SEARCH · PubMed Health

Results for “Medication”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 271 records · Page 15Linked to original sources

PubMed1999

Teaching medical ethics: a review of the literature from North American medical schools with emphasis on education.

Efforts to reform medical education have emphasized the need to formalize instruction in medical ethics. However, the discipline of medical ethics education is still searching for an acceptable identity among North American medical schools; in these schools, no real consensus exists on its definition. Medical educators are grappling with not only what to teach (content) in this regard, but also with how to teach (process) ethics to the physicians of tomorrow. A literature review focused on medical ethics education among North American medical schools reveals that instruction in ethics is considered to be vitally important for medical students. Agreement by medical educators on a possible "core curriculum" in ethics should be explored. To develop such a curriculum, "deliberative curriculum inquiry" by means of a targeted Delphi technique may be a useful methodology. However, the literature reveals that medical curricular change is notoriously slow. General implications for medical ethics education as a discipline are discussed.

Curriculum↗

PubMed1993

Litigation involving medical faculty and academic medical centers, 1950-1991.

An analysis is presented of 240 cases of litigation involving medical faculty, medical schools, and academic medical centers reported over the period 1950-1991. The number of reported cases increased dramatically over the study period in association with the expansion of the national medical educational enterprise. These cases can be conveniently divided by the issues they dealt with into three broad areas: general administration (89 cases), clinical affairs (108 cases), and research issues (43 cases). Cases of litigation related to general administration were most often concerned with the hiring, promotion and/or tenure, and discharge of faculty, with nearly half of these alleging discrimination. General administrative disputes also arose over allocation of departmental resources and responsibilities, faculty conduct, Veterans Affairs, relationships, employee benefits, system-wide discrimination, and collective bargaining. Courts generally supported the exercise of administrative discretion, yet examined procedures carefully. Litigation related to clinical affairs increased dramatically in recent years. Issues litigated reflect the complexity of the existing academic health care system and environment: sovereign immunity and/or malpractice, practice plans, staff privileges, indemnification, access to peer review records or other records, and conduct of practice. Outcomes of clinically related litigation through 1991 indicate substantial leeway for medical faculty, medical schools, and academic medical centers to innovate and advance their patient mission. Litigation related to medical research also accelerated recently. Issues litigated involved grants and/or personnel management, research risks, commercialization, research funding, ethics, and research animals. Litigation has paralleled (1) federal policy initiatives designed to stimulate collaboration between industry and academia and (2) the growth of regulations designed to monitor policy areas affecting research. The exposure of academic medical administrators and faculty to litigation has increased in the last 40 years. Medical schools and academic medical centers should take active steps to reduce future risks of litigation.

Academic Medical Centers↗

PubMed1995

Community hospital and medical school cooperation in continuing medical education.

PURPOSE: To determine the extent and trends of cooperation in continuing medical education (CME) between community teaching hospitals and medical schools in the United States. METHOD: A questionnaire was sent in September 1992 to the directors of CME at 276 teaching hospital members of the Association for Hospital Medical Education (AHME). The survey was designed to answer two questions: (1) What is the extent of cooperation between hospital CME providers and medical schools? (2) In the next three years will community hospitals seek competitive or collaborative relationships in CME with medical schools? RESULTS: By late April 1993, 216 (78%) of the questionnaires had been returned. Of these, 177 (64% of the sample) were analyzed. Of the responding hospitals, 91 (52%) cooperated with 92 medical schools in CME; 75 (45%) of the hospitals planned to increase cooperation. Only ten (11%) of the hospitals described their current CME relationship with a medical school as "competitive in most areas"; 23 (14%) expected to increase competition in the next three years. Forty-one (24%) of the respondents were part of a community hospital CME consortium; only 20 (16%) of the other institutions expected to participate in a consortium in the next three years. Hospital size and membership in the Association of American Medical Colleges' Council of Teaching Hospitals were generally correlated with current and future competition in CME with a medical school and likely participation in a community CME consortium. CONCLUSION: The majority of teaching hospital members of the AHME perceived that they would have cooperative relationships in CME with affiliated medical schools in the three years following the survey. These collaborative relationships should provide an important basis for the further planning and development of medical education consortia.

