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At least 775 records · Page 43Linked to original sources
PubMed1993

The effect of reimbursement on the use of antibiotics.

OBJECTIVE: To examine the effect of a reduction on the reimbursement of drugs on the use of antibiotics by general practitioners in Denmark. DESIGN: A prospective study using a questionnaire comparing the results with a similar study 3 years before, a period with normal reimbursement. PARTICIPANTS: 553 general practitioners prescribed antibiotics for 5765 patients. MAIN OUTCOME MEASURE: Number of treated patients and choice of antibiotics. RESULTS: 7607 patients were treated in 1987 compared with 5765 in 1990, the relative number of patients treated for sinusitis, other upper respiratory tract infections, acute bronchitis, pneumonia and upper gynaecological infections was significantly less in 1990 than in 1987. Other infections, particularly those that are often diagnosed by culture or microscopy by the general practitioners themselves, increased significantly. They included tonsillitis and urinary tract infections. CONCLUSION: Reimbursement can be a very powerful tool controlling the use of antibiotics by general practitioners.

Adolescent↗
PubMed2000

A personal account of a medical mission.

The author participated in a medical mission to the Philippines while he was a student in a family nurse practitioner program. This first person account of his two weeks in the Philippines details his impressions of the country, experiences with poverty, and the challenges of working with limited resources.

Delivery of Health Care↗
PubMed1990

Decontamination of instruments and control of cross infection in general practice.

OBJECTIVE: To assess the effectiveness of decontamination procedures in general practice. DESIGN: Anonymous postal questionnaire survey of 600 general practitioners randomly selected from the national register. SETTING: General practices throughout the United Kingdom. SUBJECTS: 382 General practitioners, a response rate of 65%. RESULTS: 186 General practitioners had autoclaves but 125 used hot water disinfectors or chemical disinfectants to reprocess instruments. 22% (474/2132) Of high risk instruments were inadequately decontaminated. Decontamination was performed by the practice nurse or receptionist in 306 practices. Knowledge of treatment of spillages of blood fluids was uncertain, and only 114 general practitioners used effective methods for dealing with spillages. CONCLUSIONS: A comprehensive central code of practice for control of infection is needed for primary health care staff.

Cross Infection↗
PubMed1995

A clinical trial of a knowledge-based medical record.

To meet the needs of primary care physicians caring for patients with HIV infection, we developed a knowledge-based medical record to allow the on-line patient record to play an active role in the care process. These programs integrate the on-line patient record, rule-based decision support, and full-text information retrieval into a clinical workstation for the practicing clinician. To determine whether use of a knowledge-based medical record was associated with more rapid and complete adherence to practice guidelines and improved quality of care, we performed a controlled clinical trial among physicians and nurse practitioners caring for 349 patients infected with the human immuno-deficiency virus (HIV); 191 patients were treated by 65 physicians and nurse practitioners assigned to the intervention group, and 158 patients were treated by 61 physicians and nurse practitioners assigned to the control group. During the 18-month study period, the computer generated 303 alerts in the intervention group and 388 in the control group. The median response time of clinicians to these alerts was 11 days in the intervention group and 52 days in the control group (PJJ0.0001, log-rank test). During the study, the computer generated 432 primary care reminders for the intervention group and 360 reminders for the control group. The median response time of clinicians to these alerts was 114 days in the intervention group and more than 500 days in the control group (PJJ0.0001, log-rank test). Of the 191 patients in the intervention group, 67 (35%) had one or more hospitalizations, compared with 70 (44%) of the 158 patients in the control group (PJ=J0.04, Wilcoxon test stratified for initial CD4 count). There was no difference in survival between the intervention and control groups (P = 0.18, log-rank test). We conclude that our clinical workstation significantly changed physicians' behavior in terms of their response to alerts regarding primary care interventions and that these interventions have led to fewer patients with HIV infection being admitted to the hospital.

AIDS-Related Opportunistic Infections↗
PubMed1990

HIV and measures to control infection in general practice.

