Centralized exchanges of scientific materials existed by the late nineteenth century, but they did not include medical publications. North American medical leaders therefore formed an association of institutions to run their own exchange: the Medical Library Association (MLA). After providing background to the exchange concept and the importance of institutional ...

BACKGROUND: Although individuals from low tuberculosis (TB) burden countries experience an increased risk of TB infection when traveling to high burden countries for medical training or service, the degree of risk has not been well quantified. OBJECTIVE: Improved knowledge will aid development of guidelines for TB screening, pre/post-travel education, and ...

Fecal incontinence (FI) is a common problem treated by many different interventions. No treatment is optimal. Based on its success for urinary incontinence, sacral nerve stimulation (SNS) has been used successfully outside the United States for FI. In direct comparison with standard medical treatment or the artificial bowel sphincter, SNS ...

To study obstetricians' attitudes in Finnish antenatal screening units concerning fetal sex determination without medical indication. A structured questionnaire to all delivery units (n = 37) and the main outpatient screening units (n = 18) in the country. The majority of units made fetal sex determination without medical indication at ...

Several recent physician workforce reports in Alaska have called for a rapid increase in the number of state-supported medical school positions to between 30 and 50 new students per year, preferably through WWAMI--Alaska's Medical School. Here we compare the number of clinical experiences for undergraduate and graduate medical education in ...

Research suggests that military unit cohesion may protect against the development of post-traumatic stress disorder (PTSD). However, equivocal findings have led researchers to hypothesize a potential curvilinear interaction between unit cohesion and warzone stress. This hypothesis states that the protective effects of cohesion increase as warzone stress exposure intensifies from ...

One manifestation of globalization is medical tourism. As its implications remain largely unknown, we reviewed claimed benefits and risks. Driven by high health-care costs, long waiting periods, or lack of access to new therapies in developed countries, most medical tourists (largely from the United States, Canada, and Western Europe) seek ...

The effectiveness of entertainment-education is evidenced in previous research; nevertheless, content analytic research on the health content in such programs has been relatively meager in comparison to the large amount of content analyses of health content in news or ads in print media or on television. To address this issue, ...

Modernization of specialist training in a competency-based framework is not unique to the United States. In the following commentary, the authors explore the current environment within which graduate medical education (GME) in the United States operates, using the perspective framework developed by Wallenburg and colleagues from the Netherlands: the accountability ...

The notion of a patient-centered medical home features prominently in policy reform initiatives across the country, with both state and federal legislation focusing on this new model. We sought to understand the views of key stakeholders and to examine the challenging landscape facing policymakers and practitioners as they attempt to ...

This paper compares the histories of male circumcision in the United States and Great Britain to explicate the theoretically important, yet inadequately specified, processes of demedicalisation and remedicalisation. Circumcision became medicalised to a similar extent, through similar processes, in both countries before World War II. However, by the 1960s, circumcision ...

This rule revises the final rule published on December 3, 2008 to implement provisions of section 6044 of the Deficit Reduction Act of 2005, which amends the Social Security Act by adding a new section 1937 related to the coverage of medical assistance under approved State plans. That rule provides ...

Twenty-five percent of the U.S. physician workforce is made up of international medical graduates (IMGs), a growing proportion of whom (27% in 2005) are U.S. citizens. Most IMGs graduate from "offshore medical schools" (OMSs), for-profit institutions primarily located in the Caribbean region and established to train U.S. students who will ...

BACKGROUND: The Centers for Disease Control and Prevention (CDC) recently adapted global guidance on contraceptive use from the World Health Organization (WHO) to create the United States Medical Eligibility Criteria for Contraceptive Use (MEC). This guidance includes recommendations for use of specific contraceptive methods by people with certain characteristics or ...

In this paper, both synchronous and asynchronous web based learning of 3D medical equipment models used in hospital intensive care unit have been described over the moodle course management system. 3D medical equipment models were designed with 3ds Max 2008, then converted to ASE format and added interactivity displayed with ...

The choice of therapeutic agents for patients with moderate-to-severe psoriasis has expanded significantly in the past decade. With new understanding of the immunologic basis of psoriasis, multiple new potential targets for therapy have been identified. It is likely that a series of new medications to focus on the newly identified ...

This rule amends Department of Justice regulations to increase the settlement and waiver authority delegated to heads of departments and agencies of the United States responsible for the furnishing of hospital, medical, surgical, or dental care. This change responds to the increase in medical costs since 1992, when the current ...

