SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
The Executive Committee of the West of Scotland Branch of the BDA decided to investigate the views of the members on the way that branch activities were being run. A sub-committee was set up to plan and carry out a survey and to report on the results.
Explore the source record for details and available documents.
After years of good service, EU legislation on chemicals is currently subject to a major review. This process, initiated by the Council of Ministers at Chester in April 1998, will soon lead to new legislative proposals. In the meantime, a review of the Commission's White Paper on "Strategy for a Future Chemicals Policy," published in February 2001, clearly shows that the regulatory landscape in this area will be significantly reshaped and that a new burden will be imposed on industry to demonstrate that the production and use of chemicals indeed conform to high standards of protection of human health and the environment. In the view of industry, on both sides of the Atlantic, while the objectives of the proposed reform can be supported, the measures proposed in the White Paper to implement these objectives are not properly balanced and will lead to substantial societal and economic drawbacks, unless significant adjustments are made. The purpose of this article is to present the pitfalls and difficulties of the reform as they are perceived by the EU Committee of the American Chamber of Commerce in Brussels, an organization that regroups about 150 European companies of American parentage, belonging to a broad range of European business sectors, including producers and users of chemicals. In view of the transatlantic and cross-business character of its membership, the EU Committee offers a different perspective on the debate.
The AICPA's Auditing Standards Board issued Statement on Auditing Standards (SAS) No. 90, Improving the Effectiveness of Corporate Audit Committees, in response to a related Securities and Exchange Commission (SEC) rule change. Under the standard, audit committees of publicly traded organizations must enter into discussions with their organization's auditors regarding the quality and the acceptability of the accounting principles that have been applied in the organization's financial statements. Although SAS No. 90 is intended for publicly traded entities, the standard has significant implications for all healthcare organizations in defining what constitutes an effective audit committee. To comply with the standard, audit committees should have independent directors who are rotated on and off the committee, training for committee members on the effective performance of their duties, a charter specifying committee responsibilities and membership requirements, meetings at least four times annually, and responsibility for retaining services of CPA firms to conduct the organization's annual audits.
The International Federation of Obstetricians and Gynecologists (FIGO) Committee for the Ethical Aspects of Human Reproduction and Women's Health considers the ethical aspects of issues that impact the discipline of obstetrics, gynecology and women's health. The following document represents the result of that carefully researched and considered discussion. This material is not intended to reflect an official position of FIGO, but to provide material for consideration and debate about these ethical aspects of our discipline for member organizations and their constituent membership.
Conscious of its responsibilities to its Fellows and Members who are paediatricians, the Royal College of Physicians (RCP) is anxious to play its part, along with others, in maintaining and improving standards in paediatrics. Recognising the importance and prominence of the specialty within the generality of specialist medicine, and alongside general internal medicine, it has established a Paediatric Board, reporting directly to Council, which will deal with and advise on all matters concerning paediatrics and child health, and thus enhance the autonomy and influence of the specialty both within the College and on medical affairs in general. It will do this in close association with the British Paediatric Association (BPA) which will nominate members of the Board. In particular the RCP will continue to set standards in paediatrics through examinations, accreditation, representatives on consultant advisory appointment committees, and its membership of the GMC and the Conference of Medical Royal Colleges and their Faculties, to which the Paediatric Board will make a substantial contribution. The network of regional paediatric advisers to the RCP will ensure that the Board is kept in touch with paediatric opinion throughout England, Wales and Northern Ireland. Relationships with Scottish paediatrics and paediatricians will be important, for example, in the organisation and development of the MRCP(UK) examination and its paediatric Part II. Links with paediatricians in the Irish Republic exist through the Joint Committee on Higher Medical Training.
