Needs, conditions of intervention and staff in medical physics for medical imagery

International Nuclear Information System (INIS)

Salvat, Cecile; Dieudonne, Arnaud; Guilhem, Marie-Therese; Le Du, Dominique; Pierrat, Noelle; Isambert, Aurelie; Valero, Marc; Blanchard, Vincent

2013-04-01

This guide proposes information on the types and quantification of medical physics tasks to be performed when performing medical imagery using ionizing radiations. It gives recommendations about the commitment of medical physicists (with or without support staff) and the required staff in nuclear medicine and, more generally in imagery (interventional radiology, scanography, conventional radiology). It first gives an overview of the situation in France in 2012 in terms of observations made by the ASN during inspections, and of results of a survey conducted among medical physicists involved in medical imagery. It indicates the current regulatory requirements, and international and national recommendations, and describes the commitment in imagery of medical physicists in three countries (Spain, Belgium and Germany). It analyses and describes the fields of intervention of medical physicists in imagery and identifies associated tasks in France (in equipment purchasing, equipment installation, equipment routine usage, patient care, nuclear medicine or internal vectorized radiotherapy, or staff training). Recommendations of a work-group about sizing criteria are proposed

Exposure of Medical Staff during Interventional Procedures

International Nuclear Information System (INIS)

Osvay, M.; Turak, O.

2013-01-01

The medical staff during interventional procedures receives significant doses on their hands, or parts of their body not covered with protective shielding equipment, as they are close to X-rays field. It can be stated, that interventional radiology and cardiology have one of the highest doses among the X-ray diagnostic procedures. The radiologist use X-ray machine directly in the interventional procedures. The occupational dose is measured only by one Kodak film badge worn under the lead apron for the estimation of the effective dose in Hungary. Our lecture presents the results of dose measurements on eye lens, hands, knees using LiF thermoluminescent dosemeters on the medical staff of two Hungarian hospitals. Results suggest that wearing only one film badge (or other dosemeter system) under the lead apron does not provide proper information on the real occupational dose of medical staff.(author)

MEDICAL STAFF SCHEDULING USING SIMULATED ANNEALING

Directory of Open Access Journals (Sweden)

Ladislav Rosocha

2015-07-01

Full Text Available Purpose: The efficiency of medical staff is a fundamental feature of healthcare facilities quality. Therefore the better implementation of their preferences into the scheduling problem might not only rise the work-life balance of doctors and nurses, but also may result into better patient care. This paper focuses on optimization of medical staff preferences considering the scheduling problem.Methodology/Approach: We propose a medical staff scheduling algorithm based on simulated annealing, a well-known method from statistical thermodynamics. We define hard constraints, which are linked to legal and working regulations, and minimize the violations of soft constraints, which are related to the quality of work, psychic, and work-life balance of staff.Findings: On a sample of 60 physicians and nurses from gynecology department we generated monthly schedules and optimized their preferences in terms of soft constraints. Our results indicate that the final value of objective function optimized by proposed algorithm is more than 18-times better in violations of soft constraints than initially generated random schedule that satisfied hard constraints.Research Limitation/implication: Even though the global optimality of final outcome is not guaranteed, desirable solutionwas obtained in reasonable time. Originality/Value of paper: We show that designed algorithm is able to successfully generate schedules regarding hard and soft constraints. Moreover, presented method is significantly faster than standard schedule generation and is able to effectively reschedule due to the local neighborhood search characteristics of simulated annealing.

Medication reconciliation in nursing homes: thematic differences between RN and LPN staff.

Science.gov (United States)

Vogelsmeier, Amy A; Scott-Cawiezell, Jill R; Pepper, Ginette A

2011-12-01

The purpose of this qualitative descriptive study was to describe medication reconciliation practices in nursing homes with a specific focus on nursing staff involvement in the process. The study was conducted in eight Midwestern nursing homes and included 46 onsite observations of resident transfers to the nursing home. Informal interviews of nursing staff performing medication reconciliation were conducted during each observation. Findings suggest nursing home nursing staff, including both RN and licensed practical nurse (LPN) staff, were primarily responsible for performing medication reconciliation; however, these staff often varied in how they processed resident transfer information to identify medication order discrepancies. Patterns of differences were found related to their perceptions about medication reconciliation, as well as their actions when performing the process. RN staff were more often focused on resident safety and putting the "big picture" together, whereas LPN staff were more often focused on the administrative assignment and "completing the task." Copyright 2011, SLACK Incorporated.

An Assessment of Psychological Need in Emergency Medical Staff in the Northern Health and Social Care Trust Area.

Science.gov (United States)

Aisling, McAleese; Aisling, Diamond; David, Curran

2016-05-01

Psychological stress is increasingly recognised within emergency medicine, given the environmental and clinical stressors associated with the specialism. The current study assessed whether psychological distress is experienced by emergency medical staff and if so, what is the expressed need within this population? Participants included ambulance personnel, nursing staff, doctors and ancillary support staff within two Accident and Emergency (A&E) departments and twelve ambulance bases within one Trust locality in NI (N = 107). The General Health Questionnaire (GHQ-12, Goldberg, 1972, 1978), Secondary Traumatic Stress Scale (STSS, Bride, 2004) and an assessment of need questionnaire were completed and explored using mixed method analysis. Results showed elevated levels of psychological distress within each profession except ambulance service clinical support officers (CSOs). Elevated levels of secondary trauma symptomatology were also found; the highest were within some nursing grades and junior doctors. Decreased enjoyment in job over time was significantly associated with higher scores. Analysis of qualitative data identified sources of stress to include low morale. A total of 65% of participants thought that work related stressors had negatively affected their mental health. Participants explored what they felt could decrease psychological distress including improved resources and psychoeducation. There were elevated levels of distress and secondary traumatic stress within this population as well as an expressed level of need, on both systemic and support levels.

Forty project management strategies for the medical practice staff.

Science.gov (United States)

Hills, Laura Sachs

2010-01-01

Most every medical practice will embark at one time or another on a large and complex new project. The practice may, for instance, undertake a project in office construction or renovation, practice expansion, new technology, or a new large-scale event. The medical practice staff may find itself creating the project plan, overseeing its execution, and working through the plan day to day until its completion. In short, the staff may find itself responsible for project management. This article contains 40 specific, easy-to-implement project management strategies medical practice employees can use to manage both the large and small projects they undertake on behalf of the practice. It suggests effective project management strategies the staff can use before the onset of a new project as well as strategies to help define the project, to deliver the project, and to close and review the project. This article also describes five reasons medical practices often fail at project management and suggests more effective approaches that will ensure that the projects the medical practice undertakes are completed well, on time, and within budget.

The role of the psychiatrist: job satisfaction of medical directors and staff psychiatrists.

Science.gov (United States)

Ranz, J; Stueve, A; McQuistion, H L

2001-12-01

In a previous survey of Columbia University Public Psychiatry Fellowship alumni, medical directors reported experiencing higher job satisfaction compared to staff psychiatrists. To further this inquiry, the authors conducted an expanded survey among the membership of the American Association of Community Psychiatrists (AACP). We mailed a questionnaire to all AACP members. Respondents categorized their positions as staff psychiatrist, program medical director or agency medical director, and rated their overall job satisfaction. The form also included a number of demographic and job characteristic items. Of 479 questionnaires mailed, a total of 286 individuals returned questionnaires (61%-12 forms were undeliverable). As in our previous survey, medical directors experience significantly higher job satisfaction compared to staff psychiatrists. Program and agency medical directors do not differ significantly. In addition, job satisfaction is strongly and negatively correlated with age for staff psychiatrists but not for medical directors. This survey strengthens the previously reported advantage medical directors have over staff psychiatrists regarding job satisfaction. The finding that job satisfaction decreases with increasing age of staff psychiatrists but not medical directors is particularly interesting, suggesting that staff psychiatrist positions may come to be regarded as "dead-end" over time. Psychiatrists are advised to seek promotions to program medical director positions early in their careers, since these positions are far more available, and provide equal job satisfaction, compared to agency medical director positions.

THE QUALITY OF THE MEDICAL STAFF AND THE EFFICIENCY OF OUTPATIENT CARE

Directory of Open Access Journals (Sweden)

Виталий Анатольевич Чирков

2014-05-01

Full Text Available The paper presents the main results obtained in the course of complex social and health study to study and compare the qualitative characteristics of the medical staff and the effectiveness of providing primary health care urban population.Comparative characteristics of these indices revealed that the highest category had only 22.5% of the respondents, 35% - the first category, 3.7% - 38.8%, and the second - the categories did not have. Among the respondents, an overwhelming majority of 94.4% were non-degree, 5.6% - have a PhD degree in medical sciences. Passed the initial training in internship 80% residency - 20%.Ranking the areas of health services revealed that the lowest averages are obtained in such sections of the medical organization, such as the rehabilitation and prevention, satisfactory - in relation to diagnostic and therapeutic interventions. From this we can conclude that a low enough health care workers evaluation of services provided in their institution, which also indicates low self-esteem results of their own activities. Thus, the average score on the activities of the agencies as a whole was 3,4 ± 0,17.Thus, the lack of an integrated system of quality assurance staff in outpatient clinics leads to poor quality of health services provided to patients. The existing problems related to the lack of differentiated pay, as well as the insufficient information and resourcing of staff of medical institutions.DOI: http://dx.doi.org/10.12731/2218-7405-2013-10-35

Medical staff organization in nursing homes: scale development and validation.

Science.gov (United States)

Katz, Paul R; Karuza, Jurgis; Intrator, Orna; Zinn, Jacqueline; Mor, Vincent; Caprio, Thomas; Caprio, Anthony; Dauenhauer, Jason; Lima, Julie

2009-09-01

To construct a multidimensional self-report scale to measure nursing home (NH) medical staff organization (NHMSO) dimensions and then pilot the scale using a national survey of medical directors to provide data on its psychometric properties. Instrument development process consisting of the proceedings from the Nursing Home Physician Workforce Conference and focus groups followed by cognitive interviews, which culminated in a survey of a random sample of American Medical Directors Association (AMDA) affiliated medical directors. Analyses were conducted on surveys matched to Online Survey Certification and Reporting (OSCAR) data from freestanding nonpediatric nursing homes. A total of 202 surveys were available for analysis and comprised the final sample. Dimensions were identified that measured the extent of medical staff organization in nursing homes and included staff composition, appointment process, commitment (physiciancohesion; leadership turnover/capability), departmentalization (physician supervision, autonomy and interdisciplinary involvement), documentation, and informal dynamics. The items developed to measure each dimension were reliable (Cronbach's alpha ranged from 0.81 to 0.65).Intercorrelations among the scale dimensions provided preliminary evidence of the construct validity of the scale. This report, for the first time ever, defines and validates NH medical staff organization dimensions, a critical first step in determining the relationship between physician practice and the quality of care delivered in the NH.

What is the job satisfaction and active participation of medical staff in public hospital reform: a study in Hubei province of China.

Science.gov (United States)

Fang, Pengqian; Luo, Zhenni; Fang, Zi

2015-05-16

In China, public hospital reform has been underway for almost 5 years, and 311 pilot county hospitals are the current focus. This study aimed to assess the job satisfaction and active participation of medical staff in the reform. A total of 2268 medical staff members in pilot and non-pilot county hospitals in Hubei, China, were surveyed. Questionnaires were used to collect data. The Pearson chi-square statistical method was used to assess the differences between pilot and non-pilot county hospitals and identify the factors related to job satisfaction as well as the understanding and perception of the reform. Binary logistic regression was performed to determine the significant factors that influence the job satisfaction of medical staff in pilot county hospitals. Medical staff members in pilot county hospitals expressed higher satisfaction on current working situation, performance appraisal system, concern showed by leaders, hospital management, and compensation packages (P job and they have evidently less satisfaction on compensation packages and learning and training opportunities. The working hours and work stress were negatively related to the job satisfaction (P Satisfaction on the performance appraisal system, hospital management, compensation packages, and learning and training opportunities were positively related to job satisfaction (P pay attention to influencing factors of job satisfaction and focus on the reasonable demands of medical staff. In addition, the medical staff in pilot county hospitals exhibited a better understanding of the public hospital reform programme and showed more firm confidence, but there still were some medical staff members who hold negative attitude. The publicity and education of the public hospital reform still need improvement.

77 FR 25105 - Reporting of Ancillary Airline Passenger Revenues

Science.gov (United States)

2012-04-27

...This document announces a public meeting on a Notice of Proposed Rulemaking (NPRM) issued on July 15, 2011. The NPRM proposed changes regarding reporting of airline ancillary passenger revenues, computation of mishandled baggage rates, and collection of separate statistics for mishandled wheelchairs and scooters used by passengers with disabilities. During the public meeting, DOT staff will provide a summary of the proposals in the NPRM and seek input on costs and benefits associated with the implementation of the proposals.

Assessment of Non-Professional Staff Training programme In ...

African Journals Online (AJOL)

The study identified training and development for non-professional staff in Nigerian University Libraries, the categories of staff that are enjoying the training programme, the relevance of the course contents, and the effect of the training programme for non-professional and job performance. The method adopted for the study ...

Roles of Medical Record and Statistic Staff on Research at the Tawanchai Center.

Science.gov (United States)

Pattaranit, Rumpan; Chantachum, Vasana; Lekboonyasin, Orathai; Pradubwong, Suteera

2015-08-01

The medical record and statistic staffs play a crucial role behind the achievements of treatment and research of physicians, nurses and other health care professionals. The medical record and statistic staff are in charge of keeping patient medical records; creating databases; presenting information; sorting patient's information; providing patient medical records and related information for various medical teams and researchers; Besides, the medical record and statistic staff have collaboration with the Center of Cleft Lip-Palate, Khon Kaen University in association with the Tawanchai Project. The Tawanchai Center is an organization, involving multidisciplinary team which aims to continuing provide care for patients with cleft lip and palate and craniofacial deformities who need a long term of treatment since newborns until the age of 19 years. With support and encouragement from the Tawanchai team, the medical record and statistic staff have involved in research under the Tawanchai Centre since then and produced a number of publications locally and internationally.

[Status of subjective well-being for medical staff in a tertiary hospital].

Science.gov (United States)

Deng, Yunlong; Liu, Yan; Xu, Shaorong; Zhao, Min; Li, Junping; Xiong, Yan

2016-06-28

To investigate the status of subjective well-being (SWB) for medical staffs who contact with patients directly in a tertiary hospital.
 Staffs from a tertiary hospital in Hunan province were investigated the SWB Scale (SWBS-cc20) from 2012 to 2014.
 The scores of SWB for medical staffs are high (81.67±12.33). Among the 10 sub-dimensions of SWB, medical staffs performed the best in family atmosphere, personal growth, and interpersonal adaptation, while performed the worst in physical health, mental health and material contentment. Title, job nature, education and occupation significantly affected the status of SWB. Staffs who directly connected with patients have less scores of SWB than those who do not (t=-4.80, Pmental health (OR=1.315, 95% CI 1.023 to 1.690, Phealth (OR=1.313, 95% CI 1.029 to 1.677, Pmental health and physical health.

Medical staff involvement in nursing homes: development of a conceptual model and research agenda.

Science.gov (United States)

Shield, Renée; Rosenthal, Marsha; Wetle, Terrie; Tyler, Denise; Clark, Melissa; Intrator, Orna

2014-02-01

Medical staff (physicians, nurse practitioners, physicians' assistants) involvement in nursing homes (NH) is limited by professional guidelines, government policies, regulations, and reimbursements, creating bureaucratic burden. The conceptual NH Medical Staff Involvement Model, based on our mixed-methods research, applies the Donabedian "structure-process-outcomes" framework to the NH, identifying measures for a coordinated research agenda. Quantitative surveys and qualitative interviews conducted with medical directors, administrators and directors of nursing, other experts, residents and family members and Minimum Data Set, the Online Certification and Reporting System and Medicare Part B claims data related to NH structure, process, and outcomes were analyzed. NH control of medical staff, or structure, affects medical staff involvement in care processes and is associated with better outcomes (e.g., symptom management, appropriate transitions, satisfaction). The model identifies measures clarifying the impact of NH medical staff involvement on care processes and resident outcomes and has strong potential to inform regulatory policies.

28 CFR 345.64 - Referral of releasable medical data to FPI staff.

Science.gov (United States)

2010-07-01

... the FPI staff member who directly supervises the assignment. ... FPI staff. 345.64 Section 345.64 Judicial Administration FEDERAL PRISON INDUSTRIES, INC., DEPARTMENT... Referral of releasable medical data to FPI staff. The SOI is responsible for ensuring that appropriate...

Concussion knowledge and management practices among coaches and medical staff in Irish professional rugby teams.

Science.gov (United States)

Fraas, M R; Coughlan, G F; Hart, E C; McCarthy, C

2015-06-01

Self-reported concussion rates among U-20 and elite rugby union players in Ireland are 45-48%. Half of these injuries go unreported. Accurate knowledge of concussion signs and symptoms and appropriate management practices among coaches and medical staff is important to improve the welfare of players. Examine concussion knowledge among coaches, and management techniques among medical staff of professional Irish rugby teams. Surveys were administered to 11 coaches and 12 medical staff at the end of the 2010-2011 season. Coaches demonstrated an accurate knowledge of concussion with a good understanding of concussion-related symptoms. Medical staff reported using a variety of methods for assessing concussion and making return-to-play decisions. Reliance on subjective clinical methods was evident, with less reliance on objective postural stability performance. Overall, the coaches in this investigation have accurate knowledge of concussion and medical staff use effective techniques for managing this injury. On-going education is needed to assist coaches in identifying concussion signs and symptoms. It is recommended that medical staff increase their reliance on objective methods for assessment and return-to-play decision making.

Evaluation of Patient and Medical Staff Satisfaction regarding Healthcare Services in Wuhan Public Hospitals.

Science.gov (United States)

Meng, Runtang; Li, Jingjing; Zhang, Yunquan; Yu, Yong; Luo, Yi; Liu, Xiaohan; Zhao, Yanxia; Hao, Yuantao; Hu, Ying; Yu, Chuanhua

2018-04-17

Satisfaction evaluation is widely used in healthcare systems to improve healthcare service quality to obtain better health outcomes. The aim of this study was to measure employee work satisfaction and patient satisfaction status in Wuhan, China. A cross-sectional study was conducted in 14 medical institutions. The final valid sample comprised a total of 696 medical staff and 668 patients. The overall satisfaction levels of medical staff and patients were 58.28 ± 14.60 (10.47–100.00) and 65.82 ± 14.66 (8.62–100.00), respectively. The factors affecting medical staff satisfaction, ranking in sequence from most to least satisfied, were: the work itself, working environment and atmosphere, hospital management, practicing environment, and job rewards. Patient satisfaction factors, from most to least affecting, were ranked as follows: physician-patient relationship and communication, service organization and facilities, continuity and collaboration of medical care, access to relevant information and support, and healthcare and related services, respectively. The overall satisfaction evaluation of medical staff was average. Healthcare policy makers and medical institution management staff should focus on job rewards and working environment. This would allow them to increase their work happiness and sense of belonging, which in turn would allow them to provide better medical services to patients. The overall patient evaluation was satisfactory, with patients satisfied at all levels of the satisfaction evaluation.

Evaluation of Patient and Medical Staff Satisfaction regarding Healthcare Services in Wuhan Public Hospitals

Science.gov (United States)

Li, Jingjing; Yu, Yong; Liu, Xiaohan; Zhao, Yanxia; Hao, Yuantao; Hu, Ying

2018-01-01

Satisfaction evaluation is widely used in healthcare systems to improve healthcare service quality to obtain better health outcomes. The aim of this study was to measure employee work satisfaction and patient satisfaction status in Wuhan, China. A cross-sectional study was conducted in 14 medical institutions. The final valid sample comprised a total of 696 medical staff and 668 patients. The overall satisfaction levels of medical staff and patients were 58.28 ± 14.60 (10.47–100.00) and 65.82 ± 14.66 (8.62–100.00), respectively. The factors affecting medical staff satisfaction, ranking in sequence from most to least satisfied, were: the work itself, working environment and atmosphere, hospital management, practicing environment, and job rewards. Patient satisfaction factors, from most to least affecting, were ranked as follows: physician-patient relationship and communication, service organization and facilities, continuity and collaboration of medical care, access to relevant information and support, and healthcare and related services, respectively. The overall satisfaction evaluation of medical staff was average. Healthcare policy makers and medical institution management staff should focus on job rewards and working environment. This would allow them to increase their work happiness and sense of belonging, which in turn would allow them to provide better medical services to patients. The overall patient evaluation was satisfactory, with patients satisfied at all levels of the satisfaction evaluation. PMID:29673134

[Effective Techniques to Reduce Radiation Exposure to Medical Staff during Assist of X-ray Computed Tomography Examination].

Science.gov (United States)

Miyajima, Ryuichi; Fujibuchi, Toshioh; Miyachi, Yusuke; Tateishi, Satoshi; Uno, Yoshinori; Amakawa, Kazutoshi; Ohura, Hiroki; Orita, Shinichi

2018-01-01

Medical staffs like radiological technologists, doctors, and nurses are at an increased risk of exposure to radiation while assisting the patient in a position or monitor contrast medium injection during computed tomography (CT). However, methods to protect medical staff from radiation exposure and protocols for using radiological protection equipment have not been standardized and differ among hospitals. In this study, the distribution of scattered X-rays in a CT room was measured by placing electronic personal dosimeters in locations where medical staff stands beside the CT scanner gantry while assisting the patient and the exposure dose was measured. Moreover, we evaluated non-uniform exposure and revealed effective techniques to reduce the exposure dose to medical staff during CT. The dose of the scattered X-rays was the lowest at the gantry and at the examination table during both head and abdominal CT. The dose was the highest at the trunk of the upper body of the operator corresponding to a height of 130 cm during head CT and at the head corresponding to a height of 150 cm during abdominal CT. The maximum dose to the crystalline lens was approximately 600 μSv during head CT. We found that the use of volumetric CT scanning and X-ray protective goggles, and face direction toward the gantry reduced the exposure dose, particularly to the crystalline lens, for which lower equivalent dose during CT scan has been recently recommended in the International Commission on Radiological Protection Publication 118.

Use of Ancillary Tests When Determining Brain Death in Pediatric Patients in the United States.

