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At least 307 records · Page 17Linked to original sources
PubMed1999

The Internal Medicine Center--an integrated solution for information on internal medicine on the World Wide Web.

The World Wide Web (WWW) has grown from being a resource center for a select group of scientists to a large database of information that is available to both professionals and public. The amount of medical information on the Web has been increasing exponentially and thus, it has become increasingly difficult for anyone to be able to search for a specific quantum of information among this mass. Even in mid 1996, it was noted that the amount of information on internal medicine was growing rapidly. Hence, on 21 March 1997, the Internal Medicine Center (IMC) was created and launched. The IMC is an unique concept and it represents the first time that medical data on the web has been organized into a form that intimately parallels clinical medicine. The rationale behind the creation of the IMC can be summarized in three words: information, speed and convenience. The interface used by this center reflects these goals because overuse of large image files are avoided, hence decreasing the access time and yet keeping the information in an easily comprehensible manner. In conclusion, the IMC serves as a useful tool for the layman as well as the expert because the comprehensive information that it offers can be accessed rapidly and conveniently.

Information Services↗
PubMed1998

Hepatitis C in France: a national survey in the Departments of Internal Medicine and Infectious Diseases. The GERMIVIC (Joint Study Group on Hepatitis C virus of the French National Society of Internal Medicine and the French Society of Infectious Diseases).

Infection with Hepatitis C virus is a significant public health problem that has important clinical and financial consequences. Understanding of the epidemiology of HCV is needed to help define future therapeutic and preventive strategies. So far, the importance and characteristics of the epidemics have been best appreciated in specialist units dealing with liver disease. The purpose of our study was to survey the number and characteristics of hepatitis C antibody positive patients in Departments of Internal Medicine and Infectious Diseases. We conducted a multicentre national prospective analysis of all positive HCV-antibody patients, either inpatient or outpatient, reported over a period of one month across France. Two thousand and two cases were identified. Epidemiological, clinical and therapeutic characteristics are described. Risk factors were identified in 86%. For 10% of the patients, hepatitis C seropositivity was discovered during the period of survey. At the time of first diagnosis, 47% of patients presented with no clinical or biological abnormality. Coinfection with HIV was frequent (59%). Only 20.3% of the patients had received or were receiving a treatment with interferon. Within the limits of the methodology used, this study shows that Hepatitis C infection is a substantial clinical problem in French Departments of Internal Medicine and Infectious Diseases. Our findings may help the public health authorities in better appreciating the impact of hepatitis C and making policy decisions.

Adolescent↗
PubMed2006

Center for Victims of Torture--Guinea 2004-2005 International Mental Health Team: international humanitarian award.

Presents the citation for the Center for Victims of Torture--Guinea 2004-2005 International Mental Health Team, who received the International Humanitarian Award "for their outstanding commitment to the healing of torture victims and to educating the world community about torture and war trauma." A brief profile of the Center is presented, as well as the Center's award address, entitled Trauma Healing in Refugee Camps in Guinea: A Psychosocial Program for Liberian and Sierra Leonean Survivors of Torture and War. ((c) 2006 APA, all rights reserved).

Altruism↗
PubMed2002

Cross-mapping the ICNP with NANDA, HHCC, Omaha System and NIC for unified nursing language system development. International Classification for Nursing Practice. International Council of Nurses. North American Nursing Diagnosis Association. Home Health Care Classification. Nursing Interventions Classification.

Nursing language plays an important role in describing and defining nursing phenomena and nursing actions. There are numerous vocabularies describing nursing diagnoses, interventions and outcomes in nursing. However, the lack of a standardized unified nursing language is considered a problem for further development of the discipline of nursing. In an effort to unify the nursing languages, the International Council of Nurses (ICN) has proposed the International Classification for Nursing Practice (ICNP) as a unified nursing language system. The purpose of this study was to evaluate the inclusiveness and expressiveness of the ICNP terms by cross-mapping them with the existing nursing terminologies, specifically the North American Nursing Diagnosis Association (NANDA) taxonomy I, the Omaha System, the Home Health Care Classification (HHCC) and the Nursing Interventions Classification (NIC). Nine hundred and seventy-four terms from these four classifications were cross-mapped with the ICNP terms. This was performed in accordance with the Guidelines for Composing a Nursing Diagnosis and Guidelines for Composing a Nursing Intervention, which were suggested by the ICNP development team. An expert group verified the results. The ICNP Phenomena Classification described 87.5% of the NANDA diagnoses, 89.7% of the HHCC diagnoses and 72.7% of the Omaha System problem classification scheme. The ICNP Action Classification described 79.4% of the NIC interventions, 80.6% of the HHCC interventions and 71.4% of the Omaha System intervention scheme. The results of this study suggest that the ICNP has a sound starting structure for a unified nursing language system and can be used to describe most of the existing terminologies. Recommendations for the addition of terms to the ICNP are provided.

