The prospects of rapid climate change and the potential existence of tipping points in marine ecosystems where nonlinear change may result from them being overstepped, raises the question of strategies for coping with ecosystem change. There is broad agreement that the combined forces of climate change, pollution and increasing economic ...

Access to an electronic medical record is essential for personalized medicine. Currently, only 40% of US physicians have such access, but this is rapidly changing. It is expected that 100,000 Americans will have their whole genome sequenced in 2012. The cost of such sequencing is rapidly dropping, and is estimated ...

Invasive plants cause substantial economic and environmental damage throughout the world. However, eradication of most invasive species is impossible and, in some cases, undesirable. An alternative is to slow the spread of an invasive species, which can delay impacts or reduce their extent. We identify three main areas where models ...

Benchmarking is as a structured continuous collaborative process in which comparisons for selected indicators are used to identify factors that, when implemented, will improve transfusion practices. This study aimed to identify transfusion medicine studies reporting on benchmarking, summarize the benchmarking approaches used, and identify important considerations to move the concept ...

Past asthma surveys have shown suboptimal management and control of asthma in the United States. No major survey of asthma management has been conducted since the Third Expert Panel Report for the National Asthma Education and Prevention Program (NAEPP) guidelines on diagnosis and treatment of asthma (August 2007). This study ...

The current conflict in Afghanistan is the first major military action in which the United States and other North Atlantic Treaty Organization (NATO) forces have found themselves regularly engaged in combat at high altitudes. However, high altitude warfare is not a new concept in Asia by any means. This article ...

ACADEMIC EMERGENCY MEDICINE 2011; 18:1246-1254 © 2011 by the Society for Academic Emergency Medicine ABSTRACT: This article presents a model of how a build-up of interruptions can shift the dynamics of the emergency department (ED) from an adaptive, self-regulating system into a fragile, crisis-prone one. Drawing on case studies of ...

OBJECTIVE: To analyze the characteristics of inpatient medicines placed on the list of innovative high-cost medicines funded in addition to DRG-based payment, and to identify whether they really are innovative and/or high-cost. METHODOLOGY: The medicines placed on the list of innovative and high-cost medicines were analyzed on the basis of ...

In 2010, the European Regulation for Orphan Medicinal Products (OMPs) was in force for ten years. In this study we assessed possible determinants of applications for OMPs in the EU since 2000 that are associated with a successful marketing authorisation. Our analysis shows that clinical trial characteristics such as demonstrating ...

Effectively managing and optimizing the value of the patent portfolio is a major challenge for many firms, especially those in knowledge intensive industries, such as the pharmaceutical, biotechnological and chemical industry. However, insights on effective patent portfolio strategies are rare. Therefore, in this article we investigate in detail how firms ...

While doctor-engineer collaborations are imperative for the advancement of medical technology to improve patient care, these partnerships are often fraught with poorly understood barriers, including differences in knowledge base, conflicts over authorship and difficulty in applying deterministic solutions to biological data. As there is scarce literature on the dynamics of ...

The wars in Iraq and Afghanistan have resulted in the most severe survivable war injuries ever seen in prolonged conflict. The Armed Forces Institute of Regenerative Medicine (AFIRM) was conceived as a way to deliver solutions to the existing gaps in military trauma care. The AFIRM is a collaborative effort ...

  The success of adaptive management in conservation has been questioned and the objective-based management paradigm on which it is based has been heavily criticized. Soft systems thinking and social-learning theory expose errors in the assumption that complex systems can be dispassionately managed by objective observers and highlight the fact ...

Within all organisations, business continuity disruptions present a set of dilemmas that managers may not have dealt with before in their normal daily duties. The disruption management model provides a simple but effective management tool to enable crisis management teams to stay focused on recovery in the midst of a ...

Empirical relationships between phytoplankton biomass and nutrient concentrations established across a wide range of different ecosystems constitute fundamental quantitative tools for predicting effects of nutrient management plans. Nutrient management plans based on such relationships, mostly established over trends of increasing rather than decreasing nutrient concentrations, assume full reversibility of coastal ...

The authors use a multilevel framework to introduce peer-based control as a motivational state that emerges in self-managing teams. The authors specifically describe how peer-based rational control, which is defined as team members perceiving the distribution of economic rewards as dependent on input from teammates, extends and interacts with the ...

The Canadian dairy industry operates under a supply management system with production quotas (expressed in kilograms of butterfat per day) owned by dairy producers. Any management strategy influencing production responses must, therefore, be evaluated to estimate its effects on quota needed to sell the milk produced. In the present study, ...

