In this paper we examine the problems New Zealand faces with regards the identified shortage and uneven distribution of medical practitioners across urban and rural areas. In particular, we examine the extent to which the origin of training and location of practice affect the mobility of medical practitioners over the ...

The incremental and endurance shuttle walking tests (ISWT and ESWT) are measures of exercise tolerance commonly used in pulmonary rehabilitation (PR). A practice ISWT is advocated but often omitted by PR centres. We aimed to investigate the effect of such an omission within a clinical PR service. Between October 2002 ...

A major challenge in the evidence-based design (EBD) practice model has been in determining the degree of credibility of specific (or a body of) evidence. This challenge has remained one of the key impediments to the broader adoption of EBD. Borrowing from evidence-based medicine and evidence-based practice literatures, this paper ...

Upper respiratory tract infections (URIs) are a common complaint in competitive swimmers and can adversely affect performance. No intervention has yet been shown to reduce URI incidence in intensively trained athletes. The University of Virginia varsity swim team received three weeks of training in qigong for the purpose of reducing ...

Faculty members in medical schools and academic medical centers are in a constant process of generating new knowledge. The cornerstone of academia--and academic medicine--is scholarship. Traditionally, tenure and/or academic promotion in the professorial ranks is awarded to those who meet institutional criteria in the missions of research, teaching, and service, ...

Chronic condition self-management and lifestyle risk modification education is paramount for General Practice registrars. A multi-dimensional learning package 'Better Knowledge, Better Health' was developed and piloted to improve General Practice registrars' understanding of their role in supporting chronic condition self-management in patients with osteoarthritis. This pilot study was supported by ...

Massage therapy has grown in popularity, yet little is known globally or in New Zealand about massage therapists and their practices. PURPOSE AND SETTING: The aims of this study were to describe the practice patterns of trained Massage New Zealand massage therapists in New Zealand private practice, with regard to ...

We assessed knowledge, attitude, and provision of recommended fall prevention (FP) practices by employees of senior-serving organization and participation in FP practices by at-risk elders. The Washington State Department of Health administered structured telephone surveys to 50 employees and 101 elders in Washington State. Only 38% of employees felt "very ...

Introduction In order to provide baseline data on genetic testing as a key element of personalised medicine (PM), Canadian physicians were surveyed to determine roles, perceptions and experiences in this area. The survey measured attitudes, practice, observed benefits and impacts, and barriers to adoption. Methods A self-administered survey was provided ...

Management of residual limb volume affects decisions regarding timing of fit of the first prosthesis, when a new prosthetic socket is needed, design of a prosthetic socket, and prescription of accommodation strategies for daily volume fluctuations. This systematic review assesses what is known about measurement and management of residual limb ...

ABSTRACT: Herbal Medicines (HMs) are playing major roles in the health of the millions of people worldwide. Muslim Religious Leader (MRLs), being an important component of the society with huge influence on it, could contribute a lot to promote HM. This study was aimed at evaluating perceptions of the MRLs, ...

This paper highlights the environmental impacts of implementing beneficial management practices to address cattle bedding and direct access to the creek in a study watershed in southern Alberta, Canada. Approximately 35 cow-calf pairs grazed 194 ha of grass forage and had direct access to the creek in the spring and ...

Objective: Our questioning focuses on the role played by the gendered division of labour and by the collective organisation of work in strategies deployed by workers in order to reconcile professional and private lives. How does work organisation facilitate schedule management so as to fit in with workers' domestic lives ...

In Lithuania there are two types of specialists working in medical laboratories and having a university degree: laboratory medicine physicians and medical biologists. Both types of specialists are officially being recognized and regulated by the Ministry of Health of Lithuania. Laboratory medicine physicians become specialists in laboratory medicine after an ...

Appropriate practice of pharmacovigilance in Nigeria will require total involvement of the private medical practitioners considering their number and closeness to the community. Thus, the understanding and attitude of Doctors practicing in the private sectors, towards Pharmacovigilance, was investigated. A consecutive sampling was used to distribute two hundred and seventy ...

Historians have not so far considered Britain as a pioneer in sports medicine, instead arguing that an amateur ethos retarded developments in science and medicine. This article demonstrates that Britain institutionalized and formally recognized sport (and exercise) medicine in advance of most other nations. Further, its sports medicine grew from ...

Objectives Diagnoses-specific sickness certification guidelines were recently introduced in Sweden. The aim of this study was to investigate to which extent general practitioners (GPs) used these guidelines and how useful they found them, 1 year after introduction. Design A cross-sectional questionnaire study. A comprehensive questionnaire about sickness certification practices in ...