Data Interpretation, Statistical↗

PubMed2004

Unprofessional behavior in medical school is associated with subsequent disciplinary action by a state medical board.

PURPOSE: To determine if medical students who demonstrate unprofessional behavior in medical school are more likely to have subsequent state board disciplinary action. METHOD: A case-control study was conducted of all University of California, San Francisco, School of Medicine graduates disciplined by the Medical Board of California from 1990-2000 (68). Control graduates (196) were matched by medical school graduation year and specialty choice. Predictor variables were male gender, undergraduate grade point average, Medical College Admission Test scores, medical school grades, National Board of Medical Examiner Part 1 scores, and negative excerpts describing unprofessional behavior from course evaluation forms, dean's letter of recommendation for residencies, and administrative correspondence. Negative excerpts were scored for severity (Good/Trace versus Concern/Problem/Extreme). The outcome variable was state board disciplinary action. RESULTS: The alumni graduated between 1943 and 1989. Ninety-five percent of the disciplinary actions were for deficiencies in professionalism. The prevalence of Concern/Problem/Extreme excerpts in the cases was 38% and 19% in controls. Logistic regression analysis showed that disciplined physicians were more likely to have Concern/Problem/Extreme excerpts in their medical school file (odds ratio, 2.15; 95% confidence interval, 1.15-4.02; p =.02). The remaining variables were not associated with disciplinary action. CONCLUSION: Problematic behavior in medical school is associated with subsequent disciplinary action by a state medical board. Professionalism is an essential competency that must be demonstrated for a student to graduate from medical school.

Adult↗

PubMed1996

Feed us nutrition: final year medical students' perceptions of nutrition medical education.

BACKGROUND: Nutrition is recognised as an integral aspect of Australian medical education. Since medical students will learn more of a subject they consider important, there is a need for their perceptions of nutrition to be investigated. AIMS: To identify final year medical students' perceptions about nutrition and its inclusion in their medical course, and to compare priority nutrition topics identified with those previously identified by Faculty and General Practitioners (GPs) who teach in the undergraduate curriculum. METHODS: A cross-sectional survey of all final year medical students attending the University of Newcastle was conducted, using a distributed questionnaire, comprising three sections: demographics, perceptions about nutrition and its inclusion in the medical course, and a listing of 38 major nutrition topics. Main outcome measures were: interest in nutrition, and whether it should be included in the undergraduate medical curriculum; rated importance of listed nutrition topics; comparison between students and Faculty and GPs. Frequency distributions and Chi square analyses were used to compare group responses. RESULTS: Seventy-one per cent of the students were interested in nutrition and 94% believed it should be included in the medical curriculum. More than 60% of the students nominated 21 of the 38 topics, essential or important. Thirteen of these topics were also highly rated by Faculty and GPs, although Faculty and GPs rated more topics as essential or important. CONCLUSIONS: Newcastle medical students are interested in nutrition and believe it should be included in their medical curriculum. This may be due to their clinical exposure and the educational milieu of the University of Newcastle Medical School. Exposure to nutrition in their undergraduate education appears to be an important determinant for priority designated nutrition topics.

Australia↗

PubMed2001

What does the medical record reveal about functional status? A comparison of medical record and interview data.

OBJECTIVE: Functional status measures are potent independent predictors of hospital outcomes and mortality. The study objective was to compare medical record with interview data for functional status. SUBJECTS AND METHODS: Subjects were 525 medical patients, aged 70 years or older, hospitalized at an academic medical center. Patient interviews determined status for 7 basic activities of daily living (BADLs) and 7 instrumental activities of daily living (IADLs). Medical records were reviewed to assess documentation of BADLs and IADLs. RESULTS: Most medical records contained no documentation of individual BADLs and IADLs (61% to 98% of records lacking documentation), with the exception of walking (24% of medical records lacking documentation). Impairment prevalence was lower in medical records than at interview for all BADLs and IADLs, and agreement between interview and medical record was poor (kappa < 0.40 for individual BADLs and IADLs). Sensitivity of the medical record for BADL and IADL impairment was poor (range 95% to 44%), using the interview as a reference standard. Sensitivity and specificity of the medical record for detection of BADL and IADL impairment changed substantially when records with nondocumentation of functional status were excluded or were assumed to be equivalent to independence. CONCLUSIONS: The results suggest that the medical record is a poor source of data on many functional status measures, and that assuming that nondocumentation of functional status is equivalent to independence may be unwarranted. Given the prognostic importance of functional status measures, the results highlight the importance of developing reliable and efficient means of obtaining functional status information on hospitalized older patients.

