Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Institutional 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 109 records · Page 6Linked to original sources
PubMed1996

Antibiotic Prophylaxis for Endocarditis Prevention During Transesophageal Echocardiography: Controversy, Consideration, and What Really Happens.

A survey was conducted in order to gain a better understanding of actual practice policies followed by academically affiliated institutions regarding the use of prophylactic antibiotics during transesophageal echocardiography. Results revealed that 10 of the 20 centers routinely used intravenous antibiotic prophylaxis for high risk transesophageal echocardiography. However, 5 of the 20 centers did not use any prophylactic antibiotics routinely, and the remaining 5 centers used primarily oral prophylactic regimens. In addition, the type of patient that was considered high risk for which antibiotic prophylaxis was used differed among institutions. Practice guidelines in 4 of the 20 institutions have changed in the last 5 years. These findings demonstrate a wide variation in the actual practice policies of different institutions, probably reflecting, in part, the lack of convincing evidence that prophylactic antibiotics benefit this subgroup of patients. (ECHOCARDIOGRAPHY, Volume 13, September 1996)

Journal Article↗
PubMed2002

National practices regarding payment to research subjects for participating in pediatric research.

OBJECTIVE: Payment to subjects for participation in research is reportedly common, but no published data documents the nature of this practice. Institutional review boards (IRBs) are responsible for ensuring both the safety and voluntary participation of research subjects, yet guidance from federal and expert pediatric sources regarding appropriate payment approaches is conflicting. Ethical issues of payment for participation of adult versus pediatric research subjects may differ. This empirical study sought to examine current payment practices for participation in pediatric research as reported by IRBs. DESIGN: An 18-question survey regarding payment practices for participation in pediatric research was sent to IRB chairs at member institutions of the National Association of Children's Hospitals and Related Institutions, and to a systematic random sample of IRB chairs listed with the Office for Protection From Research Risks. Descriptive, nonparametric, and qualitative analyses were used to describe institution types, payment practices, and correlations among responses. RESULTS: Data from 128 institutions that conduct pediatric research revealed that payment for participation in pediatric research was allowed by 66% of responding institutions, and practices varied widely among institutions. Most responding IRBs that allowed payment required disclosure of payment before enrollment (during the consent process), following federal guidelines more closely than American Academy of Pediatrics guidelines. An IRB's perception of potential benefits or harms of a study correlated with the amount of payment approved. CONCLUSIONS: IRBs must balance the need to recruit pediatric research subjects against the risk of undue influence during the recruitment process. Federal guidelines and expert pediatric opinion differ in recommendations regarding payment; responding IRBs appeared to follow federal guidelines more closely than guidelines proposed by the American Academy of Pediatrics.

Child↗
PubMed1998

Responsive medical professionalism: integrating education, practice, and community in a market-driven era.

Revolutionary changes in the nature and form of medical practice institutions are likely to reverberate backward into medical education as leaders of the new practice organizations demand that the educational mission be responsive to their needs, and as these demands are increasingly backed by market power. In the face of this pressure, medical education's traditional response--that it should have autonomy in defining its mission--is no longer viable. Instead, more explicit, formal, and systemic linkages between practice and educational institutions are inevitable. The crucial question is whether these linkages will reflect the values of the market, oriented by economic self-interest, or the values of medical professionalism, oriented by the obligation to sacrifice economic self-interest in the service of patients. The authors maintain that the realization of the normative ideal of professionalism in medical education within the emerging market environment requires that a vision be articulated that is distinct from that of either autonomy or the market, and that combined lay-professional institutions be established to integrate--and perhaps merge--education and practice, and to foster responsiveness to lay values and community needs. The authors conclude by briefly describing examples of current efforts in this direction.

Academic Medical Centers↗
PubMedDate not supplied

Perioperative factors associated with puppy vigor after delivery by cesarean section.

