0.001). Cancer center patients had a significantly longer hospitalization period prior to rapid response team activation (11.4 vs 6.1 d, p < 0.001). There was no significant difference between proportions of patients requiring ICU transfer between the two groups (odds ratio, 1.2; 95% CI, 0.8-1.8). Cancer center patients had a significantly higher in-hospital mortality compared with the other subspecialty medical patients (33% vs 18%; odds ratio, 2.2; 95% CI, 1.50-3.5). If the rapid response team event required an ICU transfer, this finding was more pronounced (56% vs 23%; odds ratio, 4.0; 95% CI, 2.0-7.8). The utilization of rapid response team resources during the 2-year period studied was also much higher for the oncology patients with 37.34 activations per 1,000 patient discharges compared with 20.86 per 1,000 patient discharges for the general medical patients. Oncology patients requiring rapid response team activation have a significantly higher in-hospital mortality rate, particularly if the rapid response team requires ICU transfer. Oncology patients also utilize rapid response team resources at a much higher rate.

Creating a Longitudinal Integrated Clerkship with Mutual Benefits for an Academic Medical Center and a Community Health System

PubMed Central

Poncelet, Ann Noelle; Mazotti, Lindsay A; Blumberg, Bruce; Wamsley, Maria A; Grennan, Tim; Shore, William B

2014-01-01

The longitudinal integrated clerkship is a model of clinical education driven by tenets of social cognitive theory, situated learning, and workplace learning theories, and built on a foundation of continuity between students, patients, clinicians, and a system of care. Principles and goals of this type of clerkship are aligned with primary care principles, including patient-centered care and systems-based practice. Academic medical centers can partner with community health systems around a longitudinal integrated clerkship to provide mutual benefits for both organizations, creating a sustainable model of clinical training that addresses medical education and community health needs. A successful one-year longitudinal integrated clerkship was created in partnership between an academic medical center and an integrated community health system. Compared with traditional clerkship students, students in this clerkship had better scores on Clinical Performance Examinations, internal medicine examinations, and high perceptions of direct observation of clinical skills. Advantages for the academic medical center include mitigating the resources required to run a longitudinal integrated clerkship while providing primary care training and addressing core competencies such as systems-based practice, practice-based learning, and interprofessional care. Advantages for the community health system include faculty development, academic appointments, professional satisfaction, and recruitment. Success factors include continued support and investment from both organizations’ leadership, high-quality faculty development, incentives for community-based physician educators, and emphasis on the mutually beneficial relationship for both organizations. Development of a longitudinal integrated clerkship in a community health system can serve as a model for developing and expanding these clerkship options for academic medical centers. PMID:24867551

Creating a longitudinal integrated clerkship with mutual benefits for an academic medical center and a community health system.

PubMed

Poncelet, Ann Noelle; Mazotti, Lindsay A; Blumberg, Bruce; Wamsley, Maria A; Grennan, Tim; Shore, William B

2014-01-01

The longitudinal integrated clerkship is a model of clinical education driven by tenets of social cognitive theory, situated learning, and workplace learning theories, and built on a foundation of continuity between students, patients, clinicians, and a system of care. Principles and goals of this type of clerkship are aligned with primary care principles, including patient-centered care and systems-based practice. Academic medical centers can partner with community health systems around a longitudinal integrated clerkship to provide mutual benefits for both organizations, creating a sustainable model of clinical training that addresses medical education and community health needs. A successful one-year longitudinal integrated clerkship was created in partnership between an academic medical center and an integrated community health system. Compared with traditional clerkship students, students in this clerkship had better scores on Clinical Performance Examinations, internal medicine examinations, and high perceptions of direct observation of clinical skills.Advantages for the academic medical center include mitigating the resources required to run a longitudinal integrated clerkship while providing primary care training and addressing core competencies such as systems-based practice, practice-based learning, and interprofessional care. Advantages for the community health system include faculty development, academic appointments, professional satisfaction, and recruitment.Success factors include continued support and investment from both organizations' leadership, high-quality faculty development, incentives for community-based physician educators, and emphasis on the mutually beneficial relationship for both organizations. Development of a longitudinal integrated clerkship in a community health system can serve as a model for developing and expanding these clerkship options for academic medical centers.

My revolutionary adventures in the development of modern emergency medical systems in our country.

PubMed

Edlich, Richard F

2008-05-01

The purpose of this article is to describe my exciting adventures in the development of the emergency medical systems in our country. After my training in plastic surgery at the University of Virginia, I accepted the position of Acting Director of the Emergency Room at the University of Virginia Health Science Center. Working with gifted physicians, basic scientists, nurses, and students, we coordinated the development of an emergency medical system that has been replicated throughout our country. Our system included the following: State legislation for the sexual assault victim, public access by the 9-1-1 telephone number, training of rescue squads, emergency radio communication system, trauma centers, poison control centers, emergency medical plan for the President of the United States, national telecommunications system for the deaf, and the first air medical transportation system in Virginia.

Master's Level Graduate Training in Medical Physics at the University of Colorado Health Sciences Center.

ERIC Educational Resources Information Center

Ibbott, Geoffrey S.; Hendee, William R.

1980-01-01

Describes the master's degree program in medical physics developed at the University of Colorado Health Sciences Center. Required courses for the program, and requirements for admission are included in the appendices. (HM)

Photocopy of photograph in Fitzsimons Army Medical Center real property ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Photocopy of photograph in Fitzsimons Army Medical Center real property book (green cloth cover), showing south and east sides. - Fitzsimons General Hospital, Ice Plant, Southwest Corner of East I Avenue & North Thirteenth Street, Aurora, Adams County, CO

Joint marketing cites excellence: Fairview-University Medical Center advertises cooperatively with University of Minnesota Physicians.

PubMed

Botvin, Judith D

2004-01-01

Fairview-University Medical Center and University of Minnesota Physicians, both in Minneapolis, are enjoying the benefits of a co-branded advertising campaign. It includes print ads, brochures, and other marketing devices.

Community health centers employ diverse staffing patterns, which can provide productivity lessons for medical practices.

PubMed

Ku, Leighton; Frogner, Bianca K; Steinmetz, Erika; Pittman, Patricia

2015-01-01

Community health centers are at the forefront of ambulatory care practices in their use of nonphysician clinicians and team-based primary care. We examined medical staffing patterns, the contributions of different types of staff to productivity, and the factors associated with staffing at community health centers across the United States. We identified four different staffing patterns: typical, high advanced-practice staff, high nursing staff, and high other medical staff. Overall, productivity per staff person was similar across the four staffing patterns. We found that physicians make the greatest contributions to productivity, but advanced-practice staff, nurses, and other medical staff also contribute. Patterns of community health center staffing are driven by numerous factors, including the concentration of clinicians in communities, nurse practitioner scope-of-practice laws, and patient characteristics such as insurance status. Our findings suggest that other group medical practices could incorporate more nonphysician staff without sacrificing productivity and thus profitability. However, the new staffing patterns that evolve may be affected by characteristics of the practice location or the types of patients served. Project HOPE—The People-to-People Health Foundation, Inc.

NASA Johnson Space Center Medical Licensing Opportunities

NASA Technical Reports Server (NTRS)

Hernandez-Moya, Sonia

2009-01-01

This presentation reviews patented medical items that are available for licensing in the areas of Laboratory Technologies, Medical Devices, Medical Equipment and other technologies that are of interest to the medical community.

Statement of the American Psychological Association in response to the "joint principles: integrating behavioral health care into the patient-centered medical home".

PubMed

Anderson, Norman B; Belar, Cynthia D; Cubic, Barbara A; Garrison, Ellen G; Johnson, Suzanne Bennett; Kaslow, Nadine J

2014-06-01

Comments on the article "Joint principles: Integrating behavioral health care into the patient-centered medical home" (see record 2014-24217-011), presented by the Working Party Group on Integrated Behavioral Healthcare. The American Psychological Association (APA) shares concerns about the lack of reference to behavioral health care in the original 2007 Joint Principles of the Patient-Centered Medical Home for which this new document is intended to supplement but not replace. The decision to support the supplemental Joint Principles was not an easy one for APA, as there is one area of significant concern. That concern is related to the use of the term "physician-directed medical practice"

Holmium:YAG laser coronary angioplasty: quantitative angiography and clinical results in a large experience of a single medical center

NASA Astrophysics Data System (ADS)

Topaz, On; Luxenberg, Michael; Schumacher, Audrey

1994-07-01

Clinical experience with the mid IR holmium:YAG laser in a single medical center (St. Paul Ramsey Medical Center, University of Minnesota Medical School, St. Paul, MN) includes 112 patients who underwent holmium laser coronary angioplasty. Utilizing a unique lasing technique; `pulse and retreat,' we applied this laser to thrombotic and nonthrombotic lesions in patients presenting with unstable angina, stable angina, and acute myocardial infarction. A very high clinical success and very low complication rates were achieved. Holmium:YAG laser is effective and safe therapy for patients with symptomatic coronary artery disease. Unlike excimer lasers, the clinical success, efficacy and safety of holmium laser angioplasty is not compromised when thrombus is present.

Person-centered medical interview

PubMed Central

Đorđević, Veljko; Braš, Marijana; Brajković, Lovorka

2012-01-01

Abstract We are witnessing an unprecedented development of medical science and personalized medicine. However, technological superiority must not make us lose sight of the physical, psychological, social, and spiritual totality of the patient. The core of the medical profession has always been and will be the relationship between the health professional and the person seeking assistance. However, the traditional relationship between the physician and the patient has changed and is greatly impacted by huge social, philosophical, economic, and scientific developments. It is important to develop and promote the culture of health instead of the culture of illness through a patient-doctor collaborative partnership, as well as partnership among professionals. Person-centered medical interview is an important bridge between personalized and person-centered medicine. PMID:22911522

Substantial variation in the acceptance of medically complex live kidney donors across US renal transplant centers

PubMed Central

Reese, PP; Feldman, HI; McBride, MA; Anderson, K; Asch, DA; Bloom, RD

2008-01-01

Concern exists about accepting live kidney donation from “medically complex donors” -those with risk factors for future kidney disease. This study’s aim was to examine variation in complex kidney donor use across United States (US) transplant centers. We conducted a retrospective cohort study of live kidney donors using Organ Procurement and Transplantation Network data. Donors with hypertension, obesity, or estimated glomerular filtration rate (eGFR) <60 ml/minute/1.73m2 were considered medically complex. Among 9319 donors, 2254 (24.2%) were complex: 1194 (12.8%) were obese, 956 (10.3%) hypertensive, and 392 (4.2%) had low eGFR. The mean proportion of medically complex donors at a center was 24% (range 0 – 65%.) In multivariate analysis, donor characteristics associated with medical complexity included spousal relationship to the recipient (OR 1.29, CI 1.06-1.56, p<0.01), low education (OR 1.19, CI 1.04-1.37, p=0.01), older age (OR 1.01 per year, CI 1.01-1.02, p<0.01), and non-US citizenship (OR 0.70, CI 0.51-0.97, p=0.01). Renal transplant centers with the highest transplant volume (OR 1.26, CI 1.02-1.57, p=0.03), and with a higher proportion of (living donation)/(all kidney transplants) (OR 1.97, CI 1.23-3.16, p<0.01) were more likely to use medically complex donors. Though controversial, the use of medically complex donors is widespread and varies widely across centers. PMID:18727695

Photocopy of photograph in the Fitzsimons Army Medical Center real ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Photocopy of photograph in the Fitzsimons Army Medical Center real property book (green cloth cover), east and south sides. - Fitzsimons General Hospital, Pharmacy & Prophylactic Station, Northwest Corner of West McAfee Avenue & South Eighth Street, Aurora, Adams County, CO

Predictors of Late Reperfusion in STEMI Patients Undergoing Primary Angioplasty. Impact of the Place of First Medical Contact.

PubMed

Carol Ruiz, Antoni; Masip Utset, Josep; Ariza Solé, Albert

2017-03-01

The benefit of primary angioplasty may be reduced if there are delays to reperfusion. Identification of the variables associated with these delays could improve health care. Analysis of the Codi Infart registry of Catalonia and of the time to angioplasty depending on the place of first medical contact. In 3832 patients analyzed, first medical contact took place in primary care centers in 18% and in hospitals without a catheterization laboratory in 37%. Delays were longer in these 2 groups than in patients attended by the outpatient emergency medical system or by hospitals with a catheterization laboratory (P < .0001, results in median): first medical contact to reperfusion indication time was 42minutes in both (overall 35minutes); first medical contact to artery opening time was 131 and 143minutes, respectively (overall 121minutes); total ischemia time was 230 and 260minutes (overall 215minutes). First medical contact to artery opening time > 120minutes was strongly associated with first medical contact in a center without a catheterization laboratory (OR, 4.96; 95% confidence interval, 4.14-5.93), and other factors such as age, previous coronary surgery, first medical contact during evening hours, nondiagnostic electrocardiogram, and Killip class ≥ III. Mortality at 30 days and 1 year was 5.6% and 8.7% and was independently associated with age, longer delay to angioplasty, Killip class ≥ II, and first medical contact in a center with a catheterization laboratory. In more than 50% of patients requiring primary angioplasty, the first medical contact occurs in centers without a catheterization laboratory, which is an important predictor of delay from diagnosis to artery opening. Copyright © 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Reduced acute inpatient care was largest savings component of Geisinger Health System's patient-centered medical home.

PubMed

Maeng, Daniel D; Khan, Nazmul; Tomcavage, Janet; Graf, Thomas R; Davis, Duane E; Steele, Glenn D

2015-04-01

Early evidence suggests that the patient-centered medical home has the potential to improve patient outcomes while reducing the cost of care. However, it is unclear how this care model achieves such desirable results, particularly its impact on cost. We estimated cost savings associated with Geisinger Health System's patient-centered medical home clinics by examining longitudinal clinic-level claims data from elderly Medicare patients attending the clinics over a ninety-month period (2006 through the first half of 2013). We also used these data to deconstruct savings into its main components (inpatient, outpatient, professional, and prescription drugs). During this period, total costs associated with patient-centered medical home exposure declined by approximately 7.9 percent; the largest source of this savings was acute inpatient care ($34, or 19 percent savings per member per month), which accounts for about 64 percent of the total estimated savings. This finding is further supported by the fact that longer exposure was also associated with lower acute inpatient admission rates. The results of this study suggest that patient-centered medical homes can lead to sustainable, long-term improvements in patient health outcomes and the cost of care. Project HOPE—The People-to-People Health Foundation, Inc.