Academic Medical Centers↗

PubMed2006

International student exchange and the medical curriculum: evaluation of a medical sciences translational physiology course in Brazil.

The objective of the present study was to conduct a short-term international course on translational physiology for medical students from Wright State University and the University of Iowa. The goals were to 1) provide students with an exposure to the academic, cultural, and medical environments in Brazil; 2) promote awareness of the global medical community; and 3) provide an academic course focused on translational physiology. An evaluation of the students was conducted to determine whether such a short-term course might be useful in the medical curriculum. The 2-wk course was held in the summer of 2005 at the University of São Paulo School of Medicine in Ribeirão Preto, Brazil, for 23 American students. The program included presentations of basic and clinical topics, meetings with medical students, and clinical presentations. The program finished with student attendance at a scientific meeting sponsored by the Brazilian Society of Hypertension. Student surveys evaluated issues related to perceived treatment, Brazilian medical school environment, culture and personal attributes, and career aspirations. The international Medical Sciences Translational Physiology course for medical students provided a brief, but intense, experience. It gave students a picture of the medical environment in Brazil and an appreciation for the differences and similarities in cultures. Most students reported that it was a positive experience that would be beneficial to their careers. In conclusion, a short-term international course provides an efficient means for medical students to experience aspects of global medical science.

Brazil↗

PubMed1999

Contemporary issues in medicine--medical informatics and population health: report II of the Medical School Objectives Project.

The Association of American Medical Colleges established the Medical School Objectives Project (MSOP) to set forth program-level learning objectives that medical school deans and faculties can use as guides in reviewing their medical student education programs (initial phase), and to suggest strategies that they might employ in implementing agreed-upon changes in those programs (implementation phase). The publication of MSOP Report I in 1998 concluded the initial phase of the project by presenting 30 program-level learning objectives that represent a consensus within the medical education community on the knowledge, skills, and attitudes that students should possess before graduation from medical school. Report II, published here, is the work of two expert panels that focus on the two interrelated topics of medical informatics and population health for which Report I developed learning objectives. The Medical Informatics Panel identified five roles played by physicians--lifelong learner, clinician, educator-communicator, researcher, and manager--in which medical informatics plays a vital part, and defined one or more informatics learning objectives important for each role (e.g., the successful medical school graduate, in his or her role as a clinician, should be able to retrieve patient-specific information from a clinical information system). The panel then identified ways that schools might implement educational programs to address the various informatics learning objectives and to eventually embed informatics experiences throughout the curriculum rather than relying on an informatics course to achieve some or all of the objectives. The Population Health Perspective Panel developed a consensus definition of "population health perspective" (PHP); chose four types of populations to discuss (e.g., the geographic community); reviewed pressures for and against the implementation of a PHP in the curriculum (e.g., the cross-disciplinary nature of the topic is a barrier); named the fields that encompass training in a PHP (e.g., public health); listed several educational objectives, three principles to govern the design of educational activities, and a number of recommendations; and closed with a list of the knowledge, skills, and attitudes that should be instilled by a successful PHP curriculum.

Education, Medical, Undergraduate↗

PubMed1991

Recent status of the medical examiner system in Japan: demographic variation of medicolegal deaths in Hyogo Prefecture and uncertainty in medicolegal investigations conducted by medical practitioners.

