“
“Background: Since the 1970s, many countries have employed the use of the General practitioner group practice, but there is contrasting evidence about its effectiveness. A systematic review was performed to assess whether group practice has a more positive impact compared with the single-handed
practice on different aspects of health care.
Methods: selleck inhibitor A systematic review was conducted by querying electronic databases and reviewing articles published between 1990 and 2012. A quality assessment was performed. The effect of group practice was evaluated by collecting all items analysed by the articles into four main categories: (1) studies of quality (measured in terms of clinical processes) and productivity (measured in terms of throughput), named “”Clinical process measures and throughput”"; (2) studies exploring physician’s opinion – “”Doctor’s
perspective”"; (3) studies looking into the use of innovation, information and communication technology (ICT) and quality assurance – “”Innovation, ICT and quality assurance”"; (4) studies focused on patient’s opinion – “”Patient’s perspective”". The results were synthesized according to three levels of scientific evidence.
Results: A total of 26 studies were selected. The most studied category was Clinical process measures and throughput (58%). A positive impact of group medicine on “”Clinical process measures and throughput”", “”Doctor’s perspective”", “”Innovation, ICT and quality assurance”" was found. There was contrasting evidence SB202190 molecular weight considering the “”Patient’s perspective”".
Conclusions: Group practice might be a successful organizational requirement to improve the quality of clinical practice in Primary Health Care. Further comparative studies are needed to investigate the impact of organizational and professional determinants such as physician’s
economic incentives, mode selleck chemical of payment, size of the groups and multispecialty on the effectiveness of medical primary care. (C) 2013 Elsevier Ireland Ltd. All rights reserved.”
“1-Halomethyl-2-oxa-5-azoniaspiro[4.5]decane halides were synthesized by reaction of 1-(2-vinyloxy)ethylpiperidine with bromine and iodine. The product structure was confirmed by H-1 NMR and IR spectroscopy, and their steric configuration was optimized in terms of the density functional theory.”
“Electric injury is a common physical injury in daily life. Because of the low resistance of vascular tissue, vascular injury and thrombosis are frequently found in cases of high-voltage electric injury but are rarely reported in low-voltage conditions. We present the case of a diabetic woman who suffered symptomatic brainstem stroke after a short duration of 60 Hz/110V alternate current electric contact with a home washer socket.