EDITORIAL COMMENT on END-2011-0214-CRT.R3 Laparoscopic RPLND: Is it safe, does it harm, what does the robot add? G. Janetschek, Medical University Salzburg, Dept. of Urology.

Malaise and fainting are unpleasant acupuncture adverse effects. This paper shows how the use of thermography might identify subjects before the systematic responses become clinically significant.

The purpose of this study was to develop a method to define and rate the severity of adverse events (AEs) in emergency medical services (EMS) safety research. They used a modified Delphi technique to develop a consensus definition of an AE. The consensus definition was as follows: "An adverse event ...

This study was initiated by a Pastoral Care Department of a large academic medical center in order to establish hospital chaplaincy policies and procedures. Four basic questions were asked about professional hospital chaplains and record keeping. The results of the survey show that the standard of practice is that chaplains ...

Medical abortion is one of the most important advances of the last century in the field of reproductive health. However, the introduction and use of the technology varies widely among countries. The article examines the commercial, political, regulatory, and legislative history of the introduction of mifepristone-misoprostol in France and the ...

Background: Pharmaceutical industry involvement in biomedicine has produced major benefits but has also caused concern. At present, there is no consensus as to how medical and government organizations should relate to the pharmaceutical industry and this is partly due to the absence of systematic study of the various alternatives. In ...

BackgroundPoison centres are an underutilized source of information on adverse events related to medications, including therapeutic errors and adverse drug reactions.ObjectiveTo demonstrate the feasibility of using a poison centres' electronic data to identify and describe adverse events related to medications.MethodsThis one-year, retrospective cross-sectional pilot study was conducted at one Canadian ...

As part of a 10-year follow-up study of morbidity following spouse bereavement, concordance between subject reports of their illness experience and that given by their doctors' and other medical records has been assessed. Enumeration from medical records involved extensive and careful perusal of general practitioner, specialist, and hospital records while ...

The Clinical Narrative Temporal Relation Ontology (CNTRO)1 project offers a semantic-web based reasoning framework, which represents temporal events and relationships within clinical narrative texts, and infer new knowledge over them. In this paper, the CNTRO reasoning framework is applied to temporal analysis of medical device adverse event files. One specific ...

On red grouse estates in the UK the nematode parasite Trichostrongylus tenuis is often controlled by application of grit medicated with the anthelmintic fenbendazole (FBZ). To date, assessment of the efficacy has been inhibited by the inability to quantify uptake of FBZ by the birds. We have developed a simple ...

Work stress and coping resource may contribute to the quality of life in medical professionals. This study is to determine the relationships among work stressor, personal strain, coping resource and the quality of life (QOL) and its two dimensions in medical professionals. The Chinese version of Short Form-36 Health Survey ...

Good medical leadership is vital in delivering high-quality healthcare, and yet medical career progression has traditionally seen leadership lack credence in comparison with technical and academic ability. Individual standards have varied, leading to variations in the quality of medical leadership between different organisations and, on occasions, catastrophic lapses in the ...

A recent systematic review found no "good quality evidence" that elective induction of labor confers substantial benefits to either mothers or babies, but concluded that elective induction is associated with a decreased risk of "cesarean delivery." Admittedly, elective induction was qualified as "at 41 weeks of gestation and beyond" with ...

The current medical education model is based on the assumption that students progress from a mastery of basic mechanisms of human structure and function to an understanding of a variety of pathologies and treatments using sound scientific principles. In this commentary, the authors suggest another approach to developing medical school ...

Good marital quality (MQ) is associated with better outcomes in many medical illnesses, especially for women. However, improved outcome is only apparent when MQ is measured across a range of marital functioning and when it is statistically described as either good or poor functioning. This article describes the biological processes ...

Medical laboratories, and specifically genetic testing laboratories, provide vital medical services to different clients: clinicians requesting a test, patients from whom the sample was collected, public health and medical-legal instances, referral laboratories and authoritative bodies. All expect results that are accurate and obtained in an efficient and effective manner, within ...

Objective To evaluate quality of life among patients of Family Health Strategy Units and how it relates to the prescribing complexity and to the number of psychotropic medications prescribed, including adjustments for sociodemographic characteristics. Setting Family Health Strategy Units in a municipality in the Brazilian state of Rio Grande do ...

Frequently, prescribers fail to account for changing kidney function when prescribing medications. We evaluated the use of a computerized provider order entry intervention to improve medication management during acute kidney injury. Quality improvement report with time series analyses. 1,598 adult inpatients with a minimum 0.5-mg/dL increase in serum creatinine level ...

