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Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

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At least 847 records · Page 47Linked to original sources
PubMed2006

[Barriers to effective cancer pain management].

Pain is one of the most feared consequences of cancer experienced by patients. Despite numerious education programs, intervention strategies and multidiciplinary pain societies, approximately 60% of patients with cancer are experiencing pain. Cancer-related pain may affect patient's life in every way, and therefore it has a great influence on the overall quality of life. Barriers to adequate pain management exist, including those related to health-care professionals, the health-care system, and the patients. The most common barriers to pain management include knowledge deficits, misconceptions about opioids and their side effects, inadequate assessment, and organizational issues. The purpose of this article is to provide information about barriers to effective cancer pain management.

Communication Barriers↗
PubMed1997

Achieving treatment goals for schoolchildren with asthma.

OBJECTIVES: To identify problems in managing asthmatic children in school, which if dealt with would help reduce absenteeism and improve participation in school activities. DESIGN: A survey by questionnaire to headteachers. SETTING: Schools in Merthyr and Rhondda Cynon Taff, South Wales. SUBJECT: Asthmatic schoolchildren in areas studied. MAIN OUTCOME MEASURES: Facilities in schools to manage asthma, headteachers' perceptions of knowledge of asthma management by teachers, possession of written policies, and desire for further training. RESULTS: There are 216 schools in the area studied, with 55,166 schoolchildren. A total of 191 (88%) headteachers returned the completed questionnaire. Five hundred and twenty seven (17%) children were reported absent from school during one term because of asthma, with an average of nine days of schooling lost per asthmatic child per term (range 2-16 days). Only 76 (40%) schools allowed children to be responsible for their inhalers, and 12 (6%) schools required parents to administer inhalers. In 115 (60%) schools, headteachers believed their staff were familiar with the management of asthma. A total of 174 (91%) headteachers expressed interest in further training. CONCLUSION: This study highlights the need to train teachers and provide an agreed joint education and health policy on managing asthma in school.

Absenteeism↗
PubMed1999

[Routines required for management of minor head injuries].

Developing guidelines for quality assurance in the management of head injury requires knowledge concerning present management practice. We studied management of minor head injury (MHI) using a cross-sectional mail survey of 76 Swedish hospitals. In 96% of the hospitals, initial patient evaluation, frequently performed by inexperienced physicians, entails neurological assessment according to the Swedish Reaction Level Scale or the Glasgow Coma Scale, while computerised tomography (CT) is used routinely in 4%. This survey indicates great variability in the management of MHI in hospitals in Sweden. Fifteen (21%) hospitals consistently hospitalize all MHI patients for overnight observation, while 56 (79%) have established criteria for early discharge of selected patients. Routines for neurological assessment are satisfactory, while CT scan for skull fracture and early diagnosis of intracranial complications is usually not performed.

Brain Injuries↗
PubMed2001

An examination of critical care nurses' knowledge and attitudes regarding pain management in hospitalized patients.

The purpose of this study was to determine the effectiveness of an educational intervention focused on pain management. The sample consisted of 30 medical/surgical intensive care nurses (age range, 23 to 62 years) employed in a large metropolitan hospital in the southeastern United States. McCaffery and Ferrell's Nurses' Knowledge and Attitude Survey Regarding Pain was administered at 2 points in time: before and after the educational program. The survey simultaneously measures knowledge and attitude levels regarding pain control. The paired t test was used to test for differences between pre- and posttest scores. The Point-biserial and Spearman's correlation coefficients were computed to examine relationships between selected sociodemographic variables and scores (baseline and change) on the survey. Results revealed a significant increase in scores after the educational intervention (t = 9.60. p = .0005). Additionally, a statistically significant correlation was found between change scores (posttest minus pretest scores) and years of nursing experience (rs = .37, p = .047). However, no significant relationships were found between type of nursing degree and baseline or change scores (rpb = .11, p = .575; rpb = .01, p = .955). These results support previous research findings related to the problem of inadequate pain management in the hospital setting. Further, the findings indicate that education regarding pain control is crucial for current nursing students as well as practicing nurses. The challenge for nurses is to be responsive to and integrate current pain management techniques in an effort to decrease the discomfort of hospitalized patients.