International Council of Nurses↗
PubMed2002

Protocols for the dosimetry of high-energy photon and electron beams: a comparison of the IAEA TRS-398 and previous international codes of practice. International Atomic Energy Agency.

A new international Code of Practice for radiotherapy dosimetry co-sponsored by several international organizations has been published by the IAEA, TRS-398. It is based on standards of absorbed dose to water, whereas previous protocols (TRS-381 and TRS-277) were based on air kerma standards. To estimate the changes in beam calibration caused by the introduction of TRS-398, a detailed experimental comparison of the dose determination in reference conditions in high-energy photon and electron beams has been made using the different IAEA protocols. A summary of the formulation and reference conditions in the various Codes of Practice, as well as of their basic data, is presented first. Accurate measurements have been made in 25 photon and electron beams from 10 clinical accelerators using 12 different cylindrical and plane-parallel chambers, and dose ratios under different conditions of TRS-398 to the other protocols determined. A strict step-by-step checklist was followed by the two participating clinical institutions to ascertain that the resulting calculations agreed within tenths of a per cent. The maximum differences found between TRS-398 and the previous Codes of Practice TRS-277 (2nd edn) and TRS-381 are of the order of 1.5-2.0%. TRS-398 yields absorbed doses larger than the previous protocols, around 1.0% for photons (TRS-277) and for electrons (TRS-381 and TRS-277) when plane-parallel chambers are cross-calibrated. For the Markus chamber, results show a very large variation, although a fortuitous cancellation of the old stopping powers with the ND,w/NK ratios makes the overall discrepancy between TRS-398 and TRS-277 in this case smaller than for well-guarded plane-parallel chambers. Chambers of the Roos-type with a 60Co ND,w calibration yield the maximum discrepancy in absorbed dose, which varies between 1.0% and 1.5% for TRS-381 and between 1.5% and 2.0% for TRS-277. Photon beam calibrations using directly measured or calculated TPR20,10 from a percentage dose data at SSD = 100 cm were found to be indistinguishable. Considering that approximately 0.8% of the differences between TRS-398 and the NK-based protocols are caused by the change to the new type of standards, the remaining difference in absolute dose is due either to a close similarity in basic data or to a fortuitous cancellation of the discrepancies in data and type of chamber calibration. It is emphasized that the NK-ND,air and ND,w formalisms have very similar uncertainty when the same criteria are used for both procedures. Arguments are provided in support of the recommendation for a change in reference dosimetry based on standards of absorbed dose to water.

Air↗
PubMed2003

Present and future activities of the IAEA on internal dosimetry: lessons learned from international intercomparisons.

The International Atomic Energy Agency (IAEA) conducts safety activities to support the assessment of occupational exposure due to intakes of radionuclides; a comprehensive set of safety documents will soon be completed. In recent years, extensive improvements in measurement techniques, phantoms and computational tools have been made. Thus, it is important for laboratories involved in internal dosimetry to undergo performance testing procedures to demonstrate the correctness of the methods applied and also to determine the consistency of their results with those obtained by other laboratories. Several intercomparisons were organised, and they revealed significant differences among laboratories in their approaches, methods and assumptions, and consequently in their results. This paper presents the current and future IAEA activities in support of assessment of occupational exposure due to intakes of radionuclides in the IAEA Member States, as well as the lessons learned from several intercomparison exercises in the last 5 years.

Benchmarking↗
PubMedDate not supplied

Hospital postgraduate training: factors affecting prospective interns' ranking of a municipal hospital program in internal medicine.