While the scientific and medical communities continue to be divided on the therapeutic benefits and risks of cannabis use, anecdotal evidence from medical users themselves suggests that using cannabis is indeed improving their quality of life by alleviating their pain and discomfort. Notwithstanding the benefits anecdotally claimed by these medical ...

BACKGROUND: Abraham Flexner's report on medical education, published 100 years ago, remains influential in the United States today, although its international impact is unclear. In addition to global variability in content and delivery of medical education programs, systems of quality assurance oversight are not universal, and there are variations in ...

In the era of targeted therapies and combined modalities of treatment, scientific research plays a role of paramount importance in improving knowledge of cancer treatment. The aim of this survey was to review the scientific activity of medical oncology units in Sicily and to analyze their needs and possible pitfalls ...

Evidence-based pharmacotherapy is a central aspect of optimal patient care for many chronic conditions. However, medication non-adherence frequently inhibits the attainment of optimal pharmacotherapy regimens. In this study, we designed, developed, and implemented a multifaceted clinical decision support (CDS) intervention that supports evidence-based pharmacotherapy and enhanced medication adherence through the ...

The United States far outspends Canada on health care, but the sources of additional spending are unclear. We evaluated the importance of incomes, administration, and medical interventions in this difference. Pooling various sources, we calculated medical personnel incomes, administrative expenses, and procedure volume and intensity for the United States and ...

For over two hundred years, Australia has been portrayed as a terminus rather than a hub for scientific exchange. Alongside narratives valorising the struggle for a distinct national identity, the motif of isolation abounds in the historiography of Australian medical research. Yet these orthodoxies are ripe for rescripting, as illustrated ...

Use of terminology standards facilitates aggregating data from multiple sources for information retrieval, exchange and analysis. However, medical vocabularies are continuously updated and incorporating those changes consistently into clinical data warehouses requires rigorous methodology. To integrate pharmacy data from two hospital pharmacy information systems the Stanford Translational Research Integrated Database ...

Before World War 1 both the United States of America and Australia had rather rudimentary medical systems. Enterprising practitioners in both countries tended to look to continental Europe (especially Germany) and the United Kingdom as places of medical renown. The outbreak of World War 1 changed this but also enabled ...

In the United States, Canada, and the United Kingdom, the medical profession is accountable to the public for the delivery and quality of care provided to patients. Traditionally, this accountability has been achieved through the development and maintenance of professional standards established by the profession itself-self-regulation. Medical self-regulation is being ...

AIM: To analyze the accuracy of short-term bio-impedance as a means of measuring gastric motility. METHODS: We evaluated differences in the short-term electrical bio-impedance signal from the gastric region in the following conditions: (1) fasting state, (2) after the administration of metoclopramide (a drug that induces an increase in gastric ...

The Thomsonian movement, founded by Samuel Thomson, was the first major challenge to the therapies and the social and economic standing of the orthodox medical profession in the United States. In the late-eighteenth or early-nineteenth century, many states chartered a state medical society with power to administer a licensing law ...

Experts in the United States believe that observation of art can help healthcare professionals diagnose illnesses and injuries in patients. This article reports on an art observation programme involving the University of Chicago Medical Center and the Art Institute of Chicago, Illinois, and reflects on whether such programmes can be ...

OBJECTIVE: This study was conducted to describe the current content and context of change of shift report (CoSR) on medical and surgical units and explore whether nurses use computerized support during the CoSR process. BACKGROUND: Change of shift report is a commonly occurring handoff that could contribute to gaps in ...

BACKGROUND: To reduce atherothrombosis-related morbidity and mortality, implementation of guideline-recommended therapies for primary and secondary prevention is necessary. Few data are available for outpatients in actual clinical practice, especially those without known heart disease treated by physicians trained in different specialties across the geographic regions of the United States. METHODS: ...

Disasters have an enormous economic impact on the United States as well as short- and long-term healthcare implications. Federal and state governments are providing billions of dollars to communities across the nation for emergency preparedness activities. An online poll conducted in July 2008 indicated that most medical practices in the ...

The field of cross-cultural care focuses on the ability to communicate effectively and provide quality health care to patients from diverse sociocultural backgrounds. In recent years, medical schools in the United States have increasingly recognized the growing importance of incorporating cross-cultural curricula into medical education. Cross-cultural medical education in the ...