Digital Signal Processing Based Biotelemetry Receivers

NASA Technical Reports Server (NTRS)

Singh, Avtar; Hines, John; Somps, Chris

1997-01-01

This is an attempt to develop a biotelemetry receiver using digital signal processing technology and techniques. The receiver developed in this work is based on recovering signals that have been encoded using either Pulse Position Modulation (PPM) or Pulse Code Modulation (PCM) technique. A prototype has been developed using state-of-the-art digital signal processing technology. A Printed Circuit Board (PCB) is being developed based on the technique and technology described here. This board is intended to be used in the UCSF Fetal Monitoring system developed at NASA. The board is capable of handling a variety of PPM and PCM signals encoding signals such as ECG, temperature, and pressure. A signal processing program has also been developed to analyze the received ECG signal to determine heart rate. This system provides a base for using digital signal processing in biotelemetry receivers and other similar applications.

EVAcon: a protein contact prediction evaluation service

PubMed Central

Graña, Osvaldo; Eyrich, Volker A.; Pazos, Florencio; Rost, Burkhard; Valencia, Alfonso

2005-01-01

Here we introduce EVAcon, an automated web service that evaluates the performance of contact prediction servers. Currently, EVAcon is monitoring nine servers, four of which are specialized in contact prediction and five are general structure prediction servers. Results are compared for all newly determined experimental structures deposited into PDB (∼5–50 per week). EVAcon allows for a precise comparison of the results based on a system of common protein subsets and the commonly accepted evaluation criteria that are also used in the corresponding category of the CASP assessment. EVAcon is a new service added to the functionality of the EVA system for the continuous evaluation of protein structure prediction servers. The new service is accesible from any of the three EVA mirrors: PDG (CNB-CSIC, Madrid) (); CUBIC (Columbia University, NYC) (); and Sali Lab (UCSF, San Francisco) (). PMID:15980486

The Impact of Centers and Institutes on Faculty Life: Findings from a Study of Life Sciences Faculty at Research-Intensive Universities' Medical Schools

ERIC Educational Resources Information Center

Bunton, Sarah A.; Mallon, William T.

2007-01-01

This article reports on the impact of organized research centers on professional effort, productivity, and perceptions of work satisfaction for life sciences faculty members at research intensive universities' medical schools in the U.S. Results indicate that senior center-affiliated faculty members taught less but worked more total hours than…

Providing Medical Information to College Health Center Personnel: A Circuit Librarian Service at the University of Illinois

ERIC Educational Resources Information Center

Stumpff, Julia C.

2003-01-01

College health center personnel are no different from other health practitioners in their need for medical information. To help meet this need, the McKinley Health Center, University of Illinois Urbana-Champaign, developed a partnership in 1997 with the Library of the Health Sciences-Urbana, a regional site library of the University of Illinois at…

Military Nurses Perceptions of Autonomy

DTIC Science & Technology

2002-05-01

Medical Battalion, Fort Sam Houston, TX. 1996-1998 Head Nurse, Newborn Nursery, Bayne -Jones Army Community Hospital, Fort Polk, LA. 1996-1998 Staff Nurse...Army Medical Center, Fort Sam Houston, TX. 1984-1990 NCOIC, Department of Biochemistry , Division of Biochemistry , Walter Reed Army Institute of...Publications:(under previous name De La Hoz)(Selected) De La Hoz, D. and Wood, S. (1995). Pediatric Quick Reference. Brooke Army Medical Center, Fort Sam

The Medical Library and Media Center of Keio University in Tokyo: report on a visit.

PubMed Central

Accart, J P

1995-01-01

The Medical Library and Media Center at Keio University in Tokyo offers many facilities to its users: access to medical information within a large catalog of monographs and journals, online searching and CD-ROM databases, and a dynamic interlibrary loan service. This article is a report of a professional visit to the library on September 30, 1993. PMID:7703947

PASTE: patient-centered SMS text tagging in a medication management system.

PubMed

Stenner, Shane P; Johnson, Kevin B; Denny, Joshua C

2012-01-01

To evaluate the performance of a system that extracts medication information and administration-related actions from patient short message service (SMS) messages. Mobile technologies provide a platform for electronic patient-centered medication management. MyMediHealth (MMH) is a medication management system that includes a medication scheduler, a medication administration record, and a reminder engine that sends text messages to cell phones. The object of this work was to extend MMH to allow two-way interaction using mobile phone-based SMS technology. Unprompted text-message communication with patients using natural language could engage patients in their healthcare, but presents unique natural language processing challenges. The authors developed a new functional component of MMH, the Patient-centered Automated SMS Tagging Engine (PASTE). The PASTE web service uses natural language processing methods, custom lexicons, and existing knowledge sources to extract and tag medication information from patient text messages. A pilot evaluation of PASTE was completed using 130 medication messages anonymously submitted by 16 volunteers via a website. System output was compared with manually tagged messages. Verified medication names, medication terms, and action terms reached high F-measures of 91.3%, 94.7%, and 90.4%, respectively. The overall medication name F-measure was 79.8%, and the medication action term F-measure was 90%. Other studies have demonstrated systems that successfully extract medication information from clinical documents using semantic tagging, regular expression-based approaches, or a combination of both approaches. This evaluation demonstrates the feasibility of extracting medication information from patient-generated medication messages.

Outsourcing your medical practice call center: how to choose a vendor to ensure regulatory compliance.

PubMed

Johnson, Bill

2014-01-01

Medical practices receive hundreds if not thousands of calls every week from patients, payers, pharmacies, and others. Outsourcing call centers can be a smart move to improve efficiency, lower costs, improve customer care, ensure proper payer management, and ensure regulatory compliance. This article discusses how to know when it's time to move to an outsourced call center, the benefits of making the move, how to choose the right call center, and how to make the transition. It also provides tips on how to manage the call center to ensure the objectives are being met.

Toward an Integrated BAC Library Resource for Genome Sequencing and Analysis

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

Simon, M. I.; Kim, U.-J.

We developed a great deal of expertise in building large BAC libraries from a variety of DNA sources including humans, mice, corn, microorganisms, worms, and Arabidopsis. We greatly improved the technology for screening these libraries rapidly and for selecting appropriate BACs and mapping BACs to develop large overlapping contigs. We became involved in supplying BACs and BAC contigs to a variety of sequencing and mapping projects and we began to collaborate with Drs. Adams and Venter at TIGR and with Dr. Leroy Hood and his group at University of Washington to provide BACs for end sequencing and for mapping andmore » sequencing of large fragments of chromosome 16. Together with Dr. Ian Dunham and his co-workers at the Sanger Center we completed the mapping and they completed the sequencing of the first human chromosome, chromosome 22. This was published in Nature in 1999 and our BAC contigs made a major contribution to this sequencing effort. Drs. Shizuya and Ding invented an automated highly accurate BAC mapping technique. We also developed long-term collaborations with Dr. Uli Weier at UCSF in the design of BAC probes for characterization of human tumors and specific chromosome deletions and breakpoints. Finally the contribution of our work to the human genome project has been recognized in the publication both by the international consortium and the NIH of a draft sequence of the human genome in Nature last year. Dr. Shizuya was acknowledged in the authorship of that landmark paper. Dr. Simon was also an author on the Venter/Adams Celera project sequencing the human genome that was published in Science last year.« less

Early vs late age at onset frontotemporal dementia and frontotemporal lobar degeneration.

PubMed

Seo, Sang Won; Thibodeau, Marie-Pierre; Perry, David C; Hua, Alice; Sidhu, Manu; Sible, Isabel; Vargas, Jose Norberto S; Gaus, Stephanie E; Rabinovici, Gil D; Rankin, Katherine D; Boxer, Adam L; Kramer, Joel H; Rosen, Howard J; Gorno-Tempini, Maria Luisa; Grinberg, Lea T; Huang, Eric J; DeArmond, Stephen J; Trojanowski, John Q; Miller, Bruce L; Seeley, William W

2018-03-20

To examine clinicopathologic correlations in early vs late age at onset frontotemporal dementia (FTD) and frontotemporal lobar degeneration (FTLD). All patients were clinically evaluated and prospectively diagnosed at the UCSF Memory and Aging Center. Two consecutive series were included: (1) patients with a clinically diagnosed FTD syndrome who underwent autopsy (cohort 1) and (2) patients with a primary pathologic diagnosis of FTLD, regardless of the clinical syndrome (cohort 2). These series were divided by age at symptom onset (cutoff 65 years). In cohort 1, 48 (25.3%) were 65 years or older at symptom onset. Pathologic causes of behavioral variant FTD (bvFTD) were similar in the early age at onset (EO) and late age at onset (LO) bvFTD groups. In corticobasal syndrome (CBS), however, the most common pathologic substrate differed according to age at onset: progressive supranuclear palsy (42.9%) in LO-CBS and Alzheimer disease (AD; 40.7%) in EO-CBS. In cohort 2, 57 (28.4%) were classified as LO-FTLD. Regarding FTLD major molecular classes, FTLD with transactive response DNA-binding protein of 43 kDa was most common in EO-FTLD (44.4%), whereas FTLD-tau (58.3%) was most common in LO-FTLD. Antemortem diagnosis of a non-FTD syndrome, usually AD-type dementia, was more frequent in LO-FTLD than EO-FTLD (19.3% vs 7.7%, p = 0.017). LO-FTLD was also associated with more prevalent comorbid pathologic changes. Of these, moderate to severe AD neuropathologic change and argyrophilic grain disease were overrepresented among patients who received an antemortem diagnosis of AD-type dementia. Patients with FTD and FTLD often develop symptoms after age 65, and age at onset represents an important consideration when making antemortem neuropathologic predictions. © 2018 American Academy of Neurology.

[The medical social aspects of ambulatory medical care to victims of road traffic accidents].

PubMed

Gorbunkov, V Ia; Bugaev, D A; Derevianko, D V

2012-01-01

The article discusses the issues of the organization of medical care to victims of road traffic accidents. The analysis of primary appealability of patients to the first-aid center of Stavropol and Novorossiysk during 2008-2010 is presented. The sampling consisted of 904 cases of this kind of trauma. It is established that among victims of road traffic accident appealed to first-aid centers the pedestrians consist the major part. The traumas of limbs are among the most frequently occurred cases. The victims with cranio-cerebral injuries are among those who appealed most frequently for medical aid. Besides that in most cases (63.4%) the victims with cranio-cerebral injuries were transported not to the neurologic surgery clinic but to the first-aid center This action increased the number of transport stages and duration of time gap before specialized medical care was applied. The conclusion is made concerning the need of further development of out-patient urgent medical care to victims of road traffic accidents.

Nursing Home Stakeholder Views of Resident Involvement in Medical Care Decisions

PubMed Central

Garcia, Theresa J.; Harrison, Tracie C.; Goodwin, James S.

2017-01-01

Demand by nursing home residents for involvement in their medical care, or, patient-centered care, is expected to increase as baby boomers begin seeking long-term care for their chronic illnesses. To explore the needs in meeting this proposed demand, we used a qualitative descriptive method with content analysis to obtain the joint perspective of key stakeholders on the current state of person-centered medical care in the nursing home. We interviewed 31 nursing home stakeholders: 5 residents, 7 family members, 8 advanced practice registered nurses, 5 physicians, and 6 administrators. Our findings revealed constraints placed by the long-term care system limited medical involvement opportunities and created conflicting goals for patient-centered medical care. Resident participation in medical care was perceived as low, but important. The creation of supportive educational programs for all stakeholders to facilitate a common goal for nursing home admission and to provide assistance through the long-term care system was encouraged. PMID:25721717

Patient-centered medical home model: do school-based health centers fit the model?

PubMed

Larson, Satu A; Chapman, Susan A

2013-01-01

School-based health centers (SBHCs) are an important component of health care reform. The SBHC model of care offers accessible, continuous, comprehensive, family-centered, coordinated, and compassionate care to infants, children, and adolescents. These same elements comprise the patient-centered medical home (PCMH) model of care being promoted by the Affordable Care Act with the hope of lowering health care costs by rewarding clinicians for primary care services. PCMH survey tools have been developed to help payers determine whether a clinician/site serves as a PCMH. Our concern is that current survey tools will be unable to capture how a SBHC may provide a medical home and therefore be denied needed funding. This article describes how SBHCs might meet the requirements of one PCMH tool. SBHC stakeholders need to advocate for the creation or modification of existing survey tools that allow the unique characteristics of SBHCs to qualify as PCMHs.

Astronaut Gordon Cooper receives preflight medical exam for Gemini 5 flight

NASA Image and Video Library

1965-08-17

S65-28710 (17 Aug. 1965) --- Astronaut L. Gordon Cooper Jr., command pilot for the Gemini-5 spaceflight, has his blood pressure checked by Dr. Charles A. Berry, chief, Center Medical Programs, Manned Spacecraft Center, during a preflight physical examination.

38 CFR 17.351 - Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center.

Code of Federal Regulations, 2010 CFR

2010-07-01

... Philippines § 17.351 Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center. Grants to assist the Republic of the Philippines in the replacement and upgrading of equipment and in...

38 CFR 17.351 - Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center.

Code of Federal Regulations, 2011 CFR

2011-07-01

... Philippines § 17.351 Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center. Grants to assist the Republic of the Philippines in the replacement and upgrading of equipment and in...

38 CFR 17.351 - Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center.

Code of Federal Regulations, 2014 CFR

2014-07-01

... Philippines § 17.351 Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center. Grants to assist the Republic of the Philippines in the replacement and upgrading of equipment and in...

38 CFR 17.351 - Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center.

Code of Federal Regulations, 2013 CFR

2013-07-01

... Philippines § 17.351 Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center. Grants to assist the Republic of the Philippines in the replacement and upgrading of equipment and in...

38 CFR 17.351 - Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center.

Code of Federal Regulations, 2012 CFR

2012-07-01

... Philippines § 17.351 Grants for the replacement and upgrading of equipment at Veterans Memorial Medical Center. Grants to assist the Republic of the Philippines in the replacement and upgrading of equipment and in...

78 FR 36200 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-06-17

... personal privacy. Name of Committee: National Cancer Institute Special Emphasis Panel; Cancer Biology and... Logistics Branch, Division of Extramural Activities, National Cancer Institute, NIH, 9609 Medical Center... Branch, Division of Extramural Activities, National Cancer Institute, NIH, 9609 Medical Center Drive...