OBJECTIVE: To examine the characteristics of state legislators who introduce child health bills. METHODS: We conducted a cross-sectional analysis of all bills introduced in Colorado, Louisiana, and Michigan during the 1997-1998 legislative session. We identified the topic for each bill while blinded to legislator characteristics. The primary study outcome was whether the bill topic related to child health. We also categorized whether the bill was signed into law. We examined associations between the outcomes and characteristics of the sponsoring legislators (gender, political party, terms served, chairpersonship of committees, legislative chamber, membership in the legislature's Black Caucus). RESULTS: During 1997 and 1998, legislators in the 3 study states introduced 9833 bills (1234 in Colorado, 4905 in Louisiana, and 3694 in Michigan). Sixty-five bills (0.66%) related to child health issues. Child health bills comprised a significantly higher proportion of all legislation introduced by female legislators compared with male legislators (1.5% vs 0.5%, P <.001). Of bills introduced by Black Caucus members, 1.4% pertained to child health compared with 0.59% of bills introduced by nonmembers (P <.01). In contrast, 0.23% of bills introduced by committee chairpersons pertained to child health versus 0.96% of bills introduced by nonchair legislators (P <.001). These associations remained statistically significant in multivariate analyses controlling for state effects. Whether child health bills were signed into law was not associated with other legislator characteristics. CONCLUSIONS: This study offers valuable insights about the different roles of women, Black Caucus members, and committee chairpersons in the state legislative process regarding children's health.
The Patient Care Committee of the American Gastroenterological Association determined that no data existed on the views or demographics of our rapidly growing membership. A 48-item questionnaire was developed and administered during 1982-1983. A random sample (232 of 2751 active members) was queried; 85% (196) replied and all returns were correctly completed. Respondents rate the American Gastroenterological Association as "somewhat responsive" to practitioners' needs but closer to "extremely responsive" to the needs of academic physicians. Full-time medical school faculty average 33% of their time in direct (digestive disease related) patient care, with 15% spent on endoscopy; non-faculty members spend 56% of their time on such care and 22% on endoscopy. Only 2% of the 22% of members who do some "bench research" are less than 35 yr old compared with 7% of the general membership. Most (97.9%) members have attended a Digestive Disease Week in the last 5 yr; they averaged 3.9 meetings and 2.5 courses. Members rank both Digestive Disease Week and GASTROENTEROLOGY a little toward the "research side" of a perfect balance.
Biomedical ethical dilemmas occur in long-term care facilities (LTCFs), particularly in the absence of residents' advance directives. Ethics committees are required in hospitals and long-term care facilities accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), but many LTCFs do not have JCAHO accreditation. A survey of LTCFs in one county in a Southwestern state found that only 29% of those LTCFs responding had an organized ethics committee. This article discusses the purpose, membership, and meetings of an ethics committee in LTCFs. A sample process for resolving a biomedical ethical dilemma is presented. Nurses can initiate the development of an ethics committee using available resources or combining resources with other local LTCFs. The ethics committee should consider the education of all persons involved to facilitate resolution of clinical ethical dilemmas.
INTRODUCTION: Currently, there is no international co-ordinated approach to research into childhood obesity. This is despite much research activity in this area and the universality of the condition. METHOD: This proposal involves the development of an international register of randomized controlled trials of weight management in overweight and obese children. The primary purpose of the register will be to generate and perform important, focussed prospective meta-analysis of data from trials using the conventional weight management strategies. Prospective meta-analysis is an emerging methodology and has some methodological advantages over retrospective meta-analysis. PROPOSAL: The fundamental initial tasks will be to create scientific interest in the proposal, to identify and co-ordinate Management and Advisory Committees with international membership, to determine and define inclusion and exclusion criteria for trial registration, to define the questions that need to be addressed by prospective meta-analysis and finally to engage investigators to register.
