Physician assistant (American Academy of Physician Assistants)最新文献

Emerging infectious diseases pose a significant but underappreciated threat to public health. In a world where international travellers, immigrants, and refugees can carry dangerous organisms almost anywhere, no region should be considered free from risk. Outbreaks of disease may be caused by newly recognized pathogens and drug-resistant organisms. These outbreaks demonstrate the need for improved worldwide surveillance and for improved compliance with guidelines for the use of antimicrobial agents.

PAs can improve the health of their patients by promoting healthy life-styles. By integrating a smoking cessation program into a surgical practice, the authors were able to achieve a cessation rate of 64% at 6 months and 1 year. The method, which includes screening, education, motivation, and follow-up, is applicable to any type of practice.

Nutritional counseling and support has emerged as a crucial factor in the prognosis for HIV-infected individuals. A thorough nutritional history and assessment for obstacles to adequate nutritional intake is essential, as well as close monitoring of nutritional status. PAs should be knowledgeable about the beneficial effects of high-dose nutritional supplementation on the immune system and interactions between nutrients and therapeutic and prophylactic drugs used in HIV infection.

A model for inclusion of information about self-help groups into a PA training program is provided based on the results of a study of 26 PA students enrolled in a patient-counseling class. Interactions with self-help groups yield more positive beliefs and greater intentions to collaborate with self-help groups than training programs that do not address self-help groups. The experiential component is also useful for increasing understanding of appropriate roles for professionals interacting with self-help groups.

Assisted suicide continues to be a topic of debate among health care providers, including PAs. The Public Policy Committee of the Michigan Academy of Physician Assistants surveyed all licensed PAs in Michigan regarding assisted suicide in an effort to determine whether a public policy statement should be developed, and whether that could be extrapolated into a resolution to be taken to the House of Delegates (HOD) of the American Academy of Physician Assistants in 1994. Based on the divergent results of the survey, the Michigan delegation did not submit a resolution to the HOD.

The Patient Self-Determination Act (PSDA) is a federal law, and compliance is mandatory. It is the purpose of this act to ensure that a patient's right to self-determination in health care decisions be communicated and protected. Through advance directives--the living will and the durable power of attorney--the right to accept or reject medical or surgical treatment is available to adults while competent, so that in the event that such adults become incompetent to make decisions, they would more easily continue to control decisions affecting their health care. Without advance directives and the proper adherence to such directives, former President Richard Nixon and former First Lady Jacqueline Kennedy Onassis might still be alive today, in persistent vegetative states. This article examines the history of the act, its importance to each individual, the clinical, ethical and legal issues, and the role of health care professionals in effectively implementing and ensuring compliance of the PSDA.

The American health industry is now focusing on managed care, capitated payment, and the formation of regional networks. As a result, additional cost constraints in the delivery of our nation's health services should be expected. Such proposals are also anticipated to have a major impact on PAs: (a) there will be an increased demand for qualified PAs to provide primary care services; (b) PAs will be better positioned for advancement than other health professionals despite industry-wide cost-containment efforts; and (c) most PAs can expect to practice in less "user-friendly" environments, irrespective of the implementation of the procompetitive concept of managed care or more regulatory global budgetary targets.