OBJECTIVE: To investigate the price and affordability of key essential medicines for children in Sri Lanka. METHODS: This national survey investigated the prices and affordability of 25 key essential medicines for children in private sector pharmacies using the WHO/Health Action International (HAI) medicine price methodology. Data were collected from a ...

Access to medicines filling children's therapeutic needs is a long-standing global problem. The problem has been recognised and initiatives for correction were adopted in the USA in the late 1990s, and in the European Union in the first decade of this century. Paediatric medicines are particularly problematic in middle- and ...

The limited extent of data available for herbal medicinal products (HMPs) in the paediatric population is related to missing documentation of their use in practice and in literature. Therefore, information for properly evaluating indications, posology, length of treatment and safety in children is often lacking. Frequently, these documentation gaps are ...

The fourth annual European Paediatric Formulation Initiative (EuPFI) conference on Formulating Better Medicines for Children was held on 19-20 September 2012 at the Institute of Molecular Genetics Congress Centre, Prague, Czech Republic. The 2-day conference concentrated on the latest advances, challenges and opportunities for developing medicinal products and administration devices ...

Preschool children have a high risk of poisoning. While medicines prescribed by primary care are potential poisoning agents, the risk factors for poisoning from medication are not well described. To identify risk factors for medicinal and non-medicinal poisoning in preschool children. Population-based nested case-control study using The Health Improvement Network ...

Kidney Disease: Improving Global Outcomes (KDIGO) recently published the clinical practice guideline on glomerulonephritis (GN) to assist the practitioner caring for patients with GN. Chapter 4 of the guideline focuses on managing children aged 1-18 years with steroid-resistant nephrotic syndrome (SRNS), defined by an inability to achieve complete remission with ...

Abstract Objectives: The study objective was to evaluate the effectiveness of homeopathic medicines for the prevention and treatment of migraine in children. Design: This was an observational, prospective, open, nonrandomized, noncomparative, multicenter study. Setting/location: The study was conducted in 12 countries worldwide. Subjects: Fifty-nine (59) physicians trained in the prescription ...

Sugar in food and drinks is responsible for the poor dental health of many children and adults. On the other hand, there is no evidence that the small amount of sugar in medicines has been responsible for any dental problems. A recent British Heart Foundation survey found that nearly one ...

As case management is under development in France for elderly people, this study sets out to identify and analyse key situations responsible for ethical dilemmas for French case managers. We based our study on the analyses of individual interviews made with case managers and focus-group discussions, bringing together all case ...

This article outlines one element of the work carried out by a group of Canadian ethicists [Practicing Healthcare Ethicists Exploring Professionalization (PHEEP)]-to begin the deliberative development of a set of practice standards for the Canadian context. To provide a backdrop, this article considers the nature and purpose of practice standards ...

There are several important conceptual issues and questions about the practice of healthcare ethics that can, and should, inform the development of any practice standards. This paper provides a relatively short overview of seven of these issues, with the invitation for further critical reflection and examination of their relevance to ...

Objective.  There are many external influences in today's market force that impair the relationship between the pain medicine specialist and the patient, and ultimately prevent optimal quality of care. This article explores the ethical challenges facing the pain medicine specialist in today's increasingly "business" environment and will offer solutions for ...

In the United Kingdom (UK), ethical guidance for doctors assumes a therapeutic setting and a normal doctor-patient relationship. However, doctors with dual obligations may not always operate on the basis of these assumptions in all aspects of their role. In this paper, the situation of UK occupational physicians is described, ...

Our perception of the mechanism by which single genes can cause disease is evolving. This has led to the understanding of the pathophysiological basis of common diseases. Genomic Medicine continues to contribute to the understanding of the molecular basis of disease. Medicine has strived to achieve the goal of tailoring ...

Biobanks and biospecimens are critical components for many areas of clinical and basic research. The quality of biospecimens and associated data must be consistent and collected according to standardized methods in order to prevent spurious analytical results that can lead to artifacts being interpreted as valid findings. A number of ...

Kevin Smith's utilitarian argument against homeopathy(1) is flawed because he did not review and refute the relevant basic science literature on ultra-high dilutions. He also failed to appreciate that allopathic medicine is based on a deductive-nomothetic method and that homeopathic medicine is based on an inductive-idiographic method, and thus that ...