Preparing a medical school for institutional review can be a challenging undertaking for any institution requiring an understanding of the international standards being used and adequate preparation and planning (MacCarrick et al. in Med Teach 32(5):e227-e232, 2010). This series examines each of the nine standards developed by the World Federation ...

The currently known distribution range of Achatina fulica Bowdich, 1822, in the state of São Paulo, Brazil, is presented. The record of A. fulica naturally infested with Aelurostrongylus abstrusus larvae (Railliet, 1898) (Nematoda: Metastrongylidae) can be found in the city of Guaratinguetá. It was found A. fulica with Metastrongylidae larvae ...

Concern about the quality and safety of health care persists, 10 years after the 1999 Institute of Medicine report To Err is Human. Despite growing awareness of quality and safety risks, and significant efforts to improve, progress is difficult to measure. Hospital leaders, including boards and medical staffs, are accountable ...

OBJECTIVES: To examine socio-demographic disparities associated with a quality medical home. METHODS: A nationally representative sample of children ages 0-17 years (n = 102,353) from the 2003 National Survey of Children's Health. Risk factors including non-white race/ethnicity, income <200% of the federal poverty level (FPL), uninsured, parent education lesser than ...

To identify factors affecting doctors' engagement with the Safer Patients Initiative (SPI). Qualitative interview study. Four organisations participating in phase 1 of the SPI programme, from four different geographical locations in the UK. 34 staff members, comprising senior executive/management leads involved in the SPI programme, the principal SPI programme coordinator ...

Geographic variations in service utilization have emerged as sentinels of quality of care. We used data from the National Survey of Child and Adolescent Well-Being (NSCAW), the Kaiser Family Foundation, and the Area Resource File to examine interstate variations in psychotropic medication use among children coming into contact with child ...

Transitions between healthcare settings are associated with errors in communication of information and treatment plans for frail older patients, but strategies to improve transitional care are lacking. A systematic review was conducted to identify and evaluate interventions to improve communication of accurate and appropriate medication lists and advance directives for ...

Lagging quality of care in the U.S. health care system has been a persistent problem and challenge. In the past, medical professionalism and professional certification have served as cornerstones for improving quality in health care. Among newer efforts to improve quality, pay for performance has been proposed to propel better ...

The effectiveness of a quality improvement (QI) program developed by Spectrum Health in Grand Rapids, Mich., is in many ways exemplified by its Acute Myocardial Infarction/Percutaneous Coronary Intervention (AMI/PCI) Improvement project, launched in 2003. Team structure played a major part in the AMI/PCI Improvement project's success. Indispensable members of the ...

To examine the impact of billing and clinical data extracted from an electronic medical record system on the calculation of an adverse drug event (ADE) quality measure approved for use in The Joint Commission's ORYX program, a mandatory national hospital quality reporting system. The Child Health Corporation of America's "Use ...

BACKGROUND: Quality improvement programs that allow physicians to document medical reasons for deviating from guidelines preserve clinicians' judgment while enabling them to strive for high performance. However, physician misconceptions or gaming potentially limit programs. OBJECTIVE: To implement computerized decision support with mechanisms to document medical exceptions to quality measures and ...

PURPOSE: This study examines the contributions of known predictors of survival and quality of life (QOL) to 1-year survival in ICD recipients. METHODS: This study used the data set from the antiarrhythmia versus implanted defibrillator (AVID) controlled clinical trial conducted by the National Institutes of Health, National Heart, Lung, and ...

OBJECTIVE: The purpose of this study was to provide enough information so beginners can feel comfortable starting and completing a simple radiology process improvement project. CONCLUSION: Medical practices (including radiology departments) need to address outstanding quality and safety issues that threaten their patients. Addressing these issues improves patient care and ...

OBJECTIVE: The aim of this study was to show the possibility to identify what decisions in the initial regional medical command and control (IRMCC) that have to be improved. DESIGN: This was a prospective, observational study conducted during nine similar educational programs for regional and hospital medical command and control ...

Wireless medical ultrasound streaming is considered one of the emerging application within the broadband mobile healthcare domain. These applications are considered as bandwidth demanding services that required high data rates with acceptable diagnostic quality of the transmitted medical images. In this paper, we present the performance analysis of a medical ...