Is it necessary to write an introduction for a man whose name is familiar to every phlebologist and angiologist, and who is currently the President of the International Union of Phlebology? (Figure 1) The list of Professor Hugo Partsch's publications (more than 360) and his memberships in scientific committees and advisory boards would fill several pages. In the early 1970s I was reading, with great interest, his articles in "VASA," and several of them have become part of my basic medical knowledge. In all these years, the flow of numerous publications has not diminished, now covering the entire spectrum of angiology. Just by looking to his enormous scientific production, the average reader would probably picture the author as a "typical textbook scientist" caught in a strange world consisting of vessels, either too wide or too narrow. Anyone who has met Hugo Partsch will agree that the contrary is true. It must be assumed that most readers have already seen him as a regular guest speaker at international meetings. It is still a mystery to me how he finds time for all his scientific work, at the same time overseeing the University Clinic in Vienna and traveling from one Congress to the next. Readers will know him as a highly respected scientist, as a fair and diplomatic discussant that speaks several languages, and last but not least, an untiring skier and dancer. Hugo Partsch has helped to bring European Angiology to the United States, and using his broad knowledge and Viennese charm, to merge the diverse studies and interests of phlebology, angiology, lymphology and dermatology.He was born in Vienna in 1938 where he completed all of his studies. He graduated in 1962 and served three years as a resident in southern Austria. In 1965 he continued his residency at the Wilhelmine Spital; at this hospital he would become the head of the dermatological department in 1987. Starting his training in dermatology in 1966, he became a senior registrar in 1970. He acquired the Venia Legendi in 1978 and received the title of Professor of Dermatology at the University of Vienna in 1985. He is the father of three children and has four grandchildren. One could simply define Hugo Partsch as Professor of Dermatology in Vienna. But he is the only dermatologist, to my knowledge, having done so much in the fields of thrombosis, lymphology, peripheral neuropathies, phlebology and angiology in general.
Formulary management implications in a Massachusetts integrated health system consisting of a physician group practice clinic, an HMO, a hospital, a long-term care facility, a physician-hospital organization, a home care agency, and a clinical laboratory are described. Two formularies govern drug therapy for most patients in the system. The formulary of the group practice (Fallon Clinic) is used for 180,000 patients covered by the HMO. The formulary of Saint Vincent Hospital influences drug use in the hospital and the system's long-term care facility. Both formularies require formal review before a drug is added and have structured processes for nonformulary requests. Entities in the health system are still being integrated at the operational level. The system does not have a formal position on integration of the formularies, but information exchange and collaboration occur because of overlap in the membership of the committees that approve the two formularies. Formulary decision-making has been coordinated to account for systemwide needs (for example, enoxaparin was not added to the hospital's formulary because of concerns about continuity of drug therapy after discharge, and the hospital's formulary includes the oral agents on the clinic's formulary). The systems uses one group-purchasing organization and one wholesaler; one person negotiates separate contracts for the hospital and the clinic. System coordination of formulary management has had little effect on daily activities of the pharmacy staff. Drug use among ambulatory patients in this integrated health system is influenced by the clinic's formulary, and drug use among patients in the hospital and subacute care beds is influenced by the hospital's formulary.
Brief comments are addressed to definition of the best possible applicants to medical school and the means by which colleges and universities help to prepare them. In an effort to minimize the ill effects of "premed behavior" in higher education, the author makes 10 specific recommendations regarding the admissions policies and practices of medical schools. These recommendations involve such matters as the nature of an applicant's undergraduate major and other courses (the premed major should be abolished, for example), the Medical College Admission Test, the B.A. degree, grades and grading systems, early admission, and membership on admissions committees.
Rural health issues are increasingly recognized as needing attention, but many health policies in Canada are developed for the urban context and universally applied to rural settings. Addressing rural nurses' opportunities for involvement in policy will contribute to our general understanding of rural health while improving community health services. Rural nurses are in a unique position to assist because of their intimate knowledge of their communities and their position as informal community leaders. Challenges to their involvement include decreased numbers and lack of educational preparation about policy. A strength is the higher percentage of rural nurses who are managers compared to their urban counterparts. Nursing education programs need to include theoretical content and practical opportunities related to health policy. Managers need to support rural nurses' attempts in policy development by providing opportunities for membership on policy committees. Finally, once obtaining skills in the policy arena, rural nurses need to work within their communities and workplaces to help develop and implement more appropriate rural-based policies.
