Background Strategies are needed to contain emergency-department attendance. Quality of care in general practice might influence the use of emergency departments, including management of patients with chronic conditions and access to consultations. Aim The aim was to determine whether emergency-department attendance rates are lower for practices with higher quality and ...

Benefit-risk assessment in medicine has been a valuable tool in the regulation of medicines since the 1960s. Benefit-risk assessment takes place in multiple stages during a medicine's life-cycle and can be conducted in a variety of ways, using methods ranging from qualitative to quantitative. Each benefit-risk assessment method is subject ...

Much of the information on safety and efficacy of drugs in older people is obtained after marketing. Pharmacoepidemiologic studies play an increasing role in obtaining this information. Pharmacoepidemiologic studies contribute significantly to knowledge of risks associated with medicines in older people and less so to that of benefits. Recent improvements ...

This study presents a method for assessing conservation opportunity on private land based on landholders' socio-economic, behavioral, and farm characteristics. These characteristics include age, gender, education, level of off-farm income, farm size, proportion of remnant native vegetation on-farm, and ecological value of native vegetation on-farm. A sample of landholders who ...

Family medicine is undergoing dramatic transformation around the world. Its organisation, delivery, and funding are changing in profound ways. While the specifics of primary care reform vary, a common emerging strategy involves establishment of primary health care teams that provide improved access, use electronic records, are networked with other teams, ...

Current proposals for significant primary health care reform in Australia create a timely opportunity to reflect on the education and training requirements of future general practitioners. Australian general practice will become increasingly team-based, with growing emphasis on coordinated care, chronic disease management, and disease prevention and self-management, while maintaining its ...

INTRODUCTION:: Human factors have been identified as root causes of human error in medicine. The "Anesthetists' Non-Technical Skills (ANTS) system" evaluates the effect of simulation training and debriefing on nontechnical skills (NTS). Studies suggest that residents' NTS may improve after simulation training but the effect on NTS of practicing anesthesiologists ...

The practice of traditional bone setting (TBS) is extensive in Nigeria and it enjoys enormous patronage by the populace. However, the outcome of the intervention of TBS treatment is usually poor with profound effects on the patient. There are many publications highlighting different aspects of this subject but none has ...

Concern that has been expressed about the provision of complementary and alternative medicine (CAM) in an orthodox medicine context with regard to the possibility of a client not being referred to the latter when the condition is readily dealt with by it. There have been some negative outcomes for clients ...

Older people, particularly those who are frail, are vulnerable to dehydration. Management of dehydration in older people can be more complex than in younger adults because of the physical effects of ageing. As the population ages, nurses will increasingly care for older patients in every setting. This article provides an ...

"Sixteen years as a general practitioner [GP] showed me that the prevailing biomedical reductionist model fails to address the complexity of human experience and psychosomatic illness that daily practice brings up, and for which I was not trained. Even at the purely physical level, there are huge gaps in conventional ...

The expansion of knowledge and technological advances in nuclear medicine and radiology require physicians to have more expertise in functional and anatomic imaging. The convergence of these two specialties into the new discipline of molecular imaging has also begun to place demands on residency training programs for additional instruction in ...

Much conjecture abounds about the origin of the Asklepian serpent of healing, this latter the universal metonym for curative medicine. Iconographic evidence of Asklepios with his staff-entwined serpent exists from Hippocratic times. Many theories exist about the origin of this reptilian symbol of curative medicine. Speculation has ranged from the ...

AIM OF THE STUDY: To study the prevalence of herbal medicine use in treating illness and concomitant use with pharmaceutical medicines in Jamaica. SUBJECTS AND METHODS: A survey using a structured questionnaire was administered by a trained interviewer to randomly selected adults in systematically selected households within randomly selected urban ...

The current management of sports concussion involves a return to the baseline 'asymptomatic' status prior to returning to play and training. Unfortunately, although the term 'asymptomatic' is widely used it has not been operationally defined. This review identifies the need to formally define the term 'asymptomatic' as used in sports ...

This paper contributes to current literature on the under-representation of women in academic medicine by critically examining appointment practices for medical professors in the Netherlands. By opening the black box of these highly secretive appointments, it is shown how allegedly gender-neutral practices contribute to the perpetuation of gender inequalities in ...

