The advent of universal antenatal ultrasonography in many countries has revealed the full spectrum of congenital thoracic malformations (CTMs) and presented clinicians with a number of practical dilemmas to do with diagnosis and management. We present a review of the most common forms of CTMs, including congenital cystic adenomatoid malformation, ...

The European Respiratory Society task force on primary ciliary dyskinesia (PCD) in children recently published recommendations for diagnosis and management. This paper compares these recommendations with current clinical practice in Europe.Questionnaires were returned by 194 paediatric respiratory centres caring for PCD patients in 26 countries. In most countries, PCD care ...

Alzheimer's disease (AD) is a chronic neurodegenerative disorder and is the most common cause of progressive dementia in aging. Research on AD therapy has been partly successful in terms of developing symptomatic treatments, but there have been a number of failures with regard to developing disease-modifying therapies. The pathogenesis of ...

PURPOSE: Significant controversy surrounds the management of blood glucose levels during labor and delivery. The American College of Obstetrics and Gynecology has recommended "tight" blood glucose control (<110 mg/dL). However, there is concern that tight control can increase the incidence of maternal hypoglycemia. Thus, there remains a lack of consensus regarding ...

A total of 850 Holstein cows from 13 commercial dairy herds were involved in the present study to compare the effects of 2 different dry period (DP) management strategies on health and reproductive parameters. Cows were assigned to either a short (SDP; 35-d) or a conventional (CDP; 60-d) DP management ...

Many medicines can be destroyed by storage and transportation at the wrong temperature. Joe Fudge, service manager at ABB Measurement Products, examines how proper monitoring supports best practice.

This article discusses the decisions involved with hiring a consultant for the medical practice: when to hire one, how to locate the best one for a particular practice, finding a consultant and analyzing their skills in terms of the needs of the practice, and other essential advice to provide the ...

This is the first national audit of Fellows of the British Association of Oral and Maxillofacial Surgeon with the specific purpose of supporting consultant revalidation. The audit was performed online. There were 127 responses from 275 email invitations. The audit reflects the range of activity by consultants with over 90% ...

Oral dysplastic lesions may have an increased chance of becoming oral squamous cell carcinoma, but to date their management remains controversial. The aim of this survey was to explore the current practical aspects of the management of patients with dysplasia by oral and maxillofacial consultants in the UK. In the ...

We investigated the current provision of oral medicine in oral and maxillofacial (OMF) departments in the UK. We examined the number of specialists in oral medicine in OMF departments, the training given to OMF consultants in oral medicine, and the estimated time dedicated to treating patients with oral medical conditions ...

This is the third in a series of articles exploring issues involved in doctors treating other doctors. The first article looked at barriers to good medical care when the patient is a doctor. The second article discussed strategies that can be used before the consultation takes place. Particular emphasis was ...

The rigorous credentialing process that physicians joining a medical practice out of residency or relocating to a new area must endure requires a vast amount of paperwork and months of follow-up to track their health plan and government payer applications. TMA Practice Consulting can help physicians and practice administrators streamline ...

This article investigates the perspectives of University of Liverpool graduate foundation doctors and their consultants on their preparedness for professional practice.

The resolution of technical, theoretical, and practical issues for a small consultancy in a remote location brings better results and greater satisfaction to all involved. This paper will describe the range of consulting projects encountered in a typical year and will briefly cover the technical tools used and their application ...

In recent years in the UK there has been a shift towards doctors practising preventative medicine. Research suggests, however, that doctors are more comfortable in their traditional role, and may be reluctant to engage in discussion of lifestyle issues with patients. In this article, we use data from GPs' consultations ...

BACKGROUND: Utilization studies in inpatient psychosomatic medicine have focused on patterns of consultation requests, timing of consultation requests relative to date of hospital admission, and the association between time to initial psychiatric consultation and length of stay. OBJECTIVE: The authors studied the association of time to initial psychosomatic medicine consultation ...

OBJECTIVES: Increasing numbers of emergency department (ED) visits and higher leaving-without-being-seen rates resulted in an evaluation of the contribution of the internal medicine service to the admission process. METHODS: Standardized ED encounter sheets were completed by the medicine physician on duty (MOD) assessing various admission and consultative parameters. RESULTS: 304 ...

