General practitioners manage complex medicine regimens and multiple comorbidities in older people. While medicine use usually leads to benefits for older people, the process of prescribing medicines is becoming increasingly complex. The quality use of medicines (QUM) is one of the four central objectives of Australia's National Medicines Policy. The ...

Background Older people with dementia may be particularly susceptible to cognitive impairment associated with anticholinergic and sedative medicines. This impairment may be misattributed to the disease process itself. Objective This review examines clinical considerations associated with using anticholinergic and sedative medicines in people with dementia or incipient cognitive impairment. It ...

OBJECTIVE: To systematically review the evidence available for nonsurgical management of hip dysplasia (HD). STUDY DESIGN: Literature review. METHODS: Databases (Pubmed, Veterinary Information Network) were searched for clinical studies on nonsurgical management of HD in dogs. The evidence in each study was reviewed and assigned a score (I-IV) based on ...

A survey was mailed to a representative sample of US orthopedic surgeons to assess protocols for the prevention of venous thromboembolism after lower extremity total joint arthroplasty. Practices were examined by type of operation, annual surgical volume, and opinions of consensus guidelines issued by the American Academy of Orthopaedic Surgeons ...

Osteonecrosis of the femoral head is a multifactorial disease that can result in significant clinical morbidity and affects patients of any age, including young and active patients. Late sequelae of femoral head osteonecrosis include femoral head collapse and subsequent degeneration of the hip joint. A high index of suspicion and ...

Osteonecrosis of the femoral head is a multifactorial disease that can result in significant clinical morbidity and affects patients of any age, including young and active patients. Late sequelae of femoral head osteonecrosis include femoral head collapse and subsequent degeneration of the hip joint. A high index of suspicion and ...

Background Physical therapy has an important role in hip fracture rehabilitation to address issues of mobility and function, yet current best practice guidelines fail to make recommendations for specific physical therapy interventions beyond the first 24 hours postsurgery. Objectives The aims of this study were: (1) to gain an understanding ...

AIM: To establish which musculoskeletal conditions are deemed to be the most important in clinical practice. To use this information to inform the development of a new musculoskeletal curriculum, with emphasis on common and relevant conditions. METHODS: A survey listing 29 musculoskeletal conditions was sent to 150 doctors in Auckland, ...

Plasma volume expanders comprise a heterogeneous group of substances used in medicine that are intravenously administered in cases of great blood loss owing to surgery or medical emergency. These substances, however, can also be used to artificially enhance performance of healthy athletes in sport activities, and to mask the presence ...

A divergent route was developed to access 3-iodo- and 6-chloro-3-iodo-4(1H)-quinolones for further elaboration via mono and/or sequential Suzuki-Miyaura cross-coupling to generate novel and medicinally important 4(1H)-quinolones. Copper- and palladium-catalyzed cyanations were used to functionalize the 4-quinolone core further.

Objectives. The aim of this study is to describe primary health care managers' attitudes and views on recruitment and human resource development in general and to ascertain whether there are any differences in the views of managers in the southern and northern regions of Finland. Study design. A postal questionnaire ...

Inhibitors of the epidermal growth factor receptor (EGFR) are increasingly used in the treatment of various entities of malignant tumors. Patients treated with EGFR inhibitors very likely develop cutaneous side effects. The development of a papulopustular, follicular exanthema during the first weeks of therapy correlates with therapeutic benefit. However, this ...

Environmental Management System (EMS) has been one of the important tools for sustainable construction for around two decades. However, many issues concerning sustainable development have not been properly addressed, and there is a need for the introduction of green specifications to advance green performance in construction through contract management. This ...

This paper presents a process of developing practices in self management support (PSMS) - a measure assessing clinicians' self reported use of self management support practices in clinical consultations for patients with long term conditions (LTCs). The development process comprised the following steps: literature review to define what skills clinicians ...

Although much has been written about the history of water supply systems, there is a lack of corresponding information on wastewater management. This is surprising since the lack of sanitation affects human development to the same or even greater extent as the lack of clean water. While there may be ...

Most of the world's coral reefs line the coasts of developing nations, where impacts from intense and destructive fishing practices form critical conservation issues for managers. Overfishing of herbivorous fishes can cause phase shifts to macroalgal dominance, and fishers' use of rocks as anchors lowers coral cover, giving further competitive ...