Science.gov (United States)

Lewis, Ariane; Adams, Nellie; Chopra, Arun; Kirschen, Matthew P

2017-10-01

Although pediatric brain death guidelines stipulate when ancillary testing should be used during brain death determination, little is known about the way these recommendations are implemented in clinical practice. We conducted a survey of pediatric intensivists and neurologists in the United States on the use of ancillary testing. Although most respondents noted they only performed an ancillary test if the clinical examination and apnea test could not be completed, 20% of 195 respondents performed an ancillary test for other reasons, including (1) to convince a family that objected to the brain death determination that a patient is truly dead (n = 21), (2) personal preference (n = 14), and (3) institutional requirement (n = 5). Our findings suggest that pediatricians use ancillary tests for a variety of reasons during brain death determination. Medical societies and governmental regulatory bodies must reinforce the need for homogeneity in practice.

Satisfaction of staff of Swiss insurance companies with medical appraisals: a cross sectional study

Directory of Open Access Journals (Sweden)

Gyr Niklaus

2011-03-01

Full Text Available Abstract Background A high quality of timely delivered medical appraisals is crucial for social and other insurances to judge possible occupational reintegration measures for patients with medical conditions who are in danger to lose their job. However, little is known about the satisfaction of staff of insurance companies with medical appraisals that they have commissioned. Our questionnaire survey prospectively included all medical appraisals arriving at Swiss insurances from FEB to APR 2008. We assessed the satisfaction of the commissioner with medical appraisals performed by medical assessors. In addition, we evaluated the contribution of several factors to overall satisfaction. The unit of sample was the medical appraisal. Findings We analysed 3165 medical appraisals, 2444 (77% of them from the public disability insurance, 678 (22% from private accident, liability and loss of income insurances and 43 (1% from other insurances. Overall satisfaction of staff of insurance companies in Switzerland was high, but satisfaction of the disability insurance with appraisals was generally lower compared to satisfaction of private insurances. The staff of the disability insurance judged time for preparation as too long in 30%. For staff of private insurance companies 20% of appraisals were not "worth its price". Well-grounded and comprehensible conclusions were the single most important factor for high overall satisfaction (OR 10.1; 95%-CI: 1.1-89.3. Conclusions From the viewpoint of staff of insurance companies, a relevant part of medical appraisals arrives too late. Medical assessors have to take the specific needs of insurances into account, to perform more appraisals with sound conclusions in due time.

Responsibility for quality improvement and patient safety: hospital board and medical staff leadership challenges.

Science.gov (United States)

Goeschel, Christine A; Wachter, Robert M; Pronovost, Peter J

2010-07-01

Concern about the quality and safety of health care persists, 10 years after the 1999 Institute of Medicine report To Err is Human. Despite growing awareness of quality and safety risks, and significant efforts to improve, progress is difficult to measure. Hospital leaders, including boards and medical staffs, are accountable to improve care, yet they often address this duty independently. Shared responsibility for quality and patient safety improvement presents unique challenges and unprecedented opportunities for boards and medical staffs. To capitalize on the pressure to improve, both groups may benefit from a better understanding of their synergistic potential. Boards should be educated about the quality of care provided in their institutions and about the challenges of valid measurement and accurate reporting. Boards strengthen their quality oversight capacity by recruiting physicians for vacant board seats. Medical staff members strengthen their role as hospital leaders when they understand the unique duties of the governing board. A quality improvement strategy rooted in synergistic efforts by the board and the medical staff may offer the greatest potential for safer care. Such a mutually advantageous approach requires a clear appreciation of roles and responsibilities and respect for differences. In this article, we review these responsibilities, describe opportunities for boards and medical staffs to collaborate as leaders, and offer recommendations for how boards and medical staff members can address the challenges of shared responsibility for quality of care.

Evaluation of knowledge regarding Shaken Baby Syndrome among parents and medical staff.

Science.gov (United States)

Marcinkowska, Urszula; Tyrala, Kinga; Paniczek, Monika; Ledwon, Martyna; Josko-Ochojska, Jadwiga

2016-06-08

Shaken Baby Syndrome (SBS), currently functioning as Abusive Head Trauma (AHT), is a form of violence against children mainly under 2 years of age. The number of SBS might be underestimated, as many cases of violence remain unreported. The aim of the study was evaluation of the state of knowledge of the SBS phenomenon, its scale and diagnostic methods among parents, medical staff and medical students. 639 people were examined: 39% of parents, 32,5% medical staff members and 28,5% of medical students. 82% were women. The average age was 34,9 years (SD=9,78). 70% of them had children. The research tool was an anonymous survey. The 34 questions concerned numerous aspects of violence against children as well as knowledge about SBS. According to 90% of the interviewees shaking a baby may be dangerous but 43% have ever heard about shaken baby syndrome. 'SBS is a form of violence' said 88% of respondents but 57% realize that one-time shaking can lead to death and only 19% indicated men as aggressors. 16% of medical staff members did not know how long it takes for the consequences of shaking a baby to be revealed. Majority of the medical staff members working with children have never heard about SBS. Only half of the surveyed understands the connection of shaking with vision loss or child's death. Among the long-term consequences of shaking a baby the greatest knowledge concerns emotional consequences of shaking.

Evaluation of medical staff and patient satisfaction of Chinese hospitals and measures for improvement.

Science.gov (United States)

Li, Min; Huang, Chengyu; Lu, Xiangchan; Chen, Siyuan; Zhao, Pan; Lu, Hongzhou

2015-06-01

Our goal is to establish criteria for evaluating satisfaction of medical staff and patients of Chinese hospitals and propose measures for improvement. A survey was conducted among medical staff and patients of infectious disease hospitals in three locations, i.e., Shanghai, Chongqing, and Nanning. The analyses included item analysis, factor analysis, reliability analysis, Pearson correlation and one-way analysis of variance. For the patient group, Kaiser-Meyer-Olkin (KMO) = 0.973, Cronbach's α = 0.962 and the Pearson correlation coefficients among the five dimensions of satisfaction ranged from 0.583 to 0.795. For the medical staff group, KMO = 0.972, Cronbach's α = 0.970, and the Pearson correlation coefficients among the five dimensions of satisfaction ranged from 0.603 to 0.854. The means on the five dimensions of satisfaction for the patient group were 0.74 to 1.34, 0.81 to 1.17, 0.78 to 1.07, 0.89 to 1.34, and 0.71 to 1.10. The means on the five dimensions of satisfaction for the medical staff group were 0.17 to 1.03, ‒ 0.16 to 0.60, ‒ 0.18 to 0.74, 0.23 to 0.72, and ‒ 0.39 to 0.37. The clinicians were less satisfied with the hospitals than the patients. Medical staff and patients in Shanghai were relatively more satisfied. Improving the evaluation criteria and survey methods with respect to medical staff and patient satisfaction with Chinese hospitals may increase clinician and patient satisfaction and improve the health care environment in China.

18 CFR 35.40 - Ancillary services.

Science.gov (United States)

2010-04-01

... 18 Conservation of Power and Water Resources 1 2010-04-01 2010-04-01 false Ancillary services. 35.40 Section 35.40 Conservation of Power and Water Resources FEDERAL ENERGY REGULATORY COMMISSION... Sales of Electric Energy, Capacity and Ancillary Services at Market-Based Rates § 35.40 Ancillary...

Development of a medical staff recruitment system for teaching ...

African Journals Online (AJOL)

Development of a medical staff recruitment system for teaching hospitals in Nigeria. ... Nigeria, were visited and relevant information was collated through personal ... The design and development of the system employs 3-tier web architecture.

Ancillary obligations as an additional obligation of a limited liability company's member

Directory of Open Access Journals (Sweden)

Marjanski Vladimir Ž.

2016-01-01

Full Text Available Ancillary obligation can be defined as an obligation of a limited liability company's member undertaken through the instrument of incorporation, which can take the form of monetary or non-monetary obligation (usually it is an obligation of a non-monetary character, which has a certain financial value and can be the object of a legally valid obligation. Ancillary obligations, as a contribution to activities of the company, are not regulated in the Law on Companies. The legal nature of this obligation is different from the obligation to make a contribution in money or in kind to a company's assets, to make additional pay-ins or from the landing of funds to the company. Ancillary obligation is an optional and additional obligation of a limited liability company's member and the obligation itself and its contents is defined in the instrument of incorporation. When a limited liability company's member undertakes an ancillary obligation this creates a distinctive relationship between the member and the company, concerning their respective obligations and the legal status of the company, as well as certain consequences derived from those obligations.

Urology Group Compensation and Ancillary Service Models in an Era of Value-based Care.

Science.gov (United States)

Shore, Neal D; Jacoby, Dana

2016-01-01

Changes involving the health care economic landscape have affected physicians' workflow, productivity, compensation structures, and culture. Ongoing Federal legislation regarding regulatory documentation and imminent payment-changing methodologies have encouraged physician consolidation into larger practices, creating affiliations with hospitals, multidisciplinary medical specialties, and integrated delivery networks. As subspecialization and evolution of care models have accelerated, independent medical groups have broadened ancillary service lines by investing in enterprises that compete with hospital-based (academic and nonacademic) entities, as well as non-physician- owned multispecialty enterprises, for both outpatient and inpatient services. The looming and dramatic shift from volume- to value-based health care compensation will assuredly affect urology group compensation arrangements and productivity formulae. For groups that can implement change rapidly, efficiently, and harmoniously, there will be opportunities to achieve the Triple Aim goals of the Patient Protection and Affordable Care Act, while maintaining a successful medical-financial practice. In summary, implementing new payment algorithms alongside comprehensive care coordination will assist urology groups in addressing the health economic cost and quality challenges that have been historically encountered with fee-for-service systems. Urology group leadership and stakeholders will need to adjust internal processes, methods of care coordination, cultural dependency, and organizational structures in order to create better systems of care and management. In response, ancillary services and patient throughput will need to evolve in order to adequately align quality measurement and reporting systems across provider footprints and patient populations.

Job sharing at a children's hospital: evaluation by medical staff.

Science.gov (United States)

Valentine, J P; Martin, C J

1996-01-13

To evaluate job sharing for registrars at Princess Margaret Hospital for Children, Perth, by seeking responses from members of the relevant medical teams. A questionnaire was sent to all 126 medical staff within the hospital (and three managers in medical administration) asking their views on job sharing for registrars. Whether job sharing should continue, who should do it, at what stage of training, and the effects on patient care. Among the 77 respondents (60%) there was broad support for the continuation of job sharing at the hospital: only 5 of 37 consultants and 2 of 19 non-job sharing registrars rejected the idea (with a further 4 consultants uncertain). 43% Of the consultants who had worked with job sharing registrars thought continuity of care was adversely affected. The committee for physician training of the Royal Australasian College of Physicians emphasises that advanced training should be flexible, with a wide range of opportunities for individuals to plan an appropriate training programme in line with their personal goals. This study has shown that job sharing for registrars at Princess Margaret Hospital for Children allows this choice. Action on concerns over any adverse effects on patient care should resolve any persisting disquiet.

Medication administration errors in assisted living: scope, characteristics, and the importance of staff training.

Science.gov (United States)

Zimmerman, Sheryl; Love, Karen; Sloane, Philip D; Cohen, Lauren W; Reed, David; Carder, Paula C

2011-06-01

To compare rates of medication errors committed by assisted living staff with different training and to examine characteristics of errors. Observation of medication preparation and passes, chart review, interviews, and questionnaires. Stratified random sample of 11 assisted living communities in South Carolina (which permits nonnurses to administer medications) and Tennessee (which does not). All staff who prepared or passed medications: nurses (one registered nurse and six licensed practical nurses (LPNs)); medication aides (n=10); and others (n=19), including those with more and less training. Rates of errors related to medication, dose and form, preparation, route, and timing. Medication preparation and administration were observed for 4,957 administrations during 83 passes for 301 residents. The error rate was 42% (20% when omitting timing errors). Of all administrations, 7% were errors with moderate or high potential for harm. The odds of such an error by a medication aide were no more likely than by a LPN, but the odds of one by staff with less training was more than two times as great (odds ratio=2.10, 95% confidence interval=1.27-3.49). A review of state regulations found that 20 states restrict nonnurses to assisting with self-administration of medications. Medication aides do not commit more errors than LPNs, but other nonnurses who administered a significant number of medications and assisted with self-administration committed more errors. Consequently, all staff who handle medications should be trained to the level of a medication aide. © 2011, Copyright the Authors. Journal compilation © 2011, The American Geriatrics Society.

Views of Health Information Management Staff on the Medical Coding Software in Mashhad, Iran.

Science.gov (United States)

Kimiafar, Khalil; Hemmati, Fatemeh; Banaye Yazdipour, Alireza; Sarbaz, Masoumeh

2018-01-01

Systematic evaluation of Health Information Technology (HIT) and users' views leads to the modification and development of these technologies in accordance with their needs. The purpose of this study was to investigate the views of Health Information Management (HIM) staff on the quality of medical coding software. A descriptive cross-sectional study was conducted between May to July 2016 in 26 hospitals (academic and non-academic) in Mashhad, north-eastern Iran. The study population consisted of the chairs of HIM departments and medical coders (58 staff). Data were collected through a valid and reliable questionnaire. The data were analyzed using the SPSS version 16.0. From the views of staff, the advantages of coding software such as reducing coding time had the highest average (Mean=3.82) while cost reduction had the lowest average (Mean =3.20), respectively. Meanwhile, concern about losing job opportunities was the least important disadvantage (15.5%) to the use of coding software. In general, the results of this study showed that coding software in some cases have deficiencies. Designers and developers of health information coding software should pay more attention to technical aspects, in-work reminders, help in deciding on proper codes selection by access coding rules, maintenance services, link to other relevant databases and the possibility of providing brief and detailed reports in different formats.

Medical management of radiological accidents in non-specialized clinics: mistakes and lessons

International Nuclear Information System (INIS)

Jikia, D.

2009-01-01

In 1996-2002 three radiological accidents were developed in Georgia. There were some people injured in those accidents. During medical management of the injured some mistakes and errors were revealed both in diagnostics and scheme of the treatment. The goal of this article is to summarize medical management of the mentioned radiological accidents, to estimate reasons of mistakes and errors, to present the lessons drawn in result of Georgia radiological accidents. There was no clinic with specialized profile and experience. Accordingly due to having no relevant experience late diagnosis can be considered as the main error. It had direct influence on the patients' health and results of treatment. Lessons to be drawn after analyzing Georgian radiological accidents: 1. informing medical staff about radiological injuries (pathogenesis, types, symptoms, clinical course, principles of treatment and etc.); 2. organization of training and meetings in non-specialized clinics or medical institutions for medical staff; 3. preparation of informational booklets and guidelines.(author)

Ancillary benefits of climate policy in a small open economy: The case of Sweden

International Nuclear Information System (INIS)

Krook Riekkola, Anna; Ahlgren, Erik O.; Soederholm, Patrik

2011-01-01

It is increasingly recognised that GHG reduction policies can have important ancillary benefits in the form of positive local and regional environmental impacts. The purpose of this paper is to estimate the domestic ancillary pollution benefits of climate policy in Sweden, and investigate how these are affected by different climate policy designs. The latter differ primarily in terms of how the country chooses to meet a specific target and where the necessary emission reductions take place. The analysis relies on simulations within the energy system optimisation model TIMES-Sweden, and focuses on four non-GHG pollutants: Nitrogen Oxides (NO X ), Non Methane Volatile Organic Compounds (NMVOC), inhalable particles (PM 2.5 ), and Sulphur dioxide (SO 2 ). The simulations permit detailed assessments of the respective technology and fuel choices that underlie any net changes in the estimated ancillary effects. The results indicate that the ancillary benefits constitute a far from insignificant share of total system costs, and this share appears to be highest in the scenarios that entail the largest emission reductions domestically. This result reflects the fact that carbon dioxide emission reductions abroad also implies a lost opportunity of achieving substantial domestic welfare gain from the reductions of regional and local environmental pollutants. - Highlights: → We estimate the domestic ancillary pollution benefits of climate policy in Sweden. → These constitute a sizeable share of total system costs. → The ancillary benefits are highest in the policy scenarios that entail the largest emission reductions domestically.

[Monitoring of hematogenous occupational exposure in medical staff in infectious disease hospital].

Science.gov (United States)

Xie, Manxia; Zhou, Jin; Wang, Yimei

2015-10-01

To investigate the status and risk factors for hematogenous occupational exposure in medical staff in an infectious disease hospital, and to provide a scientific basis for targeted preventive and control measures. The occupational exposure of 395 medical workers in our hospital was monitored from January 2012 to December 2014, among whom 79 individuals with occupational exposure were subjected to intervention and the risk factors for occupational exposure were analyzed. The high-risk group was mainly the nursing staff (69.6%). The incidence of hematogenous occupational exposure was high in medical personnel with a working age under 3 years, aged under 25 years, and at the infection ward, accounting for 63.3%, 72.1%, and 72.2%, respectively. Hepatitis B virus, hepatitis C virus, Treponema pallidum, and human immunodeficiency virus were the primary exposure sources. Sharp injury was the major way of injury (91.1%), with needle stick injury accounting for the highest proportion (86.1%). Injury occurred on the hand most frequently (91.1%). The high-risk links were improper disposal during or after pulling the needle, re-capturing the needle, and processing waste, accounting for 46.8%, 17.7%, and 12.7%, respectively. Seventy-nine professionals with occupational exposure were not infected. The main risk factor for hematogenous occupational exposure in medical staff in the infectious disease hospital is needle stick injury. Strengthening the occupational protection education in medical staff in infectious disease hospital, implementing protective measures, standardizing operating procedures in high-risk links, and enhancing the supervision mechanism can reduce the incidence of occupational exposure and infection after exposure.

Ancillary service provision from distributed generation

International Nuclear Information System (INIS)

2004-01-01

This report summarises the findings of a study undertaken to investigate the potential for establishing ancillary service markets at the distribution level in the UK. Existing arrangements for ancillary service markets globally, the design of these markets, regulatory and legislative changes that may be required, different forms of distributed generation (DG), and prospects of increasing the connection to the distributed network are examined along with commercial frameworks and technical procedures, infrastructure requirements, and the effects on different market participants. The scope for new ancillary services at the distribution level, ancillary services from DG, the prospects for DG, commercial and technical aspects, and impact assessments are reviewed

Ancillary service provision from distributed generation

Energy Technology Data Exchange (ETDEWEB)

NONE

2004-07-01

This report summarises the findings of a study undertaken to investigate the potential for establishing ancillary service markets at the distribution level in the UK. Existing arrangements for ancillary service markets globally, the design of these markets, regulatory and legislative changes that may be required, different forms of distributed generation (DG), and prospects of increasing the connection to the distributed network are examined along with commercial frameworks and technical procedures, infrastructure requirements, and the effects on different market participants. The scope for new ancillary services at the distribution level, ancillary services from DG, the prospects for DG, commercial and technical aspects, and impact assessments are reviewed.

Workplace violence and its effect on burnout and turnover attempt among Chinese medical staff.

Science.gov (United States)

Chen, Shiying; Lin, Shaowei; Ruan, Qishuang; Li, Huangyuan; Wu, Siying

2016-11-01

The present study was to evaluate workplace violence and examine its effect on job burnout and turnover attempt among medical staff in China. A total of 2,020 medical employees were selected from Fujian province by using stratified cluster sampling method. The Chinese version of the Workplace Violence Scale and the Maslach Burnout Inventory-General Survey were used to measure the workplace violence and job burnout, respectively. Other potential influencing factors for job burnout and turnover attempt were collected using a structured questionnaire. The incidence of workplace violence among medical staff was 48.0%. Workplace violence had a positive correlation with emotional exhaustion and cynicism and a negative correlation with professional efficacy. Workplace violence, marital status, employment type, working time (≥ 10 h/day), performance recognition, and life satisfaction were significant predictors for turnover attempt among Chinese medical staff.

Workplace violence against medical staff in healthcare facilities in Barbados.

Science.gov (United States)

Abed, M; Morris, E; Sobers-Grannum, N

2016-10-01

Anecdotal evidence suggests increasing workplace violence against healthcare workers in the Caribbean, but the prevalence is largely undocumented. To determine the prevalence of workplace violence reported by medical staff at primary care clinics in Barbados. A study utilizing a modified version of the standard World Health Organization Workplace Violence Questionnaire, designed to assess the incidence, types and features of workplace violence. All nursing and physician staff on duty at the island's eight primary care clinics during the study period were invited to participate. Of the 102 respondents (72% response rate), 63% of nursing and physician staff at the polyclinics in Barbados reported at least one episode of violence in the past year. The majority reported being exposed to verbal abuse (60%) and 19% reported being exposed to bullying. Seven percent of the staff reported incidents of sexual harassment, 3% physical violence and another 3% reported racial harassment. Patients emerged as the main perpetrators of violence (64%). Logistic regression showed statistically significant associations between gender and workplace violence. Females and nurses were more predisposed to experience violent incidents than males and physicians. Over a half of medical staff surveyed reported experiencing some type of violence in the past year, female gender being a significant predictor of abuse. Adequate documentation and implementing clear policies and violence prevention programmes in health institutions are crucial steps towards addressing this issue. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Cognitive emotions: depression and anxiety in medical students and staff.

Science.gov (United States)

Ahmed, Isra; Banu, Haseena; Al-Fageer, Reem; Al-Suwaidi, Reem

2009-09-01

Medical students represent a highly educated population under significant pressures. They encounter multiple emotions during the transformation from insecure student to young knowledgeable physician. During the transition to clinical settings in the third year, the student may experience a loss of external control and may counter this with an increase in depression and/or anxiety symptoms. Studies suggest that mental health worsens after students begin medical school and remains poor throughout training. It is not just the undergraduate study period, which brings about these changes; it may continue later in internship, postgraduate study, and in physicians' practical life, and it may reach burnout level. The greater the psychosocial health, the greater is the well-being and the capacity for adaptation and overcoming problems and common life frustrations in family, relationships, and work. Medical students and practicing physicians, in comparison with the general population and that of other professions, are exposed to academic and professional stress and therefore are vulnerable to psychosocial health problems and certain specific dysfunctions that may compromise their physical, mental, and social health. Our study examines the phenomenology of depression and anxiety in medical doctors in 3 government hospitals, 3 primary health care centers and the students (all years) and staff of Dubai Medical College for Girls (DMCG). This cross-sectional study was conducted in November 2008. One hundred sixty-five medical students of DMCG and 93 doctors (including medical staff of DMCG) completed a set of 2 questionnaires regarding Beck Depression Inventory (BDI) & Beck Anxiety Inventory (BAI). Results were analyzed using SPSS 11, and adequate statistical significant tests were done. A P value of students, 28.6% showed depression and 28.7% showed anxiety. Of medical staff, 7.8% showed depression and 2.2% of them showed anxiety. The second-year medical students exhibited the

A Committee on Well-Being of Medical Students and House Staff.

