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PubMedDate not supplied

The art and science of medical group turnarounds. Acting in several directions at once, acting at several points in time.

Developing a strategy and turnaround plan for a struggling medical group practice requires a combination of art and science. Orchestrating an effective about-face calls for decisive action on several fronts at once. Too many groups are slow to recognize the need to rescue a perilous situation. And rather than taking immediate action on multiple fronts, they try taking incremental steps over time. Implementing a successful turnaround requires both the diligence of follow-through and the vision to make necessary adjustments throughout the process.

Financial Management↗
PubMed2000

[Radiography scale in rheumatology. State of the art and consequences for clinical practice].

PURPOSE: Realize a "state of the art" of numerization and reduction or magnification scale of musculoskeletal radiography. Looking for the factors associated with this scale variation. How do they influence rheumatology practice. MATERIALS AND METHODS: The study recenced all the numerized (RN) and conventional radiography (RC) of one hundred consecutive patients consulting a rheumatologist practitioner. The scale was read directly or on gradations on the side of the radio. All the measure was made with a graduated magnifying glass. RESULTS: This study confirms that RN gradually replace RC in musculoskeletal radiology (0% before 1994, 65% in 1999). It also confirms that reducing scale is more frequent (50% in 1994, 82% in 1999). The scale of reduction is significantly different depending on some anatomic area, some diagnosis and some geographical provinces. These scale modifications disturb some recommended measures in rheumatology practice. The significant correlation between reducing scale and joint space (r=-0,32; p=0, 009; n=67) tend to show that scale reduction provide an overestimation of joint space. CONCLUSION: Given the perturbation induced in rheumatology practice it would be better to keep the scale of 100% until relevance of reducing scale has been demonstrated.

Humans↗
PubMed1994

Recommendations of the ECVAM Workshop on "Alternatives to Animal Testing in the Quality Control of Immunobiologicals; State of the Art and Future Prospects"

With regard to the principles of replacement, reduction and refinement, art. 231 of the Council Directive 86/609/EEC on the Protection of Animals used for Experimental and other Scientific Purposes, is of utmost importance. This article states that "The Commission and Member States. would take steps. to encourage research into the development and validation of alternative techniques.". In order to carry into effect this article, the Commission of the European Communities (EC) has established the European Centre for the Validation of Alternative Methods (ECVAM) on October 29, 1991. The centre is located at the Joint Research Centre (DG XI) at Ispra (Italy), its first director is Michael Balls from the UK. The main goal of ECVAM is to promote the regulatory acceptance of alternative methods which are of importance to the biosciences and which reduce, refine or replace the use of laboratory animals. The activities of the centre are focused on facilitating, co-ordinating, supporting and/or organising international validation studies, preferably in collaboration with other bodies. A working program has been made for 1993 and 1994 by ECVAM"s scientific advisory committee. Animal testing in the quality control of vaccines was selected as one of the area"s of interest. As a first step it was decided to organise a workshop, with the aim to evaluate potential alternatives, to identify obstacles in development, validation and implementation and to discuss possible solutions. The workshop was held in Utrecht, April 16-17 and the 20 invited participants came from national control laboratories, regulatory bodies, vaccine manufacturers and academic world. (article in English) (The main conclusions and recommendations in the field of the quality control of veterinary vaccines have been published in ATLA 22, 420-434, 1994)

Journal Article↗
PubMed1996

Egg Yolk Antibodies, State of the Art and Future Prospects.

Immunization of chickens and extraction of antibodies from egg yolk belongs to the alternative methods since the animals suffering is reduced by non-invasive antibody-sampling. Also, the number of animals needed to produce a certain amount of antibody can be reduced since chickens produce a significant higher antibody quantity than rabbits. Despite its several advantages this technology (IgY-technology) is rather scarcely used. Traditional behavior as well as limited or no information at all may hamper a broader acceptance at present. However, significant arguments exist in chicken housing, the choice of appropriate IgY-extraction methods and a lack of information regarding the use of IgY-antibodies. This paper intends to give a short introduction in the IgY-technology, to briefly discuss the state of the art and to inform on recent developments and discussions in this field. The suitability of IgY for special fields of application (as a result of the structural differences between IgY and IgG) is emphasized (e.g. assays combining IgG and IgY, immunization of chickens against highly conserved anti-genes). In addition, it is stressed that the IgY-technology as an alternative method can particularly integrate requirements of animal protection (reduce, replace, refine), science (characteristics of avian immune system and resulting properties of IgY) and economy (amount of IgY produced from one chicken).

Journal Article↗
PubMed1999

State-of-the-art protection for garages: what's new? What are major med centers using?

With garages and parking areas continuing to account for a substantial percentage of criminal incidents taking place on hospital property, parking and security officials are seeking ways to maximize protection of staff and visitors, including the employment of state-of-the-art security measures. In this report, we'll describe what officials of two of the largest medical center garages in the country have done and give details on new developments in access control--heavy-duty barrier gates.