The Tissue Engineering and Regenerative Medicine International Society-North America (TERMIS-NA) Industry Committee was formed in February 2009 to address the common roadblocks (i.e., hurdles) in the commercialization of tissue engineering/regenerative medicine products for its members. A semiquantitative online opinion survey instrument that delineated potentially sensitive hurdles to commercialization in each ...

Skilled facilitation is at the heart of transformational practice development, and facilitators carry the hopes and expectations of those eager to see the promises of practice development come to fruition. The aim of this paper is to present a framework that assists facilitators to understand their progress in relation to ...

The term COPD which comprises chronic obstructive bronchitis and emphysema, was first defined in 1964. Key milestones to the understanding of the etiopathology of COPD were the discovery of the association between tobacco consumption and the development of chronic bronchitis as well as the discovery of the role of a ...

Development and organization of an interventional pulmonology department requires careful consideration of many elements, including personnel, equipment, logistics, procedures performed, practice management, institutional vision and biases, practice setting, continued medical education, risk management, communication and fiscal responsibility. In this paper, a patient-centric approach is used to begin addressing these issues ...

OBJECTIVES: To develop fact sheets about tocilizumab, in order to assist physicians in the management of patients with inflammatory joint disease. METHODS: 1. selection by a committee of rheumatology experts of the main topics of interest for which fact sheets were desirable; 2. identification and review of publications relevant to ...

The Hedgehog (Hh) signaling pathway is crucial for normal embryonic development. Aberrant Hh signaling is implicated in numerous pathologic conditions including proliferative diseases such as cancer. During the past decade, academic and industrial research efforts have resulted in the discovery of a variety of Hh pathway antagonists. This review focuses ...

The first descriptions of endoscopy date back to the times of Hippocrates (460-377 BC), who described the use of a rectal speculum in humans. Since that time, technologic advances have fueled the development of endoscopy equipment. The application of human pediatric instruments in exotic pet medicine has enabled these minimally ...

There is increasing interest in the study of fractals in medicine. In this review, we provide an overview of fractals, of techniques available to describe fractals in physiological data, and we propose some reasons why a physician might benefit from an understanding of fractals and fractal analysis, with an emphasis ...

Objective: A national survey was conducted to obtain an overall view of the current management of children with cleft lip and/or palate in Nigeria. Method: Questionnaires were sent to 44 identified cleft surgeons in all teaching and specialist hospitals in Nigeria. Results: A total of 38 respondents returned completed questionnaires. ...

Since our ancestors began trading several millennia ago, counterfeit and substandard medicines have been a recurring problem, with history punctuated by crises in the supply of anti-microbials, such as fake cinchona bark in the 1600s and fake quinine in the 1800s. Unfortunately this problem persists, in particular afflicting unsuspecting patients ...

Hans Goldmann (1899-1991), born in Komotau in Bohemia, studied medicine in Prague. He was trained in physiology by A.V. Tchermak-Seysenegg and in ophthalmology by A. Elschnig in Prague and by A. Siegrist in Berne. He succeeded Siegrist as chairman of the Department of Ophthalmology in Berne in 1935. He was ...

This paper examines the rise of an epistemic genre, the Observationes, a new form of medical writing that emerged in Renaissance humanistic medicine. The Observationes (collections of case-histories) originated in the second half of the sixteenth century, grew rapidly over the course of the seventeenth, and had become a primary ...

Urban water infrastructures provide essential services to modern societies and represent a major portion of the value of municipal physical assets. Managing these assets rationally is therefore fundamental for the sustainability of the services and to the economy of societies. "Asset Management" (AM) is a modern term for an old ...

A legislative framework introducing European public health measures on orphan medicinal products came into force in the European Union in April 2000. The aim of the orphan legislation is to stimulate research and development of medicinal products for rare diseases by providing incentives to the sponsors. Incentives include, among others, ...

Developing and delivering appropriate, affordable, well-adapted medicines for HIV/AIDS remains an urgent challenge: as first-line therapies fail, increasing numbers of people require costly second-line therapy; one-third of ARVs are not available in pediatric formulations; and certain key first- and second-line triple fixed-dose combinations do not exist or sufficient suppliers are ...

Bone marrow derived stem cells administered after minimal manipulation represent an important cell source for cell-based therapies. Clinical trial results, have revealed both safety and efficacy of the cell reinfusion procedure in many cardiovascular diseases. Many of these early clinical trials were performed in a period before the entry into ...