BACKGROUND & OBJECTIVE: A scheme of Mobile Medical Units (MMUs) has been initiated under NRHM in Jharkhand state from the year 2008 in an effort to take healthcare to doorstep of the public in rural areas, especially in underserved areas. The objective of the study was to assess the functioning ...

BACKGROUND: Our 2001 study in 5 states found that medical problems contributed to at least 46.2% of all bankruptcies. Since then, health costs and the numbers of un- and underinsured have increased, and bankruptcy laws have tightened. METHODS: We surveyed a random national sample of 2314 bankruptcy filers in 2007, ...

CONTEXT: Relatively few osteopathic physicians (DOs) practice in the deep central southern geographic region as compared to other parts of the United States. OBJECTIVE: To assess the potential effects of underrepresentation on the perception of osteopathic medicine among allopathic physicians (MDs) in this geographic region. METHODS: A 20-item, Likert scale ...

The purpose of this study was to describe Operation Iraqi/Enduring Freedom and Operation Desert Storm/Shield deployment experiences from the perspectives of 39 Army Medical Department personnel using a qualitative method in 2004. Thematic content analysis revealed themes from data collected during twelve focus groups. The themes with the most discussion ...

The southern and eastern margins of the range of the brown recluse spider run through the southeastern quadrant of the United States. Populations vary from abundant in states such as Arkansas and west and central Kentucky and Tennessee to absent in the Atlantic seaboard states. The diagnosis of loxoscelism should ...

Although widely practiced in China for 2,000 years, acupuncture was introduced in the United States 40 years ago, and it has only gained acceptance by the medical establishment here in recent years. Now, a growing body of evidence supports its efficacy for a number of conditions, and it is being ...

To describe the current state of design characteristics determined to be desirable by the Agency for Health Research and Quality (AHRQ) in U.S. adult medical, surgical, and intensive care units (ICUs). Descriptive study of patient visibility; distance to hygiene, toileting, charting, and supplies; unit configuration; percentage of private rooms; and ...

INTRODUCTION: Members of the International Civil Aviation Organization (ICAO) use various criteria to control flight crew scheduling and rest periods with the intention of reducing fatigue and thus improving airline safety. Comparison of these rules across nations may allow future harmonization of the criteria. METHODS: The regulations of 10 ICAO ...

Medication administration is a major safety issue for patients and providers. The authors describe a commercial aviation-based system safety assessment conducted on the medication administration process for a community teaching hospital in the northeast United States. Processes on 2 medical units and 1 surgical unit were assessed. A sampling of ...

Oxytocin use for induction or augmentation of labor is a common occurrence in labor and delivery, as well as a common source of conflict between obstetric providers and nurses. Allegations regarding inappropriate oxytocin use and excessive uterine activity arise in obstetric litigation in both the United States and abroad, and ...

The US Department of Defense (DOD) is evolving to meet new security challenges in the twenty-first century. Today's challenges result from growing political, environmental, and economic instability in important areas of the globe that threaten national and global security. Immediate outreach to foreign nations in times of violent instability or ...

To obtain a full and unrestricted license to practice medicine in the United States, students and graduates of the MD-granting US medical schools and of medical schools located outside of the United States must take and pass the United States Medical Licensing Examination. United States Medical Licensing Examination began as ...

The identification and evaluation of medically impaired drivers is an important safety issue. Medical fitness to drive is applicable to all ages but is particularly salient for older adults. Voluntary procedures, whereby various professionals and family members may report medical fitness concerns to State driver license bureaus, are common in ...

Whereas hormonal and surgical sex change have been increasingly refined and accepted medically during the past 40 years, legal protections have only recently received attention. This overview focuses on employment, medical treatment, and civil status as male or female in the United States and the United Kingdom. Employment protection in ...

This final rule will implement provisions of section 6044 of the Deficit Reduction Act of 2005, which amends the Social Security Act by adding a new section 1937 related to the coverage of medical assistance under approved State plans. It also provides States increased flexibility under an approved State plan ...

Many ED managers know that an observation unit can be an important tool in relieving ED overcrowding and controlling length of stay. However, the ED at Wake Forest University Baptist Medical Center has gone a step farther and created a "hybrid" observation unit. This unit allows them to quickly remove ...

OBJECTIVE: Despite a growing body of literature on complementary and alternative medicine, there is still limited information on the use of Ayurveda in the United States. Because Ayurveda is one of the world's major traditional medical systems, knowledge of its use is important. In particular, information on utilization by Asian ...