Background As our population ages, the proportion of drivers with dementia will continue to rise. Increasingly, health professionals are faced with the clinical dilemma of determining fitness to drive. Unfortunately, the management of drivers with dementia is fraught with hazards. Objective This article attempts to provide an overview of the ...

To explore the experience of non-UK-qualified doctors in working within the regulatory framework of the General Medical Council (GMC) document Good Medical Practice. Individual interviews and focus groups. United Kingdom. Non-UK-qualified doctors who had registered with the GMC between 1 April 2006 and 31 March 2008, doctors attending training/induction programmes ...

Intentional ingestion and insertion of foreign objects is a topic that has generated mounting interest among medical professionals over the past two decades. When featured in the literature, it has been typically discussed in medical subdisciplines, such as emergency medicine, surgery, gastroenterology, and urology. However, in-depth exploration of this multidimensional ...

Abstract:Although the practice of medicine continually changes in response to new biomedical understanding, novel technologies, and evolving cultural contexts, the ethical foundations of the clinical relationship between patient and physician paradoxically remain constant. There are fundamental characteristics with respect to character, behavior, and responsibilities that are descriptive of and necessary ...

The Cartwright Report was released at a time of massive ethical change in New Zealand medicine, the shock waves spreading throughout the region as they caught the surge of interest in patient autonomy and patient rights. The mood was as revolutionary for health professionals as the late 1960s and 1970s ...

A practicing psychiatrist faces dilemmas on a number of occasions, in deciding the best course of action he/she needs to undertake while treating a patient. At times, this choice may not be in accordance with the ethical and moral principles and may in fact appear to violate patient's autonomy and ...

BACKGROUND: The management of vitamin K antagonists (VKAs) associated coagulopathy is a cornerstone of pre-endoscopic assessment of anticoagulated patients presenting with acute gastrointestinal bleeding. AIMS: To evaluate physician attitudes in the management of VKAs-associated coagulopathy in patients presenting with gastrointestinal bleeding and to assess their compliance to current practice guidelines. ...

The critical incident technique provides a means to better understand the reasons behind clinicians' practices and changes in practice. No standardized tool exists to elicit information using this technique. To create and validate a standardized tool that explores change and reasons for change in professional practice. Item generation was based ...

Current fisheries management is, unfortunately, reactive rather than proactive to changes in fishery characteristics. Furthermore, anglers do not act independently on waterbodies, and thus, fisheries are complex socio-ecological systems. Proactive management of these complex systems necessitates an approach-adaptive fisheries management-that allows learning to occur simultaneously with management. A promising area for implementation ...

As knowledge exploded and technology advanced in the last 2 centuries or so, present and several recent generations became the first in history to experience massive change in their lifetimes. In our era of rapid change for which no end is in sight, people have had to adjust to the ...

Everyone in healthcare can feel the ground shifting. The changes are driving demand for information management, and HIM professionals can find new opportunities by keeping engaged and acquiring new skills.

Research, evidence-based practices are emphasized. Measures should address a process proximate to desired outcome. Changes should strengthen the hand of quality managers.

Collaborative efforts among hospitals can facilitate the exchange of ideas, provide a forum for discussing the development of new policies or practices or changes to existing policies and practices, and increase the implementation of best practices. In November 2008, the Massachusetts Breastfeeding Coalition formed a collaborative of maternity facilities wishing ...

With all due respect, the simple truth is that doctors don't always play well in the sandbox. Add in challenges such as reduced reimbursement, shifting to electronic records, and a merger or acquisition, and you have a recipe for trouble. Think marriage is difficult? Work with unhappy doctors and you'll ...

We discuss some issues relevant to paper of Clegg and co-authors published in Statistics in Medicine; 28, 3670-3682. Emphasis is on computation of the variance of the sum of products of two estimates, slopes and breakpoints.

Managers and conservationists often need to prioritize which impacts from climate change to deal with from a long list of threats. However, data which allows comparison of the relative impact from climatic threats for decision-making is often unavailable. This is the case for the management of sea turtles in the ...

Endoscopy is performed frequently in children with chronic abdominal pain (CAP), but its impact on clinical management is unclear. We aimed to examine the frequency of changes in immediate medical management resulting from endoscopy with biopsy evaluating CAP in children. We conducted a prospective cross-sectional study to assess the frequency ...

