Slipped Capital Femoral Epiphyses
Australian Capital Territory
Financial Management, Hospital
Femur Head Necrosis
Social Determinants of Health
Interviews as Topic
Costs and Cost Analysis
Public-Private Sector Partnerships
Health Facility Merger
Health Care Sector
Health Status Disparities
Equipment and Supplies
Health Services Accessibility
Health Status Indicators
Social Control, Informal
Diffusion of Innovation
Community Health Planning
Range of Motion, Articular
Delivery of Health Care
Medically Underserved Area
Education, Public Health Professional
Cost of Illness
Central African Republic
Conservation of Natural Resources
Health Care Costs
Decision Making, Organizational
Emigration and Immigration
Age Determination by Skeleton
Reform follows failure: II. Pressure for change in the Lebanese health sector. (1/86)This paper describes how, against a background of growing financial crisis, pressure for reform is building up in the Lebanese health care system. It describes the various agendas and influences that played a role. The Ministry of Health, backed by some international organizations, has started taking the lead in a reform that addresses both the way care is delivered and the way it is financed. The paper describes the interventions made to prepare reform. The experience in Lebanon shows that this preparation is a process of muddling through, experimentation and alliance building, rather than the marketing of an overall coherent blueprint. (+info)
Assessing the use of nuclear medicine technology in sub-Saharan Africa: the essential equipment list. (2/86)OBJECTIVE: The primary aim of the survey was to determine the core equipment required in a nuclear medicine department in public hospitals in Kenya and South Africa, and evaluate the capital investment requirements. METHODS: Physical site audits of equipment and direct interviews of medical and clinical engineering professionals were performed, as well as examination of tender and purchase documents, maintenance payment receipts, and other relevant documents. Originally, 10 public hospitals were selected: 6 referral and 4 teaching hospitals. The 6 referral hospitals were excluded from the survey due to lack of essential documents and records on equipment. The medical and technical staff from these hospitals were, however, interviewed on equipment usage and technical constraints. Data collection was done on-site and counter-checked against documents provided by the hospital administration. RESULTS: A list of essential equipment for a nuclear medicine department in sub-Saharan Africa was identified. Quotations for equipment were provided by all major equipment suppliers, local and international. CONCLUSION: A nuclear medicine department requires eight essential pieces of equipment to operate in sub-Saharan Africa. Two additional items are desirable but not essential. (+info)
Reengineering the picture archiving and communication system (PACS) process for digital imaging networks PACS. (3/86)Prior to June 1997, military picture archiving and communications systems (PACS) were planned, procured, and installed with key decisions on the system, equipment, and even funding sources made through a research and development office called Medical Diagnostic Imaging Systems (MDIS). Beginning in June 1997, the Joint Imaging Technology Project Office (JITPO) initiated a collaborative and consultative process for planning and implementing PACS into military treatment facilities through a new Department of Defense (DoD) contract vehicle called digital imaging networks (DIN)-PACS. The JITPO reengineered this process incorporating multiple organizations and politics. The reengineered PACS process administered through the JITPO transformed the decision process and accountability from a single office to a consultative method that increased end-user knowledge, responsibility, and ownership in PACS. The JITPO continues to provide information and services that assist multiple groups and users in rendering PACS planning and implementation decisions. Local site project managers are involved from the outset and this end-user collaboration has made the sometimes difficult transition to PACS an easier and more acceptable process for all involved. Corporately, this process saved DoD sites millions by having PACS plans developed within the government and proposed to vendors second, and then having vendors respond specifically to those plans. The integrity and efficiency of the process have reduced the opportunity for implementing nonstandard systems while sharing resources and reducing wasted government dollars. This presentation will describe the chronology of changes, encountered obstacles, and lessons learned within the reengineering of the PACS process for DIN-PACS. (+info)
Technology assessment and requirements analysis: a process to facilitate decision making in picture archiving and communications system implementation. (4/86)In a time of decreasing resources, managers need a tool to manage their resources effectively, support clinical requirements, and replace aging equipment in order to ensure adequate clinical care. To do this successfully, one must be able to perform technology assessment and capital equipment asset management. The lack of a commercial system that adequately performed technology needs assessment and addressed the unique needs of the military led to the development of an in-house Technology Assessment and Requirements Analysis (TARA) program. The TARA is a tool that provides an unbiased review of clinical operations and the resulting capital equipment requirements for military hospitals. The TARA report allows for the development of acquisition strategies for new equipment, enhances personnel management, and improves and streamlines clinical operations and processes. (+info)
