prac Coronavirus - Webinar - Listen again - In-depth insights and practical advice regarding Force Majeure, Frustration and reconsidering Commercial Contracts UK By www.eversheds.com Published On :: 2020-04-06 Listen as our panel answer some of the most common questions clients have asked us over recent weeks as well as digging into more detail around how your business should proceed with specific legal and technical challenges. A recording of the session... Full Article
prac Chambers Global Practice Guide Public Procurement & Government Contracts 2019 By www.eversheds.com Published On :: 2018-10-22 ... Full Article
prac Private Companies in South Africa: Practical and Legal Considerations Concerning Acquisitions and Disposals By www.eversheds.com Published On :: 2019-11-29 Mergers and acquisitions (“M&As”) involving privately held companies in South Africa entail various legal, financial and other issues. Advanced preparation and an understanding of the fundamental practical and legal issues concerned ... Full Article
prac Land Registry change of practice in relation to discharge of mortgages By www.eversheds.com Published On :: 2009-06-19 The Land Registry is changing its practice on the discharge of mortgages in cases where form DS1 is not available when the application is made to the Land Registry. On 3 August 2009, the Land Registry will implement an important change in practice ... Full Article
prac Webinar: Navigating Lockdown and Beyond - Practical steps to support ourselves and others through a unique time By www.eversheds.com Published On :: 2020-05-01 Eversheds Sutherland were delighted to partner with Women in ETFs for a one hour webinar 'Navigating Lockdown and Beyond - Practical steps to support ourselves and others through a unique time' on 30 April. The presentation was delivered by Á... Full Article
prac Coronavirus a practical guide for employers in the Czech Republic By www.eversheds.com Published On :: 2020-05-05 We are continually updating this guide in response to the gradual publication of official information by public authorities. Latest update: 5 May 2020, 17:00 (Restrictions on movement of persons, Mandatory quarantine when crossing borders, Children&... Full Article
prac New European Works Council legislation: what will it mean in practice? By www.eversheds.com Published On :: 2009-12-08 The Government has responded to the 2009 European Works Council (EWC) Directive by publishing draft implementing Regulations and stating their intention to finalise them in 2010, but delay implementation until 5 June 20... Full Article
prac Practical Implications of RMT v Serco Ltd and Aslef v London & Birmingham Railway Ltd By www.eversheds.com Published On :: 2011-04-19 Introduction Full Article
prac Infosys To Acquire Simplus For Quote-To-Cash Consulting Practice By seekingalpha.com Published On :: Wed, 12 Feb 2020 19:54:17 -0500 Full Article INFY Donovan Jones
prac Invoice hijacking fraud - Court adopts practical approach to assist recovery By www.eversheds.com Published On :: 2019-10-16 Email scams are becoming more and more difficult to spot. Hackers replicate genuine email traffic, posing as genuine suppliers providing invoices that appear genuine. It is often only when the supplier chases on payment, which as far as... Full Article
prac European Commission aims to level the playing field between suppliers and large customers by introducing recommendations on unfair trade practices By www.eversheds.com Published On :: 2014-08-01 European Commission aims to level the playing field between suppliers and large customers by introducing recommendations on unfair trade practices The European Commission recently adopted a Communication encouraging EU Member States to look at ways ... Full Article
prac French Competition Authority puts model agencies price-fixing practices in the spotlight By www.eversheds.com Published On :: 2016-12-07 On 29 September 2016, the French Competition Authority (l’Autorité de la concurrence - the “Autorité”) imposed a fine of EUR 2.4 million on 37 model agencies and their main trade association, the SYNAM, in relation to... Full Article
prac ICO issues the long awaited data sharing code of practice for consultation By www.eversheds.com Published On :: 2019-07-26 The ICO has launched a public consultation on its new draft data sharing code of practice. The consultation period ends on 9 September 2019. It is an update of the previous code, to align it with GDPR so as to address transparency, lawful bases for ... Full Article
prac FCAs Market Study into General Insurance Pricing Practices: Pricing interventions proposed to tackle competition concerns By www.eversheds.com Published On :: 2019-10-09 The FCA has published its interim report in relation to its market study into how general insurance firms charge their customers for home and motor insurance (Interim Report). The FCA has provisionally found that the market is not working well for ... Full Article
