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Appropriate Role (appropriate + role)

Distribution by Scientific Domains

Medical Sciences	50%

Selected Abstracts

The use of systemic antibiotics in the treatment of chronic wounds

DERMATOLOGIC THERAPY, Issue 6 2006
Robert Hernandez
ABSTRACT:, The role of microorganisms in the etiology and persistence of chronic wounds remains poorly understood. The chronic wound bed houses a complex microenvironment that typically includes more than one bacterial species. Difficulty lies in determining when the presence of bacteria impedes wound healing, thereby warranting intervention. Indications for antibiotic therapy and optimal treatment regimens are ill defined. The goal of this article is to describe the appropriate role of systemic antibiotics in the management of chronic wounds. A common sense approach will be offered based on six clinically pertinent questions: ,,Is infection present? ,,Are systemic antibiotics necessary? ,,Should treatment be enteral or parenteral? ,,What antibiotic or combination of antibiotics should be used? ,,What should be the duration of therapy? ,,What special circumstances are present (i.e., concomitant illnesses, potential drug,drug interactions) that can impact therapy? [source]

LIFE INSURANCE: REGULATION AS CONTRACT ENFORCEMENT,

ECONOMIC AFFAIRS, Issue 4 2004
Alan D. MorrisonArticle first published online: 28 JUN 200
Debating the minutiae of insurance regulation without a clear understanding of why insurance companies are regulated is futile. In this article I discuss the economic rationale for insurance business regulation and conclude that the appropriate role of the regulator is to enforce contracts which might otherwise be broken. I argue that if this is the case, regulation should be optional, and that it need not be a monopoly activity. [source]

STATE SUPREME COURT APPLICATIONS OF TROXEL v. GRANVILLE AND THE COURTS' RELUCTANCE TO DECLARE GRANDPARENT VISITATION STATUTES UNCONSTITUTIONAL

FAMILY COURT REVIEW, Issue 1 2003
Kristine L. RobertsArticle first published online: 15 MAR 200
In this article, the author reviews state supreme court applications of Troxel v. Granville, analyzing the impact of the decision on the courts' ongoing efforts to adjudicate visitation disputes between parents and grandparents. Set against a background of legislative recognition of grandparents' rights and judicial uncertainty regarding the appropriate role of nonparents in children's lives, Troxel reaffirmed the constitutional right of parents to direct their children's upbringing. The author argues that state supreme courts evaluating gradparent visitation statutes and seeking to enforce Troxel's presumption in favor of parents should be more willing to strike down overly broad statutes. Such an approach would be a positive step toward addressing the excessive judicial discretion that the Troxel Court found so problematic, and would signal to state legislatures the need for statutes that both provide for the needs of children and protect parental rights. [source]

Variations in prescribing atypical antipsychotic drugs in primary care: cross-sectional study

PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 4 2002
Darren M. Ashcroft
Abstract Background Side-effects from conventional antipsychotic drugs, in particular extrapyramidal side-effects, limit their use for some patients, lead to non-compliance and may adversely affect the quality of life of others. Newer, more expensive, ,atypical' antipsychotics have been developed in attempts to address these problems, although debate about the most appropriate role for these medications remains. Objectives To examine variations in prescribing of the ,atypical' antipsychotics in primary care, over a 5-year period. Setting All 13 health authorities within the West Midlands region. Method Cross-sectional analysis of prescribing analysis and cost (PACT) data for atypical antipsychotic drugs (amisulpride, clozapine, olanzapine, risperidone, sertindole, and zotepine) was performed using one-way analysis of variance. To test whether the differences reflected variation in local population need, the prescribing data were adjusted using Mental Illness Needs Index scores. Regression analysis was used to examine the relationship between the overall levels of prescribing and local population need. Results The total volume of prescribing of atypical antipsychotic drugs in primary care increased nearly six-fold from 1996/97 to 2000/01 in the West Midlands region. Olanzapine was the most commonly prescribed drug during 1999/2000, accounting for 45% of defined daily doses, while risperidone accounted for 38% of the total. In 1996/97, a four-fold variation in rates of atypical antipsychotic prescribing between health authorities was found, compared with a three-fold variation in 2000/01, after adjusting for measures of local population need. Conclusions There has been a substantial increase in the prescription of atypical antipsychotics in primary care over the last 5 years, but the rate of increase has varied widely between health authorities. Further studies are needed to determine the factors that have led to these differences in uptake, and the likely impact of national guidance on future prescribing patterns. Copyright © 2002 John Wiley & Sons, Ltd. [source]