Science.gov (United States)

Weinstein, Harvey M.

1983-01-01

A committee was established in a university medical center to address socioemotional aspects of medical training and to enhance the learning environment. Problem areas identified for program development included poor communication, stress on self and relationships, need for advocacy, and lack of support for house staff members. (MSE)

Language barriers in medical education and attitudes towards Arabization of medicine: student and staff perspectives.

Science.gov (United States)

Sabbour, S M; Dewedar, S A; Kandil, S K

2012-12-04

Students and staff perspectives on language barriers in medical education in Egypt and their attitude towards Arabization of the medical curriculum were explored in a questionnaire survey of 400 medical students and 150 staff members. Many students (56.3%) did not consider learning medicine in English an obstacle, and 44.5% of staff considered it an obstacle only in the 1st year of medical school. Many other barriers to learning other than language were mentioned. However, 44.8% of students translated English terms to Arabic to facilitate studying and 70.6% of students in their clinical study years would prefer to learn patient history-taking in Arabic. While Arabization in general was strongly declined, teaching in Arabic language was suggested as appropriate in some specialties.

Health effects assessment of staff involved in medical practices of radiation exposures

Energy Technology Data Exchange (ETDEWEB)

Popescu, I.A.; Lacob, O. [Institute of Public Health Iasi, Radiation Hygiene Lab. (Romania); Roman, I.; Havarneanu, D. [Institute of Public Health Iasi, Occupational Medicine Dept. (Romania)

2006-07-01

This study aimed, starting from new national recommendation appearance, to detect health effects of medical staff from six counties of Moldavia region involved in radiation practices and to create a national register data for radiation-induce cancer. Staff involved in medical ionizing radiation uses in Romania - health care level I are monitored on recent new recommendations for three years. The micro nuclei high levels and morphological lymphocytes changes vs. clinical diagnostic can be considered as early possible malignant signs. The micro nuclei test, although unspecific, as a new exam in our legislation can bring useful information on staff exposure and provides a guidance to occupational physician in making his medical recommendations. This cytogenetic test does not seem to correlate with smoking habit or length of exposure. Micro nuclei test both in oral mucous epithelial cells and peripheral culture lymphocytes can be considered of much specificity and correlates with a recent acute exposure level. The conclusions of individual health status surveillance and assessment of personal dose equivalent are very useful data for recording in the radiation cancer-induced register.

Health effects assessment of staff involved in medical practices of radiation exposures

International Nuclear Information System (INIS)

Popescu, I.A.; Lacob, O.; Roman, I.; Havarneanu, D.

2006-01-01

This study aimed, starting from new national recommendation appearance, to detect health effects of medical staff from six counties of Moldavia region involved in radiation practices and to create a national register data for radiation-induce cancer. Staff involved in medical ionizing radiation uses in Romania - health care level I are monitored on recent new recommendations for three years. The micro nuclei high levels and morphological lymphocytes changes vs. clinical diagnostic can be considered as early possible malignant signs. The micro nuclei test, although unspecific, as a new exam in our legislation can bring useful information on staff exposure and provides a guidance to occupational physician in making his medical recommendations. This cytogenetic test does not seem to correlate with smoking habit or length of exposure. Micro nuclei test both in oral mucous epithelial cells and peripheral culture lymphocytes can be considered of much specificity and correlates with a recent acute exposure level. The conclusions of individual health status surveillance and assessment of personal dose equivalent are very useful data for recording in the radiation cancer-induced register

Job characteristic perception and intrinsic motivation in medical record department staff.

Science.gov (United States)

Isfahani, Sakineh Saghaeiannejad; Bahrami, Soosan; Torki, Sedighe

2013-01-01

Human resources are key factors in service organizations like hospitals. Therefore, motivating human recourses to achieve the objectives of an organization is important. Job enrichment is a strategy used to increase job motivation in staffs. The goal of the current study is to determine the relationship between job characteristics and intrinsic motivation in medical record staff in hospitals related to Medical Science University in Isfahan in 2011-2012 academic year. The type of the study is descriptive and corelational of multi variables. The population of the study includes all the medical record staffs of medical record department working in Medical Science hospitals of Isfahan. One hundred twentyseven subjects were selected by conducting a census. In the present study, data collected by using two questionnaires of job characteristics devised by Hackman and Oldeham, and of intrinsic motivation. Content validity was confirmed by experts and its reliability was calculated through coefficient of Cronbach's alpha (r1 = 0.84- r2 = 0.94). The questionnaires completed were entered into SPSS(18) software; furthermore, statistical analysis done descriptively (frequency percent, mean, standard deviation, Pierson correlation coefficient,...) and inferentially (multiple regression, MANOVA, LSD). A significant relationship between job characteristics as well as its elements (skill variety, task identity, task significance, autonomy and feedback) and intrinsic motivation was noticed. (p intrinsic motivation was significant and job feedback had the most impact upon the intrinsic motivation. No significant difference was noticed among the mean amounts of job characteristic perception according to age, gender, level of education, and the kind of educational degree in hospitals. However, there was a significant difference among the mean amounts of job characteristic perception according to the unit of service and the years of servicein hospitals. The findings show that all job

Cultural Awareness Among Nursing Staff at an Academic Medical Center.

Science.gov (United States)

McElroy, Jennifer; Smith-Miller, Cheryl A; Madigan, Catherine K; Li, Yin

2016-03-01

The goal is to identify areas for targeted improvement in regard to cultural awareness and competence among nursing staff and in the work environment. Many facilities have initiated programs to facilitate cultural competence development among nursing staff; however, there has been little examination of the effect of these initiatives, assessment of experienced nurses' cultural awareness, or investigation of nurse leader's role in promoting cultural competence in the literature. In this cross-sectional descriptive study, a cultural awareness survey was modified and electronically distributed to all registered nurses and assistive personnel at an academic medical center. The modified survey instrument showed good reliability and validity among the study population. Most nursing staff exhibited a moderate to high level of cultural awareness and held positive opinions about nursing leadership and the work environment with regard to cultural issues. In increasingly diverse work environments, assessing the cultural awareness of nursing staff enables nurse leaders to evaluate efforts in promoting cultural competence and to identify specific areas in which to target staff development efforts and leadership training.

A study on job satisfaction among clinical and non-clinical hospital staff in a teaching hospital in Lagos, Nigeria.

Science.gov (United States)

Coker, O O; Coker, A O; Onuoha, B

2011-12-01

Previous studies had demonstrated that continuous and effective productivity of hospital staff are linked to job satisfaction and only those who are satisfied with their job can be maximally effective and productive. This cross-sectional descriptive survey was designed to determine the levels of job satisfaction among various groups of health care professionals working in a teaching hospital in Lagos, Nigeria. Two hundred clinical and non-clinical hospital staff were invited to take part in the study. They completed a sociodemographic questionnaire and the Job Descriptive Index (JDI). The results indicated that majority clinical and non-clinical staff were satisfied with their jobs as regards the parameters of the JDI compared with those not satisfied with their jobs. The government and health policy makers should continue to pay attention to boost job morale and satisfaction of medical health workers to continue to make them to be satisfied with their job.

Development of a 2-h suicide prevention program for medical staff including nurses and medical residents: A two-center pilot trial.

Science.gov (United States)

Nakagami, Yukako; Kubo, Hiroaki; Katsuki, Ryoko; Sakai, Tomomichi; Sugihara, Genichi; Naito, Chisako; Oda, Hiroyuki; Hayakawa, Kohei; Suzuki, Yuriko; Fujisawa, Daisuke; Hashimoto, Naoki; Kobara, Keiji; Cho, Tetsuji; Kuga, Hironori; Takao, Kiyoshi; Kawahara, Yoko; Matsumura, Yumi; Murai, Toshiya; Akashi, Koichi; Kanba, Shigenobu; Otsuka, Kotaro; Kato, Takahiro A

2018-01-01

Suicide is a crucial global health concern and effective suicide prevention has long been warranted. Mental illness, especially depression is the highest risk factor of suicide. Suicidal risk is increased in people not only with mental illness but also with physical illnesses, thus medical staff caring for physically-ill patients are also required to manage people with suicidal risk. In the present study, we evaluated our newly developed suicide intervention program among medical staff. We developed a 2-h suicide intervention program for medical staff, based on the Mental Health First Aid (MHFA), which had originally been developed for the general population. We conducted this program for 74 medical staff members from 2 hospitals. Changes in knowledge, perceived skills, and confidence in early intervention of depression and suicide-prevention were evaluated using self-reported questionnaires at 3 points; pre-program, immediately after the program, and 1 month after program. This suicide prevention program had significant effects on improving perceived skills and confidence especially among nurses and medical residents. These significant effects lasted even 1 month after the program. Design was a single-arm study with relatively small sample size and short-term follow up. The present study suggests that the major target of this effective program is nurses and medical residents. Future research is required to validate the effects of the program with control groups, and also to assess long-term effectiveness and actual reduction in suicide rates. Copyright © 2017 Elsevier B.V. All rights reserved.

Opinion and knowledge among hospital medical staff regarding diagnosis of diabetes and proper usage of a specific test tube for glucose analysis.

Science.gov (United States)

Bar-Dayan, Y; Bogaiov, A; Boaz, M; Landau, Z; Wainstein, J

2014-02-01

Accuracy of blood sugar values, as examined by glucose analysis, has significant importance on the diagnosis of diabetes and follow up of diabetes treatment. Usage of a designated test tube significantly improves the accuracy of measurement. Knowledge of the medical staff is a major determinant in the current usage of such a technology. The aim of the study was to assess the level of knowledge exhibited by medical staff in the diabetes field and specifically for the usage of a designated tube to test blood glucose level. A prospective study. The staff of the internal and surgical departments and outpatient clinics at the Wolfson Medical Center completed a questionnaire that assessed the level of knowledge about the designated glucose test tube, other randomly used test tubes, the parameters that influence the blood glucose values in a non-designated tube and the diagnosis of diabetes. A number of 160 questionnaires (50% from internal departments, 36% from surgical departments and 14% from outpatient clinics) were analysed. The majority of the staff members (65%) knew that diabetes is diagnosed by glucose levels in blood. Of the 35% that did not know, 91% were nurses. The majority (75%) knew that diabetes is diagnosed during fasting conditions; however, most of the staff indicated that 12 h is needed. Only 25% knew of the designated test tube, and most of the staff indicated that a regular chemistry tube was the tube of choice for them. The staff exhibited poor level of knowledge regarding the parameters that influence the quality of the test. Staff members are not aware of the various aspects of diabetes diagnosis and the designated test tube for glucose measurements, and most of them use a tube that gives inaccurate measurements, therefore there is an urgent need to improve diabetes knowledge among staff members. © 2013 John Wiley & Sons Ltd.

Behavioral Emergency Response Team: Implementation Improves Patient Safety, Staff Safety, and Staff Collaboration.

Science.gov (United States)

Zicko, Cdr Jennifer M; Schroeder, Lcdr Rebecca A; Byers, Cdr William S; Taylor, Lt Adam M; Spence, Cdr Dennis L

2017-10-01

Staff members working on our nonmental health (non-MH) units (i.e., medical-surgical [MS] units) were not educated in recognizing or deescalating behavioral emergencies. Published evidence suggests a behavioral emergency response team (BERT) composed of MH experts who assist with deescalating behavioral emergencies may be beneficial in these situations. Therefore, we sought to implement a BERT on the inpatient non-MH units at our military treatment facility. The objectives of this evidence-based practice process improvement project were to determine how implementation of a BERT affects staff and patient safety and to examine nursing staffs' level of knowledge, confidence, and support in caring for psychiatric patients and patients exhibiting behavioral emergencies. A BERT was piloted on one MS unit for 5 months and expanded to two additional units for 3 months. Pre- and postimplementation staff surveys were conducted, and the number of staff assaults and injuries, restraint usage, and security intervention were compared. The BERT responded to 17 behavioral emergencies. The number of assaults decreased from 10 (pre) to 1 (post); security intervention decreased from 14 to 1; and restraint use decreased from 8 to 1. MS staffs' level of BERT knowledge and rating of support between MH staff and their staff significantly increased. Both MS and MH nurses rated the BERT as supportive and effective. A BERT can assist with deescalating behavioral emergencies, and improve staff collaboration and patient and staff safety. © 2017 Sigma Theta Tau International.

Factors influencing the perception of medical staff and outpatients of dual practice in Shanghai, People's Republic of China.

Science.gov (United States)

Chen, Haiping; Li, Meina; Dai, Zhixin; Deng, Qiangyu; Zhang, Lulu

2016-01-01

Dual practice is defined as a physician's performance of medical activities in different health care institutions (two or more) simultaneously. This study aimed to examine the perception and acceptance of medical staff and outpatients of dual practice and explore the possible factors affecting people's perception. A cross-sectional study was conducted in 13 public hospitals in Shanghai. Participants included medical staff and outpatients. We distributed 1,000 questionnaires to each participant group, and the response rates were 66.7% and 69.4%, respectively. Statistical differences in variables were tested, and multinomial logistic regression methods were employed for statistical analysis. The study included two parts: medical staff survey and outpatient survey. The results of medical staff survey showed that 63.0% of the respondents supported dual practice. Medical staff who belonged to the surgical department or held positive belief of dual practice were more willing to participate in dual practice. Moreover, the publicity activities of dual practice and hospitals' human resource management system were important factors affecting the willingness of the medical staff. The results of outpatient survey showed that 44.5% of respondents believed that dual practice could reduce difficulty in consulting a doctor. Regarding the perceived benefits of dual practice, the proportion of outpatients who believed that dual practice could meet the demand for health convenience, minor illness, and chronic disease were 45.4%, 42.4%, and 53.7%, respectively. Additionally, demographic characteristics significantly influenced the perception of outpatients. This study confirmed that both medical staff and outpatients generally held positive attitudes toward dual practice. Medical staff who belonged to the surgical department or held positive belief of dual practice were more willing to participate in dual practice. Moreover, the existence of publicity activities and more flexible

Alternative dispute resolution and the physician--the use of mediation to resolve hospital-medical staff conflicts.

Science.gov (United States)

Hall, J L; Stong, R A

1993-01-01

The use of adversarial methods to resolve disputes arising out of medical staff matters can be time-consuming, costly, and disruptive to the hospital-medical staff relationship. As this article suggests, mediation is the preferred method of alternative dispute resolution for reaching mutually acceptable solutions with minimal harm to relationships.

Toxic effects of formalin-treated cadaver on medical students, staff ...

African Journals Online (AJOL)

Background: Formaldehyde can be toxic, allergenic and carcinogenic. Evaporation of formaldehyde from formalin-treated cadavers in the anatomy dissection rooms can produce high exposure. This study was conducted to assess acute and chronic toxic effects of formalin-treated cadavers on medical students, staff ...

Ethics of Ancillary Care in Clinical Trials in Low Income Countries: A ...

African Journals Online (AJOL)

AJRH Managing Editor

income countries where HIV incidence is high, but the benefits of research are ... provision of ancillary care – medical care provided to clinical trial participants during a ... to or use of quality delivery services is an issue of ... with drastically reduced costs, questions arise over .... The 'partial entrustment' model differentiates.

[Analysis medical staff opinion according to quality management in health care].

Science.gov (United States)

Łopacińska, Iwona

2012-10-01

The practice of documenting the credibility of quality management system of companies in the medical sector in Poland does not have a long history. In the recent years hospitals have started to work in a system similar to a competitive market with features specific for medical service preserved. As a result quality focused activity instruments were introduced to the medical service market, such as ISO family of standards. The aim of the work objective was to get to know the opinion of medical staff about the changes resulting in the quality management system implementation. The answers of a team of 200 medical staff from two Polish hospitals were analysed. The respondents were employed in medical institutions before and after the introduction of ISO 9001. A large number of participants claimed that standardization in work organization made a significant improvement (45.50%, n = 91), but part of them (36.50%, n = 73) claimed that this new organization improved the situation not very much. And a small group (18,00%, n = 36) said that the organization did not change after the introduction of standardization. Nurses and medical rescue workers more often claimed (the result being statistically significant) that their work organization improved after the standardization implementation (48.54%), differently from doctors (27.59%, p = 0.008). Doctors in the research often claimed that the changes after the introduction of standardization caused an increase in the requirements of their professional qualifications (79.13%), but the nurses and medical rescue workers found it a bit less (74.85%). Most participants (87.50%, n = 175) claimed that the changes which appeared as a result of the introduction of standardization motivated them to compete against others health care institutions. Medical staff in the research claimed that the changes after the introduction of standardization resulted in work organization improvement. Nurses and medical rescue workers more often claimed

Guidelines for Professional Training of Junior Medical Staff in the Context of European Experience

Science.gov (United States)

Sosnova, Myroslava

2016-01-01

The article deals with outlining guidelines for improving professional training of junior medical staff based on European experience. Consequently, guidelines and recommendations on enhancing the efficiency of medical education in general and junior medical specialists' professional training, in particular, published by European Union of Medical…

Survey of U.S. Ancillary Services Markets

Energy Technology Data Exchange (ETDEWEB)

Zhou, Zhi; Levin, Todd; Conzelmann, Guenter

2016-06-01

In addition to providing energy to end-consumers, power system operators are also responsible for ensuring system reliability. To this end, power markets maintain an array of ancillary services to ensure that it is always possible to balance the supply and demand for energy in real-time. A subset of these ancillary services are commonly procured through market-based mechanisms: namely, Regulation, Spinning, and Non-spinning Reserves. Regulation Reserves are maintained to respond to supply/demand imbalances over short time frames, typically on the order of several seconds to one minute. Resources that provide Regulation Reserves adjust their generation or load levels in response to automatic generation control (AGC) signals provided by the system operator. Contingency reserves are maintained to provide additional generation capacity in the event that load increases substantially or supply side resources reduce their output or are taken offline. The reserves are typically segmented into two categories, 1) Spinning or Synchronized Reserves that are provided by generation units that are actively generating and have the ability to increase or decrease their output, 2) Non-spinning or Non-synchronized Reserves that are provided by generation resources that are not actively generating, but are able to start up and provide generation within a specified timeframe. Contingency reserves typically have response times on the order of ten to 30 minutes and can also be provided by demand-side resources that are capable of reducing their load. There are seven distinct power markets in the United States, each operated by a Regional Transmission Operator (RTO) or Independent System Operator (ISO) that operates the transmission system in its territory, operates markets for energy and ancillary services, and maintains system reliability. Each power market offers its own set of ancillary services, and precise definitions, requirements, and market mechanisms differ between markets

CEO must have authority to coordinate governance, management, medical staff.

Science.gov (United States)

Johnson, R L

1984-04-01

As hospitals attempt to survive in today's new competitive environment, they will find that the traditional organizational structure does not work. This structure can be characterized as a three-legged stool. Governance, management, and medical staff existed in relative harmony, with each able to attend to its own distinct, separate responsibilities. The medical staff regulated itself, the governing board had no serious difficulties in coping with the institution's finances, and the CEO was concerned solely with the physical plant and hospital personnel. In a riskless economic environment, this three-legged stool could remain stable. In the coming years,however, a hospital will need a clear-cut, identifiable leader if it is to survive. To centralize authority primarily in the CEO's hands will be a difficult step for nonprofit hospitals, particularly those sponsored by religious institutions, because of their tradition of operating much as a charitable social agency rather than a business. But this step must be taken, even to the extent of naming the CEO as chairman of the board, for a leader is required who has the authority to make quick decisions in the competitive marketplace. Timeliness is of strategic importance in such an environment, and governing boards increasingly will find it impossible to make timely decisions on a collective basis. Moreover, CEOs will have to coordinate the activities of management, medical staff, and the governing board. They will need to play a strong role in ensuring that target levels in DRG costs are met, and they will need the authority to mediate in issues in which the hospital's economic interests are pitted against physicians'.(ABSTRACT TRUNCATED AT 250 WORDS)

Evaluation of radiation doses in patient and medical staff during endoscopic retrograde cholangio-pancreatography procedures

International Nuclear Information System (INIS)

Seo, Deoknam; Kim, Kie Hwan; Park, Kyung; Kim, Jung-Su; Han, Seonggyu; Kim, Jungmin

2016-01-01

The radiation exposure dose must be optimised because the hazard resulting from an interventional radiology procedure is long term depending on the patient. The aim of this study was to measure the radiation doses received by the patients and medical staff during endoscopic retrograde cholangio-pancreatography (ERCP) procedures. Data were collected during 126 ERCP procedures, including the dose-area product (DAP), entrance dose (ED), effective dose (E), fluoroscopy time (T) and number of digital radiographs (F). The medical staff members each wore a personal thermoluminescence dosemeter to monitor exposure during ERCP procedures. The mean DAP, ED, E and T were 47.06 Gy cm 2 , 196.06 mGy, 8.93 mSv, 7.65 min and 9.21 images, respectively. The mean dose to the staff was 0.175 mSv and that to the assistant was 0.069 mSv. The dose to the medical staff was minimal when appropriate protective measures were used. The large variation in the patient doses must be further investigated. (authors)

Testing a Mediational Model of Communication Among Medical Staff and Families of Cancer Patients

Science.gov (United States)

Gionta, Dana A.; Harlow, Lisa L.; Loitman, Jane E.; Leeman, Joanne M.

2005-01-01

Three structural equation models of communication between family members and medical staff were examined to understand relations among staff accessibility, inhibitory family attitudes, getting communication needs met, perceived stress, and satisfaction with communication. Compared to full and direct models, a mediational model fit best in which…

Research Productivity of ]unior Academic Staff at a Tertiary Medical ...

African Journals Online (AJOL)

Research Productivity of ]unior Academic Staff at a Tertiary Medical College in South West, Nigeria. OA Lesi, OO Orenuga, A Roberts, OO Abudu. Abstract. No Abstract. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL.

