During the past decade, our understanding of biomechanics and its importance in rehabilitation has advanced significantly. The kinetic chain, a concept borrowed from engineering, has helped us better understand the underlying physiology of human movement. This understanding, in turn, has facilitated the development of new and more rational rehabilitation strategies. ...

Background. Case management provided by health care assistants (HCAs) is effective in improving primary care for depressive patients. Little is known on the implementation-related aspects of case management performed in small family practices. Objective. To explore family doctors' perspectives on clinical and organizational aspects of implementation of case management and ...

INTRODUCTION: Majority of studies on evaluation of emergency management courses have focused on outcomes such as knowledge and skills demonstrated in non-clinical or traditional testing manner. Such surrogate outcomes may not necessarily reflect vital changes in practice. The aim of this study was to determine if and to what extent, ...

AIM: To investigate ownership and perceived utility of written asthma action plans (WAAPs) in general practice. METHODS: Questionnaires were completed by 225 adults and 75 children with GP-diagnosed asthma from 31 practices. Regression models for WAAP ownership allowed for confounders and clustering by practice. Five audio-recorded focus groups were conducted ...

Vaginal practices in sub-Saharan Africa may increase HIV transmission and have important implications for development of microbicides and future HIV prevention technologies. It remains unclear which women undertake vaginal practices and what factors predict prevalence, practice type and choice of products. Using cross-sectional data from mixed research methods, we identify ...

A workshop at the 2008 ASPHO Annual Meeting functioned as the first step in a systematic needs assessment of the particular challenges to satisfaction and success in the middle and senior phases of career development for pediatric hematologist/oncologists (PHOs). The 61 ASPHO members who attended were randomly distributed to small ...

The ability to alter cell identity with small molecules represents a powerful approach to restore biological function lost because of cellular deficiency. Developing this capability through advances in chemical biology could have an enormous impact on human health.

To analyze the component law of Chinese patent medicines for anti-influenza and develop new prescriptions for anti-influenza by unsupervised data mining methods. Chinese patent medicine recipes for anti-influenza were collected and recorded in the database, and then the correlation coefficient between herbs, core combinations of herbs and new prescriptions were ...

To estimate the self-medication prevalence in low-income adults and identify associated factors. Data from a population survey performed in São Paulo municipality, Southeastern Brazil in 2005, were used. The sample strategy included two domains, favelas and non-favelas, with clustered sampling performed in two stages with a total of 3,226 eligible ...

Some of the most celebrated triumphs of chemical biology are molecularly targeted therapeutics to combat human disease. However, a grand challenge looms as informative diagnostic strategies must be developed to realize the full impact of these promising pharmaceutical agents.

Chronic myeloid leukemia (CML) management varies across Asia due to disparities in affluence and healthcare provision. We surveyed CML management practice at 33 hospitals in 14 countries/regions to identify treatment challenges and opportunities for harmonization. Patients were generally treated according to international guidelines; however, tyrosine kinase inhibitors (TKIs) and molecular ...

The purpose of Clinical Problem Solving manuscripts is to present management challenges in an attempt to give practicing neurosurgeons insight into how field leaders address these dilemmas. This illustration is accompanied by a brief review of the literature on the topic. We describe the case of a patient who presented ...

This paper applies the concepts of 'adaptive leadership', as developed by Ron Heifetz, MD, to the practice of medicine. Literature review and theory development. Patients are complex adaptive systems facing both adaptive and technical health challenges. Technical health challenges are amenable to the simple or complicated expert-mediated technical interventions that ...

Massive hemoptysis is a life-threatening condition requiring multidisciplinary management not often available in resource-deprived countries with a limited range of therapeutic options. Prognosis is poor when salvage surgery is offered during active bleeding.

Regenerative medicine is a new multi-disciplinary field aiming at the repair or replacement of disease body parts. The field is progressing at an unprecedented pace and although the opportunities are immense, many hurdles lie ahead. This brief review analyses the opportunities and challenges faced by regenerative medicine.

Widespread global use of rifampin for 2 decades preceded the emergence of clinically significant multidrug-resistant tuberculosis (MDR-TB) in the early 1990s. The prevalence of MDR-TB has gradually increased such that it accounts for approximately 5% of the global case burden of disease (approximately half a million cases in 2007). Eclipsing ...