Crisp, The Senate, And The Constitution

AUSTRALIAN JOURNAL OF POLITICS AND HISTORY, Issue 4 2008
Stanley Bach
This essay explores the development of L.F. Crisp's understanding of the appropriate role of Australia's Senate in the national political system. A review of his widely-used textbook over three decades reveals that, to Crisp, the Senate was conceived primarily to protect state interests, but that role was nullified almost immediately by the emergence of disciplined parties. Thereafter, the Senate usually was an ineffectual irrelevancy until the introduction of proportional representation transformed it into a threat to the constitutional system as it should operate. Crisp also appreciated that disciplined parties undermined effective control of government by the House of Representatives, yet he consistently failed to recognize in the Senate an institution capable of doing what the House of Representatives cannot: enforcing accountability on the government of the day. [source]

Pharmacy support staff involvement in, and attitudes towards, pharmacy-based services for drug misusers

INTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 6 2009
Jenny Scott
Abstract Objective This study aimed to examine involvement of pharmacy support staff in delivering services to drug misusers; to quantify their participation in related training; and to examine relationships between attitudes, practice experience and training. Methods The setting was a random sample of 10% of UK community pharmacies (n = 1218) using a postal questionnaire with two reminders. Pharmacy managers were used as gate-keepers to access pharmacy support staff, which included dispensary technicians and medicines counter assistants. Key findings Six hundred and ninety (56.7%) pharmacies responded, and 1976 completed questionnaires were returned from 610 (50.1%) pharmacies. A further 80 (6.6%) opted out. Three-fifths of staff had no input into decisions about whether their pharmacy provided services for drug misusers. One-third working in pharmacies that provide services were uncertain or negative about whether their pharmacy should do so. Staff were more involved in needle exchange (91%) and decisions to sell needles (95%) than supervising consumption of therapies (64%) or handing out dispensed medicines to drug misusers (73%), suggesting managers perceive needle exchange and sales as appropriate roles. Three-quarters of those working in pharmacies that provide services had not received any training to do so. Those who had undertaken training and who worked in pharmacies that provided services had significantly more positive attitudes compared to those had not undertaken training but also worked in pharmacies that provided services, or those who had undertaken training but did not provide services. Conclusions Pharmacy support staff were involved extensively in drug-misuse services but the majority had not been trained to do so. Attitudes were more positive in those who were involved in service provision and had undertaken training. The findings suggest a need for more extensive training and for further exploration of the views of managers on appropriate roles, particularly the clinical versus supply nature of needle exchange. This is timely given the recent publication of guidelines by the National Institute of Health and Clinical Excellence (NICE) on needle exchange. [source]

Interdisciplinary team interactions: a qualitative study of perceptions of team function in simulated anaesthesia crises

MEDICAL EDUCATION, Issue 4 2008
Jennifer M Weller
Objectives, We placed anaesthesia teams into a stressful environment in order to explore interactions between members of different professional groups and to investigate their perspectives on the impact of these interactions on team performance. Methods, Ten anaesthetists, 5 nurses and 5 trained anaesthetic assistants each participated in 2 full-immersion simulations of critical events using a high-fidelity computerised patient simulator. Their perceptions of team interactions were explored through questionnaires and semi-structured interviews. Written questionnaire data and interview transcriptions were entered into N6 qualitative software. Data were analysed by 2 investigators for emerging themes and coded to produce reports on each theme. Results, We found evidence of limited understanding of the roles and capabilities of team members across professional boundaries, different perceptions of appropriate roles and responsibilities for different members of the team, limited sharing of information between team members and limited team input into decision making. There was a perceived impact on task distribution and the optimal utilisation of resources within the team. Conclusions, Effective management of medical emergencies depends on optimal team function. We have identified important factors affecting interactions between different health professionals in the anaesthesia team, and their perceived influences on team function. This provides evidence on which to build appropriate and specific strategies for interdisciplinary team training in operating theatre staff. [source]

One Size Cannot Fit All: A Stage Model for Psychotherapy Manual Development

CLINICAL PSYCHOLOGY: SCIENCE AND PRACTICE, Issue 4 2002
Kathleen M. Carroll
There has been controversy surrounding the roles and value of psychotherapy manuals in clinical practice since their inception. It has been underrecognized that the appropriate roles and content of manuals should evolve with the stage of development of a given treatment. This article proposes a stage model in which manuals are seen as evolving with the level of development of the treatment, from the basic outlines necessary for preliminary evaluation of the treatment in early pilot studies (stage I), to highly defined guidelines that demark the internal and external boundaries of treatment for efficacy studies (stage II), and finally to elaborated systems appropriate for use with diverse clinical populations (stage III). We propose guidelines for the content of manuals at the various stages, as well as strategies for developing "clinician-friendly" manuals to facilitate broader use of empirically supported treatments. [source]