OBJECTIVE: To assess the impact of HIV on procedures to control infection in general practices. DESIGN: A postal questionnaire survey. SETTING: General practices throughout Britain. SUBJECTS: 5359 General practitioners, 3429 (63.9%) of whom returned the questionnaire. MAIN OUTCOME MEASURE: Response to questionnaire on knowledge about HIV and policies for controlling infection. RESULTS: Most doctors (2018) had started to wear gloves when taking blood. Almost half (1510) had not resheathed needles previously but a further 776 had adopted this policy because of HIV. Over half of the doctors did not know or were unsure about the risk of infection from needlestick injuries, and 1759 had no practice policy for controlling infection. CONCLUSIONS: Many doctors are uncertain about measures to control infection in general practice. More information and advice are needed to help doctors develop policies to protect patients and staff.

Acquired Immunodeficiency Syndrome↗
PubMed2004

[A quantitative and qualitative study on effective information flow for infectious disease control in welfare facilities for the elderly].

OBJECTIVES: To clarify factors associated with effective information tranges among staff of welfare facilities for the elderly, and to propose measures for an appropriate information flow system in welfare facilities and public health centers, communication channels and methods, and encouraging factors and barriers were investigated in terms of a printed medium on the control and management of scabies infections. METHODS: A self-administered questionnaire survey and an interview survey were conducted with the staff of welfare facilities for the elderly where "Control and management manual of scabies infection" had been distributed by the Tama-Tachikawa Public Health Center in Tokyo. A self-administered questionnaire was sent to managers and chief practitioners of 66 facilities. Respondents were obtained from 66 managers and chief practitioners (response rate: 84.8%), and 831 practitioners (response rate: 53.1%). The questionnaire consisted of 20 items for managers and 18 items for chief practitioners, including experience of scabies epidemics in facilities, training experience for the use of "Control and management manual of scabies infection," measures for information gathering, and current information flow within the facility. A semi-structured interview survey was conducted with the manager and/or chief practitioner and practitioners in five facilities. The number of respondents was 10. The interview questions included job description, scabies control measures, dissemination of the manual to the staff, use of the manual, flows of health-related information, and factors associated with information flows. Summarized codes were extracted from the transcriptions from tape recording and were categorized repeatedly according to similarity. RESULTS: In the questionnaire survey, differences of Community information flow by types of facilities and professional backgrounds were found. Variation was detected in measures for information gathering and focuses in information management between managers/chief practitioners and practitioners. Practitioners wanted opportunities for information exchange while managers/chief practitioners mainly focused on prioritization of information collected. In addition, many respondents felt that information networks outside the facilities were poorly organized. From the interview survey, three major categories were extracted, that is, 'Information flow system,' 'Personal qualification,' and 'Factors related to the information flow system.' As factors related to the information flow system, the following 7 subcategories were extracted. 1. Interest in information; 2. Working style and workload; 3. Information networks outside the facility; 4. Information management in the facility; 5. Environment for information sharing; 6. Budget for the information system; and 7. Interpersonal communication. CONCLUSIONS: For an effective information system, welfare facilities for the elderly should work on staff training, building their own information flow systems and improving the environment for information sharing and networking with specialized agencies, such as public health centers. At the same time, public health centers should support networking, interpersonal two-way communication and training of welfare-facility workers.

Aged↗
PubMed1995

Comparative study of marbofloxacin and amoxicillin-clavulanic acid in the treatment of urinary tract infections in dogs.

One hundred and four dogs with clinical signs of urinary tract infection were selected by 15 practitioners in a multicentric, controlled and randomised study. The clinical diagnosis was confirmed by urinalysis and imaging. Each dog received either marbofloxacin (2 mg/kg orally once daily or 4 mg/kg by subcutaneous injection every four days) or amoxicillin-clavulanic acid tablets (12.5 mg/kg twice daily) for 10 or 28 days, depending on the clinical diagnosis. Rectal temperature, general condition, appetite, urinary signs, defecation disorders and pain on abdominal palpation were monitored at each visit, the timetable depending on diagnosis: three urinalyses and at least three examinations per case were performed. Side effects were also thoroughly sought at each examination. Marbofloxacin and amoxicillin-clavulanic acid both yielded good bacteriological cure rates (96.2 per cent versus 85.0 per cent, respectively) and clinical cure rates (83.3 per cent versus 69.7 per cent). Fewer relapses were observed in those dogs that received marbofloxacin. Few mild side effects were recorded with both products.