Many lesbian, gay, and bisexual (LGB) individuals manage the degree to which their sexual orientation is known to others. Visibility management, the process of regulating the exposure of one's orientation, is an important part of the lesbian/gay/bisexual experience in community, family, and virtually all other social settings. The degree to ...

The paper reviews the development of key policy relating to estuary management, highlighting the trends and drivers in policy development which have shaped the management and protection of the estuary environment. Focusing on policy developments over the last three decades, the paper draws attention to the significant influence of European ...

BACKGROUND: Realist evaluation offers an interesting approach to evaluation of interventions in complex settings, but has been little applied in health care. We report on a realist case study of a well performing hospital in Ghana and show how such a realist evaluation design can help to overcome the limited ...

Telecare, the provision of care through remote interaction enabled by information and communication technology, is quickly developing. Integration with other technological developments is to be expected and will create systems that enable more intense, continuous and unobtrusive monitoring of health, and more personalized feedback and instructions. One of the goals ...

In February 2005 the government announced that sport and exercise medicine would be developed as a new speciality of medicine. This article provides an understanding of the process involved in the development of the new speciality of sport and exercise medicine, its scope and curriculum.

In England (UK) the discharge of patients from hospital is a source of constant scrutiny from primary care trusts in order to reduce the patient length of stay in Hospital. To support nurses in practice a part time, post registration discharge practice education module was developed entitled Facilitating Timely Patient ...

The new paediatric European Union (EU) regulation and the consequent demand for paediatric studies on one hand and the ethical need for minimizing the burden of studies in children on the other hand necessitate optimal techniques in the assessment of safety/efficacy and use of drugs in children. Modelling and simulation ...

The Children's Centre Programme is a recent development in the UK and brings together multi-agency teams to work with disadvantaged families. Practice development methods enable teams to work together in new ways. Although the term practice development remains relatively poorly defined, its key properties suggest that it embraces engagement, empowerment, ...

OBJECTIVES: (i) To develop a group-based intervention for the management of multiple sclerosis (MS) fatigue incorporating energy effectiveness and cognitive behavioural approaches and (ii) to undertake a process and preliminary evaluation. METHODS: Drawing upon a literature search, a local model of good practice and the views of service users and ...

There are seven simple steps hospitals can take to address the development of department managers: Survey the development needs of department managers. Prioritize development needs. Implement results-oriented, hands-on education. Implement tracking reports and review sessions. Provide accessible tactical financial management support. Create top-level mentoring relationships for managers. Celebrate successes.

The European medicinal leech, Hirudo verbana, harbors simple microbial communities in the digestive tract and bladder. The colonization history, infection frequency, and growth dynamics of symbionts through host embryogenesis are described using diagnostic PCR and quantitative PCR. Symbiont species displayed diversity in temporal establishment and proliferation through leech development.

OBJECTIVES: Nuclear medicine has changed rapidly as a result of technological developments. Very little is reported on the effects these developments may have on technologist productivity. This study aims to determine whether advances have created a workplace where more patient studies can be performed with fewer technologists. The level of ...

The authors present the development of the concept of mental disease and treatment in Serbian medicine. Serbian medieval medicine did not acknowledge fortune telling, sorcery, the use of amulets and magical rituals and formulas. These progressive concepts were confirmed by the Church and the Serbian state in what is known ...

This paper explores the concept of practice development in the context of professional development and strategies for facilitating learning in practice. In this paper we present the background to the methodology of emancipatory and transformational practice development. Key concepts underpinning a contemporary definition of practice development are unravelled and nine ...

This article examines the proposals contained in health minister Lord Darzi's Next Stage Review final report and considers how clinical teams can implement them in their everyday practice. While the article acknowledges that clinical teams may already meet many of the recommendations in the review, some may have insufficient evidence ...

A short history of hybrid molecules based on aminoquinolines gave interesting and important information useful for organic and medicinal chemistry, which are deeply involved in the design and development of new antimalarial agents. The highlights in the preparation of aminoquinoline antimalarials, their protocols and antiplasmodial activity and, specially, the development ...

OBJECTIVE: This self-directed learning module highlights common conditions associated with specific populations. It is part of the study guide on sports and performing arts medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. Using a case vignette format, this article specifically focuses on ...

INTRODUCTION: Integrated medicine has become an important issue in this century. In order to bridge the gap between traditional Chinese medicine (TCM) and modern medicine, we have established a first final version of a Yang-Xu constitution questionnaire, the BCQ+, in a previous study. The objective of the present investigation is ...