Factors influencing the perception of medical staff and outpatients of dual practice in Shanghai, People’s Republic of China

Science.gov (United States)

Chen, Haiping; Li, Meina; Dai, Zhixin; Deng, Qiangyu; Zhang, Lulu

2016-01-01

Objective Dual practice is defined as a physician’s performance of medical activities in different health care institutions (two or more) simultaneously. This study aimed to examine the perception and acceptance of medical staff and outpatients of dual practice and explore the possible factors affecting people’s perception. Methods A cross-sectional study was conducted in 13 public hospitals in Shanghai. Participants included medical staff and outpatients. We distributed 1,000 questionnaires to each participant group, and the response rates were 66.7% and 69.4%, respectively. Statistical differences in variables were tested, and multinomial logistic regression methods were employed for statistical analysis. Results The study included two parts: medical staff survey and outpatient survey. The results of medical staff survey showed that 63.0% of the respondents supported dual practice. Medical staff who belonged to the surgical department or held positive belief of dual practice were more willing to participate in dual practice. Moreover, the publicity activities of dual practice and hospitals’ human resource management system were important factors affecting the willingness of the medical staff. The results of outpatient survey showed that 44.5% of respondents believed that dual practice could reduce difficulty in consulting a doctor. Regarding the perceived benefits of dual practice, the proportion of outpatients who believed that dual practice could meet the demand for health convenience, minor illness, and chronic disease were 45.4%, 42.4%, and 53.7%, respectively. Additionally, demographic characteristics significantly influenced the perception of outpatients. Conclusion This study confirmed that both medical staff and outpatients generally held positive attitudes toward dual practice. Medical staff who belonged to the surgical department or held positive belief of dual practice were more willing to participate in dual practice. Moreover, the existence of

Self-medication with antibiotics in the Republic of Srpska community pharmacies: pharmacy staff behavior.

Science.gov (United States)

Marković-Peković, Vanda; Grubiša, Nataša

2012-10-01

Self-medication with antibiotics adds to the global risk of increased spread of bacterial resistance. Attitudes and behavior of health professionals also may reinforce self-medication with antibiotics. The aim of this study was to determine whether self-medication with antibiotics is possible in our community pharmacies and to what extent, and to evaluate the behavior and service of pharmacy health professionals regarding non-prescription antibiotic dispensation. An observational, cross-section study was conducted, and pseudo-patient methodology was used to establish the kind of professional service provided in case of patient's explicit demand to buy an antibiotic for treatment of self-diagnosed upper respiratory tract infection. Of the total 318 community pharmacies, 131 (41%) were visited and included in the study. Non-prescription antibiotics were dispensed in 76 (58%) pharmacies. Counseling and symptomatic therapy was offered in 88 (67%) pharmacies. In 25% of pharmacies, no symptomatic therapy was offered; instead, only an antibiotic was sold. Amoxicillin was sold in 85% of cases and, mostly, the one of 1.30 Euro per pack. Both oral and written use instructions were given in 78% cases, whereas none was given in 3% of cases. Self-medication with antibiotics occurs in our community pharmacies, despite being illegal. Pharmacy staff behavior can be a factor that puts patients at risk for self-medication with antibiotics. Community pharmacies are failing their tasks in enhancing rational use of antibiotics. Such a practice may be a consequence of weak enforcement and control over the legislation and professional standards. Copyright © 2012 John Wiley & Sons, Ltd.

Ancillary effects of selected acid deposition control policies

Energy Technology Data Exchange (ETDEWEB)

Moe, R.J.; Lyke, A.J.; Nesse, R.J.

1986-08-01

NAPAP is examining a number of potential ways to reduce the precursors (sulfur dioxide and nitrogen oxides) to acid deposition. However, the policies to reduce acid deposition will have other physical, biological and economic effects unrelated to acid deposition. For example, control policies that reduce sulfur dioxide emissions may also increase visibility. The effects of an acid deposition policy that are unrelated to acid deposition are referred to as ''ancillary'' effects. This reserch identifies and characterizes the principle physical and economic ancillary effects associated with acid deposition control and mitigation policies. In this study the ancillary benefits associated with four specific acid deposition policy options were investigated. The four policy options investigated are: (1) flue gas desulfurization, (2) coal blending or switching, (3) reductions in automobile emissions of NO/sub x/, and (4) lake liming. Potential ancillary benefits of each option were identified and characterized. Particular attention was paid to the literature on economic valuation of potential ancillary effects.

Health physics limitations for radiation protection of patients and medical staff

International Nuclear Information System (INIS)

Golikov, V.Ya.; Ermolina, E.P.

1997-01-01

Norm-setting documents regulating the requirements to radiation safety during medical x-ray and radiological procedures are reviewed. Besides the Federal Law On Radiation Safety of the Population and Radiation Safety Norms-96, the authors comment on the norm-setting documents issued later and supplementing the above documents. The authors emphasize the obligatory licensing during medical use of ionizing radiation sources. Effective dose is introduced as the criterion of radiation safety of the patients and staff during prophylactic x-ray examinations. Principles of normsetting, validation, and optimization of medical exposures and criteria of radiation safety of patients are discussed

78 FR 59038 - Mobile Medical Applications; Guidance for Industry and Food and Drug Administration Staff...

Science.gov (United States)

2013-09-25

... FDA intends to apply its regulatory oversight to only those mobile apps that are medical devices and...] Mobile Medical Applications; Guidance for Industry and Food and Drug Administration Staff; Availability...) is announcing the availability of the guidance entitled ``Mobile Medical Applications.'' The FDA is...

Risk of cataract among medical staff in neurosurgical department occupationally exposed to radiation

International Nuclear Information System (INIS)

Stankova-Mileva, I.; Vassileva, J.; Djounova, J.

2012-01-01

In this study we present the risk of cataract among medical staff in neurosurgical department occupationally exposed to radiation compared to those of non-radiation workers. Cataract is the most common degenerative opacity of the crystalline lens developing with aging. Other risk factors for cataract are: infrared and ultraviolet radiation, systemic diseases (diabetes, hypertonic disease), eye diseases (glaucoma, high myopia), drugs (steroids), etc. High risk of developing cataract we find among staff occupationally exposed to radiation during operations - interventional cardiologists and neurosurgeons. This study includes 30 people between 33 and 60 years of age working in neurosurgical department and control group (the same amount and age of people not exposed to radiation in their work). After visual acuity measurement, the lens was examined by retroillumination method (red reflex) and using a bio microscope. The patients were asked for presence of ocular and systemic diseases, eye trauma, drug, alcohol and tobacco abuse and for how many years they work in this department. There was one case with cataract among neurosurgeons. The doctor doesn't have eye or systemic diseases, doesn't take any drugs and is not alcohol or tobacco abuser. In the control group there were two persons with subcapsular cataract but they have diabetes. Radiation is one of the risk factors for cataract. Continuing of this epidemiological survey will provide further knowledge on the potential risk of occupational radiation-induced cataract among neurosurgical staff and will contribute for optimization of radiation protection. (authors)

AX Tank Farm ancillary equipment study

International Nuclear Information System (INIS)

SKELLY, W.A.

1999-01-01

This report examines the feasibility of remediating ancillary equipment associated with the 241-AX Tank Farm at the Hanford Site. Ancillary equipment includes surface structures and equipment, process waste piping, ventilation components, wells, and pits, boxes, sumps, and tanks used to make waste transfers to/from the AX tanks and adjoining tank farms. Two remedial alternatives are considered: (1) excavation and removal of all ancillary equipment items, and (2) in-situ stabilization by grout filling, the 241-AX Tank Farm is being employed as a strawman in engineering studies evaluating clean and landfill closure options for Hanford single-shell tanks. This is one of several reports being prepared for use by the Hanford Tanks Initiative Project to explore potential closure options and to develop retrieval performance evaluation criteria for tank farms

28 CFR 570.42 - Non-medical escorted trips.

Science.gov (United States)

2010-07-01

... member of an inmate's immediate family. For purposes of this rule, immediate family refers to mother, father, brother, sister, spouse, children, step-parents, and foster parents. (2) Non-emergency, non... persons (e.g., attending physician, hospital staff, funeral home staff, family members, U.S. Probation...

The evolving design of RTO ancillary service markets

International Nuclear Information System (INIS)

Isemonger, Alan G.

2009-01-01

Although the markets for ancillary services at the North American Independent System Operators are often structured in quite different ways there is an emerging set of core design elements that represent a rough consensus as to what the optimal design configuration for ancillary services should be, albeit with some regional variation. This paper looks back at how the design of ancillary services markets has recently evolved to put this development in context. Thereafter it examines the methods by which ancillary services are procured by highlighting the procurement practices at a number of different Independent System Operators, principally those in California, New York, New England, Texas and the PJM Interconnection, in an attempt to tease out the remaining reasons why the ancillary service markets are still so different. This is important as there are many innovations that are not rooted in regional differences but reflect genuine technical advances and economic efficiency gains and can be replicated across other ISOs to produce more efficient designs, greater reliability and lower costs. (author)

39 CFR 122.1 - Ancillary special services.

Science.gov (United States)

2010-07-01

... 39 Postal Service 1 2010-07-01 2010-07-01 false Ancillary special services. 122.1 Section 122.1 Postal Service UNITED STATES POSTAL SERVICE POST OFFICE SERVICES [DOMESTIC MAIL] SERVICE STANDARDS FOR MARKET-DOMINANT SPECIAL SERVICES PRODUCTS § 122.1 Ancillary special services. (a) For the market-dominant...

Modeling the acceptance of clinical information systems among hospital medical staff: an extended TAM model.

Science.gov (United States)

Melas, Christos D; Zampetakis, Leonidas A; Dimopoulou, Anastasia; Moustakis, Vassilis

2011-08-01

Recent empirical research has utilized the Technology Acceptance Model (TAM) to advance the understanding of doctors' and nurses' technology acceptance in the workplace. However, the majority of the reported studies are either qualitative in nature or use small convenience samples of medical staff. Additionally, in very few studies moderators are either used or assessed despite their importance in TAM based research. The present study focuses on the application of TAM in order to explain the intention to use clinical information systems, in a random sample of 604 medical staff (534 physicians) working in 14 hospitals in Greece. We introduce physicians' specialty as a moderator in TAM and test medical staff's information and communication technology (ICT) knowledge and ICT feature demands, as external variables. The results show that TAM predicts a substantial proportion of the intention to use clinical information systems. Findings make a contribution to the literature by replicating, explaining and advancing the TAM, whereas theory is benefited by the addition of external variables and medical specialty as a moderator. Recommendations for further research are discussed. Copyright © 2011 Elsevier Inc. All rights reserved.

"Hi Mommy": Parental Preferences of Greetings by Medical Staff.

Science.gov (United States)

Wilks-Gallo, Lisa; Aron, Chaim Zev; Messina, Catherine R

2018-04-01

The therapeutic alliance between pediatricians and parents begins at the initial encounter. The manner in which pediatricians greet family members influences this relationship. This study evaluated whether parents are addressed using generic titles and investigated perceptions of parents regarding how they are addressed by medical staff. Written surveys of 137 parents of pediatric inpatients collected opinions about greetings during medical encounters. Parents were asked if they have been addressed as Mom/Dad/Mommy/Daddy during past medical encounters and which generic titles they would prefer. Using a Likert-type scale, the parents' perceptions of various salutations were assessed and compared. In this sample, 86% of parents were previously called Mom/Dad/Mommy/Daddy. Parents preferred to be addressed as Mom or Dad over other generic titles. Many disliked being addressed as Mommy/Daddy, Ma'am/Sir, or without a name, suggesting that providers should avoid the use of these salutations.

Pediatrics patient in computed tomography: risk awareness among medical staff

International Nuclear Information System (INIS)

Arandjic, D.; Ciraj-Bjelac, O.; Kosutic, D.; Lazarevic, Dj.

2009-01-01

In this paper the results of investigation about risk awareness in pediatrics computed tomography among medical staff are presented. Questionnaires were distributed along seven hospitals, 84 people were enrolled in this investigation. The results showed awareness of the potential risks associated with ionizing radiation in computed tomography. However, there is still widespread underestimation of relative doses and risks in case of pediatric patients. (author) [sr

Reconsidering the measurement of ancillary service performance.

Science.gov (United States)

Griffin, D T; Rauscher, J A

1987-08-01

Prospective payment reimbursement systems have forced hospitals to review their costs more carefully. The result of the increased emphasis on costs is that many hospitals use costs, rather than margin, to judge the performance of ancillary services. However, arbitrary selection of performance measures for ancillary services can result in managerial decisions contrary to hospital objectives. Managerial accounting systems provide models which assist in the development of performance measures for ancillary services. Selection of appropriate performance measures provides managers with the incentive to pursue goals congruent with those of the hospital overall. This article reviews the design and implementation of managerial accounting systems, and considers the impact of prospective payment systems and proposed changes in capital reimbursement on this process.

California decides that medical staff bylaws are not contracts.

Science.gov (United States)

Cassidy, Michael A

2002-03-01

The point of conflict between the majority and minority views is the existence of consideration. There is no question that hospitals are required to adopt medical staff bylaws, nor is there any doubt hornbook law states the performance of a pre-existing duty does not constitute consideration. Therefore, the issue of law is whether the hospital's grant of privileges and the physician's agreement to abide by the bylaws is separate or different "consideration" sufficient to justify the creation of a contract.

42 CFR 414.40 - Coding and ancillary policies.

Science.gov (United States)

2010-10-01

... 42 Public Health 3 2010-10-01 2010-10-01 false Coding and ancillary policies. 414.40 Section 414.40 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES... Practitioners § 414.40 Coding and ancillary policies. (a) General rule. CMS establishes uniform national...

Motivation and job satisfaction among medical and nursing staff in a Cyprus public general hospital.

Science.gov (United States)

Lambrou, Persefoni; Kontodimopoulos, Nick; Niakas, Dimitris

2010-11-16

The objective of this study was to investigate how medical and nursing staff of the Nicosia General Hospital is affected by specific motivation factors, and the association between job satisfaction and motivation. Furthermore, to determine the motivational drive of socio-demographic and job related factors in terms of improving work performance. A previously developed and validated instrument addressing four work-related motivators (job attributes, remuneration, co-workers and achievements) was used. Two categories of health care professionals, medical doctors and dentists (N = 67) and nurses (N = 219) participated and motivation and job satisfaction was compared across socio-demographic and occupational variables. The survey revealed that achievements was ranked first among the four main motivators, followed by remuneration, co-workers and job attributes. The factor remuneration revealed statistically significant differences according to gender, and hospital sector, with female doctors and nurses and accident and emergency (A+E) outpatient doctors reporting greater mean scores (p job satisfaction compared to the nursing staff. Surgical sector nurses and those >55 years of age reported higher job satisfaction when compared to the other groups. The results are in agreement with the literature which focuses attention to management approaches employing both monetary and non-monetary incentives to motivate health care professionals. Health care professionals tend to be motivated more by intrinsic factors, implying that this should be a target for effective employee motivation. Strategies based on the survey's results to enhance employee motivation are suggested.

Redefining Requirements of Ancillary Services for Technology Agnostic Sources

DEFF Research Database (Denmark)

Bondy, Daniel Esteban Morales; MacDonald, Jason; Kara, Emre Can

2018-01-01

New sources for ancillary services are needed, yet the requirements for service provision in most countries are explicitly formulated for traditional generators. This leads to waste of the potential for new technologies to deliver ancillary services. In order to harness this potential, we propose...... to parameterize the requirements of ancillary services so that reserves can be built by combining the advantageous properties of different technologies. The proposal is exemplified through a laboratory test where it shown that the system needs can be covered through cheaper and smaller reserves....

Examination of occupational exposure to medical staff (primarily nurses) during 131I medical treatments

International Nuclear Information System (INIS)

Watanabe, Masayoshi; Ishikawa, Naofumi; Ito, Kunihiko; Ito, Koichi

2004-01-01

Recently, a new amendment to protect against radiation damage to humans has been enacted based on a 1990 recommendation by the International Commission on Radiological Protection (ICRP). Consequently, the dose limits of occupational exposure to medical staff were cut down sharply compared with conventional readjustments. This amended bill, however, may be triggering a reduction in the number of applicants, which hope to engage in radiotherapy. This being the case, we measured the dose levels of the occupational exposure to medical staff (doctor's group, nuclear medicine technologist's group, nurse's group and pharmacist's group) from 1999 to 2002. Moreover, we investigated what the main factor is in nurse's occupational exposure to 131 I. The highest doses of occupational exposure were 3.640 mSv to doctors, 7.060 mSv to nuclear medicine technologists, 1.486 mSv to nurses and 0.552 mSv to pharmacists. According to our results, it was clear that the highest doses in each group were far below the legally mandated upper limits of exposure doses. Although we investigated the correlations between the factors of nurse's occupational exposure to 131 I with the number of inpatients, the amount of 131 I and the number of servicing times for patients, there were no correlations found. Furthermore, to analyzing the factors in detail, it became clear that the main factor in the nurse's occupational exposure was due to the existence of patients who needed many more servicing times for their care than ordinary patients. (author)

Options for pricing ancillary services in a deregulated power system

Science.gov (United States)

Yamin, Hatim Yahya

2001-07-01

GENCOs in restructured systems are compensated for selling energy in the market. In a restructured market, a mechanism is required to entice participants in the market to provide ancillary services and to ensure adequate compensation that would guarantee its economic viability. The ISO controls the dispatch of generation, manages the reliability of the transmission grid, provides open access to the transmission, buys and provides ancillary services as required, coordinates day-ahead, hour-ahead schedules and performs real time balancing of load and generation, settles real time imbalances and ancillary services sales and purchases. The ISO, also, administers congestion management protocols for the transmission grid. Since the ISO does not own any generating units it must ensure that there is enough reserves for maintaining reliability according to FERC regulations, and sufficient unloaded generating capacity for balancing services in a real-time market. The ISO could meet these requirements by creating a competitive market for ancillary services, which are metered and remain unbundled to provide an accurate compensation for each supplier and cost to each consumer, In this study, we give an overview for restructuring and ancillary services in a restructured power marketplace. Also, we discuss the effect of GENCOs' actions in the competitive energy and ancillary service markets. In addition, we propose an auction market design for hedging ancillary service costs in California market. Furthermore, we show how to include the n-1 and voltage contingencies in security constrained unit commitment. Finally, we present two approaches for GENCOs' unit commitment in a restructured power market; one is based on game theory and the other is based on market price forecasting. In each of the two GENCOs' unit commitment approaches, we discuss the GENCOs' optimal bidding strategies in energy and ancillary service markets to maximize the GENCOs' profit.

Elected medical staff leaders: who needs 'em?

Science.gov (United States)

Thompson, R E

1994-03-01

Authority, influence, and power are not synonyms. In working with elected medical staff leaders, a physician executive who chooses to exert authority may soon find him- or herself relatively powerless. But one who chooses to downplay authority, to influence through persuasion, and to coach leaders to lead effectively soon generates support for his or her ideas. The need to coax, cajole, explain, persuade, and "seek input" frustrates many leaders in all kinds of organizations. It would be much easier just to order people about. It's so tempting to think: "Who needs 'em? I'm the 'chief physician.' I know what needs to be done. Let's weigh anchor, take her out, and do what it takes to sail those rough, uncharted seas." If you really enjoy sailing a large ship in rough seas without a crew, go right ahead. Or if you think it makes sense to run an organization with only an executive staff and no knowledgeable middle managers, by all means let clinician leaders know that, now that you're aboard, they're just window-dressing. If you can make this approach work, well and good. Your life will be much less complicated, each day will have far fewer frustrations, and progress toward established goals will be much faster. However, given the reality of traditionally thinking physicians, it would be best to keep an up-dated resume in the locked lower left-hand drawer of your desk.

Predicting medical staff intention to use an online reporting system with modified unified theory of acceptance and use of technology.

Science.gov (United States)

Chang, I-Chiu; Hsu, Hui-Mei

2012-01-01

Barriers to report incident events using an online information system (IS) may be different from those of a paper-based reporting system. The nationwide online Patient-Safety Reporting System (PSRS) contains a value judgment behind use of the system, similar to the Value of Perceived Consequence (VPC), which is seldom discussed in ISs applications of other disciplines. This study developed a more adequate research framework by integrating the VPC construct into the well-known Unified Theory of Acceptance and Use of Technology (UTAUT) model as a theoretical base to explore the predictors of medical staff's intention to use online PSRS. The results showed that management support was an important factor to influence medical staff's intention of using PSRS. The effects of factors such as performance expectancy, perceived positive, and perceived negative consequence on medical staff's intention of using PSRS were moderated by gender, age, experience, and occupation. The results proved that the modified UTAUT model is significant and useful in predicting medical staff's intention of using the nationwide online PSRS.

The Iatroref study: medical errors are associated with symptoms of depression in ICU staff but not burnout or safety culture.

Science.gov (United States)

Garrouste-Orgeas, Maité; Perrin, Marion; Soufir, Lilia; Vesin, Aurélien; Blot, François; Maxime, Virginie; Beuret, Pascal; Troché, Gilles; Klouche, Kada; Argaud, Laurent; Azoulay, Elie; Timsit, Jean-François

2015-02-01

Staff behaviours to optimise patient safety may be influenced by burnout, depression and strength of the safety culture. We evaluated whether burnout, symptoms of depression and safety culture affected the frequency of medical errors and adverse events (selected using Delphi techniques) in ICUs. Prospective, observational, multicentre (31 ICUs) study from August 2009 to December 2011. Burnout, depression symptoms and safety culture were evaluated using the Maslach Burnout Inventory (MBI), CES-Depression scale and Safety Attitudes Questionnaire, respectively. Of 1,988 staff members, 1,534 (77.2 %) participated. Frequencies of medical errors and adverse events were 804.5/1,000 and 167.4/1,000 patient-days, respectively. Burnout prevalence was 3 or 40 % depending on the definition (severe emotional exhaustion, depersonalisation and low personal accomplishment; or MBI score greater than -9). Depression symptoms were identified in 62/330 (18.8 %) physicians and 188/1,204 (15.6 %) nurses/nursing assistants. Median safety culture score was 60.7/100 [56.8-64.7] in physicians and 57.5/100 [52.4-61.9] in nurses/nursing assistants. Depression symptoms were an independent risk factor for medical errors. Burnout was not associated with medical errors. The safety culture score had a limited influence on medical errors. Other independent risk factors for medical errors or adverse events were related to ICU organisation (40 % of ICU staff off work on the previous day), staff (specific safety training) and patients (workload). One-on-one training of junior physicians during duties and existence of a hospital risk-management unit were associated with lower risks. The frequency of selected medical errors in ICUs was high and was increased when staff members had symptoms of depression.