The rapidly shifting healthcare landscape requires all-wheel-drive management. Organizations must expect and be prepared for constant change.

It is widely accepted that climate change poses severe threats to freshwater ecosystems. Here we examine the scientific basis for adaptively managing vulnerable habitats and species. Our views are shaped by a literature survey of adaptation in practice, and by expert opinion. We assert that adaptation planning is constrained by ...

The unique physiological changes that occur at birth and the adaptations that come in the first weeks of life profoundly affect the clinical management of the surgical newborn patient. The newborn has adaptive challenges that have to be met at birth: (a) establish a functional residual capacity and breathe; (b) ...

In this paper we set forth what we believe to be a relatively controversial argument, claiming that 'bioethics' needs to undergo a fundamental change in the way it is practised. This change, we argue, requires philosophical bioethicists to adopt reflexive practices when applying their analyses in public forums, acknowledging openly ...

Technological and medical advancements have dramatically accelerated the speed of change in the realm of health care. New technology, the changing needs of patients, and economic pressures all contribute to the need for health organizations to modify practices continually. Quality improvement (QI) of current processes is central to these efforts. ...

Negotiating with payers for better reimbursement, contract language, support for practice enhancement, or changes in policies and procedures is a critical function that may greatly enhance a practice's success over time. This article discusses keys to successful negotiating and several specific areas beyond reimbursement that deserve the reader's attention.

Climate change has the potential to compromise the sustainability of natural resources in Mediterranean climatic systems, such that short-term reactive responses will increasingly be insufficient to ensure effective management. There is a simultaneous need for both the clear articulation of the vulnerabilities of specific management systems to climate risk, and ...

The success of Johne's disease (JD) control programs based on risk assessment (RA) depends on producers' compliance with suggested management practices. One objective of this study was to describe the perception of participating Canadian dairy farmers of the impact of JD, the RA process, and suggested management strategies. The second ...

This field study aimed at examining the role of anesthesia teams' adaptive coordination in managing changing situational demands, such as in nonroutine events (NREs). Medical teams' ability to adapt their teamwork (e.g., their coordination activities) to changing situational demands is crucial to team performance and, thus, to patient safety. Whereas ...

When local resource users detect, understand, and respond to environmental change they can more effectively manage environmental resources. This article assesses these abilities among artisanal fishers in Roviana Lagoon, Solomon Islands. In a comparison of two villages, it documents local resource users' abilities to monitor long-term ecological change occurring to ...

There are three principal elements related to viral safety in the context of immunological veterinary medicinal products: the presence of extraneous agents in either raw material used for production or in the finished product, residual pathogenicity of live viruses used as active ingredients, and incomplete inactivation of inactivated viruses used ...

In the United States, many state and federally funded conservation programs are required to quantify the water quality benefits resulting from their efforts. The objective of this research was to evaluate the impact of conservation practices subsidized by the Oklahoma Conservation Commission on phosphorus and sediment loads to Lake Wister. ...

California Assembly Bill AB487 mandates that all practicing physicians are required to obtain 12 h of Continuing Medical Education in Pain Management and End of Life Care before the year 2006 in order to renew their state license to practice medicine. In order to determine the effectiveness of this bill ...

Recent climate talks in Copenhagen reaffirmed the crucial role of reducing emissions from deforestation and degradation (REDD). Creating and strengthening indigenous lands and other protected areas represents an effective, practical, and immediate REDD strategy that addresses both biodiversity and climate crises at once.

The extent to which current landscapes deviate from the historical range of natural variability (RNV) is a common means of defining and ranking regional conservation targets. However, climate-induced shifts in forest composition may render obsolete restoration strategies and conservation targets based on historic climate conditions and disturbance regimes. We used ...

Increasing demands on general practice to manage chronic disease may warrant organisational change at the practice level. Staff's readiness for organisational change can act as a facilitator or barrier to implementing interventions aimed at organisational change. To explore general practice staff readiness for organisational change and its association with staff ...

Comprehensive oxygen management, focused on avoiding hyperoxia and repeated episodes of hypoxia-hyperoxia in very low birth weight infants, has been successfully used for the reduction of retinopathy of prematurity. Building on this experience, the Comprehensive Oxygen Management for the Prevention of Retinopathy of Prematurity quality improvement initiative was developed to ...