Capitalizing on spousal support may enhance the effectiveness of interventions for chronic disease management. However, couples-based interventions present logistical challenges. We describe our experience and lessons learned while recruiting couples into the Couples Partnering for Lipid-Enhancing Strategies (CouPLES) trial. This trial seeks to reduce serum low-density lipoprotein cholesterol levels using ...

A survey about time management in the workplace was distributed to obtain a sense of the level of job satisfaction among preclinical safety professionals in the current economic climate, and to encourage reflection upon how we manage time in our work environment. Roughly equal numbers of respondents (approximately 32%) identified ...

Trainees may encounter a range of difficulties during their training period. Supporting a trainee in difficulty can be extremely challenging, yet immensely rewarding.

The phenomenon of plagiarism has evolved as a major problem in many fields with the increasing accessibility of material on the internet. It poses dilemmas for those involved in secondary and tertiary education, as well as for book publishers and those who edit journals. This editorial reviews important recent decisions ...

Severe hemorrhagic cystitis often arises from anticancer chemotherapy or radiotherapy for pelvic malignancies. Infectious etiologies are less common causes except in immunocompromised hosts. These cases can be challenging problems for the urologist and a source of substantial morbidity and sometimes mortality for the patients. A variety of modalities of treatment ...

Neurologic complications of bacterial endocarditis have been observed for centuries but its management has remained challenging at all times. The cerebrovascular complications of this disorder are the most feared and difficult to address. The management of mycotic aneurysms, recent ischemic/hemorrhagic strokes with and without brain abscesses, and mechanical valve patients ...

One response to the challenges of modern day clinical practice has been to employ "mid-level providers" (MLPs), such as physician assistants and nurse practitioners. MLPs may complement physicians by supporting patient self-management and performing routine, protocol-guided management. In turn, MLPs may improve health outcomes and simultaneously lower costs. Within gastroenterology, ...

Personalized medicine is health care that tailors interventions to individual variation in risk and treatment response. Although medicine has long strived to achieve this goal, advances in genomics promise to facilitate this process. Relevant to present-day practice is the use of genomic information to classify individuals according to disease susceptibility ...

Pediatric sedation is a challenge which spans all continents and has grown to encompass specialties outside of anesthesia, radiology and emergency medicine. All sedatives are not universally available and local and national regulations often limit the sedation practice to specific agents and those with specific credentials. Some specialties have established ...

BACKGROUND: Sound human resources (HR) management practices are essential for retaining effective professionals in hospitals. Given the recruitment and retention reality of health workers in the twenty-first century, the role of HR managers in hospitals and those who combine the role of HR managers with other responsibilities should not be ...

BACKGROUND: A delay is evident between the development of new policies on TB diagnostics and their implementation at country level. The Stop TB Partnership would benefit from information from national TB program (NTP) managers on progress towards implementation of new recommendations as well as the opportunities and challenges encountered in ...

AIM: While China has become a significant contributor and prolific publisher in regenerative medicine, its role in the field is not well understood. We analyze how capacity in regenerative medicine was built in China to identify some of its main strengths and challenges. MATERIALS & METHODS: This case study of ...

Biomechanical factors profoundly influence the processes of tissue growth, development, maintenance, degeneration, and repair. Regenerative strategies to restore damaged or diseased tissues in vivo and create living tissue replacements in vitro have recently begun to harness advances in understanding of how cells and tissues sense and adapt to their mechanical ...

This collection of case studies is designed to illustrate challenging and controversial aspects of perioperative medicine. The authors guide readers through four case narratives punctuated by practical multiple-choice questions followed by the authors' commentary on the evidence supporting various answer choices and related considerations. The objective is to examine issues ...

The approach to managing a point-of-care testing (POCT) program has evolved over recent years. Although many of the essential features of early POCT management programs remain intact, contemporary challenges including expansion of the test menu, changing regulatory requirements, and the development of more sophisticated data management connectivity require ongoing adaptation ...

Michael Servetus was the first doctor ever to challenge and scientifically argue against the theories of Galen, which predominated for 14 centuries in medical schools worldwide. Even though he was relatively correct in scientific terms, Servetus was punished because of his boldness in challenging Galen's theories and was condemned to ...

Cerebral palsy is a long recognized ''symptom-complex'' that is the most common cause of childhood physical impairment. A neurodevelopmental disability sub-type, it has an essential core of objective neuro-motor impairment and its present conceptualization includes explicit recognition of activity limitations and varying associated co-morbidities. This review explores this disorder's incidence, ...