prac The Italian Competition Authoritys enforcement against so called IBAN discrimination practices By www.eversheds.com Published On :: 2019-12-03 Introduction The Italian Competition Authority (“ICA”) has recently adopted a harsh approach imposing quite significant fines on those operators who accept direct debit payments only to the extent that their customers are holders of an ... Full Article
prac DOJ further aligns Export Control and Sanctions Enforcement Policy with FCPA enforcement practices By www.eversheds.com Published On :: 2020-01-14 On 13 December 2019, the US Department of Justice (DOJ) announced a revised Export Control and Sanctions Enforcement Policy for Business Organizations (Revised EC/S Policy),1 clarifying its prior guidance on voluntary self-disclosure requirements fo... Full Article
prac Eversheds Harry Elias Enhances Banking and Financial Services Practice with First Lateral Partner Hire since merger By www.eversheds.com Published On :: 2019-06-06 The Singapore office of global legal practice Eversheds Sutherland today announced the appointment of Gerard Ng as a partner in the Banking and Financial Services Practice group. With over 20 years of experience, Gerard is a specialist in len... Full Article
prac A case study in receivership practice: Devon Commercial Property Limited v Robert Adrian Barnett, Robert John Blecher By www.eversheds.com Published On :: 2019-06-13 Key Points • The self-dealing rule does not extend to a sale by a receiver to a party in which the mortgagee has an interest. • Although the duties of a receiver and a mortgagee are similar as to the Property, a receiver, unlike a mortgage... Full Article
prac Falcons' Allen says idea of practice is 'nerve-racking' By article.wn.com Published On :: Sat, 09 May 2020 16:50 GMT ATLANTA (AP) — Ricardo Allen didn't budge when Georgia was one of the first states to open businesses during the coronavirus pandemic. The Atlanta Falcons safety... Full Article
prac NBA teams starting to reopen practice facilities with restrictions By www.japantimes.co.jp Published On :: Sat, 09 May 2020 19:02:52 +0900 The NBA is taking small steps toward a return to normalcy Full Article Sports Adam Silver covid-19
prac Good harvest practices will improve prices By www.monitor.co.ug Published On :: 2020-05-09T13:13:47Z The bags should be placed a good distance from the walls. The roof must be leak proof and the room must be well ventilated. When the coffee is to be transported from the farm to the market the bags must be protected from dust and rain and the farmer should use trucks that have tarpaulin covers, writes Michael J Ssali Full Article
prac COVID-19 & Human Health Risks Linked to Wildlife Trade Practices By www.ipsnews.net Published On :: Thu, 07 May 2020 15:09:03 +0000 Steven Broad is Executive Director, TRAFFIC, the Wildlife Trade Monitoring Network The post COVID-19 & Human Health Risks Linked to Wildlife Trade Practices appeared first on Inter Press Service. Full Article Civil Society Economy & Trade Featured Global Headlines Health Humanitarian Emergencies TerraViva United Nations
prac Improving Water, Sanitation, and Hygiene in Schools: A Guide for Practitioners and Policy Makers in Mongolia By feedproxy.google.com Published On :: 2020-04-30 00:00:00 This publication provides essential information on the planning, implementation, and management of improved water, sanitation, and hygiene (WASH) in schools, particularly for small and isolated rural settlements in Mongolia. Full Article Publication
prac Improving Water, Sanitation, and Hygiene in Schools: A Guide for Practitioners and Policy Makers in Mongolia By feedproxy.google.com Published On :: 2020-04-30 00:00:00 This publication provides essential information on the planning, implementation, and management of improved water, sanitation, and hygiene (WASH) in schools, particularly for small and isolated rural settlements in Mongolia. Full Article
prac Google’s quantum supremacy algorithm has found its first practical use By www.newscientist.com Published On :: Fri, 13 Dec 2019 18:36:25 +0000 Google has put the algorithm it used to achieve quantum supremacy to work. It generated verifiably random numbers, which could be used one day in encryption or lotteries Full Article
prac Vampire bats practise social distancing when they feel ill By www.newscientist.com Published On :: Thu, 30 Apr 2020 17:51:16 +0000 Vampire bats are social creatures that build relationships through grooming and food-sharing, but when they feel ill, they self-isolate and call out for contact far less Full Article
prac Vampire bats practise social distancing when they feel ill By www.newscientist.com Published On :: Thu, 30 Apr 2020 17:51:16 +0000 Vampire bats are social creatures that build relationships through grooming and food-sharing, but when they feel ill, they self-isolate and call out for contact far less Full Article
