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Speciality
Kinds of Speciality Terms modified by Speciality Selected AbstractsA New Speciality Is Being BornJOURNAL OF CLINICAL HYPERTENSION, Issue 6 2009Thomas D. Giles MD President No abstract is available for this article. [source] Dilaceration of maxillary central incisor: a literature reviewDENTAL TRAUMATOLOGY, Issue 5 2010Nikolaos Topouzelis In early developmental stages, the permanent tooth germ of the maxillary incisor is situated palatally and superiorly to the apex of the primary incisor and gradually changes direction in a labial direction with its crown coming closer to the resorbing primary root. For reasons of this close relationship between the permanent tooth germ and the apex of the primary incisor, it is believed that an acute trauma to the primary predecessor can cause dilaceration of the long axis of the permanent successor. Clinically, dilaceration can be revealed by palpation high in the labial sulcus or in the hard palate, while its radiographic view is characteristic. The therapeutic approach to the dilacerated maxillary central incisors has to be carefully planned and needs the cooperation of several specialities to attain the final objective. [source] Treatment of erythema multiforme, Stevens,Johnson Syndrome, and toxic epidermal necrolysisDERMATOLOGIC THERAPY, Issue 4 2002Klemens Rappersberger The "erythema multiforme disease spectrum" comprises four distinct, severe, clinical subvariants: (1) bullous erythema multiforme (bullous-EM), (2) Stevens,Johnson syndrome (SJS), (3) SJS,toxic epidermal necrolysis (TEN)-overlap syndrome, and (4) TEN. These diseases are closely related to severe mucocutaneous intolerance reactions that are mostly elicited by drugs/drug metabolites and associated with a high mortality rate. Old age and area of detached skin negatively influence the course of disease, and early withdrawal of causative drugs with short half-life is a positive prognostic factor. Therapeutic management represents a multidisciplinary challenge for colleagues from various specialities including specialized nurses and usually can be performed at a dermatologic ward unless technical equipment of an intensive care unit is needed. Topical therapy with biologic and (semi-)synthetic dressings is aimed at early re-epithelialization and the prevention of scarring, synechia formation, and infection. Systemic treatment includes antibiotics, fluid and electrolyte replacement, protein preparations and blood products, etc. Various anti-inflammatory and immunosuppressive treatment regimens with corticosteroids, cyclosporine A, cyclophosphamide, plasmapheresis have been considered to halt ongoing immunologic pathomechanisms, and some of these have shown significant efficacy. However, because we lack formal clinical trials, none of these regimens can be definitively proposed as a therapy of choice in any of the severe clinical variants of the EM spectrum. [source] Orals: Clinical practice and specialitiesDIABETIC MEDICINE, Issue 2009Article first published online: 4 MAR 200 First page of article [source] Comparison of dental licensure, specialization and continuing education in five countriesEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 4 2002Titus Schleyer Dental practice and education are becoming more globalized. Greater practitioner and patient mobility, the free flow of information, increasingly global standards of care and new legal and economic frameworks (such as European Union [EU] legislation) are forcing a review of dental licensure, specialization and continuing education systems. The objective of this study was to compare these systems in Canada, France, Germany, the UK and the US. Representatives from the five countries completed a 29-item questionnaire, and the information was collated and summarized qualitatively. Statutory bodies are responsible for licensing and re-licensing in all countries. In the two North American countries, this responsibility rests with individual states, and in Europe, with the countries themselves, mainly governed by the legal framework of the EU. In some countries, re-licensure requires completion of continuing education credits. Approaches to dental specialization tend to differ widely with regard to definition of specialities, course and duration of training, training facilities, and accreditation of training programmes. In most countries, continuing education is provided by a number of different entities, such as universities, dental associations, companies, institutes and private individuals. Accreditation and recognition of continuing education is primarily process-driven, not outcome-orientated. Working towards a global infrastructure for dental licensing, specialization and continuing education depends on a thorough understanding of the international commonalities and differences identified in this article. [source] Testing of fine motor skills in dental studentsEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 1 2000Olaf Luck Manual skills form only a part of the capabilities required of future dentists, but they are a very important component, which should be tested. With regard to the dental specialities, the present study tested speciality-independent fine motor skills. No objective, practical solution has been found up to now. 88 dental students and, as a control group, 23 medical students were examined in the longitudinal study. In the course of the analysis, 4 fine motor tests were carried out at the beginning of the 2nd and 6th semesters. The tests comprised the tremometer test, the tremometer test with a mirror, the 2-hand sinusoid test and archery using the