OBJECTIVES:: To identify the percentage of alumni of one Pediatric Emergency Medicine (PEM) fellowship program who consider themselves to still practice in the field. METHODS:: A brief survey (5 questions) was sent to all physicians who began the PEM fellowship program at the University of Alabama at Birmingham between the ...

Registered dental practices must achieve all the essential standards of the Care Quality Commission (CQC), whose outcome 9 is focused entirely on the way practices manage medicines. Experience with specialist dental services and other healthcare professions shows that focused assessments with a CQC-experienced pharmacist can deliver quality patient outcomes from ...

ABSTRACT: BACKGROUND: It is critical that vector control pesticides are used for their acceptable purpose without causing adverse effects on health and the environment. This paper provides a global overview of the current status of pesticides management in the practice of vector control. METHODS: A questionnaire was distributed to WHO ...

The expansion of knowledge and technological advances in nuclear medicine and radiology require physicians to have more expertise in functional and anatomic imaging. The convergence of these two specialties into the new discipline of molecular imaging has also begun to place demands on residency training programs for additional instruction in ...

Over the past few decades the health professions have witnessed increasing pressure to shift from a culture of delivering care based on tradition and intuition, to a situation where decisions are guided and justified by the best available evidence. While there are concerns that many complementary and alternative medicine (CAM) ...

Osteopathic manipulative medicine (OMM) is the most visible distinction between osteopathic physicians and allopathic physicians, and the osteopathic medical profession recognizes the proven clinical efficacy and value of OMM. The recently published report by the US Army Surgeon General's Pain Management Task Force provides a strong endorsement for the Army ...

Health technology assessment (HTA) plays an increasing role in translating emerging technologies into clinical practice and policy. Private payers are important users of HTA whose decisions impact adoption and use of new technologies. We examine the current use of HTA by private payers in coverage decisions for personalized medicine, a ...

This article describes the development of a Structured Education Pulmonary Rehabilitation Programme (SEPRP), for the PRINCE (Pulmonary Rehabilitation In Nurse-led Community Environments) study. This process involved a literature review of existing PR programmes, a content analysis of national and international PR programmes and a concept analysis of empowerment. Secondly, two ...

The birth of nanotechnology in human society was around 2000 years ago and soon found applications in various ields. In this article, we highlight the current status of research and preclinical applications and also future prospects of nanotechnology in medicine and in nuclear medicine. The most important field is cancer. ...

The ever-changing environment of healthcare leads many practices to consider how they will control the cost of overhead, give access to their patients, and maintain or increase practice income. The solution may be to add a midlevel provider (MLP)--a Physician Assistant (PA) or Nurse Practitioner (NP)--to the staff. Both of ...

Improvement in functional skills is typically a goal of spasticity management. Spasticity management alone will improve the positive signs of the upper motor neuron syndrome without functional change. In this review, we demonstrate that a variety of therapy modalities are required to facilitate these improvements and impact the negative signs ...

Health technology assessment (HTA) plays an increasing role in translating emerging technologies into clinical practice and policy. Private payers are important users of HTA whose decisions impact adoption and use of new technologies. We examine the current use of HTA by private payers in coverage decisions for personalized medicine, a ...

The innovation described in this paper was motivated by concern that in Africa, parasite resistance to antimalarial drugs is associated with irrational drug use where health facilities are inaccessible. However, advancement in digital technology, simple diagnostic devices and smart drug packaging inspire innovative strategies. The combination of communication technology, rapid ...

Background: Effective prescription medications are available to treat menopausal symptoms. However, due to adverse effects and risks associated with use, many women are seeking complementary and alternative options to treat their symptoms. Nonpharmacological options for the management of menopausal symptoms are widely available and frequently used. Objective: This article outlines ...

The use of mindfulness training for increasing psychological well-being in a variety of clinical and nonclinical populations has exploded over the last decade. In the area of stuttering, it has been widely recognized that effective long-term management often necessitates treatment of cognitive and affective dimensions of the disorder in addition ...

Purpose: Among all the emergency scenarios, the most common medical emergency event in Israel is the conventional mass casualty event (MCE). This article describes the Israeli model of emergency preparedness and management at the national level, step-by-step emergency management at the hospital level, and nursing roles in emergency events. Setting: ...

Yours may be among the many oncology practices without an appropriate performance review system in place. Lack of an effective evaluation system increases the risk of inefficiency, poor office morale, and high turnover rates.

