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At least 1,243 records · Page 69Linked to original sources
PubMed2004

Biotechnology and the popular press: hype and the selling of science.

The popular media has emerged as an important source of scientific information. It has been suggested that the portrayal of genetics by the media is often inaccurate--a phenomenon branded 'genohype'--and, as a result, is having an adverse impact on public understanding and policy development. However, emerging data suggest that, in some circumstances, the media reporting of science is surprisingly accurate and portrays a message created by the scientific community. As such, there are reasons to believe that the hyping of research results might be part of a more systemic problem associated with the increasingly commercial nature of the research environment.

Biotechnology↗
PubMed2006

Professional organisation profile: Travel Health Advisory Group, Australia.

The Australian Travel Health Advisory Group was established in 1997 and its membership has been active in several areas, including networking, policy development, research and education in Australia. Information is given on purpose, membership and the various activities of the group.

Advisory Committees↗
PubMed2006

Drug-resistant tuberculosis in Cuba. Results of the three global projects.

SETTING: The spread of multidrug-resistant tuberculosis (MDR TB) in the world remains a major public health problem. Surveillance of anti-TB drug resistance is therefore an essential tool for monitoring the effectiveness of TB control program and, through policy development, for improving national and global TB control. OBJECTIVE: To determine the prevalence of anti-TB drug resistance in Cuba during the execution of the three global projects. DESIGN: Drug-resistance was determined using the proportion method in 1528 Mycobacterium tuberculosis strains to first line anti-TB drugs. RESULTS: Resistance in new cases was 8.3%, 4.6% and 5.0%; MDR was 0.7%, 0% and 0.3% in the first (1997), second (2000) and third (2004) global projects, respectively. In new cases, none showed resistance to the four drugs. There were among previously treated cases statistically significant decreases in the prevalence of resistance to at least one drug when comparing the results obtained in the three global projects. CONCLUSIONS: The contributed data through Cuba demonstrated that our country is relatively free of MDR strains, reflecting the good National Control Program and the possibility of TB elimination in Cuba.

Antitubercular Agents↗
PubMed2005

AORN guidance statement: safe on-call practices in perioperative practice settings. Association of periOperative Registered Nurses.

Call staffing and the associated long work hours can be challenging for both perioperative staff members and the health care organization. A change in culture is needed to recognize exhaustion as an unacceptable risk to patients and perioperative personnel safety. Perioperative health care providers have a personal responsibility to arrive at work fully rested. Health care organizations have a responsibility to create work and call schedules that consider the effect of long work hours on patient safety as well as perioperative staff members' welfare. The development of standardized safe work hours and call practices should reflect current recommendations emerging from authoritative sources, legislation, and empirical data. Prolonged work periods without adequate rest may contribute to diminished performance by perioperative personnel, placing both patients and workers at risk. This guidance statement may assist managers and clinicians in developing policies and procedures for safe call practices.

Emergencies↗
PubMed1996

Hyperthermic intraoperative intraperitoneal chemotherapy safety considerations.

Perioperative staff members encounter many occupational exposure hazards in the workplace. Cytotoxic agent exposure is a relatively new hazard that perioperative staff members are experiencing as more surgeons use hyperthermic intraoperative intraperitoneal chemotherapy (HIIC) to treat patients with abdominopelvic cavity malignancies. Routes of exposure include inhalation, ingestion, injection, and skin contact. The National Cancer Institute, the Occupational Safety and Health Administration, and the Joint Commission on Accreditation of Healthcare Organizations provide guidelines for the safe administration and handling of cytotoxic agents. Institutions in which cytotoxic agents are administered should use these guidelines to develop policies, procedures, and educational programs to protect surgical patients and perioperative staff members.

Abdominal Neoplasms↗
PubMed1995

Surgical patients with multiantibiotic-resistant bacteria.

Although antibiotics can cure most bacterial infections, there is an increasing number of bacteria that are resistant to antibiotics. Methicillin-resistant Staphylococcus aureus (MRSA) is becoming increasingly prevalent in US health care facilities. The majority of these infections are found in patients who have extensive burns or surgical wounds. As a result, perioperative nurses must be knowledgeable about MRSA and its implications for the OR. There are many theories on how to control the spread of MRSA but not one definitive set of control measures. Perioperative nurses, in cooperation with infection control practitioners, must develop policies that detail how patients with MRSA will be treated.

