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PubMed2004

The withdrawal of nutrition and hydration in the vegetative state patient: societal dimension and issues at stake for the medical profession.

The withdrawal of assisted nutrition and hydration (ANH) is increasingly supported by scientific societies, by hospitals and by some families, once the condition of vegetative state could be considered permanent. In the first part of this article, the authors present the factors used to support the decision to withdraw ANH: a) the prognostic evaluation about outcome transformed into a clinical diagnosis of permanency; b) basic health care transformed into a medical treatment, subject to refusal by the patient; c) the human life (an undisposable good) transformed into a disposable one, open to decisions made by surrogates; d) the evaluations about quality of life transformed into judgments about the indignity of human life to be lived. In the second part, the authors outline the changes that this attitude can provoke in the integrity and the juridical status of the medical and nursing professions, and its potential impact on the society at large.

Attitude to Death↗
PubMed2004

Update on the Allied Health Professions Reinvestment Act of 2004.

We are facing a crisis in health care: the ever-increasing number of patients needing care, coupled with the decreasing number of qualified staff to provide that care. This is not a vague concept that might happen to "someone else." This a very real trend that will affect us all (some sooner than later). We are in a position at this time to do something about the future of our health care, particularly the care we will need when we have finished providing care. ASET has been sending a representative to the CAHL sessions for the past seven years. CAHL is the Coalition for Allied Health Leadership, and they meet in Washington, DC, for a week in the spring, and again in the fall. In between these sessions, they network with other participants to produce projects that will develop leadership, and directly help "The Cause." "The Cause" this time around is to promote H.R.4016 and S.2491, "The Allied Health Professions Reinvestment Act." Among other things, these bills address shortages of qualified staff through a variety of educational and training programs. ASET members need to become aware of the basic information contained within these bills, and what they can do to help increase their chances of passing. We can make a difference.

Allied Health Occupations↗
PubMed2004

[The current managements and controversies of the clinical practice for patients with asthma. A questionnaire survey of asthma management for doctors professing internal medicine in Saitama prefecture].

A questionnaire survey of the current medical therapy in patients with mild persistent (step 2) asthma was conducted of doctors professing internal medicine in Saitama prefecture. Responses were obtained from 933 of those surveyed (response rate: 53%). Medications frequently prescribed for asthma control were theophylline (77%), inhaled corticosteroids (ICSs: 75%), and leukotriene modifiers (64%). Usage of theophylline in exacerbation reached 87% and was given priority over inhaled beta2-agonist, suggesting too much usage of theophylline among respondents. ICSs were used in 75% of respondents. Doctors specializing in respiratory or allergic medicine used ICSs more frequently than the others. They started ICSs at large doses initially (48%), followed by small doses, and they showed a trend of continuing ICSs after the asthma was under control (75%). Eighty-three percent of respondents used leukotriene modifiers, which were evaluated as easy to administer orally, having a synergistic effect with ICSs, and having fewer side effects compared with other asthma medications.

Administration, Inhalation↗
PubMed2005

Pipeline, profession, and practice program: evaluating change in dental education.

This article describes the conceptual and analytical framework that will be used to assess the effectiveness of the Pipeline, Profession, and Practice: Community-Based Dental Education Program. The evaluation will use a mixed method qualitative and quantitative data collection, analysis, and triangulation. Baseline measures are reported using data from the 2003 ADEA survey of dental school seniors. Baseline measures show the dental schools are confronting a major recruitment challenge that will require short and long pipeline efforts to attract and retain underrepresented and low-income (URM/LI) persons. Gaps were found between the perceptions of URM and non-URM students in the adequacy of the curricula. The majority of all seniors described the current extramural clinical rotations as positive experiences, but URMs were more likely to report the experience improved their ability to care for diverse groups.

Community Dentistry↗
PubMed2004

[Legal framework of the medical profession and of the neurology speciality].

The law on the general organization of Health Care Professionals (GOHCP) and the Framework Statute make up a new regulatory framework for the practice of medicine, which is completed with the legal debate on the obligatory association to the medical college, pending in the Constitutional Court based on certain regional legal developments. The GOHCP defines the functions of the different professions according to degree, establishes a public registry of physicians, converts the obligation of practicing according to the state of the art into law and updates the training, introduces the Resident core training program and opens the door to superspecialities. It also regulates the professional career, in order to establish a common body of four grades to which the health services can add a fifth one with previous character. Among the novelties of the Framework Statute, there is extensive updating of the offences and sanctions -- that include aspects such as work harassment and adaptation of the workday to the European guidelines, so that the maximum workday is established in 48 hours per week and the complementary (having a voluntary character) cannot exceed 150 hours per year. Lowering retirement age to 65 years foreseen in this guideline will require planning of human resources and has already generated suits in the courts. The obligatory nature of belonging to the medical college has also been modified, this time by some guidelines on the regional level. They would require a decision by the Constitutional Court on whether the college members can be exempted in some cases.