A 5-year scientometric analysis of research centers affiliated to Tehran University of Medical Sciences.

PubMed

Yazdani, Kamran; Rahimi-Movaghar, Afarin; Nedjat, Saharnaz; Ghalichi, Leila; Khalili, Malahat

2015-01-01

Since Tehran University of Medical Sciences (TUMS) has the oldest and highest number of research centers among all Iranian medical universities, this study was conducted to evaluate scientific output of research centers affiliated to Tehran University of Medical Sciences (TUMS) using scientometric indices and the affecting factors. Moreover, a number of scientometric indicators were introduced. This cross-sectional study was performed to evaluate a 5-year scientific performance of research centers of TUMS. Data were collected through questionnaires, annual evaluation reports of the Ministry of Health, and also from Scopus database. We used appropriate measures of central tendency and variation for descriptive analyses. Moreover, uni-and multi-variable linear regression were used to evaluate the effect of independent factors on the scientific output of the centers. The medians of the numbers of papers and books during a 5-year period were 150.5 and 2.5 respectively. The median of the "articles per researcher" was 19.1. Based on multiple linear regression, younger age centers (p=0.001), having a separate budget line (p=0.016), and number of research personnel (p<0.001) had a direct significant correlation with the number of articles while real properties had a reverse significant correlation with it (p=0.004). The results can help policy makers and research managers to allocate sufficient resources to improve current situation of the centers. Newly adopted and effective scientometric indices are is suggested to be used to evaluate scientific outputs and functions of these centers.

Student perceptions of a patient- centered medical training curriculum

PubMed Central

Gallentine, Ashley; Salinas-Miranda, Abraham A.; Shaffer-Hudkins, Emily; Hinojosa, Sara; Monroe, Alicia

2014-01-01

Objectives To evaluate a patient-centered medical training curriculum, the SELECT program, through perceptions of the inaugural student cohort. Methods Data were collected from two focus groups conducted in the university setting, comprised of fifteen first-year medical students who participated in the SELECT program during its inaugural year. A questioning protocol was used to guide the focus group discussion, which was transcribed and hand-coded through thematic analyses. Results Various themes related to patient-centered care were identified. Students noted changes in their attitudes towards interacting with patients in an empowering and educative manner as a result of communication and motivational interviewing exercises. Additionally, they recognized certain external, structural barriers as well as internal conflict between pragmatism and emotional intelligence that could potentially hinder patient-centered care. The impact of family dynamics and social support on quality of life and health outcomes was acknowledged. Students also emphasized the value of collaborating with multiple health professionals. Lastly, students provided suggestions for program improvement, namely additional simulations, more education regarding other healthcare professionals’ roles, more standardized experiences, and application of principles to acute and primary care. Conclusions Upon completion of the first year of the SELECT program, students gained an appreciation for patient-centered care and various factors and skills that facilitate such care. Additionally, they experienced a dissonance between didactic concepts from the curriculum and observed medical practices. This study highlights the educational benefits of a patient-centered medical curriculum and provides suggestions for future improvement. PMID:25341218

When a physician and a clinical ethicist collaborate for better patient care.

PubMed

Arawi, Thalia; Charafeddine, Lama

2018-06-01

Bioethics is a relatively new addition to bedside medical care in Arab world which is characterized by a special culture that often makes blind adaptation of western ethics codes and principles; a challenge that has to be faced. To date, the American University of Beirut Medical Center is the only hospital that offers bedside ethics consultations in the Arab Region aiming towards better patient-centered care. This article tackles the role of the bedside clinical ethics consultant as an active member of the medical team and the impact of such consultations on decision-making and patient-centered care. Using the case of a child with multiple medical problems and a futile medical condition, we describe how the collaboration of the medical team and the clinical ethics consultant took a comprehensive approach to accompany and lead the parents and the medical team in their decision-making process and how the consultations allowed several salient issues to be addressed. This approach proved to be effective in the Arab cultural setting and indeed did lead to better patientcentered care. © 2018 John Wiley & Sons Ltd.

The safety net medical home initiative: transforming care for vulnerable populations.

PubMed

Sugarman, Jonathan R; Phillips, Kathryn E; Wagner, Edward H; Coleman, Katie; Abrams, Melinda K

2014-11-01

Despite findings that medical homes may reduce or eliminate health care disparities among underserved and minority populations, most previous medical home pilot and demonstration projects have focused on health care delivery systems serving commercially insured patients and Medicare beneficiaries. To develop a replicable approach to support medical home transformation among diverse practices serving vulnerable and underserved populations. Facilitated by a national program team, convening organizations in 5 states provided coaching and learning community support to safety net practices over a 4-year period. To guide transformation, we developed a framework of change concepts aligned with supporting tools including implementation guides, activity checklists, and measurement instruments. Sixty-five health centers, homeless clinics, private practices, residency training centers, and other safety net practices in Colorado, Idaho, Massachusetts, Oregon, and Pennsylvania. We evaluated implementation of the change concepts using the Patient-Centered Medical Home-Assessment, and conducted a survey of participating practices to assess perceptions of the impact of the technical assistance. All practices implemented key features of the medical home model, and nearly half (47.6%) implemented the 33 identified key changes to a substantial degree as evidenced by level A Patient-Centered Medical Home-Assessment scores. Two thirds of practices that achieved substantial implementation did so only after participating in the initiative for >2 years. By the end of the initiative, 83.1% of sites achieved external recognition as medical homes. Despite resource constraints and high-need populations, safety net clinics made considerable progress toward medical home implementation when provided robust, multimodal support over a 4-year period.

Responses of a vulnerable Hispanic population in New Jersey to Hurricane Sandy: Access to care, medical needs, concerns and ecological ratings

PubMed Central

Burger, Joanna; Gochfeld, Michael; Pittfield, Taryn; Jeitner, Christian

2017-01-01

Recent increases in hurricanes led to a need to evaluate access to medical care, medical needs, and personal and community impact on vulnerable populations, particularly elderly, low income, and minority communities. This article examines access to care, interruptions in medical services, personal impact from Hurricane Sandy, and agreement with ecological statements related to storms, flooding and damages in Hispanic/Latino patients receiving health care at Federally Qualified Health Centers in New Jersey. Only 10 % of 335 Hispanic interviewees were U.S. born. Self-identified personal impact was a better indicator of effects from Sandy, health center use, and medical issues, than was a community impact rating. Respondents who gave a high personal impact rating were more likely to have evacuated, had longer power outage, were more likely to need medical care, had more trouble getting to centers, and had more medical interruptions during Sandy. A higher percentage of respondents who evacuated, needed the center, had trouble getting there, and had more “medical need” than those who did not evacuate. The greatest impacts were on respondents who were told to evacuate before the storm, but did not (46 % had “medical need”). The respondents had high agreement ratings for “storms are due to climate change”, followed by “frequent and stronger storms will come more often”, “flooding is due to sea level rise”, and “changing climate is due mainly to human activity and not natural causes”. These ratings will aid public policy makers and planners in developing resiliency strategies for vulnerable coastal communities. PMID:28644717

Responses of a vulnerable Hispanic population in New Jersey to Hurricane Sandy: Access to care, medical needs, concerns, and ecological ratings.

PubMed

Burger, Joanna; Gochfeld, Michael; Pittfield, Taryn; Jeitner, Christian

2017-01-01

Recent increases in hurricanes led to a need to evaluate access to medical care, medical needs, and personal and community impact on vulnerable populations, particularly elderly, low income, and minority communities. This investigation examined (1) access to care, (2) interruptions in medical services, (3) personal impact from Hurricane Sandy, and (4) agreement with ecological statements related to storms, flooding, and damages in Hispanic/Latino patients receiving health care at Federally Qualified Health Centers in New Jersey. Only 10% of 335 Hispanic interviewees were US born. Self-identified personal impact was a better indicator of effects from Sandy, health center use, and medical issues, than community impact rating. Respondents who provided a high personal impact rating were more likely to have evacuated, had longer power outage, were more likely to need medical care, displayed more trouble getting to centers, and exhibited more medical interruptions during Sandy. A higher % respondents who evacuated, needed the center, had trouble getting there, and had more "medical need" than those who did not evacuate. The greatest impacts were on respondents who were told to evacuate before the storm, but did not (46% had "medical need"). The respondents had high agreement ratings for "storms are due to climate change," followed by "frequent and stronger storms will come more often," "flooding is due to sea level rise," and "changing climate is due mainly to human activity and not natural causes". These ratings may aid public policymakers and planners in developing resiliency strategies for vulnerable coastal communities.

[Training of medical physicists in radiation therapy at the International Educational Center of the Association of Medical Physicists in Russia].

PubMed

Kostylev, V A; Lysenko, M N; Zhgutov, A V; Ulanov, D V; Kislyakova, M V; Kazantsev, P V; Kostylev, D V; Narkevich, B Y

2015-01-01

The efficiency of radiotherapy treatment for cancer patients and use of the state-of-the-art accelerator facilities, in the first place, depends on the qualification and number of medical physicists. The need for the training and continuing professional development (CPD) of medical radiation physicists in Russia and CIS countries has dramatically increased today. The article considers the system of refresher training which should provide the continuing professional development and advance training of medical radiation physicists. The authors analyze the experience of the International Educational Center of the Association of Medical Physicists in Russia involved in the CPD of medical physicists under the IAEA TC projects, RMAPO and N.N. Blokhin RCRC joint educational programs.

The Impact of Price Transparency for Surgical Services.

PubMed

Mehta, Ambar; Xu, Tim; Bai, Ge; Hawley, Kristy L; Makary, Martin A

2018-04-01

Increasing insurance deductibles have prompted some medical centers to initiate transparent pricing. However, the impact of price transparency (PT) on surgical volume, revenue, and patient satisfaction is unknown, along with the barriers to achieving PT. We identified ambulatory surgical centers in the Free Market Medical Association database that publicly list prices for surgical services online. Six of eight centers (75%) responded to our data collection inquiry. Among five centers that reported their patient volume and revenue after adopting PT, patient volume increased by a median of 50 per cent (range 10-200%) at one year. Four centers (80%) reported an increase in revenue by a median of 30 per cent (range 4-75%), whereas three centers (60%) experienced an increase in third-party administrator contracts with the average increase being seven new third-party administrator contracts (range = 2-12 contracts). Three centers (50%) reported a reduction in their administrative burden and five centers (83%) reported an increase in patient satisfaction and patient engagement after PT. The leading barrier reported to making prices transparent was discouragement from another practice, hospital, or insurance company. The findings of this preliminary study may help guide medical practices in designing and implementing PT strategies.

Biomedical Research and Technology. A Prognosis for International Economic Leadership. Commission on Academic Medical Centers and the Economy of New England [Report].

ERIC Educational Resources Information Center

New England Board of Higher Education, Boston, MA.

The focus of the work of the Commission on Academic Medical Centers and the Economy of New England is the financing competitors strength and future development of academic centers and biomedical companies in New England. Among the findings and recommendations of the Commission are the following: (1) the New England region will require several…

EEOC raps hospital. Equal Employment Opportunity Commission.

PubMed

1998-02-06

Baltimore's Veterans Affairs Medical Center lost a $260,000 judgement to a former medical clerk discriminated against by the hospital. The hospital alleged the employee was unreliable and had poor attendance, and the employee lost his home and custody of his daughter after being fired. The Equal Employment Opportunity Commission (EEOC) found the medical center's position implausible. In addition to the cash award, the EEOC recommended that the employee be reinstated.

Emergency Medical Treatment Needs: Chronic and Acute Exposure to Hazardous Materials.

DTIC Science & Technology

1982-06-01

II. CONTROLLING OFFICE NAME AND ADDRESS 12. REPORT DATE Federal Emergency Management Agency June 1982 Washington, D.C. 20472 IS. NUMBER OF PAGES 109...and Centers for Disease Control / NIOSHl . Local or regional (within state) providers/ coordinators of medical care for chemical casualties, i.e...from Poison Control Centers; from Ecology and Environment, Incorporated; and from the Medical University of South Carolina. The major computerized data

Who killed Rambhor?: The state of emergency medical services in India

PubMed Central

Garg, Rajesh H

2012-01-01

In India, the healthcare delivery system starts up from the sub-center at the village level and reaches up to super specialty medical centers providing state of the art emergency medical services (EMS). These highest centers, located in big cities, are considered the last referral points for the patients from nearby cities and states. As the incidents of rail and road accidents have increased in recent years, the role of EMS becomes critical in saving precious lives. But when the facilities and management of these emergency centers succumbs before the patient, then the question arises regarding the adequate availability and quality of EMS. The death of an unknown common man, Rambhor, for want of EMS in three big hospitals in the national capital of India put a big question on the “health” of the emergency health services in India. The emergency services infrastructure seems inadequate and quality and timely provision of EMS to critical patients appears unsatisfactory. There is lack of emergency medicine (EM) specialists in India and also the postgraduation courses in EM have not gained foot in our medical education system. Creation of a Centralized Medical Emergency Body, implementation of management techniques, modification of medical curriculum, and fixing accountability are some of the few steps which are required to improve the EMS in India. PMID:22416155

A Cultural Assessment of Tripler Regional Medical Center.

DTIC Science & Technology

1997-05-15

add value to the beneficiaries. The path Tripler Regional Medical Center has chosen to achieve the level of service quality required to sustain or grow...employing TQM management methods. The goals of this training include improvement in management, service quality , and in employee satisfaction, among

76 FR 14802 - Establishment of Class E Airspace; Lancaster, NH

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-18

... Standard Instrument Approach Procedure (SIAP) serving the Weeks Medical Center Heliport. This action enhances the safety and airspace management of Instrument Flight Rules (IFR) operations within the National... required to support the special standard instrument approach procedures developed for Weeks Medical Center...

Telemedicine: The Up Side, and . . .