This study examines the statistical relationship between potential influencing factors and the rank that prospective intern applicants assigned to Boston City Hospital in the National Internship and Residency Matching Program. Types of factors examined include personal considerations, the applicant's experience during the personal interview, hospital attributes, the academic program itself, and perceived house officer experience. A brief questionnaire was mailed to prospective interns ranked by the Department of Medicine. Analysis of questionnaire data indicates that personal reasons and two hospital characteristics, ancillary staff and type of hospital, were predominant influencing factors.

Boston↗
PubMed2000

A time-motion study of the activities of attending physicians in an internal medicine and internal medicine-pediatrics resident continuity clinic.

PURPOSE: To describe the activities of attending physicians in a residency-based continuity clinic and to examine factors that affect their teaching of, supervision of, and interaction with residents. METHOD: Six full-time board-certified faculty members (three internal medicine, three internal medicine-pediatrics) in an urban residency program participated in a descriptive observational time-motion study. The attending faculty were directly observed by "shadow" technique for 30 half-day sessions from April 1994 through September 1994. Each activity was measured by a trained research assistant using a digital stopwatch. The observed activities were assigned to one of 16 subcategories. RESULTS: 6,389 minutes of activities were observed. Activities were distributed among four general categories: direct contact with residents (43.1%), clinic operations (33.7%), personal and/or professional activities (18.0%), and miscellaneous time (5.2%). Attending physicians spent the most time in direct contact with residents when the patient-to-attending ratio was 10-14:1. DISCUSSION: The activities of the clinic's attending physicians were quite varied. Less than half of their time in the clinic was spent in contact with residents. This contact time may be significantly increased by changes to clinic policies, such as optimizing the patient-to-faculty ratio and increasing administrative support for the clinic. These findings can be used as a reference point for studies of attending physicians' activities since the federally mandated rules changes regarding their responsibilities for supervising residents.

Administrative Personnel↗
PubMed2004

A medical school for international health run by international partners.

In early 1996, the Ben Gurion University Faculty of Health Sciences (BGU), Beer-Sheva, Israel, in collaboration with Columbia University Medical Center (CUMC), New York City, United States, decided to found a second medical school within BGU, the Medical School for International Health (MSIH), to prepare students to work both in medicine and in cross-cultural and international health and medicine (IHM). Methods used to establish and jointly run MSIH include (1) defining clearly the tasks of each university according to how it can best contribute to the new school; (2) establishing an organizational structure in each university for accomplishing these tasks; (3) establishing clear communication between the two organizational structures; (4) defining outcomes to measure success; and (5) developing methods for addressing management problems. CUMC's functions were admission, public relations, and the fourth-year elective program. BGU's functions were developing and running an innovative curriculum, including a four-year required track in IHM, evaluating students, taking the lead in helping students' with their personal problems, and managing financial aid. The first students were admitted in 1998. Variables reflecting MSIH's success include scores on the United States Medical Licensing Examination, residency placement, the attrition rate, and success in preparing students in IHM (e.g., success in learning cross-cultural medicine and the percentage of students who work in IHM). MSIH is running well and has solved its inter-university management problems. Its 85 graduates matched at very good to excellent U.S. hospitals and have learned and maintained enthusiasm for the IHM curriculum.

Academic Medical Centers↗
PubMed2005

Epileptic seizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE).

The International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE) have come to consensus definitions for the terms epileptic seizure and epilepsy. An epileptic seizure is a transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain. Epilepsy is a disorder of the brain characterized by an enduring predisposition to generate epileptic seizures and by the neurobiologic, cognitive, psychological, and social consequences of this condition. The definition of epilepsy requires the occurrence of at least one epileptic seizure.

Brain↗
PubMed1994

Review of the problems involved in using enzymes in blood group serology--provision of freeze-dried ICSH/ISBT protease enzyme and anti-D reference standards. International Council for Standardization in Haematology. International Society of Blood Transfusion.