This article provides a concise overview of therapeutic apheresis medicine instrumentation. Three instrument modalities are discussed: (1) centrifugation-based instruments, (2) extracorporeal photopheresis instruments (a subset of centrifugation-based instruments), and (3) column-based instruments. © 2011 Wiley-Liss, Inc.

ABSTRACT: BACKGROUND: The practice and research of medicine generates considerable quantities of data and model resources (DMRs). Although in principle biomedical resources are re-usable, in practice few can currently be shared. In particular, the clinical communities in physiology and pharmacology research, as well as medical education, (i.e. PPME communities) are ...

Increasing numbers of medical students and junior doctors learn and work in general practice. Increased supervisory responsibilities for general practitioners threaten the quality of care provided to patients and the income thus derived. Incremental changes to infrastructure and funding are welcome, but insufficient. Alternative models must be funded, trialled and ...

Background: After the expiry of patents for originator medicines, generic medicines can enter the market, and price competition may occur. This process generates savings to the healthcare payer and to patients, but knowledge about the factors affecting price competition in the pharmaceutical market following patent expiry is still limited. Objective: ...

The expiration of patents on many biological medicinal products has prompted the development of these products as similar biological (biosimilar) products. The standard approach of demonstration of bioequivalence for chemical generic products is scientifically not applicable for biosimilar products. The biosimilar product approach, based on comparability (demonstration of similarity), should ...

The classification procedure, introduced by the European Regulation on advanced therapy medicinal products (ATMPs), has received a tremendous interest from companies, academic and public sponsors developing ATMPs. This procedure gives companies the opportunity to verify whether or not the product they are developing can be considered an ATMP and can ...

Typical public and military-sponsored websites on stress and depression tend to be prescriptive. Some require users to complete lengthy questionnaires. Others reproduce printed flyers, papers, or educational materials not adapted for online use. Some websites require users to follow a prescribed path through the material. Stress Gym was developed as ...

1. Better understanding of the mechanisms affecting demographic variation in ungulate populations is needed to support sustainable management of harvested populations. While studies of moose Alces alces L. populations have previously explored temporal variation in demographic processes, managers responsible for populations that span large heterogeneous landscapes would benefit from an understanding ...

Habitat loss is one of the greatest threats for biodiversity. In Finland, two thirds of natural mires have been drained for silviculture, which transforms open wetlands into dense forests. However, vegetation management of power line rights-of-way (ROW) maintain the drained mires as open areas. The aim of this study was ...

Sexual violence is an insidious and pervasive problem that insinuates itself into all aspects of contemporary society. It can neither be mitigated nor adequately controlled through current socio-legal practices. A more promising approach must embrace four integrated elements: (1) public policy, (2) primary prevention, (3) statutory management, and (3) secondary ...

With the impending termination of USAF operations at Brooks Air Force Base (AFB) in San Antonio, TX, it is time to consider its historic role in Aerospace Medicine. The base was established in 1917 as a flight training center for the U.S. Army Air Service and in 1926 became home ...

In this paper, we describe: 1) the environmental forces driving performance measurement and management in the University of California San Diego Department of Medicine; 2) the systematic process used by the department to implement a Balanced Scorecard; 3) the initial direct and indirect outcomes of this effort; 4) the opportunities ...

Complementary and alternative medicine (CAM) is popular with patients, yet how patients use CAM in relation to orthodox medicine (OM) is poorly understood. To explore how patients integrate CAM and OM when self-managing chronic illness. Qualitative analysis of interviews. Semi-structured interviews were conducted with individuals attending private CAM practices in ...

Health Related Quality of Life (HRQOL) questionnaires are increasingly used in clinical practice. These Patient Reported Outcomes (PROs) are provided to the paediatrician to facilitate communication with patients during a consultation. The aim of the current article is to describe the development and introduction of a new web-based application for ...

Experience-based access management incorporates models, techniques, and tools to reconcile differences between the ideal access model and the enforced access control.

This paper seeks to explore the development of a discharge programme in one learning disability hospital in Scotland. The study aims to concentrate on organisational developmental changes in that institution. The model of the management during the discharge programme was investigated. The aim of the study is to explore how ...

Special Operations Forces (SOF) medical personnel (clinicians) directly impact their patients? outcomes, regardless if the patient is a Soldier, civilian, or indigenous person. Any health practitioner who specializes in trauma, Soldiers? healthcare, or tactical and/or operational healthcare must have a working knowledge of SOF medicine and its philosophical, political, and ...