Characteristics of private medical practice in India: a provider perspective. (5/86)Supply factors, depicted by input market conditions and government regulations, and demand factors, depicted by financing mechanisms and utilization patterns, are likely to determine the shape and character of private medical practice. The interaction of this complex set of factors will have considerable implications for the cost access and quality of services offered by this sector. Understanding these characteristics from a provider perspective is imperative to influence the behaviour of providers in this sector. This paper describes some of the important characteristics of private medical practice using a case study of an urban district in India, Ahmedabad, and analyzes their implications. Using survey data of 130 private doctors in the allopathic system, the paper describes broad characteristics of private medical practice using parameters such as growth of private practice, patient load and referrals within the sector, payment methods and determinants, patient concerns, and risks associated with private practice. The paper presents views on the prevalence of various undesirable practices in the private medical sector. It also discusses the awareness of providers about selected important regulations. The findings suggest that growing capital intensity due to cost of location, medical equipment and technology, and financial sources of capital investments are some unfavourable environmental factors experienced by private providers. The findings also indicate a high prevalence of various undesirable practices and low awareness of the objectives of important legislation among practicing doctors. Lack of awareness of important and relevant legislation raises serious questions about the implementation of these laws. The paper identifies the strong need for instituting and implementing an effective continuing medical education programme for practicing doctors, and linking it with their registration and continuation of their license to practice. The paper also suggests that cost of health care, access and quality problems will worsen with the growth of the private sector. The public policy response to check some of the undesirable consequences of this growth is critical and should focus on strengthening the existing institutional mechanisms to protect patients, developing and implementing an appropriate regulatory framework and strengthening the public health care delivery system. The study also discusses various other policy implications arising. (+info)
Capital finance and ownership conversions in health care. (6/86)This paper analyzes the for-profit transformation of health care, with emphasis on Internet start-ups, physician practice management firms, insurance plans, and hospitals at various stages in the industry life cycle. Venture capital, conglomerate diversification, publicly traded equity, convertible bonds, retained earnings, and taxable corporate debt come with forms of financial accountability that are distinct from those inherent in the capital sources available to nonprofit organizations. The pattern of for-profit conversions varies across health sectors, parallel with the relative advantages and disadvantages of for-profit and nonprofit capital sources in those sectors. (+info)
Research capacity in UK primary care. (7/86)BACKGROUND: Moves towards a 'primary care-led' National Health Service (NHS) and towards evidence-based care have focused attention upon the need for evaluative research relating to the structure, delivery, and outcome of primary health care in the United Kingdom (UK). This paper describes work carried out to inform the Department of Health Committee on Research and Development (R&D) in Primary Care (Mant Committee). AIM: To describe the extent and nature of current research capacity in primary care in the UK and to identify future needs and priorities. METHOD: Funding data were requested from NHS National Programmes, NHS Executive Regional Offices, the Department of Health (DoH), Scottish Office, Medical Research Council, and some charities. A postal survey was sent to relevant academic departments, and appropriate academic journals were reviewed from 1992 to 1996. In addition, interviews were conducted with academic and professional leaders in primary care. RESULTS: Overall, total annual primary care R&D spend by the NHS and the DoH was found to be 7% of the total spend, although annual primary care R&D spend differs according to funding source. Journals relating to primary care do not, with some notable exceptions (e.g. British Journal of General Practice, Family Practice), have high academic status, and research into primary care by academic departments is, with perhaps the exception of general practice, on a small scale. The research base of most primary care professions is minimal, and significant barriers were identified that will need addressing if research capacity is to be expanded. CONCLUSION: There are strong arguments for the development of primary care research in a 'primary care-led' NHS in the UK. However, dashes for growth or attempts to expand capacity from the present infrastructure must be avoided in favour of endeavours to foster a sustainable, long-term research infrastructure capable of responding meaningfully to identified needs. (+info)
Understanding financing options for PACS implementation. Picture archiving and communication systems. (8/86)The acquisition of expensive equipment such as picture archiving and communication systems (PACS) becomes increasingly difficult as capital budgets become tighter. Traditional ownership financing options in the form of direct purchase or financing (loan) have several limitations including technology obsolescence, higher fixed pricing, limited options for equipment disposal, and the need to tie up valuable capital. Alternative financing options, in the form of conventional lease and risk sharing arrangements, offer several theoretical advantages including technology obsolescence protection in the form of built-in upgrades, preservation of borrowing power, multiple end-of-term options, and payment flexibility (which can be directly tied to realized productivity and operational efficiency gains). These options are discussed, with emphasis on the acquisition of PACS. (+info)
A condition in which the bone end of a growth plate (epiphysis) becomes separated from the rest of the bone. This can occur due to injury, overuse, or a congenital condition. It is also known as slipped capital femoral epiphysis (SCFE).
