The nursing service is a significant element in the dermatological capacity to respond to skin care and dermatological needs worldwide. Although it is an area of development often neglected by dermatologists, it is one that is undergoing rapid and substantial evolution. This paper outlines the initiatives undertaken by nurses to enhance their contribution, and examines the development of nursing within the dermatology field. It argues for the need to develop a service delivery model in dermatology care that utilizes specialist-nursing expertise to cascade dermatological knowledge and skill through primary care. The paper summarizes the strategic importance of nursing in dermatology care delivery, whether in resource-rich or -poor countries, and its unmet potential in the capacity to benefit and meet skin care and dermatological care needs. The paper specifically focuses on the development work led by the International Skin Care Nursing Group (ISNG) to stimulate and develop the capacity of nursing to respond to these widespread needs through promoting service delivery models that operate interdependently with dermatologist-led care.
Aim-Controversy exists regarding the evidence base of medicine. Estimates range from 20% to 80% in various specialties, but there have been no studies in paediatrics. The aim of this study was to ascertain the evidence base for community paediatrics. Methods-Twelve community paediatricians working in clinics and schools in Yorkshire, Manchester, Teesside, and Cheshire carried out a prospective review of consecutive clinical contacts. Evidence for diagnostic processes, prescribing, referrals, counselling/advice, and child health promotion was found by searching electronic databases. This information was critically appraised and a consensus was obtained regarding quality and whether it supported actions taken. Results-Two hundred and forty seven consultations and 1149 clinical actions were performed. Good evidence was found from a randomised controlled trial or other appropriate study for 39.9% of the 629 actions studied; convincing nonexperimental evidence for 7%; inconclusive evidence for 25.4%; evidence of ineVectiveness for 0.2%; and no evidence for 27.5%. Prescribing and child health promotion activities had the highest levels of quality evidence, and counselling/ advice had the lowest. Conclusions-An encouraging amount of evidence was found to support much of community paediatric practice. This study improved on previous research in other specialties because actions other than medications and surgery were included. (Arch Dis Child 1999;80:257-261)
Law and medical ethics are two disciplines with a considerable overlap. Law lays down the established rule for conduct, the violation of which creates criminal or civil liability; ethics is more about expected conduct, that is, what ought to be? The two key issues in medical ethics are confidentiality and consent. In no other disease scenario do these two take on such importance as in HIV and AIDS. The fact that often patients confidentiality and public interest come into conflict further complicates matters. Whether it is with regard to marriage or employment, there is no National Law yet, as to which can be used as a guideline. Different High Courts and the Supreme Court have at different times given judgments that vary vastly, and so the matter remains confusing. A National Initiative has requested lawyers to collectively draft a bill, to provide clarity, consistency, and predictability. The article examines the dynamics of such issues, citing examples from India and abroad and the present status of the draft bill prepared in 2006 is that it has been and submitted to the government.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.