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PubMed1995

[Theory and practice of alternative practice].

So-called alternative medical practices, now favored in Brazil, are discussed in terms of their methods and rationale. Cursory inquiries show that personal choices of diagnostic and therapeutic systems is made, usually, on the basis of family tradition, cultural inheritance, and fashion, and not upon a critical examination of the principles upon which the alternatives are based. In general, a syncretic approach combining conflicting elements from different systems is adopted. In contrast, the author shows that the actual differences between the systems lie in their foundations principles, not in their practices.

Brazil↗
PubMed1999

Feline transfusion practice in South Africa: current status and practical solutions.

Blood transfusion therapy is often under-utilised in feline practice in South Africa. However, it is a technique that can be safely and effectively introduced in practice. Cats have naturally occurring allo-antibodies against the blood type that they lack, which makes blood typing, or alternatively cross-matching, essential before transfusions. Feline blood donors must be carefully selected, be disease free and should be sedated before blood collection. The preferred anticoagulant for feline blood collection is citrate-phosphate-dextrose-adenine. Blood can either be administered intravenously or into the medullary cavity, with the transfusion rate depending on the cat's hydration status and cardiac function. Transfusion reactions can be immediate or delayed and they are classified as immunological or non-immunological. Indications, methods and techniques to do feline blood transfusions in a safe and economical way are highlighted.

Anemia↗
PubMed2003

Medical rosters and the Trade Practices Act.

Medical rosters are not free of trade practices problems, notwithstanding assurances by the Australian Competition and Consumer Commission (ACCC). Neither the ACCC nor the recently convened Wilkinson Committee has applied rigorous legal principles in interpreting the Trade Practices Act 1974 (Cwlth) to reach its conclusions. The Australian law should be changed to bring it into line with that of the United States and New Zealand.

Australia↗
PubMed1999

'Practice professional development plans': general practitioners' perspectives on proposed changes in general practice education.

BACKGROUND: The Chief Medical Officer has presented a report proposing a change in general practitioners' education towards a 'Practice Professional Development Plan', which, in principle, is based around formal needs assessment, practice-based learning in areas identified by those involved, and with the potential for multi-professional learning. This aims to replace the present system of a financial allowance earned by attending a certain amount of educational activity. AIM: To study the opinions of a group of general practitioners attending a course that included workshops that introduced and considered this educational initiative. METHOD: Semi-structured interviews four weeks after the course. RESULTS: Educational benefits were clearly seen, while issues such as funding and time will present difficulties in implementation. CONCLUSIONS: This proposal was seen as an improvement to the existing postgraduate educational allowance system. To maintain enthusiasm, successful introduction will depend on the issues of support and resources.

Adult↗
PubMed2001

[Patient security through algorithm standardization in a urology practice--account of practical experience and medical certification].

Visiting a physician means taking a risk, of which our patients (clients) know too little. Those who run the practice know about critical points and have the duty to protect their clients. One way of doing so is to standardize working routines. An even better way is to have the practice certified and audited (controlled) annually by an objective institution (e.g., the German TUV).

Algorithms↗
PubMed2001

[Role of bodily practices with newborn in the development of cultural identity. Examples of bodily practices in Africa and India].

Bodily practices on newborns are the indicators of communication between the child and his/her surroundings. The culture has to introduce individuals into a specific group by using particular practices that have applied to the past generations. The techniques are different according to the ethnic group and allow the child to reach a social birth. To emphasize the relation between the identity and the culture, four cultural examples are presented. In Bambara country, the grandmothers massage and stretch the newborn in order to let him feel the limits of his body and get into the Bambara identity. For the Wolof, the psychomotor development will be made with specific movements on the body of the child according to initiation rituals. In Kabylie, the child will be protected from the outside world before he gets his proper name. In Tamil country, the way the foetus and the child are helped emphasize his coming into the living world and his reincarnated identity. The psychic structuring and the culture are tightly connected and the body is the first mediator of that representation.

Adult↗
PubMedDate not supplied

[Good clinical practice in clinical trials: training clinicians,incentives to apply good clinical practice and assessment of compliance].

