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PubMedDate not supplied

[Experience gained with the training of interns-hygienists and its use in creating the structure of an integrated licensing examination "Step 3 - Sanitary-Hygienist Work"].

The experience gained with the training of interns-hygienists at the National Medical University has proved its value, contributing to which fact were modern material-and-technical resources, close cooperation of chairs of hygiene with sanitary epidemiologic stations and scientific-research institutes, highly skilled scientific and teaching personnel, systematic sharing of experience gained in training of specialists with institutions of higher learning of Ukraine. However, interns, Masters, practitioners are still in great need of modern educational literature/training aids. There has not yet been developed a general concept of structure of sanitary epidemiological service of Ukraine, forms and methods of its work under present-day conditions. Publication of joint educational literature and textbooks of methodics to complete training of physicians-hygienists, Masters in hygiene and epidemiology, introduction of an integrated licensed examination "Step 3--Sanitarno-Gigiyenicheskoye Delo" (sanitation-and-hygiene-related work) will, we believe, help in solving the above problems.

Academies and Institutes↗

PubMed2002

Student performance on the Comprehensive Osteopathic Medical Licensing Examination-USA level 2 following a clinical evaluation, feedback, and intervention program.

The purpose of this study was to examine student performance on the Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) level 2 examination following a clinical evaluation, feedback, and intervention program. Students who completed their core clinical training (year 3) at the Lake Erie College of Osteopathic Medicine in Erie, Pennsylvania, returned to the campus for a weeklong series of clinical science testing. Their performance in this program was compared to their performance on COMLEX-USA level 2 administered by the National Board of Osteopathic Medical Examiners approximately 3 months later. The authors analyzed other student data (Medical College Admission Test scores, grade point averages, and COMLEX-USA level 1 scores) to identify the relationship between these variables and the students' success (or failure) on COMLEX-USA level 2. Using a correlation approach, the authors found a relationship between COMLEX-USA levels 1 and 2 as well as between the preparation week and COMLEX-USA level 2, and that the significant difference in the results of the "at-risk" students continues in the COMLEX-USA level 2 performance. Further, the intervention used with students performing at less-than-satisfactory levels in the preparation program was successful in improving the performance of this group to a level equal to that of the second decile, thus increasing the likelihood that these students will pass the COMLEX-USA level 2 examination.

Adult↗

PubMed2001

Mesopic visual acuity requirements for driving licenses in the European Union-Research Report.

In this study different methods for determining the mesopic visual acuity in candidates for driving licenses group 2 are presented (Royal Decree, 1998, European norms). Results of normal subjects are compared. Depending on the method used, visual acuity obtained under mesopic conditions, with an illuminance of 1 lux, showed a mean ranging from 0.5 to 0.65, which is clearly above the legal norm of 0.2. A comparative study of the three published official norms demonstrates that the stringent norms of 1966 do not match those of 1988 and 1998, resulting in a wider margin of acceptability, to the advantage of the candidate.

Adult↗

PubMedDate not supplied

Characteristics of visits to licensed acupuncturists, chiropractors, massage therapists, and naturopathic physicians.

BACKGROUND: Despite growing popularity of complementary and alternative medical (CAM) therapies, little is known about the patients seen by CAM practitioners. Our objective was to describe the patients and problems seen by CAM practitioners. METHODS: We collected data on 20 consecutive visits to randomly sampled licensed acupuncturists, chiropractors, massage therapists, and naturopathic physicians practicing in Arizona, Connecticut, Massachusetts, and Washington. Data were collected on patient demographics, smoking status, referral source, reasons for visit, concurrent medical care, payment source, and visit duration. Comparative data for conventional physicians were drawn from the National Ambulatory Medical Care Survey. RESULTS: In each profession, at least 99 practitioners collected data on more than 1,800 visits. More than 80% of visits to CAM providers were by young and middle-aged adults, and roughly two thirds were by women. Children comprised 10% of visits to naturopathic physicians but only 1% to 4% of all visits to other CAM providers. At least two thirds of visits resulted from self-referrals, and only 4% to 12% of visits were from conventional physician referrals. Chiropractors and massage therapists primarily saw musculoskeletal problems, while acupuncturists and naturopathic physicians saw a broader range of conditions. Visits to acupuncturists and massage therapists lasted about 60 minutes compared with 40 minutes for naturopathic physicians and less than 20 minutes for chiropractors. Most visits to chiropractors and naturopathic physicians, but less than one third of visits to acupuncturists and massage therapists, were covered by insurance. CONCLUSIONS: This information will help inform discussions of the roles CAM practitioners will play in the health care system of the future.

Acupuncture↗

PubMed2002

[Driving license for diabetic patients].