Drug Resistance, Multiple↗
PubMed1995

Barrier protection and latex allergy associated with surgical gloves.

Latex continues to be the material of choice for surgical gloves because it is resealable and flexible, and it maintains the wearer's tactile sensitivity. The use of latex gloves for barrier protection may need to be reevaluated in light of the increasing number of individuals who are sensitive to latex. Hospital personnel can use low-allergen gloves or nonlatex gloves when caring for patients with known sensitivity to latex; however, only nonlatex gloves may be effectives at reducing or preventing anaphylactic reaction. Health care facilities must develop policies and procedures for dealing with latex-sensitive patients and health care workers.

Gloves, Surgical↗
PubMed2001

The western australian road injury database (1987-1996): ten years of linked police, hospital and death records of road crashes and injuries.

Accurate information about injuries and their causes is essential to road safety research, policy development and evaluation. Such information is most powerful when it is available for all road crashes within a jurisdiction. The Western Australian Road Injury Database achieves this through the on-going linkage of crash details from reports to police with the details of injuries to casualties contained in hospital and death records. Over the 10-year period 1987-1996, 386,132 road crashes involving 142,308 casualties were reported to the police in Western Australia. There were also 47,757 hospital discharge records and 2,906 death records related to road crashes during this period. Of the 142,308 police casualties, 17 848 had a matching hospital discharge record and 2,454 had a matching death registration. Linkage within the hospital records revealed that the 47,757 discharge records involved 43,179 individuals, of whom 39,073 were admitted to hospital once, 3,653 were admitted twice, 374 were admitted three times and 78 were admitted more than three times. Of the 43,179 hospitalised casualties, 817 had a matching death record. Linked police, hospital and death records of road crash casualties provide accurate outcome information for casualties in crashes reported to the police. In addition, estimates of under reporting of crashes for different road user groups can be made by comparing hospital records with and without a matching police record. This article demonstrates the power of a linked system to answer complex research questions related to outcome and under-reporting.

Accidents, Traffic↗
PubMed2003

Education for health: case studies of two multidisciplinary MPH/MSc public health programmes in the UK.

Amidst the winds of change that are blowing across the UK public health (PH) landscape in relation to the essential abilities and national standards that are required for the 'art and science' of PH, the preparation for a new cadre of 'PH professionals' is already underway. Several postgraduate masters programmes in public health (MPH) have taken on board the challenge of addressing the requisite sets of skills and expertise as a guide to their content and delivery. Although there are recommendations regarding teaching PH to undergraduate medical students, little consensus seems to exist on teaching postgraduate PH to non-medically qualified professionals, health managers and administrators. Employing a case study approach, this article analyses the methods used, philosophies and processes, structure and organization, outcomes to date, and lessons learnt from MPH programmes implemented at two institutions in the UK. The programmes have been initiated recently, and have had the opportunity to take on board the recent national guidelines about training standards. The findings indicate that preparatory work of the programmes, and the challenges and strengths in meeting the recent policy developments in PH training are pertinent points. The MPH programmes highlight key issues in interprofessional education and its purpose, its process and its outcomes in relation to multidisciplinary specialist practice. These programmes provide a variety of models for others wishing to develop or restructure their postgraduate PH teaching programmes. The finalization of the national standards for specialist practice in PH in the UK is encouraged, along with clearer working definitions of the domains of expertise required. Collectively, attention to these measures can ensure that the processes which teaching programmes embrace to refine their content and delivery will equip tomorrow's professionals with PH knowledge and skills.

Curriculum↗
PubMed2003

Evidence-based health policy: three generations of reform in Mexico.

