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This is the fourth of several presentations that were made at a conference on federal, state and private activities regarding graduates of foreign medical schools. Presentations on behalf of the states were made by representatives from the medical licensing boards of Florida. Illinois, New Jersey and New York, as well as the Federation of State Medical Boards of the United States. Articles adapted from these presentations were printed in the October and December 1985 and the January 1986 numbers of the BULLETIN. This article by Dorothy Faircloth concludes the series on activities of the states in this contest.
The Food and Drug Administration (FDA) is announcing that the tentative final rule on medical device distributor reporting that appeared in the Federal Register of November 26, 1991 (56 FR 60024), is now a final rule by operation of law. This final rule requires distributors to submit reports to FDA and to manufacturers, of deaths, serious illnesses, and serious injuries related to medical devices and to submit reports to manufacturers of certain malfunctions that may cause a death, serious illness, or serious injury, if the malfunction were to recur. The final rule also changes the reporting standard for certain distributors that are importers, and changes the definition of the term "serious injury" to conform to a recent statutory amendment. In issuing this final rule, FDA is announcing that the tentative final rule relating to adverse event reporting requirements for distributors, including importers, has the status of a final rule, as of May 28, 1992, by operation of law under the Safe Medical Devices Act of 1990 (the SMDA), as amended by the Medical Device Amendments of 1992 (the 1992 amendments), and is setting forth the regulations reflecting those requirements. FDA is also amending the regulations, based on consideration of comments on the November 26, 1991, tentative final rule, to require distributors to register their facilities and to list their devices with FDA.
OBJECTIVE: To assess and compare the quality of nonstructured and structured abstracts of original research articles in three medical journals. DESIGN: Blind, criterion-based observational study. SAMPLE: Random sample of 300 abstracts (25 abstracts per journal each year) of articles published in the British Medical Journal (BMJ), the Canadian Medical Association Journal and the Journal of the American Medical Association (JAMA) in 1988 and 1989 (nonstructured abstracts) and in 1991 and 1992 (structured abstracts). MAIN OUTCOME MEASURES: The quality of abstracts was measured against 33 objective criteria, which were divided into eight categories (purpose, research design, setting, subjects, intervention, measurement of variables, results and conclusions). The quality score was determined by dividing the number of criteria present by the number applicable; the score varied from 0 to 1. RESULTS: The overall mean quality scores for nonstructured and structured abstracts were 0.57 and 0.74 respectively (p < 0.001). The frequency in meeting the specific criteria was generally higher for the structured abstracts than for the nonstructured ones. The mean quality score was higher for nonstructured abstracts in JAMA than for those in BMJ (0.60 v. 0.54, p < 0.05). The scores for structured abstracts did not differ significantly between the three journals. CONCLUSIONS: The findings support recommendations that promote the use of structured abstracts. Further studies should be performed to assess the effect of time on the quality of abstracts and the extent to which abstracts reflect the content of the articles.
With advancement of the molecular biology, gene diagnosis is widely utilized in clinical application of medicine. For medical technologists, it is necessary to receive continued education to practice such advanced scientific trends. The Japanese Association of Medical Technologists established a working group for a staff development program of gene diagnosis and chromosome analysis in 1996, and has continued its activities in making inquiries about the present conditions, publishing a textbook, and providing seminars. The internal laboratory utilization of gene diagnosis was 8.7%(213 of 2437 hospitals). Based on the fact that about half of the hospitals use external laboratory, staff development for the internal utilization of gene diagnosis is an urgent issue. We have been providing seminars to meet the educational needs of our members. In addition to those activities, we have continued our efforts in providing a manual with clinically useful information, standardizing methods, establishing an information network, and conducting a controlled survey. The role of the working group is now shared by the local prefecture to further increase the numbers of those with expertise in gene diagnosis. We, medical technologists, need to have a global view of professional growth, and also to cooperate with academic societies related to gene diagnosis to establish a certification system.
The Charity Hospital system of care for the medically indigent in Louisiana has been underfunded both for operation and for capital for a number of years. As a consequence, care is declining in quality and medical education suffers. This article examines the problems, issues, and possible courses of action. Considered are operating authority and governance, organization and finance of care, and the likely impact on medical education; it does not reach conclusions or make recommendations. Rather, its purpose is to stimulate rational discussion about these important matters.
