In a 1 year prospective study we evaluated the effect of feedback of laboratory data on the requesting behaviour of physicians in general medicine. Data on within-hours and out-of-hours clinical chemistry laboratory usage and revenue expenditure for inpatients and outpatients, expressed in terms of clinical workload, were supplied monthly to a group of three consultant physicians in general medicine. With these data the physician could monitor his performance over a period of time and compare it with that of his peers. Two consultants in general medicine who received no information served as controls. Over a period of 6 months, there was a 25%, 13% and 18% decrease in tests (P less than 0.01), requests (P less than 0.05) and revenue expenditure (P less than 0.01) per outpatient visit, respectively, in the intervention group of physicians following the introduction of feedback when compared to their baseline period and to the control group. The decrease (P less than 0.01) was in the commonly requested and 'seemingly cheap' tests. There was no significant change in laboratory use and expenditure on inpatients. The feedback of laboratory data was acceptable to the physicians, raised their awareness of laboratory usage and costs and decreased laboratory workload and expenditure.
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http://dx.doi.org/10.1177/000456329102800204 | DOI Listing |
Anat Sci Educ
January 2025
Faculty of Engineering, University of Porto, Porto, Portugal.
Histology is a preclinical subject transversal in medical, dental, and veterinary curricula. Classical teaching approaches in histology are often undermined by lower motivation and engagement of students, which may be addressed by innovative learning environments. Herein, we developed a serious game approach and compared it with a classical teaching style.
View Article and Find Full Text PDFInt J Biol Sci
January 2025
Department of Urology, the Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, China.
Clear cell renal cell carcinoma (ccRCC) is one of the most common and aggressive malignancies of the urinary system. Despite being the first-line treatment for advanced ccRCC, vascular endothelial growth factor receptor inhibitors (VEGFRis) face significant limitations due to both initial and acquired resistance, which impede complete tumor eradication. Using a CRISPR/Cas9 library screening approach, was identified as a resistance-associated gene for three prevalent VEGFRis (Sunitinib, Axitinib, and Sorafenib).
View Article and Find Full Text PDFCan Commun Dis Rep
January 2025
Data, Surveillance and Foresight Branch, Public Health Agency of Canada, Ottawa, ON.
Background: Antimicrobial resistance (AMR) is associated with significant human and financial costs, particularly among vulnerable populations like older adults living in long-term care homes (LTCHs). Urinary tract infection (UTI) is the leading indication for antibiotic use in this population, with some estimates suggesting that up to 70% of these prescriptions may be avoidable.
Objective: The purpose of this study is to develop and test novel behavioural science-informed antimicrobial stewardship (AMS) quality improvement strategies in Canadian LTCHs, which aim to decrease unnecessary testing and treatment for residents who lack the minimum clinical signs and symptoms of UTI.
Small
January 2025
Department of Orthopedics, Laboratory of Biological Tissue Engineering and Digital Medicine, Affiliated Hospital of North Sichuan Medical College, No. 1 The South of Maoyuan Road, Nanchong, Sichuan, 637000, P. R. China.
Efferocytosis in macrophages typically engages an anti-inflammatory positive feedback regulatory mechanism. In osteoarthritis (OA), characterized by imbalanced inflammatory homeostasis, the proinflammatory state of macrophages in the immune microenvironment can be reversed through enhanced efferocytosis. This study develops an in situ proefferocytosis hydrogel microsphere (macrophage polarity converter, H-C@IL) for OA treatment.
View Article and Find Full Text PDFPhilos Trans R Soc Lond B Biol Sci
January 2025
Department of Genetics, Evolution and Environment, University College London, London WC1E 6BT, UK.
Anthropogenic climate change is projected to become a major driver of biodiversity loss, destabilizing the ecosystems on which human society depends. As the planet rapidly warms, the disruption of ecological interactions among populations, species and their environment, will likely drive positive feedback loops, accelerating the pace and magnitude of biodiversity losses. We propose that, even without invoking such amplifying feedback, biodiversity loss should increase nonlinearly with warming because of the non-uniform distribution of biodiversity.
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