Fully 23 years after enactment of the Health Care Quality Improvement Act and 19 years after initiation of the National Practitioner Data Bank reporting requirements, the identification and proper processing of adverse privileging actions continues to be a dynamic, challenging, and rights-preserving system at the forefront of the quality assurance ...

Life as a doctor or medical student poses particular challenges and stressors which can impact on quality of life. This paper sets out to review what is known about the quality of life of doctors and medical students and the ramifications of a poor quality of life. This paper summarises ...

Medication-related problems are prevalent in older adults and adversely affect the quality of care. It has been suggested that racial differences exist in medication use. Most efforts to evaluate the quality of medication use target specific drugs or disease states, or a set of pre-defined quality indicators, rather than the ...

The present study is to evaluate quality of life (QOL) among Chinese medical professionals and explore its main influencing factors. A total of 2,721 medical professionals were selected from two provinces by using stratified cluster sampling method. The Chinese version of Short Form-36 Health Survey (SF-36) was used to measure ...

The medical home (also known as patient-centered medical home or advanced medical home) is a composite policy construct representing a set of interventions intended to revitalize primary care practices and improve patient care. As an idealized vision, the medical home has gained the support of stakeholders including employers, health professional ...

BACKGROUND: Medication-related problems are prevalent in older adults, contributing to increased harm and health care costs and negatively impacting quality of care. Older adults with psychiatric disease are at an increased risk because of their underlying disease and types of medications prescribed. Efforts to improve the quality of medication use ...

Identifying issues as strategic initiatives can enhance likelihood of success. Interdepartmental quality improvement team includes director of case management and medical director of hospitalist program. Clinicians appreciated the fact that LOS was seen first and foremost as a medical issue.

Vargus-Adams JN, Martin LK. Measuring what matters in cerebral palsy: a breadth of important domains and outcome measures. OBJECTIVE: To establish domains of importance for evaluating therapeutic effects in childhood cerebral palsy (CP) and the best means of evaluating those domains. DESIGN: Delphi iterative survey. SETTING: Tertiary pediatric hospital with ...

PURPOSE: Part 2 of this study presents the results of the clinical audits of the "Arztliche Stelle" (AS) concerning process quality in the radiation therapy units in Baden-Württemberg, Germany. MATERIAL AND METHODS: The process quality of nine main test groups (laws, organizations, technical equipment, GMP [Good Medical Practice] principles, radiotherapy, ...

Despite dramatic innovation in medical imaging and information system technologies, the radiology report has remained stagnant for more than a century. Structured reporting was created in the hopes of addressing well-documented deficiencies in report content and organization but has largely failed in its adoption due to concerns over workflow and ...

A method is summarized to improve quality control of the patient history in the medical record, incorporating the patient as a partner to review and correct the information. This method has been implemented at every patient visit to the senior author since 2000, in the infrastructure of usual medical care, ...

BACKGROUND: Medical consultation is an integral part of hospitalist physicians' practice, yet there is no uniform training to achieve competency in this area during residency. OBJECTIVE: To improve the quality of medical consultations performed by hospitalists in an academic medical center. DESIGN: Single group pre-post study design comparing knowledge and ...

BACKGROUND: Quality improvement (QI) measures often are cited as goals for individual practices and medical centers and may someday form a component of reimbursement guidelines. Relatively few QI metrics relevant to ambulatory pulmonary medicine have been published. We describe the development and implementation of a QI program in an academic ...

With the new ISO 9001:2008 quality management system (QMS) superseding ISO 9001:2000, Charles Bright, BSc, MBA, principal quality consultant and medical devices lead auditor at specialist medical devices and healthcare sector consultancy Plasmed, discusses implementation of the latest standard, touching on the experience of a large English NHS acute hospital ...

This article identifies three categories of case management (CM), in-country, international, and micro, that are poised to serve as the quality proxy for the international medical patient in the rapidly emerging globalized healthcare marketplace. The content concentrates on describing in-country CM and international CM (ICM). Because CM professionals are the ...

To evaluate the performance of health workers with respect to diagnosis and treatment of acute respiratory infection (ARI) and acute diarrhoea (AD) in children < 5 years in 11 rural heath facilities in Yemen, we carried out a cross-sectional study on 219 cases of ARI and 93 cases of AD. ...

People look to medical tourism to save money and to get treatments that are not approved or that are not available at home due to political prohibitions. Medical tourism will be affected by the global economic downturn, concern about lower quality of care, and political instability. The international marketplace could ...