Proteolytic enzyme preparations and techniques used routinely in blood group serology for the detection of atypical patient antibodies prior to transfusion vary widely and are often poorly standardised. Recent advances have been made in the use of biochemical methods to standardise and stabilise the potency of the enzyme preparations used. A joint working party of the International Council for Standardization in Haematology (ICSH) and the International Society of Blood Transfusion (ISBT) has investigated possibilities for the provision of standards for the protease preparations and techniques. The specification for these standards was that the performance of enzyme reference preparation in the reference technique should be of equivalent sensitivity to the ICSH/ISBT LISS spin indirect antiglobulin test using a titration series of a reference weak anti-D, and be free from false-positive reactions. The working party circulated materials for evaluation in inter-laboratory trials, followed by a laboratory workshop meeting to achieve agreement on the specification for reference materials and methods. Reference freeze-dried papain at 0.6 azoalbumin units and weak anti-D preparations (91/562) have been prepared and validated to meet these specifications. The performance of a test enzyme preparation in the technique for which it is recommended for use should be at least equal to that of the reference papain preparation, by the reference two-stage technique in terms of sensitivity, using a titration series of the reference anti-D, and freedom from false-positive reactions, using six fresh inert sera. The reference papain and weak anti-D can also be used to calibrate the level of proteolytic activity required in other procedures in blood group serology, such as new technology methods for antibody detection, and automated and microplate cell grouping procedures. These preparations and an agreed method for their use are now available from listed centres as ICSH/ISBT and Food and Drug Administration reference materials.

Blood Grouping and Crossmatching↗
PubMed2005

An international collaborative study to replace the 1st international standard for prekallikrein activator.

BACKGROUND AND OBJECTIVES: The aim of this study was to replace the 1st International Standard (IS) for prekallikrein activator (PKA) (code 82/530) with a new IS and European Biological Reference Preparation (BRP). The new standards were freeze dried 20% albumin solution containing PKA, the same solution that is tested using these standards. Aspects of the methodology for PKA determination were also examined as part of this study. MATERIALS AND METHODS: A batch of 20% albumin containing approximately 30 IU/ml was donated by a manufacturer of blood products and dispensed into ampoules at the National Institute for Biological Standards and Control (NIBSC) to create the candidate IS (02/168, sample B in the study) and at the European Directorate for the Quality of Medicines (EDQM) to create the candidate BRP (sample C in the study). The concentration of PKA in these preparations was determined in an international collaborative study involving 31 laboratories from 17 countries worldwide in comparison with the 1st IS for PKA (82/530) containing 85 IU of PKA per ampoule. Participants were requested to perform their own in-house method, based on the current Ph. Eur. monograph for determination of PKA in albumin solutions. Participants were provided with sufficient samples to perform two or three assays and were asked to use their local prekallikrein substrate (PKS) and also to use a commercial PKS provided as part of the study, in order to investigate the importance of the source of PKS on the final potency values. RESULTS: Samples B and C emerged with identical PKA concentrations of 29 IU/ml, very close to the expected value. This figure was determined using a variety of statistical methods, with the participants' own calculated values and values calculated centrally at the EDQM using raw data. The value of 29 IU/ml was consistent and independent of the method of calculation, although interlaboratory variability was more sensitive to the statistical analysis method. There was no statistically significant difference in mean potencies when comparing results with the laboratories' own local substrate and the substrate provided for the study. All stability studies indicate that these lyophilized preparations of PKA in 20% albumin are extremely stable. CONCLUSIONS: Samples B and C were established as the 2nd IS (code 02/168) and PKA activator in albumin BRP batch 1 (Y0000263), respectively, with a potency of 29 IU per ampoule. Results from this study indicate that testing for PKA in albumin may be less sensitive to the source of PKS than previously feared. The study highlights a number of methodological issues that may need revising in the Ph. Eur. general chapter 2.6.15.

Cooperative Behavior↗
PubMed1996

Evaluating the international humanitarian system: rationale, process and management of the joint evaluation of the international response to the Rwanda genocide.

The Rwanda evaluation has been termed a landmark in evaluation, not only because of its quality and the insights it has produced. It was also an unprecedented international collaboration to learn the lessons from the immense tragedy that was the genocide in Rwanda and its aftermath. This paper reports on the rationale, process and management of the joint evaluation of the international response to the Great Lakes crisis of 1994-5.

Altruism↗
PubMed2006

International Clinical Epidemiology Network: an opportunity for SGIM international cooperation.

The Canadian/American regional group of the International Clinical Epidemiology Network (INCLEN) invites SGIM members to join in an international network dedicated to improving health in low and middle-income countries and reducing health disparities in North America-not only because many goals and activities of the 2 organizations are compatible such as evidence-based medicine, mentoring, and training; but because collaboration between SGIM and INCLEN could strengthen both groups. With increasing brain drain from the developing world to the North, there is an ever-increasing need for academic contributions from the North to swing the balance toward brain gain for the South. SGIM members have the academic expertise to make an important contribution to global health. Participation and contribution from SGIM members is welcomed at the individual or organizational level. We invite you to explore possible partnership and collaboration.

