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PubMed1992

Ten statements on the motivation of medical teachers to teach.

Not only high number of students, increasing disintegration of curricula, lack of resources or hindering state regulations and laws seem to be the crucial problem in medical education worldwide but in particular substantially reduced interest and poor commitment in educational matters. Ten statements on possible reasons for the teachers' lack of motivation to teach are given and proposals for promoting their commitment are made.

Career Choice↗
PubMed1989

[A study of the process of self-concept formation in adolescence: an investigation of self-descriptions using the Twenty Statement Test (TST)].

The Twenty Statement Test (TST) was administered to four groups of subjects consisting of fifth graders in an elementary school, second graders in a junior high school, senior high school and university. In addition to the traditional analysis of TST in which the major emphasis is on content aspects of mode of self with respect to elementary contents of self-descriptions, further analysis was undertaken in terms of structural aspects of mode of self by focusing on the relation of the self with the elementary contents of self-descriptions. The results of the content-oriented analysis conformed in general to those reported by other investigators in the past. The structurally-oriented analysis indicated a decrease in descriptions of the relationship of the self to things, events and persons in one's environment and an increase in these aspects with respect to one's own traits. It was suggested that by employing both these analytic procedures, an enhanced understanding of self-concept might be facilitated.

Adolescent↗
PubMed1993

Holism, care and nursing: points of reflection during the evolution of a philosophy of nursing statement.

An exploration of the diversity and complexity of perspectives from which holism and care can legitimately be constructed. The preparation of a document for accreditation of a proposed pre-registration Bachelor of Nursing award was the impetus for this exploration. School members deemed holism and care to be central to our philosophy of nursing statement, however, difficulty arose in determining a shared understanding of these notions. Through reflective deliberation and a review of the literature, the authors attempted to unravel the range of meanings given to these problematic terms.

Education, Nursing, Baccalaureate↗
PubMed1995

Maternal and neonatal outcome of patients classified according to the Australasian Society for the Study of Hypertension in Pregnancy Consensus Statement.

OBJECTIVE: To outline the maternal and perinatal features and outcome of patients referred to a tertiary referral obstetric hospital for management of their hypertension. SETTING AND PATIENTS: 205 consecutive public patients admitted for assessment of hypertension (either full admission or day-stay) to King George V Hospital's Hypertension in Pregnancy Unit, between February 1993 and January 1994. DESIGN: A prospective study in which patients were classified according to the Australasian Society for the Study of Hypertension in Pregnancy (ASSHP) Consensus Statement classification. RESULTS: Of the 205 patients, 25% did not meet the criteria for pre-eclampsia or chronic hypertension, 33% had mild pre-eclampsia, 34% had severe pre-eclampsia and the remainder had chronic hypertension. The mean gestation at delivery for those with mild pre-eclampsia was 38.3 weeks and for severe pre-eclampsia 35.3 weeks. For the mild and severe groups respectively, the rate of elective delivery for raised blood pressure was 56% and 53%; for caesarean section, 17% and 61%; and for perinatal death, 2% and 4%. In the severe group, 49% had fetal problems and 25% required intravenous antihypertensives. CONCLUSIONS: The multisystem nature of pre-eclampsia makes comparison of management protocols difficult. Ongoing audit is needed of maternal and perinatal outcomes and features of disease in patients with hypertension in pregnancy under a universal classification. The ASSHP classification system successfully identifies patients who require more intensive management and intervention.

Chronic Disease↗
PubMed1999

A shared statement of ethical principles for those who shape and give health care: a working draft from the Tavistock group.