The right to be able to drive an automobile is not only one of the most cherished manifestations of adulthood, but increasingly a necessity in modern life. However, it is important to remember that in most countries, driving license for diabetic patients is generally a privilege rather than a right.

Accidents, Traffic↗

PubMed2003

Graduation from a zero to .05 BAC restriction in an Australian graduated licensing system: a difficult transition for young drivers?

In Victoria, Australia, 21-26-year-old drivers are over-represented in alcohol-related fatal crashes. At this age drivers generally transfer from intermediate to full licensure, correspondingly experiencing an increase in legal BAC limit from zero to.05. This study used telephone surveys to compare drinking-driving profiles of 21-26-year-old fully-licensed, 18-20-year-old intermediate and 31-40-year-old experienced drivers ( N congruent with 700) to identify potential crash-risk factors. High driving and drinking exposure was a likely contributor to the over-involvement of male 21-26-year-olds, but not females. A tendency by 21-26-year-olds to rely on other drivers was both successful and unsuccessful in avoiding drink-driving. When driving themselves, there was a tendency to count or space drinks - less successful than abstaining from alcohol. The need to return home, convenience and lack of transport options were common reasons for drink-driving. Fear of crashes/injuries, licence loss and detection/arrest were common motivators to avoid drink-driving. Findings suggest the increase in BAC limit is a difficult transition for some drivers and may contribute to their crash involvement.

Accidents, Traffic↗

PubMed1962

Your license and the law.

Rare is the individual respondent in a hearing before the California Board of Medical Examiners who has read the compilation of laws relating to the practice of medicine and surgery before he became involved with the law. Many physicians do not realize that the conviction of either a felony or any offense, misdemeanor or felony involving moral turpitude constitutes unprofessional conduct and that, after being penalized by the civil courts, they then are subject to action by the Board which may revoke the license to practice. During 1960, forty-two hearings on charges of unprofessional conduct were held. Many of these could have been avoided had the doctors involved not been ignorant of the law.

California↗

PubMed2003

Microbiological and genetic analysis of probiotic products licensed for medicinal purposes.

BACKGROUND: The purpose of our study was to investigate both qualitatively and quantitatively the microbial content of probiotic products licensed for medicinal purposes. MATERIAL/METHODS: Microbiological analysis was performed on five different brands of probiotic products that claimed to contain lactobacilli and/or bifidobacteria. The species were determined based on phenotypic characters, using API 50CH, API 20A, and API rapid ID 32A kits. Bacterial strains belonging to the Bifidobacterium genus were further identified using genotypic methods (amplification of specific DNA fragments by PCR and analysis of their nucleotide sequences). The products were also analyzed for pathogenic bacteria. The number of microorganisms contained in four of the products was determined using the plate-count method and the most-probable-number method. The actual and claimed content of probiotic products was analyzed statistically. RESULTS: Microbiological and genetic analysis showed that, in terms of quality, only three of the five products contained the bacterial strains claimed on the label. None of the tested products contained pathogens. Quantitative analysis demonstrated that 57 of 64 samples (89% [95% CI: 81-97]) contained bacterial counts at the cell densities (doses) claimed on the label. CONCLUSIONS: Our study demonstrates unsatisfactory qualitative microbiological specification in the tested products. However, there was good quantitative agreement with the labeling. Our findings indicate that regulations governing the labeling of probiotic products are urgently required.

Bacterial Typing Techniques↗

PubMed2003

In vitro antifungal activities of anidulafungin and micafungin, licensed agents and the investigational triazole posaconazole as determined by NCCLS methods for 12,052 fungal isolates: review of the literature.