This prospective study examined the perioperative factors associated with puppy vigor in a clinical population of 807 litters containing 3,410 cesarean-derived puppies. Information was obtained from 109 private and institutional practices in the United States and Canada. Puppy vigor was determined by assessing three spontaneous conditions within 2 minutes after delivery: breathing, moving, and vocalizing. The percentages of live-born puppies with these characteristics were 85%, 73%, and 60%, respectively. After screening tests, logistic-regression models were run on all remaining factors using the litter as the unit of analysis, and odds ratios [OR] were determined. An OR <1.0 means that the odds are decreased for that puppy vigor condition when the factor is present, compared with a litter in which the factor is not present. Conversely, when the OR is >1.0, the odds are increased for that puppy vigor condition when that factor is present. The following factors were associated with the litter having all puppies breathing at birth: using an inhalant anesthetic (0.36 OR) or ketamine (0.43 OR), surgery at one particular private practice (3.52 OR), and surgery at a teaching institute rather than a private practice (0.36 OR). The following factors were associated with the litter having any spontaneously moving puppies at birth: all puppies breathing spontaneously (2.72 OR), any puppy vocalizing spontaneously (117 OR), using inhalant anesthesia (0.26 OR), and using thiopental or thiamylal (0.37 OR). The following factors were associated with the litter having any spontaneously vocalizing puppies at birth: all puppies breathing spontaneously (2.58 OR), any puppy moving spontaneously (152 OR), brachycephalic dam (0.62 OR), the dam was a Labrador retriever (7.23 OR), and using isoflurane (2.51 OR). In conclusion, the anesthetic factors associated with increased puppy vigor included the use of isoflurane and the avoidance of ketamine, thiamylal, and thiopental.

Anesthesia, Obstetrical↗
PubMed1987

Mandating unit dose drug distribution and i.v. admixture services in New Jersey hospitals.

Efforts by New Jersey hospital pharmacists that led to a state mandate for unit dose drug distribution and i.v. admixture services are described. The New Jersey Society of Hospital Pharmacists' proposal for revision of state board of pharmacy regulations for institutional practice had been rejected in 1977. In 1979, NJSHP began to work through the state health department to upgrade standards for institutional pharmacy practice. In 1981, NJSHP submitted to the health department a position paper to justify revised standards on the basis of patient safety and cost-effectiveness, and in 1982 NJSHP conducted a seminar for pharmacists, nurses, and hospital administrators on the cost-effectiveness of unit dose distribution and i.v. admixture programs. The standards were revised and were adopted in June 1984, and hospitals had two years to implement the mandated programs.

Drug Compounding↗
PubMedDate not supplied

Anesthesia hazards to animal workers.

Anesthetic agents are used extensively in veterinary medicine to facilitate safe restraint of animals and to provide humane conditions for diagnostic procedures and surgery. Animal workers in traditional veterinary practice, as well as those in research institutions, may become chronically exposed to trace levels of waste inhalant anesthetic agents during the daily performance of their duties. Individuals in private or institutional practice, municipal animal control officers, wildlife biologists, and zoological park employees are at risk for accidental exposure to potentially lethal quantities of injectable anesthetic agents during chemical restraint of domestic animals and capture of free-ranging animals. The purpose of this chapter is to review the health risks of anesthetic agents to animal workers and to provide specific recommendations for reducing worker exposure to these agents.

Accidents, Occupational↗
PubMed1997

Knowledge and power: a critique of an international relief operation.

Exploring an alternative way to approach famine relief interventions, this paper draws on the work of French philosopher Michel Foucault and David Keen's recent work on south-west Sudan. It suggests that different discourses on 'famine' can lead to the dominance of certain kinds of institutional practices, and the prioritisation of special kinds of knowledge, at the expense of other modes of understanding and action. Using the case of the relief operation to Tigrayan refugees in eastern Sudan in 1984/5, the paper examines the specific ways in which 'power' was elaborated in the midst of the operation, and the manner in which institutional practices-designed to save as many lives as possible-influenced the reaction of international agencies to the spontaneous repatriation of the Tigrayans back to Ethiopia.

Ethiopia↗