Despite increasing practice of teledermatology in the U.S., teledermatology practice models and real-world challenges are rarely studied. The primary objective was to examine teledermatology practice models and shared challenges among teledermatologists in California, focusing on practice operations, reimbursement considerations, barriers to sustainability, and incentives. We conducted in-depth interviews with teledermatologists ...

Residents will most effectively learn about ambulatory, systems-based practice by working in highly functional ambulatory practices; however, systems experiences in ambulatory training are thought to be highly variable. The authors sought to determine the prevalence of functional-practice characteristics at clinics where residents learn. In 2007, the authors conducted a national ...

Risk management is an important aspect of education for all residents. Unfortunately, few curricula currently exist to fulfill this educational need. We developed a curriculum that teaches residents basic principles of risk management with the goals of (1) educating residents about the medical-legal environment in which they operate, (2) helping ...

the diagnosis and management of obstructive airway diseases (OADs) such as asthma and chronic obstructive pulmonary disease (COPD) can be challenging in older people. to assess the clinical, functional, biological and behavioural characteristics relevant to the management of older people with OAD. a cross-sectional study was conducted in a tertiary ...

Background: In the developing world, the diagnostic power of nephrologists is heavily limited by financial, technical and human resource constraints. Urine microscopy (UM) is a basic, inexpensive and relatively simple diagnostic tool, which supplies irreplaceable information. Recently, a theoretical and practical course on UM was organized during the 22nd annual ...

With growing knowledge of morphology and pathophysiology of varicosis, the relative deficiency of the official Terminologica anatomica with regard to the veins of the lower limbs attracted attention. An incorrect and misleading nomenclature was responsible for clinical complications, missing denotation and even wrong treatments. These circumstances caused an urgent need ...

Does mindfulness offer more to psychology than a useful therapeutic technique? This paper argues that it can also establish a state of presence which is understood in relation to the practice of phenomenology. Mindfulness is then both linked to a Western intellectual tradition and offers that tradition a systematic method. ...

Clinical algorithms contribute to the problem- and priority-orientated management of patients and their disease in healthcare. Algorithms are of particular importance in all aspects of emergency medicine where the fast completion of a complex problem according to a hierarchy is required. The advantages and success of this priority- and problem-orientated ...

Debates about appropriate action in medicine often turn on finding the right emotional orientation to new developments. In this article enthusiasm emerges as a key term in a professional 'vocabulary of motive' around innovation, complicating current sociological interest in expectations. The negative associations that adhere to this word among clinical ...

Asia has a disproportionate share of the world's burden of hepatocellular carcinoma (HCC). However, the highly regarded clinical practice guidelines and recommendations for the design and conduct of clinical trials for HCC largely reflect Western practice. In order to design mutually beneficial international clinical trials of promising targeted therapies, it ...

Aortic stenosis (AS) is a chronic, progressive disease predominantly affecting individuals aged over 60 years. Symptoms are the result of progressive left ventricular outflow obstruction, and herald rapid clinical decline and high mortality. Medical therapies for AS remain ineffective; operative valve replacement remains the only effective long-term treatment. We review ...

We performed a systematic review of the literature addressing teledermatology: (1) diagnostic accuracy/concordance; (2) management accuracy/concordance; (3) clinical outcomes; and (4) costs. Peer-reviewed controlled trials published in English between 1990 and 2009 were identified through MEDLINE and PubMed searches. Of 78 included studies, approximately two-thirds comparing teledermatology and clinic dermatology ...

Over the years, pharmacy benefit managers (PBMs) have conducted and published peer-reviewed research covering a broad spectrum of activities ranging from studying the impact of alternative-benefit designs on outcomes to identifying the epidemiology of treated disease to understanding the impact of medication use on overall health-care costs. It is the ...

Objective To describe the impact of an expanded primary care-based sports medicine clinic on referrals to an orthopaedics clinic and to describe the patients seen and procedures performed. Design Retrospective cohort study. Setting Primary care-based sports medicine clinic and orthopaedics clinic at a tax-supported American safety net healthcare system. Participants ...

A growing body of literature investigates heterosexual donor conception and there is now also a small body of work which investigates the experiences of single women and lesbian couples. Both of these focus on a clinical setting. Women, notably single and lesbians, also undertake non-clinical donor conception, and insufficient consideration ...

To evaluate the strengths and weaknesses of a register of management and outcomes of recently diagnosed RA, and allow comparisons between rheumatology centres on good clinical practice and guidelines. A register of newly diagnosed RA was initiated in 1986 in nine different regions of England, later expanded to UK-wide membership ...