Aromatherapy alleviates endothelial dysfunction of medical staff after night-shift work: preliminary observations.

Science.gov (United States)

Shimada, Kenei; Fukuda, Shota; Maeda, Kumiko; Kawasaki, Toshihiro; Kono, Yasushi; Jissho, Satoshi; Taguchi, Haruyuki; Yoshiyama, Minoru; Yoshikawa, Junichi

2011-02-01

Night-shift work causes mental stress and lifestyle changes, and is recognized as a risk of cardiovascular diseases associated with impaired endothelial function. Aromatherapy is becoming popular as a complementary therapy that is beneficial for mental relaxation. The purpose of this study was to investigate the effect of aromatherapy on the endothelial function of medical staff after night-shift work. This study consisted of 19 healthy medical personnel (19 men, mean age 32 ± 7 years), including 11 physicians and 8 technicians. Aromatherapy was performed for 30 min by inhalation of the essential oil of lavender. Flow-mediated dilation (FMD) of the brachial artery was measured three times in each subject: on a regular workday, and after night-shift work before and immediately after aromatherapy. A control study was performed to assess the effect of a 30-min rest without aromatherapy. The mean value of sleep time during night-shift work was 3.3 ± 1.3 h. FMD after night-shift work was lower than on a regular workday (10.4 ± 1.8 vs. 12.5 ± 1.7%, Pnight-shift work impaired endothelial function in medical staff, an effect that was alleviated by short-term aromatherapy.

Integration of Flexible Consumers in the Ancillary Service Markets

DEFF Research Database (Denmark)

Biegel, Benjamin; Westenholz, Mikkel; Hansen, Lars Henrik

2014-01-01

services. In this work we present a simple method based on the existing ancillary service markets that resolves these issues via increased information and communication technology. The method allows an aggregator to continuously utilize the markets for slower ancillary service to ensure that its portfolio...

Analysis of chromosomal aberration in seven medical staffs suspected with exposure to ionizing radiation

International Nuclear Information System (INIS)

Han Lin; Zhao Fengling; Wang Xi'ai; Wang Ping; Jiang Feng; Lu Yumin

2012-01-01

Objective: To investigate the chromosomal aberrations in seven medical staffs suspected with exposure to ionizing radiation and to speculate its possible causation. Methods: The hospital staffs, including 6 females and 1 male,worked in a clinical laboratory where a CT room was located downstairs. The thickness of precast slab between these two rooms was 6 cm. Peripheral blood lymphocytes of seven staffs were examined for conventional chromosomal aberrations. Results: The frequencies of dicentrics in the peripheral lymphocytes of 4 females were from 0.40% to 1.60% that was significantly higher than the spontaneous frequency of dicentrics (0.03%, χ 2 =36.79, P<0.05). The translocation was observed in the lymphocytes from all subjects with frequencies from 0.33% to 1.20%, obviously higher than its spontaneous frequency of 0.01% (χ 2 =42.90, P<0.05). Conclusion: These staffs suffer from ionizing radiation. (authors)

Investigation of radiation protection of medical staff performing medical diagnostic examinations by using PET/CT technique

International Nuclear Information System (INIS)

Wrzesień, Małgorzata; Napolska, Katarzyna

2015-01-01

Positron emission tomography (PET) is now one of the most important methods in the diagnosis of cancer diseases. Due to the rapid growth of PET/CT centres in Poland in less than a decade, radiation protection and, consequently, the assessment of worker exposure to ionising radiation, emitted mainly by the isotope 18 F, have become essential issues. The main aim of the study was to analyse the doses received by workers employed in the Medical Diagnostic Centre. The analysis comprises a physicist, three nurses, three physicians, three technicians, as well as two administrative staff employees. High-sensitivity thermoluminescent detectors (TLDs) were used to measure the doses for medical staff. The personnel was classified into categories, among them employees having direct contact with the ‘source of radiation’— 18 FDG. The TLDs were placed on the fingertips of both hands and they were also attached at the level of eye lenses, thyroid and gonads depending on the assigned category. The highest dose of radiation was observed during the administration of the 18 FDG to the patients. In the case of the physicist, the highest dose was recorded during preparation of the radiopharmaceutical— 18 FDG. The body parts most exposed to ionizing radiation are the fingertips of the thumb, index and middle finger. (paper)

Investigation of radiation protection of medical staff performing medical diagnostic examinations by using PET/CT technique.

Science.gov (United States)

Wrzesień, Małgorzata; Napolska, Katarzyna

2015-03-01

Positron emission tomography (PET) is now one of the most important methods in the diagnosis of cancer diseases. Due to the rapid growth of PET/CT centres in Poland in less than a decade, radiation protection and, consequently, the assessment of worker exposure to ionising radiation, emitted mainly by the isotope (18)F, have become essential issues. The main aim of the study was to analyse the doses received by workers employed in the Medical Diagnostic Centre. The analysis comprises a physicist, three nurses, three physicians, three technicians, as well as two administrative staff employees. High-sensitivity thermoluminescent detectors (TLDs) were used to measure the doses for medical staff. The personnel was classified into categories, among them employees having direct contact with the 'source of radiation'-(18)FDG. The TLDs were placed on the fingertips of both hands and they were also attached at the level of eye lenses, thyroid and gonads depending on the assigned category. The highest dose of radiation was observed during the administration of the (18)FDG to the patients. In the case of the physicist, the highest dose was recorded during preparation of the radiopharmaceutical-(18)FDG. The body parts most exposed to ionizing radiation are the fingertips of the thumb, index and middle finger.

16 CFR 1.62 - Ancillary court orders pending review.

Science.gov (United States)

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Ancillary court orders pending review. 1.62 Section 1.62 Commercial Practices FEDERAL TRADE COMMISSION ORGANIZATION, PROCEDURES AND RULES OF PRACTICE GENERAL PROCEDURES Injunctive and Condemnation Proceedings § 1.62 Ancillary court orders pending review...

Promoting the maintenance of satisfactory communication: strategies used by caregivers and medical staff with people suffering from Alzheimer's disease.

Science.gov (United States)

Vachon, Marie; Veilleux, Marie-Christine; Macoir, Joël

2017-06-01

The goal of this literature review was to determine communication strategies that foster interactions between individuals with Alzheimer's disease (AD) and caregivers or medical staff. A search of PubMed and PsycINFO databases was conducted using combinations of the following terms: Alzheimer, family, caregiver, communication, language, treatment, intervention, therapy, communication strategies, functional communication and daily living activities. Studies were chosen based on the original language of the text, year of publication, peer-review status and specificity of the results regarding communication strategies in AD. This review covers 14 articles published between 1994 and 2014. The in-depth analysis of these studies shows that various communication strategies used by caregivers and medical staff are effective to promote interactions with people with AD at different stages of the disease. For caregivers, these strategies include producing short and syntactically simple sentences, relying on semantic memory rather than on episodic memory, providing more information and reformulate, removing potential distractions from the environment, specifying the topic of the conversation, using precise terms to identify communication breakdowns. Other strategies also appeared to be effective for medical staff, such as asking close-ended questions, providing response choices, verbalizing the actions performed during medical care and activities, paying attention to the needs expressed through verbal and non-verbal messages, adopting a supportive way of speaking. Furthermore, other communication strategies rather appear to be harmful to functional communication. These harmful strategies involve insisting that the person produce a specific word, asking him/her to repeat or tune out in case of communication breakdown. Finally, contradictory outcomes are reported for some strategies such as speaking slowly, repeating or rephrase questions and information. This article provides

Optimal generator bidding strategies for power and ancillary services

Science.gov (United States)

Morinec, Allen G.

As the electric power industry transitions to a deregulated market, power transactions are made upon price rather than cost. Generator companies are interested in maximizing their profits rather than overall system efficiency. A method to equitably compensate generation providers for real power, and ancillary services such as reactive power and spinning reserve, will ensure a competitive market with an adequate number of suppliers. Optimizing the generation product mix during bidding is necessary to maximize a generator company's profits. The objective of this research work is to determine and formulate appropriate optimal bidding strategies for a generation company in both the energy and ancillary services markets. These strategies should incorporate the capability curves of their generators as constraints to define the optimal product mix and price offered in the day-ahead and real time spot markets. In order to achieve such a goal, a two-player model was composed to simulate market auctions for power generation. A dynamic game methodology was developed to identify Nash Equilibria and Mixed-Strategy Nash Equilibria solutions as optimal generation bidding strategies for two-player non-cooperative variable-sum matrix games with incomplete information. These games integrated the generation product mix of real power, reactive power, and spinning reserve with the generators's capability curves as constraints. The research includes simulations of market auctions, where strategies were tested for generators with different unit constraints, costs, types of competitors, strategies, and demand levels. Studies on the capability of large hydrogen cooled synchronous generators were utilized to derive useful equations that define the exact shape of the capability curve from the intersections of the arcs defined by the centers and radial vectors of the rotor, stator, and steady-state stability limits. The available reactive reserve and spinning reserve were calculated given a

Integration of foreign and local medical staff in a disaster area: the Honduras and El Salvador experiences.

Science.gov (United States)

Waisman, Yehezkel

2003-06-01

International medical aid after natural disasters may take various forms, ranging from self-sufficient military forces to single experts or specialists who function primarily as advisers. A model integrating foreign and local medical staff has not previously been reported. In response to the call for international aid by the Honduran and El Salvadorian governments in the wake of Hurricane Mitch in November 1998 and the San Salvador earthquake in January 2001, Israel sent medical supplies and 10 member teams of medical professionals to each country. The aim of the present paper is to describe the unique Israeli approach to providing healthcare in disaster areas by integrating foreign and local medical staff, and to discuss its advantages and disadvantages. The paper focuses on the experience of the two emergency medicine physicians on the team who were assigned to the Atlantida General Hospital in La Ceiba, Honduras. The same team in San Salvador subsequently applied the same approach.

Awareness and knowledge among internal medicine house-staff for dose adjustment of commonly used medications in patients with CKD.

Science.gov (United States)

Surana, Sikander; Kumar, Neeru; Vasudeva, Amita; Shaikh, Gulvahid; Jhaveri, Kenar D; Shah, Hitesh; Malieckal, Deepa; Fogel, Joshua; Sidhu, Gurwinder; Rubinstein, Sofia

2017-01-17

Drug dosing errors result in adverse patient outcomes and are more common in patients with chronic kidney disease (CKD). As internists treat the majority of patients with CKD, we study if Internal Medicine house-staff have awareness and knowledge about the correct dosage of commonly used medications for those with CKD. A cross-sectional survey was performed and included 341 participants. The outcomes were the awareness of whether a medication needs dose adjustment in patients with CKD and whether there was knowledge for the level of glomerular filtration rate (GFR) a medication needs to be adjusted. The overall pattern for all post-graduate year (PGY) groups in all medication classes was a lack of awareness and knowledge. For awareness, there were statistically significant increased mean differences for PGY2 and PGY3 as compared to PGY1 for allergy, endocrine, gastrointestinal, and rheumatologic medication classes but not for analgesic, cardiovascular, and neuropsychotropic medication classes. For knowledge, there were statistically significant increased mean differences for PGY2 and PGY3 as compared to PGY1 for allergy, cardiovascular, endocrine, and gastrointestinal, medication classes but not for analgesic, neuropsychotropic, and rheumatologic medication classes. Internal Medicine house-staff across all levels of training demonstrated poor awareness and knowledge for many medication classes in CKD patients. Internal Medicine house-staff should receive more nephrology exposure and formal didactic educational training during residency to better manage complex treatment regimens and prevent medication dosing errors.

Exploring the impact of staff absenteeism on patient satisfaction using routine databases in a university hospital.

Science.gov (United States)

Duclay, E; Hardouin, J B; Sébille, V; Anthoine, E; Moret, L

2015-10-01

To explore the influence of staff absenteeism on patient satisfaction using the indicators available in management reports. Among factors explaining patient satisfaction, human resource indicators have been studied widely in terms of burnout or job satisfaction, but there have not been many studies related to absenteeism indicators. A multilevel analysis was conducted using two routinely compiled databases from 2010 in the clinical departments of a university hospital (France). The staff database monitored absenteeism for short-term medical reasons (5 days or less), non-medical reasons and absences starting at the weekend. The patient satisfaction database was established at the time of discharge. Patient satisfaction related to relationships with staff was significantly and negatively correlated with nurse absenteeism for non-medical reasons (P absenteeism starting at weekends (P absenteeism for short-term medical reasons (P absenteeism and should lead to a better understanding of the impact of human resources on patient satisfaction. To enhance patient satisfaction, managers need to find a way to reduce staff absenteeism, in order to avoid burnout and to improve the atmosphere in the workplace. © 2014 John Wiley & Sons Ltd.

Preparation and medical outcomes of Nepalese staff and porters compared with foreign nationals on the Annapurna trekking circuit.

Science.gov (United States)

Drew, Christian M; Colleran, Shane; Zijp, Maarten; Lama, Lama Phuri; Sherpa, Nuru J; Kelly, Julia L; Sulzbach, Nina; Prior, Denise; Currin, Sally A; Currin, Simon; Nickol, Annabel H; Morrell, Mary J

2011-01-01

This cross-sectional study investigates preparedness and medical problems in Nepalese staff and porters compared with foreign nationals trekking at altitude in the Nepal Himalaya. 331 Nepalese and 338 foreign nationals in 61 trekking groups were surveyed over 4 weeks on the Annapurna trekking circuit. Foreign nationals reported that 92% of trekking groups received altitude illness information and carried a medical kit. However, fewer than 30% knew the evacuation insurance status of the Nepalese staff and porters on their trek, 39% would not pay for an ill Nepalese national's helicopter evacuation, and 41% reported insufficient resources to carry an individual. Medical problems occurred in 44% of groups. A significantly higher proportion of Nepalese staff and porters were evacuated compared with foreign nationals. No significant differences in Nepalese and foreign national preparation were found between groups with and without medical problems. Medical problems were commonly encountered, yet many groups lacked resources to evacuate someone dangerously ill. Foreign and Nepalese nationals have a duty of care towards each other; recognizing that preparedness relies not only on a first aid kit, but also on knowledge of acclimatization and individuals' insurance is an important part of health and safety for individuals trekking at altitude.

The relationship between knowledge of ergonomic science and the occupational health among nursing staff affiliated to Golestan University of Medical Sciences

OpenAIRE

Juibari, Leila; Sanagu, Akram; Farrokhi, Nafiseh

2010-01-01

BACKGROUND: Occupational hazards are much higher for nurses than many other jobs and neglecting this fact may reduce the quality of nursing services. The aim of this study was to investigate the relationship between knowledge of ergonomics and occupational health among the nursing staff affiliated to Golestan University of Medical Sciences. METHODS: It was a cross-sectional analytical study on 423 nursing staff working in various medical centers affiliated to Golestan University of Medical Sc...

Optimization of working conditions of medical staff of isotopic diagnostic departments. Optimizatsiya uslovij truda meditsinskogo personala radiodiagnosticheskikh otdelenij

Energy Technology Data Exchange (ETDEWEB)

Ovsyannikov, A S [Akademiya Meditsinskikh Nauk SSSR, Moscow (USSR). Inst. Gigieny Truda i Professional' nykh Zabolevanij

1989-01-01

The study was undertaken to analyze the characteristics of the work of medical staff of isotopic diagnostic departments during use of {sup 99m}Tc isotope generators. The data on the functional load of physicians and paramedical staff were given along with the description of radiation doses and dose rates at various stages of work. The measures on optimization of labour conditions by means of the appropriate department's design, improvement of the regime of nurses' work and adequate allocation and utilization of medical equipment were developed.

The new system of education and training of medical staff in radiation protection in Albania

International Nuclear Information System (INIS)

Grillo, B.; Preza, K.; Titka, V.; Shehi, G.

2001-01-01

The present situation as regarding the education and training of medical staff in radiological protection is discussed. In particular the protection of patients, children and pregnant women were the most sensible topics in some courses held in recent years. Emphasis is given on a number of courses and course units dealing with radiation safety problems in the medical field and their content. (author)

Ancillary Services 4.0: A Top-To-Bottom Control-Based Approach for Solving Ancillary Services Problems in Smart Grids

DEFF Research Database (Denmark)

De Zotti, Giulia; Pourmousavi, S. Ali; Madsen, Henrik

2018-01-01

of AS are not able to benefit from the flexible energy resources. They also cannot cope with the new level of stochasticity, non-linearity, and dynamics of generation and flexibility. To overcome such issues and exploit the potential of flexibility resources, a new strategy is required. In this paper......Power systems are experiencing a large amount of renewable generation with highly stochastic and partly unpredictable characteristics. This change in energy production implies significant consequences related to the provision of ancillary services (AS). Current markets dedicated to the provision......, by capitalizing on flexibility resources' potential, AS 4.0 approach is proposed, which offers a comprehensive solution for the AS provision in the smart grid era....

SU-F-I-72: Evaluation of the Ancillary Lead Shielding for Optimizing Radiation Protection in the Interventional Radiology Department

Energy Technology Data Exchange (ETDEWEB)

Tonkopi, E; Lightfoot, C [Dalhousie University, Queen Elizabeth II Health Sciences Ctr, Halifax, NS (Canada); LeBlanc, E [Queen Elizabeth II Health Sciences Ctr, Halifax, NS (Canada)

2016-06-15

Purpose: The rising complexity of interventional fluoroscopic procedures has resulted in an increase of occupational radiation exposures in the interventional radiology (IR) department. This study assessed the impact of ancillary shielding on optimizing radiation protection for the IR staff. Methods: Scattered radiation measurements were performed in two IR suites equipped with Axiom Artis systems (Siemens Healthcare, Erlangen, Germany) installed in 2006 and 2010. Both rooms had suspended ceiling-mounted lead-acrylic shields of 75×60 cm (Mavig, Munich, Germany) with lead equivalency of 0.5 mm, and under-table drapes of 70×116 cm and 65×70 cm in the newer and the older room respectively. The larger skirt can be wrapped around the table’s corner and in addition the newer suite had two upper shields of 25×55 cm and 25×35 cm. The patient was simulated by 30 cm of acrylic, air kerma rate (AKR) was measured with the 180cc ionization chamber (AccuPro Radcal Corporation, Monrovia, CA, USA) at different positions. The ancillary shields, x-ray tube, image detector, and table height were adjusted by the IR radiologist to simulate various clinical setups. The same exposure parameters were used for all acquisitions. AKR measurements were made at different positions relative to the operator. Results: The AKR measurements demonstrated 91–99% x-ray attenuation by the drapes in both suites. The smaller size of the under-table skirt and absence of the side-drapes in the older room resulted in a 20–50 fold increase of scattered radiation to the operator. The mobile suspended lead-acrylic shield reduced AKR by 90–94% measured at 150–170 cm height. The recommendations were made to replace the smaller under-table skirt and to use the ceiling-mounted shields for all IR procedures. Conclusion: The ancillary shielding may significantly affect radiation exposure to the IR staff. The use of suspended ceiling-mounted shields is especially important for reduction of

[On gods, snakes and staffs--the emblem of the medical profession].

Science.gov (United States)

Rabinerson, David; Salzer, Liat; Gabbay-Benziv, Rinnat

2014-10-01

The commonly accepted emblems of the Medical Profession are the staff of the Greek god of medicine--Asklepios (or Asclepius], on which one serpent is entwined. Later, around the 16th century C.E., the wand of the herald of the Greek Gods, e.g., Hermes, on which two snakes are entwined and facing each other, became popular as the emblem of the medical profession. We elaborate on the history of the evolution of these emblems as symbols of medicine, including earlier influences from the times of the ancient Egyptians and Babylonians, which were followed by Judeo-Christian traditions and concepts. The relevance of the use of the wand of Hermes as an emblem of our profession is further discussed.

The impact of communication barriers on diagnostic confidence and ancillary testing in the emergency department.

Science.gov (United States)

Garra, Gregory; Albino, Hiram; Chapman, Heather; Singer, Adam J; Thode, Henry C

2010-06-01

Communication barriers (CBs) compromise the diagnostic power of the medical interview and may result in increased reliance on diagnostic tests or incorrect test ordering. The prevalence and degree to which these barriers affect diagnosis, testing, and treatment are unknown. To quantify and characterize CBs encountered in the Emergency Department (ED), and assess the effect of CBs on initial diagnosis and perceived reliance on ancillary testing. This was a prospective survey completed by emergency physicians after initial adult patient encounters. CB severity, diagnostic confidence, and reliance on ancillary testing were quantified on a 100-mm Visual Analog Scale (VAS) from least (0) to most (100). Data were collected on 417 ED patient encounters. CBs were reported in 46%; with a mean severity of 50 mm on a 100-mm VAS with endpoints of "perfect communication and "no communication." Language was the most commonly reported form of CB (28%). More than one CB was identified in 6%. The 100-mm VAS rating of diagnostic confidence was lower in patients with perceived CBs (64 mm) vs. those without CBs (80 mm), p Communication barriers in our ED setting were common, and resulted in lower diagnostic confidence and increased perception that ancillary tests are needed to narrow the diagnosis. Copyright 2010 Elsevier Inc. All rights reserved.

Long-term pavement performance ancillary information management system (AIMS) reference guide.

Science.gov (United States)

2012-11-01

This document provides information on the Long-Term Pavement Performance (LTPP) program ancillary information. : Ancillary information includes data, images, reference materials, resource documents, and other information that : support and extend the...

Building Trusting Relationships in the Medical Practice Team: Thirty Rules to Live By for You and Your Staff.

Science.gov (United States)

Hills, Laura

2015-01-01

A medical practice team without trust isn't really a team; it's just a group of individuals who work together in a medical practice, often making disappointing progress. This is true no matter how capable or talented the individuals are. Your staff may never reach its full potential if trust is not present. This article offers medical practice managers 30 rules for building trust in their practices: 15 rules that will help them in their leadership roles, and 15 rules to teach and discuss with their employees. It suggests a trust-building screening question to include in job interviews to determine if applicants have a high capacity for trust. It also describes Reina and Reina's "Three C's of Trust," a model that practice managers may find useful as they develop trust competencies in their staffs. This article also includes 10 inspiring quotes that will help medical practice employees build trust and five easy-to-facilitate trust-building exercises that managers can use with the medical practice team.

