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PubMed1993

Agencies issue statement on TBA training.

WHO, UNICEF, and UNFPA have produced a joint statement on training traditional birth attendants (TBAs), putting the issue of such training into the context of local conditions. It followed considerable debate on the issue. It says: "Because of the current shortage of professional midwives and institutional facilities to provide prenatal care and clean, safe deliveries as well as a variety of primary health care functions, WHO, UNICEF and UNFPA promote the training of TBAs in order to bridge the gap until there is access to acceptable, professional, modern health care services for all women and children." However, the statement goes on to point out the limitations of concentrating on TBA training alone. "Training of TBAs cannot be used as a single approach to improving maternal and child health care. Without implementation of appropriate technologies and strengthening of referral and support systems, TBA training alone cannot contribute to a substantial improvement in health care. Furthermore, trained TBAs cannot be expected to reduce overall mortality and morbidity rates when poverty, illiteracy, and discrimination--the underlying causes of these problems--are not addressed."

Delivery of Health Care↗

PubMedDate not supplied

The utility of Pro Forma Income Statements.

Recent headlines surrounding the financial demise of the nation's seventh largest company, Enron, and its subsequent entanglements with its accounting and consulting firm, Arthur Andersen, have placed a cloud of suspicion upon many reasonable business practices that otherwise are considered standard procedure. The proforma income statement is one of those practices. An oft-used tool in financial management, pro formas play a useful role for projecting financial performance based on predictable forecasts or assumptions. Regardless of the current scrutiny, there is still a valid use for accurately prepared statements.

Accounting↗

PubMed2002

Out of a recent CVI consensus: some features of a basic statement.

In March 1997 at the Abbaye des Vaux de Cernay, France, a multidisciplinary meeting of venous specialists, to do guidelines on venous management was held. Subsequently the faculty members revised the document and a consensus statement was published in Circulation, in November 2000, based on wide-ranging and authoritative research into the investigation of chronic venous insufficiency (CVI). The statement gives information on the epidemiology and pathophysiology of CVI including the changes in the major veins as well as in the microcirculation and the associated hematological changes. It sets out the methods used for morphologic and hemodynamic investigations into venous disease and for the study of the microcirculation stating their usefulness and limitations, and indicating their place in clinical practice and research. A section deals also with the rare venous malformations. It concludes with an application of the methods in the investigation on CVI based on the CEAP classification that gives a uniform way of reporting venous disorders. The document is intended both for the clinician and the researcher. A shortened version appears below.

Chronic Disease↗

PubMed2004

Policy statement: organizational principles to guide and define the child health care system and/or improve the health of all children.

The American Academy of Pediatrics proposed a definition of the medical home in a 1992 policy statement. Efforts to establish medical homes for all children have encountered many challenges, including the existence of multiple interpretations of the "medical home" concept and the lack of adequate reimbursement for services provided by physicians caring for children in a medical home. This new policy statement contains an expanded and more comprehensive interpretation of the concept and an operational definition of the medical home.

Child↗

PubMed2004

Global: HIV/AIDS-related travel restrictions--UNAIDS/IOM statement and revision of International Health Regulations.

In June 2004 UNAIDS and the International Organization for Migration (IOM) issued a joint statement on HIV/AIDS-related travel restrictions. While acknowledging that the regulation of immigration matters is widely recognized as falling within the sovereign power of the individual state concerned, the statement distinguishes between short-term (one month or less) and long-term travel.

HIV Infections↗

PubMed2005

FIP statement of professional standards: the supply of medicines affecting driving performance.

The International Pharmaceutical Federation (Fédération Internationale Pharmaceutique, FIP) has published a statement on medications affecting driving. This statement discusses labeling, professionals' obligations in educating patients and the roles that professional organizations can take to assure that appropriate patient s counseling and education is provided.

Automobile Driving↗

PubMed1995

A review of selected blood-borne pathogen position statements and federal regulations.

One response to the AIDS epidemic has been the formation of blood-borne pathogen policy statements by medical associations, athletic governing bodies, and the federal government. The policy statements by medical associations and athletic governing bodies discuss a wide range of issues, including the eligibility of infected athletes and the right of infected health care workers to practice. In contrast, federal regulations are limited to employees in the work environment. Despite the apparent comprehensiveness of these documents, major deficiencies in the documents do exist. For example, employees exposed to body fluids are entitled to free, employer-provided HIV testing. Similarly, athletes exposed to body fluids also are entitled to voluntary HIV testing. However, it is unclear who should pay for this testing. Furthermore, AIDS testing of student athletic trainers is never discussed. Although there are deficiencies, these documents provide guidelines for resolving the deficiencies. For example, because student athletic trainers act as employees of their institution, it is reasonable to suggest that they receive the same protections that federal regulations provide to employees. Thus, the athletic trainer should find these documents useful for developing policies related to blood-borne pathogens.