PURPOSE: The objective of this work was to assess problem-based learning (PBL) as a method for teaching information and communication technology in medical informatics (MI) courses. A study was conducted in the Schools of Medicine of Rennes and Rouen (France) with third-year medical students. METHODS: The "PBL-in-MI" sessions included a first tutorial group meeting, then personal work, followed by a second tutorial group meeting. A problem that simulated practice and was focused on information technology was discussed. In Rouen, the students were familiar with PBL, and they enrolled on a voluntary basis, while in Rennes, the students were first-ever participants in PBL courses, and the program was mandatory. One hundred and seventy-seven students participated in the PBL-in-MI sessions and were given a questionnaire in order to evaluate qualitatively the sessions. RESULTS AND DISCUSSION: The response rate was 92.1%. The overall opinion of the students was good. 69.8% responded positively to the program. In Rouen, where the students participated in PBL-in-MI sessions on a voluntary basis, the students were significantly more enthusiastic about PBL-in-MI. Moreover, attitudes and opinions of students are plausibly related to differences in previous PBL skills. The fact that the naïve group had two tutors, one trained and one naïve as the students, has been investigated. Teacher naivety was an explanatory factor for the differences between Rennes and Rouen.
The aim of this study was to evaluate the association between thyroid cancer and diagnostic X-ray radiation based on medical records. By using the Swedish Cancer Registry, 187 living cases with thyroid cancer (81%), aged 20-70 years at the time of their diagnosis in 1980-1989 were identified in the Northern Health Care Region of Sweden. Seven cases were reclassified as having a disease other than thyroid cancer and were excluded. The investigation included 180 living cases and 360 controls from the National Population Registry. In 132 cases and 251 controls data from X-ray records on earlier investigations > 5 years prior to diagnosis and corresponding years for the controls were analysed. The mean calculated thyroid dose for the cases was 7.0 mGy (median 1.1) and for the controls 7.4 mGy (median 1.0). This study showed no difference in the total material between calculated absorbed thyroid dose of medical diagnostic X-ray in cases versus controls. In younger women (< or = 50 years at diagnosis) with papillary thyroid cancer an association was found, however it was not significant. The results could be related to selective bias and should be treated with caution. Future studies require analysis of diagnostic medical X-ray investigations involving the thyroid gland including more specific data on sex and age of exposure in the whole study group.
BACKGROUND: We compared the quality of structured abstracts of original research articles from the British Medical Journal (BMJ), Canadian Medical Association Journal (CMAJ), and the Journal of the American Medical Association (JAMA) from 1991 to 1992 and 2001 to 2002 between journals. METHODS: A random, stratified sample of 54 abstracts from 2001 to 2002 in BMJ, CMAJ, and JAMA was compiled and coded. Two blinded raters reviewed 27 abstracts each against 33 objective criteria, separated into eight categories (purpose, research design, setting, subjects, intervention, measurement of variables, results, and conclusion). The quality score was the proportion of criteria present (range = 0-1). RESULTS: The overall mean quality score (0.74) for 2001-2002 was significantly higher than the 1988-1989 unstructured abstracts (mean = 0.57; p<0.001) but not different from the 1991-1992 structured abstracts (mean = 0.74; p>0.05). In 2001-2002, abstracts of CMAJ and JAMA (both means = 0.76) improved significantly over 1991-1992 (p<0.05) and scored significantly higher than BMJ (mean = 0.71; d.f. = 16, p<0.05). Some individual criteria scores (intervention, statistical information) improved but information was found consistently under-represented in areas that imply shortcomings of the studies. INTERPRETATION: We found a consistency in abstract quality regardless of the precise format used by different journals. This indicates that the framework for research articles already in place should be maintained and further modification of the framework may not necessarily improve the abstract quality.
Thirty in-patients received one of three treatments - medication (nortriptyline) alone (MA), relaxation therapy plus medication (RT&M), or cognitive therapy plus medication (CT&M) (each n = 10) - along with ward milieu. The relaxation and cognitive therapy groups participated in 12 therapy sessions. Symptoms of depression and related cognitive variables were assessed at sessions 1, 6 and 12, and at discharge. All groups improved over the course of the study. CT&M and RT&M groups reported significantly fewer depressive symptoms and negative cognitions at discharge than the MA group. The number of subjects judged depressed at discharge was lower in the CT&M group than in the MA and RT&M groups. It is proposed that a consistent rationale for treatment is a significant facilitating factor in achieving behavioural and cognitive changes in depression.