Removal Action Work Plan for 105-DR and 105-F Building Interim Safe Storage Projects and Ancillary Buildings

International Nuclear Information System (INIS)

Morton, M.R.

2000-01-01

This document contains the removal action work plan for the 105-DR and 105-F Reactor buildings and ancillary facilities. These buildings and facilities are located in the 100-D/DR and 100-F Areas of the Hanford Site, which is owned and operated by the US Department of Energy (DOE), in Benton County, Washington. The 100 Areas (including the 100-D/DR and 100-F Areas) of the Hanford Site were placed on the US Environmental Protection Agency's (EPA's) National Priorities List under the ''Comprehensive Environmental Response, Compensation, and Liability Act of 1980'' (CERCLA). The DOE has determined that hazardous substances in the 105-DR and 105-F Reactor buildings and four ancillary facilities present a potential threat to human health or the environment. The DOE has also determined that a non-time critical removal action is warranted at these facilities. Alternatives for conducting a non-time critical removal action were evaluated in the ''Engineering Evaluation/Cost Analysis for the 105-DR and 105-F Reactor Facilities and Ancillary Facilities'' (DOE-RL 1998a). The engineering evaluation/cost analysis (EE/CA) resulted in the recommendation to decontaminate and demolish the contaminated reactor buildings (except for the reactor blocks) and the ancillary facilities and to construct a safe storage enclosure (SSE) over the reactor blocks. The recommendation was approved in an action memorandum (Ecology et al. 1998) signed by the Washington State Department of Ecology (Ecology), EPA, and DOE. The DOE is the agency responsible for implementing the removal actions in the 105-D/DR and 105-F Areas. Ecology is the lead regulatory agency for facilities in the 100-D/DR Area, and EPA is the lead regulatory agency for facilities in the 100-F Area. The term ''lead regulator agency'' hereinafter, refers to these authorities. This removal action work plan supports implementation of the non-time critical removal action

Supervision and feedback for junior medical staff in Australian emergency departments: findings from the emergency medicine capacity assessment study

Directory of Open Access Journals (Sweden)

Weiland Tracey J

2010-11-01

Full Text Available Abstract Background Clinical supervision and feedback are important for the development of competency in junior doctors. This study aimed to determine the adequacy of supervision of junior medical staff in Australian emergency departments (EDs and perceived feedback provided. Methods Semi-structured telephone surveys sought quantitative and qualitative data from ED Directors, Directors of Emergency Medicine Training, registrars and interns in 37 representative Australian hospitals; quantitative data were analysed with SPSS 15.0 and qualitative data subjected to content analysis identifying themes. Results Thirty six of 37 hospitals took part. Of 233 potential interviewees, 95 (40.1% granted interviews including 100% (36/36 of ED Directors, and 96.2% (25/26 of eligible DEMTs, 24% (19/81 of advanced trainee/registrars, and 17% (15/90 of interns. Most participants (61% felt the ED was adequately supervised in general and (64.2% that medical staff were adequately supervised. Consultants and registrars were felt to provide most intern supervision, but this varied depending on shift times, with registrars more likely to provide supervision on night shift and at weekends. Senior ED medical staff (64% and junior staff (79% agreed that interns received adequate clinical supervision. Qualitative analysis revealed that good processes were in place to ensure adequate supervision, but that service demands, particularly related to access block and overcrowding, had detrimental effects on both supervision and feedback. Conclusions Consultants appear to provide the majority of supervision of junior medical staff in Australian EDs. Supervision and feedback are generally felt to be adequate, but are threatened by service demands, particularly related to access block and ED overcrowding.

New developments in segment ancillary logic for FASTBUS

International Nuclear Information System (INIS)

Walz, H.V.; Bertolucci, B.

1983-01-01

Segment Ancillary Logic hardware for FASTBUS systems provides logical functions required in common by all devices attached to a segment. It controls the execution of arbitration cycles, and geographical address cycles, and generates the system handshake responses for broadcast operations. The mandatory requirements for Segment Ancillary Logic in the FASTBUS specifications are reviewed. A detailed implementation based on ECL logic is described, and the hardware to be used on an ECL cable segment for an experimental FASTBUS system at SLAC is shown

Qualification and authorization of staff carrying out non-destructive testing in Electricite de France

International Nuclear Information System (INIS)

Sermadiras, P.; Lhermitte, R.; Boulet, J.

1985-01-01

The surveillance carried out by the Group des laboratoires of the Service de la Production thermique on components submitted to Quality Assurance in nuclear power plants of all types requires the use for non-destructive testing of staff who have been given authorization for their particular services. These authorizations are for activities specific to Electricite de France. In the first part, the authors describe the staff of the Groupe des Laboratoires and show how the different levels of authorization (4 levels) are given, taking into account staff qualifications. In the second part, the procedures for qualification and authorization of the staff of outside companies working with and on behalf of the Groupe des Laboratoires are described

Validity of the SMS, Phone, and medical staff Examination sports injury surveillance system for time-loss and medical attention injuries in sports

DEFF Research Database (Denmark)

Møller, M; Wedderkopp, N; Myklebust, Grete

2018-01-01

The accurate measurement of sport exposure time and injury occurrence is key to effective injury prevention and management. Current measures are limited by their inability to identify all types of sport-related injury, narrow scope of injury information, or lack the perspective of the injured...... by trained on-field observers and medical staff (comparison method). We followed 24 elite adolescent handball players over 12 consecutive weeks. Eighty-six injury registrations were obtained by the SPEx and comparison methods. Of them, 35 injury registrations (41%) were captured by SPEx only, 10 injury...... athlete. The aims of the study were to evaluate the proportion of injuries and the agreement between sport exposures reported by the SMS messaging and follow-up telephone part of the SMS, Phone, and medical staff Examination (SPEx) sports injury surveillance system when compared to measures obtained...

Spread of Staphylococcus aureus between medical staff and high-frequency contact surfaces in a large metropolitan hospital

Directory of Open Access Journals (Sweden)

Li-sha Shi

2015-12-01

Conclusion: Cross-contamination of S. aureus or MRSA on medical workers' hands and contact surfaces was demonstrated within and between departments of a large metropolitan hospital. Improvements are needed in medical staff hygiene habits and in the cleaning of high-frequency contact surfaces to help prevent and control nosocomial infections.

Home Medication Cabinets and Medication Taking Behavior of the Staffs in a University in China

Science.gov (United States)

Xue, Chengbin; Ye, Juan; Dong, Yuzhen; Xu, Chunmei

2018-01-01

Background: A growing sum of medicines is stored in home medication cabinets in China, with the behavior of self-medication increasing. Although responsible self-medication can help prevent and treat ailments that do not need professional consultation, it bears the risk of misuse of medicines issued on prescription due to inadequate prescription medicine administration. Objective: The objective of this study was to investigate the condition and safety of medication storage and intended self-medication in a University in China. Method: The study was conducted over 10 month period (May 2015-March 2016) and involved a random sample of households. The questionnaire survey and personal insight into household medicine supplies was performed by a team of trained pharmacy staffs. Interviewees (N = 398, aged 16-88 y) were visited door to door and the home medication cabinets were catalogued after the participants were interviewed. Results: The majority (89.71%) households have home medicine cabinets. The total number of medicine items in the 398 households was 5600, with a median of 14 per household. The most frequently encountered categories of registered medicines were cough and cold medcines (47.8%), antibacterials for systemic use (30.0%), topical products for joint and muscular pain(26.1%), vitamins (23.2%), medication for functional gastrointestinal disorders (23.2%), oral and external forms have not kept separately(55.1%). The most treatment related problems recorded were curative effect not ideal (57.9%). 68% of the sample population would choose doctors as medication consultation object about medicines purchased. Conclusion: Large sum of medicines were found per household, with a high prevalence of cough and cold medcines. Public services in China, mainly government and health organizations, need put more effort on educating people on how to store medicines, as well as finding a way to raise awareness of the public in promoting behavioral change about medication

Non-medical influences on medical decision-making.

Science.gov (United States)

McKinlay, J B; Potter, D A; Feldman, H A

1996-03-01

The influence of non-medical factors on physicians' decision-making has been documented in many observational studies, but rarely in an experimental setting capable of demonstrating cause and effect. We conducted a controlled factorial experiment to assess the influence of non-medical factors on the diagnostic and treatment decisions made by practitioners of internal medicine in two common medical situations. One hundred and ninety-two white male internists individually viewed professionally produced video scenarios in which the actor-patient, presenting with either chest pain or dyspnea, possessed various balanced combinations of sex, race, age, socioeconomic status, and health insurance coverage. Physician subjects were randomly drawn from lists of internists in private practice, hospital-based practice, and HMO's, at two levels of experience. The most frequent diagnoses for both chest pain and dyspnea were psychogenic origin and cardiac problems. Smoking cessation was the most frequent treatment recommendation for both conditions. Younger patients (all other factors being the same) were significantly more likely to receive the psychogenic diagnosis. Older patients were more likely to receive the cardiac diagnosis for chest pain, particularly if they were insured. HMO-based physicians were more likely to recommend a follow-up visit for chest pain. Several interactions of patient and physician factors were significant in addition to the main effects. The variability in decision-making evidenced by physicians in this experiment was not entirely accounted for by strictly rational Bayesian inference (the common prescriptive model for medical decision-making), in-as-much as non-medical factors significantly affected the decisions that they made. There is a need to supplement idealized medical schemata with considerations of social behavior in any comprehensive theory of medical decision-making.

Bullying in the American Graduate Medical Education System: A National Cross-Sectional Survey

Science.gov (United States)

2016-01-01

Objectives To deliver an estimate of bullying among residents and fellows in the United States graduate medical education system and to explore its prevalence within unique subgroups. Design/Setting/Participants A national cross-sectional survey from a sample of residents and fellows who completed an online bullying survey conducted in June 2015. The survey was distributed using a chain sampling method that relied on electronic referrals from 4,055 training programs, with 1,791 residents and fellows completing the survey in its entirety. Survey respondents completed basic demographic and programmatic information plus four general bullying and 20 specific bullying behavior questions. Between-group differences were compared for demographic and programmatic stratifications. Main Outcomes/Measures Self-reported subjected to workplace bullying from peers, attendings, nurses, ancillary staff, or patients in the past 12 months. Results Almost half of the respondents (48%) reported being subjected to bullying although both those subjected and not subjected reported experiencing ≥ 1 bullying behaviors (95% and 39% respectively). Attendings (29%) and nurses (27%) were the most frequently identified source of bullying, followed by patients, peers, consultants and staff. Attempts to belittle and undermine work and unjustified criticism and monitoring of work were the most frequently reported bullying behaviors (44% each), followed by destructive innuendo and sarcasm (37%) and attempts to humiliate (32%). Specific bullying behaviors were more frequently reported by female, non-white, shorter than bullying in the United States graduate medical education programs. Including specific questions on bullying in the Accreditation Council for Graduate Medical Education annual resident/fellow survey, implementation of anti-bullying policies, and a multidisciplinary approach engaging all stakeholders may be of great value to eliminate these pervasive behaviors in the field of

Bullying in the American Graduate Medical Education System: A National Cross-Sectional Survey.

Directory of Open Access Journals (Sweden)

Amar R Chadaga

Full Text Available To deliver an estimate of bullying among residents and fellows in the United States graduate medical education system and to explore its prevalence within unique subgroups.A national cross-sectional survey from a sample of residents and fellows who completed an online bullying survey conducted in June 2015. The survey was distributed using a chain sampling method that relied on electronic referrals from 4,055 training programs, with 1,791 residents and fellows completing the survey in its entirety. Survey respondents completed basic demographic and programmatic information plus four general bullying and 20 specific bullying behavior questions. Between-group differences were compared for demographic and programmatic stratifications.Self-reported subjected to workplace bullying from peers, attendings, nurses, ancillary staff, or patients in the past 12 months.Almost half of the respondents (48% reported being subjected to bullying although both those subjected and not subjected reported experiencing ≥ 1 bullying behaviors (95% and 39% respectively. Attendings (29% and nurses (27% were the most frequently identified source of bullying, followed by patients, peers, consultants and staff. Attempts to belittle and undermine work and unjustified criticism and monitoring of work were the most frequently reported bullying behaviors (44% each, followed by destructive innuendo and sarcasm (37% and attempts to humiliate (32%. Specific bullying behaviors were more frequently reported by female, non-white, shorter than < 5'8 and BMI ≥ 25 individuals.Many trainees report experiencing bullying in the United States graduate medical education programs. Including specific questions on bullying in the Accreditation Council for Graduate Medical Education annual resident/fellow survey, implementation of anti-bullying policies, and a multidisciplinary approach engaging all stakeholders may be of great value to eliminate these pervasive behaviors in the field of

Review of Standby and Ancillary Services in the Context of Behind-the-Meter Photovoltaics

Energy Technology Data Exchange (ETDEWEB)

Gagnon, Pieter J [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Holm, Alison [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

2018-04-25

The New Mexico Public Regulatory Commission (NMPRC) requested information on the following topics: Overview of ancillary and standby services. Examples of how ancillary and standby services are defined, used, and analyzed in other jurisdictions. Considerations regarding how ancillary and standby services may be economically valued. Background information on how ancillary and standby services differ from fixed costs to serve owners of behind-the-meter solar photovoltaic (BTM PV) systems.

"A small cog in a large wheel": an exploratory study into the experiences of porters, ward clerks and domestics working in an English Cancer Centre.

Science.gov (United States)

Mack, Hazel; Froggatt, Katherine; McClinton, Pam

2003-09-01

The effect of working in an oncology environment on nurses has been widely researched but the experiences of non-clinical staff such as ancillary workers in the oncology environment have rarely been examined. This exploratory study had three aims: to explore ancillary workers' understandings of cancer, their experiences of working in a Cancer Centre and their training and support needs. Working within a naturalistic paradigm, a descriptive exploratory design was utilised employing in-depth interviews and drawing on aspects of grounded theory for data analysis. Findings indicated that these ancillary workers lacked an in-depth understanding of cancer. The experience of working in a Cancer Centre appeared to bring both costs and benefits to these ancillary workers. These ancillary workers enjoyed the level of contact they have with patients in a Cancer Centre and subsequently ascribed great value to their jobs. However, they felt that health-care professional colleagues did not always value their contribution to the care of patients. There are implications for nurses and other health-care staff working in oncology alongside these ancillary staff in terms of valuing and supporting them in the work that they do.

Need assessment of staffs' welfare services at tehran university of medical sciences: a cross-sectional study.

Science.gov (United States)

Dehghan, Reza; Mafimoradi, Shiva; Hadi, Mohammad

2015-01-01

Reviewing the human resources management literature shows an absence of attention given to the employee's benefits. Taking a look at functions of the Tehran University of Medical Sciences' wellbeing services system, it uncovers a gap between employees' real needs and what is delivered to meet their needs. So it requires an improved comprehensive system for delivering wellbeing services (financial, insurance, health care services, educational and training services, etc). Wellbeing need assessment can helps planners to identify vital needs of employee and response to them effectively. Moreover it can be used to evaluate the effectiveness of the current services which are delivered. Thus, the aim of this study is to assess wellbeing services of staffs working in TUMS to (1) evaluate the satisfactory rate of services which are delivered, and (2) exploring those wellbeing needs which were not fulfilled by the organization. Being a cross-sectional and analytic-descriptive survey including 98 responding participants, it is conducted by a questionnaire collecting employees' demographic information, their satisfactory rate of the implemented services, and determines unfulfilled wellbeing needs which were not already covered. Results indicated that services related to financial, educational, non-financial, insurance, occupational health and tourism/recreational services were the most satisfactory services successively. 'Staff's unwillingness to receive services' and 'poor announcement' (unawareness on the wellbeing services),' were found to be the most frequent reasons for not receiving the existing wellbeing services. To increase the satisfaction rate and responsiveness to the real needs of the staff, the current delivery system of wellbeing services in the TUMS should be redesigned by defining new wellbeing packages.

Differences of smoking knowledge, attitudes, and behaviors between medical and non-medical students.

Science.gov (United States)

Han, Min-Yan; Chen, Wei-Qing; Wen, Xiao-Zhong; Liang, Cai-Hua; Ling, Wen-Hua

2012-03-01

Previous studies in the world reported inconsistent results about the relationship of medical professional education with medical students' smoking behaviors, and no similar research had been published in China. This paper aims to explore whether the differences of smoking-related knowledge, attitudes, and behaviors existed between medical and non-medical undergraduate students. Eight thousand one hundred thirty-eight undergraduate students sampled from a university in Guangzhou were investigated with a self-administered structured questionnaire about their smoking-related knowledge, attitude and behaviors, and other relevant factors. General linear model and multinomial logistic regression were conducted to test the differences in smoking-related knowledge, attitude, and behaviors between medical and non-medical students while controlling for potential confounding variables. There was no difference in smoking-related knowledge scores between medical and non-medical freshmen, but medical sophomores and juniors had higher scores of smoking-related knowledge than their non-medical counterparts. The medical sophomores had higher mean score of attitudes towards smoking than non-medical ones. Before entering university, the difference in the prevalence of experimental and regular smoking between medical and non-medical college students was not significant. After entering university, in contrast, the overall prevalence of regular smoking was significantly higher among male non-medical college students than among male medical students. Stratified by current academic year, this difference was significant only among male sophomores. Medical students have higher smoking-related knowledge, stronger anti-smoking attitude, and lower prevalence of regular smoking than non-medical college students of similar age, which may be associated with medical professional education.

Impact of supply problems of preservative-free glaucoma medications on patients and hospital staff.

Science.gov (United States)

Shah, Shima; Theodossiades, Julia; Chapman, Kristin; Murdoch, Ian

2015-03-01

Glaucoma is a chronic ocular disease, which is usually managed with long-term daily medical therapy, in the form of eye drops. Patients who are intolerant to preservatives in topical medicines require preservative-free versions. From early 2011 patients attending Moorfields Eye Hospital, London, UK, started to report recurring problems with the supply of the following preservative-free glaucoma medications: Timolol 0.25% (Timoptol 0.25%, MSD UK); Dorzolamide (Trusopt, MSD UK); Dorzolamide and Timolol 0.5% (Cosopt, MSD UK). This study investigates the impact of the supply problems of these medications at Moorfields Eye Hospital from a patient, administrative and clinical perspective. Information was sought by interviewing both patients and hospital staff, and by a retrospective case note review between April 2010 and May 2013. Many hospital roles, both administrative and clinical, were involved in attempting to resolve the impact of the supply problems. All staff reported a considerable increase in their workload. At the peak of the problem, the glaucoma secretaries received about 150 enquiries per week. A review of 83 sets of patient notes, retrieved from a random sample of 125 patients, showed that 22% encountered a supply problem. Of these, more than one-third attended Moorfields Eye Hospital Accident & Emergency (A&E) for repeat supplies and 89% eventually had their medication changed. In telephone interviews with 39 of a random sample of 50 patients (a subset of the 83 notes retrieved), 59% of the interviewees reported a supply problem. Of these, one-third attended Moorfields Eye Hospital A&E for repeat supplies and half eventually required an alternative medication. Some patients reported going to considerable lengths to obtain ongoing supplies in the community. This study shows that medication supply problems can have a major impact on patients and hospital services. Supply problems occur across many fields of medicine and with increasing frequency. The

Impact of Robotic Antineoplastic Preparation on Safety, Workflow, and Costs

Science.gov (United States)

Seger, Andrew C.; Churchill, William W.; Keohane, Carol A.; Belisle, Caryn D.; Wong, Stephanie T.; Sylvester, Katelyn W.; Chesnick, Megan A.; Burdick, Elisabeth; Wien, Matt F.; Cotugno, Michael C.; Bates, David W.; Rothschild, Jeffrey M.

2012-01-01

Purpose: Antineoplastic preparation presents unique safety concerns and consumes significant pharmacy staff time and costs. Robotic antineoplastic and adjuvant medication compounding may provide incremental safety and efficiency advantages compared with standard pharmacy practices. Methods: We conducted a direct observation trial in an academic medical center pharmacy to compare the effects of usual/manual antineoplastic and adjuvant drug preparation (baseline period) with robotic preparation (intervention period). The primary outcomes were serious medication errors and staff safety events with the potential for harm of patients and staff, respectively. Secondary outcomes included medication accuracy determined by gravimetric techniques, medication preparation time, and the costs of both ancillary materials used during drug preparation and personnel time. Results: Among 1,421 and 972 observed medication preparations, we found nine (0.7%) and seven (0.7%) serious medication errors (P = .8) and 73 (5.1%) and 28 (2.9%) staff safety events (P = .007) in the baseline and intervention periods, respectively. Drugs failed accuracy measurements in 12.5% (23 of 184) and 0.9% (one of 110) of preparations in the baseline and intervention periods, respectively (P < .001). Mean drug preparation time increased by 47% when using the robot (P = .009). Labor costs were similar in both study periods, although the ancillary material costs decreased by 56% in the intervention period (P < .001). Conclusion: Although robotically prepared antineoplastic and adjuvant medications did not reduce serious medication errors, both staff safety and accuracy of medication preparation were improved significantly. Future studies are necessary to address the overall cost effectiveness of these robotic implementations. PMID:23598843

The views of domestic staff and porters when supporting patients with dementia in the acute hospital: An exploratory qualitative study.

Science.gov (United States)

Ashton, Caroline; Manthorpe, Jill

2017-01-01

There is increasing recognition that very many hospital patients have dementia but there are many concerns about the quality of care and support they receive. Consequently there have been numerous calls for hospital staff to have dementia training. While cleaning or domestic staff and porters form considerable parts of the hospital workforce they are infrequently considered in discussions of dementia care training and practice. This exploratory study aimed to investigate the experiences of domestic staff and porters working in an acute hospital setting who are in contact regularly with patients with dementia. Semi-structured interviews were undertaken in 2016 with seven domestic staff and five porters in one English acute hospital to investigate their views and experiences. Data were analysed thematically by constant comparison technique and theoretical sampling. Themes were identified and realistic concepts developed. Participants observed that caring attitudes and behaviour in their encounters with patients with dementia are important but challenging to put into practice. Several would have valued more information about dementia. Some noted situations in the hospital stay that seemed particularly difficult for patients with dementia such as travelling to different parts of the hospital for treatments. The study suggests the need for improving the dementia-related knowledge and skills of all non-clinical staff especially those new to the NHS. The impact of witnessing dementia symptoms and distress on emotional well-being requires further research so that ancillary staff can improve the hospital stay of patients with dementia.