Adult↗
PubMed2001

Where are we in risk assessment of food allergens? The regulatory view.

Assessing the risk of exposure to chemicals is done every day worldwide. This assessment includes hazard identification, dose (concentration)-response (effect) assessment, exposure assessment and risk characterization. The present paper discusses the possibilities and limitations of using these procedures when assessing the risk of food allergens. It is concluded that hazard identification is not a problem. The medical literature is full of descriptions of cases of food allergy where the offending food or even allergen is identified. More knowledge on the relationship between dose and response of different allergens in different patient populations is needed. Exposure assessment is possible but may not be easy. Determining the distribution of contamination with an allergen may be crucial. To do risk characterization, and as a consequence to be able to manage risk, knowledge of a threshold for effect is needed and the possibility of using a safety factor. If we do not manage to establish thresholds for elicitation of allergic response in food allergy, risk assessment and management will be very difficult. It will be difficult to avoid labeling like "May contain peanuts" used with and without reason. In the long run, unjustified warnings will not help the allergic consumer but will create more confusion than guidance.

Allergens↗
PubMed2005

Ethnoecology and conservation in protected natural areas: incorporating local knowledge in Superagui National Park management.

The majority of protected natural areas in Brazil were created in coastal areas inhabited by humans for centuries. However, legal protection has triggered a series of conflicts involving human settlements in these areas. To overcome part of these problems, ethnoecological studies have been conducted in order to discover what is known by local indigenous communities with respect to the land, its natural cycles, occurrence and abundance of animal species, and their use. This knowledge, coupled with that acquired in dealing with current situations that negatively affect the quality of life, is useful in protected natural-area planning and management. To that end, the present study proposes environmental education based on ethnoscientific methods, designed to facilitate the maintenance of sociodiversity in the Superagui National Park.

Animals↗
PubMed1993

A 10-year review of maternal mortality in Chon Buri Hospital, Thailand.

1. The overall maternal mortality rate (MMR) in Chon Buri Hospital in the 10-yr period from 1982-1991 was 51.1/100,000 livebirths. 2. The top causes of death were abortion related complications, pregnancy induced hypertension, puerperal infection and postpartum hemorrhage. 3. What we have done is to improve the quantity and quality of obstetric and medical care, solve the problem of vital statistics reports in our hospital, contact doctor in nearby hospitals in referral and interhospital OB-GYN conferences to meet and discuss both knowledge and management problems. 4. What we still faced in the last 4-yr were deaths from abortion related complications, puerperal sepsis and postpartum hemorrhage. Most of the deaths were preventable. 5. So what we have to target to lessen the MMR is to improve the obstetric and medical care, improve the quality of medical personnel in our area in KAP aspect (knowledge, attitude, practice) especially in the field of family planning to prevent unwanted pregnancies, proper prevention and management of postpartum hemorrhage, and prevention and treatment of puerperal and postabortal infection.

Adolescent↗
PubMed2026

Female genital mutilation knowledge, attitudes and training needs among health professionals in non-practicing countries: A literature review.

BACKGROUND: With increasing globalization and migration, the number of women affected by female genital mutilation who reside in countries where the practice is not traditionally performed is constantly increasing. Healthcare providers in these settings are required to address the complex health needs of this vulnerable population. We aimed to synthesize recent literature on their knowledge, preparedness, and educational background. METHODS: We conducted a systematic review across PubMed, Scopus and Embase, identifying papers published from January 2015 onwards, examining providers' knowledge, education and attitudes toward female genital mutilation in non-practicing countries. Both quantitative and qualitative observational studies were eligible. Given heterogeneity in study populations, outcome definitions, and assessment tools, findings were synthesized narratively. The review protocol was registered with the International Prospective Register of Systematic Reviews (CRD420251044761). FINDINGS: 1046 records were screened by title and abstract, and 140 full-text articles were assessed for eligibility. 31 studies met the inclusion criteria (23 quantitative, 8 qualitative). Many providers reported clinical experience with women affected by female genital mutilation, yet substantial variability was observed in knowledge, training, and attitudes. Gaps were particularly evident regarding legislation, World Health Organization classification, clinical guidelines, referral pathways, workplace protocols. Midwives and younger professionals tended to demonstrate higher knowledge levels. Training exposure ranged from 5% to 91%, and many participants perceived it as insufficient. Qualitative findings echoed these patterns, highlighting challenges in female genital mutilation classification, legal awareness, documentation systems, the impact of providers' cultural beliefs on care delivery. CONCLUSION: Considerable efforts are needed to equip healthcare providers to deliver high-quality, culturally competent care to women affected by female genital mutilation. Research should develop validated tools to assess preparedness, adopt mixed-methods strategies to capture patient and provider perspectives, and guide standardized, up-to-date training programs, strengthening knowledge in managing female genital mutilation.

