Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Previous Practice”

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.

At least 811 records · Page 45Linked to original sources
PubMed1991

General practitioners and work in the Third World.

In recent years the number of general practitioners who have worked in the third world before entering general practice has fallen. The reasons for this are not clear but may include worries about future career prospects. Ninety four doctors who had entered general practice since 1984, after previously working in the third world, completed a questionnaire about their career experience and views about the value of such work. They were generally widely experienced and well-qualified and work abroad had not apparently harmed their careers, rather, many believed it had enhanced it. Work in the usually arduous conditions of poor countries was often considered by the respondents to lead to a wider perspective, increased maturity, confidence, self-reliance, adaptability and initiative. Doctors who are interested and suitable for work in the third world prior to entering general practice should be encouraged to pursue this possibility.

Career Mobility↗
PubMed1995

A review of cervical cancer and cervical screening: implications for nursing practice.

In this paper we review epidemiological and other research evidence on cervical cancer and cervical screening. We outline recent research evidence implicating sexually transmitted human papillomavirus as one of the causes of cervical cancer, but stress the uncertainty surrounding the causes and natural history of the disease. We go on to discuss evidence on risk factors associated with increased incidence of and mortality from cervical cancer, including age, sexual behaviour, smoking, socioeconomic status and prolonged use of oral contraceptives. Cervical screening has reduced mortality in some countries, and we outline the necessary features of a successful, effective screening programme before going on to describe why screening failed in Britain, at least until the late 1980s. Current screening policy is designed to remedy this, and we discuss its implications, and those of previous research, for nursing practice.

Female↗
PubMed2006

The response of general practitioners to the threat of violence in their practices: results from a qualitative study.

BACKGROUND: Violence directed towards GPs has been recognized as a significant problem in the UK. In Australian urban general practice, no study has previously examined this topic. OBJECTIVE: The objective of this study was to investigate the responses of Australian urban GPs to experiences of violence and to perceptions of risk of violence. METHODS DESIGN: A qualitative study of data collected from two sources-focus group discussions and qualitative questionnaire responses. Focus group discussions were audiotaped and transcribed. Questionnaires offered the opportunity for respondents to make qualitative comments. The focus group transcripts and qualitative questionnaire responses were coded independently by members of the research team and subjected to thematic analysis. SETTING: Three urban Divisions of General Practice in New South Wales, Australia. SUBJECTS: Focus groups were conducted with male and female GPs comprising a range of ages, socio-economic practice catchments and practice structures. Questionnaires were distributed to all GPs in the three divisions. RESULTS: The GPs in this study perceived themselves as being at significant risk of occupational violence. Despite responses to violence being largely ad hoc and uncoordinated, a coherent schema of GPs' responses to the threat of violence is apparent in the data. This has been characterized as encompassing primary, secondary and tertiary responses, and reflects a continuum of proactive to reactive responses. CONCLUSION: The findings will have implications for further research and for policy in the area.

After-Hours Care↗
PubMedDate not supplied

Home uterine activity monitoring in the prevention of very low birth weight.

OBJECTIVES: Despite controversy regarding the efficacy of home uterine activity monitoring (HUAM), it is currently licensed for detection of preterm labor in women with previous preterm deliveries. In practice, however, it is being more widely utilized in an effort to prevent preterm delivery. This study seeks to determine which group of mothers delivering very low birth weight (VLBW) infants would have qualified for HUAM given three different sets of criteria and in which women it could have been used to help prolong gestation. METHODS: The authors reviewed the medical records of mothers of VLBW infants born in five U.S. locations (N = 1440), retrospectively applying three sets of eligibility criteria for HUAM use: (a) the current FDA licensing criterion for use of HUAM, a previous preterm birth; (b) indication for HUAM commonly cited in published reports; (c) a broad set of criteria based on the presence of any reproductive or medical conditions that might predispose to premature delivery. The authors then analyzed the conditions precipitating delivery for each group to determine whether delivery might have been prevented with HUAM and tocolytic therapy. RESULTS: Only 4.4% of the total group of women delivering VLBW infants would have been eligible for HUAM under the FDA criterion and might potentially have benefited from this technology. If extremely broad criteria had been applied to identify those eligible for monitoring, under which almost 80% of all women who delivered VLBW infants would have been monitored, only 20.3% of the total group would have been found eligible and would potentially have benefited. If such broad criteria were applied to all pregnant women, a sizable proportion of pregnancies would be monitored at great expense with small potential clinical benefit. CONCLUSIONS: Because VLBW births are usually precipitated by conditions that are unlikely to benefit from HUAM, this technology will have little impact on reducing VLBW and neonatal mortality rates. More comprehensive preventive strategies should be sought.

Female↗
PubMed1990

Practical application of intraoperative ultrasound imaging.