Game Gear by SEGA. The test devices facilitate primarily the testing of components of accuracy of movements, indirect working methods, and eye-hand coordination. In the comparison of performances on test day A, the medical students' performance was noticeably better. As testing progressed, results showed stagnation in the performance of the medical students and a significant improvement in the performance of the dental students. That means that the test system can be used for a test over the course of study, but not as an initial test. [source] Measuring the quality of hospital care: an inventory of indicatorsINTERNAL MEDICINE JOURNAL, Issue 6 2009B. Copnell Abstract Background: Development of indicators to measure health-care quality has progressed rapidly. This development has, however, rarely occurred in a systematic fashion, and some aspects of care have received more attention than others. The aim of this study is to identify and classify indicators currently in use to measure the quality of care provided by hospitals, and to identify gaps in current measurement. Methods: A literature search was undertaken to identify indicator sets. Indicators were included if they related to hospital care and were clearly being collected and reported to an external body. A two-person independent review was undertaken to classify indicators according to aspects of care provision (structure, process or outcome), dimensions of quality (safety, effectiveness, efficiency, timeliness, patient-centredness and equity), and domain of application (hospital-wide, surgical and non-surgical clinical specialities). Results: 383 discrete indicators were identified from 22 source organizations or projects. Of these, 27.2% were relevant hospital-wide, 26.1% to surgical patients and 46.7% to non-surgical specialities, departments or diseases. Cardiothoracic surgery, cardiology and mental health were the specialities with greatest coverage, while nine clinical specialities had fewer than three specific indicators. Processes of care were measured by 54.0% of indicators and outcomes by 38.9%. Safety and effectiveness were the domains most frequently represented, with relatively few indicators measuring the other dimensions. Conclusion: Despite the large number of available indicators, significant gaps in measurement still exist. Development of indicators to address these gaps should be a priority. Work is also required to evaluate whether existing indicators measure what they purport to measure. [source] The future role of the Scandinavian anaesthesiologist: a web-based surveyACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 9 2010A. ÅNEMAN Background: The Board of the Scandinavian Society for Anaesthesiology and Intensive Care Medicine (SSAI) decided in 2008 to undertake a survey among members of the SSAI aiming at exploring some key points of training, professional activities and definitions of the specialty. Methods: A web-based questionnaire was used to capture core data on workforce demographics and working patterns together with opinions on definitions for practice/practitioners in the four areas of anaesthesia, intensive care medicine, emergency medicine and pain medicine. Results: One thousand seven hundred and four responses were lodged, representing close to half of the total SSAI membership. The majority of participants reported in excess of 10 years of professional experience in general anaesthesia and intensive care medicine as well as emergency and pain medicine. While no support for separate or secondary specialities in the four areas was reported, a majority of respondents favoured sub-specialisation or recognition of particular medical competencies, notably so for intensive care medicine. Seventy-five percent or more of the respondents supported a common framework of employment within all four areas irrespective of further specialisation. Conclusions: The future of Scandinavian anaesthesiology is likely to involve further specialisation towards particular medical competencies. With such diversification of the workforce, the majority of the respondents still acknowledge the importance of belonging to one organisational body. [source] Deliberate self-harm (DSH) among older people: a retrospective study in Barnet, North LondonINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 2 2005Florian Alexander Ruths Abstract Background Rates of suicide remain high among older people and those who deliberately self harm are believed to be at an increased risk of killing themselves in the future. If older people who deliberately harm themselves are to be helped by developments in services we need to understand what currently happens to them in terms of service provision and outcome. Methods A retrospective paper and electronic case note survey was carried out on all older people living in the London Borough of Barnet who presented to Accident & Emergency Departments with DSH over a two-year period. Ensuing actions and events were then tracked. Results Forty-three older people with DSH were identified. 