prac ER Practices Key to Helping Those Addicted to Painkillers: Study By www.medicinenet.com Published On :: Sat, 9 May 2020 00:00:00 PDT Title: ER Practices Key to Helping Those Addicted to Painkillers: StudyCategory: Health NewsCreated: 4/28/2015 12:00:00 AMLast Editorial Review: 4/29/2015 12:00:00 AM Full Article
prac Evaluation of Faculty Mentoring Practices in Seven U.S. Dental Schools By www.jdentaled.org Published On :: 2019-12-01T06:00:18-08:00 The aim of this cross-sectional study was to examine the faculty mentoring practices in seven dental schools in the U.S. A 34-item survey was administered electronically to dental faculty members of all ranks, tracks, and job categories in seven dental schools using faculty listservs. Survey questions addressed current mentoring practices in which the faculty members were involved; their perceptions of those mentoring practices; their perceived characteristics of an ideal mentoring program, mentor, and mentee; perceived best practices; and respondents’ demographics. The survey was conducted from October 2017 to February 2018. A total of 154 surveys were completed (response rate 22%). Over 58% (90/154) of the respondents reported receiving no mentoring; 31.9% (49/154) said they received informal mentoring; and 9.7% (15/154) received formal mentoring. Of the 64 respondents who received mentoring, both formal and informal, 92.2% (59/64) were full-time faculty, and 7.8% (5/64) were part-time faculty (p=0.001). Approximately 39% of the respondents indicated that their mentoring program was not overseen by anyone and that participation was voluntary. The top three perceived benefits of mentoring were increased overall professional development, development of a career plan, and increased professional networks. The three most important characteristics of an ideal mentoring program for the respondents were a program based on the needs of the mentee, a mentor who has the desire to help the mentee, and a mentee who is eager to learn. The results of this study showed a very low level of formal or informal faculty mentoring programs in the dental schools surveyed. Future studies are needed to determine best practices and strategies to expand and enhance mentoring of faculty members. Full Article
prac The Additive Effects of Cell Phone Use and Dental Hygiene Practice on Finger Muscle Strength: A Pilot Study By jdh.adha.org Published On :: 2020-04-30T12:39:03-07:00 Purpose: The purpose of this study was to determine strength of muscles involved with instrumentation (scaling) by dental hygienists and the additive effects of cellular (mobile) phone usage, as indicated by measurements of muscular force generation.Methods: A convenience sample of licensed dental hygienists currently in clinical practice (n=16) and an equal number of individuals not currently using devices/tools repetitively for work (n=16), agreed to participate in this pilot study. All participants completed a modified cell phone usage questionnaire to determine their use pattern and frequency. Upon completion of the questionnaire, participants' force production in six muscle groups was measured using a hand-held dynamometer. Descriptive statistics were used to analyze the data.Results: A total of 16 licensed dental hygienists (n=16) and 16 participants with no history of using tools/devices repetitively for work (n=16), comprised the experimental and control groups, repectively. The control group generated greater muscle force than the experimental group for the abductor pollicis longus (p=0.045). Significant differences were identified when comparing the low mobile phone users in the experimental group to the control group for the flexor pollicis brevis (p=0.031), abductor pollicis longus (p=0.031), and flexor digitorum (p=0.006), with the control group demonstrating higher muscle force. Years in clinical practice and mobile phone use was shown to have a significant effect on muscular force generation for the flexor pollicis brevis (F=3.645, df=3, p=0.020) and flexor digitorum (F=3.560, df=3, p=0.022); subjects who practiced dental hygiene the longest produced the least amount of muscle force.Conclusion: Results from this pilot study indicate there are no significant additive effects of cell phone use and dental hygiene practice on finger muscles used for instrumentation. However, results indicate that dental hygiene practice demonstrated significant effects on muscular strength as compared to individuals who do not use tools/devices repetitively for work. The small sample size may have impacted results and the study should be repeated with a larger sample. Full Article
