Rationale and aims  Evidence-based medicine (EBM) has gained worldwide attention. Many studies have used questionnaires to discuss factors obstructing the practice of EBM. However, no large-scale data analysis has focused on who has practised EBM and when they practised it. This retrospective study aims to fill the research gap by ...

Abstract Objective. To explore GPs' experiences using cognitive behavioural therapy (CBT), with a focus on factors that promote or limit the use of CBT in general practice. Design. Qualitative study using data from written evaluation reports and focus-group interviews. Setting. Norwegian general practice. Subjects. GPs who participated in a longitudinal ...

Objective The aim was to describe parental attitudes towards medicine use in children, and the factors associated with them. Setting A cross-sectional population survey of a random sample of children under 12 years of age (n = 6,000) was carried out in Finland in the spring of 2007, with a response rate of ...

OBJECTIVE: Little is known about the interactions between pharmacy staff and parents/carers who buy nonprescription medicines for children. Responsibility for choice and administration of children's medicines falls to the parent/carer. Pharmacy advice should support safe and effective use of medicines for children. This paper explores the interactions between pharmacy staff ...

Climate change will pose increasingly significant challenges to managers of parks and other forms of protected areas around the world. Over the past two decades, numerous scientific publications have identified potential adaptations, but their suitability from legal, policy, financial, internal capacity, and other management perspectives has not been evaluated for ...

This article explores the professional challenges of treating patients with complex/severe forms of chronic oedema/lymphoedema with compression therapy. Four focus groups were held, two in the UK and two in Canada, to examine the challenges faced by practitioners in their everyday practice. A number of challenges were identified by participants ...

This series of articles for rehabilitation in practice aims to cover a knowledge element of the rehabilitation medicine curriculum. Nevertheless they are intended to be of interest to a multidisciplinary audience. The competency addressed in this article is 'The trainee consistent demonstrates a knowledge of how evidence based methods and ...

Objective Parents are exposed to many different information sources about children's medicines, including recommendations from other people, the media, and their own previous experience. The aim of this paper is to explore the influence of different information sources upon their non-prescription medicine purchases for children aged 0-4 years. Setting The ...

OBJECTIVES/HYPOTHESES: There are many documented barriers to successful adherence to voice therapy. However, methods for facilitating adherence are not well understood. The purpose of this study was to determine if patient adherence and motivation for practice could be improved by providing patients with practice support between sessions using mobile treatment ...

Best practices take time to spread passively, at times contributing to suboptimal results in health care. Managed diffusion, often referred to as "spread," may hasten broad-scale implementation of best practices. At our institution, appropriate use of venous thromboembolism (VTE) prophylaxis had been markedly improved in select areas by 2 independent ...

BACKGROUND: Within the treatment of dementia, management of behavioural and psychological symptoms (BPSD) is a complex component. PURPOSE: We wanted to offer a pragmatic synthesis of existing specific practice recommendations for managing BPSD, based on agreement among systematically appraised dementia guidelines. DATA SOURCES: We conducted a systematic search in MEDLINE ...

OBJECTIVE: To assess the erosive potential of 94 pediatric medicines of various therapeutic groups in vitro. METHODS: In vitro measurement of endogenous pH and titratable acidity (mmol) of 94 formulations was done. Endogenous pH was measured using a pH meter, followed by titration with 0.1-M NaOH using phenolphthalein as indicator. ...

The aging of the U.S. population poses one of the greatest future challenges for family medicine and internal medicine residency training. One important barrier to providing quality education and training in geriatric medicine to residents is a serious and growing shortage of practicing geriatricians and geriatrics faculty. The Accreditation Council ...

BACKGROUND: Salary discrepancies between male and female physicians are well documented; however, gender-based salary differences among clinically practicing physician assistants (PAs) have not been studied since 1992 (Willis, 1992). Therefore, the objectives of the current study are to evaluate the presence of salary discrepancies between clinically practicing male and female ...

What is known and Objective:  Economic evaluation is used to assess the value for money of medicines and inform pharmaceutical pricing/reimbursement decisions in many countries. This paper aims to report on estimates of the value for money of medicines in Europe. Methods:  Estimated cost-utilities were derived from studies included in ...

An electronic survey was used to assess perceptions of the disruption caused by the August transition and explore support for possible solutions. In total, 763 responses from members and fellows of the Royal College of Physicians of Edinburgh and the Society of Acute Medicine were received. The majority perceived the ...

A philosophic discussion is pertinent to all residents and practicing thoracic surgeons as they see retirement as just a continuum of their lives in the context of full engagement in life. In this article, the author extends the concept of engagement into a third dimension, one that includes autonomy, mastery, ...