18/43 (42%) had previous contact with local psychiatric services. The main method of DSH was overdose of medication (36/43 or 84%). Compared to the general population there were more women and widows. There were similar levels of physical ill-health. Thirty-seven of 43 (86%) received documented psychiatric input outside of hospital following the DSH. The mean follow-up period was 789.0 days (SD 419.8) and during this time 8/43 (19%) had a further documented episode of DSH, and 18/43 (40%) died from natural causes. Conclusions This study confirms the need for improved documentation of DSH and its coding; this needs to be reviewed at local and national level. The vast majority of older people who attempt suicide do have subsequent contact with psychiatric services. There is a strong likelihood of repeat DSH and a higher risk of death by natural causes, emphasising the need to conceptualise DSH as a risk factor relevant to all medical specialities. Copyright © 2005 John Wiley & Sons, Ltd. [source] The development of integrated haematopathology laboratories: a new approach to the diagnosis of leukaemia and lymphomaINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 6 2003S. J. Richards Summary The diagnosis and monitoring of leukaemia and lymphoma requires the effective integration of a wide range of diagnostic techniques and expertise. The need to develop this type of service that crosses traditional boundaries of laboratory specialities is being recommended in national guidance. The Haematological Malignancy Diagnostic Service based within the Leeds Teaching Hospitals NHS Trust was established in 1993 to provide specialist laboratory services for the diagnosis of haematological malignancy for Yorkshire and Humberside in the UK. The department uses a wide range of methodologies including morphology, immunocytochemistry, flow cytometry and molecular genetics [fluorescent in situ hybridization (FISH) and polymerase chain reaction (PCR)] in a systematic and co-ordinated way. We describe how the department was established, its current working practices and highlight the advantages of an integrated laboratory for diagnosis of tumours of the haematopoietic system. [source] Treatment of intrinsic discoloration in permanent anterior teeth in children and adolescentsINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 4 2001Alyson Wray The tenth National Clinical Guideline in Paediatric Dentistry is published here. The process of guideline production began in 1994, resulting in first publication in 1997. Each guideline has a nominated main author but the content is not a personal view; it represents rather a consensus of opinion of current best clinical practice. Each guideline has been circulated to all consultants in Paediatric Dentistry in the UK, to Council of BSPD, and to people of related specialities recognised to have expertise in the subject. The final version of the guideline is produced from a combination of this input and thorough review of published literature. The intention is to encourage improvement in clinical practice and to stimulate research and clinical audit in areas where scientific evidence is inadequate. Evidence underlying recommendations is scored according to the SIGN classification and guidelines should be read in this context. For those wishing for further detail, the process of guideline production in the UK is described in International Journal of Paediatric Dentistry 1997; 7: 267,268. [source] Periodontology as a recognized dental speciality in EuropeJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2006Mariano Sanz Abstract The impetus of the Bologna Process under the auspices of European Union governments has raised enormous expectations. It is the major educational change in Europe within the last 50 years and all the focus from university institutions, learned societies and thematic networks has shifted to this process, with the aim of developing consensus schemes in order to arrive at the expected European Convergence in Higher Education (to be completed by 2010). Dentistry as one of the health professions with clear Educational Standards, as defined by the European Dental Directives, is also reviewing its educational processes within this Bachelor,Master,Doctorate scheme and evaluating how the current and future dental specialities should be accommodated within this framework. Among these specialities, Periodontology is currently considered a formal dental speciality in 11 countries belonging to the EU however it lacks this legal status in the rest of the 14 EU countries. The purpose of this position paper is to provide evidence for the need for a recognized specialty in Periodontology at European level focusing on both the educational and professional perspective, with the hope of providing discussions that may contribute to facilitate its legal establishment as a new dental speciality in Europe. [source] Post-operative anxiety and depression levels in orthopaedic surgery: a study of 56 patients undergoing hip or knee arthroplastyJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 2 2009Richard S. J. Nickinson Abstract Objective, To investigate the presence and rates of anxiety and depression in postsurgical patients. Methods, The Hospital Anxiety and Depression Scale was used to measure anxiety and depression levels. Patients completed the questionnaire on the day prior to surgery, then on each post-operative day up to and including their day of discharge. Statistical analysis using logistic regression was performed to determine whether any variables were risk factors for developing anxiety or depression. Fifty-six patients undergoing lower limb arthroplasty agreed to take part. Results, Post-operatively 17 patients became anxious prior to discharge. No variables were significant predictors of anxiety. Post-operatively 28 subjects (50%) became depressed at some point prior to discharge. Females were more likely to become depressed than males odds ratio (OR) = 3.48 [95% confidence interval (CI) 1.01,11.88]. Those who had had a previous lower limb arthroplasty were more likely to develop post-operative depression, OR = 3.92 (95% CI 1.05,14.6). Site of operation was not found to be significant, OR = 0.67 (95% CI 0.20,2.22). Age and anaesthetic method were not predictive