Ergonomic Intervention Effect in Reducing Musculoskeletal Disorders in Staff of Shiraz Medical School

Directory of Open Access Journals (Sweden)

Keyvan Pakshir

2012-05-01

Full Text Available Background and aims: High percentage of musculoskeletal disorders occurs due to awkward working posture and poor workstation design. So this study was conducted to determine the prevalence rate of musculoskeletal disorders , evaluate workstations and investigate the effectiveness of ergonomic interventional measures among medical school staff of Shiraz University of Medical Sciences (SUMS.   Methods: In this interventional study, 200 employees of different units of medical school of SUMS participated. They were randomly divided into experimental and control groups. Data were collected via anonymous questionnaire, RULA and QEC techniques as well as an ergonomic workstation checklist that was used to evaluate working conditions.   Results: The results showed that after conducting interventional program for the experimental group there was a significant relationship between employees' increased awareness of ergonomics and workstation improvement (p≤0.05. Additionally, the prevalence rate of reported musculoskeletal disorders in experimental group was significantly reduced following intervention (p≤0.05. After corrective measures, level of risk was decreased and working postures were improved. A significant relationship was observed between risk levels and neck and shoulder pain in the experimental group (p≤0.05 . Following the intervention, workstations scores were increased significantly. Conclusion: On the basis of the findings of this study, it could be noted that the ergonomic interventional program was effective to improve working posture and workstations as well as to reduce the prevalence of musculoskeletal disorders among the staff.

Gatekeepers as Care Providers: The Care Work of Patient-centered Medical Home Clerical Staff.

Science.gov (United States)

Solimeo, Samantha L; Ono, Sarah S; Stewart, Kenda R; Lampman, Michelle A; Rosenthal, Gary E; Stewart, Greg L

2017-03-01

International implementation of the patient-centered medical home (PCMH) model for delivering primary care has dramatically increased in the last decade. A majority of research on PCMH's impact has emphasized the care provided by clinically trained staff. In this article, we report our ethnographic analysis of data collected from Department of Veterans Affairs staff implementing PACT, the VA version of PCMH. Teams were trained to use within-team delegation, largely accomplished through attention to clinical licensure, to differentiate staff in providing efficient, patient-centered care. In doing so, PACT may reinforce a clinically defined culture of care that countermands PCMH ideals. Such competing rubrics for care are brought into relief through a focus on the care work performed by clerks. Ethnographic analysis identifies clerks' care as a kind of emotional dirty work, signaling important areas for future anthropological study of the relationships among patient-centered care, stigma, and clinical authority. © 2016 by the American Anthropological Association.

Creating competitive markets for ancillary services

Energy Technology Data Exchange (ETDEWEB)

Hirst, E.; Kirby, B.

1997-10-01

This report describes the structure of, and results from, a spreadsheet model. The model simulates markets for seven services: losses, regulation, spinning reserve, supplemental reserve,load following, energy imbalance, and voltage support. For completeness, the model also calculates costs for system control, although this service will continue to be provided solely the the system operator under cost-based prices. This computer model demonstrated the likely complexity of markets for energy and ancillary services. This complexity arises because these markets are highly interdependent. Because these markets are interactive, the costs and therefore the prices of these services will vary considerably as functions of system load and the current spot price of energy. The price of ancillary services in aggregate is highly correlated with the price of energy. A base-case utility was developed for use with the model and included in the report.

School Indicators of Violence Experienced and Feeling Unsafe of Dutch LGB Versus Non-LGB Secondary Students and Staff, 2006-2010.

Science.gov (United States)

Mooij, Ton

2016-12-01

Gender and sexual orientation are expressed in heterosexual, lesbian (L), gay (G), bisexual (B), transgender (T), or queer (Q) interests and behavior. Compared with heterosexual persons, LGBTQ persons seem to experience more antisocial behavior, including negative discrimination and violence. To assess differences in LGBTQ-related discrimination in schools, the question for this research is "Do the degrees of violence experienced and feeling unsafe of LGBTQ students and staff in a school differ from those of non-LGBTQ students and staff in the same school?" Secondary analysis was carried out on data from a Dutch national digital monitor survey on safety in secondary schools. In 2006, 2008, and 2010, participation amounted to 570 schools, 18,300 teaching and support staff, and 216,000 students. Four indicators were constructed at the school level: two Mokken Scale means assessing severity of violence experienced and two Alpha Scale means assessing feeling unsafe. Analysis of mean differences showed that LGB students experienced more violence and felt less safe than non-LGB students; LGB staff felt less safe in school than non-LGB staff. When LGB students experienced more violence at school than non-LGB students, LGB students also felt less safe than non-LGB students for all 3 years. No such relationships existed for LGB staff, or between LGB staff and LGB students. No significant relationships were found between the four LGB school indicators and contextual school variables. The outcomes and uniqueness of the study are discussed. Recommendations are made to improve assessment and promote prosocial behavior of students and staff in schools. © The Author(s) 2015.

Knowledge sharing behaviour among non-academic staff in higher learning institutes: The role of trust and perceived risk

Directory of Open Access Journals (Sweden)

Muhammad Sabbir Rahman

2018-03-01

Full Text Available The purpose of the paper is to analyse knowledge sharing behaviour among non-academic staff of higher learning institutions. This research focuses on the mediation impact of perceived risk on trust and knowledge sharing behaviour. The research also proposes actions that can be taken by higher learning institutions to enhance trust among the staff in order to create a knowledge sharing environment at the workplace. This research applied confirmatory factor analysis and Structural Equation Modeling (SEM to evaluate the proposed measurement model and proved the research hypotheses. The findings from the research show that perceived risk plays a strong mediating role between trust and knowledge sharing behaviour among the non-academic staff of higher learning institutions. The SEM analysis also confirmed that the research model shows a good fit. This research highlights issues concerning knowledge sharing practices among non-academic staff and provides some recommendations to the managers to address these issues. The researchers agreed that more research needs to be done in this area as there are aspects that are yet to be explored. The findings of this research serve to add to the literature on knowledge sharing focussing on non-academic staff of higher learning institutions.

CANCER SCREENING AWARENESS AMONG NURSING STAFF IN GOVERNMENT MEDICAL COLLEGE: A PROSPECTIVE STUDY

Directory of Open Access Journals (Sweden)

Mukesh Shanthilal

2016-07-01

Full Text Available BACKGROUND Cervical and breast cancers are the common malignancies among female population in India. Though there are approved screening methods available to prevent and detect these cancers at an early stage, there is a lack of awareness about cancer screening among general public as well as the health care professionals. This study is aimed to identify the knowledge, attitude and practice (KAP among the nursing staff regarding cancer screening in these two diseases. METHOD A cross-sectional interview based survey was conducted among 303 female nursing staff working in a government medical college hospital from November 2015 to December 2015. Ethical committee approval was taken. Verbal informed consent was sought from the study subjects. Nursing staff who gave consent to participate in the study were enrolled. There were no specific inclusion or exclusion criteria for the study subjects. A structured pretested questionnaire regarding knowledge, attitude and practice (KAP was used to collect the data. The questions were open-ended. Recall and recognition type of questions were used. The data was entered into MS Excel worksheet and analysed using descriptive statistics. RESULTS Total of 303 nurses included in the study. The age ranged from 21 to 64 years. Median age is 38 years. Only 24.4% (74/303 of Nurses were aware of cancer screening and many of them were aware of Pap smear (55.1%, 167/303 and mammogram (66.3%, 201/303 as investigational tools in diagnosing cancer. Only 17 out of 303 (5.6% nurses had Pap smear test done with an average of 1.23% Pap smear per individual. Mammogram screening was done in 13% (15/115 of the eligible nurses with an average of 1.2% mammogram per individual. The most common reason for not undergoing screening as expressed was they did not feel the need to be screened unless they were symptomatic (55%, they are too young for screening (14.8%, shyness (11.1%, fear (11.1% and lack of time (7.4%. However, 90% of them

An analysis of ongoing trends in airline ancillary revenues

OpenAIRE

Warnock-Smith, David; O'Connell, John F.; Maleki, Mahnaz

2017-01-01

This paper examines the performance of the two core classifications of airline ancillary revenues, which are unbundled products and commission based income. It also investigates the willingness of passengers to pay (WTP) for these services together with what type of ancillary items are acceptable at a particular price point. The study found that passengers value a narrow range of perceived ‘necessity’ products and services such as food and drink, checked baggage and seat assignment as opposed...

Ancillary Services Provided from DER

Energy Technology Data Exchange (ETDEWEB)

Campbell, J.B.

2005-12-21

Distributed energy resources (DER) are quickly making their way to industry primarily as backup generation. They are effective at starting and then producing full-load power within a few seconds. The distribution system is aging and transmission system development has not kept up with the growth in load and generation. The nation's transmission system is stressed with heavy power flows over long distances, and many areas are experiencing problems in providing the power quality needed to satisfy customers. Thus, a new market for DER is beginning to emerge. DER can alleviate the burden on the distribution system by providing ancillary services while providing a cost adjustment for the DER owner. This report describes 10 types of ancillary services that distributed generation (DG) can provide to the distribution system. Of these 10 services the feasibility, control strategy, effectiveness, and cost benefits are all analyzed as in the context of a future utility-power market. In this market, services will be provided at a local level that will benefit the customer, the distribution utility, and the transmission company.

Analysis of databases appropriation in the academic staffs of Iranian Universities of Medical Sciences according to the social appropriation approach.

Science.gov (United States)

Keyvanara, Mahmoud; Sohrabi, Mozaffar Cheshmeh; Zare, Firoozeh; Hassnazadeh, Akbar; Malekahmadi, Parisa

2014-01-01

Numerous researches conducted on about the quality of perception of media messages shows that the people are not passive receivers but they have the ability of understanding, interpreting and accepting or rejecting messages. In order to make clear the relationship of information and communication technologies with social changes and to gain a broader vision from this scope, sociological theories about information and communication technologies' usage, especially appropriation approach can be very useful. So, keeping in mind the important role of Databases in the qualitative expansion of education, research, diagnosis, remedy and medical services presentation, this research was carried out with the aim of status determination of databases appropriation in the academic staffs of Iranian Universities of Medical Sciences according to the social appropriation approach in 2012. This is an applicative research of an analytical-descriptive type, which was carried out by measurement approach. The statistical society of this research was composed of the academic staffs of the Iranian Universities of Medical Sciences in 2012 and finally 390 academic staffs were selected according to the Cochran's formula were selected. The research tool are searcher's made questionnaire, which was composed of nine separate parts. Its validity was accepted by the specialists and its reliability was calculated and found to be 0.961 by Cronbakh's alpha. Database appropriation score in the academic staffs of Iranian Universities of Medical Sciences with 65.020% was in a good status and data bases dis appropriation score with 71.484 was in a high status. According to the findings of this research, Librarians and politicians in this scope-with determination of the academic staff's positive and negative points in usage and appropriation would be capable of accurately diagnozing and analyzing the chances and challenges of the academic staffs members in using databases and would also be capable of

Colombian ancillary services and international connections: Current weaknesses and policy challenges

International Nuclear Information System (INIS)

Carvajal, S.X.; Serrano, J.; Arango, S.

2013-01-01

Ancillary services are required to maintain the unity, stability, and quality of power systems. In Colombia these services are required to operate the national power system and the international connections with the neighboring countries. The system is influenced by factors ranging from system's topology to social and political aspects, such as the large number of terrorist attacks. In light of these particularities, we consider Colombia as a learning lab for ancillary services in the region. Colombia's power system relies on three ancillary services for its operation, namely frequency regulation, voltage control, and blackstart service. From 2010 Special Protection Systems were also added. In this paper we first analyze the technical aspects, operational restrictions, financial management, and the most relevant regulatory conditions of these ancillary services of the SIN. We also take into consideration the main regulatory characteristics and statistical data related to energy exchanges that have taken place between Colombia and Venezuela and Ecuador. Thereafter, we depict the main weaknesses and policy challenges that Colombia must address in order to increase the effectiveness and coverage of ancillary services in both the SIN and in the international interconnections. Finally, we propose new market oriented regulations to encourage investments and new tools for international connections. - Highlights: ► Blackout of 2007 forces Colombian regulator to improve security of power system. ► Four ancillary services are currently used for secure operation of Colombian system. ► Special Protection Systems service added in 2010. ► Frequency control is the only remunerated service in Colombia. ► Legislation should exist for remuneration of voltage control and black start services.

Exploiting ancillary services from distributed generation - perspectives for the Danish power system

DEFF Research Database (Denmark)

Nyeng, Preben; Pedersen, Knud Ole Helgesen; Østergaard, Jacob

2007-01-01

The share of the electric power production originating from distributed energy resources has rapidly increased during the recent past. However when it comes to ancillary services necessary to ensure the stability and appropriate operation of the power system, the distributed energy resources take...... a very passive role. This paper outlines suggestions on how to activate the potential of ancillary services from distributed energy resources, thereby exploiting their ability to contribute to power system operation. Furthermore, methods for integrating the ancillary service delivery into a deregulated...

Marital satisfaction: the differential impact of social support dependent on situation and gender in medical staff in Iran.

Science.gov (United States)

Rostami, Arian; Ghazinour, Mehdi; Richter, Jörg

2013-05-12

Stress is unavoidable in everyday life and it can effect on marital relationship. Social support especially from emotionally closed persons as a protective factor can help individuals to deal with stress and buffers the negative effects of life stress on marital satisfaction. In the present cross-sectional study we investigated the relationship between social and spousal support and marital satisfaction in medical staff in Iran. Data collection was performed in 653 medical staff using socio-demographic questions, the ENRICH Marital Satisfaction Inventory, and the Social Support Questionnaire. Women and men did not differ in total social support satisfaction and the total number of supporting people; but, women were more often support providers for their husbands than men were for their wives. Spouse support was a more important indicator of marital satisfaction for women than for men. Also results revealed that spouse support is more important than social support from other resources to explain marital satisfaction. Job satisfaction had an explanatory effect on marital satisfaction especially in men. Furthermore, the findings showed that social support could decrease the explanatory impact of job satisfaction on scales of marital satisfaction. Therefore, focusing on social support, especially spouse support could be an effective approach in family counseling or family education programs to improve marital satisfaction in medical staff.

75 FR 17143 - Draft Guidance for Industry and Food and Drug Administration Staff; Medical Devices; Neurological...

Science.gov (United States)

2010-04-05

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2009-D-0495] Draft Guidance for Industry and Food and Drug Administration Staff; Medical Devices; Neurological and Physical Medicine Device Guidance Documents; Availability AGENCY: Food and Drug Administration, HHS. ACTION...

76 FR 43689 - Draft Guidance for Industry and Food and Drug Administration Staff; Mobile Medical Applications...

Science.gov (United States)

2011-07-21

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-D-0530] Draft Guidance for Industry and Food and Drug Administration Staff; Mobile Medical Applications; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug...

75 FR 44267 - Draft Guidance for Industry and Food and Drug Administration Staff; Medical Devices; Neurological...

Science.gov (United States)

2010-07-28

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2009-N-0495] Draft Guidance for Industry and Food and Drug Administration Staff; Medical Devices; Neurological and Physical Medicine Device Guidance Document; Reopening of Comment Period AGENCY: Food and Drug...

Use of face masks by non-scrubbed operating room staff: a randomized controlled trial.

Science.gov (United States)

Webster, Joan; Croger, Sarah; Lister, Carolyn; Doidge, Michelle; Terry, Michael J; Jones, Ian

2010-03-01

Ambiguity remains about the effectiveness of wearing surgical face masks. The purpose of this study was to assess the impact on surgical site infections (SSIs) when non-scrubbed operating room staff did not wear surgical face masks. Eight hundred twenty-seven participants undergoing elective or emergency obstetric, gynecological, general, orthopaedic, breast or urological surgery in an Australian tertiary hospital were enrolled. Complete follow-up data were available for 811 patients (98.1%). Operating room lists were randomly allocated to a 'Mask group' (all non-scrubbed staff wore a mask) or 'No Mask group' (none of the non-scrubbed staff wore masks). The primary end point, SSI was identified using in-patient surveillance; post discharge follow-up and chart reviews. The patient was followed for up to six weeks. Overall, 83 (10.2%) surgical site infections were recorded; 46/401 (11.5%) in the Masked group and 37/410 (9.0%) in the No Mask group; odds ratio (OR) 0.77 (95% confidence interval (CI) 0.49 to 1.21), p = 0.151. Independent risk factors for surgical site infection included: any pre-operative stay (adjusted odds ratio [aOR], 0.43 (95% CI, 0.20; 0.95), high BMI aOR, 0.38 (95% CI, 0.17; 0.87), and any previous surgical site infection aOR, 0.40 (95% CI, 0.17; 0.89). Surgical site infection rates did not increase when non-scrubbed operating room personnel did not wear a face mask.

Understanding the Use of Educational Technology among Faculty, Staff, and Students at a Medical University

Science.gov (United States)

Kazley, Abby Swanson; Annan, Dustin L.; Carson, Nancy E.; Freeland, Melissa; Hodge, Ashley B.; Seif, Gretchen A.; Zoller, James S.

2013-01-01

A college of health professions at a medical university located in the southeastern United States is striving to increase the use of educational technology among faculty, staff, and students. A strategic planning group was formed and charged with enhancing the use of educational technology within the college. In order to understand the current…

Perceptions of University Mission Statement and Person-Environment Fit by Osteopathic Medical School Faculty and Staff

Science.gov (United States)

Poppre, Beth Anne Edwards

2017-01-01

Understanding how university medical school faculty and staff perceive the institution's mission statement, in conjunction with their person-environment fit, can provide administration with useful insight into: employee's match to the institution's mission statement, employee level of organizational commitment, and reasons for retention. This…

Loads Providing Ancillary Services: Review of International Experience

Energy Technology Data Exchange (ETDEWEB)

Heffner, Grayson; Goldman, Charles; Kintner-Meyer, Michael

2007-05-01

In this study, we examine the arrangements for and experiences of end-use loads providing ancillary services (AS) in five electricity markets: Australia, the United Kingdom (UK), the Nordic market, and the ERCOT and PJM markets in the United States. Our objective in undertaking this review of international experience was to identify specific approaches or market designs that have enabled customer loads to effectively deliver various ancillary services (AS) products. We hope that this report will contribute to the ongoing discussion in the U.S. and elsewhere regarding what institutional and technical developments are needed to ensure that customer loads can meaningfully participate in all wholesale electricity markets.

Usage of emergency contraception between medical related and non-medical related students.

LENUS (Irish Health Repository)

Khalid, A K

2009-04-01

Teenagers and young adultshave the most risk of unplanned pregnancy, due to lack of awareness to see a family planning provider after unprotected sexual intercourse. In addition, nearly one in five physicians is reluctant to provide information regarding Emergency Contraception (EC) to women and this may contribute to their lack of awareness. This study was conducted to assess the knowledge, attitudes and practices regarding the use of EC between medical related students compared to non-medical related students. Data collection was done using questionnaires distributed among students in University College Cork (UCC). 93% of medically related students were aware of EC compared to only 73.5% of non-medically related students. Medical related students also were more aware about the mechanism of action and detailed knowledge of EC compared to the non-medical students. This study has proven that medically related students have more detailed knowledge regarding EC compared to non-medical related students. However, there was no significant difference noted regarding the attitude and practice between the two groups.

Occupational radiation exposure of medical staff performing 90Y-loaded microsphere radioembolization

International Nuclear Information System (INIS)

Laffont, Sophie; Ardisson, Valerie; Lenoir, Laurence; Rolland, Yan; Rohou, Tanguy; Edeline, Julien; Pracht, Marc; Sourd, Samuel Le; Lepareur, Nicolas; Garin, Etienne

2016-01-01

Radioembolization of liver cancer with 90 Y-loaded microspheres is increasingly used but data regarding hospital staff exposure are scarce. We evaluated the radiation exposure of medical staff while preparing and injecting 90 Y-loaded glass and resin microspheres especially in view of the increasing use of these products. Exposure of the chest and finger of the radiopharmacist, nuclear medicine physician and interventional radiologist during preparation and injection of 78 glass microsphere preparations and 16 resin microsphere preparations was monitored. Electronic dosimeters were used to measure chest exposure and ring dosimeters were used to measure finger exposure. Chest exposure was very low for both products used (<10 μSv from preparation and injection). In our experience, finger exposure was significantly lower than the annual limit of 500 mSv for both products. With glass microspheres, the mean finger exposure was 13.7 ± 5.2 μSv/GBq for the radiopharmacist, and initially 17.9 ± 5.4 μSv/GBq for the nuclear medicine physician reducing to 13.97 ± 7.9 μSv/GBq with increasing experience. With resin microspheres, finger exposure was more significant: mean finger exposure for the radiopharmacist was 295.1 ± 271.9 μSv/GBq but with a reduction with increasing experience to 97.5 ± 35.2 μSv/GBq for the six most recent dose preparations. For administration of resin microspheres, the greatest mean finger exposure for the nuclear medicine physician (the most exposed operator) was 235.5 ± 156 μSv/GBq. Medical staff performing 90 Y-loaded microsphere radioembolization procedures are exposed to safe levels of radiation. Exposure is lower than that from treatments using 131 I-lipiodol. The lowest finger exposure is from glass microspheres. With resin microspheres finger exposure is acceptable but could be optimized in accordance with the ALARA principle, and especially in view of the increasing use of radioembolization. (orig.)

