We built on evidence searches developed for a comprehensive systematic review of evidence about staffing in emergency departments [4]. We searched MEDLINE, CINAHL and the Cochrane Library using terms such as “substitute/nurse specialist/physician assistant/advanced practice nurse”, “skill mix”, linked with terms such as ‘‘emergency nursing’’, ‘‘Accident and emergency or emergency department’’, ...

UNLABELLED One of the most controversial issues in anesthesia is whether nonmedically directed nurse anesthetists are relatively more cost-effective than anesthesiologists in the provision of anesthesia care. We electronically surveyed anesthesia practices throughout the United States to estimate the range in anesthesia professional costs from the payer perspective. Using this survey data on an...

BACKGROUND Parental and professional agreement as to the presence of wheezing in infants and preschool children has been shown to be poor. Agreement on the absence or presence of physical signs on chest examination in these populations is far from perfect, even among experienced physicians. OBJECTIVES We sought to compare the assessment of a parent, nurse, and physician with the "gold standar...

The findings by Peterson et al. show that over half of all family physicians work with nurse practitioners, physician assistants, and certified nurse midwives. While tensions surrounding leadership of teams remain an issue, there are many systems problems that all primary care providers need to face together. This commentary presents the challenges we need to address in order to keep the focus ...

OBJECTIVE To examine the effectiveness of a brief, school-based intervention for preventing alcohol use. DESIGN AND SETTING Randomized, control trial assigning inner-city public school students to an intervention program or a comparison program. PARTICIPANTS Sixth, seventh, and eighth grade students in Jacksonville, Fla (N=104). INTERVENTIONS Students assigned to the intervention program ...

OBJECTIVE Overactive bladder (OAB) affects 16.9% of women in the United States. Percutaneous tibial nerve stimulation (PTNS) is a third-line treatment for patients who are refractory to behavioral and pharmacologic therapies. We aimed to evaluate the effects of PTNS on urinary symptoms in patients diagnosed as having refractory OAB and investigate the cost of medications and clinical visits bef...