of depression. The mean time point for development of depression was 2.43 days (SD = 1.40 days) and the time of deepest depression was 2.93 days (SD = 1.72 days). The mean length of depression was 1.93 days (SD = 1.21 days). The mean length of stay for depressed patients was 5 days (SD = 1.72), compared with 4 days for the non-depressed patients (SD = 1.62 days). Conclusion, The results suggest that post-operative depression does occur in orthopaedic surgery. The prevalence may be higher than that reported in other surgical specialities. These findings emphasize the need for evaluation of patients' psychiatric state post-operatively. [source] The times they are a changinJOURNAL OF NURSING MANAGEMENT, Issue 5 2009Cert Ed, MIKE THOMAS PhD Aim, A discussion paper outlining the potential for a multi-qualified health practitioner who has undertaken a programme of study incorporating the strengths of the specialist nurse with other professional routes. Background and rationale, The concept and the context of ,nursing' is wide and generalized across the healthcare spectrum with a huge number of practitioners in separate branches, specialities and sub-specialities. As a profession, nursing consists of different groups in alliance with each other. How different is the work of the mental health forensic expert from an acute interventionalist, or a nurse therapist, from a clinical expert in neurological deterioration? The alliance holds because of the way nurses are educated and culturalized into the profession, and the influence of the statutory bodies and the context of a historical nationalized health system. This paper discusses the potential for a new type of healthcare professional, one which pushes the intra- and inter-professional agenda towards multi-qualified staff who would be able to work across current care boundaries and be more flexible regarding future care delivery. In September 2003, the Nursing and Midwifery Council stated that there were ,more than 656 000 practitioners' on its register and proposed that from April 2004, there were new entry descriptors. Identifying such large numbers of practitioners across a wide range of specialities brings several areas of the profession into question. Above all else, it highlights how nursing has fought and gained recognition for specialisms and that through this, it may be argued client groups receive the best possible ,fit' for their needs, wants and demands. However, it also highlights deficits in certain disciplines of care, for example, in mental health and learning disabilities. We argue that a practitioner holding different professional qualifications would be in a position to provide a more holistic service to the client. Is there then a gap for a ,new breed' of practitioner; ,a hybrid' that can achieve a balanced care provision to reduce the stress of multiple visits and multiple explanations? Methods, Review of the literature but essentially informed by the authors personal vision relating to the future of health practitioner education. Implications for nursing management, This article is of significance for nurse managers as the future workforce and skill mix of both acute and community settings will be strongly influenced by the initial preregistration nurse education. [source] PRACTICAL MANAGEMENT OF DIET AND LIFESTYLE INTERVENTIONS FOR PEOPLE WITH DIABETES OR CARDIOVASCULAR DISEASEJOURNAL OF RENAL CARE, Issue 2010Fiona Symes BSc (Hons) SUMMARY Increased collaboration between the vascular specialities is clearly leading to increased understanding of the interrelationships between the different disease states and how each impacts and influences the other. This advantage will be reflected in improved patient care if the practical outputs of this growing knowledge are carefully implemented at service level. This article outlines how the aspects of diet and lifestyle associated with vascular-related disease complement, contrast and in some cases contradict each other. It gives information and guidelines as to how the expertise of dietitians working in the different specialist areas might usefully be shared to be of maximum advantage to all patients. [source] Sexual dysfunction in dermatological diseasesJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 9 2009AT Ermertcan Abstract Decrease or loss of sexual function in many chronic diseases has recently attracted significant attention owing to its impact on quality of life. Generic and disease-specific quality-of-life questionnaires measure changes in work, school, social life and emotional status regarding the disease and its treatment. Specific questionnaires have been designed to evaluate changes in sexuality and sexual function. Sexual dysfunction, especially female sexual dysfunction, in different diseases became a popular and important health concern in recent years. There are a lot of studies about sexual dysfunction in the areas of other specialities of medicine, but there are only a few studies in dermatological diseases. In this paper, sexual dysfunction and the studies performed about this subject in dermatology will be reviewed. Conflict of Interest None declared. [source] Changing patterns of coeliac serology requestsALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 10 2009K. E. EVANS Summary Background, Accurate serological tests have revolutionized the diagnosis of coeliac disease. Aim, To quantify the volume of coeliac serology requests at a district hospital over a decade, identify their origin, assess positivity rates and subsequent duodenal biopsy and histological confirmation rates. Methods, Details of patients in whom coeliac serology was requested from 