prac Knowledge, Attitudes and Practices of Dental Hygienists Regarding Diabetes Risk Assessments and Screenings By jdh.adha.org Published On :: 2020-04-30T12:39:03-07:00 Purpose: Untreated and poorly controlled diabetes causes increased levels of blood glucose associated with poor periodontal disease outcomes. Dental hygienists can play a significant role in screening patients for diabetes mellitus, leading to referral and early diagnosis. The purpose of this study was to determine the knowledge, attitudes, practices, and barriers faced by clinical dental hygienists regarding diabetes risk assessment and screenings.Methods: A mixed method design was used with a convenience sample of dental hygienists in clinical practice (n=316). A 32 item, electronic survey was validated at item-level, and participants were recruited through multiple dental hygiene Facebook groups. Descriptive statistics were used to analyze the data. The survey also included two open-ended attitude questions that were interpreted using thematic analysis to pinpoint common patterns within the data.Results: Dental hygienists had high knowledge scores regarding diabetes and oral health, although many were unaware of their states' specific statutes and regulations for screening practices. Nearly all (95.9%), were likely to educate and refer patients (82%), although fewer than half (40.9%), were likely to perform chairside screening for diabetes. Emergent themes for barriers to screening were time, money, patient acceptance/willingness, lack of education, not having the proper tools, and states' rules and regulations.Conclusion: Despite high knowledge scores regarding diabetes and oral health, there is a gap in regards to dental hygienists' willingness to perform diabetes screenings in a clinical setting. Dental hygienists should be capable of integrating chairside diabetes screening practices into the process of care with proper training. Full Article
prac Challenges with Adherence to Clinical Practice Guidelines: Lessons for Implementation Science By jdh.adha.org Published On :: 2020-04-30T12:39:03-07:00 Full Article
prac Re: Primary Care Practices Implementation of Patient-Team Partnership: Findings from EvidenceNOW Southwest By www.jabfm.org Published On :: 2020-03-16T09:31:37-07:00 Full Article
prac Dedicated Workforce Required to Support Large-Scale Practice Improvement By www.jabfm.org Published On :: 2020-03-16T09:31:37-07:00 Background: Facilitation is an effective approach for helping practices implement sustainable evidence-based practice improvements. Few studies examine the facilitation infrastructure and support needed for large-scale dissemination and implementation initiatives. Methods: The Agency for Health care Research and Quality funded 7 Cooperatives, each of which worked with over 200 primary care practices to rapidly disseminate and implement improvements in cardiovascular preventive care. The intervention target was to improve primary care practice capacity for quality initiative and the ABCS of cardiovascular disease prevention: aspirin in high-risk individuals, blood pressure control, cholesterol management, and smoking cessation. We identified the organizational elements and infrastructures Cooperatives used to support facilitators by reviewing facilitator logs, online diary data, semistructured interviews with facilitators, and fieldnotes from facilitator observations. We analyzed these data using a coding and sorting process. Results: Each Cooperative partnered with 2 to 16 organizations, piecing together 16 to 35 facilitators, often from other quality improvement projects. Quality assurance strategies included establishing initial and ongoing training, processes to support facilitators, and monitoring to assure consistency and quality. Cooperatives developed facilitator toolkits, implemented initiative-specific training, and developed processes for peer-to-peer learning and support. Conclusions: Supporting a large-scale facilitation workforce requires creating an infrastructure, including initial training, and ongoing support and monitoring, often borrowing from other ongoing initiatives. Facilitation that recognizes the need to support the vital integrating functions of primary care might be more efficient and effective than this fragmented approach to quality improvement. Full Article
prac Impact of Changes in Clinical Microbiology Laboratory Location and Ownership on the Practice of Infectious Diseases [Epidemiology] By jcm.asm.org Published On :: 2020-04-23T08:00:28-07:00 The number of onsite clinical microbiology laboratories in hospitals is decreasing, likely related to the business model for laboratory consolidation and labor shortages, and this impacts a variety of clinical practices, including that of banking isolates for clinical or epidemiologic purposes. To determine the impact of these trends, infectious disease (ID) physicians were surveyed regarding their perceptions of offsite services. Clinical microbiology practices for retention of clinical isolates for future use were also determined. Surveys were sent to members of the Infectious Diseases Society of America’s (IDSA) Emerging Infections Network (EIN). The EIN is a sentinel network of ID physicians who care for adult and/or pediatric patients in North America and who are members of IDSA. The response rate was 763 (45%) of 1,680 potential respondents. Five hundred forty (81%) respondents reported interacting with the clinical microbiology