OBJECTIVE: Chest x rays (CXRs) are among the most difficult radiographs to interpret accurately. The aim of this study was to assess the ability of different grades and specialities of clinicians to evaluate a series of CXRs correctly. METHODS: 60 clinicians of different grades and from different specialities were randomly ...

This paper focuses on the work involved for service users in arranging and negotiating the use of informal interpreters from their social networks for general practice consultations. The data are drawn from a participatory learning and action research study, carried out in the west of Ireland. Qualitative data were gathered ...

OBJECTIVES: To measure the variations amongst consultant gynaecologists all over the UK in managing women with postcoital bleeding (PCB). STUDY DESIGN: A questionnaire was sent to 1020 consultant gynaecologists in the UK, using the database of The Royal College of Obstetricians and Gynaecologists, enquiring about their opinions and the details ...

Evidence now suggests that work is generally good for physical and mental health and well-being. Worklessness for whatever reason can lead to poorer physical and mental health. The role of the general practitioner (GP) in the management of fitness for work is pivotal. To understand the interaction between GP and ...

AIM: This study aimed to establish current management practice for patent ductus arteriosus (PDA) among individual consultant neonatologists in Australia and New Zealand, to examine the influences that drives practice and highlight the importance of future randomised controlled trials in the region. METHODS: Eligible subjects were identified from the Directory ...

With anesthesiology increasingly practiced outside the operating room (OR) environment, it is important that anesthesiologists begin to identify and to teach the communication skills required for practice in non-OR general hospital settings. The "one back" position of the consultant, and the associated diminished sense of immediate control, can generate discomfort ...

The authors wished to obtain a 'snapshot' of the range of practice in the management of split skin graft donor sites in the British Isles. Questionnaires were sent to all British consultants and locum consultant plastic surgeons on 1 July 2006. Of the 357 questionnaires, 279 were returned (a response ...

The integration of the contact lens (CL) practice with the VISION 2020 initiative is important. We assessed the facilities at the private CL clinics of Muscat. Accordingly, we suggested the appropriate eye care for CL wearers in Oman. This was a descriptive study. This study was conducted between May and ...

Background  Many healthcare providers acknowledge the importance of encouraging health professionals to base their practice on current evidence. There is a plethora of evidence supporting tight glucose control in critically ill patients to reduce mortality and morbidity and many studies have shown that hyperglycaemia in critically ill patients has been ...

Tracy Cook, the NHS European Office's European policy manager (pictured), examines the European Emissions Trading Scheme (the ETS) and its implications for the NHS, and focuses on some of the key concerns expressed by NHS estates and facilities managers during recent consultations as proposed revisions to the scheme are discussed ...

There is very limited literature available on the use of Kielland's forceps in the management of deep transverse arrest, and currently no studies looking at the correlation between obstetricians' personality traits and Kielland's forceps use. This study, therefore, aims to explore this relationship. All practicing consultant obstetricians in Wales received ...

So, you want to buy your own dental practice. Sounds great, but proceed with caution and follow the critical steps to success. Having spent the last 15-plus years in her management consulting business assisting dentists with selling, buying, and practice transitions, the author has outlined key steps to ensure a ...

OBJECTIVE: To describe consultations in Danish general practice as a context for a mass strategy of smoking cessation advice. METHODS: The focus of the study was on consultations for health problems that were not related to smoking. Interviews with eleven patients and their six GPs were grounded in observation of ...

OBJECTIVE: The objectives of this study were to: (1) explore pharmacy support staff (PSS) opinions of and attitudes towards the supply of non-prescription medicines (NPMs); (2) assess whether NPM supply is compliant with professional and good practice guidelines. METHODS: This exploratory study was conducted in community pharmacies in Grampian, Scotland, ...

AIMS: This study surveys the current use of investigations for the management of glaucoma in hospital practice by UK ophthalmologists. METHODS: A total of 1007 questionnaires were posted to all active NHS consultant ophthalmologists. They were asked to indicate the type of hospital (whether university (UTH) or general (DGH) hospital), ...

This report reflects the discussion and conclusions of an informal consultation held on 19-20 April 2007 at the World Health Organization concerning the regulatory evaluation of therapeutic biological medicinal products. The objectives of this meeting were to discuss the current status of so-called "similar" biological medicinal products (biosimilars) and to ...