1997 to 2006 were obtained from laboratory databases. The origins of request were categorized into gastroenterology, general practice, paediatrics and other specialities. Duplicate requests were excluded. Results, A total of 9976 serological tests were requested. Testing increased from 302 in 1997, to 1826 in 2006. In all, 66% of requests were in females. Tests in children accounted for 14,25% of each year's total. General practitioner requests increased from 3.3% in 1997 to 52% in 2006. The proportion of positive serological results fell from 5.7% in 1997 to 2.6% in 2006. Duodenal biopsies were performed in approximately 85% of seropositive patients in earlier years and approximately 75% of seropositive patients in later years. Most nonbiopsied seropositive patients had serology requested by general practitioners. Biopsies confirmed coeliac disease in 91% of seropositive patients. Conclusion, Increasingly, coeliac serological testing is requested by general practitioners. Twice as many females are tested. Increasing test numbers but diminishing positivity rates suggest testing is requested at lower symptom thresholds. Positive serological results are often not confirmed histologically. [source] Marathon of Eponyms: 1 Albers-Schönberg disease (osteopetrosis)ORAL DISEASES, Issue 3 2009C Scully Abstract: The use of eponyms has long been contentious, but many remain in common use, as discussed elsewhere (Editorial: Oral Diseases. 2009 in press). The use of eponyms in diseases of the head and neck is mainly in specialities dealing with medically compromised individuals (paediatric dentistry, special care dentistry, oral and maxillofacial medicine, oral and maxillofacial pathology, oral and maxillofacial radiology and oral and maxillofacial surgery) and particularly by hospital-centred practitioners. This series has selected some of the more recognised relevant eponymous conditions and presents them alphabetically. The information is based largely on data available from MEDLINE and a number of internet websites as noted below: the authors would welcome any corrections. This paper summarises data about Albers-Schönberg disease. [source] Biosimilar epoetins and other "follow-on" biologics: Update on the European experiences,AMERICAN JOURNAL OF HEMATOLOGY, Issue 10 2010Wolfgang Jelkmann After the patents of biopharmaceuticals have expired, based on specific regulatory approval pathways copied products ("biosimilars" or "follow-on biologics") have been launched in the EU. This article summarizes experiences with hematopoietic medicines, namely the epoetins (two biosimilars traded under five different brand names) and the filgrastims (two biosimilars, six brand names). Physicians and pharmacists should be familiar with the legal and pharmacological specialities of biosimilars: The production process can differ from that of the original, clinical indications can be extrapolated, glycoproteins contain varying isoforms, the formulation may differ from the original, and biopharmaceuticals are potentially immunogenic. Only on proof of quality, efficacy and safety, biosimilars are a viable option because of their lower costs. Am. J. Hematol. 2010. © 2010 Wiley-Liss, Inc. [source] Changes in the impact factor of anesthesia/critical care journals within the past 10 yearsACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 7 2000J. Boldt Background: The impact factor (IF) is published by the Institute for Scientific Information (ISI). There is a tendency to assess quality of scientific journals with the help of the IF. An analysis of the changes in the IF over time in the different specialities may help to further enlighten the worth and problems of the IF. Methods: The IFs listed under the subheadings Anesthesiology and Emergency Medicine & Critical Care in the Science Citation Index , Journal Citation Report were descriptively analysed over the past 10 years. Additionally, IFs of some other important journals (subheadings Surgery, Cardiovascular, General Medicine) were analysed. Results: The IF of most of the journals showed a constant increase over the years (average in Anesthesiology: +65%; average in Emergency Medicine & Critical Care: +145%). IFs of the highest ranked journals of other specialities showed a similar increase over the years (average in surgical journals: +56%; average in cardiac journals: +59%; average in general journals: +40%). More Anesthesiology and Emergency Medicine & Critical Care journals originated from the USA show an IF >2.0 over the past 10 years than do European journals. Conclusion: Although the value of the IF is highly controversial, it is a frequently used tool to assess rating of a medical journal. Anesthesiology and Emergency Medicine & Critical Care journals showed a continuous increase in the IF over the past 10 years. [source] Vascular closure staples reduce intimal hyperplasia in prosthesis implantationANZ JOURNAL OF SURGERY, Issue 12 2002Wayne J. Hawthorne Background: Vascular surgery, like the various other surgical specialities, has seen an increasing demand toward faster and more minimally invasive procedures. One such need is to create a reliable vascular anastomosis that is faster, easier and less damaging to the tissue. The vascular closure staples (VCS*) device provides such characteristics but, to date, no studies have investigated its effectiveness in reducing intimal hyperplasia when used for vascular prosthesis implantation. The present study evaluated its effectiveness compared with suturing of a graft in vascular prosthesis implantation. Methods: Twelve female Merino sheep underwent gelatin sealed Dacron patch graft implantation into the left and right