The article covers algorithm to calculate individuals who are subjects for periodic medical examinations in Occupational medical centers. The algorithm involves assessing workers exposed to chemical and occupational hazards and counting repetition factor of thorough medical examinations according to Russian Health Ministry Order No 90 (March, 14, 1996).
Eleven southeastern medical schools cooperated to evaluate nutrition knowledge and attitudes of medical students. This study complements previous reports of an examination of entering freshmen and seniors. Average knowledge scores for 165 students tested after basic sciences (preclinical) training in this study were 67 +/- 7% compared with 53 +/- 6% for freshmen and 69 +/- 8% for seniors. The upperclassmen's scores were higher than the freshmen's (p less than 0.001) and varied with the amount of required nutrition teaching. Only 13% of preclinical students perceived nutrition as important to their careers compared with 74% of entering and 59% of graduating students, suggesting that preclinical teaching reduces their sense of relevance of nutrition to medicine. These findings suggest that nutrition knowledge can be increased through preclinical coursework and that the knowledge level can be maintained through the clinical years. However, the positive attitude of freshmen toward nutrition is lost after preclinical training and is only partially regained after the clinical years.
A structured questionnaire was administered to 346 medical and dental students who were about to take the Part I MBBS/BDS degree examination. Apart from personal data of each student, the questionnaire sought information on their post-graduation career preferences in ten medical specialties, lectureship in anatomy, physiology or biochemistry, career in the armed forces, politics or business. They were required to give reasons for their choices. The results showed that 89.6% of the students were aged 19 to 24 years and 94.8% were admitted via concessional entry. Forty-one percent of the students preferred surgery, while 15%, 11% and 7.8% chose careers in obstetrics and gynaecology, paediatrics and internal medicine respectively. The specialties of radiology, anaesthesia, psychiatry, pathology, community medicine and general practice were unattractive to most students. Only 1.5% of the students wanted to become lecturers in anatomy and physiology while none wanted to lecture in biochemistry. Choice of career in the armed forces, politics and business was low. Nine students (2.6%) wanted to be pastors/missionary doctors. The main reasons for the choices are personal interest (73.7) and better financial reward 11.8%. Sex had a significant effect on choices. The results were discussed and their implications were highlighted. Suggestions on how to solve the problems identified were made.
The article is devoted to graduates from the army medical faculty with the Kuibyshev Medical Institute in 1979. The above faculty graduates service in the Armed Forces of Ukraine and at the Defence Ministry of the Republic of Belarus is briefly analysed.
OBJECTIVE: To review the methods of electronic retrieval of biomedical journal articles; to demonstrate CD-ROM and online searching techniques; and to compare major biomedical databases. DESIGN: A CD-ROM MEDLINE search was made by a medical practitioner, with the assistance of an experienced librarian. An online MEDLINE/Excerpta Medica search was made by the same medical practitioner after completion of a two-day course in search techniques. The search example covered the period 1983 to 1992, and the topic was "whether steroid use for asthma/airways disease leads to osteoporosis". OUTCOMES: Search duration, article yield and search cost were assessed. RESULTS: The CD-ROM MEDLINE literature search took 60 minutes to find 31 articles (43% of the possible articles). This compared with an online search to the Bibliographic Retrieval Services database in Chicago, which produced the same articles when MEDLINE was searched (but took only 16 minutes) and which also found 47 articles (with an overlap of only seven) when Excerpta Medica was searched. We estimated that the combined MEDLINE and Excerpta Medica search detected 93% of all known relevant articles, based upon an assumed gold standard. CONCLUSIONS: Online searching is a fast and powerful alternative to CD-ROM searching. Formal training is necessary for quick and cheap reference finding. Other benefits such as direct transfer from online searching to your own computer bibliography database make online searching of biomedical databases essential to consider.
Modern higher school requires great physical, intellectual, and psychoemotional efforts from students. Adolescent health is a most important prerequisite for higher education and work in accordance with the specialization acquired at higher school. Therefore, the priority task in students' health preservation today is improvement of the continuity and quality of physicians' activities as regards medical vocational counselling of adolescent children and young people.
The classic function of health sciences libraries is to build and maintain a knowledge base and to provide timely access to that collective memory for the purpose of learning, teaching, caring for patients, conducting research or managing an organization. The formats and representation of that knowledge base are changing rapidly, as are the methods and techniques for gaining access to information. Medical libraries have long used computers for cataloging and controlling records but are now shifting to acquiring, managing and distributing bibliographic and full-text information to local library "networks."
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