General practice residency aims to produce competent general practitioners (GPs) who will practice independently, i.e. who demonstrate adequate levels of actual and self-perceived competence. To measure self-perceived competence in GP residents at our institution and explore potential determinants. We conducted a cross-sectional study of our GP residents. Self-perceived competence was ...

Underuse of best practices in chronic disease prevention (CDP) represents missed opportunities to promote healthy living and prevent chronic disease. Better understanding of how CDP programs, practices and policies (PPPs) are transferred from 'resource' organizations that develop them to 'user' organizations that implement them is crucial. The objectives of this ...

The public, payers, hospitals, and Centers for Medicare and Medicaid Services (CMS) are demanding that emergency departments (EDs) measure and improve performance, but this cannot be done unless we define the terms used in ED operations. On February 24, 2010, 32 stakeholders from 13 professional organizations met in Salt Lake ...

The efficient management of diseases, pests, or endangered species is an important global issue faced by agencies constrained by limited resources. The management challenge is even greater when organisms are difficult to detect. We show how to prioritize management and survey effort across time and space for networks of susceptible-infected-susceptible ...

The Regional Anesthesiology and Acute Pain Medicine Fellowship Directors Group develops and maintains guidelines for fellowship training in the subspecialty. These guidelines update the original guidelines that were published in 2005. The guidelines address 3 major topic areas: organization and resources, the educational program, and the evaluation process.

Childhood obesity is recognized by the World Health Organization as one of the most serious public health challenges of the 21st century. Current treatment recommendations consider the role of pharmacotherapy in the treatment of childhood obesity, as an adjunct to lifestyle modifications. This article focuses on key requirements for paediatric development ...

Wellness Self-Management (WSM) is a recovery-oriented, curriculum-based practice designed to help adults with serious mental health problems make informed decisions and take action to manage symptoms and improve their quality of life. WSM is an adaptation of the illness management and recovery program, a nationally recognized best practice. WSM uses ...

Each year, a number of clinical trials emerge with data sufficient to change clinical practice. Determining which findings will result in practice change and which will provide only incremental benefit can be a dilemma for clinicians. The authors review selected clinical trials reported in 2010 in journals, at society meetings, ...

As reimbursement policies and healthcare reform legislation add pressure onto the independent practice of cardiology, many cardiology groups seek refuge in hospital employment. This has implications for healthcare costs and the future of the practice of cardiology, especially in the age of accountable care organizations.

In order to promote uniformity between jurisdictions, the Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) has developed the National Directory for Radiation Protection, which is a regulatory framework that all Australian governments have agreed to adopt. There is a large and diverse range of industries involved in mining or ...

This paper examines the sources of practice variations and definitions of unwarranted variation, as derived from the literature. The literature suggests variables/factors related to patient health needs, doctor 'practice style' and environmental constraints/opportunities as sources of practice variations. However, this list is likely to be incomplete because of significant unexplained ...

Profuse bleeding from the lower uterine segment secondary to placenta praevia/accreta during caesarean delivery is a challenging problem in obstetrics. We present our experiences using intrauterine Foley balloon tamponade for the conservative management of post-partum haemorrhage from the lower uterine segment. Intraoperative haemostasis was achieved in all women who were ...

The Academy of Breastfeeding Medicine is a worldwide organization of physicians dedicated to the promotion, protection and support of breastfeeding and human lactation. Its mission is to unite into one organization members of the various medical specialties with this common purpose.

Expert Panel Report 3 Guidelines recommend that physicians use adherence management strategies; however, the evidence for these interventions is weak. Clinicians need effective proven adherence interventions, because approximately 50% of patients with asthma do not follow physician medication recommendations, resulting in unnecessary morbidity. This review examines components of an organized ...

In recent years, significant advances have been made in business organization and management. The growing demands of clients as well as the globalization of world markets are among the many factors that have led to the establishment of systems of quality control and environmental management as a competitive strategy for ...

Given the current operating climate, organizations are coming under pressure to develop and implement sustainability programs and projects, yet few managers truly understand what is meant by sustainability and its implications for managing organizations. This article examines the concept of sustainability and provides a broader definition of the term than ...

Exception reporting allows practices to exclude eligible patients from indicators or an entire clinical domain of the Quality and Outcomes Framework (QOF). It is a source of contention, viewed by some as a 'gaming' mechanism. To explore GP and practice staff views and experiences of exception reporting in the QOF. ...