common carotid artery. Grafts were randomly allocated so that one carotid artery and graft was anastomosed using sutures and the other with VCS*. The two techniques were compared for operation time, clip/suture numbers and blood loss during the implantation procedure. After a 4-week period, the sheep were killed and the grafts were harvested for intimal hyperplasia (IH) assessment. Results: There was a significant reduction in the amount of IH seen in the VCS* group (mean ± SD: 0.278 ± 0.079 mm2/mm) when compared with the sutured group (0.575 ± 0.331 mm2/mm) (P < 0.05). There was also significant reduction in anastomosis time (mean ± SD: 14 ± 4.4 min) and fewer points of contact (23 ± 1.4) using the VCS* compared with suturing (22 ± 3.2 min, P < 0.01; 27 ± 3.3, P < 0.05, respectively). Conclusions: In this model, the VCS* shows several distinct advantages over suturing with significant time saving at operation and, most importantly, the reduction of IH seen at 1 month. [source] Promoting mental health care in a rural paediatric unit through participatory action researchAUSTRALIAN JOURNAL OF RURAL HEALTH, Issue 3 2009Brenda Happell Abstract Objective:,To explore, advance and evaluate mental health practices in a rural general paediatric unit through participatory action research. Design:,A participatory action research approach guided this study, providing an opportunity for nursing staff to become actively involved in the design, direction and outcomes of the research. Setting:,A 16-bed paediatric unit of a rural general hospital. Participants:,A purposive convenience sample of all paediatric nursing staff (n = 20; of 24 nurses). Outcome measures:,In the first phase of this study, focus groups were conducted to explore the experiences of nurses. Results:,Participants considered mental health to be a specialist discipline area and the role of the mental health nurse to be complex. They felt that their lack of training and experience with mental health issues was detrimental to the delivery of optimal patient care. There was concern about differing approaches to treatment, relationships with other mental health services and the suitability of the ward environment for young people with a mental health problem. Participants called for training by qualified mental health staff and the development of policies and clinical guidelines to facilitate their delivery of care to patients with a mental health problem in an acute medical environment. Conclusions:,There is a clear need for nursing specialities to work together to ensure that optimal care is given to patients admitted to general hospital with a mental health issue. Given the absence of accessible specialist child mental health inpatient units in regional and remote areas, upskilling paediatric nurses must be a priority. [source] Occupational therapists' perception of their practice: A phenomenological studyAUSTRALIAN OCCUPATIONAL THERAPY JOURNAL, Issue 2 2009Liv Grethe Kinn Background:,International literature seems consistent in reporting that occupational therapists value their methods. However, little empirical evidence has been generated supporting the basic system of belief for occupational therapy. Few studies have explored the nature of the occupational therapists' experiences and thoughts about their use of occupation as means and ends, and which strategies they use to implement their tools in their current practice. Accordingly, the aim of this study was to explore how occupational therapists understood and presented their practice and interventions. Methods:,A sample of six occupational therapists graduated in different decades, from diverse client populations and health-care settings was selected to participate in a semistructured interview. Results:,Three main themes were developed: ,To make the client's potentials visible', ,reaching a position one values' and ,looking with other eyes'. Whatever their specialities, the participants were unanimous in the way they described their role. Their common focus was ,activities of daily living'. However, they had problems describing their therapeutic tools, and were not able to clearly articulate the ,common sense aspects' of their own methods. The participants were engaged in constructing their professional identities, and stressed the need to construct professional boundaries relevant to their particular work. Conclusion:,The occupational therapists perceived their practice and interventions as distinctly different from other team members, thus, they provided a ,counterpoint'. The participants used various ways of marketing their perspectives. While the novices tended to go along with the team, the experienced therapists tended to assert their own special contribution. [source] Teilsicherheitsfaktoren für die Berechnung von GroßkraftwerkenBETON- UND STAHLBETONBAU, Issue 7 2010Simon Glowienka Dr.