laboratory. Eighty-six percent of respondents thought an onsite laboratory very important for timely diagnostic reporting and ongoing communication with the clinical microbiologist. Thirty-five percent practiced in institutions where the core microbiology laboratory has been moved offsite, and an additional 7% (n = 38) reported that movement of core laboratory functions offsite was being considered. The respondents reported that only 24% of laboratories banked all isolates, with the majority saving isolates for less than 30 days. Based on these results, the trend toward centralized core laboratories negatively impacts the practice of ID physicians, potentially delays effective implementation of prompt and targeted care for patients with serious infections, and similarly adversely impacts infection control epidemiologic investigations. Full Article
prac ProPSMA: A Callout to the Nuclear Medicine Community to Change Practices with Prospective, High-Quality Data By jnm.snmjournals.org Published On :: 2020-05-01T06:31:37-07:00 Full Article
prac Coaching Intensity, Adherence to Essential Birth Practices, and Health Outcomes in the BetterBirth Trial in Uttar Pradesh, India By ghspjournal.org Published On :: 2020-03-31T15:28:55-07:00 ABSTRACTBackground:Coaching can improve the quality of care in primary-level birth facilities and promote birth attendant adherence to essential birth practices (EBPs) that reduce maternal and perinatal mortality. The intensity of coaching needed to promote and sustain behavior change is unknown. We investigated the relationship between coaching intensity, EBP adherence, and maternal and perinatal health outcomes using data from the BetterBirth Trial, which assessed the impact of a complex, coaching-based implementation of the World Health Organization's Safe Childbirth Checklist in Uttar Pradesh, India.Methods:For each birth, we defined multiple coaching intensity metrics, including coaching frequency (coaching visits per month), cumulative coaching (total coaching visits accrued during the intervention), and scheduling adherence (coaching delivered as scheduled). We considered coaching delivered at both facility and birth attendant levels. We assessed the association between coaching intensity and birth attendant adherence to 18 EBPs and with maternal and perinatal health outcomes using regression models.Results:Coaching frequency was associated with modestly increased EBP adherence. Delivering 6 coaching visits per month to facilities was associated with adherence to 1.3 additional EBPs (95% confidence interval [CI]=0.6, 1.9). High-frequency coaching delivered with high coverage among birth attendants was associated with greater improvements: providing 70% of birth attendants at a facility with at least 1 visit per month was associated with adherence to 2.0 additional EBPs (95% CI=1.0, 2.9). Neither cumulative coaching nor scheduling adherence was associated with EBP adherence. Coaching was generally not associated with health outcomes, possibly due to the small magnitude of association between coaching and EBP adherence.Conclusions:Frequent coaching may promote behavior change, especially if delivered with high coverage among birth attendants. However, the effects of coaching were modest and did not persist over time, suggesting that future coaching-based interventions should explore providing frequent coaching for longer periods. Full Article
prac Women’s experiences of diagnosis and management of polycystic ovary syndrome: a mixed-methods study in general practice By bjgp.org Published On :: 2020-04-30T16:04:41-07:00 BackgroundPolycystic ovary syndrome (PCOS) is a common lifelong metabolic condition with serious associated comorbidities. Evidence points to a delay in diagnosis and inconsistency in the information provided to women with PCOS.AimTo capture women’s experiences of how PCOS is diagnosed and managed in UK general practice.Design and settingThis was a mixed-methods study with an online questionnaire survey and semi-structured telephone interviews with a subset of responders.MethodAn online survey to elicit women’s experiences of general practice PCOS care was promoted by charities and BBC Radio Leicester. The survey was accessible online between January 2018 and November 2018. A subset of responders undertook a semi-structured telephone interview to provide more in-depth data.ResultsA total of 323 women completed the survey (average age 35.4 years) and semi-structured interviews were conducted with 11 women. There were five key themes identified through the survey responses. Participants described a variable lag time from presentation to PCOS diagnosis, with a median of 6–12 months. Many had experienced mental health problems associated with their PCOS symptoms, but had not discussed these with the GP. Many were unable to recall any discussion about associated comorbidities with the GP. Some differences were identified between the experiences of women from white British backgrounds and those from other ethnic backgrounds.ConclusionFrom the experiences of the women in this study, it appears that PCOS in general practice is not viewed as a long-term condition with an increased risk of comorbidities including mental health problems. Further research should explore GPs’ awareness of comorbidities and the differences in PCOS care experienced by women from different ethnic backgrounds. Full Article