Health care delivery in many countries has expanded over the past 150 years from a largely social service delivered by individual practitioners to an intricate network of services provided by teams of professionals. The problems of increasing resource consumption, financial constraints, complexity, and poor system design that have emerged as consequences of these changes have exacerbated many of the ethical tensions inherent in health care and have created new ones. Many groups of professionals that give and affect health care have established separate codes of ethics for their own disciplines, but no shared code exists that might bring all stakeholders in health care into a more consistent moral framework. A multidisciplinary group therefore recently met at Tavistock Square in London in an effort to prepare such a shared code. The result was not a code but a more basic and generic statement of ethical principles. The intent and hope is that it will offer clear guidance for tough calls in real world settings. It is presented here not as a finished work, but as a draft to elicit comment, critique, suggestions for revision, and, especially, ideas for implementation.

Codes of Ethics↗
PubMed2004

Better reporting of harms in randomized trials: an extension of the CONSORT statement.

In response to overwhelming evidence and the consequences of poor-quality reporting of randomized, controlled trials (RCTs), many medical journals and editorial groups have now endorsed the CONSORT (Consolidated Standards of Reporting Trials) statement, a 22-item checklist and flow diagram. Because CONSORT primarily aimed at improving the quality of reporting of efficacy, only 1 checklist item specifically addressed the reporting of safety. Considerable evidence suggests that reporting of harms-related data from RCTs also needs improvement. Members of the CONSORT Group, including journal editors and scientists, met in Montebello, Quebec, Canada, in May 2003 to address this problem. The result is the following document: the standard CONSORT checklist with 10 new recommendations about reporting harms-related issues, accompanying explanation, and examples to highlight specific aspects of proper reporting. We hope that this document, in conjunction with other CONSORT-related materials (http://www.consort-statement.org), will help authors improve their reporting of harms-related data from RCTs. Better reporting will help readers critically appraise and interpret trial results. Journals can support this goal by revising Instructions to Authors so that they refer authors to this document.

Evidence-Based Medicine↗
PubMedDate not supplied

Advance statements: legal and ethical implications.

This article informs nurses of the background and purpose of advance statements (advance directives or living wills), and discusses the legal and ethical issues associated with their use.

Advance Directives↗
PubMed1996

[Analysis of financial statements of Japanese private hospitals (1982-1991)].

In order to clarify the financial situation of Japanese private hospitals, the financial statements provided by the Social Welfare and Medical Service Corporation were analyzed for the period from 1982 to 1991. The results clarified the low growth rate and low profitability of the Japanese private hospitals, although their financial situation was relatively stable. However, the efficiency of cost has been stalled in recent years and profitability has been declining due to the low turnover rate of capital. According to the CVP analysis, the Profit volume ratio of the investigated hospitals has been increased to the level of 95%. This situation means that, in the current financial situation, more than half of the Japanese private hospitals will go into the red if revenue declines 5% due to some short term change in the managerial environment.

Cost-Benefit Analysis↗
PubMed1991

Employers protected by at-will statements.

Requiring job candidates to sign at-will statements before they're hired will not protect all employers from wrongful discharge claims. This protections process, however, can reduce the number of risks brought on by employee termination.

Contract Services↗
PubMed1991

Indian Health Service; statement of organization, functions, and delegations of authority--PHS.

Part H, chapter HG (Indian Health Service) of the Statement of Organization, Functions, and Delegations of Authority of the Department of Health and Human Services, Public Health Service (PHS), chapter HG, Indian Health Service (IHS), 52 FR 47053-67, December 11, 1987, as most recently amended at 56 FR 22015-16, May 13, 1991, is amended to reflect the establishment of an organizational substructure for the Bemidji Area Office to more accurately reflect current activities in the Area Office.

Community Health Services↗
PubMedDate not supplied

Removing life support: motivations, obligations. An opinion on NCCB Committee for Pro-Life Activities' statement on artificial hydration and nutrition.