Canada↗
PubMed2004

International multicenter international sensitivity index (ISI) calibration of a new human tissue factor thromboplastin reagent derived from cultured human cells.

The international sensitivity index (ISI) of the first working standard of Simplastin HTF, a new human tissue factor thromboplastin derived from cultured human cells, has been assessed in a calibration exercise in two Canadian and five European laboratories. Calibrations against international reference preparations (IRP) were performed for the manual method and six types of automated coagulometers that cover the majority of clotting endpoint principles in routine use. The ISI was method-dependent and varied between 1.03 and 1.29 when calibrated against rTF/95 (human IRP). The ISI was also dependent on the route of calibration. Compared with calibration against rTF/95, the ISIs obtained by calibration against RBT/90 (rabbit IRP) were on average 4.4% higher (P < 0.005). Considering the principle of 'like vs. like', the ISIs obtained by calibration against rTF/95 should be preferred.

Blood Coagulation Tests↗
PubMed2000

International assessment of the internal consistency of respiratory symptoms. European Community Respiratory Health Study (ECRHS).

We aimed to assess cross-cultural validity of the reporting of respiratory symptoms in the European Community Respiratory Health Study (ECRHS). A random sample of subjects from the general population (aged 20-44 yr), from 35 centers in 15 countries, answered a questionnaire and underwent allergy tests and airway challenge with methacholine. The overall response rate to the questionnaire was 60% (n = 16,635). Exploratory factor analysis was used to identify how symptoms were grouped (i.e., to specify factor structure), using data from the United Kingdom. Subsequently, a confirmatory factor analysis of the prespecified structure for the United Kingdom was assessed for each country in consecutive nested models, increasing at each step the number of parameters forced to be equal to the United Kingdom, and assessing the goodness of fit. Variables were clustered in the same four groups (factors) in all countries. The four factors, mutually adjusted, were associated with either bronchial responsiveness, atopy, or smoking, which provides coherence for the separation of the four factors. In the confirmatory factor analysis, when the load of each of the symptoms in the corresponding factor was prespecified, all countries except Spain showed an adequate fit; in Spain there were differences in answers concerning asthma treatment. We conclude that the ECRHS multilingual translated respiratory symptoms questionnaire shows high internal consistency, suggesting that international comparisons are not affected by errors due to cross-cultural variations in the reporting of symptoms.

Adult↗
PubMed2005

Developing a new resource on international nurse migration: the international centre on nurse migration.

A new collaborative project on nurse migration was recently launched by the International Council of Nurses and the Commission on Graduates of Foreign Nursing Schools. This collaboration, the International Centre on Nurse Migration, guided by the principles of ethical recruitment and equitable treatment of migrating nurses, focuses on promoting, collecting, creating, and disseminating data and information on nurse migration; acting as a resource center; tracking trends and patterns of global health care workforce migration; analyzing policy; generating policy options; advocating for sound policy concerning nurse migration; promoting, undertaking, and disseminating research; providing consultant and expert advice; and offering continuing education about migration.

Foreign Professional Personnel↗
PubMedDate not supplied

Opportunities, challenges, and lessons of international research in practice-based research networks: the case of an international study of acute otitis media.

The requirements of research become more complex and demanding in international collaborations. The opportunity to study naturally occurring variation in treatment prompted networking primary care research networks in the United Kingdom, The Netherlands, and North America to study acute otitis media. Additional challenges faced and addressed in this study included (1) differing national requirements for protecting human subjects; (2) variation in data collection processes in primary care practices; (3) data transmission among participants; (4) duties and tariffs on necessary instruments; (5) fluctuation in currency exchange rates; (6) incapacitation of coinvestigators; (7) complex administration of funds; (8) financing the additional, legitimate costs of collaboration; (9) sustaining strong personal relationships among coinvestigators; and (10) accepting longer time frames than would otherwise be expected. Overall, international practice-based research can be productive, affect millions of people, and be extremely rewarding to investigators. It is not, however, for the faint-hearted.

Adolescent↗