This term is used in the medical field to describe a specific type of bone fracture or injury that occurs in the growth plates of children and adolescents. The growth plates are areas at the ends of long bones where new bone tissue is formed as the bone grows. Slipped epiphyses can occur in any long bone, but they are most common in the femur (thighbone) and humerus (upper arm bone).
Symptoms of slipped epiphyses may include pain, swelling, limited mobility, and an obvious deformity in the affected limb. Treatment typically involves immobilization in a cast or brace for several weeks to allow the bone to heal properly. In severe cases, surgery may be necessary to realign the bones and secure them with screws or pins.
Slipped epiphyses can have long-term consequences if not properly treated, including joint instability, stiffness, and arthritis. Therefore, prompt medical attention is essential to ensure proper healing and minimize potential complications.
This can cause pain, stiffness, and difficulty walking. In severe cases, it can lead to complete hip joint dislocation. FHN is typically caused by trauma or aseptic conditions such as osteonecrosis (death of bone cells due to lack of blood supply), sickle cell disease, Gaucher's disease, and long-term use of steroids. Treatment options include conservative management with pain management, physical therapy, and avoiding activities that exacerbate the condition; or surgical intervention such as femoral head osteotomy (cutting and realigning the bone) or hip replacement.
The prognosis for FHN depends on the severity of the condition, with more severe cases carrying a worse prognosis. Early diagnosis and treatment are key to improving outcomes.
Note: The word "toothache" refers to pain in one or more teeth, and not to general gum pain or discomfort.
FAI is a common cause of hip pain in young adults and athletes who participate in high-impact activities such as running or jumping. It can also occur in older individuals as a result of wear and tear on the joint over time. The condition is typically diagnosed through a combination of physical examination, imaging tests such as X-rays or MRIs, and patient history.
FAI can be classified into three types based on the location and severity of the impingement:
1. Cam impingement: This occurs when the femur is not properly positioned in the socket, causing the head of the femur to jam against the rim of the acetabulum.
2. Pincer impingement: This occurs when the acetabulum is too deep and covers the femur head, causing it to be pinched between the bone and soft tissue.
3. Combination impingement: This occurs when both cam and pincer impingements are present.
Treatment for FAI typically involves a combination of non-surgical and surgical options, depending on the severity of the condition and the individual patient's needs. Non-surgical treatment may include physical therapy to improve strength and range of motion, medication to reduce pain and inflammation, and lifestyle modifications such as avoiding activities that exacerbate the condition. Surgical options may include hip arthroscopy to remove any bone spurs or repair damaged tissue, or hip replacement surgery if the joint is severely damaged.
Exostoses are benign bone tumors that grow on the surface of a bone. They are usually found in the long bones of the arms and legs, but can also occur in other bones. Exostoses are relatively rare and tend to affect children and young adults more frequently than older adults.
