When I began my career in dentistry twenty-five years ago, the "fee-for-service" practice was by far the most common approach for delivery of care. Time was not taken to define individuality and purpose, and outside factors such as insurance did not attempt to dictate the direction we took toward a treatment plan. Marketing was not mentioned and practice management as we know it was just beginn...

The failure to address child neglect prevention efforts from a system viewpoint is presented as a major impediment to the generation of truly preventive interventions. Child neglect prevention is discussed at three levels: at the level of the individual, at the level of social systems and at the level of fundamental beliefs and cultural agreements. A process of component selection and placement...

Arthroscopic management of labral problems in the hip has become an accepted therapeutic modality in appropriately selected patients. We performed a systematic review of the literature to determine the rate of patient satisfaction that can be expected following acetabular labral débridement. Computerized literature databases were searched from January 1980 to September 2005 to identify relevant...

The use of unlicensed and "off-label" medicines in children is widespread. Between 50-80% of the medicines currently administered to children have neither been tested nor authorized for their use in the paediatric population which represents approximately 25% of the whole European population. On 26 January 2007, entered into force the European Regulation of Paediatric Medicines. It aims at the ...

• Two auditors: one to ask open questions, the other as witness and scribe. • Interview staff individually, establishing their knowledge of trial procedures and incident. Note conflicting information. • Establish key facts: 1. Were participants real and eligible? 2. Did they consent? 3. Are test/clinical measurements/data valid? 4. Was appropriate treatment/intervention given? 5. Was follow-up ...

It is difficult to draw up a list of medicines that are essential for infants and children. It is clear, however, that many of the medicines used appropriately to treat infants and children are not licensed for such use.1 The medicines concerned may be used outside the terms of their product license, ie, used off-label, or unlicensed for use in children at any age.2 Off-label use appears to be ...

We diagnosed 50 patients (58 shoulders) with a mean age at presentation of 17.3 years, as having involuntary positional instability of the shoulder. They were managed by a programme consisting of a careful explanation, analysis of abnormal muscle couples and then muscle retraining carried out by a specialist physiotherapist. The mean follow-up was two years. Six shoulders had a poor result, but...

BACKGROUND Public opinion polls indicate that a majority of Canadians are in favour of euthanasia. However, there have been many criticisms of the validity of these findings. The objective of this study was to assess public opinion towards euthanasia while controlling for possible threats to validity indicated in the literature review. METHODS A telephone public opinion poll was conducted in ...

BACKGROUND Medications are frequently prescribed outside their regulatory approval (off-label) by physicians particularly where appropriate therapies are not available. However, the risk/benefit ratio of drugs in off-label use needs to be critically appraised because it may differ from approved on-label usage. Therefore, an extensive exploration of current evidence on clinical data is well-advi...