The medical examiner system has been steadily abolished in Japan. Instead, medicolegal investigations are entrusted by the police to medical practitioners, who are not permitted to perform autopsies. The necessity for the medical examiner system was assessed through inquest records in Hyogo, one of the three prefectures which still have medical examiner systems. Standardized mortality ratios (SMRs) for accidents and suicides were negatively associated with population density, being high in rural areas with a large proportion of elderly citizens, while the SMR for natural deaths was high in urbanized areas and associated with the proportion of inquests to total resident deaths. The high proportion of inquests, however, did not always mean that inquest records were of good quality. Significant differences in the quality of medicolegal investigations seemed to exist between medical examiners and medical practitioners. That is, in order to certify the cause-of-death, medical examiners performed autopsies in about half of their cases, while only 2% of medical practitioner cases were subjected to autopsies. Medical practitioners, who certified the cause-of-death as "heart failure" without advising an autopsy, were regularly entrusted with inquests. It is likely that the causes-of-death for medicolegal cases may be questionable since more than 85% of all medicolegal deaths were investigated by medical practitioners, which may cause inaccuracy in at least 3-7% of mortality statistics. It is necessary to educate medical practitioners concerning the importance of mortality statistics and ICD and on the validity of autopsies, in order to obtain accurate mortality statistics from medicolegal cases.

Accidents↗

PubMedDate not supplied

The Air Medical Leadership Congress: setting the health care agenda for the air medical community.

BACKGROUND: Emergency air medical transport provides the means for critically ill or injured patients to rapidly access sophisticated medical flight teams and medical centers. However, issues such as surging emergency medical services helicopter accidents, expected pilot and nurse shortages, falling reimbursements, and new compliance regulations are now threatening these important but expensive transport services. Unless an industry strategy can be developed to address these and other threats, many medical flight programs may be forced to curtail the availability of these lifesaving services. PURPOSE: On September 4-6, 2003, air medical leaders, experts, program managers, providers, and users of emergency air medical services gathered in Salt Lake City, Utah, to discuss and formulate recommendations to address the top issues that threaten the future of air medical transport services. This congress was open to anyone engaged in the field of air medical transport. This historic meeting resulted in a plan to enhance transport safety, foster appropriate utilization, improve in-flight medical care, maximize cost and reimbursement effectiveness, and develop strategies to reduce the adverse effects of new regulatory and compliance mandates. OBJECTIVES: This article describes the significance of the Air Medical Leadership Congress and the 10-Point Plan method used to develop it.

Air Ambulances↗

PubMed2002

Board certification of medical doctors and medical technologists in transfusion medicine in Japan.

The Japan Society of Blood Transfusion (JSBT) organized a Board for certification of medical doctors in Transfusion Medicine (Board certified medical doctors by the JSBT) and a Board for certification of medical technologists for transfusion medicine (qualified medical technologists in Transfusion Medicine). For certified medical doctors the JSBT co-ordinated with the Japanese Association of Medical Science and with the Japan Medical Association, and for qualified medical technologists the JSBT co-organized with the Japanese Society of Laboratory Medicine, the Japanese Association of Medical Technologist and the College of Clinical Pathology of Japan. By May 2001, 259 of the certified medical doctors and 875 of the qualified medical technologists have been certified and are participating actively to increase the level of transfusion practice at individual facilities.

Blood Transfusion↗

PubMed2005

Drivers of electronic medical record adoption among medical groups.

BACKGROUND: Use of electronic medical records (EMRs) in health care organizations can reduce medical errors and improve quality of care through physicians' increased use of evidence-based patient care processes. However, only 20%-25% of physician organizations have adopted EMRs. A study was undertaken to determine the characteristics of primary care medical groups that distinguish EMR adopter from nonadopter organizations. METHODS: A quantitative nationwide survey was undertaken of all primary care medical groups in the United States with 20 or more physicians; data were collected on 738 medical groups (70% response rate). RESULTS: Fewer than one-third of the medical groups reported having either patients' medical records or progress notes in an EMR. Large organizations with relatively fewer practice locations were more likely to adopt an EMR. DISCUSSION: Large medical groups are more likely to have the financial and human resources necessary to overcome barriers to the adoption of an EMR. Knowing the influence of the other organizational characteristics on EMR adoption will help prepare organizational leaders for the complicated process of achieving consensus among physicians and others in medical groups on the expenditure of funds and other resources to acquire an EMR. Financial incentives for all medical groups will help drive EMR adoption, but financial and technical assistance aimed specifically at smaller groups is particularly warranted. Widespread adoption of EMR among medical groups will take time.

Data Collection↗

PubMed2004

Medical professionalism and continuing professional development for medical specialists.