Amid increases in costs and numbers of patients combined with decreasing or stagnant reimbursements from payers, many oncology practices are improving efficiency and decreasing costs. The National Oncology Practice Benchmark, a national survey of community practices, provides data to help practices improve and monitor progress as they adapt to the ...

Current general practitioner shortages need to be addressed, especially in areas of need. This study was designed to investigate which registrar characteristics were associated with retention in the field of general practice (and in the region of training). The authors performed a retrospective cohort study of people who entered general ...

The European School of Internal Medicine (ESIM) is a meeting aimed at young physicians training in internal medicine throughout Europe. Since 1998 the school has been held annually, and in this report we reflect on our experiences during the recent school in Brighton in July 2010. The school combined a ...

To assess the predictive value of in-training evaluation for determining future success in the internal medicine board certifying examination. Ninety-seven internal medicine residents from Faculty of Medicine Siriraj Hospital who undertake the Thai Board examination during the academic year 2006-2008 were enrolled. Correlation between the scores during internal medicine rotation ...

This study used the Maslach Burnout Inventory to evaluate the degree of burnout among junior doctors at Red Cross War Memorial Children's Hospital (RXH), Cape Town, and the influence thereof on the retention of valuable skills in the hospital. It further considered measures that could be taken to mitigate the ...

Allocation decisions in emergency medicine must occur when demand for emergency services exceeds supply. In many circumstances, strong clinical or cost evidence upon which to base allocation decisions is lacking. In these circumstances, patient or community preference may be used to inform decisions. If preference is to be incorporated into ...

Self-management education may help patients with cystic fibrosis and their families to choose, monitor and adjust treatment requirements for their illness, and also to manage the effects of illness on their lives. Although self-management education interventions have been developed for cystic fibrosis, no previous systematic review of the evidence of ...

Clinicians in developing countries have had limited access to continuing education (CE) outside major cities, and CE strategies have had limited impact on sustainable change in performance. New educational tools could improve CE accessibility and effectiveness. The objective of this study was to evaluate an interactive Internet-based CE course on ...

Atrial fibrillation is a supraventricular tachyarrhythmia with significant consequences in terms of morbidity and mortality. In light of the limitations of available pharmacologic treatment options (suboptimal efficacy plus safety and tolerability issues), atrial fibrillation management should be individualized based on patient characteristics and comorbidities that could influence response to specific ...

Lymphatic malformation results from an error in the embryonic development of the lymphatic system. Clinically, lymphatic malformation is characterized by the size of the malformed channels: microcystic, macrocystic, or combined (microcystic/macrocystic).This article describes the clinical features, diagnosis, and management of lymphatic malformations.

Dual practice, whereby health workers hold two or more jobs, is a common phenomenon globally. In resource constrained low- and middle-income countries dual practice poses an ongoing threat to the efficiency, quality and equity of health services, especially in the public sector. Identifying effective interventions to manage dual practice is ...

Background. There is no clear distinction between the regulation of food, supplements and medicines in South Africa. Consequently, grey areas exist in implementing the legislation, particularly in the supplement industry. The increase in supplement sales in South Africa can be attributed to aggressive marketing by manufacturers whose claims are not ...

The new age clinical research professional is now geared toward an "integrated monitoring" approach. A number of critical activities at the site level and at the sponsor's organization need convergence to harness rich dividends in early study start and quick close of the study. The field monitor needs full integration ...

Geriatric medicine is a subspecialty of internal medicine concerned with the health and well-being of older adults. Specific for geriatric medicine is the need for comprehensive geriatric assessment which is promoted as the key for successful preventive, diagnostic and therapeutic approach. Geriatricians possess specific skills which are necessaryto achieve high ...

Small practices often lack the human, financial and technical resources to make necessary practice improvements and infrastructure investments in order to achieve sustainable change that promotes quality and efficiency. To report on an effort to assist small primary care practices in improving quality of care and efficiency of practice management ...

Healthcare reforms in Georgia parallel some of the major changes made by other Central and Eastern European countries. This is especially true of efforts to privatize the health sector and secure capital investments from Western Europe. Privatization of Georgian healthcare requires an understanding of the Soviet-era healthcare system and ideological ...

Practitioners variably use restrictive practices with assertive community treatment (ACT) consumers. Little is known about practitioner attributes, such as pessimistic attitudes and lack of advanced education, which may predict greater use of restrictive practices. To describe the frequency of restrictive practices in ACT and examine the relationship between practitioner attributes, ...