This guideline is intended to guide appropriately trained and licensed physicians performing therapy with unsealed radiopharmaceutical sources. Adherence to this guideline should help to maximize the efficacious use of these procedures, maintain safe conditions, and ensure compliance with applicable regulations. The topics dealt with in this guideline include indications for ...

Constipation is a particularly troublesome complaint in the elderly yet it is usually considered to be a simple management issue. Therefore physicians' lack of interest in and inadequate training about the etiology of constipation may contribute to their inability to manage the problem of constipation effectively. Constipation can become a ...

A cross-sectional survey was conducted with the objective to explore a community's knowledge and practices towards prevention of Influenza A (H1N1) in three residential areas in Tampin. Respondents were randomly selected from a list of residences and interviewed face-to-face using a structured questionnaire. A total of 221 respondents (80.9%) were ...

Objective To obtain community pharmacists' opinions of their role in administering Pharmacy (S2) and Pharmacist Only (S3) Medicines in a medical emergency. These medicines can only be sold in a pharmacy and are not available for self-selection by patients. Whilst qualified pharmacy assistants can supply S2 medicines, pharmacists must be ...

This study examines changes in self management abilities among women in a friendship enrichment programme. The study is based on the theory of self management of well-being which identifies relevant self-management skills as self-efficacy, taking initiative, investment behaviour and attaining variety in resources. An intervention group (N  =  60) and a control ...

When there is more than one possible intervention, clinicians have to decide which intervention to offer first. This paper hypothesises that where there is more than one intervention for which the evidence indicates there is similar effectiveness that selecting the intervention with the lowest credibility first may lead to optimal ...

Introduction:  The quality of anticoagulation management is not readily or frequently assessed, particularly between different centres. This study sought to evaluate agreement in oral anticoagulant management decisions between participating centres in UK NEQAS programmes. Methods:  Participants were asked to indicate whether they used computerized dosing support software (CDSS) and to ...

General medicine is being challenged by increasing numbers of patients who are presenting with multiple comorbidities and a decline in numbers of suitably trained personnel to manage these patients. A resurgence in generalist care, with collaboration between generalists and specialists, is the key to successfully managing patients who present with ...

To identify characteristics of doctors who are repeated subjects of complaints by patients. Case-control study of doctors about whom patients had complained to the Victorian Health Services Commissioner between 1 January 2000 and 31 December 2009. 384 doctors in private practice; cases comprised 96 doctors who were the subject of ...

A recently published critique of a set of Australian clinical practice guidelines (CPG) highlighted problematic issues in guideline development concerning conflicts of interest of guideline panellists, validity and strength of recommendations, and involvement of end users and external stakeholders. Management of financial or intellectual conflicts of interest requires: full disclosure; ...

Background: Simulation in medical education offers the promise of safely and effectively preparing trainees for a variety of tasks encountered in clinical medicine. Purpose: The objective was to determine internal medicine (IM) clerkship directors' perceptions of the use of simulations during the medicine clerkship. Methods: A cross-sectional survey of 110 ...

Musculoskeletal disorders are the principal reason for primary care outpatient visits and make up 14% of visits to emergency departments, with the upper extremity as the most common site affected. However, formal musculoskeletal education is inconsistent in medical school and primary care residencies, with many first-year residents reporting a lack ...

The present study is aimed to diagnose the current public programs focused on herbal medicines in Brazil by means of in loco visits to 10 programs selected by means of questionnaires sent to 124 municipalities that count on herbal medicine services. The main purpose of the implementation of program programs ...

Practice redesign is one of the core principles of the Patient-centered Medical Home. Little is known about how such large-scale changes in a residency practice affect the providers and staff involved. Focus groups were conducted with residents, faculty, and medical support staff of a redesigned practice to determine the factors ...

Due to the growing prominence of total quality management (TQM) in health care, the present study was conducted to identify the set of TQM practices for its successful implementation in healthcare institutions through a systematic review of literature. A research strategy was performed on the selected papers published between 1995 ...

William Henry Welch's selection in 1884 as the first faculty member of the new medical school at Johns Hopkins created the invigorating atmosphere that generated the revolutionary changes in medical training and laboratory medicine that transformed medicine in America. Dr. Welch's family traditions, his New England upbringing, Yale education, and ...

Expanded competencies in population health and systems-based medicine have been identified as a need for primary care physicians. Incorporating formal training in preventive medicine is one method of accomplishing this objective. We identified three family medicine residencies that have developed formal integrated pathways for residents to also complete preventive medicine ...

