Although such initiatives are designed to improve healthcare qual

Although such initiatives are designed to improve healthcare quality by promoting competition and increasing transparency, review of their efficacy and unintended effects is just coming to the national spotlight.

Recent findings

Critical evaluation of external quality assessment programs remains limited despite their scope, speed and breadth of implementation. Recent

publications, however, suggest that external quality assessment efforts may have major unintended consequences. These include effects on patient decision-making, click here the ‘dynamic equilibrium’ of patient care, healthcare disparities, medical innovation and practice patterns.


In their early years of implementation, external quality assessment programs have already had significant consequences in the healthcare system. As new tools become available, their full impact on care and caregivers must be thoroughly evaluated. Careful consideration of clinical practice implications and an understanding of the risks are critical before accepting and implementing new assessment paradigms. The substantial and widespread effects of these programs should prompt further evaluation from the medical community.”

sclerosis (MS) is a demyelinating disease of the central nervous system characterized by episodic decline in various neurologic functions. Gait dysfunction in MS is distinguished by decreased gait speed, walking endurance, step length, cadence and joint motion, as well as increased metabolic cost of walking and increased variability of Veliparib cost gait. Standardized clinical, timed, and patient-based measures can identify MS patients with gait dysfunction, and observational gait analysis, Cytoskeletal Signaling inhibitor instrumented walkways, or three-dimensional gait analysis can help determine which problem underlies their gait dysfunction to help direct effective treatment. Exercise may ameliorate all types of gait dysfunction. In addition, gait dysfunction due to weakness may be alleviated by orthoses or functional electrical stimulation; gait dysfunction

due to spasticity may be relieved by oral, intrathecal, or intramuscular medications. Assistive devices and balance training may reduce gait dysfunction from imbalance, and dalfampridine may accelerate gait in people with MS who walk slowly.”
“Automated powder dispensing systems enable supplying early clinical studies using drug-in-capsule approach, which is material sparing and requires a minimum amount of resources. However, the inability of accurately filling the capsule with a small amount, e.g., several micrograms, of drug limits the use of these systems for potent drugs. We demonstrate that formulated powder blends can be used to successfully fill capsules containing 5 mu g to 5 mg of drug with adequate content uniformity.

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