This study examines India and Turkey as case studies relevant to the Senlis Council’s ‘poppies for medicine’ proposal. The proposal is that Afghan farmers are licensed to produce opium for medical and scientific purposes. Here it is posited that the Senlis proposal neglects at least three key lessons from the ...

The purpose of this study was to assess whether management of heart failure (HF) guided by an individualized N-terminal pro-B-type natriuretic peptide (NT-proBNP) target would lead to improved outcome compared with HF management guided by clinical assessment alone. Natriuretic peptides may be attractive biomarkers to guide management of heart failure ...

Traditional Japanese medicine (Kampo) is used to treat various disorders of the gastrointestinal tract in Japan, where it is fully integrated into the modern healthcare system. Recently, scientific research on herbal medicine in Japan has been reported in English journals. The objective of the current review is to introduce two ...

The stabilizing constraints of the distal radioulnar joint (DRUJ) include its bony geometry and the surrounding soft tissue support. Given the shallow nature of the sigmoid notch, reconstruction of the palmar and dorsal ligamentous sleeve provides the best solution for restoring stability in cases of chronic DRUJ instability. The pertinent ...

Previous studies using cross-sectional designs suggest that asthma trigger recognition and management are suboptimal in clinical practice. The objective of this study was to assess gaps between asthma guideline recommendations and clinical practice regarding asthma trigger recognition and management by tracking poorly controlled asthma patients over a 2-year period. A ...

Most human beings will do almost anything to prolong their existence or to relieve themselves from the suffering of a disease. Others will do anything to exploit these desires by selling what they claim to be magical remedies or panacea for all diseases-even for the incurable ones. Quack is one ...

PRACTICAL RELEVANCE: Feline bronchial asthma is one of the most commonly diagnosed respiratory conditions of cats. Clinical signs range from intermittent wheezing and coughing, which can compromise quality of life, to episodes of severe dyspnea that can be life-threatening. CLINICAL CHALLENGES: Feline asthma can be easily disregarded as a simplistic ...

Asthma is the most common chronic disease in children. Previous studies described significant variations in acute asthma management in children. This study was conducted to examine whether asthma management in the pediatric emergency department (ED) was improved through the use of an evidence-based acute asthma care guideline reminder card. The ...

In 10- to 13-year-old children with asthma, we know less than is desirable about the nature of the disease management tasks they face as youngsters approaching adolescence. This article reviews aspects of asthma management in youngsters at a time of significant transition. They experience puberty and growth spurts. Their cognitive ...

These parameters were developed by the Joint Task Force on Practice Parameters, representing the American Academy of Allergy, Asthma & Immunology (AAAAI); the American College of Allergy, Asthma & Immunology (ACAAI); and the Joint Council of Allergy, Asthma and Immunology. The AAAAI and the ACAAI have jointly accepted responsibility for ...

There is a well-recognized association of aspirin sensitivity, aspirin-induced asthma, nasal polyposis or sinusitis, known as Samter's triad. This article outlines the pathogenesis and clinical features of this condition and reviews current management options.

This supplement to CHEST, titled "Airway Hyperresponsiveness in Asthma: Its Measurement and Clinical Significance," resulted from a symposium that brought together experts from Canada, the United States, and Australia to discuss the progress in the understanding of measurements of airway hyperresponsiveness. There was an additional focus on the indirect measurement ...

BACKGROUND AND OBJECTIVE: Asthma is an example of a chronic disease for which there are evidence-based guidelines for primary care. The authors undertook this study to demonstrate that physicians' use and adherence to asthma management guidelines are improved when the guidelines are furnished in a computer-based format. METHODS: Based on ...

Asthma, which affects more than 22 million people in the U.S. every year, poses a significant clinical and economic burden to our health care system. Patients, health care practitioners, and payers require a variety of resources to ensure optimal disease management and positive clinical outcomes while also managing costs. In ...

To develop an action plan based on asthma management challenges identified by Head Start teachers in a multisite program. Qualitative, participatory action research project. Three focus groups were conducted with Head Start teachers (n=14), and 1 with Center managers (n=15) in an urban Midwestern program. Brief background questionnaire and semistructured ...

The goal of managing asthma is to maintain disease control. Current approaches to assessment of control do not include measurement of airway inflammation. This study was designed to assess the usefulness of biomarkers of airway inflammation in guiding asthma management decisions. A literature review was performed. Bronchial biopsy is a ...