In April 1992 the Committee for Pro-Life Activities of the National Conference of Catholic Bishops issued a resource paper titled "Nutrition and Hydration: Moral and Pastoral Reflections." At best, this document and its conclusions may be viewed as a pastoral statement, offering some tentative reasoning and conclusions to be considered in cases that concern the use of medically assisted nutrition and hydration. When discussing the question, is the withholding or withdrawing of medically assisted hydration and nutrition always direct killing? the document applies two principles--"no reasonable hope of benefit" and "involving excessive burdens." The document's crucial part is its admission that artificial hydration and nutrition may be removed without the intention of causing death, and that "this kind of decision should not be equated with a decision to kill or with suicide." The committee assigns decision-making responsibility to patients, families, and healthcare professionals, but continues its discussion for 20 pages and offers cautions conclusions concerning removal of such therapy. Two assumptions seem to underlie the document's overly cautious conclusions, the first being that mere vegetative function mandates continued life support. The first assumption overemphasizes the value of physiological functioning insofar as the purpose of human life is concerned. It also is contrary to the goal of medicine, which envisions restoration of cognitive-affective function as an element of successful therapy. The second assumption is that withdrawal of artificial hydration and nutrition from persons in PVS may lead to euthanasia. But mandating the continuation of nonbeneficial therapy simply because it prolongs physiological function seems to lead people to favor euthanasia rather than reject it.(ABSTRACT TRUNCATED AT 250 WORDS)

Catholicism↗
PubMed1993

Establishment of a public docket for medical device/radiological health policy statements and operating procedure guides--FDA. Notice.

The Food and Drug Administration (FDA) is announcing that it is establishing a public docket for policy speeches, policy statements, and standard operating procedure guides pertaining to product evaluation and regulatory enforcement for its medical device and radiological health programs. The docket will operate on a 1-year trial basis and will serve both as a repository for critical policy documents generated by the Center for Devices and Radiological Health (CDRH) and as a public display mechanism for access by representatives of the industry and other interested persons. This action is one element of an overall communications initiative to ensure uniform and timely access to important information.

Equipment and Supplies↗
PubMed1993

American Health Information Management Association. Position statement. Issue: physician signatures on attestations.

Currently, payment under Medicare's prospective payment system requires that a physician sign an attestation statement on each Medicare patient, attesting to the diagnoses and procedures recorded for that patient. This requirement places a significant administrative burden on both healthcare facilities and physicians, without adding any value to the claims process. AHIMA believes this requirement should be eliminated. Physicians should continue to be responsible for recording complete, accurate, and timely information (including final diagnoses and procedures) in the patient's health record. Healthcare facilities and their health information management professionals should be held responsible for reporting complete and accurate diagnoses and procedures based on official coding guidelines and documentation in the patient's health record. Sufficient penalties exist for healthcare facilities and physicians who submit fraudulent claims, without subjecting all physicians and healthcare facilities to this administrative burden, which adds unnecessarily to the cost of healthcare.

Authorship↗
PubMed1995

Medicare program; physician self-referral regulations: change in date for submission of group attestation statement--HCFA. Final rule--technical amendment.

This final rule changes (delays) the date by which a group of physicians that wishes to be identified as a group practice for purposes of the physician self-referral regulations (42 CFR 411.350 through 411.361) must file a statement attesting that it meets certain specified conditions.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1997

Complying with current Joint Commission Statement of Conditions (SOC) requirements.

This Technical Document has been developed to provide the reader with insight into the Joint Commission on Accreditation of Healthcare Organizations' (JCAHO) Statement of Conditions (SOC) process and recent changes for completing the SOC for Business Occupancies. The intent of this document is not to replace the instructions in Part 1 of the SOC or to give a complete review of the National Fire Protection Agency's (NFPA) Life Safety Code for health care or business occupancies, but rather to complement them.

Accreditation↗
PubMed1998

Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE program; nonavailability statement requirements--DoD. Final rule.

This final rule revises certain requirements and procedures for the TRICARE Program, the purpose of which is to implement a comprehensive managed health care delivery system composed of military medical treatment facilities and CHAMPUS. Issues addressed in this rule include priority for access to care in military treatment facilities and requirements for payment of enrollment fees. This rule also includes provisions revising the requirement that certain beneficiaries obtain a non-availability statement from a military treatment facility commander prior to receiving certain health care services from civilian providers.

Government Agencies↗