Sitting with Death.

A social worker on a dialysis unit bears witness to patients' life or death choices.

Math-free guides for glycerin and allergens at variable subcutaneous injection volumes: How's my dosing? Update.

Background: Current summaries of effective maintenance dose ranges for subcutaneous immunotherapy (SCIT) are based on administration of 0.5-mL volumes. Extract formulations delivering equivalent dose ranges for practices using different injection volumes have not been reported, and calculation of the final glycerin concentrations in these solutions remains an inconvenient and repetitive process.

Methods of Observing Variations in Physicians' Decisions: The Opportunities of Clinical Vignettes.

To support their efforts to promote high quality and efficient care, policymakers need to better understand the key factors associated with variations in physicians' decisions, and in particular, physician deviations from evidence-based care. Clinical vignette survey instruments hold potential for research in this area as an approach that both allows for practical, large-scale study and overcomes the data quality challenges posed by analysis of clinical data. These surveys present respondents with a narrative description of a hypothetical patient case and solicit responses to one or more questions regarding the care of the patient.

Solving the Sustainable Growth Rate formula conundrum continues steps toward cost savings and care improvements.

Congress is again attempting to repeal the Sustainable Growth Rate (SGR) formula. The formula is a failed mechanism intended to constrain Medicare Part B physician spending by adjusting annual physician fee updates. Congress has averted formula-driven physician fee cuts each year beginning in 2003 by overriding the SGR, usually accompanied with last-minute disputes about how these overrides should be paid for.

A new technique for single-person fascia lata harvest.

Objective: Reconstitution of a watertight dural closure at the conclusion of most neurosurgical operations is a very important step to prevent cerebrospinal fluid leak, encephalocele formation, or infection. If sufficient native dura is not available to accomplish this goal, a dural substitute is required.

Methods: We have developed a system of single-person fascia lata harvest that is fast, safe, and easily mastered.