ERIC Educational Resources Information Center

Risser, Joseph

1998-01-01

Explores universities involved with training in telemedicine and medical care provided through technology (International Telemedicine Center Inc. www.int-telemedicine.com/univ.html). Discusses the market for telemedicine, companies and university medical centers involved in its development, costs and savings to health care system, barriers to the…

Attitudes of medical students in Lahore, Pakistan towards the doctor–patient relationship

PubMed Central

Krupat, Edward; Asma, Yumna; Fatima, Noor-E-; Attique, Rayan; Mahmood, Umar; Waqas, Ahmed

2015-01-01

Background. A good doctor–patient relationship is the centre stone of modern medicine. Patients are getting increasingly aware about exercising their autonomy and thus modern medicine cannot deliver all its advances to the patients if a good doctor–patient relationship is not established. We initiated this study with the aim to assess the leaning of medical students, who are the future physicians, towards either a doctor-centered or a patient-centered care, and to explore the effects of personal attributes on care such as gender, academic year, etc. Materials & Methods. A cross-sectional study was conducted between July and Sep 2013. CMH Lahore Medical and Dental College Ethical Review Committee approved the study questionnaire. The study population consisted of 1,181 medical students in years 1–5 from two medical colleges. The English version of Patient Practitioner Orientation Scale (PPOS) was used to assess attitudes of medical students towards doctor–patient relationship. PPOS yields a mean score range of 1–6, where 1 signifies tendency towards a doctor centered relationship and 6 signifies patient-centered relationship. The relationship between PPOS scores and individual characteristics like gender, academic year etc. were examined by multiple regression. Results. A total of 783 students formed the final sample (response rate = 92%). Mean PPOS score of the entire sample was 3.40 (± .49 S.D.). Mean sharing sub-scale score was 3.18 (± 0.62 S.D. Mean caring sub-scale score was 3.63 (± 0.56 S.D.). Characteristics associated with most patient-centered attitudes were advanced academic year, having a clinical rotation, foreign background and studying in a private college. Gender, having doctor parents, relationship and residence status had no bearing on the attitudes (p > 0.05). Conclusion. Despite ongoing debate and the emphasis on a patient-centered curriculum, our study suggests that the current curriculum and its teachings are not producing the results they are designed to achieve. Students should be adequately exposed to the patients from the beginning of their medical education in clinical settings which are more sympathetic to a patient-centered care. PMID:26157621

United States Air Force Summer Research Program -- 1993. Volume 16. Arnold Engineering Development Center. Frank J. Seiler Research Laboratory. Wilford Hall Medical Center

DTIC Science & Technology

1993-12-01

A I 7f t UNITED STATE AIR FORCE SUMMER RESEARCH PROGRAM -- 1993 SUMMER RESEARCH PROGRAM FINAL REPORTS VOLUME 16 ARNOLD ENGINEERING DEVELOPMENT CENTER...FRANK J. SELLER RESEARCH LABORATORY WILFORD HALL MEDICAL CENTER RESEARCH & DEVELOPMENT LABORATORIES 5800 Uplander Way Culver City, CA 90230-6608...National Rd. Vol-Page No: 15-44 Dist Tecumseh High School 8.4 New Carlisle, OH 45344-0000 Barber, Jason Laboratory: AL/CF 1000 10th St. Vol-Page No

Center of Excellence for Laser Applications in Medicine, Microlaser Microscope

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

Webb, R. H.

The Center of Excellence for Laser Applications in Medicine at the Schepens Eye Research Institute (SERI) is a Center for: A core group of researchers who support each other and their various projects for real-time medical imaging and diagnostics in contiguous space at SERI. Clinical collaborators who participate in the core research at SERI, MEEI, and local ophthalmology practices, and at associated sites around the world. Industrial partners who transfer our technology to commercial products that will reach clinical usage everywhere. Students, post-doctoral associates and medical fellows who work with us and learn how to practice real-time medical imaging andmore » diagnostics.« less

A Study to Develop an Assessment Tool and Evaluate the Social Work Service Quality Assurance Plan at Walter Reed Army Medical Center, Brooke Army Medical Center, and Fitzsimons Army Medical Center

DTIC Science & Technology

1987-07-01

the plan identify methods of integration with other military services (Army Community Service, Ariny Drug and Alcohol Prevention and Control Program...home care or out-of-home care setting. 1 2 3 4 5 NA 21.2.2.4 Patient safety and infection control . 1 2 3 4 5 NA 21.2.3 Personnel who provide social...4 5 NA SO2.2.4 Patient safety and infection control . 1 2 3 4 5 NA SO.2.3 Personnel who provide social work services participate in relevant continuing

Academic medical center libraries on the Web.

PubMed Central

Tannery, N H; Wessel, C B

1998-01-01

Academic medical center libraries are moving towards publishing electronically, utilizing networked technologies, and creating digital libraries. The catalyst for this movement has been the Web. An analysis of academic medical center library Web pages was undertaken to assess the information created and communicated in early 1997. A summary of present uses and suggestions for future applications is provided. A method for evaluating and describing the content of library Web sites was designed. The evaluation included categorizing basic information such as description and access to library services, access to commercial databases, and use of interactive forms. The main goal of the evaluation was to assess original resources produced by these libraries. PMID:9803298

Results of an Institutional LGBT Climate Survey at an Academic Medical Center.

PubMed

Chester, Sean D; Ehrenfeld, Jesse M; Eckstrand, Kristen L

2014-12-01

The purpose of this study was to characterize the climate and culture experienced by lesbian, gay, bisexual, and transgender (LGBT) employees and students at one large academic medical center. An anonymous, online institutional climate survey was used to assess the attitudes and experiences of LGBT employees and students. There were 42 LGBT and 14 non-LGBT survey participants. Results revealed that a surprisingly large percentage of LGBT individuals experienced pressure to remain "closeted" and were harassed despite medical center policies of non-discrimination. Continuing training, inclusive policies and practices, and the development of mechanisms to address LGBT-specific harassment are necessary for improving institutional climate.

FDA working to ensure the safety of medical devices used in the pediatric population.

PubMed

Flack, Marilyn Neder; Gross, Thomas P; Reid, Joy Samuels; Mills, Thalia T; Francis, Jacqueline

2012-12-01

Special initiatives exist in FDA's Center for Devices and Radiological Health (CDRH), the Center for Drug Evaluation and Research, and the Center for Biologics Evaluation and Research to ensure the safety and effectiveness of medical products used in the vulnerable pediatric population. This article focuses on the special programs, projects, and special studies implemented by CDRH to ensure this safety and effectiveness in devices used in pediatric patients throughout the devices' total product life-cycles. Pediatricians play a major role in keeping medical devices safe for use in children by reporting device problems to FDA. Published by Elsevier Inc.

PASTE: patient-centered SMS text tagging in a medication management system

PubMed Central

Johnson, Kevin B; Denny, Joshua C

2011-01-01

Objective To evaluate the performance of a system that extracts medication information and administration-related actions from patient short message service (SMS) messages. Design Mobile technologies provide a platform for electronic patient-centered medication management. MyMediHealth (MMH) is a medication management system that includes a medication scheduler, a medication administration record, and a reminder engine that sends text messages to cell phones. The object of this work was to extend MMH to allow two-way interaction using mobile phone-based SMS technology. Unprompted text-message communication with patients using natural language could engage patients in their healthcare, but presents unique natural language processing challenges. The authors developed a new functional component of MMH, the Patient-centered Automated SMS Tagging Engine (PASTE). The PASTE web service uses natural language processing methods, custom lexicons, and existing knowledge sources to extract and tag medication information from patient text messages. Measurements A pilot evaluation of PASTE was completed using 130 medication messages anonymously submitted by 16 volunteers via a website. System output was compared with manually tagged messages. Results Verified medication names, medication terms, and action terms reached high F-measures of 91.3%, 94.7%, and 90.4%, respectively. The overall medication name F-measure was 79.8%, and the medication action term F-measure was 90%. Conclusion Other studies have demonstrated systems that successfully extract medication information from clinical documents using semantic tagging, regular expression-based approaches, or a combination of both approaches. This evaluation demonstrates the feasibility of extracting medication information from patient-generated medication messages. PMID:21984605

San Antonio's Medical Center Corridor: Lessons Learned From The Metropolitan Model Deployment Initiative: Reducing Delay Through Integrated Freeway & Arterial Management

DOT National Transportation Integrated Search

2000-10-01

This report demonstrates the benefits and potential pitfalls of deploying and operating an integrated freeway and arterial management system. In particular, it discusses the lessons learned about the Medical Center Corridor (MCC) Project deployed in ...

WASTE MINIMIZATION OPPORTUNITY ASSESSMENT: OPTICAL FABRICATION LABORATORY - FITZSIMMONS ARMY MEDICAL CENTER

EPA Science Inventory

Under the Waste Reduction Evaluations at Federal Sites (WREAFS) program, RREL has taken the initiative to merge the experience and resources of the EPA with other Federal agencies. At the Fitzsimmons Army Medical Center (FAMC) in Aurora, Colorado, the Army and the EPA cooperated ...

A Sustained Partnership between a Haitian Children’s Hospital and North American Academic Medical Centers

PubMed Central

Koster, Michael P.; Williams, Jackson H.; Gautier, Jacqueline; Alce, Renee; Trappey, Bernard E.

2017-01-01

Global health initiatives from academic medical centers have rapidly proliferated over the last decade. This paper endeavors to describe our 5-year experience as an academic medical collaborative supporting healthcare delivery, medical training, and research at Hôpital Saint Damien-Nos Petits Frères et Soeurs, the only freestanding children’s hospital in Haiti. Descriptions of the history and current activities of our academic medical collaborative, its partnership and communication structure, its evolution to fill the expressed needs of our host site, its funding mechanisms, and its challenges and opportunities for the future are included. PMID:28611976

Development a heuristic method to locate and allocate the medical centers to minimize the earthquake relief operation time.

PubMed

Aghamohammadi, Hossein; Saadi Mesgari, Mohammad; Molaei, Damoon; Aghamohammadi, Hasan

2013-01-01

Location-allocation is a combinatorial optimization problem, and is defined as Non deterministic Polynomial Hard (NP) hard optimization. Therefore, solution of such a problem should be shifted from exact to heuristic or Meta heuristic due to the complexity of the problem. Locating medical centers and allocating injuries of an earthquake to them has high importance in earthquake disaster management so that developing a proper method will reduce the time of relief operation and will consequently decrease the number of fatalities. This paper presents the development of a heuristic method based on two nested genetic algorithms to optimize this location allocation problem by using the abilities of Geographic Information System (GIS). In the proposed method, outer genetic algorithm is applied to the location part of the problem and inner genetic algorithm is used to optimize the resource allocation. The final outcome of implemented method includes the spatial location of new required medical centers. The method also calculates that how many of the injuries at each demanding point should be taken to any of the existing and new medical centers as well. The results of proposed method showed high performance of designed structure to solve a capacitated location-allocation problem that may arise in a disaster situation when injured people has to be taken to medical centers in a reasonable time.

Better trauma care. How Maryland does it.

PubMed

Wish, John R; Long, William B; Edlich, Richard F

2005-01-01

In March, 1970, the Maryland State Police, in cooperation with the University of Maryland, started the first statewide airborne transportation system. It was modeled after the army's success in Korea and Vietnam, where battlefield injuries were flown to front-line MASH units. The world's premier statewide medical aviation division was made possible through a cooperative effort between the Maryland State Police Aviation Division and Dr. R Adams Cowley at the University of Maryland Hospital as a public service to the citizens of the state. The Maryland Institute for Emergency Medical Services Systems (MIEMSS) has five components: (1) aircraft, (2) state troopers, (3) system communications (SYSCOM) center, (4) ambulance and fire emergency rescue, and (5) Level I adult and pediatric trauma centers and a regional burn center. The Maryland State Police Aviation Division now has 12 Aerospace Dauphin AS365N helicopters that operate out of eight fixed points throughout the state. Each helicopter has a two-person crew that consists of a pilot and a paramedic. Since 1993, the overall coordination of emergency medical services (EMS) has been under the purview of MIEMSS, an independent executive-level state agency that is governed by an appointed board and advisory council. To ensure stable funding for Maryland's world renowned emergency medical services (EMS) system, including med-evac helicopters, ambulances, fire equipment, rescue squads, and trauma units, a "surcharge" of $13.50 per year is collected with the automobile registration fee where applicable. The SYSCOM center in Baltimore coordinates the helicopter transport to the scene of the accident as well as referral to the specialty care facility: Adult Level I Trauma Center, Pediatric Level I Trauma Center, and Regional Burn Center. An on-the-scene evaluation of this exemplary emergency medical system in Maryland provides further convincing evidence of the performance of the Maryland State Police Aviation Division as they transported an injured child to the Johns Hopkins Pediatric Level I Trauma Center. It is our belief that the model emergency medical system in Maryland, if replicated throughout our nation, would save the lives of the critically injured.

Critical Care Organizations in Academic Medical Centers in North America: A Descriptive Report.

PubMed

Pastores, Stephen M; Halpern, Neil A; Oropello, John M; Kostelecky, Natalie; Kvetan, Vladimir

2015-10-01

With the exception of a few single-center descriptive reports, data on critical care organizations are relatively sparse. The objectives of our study were to determine the structure, governance, and experience to date of established critical care organizations in North American academic medical centers. A 46-item survey questionnaire was electronically distributed using Survey Monkey to the leadership of 27 identified critical care organizations in the United States and Canada between September 2014 and February 2015. A critical care organization had to be headed by a physician and have primary governance over the majority, if not all, of the ICUs in the medical center. We received 24 responses (89%). The majority of the critical care organizations (83%) were called departments, centers, systems, or operations committees. Approximately two thirds of respondents were from larger (> 500 beds) urban institutions, and nearly 80% were primary university medical centers. On average, there were six ICUs per academic medical center with a mean of four ICUs under critical care organization governance. In these ICUs, intensivists were present in-house 24/7 in 49%; advanced practice providers in 63%; hospitalists in 21%; and telemedicine coverage in 14%. Nearly 60% of respondents indicated that they had a separate hospital budget to support data management and reporting, oversight of their ICUs, and rapid response teams. The transition from the traditional model of ICUs within departmentally controlled services or divisions to a critical care organization was described as gradual in 50% and complete in only 25%. Nearly 90% indicated that their critical care organization governance structure was either moderately or highly effective; a similar number suggested that their critical care organizations were evolving with increasing domain and financial control of the ICUs at their respective institutions. Our survey of the very few critical care organizations in North American academic medical centers showed that the governance models of critical care organizations vary and continue to evolve. Additional studies are warranted to improve our understanding of the factors that can foster the growth of critical care organizations and how they can be effective.

Towards Interactive Medical Content Delivery Between Simulated Body Sensor Networks and Practical Data Center.