Academic Medical Centers↗
PubMed2001

Contemporary posterior direct composites using state-of-the-art techniques.

The dental team that wishes to increase the use of posterior composite restorations will benefit greatly by the information and step-by-step techniques found in this article (Fig. 7A and B). Starting with a clean slate and analyzing the chemistries, the physical nature of resin-based composites, and the systems and devices available to use them most efficiently, the author presents a state-of-the-art, evidence-based technique. By cutting out many of the steps that follow traditional methods with traditional materials and instruments for the placement of silver amalgam, sophisticated practitioners will readily understand the reasoning behind this successful, contemporary, direct posterior composite technique (Fig. 8A-J).

Acid Etching, Dental↗
PubMed2000

[Perinatal outcome in multiple pregnancy after natural reproduction and ART techniques].

In this study we analysed occurrence of multifetal pregnancy in groups of patients after natural reproduction and after using ART between 1991-1998 in clinical material. We showed the most important complications during pregnancy, occurrence of TTTS, percentage of prematurity, percentage and indications to caesarean sections. We found that above-mentioned manifestations of perinatal care were comparable with reports of Polish and foreign authors.

Cesarean Section↗
PubMed2000

The art of getting what you want for optimal patient care.

Getting your way is a mix of logical and emotional issues. It is important to establish rapport and meet a person emotionally before trying to sell an idea. It is essential to think an idea through clearly ahead of time and to present it clearly and logically. The possibility of resistance should be anticipated so that the presentation addresses potential areas of resistance. It is important to actively listen, to agree when possible, and to not appear too eager. Persuasion is both an art and science. When used skillfully, persuasive techniques are powerful tools of communication and productivity.

Education, Nursing, Continuing↗
PubMed2001

CASE tools and UML: state of the ART.

With increasing need for automated tools to assist complex systems development, software design methods are becoming popular. This article analyzes the state of art in computer-aided software engineering (CASE) tools and unified modeling language (UML), focusing on their evolution, merits, and industry usage. It identifies managerial issues for the tools' adoption and recommends an action plan to select and implement them. While CASE and UML offer inherent advantages like cheaper, shorter, and efficient development cycles, they suffer from poor user satisfaction. The critical success factors for their implementation include, among others, management and staff commitment, proper corporate infrastructure, and user training.

Computer-Aided Design↗
PubMed2000

Anaerobic digestion of solid waste: state-of-the-art.

In order to make a correct assessment of the state-of-the-art of the technology, a study was made on the development of digestion capacity for solid waste in Europe. The study was limited to plants in operation or under construction that were treating at least 10% organic solid waste coming from market waste or municipal solid waste. A total treatment capacity for solid waste organics, excluding the tonnage used for sewage sludge and manures, evolved from 122,000 ton per year in 1990 to 1,037,000 ton available or under construction by the year 2000 in 53 plants across Europe, an increase by 750%. Both mesophilic and thermophilic technologies have been proven, with about 62% of capacity being operated at mesophilic temperatures. Wet and dry digestion are almost evenly split, while a clear choice was made for one-phase systems instead of two-phase systems, which represent only 10.6% of capacity. The capacity provided by co-digestion systems is limited, while there is a rising interest in digestion of mixed household waste. The reliable performance has been demonstrated for all types of anaerobic digestion systems. On the basis of the Dranco technology, a single-phase thermophilic dry digestion process, performances were reached similar to high-rate wastewater digestion. An annual average loading rate of 18.5 kg COD/m3.day, resulting in a biogas production of 9.2 m3/m3 reactor.day was obtained at a full-scale plant. The plant operated at a retention time of 15.3 days. Feedstocks range from clean organic wastes (31% dry matter) to heavily polluted grey waste organics (57% dry matter). Average dry matter concentrations of the digested residue of 41% were obtained.

Bacteria, Anaerobic↗
PubMed2001

In situ hybridization to mRNA: from black art to guiding light.

In situ hybridization to mRNA in embryo sections or wholemount embryos is one of the most powerful analytical tools available to the molecular developmental biologist. For many workers, this procedure provides the first insights into the function of newly isolated genes, allowing the formulation of hypotheses and setting the course for further research. This paper presents a personal historical perspective of the development of in situ hybridization, looks at the theory and practice of the technique, summarizes the current state of the art, and speculates on possible directions for the future as a tool in functional genomics.

Animals↗
PubMed1999

Study on Shamanistic healing art of Mongolian nationality.

Shamanism, the earliest religious belief of Mongolian nationality, has a remote origin. It was highly developed and mature as early as in the matriachal society. The primitive healing art contributed to the belief of ancient Shamanism by folk people was combined with ancient Mongolian medicine. Appraising from the development of history of Mongolian medicine as a whole, Shamanism did exert a positive influence rather than a negative one.

China↗
PubMed2000

[Discussion on the contribution of Thousand golden prescriptions to the art of tuina].