-Ing. Normen, Vorschriften, Richtlinien; Berechnungs- und Bemessungsverfahren Abstract Die Baustrukturen von Großkraftwerken werden in Deutschland u. a. auf Basis der VGB-Richtlinie R 602 U berechnet und bemessen. In dieser Richtlinie sind unter Berücksichtigung der Besonderheiten des Großkraftwerksbaus Einwirkungen und Teilsicherheitsfaktoren definiert. Während die Lasten auf diese Randbedingungen abgestimmt wurden, hat man die Teilsicherheitsfaktoren auf der Lastseite aus der DIN 1055-100 entnommen und lediglich die Kombinationsbeiwerte angepasst. Diese Sicherheitsbeiwerte tragen jedoch den speziellen Randbedingungen eines Kraftwerks oder Schwerindustriebaus nur bedingt Rechnung. Im Rahmen des Beitrags werden die Teilsicherheitsbeiwerte auf der Einwirkungsseite , insbesondere für das Konstruktionseigengewicht , für die Bemessung von Stahlbetonteilen vor diesem Hintergrund kritisch diskutiert und ein optimierter, wissenschaftlich abgesicherter Vorschlag unterbreitet. Partial Safety Factors for the Design of Power Plants In Germany power plants are designed in accordance to VGB regulation R 602 U. In this code load actions and partial safety factors are applied taking the special characteristics of power plants into consideration. The actions are defined regarding these circumstances, however the safety coefficients are assumed according to DIN 1055-100 and only the combination coefficients are adjusted. However it has to be recognized that the partial safety factors in DIN 1055-100 are calibrated for building constructions and thus do not consider the specialities of power plants in an adequate manner. In this paper the partial safety factors for the design of power plants and other heavy industry buildings are discussed for structural concrete elements and a scientific based optimized approach for the safety factor for dead load is presented. [source] Hypospadias surgery: when, what and by whom?BJU INTERNATIONAL, Issue 8 2004Gianantonio Manzoni Summary Hypospadias is repaired by paediatric surgeons, paediatric urologists, adult reconstructive urologists and plastic surgeons. This review is unique in representing all four specialities, to provide a unified policy on the management of hypospadias. The surgeon of whichever speciality should have a dedicated interest in this challenging work, ideally having an annual volume of at least 40,50 cases. The ideal time for primary repair is at 6,12 months old, although when this is not practicable there is another opportunity at 3,4 years old. A surgical protocol is presented which emphasises both functional and cosmetic refinement. Using a logical progression of a very few related procedures allows the reliable correction of almost any hypospadias deformity. A one-stage repair is used when the urethral plate does not require transection and its axial integrity can be maintained. Occasionally, when the plate is of adequate width and depth, it can be tubularized directly using the second stage of the two-stage repair. When (usually) the urethral plate is not adequately developed and requires augmentation before it can be tubularized, then that second-stage procedure is modified by adding a dorsal releasing incision ± a graft (alias Snodgrass and ,Snodgraft' procedures). The two-stage repair offers the most reliable and refined solution for those patients who require transection of the urethral plate and a full circumferential substitution urethroplasty. From available evidence this protocol combines excellent function and cosmesis with optimum reliability. Nevertheless, it would be complacent to assume that these gratifying results will be maintained into adult life. We therefore recommend that there is still a need for active follow-up through to genital maturity. [source] Publication rates of scientific papers presented at the Otorhinolarygological Research Society meetingsCLINICAL OTOLARYNGOLOGY, Issue 3 2001D. Roy The aim of this study was to determine the publication rate of scientific papers in peer review journals presented at the Otorhinolarygological Research Society (ORS) meetings from 1978 to 1995 inclusive. The abstracts of the presentations at ORS meetings are published in Clinical Otolaryngology. A MEDLINE search was performed on abstracts presented at ORS meetings from 1978 to 1995 using both authors and key words within the text of the abstract. The publication rate, journal of publication, time to publication, change in contents, change in authors and change in conclusions of abstracts were tabulated. The publication rate for papers presented at ORS meetings from 1978 to 1995 was 69.09%. The average time to publication was 22.5 months. Papers derived from the ORS abstracts were most commonly published in Clinical Otolaryngology (34%) and Journal of Laryngology and Otology (18.64%). The results indicate that nearly 69% of presented material at the biannual ORS meetings eventually get published in peer reviewed journals. This compares favourably with publication rate of other specialities. [source] Coxibs: evolution of prescription's behaviour in FranceFUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 3 2007Julie Biga Abstract The aim of the present study was, first to characterize profiles of coxibs' prescribers [general practitioners (GPs) and rheumatologists] in 2002 in France and, secondly, to identify factors associated with modification of this profile 1 year later. All GPs and rheumatologists from Midi-Pyrenees, Aquitaine, Languedoc-Roussillon and Pays de Loire areas (South of France: 11 050 000 inhabitants) were included in the study. For each practitioner, we used data concerning all non-steroidal anti-inflammatory drugs (NSAIDs) including coxibs reimbursed during period 1 (P1; January,March 2002) and period 2 (P2; January,March 2003). The ratio between the number of coxibs' prescriptions and the total number of NSAIDs' prescriptions (including coxibs) was used to define the two profiles of prescribers, one with a low level of coxibs' prescriptions and another one with a high level of coxibs' prescriptions. Characteristics of practitioners and characteristics of their practices were compared according to this profile. In the second step, we investigated the characteristics (of practitioners and practices) associated with an increase in the level of coxibs' prescriptions in P2 for practitioners with a low level of coxibs' prescriptions in P1. Results are expressed as odds ratio with their 95% confidence intervals. A