PubMed

Shi, Xiaobo; Li, Wei; Song, Jeungeun; Hossain, M Shamim; Mizanur Rahman, Sk Md; Alelaiwi, Abdulhameed

2016-10-01

With the development of IoT (Internet of Thing), big data analysis and cloud computing, traditional medical information system integrates with these new technologies. The establishment of cloud-based smart healthcare application gets more and more attention. In this paper, semi-physical simulation technology is applied to cloud-based smart healthcare system. The Body sensor network (BSN) of system transmit has two ways of data collection and transmission. The one is using practical BSN to collect data and transmitting it to the data center. The other is transmitting real medical data to practical data center by simulating BSN. In order to transmit real medical data to practical data center by simulating BSN under semi-physical simulation environment, this paper designs an OPNET packet structure, defines a gateway node model between simulating BSN and practical data center and builds a custom protocol stack. Moreover, this paper conducts a large amount of simulation on the real data transmission through simulation network connecting with practical network. The simulation result can provides a reference for parameter settings of fully practical network and reduces the cost of devices and personnel involved.

Cross-cultural medical education: can patient-centered cultural competency training be effective in non-Western countries?

PubMed

Ho, Ming-Jung; Yao, Grace; Lee, Keng-Lin; Beach, Mary Catherine; Green, Alexander R

2008-01-01

No evidence addresses the effectiveness of patient-centered cultural competence training in non-Western settings. To examine whether a patient-centered cultural competency curriculum improves medical students' skills in eliciting the patients' perspective and exploring illness-related social factors. Fifty-seven medical students in Taiwan were randomly assigned to either the control (n = 27) or one of two intervention groups: basic (n = 15) and extensive (n = 15). Both intervention groups received two 2-hour patient-centered cultural competency workshops. In addition, the extensive intervention group received a 2-hour practice session. The control group received no training. At the end of the clerkship, all students were evaluated with an objective structured clinical examination (OSCE). Students in the extensive intervention group scored significantly higher than the basic intervention and control groups in eliciting the patient's perspective (F = 18.38, p < 0.001, eta(2) = 0.40). Scores of both intervention groups were significantly higher than the control group in the exploring social factors (F = 6.66, p = 0.003, eta(2) = 0.20). Patient-centered cultural competency training can produce improvement in medical students' cross-cultural communication skills in non-Western settings, especially when adequate practice is provided.

A management plan for hospitals and medical centers facing radiation incidents.

PubMed

Davari, Fereshteh; Zahed, Arash

2015-09-01

Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

Case management: a case study.

PubMed

Stanton, M P; Walizer, E M; Graham, J I; Keppel, L

2000-01-01

This article describes the implementation of a pilot case management program at Walter Reed Army Medical Center. I, it we discuss obvious pitfalls and problems implementing case management in a large multiservice center and the steps and processes implemented to expedite and move case management forward in its early stages. The insights shared may be useful for those implementing case management in a complex medical center situation. Other models used in similar situations are also reviewed.

A journey through meaningful use at a large academic medical center: lessons of leadership, administration, and technical implementation.

PubMed

Unger, Melissa D; Aldrich, Alison M; Hefner, Jennifer L; Rizer, Milisa K

2014-01-01

Successfully reporting meaningful use of electronic health records to the Centers for Medicare and Medicaid Services can be a challenging process, particularly for healthcare organizations with large numbers of eligible professionals. This case report describes a successful meaningful use attestation process undertaken at a major academic medical center. It identifies best practices in the areas of leadership, administration, communication, ongoing support, and technological implementation.

Federal Health Care Center: VA and DOD Need to Develop Better Information to Monitor Operations and Improve Efficiency

DTIC Science & Technology

2017-01-01

delivery of health care that would be more accessible and less expensive than operating two federal medical centers serving VA and DOD beneficiaries in...departments—including DOD’s operational readiness mission—by integrating services previously provided by the former North Chicago VA Medical Center...1VA beneficiaries include veterans of military service and certain dependents and survivors. DOD beneficiaries include active duty

The Ambulatory Care Workload Management System for Nursing Reference Manual

DTIC Science & Technology

1991-05-31

MEDICAL DATA SERVICES CENTER BETHESDA, MARYLAND 2088Q-506. 91-03029 SECuRItY CLASSIFICATION OF THIS PAGEr REPORT DOCUMENTATION PAGE Ia. REPORT SECURITY...ORGANIZATION 6b OFFICE SYMBOL 7a. NAME OF MONITORING ORGANIZATION Naval Medical Data Servics (If applicable) Center 6c. ADDRESS (City, State, and ZIPCode) 7b...staffing methodology developed for emergency and ambulatory care departments in naval medical treatment facilities . The staffing model translates varying

The Manned Spacecraft Center and medical technology

NASA Technical Reports Server (NTRS)

Johnston, R. S.; Pool, S. L.

1974-01-01

A number of medically oriented research and hardware development programs in support of manned space flights have been sponsored by NASA. Blood pressure measuring systems for use in spacecraft are considered. In some cases, complete new bioinstrumentation systems were necessary to accomplish a specific physiological study. Plans for medical research during the Skylab program are discussed along with general questions regarding space-borne health service systems and details concerning the Health Services Support Control Center.

38 CFR 17.241 - Sharing medical information services.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 1 2012-07-01 2012-07-01 false Sharing medical... AFFAIRS MEDICAL Sharing of Medical Facilities, Equipment, and Information § 17.241 Sharing medical... Under Secretary for Health shall prescribe, Directors of Department of Veterans Affairs medical centers...

[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.

[The specialty clinical centers within the structure of the regional multi-specialty hospital].

PubMed

Fadeev, M G

2008-01-01

The analysis of the functioning of the regional referral clinical center of hand surgery, the eye injury center, the pediatric burns center and the neurosurgical center situated on the basis of large multi-field hospitals of the City of Ekaterinburg is presented. Such common conditions of their activity as experienced manpower availability and medical Academy chairs maintenance are revealed. The special referral clinical centers organized prior to the perstroyka and reformation, continue to function successfully providing high-tech medical care to the patients of the megapolis and to the inhabitants of the Sverdlovskaya Oblast. The effectiveness and perspectiveness of further functioning of the special referral clinical centers embedded into the structure of the municipal multi-field hospitals in the conditions of health reforms is demonstrated.

77 FR 75640 - Merchant Mariner Medical Advisory Committee: Intercessional Meeting

Federal Register 2010, 2011, 2012, 2013, 2014

2012-12-21

... Simulation, Training, Assessment, and Research (STAR) Center, Room 217, 2 West Dixie Highway, Dania Beach, FL... 6 (Medical Review Process, 4 (Medications), and 3 (Medical Conditions Subject to Further Review) of...

U.S. Army Medical Department Journal, January-March 2007

DTIC Science & Technology

2007-03-01

Rehabilitation at Walter Reed Army Medical Center, The Growth of the Profession of Occupational Therapy,Medical Care in the Sustainment Brigade, Evidence - Based Medicine : The Way to Cost Effective, Quality Medical Care.

Transforming a family medicine center and residency program into a federally qualified health center.

PubMed

Cousineau, Michael R; Flores, Hector; Cheng, Scott; Gates, Jerry D; Douglas, James H; Clute, Gerald B; Coan, Carl E

2013-05-01

The authors describe a family medicine center before and after a merger between the Keck School of Medicine of the University of Southern California, the California Hospital Medical Center, and the Eisner Pediatric and Family Medical Center in 2012. The merger provided new opportunities to stabilize the financial base of a clinical practice struggling financially and to enhance the training of residents and other health professionals in primary care, which motivated the partners to consider this new model. After 18 months of negotiations, they were able to convert the family medicine center and residency program into a new federally qualified health center. The benefits to this new model include an increase in both patient volume and the quality of education, supporting residency accreditation; a greater number of residents from U.S. medical schools; enhanced education and preparation of primary care physicians for practice in medically underserved communities; enhanced reimbursements and new opportunities for state, local, and federal grants; and quality improvement and new information technology. The partners overcame academic, administrative, legal, and regulatory obstacles, communication barriers, and differences in culture and expectations to achieve this merger. Keys to their success include the commitment of the leaders at the three institutions to the goals of the merger, a dedicated project manager and consultants, opportunities for new revenue sources and reimbursements, and support from a pioneering charitable foundation. The authors conclude by discussing the implications of using community health centers as the focal point for training primary care clinicians and addressing workforce shortages.

A 5-year scientometric analysis of research centers affiliated to Tehran University of Medical Sciences

PubMed Central

Yazdani, Kamran; Rahimi-Movaghar, Afarin; Nedjat, Saharnaz; Ghalichi, Leila; Khalili, Malahat

2015-01-01

Background: Since Tehran University of Medical Sciences (TUMS) has the oldest and highest number of research centers among all Iranian medical universities, this study was conducted to evaluate scientific output of research centers affiliated to Tehran University of Medical Sciences (TUMS) using scientometric indices and the affecting factors. Moreover, a number of scientometric indicators were introduced. Methods: This cross-sectional study was performed to evaluate a 5-year scientific performance of research centers of TUMS. Data were collected through questionnaires, annual evaluation reports of the Ministry of Health, and also from Scopus database. We used appropriate measures of central tendency and variation for descriptive analyses. Moreover, uni-and multi-variable linear regression were used to evaluate the effect of independent factors on the scientific output of the centers. Results: The medians of the numbers of papers and books during a 5-year period were 150.5 and 2.5 respectively. The median of the "articles per researcher" was 19.1. Based on multiple linear regression, younger age centers (p=0.001), having a separate budget line (p=0.016), and number of research personnel (p<0.001) had a direct significant correlation with the number of articles while real properties had a reverse significant correlation with it (p=0.004). Conclusion: The results can help policy makers and research managers to allocate sufficient resources to improve current situation of the centers. Newly adopted and effective scientometric indices are is suggested to be used to evaluate scientific outputs and functions of these centers. PMID:26157724

Print campaign. Branding through print for Corpus Christi (TX) Medical Center.

PubMed

2007-01-01

Corpus Christi Medical Center, a 582-bed healthcare system consisting of four hospitals throughout south Texas, launched a print branding effort at the beginning of the year featuring its own doctors. The print ads promote several of the various service lines offered at the hospitals, including cardiac care.

Marketing the academic medical center group practice.

PubMed

Eudes, J A; Divis, K L

1992-01-01

From a marketing perspective, there are many differences between private and academic medical center (AMC) group practices. Given the growing competition between the two, write John Eudes and Kathy Divis, it is important for the AMC group practice to understand and use these differences to develop a competitive market advantage.

Claretian Medical Center Task Analysis. Worker Education Program.

ERIC Educational Resources Information Center

Union of Needletrades, Industrial and Textile Employees.

This task analysis for positions at the Claretian Medical Center in southeast Chicago was developed to improve communication and customer service in the workplace. The task analysis was prepared through clinic tours, employee interviews, and supervisor questionnaires. It is used for the purpose of curriculum development for onsite instruction in…

21 CFR 312.48 - Dispute resolution.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 5 2011-04-01 2011-04-01 false Dispute resolution. 312.48 Section 312.48 Food and... division in FDA's Center for Drug Evaluation and Research or Center for Biologics Evaluation and Research... 20. (c) Scientific and medical disputes. (1) When scientific or medical disputes arise during the...

78 FR 30933 - National Cancer Institute; Notice of Closed Meetings

Federal Register 2010, 2011, 2012, 2013, 2014

2013-05-23

... proposals. Place: National Cancer Institute Shady Grove, Shady Grove, 9609 Medical Center Drive, Room 4W032... Review Officer, Special Review and Logistics Branch, Division of Extramural Activities, National Cancer Institute, 9609 Medical Center Drive, Room 7W108, Bethesda, Md 20892-9750, 240-276-6378, [email protected

Photocopy of post card from Fitzsimons Army Medical Center Public ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Photocopy of post card from Fitzsimons Army Medical Center Public Affairs Office, building 120. Photograph by Rocky Mountain photo. CO was no copyrighted and is , therefore, in the public domain. - Fitzsimons General Hospital, Memorial Tablet, West McAfee, South of Building No. 524, Aurora, Adams County, CO

A bill to designate the Department of Veterans Affairs Medical Center in Spokane, Washington, as the "Mann-Grandstaff Department of Veterans Affairs Medical Center".

THOMAS, 112th Congress

Sen. Murray, Patty [D-WA

2011-10-13

Senate - 06/27/2012 Committee on Veterans' Affairs. Hearings held. Hearings printed: S.Hrg. 112-668. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

5. Photograph of a line drawing in the possession of ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. Photograph of a line drawing in the possession of the Engineer's Office of the Marion, IL Veterans Administration Medical Center. PLOT PLAN; DRAWING 1R, DATED SEPTEMBER 4, 1940. (8 x 10 negative) - Veterans Administration Medical Center, Old State Route 13 West, Marion, Williamson County, IL

3. Photograph of an historic photograph in the possession of ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

3. Photograph of an historic photograph in the possession of the Engineer's Office of the Marion, Illinois Veterans Administration Medical Center. DINING HALL BUILDING #2, LOOKING NE; DATED JANUARY 31, 1942. - Veterans Administration Medical Center, Building No. 2, Old State Route 13 West, Marion, Williamson County, IL

16. Photograph of an historic photograph in the possession of ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

16. Photograph of an historic photograph in the possession of the Engineer's Office of the Marion, IL Veterans Administration Medical Center. HOSPITAL BUILDING #1, LOOKING NE; DATED NOVEMBER 30, 1941. - Veterans Administration Medical Center, Building No. 1, Old State Route 13 West, Marion, Williamson County, IL

PREFLIGHT MEDICAL (GT-7)

NASA Image and Video Library

1965-12-02

S65-56315 (2 Dec. 1965) --- Dr. Charles A. Berry (left), chief of the Manned Spacecraft Center (MSC) Medical Programs, and astronauts James A. Lovell Jr. (center), Gemini-7 pilot, and Frank Borman, Gemini-7 command pilot, examine a series of chest x-rays taken during the preflight physical. Photo credit: NASA

To name the Department of Veterans Affairs medical center in Spokane, Washington, as the "Mann-Grandstaff Department of Veterans Affairs Medical Center".

THOMAS, 112th Congress

Rep. McMorris Rodgers, Cathy [R-WA-5

2011-10-13

Senate - 12/21/2012 Received in the Senate and Read twice and referred to the Committee on Veterans' Affairs. (All Actions) Tracker: This bill has the status Passed HouseHere are the steps for Status of Legislation:

Sustaining Engagement and Rural Scholarship

ERIC Educational Resources Information Center

Longenecker, Randall

2003-01-01

The Ohio State University Medical Center, a large urban academic medical center, and Mary Rutan Hospital, a rural community hospital in Logan County, Ohio, have been linked through a series of scholarly engagements spanning more than thirty years. What emerges from a qualitative study of key informants with personal knowledge of this interaction…

Program review of the USDA Center for Medical, Agricultural and Veterinary Entomology

USDA-ARS?s Scientific Manuscript database

The USDA-ARS Center for Medical, Agricultural and Veterinary Entomology (CMAVE) has a history that starts in 1932 in Orlando to develop methods to control mosquitoes, including malaria vectors under conditions simulating those of the south Pacific jungles, and other insects affecting man and animals...