The echinocandins anidulafungin and micafungin and the triazole posaconazole are currently undergoing phase III clinical trials. Caspofungin and voriconazole have recently been licensed for the treatment of aspergillosis (both agents), other less common mould (voriconazole) and candidal (caspofungin) infections. This review summarizes the published in vitro data obtained by NCCLS or NCCLS modified methods on the in vitro fungistatic and fungicidal activities of these five agents for yeasts and moulds in comparison to the established agents, amphotericin B, fluconazole, itraconazole, and flucytosine. Among the yeasts, the echinocandins have less activity for Candida parapsilosis and Candida guilliermondii, no activity for Cryptococcus neoformans and Trichosporon spp., but good fungistatic and fungicidal activity in vivo and in vitro for most of the other Candida spp.; this fungicidal activity has been reported by minimum fungicidal concentrations (MFCs) or time kill curve results. The new triazoles exhibit good fungistatic activity (but not fungicidal) for most Candida spp., C. neoformans, and Trichosporon spp. For the Aspergillus spp. evaluated, the echinocandins have similar or better fungistatic activity than those of amphotericin B and the triazoles, but fungicidal activity has been demonstrated only with amphotericin B and the triazoles, with the exception of fluconazole. Most studies showed posaconazole and voriconazole minimum inhibitory concentrations (MICs) ranging from 0.25 to 8 microg/ml for non-solani Fusarium spp., while MIC and minimum effective concentration (MEC) endpoints of the echinocandins were >8 microg/ml. The fungistatic activity of the triazoles is also superior to that of the echinocandins for most of the dimorphic fungi and the Zygomycetes. However, micafungin has activity for the mould phase of most dimorphic fungi, but not for the parasitic or yeast phase of Paracoccidioides brasiliensis. The echinocandins appear to have variable and species dependent fungistatic activity for the dematiaceous fungi, but all agents have poor or no activity against most isolates of Scedosporium prolificans. Only amphotericin B exhibit good fungistatic activity against the Zygomycetes. The combination of caspofungin with some triazoles, amphotericin B or liposomal amphotericin B has been synergistic in vitro, in animal models and in patients. Breakpoints are not available for any mould and antifungal agent combination. In vitro/in vivo correlations should aid in the interpretation of these results, but standard testing conditions are needed for the echinocandins, especially for mould testing, to obtain reliable results.

Anidulafungin↗

PubMed2005

Correlation between housestaff performance on the United States Medical Licensing Examination and standardized patient encounters.

BACKGROUND: There is interest in the use of "standardized patients" to assist in evaluating medical trainees' clinical skills, which may be difficult to evaluate with written exams alone. Previous studies of the validity of observed structured clinical exams have found low correlation with various written exams as well as with faculty evaluations. Since the United States Medical Licensing Examination (USMLE) results are often used by training programs in the selection of applicants, we assessed the correlation between performance on an observed structured clinical exam and the USMLE, steps 1 and 2, for internal medicine housestaff. METHODS: We collected scores on the USMLE, steps 1 and 2, and the overall score from a required standardized patient encounter for all PGY-1 trainees, in a single urban teaching hospital. Pearson coefficients were used to compare the USMLE and observed structured clinical exam performance. RESULTS: The two steps of the USMLE correlated with each other to a large extent (r=0.65, df=30, p=0.0001). However, both steps of the USMLE correlated poorly with the observed structured clinical exam (step 1 r=0.2, df=32, p=0.27; step 2 r=0.09, df=30, p=0.61). CONCLUSIONS: The low correlation between the USMLE and performance on a structured clinical exam suggests that either the written exam is a poor predictor of actual clinical performance, the small window of clinical skills measured by the structured clinical exam is inadequate, or the two methods evaluate different skill sets entirely. Our findings are consistent with previous work finding low correlations between structured clinical exams and accepted common means of evaluation, such as faculty evaluations, other written exams and program director assessments. The medical education community needs to develop an objective, valid method of measuring important, yet subjective, skill-sets such as interpersonal communication, empathy and efficient data collection.

Clinical Competence↗

PubMed2005

Workplace assessment for licensing in general practice.

With the redesign of general practice training implicit in the Department of Health's programme of reform, Modernising Medical Careers, there is the opportunity to bring summative assessment and the MRCGP examination together into a unified assessment framework for licensing. It is likely that assessment in the workplace will play a central role in such a process. Workplace assessment is of high validity and has the potential to reconnect teaching and testing in general practice. Five principles to underpin the design of a workplace assessment are proposed, namely that it should be: competency-based, developmental, evidential, locally assessed, and triangulated. Successful implementation of workplace assessment will not only serve to reduce the current testing burden on trainees, but will also harness the involvement of medical teachers. In doing so, general practice has the opportunity to create a powerful tool for professional development.

Education, Medical, Continuing↗

PubMed2005

Correlation of United States medical licensing examination step 2 and obstetrics and gynecology clerkship final examination scores with clerkship clinical evaluation scores.