The exact cause of exostoses is not known, but they may be associated with certain genetic conditions or trauma to the affected bone. Treatment for exostoses usually involves surgical removal of the tumor, and in some cases, radiation therapy may be recommended to prevent recurrence.
Exostoses can cause a variety of symptoms depending on their location and size. These may include pain, swelling, and limited mobility in the affected limb. In some cases, exostoses may also lead to fractures or other complications if they weaken the bone structure.
There are several different types of exostoses, including:
1. Juvenile osteochondromas: These are the most common type of exostose and typically affect children and young adults. They are usually found in the long bones of the arms and legs.
2. Osteochondromas: These are similar to juvenile osteochondromas but occur more frequently in adults.
3. Enchondromas: These are benign tumors that occur within the cartilage of a bone.
4. Osteoid osteomas: These are small, painful bone tumors that can occur in any bone of the body.
5. Fibrous dysplasia: This is a condition where abnormal growth and development of bone tissue leads to the formation of bony outgrowths or tumors.
The diagnosis of exostoses usually involves a combination of physical examination, imaging studies such as X-rays or CT scans, and biopsy to confirm the presence of a benign bone tumor. Treatment options for exostoses will depend on the size, location, and severity of the tumor, as well as the patient's age and overall health status.
1. Dislocation of the femoral head: This occurs when the ball-shaped head of the femur (thigh bone) is forced out of the socket of the pelvis.
2. Dislocation of the acetabulum: This occurs when the cup-shaped socket of the pelvis is forced out of its normal position.
Hip dislocation can cause severe pain, swelling, and difficulty moving the affected leg. Treatment options for hip dislocation vary depending on the severity of the condition and may include:
1. Reduction: This involves manually putting the bones back into their proper position.
2. Surgery: This may be necessary to repair or replace damaged tissues or bones.
3. Physical therapy: This can help improve mobility and strength in the affected limb.
4. Medications: These may be prescribed to manage pain, inflammation, and other symptoms.
Early diagnosis and treatment of hip dislocation are essential to prevent long-term complications and improve outcomes for patients.
There are several types of tooth injuries that can occur, including:
1. Tooth fractures: A crack or break in a tooth, which can vary in severity from a small chip to a more extensive crack or split.
2. Tooth avulsions: The complete loss of a tooth due to trauma, often caused by a blow to the mouth or face.
3. Tooth intrusions: When a tooth is pushed into the jawbone or gum tissue.
4. Tooth extrusions: When a tooth is forced out of its socket.
5. Soft tissue injuries: Damage to the lips, cheeks, tongue, or other soft tissues of the mouth.
6. Alveolar bone fractures: Fractures to the bone that surrounds the roots of the teeth.
7. Dental luxation: The displacement of a tooth from its normal position within the jawbone.
8. Tooth embedded in the skin or mucous membrane: When a tooth becomes lodged in the skin or mucous membrane of the mouth.
Treatment for tooth injuries depends on the severity of the injury and can range from simple restorative procedures, such as fillings or crowns, to more complex procedures, such as dental implants or bone grafting. In some cases, urgent medical attention may be necessary to prevent further complications or tooth loss.
The symptoms of AIDS can vary depending on the individual and the stage of the disease. Common symptoms include:
3. Swollen glands
5. Muscle aches and joint pain
6. Night sweats
8. Weight loss
9. Memory loss and other neurological problems
10. Cancer and other opportunistic infections.
AIDS is diagnosed through blood tests that detect the presence of HIV antibodies or the virus itself. There is no cure for AIDS, but antiretroviral therapy (ART) can help manage the symptoms and slow the progression of the disease. Prevention methods include using condoms, pre-exposure prophylaxis (PrEP), and avoiding sharing needles or other injection equipment.
In summary, Acquired Immunodeficiency Syndrome (AIDS) is a severe and life-threatening condition caused by the Human Immunodeficiency Virus (HIV). It is characterized by a severely weakened immune system, which makes it difficult to fight off infections and diseases. While there is no cure for AIDS, antiretroviral therapy can help manage the symptoms and slow the progression of the disease. Prevention methods include using condoms, pre-exposure prophylaxis, and avoiding sharing needles or other injection equipment.