Syndrome surveillance of fentanyl-laced heroin outbreaks: Utilization of EMS, Medical Examiner and Poison Center databases.

PubMed

Moore, P Quincy; Weber, Joseph; Cina, Steven; Aks, Steven

2017-11-01

Describe surveillance data from three existing surveillance systems during an unexpected fentanyl outbreak in a large metropolitan area. We performed a retrospective analysis of three data sets: Chicago Fire Department EMS, Cook County Medical Examiner, and Illinois Poison Center. Each included data from January 1, 2015 through December 31, 2015. EMS data included all EMS responses in Chicago, Illinois, for suspected opioid overdose in which naloxone was administered and EMS personnel documented other criteria indicative of opioid overdose. Medical Examiner data included all deaths in Cook County, Illinois, related to heroin, fentanyl or both. Illinois Poison Center data included all calls in Chicago, Illinois, related to fentanyl, heroin, and other prescription opioids. Descriptive statistics using Microsoft Excel® were used to analyze the data and create figures. We identified a spike in opioid-related EMS responses during an 11-day period from September 30-October 10, 2015. Medical Examiner data showed an increase in both fentanyl and mixed fentanyl/heroin related deaths during the months of September and October, 2015 (375% and 550% above the median, respectively.) Illinois Poison Center data showed no significant increase in heroin, fentanyl, or other opioid-related calls during September and October 2015. Our data suggests that EMS data is an effective real-time surveillance mechanism for changes in the rate of opioid overdoses. Medical Examiner's data was found to be valuable for confirmation of EMS surveillance data and identification of specific intoxicants. Poison Center data did not correlate with EMS or Medical Examiner data. Copyright © 2017 Elsevier Inc. All rights reserved.

77 FR 6915 - Medical Diagnostic Equipment Accessibility Standards

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-09

... Israel Deaconess Medical Center (October 22, 2009) accessible facilities and accessible medical equipment... of types of accessible medical equipment required in different types of health care facilities. If... facilities, accessible medical equipment, and auxiliary aids and services; University of Southern California...

Staff Responses When Parents Hit Children in a Hospital Setting.

PubMed

Font, Sarah A; Gershoff, Elizabeth T; Taylor, Catherine A; Terreros, Amy; Nielsen-Parker, Monica; Spector, Lisa; Foster, Rebecca H; Budzak Garza, Ann; Olson-Dorff, Denyse

Physical punishment of children is a prevalent practice that is condemned by most medical professionals given its link with increased risk of child physical abuse and other adverse child outcomes. This study examined the prevalence of parent-to-child hitting in medical settings and the intervention behaviors of staff who witness it. Staff at a children's medical center and a general medical center completed a voluntary, anonymous survey. We used descriptive statistics to examine differences in the experiences of physicians, nurses, and other medical staff. We used logistic regression to predict intervention behaviors among staff who witnessed parent-to-child hitting. Of the hospital staff who completed the survey (N = 2863), we found that 50% of physicians, 24% of nurses, 27% of other direct care staff, and 17% of nondirect care staff witnessed parent-to-child hitting at their medical center in the past year. A majority of physicians, nurses, and other direct care staff reported intervening sometimes or always. Nondirect care staff rarely intervened. Believing staff have the responsibility to intervene, and having comfortable strategies with which to intervene were strongly predictive of intervention behavior. Staff who did not intervene commonly reported that they did not know how to respond. Many medical center staff witness parent-to-child hitting. Although some of the staff reported that they intervened when they witnessed this behavior, the findings indicate that staff may need training to identify when and how they should respond.

Staff Responses When Parents Hit Children in a Hospital Setting

PubMed Central

Font, Sarah A.; Gershoff, Elizabeth T.; Taylor, Catherine A.; Terreros, Amy; Nielsen-Parker, Monica; Spector, Lisa; Foster, Rebecca H.; Budzak Garza, Ann; Olson-Dorff, Denyse

2016-01-01

Objective Physical punishment of children is a prevalent practice that is condemned by most medical professionals given its link with increased risk of child physical abuse and other adverse child outcomes. This study examined the prevalence of parent-to-child hitting in medical settings and the intervention behaviors of staff who witness it. Method Staff at a children's medical center and a general medical center completed a voluntary, anonymous survey. We used descriptive statistics to examine differences in the experiences of physicians, nurses, and other medical staff. We used logistic regression to predict intervention behaviors among staff who witnessed parent-to-child hitting. Results Of the hospital staff who completed the survey (N=2,863), we found that 50% of physicians, 24% of nurses, 27% of other direct care staff, and 17% of non-direct care staff witnessed parent-to-child hitting at their medical center in the past year. A majority of physicians, nurses and other direct care staff reported intervening sometimes or always. Non-direct care staff rarely intervened. Believing staff have the responsibility to intervene and having comfortable strategies with which to intervene were strongly predictive of intervention behavior. Staff who did not intervene commonly reported that they did not know how to respond. Conclusion Many medical center staff witness parent-to-child hitting. Although some of the staff reported that they intervened when they witnessed this behavior, the findings indicate that staff may need training to identify when and how they should respond. PMID:27802257

Health Hazard Evaluation Report HETA 84-046-1584, Hennepin County Medical Center, Minneapolis, Minnesota. [Ethylene oxide and waste anesthetic gases

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

Daniels, W.J.; Orris, P.

1985-04-01

Personal and area air samples were analyzed for ethylene oxide and waste anesthetic gases at Hennepin County Medical Center, Minneapolis, Minnesota in February, April, and July, 1984. The survey was requested by the center to evaluate health problems among employees. Medical questionnaires were administered and interviews were conducted with 59 employees in the instrument and operating room areas of the ear, nose, and throat, and surgery clinics. Ethylene-oxide was not detected during operation of the sterilizer. Nitrous-oxide concentrations of 66 to 138ppm were detected during surgical procedures. The authors conclude that a health hazard due to exposure to waste anestheticmore » gases exists at the center. Recommendations include evaluating the ventilation system and conducting additional monitoring for waste anesthetic gases.« less

Improving communication skill training in patient centered medical practice for enhancing rational use of laboratory tests: The core of bioinformation for leveraging stakeholder engagement in regulatory science.

PubMed

Moura, Josemar de Almeida; Costa, Bruna Carvalho; de Faria, Rosa Malena Delbone; Soares, Taciana Figueiredo; Moura, Eliane Perlatto; Chiappelli, Francesco

2013-01-01

Requests for laboratory tests are among the most relevant additional tools used by physicians as part of patient's health problemsolving. However, the overestimation of complementary investigation may be linked to less reflective medical practice as a consequence of a poor physician-patient communication, and may impair patient-centered care. This scenario is likely to result from reduced consultation time, and a clinical model focused on the disease. We propose a new medical intervention program that specifically targets improving the patient-centered communication of laboratory tests results, the core of bioinformation in health care. Expectations are that medical students training in communication skills significantly improve physicians-patient relationship, reduce inappropriate use of laboratorial tests, and raise stakeholder engagement.

Early experiences with big data at an academic medical center.

PubMed

Halamka, John D

2014-07-01

Beth Israel Deaconess Medical Center (BIDMC), an academic health care institution affiliated with Harvard University, has been an early adopter of electronic applications since the 1970s. Various departments of the medical center and the physician practice groups affiliated with it have implemented electronic health records, filmless imaging, and networked medical devices to such an extent that data storage at BIDMC now amounts to three petabytes and continues to grow at a rate of 25 percent a year. Initially, the greatest technical challenge was the cost and complexity of data storage. However, today the major focus is on transforming raw data into information, knowledge, and wisdom. This article discusses the data growth, increasing importance of analytics, and changing user requirements that have shaped the management of big data at BIDMC. Project HOPE—The People-to-People Health Foundation, Inc.

[Variables determining the amount of care for very preterm neonates: the concept of medical stance].

PubMed

Burguet, A; Menget, A; Chary-Tardy, A-C; Savajols, E; Abed, N; Thiriez, G

2014-02-01

To compare the amount of medical interventions on very preterm neonates (24-31 weeks of gestation) in two French university tertiary care centers, one of which is involved in a Neonatal Developmental Care program. A secondary objective is to assess whether this difference in medical interventions can be linked to a difference in mortality and morbidity rates. We prospectively included all very preterm neonates free from lethal malformation born live in these two centers between 2006 and 2010. These inclusion criteria were met by 1286 patients, for whom we compared the rate of five selected medical interventions: birth by caesarean section, chest intubation in the delivery room, surfactant therapy, pharmacological treatment of patent ductus arteriosus, and red blood cell transfusion. The rates of the five medical interventions were systematically lower in the center that is involved in Neonatal Developmental Care. There was no significant difference in survival at discharge with no severe cerebral ultrasound scan abnormalities between the two centers. There were, however, significantly higher rates of bronchopulmonary dysplasia and nosocomial sepsis and longer hospital stays when the patients were not involved in a Neonatal Developmental Care program. This benchmarking study shows that in France, in the first decade of the 21st century, there are as many ways to handle very preterm neonates as there are centers in which they are born. This brings to light the concept of medical stance, which is the general care approach prior to the treatment itself. This medical stance creates the overall framework for the staff's decision-making regarding neonate care. The different parameters structuring medical stance are discussed. Moreover, this study raises the problematic issue of the aftermath of benchmarking studies when the conclusion is an increase of morbidity in cases where procedure leads to more interventions. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

[E-learning in ENT: Usage in University Medical Centers in Germany].

PubMed

Freiherr von Saß, Peter; Klenzner, Thomas; Scheckenbach, Kathrin; Chaker, Adam

2017-03-01

E-learning is an essential part of innovative medical teaching concepts. The challenging anatomy and physiology in ENT is considered particularly suitable for self-assessed and adaptive e-learning. Usage and data on daily experience with e-learning in German ENT-university hospitals are currently unavailable and the degree of implementation of blended learning including feed-back from medical students are currently not known. We investigated the current need and usage of e-learning in academic ENT medical centers in Germany. We surveyed students and chairs for Otorhinolaryngology electronically and paperbased during the summer semester 2015. Our investigation revealed an overall heterogenous picture on quality and quantity of offered e-learning applications. While the overall amount of e-learning in academic ENT in Germany is rather low, at least half of the ENT-hospitals in medical faculties reported that e-learning had improved their own teaching activities. More collaboration among medical faculties and academic ENT-centers may help to explore new potentials, overcome technical difficulties and help to realize more ambitious projects. © Georg Thieme Verlag KG Stuttgart · New York.

Optimizing perioperative Crohn's disease management: role of coordinated medical and surgical care.

PubMed

Bennett, Jennifer L; Ha, Christina Y; Efron, Jonathan E; Gearhart, Susan L; Lazarev, Mark G; Wick, Elizabeth C

2015-01-28

To investigate rates of re-establishing gastroenterology care, colonoscopy, and/or initiating medical therapy after Crohn's disease (CD) surgery at a tertiary care referral center. CD patients having small bowel or ileocolonic resections with a primary anastomosis between 2009-2012 were identified from a tertiary academic referral center. CD-specific features, medications, and surgical outcomes were abstracted from the medical record. The primary outcome measure was compliance rates with medical follow-up within 4 wk of hospital discharge and surveillance colonoscopy within 12 mo of surgery. Eighty-eight patients met study inclusion criteria with 92% (n=81) of patients returning for surgical follow-up compared to only 41% (n=36) of patients with documented gastroenterology follow-up within four-weeks of hospital discharge, P<0.05. Factors associated with more timely postoperative medical follow-up included younger age, longer length of hospitalization, postoperative biologic use and academic center patients. In the study cohort, 75.0% of patients resumed medical therapy within 12 mo, whereas only 53.4% of patients underwent a colonoscopy within 12 mo of surgery. Our study highlights the need for coordinated CD multidisciplinary clinics and structured handoffs among providers to improve of quality of care in the postoperative setting.

Medically Unexplained Symptoms

MedlinePlus

WRIISC War Related Illness and Injury Study Center Office of Public Health Department of Veterans Affairs MEDICALLY UNEXPLAINED SYMPTOMS A RESOURCE FOR VETERANS, SERVICE MEMBERS, AND THEIR FAMILIES Medically Unexplained ...

A Journey through Meaningful Use at a Large Academic Medical Center: Lessons of Leadership, Administration, and Technical Implementation

PubMed Central

Unger, Melissa D.; Aldrich, Alison M.; Hefner, Jennifer L.; Rizer, Milisa K.

2014-01-01

Successfully reporting meaningful use of electronic health records to the Centers for Medicare and Medicaid Services can be a challenging process, particularly for healthcare organizations with large numbers of eligible professionals. This case report describes a successful meaningful use attestation process undertaken at a major academic medical center. It identifies best practices in the areas of leadership, administration, communication, ongoing support, and technological implementation. PMID:25593572

The patient-centered medical home neighbor: A primary care physician's view.

PubMed

Sinsky, Christine A

2011-01-04

The American College of Physicians' position paper on the patient-centered medical home neighbor (PCMH-N) extends the work of the patient-centered medical home (PCMH) as a means of improving the delivery of health care. Recognizing that the PCMH does not exist in isolation, the PCMH-N concept outlines expectations for comanagement, communication, and care coordination and broadens responsibility for safe, effective, and efficient care beyond primary care to include physicians of all specialties. As such, it is a fitting follow-up to the PCMH and moves further down the road toward improved care for complex patients. Yet, there is more work to be done. Truly transforming the U.S. health care system around personalized medical homes embedded in highly functional medical neighborhoods will require better staffing models; more robust electronic information tools; aligned incentives for quality and efficiency within payment and regulatory policies; and a culture of greater engagement of patients, their families, and communities.

Luxury primary care, academic medical centers, and the erosion of science and professional ethics.

