Antipseudomonal carbapenems have played a useful role in our antimicrobial armamentarium for 20 years. However, a review of their use during that period creates concern that their clinical effectiveness is critically dependent on attainment of an appropriate dosing range. Unfortunately, adequate carbapenem dosing is missed for many reasons, including benefit/risk misconceptions, a narrow therap...

BACKGROUND Aim of study was to document 1) that patient safety culture scores vary considerably by hospital department and ward, and 2) that much of the variation is across the lowest level organizational units: the wards. Setting of study: 500-bed Norwegian university hospital, September-December 2006. METHODS Data collected from 1400 staff by (the Norwegian version of) the generic version o...

BACKGROUND Integrated health care delivery is a goal of health care systems; to date there has been limited information on the integration of medical care in practice. PURPOSE To examine and compare perceptions of clinical integration and to identify associated strategic, cultural, technical and structural factors. DESIGN AND SETTING A NATIONAL SURVEY ADDRESSED TO: all county administrative...

This report concerns a case that shows the apparent successful use of acupuncture and moxibustion in treating hypersexuality. The patient was a 60-year-old Chinese woman with a history of uraemia for 4 years and hypersexuality for 7 months, the latter being a rare condition. The presenting symptoms were persistent sexual desires and fantasies, in addition to being irritated when her continuous ...

BACKGROUND South Africa (SA)'s planned National Health Insurance reforms require the use of International Statistical Classification of Diseases (ICD) codes for hospitals to purchase services from the proposed National Health Authority. However, compliance with coding at public hospitals in the Western Cape Province has been challenging. A computer application was developed to aid clinicians in...

BACKGROUND In France, advance directives are favourably perceived by most of the population, although the drafting rate is low. This ambivalence is challenging because advance directives are meant to promote the autonomy and freedom of choice of patients. The purpose of this study was to analyse the content of advance directives written by patients suffering from malignant haemopathies to bette...

CONTEXT   Consultants in charge of postgraduate medical education (PGME) in hospital departments ('lead consultants') are responsible for the implementation of educational change. Although difficulties in innovating in medical education are described in the literature, little is known about how lead consultants approach educational change. OBJECTIVES   This study was conducted to explore lead...

Denmark is facing a reduction in clinical trial activity as the pharmaceutical industry has moved trials to low-cost emerging economies. Competitiveness in industry-sponsored clinical research depends on speed, quality, and cost. Because Denmark is widely recognized as a region that generates high quality data, an enhanced ability to attract future trials could be achieved if speed can be impro...

OBJECTIVE Because a centre effect can sometimes exist in HIV treatment, we sought to measure the heterogeneity of French hospital departments delivering HIV care and to test the presence of such an effect on adherence and response to highly active antiretroviral therapy. METHODS The ANRS-EN12-VESPA study is a nationally representative 2-stage cross-sectional survey conducted in France in 2003...

Aims: To test selected propositions of the middle-range theory of nursing intellectual capital. Background: The nursing intellectual capital theory conceptualizes nursing knowledge’s influence on patient and organizational outcomes. The theory proposes nursing human capital, nurses’ knowledge, skills and experience, is related to the quality of patient care and nurse recruitment and retention o...