Summary (En)Second job number AI428 added acc. to DOCREP assignment

RATIONALE: Changes in the demography of doctors require changes in care practices. OBJECTIVES: The aim of this study was to identify factors associated with doctors' workload in the ophthalmology consultation department of a university hospital, with a view to developing methods to improve the organization of hospital outpatient clinics. METHODS: ...

INTRODUCTION: Gigantomastia is a rare, psychologically and physically disabling condition characterised by excessive breast growth. To date, there is no universal classification or accepted definition for this condition. Many authors cite gigantomastia as breast enlargement that requires reduction of over 1500 g per breast. However, there is discordance in the ...

OBJECTIVES: To describe the patterns of computer use during patient visits to family doctors and to determine whether doctors alter their pattern of computer use in consultations which have significant psychological content. DESIGN: Observational, non-randomised cluster trial with data being collected from videotaped consultations. SETTING: Three inner-city Family Practice offices ...

Twenty routine General Practice surgeries were studied in an Irish urban setting by 2 independent observers. There were 212 observed consultations and 53 (25%) were interrupted. Of this 53 there were 80 interruptions in total, 32 (40%) of which were significant. The commonest source of interruption was the telephone (50%). ...

Given the diversity of nutritional background of beef cattle, the more information the nutritionist can acquire, the better the nutritional management programs during the finishing period can be developed. Some factors that should be accounted for include weaning status and previous growing treatments. Working cattle up on feed and bunk ...

BACKGROUND: Little information in the literature exists to guide consult interactions between different medical specialties. METHODS: A total of 323 general internists, family medicine physicians, general surgeons, orthopedic surgeons, and obstetricians/gynecologists (OB/GYNs) from 3 academic medical centers completed a survey addressing their ideal relationship with consultants. Differences between surgeons and ...

To build this process it is necessary to consult customers for preferences, build familiarity and knowledge to build a relationship and conduct business in a customized fashion. The process takes every opportunity to build customer satisfaction with each customer contact. It is an important process to have, since customers today ...

Practice management consulting focuses on placing a sound business system under the technical expertise of dentists. Dentists should spend almost all of their time at chairside where they can add greatest value to their patients. The good practices of business can be learned and implemented just like the good practices ...

BACKGROUND: Benchmarking is the comparison of a process to the work or results of others. We conducted a national benchmarking exercise to determine how UK pulmonologists manage common clinical scenarios in diffuse parenchymal lung disease (DPLD), and to determine current use and availability of investigative resources. We compared management decisions ...

INTRODUCTION: It is generally agreed that the successful management of a vestibular schwannoma (VS) usually involves close collaboration between a neuro-otologist and neurosurgeon. In addition, it is accepted that the experience of the team managing such tumours is one of the key determinants of outcome after surgical intervention. The aim ...

This study aimed to compare the confidence of oncology consultants and specialist registrars (SpRs) in the performance of practical procedures, to contrast this with confidence in other areas of practice and to determine at what grade they felt most confident. Questionnaires were sent to all 57 oncology consultants and SpRs ...

OBJECTIVE: To review the guidelines for geographic representativeness applied to sentinel influenza surveillance as proposed in the Framework for an Australian Influenza Pandemic Plan (1999). METHODS: The number of sentinel practices, participating general practitioners and their consultation rates per 100,000 population, by region, were described for the Victorian sentinel surveillance ...

OBJECTIVE: The purpose of this study was to undertake linguistic analysis of consultations between medicine counter assistants (MCAs) and customers for the supply of nonprescription medicines. METHODS: The linguistic corpus comprised 168 recorded and transcribed consultations. Utterances were tagged as information eliciting, information or advice giving and other. The analysis ...

BACKGROUND: Consultants in emergency medicine have to deal with a wide range of problems, many of which they will not have encountered during their training. One way to assess the adequacy of specialist training is to ask recently appointed consultants whether or not they feel adequately prepared for their role. ...

The teaching of nephrology and of practical medicine in general (that is, clinical medicine) in Naples University (Studium) in the 17th and 18th centuries can be reconstructed through a plurality of textual testimonies: prominent among them the manuscript of students' notes. Notes taken by students attending the lessons of the ...

OBJECTIVES: To identify the key features of effective clinical supervision in the emergency department (ED) from the perspectives of enthusiastic consultants and specialist registrars. To highlight the importance of clinical supervision within emergency medicine, and identify obstructions to its occurrence in everyday practice. METHODS: A critical incident study was undertaken ...