Health services managers are responsible for management and financing of health care in a variety of delivery models. This article provides information about the profession of health services management. It includes a brief historical overview of the profession, describes the various job roles that health service managers can assume, and outlines the educational curriculum to prepare and qualify for a career as health services manager. Educational preparation is available at the baccalaureate, masters, and doctoral levels. Finally, the article discusses future prospects for employment in the profession.

Biofilms are the source of vascular catheter infections and arefound uniformly on central venous catheters after 3 days.Only about half of these biofilms are culture positive.Of those that are culture positive the timing of initial colonization varies by catheter site:subcutaneous segment (average:5.1 days),tip segment (8.6d),and lumen (13.1d).The more organisms that come to reside on a catheter,the greater the likelihood that the catheter will have associated purulence or bloodstream infection.The risk of catheter-related bloodstream infection ranges considerably from≤2/1 000 patient days (peripheral venous catheters,peripherally inserted central catheters (PICC)),cuffed central venous catheters,ports,10/1 000 patient days (arterial and Wwan-Ganz catheters)to 30-50/1 000 patient days (multilumen,hemodialysis).Intrinsic factors that affect the risk of vascular catheter infection include host factors,type of organism,catheter material,and the manufacturing process.Humans are quite susceptible to Saureus,rabbits are not.S.epidermidis requires a polysaccharide adhesin to produce catheter infections.Silicone catheters have a greater risk of infection than polyurethane,polyvinylchloride,or teflon,and this increased risk is related to excess complement activation.Extrinsic factors that can affect the risk of infection include the use of maximal sterile barriers,chlorhexidine skin preparation,insertion by inadequately trained personnel,the number of line breaks,hyperalimentation fluid (favors yeasts),5% dextrose (favors gram-negative organisms),and lipid emulsions (favors Malassezia).

Family physicians can play an important role in providing lifestyle advice that aims to prevent or delay chronic disease. Given the vast amount of evidence that regular physical activity improves health and wellbeing, providing brief tailored advice in a clinic setting has the potential to make a positive impact on population health. Working side by side with physicians, the Health Promotion Board has developed the Physical Activity Advice Tool (PAAT) to enable physicians to quickly and accurately provide evidence-based tailored physical activity advice.

No abstract available.
Aviation* ; Emergencies* ; Medical Assistance*

Delivery of Health Care ; ethics ; Ethics, Medical ; Ethics, Research ; Humans ; Physicians ; ethics

Adolescent* ; Humans ; Insulin Resistance* ; Insulin* ; Polycystic Ovary Syndrome*

One of the main problems of treatment of bifurcation lesions is side branch (SB) stenosis appearing after stent placement in the main vessel.The aim of this study was to create quantitative method for prediction of side branch compromise extent.We accepted that the main mechanism for SB ostial stenosis is flow divider (FD) displacement from stent struts after stent implantation in the main vessel.Using easily measurable parameters from coronary angiography,as SB diameter,angle α (initial angle between axes of parent vessel and SB axis) and angle α' (angle between above mentioned axes after stent placement) we can calculate percentage diameter stenosis at branch ostium (%DS):%DS = sin (α - α')/(tan α).In boundary condition of full FD displacement %DS = cos α.We tested our theoretical predictions with fluoroscopic observation of elastic wall model of bifurcation (45°distal angle between branches)permitting wall deformations with stent.There is full coincidence of values of %DS and percentage area stenosis (%AS).The regular formulas for calculations of %DS and %AS overestimate stenosis severity between 10% and 25%.Our model tests have shown full coincidence between predicted values for %DS and observed values.We demonstrate that part of the SB ostium is not visible in regular angiography and contributes to ostial lumen area.This is a method that permits quantitative prediction of side branch compromise.