This paper examines clinician-manager interactions within healthcare organizations in the UK and contrasts the notions of dialetics and dialogues within such interactions. We draw particularly on Bakhtin's work on dialogue to frame our focal research question, which considers the extent to which clinician-manager interactions are dialogic. Using data drawn from ...

The profession of medicine has evolved into an extremely specialised occupation. Yet, recent research has neglected the intra-occupational processes influencing medical specialisation. This article aims to correct this oversight. It develops an historical account of intra-occupational factors influencing the decision to establish gynaecologic oncology as American ob/gyn's surgical subspecialty in ...

In this study, we used a normative theoretical perspective to examine the relationship between uncertainty management and support in the lives of organ transplant patients. We conducted in-depth interviews with 8 pretransplant and 30 posttransplant patients, including individuals who were waiting for or had received a kidney, liver, heart, or ...

OBJECTIVE: Effective use of staff is a major aim in all health-care systems both to maximize their impact and to minimize costs. In England, a few general practitioners (GPs) have been recruiting physician assistants (PAs) to work in their practices, independent of any pilot schemes. Our objective was to study ...

To meet a critical and growing need for emergency physicians and emergency medicine resources worldwide, physicians must be trained to deliver time-sensitive interventions and lifesaving emergency care. Currently, there is no globally recognized, standard curriculum that defines the basic minimum standards for specialist trainees in emergency medicine. To address this ...

The successful commercialization of regenerative medicine products provides a unique challenge to the manufacturer owing to a lack of suitable investment/business models and a constantly evolving regulatory framework. The resultant slow translation of scientific discovery into safe and clinically efficacious therapies is preventing many potential products from reaching the market. ...

Tissue hypoperfusion is an important factor in the development of multiple organ failure. Therefore, recognition of sepsis-induced tissue hypoperfusion and timely clinical intervention to prevent and correct this are fundamental aspects of managing patients with sepsis and septic shock. Hemodynamic monitoring plays a key role in the management of the ...

As donation after cardiac death practices expand, the number of institutional policies is increasing. We contacted organ procurement organizations throughout the United States and requested protocols in hospitals in their donor service areas. Sixty-four protocols were obtained with representation from 16 different states. The terminology and recommended practices varied substantially. ...

Marine spatial planning tends to prioritise biological conservation targets over socio-economic considerations, which may incur lower user compliance and ultimately compromise management success. We argue for more inclusion of human dimensions in spatial management, so that outcomes not only fulfill biodiversity and conservation objectives, but are also acceptable to resource ...

Traditional Chinese medicine (TCM) is a holistic approach to health that attempts to bring the body, mind and spirit into harmony. Entering 21st century, TCM is getting more and more popular in the whole world for improving health condition of human beings and preventing or healing diseases, especially shows great ...

Lymphoedema is a chronic swelling condition that contributes to disability, dysfunction and lost quality of life. Significant disparities exist worldwide regarding the availability of resources necessary to identify, treat and manage lymphoedema. This disparity transcends socio-economic status and is a common problem in both developed and developing countries. The overall ...

  Unintended effects of recreational activities in protected areas are of growing concern. We used an adaptive-management framework to develop guidelines for optimally managing hiking activities to maintain desired levels of territory occupancy and reproductive success of Golden Eagles (Aquila chrysaetos) in Denali National Park (Alaska, U.S.A.). The management decision ...

A key challenge has been to define and measure "success" in managing protected areas. A case study was conducted of efforts to evaluate the new protected area management system in Trinidad and Tobago using a participatory approach. The aim of the case study was to (1) examine whether stakeholder involvement ...

In order to develop a sound material-cycle society, cost-effective municipal solid waste (MSW) management systems are required for the municipalities in the context of the integrated accounting system for MSW management. Firstly, this paper attempts to establish an integrated cost-benefit analysis (CBA) framework for evaluating the effectiveness of MSW management ...

Aim: This paper presents the development process of the European framework for psychosocial risk management (PRIMA-EF). It also summarises and discusses key findings of research conducted through this policy-orientated research programme. Objectives: This paper presents an overview of the development process of PRIMA-EF. The background, methods and outcomes are described ...

INTRODUCTION: The aim of this work is to present a historical review of urological pharmacotherapy. The containers used to preserve and store medicines are an important source of information in historical research. MATERIAL AND METHODS: I studied written sources such as treaties of Medical and Therapeutical Materials, as well as ...

A common framework is necessary for the transparent articulation of the benefits and risks of a therapeutic product across disparate stakeholders. The assignment of value and weighting to each component parameter presents challenges deriving from different stakeholder objectives, methods, and perspectives. Building on prior experiences with a validated framework approach, ...