prac A quick reference guide for rare disease: supporting rare disease management in general practice By bjgp.org Published On :: 2020-04-30T16:04:41-07:00 Full Article
prac Fitter, Better, Sooner: helping your patients in general practice recover more quickly from surgery By bjgp.org Published On :: 2020-04-30T16:04:41-07:00 Full Article
prac Patient and public involvement in general practice research By bjgp.org Published On :: 2020-04-30T16:04:41-07:00 Full Article
prac INTRODUCING THE BEST PRACTICE GUIDE FOR STRATEGIC PLANNING TO INCREASE STUDENT CHOICE OF FAMILY MEDICINE [Family Medicine Updates] By www.annfammed.org Published On :: 2020-03-09T14:00:11-07:00 Full Article
prac Connecting General Practitioners Through a Peer-Facilitated Community of Practice for Chronic Disease Care [Innovations in Primary Care] By www.annfammed.org Published On :: 2020-03-09T14:00:11-07:00 Full Article
prac Anticoagulants Safety and Effectiveness in General Practice: A Nationwide Prospective Cohort Study [Original Research] By www.annfammed.org Published On :: 2020-03-09T14:00:11-07:00 PURPOSE Most real-world studies on anticoagulants have been based on health insurance databases or performed in secondary care. The aim of this study was to compare safety and effectiveness between patients treated with vitamin K antagonists (VKAs) and patients treated with direct oral anticoagulants (DOACs) in a general practice setting. METHODS The CACAO study (Comparison of Accidents and their Circumstances with Oral Anticoagulants) is a multicenter prospective cohort study conducted among ambulatory patients taking an oral anticoagulant. Participants were patients from the study’s cross-sectional phase receiving oral anticoagulants because of nonvalvular atrial fibrillation, for secondary prevention of venous thromboembolism, or both. They were followed as usual for 1 year by their general practitioners, who collected data on changes in therapy, thromboembolic events, bleeding, and deaths. All events were adjudicated by an independent committee. We used a propensity score and a Cox regression model to derive hazard ratios. RESULTS Between April and December 2014, a total of 3,082 patients were included. At 1 year, 42 patients (1.7%) had experienced an arterial or venous event; 151 (6.1%) had experienced bleeding, including 47 (1.9%) who experienced major bleeding; and 105 (4.1%) had died. There was no significant difference between the VKA and DOAC groups regarding arterial or venous events, or major bleeding. The VKA group had a lower risk of overall bleeding (hazard ratio = 0.65; 95% CI, 0.43-0.98) but twice the risk of death (hazard ratio = 1.98; 95% CI, 1.15-3.42). CONCLUSIONS VKAs and DOACs had fairly similar safety and effectiveness in general practice. The substantially higher incidence of deaths with VKAs is consistent with known data from health insurance databases and calls for further research to understand its cause. Full Article
prac General Practitioners in US Medical Practice Compared With Family Physicians [Original Research] By www.annfammed.org Published On :: 2020-03-09T14:00:11-07:00 PURPOSE General practitioners (GPs) are part of the US physician workforce, but little is known about who they are, what they do, and how they differ from family physicians (FPs). We describe self-identified GPs and compare them with board-certified FPs. METHODS Analysis of data on 102,604 Doctor of Medicine and Doctor of Osteopathy physicians in direct patient care in the United States in 2016, who identify themselves as GPs or FPs. The study used linking databases (American Medical Association Masterfile, American Board of Family Medicine [ABFM], Area Health Resource File, Medicare Public Use File) to examine personal, professional, and practice characteristics. RESULTS Of the physicians identified, 6,661 self-designated as GPs and 95,943 self-designated as FPs. Of the self-designated GPs, 116 had been ABFM certified and were excluded from the study. Of the remaining 102,488 physicians, those who self-designated as GPs but were never ABFM certified constituted the GP group (n = 6,545, 6%). Self-designated FPs that were ABFM certified made up the FP group (n = 79,449, 78%). The remaining self-designated FPs not ABFM certified constituted the uncertified group (n = 16,494, 16%). GPs differed from FPs in every characteristic examined. Compared with FPs, GPs are more likely to be older, male, Doctors of Osteopathy, graduates of non-US medical schools, and have no family medicine residency training. GPs practice location is similar to FPs, but GPs are less likely to participate in Medicare or to work in hospitals. CONCLUSIONS GPs in the United States are a varied group that differ from FPs. Researchers, educators, and policy makers should not lump GPs together with FPs in data collection, analysis, and reporting. Full Article