Fourteen years after the concept was created, it seemed important to assess how well investigators actually apply Good Clinical Practice. Various sources of information have revealed a general deficiency in their application: "investigation by the working group, Afssaps (French Agency for the Safety of Health-Care Products) inspections, industrial data". The deficiencies identified stem from different factors: lack of professionalization, lack of training, lack of motivation, the large numbers of poorly conducted studies. The working group drew up proposals intended to improve the training of investigators, to dissuade investigators from pursuing inadequate procedure and to verify the level of compliance. However in this respect, the investigator is not the only one at fault. Improved practice unavoidably requires better assistance on the part of the sponsors, more consistent supervision of monitoring, and greater vigilence by the authorities involved in the control and use of trials.

Clinical Trials as Topic↗
PubMedDate not supplied

A practical approach to promote reflective practice within nursing.

Although reflective practice has been identified as a valuable tool to help nurses recognise their own strengths and weaknesses, many still find it a difficult concept to embrace. This article dispels some of the myths surrounding reflective practice and offers examples of how it can benefit nurses both on a personal and a professional level.

Data Collection↗
PubMed2005

[Practical management of medical conflict in hospital practice].

Practical management of a conflict in hospital practice is based on specific rules of administrative law which govern our hospital activity in terms of medical responsibility. But beyond this, it calls upon notions of common sense, medical and above all civil and diplomatic behaviour, so as not to create a critical situation in this already very unpleasant context. The author also describes some approach techniques to allow the physician facing this situation to extricate himself as well as possible. In addition, all requests for explanations, however "aggressive", do not necessarily end in the law courts, and that only 15 to 20% of cases prosecuted are eventually found guilty.

Conflict, Psychological↗
PubMedDate not supplied

[Drug flow. Good manufacturing practices, good clinical practices].

On a worldwide basis, the drug development circuit in clinical trials undergoes a general movement towards improvement which is sensitive to the degree of quality. The methods used to achieve this are found at the interface of Good Manufacturing Practices (GMP) and Good Clinical Practices (GCP). They consist primarily of two types, for which examples are given here: strengthening of controls (verification of the resemblance of test drugs in double-blind comparison by a "jury" and computerized systems of drug accountability), improvement in "compliance with therapy at the site of investigation" (use of more "intelligent" drug packages and labels).

Clinical Trials as Topic↗
PubMed1990

Transfusion and coagulation: an overview and recent advances in practice modalities. Part I: Blood banking and transfusion practices.

Increased sophistication in blood banking and transfusion practice has opened new directions in management of red cell mass and coagulation. The current trend in practice is to avoid absolute hemoglobin or hematocrit values, and to employ physiologic parameters to determine the need for transfusion. For red cell mass, those parameters include use of oximetry, particularly venous oximetry, calculation of oxygen-carrying capacity using cardiac outputs and arterial oxygen saturation, and the ability of each patient to increase cardiac output and/or maintain suitable arterial pressure with hemodilution. More exacting assessment of the coagulation profile, along with evidence that supports the critical circulating platelet and fibrinogen levels, permits judicious use of blood components.

Blood Banks↗
PubMed1989

National health insurance in America--can we practice with it? Can we continue to practice without it?

Health insurance in the United States is failing patients and physicians alike. In this country 37 million uninsured face economic barriers to care, and the health of many suffers as a result. The "corporatization" of medical care threatens professional values with an unprecedented administrative and commercial intrusion into the daily practice of medicine. Competitive strategies have also failed their most ostensible goal--cost control. In contrast, Canada offers a model of a national health insurance plan that provides universal and comprehensive coverage, succeeds at restraining health care inflation, and does little to abrogate the clinical autonomy of physicians in private practice. I propose that American physicians relent in their historical opposition to national health insurance and participate in the development of a universal, public insurance plan responsive to the needs of both patients and physicians.

Canada↗
PubMed1988

[Phase contrast microscopy demonstration of glomerular erythrocytes in urine: practicable in ambulatory practice?].