OBJECTIVE: Language has always been a means of imposing political and economic dominance. The ascendancy of the discourse of economics is examined in the context of economic rationalism. Some of the effects of this discourse, both upon our services, as well as upon different modes of conceptualizing the therapeutic relationship, ...

Sunitinib is a reference standard of care for the treatment of metastatic renal cell carcinoma (mRCC). While the tolerability of sunitinib is consistent across clinical studies, the impact of tolerability on clinical benefit necessitates effective therapy management, focusing on optimization of dosing, treatment duration, and management of adverse events. Managing ...

This article describes an evaluation of an innovative managed clinical network in the UK. The purpose of the network was to establish a better-coordinated service for those with personality disorder. The network was evaluated with regard to the extent it met its stated and implied outcomes; the process whereby it ...

The provision of complete dentures is often perceived as a clinical 'black art' as it relies on a blend of clinical skill, scientific evidence and no little artistic interpretation. Coupled to this is a heavy reliance on patient ability to control their dentures in a muscular environment while, hopefully, coping ...

The objective of this article is to correct some misconceptions that have arisen since the introduction of Twin Blocks, to identify factors leading to reduced efficiency and increased failure rate, and to improve the clinical application of Twin Block technique.

This study aimed to review the clinical basis for Sa-Ahm Five Element acupuncture. This form of acupuncture uses the Five-Shu acupoints and the tonification-sedation treatments based on the creation and control cycles of the Five Elements. A total of 28 books and papers from the ancient "Nan-Ching" to the modern ...

This review addresses practical clinical issues related to the use of ziprasidone in the treatment of schizophrenia using information from clinical trials, unpublished data, manufacturer's information, and input from an expert faculty of European psychiatrists with extensive experience of the use of ziprasidone, both in clinical trials and in everyday ...

Safe inhibition of thrombosis is a key therapeutic strategy in modern cardiovascular medicine, and both unfractionated heparin (UFH) and low-molecular-weight heparin (LMWH) are commonly used in clinical practice. However, both have several drawbacks, such as the unpredictable pharmacokinetics of UFH and the non-reversibility of LMWH. M-118, being developed by Momenta ...

Physician workforce projections by the Institute of Medicine require enhanced training in geriatrics for all primary care and subspecialty physicians. Defining essential geriatrics competencies for internal medicine and family medicine residents would improve training for primary care and subspecialty physicians. The objectives of this study were to (1) define essential ...

The Clinical Trials Network of the Society of Nuclear Medicine was formed to provide quality assurance of both imaging and radiopharmaceutical manufacturing in clinical trials. The intention is to register and qualify a large number (>200) of sites, both in the United States and internationally, to be able to do ...

N-of-1 clinical trials have the potential to contribute to individual patient management and to the accrual of important information about populations. Incorporating these studies into clinical practice will require creative thinking so as to maintain rigor without excessive disruption of routine care.

This paper reports a study conducted to explore how nurses working at advanced practice level in chronic and acute care outpatient contexts responded to decision-making concerns in clinical practice. Current theoretical explanations of clinical judgement offer insight into how healthcare professionals process information; however, they are incomplete as they do ...

Provision of indirect restorations is associated with more complaints and litigation than any other area of dentistry. In the third part of this series we identify possible causes of such complaints. We explore each of the stages from clinical assessment to treatment, highlighting areas which may trigger litigation when they ...

The American College of Physicians (ACP) established its evidence-based clinical practice guidelines program in 1981. The ACP's Guidelines Committee and the staff of the Clinical Programs and Quality of Care Department develop the clinical recommendations. The ACP develops 2 different types of clinical recommendations: clinical practice guidelines and clinical guidance ...

To present the member registry survey methods and characterize the first national clinical pharmacy practice-based research network (PBRN). Cross-sectional online survey. A national clinical pharmacy association. American College of Clinical Pharmacy (ACCP) full and associate members, integrated health system groups of pharmacists, and existing PBRNs were invited to participate in ...

The implementation of genetic data for a better prediction of response to medications and adverse drug reactions is becoming a reality in some clinical fields. However, to be successful, personalized medicine should take advantage of an informational structured framework of genetic, phenotypic and environmental factors in order to provide the ...

The experience of returning to physiotherapy practice needs to be understood from the perspective of those who have returned to practice, those thinking of returning, and clinical supervisors who have worked with people that have returned to practice. A qualitative methodology using an interpretivist theoretical framework was utilised. Participants were ...