Administration, Oral↗
PubMed1998

The living canvas.

In the United States, body art has gradually moved from the fringes of society into the mainstream. This article focuses on the health issues surrounding this practice. The literature cites numerous infectious diseases and complications resulting from or linked to body art. Tattoos have been linked to skin neoplasms, piercing has been associated with hepatitis B and C risk, and branding is strongly associated with infection. Although it is a theoretical risk, no documented cases of HIV have been acquired from a tattoo or piercing. In general, tattooing, piercing and branding are unlicensed and unregulated industries. In many communities, tattoo artists and establishments are not subject to health inspections, body art practitioners are not required to be trained in anatomy, infection control or universal precautions, and the contents of tattoo dyes have never received FDA approval. Healing times for body art are variable, depending on type and location. Obtaining body art is a long-term commitment, and patients should be fully aware of this.

Art↗
PubMedDate not supplied

Relative delivery efficiency and convenience of spray and ointment formulations of papain/urea/chlorophyllin enzymatic wound therapies.

OBJECTIVE: To determine the relative delivery efficiency and user preference for spray and ointment formulations containing papain, urea, and chlorophyllin copper complex sodium (papain/urea/chlorophyllin copper complex). METHODS: Participants applied both a spray and 3 ointment formulations of papain/urea/chlorophyllin copper complex to identical wound models. The average amount of product used per application was determined by weighing the bottle or tube before the study and after completion of the study. Participants were also asked to fill out a questionnaire regarding their preferences for the two formulations. RESULTS: The amount of product used per wound application was 30% less with the spray formulation; resulting in 29% more wound applications per container. Over 80% of the study participants found the spray easier and quicker to use than the ointments. CONCLUSIONS: The spray formulation of papain/urea/chlorophyllin copper complex resulted in less product use per wound application than did 3 different ointment formulations. Participants expressed a favorable impression of practical benefits of the spray formulation including a reduced risk of wound contamination.

Aerosols↗
PubMed1989

Why mandatory HIV antibody screening cannot work.

In 1985 this country introduced the first serologic screening test [enzyme immunoassays (EIAs)] designed to detect antibodies to the human immunodeficiency virus (HIV), the pathogen of acquired immunodeficiency syndrome (AIDS). Some people now suggest use of this test to identify people within the general population who are infected with the virus. This article will review technical and administrative problems pertaining to the use of EIAs to screen the general population for antibodies to HIV, and will explain why optometrists can provide safe and comprehensive care to all patients without knowledge of a patient's HIV antibody status. Prior knowledge by the optometrist of the patient's serological status is unnecessary if the practitioner 1) adheres to established guidelines pertaining to infection control, and 2) is aware of the various ocular manifestations of HIV disease. It concludes that mandatory HIV screening programs should not be adopted until the benefits to society have been more clearly elucidated and associated technical, administrative, and ethical problems have been resolved.

AIDS Serodiagnosis↗
PubMed2006

Attitudes, beliefs, and infection control practices of Iranian dentists associated with HIV-positive patients.

Of the 309 private dental practitioners in Fars, Iran, surveyed most, 77.7% believed they had a professional duty to treat HIV-positive patients, with 61.4% expressing some level of discomfort about treating these patients, and 75.1% believed they should be treated at a specialist practice. Gloves and masks were not always worn, 15.8% and 9.7%, respectively, and 70.2% of dentist washed their hands before treatment and 60.2% after treatment. Elementary standard precautions were not routinely implemented in private dental practices, despite high levels of concerns about transmission of infection.

Adult↗
PubMed1993

Rules of infection control.