The use of phase-contrast microscopy in microhematuria, as proposed in 1979 by Birch and Fairley, renders morphological changes in red cells easily detectable and makes it possible to distinguish glomerular from non-glomerular bleeding. The aim of this study was to evaluate the practicability of this method as a routine laboratory test in ambulatory care. 60 patients with asymptomatic microhematuria (greater than or equal to 2 erythrocytes per high power field) were followed up over a one-year period. All patients were investigated by intravenous pyelography, ultrasound of urinary tract and three cytological examinations of the urine. The description of urine samples was done with phase-contrast microscopy by a first investigator at the beginning of the study and by a second after 12.8 months, blinded to clinical results and previous examinations. In 21 patients a definitive diagnosis was possible. In 18 patients the morphologic descriptions of the two investigators correlated with the clinical results. Only in two patients with established diagnosis there were differences between the urine description of the two investigators, and in one patient the interpretations of both investigators were wrong. These incorrect descriptions concerned patients with low-grade microhematuria. Thus, phase-contrast microscopy is a practicable method for the practitioner's use as a routine laboratory investigation. In low-grade microhematuria the method seems to be of minor value.

Ambulatory Care↗
PubMed1985

Tuberculosis control practices in major metropolitan health departments in the United States. 3. Standard of practice in 1984.

Twenty-eight metropolitan health departments in the United States reporting more than 200 cases annually were surveyed to determine the standard of practice in the control of pulmonary tuberculosis. The results were compared to previous surveys done in 1978 and 1980 to determine the impact of policy changes recommended by the American Thoracic Society, American College of Chest Physicians, and Centers for Disease Control and recent reports of innovative chemotherapeutic methods. A high degree of uniformity in chemoprophylaxis practices again was demonstrated. In contrast to our previous survey of 1980, most programs now use rifampin-containing regimens with short (less than 12 month) course chemotherapy as the primary initial treatment regimen for tuberculosis. Mean duration of treatment for tuberculosis decreased from 20.2 +/- 2.1 months in 1980 to 11.7 +/- 1.0 months in 1984. Intermittent chemotherapeutic regimens also were used more frequently in 1984. However, substantial variance from other recommended guidelines still is prevalent among the major metropolitan programs in the United States.

Adolescent↗
PubMed1984

[The role of the practicing veterinarian with regard to the central theme: drugs in veterinary practice].

Alterations in agriculture have resulted in a large number of changes confronting the veterinary practitioner engaged in large animal practice. These alterations are continuing at an increased rate. Preventive medicine and herd health programmes are making steady progress and providing a powerful stimulus to veterinary practice. Compulsory post-graduate education and some degree of specialization would appear to be inescapable for practitioners. A number of laws are in slow process of formation. Standards to be imposed on drugs as well as on those dispensing and those using them are being discussed. Channelling and registration of drugs will have consequences. It is to be hoped that modern practitioners will be able to cope with these.

Animals↗
PubMed1994

[Recommendations for preventing transmission of infection with biohazard in the practice of legal medicine (2). Equipment and practical applications. The Medico-Legal Society of Japan, Committee on Expert Opinions].

In May, 1993, our committee of the Medico-Legal society of Japan published an article entitled "Recommendations for Preventing Transmission of Infection with Biohazard in the Practice of Legal Medicine" in The Japanese Journal of Legal Medicine. Concerning this article, we received a lot of useful comments and opinions from many members of the society, for which we are very grateful. We also received a lot of requests for further information concerning details on the equipment and its practical applications. Since a lot of departments of Legal Medicine at several universities throughout Japan at present are remodelling their facilities in order to be able to perform autopsies, with respect to such circumstances, our committee felt the need to provide information on basic conditions concerning the prevention of transmission of infections with hazards.

Containment of Biohazards↗
PubMed1996

Developing a Canadian prescribing practices network. Network Development Committee of the Canadian Prescribing Practices Network Project.

Expenditure on drug therapy in Canada has been growing at a faster rate than spending on any other aspect of health care. Increasing societal pressure to use scarce resources more efficiently, advances in communication technology and data indicating that there is room for improvement in drug prescribing suggest that the time has come for an organized linkage of the available drug-utilization and health-outcomes data-bases across the country. A national prescribing practices network would assist prescribers, researchers and policymakers to optimize prescribing with respect to both cost effectiveness and health outcomes. The authors outline the main concerns addressed in the 1994 report to the National Pharmaceutical Strategy and present the results of discussions by the Canadian Prescribing Practices Network Project with respect to the potential users and data sources of a national network and the communications technology on which it would rely.

Canada↗