Journal Article↗

PubMed2006

[The psychiatrist working in a multidisciplinary team and the "Revised Profile of the Psychiatrist." Legal and organizational statements outside reality?].

The document entitled 'Herziene Profielsschets Psychiater (Revised Profile of a Psychiatrist)' contains the following statement: 'Belonging to and working in a multidisciplinary team does not invalidate one of thefundamental rules of psychiatric practice according to which the psychiatrist can only refer a patientfor investigation and treatment if he himself has actually seen the patient'. This statement overlooks thefact that many psychiatrists are employees i.e. they work in hospitals or group practices, and are not in private practice. As employees they fall under a larger body of legal and organisational rules and regulations than do psychiatrists in private practice. The revised profile fails to take this aspect into account.

Employment↗

PubMedDate not supplied

Mission statements and vision documents in medical practices.

Thoughtful, carefully constructed mission statements and vision documents serve both to signal the purpose of a medical practice to the public and other professional colleagues, and to keep the practice's providers focused on its key purposes. Practice culture is the primary driver ofmission and vision. We clarify the differences between mission statements and vision documents, and offer guidelines to aid in constructing them.

Documentation↗

PubMed1992

Pertussis vaccination: acellular pertussis vaccine for reinforcing and booster use--supplementary ACIP statement. Recommendations of the Immunization Practices Advisory Committee (ACIP).

This supplementary statement provides information on and recommendations for the use of diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP). One such vaccine was recently licensed, ACEL-IMMUNE.* This vaccine is licensed for use only as the fourth and fifth doses of diphtheria, tetanus, and pertussis vaccination; it is not licensed for the initial three-dose series in infants and children, regardless of age. At least one other DTaP product is anticipated to be licensed in the future for use as the fourth and fifth doses. The current Immunization Practices Advisory Committee (ACIP) statement on diphtheria, tetanus, and pertussis issued August 8, 1991, gives general recommendations on pertussis prevention, including the use of whole-cell pertussis vaccines for primary and booster vaccination (1).

Child, Preschool↗

PubMed1991

Permanent Working Group of European Junior Hospital Doctors. Policy statement on postgraduate medical education in general practice. Prepared by the Subcommittee on Postgraduate Medical Training.

The Permanent Working Group of European Junior Hospital Doctors' Policy Statement on Postgraduate Medical Education reviewed the regulations governing postgraduate training in the European Communities and set out educational principles which the Group believed were applicable in all medical disciplines. Recognizing that the training of general practitioners poses some specific problems, the PWG has adopted this further statement on training in general practice. It reaffirms the need for trainees to have a model of good practice, extensive experience, theoretical teaching, critical scrutiny and regular, unambiguous feedback regarding progress. In addition, it argues for the availability of an appropriate number of posts for GP trainees both in hospitals and in practices and an awareness among hospital-based trainers of the educational needs of trainees who intend a career in general practice.

Education, Medical, Graduate↗

PubMed1990

Educated guesses: health risk assessment in environmental impact statements.

Environmental pollution threatens public health. The search for solutions has advanced the frontiers of science and law. Efforts to protect the environment and public health begin with describing potential adverse consequences of human activities and characterizing the predicted risk. The National Environmental Policy Act requires the preparation of environmental impact statements to describe the effects of proposed federal projects and provide information for agency decisionmakers and the public. Risks to public health are particularly difficult to quantify because of uncertainty about the relation between exposure to environmental contamination and disease. Risk assessment is the current scientific tool to present estimates of risk. The methodology has created controversy, however, when underlying assumptions and uncertainties are not clearly presented. Critics caution that the methodology is vulnerable to bias. This Note evaluates the use of risk assessment in the environmental impact statement process and offers recommendations to ensure informed decisions.

Bias↗

PubMed1990

TriCouncil for Nursing issues statement on assistive personnel for the registered nurse.

In 1987, The House of Delegates of the American Medical Association (AMA) recommended initiatives to solve the shortage of bedside caregivers. The Registered Care Technician (RCT) proposal was the result. The intent of the proposal was to create a pool of technical workers who would assist nurses. The nursing community perceived the RCT proposal as an attempt to interfere in nursing's domain, and even to undermine their struggle to create two levels of entry into nursing: associate degree and baccalaureate. Nursing organizations formed coalitions, held meetings, published position statements, and mounted campaigns to sidetrack the AMA plans. The training, supervision, and role of assistive personnel were key areas of concern. The TriCouncil for Nursing recently issued a position statement regarding the categories and functions of assistive personnel.