The subject of infection control in dentistry has aroused much controversy and debate during the past decade as a result of the global spread of the human immunodeficiency virus infection. Consequently a number of regulatory bodies have promulgated guidelines for infection control in dentistry and the current consensus is that the 'universal infection control' policy--which considers every patient as infectious--should be the norm in every dental practice. The reasons for this are the asymptomatic carriage of pathogens due to the sub-clinical nature, the prodromal period and the carrier state associated with a number of diseases. The universal infection control rules should encompass six elements: routine patient evaluation, personal protection with barrier techniques, instrument sterilisation including sterilisation control, surface and equipment disinfection, asepsis in the laboratory and appropriate disposal of contaminated waste including sharps. Finally, practitioners should attempt to keep abreast of the rules and regulations related to the subject of infection control in dentistry which are continuously evolving due to the steadily increasing data pool on infectious diseases and their modes of prevention.

Cross Infection↗
PubMed1991

Hepatitis B vaccination and infection control in Brazilian dental practice, 1990.

The aims of the study were to examine the knowledge of occupational hazards from blood-borne viruses, and practices related to cross-infection control in Brazil, by a survey of 947 Brazilian dental practitioners at a National Dental Congress in January 1990. Over 80% were aware that hepatitis B virus can be present in the oral cavity and constitutes an occupational hazard but their perceptions as to the hazards from other agents were at variance with the published evidence. Over 75% were aware of the existence of vaccines against hepatitis B virus but less than 60% appreciated the possible long-term hepatic sequelae of hepatitis B virus infection and, less than 40% were aware of the oncogenic potential. Less than 10% had been immunized against hepatitis B and only a further 30% intended to be vaccinated. Autoclaves were used by less than 10%: most appeared to use chemical means for disinfection of dental instruments. These results indicate the urgent need for a campaign to improve infection control procedures in Brazilian dental practice.

Adult↗
PubMed2003

Tuberculosis and general practitioners.

In spite of advancement of knowledge in diagnosis and management, tuberculosis is still the biggest health problem. There are more than 400 million people infected with tuberculous bacillus and more than 14 million cases are suffering from the disease. Prevention, control and care of tuberculosis are possible. General practitioners play a major role in combating the disease. Quick and right diagnosis and treating the cases effectively should be the motto. Sputum microscopy is the backbone of diagnosis of tuberculosis. With the availability of modern chemotherapy the outcome of a tuberculosis case has undergone dramatic changes. Short-course chemotherapy is the standard choice while tackling cases of tuberculosis. Results of directly observed treatment (DOT) strategy are very good provided execution is proper. HIV/AIDS, another dreaded disease if becomes co-infected along with tuberculosis, mortality and morbidity become very high. The general practitioners are the major strength of healthcare system in any society. They should be good enough to know all about the control programmes well implemented in the country.

Antitubercular Agents↗
PubMed2002

Awareness of surgical site infections for advanced practice nurses.

A primary concern in healthcare today is the prevention of infection. Surgical site infections (SSIs) are the leading type of infection among hospitalized patients. Advanced practice nurses play a vital role in patient care, and those who incorporate best practice standards can reduce the morbidity and mortality associated with SSIs. The Centers for Disease Control and Prevention have published recommendations for prevention of SSIs. This article reviews current literature regarding the prevention of SSIs and how critical care practitioners can incorporate these scientifically tested recommendations into their practice.

Adult↗
PubMed1995

Cross-infection control in general dental practice: dentists' behaviour compared with their knowledge and opinions.

This study aimed to establish how dentists' knowledge, opinion and behaviour about cross-infection control were related and how they were affected by their ages, gender and the sizes of the practices in which they worked. In 1990/91 all general dental practitioners in the North Western Health Region of England were asked to complete a questionnaire about cross-infection control; 917 (75%) did so. Responses from all single-handed and one dentist selected randomly from each group practice were analysed (n = 546). The score to measure behaviour was based on guidelines on cross-infection control issued by the British Dental Association and this was correlated with scores for knowledge and opinion. The more knowledgeable not only tended to hold favourable opinions about the guidelines but also to practise them. Younger dentists were more knowledgeable about cross-infection control measures than older and more likely to wear gloves. Irrespective of age, all female dentists were more likely to wear gloves than their male colleagues. Single-handed dentists were less willing to treat carriers of HIV and HBV. Although 65% thought that recommended control procedures are feasible, 43% considered them prohibitively expensive.

Adult↗