PubMed

Donohoe, Martin

2004-01-01

Medical schools and teaching hospitals have been hit particularly hard by the financial crisis affecting health care in the United States. To compete financially, many academic medical centers have recruited wealthy foreign patients and established luxury primary care clinics. At these clinics, patients are offered tests supported by little evidence of their clinical and/or cost effectiveness, which erodes the scientific underpinnings of medical practice. Given widespread disparities in health, wealth, and access to care, as well as growing cynicism and dissatisfaction with medicine among trainees, the promotion by these institutions of an overt, two-tiered system of care, which exacerbates inequities and injustice, erodes professional ethics. Academic medical centers should divert their intellectual and financial resources away from luxury primary care and toward more equitable and just programs designed to promote individual, community, and global health. The public and its legislators should, in turn, provide adequate funds to enable this. Ways for academic medicine to facilitate this largesse are discussed.

Luxury Primary Care, Academic Medical Centers, and the Erosion of Science and Professional Ethics

PubMed Central

Donohoe, Martin

2004-01-01

Medical schools and teaching hospitals have been hit particularly hard by the financial crisis affecting health care in the United States. To compete financially, many academic medical centers have recruited wealthy foreign patients and established luxury primary care clinics. At these clinics, patients are offered tests supported by little evidence of their clinical and/or cost effectiveness, which erodes the scientific underpinnings of medical practice. Given widespread disparities in health, wealth, and access to care, as well as growing cynicism and dissatisfaction with medicine among trainees, the promotion by these institutions of an overt, two-tiered system of care, which exacerbates inequities and injustice, erodes professional ethics. Academic medical centers should divert their intellectual and financial resources away from luxury primary care and toward more equitable and just programs designed to promote individual, community, and global health. The public and its legislators should, in turn, provide adequate funds to enable this. Ways for academic medicine to facilitate this largesse are discussed. PMID:14748866

Biocuration in the structure-function linkage database: the anatomy of a superfamily.

PubMed

Holliday, Gemma L; Brown, Shoshana D; Akiva, Eyal; Mischel, David; Hicks, Michael A; Morris, John H; Huang, Conrad C; Meng, Elaine C; Pegg, Scott C-H; Ferrin, Thomas E; Babbitt, Patricia C

2017-01-01

With ever-increasing amounts of sequence data available in both the primary literature and sequence repositories, there is a bottleneck in annotating molecular function to a sequence. This article describes the biocuration process and methods used in the structure-function linkage database (SFLD) to help address some of the challenges. We discuss how the hierarchy within the SFLD allows us to infer detailed functional properties for functionally diverse enzyme superfamilies in which all members are homologous, conserve an aspect of their chemical function and have associated conserved structural features that enable the chemistry. Also presented is the Enzyme Structure-Function Ontology (ESFO), which has been designed to capture the relationships between enzyme sequence, structure and function that underlie the SFLD and is used to guide the biocuration processes within the SFLD. http://sfld.rbvi.ucsf.edu/. © The Author 2017. Published by Oxford University Press.

Determination of ubiquitin fitness landscapes under different chemical stresses in a classroom setting.

PubMed

Mavor, David; Barlow, Kyle; Thompson, Samuel; Barad, Benjamin A; Bonny, Alain R; Cario, Clinton L; Gaskins, Garrett; Liu, Zairan; Deming, Laura; Axen, Seth D; Caceres, Elena; Chen, Weilin; Cuesta, Adolfo; Gate, Rachel E; Green, Evan M; Hulce, Kaitlin R; Ji, Weiyue; Kenner, Lillian R; Mensa, Bruk; Morinishi, Leanna S; Moss, Steven M; Mravic, Marco; Muir, Ryan K; Niekamp, Stefan; Nnadi, Chimno I; Palovcak, Eugene; Poss, Erin M; Ross, Tyler D; Salcedo, Eugenia C; See, Stephanie K; Subramaniam, Meena; Wong, Allison W; Li, Jennifer; Thorn, Kurt S; Conchúir, Shane Ó; Roscoe, Benjamin P; Chow, Eric D; DeRisi, Joseph L; Kortemme, Tanja; Bolon, Daniel N; Fraser, James S

2016-04-25

Ubiquitin is essential for eukaryotic life and varies in only 3 amino acid positions between yeast and humans. However, recent deep sequencing studies indicate that ubiquitin is highly tolerant to single mutations. We hypothesized that this tolerance would be reduced by chemically induced physiologic perturbations. To test this hypothesis, a class of first year UCSF graduate students employed deep mutational scanning to determine the fitness landscape of all possible single residue mutations in the presence of five different small molecule perturbations. These perturbations uncover 'shared sensitized positions' localized to areas around the hydrophobic patch and the C-terminus. In addition, we identified perturbation specific effects such as a sensitization of His68 in HU and a tolerance to mutation at Lys63 in DTT. Our data show how chemical stresses can reduce buffering effects in the ubiquitin proteasome system. Finally, this study demonstrates the potential of lab-based interdisciplinary graduate curriculum.

A Historical Review of R. J. Reynolds’ Strategies for Marketing Tobacco to Hispanics in the United States

PubMed Central

Parascandola, Mark

2013-01-01

Hispanics are the fastest growing racial/ethnic group in the United States, and smoking is the leading preventable cause of morbidity and mortality among this population. We analyzed tobacco industry documents on R. J. Reynolds’ marketing strategies toward the Hispanic population using tobacco industry document archives from the Legacy Tobacco Documents Library (http://legacy.library.ucsf.edu) between February–July 2011 and April–August 2012. Our analysis revealed that by 1980 the company had developed a sophisticated surveillance system to track the market behavior of Hispanic smokers and understand their psychographics, cultural values, and attitudes. This information was translated into targeted marketing campaigns for the Winston and Camel brands. Marketing targeted toward Hispanics appealed to values and sponsored activities that could be perceived as legitimating. Greater understanding of tobacco industry marketing strategies has substantial relevance for addressing tobacco-related health disparities. PMID:23488493

A historical review of R.J. Reynolds' strategies for marketing tobacco to Hispanics in the United States.

PubMed

Iglesias-Rios, Lisbeth; Parascandola, Mark

2013-05-01

Hispanics are the fastest growing racial/ethnic group in the United States, and smoking is the leading preventable cause of morbidity and mortality among this population. We analyzed tobacco industry documents on R. J. Reynolds' marketing strategies toward the Hispanic population using tobacco industry document archives from the Legacy Tobacco Documents Library (http://legacy.library.ucsf.edu) between February-July 2011 and April-August 2012. Our analysis revealed that by 1980 the company had developed a sophisticated surveillance system to track the market behavior of Hispanic smokers and understand their psychographics, cultural values, and attitudes. This information was translated into targeted marketing campaigns for the Winston and Camel brands. Marketing targeted toward Hispanics appealed to values and sponsored activities that could be perceived as legitimating. Greater understanding of tobacco industry marketing strategies has substantial relevance for addressing tobacco-related health disparities.

Building leadership among laboratory-based and clinical and translational researchers: the University of California, San Francisco experience.

PubMed

Wides, Cynthia; Mertz, Elizabeth; Lindstaedt, Bill; Brown, Jeanette

2014-02-01

In 2005 the University of California, San Francisco (UCSF) implemented the Scientific Leadership and Management (SLM) course, a 2-day leadership training program to assist laboratory-based postdoctoral scholars in their transition to independent researchers managing their own research programs. In 2011, the course was expanded to clinical and translational junior faculty and fellows. The course enrollment was increased from approximate 100 to 123 participants at the same time. Based on course evaluations, the number and percent of women participants appears to have increased over time from 40% (n = 33) in 2007 to 53% (n = 58) in 2011. Course evaluations also indicated that participants found the course to be relevant and valuable in their transition to academic leadership. This paper describes the background, structure, and content of the SLM and reports on participant evaluations of the course offerings from 2007 through 2011. © 2014 Wiley Periodicals, Inc.

The Association of Electronic Health Record Adoption with Staffing Mix in Community Health Centers.

PubMed

Frogner, Bianca K; Wu, Xiaoli; Park, Jeongyoung; Pittman, Patricia

2017-02-01

To assess how medical staffing mix changed over time in association with the adoption of electronic health records (EHRs) in community health centers (CHCs). Community health centers within the 50 states and Washington, DC. Estimated how the change in the share of total medical staff full-time equivalents (FTE) by provider category between 2007 and 2013 was associated with EHR adoption using fractional multinomial logit. 2007-2013 Uniform Data System, an administrative data set of Section 330 federal grant recipients; and Readiness for Meaningful Use and HIT and Patient Centered Medical Home Recognition Survey responses collected from Section 330 recipients between December 2010 and February 2011. Having an EHR system did significantly shift the share of workers over time between physicians and each of the other categories of health care workers. While an EHR system significantly shifted the share of physician and other medical staff, this effect did not significantly vary over time. CHCs with EHRs by the end of the study period had a relatively greater proportion of other medical staff compared to the proportion of physicians. Electronic health records appeared to influence staffing allocation in CHCs such that other medical staff may be used to support adoption of EHRs as well as be leveraged as an important care provider. © Health Research and Educational Trust.

Business continuity after catastrophic medical events: the Joplin medical business continuity report.

PubMed

Carlton, Paul K; Bringle, Dottie

2012-01-01

On May 22, 2011, The St Johns Mercy Medical Center in Joplin, MO, was destroyed by an F-5 tornado. There were 183 patients in the building at that time in this 367-bed Medical Center. The preparation and response were superbly done and resulted in many lives saved. This report is focused on the reconstitution phase of this disaster response, which includes how to restore business continuity. As 95 percent of our medical capacity resides in the private sector in the United States, we must have a proper plan for how to restore business continuity or face the reality of the medical business failing and not providing critical medical services to the community. A tornado in 2007 destroyed a medical center in Sumter County, GA, and it took more than 365 days to restore business continuity at a cost of $18M. The plan executed by the Mercy Medical System after the disaster in Joplin restored business continuity in 88 days and cost a total of $6.6M, with all assets being reusable. The recommendation from these lessons learned is that every county, state, and Federal Emergency Management Agency region has a plan on the shelf to restore business continuity and the means to be able to do so. The hard work that the State of Missouri and the Mercy Medical System did after this disaster can serve as a model for the nation in how to quickly recover from any loss of medical capability.

Elements of the patient-centered medical home associated with health outcomes among veterans: the role of primary care continuity, expanded access, and care coordination.

PubMed

Nelson, Karin; Sun, Haili; Dolan, Emily; Maynard, Charles; Beste, Laruen; Bryson, Christopher; Schectman, Gordon; Fihn, Stephan D

2014-01-01

Care continuity, access, and coordination are important features of the patient-centered medical home model and have been emphasized in the Veterans Health Administration patient-centered medical home implementation, called the Patient Aligned Care Team. Data from more than 4.3 million Veterans were used to assess the relationship between these attributes of Patient Aligned Care Team and Veterans Health Administration hospitalization and mortality. Controlling for demographics and comorbidity, we found that continuity with a primary care provider was associated with a lower likelihood of hospitalization and mortality among a large population of Veterans receiving VA primary care.

NASA Johnson Space Center Biomedical Research Resources

NASA Technical Reports Server (NTRS)

Paloski, W. H.

1999-01-01

Johnson Space Center (JSC) medical sciences laboratories constitute a national resource for support of medical operations and life sciences research enabling a human presence in space. They play a critical role in evaluating, defining, and mitigation the untoward effect of human adaption to space flight. Over the years they have developed the unique facilities and expertise required to perform: biomedical sample analysis and physiological performance tests supporting medical evaluations of space flight crew members and scientific investigations of the operationally relevant medical, physiological, cellular, and biochemical issues associated with human space flight. A general overview of these laboratories is presented in viewgraph form.

Women's Health and Complementary Approaches

MedlinePlus

... Information Center Ongoing Medical Studies Find Active Medical Research Studies on Cranberry (ClinicalTrials.gov) Find Active Medical Research Studies on Menopause (ClinicalTrials.gov) Safety Information Dream Body ...

Expanding rural primary care training by employing information technologies: the need for participation by medical reference librarians.

PubMed

Coggan, J M; Crandall, L A

1995-01-01

The use of rural sites to train badly needed primary care providers requires access to sophisticated medical information not traditionally available outside of academic health centers. Medical reference librarians can play a key role in the development of primary care training sites in rural settings. Electronic information technologies, with proactive support from medical reference librarians, can provide current and detailed information without concern for distance from the health science center library. This paper discusses recent developments in technology, describes current challenges to the application of this technology in rural settings, and provides policy recommendations for medical reference librarians to enhance rural primary care training.

Rural Medical Service Funding: Issues and Alternatives. Rural Information Center Publication Series, No. 7.

ERIC Educational Resources Information Center

Kane, John D. H., III, Comp.; Leuci, Mary Simon, Comp.

By almost any definition, rural America has been medically underserved. This bibliography includes materials available from the National Agricultural Library's (NAL) Rural Information Center. The listed materials include approximately 36 books and monographs, 106 articles, and the names and addresses of 17 related associations. Certain local…

Evaluation and Management of Combat-Related Spinal injuries: A Review Based on Recent Experiences

DTIC Science & Technology

2012-01-01

Piedras St, El Paso, TX 79920, USA bIntegrated Department of Orthopaedic Surgery and Rehabilitation, Walter Reed National Military Medical Center...Surgery, 115th Combat Support Hospital and William Beaumont Army Medical Center, 5005 N. Piedras St, El Paso, TX 79920, USA. Tel.: (330) 329 2594. E

Medical Student Psychiatric Education in Neighborhood Health Settings.

ERIC Educational Resources Information Center

Morrison, Andrew P.