Intraoperative real-time ultrasound imaging (US) was used in over 500 patients to investigate which of the previously considered applications are of practical use in everyday neurosurgery. During all intraoperative applications for a wide variety of pathological conditions, small deep-seated as well as subcortically located lesions were detected with accuracy; in many instances they could be approached through smaller surgical exposures. US guidance was accurate in 209 cases for the stereotactic introduction of needles or endoscopes into various lesions: thus burrhole evacuation was performed on 148 intracerebral haematomas; in 16 patients endoscopic biopsy and resection of ventricular tumours was performed as well as biopsies of 39 hemispheric brain tumours and aspiration of a brain abscess in 6 instances. Seventy six gliomas were investigated by US imaging; the frequently unclear boundary between tumour and surrounding oedema was not better visualized than with CT or MRI. Moreover, US imaging for the detection of residual tumour towards the end of operation was unreliable. Postoperative imaging through burrholes or other cranial defects was mostly of unacceptably low quality for therapeutic decision making.

Biopsy↗
PubMed1993

Truth and reality in psychoanalytic discourse.

In this paper, I examine the influences of two philosophical theories of truth--coherence and correspondence--on the current debate on the search for 'common ground' and on specific aspects of clinical practice. Results from a previous empirical study of analysts' approaches to transference interpretation are described in order to illustrate the way in which a network of clinical concepts is held together by explicit and implicit beliefs concerning the nature of subjectivity, truth and reality. Excerpts from interviews of psychoanalysts of varying orientations practising in different geographical locations indicate the complex interrelationships between concepts of analytic neutrality, extra-transference, the real relationship, countertransference, the death instinct and the therapeutic alliance. These findings suggest that the coherence versus correspondence theories of truth may constrain rather than enhance the investigation of the differences and commonality between varying analytic theories, schools and clinical practices.

Attitude to Death↗
PubMedDate not supplied

Dissemination and use of research findings in nursing practice.

This study built on two previous studies (Brett, 1987; Coyle & Sokop, 1990) that found no significant relationships between use of nursing research and nursing education level. These two studies had fewer than 5 per cent of their subjects with master's degrees in nursing. The new population studied had 49 per cent master's prepared nurses, which provided the necessary foundation to expand the examination of the relationship of higher education and use of research findings among nurses. Whereas the overall extent of dissemination and use of research findings among nurses in the sample was similar to that of the two previous studies, it was found that nurses with a master's degree reported higher utilization than those with a bachelor's degree. This finding suggests a unique and critical role for the master's-prepared nurse in the dissemination and use of research findings in the practice setting.

Clinical Nursing Research↗
PubMedDate not supplied

Tracking medical students' clinical experiences with a computerized medical records system.

A fully computerized system for recording and reporting of medical students' patient contacts has been developed and successfully used in a high-volume outpatient practice. In contrast to previously described systems, the need for manual recording and/or entry of patient data has been eliminated by the use of an existing, integrated computerized medical records system. This makes possible the generation of frequent reports and timely review and adjustment of student experiences. The system has broad applicability and may also be useful for research in medical education.

Clinical Clerkship↗
PubMed1984

Long-term follow-up study of hypertensive patients by practicing internists after a controlled drug trial.

Thirty patients with uncomplicated essential hypertension were treated for an average of 44 months by 14 internists in private practice. All patients had previously participated in a controlled comparative trial of antihypertensive drugs carried out by the same physicians in their offices. During the long-term follow-up period, ie, after completion of the initial trial, the physicians administered antihypertensive therapy based on their best judgment; the drugs they most commonly prescribed were diuretics (80% of patients) and beta-blocking agents (60% of patients). Although 80% of the patients received at least two different antihypertensive agents, diastolic pressures fell below 96 mmHg in approximately 60% of the patients and below 90 mmHg in only a small fraction. Thus it appears that it is not easy for physicians in private practice to optimally reduce blood pressure levels in hypertensive patients despite the availability of numerous antihypertensive drugs. The tendency of practitioners to approximate blood pressure levels to multiples of 5 or even 10 mmHg may be partially responsible for the unsatisfactory results.

Antihypertensive Agents↗
PubMed1975

Telephone messages received by seven general practices.

Telephone calls were recorded in seven general practices in Aylesbury in a study of communications received from the hospitals, local health authority (L.H.A.), social services department, and other sources, but excluding calls from patients.Analysis of 855 telephone calls revealed patterns of communication with the staff of the practices which have not previously been recorded. The general practitioners were central in communications from all sources except the local health authority, while calls to health visitors came overwhelmingly from the local health authority. Community nurses received only 36 (four per cent) of all the calls despite the interests expressed by hospital nursing staff in their responses to a postal questionnaire. A hypothesis is advanced to explain this discrepancy between interest and action.