Unwanted immunogenicity is a significant issue affecting most biotherapeutic products, including subsequent entry biological (SEB) medicines. Such immunogenicity can be associated with adverse reactions and can cause impaired clinical responses to the biotherapeutic. This feature article provides an overview of the challenges facing the biotechnology industry with regard to the ...

The open abdomen technique is one of the greatest advances in recent times and has enormous application in the daily management of the critically ill or injured patient. It results in tremendous benefits to the initial resuscitation of these patients but also brings on many challenges beyond those that might ...

SUMMARY: Anaesthetic management of surgery for tumors involving the carina is very challenging for an anaesthesiologist and has been associated with guarded prognosis. We describe the management of carinal resection and reconstruction due to a tracheal tumor involving the carina. The various anaesthetic issues involved and experienced in this clinical ...

The field of hematopathology has been a leader in the application of new technologies for both diagnostics and therapy. The ready accessibility of blood cells for examination, the ability to quantify important indices, and the relative responsiveness of otherwise fatal hematologic diseases to chemotherapy have all contributed to rapid advances ...

OBJECTIVE: The inhaled sharp foreign body is usually amenable to bronchoscopic extraction. When this fails, management poses a challenge. We present a logical approach to the inhaled pin inaccessible to the bronchoscope. CASE REPORT: A 12-year-old girl presented to the accident and emergency unit after accidentally inhaling a pin. Multiple ...

'Personalized medicine' promises to increase the quality of clinical care and, in some cases, decrease health-care costs. Despite this, only a handful of diagnostic tests have made it to market, with mixed success. Historically, the challenges in this field were scientific. However, as discussed in this article, with the maturation ...

This article summarizes the recent accomplishments and current challenges facing game-based virtual reality (VR) telerehabilitation. Specifically this article addresses accomplishments relative to realistic practice scenarios, part to whole practice, objective measurement of performance and progress, motivation, low cost, interaction devices and game design. Furthermore, a description of the current challenges ...

Interrupted aortic arch (IAA) is characterised by a lack of luminal continuity between the ascending and descending thoracic aorta. It represents a critical ductus dependent congenital heart disease, which without surgery is associated with high mortality in the neonatal period. Management remains challenging, although in recent years overall mortality appears ...

With the changing environment for medical practice, physician practice models will continue to evolve. These "supergoups'' create economies of scale, but their advantage is not only in the traditional economic sense. Practices with enough size are able to better meet the challenges of medical practice with increasing regulatory demands, explosion ...

Mental health practitioners often come across a number of challenges in their clinical practice. One such challenge that posed a management dilemma presented with the history of reincarnation. This subject has been discussed in non-scientific literature at length but there is an absolute paucity in scientific literature. This paper describes ...

Escalating challenges to security are being faced today by healthcare security with 80 to 85% of violent incidents taking place in the Emergency Department, the authors report. Despite these challenges, today's access control and other security technology breakthroughs allow for more people to be protected, more space secured and more ...

BACKGROUND: Ambiguous genitalia are a major cause of parental anxiety and can create social problems if not properly managed. Diagnosis and management can however be challenging. The aim of this study is to highlight some of the challenges in management of ambiguous genitalia in our environment. PATIENTS AND METHODS: All ...

An exploratory study was undertaken to determine the role and practice issues of radiology coding in health information management (HIM) practice. The study sought to identify the challenges of radiology coding and the solutions implemented to address these challenges. A self-report survey was sent to 828 American Health Information Management ...

A 26 year old male was impaled through his chest and upper abdomen with an iron angle, one and half meter long and five centimeters thick. The iron angle entered the chest, through the epigastrium and exited posteriorly just inferior to the angle of left scapula. The patient was transported ...

BACKGROUND: Sound human resources (HR) management practices are essential for retaining effective professionals in hospitals. Given the recruitment and retention reality of health workers in the twenty-first century, the role of HR managers in hospitals and those who combine the role of HR managers with other responsibilities should not be ...

Regeneration in medicine is a concept that has roots dating back to the earliest known records of medical interventions. Unfortunately, its elusive promise has still yet to become a reality. In the field of plastic surgery, we use the common tools of the surgeon grounded in basic operative principles to ...

In today's innovation-driven economy, understanding how to generate great ideas has become an urgent managerial priority. Suddenly, the spotlight has turned on the academics who've studied creativity for decades. How relevant is their research to the practical challenges leaders face? To connect theory and practice, Harvard Business School professors Amabile ...