Because the introduction of genetic testing into clinical medicine and public health creates concerns for the welfare of individuals affected with genetic conditions, those individuals should have a role in policy decisions about testing. Mechanisms for promoting participation range from membership on advisory committees to community dialogues to surveys that provide evidence for supporting practice guidelines. Surveys can assess the attitudes and the experiences of members of an affected group and thus inform discussions about that community's concerns regarding the appropriate use of a genetic test. Results of a survey of individuals affected with inherited dwarfism show how data can be used in policy and clinical-practice contexts. Future research of affected communities' interests should be pursued so that underrepresented voices can be heard.
OBJECTIVE: To review the status of consultation-liaison (C-L) psychiatry and the forces shaping it, and to propose strategies for dealing with the crisis in which it finds itself. METHOD: A Medline search of C-L psychiatry and related terms, together with hand-searching of C-L psychiatry and psychosomatic journals and bibliographies of found articles, was used for the literature base. The experience of membership of the committees of national and international C-L psychiatry organisations and their interaction with health care administrators was used as the basis for the discussion of strategies. RESULTS: It is argued that patients with physical/psychiatric comorbidity and somatisation have been marginalised by application of narrow definitions of what constitutes 'serious mental disorder' in the public sector. Evidence is presented to support the argument that physical/psychiatric comorbidity is the most common form of psychiatric presentation in the community, that such comorbidity has serious consequences in terms of morbidity, mortality and health-care costs, and that even subthreshold psychiatric symptoms have serious implications when physical comorbidity exists. CONCLUSION: It is concluded that a number of strategies, including pre-admission screening, integrated discharge planning, liaison, as well as shared care with general practitioners, advanced training in C-L psychiatry and more research to establish practice guidelines, are required if psychiatry is to remain a broad-based discipline rather than retreat to being a specialty for psychosis. Consultation-liaison psychiatrists must become the advocates for the psychosocial system.
Trust is a key element of effective work relationships between managers and physicians. Despite its importance, little is known about the factors that promote trust between these two professional groups. We examine whether manager and physician power over hospital decisions fosters manager-physician trust. We expect that with more power, managers and physicians will have greater control to enforce decisions that benefit the interests of both groups. Subsequently, they may gain confidence that their interests are supported and have more trust for each other. We test proposed hypotheses with data collected in a national study of chief executive officers and physician leaders in community hospitals in 1993. Findings indicate that power of managers and physicians over hospital decisions is related to manager-physician trust. Consistent with our expectations, physicians perceive greater trust between the two groups when they hold more power in four separate decision-making areas. Our hypotheses, however, are only partially supported in the manager sample. The relationship between power and trust holds in only one decision area: cost/quality management. Our findings have important implications for physician integration in hospitals. A direct implication is that physicians should be given the opportunity to influence hospital decisions. New initiatives, such as task force committees with open membership or open forums on hospital management, allow physicians a more substantial involvement in decisions. Such initiatives will give physicians more "voice" in hospital decision making, thus creating opportunities for physicians to express their interests and play a more active role in the pursuit of the hospital's mission and objectives.
Use of a collaborative team approach to design a care pathway and standing orders for carotid endarterectomy patients achieved the project's goals. Variation, LOS, and resource consumption were decreased while quality of care and patients' satisfaction levels were maintained. Education of patients, patients' families, and staff members increased. Coordination between caregivers increased. The consistent concurrent database provided a feedback loop for continued change and for setting the target. Essential to the success was sponsorship from key leadership via the hospital's steering committee. The diverse membership of key associates on the CQI team helped to create an excellent revised carotid endarterectomy process and ensured full implementation. This membership of the CQI team was essential to comprehensive education and implementation. The step-by-step implementation kept the project moving forward. Creating a care pathway and changing practice require collaboration between nurses, doctors, and administrators. Creativity and systematic, thorough steps are what move a practice change from idea to inception.