Communication↗
PubMed2001

Mental health variables and positive health practices in early adolescents.

A sample of 127 adolescents aged 12 to 14 years and attending a middle school responded to the Personal Lifestyle Questionnaire, the Depression-Dejection subscale of the Profile of Mood States, the Spielberger Trait-Anger Scale, and the Revised UCLA Loneliness Scale in classrooms. Using canonical variate analysis, three canonical variates emerged in the statistical analysis of the set of mental health variables and the set of positive health practice variables, two of which had statistically significant canonical correlations. The findings are consistent with theory and previous research linking positive health practices to depression, anger, and loneliness.

Adolescent↗
PubMed2001

Canadian guidelines for cardiac rehabilitation and atherosclerotic heart disease prevention: a summary.

Atherosclerotic heart disease (AHD) is the leading cause of death in Canadian women and men. Cardiac rehabilitation has been repeatedly shown to reduce cardiac morbidity and mortality significantly among patients with documented AHD. The Canadian Association of Cardiac Rehabilitation (CACR) has defined cardiac rehabilitation as "the enhancement and maintenance of cardiovascular health through individualized programs designed to optimize physical, psychological, social, vocational and emotional status. This process includes the facilitation and delivery of secondary prevention through heart hazard (risk factor) identification and modification in an effort to prevent disease progression and the recurrence of cardiac events". This summary presents a limited amount of background information and the majority of clinical practice recommendations contained within the previously published CACR Guidelines. These evidence-based clinical recommendations are intended as guidelines to good clinical practice rather than as standards of care. The key focus of this summary is the need for complete and targeted intervention of all heart hazards in patients at high or very high risk for, or with documented, AHD. To achieve this goal, the CACR Guidelines and this summary present risk stratification strategies designed to determine unambiguously a patient's risk of exercise-related cardiac events (short term absolute risk or disease prognosis) and their risk of recurrent AHD events (long term absolute risk from disease progression). The establishment of the short term and long term absolute AHD risks can then be used to determine heart hazard targets and the type of exercise program prescribed for patients with AHD. Despite the use of evidence-based medical practices, none of the recommendations presented in this document can replace the expert judgment of properly trained and experienced cardiac rehabilitation professionals. Health care providers must always be free to choose where and when clinical practice guidelines are applied, modified or superceded, depending on individual patient circumstances.

Canada↗
PubMed1995

Attendance patterns in general practice.

OBJECTIVE: To determine the completeness of data acquired previously on the attendance patterns of patients visiting three general practices and the exclusivity of attendance at these practices. DESIGN: A retrospective comparison of attendance data with data extracted from the Health Insurance Commission database. Three study practices were investigated to give a rough cross-section of general practice in Western Australia. RESULTS: Eighty-nine per cent of patients and 92% of services recorded in our earlier study were also recorded by the HIC, with 31% of patients also attending another general practice during the six months, mostly only once or twice. However, there was considerable variation between practices in data match and attendance at other practices. CONCLUSIONS: We found a high level of completeness of data. Sixty-nine per cent of patients attended no other practice during the six months, indicating that doctors in the study practices have some opportunity to provide continuity of care to their patients. The implications for patients' needs and doctors' resources of variations in attendance patterns need to be examined further.

Adolescent↗
PubMed1982

Single dose doxycycline, cefuroxime and pivmecillinam for treatment of bacterial cystitis.

There is now considerable evidence showing the benefits of single dose antibacterial treatment for uncomplicated urinary tract infections. If single dose therapy is to become widely used it is necessary to clarify the minimum effective dose of the most efficient drugs. This paper reports three trials in women presenting in general practice with bacterial cystitis. In each trial the patients were randomly allocated to either a five day course of oral co-trimoxazole (CTM) or to doxycycline 300 mg orally, cefuroxime 1.5 g intramuscularly or pivmecillinam 600 mg orally. Thirty-eight of 45 patients treated with doxycycline were cured, compared with 44 or 45 treated with CTM. Fourteen of 20 women given cefuroxime were cured, compared with 19 of 20 prescribed CTM. Twenty-three of 30 women treated with pivmecillinam were cured, compared with all 30 given CTM. None of these three drugs, when administered as a single dose, was as effective as a single 1.92 g or 2.88 g dose of CTM used in our previous studies in domiciliary practice. These studies confirmed, however, that single dose therapy was well tolerated, preferred by the patients and side effects were minimal.

Administration, Oral↗
PubMed1997

Leonardo Fioravanti (1517-1588): a barber-surgeon who influenced the development of reconstructive surgery.