The Mexican health system has evolved through three generations of reform. The creation of the Ministry of Health and the main social security agency in 1943 marked the first generation of health reforms. In the late 1970s, a second generation of reforms was launched around the primary health-care model. Third-generation reforms favour systemic changes to reorganise the system through the horizontal integration of basic functions-stewardship, financing, and provision. The stability of leadership in the health sector is emphasised as a key element that allowed for reform during the past 60 years. Furthermore, there has been a transition in the second generation of reforms to a model that is increasingly based on evidence; this has been intensified and extended in the third generation of reforms. We also examine policy developments that will provide social protection in health for all. These developments could be of interest for countries seeking to provide their citizens with universal access to health care that incorporates equity, quality, and financial protection.

Health Care Reform↗
PubMed2002

Child fatality review: an international movement.

OBJECTIVE: This article discusses the multidisciplinary Child Fatality Review process in the US, Canada, and Australia, including common patterns, unique programs, changes over time, impact on multiagency systems, and future directions. METHOD: An open-ended survey was shared with teams listed in the directories of the Los Angeles County Inter-Agency Council on Child Abuse and Neglect National Center on Child Fatality Review (ICAN-NCFR). Responses were received from 58 state and local Child Fatality Review teams. RESULTS: Teams exist in all 50 states, Washington, DC, most Canadian provinces, and New South Wales, Australia. Team structure varies but generally includes a similar core membership, and most teams select cases from coroner/medical examiner or vital statistics records through established protocols. While most case review is conducted by local teams, state teams may review cases because of small size or sparse population or choose to review specific types of cases (e.g., Child Protective Services). State teams often support local review through training, resources, policy development, and political assistance. An increasing number of teams collect data and issue reports, often published on the internet, allowing teams to share resources. CONCLUSIONS: Teams have matured with time, often broadening their intake spectrum, membership and data collection, and developing and following through with case management or systems change recommendations. Teams continue to improve multiagency interaction and are committed to the prevention of child injury and death. The number of teams, as well as their scope and expertise, continues to increase, developing into a national/international system.

Australia↗
PubMedDate not supplied

Preventing treatment interference: the nurse's role in maintaining technologic devices.

BACKGROUND: Treatment interference, the disruption or self-removal of technologic devices, is a primary reason for application of physical restraints in acute and critical care settings. The processes of care surrounding treatment interference and the prevention of device disruption have not been comprehensively analyzed. OBJECTIVES: To describe the processes used by critical care nurses to prevent treatment interference in critically ill older adults. METHODS: Participant observation field research was conducted in medical and intermediate medical intensive care units. Data were analyzed by using the constant comparative method and event analysis. RESULTS: Maintaining technologic devices is almost exclusively a nursing responsibility and involves the skillful assessment of patient awareness and trustworthiness and interpretation of behaviors. Critical care nurses are most protective of those devices for which accidental removal is perceived as life threatening: endotracheal tubes, arterial catheters, and central venous catheters. Nurses assess patients' cognitive status, mobility, strength, and trustworthiness, as well as device considerations such as replacement difficulty and device necessity. In addition to verbal strategies, such as explaining, nurses use distraction, deception, comfort measures, watchful family members, physical restraints, and sedation to prevent treatment interference. CONCLUSION: This analysis considers the social context of the intensive care unit, including roles and the human-technology interaction. It illustrates the tremendous responsibility that nurses assume in maintaining technologic devices. Next steps in research and policy development are also considered.

Adult↗
PubMed1998

Direct-to-consumer advertising: a pharmacy perspective.

This paper explains the current policies of the American Pharmaceutical Association (APhA) and other national organizations on direct-to-consumer (DTC) advertising, reviews the findings of a survey on DTC advertising conducted by the APhA and Prevention Magazine, and identifies key issues for DTC policy development.

Advertising↗
PubMed1998

Sequential antibiotic therapy: the right patient, the right time and the right outcome.

The aim of sequential therapy should be to provide better quality of care at lower cost. In comparison with i.v. therapy, oral administration is safer, more acceptable to the patient, facilitates early discharge from hospital and reduces the cost of consumables. However, if given to the wrong patient, oral antimicrobial therapy could both increase the cost and reduce the quality of care, either because of ineffective treatment, or unnecessary prolongation of treatment. Hospitals must develop policies for sequential therapy which define standards against which clinical care can be audited. The standards will need to be revised as new data become available from local audit and from research. Further research on sequential therapy is undoubtedly required, with particular emphasis on the reliability of absorption of oral drugs by hospitalized patients.