The present paper briefly describes a growing trend in continuing professional development (CPD) for medical practitioners, examines some recent published contributions related to professionalism in medicine and describes the theoretical platform of a CPD framework based on medical professionalism that has been developed for use in a variety of medical specialties. The work arises from a project funded by The Commonwealth Department of Health and Ageing and conducted by the Royal Australian and New Zealand College of Obstetricians and Gynaecologists on behalf of the Committee of Presidents of Medical Colleges. Overall, the aim of the project was to design and develop a framework that can be considered 'best practice' in the field of medical specialist CPD, and which could be applicable to a wide variety of medical specialties and practice environments. The project was informed by available literature in areas such as the ways in which medical practitioners learn and the effectiveness of CPD, as well as consultations with a variety of stakeholders in the health-care field, including medical boards, medical defence organisations, health complaints organisations, specialist medical colleges and practising specialists. Overwhelmingly, the primary purpose of specialists participating in ongoing CPD was, according to the project consultations conducted, the maintenance, development and improvement of skills that enable consumers of healthcare to be confident of the level of care that they receive. Coupled with the need to recognise CPD as contributing to the wider context of professional practice, the resulting framework is underpinned by a theoretical platform based on the concept of medical professionalism. It is this theoretical platform, which articulates the nature of and responsibilities associated with the practice of specialist medicine, that enables a CPD framework to be constructed that can accommodate a wide range of specialist disciplines and practice settings, while also framing ongoing education expectations from the viewpoint of a range of stakeholders, rather than a single perspective; that of practitioners themselves.

Australia↗

PubMed2001

[Questionnaire survey comparing first-year medical students and non-medical students with regard to their level of interest and knowledge of care and terminal care for the elderly].

To study the level of interest and knowledge about care and terminal care for the elderly of medical students in Nagoya University, we made a questionnaire for first-year medical students (about 90 students per year) each April from 1998 to 2000. To assess the differences, we also gave the same questionnaire to 75 first-year non-medical students in 1999. Only about 10% of students had experienced providing care for member(s) of their family, but about one third stated that other family member(s) such as their mother, cared for older family member(s). The introduction of long-term care insurance was known by 22%, 43.5% and 96.6% of medical students in 1998, 1999 and 2000, respectively. Moreover, 19.8%, 13.0% and 52.3% of medical students knew about the care managers, respectively. About 80% of students hoped to be informed about their disease if they had terminal-stage cancer. However, about half of students could not decide whether to tell a family member who had terminal-stage cancer. Medical students had significantly more interest in the care system (68.5% in 1999) and terminal care (72.8% in 1999) for the elderly than non-medical students (41.3% and 40.0% in 1999, respectively). There were no significant differences between medical and non-medical students with regard to experiences of care, knowledge of long-term care insurance system and the attitudes to informing about terminal-stage cancer. However, more medical students had an interest in the elderly care system and terminal care than non-medical students.

Adult↗

PubMedDate not supplied

The relationship between modifiable health risks and future medical care expenditures: the Korea Medical Insurance Corporation (KMIC) Study.

CONTEXT: The relationship between lifestyle risk factors, morbidity, and mortality is well established, but the relationship between lifestyle risk factors and medical care costs is not as well defined. OBJECTIVES: To determine the ability of modifiable biometric and lifestyle risk factors to predict future medical care costs. DESIGN: Prospective cohort study. SETTING AND PARTICIPANTS: Data on modifiable risk factors collected in 1992 and medical care costs collected in 1998 by the Korea Medical Insurance Corporation in South Korea. Data were examined for a final cohort of 78,728 men and 50,414 women enrolled in the health insurance plan from 1990 through 1998. MAIN OUTCOME MEASURES: Outcome measures included likelihood of any inpatient, outpatient, and total medical care costs and outlier costs; amount of inpatient, outpatient, and total medical care costs; and portion of total medical costs attributable to each risk factor through unadjusted and adjusted multivariate analyses. RESULTS: Baseline modifiable risk factors measured in 1992 (including lifestyle factors such as smoking, high body mass index, exercise, and biometric measures such as cholesterol, blood sugar, blood pressure, and urinary sugar) were important predictors of the amount of medical care costs incurred 6 years later in 1998, even after controlling for age, perceived health status, and each of the other modifiable variables. These risk factors were generally better predictors than nonmodifiable demographic risk factors, including income level and type of job. For men, lifestyle risk factors were associated with total costs that were 2.4% (for high blood pressure) to 16.1% (for former smokers) higher than among men without those risk factors. Biometric risk factors were associated with costs ranging from 9.2% (for cholesterol) to 38.2% (for positive urinary glucose) higher. For women, lifestyle risk factors were associated with total costs that were 2.5% (for exercise) to 6.4% (for current smokers) higher than among those without the risk factors. Biometric risk factors were associated with costs ranging from 10.2% (for cholesterol) to 60.4% (for positive urinary glucose) higher. For men, a cluster of six heart disease risk factors were associated with total costs 54.7% higher, and a cluster of three stroke risk factors were associated with total costs 22.2% higher than in men who had none of these risk factors. Modifiable risk factors accounted for 23.1% of medical costs for men and 8.7% for women. CONCLUSIONS: These results suggest that modifiable biometric and lifestyle risk factors can predict a moderate portion of future medical care costs. If these risk factors can be reduced, future medical care costs may be reduced.