Surgery in the Middle Ages was practiced by individuals belonging to the guild of barbers, with no basic medical education. The transformation into a scientific branch of medicine began in the sixteenth century. In this process, a great role was the one played by Leonardo Fioravanti. He was a Doctor in Medicine graduated from the University of Bologna. A controversial man, he was also an innovation in many fields of medicine, such as prevention of diseases, pharmacology, therapy, etc., and he was a surgeon himself. On the way back from one of the last Crusades, he visited the Vianeos brothers in Calabria, and he was able to learn from them the technique for reconstructing the nose that had been devised by Antonio Branca in the previous century and still practiced only by barber-surgeons. He published his experience in a book that probably inspired the contemporary, Gaspare Tagliacozzi, Professor at the University of Bologna, and allowed him to become acquainted with this kind of reconstructive surgery. Tagliacozzi understood the value of the method described by Fioravanti and transformed a barber-surgery technique into a remarkable chapter of scientific surgery by divulging in the academic circles the principles of the pedicled flap, which have been the basis for development of modern plastic surgery.

Barber Surgeons↗
PubMed2002

Victimizing behaviour among juvenile and young offenders: how different are perpetrators?

This study examined the victimizing behaviours of incarcerated juvenile and young offenders. A total of 108 juveniles and young offenders completed questionnaires relating to victimizing behaviours and were administered the Custodial Adjustment Questionnaire (CAQ: Thornton, 1987 In Applying Psychology to Imprisonment: Theory and Practice, McGurk B.J., Thornton, D. and Williams, M. (Eds). London: HMSO, pp. 445-465) and Hostility and Direction of Hostility Questionnaire (HDHQ: Caine et al., 1967. Manual of the Hostility and Direction of Hostility Questionnaire. London: University of London press). It was found that 50.9% of all respondents reported victimizing others, with verbal assaults and threats being the most common form of such behaviours. Furthermore, staff-identified "victimizers" were significantly more likely to report victimizing behaviour than the rest of the sample. Those who had been in custody longer were more likely to report victimizing others, as were younger offenders (15-17-year olds as compared to 18-21-year olds). Victimizers were also more likely to report having previously experienced victimization themselves. On the psychometric measures, self-reported victimizers scored significantly higher on the deviance sub-scale of the CAQ, and on a number of the sub-scales of the HDHQ. These findings are discussed in terms of previous literature and their practical implications considered.

Adolescent↗
PubMed2006

Blueprints for the assessment, treatment, and future study of catatonia in autism spectrum disorders.

The blueprints for the assessment, treatment, and future study of catatonia in autism spectrum disorders (ASDs), which are submitted in this chapter aim to increase early recognition and treatment of catatonia in ASDs, show the urgency of controlled treatment trials, and increase collaborative and interdisciplinary research into the co-occurrence of these two enigmatic disorders. Catatonia should be assessed in any patient with ASDs when there is an obvious and marked deterioration in movement, pattern of activities, self-care, and practical skills, compared with previous levels, through a comprehensive diagnostic evaluation of medical and psychiatric symptoms. A formal diagnosis should be ascertained using ASD specific criteria for catatonia that takes into account baseline symptoms like muteness, echophenomena, stereotypy, negativism, or other psychomotor abnormalities. Any underlying medical and neurological conditions should be treated, and culprit medications or other substances that may cause catatonia should be eliminated. Separate treatment blueprints are presented for mild, moderate, and severe catatonia, featuring combinations of a psychological approach developed by Shah and Wing and medical treatments that have shown efficacy in catatonia: lorazepam challenge, lorazepam trial, lorazepam continuation, and bilateral electroconvulsive therapy (ECT). These treatment modalities in themselves are well established. Side effects and complications are known and manageable. Legal, ethical, and practice guidelines governing all treatment aspects should be followed. The treatment blueprints should be viewed as best estimates pending future controlled studies. The blueprint for the future study of catatonia in ASDs describes promising clinical and preclinical research avenues. Longitudinal studies need to assess the possible effect of early recognition and adequate treatment of catatonia in ASDs in order to avoid the impairment associated with chronicity. Effects of current and new anticatatonic treatments should be examined in experimental models of autism and catatonia. Finally, the role of gamma-aminobutyric acid (GABA) dysfunction in autism, catatonia, and abnormal stress responses in these disorders should be further assessed.

Adult↗
PubMed1997

Clinical guidelines and the management of hypertension: a between-practice and guideline comparison.

It has previously been demonstrated that individual general practitioners (GPs) diagnose and treat at different levels of blood pressure and according to different risk factor profiles. This study sought to examine the variation in the achievement of control of hypertension in a sample of 20 treated hypertensive patients in 18 UK general practices. There was a marked between-practice variation in the percentage of patients with controlled hypertension. Practices appear to apply different hypertension guidelines to patients consistently, with significant correlations across practices in seven out of ten possible guideline combinations. There remains marked variation in the management of hypertension between different general practices in the UK. Factors other than recommendations in guidelines appear to be responsible for this variation.

England↗