OBJECTIVE: To determine if a student's subjective clinical evaluation score (CES) correlates with United States Medical Licensing Examination (USMLE) Step 1 or Step 2, obstetrics/gynecology clerkship final examination or Medical College Admission Test (MCAT) scores. STUDY DESIGN: The test scores for all students rotating at Texas Tech Health Sciences Center at Amarillo from 1994 to 2002 were obtained. Regression models were used to compare the CES and examination scores. The 10th percentile of the CES was statistically compared with each examination score as well as its 10th percentiles. RESULTS: The mean scores for the 285 students were USMLE Step 1, 204.4; USMLE Step 2, 205.0; MCAT, 29.1; obstetrics/gynecology final, 86.0; CES, 88.5. Linear correlations were found between the CES and USMLE Step 2 (r = 0.26, p < 0.001) and the obstetrics/gynecology final (r=0.25, p<0.001). Students with a poor CES (<10th percentile) had lower USMLE Step 2 scores, (188.2 vs. 206.3, p < 0.001) and more examination failures (odds ratio [OR] 8.9 [2.3-33.9]) as well as both lower obstetrics/gynecology final examination scores (81.1 vs. 86.3, p < 0.001) and more clerkship failures (OR 14.2 [1.9-107.4]). CONCLUSION: Students' subjective CESs correlate linearly with performance on both the USMLE Step 2 and obstetrics/gynecology final examinations. Poor CESs (< 10th percentile) predicted lower scores on the future standardized examinations studied.

Adult↗

PubMed2000

Anti-epileptic drugs: newly licensed and under development.

Approximately 1% of the world population (50 million people) suffers from epilepsy. Although the long-established anti-epileptic drugs allow 80% of newly diagnosed patients to remain seizure-free, many patients experience intolerable side effects the remaining 20% of patients do not respond to these drugs. There has therefore been a need for new anti-epileptic drugs, and the past decade has seen the licensing of eight new drugs worldwide, although these drugs have made little impact on the prognosis of refractory epilepsy. Furthermore, the side effect profiles of these new drugs do not differ significantly from the established antiepileptic drugs, so new anti-epileptic drugs with novel therapeutic targets, enhanced efficacy and minimal side effects are needed.

Journal Article↗

PubMed2005

The Trading with the Enemy Act of 1917 and synthetic drugs: relieving scarcity, controlling prices, and establishing pre-market licensing controls.

The "Trading with the Enemy Act" (TWEA) was enacted in October 1917 after America's entry into World War I and during a period of wartime scarcity and rising prices of synthetic drugs and dyestuffs that began in 1914. It was described as "An Act to define, regulate, and punish trading with the enemy, and for other purposes." The act and subsequent executive orders authorized an "Alien Property Custodian" to take control of all enemy property within the United States. Also, The Federal Trade Commission (FTC) was authorized to issue licenses for the use of enemy owned patents, which covered a range of industrial and consumer products. Significantly, the FTC was given the power to set the conditions for use of the patents and to fix the price for those products necessary for health. The effect of these measures was to bring federal pre-marketing control over the production, testing, and pricing of the most therapeutically significant synthetic drugs of the day. Enactment of the TWEA and the events preceding and surrounding it are significant parts of the history of the American pharmaceutical industry and federal regulation.

Antitreponemal Agents↗

PubMed2005

FCC to begin issuing licenses for use of mobile radios in the 460 to 470 MHz band.

The U.S. Federal Communications Commission (FCC) has stated that after December 31, 2005, it will begin issuing licenses for use of private land mobile radios (PLMRs) in the 460 to 470 MHz frequency band. Medical telemetry systems operating in this band after December 31 will therefore be at increased risk for interference, which could compromise patient safety. Any medical facility in the vicinity of a PLMR could be affected.

Federal Government↗

PubMedDate not supplied

Mortality among male farmers licensed to use pesticides.

The mortality experience of 4,580 male farmers licensed to buy and use pesticides in Northern Italy was examined from 1974 to 1987. The historical cohort was determined from the registers of the agricultural inspectorate offices. The vital status at the end of the study period was ascertained by municipality records and only 4 subjects were lost to follow-up. Death certificates were obtained for 100% of the 565 identified deaths. External comparison on to the Italian male population was supplemented by regional comparison. Mortality deficits were observed for all causes, all neoplasms and most specific malignancies. A non-significant mortality excess due to brain cancer, compared both to national and regional populations, was found (11 cases, Standardized Mortality Ratio 169 and 139, respectively). The excess of brain cancer became statistically significant in the age group 65-75 years. Caution must be used in the interpretation of our findings. Nevertheless, it seems reasonable to hypothesize an association of the observed excess of brain cancer with the occupational and/or environmental exposure of the cohort.

Age Factors↗

PubMed1989

Change in Sunday licensing laws and the effect on Monday absenteeism. A short report on a poultry processing plant.

Licensing laws were changed in Northern Ireland on 1st October 1987 to allow drinking of alcohol in public houses on Sundays. The effect on absenteeism was studied in the immediate period after this change using Monday absenteeism as a marker for change. The study was conducted in a small poultry processing plant employing approximately four hundred and forty people. Mean differences between Monday absenteeism for the month of October 1986 and 1985 prior to the change in laws and October 1987 were shown to be not significant.

Absenteeism↗