1978-01-01

Harvard medical students in a psychiatric rotation at the Massachusetts Mental Health Center may elect to do part of their work in a neighborhood comprehensive health center in which primary care services are offered. Students are exposed to a multiprofessional and mixed professional-paraprofessional staff, as well as to special patient problems.…

Veterans Affairs and Academic Medical Center Affiliations: The North Texas Experience

ERIC Educational Resources Information Center

Mohl, Paul Cecil; Hendrickse, William; Orsak, Catherine; Vermette, Heidi

2009-01-01

Objective: The authors review the more than 30-year history of the academic affiliation between the Department of Psychiatry at the University of Texas Southwestern Medical Center in Dallas and the Mental Health Service at the Veterans Affairs North Texas Health Care System. Methods: The authors interviewed individuals involved at various stages…

17. Photograph of a line drawing in the possession of ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

17. Photograph of a line drawing in the possession of the Engineer's Office of the Marion, IL Veterans Administration Medical Center. FRONT (NORTH) ELEVATION; DRAWING 1-7R, DATED SEPTEMBER 4, 1940. (8 x 10 negative) - Veterans Administration Medical Center, Building No. 1, Old State Route 13 West, Marion, Williamson County, IL

Context view, Building Nos. 2729, with Building No. 28 in ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

Context view, Building Nos. 27-29, with Building No. 28 in the center, looking west at front of buildings, from a spot south of Building No. 29 - U.S. Veterans Hospital, Jefferson Barracks, Medical Officer in Charge Residence, VA Medical Center, Jefferson Barracks Division 1 Jefferson Barracks Drive, Saint Louis, Independent City, MO

1. Photograph of a line drawing in the possession of ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. Photograph of a line drawing in the possession of the Engineer's Office of the Marion, Illinois Veterans Administration Medical Center. (PLANS & ELEVATIONS); DRAWING 14-1R, DATED SEPTEMBER 4, 1940. (8 x 10 negative) - Veterans Administration Medical Center, Building No. 14, Old State Route 13 West, Marion, Williamson County, IL

4. Photograph of a line drawing in the possession of ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

4. Photograph of a line drawing in the possession of the Engineer's Office of the Marion, Illinois Veterans Administration Medical Center. (PLANS, ELEVATIONS & DETAILS); DRAWING 8-1R, DATED SEPTEMBER 4, 1940. (8 x 10 negative) - Veterans Administration Medical Center, Building No. 8, Old State Route 13 West, Marion, Williamson County, IL

18. Photograph of a line drawing in the possession of ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

18. Photograph of a line drawing in the possession of the Engineer's Office of the Marion, IL Veterans Administration Medical Center. SIDE (EAST) ELEVATION & SIDE (WEST) ELEVATION; DRAWING 1-9R, DATED SEPTEMBER 4, 1940. - Veterans Administration Medical Center, Building No. 1, Old State Route 13 West, Marion, Williamson County, IL

23. Photograph of a line drawing in the possession of ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

23. Photograph of a line drawing in the possession of the Engineer's Office of the Marion, IL Veterans Administration Medical Center. TYPICAL LOBBY DETAILS; DRAWING 1-21R, DATED SEPTEMBER 4, 1940. (8 x 10 negative) - Veterans Administration Medical Center, Building No. 1, Old State Route 13 West, Marion, Williamson County, IL

4. Photograph of a line drawing in the possession of ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

4. Photograph of a line drawing in the possession of the Engineer's office of the Marion, Illinois Veterans Administration Medical Center. (PLANS, ELEVATIONS & DETAILS); DRAWING 13-1R, DATED SEPTEMBER 4, 1940. (8 x 10 negative) - Veterans Administration Medical Center, Building No. 13, Old State Route 13 West, Marion, Williamson County, IL

1. Photograph of a line drawing in the possession of ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

1. Photograph of a line drawing in the possession of the Engineer's Office of the Marion, Illinois Veterans Administration Medical Center. (PLAN, ELEVATIONS, & SECTIONS); DRAWING 15-1R, DATED SEPTEMBER 4, 1940. (8 x 10 negative) - Veterans Administration Medical Center, Building No. 15, Old State Route 13 West, Marion, Williamson County, IL

15. Photograph of an historic photograph in the possession of ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

15. Photograph of an historic photograph in the possession of the Engineer's Office of the Marion, IL Veterans Administration Medical Center. HOSPITAL BUILDING #1; E & N (FRONT) ELEVATIONS, LOOKING SW; DATED MAY 18, 1942. - Veterans Administration Medical Center, Building No. 1, Old State Route 13 West, Marion, Williamson County, IL

22. Photograph of a line drawing in the possession of ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

22. Photograph of a line drawing in the possession of the Engineer's Office of the Marion, IL Veterans Administration Medical Center. MAIN LOBBY & ELEVATOR LOBBY DETAILS; DRAWING 1-20R, DATED SEPTEMBER 4, 1940. - Veterans Administration Medical Center, Building No. 1, Old State Route 13 West, Marion, Williamson County, IL

An Expanded Model of Faculty Vitality in Academic Medicine

ERIC Educational Resources Information Center

Dankoski, Mary E.; Palmer, Megan M.; Laird, Thomas F. Nelson; Ribera, Amy K.; Bogdewic, Stephen P.

2012-01-01

Many faculty in today's academic medical centers face high levels of stress and low career satisfaction. Understanding faculty vitality is critically important for the health of our academic medical centers, yet the concept is ill-defined and lacking a comprehensive model. Expanding on previous research that examines vital faculty in higher…

The Mississippi Years (1969-1974)

ERIC Educational Resources Information Center

Agras, W. Stewart

2012-01-01

The 4 years that Michel Hersen spent at the University of Mississippi Medical Center (1970-1974) are described in this article from the viewpoint of his place in the history of the development of behavior analysis and therapy. The Department of Psychiatry at the University of Mississippi Medical Center became a leader in enhancing the role of…

Individualizing the Orientation Process for Newly Hired CRNAs in a Large Academic Medical Center

ERIC Educational Resources Information Center

Gorman, Katherine

2017-01-01

Purpose: The purpose of this scholarly project was to investigate whether an individualized clinical orientation would result in a shortened time to orient and integrate Certified Registered Nurse Anesthetists (CRNAs) into practice in a large academic medical center. By individualizing the orientation process, this project seeks to determine if…

The 'Adventist advantage'. Glendale Adventist Medical Center distinguishes itself.

PubMed

Botvin, Judith D

2002-01-01

Glendale Adventist Medical Center, Glendale, Calif., adopted an image-building campaign to differentiate the 450-bed hospital from its neighbors. This included the headline "Adventist Advantage," used in a series of sophisticated ads, printed in gold. In all their efforts, marketers consider the sensibilities of the sizable Armenian, Korean, Hispanic and Chinese populations.

Developing a Sustainable Research Culture in an Independent Academic Medical Center

ERIC Educational Resources Information Center

Joyce, Jeffrey N.

2013-01-01

Independent academic medical centers (IAMC) are challenged to develop and support a research enterprise and maintain primary goals of healthcare delivery and financial solvency. Strategies for promoting translational research have been shown to be effective at institutions in the top level of federal funding, but not for smaller IAMCs. The…

Research Strategies for Academic Medical Centers: A Framework for Advancements toward Translational Excellence

ERIC Educational Resources Information Center

Haley, Rand; Champagne, Thomas J., Jr.

2017-01-01

This review article presents a simplified framework for thinking about research strategy priorities for academic medical centers (AMCs). The framework can serve as a precursor to future advancements in translational medicine and as a set of planning guideposts toward ultimate translational excellence. While market pressures, reform uncertainties,…

Building a Culture of Inclusion: Disability as Opportunity for Organizational Growth and Improving Patient Care.

PubMed

Ailey, Sarah H; Brown, Paula; Friese, Tanya R; Dugan, Shelia

2016-01-01

Administrators at Rush University Medical Center have made a commitment to diversity, including accommodating disabilities in the workplace and for students. This article explains extensive multilevel accommodations instituted by Rush University Medical Center that promote organizational growth and a healthier work environment and improve patient care.

78 FR 19586 - Grants for Transportation of Veterans in Highly Rural Areas

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-02

... travel to VA medical centers, and to otherwise assist in providing transportation services in connection... travel to VA medical centers, and to otherwise assist in providing transportation in connection with the... grant funds are to be used to ``assist veterans in highly rural areas to travel to Department of...

Collaborative Care for Children: A Grand Rounds Presentation

ERIC Educational Resources Information Center

Foley, Michele; Dunbar, Nancy; Clancy, Jeanne

2014-01-01

At the end of the 2011-2012 school year, two collaborative initiatives took place in Springfield, MA, between the public school system and Baystate Medical Center, an affiliate of Tufts University. The success of these initiatives was highlighted during grand rounds that featured academic medical center physicians and nurses as well as public…

"Empathize with Me, Doctor!" Medical Undergraduates Training Project: Development, Application, Six-Months Follow-Up

ERIC Educational Resources Information Center

Kiosses, Vasileios N.; Tatsioni, Athina; Dimoliatis, Ioannis D. K.; Hyphantis, Thomas

2017-01-01

The aim of the study was to assess the effectiveness of specially designed, empathy training for medical undergraduates, based on the principles of Person-Centered Approach. Within the context of the humanistic person-centered patient care, the experiential, 60-hour "Empathize with me, Doctor!" training program contains theory, personal…

Strategic outsourcing of clinical services: a model for volume-stressed academic medical centers.

PubMed

Billi, John E; Pai, Chih-Wen; Spahlinger, David A

2004-01-01

Many academic medical centers have significant capacity constraints and limited ability to expand services to meet demand. Health care management should employ strategic thinking to deal with service demands. This article uses three organizational models to develop a theoretical framework to guide the selection of clinical services for outsourcing.

Correction to: Treatment patterns in patients with osteoporosis at high risk of fracture in Japan: retrospective chart review.

PubMed

Fujiwara, Saeko; Miyauchi, Akimitsu; Hamaya, Etsuro; Nicholls, Rebecca Jayne; Weston, Adele; Baidya, Santwona; Pinto, Lionel; Barron, Rich; Takada, Junichi

2018-05-08

In this article it was mistakenly stated that Akimitsu Miyauchi is affiliated with both Miyauchi Medical Center, Osaka and Amgen Astellas BioPharma K.K., Tokyo. In fact he is affiliated only with Miyauchi Medical Center; he has no connection with Amgen Astellas.

Simple Search Aids with a Little Help from My Friends

ERIC Educational Resources Information Center

Spitzer, Stephan

2008-01-01

The Uniformed Services University of the Health Sciences, located on the National Naval Medical Center's campus in Bethesda, Md., is a medical education and research facility for the nation's military and public health community. The university's James A. Zimble Learning Resource Center provides web-based access to more than 9,000 electronic…

Area health education center libraries and medical school libraries: establishing an interface.

PubMed Central

Bandy, C R

1978-01-01

Establishing an interface between area health education center (AHEC) libraries and medical school libraries requires careful planning, including: the overall plan, needs assessment, resource evaluation, a developmental plan, monitoring and evaluation, institutional agreements, and publicity. This paper reports on the development of AHEC libraries in North Dakota. PMID:708958

[Strategics of medical centers and regional hospitals in response to new labour insurance fee schedule].

PubMed

Wang, S C; Sheen, P C; Ko, Y C

1993-02-01

The purpose of this paper is to evaluate the medical centers and regional hospitals, strategic response to the implementation of new labour insurance fee schedule. This survey selects fifty-one medical centers and regional hospitals, with the response rate of 92.73%. This questionnaire was developed and evaluated by the authors and mailed to the questionnaire response by hospital's director or relative department director. We have selected Shortell et al. (1985) theory as the framework for evaluating and explaining hospital response to regulation environment (ex: change in the reimbursement system) at institutional-level response (ex: hospital association activity aimed at influencing regulation), managerial-level response (ex: increased physician participation in hospital-wide decision making; starting or expanding a planning department) and technical-level response (ex: shared clinical services such as lab., X-ray, pharmacy). The result found that hospitals with the characteristics as non-public ownership, medical centers, bigger size, and more administrative staff are more inclined to adopt institutional-level response. And a technical-level response occurs to hospital when market competibility becomes more intense which leads to higher reimbursement resource dependency.

Monitor for status epilepticus seizures

NASA Technical Reports Server (NTRS)

Johnson, Mark; Simkins, Thomas

1994-01-01

This paper describes the sensor technology and associated electronics of a monitor designed to detect the onset of a seizure disorder called status epilepticus. It is a condition that affects approximately 3-5 percent of those individuals suffering from epilepsy. This form of epilepsy does not follow the typical cycle of start-peak-end. The convulsions continue until medically interrupted and are life threatening. The mortality rate is high without prompt medical treatment at a suitable facility. The paper describes the details of a monitor design that provides an inexpensive solution to the needs of those responsible for the care of individuals afflicted with this disorder. The monitor has been designed as a cooperative research and development effort involving the United States Army Armament Research, Development, and Engineering Center's Benet Laboratories (Benet) and the Cerebral Palsy Center for the Disabled (Center), in association with the Department of Neurology at Albany Medical College (AMC). Benet has delivered a working prototype of the device for field testing, in collaboration with Albany Medical College. The Center has identified several children in need of special monitoring and has agreed to pursue commercialization of the device.

If substance use disorder treatment more than offsets its costs, why don't more medical centers want to provide it? A budget impact analysis in the Veterans Health Administration.

PubMed

Humphreys, Keith; Wagner, Todd H; Gage, Mistry

2011-10-01

Given that many studies have reported that the costs of substance use disorder (SUD) treatment are more than offset by other savings (e.g., in health care, in criminal justice, in foster care), why haven't health care system managers rushed to expand treatment? This article attempts to explain this puzzling discrepancy by analyzing 1998-2006 data from the national Veterans Affairs (VA) health care system. The main outcome measures were annual cost and utilization for VA SUD-diagnosed patients. The key independent variable was the medical centers' annual spending for SUD treatment. There was no evidence that SUD spending was associated with lower medical center costs over time within the medical center that paid for the treatment. Health care system managers may not be influenced by research suggesting that the costs of SUD treatment are more than fully offset because they bear the cost of providing treatment while the savings largely accrue to other systems. Published by Elsevier Inc.

Challenging behavior and related factors in people with intellectual disability living in residential care centers in Israel.

PubMed

Sinai, Amanda; Tenenbaum, Ariel; Aspler, Shoshana; Lotan, Meir; Morad, Mohammed; Merrick, Joav

2013-01-01

Adults with intellectual disabilities have higher rates of mental ill-health and problem behaviors than the general population. In this study, we present data on trends in challenging behavior in residential care centers in Israel from 1998 to 2008 and further data on trends in employment of psychiatrists from 1998 to 2009 and psychotropic medication use from 1998 to 2008. Data was collected from annual questionnaires sent out to all residential care centers in Israel, from the Office of the Medical Director, Division for Intellectual and Developmental Disabilities, Ministry of Social Affairs and Social Services. Rates of challenging behaviors in people with intellectual disabilities living in residential care centers in Israel continues to rise. Alongside this, trends in regular psychotropic medication use also continues to increase. Consideration of biological, psychological, social, and environmental factors in the assessment and management of people with intellectual disabilities and challenging behaviors is important. This is best conducted using a multidisciplinary approach, which may include psychiatric assessment. Non-pharmacological interventions should always be considered either alongside, or instead of medication.