Thousand Golden Prescriptions, including Thousand Golden Prescriptions for Emergencies and Supplements to Thousand Golden Prescriptions is an important medical book containing the main medical achievements before the Tang dynasty. It attaches great attention to daily tuina for health-care, enriches its contents, and makes a description to the method of tuina for children, offering detailed materials for later ages with significant reference value, and makes an important contribution to the art of tuina.

China↗
PubMed2000

["The Art of Nursing" by Florence Nightingale, published by Claud Morris Books Limited and printed in 1946, which is considered a draft of "Notes on Nursing"].

There are three versions of "Notes of Nursing," that is Nightingale's most famous work. Recently a book that is considered a draft of Nightingale's "Notes on Nursing," was published by Claud Morris Books Limited in 1946. This book is not contained in the "Bio-Bibliography of Florence Nightingale" by Bishop and Goldie. The publisher says about the source that this book is an entirely new and revised edition of Miss Florence Nightingale's personal notes on nursing, first written in 1859. The publisher acknowledges with gratitude the cooperation of Miss P.E. Nutt, in making available correspondence of Florence Nightingale and of Colonel C.H. Paynter in preparing a copy of the first edition of Miss Nightingale's "Notes on Nursing". This book is composed of the preface and 14 chapters. The preface's title is "Every woman is a nurse", and there is Nightingale's autograph with the date 1859 at the end of the preface. There are some differences between "The Art of Nursing" and "Notes on Nursing". In the former, there is a title to the preface and the first chapter's title is "Don't leave it to the doctor" and the last chapter's title is "Testament for a good nurse". In the latter, there is no title to the preface and the content of the former's first chapter is put only as a prologue before the first chapter. The former's last chapter's title is changed to "Conclusion". Further, each chapter has been somewhat expanded. From the above, we can see that, at what may be considered the draft stage of "Notes on Nursing", Nightingale wanted to emphasize the following things: "Every woman is a nurse", "Don't leave it to the doctor,; and "Testament for a good nurse". However, we can see that, at the stage of publishing of "Notes of Nursing", Nightingale had second thoughts. She complied with advice she received to avoid dissension among the knowlegeable and antipathy from doctors, and she settled on plain expression to make the contents clear to all.

England↗
PubMed1992

[The way for carrying medicine and its containers (VII): "Packaging art in the Edo Period (1600-1867)"].

A metallic phial with screw cap and an Inro containing 6 glass phials were used as medicine containers for carrying medicines in the Edo period. These samples are exhibited at "Mizutani Inro Collection", which is famous for having a lot of Inro in Hyogo, Japan. On packaging art for medicines, there were two streams in the Edo period. The one is to use tight containers for carrying medicines which were brought from Western Europe and the other is to use well closed containers for crude drugs which were traditionally used in our country and China. These containers are chosen reasonably in accordance with a kind of medicine.

Commerce↗
PubMed2000

Where the philosopher finishes, the physician begins: medicine and the arts course in thirteenth-century Oxford.

In the thirteenth century the English universities were different from others, particularly those in the south of Europe, in two important ways: they taught more natural philosophy and less medicine. But the survival of students' notes from the second half of the century shows that in the formal course of lectures on natural philosophy attention was paid to medicine inside the arts course. The present discussion examines the nature of this medical material and the institutional and intellectual relationship between medicine and philosophy.

Curriculum↗
PubMed1979

Programming, budgeting, and control in health care organization: the state of the art.

The planning, budgeting, and controlling processes (PBCP) largely subsume all of the planning and controlling activities of an organization. This paper discusses these activities within the context of a single management control system, focusing on three topics. First, a brief historical perspective of management concerns which relate to PBCP is presented and several important external pressures currently imposed on the health care industry are discussed. Second, normative models of the processes--programming, budgeting, and controlling--are presented. The discussion focuses on the elements and relationships of these processes, and numerous references to the literature are provided. Third, several issues related to the gap between the state of the art in PBCP for hospitals and the current state of practice are discussed.

Budgets↗
PubMedDate not supplied

State-of-the-art methods for geometric and biomechanical assessments of residual limbs: a review.

A review is presented on the state-of-the-art methods for geometric and biomechanical assessments of residual limb tissues. Residual limb assessments are needed throughout different stages of prosthetic management, namely preamputation, residual limb maturation, prosthetic design, prosthetic fitting, and subsequent follow-ups. Geometric assessments include the monitoring of the volumetric change as the residual limb matures after amputation. Geometric and biomechanical assessments of the residual limb are important considerations in prosthetic design. Quantitative geometric and biomechanical assessments are becoming more important in the development of a computer-aided system for prosthetic socket design. It is noted that, except for the external shape measurements of residual limbs, most of the instruments used in residual limb assessment are not particularly cost-effective for clinical applications in prosthetics. Further developments are needed to facilitate the incorporation of the internal geometric assessments and biomechanical assessments into the current computer-aided design systems for clinical prosthetics.

Amputation Stumps↗