Humans↗
PubMed1999

A proposed managed-care curriculum for podiatric residencies.

This article describes a curriculum that could be included in podiatric residencies to help residents function successfully in a managed-care environment. Various groups have identified and implemented the competencies necessary to function within such an environment. Podiatric residents, who are well trained in the clinical management of podiatric problems, can succeed in a managed-care environment if residency programs include training objectives and methods to address these competencies. This article describes the managed-care components of two primary-care residency programs and a podiatric program and proposes a managed-care curriculum for podiatric residencies. The author's goal is to educate residency directors and faculty members on possible objectives and methods that can enhance the podiatric resident's educational experience and knowledge of managed care.

Curriculum↗
PubMed1994

Part-time medical director: way station or end of the line?

This article is mostly directed to physicians who are contemplating a career change into management. You may be one of those persons who is contemplating taking a part-time position and continuing part-time clinical practice to see if you might enjoy management. It is important to understand that a part time medical director is there primarily because management perceives a need for a physician's skills and license. When a physician is hired on a part-time basis, it is unlikely that management realizes the larger benefits that can accrue to the organization from the physician manager's knowledge of health care and unique approach to the problems and opportunities in the delivery of that health care. Part-time medical directors seldom have an opportunity to be exposed to real management issues and activities and are usually sequestered and limited to functions that a naive management team thinks are most appropriate to a physician's skills and temperament. Be cautious in extrapolating a part-time experience to a full-time role. Consider taking the plunge to full-time management without a part-time transition phase.

Career Mobility↗
PubMed2006

Anesthetic management of the pregnant patient for endovascular coiling of an unruptured intracranial aneurysm.

Diagnosis of an intracranial aneurysm during pregnancy is a rare event requiring multidisciplinary care for successful management. The knowledge base for the anesthesiologist involves principles of both obstetric and neuroanesthesia, as well as critical care. This article reports such a case and discusses the relevant pathophysiology, along with details of the perioperative management by the anesthesiology team.

Adult↗
PubMed1994

A hybrid knowledge based system for therapy adjustment in gestational diabetes.

This poster describes a system to analyze self-monitoring data of gestational diabetic patients, for obtaining an assessment of their metabolic control with the final goal of supporting decision-making in therapy adjustment. The system is able to manage incomplete data and to make temporal reasoning under uncertainty, the two most important constraints when analyzing ambulatory monitoring data. Two different formalism have been used to represent and manage the knowledge: a dynamic Bayesian network and a production system based on rules. The outcomes provided by the whole system are: information on possible patient transgressions of the prescribed treatment and recommendations of treatment adjustments.

Artificial Intelligence↗
PubMed2006

Implementation and evaluation of a training program for the management of sexual assault in the emergency department.

STUDY OBJECTIVE: Sexual assault nurse examiner (SANE) programs have improved the quality of care for sexual assault victims. An adverse effect of these programs is reduced resident clinical exposure to victims of sexual assault. The objectives of this project are to determine the baseline level of resident competence in knowledge and management of sexual assault and to demonstrate the effectiveness of training in developing resident competence. METHODS: The study included 27 emergency medicine residents at an urban academic center with an active SANE program. The design included pretest, intervention, and retest at 6 months. The intervention included 8 hours of lecture, role play, and skills laboratories. Objectives were based on SANE standards. The 4 assessments were a written knowledge test, evidence collection on mannequin, standardized patient interviews, and a written emergency department note. Data were compared with paired t tests. RESULTS: Twenty-three (85%) residents completed the study. Preintervention, residents scored 56% on the written knowledge test, 63% on evidence collection, 71% on standardized patient interviews, and 66% on the written note. Residents showed significant postintervention improvements in written knowledge (improvement 24%; 95% confidence interval [CI] 20% to 27%) and evidence collection (improvement 18%; 95% CI 12% to 24%). Performance on standardized patient-based communication skills did not change after the intervention. Resident posttest scores were similar to those of SANE providers. CONCLUSION: Emergency medicine residents training in an urban center with an active SANE program had limited knowledge and skills in the treatment of victims of sexual assault. Our multimodal educational intervention increased residents' knowledge and evidence collection skills to levels equivalent to that of experienced providers in a SANE program.

