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101.
C. Craig Blackmore MD MPH Eric K. Hoffer MD Emily Albrecht PA-C Frederick A. Mann MD 《Journal of the American College of Radiology》2004,1(6):410-414
We describe a model of how physician assistants can be used in an academic medical center to expand radiologist productivity, and to enhance the departmental academic and educational missions. At Harborview Medical Center, following a training program and graduated responsibility under supervision, physician assistants provide initial interpretation of radiology studies, consultation to referring physicians, and perform less complicated interventional procedures. Acceptance of physician assistants by the radiologists, radiology residents, and referring physicians has been high. Although the impact of physician assistants on departmental clinical productivity is difficult to measure, our data suggest that radiologists are more efficient when physician assistants are assigned to service, both in terms of numbers of studies interpreted, and timeliness of reporting and billing. As a result of the success of our program, we believe that physician assistants can have an important role in radiology practice. 相似文献
102.
Background: To assist optometrists to deliver care more efficiently and effectively, in 1995 Optometrists Association Australia decided to develop standards that would assist optometrists in better managing their practices. Existing practice management standards for health professionals were thought to be either not specific enough for optometric practice or to have shortcomings in the context of optometric practice in Australia. Methods: Following a literature search, material previously developed by Optometrists Association Australia to assist practitioners with management of their practices and standards from other professions were used to assist with the development of a draft set of standards for optometric practices in Australia. Successive drafts were circulated for comment to optometrists in practice, non‐optometrists with experience in the development of practice standards for other health professions and to Australian General Practice Accreditation Limited. The comments were used to refine the standards and the accreditation guidelines to their final form. Results: Optometric Practice Standards suitable for use in a practice accreditation program were developed. The standards comprise seven sections—Practice administration, Quality assurance, Rights and needs of the patient, Practice services, Practice facilities, Communication and Patient records. These sections are divided into criteria that provide the detail of the requirements of the standard. Indicators describing how criteria can be assessed accompany the criteria. 相似文献
103.
Stacie E. Perlman M.D. Randolph B. Reinhold M.D. Geoffrey S. Nadzam M.D. 《Surgery for obesity and related diseases》2007,3(4):428-433
BACKGROUND: Little is known about the level of knowledge and comfort with bariatric surgery among family practice physicians. METHODS: Surveys were sent to all family practitioners in Connecticut querying the practice type and knowledge of bariatric surgery. The results were analyzed for the prevalence of opinion. RESULTS: Of 620 surveys sent out, 129 (21%) were completed. Of the 129 respondents, 73% were men, aged 31-79 years, and 92% were board certified, with an average of 19 years' experience. The average body mass index of respondents was 26 kg/m2 (range 16-40). Only 4% of respondents had a body mass index >30 kg/m2. Physicians reported a patient obesity rate of 43%. Of the 129 respondents, 88% believed obesity was difficult to control with diet and exercise alone. Only 6% thought obesity was best controlled surgically. Also, 85% of respondents had referred a patient for gastric bypass, although only 57% were comfortable explaining the procedure. The most common reason for refusal to refer was fear of complications and death. Additionally, 55% correctly listed a body mass index of 40 kg/m2 as qualifying for bariatric surgery without comorbidities; 48% identified the mortality rate of surgery as <1%, with 4% of respondents reporting >10%; and 84% were familiar with gastric bypass, 66% with LapBand, 33% with vertical banded gastroplasty, and 5% with duodenal switch. The respondents believed that nausea was the most common side effect, followed by anemia and fatigue. Finally, 53% believed bowel obstruction was common. CONCLUSIONS: The results of our study have shown that misconceptions about bariatric surgery exist in the family practice community despite the increasing frequency of these procedures. Educational programs need to be designed to assist family practitioners in treating and referring obese patients. 相似文献
104.
105.