Education, Medical↗
PubMed2005

[Hygienic ranking of basic professions in metallurgical industry according to labor conditions and state of health].

In order to establish priorities in health-improving programs the researchers analyzed the hygienic situation at Novolipetsk metallurgical complex and ranked its technological divisions according to labor conditions of 73 basic professions and state of health of the workers engaged to agglomeration works (AW), chemical-recovery works (CRW), plate rolling (PR) and the workers of a blast-furnace shop (BFS) and an oxygen-converter shop (OCS-I and OSC-II).

Air Pollutants, Occupational↗
PubMed2005

When considering vocational rehabilitation: describing and comparing the Swedish and American systems and professions.

Rehabilitation of functionally impaired in Sweden and the United States is compared and contrasted. Found is that there are fundamental differences in strategies. The Swedish system most often uses a medically oriented multidisciplinary team approach. The US system most often uses a single individual, the vocational rehabilitation counselor, to work with functionally impaired in helping them return to work. Emphasized is that a vocational rehabilitation counselor uses a unique array of skills that is not duplicated in Sweden by a single profession. Suggested is that a single person with a range of skills can more economically provide vocational rehabilitation services to those with functional impairments; whether this is practical for Sweden is yet to be determined. In contrasting the two systems it was evident that the US system has been in operation for a much longer time and that the Swedish system is maturing. Noted is that the governments of both countries are feeling pressure regarding funding of vocational rehabilitation. This is affecting the level and quality of services. The authors advocate wider contact between Swedish and US university-level training programs in rehabilitation. Felt is that each system has strengths and knowledge that can be used to benefit the other.

Humans↗
PubMedDate not supplied

Accommodating a new medical profession: the history of physician assistant regulatory legislation in North Carolina.

The first physician assistant program in the United States was at Duke University Medical Center. This program served as a model for other institutions to begin similar educational programs, and the profession has quickly become a major source of medical services throughout the country. Less well-known is the role of Duke University and North Carolina in the development of a unique regulatory system, which also became a national model. This system has been effective in protecting the public and the patient, and has had the flexibility to adapt to changing medical practice and changing standards. The process by which this regulatory system was developed was unique, and its unique characteristics are felt to have been a significant factor in its success. Duplication of these characteristics is recommended for those who wish to incorporate new medical occupations into the larger medical community.

Certification↗
PubMed2005

Medicine as business, learned profession, and moral enterprise: an evolution of emphasis, 1905-2005.

Despite criticisms of the medical profession from certain quarters, organized medicine has in many ways been a positive force for advancing physicians' ethics and professionalism. Review of articles published in The Journal of the South Carolina Medical Association through the past century suggests sustained concern and increasing sophistication in how we deal with these topics.

Ethics, Medical↗
PubMed2005

[The level lipids in serum for specific professions].

The high level lipids combine with other factors of risk for atherosclerotic heart disease and stroke (CVA) are one of the most important health problems all over the world. A risk for development of such changes is higher for specific profession as policemen. In this prospective study 300 policemen were medically examined; 150 tested patients and 150 policemen in control group. The same methods were applied to both groups: detailed anamnesis, physical check up, complete laboratory testing, electrophoresis of lipids at hypercholesterolinemia, Ultra-sound examination of abdomen and The Color Doppler analysis of neck arteries. Results obtained by statistical data processing have shown that the level of cholesterol and triglycerides in serums of the tested patients is significantly increased in comparison with the control group. Ultra-sound examination of abdomen detected fatty infiltration of liver for 16% patients and for 2% control group. The Color Doppler analysis of neck arteries for 14% patients revealed from hardly observable changes to dramatic narrowing of lumen up to 50%. For control group this percent was 0,66. Having in mind that this group consists of young active people, the problem of hyperlipidemy becomes even more serious.

Adult↗
PubMed2005

Oral health for people with special needs: consensus statement on implications and recommendations for the dental profession.

In November 2004, the Pacific Center for Special Care at the University of the Pacific Arthur A. Dugoni School of Dentistry, with support from the California Dental Association Foundation, hosted a conference to explore the issue of oral health for people with special needs. This conference was held in conjunction with the joint meetings of Pacific's Statewide Task Force on Oral Health for People With Special Needs and Pacific's Statewide Task Force on Oral Health and Aging. These groups of interested stakeholders meet several times a year to discuss the increasing problems faced by people with disabilities, elderly individuals, and other special populations in obtaining access to oral health services and maintaining good oral health. The purpose of this conference was to explore the changing population of people with special needs, analyze the implications for the dental profession and society, and describe systems and strategies that might lead to improved oral health for these populations. This conference also served as a forum for developing oral health recommendations as a part of the California Commission on Aging's Strategic Plan for an Aging Population. Seven nationally recognized speakers presented draft papers on various aspects of this topic. These presentations are published as the additional papers in this and the next issue of the Journal. There was time for audience reaction and discussion with the speakers. The speakers and a designated group of reactors then developed this consensus statement and recommendations for addressing these issues.