Allied Health Personnel↗

PubMed1987

Maternal serum alpha-fetoprotein screening programs and quality control for laboratories performing maternal serum and amniotic fluid alpha-fetoprotein assays: policy statement. American Society of Human Genetics.

Maternal serum alpha-fetoprotein (MSAFP) values are used primarily but not solely to predict the occurrence of open neural tube defects in the fetus; their use for prediction of Down's syndrome is a new initiative under investigation. The test is a good one, as far as such a test can be, but it is imperfect, because false-negative and false-positive results both occur. In other words, it is not an infallible test. To use the test as effectively as is currently possible requires a program capable of supplying baseline values in sufficient number and the follow-up procedures necessary for interpretation of positive tests. In other words, it is not simply an office test. Because there is no effective treatment to relax the burden of neural tube defects in the large majority of patients, prevention of disease involves termination of pregnancy at present. In other words, use of the test is value laden and controversial for some sectors of society. Despite its imperfections, the need for an elaborate societal structure to apply it, and its value-laden context the test is considered by many as a necessary procedure to maintain normal standards of practice. Indeed, the American College of Obstetricians and Gynecologists issued a statement advising its fellows to be aware of the availability of MSAFP testing and to discuss such testing with patients. It is natural that confusion about protocol and anxiety about practice and its consequences are prevalent in this context. The American Society of Human Genetics (ASHG) offers here a statement about issues that affect MSAFP testing and the attendant pitfalls.

Amniotic Fluid↗

PubMed1989

Permanent Working Group of European Junior Hospital Doctors. Policy statement on postgraduate medical education. Subcommittee on Postgraduate Training.

The Permanent Working Group of European Junior Hospital Doctors (PWG), representing junior doctors of 18 European countries, has amongst its foremost interests the quality of postgraduate medical training. Building upon the work of other groups, and notably that of the Advisory Committee on Medical Training (EC), it has developed its own policy statement on postgraduate training. The statement defines the aims of training and the needs of the trainee and proposes that these can only be met through a close relationship between the trainee and a clearly identified trainer. The duties of the trainer are set out, with emphasis on the need for both practical and theoretical teaching and on the importance of regular, unambiguous feedback regarding progress. Trainers themselves require remunerated time for carrying out these duties and training in educational methods. An appropriate balance between clinical and research experience may require an upper limit on the proportion of the training period which may be spent in research. Training programmes should be inspected and approved by appropriate professional bodies working to published criteria of sufficiency. The PWG believes that high levels of skill and knowledge amongst fully trained specialists can only be guaranteed when the training system identifies trainees' shortcomings at every stage and corrects them through unambiguous feedback.

Curriculum↗

PubMed1987

Writing a statement of philosophy of management.

A statement of philosophy of management is a powerful declaration and one that must be continually reviewed. If it is to be accepted and recognized, the statement must reflect the true beliefs of management. The actions taken by management must also mirror those beliefs. We say "we believe"; the staff say "show us." Once your philosophy of management has been set down in writing and clearly defined, there is a grave responsibility to always act in accordance with the beliefs you have formally and openly acknowledged.

Aged↗

PubMed1986

Public policy on smoking and health: toward a smoke-free generation by the year 2000. A statement of a working group to the Subcommittee on Smoking of the American Heart Association.

On May 20, 1984, the Surgeon General challenged the health community to work toward attainment of a smoke-free society by the year 2000. The leadership of the nation's three major voluntary organizations joined numerous associations of health professionals in accepting the challenge. The Subcommittee on Smoking of the American Heart Association (AHA) has concluded that attaining this objective requires the development and implementation of public policies designed to facilitate the transition from a smoking to a nonsmoking society. To study the relevant issues and recommend appropriate policies, the subcommittee commissioned a working group of distinguished experts in the field of smoking and health to prepare a policy statement. The statement, published here, has received the enthusiastic endorsement of the Subcommittee on Smoking and the leadership of the AHA. The working group discusses and recommends four policies: Increase the federal cigarette excise tax. Eliminate or restrict tobacco advertising and other forms of promotion. Assure the rights of nonsmokers to clean air through legislative means. Identify mechanisms to ease and assist the transition of tobacco farmers to other crops or careers.

Humans↗

PubMed1986

Direct mailing as a means of disseminating NIH consensus statements. A comparison with current techniques.

The Office of Medical Applications of Research of the National Institutes of Health conducted a survey to evaluate the effectiveness of mass mailing of consensus statements as compared with traditional dissemination methods. The consensus statement on osteoporosis, published earlier in JAMA, was selected for study. Physicians (N = 695) within each of five relevant specialties in two comparable metropolitan areas were surveyed. Findings suggest that while a small but significant increase of awareness resulted from direct mailing, this increase should be weighed against costs and effectiveness of other methods.

Information Services↗