In recent years many studies of unemployment and health haveshown that unemployed persons are in poorer health. However,one question remained unanswered: is the poorer health of theunemployed caused by unemployment Itself (causation hypotheses)or is it a result of selection processes, whereby people inpoor health are more likely to lose their job and less likelyto be re-employed (selection hypothesis)? Findings from a studybased on the longitudinal data of the German Socio-economicPanel (19841988, N=5, 516 persons, 1864 years)are presented. All health indicators (health satisfaction, chronicillness, handicaps in fulfilling daily life tasks, disability)showed poorer outcomes for the unemployed persons, even aftercontrolling for the possible confounding effects of sodo-demographicvariables. Unemployed persons also consulted a physician morefrequently and were hospitalized more often. But longitudinalanalyses (of becoming unemployed and of re-employment) did notlend much support to the causation hypothesis. Instead, a constantlevel of health satisfaction for persons losing their job andfor the re-employed compared to their initial ratings supportedthe selection hypotheses. This means that in the Federal Republicof Germany persons in poorer health are more likely to losetheir jobs and persons in better health are more likely to bere-employed. 相似文献
106.
R. B. HAYS 《Medical education》1993,27(3):254-258
Summary. This paper reviews the literature on career choice to investigate the undergraduate influences on the preference of Australian graduates for a career in general practice. Although isolation of influencing factors is difficult, admission criteria and undergraduate curricula may influence career preference. As the institutional environment of medical schools is weighted towards scientific research and specialized medicine, medical students may be socialized into choosing non-generalist careers. Medical schools should consider broadening selection criteria and curriculum exposure to produce graduates with a broad range of career interests. 相似文献
107.
108.
Bernadette Dierckx de Casterlé PhD RN Agnes Roelens PhD MPH CNM † & Chris Gastmans PhD 《Journal of advanced nursing》1998,27(4):829-835
Critics of Kohlberg's moral theory today focus on the content of his theory and more specifically on its justice-orientated moral concept. This has led to the well-known 'justice-care debate'. The purpose of this article is to critically examine the validity of Kohlberg's moral theory for research in nursing ethics from a caring perspective (referring to the content) as well as from a cognitive-structural perspective (referring to the basic assumptions of the model). The analysis points to the usefulness and value of the cognitive-structural model to empirically study nurses' ethical behaviour; the content of Kohlberg's model, however, needs to be adapted by adding a caring perspective as well as some personal and situational variables. An adjusted version of Kohlberg's model is proposed and discussed. 相似文献
109.
A systematic search of studies of intrapartum management of the nuchal umbilical cord at term found no published controlled studies in this area. A postal survey containing both structured and open questions and a request for local protocols and guidelines was sent to all 637 midwives in 7 maternity units in England. There were 401 (63%) responses. There appeared to be no unit guidelines for this area of practice. Midwife approaches to nuchal cord during birth varied, and included clamping and cutting of loose nuchal cords and a hands-off approach to tight nuchal cords. Reasons for specific actions included doing what had been taught during midwifery training and learning from previous personal experiences. Theories of diffusion of innovation and of planned behaviour may provide a conceptual basis for understanding the adoption of specific practices. Future qualitative and controlled studies are needed to explore the nature and consequences of varying approaches to intrapartum nuchal cord management. 相似文献
110.
护理学基础课程技术操作教学改革与实践 总被引:1,自引:0,他引:1
吕云玲 《中华医学教育杂志》2007,27(2):44-45
目的培养高素质实用型护理人才,塑造护生良好形象,使之更加适应现代护理工作需要。方法教师在护理学基础课程技术操作教学过程中,注意通过课前引导学生预习操作内容、精心设计教案、规范操作流程、善于灵活运用示教和多媒体、演练情景剧、开放实验室、强化训练、开展技能考核与比赛等方式培养学生动手操作能力。结果2001年以来,已先后有3届学生进入临床实习。通过问卷调查,学生、带教教师、病人满意度分别达到98.5%、98.2%、97.0%。 相似文献