Delivery of Health Care↗
PubMed2005

[Immigration of dentists and its effects on the dental profession in Hungary].

There were a very remarkable ethnic and demographic shift in the social composition of dental health care providers in Hungary after the collapse of the old regime in 1989. Hungary is surrounded by states with large ethnic Hungarian minorities blocked in their free migration up to the late 1980's. Although the non-educated members of the Hungarian diaspora did not leave these areas in mass numbers, a great number of highly educated people (among them preeminently health care professionals) moved to the mother state mainly for economic reasons. Dentistry comparing to other medical professions has a special financial advantage because of the considerable share of private financing in the Hungarian dental business. Unfortunately, no statistical analysis was made on the impact of this professional migration in the last 15 years. The present article based on a cross-sectional survey conducted at the end of 2004 demonstrates the proportion of immigrants (mean 7.81 %) among the total number of dental health care providers (5670 to a 10.2 million population) There are 2764 area bounded solo practices contracted to the National Health Insurance (NHI), the other 2907 professionals are engaged in the free market business, and/or they are public employees of the universities with dental faculty as well. As expected, the share of immigrants is higher in NHI-practices, but it varies in a wide range (1.9 - 23.6%) amidst the different counties (19 units plus the capital). Nevertheless, the immigrants may also participate in the free market segment of the dentistry. The variations can be explained by geographic, internal migrational and local economic reasons.

Adult↗
PubMed2005

Emerging scientific advances: how do they enter dental curricula and the profession?

What is meant by emerging scientific advances? In brief, this terminology is equivalent to new research findings, however, the term "research" is often associated with scientific investigations that have very limited direct clinical relevance. Unfortunately, basic dental research and dental clinical practice have, in many instances, been considered to have nonoverlapping spheres of existence. The existence of mutually exclusive domains is rapidly changing with considerable translational activities between basic research investigation and clinical application developing. There is a growing emphasis at a national level for the importance of moving basic biomedical research laboratory findings into clinical patient-related applications to realize improvements in health based on the research findings. Ultimately, new approaches to diagnose, treat, and prevent disease will be available and represent the translation of the best scientific evidence into clinical applications. It is critical at this time to prepare our dental graduates to be members of the dental profession who will understand the implications that new scientific advances will have on their approach to patient care. The patterns and practices of oral health care delivery will undergo major changes during the careers of our new dental graduates. They need to be prepared to respond to these changes to the benefit of their patients.

Curriculum↗
PubMed2006

[Another way to view the nursing profession: an experience in deconstruction].

The authors present a personal process to search for new meanings and ways to approach the reality how nurses exercise their profession by means of exploring, reviewing and analyzing active nursing practice, care and teaching. All this investigation permitted the authors to construct a reflexive, inquisitive and critical view, leading to a position change regarding education and the concept we hold about people and about ourselves. This method deals with listening to theory by telling one's experiences.

Education, Nursing↗
PubMed2006

[CE-marking in the dental profession].

In the present article the authors summarise the meaning and mechanism of CE-marking in the EU in general and its significance in the dental profession. Their goal was to increase the awareness of Hungarian dental professionals to issues of quality management in the European Union.

Dental Health Services↗
PubMed2006

Public health aspects of tobacco control: setting the agenda for action by oral health professions across Europe.

Tobacco use is a significant public health problem across Europe. Each year over half a million Europeans die prematurely due to a smoking-related disease. Tobacco use is a primary cause of many oral diseases and adverse oral conditions. The prevalence of tobacco use varies considerably across Europe, although in many countries overall rates of use have declined in recent years. However, tobacco use among women and young people is rising in several European countries. Tobacco behaviour is influenced by an array of factors, and quitting is a major challenge for many tobacco users. Tobacco use is now considered a chronic progressive relapsing condition requiring very specific support and assistance. To reduce tobacco use across Europe, a range of complementary actions and policies are required at an international, national and local level. The WHO Framework Convention on Tobacco Control (FCTC) outlines an array of evidence-based policies that can be implemented to prevent tobacco use and promote cessation. National dental associations and professional groups across Europe have an important role to play in supporting the ratification and implementation of the FCTC. The aim of this paper is to outline the public health aspects of tobacco control and highlight how the oral health professions across Europe can become actively engaged in this important and relevant area of prevention.

Age Factors↗
PubMed2006

Health professions' education and practice: A commentary on transformation through the internet.

The Internet, in all of its forms and functions, is well on the way to becoming the most ubiquitous technology of the 21st century. It is changing the way the world does business, the way formal education is conducted, and the way humans interact with each other. The Internet already has become an invaluable tool for formal health education and for the delivery by health professionals of information, training, and education to their employees and patients. With new paradigms for health on the horizon, modem Internet technologies will transform health care practice and systems delivery. In this report, the authors focus attention on the use of distance learning/distance education technologies and their relationship to, and use in, the health professions.

Allied Health Occupations↗