Administration, Oral↗
PubMed2002

Defining health inequality: why Rawls succeeds where social welfare theory fails.

While there has been an important increase in methodological and empirical studies on health inequality, not much has been written on the theoretical foundation of health inequality measurement. We discuss several reasons why the classic welfare approach, which is the foundation of income inequality analysis, fails to provide a satisfactory foundation for health inequality analysis. We propose an alternative approach which is more closely linked to the WHO concept of equity in health and is also consistent with the ethical principles espoused by Rawls [A Theory of Justice. Harvard University Press, Cambridge, MA, 1971]. This approach in its simplest form, is shown to be closely related to the concentration curve when health and income are positively related. Thus, the criteria presented in our paper provide an important theoretical foundation for empirical analysis using the concentration curve. We explore the properties of these approaches by developing policy scenarios and examining how various ethical criteria affect government strategies for targeting health interventions.

Efficiency↗
PubMed1997

Biotechnology: a special case for health technology assessment?

Many substances produced naturally in a wide range of living organisms have been identified to be of benefit in the treatment of human disease. Current health biotechnologies recreate DNA-recombinant cellular processes in laboratory settings to produce 'natural' therapeutics: these are potentially a step forward from traditional pharmacology which has developed synthetic analogues or sought to extract products from donor material. However, with increasing financial pressures, decision makers require evidence that the benefits of biotechnologies justify their costs. The challenges experienced when evaluating the cost-effectiveness of biotechnologies are explored with reference to three examples: HA-1A human monoclonal antibody, erythropoietin and DNase. Difficulties in economic evaluation are similar to those experienced with conventional pharmaceuticals: use of short-term clinical endpoints rather than meaningful health outcomes, the artificial nature of clinical trial protocols, and uncertainty about the applicability of economic data. However, early clinical and economic assessments are required by decision-makers, particularly where biotechnology products fill major gaps in therapy. The financial structure of biotechnology companies may limit movement towards adequate clinical and economic research for health technology assessment. Governments should negotiate with the industry to promote more relevant studies, and develop policies for the managed introduction of products as evidence on effectiveness and cost expands. New technologies often present additional costs requiring reallocation of existing resources. Careful resource planning is required so that cost-effective innovation are not denied to patients.

Antibodies, Monoclonal↗
PubMed1999

Is infection control an academic study?

This editorial aims to answer the question of whether infection control is an academic specialty. By considering the consequences of a lack of infection control in terms of patient morbidity and mortality and hence cost, it is easy to establish the importance of the area. Infection control embraces not only developing policies for preventing the physical spread of a micro-organism but also prophylactic therapy such as vaccination and therapeutic measures such as antibiotics. Infection control not only applies to localized infection in hospital due to antibiotic resistant microbes but also to the community. Bacteria such as Helicobacter pylori and Chlamydia pneumoniae and the viruses hepatitis B, hepatitis C, human lymphotropic virus type 1, Epstein-Barr viruses and human papilloma virus have been implicated in diseases not previously thought to have an infectious origin. Coping with these problems is clearly an academic area.

Bacterial Typing Techniques↗
PubMed1988

COBRA: implications for emergency medicine.

The potential impact of COBRA is staggering and must be confronted. The ultimate scope and effects will take shape quickly. Federal regulations will provide some of the rules, but the most important definitions under the law will develop in court. Because of a lack of understanding hospitals may not have been in compliance with COBRA's strict terms since August 1986 and may only become educated on COBRA through the legal process. Currently, one COBRA lawsuit has been filed in the Chicago court system, and at least one physician group in California has paid a $25,000 fine for COBRA violations. Litigation in the initial phase of COBRA is likely as most hospitals continue to be unaware of the implications of COBRA legislation. EDs, emergency medical services programs, and interhospital transport programs must begin an immediate effort to examine and develop policies to comply with COBRA. Without an effective educational, compliance, and risk management effort, any emergency medical services program or hospital may become a defendant under COBRA legislation. Delays in understanding and implementing the requirements of COBRA may adversely affect the health care system rather than improve it.

Diagnosis-Related Groups↗