Academic Medical Centers↗
PubMed1994

Development of an on-line mastitis detection system within an integrated knowledge-based system for dairy farm management support.

Some aspects of automated clinical mastitis detection and diagnosis are discussed. Knowledge representation techniques for the different steps in the diagnostic process are presented. The main focus of this paper is on automated early detection, based on data that are automatically collected in the milking parlour. Principal component analysis, logistic regression and back-propagation neural networks were used in the analysis of the automatically collected data. The 3 techniques did not differ greatly in performance. All the techniques performed better when data from milking with observed clinical signs were used, compared with data from milking before clinical symptoms were noticed. Healthy quarters were mostly correctly classified by all techniques. It seems unlikely that all clinical mastitis cases can be detected at milking before visible clinical signs occur.

Animals↗
PubMedDate not supplied

A day in the life of managed care: Health Alliance Plan's Medicare Appeals Specialist Yolanda Dodson.

Yolanda Dodson began working for Health Alliance Plan (HAP) as a high school co-op student. Through 11 years in HAP's Claims and Claims Processing Departments, as well as six months spent as a telephone customer service representative, she developed a knowledge of managed care and customer service and gained valuable first-hand experience with members' concerns. Now Dodson is a Medicare Appeals Specialist, one of two staff people handling HMO and HAP Senior Plus (HAP's Medicare+Choice program) grievances and appeals. She serves as an "advocate for the member" as she investigates their cases within a tight mandatory deadline, recommends a resolution, and submits them for consideration to HAP medical directors. The following is a glimpse at one her typical days at HAP's Detroit offices.

Administrative Personnel↗
PubMed1995

Mothers' attitudes to children's chest infections in India.

Acute Respiratory Infections (ARIs) account for a very high morbidity and mortality amongst children in the developing countries. A knowledge, attitude and practice study in relation to the literacy status of mothers whose children suffered from ARI was conducted. A sample of 140 mothers who had 265 children were selected for the study. The majority of literate mothers (75%) had complete knowledge regarding management of ARI. Literacy alone was not the only factor responsible for developing a positive attitude and adopting correct practices during ARI. Mass media and health personnel played an equally important role. Most women (89.3%) had obtained their knowledge regarding ARI through media and paramedical staff. Most mothers (96.4%) were concerned about the health of their children when they suffered from episodes of ARI and the majority of them (87.2%) were worried because they felt that their children or contacts could be adversely affected. Nearly 72% of mothers took early action during an episode of ARI. The majority of the medical practitioners practised non-allopathic medicine but all of them were prescribing allopathic drugs. Most of the mothers (70%) had no problem in taking their children to the desired health centers when needed.

Acute Disease↗
PubMed2002

Addressing tobacco in managed care: a survey of dentists' knowledge, attitudes, and behaviors.

OBJECTIVES: This study assessed the tobacco cessation knowledge, attitudes, and behaviors of dentists participating in a large managed care dental plan. METHODS: Participating dentists in 4 states were surveyed via mail. RESULTS: Dentists' perceived success in helping patients quit using tobacco was highly correlated with discussion of specific strategies for quitting, advice about the use of nicotine gum, and time spent counseling patients. Dentists who were confident about their smoking cessation knowledge frequently advised patients to quit and spent more time counseling patients about tobacco cessation. CONCLUSIONS: Tobacco cessation is not a routine part of dental practice. Knowledge, time spent counseling patients, and specific strategies for quitting were associated with dentists' perceptions of success.

Attitude of Health Personnel↗