Despite many advances in nutritional knowledge and dietary practices, sports nutrition-associated issues, such as fatigue, loss of strength and stamina, loss of speed, and problems with weight management and inadequate energy intake, are common. Sound nutritional practices and well-designed patterns of eating are not awarded the same priority as training ...

This section outlines the most important issues addressed in the management of the response in the two infected states, New South Wales and Queensland. There were differences in the management of the response between the states for logistic, geographic and organisation structural reasons. Issues included the use of control centres, ...

We completed a systematic review of the literature to examine the impact of pharmacist interventions in improving osteoporosis management. Results from randomized controlled trials suggest that pharmacist interventions may improve bone mineral density testing and calcium intake among patients at high risk for osteoporosis. INTRODUCTION: Pharmacists play a key role ...

The medicolegal death investigation system in the Kingdom of Saudi Arabia (KSA) is unique in the world. It is exclusively derived from Islamic judiciary based on Shari'ah law, which is the definitive Islamic law or doctrine. This law is applied on Saudi citizens as well as foreigners. This is different ...

Many regulatory and oversight groups require that the professional performance of radiologists be evaluated on an ongoing basis. Although the diagnostic accuracy of radiologists is routinely measured at most institutions by means of peer review processes, systems for evaluating procedural competency are not widely available. Consequently, technical skills are seldom, ...

The institutional revolution has become a major landmark of late-nineteenth century science, marking the rapid construction of large, institutional laboratories which transformed scientific training and practice. Although it has served historians of physics well, the institutional revolution has proved much more contentious in the case of chemistry. I use published ...

We compared the radiological and functional outcomes in patients with radial longitudinal deficiency treated surgically with those managed nonoperatively and correlated the ease of performance of activities with radiological and functional parameters in the two groups. A retrospective analysis was done in 446 type 3 and 4 hands (modified Bayne ...

Rationale, aim and objective  Effective tinnitus management starts with appropriate general practitioner (GP) triage, which in England can be guided by the Department of Health's Good Practice Guide (GPG). Despite the prevalence of the condition, there has never been a systematic survey of its management in primary care in England. ...

Processes for credentialing physicians and criteria for delineating their practice-specific clinical privileges vary widely across the United States. The ACR and the ABR have jointly developed this resource document to define the requisite credentials for board-certified radiologists to be privileged to practice the full gamut of diagnostic nuclear medicine, including ...

ACADEMIC EMERGENCY MEDICINE 2011; 18:1-5 © 2011 by the Society for Academic Emergency Medicine ABSTRACT: Pain is the most common reason people visit emergency departments (EDs); this implies that emergency physicians (EPs) should be experts in managing acute painful conditions. The current trend in the literature, however, demonstrates that EPs ...

Rationale, aims and objectives  Evidence-based medicine (EBM) journal clubs are used by health care practitioners to critique and remain updated on relevant health literature. Vote cards, in three different colours (green/yellow/red), allow participants to express their opinions (agree/doubt/reject) on the quality and possibility of clinical application regarding the article being ...

PURPOSE: To describe the development and psychometric properties of the Humanistic Teaching Practices Effectiveness Questionnaire (HTPE), an instrument that measures the humanistic skills of attending physicians within an academic health center (AHC) department of medicine. METHOD: From August 2005 through March 2007, the authors distributed the HTPE, along with other ...

This evaluative research study aimed to assess the effects of the central healthcare incinerator project on waste management in Yala Province. The study data were collected twice: at baseline and during the operational phase. A combination of structured interview and observation were used during data collection. The study covered 127 ...

The development of an effective therapeutic equivalence program (TEP) through the collaborative support of medical staff, using the principles of disinvestment. A TEP was introduced at Southern Health, a metropolitan health service in Melbourne, in the 2006-07 financial year. Therapeutic classes were selected for the TEP by stakeholder consensus, and a ...

AIMS: To ascertain the views of general practitioners (GPs) regarding the prevention and management of alcohol-related problems in practice, together with perceived barriers and incentives for this work; to compare our findings with a comparable survey conducted 10 years earlier. METHODS: In total, 282 (73%) of 419 GPs surveyed in ...

Introduction.  Despite a growing body of evidence supporting erectile function (EF) rehabilitation after radical prostatectomy (RP), there are no guidelines on this subject. Aim.  To explore EF rehabilitation practice patterns of American Urological Association (AUA) urologists. Methods.  A 35-question instrument was constructed assessing physician demographics, training, and EF rehabilitation practices ...