ABSTRACT: In their article, Baelani and colleagues surveyed anesthesia providers from African low- and middle-income countries (LMICs) to evaluate whether or not the current Surviving Sepsis Campaign (SSC) guidelines are feasible in such resource-constrained settings. The authors report that an alarmingly low percentage of hospitals have the capacity to implement ...

Groundwater is a key resource for global agricultural production but is vulnerable to a changing climate. Given significant uncertainty about future impacts, bottom-up approaches for developing adaptive capacity are a more appropriate paradigm than seeking optimal adaptation strategies that assume a high ability to predict future risks or outcomes. This ...

INTRODUCTION:: Management of thymoma has largely been based on single-institution retrospective, observational studies. The European Society of Thoracic Surgeons (ESTS) Thymic Working Group has investigated the current practice among ESTS members. METHODS:: A questionnaire divided into seven sections with 24 questions was designed, and it was delivered to ESTS members. ...

Regenerative medicine seeks to repair or replace damaged tissues or organs, with the goal to fully restore structure and function without the formation of scar tissue. Cell based therapies are promising new therapeutic approaches in regenerative medicine. By using mesenchymal stem cells (MSC), good results have been reported for bone ...

Using a material semiotics methodology, this paper explores the link between diagnostic practices, patient awareness of the body, and biopolitical governance. We collected video and audio recordings of a patient with chest pain involved in three medical interactions (a general practitioner [GP] consultation, an electrocardiogram stress test and a consultation ...

Stratifying preoperative risk and guiding perioperative therapy objectively has acquired critical importance, given robust data demonstrating that morbidity following non-cardiac surgery confers substantially increased risk of death, even beyond hospital discharge. The development of useful perioperative biomarkers depends fundamentally on both prospective morbidity data that enable the identification of higher ...

Participatory processes in general and also in relation to managing landscape issues are gathering importance mostly due to arguments surrounding legitimacy and effectiveness in decision-making. The main aim of this research, based on a transaction costs perspective, is to present an integrated analytical framework in order to determine individual efforts ...

This paper is focused in the management of virtual organizations (VO) inside healthcare environments where Grid technology is used as middleware for a healthcare services oriented architecture (HSOA). Some of the main tasks considered for the provision of an efficient VO management are: management of users, assignation of roles to ...

Natural resource management is littered with cases of overexploitation and ineffectual management, leading to loss of both biodiversity and human welfare. Disciplinary boundaries stifle the search for solutions to these issues. Here, I combine the approach of management strategy evaluation, widely applied in fisheries, with household utility models from the ...

We describe an integrated care pathway (ICP) for the optimal management of invasive mould disease (IMD). The ICP is for use by health professionals involved in the care of patients with haematological malignancies and haematopoietic stem cell transplant recipients who are at increased risk of IMD. The ICP is not ...

The objective of this study was to survey holdings of ephemeral veterinary literature. World Cat OCLC catalog, the Library of Congress online catalog, the US National Agricultural Library online catalog, and the Dictionary Catalog of the National Agricultural Library, 1862-1965, were used to determine current library holdings of materials published ...

The dual challenges of succession management and succession management planning are considerable. A tool, the Turn over Folder, was introduced and described in detail as a useful first step in succession management planning. The adoption of that tool will not in itself produce a succession management plan, but it will ...

Disaster preparedness and management education is essential for allowing orthopaedic surgeons to play a valuable, constructive role in responding to disasters. The National Incident Management System, as part of the National Response Framework, provides coordination between all levels of government and uses the Incident Command System as its unified command ...

Professionals can and should lead, regardless of where they are in an organization. Formal approaches to leadership activities can improve outcomes for leadership at all levels in an organization. In the types of organizations most radiologists practice within, leadership is simply too important to be left just to one person.

Toronto Rehabilitation Institute developed its Clinical Best Practice Model and Process (TR-CBPMP) to facilitate a systematic and consistent approach to best practice with the goal of shortening the path between best knowledge and clinical care and linking this process to patient needs and outcomes. The TR-CBPMP guides clinicians, inter-professional teams, ...

Rhineland leadership practices contrast sharply with the prevailing Anglo/US business model of short-term maximization of profitability, and are said to lead to greater corporate sustainability, at least in highly developed economies. However, the applicability of Rhineland leadership to less developed economies has not yet been demonstrated. This paper sets out ...