prac Association between media attention and presentation of vaccination information on Canadian chiropractors websites: a prospective mixed-methods cohort study By www.cmajopen.ca Published On :: 2020-05-05T05:00:14-07:00 Background: Historically, some chiropractors have been critical of vaccination, and this has been the subject of recent media attention in Canada. We explored the association between media attention and public dissemination of vaccination information on Canadian chiropractors’ websites. Methods: In 2016, we identified all Canadian chiropractors’ websites that provided information on vaccination by extracting details from the regulatory college website for each province using the search engine on their "find a chiropractor" page. We assessed the quality of information using the Web Resource Rating Tool (scores range from 0% [worst] to 100% [best]), determined whether vaccination was portrayed in a positive, neutral or negative manner, and conducted thematic analysis of vaccination content. We revisited all identified websites in 2019 to explore for changes to posted vaccination material. Results: In July 2016, of 3733 chiropractic websites identified, 94 unique websites provided information on vaccination: 59 (63%) gave negative messaging, 19 (20%) were neutral and 16 (17%) were positive. The quality of vaccination content on the websites was generally poor, with a median Web Resource Rating Tool score of 19%. We identified 4 main themes: there are alternatives to vaccination, vaccines are harmful, evidence regarding vaccination and health policy regarding vaccination. From 2012 to 2016, there was 1 Canadian newspaper story concerning antivaccination statements by chiropractors, whereas 51 news articles were published on this topic between 2017 and 2019. In April 2019, 45 (48%) of the 94 websites we had identified in 2016 had removed all vaccination content or had been discontinued. Interpretation: In 2016, a minority of Canadian chiropractors provided vaccination information on their websites, the majority of which portrayed vaccination negatively. After substantial national media attention, about half of all vaccination material on chiropractors’ websites was removed within several years. Full Article
prac Myositis from intramuscular oil injections in a bodybuilder [Practice] By www.cmaj.ca Published On :: 2020-05-03T21:05:14-07:00 Full Article
prac Supervised consumption services for acute care hospital patients [Practice] By www.cmaj.ca Published On :: 2020-05-03T21:05:14-07:00 Full Article
prac CT Angiography in Evaluating Large-Vessel Occlusion in Acute Anterior Circulation Ischemic Stroke: Factors Associated with Diagnostic Error in Clinical Practice [INTERVENTIONAL] By www.ajnr.org Published On :: 2020-04-09T06:30:48-07:00 BACKGROUND AND PURPOSE: It is currently not completely clear how well radiologists perform in evaluating large-vessel occlusion on CTA in acute ischemic stroke. The purpose of this study was to investigate potential factors associated with diagnostic error. MATERIALS AND METHODS: Five hundred twenty consecutive patients with a clinical diagnosis of acute ischemic stroke (49.4% men; mean age, 72 years) who underwent CTA to evaluate large-vessel occlusion of the proximal anterior circulation were included. CTA scans were retrospectively reviewed by a consensus panel of 2 neuroradiologists. Logistic regression analysis was performed to investigate the association between several variables and missed large-vessel occlusion at the initial CTA interpretation. RESULTS: The prevalence of large-vessel occlusion was 16% (84/520 patients); 20% (17/84) of large-vessel occlusions were missed at the initial CTA evaluation. In multivariate analysis, non-neuroradiologists were more likely to miss large-vessel occlusion compared with neuroradiologists (OR = 5.62; 95% CI, 1.06–29.85; P = .04), and occlusions of the M2 segment were more likely to be missed compared with occlusions of the distal internal carotid artery and/or M1 segment (OR = 5.69; 95% CI, 1.44–22.57; P = .01). There were no calcified emboli in initially correctly identified large-vessel occlusions. However, calcified emboli were present in 4 of 17 (24%) initially missed or misinterpreted large-vessel occlusions. CONCLUSIONS: Several factors may have an association with missing a large-vessel occlusion on CTA, including the CTA interpreter (non-neuroradiologists versus neuroradiologists), large-vessel occlusion location (M2 segment versus the distal internal carotid artery and/or M1 segment), and large-vessel occlusion caused by calcified emboli. Awareness of these factors may improve the accuracy in interpreting CTA and eventually improve stroke outcome. Full Article