positive statistical link was found between a high level of coxibs' prescriptions, the speciality of rheumatologist or extra costs for consultation. In contrast, a negative association was observed with female gender or age below 44 years. No relationship was found with the status of referent. Concerning practices' characteristics of practitioners, there was a positive statistical link between a high ratio of coxibs' prescriptions and high co-prescriptions of gastroprotective agents and a negative association with a high number of acts, a high proportion of patients with chronic disabling diseases (CDD) or a high number of patients between 15 and 64 years. There was no statistical link with proportion of patients covered by Universal Medical Coverage (UMC) or aged more than 65 years. Among the factors involved in the increase in the ratio (between P1 and P2), no relationship was found with practitioners' characteristics. In contrast, some factors related to practices (level of gastroprotective co-prescriptions, number of acts, number of CDD patients) were related to a change in coxibs' prescriptions between P1 and P2. This study allowed to discuss some relationships between coxibs' prescription and practitioners' (age, gender, medical speciality or extra costs for consultation) or practices' (level of medical practice, patients' age, number of CDD patients or level of gastroprotective prescriptions) characteristics. In contrast, some other factors like the referent status or the number of patients with UMC are not related. Physicians, initially low prescribers of coxibs and increasing their coxibs' prescriptions during the period of our study, were those with a high level of gastroprotective prescriptions, a low number of acts or a small proportion of CDD patients. [source] An Exchange for All Things?GEOGRAPHICAL RESEARCH, Issue 1 2001An Inquiry into the Scholarship of Fire Fire was once considered a founding element and an informing principle for analysis of the world. Today it is neither. Its study resides primarily in those countries that have both public lands, which hold fire, and scientific institutions, with which to study it. In particular, forestry has long claimed fire as a speciality and continues to harbour the most practical experience regarding it. In fact, fire may deserve better, and can give more. A case, not entirely whimsical, can be made for a programme of ,fire studies' that could span the many forms of scholarship that share an interest in humanity's species monopoly over fire's manipulation. [source] Shaping the future of Scandinavian anaesthesiology: a position paper by the SSAIACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 9 2010E. SØREIDE Traditionally, Scandinavian anaesthesiologists have had a very broad scope of practice, involving intensive care, pain and emergency medicine. European changes in the different medical fields and the constant reorganising of health care may alter this. Therefore, the Board of the Scandinavian Society of Anaesthesiology and Intensive Care Medicine (SSAI) decided to produce a Position Paper on the future of the speciality in Scandinavia. The training in the various Scandinavian countries is very similar and provides a stable foundation for the speciality. The Scandinavian practice in anaesthesia and intensive care is based on a team model where the anaesthesiologists work together with highly educated nurses and should remain like this. However, SSAI thinks that the role of the anaesthesiologists as perioperative physicians is not fully developed. There is an obvious need and desire for further training of specialists. The SSAI advanced educational programmes for specialists should be expanded and include formal assessment leading to a particular medical competency as defined by the European Union of Medical Specialists (UEMS). In this way, Scandinavian anaesthesiologists will remain leaders in perioperative, intensive care, pain and critical emergency medicine. [source] Attitudes towards skills examinations for basic surgical traineesINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 1 2005S.D. Bann Summary Objective measures of surgical skill and cognition are becoming available. A questionnaire study examining surgeons' beliefs towards a skills-based examination, current standards and possible benefits was devised. Three hundred pairs of standardised anonymous questionnaires were sent to consultants and their basic surgical trainees (BSTs) irrespective of surgical speciality. Responses were requested using a Likert scale (1,5, 3 = neutral response). Two-hundred and two replies were received (including 54 pairs). BST experience ranged from 6 to 60 months (mean 24 months). When questioned regarding current training in basic surgical skills, only 34% believed that they were given adequate training at present. Sixty-four per cent of respondents believed the introduction of a skills examination would raise standards and 66% believed it necessary. Eighty-three per cent of respondents believed that they or their BST would practice these skills, if an examination were introduced and 85% wanted or would provide dedicated teaching time for this. However, 68% had no access to a dedicated skills facility, and uptake of these, where available, was variable. When questioned about their ability to perform the six appropriate tasks, there was a poor correlation of scoring between the groups. Consultants and their BSTs do not believe that they are given adequate training in basic skills. The introduction of an examination would lead to practice of these skills and is seen as a positive move. [source] | |||||||||||||||||||||||||||||||||||||