Adult↗

PubMed1999

[Expert assessment of medical treatment errors--a new responsibility for the medical service of health insurance].

During the past few years there has been an enormous increase of inquiries for medical certificates concerning suspected mistakes in medical treatment (medical malpractice). The profound changes of the social circumstances and the social law (e.g. section 66 SGB V) are responsible for this situation. The legal involvement of the "Gesetzliche Krankenversicherung" (GKV) and the "Medizinischer Dienst der Krankenversicherung" (MDK) into social legislation concerning the expert opinion are mentioned. The general development of the judgement of medical malpractice and its legal background, which bases on the contract between doctor and patient, is shown. As a practical example serves the description of the procedure of judging medical malpractice in the MDK. First statistical results, which have been developed since summer 1997 in Hamburg are presented. Some interesting tendencies are obvious: orthopedics and surgery are involved with more than 50%. "Characteristic mistakes in therapy" are the most important question for the expert opinion. Creating a medical certificate concerning medical malpractice takes about 6-12 weeks. This tendency is decreasing because of fast learning procedures, caused by the increasing demand of expert opinions. The medical judgement of medical malpractice will become one of the main tasks of the medical service in health insurance. The "MDK's" have to adapt to this change in tasks in medical, legal and organisation-technical respect, if they want to offer competent and up to date judgement in future times.

Expert Testimony↗

PubMed1992

Principles and practice of medical audit (medical care evaluation).

1. Medical audit is a philosophy in the field of medical science which has reached to an advanced stage of practice in Western World, but yet to reach and percolate into Indian medical community. 2. Of late, community is getting increasingly aware of its health rights, gradually community participation in health matters including quantum and quality of case, has started increasing. Thus community leaders have started demanding for quality of medical care and accountability of those, responsible for delivery of medical care at various levels. 3. Medical audit or Evaluation of medical care is an answer to ensure the quality of care. But there are misgivings and distrust about medical audit due to its terminology. 4. There is need to education the medical, nursing and paramedical staff regarding medical audit and its sole purpose of self education and improvement of patient care activity. The present paper spells out fundamentals of medical audit, its scope and limitations.

Community-Institutional Relations↗

PubMed2000

The medical school Web site: medical education's newest tool.

There are few technological advancements that have had as much impact on the dissemination of information as the Internet, and especially the worldwide web. It is not surprising then that this tool is also changing the way medicine is studied, taught and practiced today. This impressive infrastructure enables us to teach and study medicine in an entirely different way. The web provides medical students and physicians with access to continuing medical education, patient education services, telemedicine, and unparalleled communication between colleagues via email. The medical school web site may be used as a dynamic newspaper or bulletin board to disseminate information internally among the faculty as well as to the outside world. It can also be the vehicle for virtual learning modules that enhance the medical school core curriculum by including lectures, exercises, tests, etc. In addition, the web allows the student access to medical literature, medical software applications and medical resource depots. To date no work has been published on the medical school web site, its construction process, and its advantages, drawbacks and future. The purpose of this article is to examine the evolution of the web as a tool for medical schools, medical students and associated physicians. We discuss the building of a web site for a medical faculty, and look to the future.

Computer-Assisted Instruction↗