The Nordic approach to market-based provision of ancillary services

International Nuclear Information System (INIS)

Kristiansen, Tarjei

2007-01-01

This paper presents an overview of the markets for ancillary services, which are regulated and traded differently within and across borders in the Nordic countries. We describe the services provided and their characteristics in terms of definition, participation, contracting approach and duration, selection of offers, and dispatch criteria. Further, we assess the costs, specify the payments, and discuss cost allocation, and we conclude with a policy discussion of ancillary services in the Nordic countries. (author)

Market and policy barriers for demand response providing ancillary services in U.S. markets

Energy Technology Data Exchange (ETDEWEB)

Cappers, Peter [Lawrence Berkeley National Laboratory (LBNL), Berkeley, CA (United States); MacDonald, Jason [Lawrence Berkeley National Laboratory (LBNL), Berkeley, CA (United States); Goldman, Charles [Lawrence Berkeley National Laboratory (LBNL), Berkeley, CA (United States)

2013-03-01

This study provides an examination of various market and policy barriers to demand response providing ancillary services in both ISO/RTO and non-ISO/RTO regions, especially at the program provider level. It is useful to classify barriers in order to create a holistic understanding and identify parties that could be responsible for their removal. This study develops a typology of barriers focusing on smaller customers that must rely on a program provider (i.e., electric investor owned utility or IOU, ARC) to create an aggregated DR resource in order to bring ancillary services to the balancing authority. The barriers were identified through examinations of regulatory structures, market environments, and product offerings; and discussions with industry stakeholders and regulators. In order to help illustrate the differences in barriers among various wholesale market designs and their constituent retail environments, four regions were chosen to use as case studies: Colorado, Texas, Wisconsin, and New Jersey.

Marital Satisfaction: The Differential Impact of Social Support Dependent on Situation and Gender in Medical Staff in Iran

Science.gov (United States)

Rostami, Arian; Ghazinour, Mehdi; Richter, Jörg

2013-01-01

Stress is unavoidable in everyday life and it can effect on marital relationship. Social support especially from emotionally closed persons as a protective factor can help individuals to deal with stress and buffers the negative effects of life stress on marital satisfaction. In the present cross-sectional study we investigated the relationship between social and spousal support and marital satisfaction in medical staff in Iran. Data collection was performed in 653 medical staff using socio-demographic questions, the ENRICH Marital Satisfaction Inventory, and the Social Support Questionnaire. Women and men did not differ in total social support satisfaction and the total number of supporting people; but, women were more often support providers for their husbands than men were for their wives. Spouse support was a more important indicator of marital satisfaction for women than for men. Also results revealed that spouse support is more important than social support from other resources to explain marital satisfaction. Job satisfaction had an explanatory effect on marital satisfaction especially in men. Furthermore, the findings showed that social support could decrease the explanatory impact of job satisfaction on scales of marital satisfaction. Therefore, focusing on social support, especially spouse support could be an effective approach in family counseling or family education programs to improve marital satisfaction in medical staff. PMID:23777731

Relationship between stress-related psychosocial work factors and suboptimal health among Chinese medical staff: a cross-sectional study.

Science.gov (United States)

Liang, Ying-Zhi; Chu, Xi; Meng, Shi-Jiao; Zhang, Jie; Wu, Li-Juan; Yan, Yu-Xiang

2018-03-06

The study aimed to develop and validate a model to measure psychosocial factors at work among medical staff in China based on confirmatory factor analysis (CFA). The second aim of the current study was to clarify the association between stress-related psychosocial work factors and suboptimal health status. The cross-sectional study was conducted using clustered sampling method. Xuanwu Hospital, a 3A grade hospital in Beijing. Nine hundred and fourteen medical staff aged over 40 years were sampled. Seven hundred and ninety-seven valid questionnaires were collected and used for further analyses. The sample included 94% of the Han population. The Copenhagen Psychosocial Questionnaire (COPSOQ) and the Suboptimal Health Status Questionnaires-25 were used to assess the psychosocial factors at work and suboptimal health status, respectively. CFA was conducted to establish the evaluating method of COPSOQ. A multivariate logistic regression model was used to estimate the relationship between suboptimal health status and stress-related psychosocial work factors among Chinese medical staff. There was a strong correlation among the five dimensions of COPSOQ based on the first-order factor model. Then, we established two second-order factors including negative and positive psychosocial work stress factors to evaluate psychosocial factors at work, and the second-order factor model fit well. The high score in negative (OR (95% CI)=1.47 (1.34 to 1.62), Pwork factors increased and decreased the risk of suboptimal health, respectively. This relationship remained statistically significant after adjusting for confounders and when using different cut-offs of suboptimal health status. Among medical staff, the second-order factor model was a suitable method to evaluate the COPSOQ. The negative and positive psychosocial work stress factors might be the risk and protective factors of suboptimal health, respectively. Moreover, negative psychosocial work stress was the most associated

A hybrid PSO technique for procuring VAR ancillary service in the deregulated electricity markets

Energy Technology Data Exchange (ETDEWEB)

El-Araby, E.E. [Department of Electrical Engineering, Suez Canal University (Egypt); Yorino, Naoto [Department of Artificial Complex Systems Engineering, Hiroshima University (Japan)

2010-07-15

This paper develops a new market-based technique for acquiring VAR ancillary service in the electricity market. The main objective of the developed market is to enable transmission operator ''TO'' to procure VAR service in a long term contract from the critical VAR providers that satisfy minimum VAR service payment while maintaining system security. Reactive power control problem for voltage stability is introduced into the VAR market problem in an explicit manner for normal and emergency states. An integration of particle swarm optimization ''PSO'' is presented with successive linear programming ''SLP'' for dealing with the VAR ancillary service problem. The problem is formulated as a large-scale nonlinear constrained optimization problem with a non-differentiable objective function representing VAR payment and operational costs. This type of problem is hard to be treated straightforwardly by the classical optimization methods. Therefore, we propose here a two-layer hybrid PSO/SLP approach, which is suited for carrying out the difficulties associated with non-differentiable and discontinuous objective functions. The proposed method has been examined on the standard IEEE 57 bus-system and compared with GA/SLP method to demonstrate its capability. (author)

The impact of night-shift work on platelet function in healthy medical staff.

Science.gov (United States)

Nakao, Tomoko; Yasumoto, Atsushi; Tokuoka, Suzumi; Kita, Yoshihiro; Kawahara, Takuya; Daimon, Masao; Yatomi, Yutaka

2018-04-18

Rotating shift work has been reported to increase the risk of cardiovascular diseases. Vascular endothelial dysfunction and platelet activation are among the leading causes of thrombus formation in patients with myocardial infarction or stroke. Endothelial function has been shown to be impaired immediately after night-shift work; however, it is not known whether platelets are also activated. The aim of this study was to investigate the acute impact of night-shift work on platelet function. This observational study included 11 healthy medical staff members (seven women, median age 32 years). We examined each subject's platelet aggregation rates and the serum concentrations of eicosanoid mediators after night-shift work and on day-shift work without preceding night-shift work (baseline). Platelet aggregation did not differ from baseline levels after night-shift work. However, serum cyclooxygenase (COX)-metabolized eicosanoid mediators, particularly thromboxane (Tx) B 2 (a stable metabolite of TxA 2 and the most important marker of platelet activation), were significantly higher after the night-shift than at baseline (median 65.3 vs 180.4 ng/ml). Although platelet aggregation did not increase, there was an increase in serum COX-metabolized eicosanoid mediators such as TxB 2 in healthy medical staff after night-shift work. This platelet hypersensitivity may be one of the mechanisms underlying the significant association between night-shift work and adverse cardiovascular outcomes.

77 FR 40413 - Third-Party Provision of Ancillary Services; Accounting and Financial Reporting for New Electric...

Science.gov (United States)

2012-07-09

... Ancillary Services; Accounting and Financial Reporting for New Electric Storage Technologies AGENCY: Federal... Ancillary Services; Accounting and Financial Reporting for New Electric Storage Technologies, 135 FERC ] 61... Commission 18 CFR Parts 35, 37, and 101 Third-Party Provision of Ancillary Services; Accounting and Financial...

Prevalence of influenza vaccination among nurses and ancillary workers in Italy: systematic review and meta analysis.

Science.gov (United States)

La Torre, Giuseppe; Mannocci, Alice; Ursillo, Paolo; Bontempi, Claudio; Firenze, Alberto; Panico, Maria Grazia; Sferrazza, Antonella; Ronga, Chiara; D'Anna, Adele; Amodio, Emanuele; Romano, Nino; Boccia, Antonio

2011-07-01

Italian Ministry of Health, recommends vaccination for seasonal influenza to all healthcare workers (HCW), particularly to nurses who have an important interaction with patients. The aim of this study is to conduct a systematic review in order to estimate the pooled prevalence of influenza vaccinations among nurses and ancillary workers in Italy and analyse the enhancing and hindering factors. The review was performed using 15 articles, six containing the prevalence of vaccination for nurses and ancillary workers, while the others qualitative analysis. In all the selected articles the score calculation has been carried out by using a protocol for observational studies. The nurses and ancillary workers pooled proportion of influenza vaccination was respectively 13.47% (95%CI 9.58-17.90%) and 12.52% (95%CI 9.97-15.31%). The Italian mean of influenza vaccination prevalence appear low if compared to other European countries, ranging from 15% to 29% in Countries such as UK, Germany, France. This situation of weakness should be seen as an opportunity to improve the vaccination rate for seasonal influenza significantly This should be done by intervening on the category which affirms caring less. In fact, this category has a priority to receive vaccination, due to their numbers and closer contact to patients. Research was conducted using medical database Scopus, PubMed, the search engine Google Scholar and ISI web of knowledge, and was concluded February 1st 2011.

A New Approach to Identify High Burnout Medical Staffs by Kernel K-Means Cluster Analysis in a Regional Teaching Hospital in Taiwan.

Science.gov (United States)

Lee, Yii-Ching; Huang, Shian-Chang; Huang, Chih-Hsuan; Wu, Hsin-Hung

2016-01-01

This study uses kernel k-means cluster analysis to identify medical staffs with high burnout. The data collected in October to November 2014 are from the emotional exhaustion dimension of the Chinese version of Safety Attitudes Questionnaire in a regional teaching hospital in Taiwan. The number of effective questionnaires including the entire staffs such as physicians, nurses, technicians, pharmacists, medical administrators, and respiratory therapists is 680. The results show that 8 clusters are generated by kernel k-means method. Employees in clusters 1, 4, and 5 are relatively in good conditions, whereas employees in clusters 2, 3, 6, 7, and 8 need to be closely monitored from time to time because they have relatively higher degree of burnout. When employees with higher degree of burnout are identified, the hospital management can take actions to improve the resilience, reduce the potential medical errors, and, eventually, enhance the patient safety. This study also suggests that the hospital management needs to keep track of medical staffs' fatigue conditions and provide timely assistance for burnout recovery through employee assistance programs, mindfulness-based stress reduction programs, positivity currency buildup, and forming appreciative inquiry groups. © The Author(s) 2016.

Medical staff radiation exposure in electrophysiology procedures: First results during biventricular ICD implantation

International Nuclear Information System (INIS)

Rossi, Pier Luca; Bianchini, David; Corazza, Ivan; Compagnone, Gaetano; Ferrari, Paolo; Gualdrini, Gianfranco; Zannoli, Romano

2011-01-01

Cardiac resynchronization therapy (CRT) requires a very long fluoroscopy time due to the need to monitor the placement of the device and electrodes inside the patient’s body at every step of the procedure. Aim of this study was to analyse staff X-ray exposure during the intervention, measuring H p (10) values with electronic dosimeters worn by medical staff. The scattered X-ray field was characterized using a spectrometric CdTe (cadmium-telluride) detector to define the radiation field impinging on the operator and thereby identify the correct dosimeter position for accurate measurement (i.e., above or under the shielding apron). In particular, knowledge of the X-ray spectrum yields information on photon flux and the energy distribution of the X-rays. Dosimetric data were then recorded in a series of 20 consecutive patients, obtaining a first set of H p (10) data that can be used to estimate the risk for the electrophysiologist performing this procedure.

Identification of documented medication non-adherence in physician notes.

Science.gov (United States)

Turchin, Alexander; Wheeler, Holly I; Labreche, Matthew; Chu, Julia T; Pendergrass, Merri L; Einbinder, Jonathan S; Einbinder, Jonathan Seth

2008-11-06

Medication non-adherence is common and the physicians awareness of it may be an important factor in clinical decision making. Few sources of data on physician awareness of medication non-adherence are available. We have designed an algorithm to identify documentation of medication non-adherence in the text of physician notes. The algorithm recognizes eight semantic classes of documentation of medication non-adherence. We evaluated the algorithm against manual ratings of 200 randomly selected notes of hypertensive patients. The algorithm detected 89% of the notes with documented medication non-adherence with specificity of 84.7% and positive predictive value of 80.2%. In a larger dataset of 1,000 documents, notes that documented medication non-adherence were more likely to report significantly elevated systolic (15.3% vs. 9.0%; p = 0.002) and diastolic (4.1% vs. 1.9%; p = 0.03) blood pressure. This novel clinically validated tool expands the range of information on medication non-adherence available to researchers.

Monte Carlo calculations on extremity and eye lens dosimetry for medical staff at interventional radiology procedures

International Nuclear Information System (INIS)

Carinou, E.; Ferrari, P.; Koukorava, C.; Krim, S.; Struelens, L.

2011-01-01

There are many factors that can influence the extremity and eye lens doses of the medical staff during interventional radiology and cardiology procedures. Numerical simulations can play an important role in evaluating extremity and eye lens doses in correlation with many different parameters. In the present study, the first results of the ORAMED (Optimisation of Radiation protection of Medical staff) simulation campaign are presented. The parameters investigated for their influence on eye lens, hand, wrist and leg doses are: tube voltage, filtration, beam projection, field size and irradiated part of the patient's body. The tube voltage ranged from 60 to 110 kVp, filtration from 3 to 6 mm Al and from 0 to 0.9 mm Cu. For all projections, the results showed that doses received by the operator decreased with increasing tube voltage and filtration. The magnitude of the influence of the tube voltage and the filtration on the doses depends on the beam projection and the irradiated part of the patient's body. Finally, the influence of the field size is significant in decreasing the doses. (authors)

Academic staff recruitment and retention challenges at the University ...

African Journals Online (AJOL)

Academic staff recruitment and retention challenges at the University of Botswana medical school. ... To document the medical school's staff recruitment and retention trends and challenges, and to propose ... AJOL African Journals Online.

Radiation protection of medical staff in the latest draft of the revised Euratom Basic Safety Standards directive

International Nuclear Information System (INIS)

Simeonov, Georgi; Mundigl, Stefan; Janssens, Augustin

2011-01-01

The European Union has a long and successful history of legislating in the area of radiation protection of the public, workers and individuals submitted to medical exposure, the first Euratom “Basic Safety Standards” (BSS) adopted in 1959 and subsequently updated and supplemented with other Directives. The recent revision of this legislation aims to update it in the light of the latest knowledge and experience and to simplify it by consolidating the current legal acts into one Directive. The draft of the revised Euratom BSS Directive has been approved by the group of scientific experts under Euratom Treaty Article 31 and is currently undergoing the European Commission’s procedures. This draft contains several new or amended provisions relating to protection of medical staff, among them: (i) a streamlining of the annual dose limit provisions, (ii) enhancing the use of dose constraints in optimization of protection, and (iii) ensuring better recording and transfer of occupational dose data including in cases of trans-border movement of workers. The Community action to radiation protection of workers is not restricted to passing relevant legislation but also includes ‘soft action’ as issuing guidance, supporting research and stakeholders’ involvement, etc. In August 2010 the Commission issued a Communication to the Council and the European Parliament dealing with the issues in the medical uses of ionizing radiation, including those relating to radiation protection of medical staff.

Resource and revenue potential of California residential load participation in ancillary services

International Nuclear Information System (INIS)

Mathieu, Johanna L.; Dyson, Mark E.H.; Callaway, Duncan S.

2015-01-01

Increasing penetrations of intermittent renewable energy resources will require additional power system services. California recently adopted an energy storage mandate to support its renewable portfolio standard, which requires 33% of delivered energy from renewables by 2020. The objective of this paper is to estimate the amount of energy storage that could be provided by residential thermostatically controlled loads, such as refrigerators and air conditioners, and the amount of revenue that could be earned by loads participating in ancillary services markets. We model load aggregations as virtual energy storage, and use simple dynamical system models and publicly available data to generate our resource and revenue estimates. We find that the resource potential is large: 10–40 GW/8–12 GWh, which is significantly more than that required by the mandate. We also find that regulation and spinning/non-spinning reserve revenues vary significantly depending upon type of load and, for heat pumps and air conditioners, climate zone. For example, mean regulation revenues for refrigerators are $11/year, for electric water heaters are $24/year, for air conditioners are $0-32/year, and for heat pumps are $22–56/year. Both consumer choices, such as appliance settings, and policy, such as the design of ancillary service compensation and appliance standards, could increase revenue potentials. - Highlights: • California's energy storage mandate requires 1.325 GW of energy storage by 2020. • Residential loads such as refrigerators have thermal energy storage. • California's residential loads could provide 10-40 GW/8-12 GWh of storage. • Loads participating in ancillary services markets could earn up to $56/load/year. • Consumer choices and policy mechanisms could increase revenue potentials

Radiation Dose to Patients and Medical Staff in Different Procedures of Nuclear Medicine

International Nuclear Information System (INIS)

Dimcheva, M.; Sergieva, S.

2015-01-01

The aim of this study is to provide information on developing technologies and clinical techniques for Hybrid SPECT/CT imaging using ionizing radiation and their associated radiation dose to patients and medical staff. A thermoluminescent dosimeters (TLD) was used in this study to analyze the historic records of the external radiation doses to staff members working in our nuclear medicine department in 7 procedures, including elution of 99mTc from "9"9"mMo/"9"9"mTc generators, syringe preparation, radiopharmacy kit preparation, injection, accompanying patients, SPECT/CT scan, oral "1"3"1I preparation. These dosimeters was worn by the staff members at the level of the chest on the front part of the body. A retrospective review of 110 clinical studies of various nuclear medicine procedures ("9"9"mTc–MIBI–Tetrofosmin, "9"9"mTc–MDP bone scan, "9"9"mTc–Tektrotyd, "9"9"mTc–Thyroid imaging, "9"9"mTc–Nanocoll, "1"3"1I–Nal (diagnostic application 185 MBq) obtained on hybrid SPECT/CT systems was performed to calculate the effective radiation dose to patients. The results from this study showed that annual effective radiation doses to nuclear medicine department staff members were within permissible levels. The contribution of total effective radiation dose from SPECT component were calculated using the activity of the injected radiopharmaceutical and dose tables published by the conversion factors listed in ICRP 53 and ICRP 80. The radiation dose for CT was calculated by Dose Length Product method. According to the results of this study the dose in each procedure depends on different factors such as the education and experience of the staff members, usage of shielding and taking the radiation protection requirements into consideration. When SPECT–CT is being performed, all measures should be taken to reduce both the radiopharmaceutical dose and the CT effective dose following the ALARA principle. (author)

Proposal for the conclusion of a partnership agreement, without competitive tendering, for the management of medical emergencies on the CERN site and the training of CERN's medical staff and firefighters in emergency situations

CERN Document Server

2014-01-01

Proposal for the conclusion of a partnership agreement, without competitive tendering, for the management of medical emergencies on the CERN site and the training of CERN's medical staff and firefighters in emergency situations

Market and Policy Barriers for Demand Response Providing Ancillary Services in U.S. Markets

Energy Technology Data Exchange (ETDEWEB)

Cappers, Peter [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); MacDonald, Jason [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Goldman, Charles [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

2013-03-01

In this study, we attempt to provide a comprehensive examination of various market and policy barriers to demand response providing ancillary services in both ISO/RTO and non-ISO/RTO regions, especially at the program provider level. It is useful to classify barriers in order to create a holistic understanding and identify parties that could be responsible for their removal. This study develops a typology of barriers focusing on smaller customers that must rely on a program provider (i.e., electric investor owned utility or IOU, ARC) to create an aggregated DR resource in order to bring ancillary services to the balancing authority.ii The barriers were identified through examinations of regulatory structures, market environments, and product offerings; and discussions with industry stakeholders and regulators. In order to help illustrate the differences in barriers among various wholesale market designs and their constituent retail environments, four regions were chosen to use as case studies: Colorado, Texas, Wisconsin, and New Jersey. We highlight the experience in each area as it relates to the identified barriers.

影响医务人员医学伦理审查认知的因素分析%Analysis of the Influential Factors of Medical Staff's Cognition on Medical Ethics Review

Institute of Scientific and Technical Information of China (English)

黄娟; 孙昌林; 张静; 程雨蒙; 左玉玲

2017-01-01

Objective:To analyze the influential factors of medical staff's cognition on medical ethics review in Wuhan municipal medical institutions,and thus to provide suggestions for strengthening the ethical construction.Methods:Aquestionnaire survey was conducted among medical staff.Chi-square test and Logistic regression method were performed to analyze the influential factors of medical staff's cognition on medical ethics review.Results:The results showed that medical staff's cognition on medical ethics review was affected by the technical tide,education background,whether had received ethical education,the cognition on ethics committees and whether the medical institution had established ethics committee.With higher technical titles,they thought more necessity to establish ethics committees and conduct ethical review of the clinical applications of new technology and new business.Those with higher technical titles and had read the ethical propaganda materials thought it more necessary to conduct ethical review of the clinical application of new technology and new business and the ethical review of biomedical research involved human beings.Conclusions:The medical institution should embody the establishment and standardization of ethical committees into the hospital assessment management system,as a necessary condition for the application of research projects and achievement awards.Also,it should conduct medical ethics training for all medical staff.Only those passed the examination can enter into the research and clinical operation with certificates,which can protect the medical ethics education into practice.It should strengthen the medical staff's cognition on ethical review,constantly innovate the operation rules and management system based on following the basic ethical review principles,and constantly improve the medical ethical review mechanism.%目的 �

Staff perceptions of challenging parent-staff interactions and beneficial strategies in the Neonatal Intensive Care Unit.

Science.gov (United States)

Friedman, Joshua; Friedman, Susan Hatters; Collin, Marc; Martin, Richard J

2018-01-01

To characterise neonatal intensive care unit (NICU) staff perceptions regarding factors which may lead to more challenging staff-parent interactions, and beneficial strategies for working with families with whom such interactions occur. A survey of 168 physician and nursing staff at two NICUs in American teaching hospitals inquired about their perceptions of challenging parent-staff interactions and situations in which such interactions were likely to occur. From a medical perspective, staff perceptions of challenging interactions were noted when infants had recent decompensation, high medical complexity, malformations or long duration of stay in the NICU. From a psychological/social perspective, a high likelihood of challenging interactions was noted with parents who were suspicious, interfere with equipment, or parents who hover in the NICU, express paranoid or delusional thoughts, repeat questions, perceive the staff as inaccessible, are managing addictions, or who require child protective services involvement. Frequent family meetings, grieving opportunities, education of parents, social work referrals, clearly defined rules, partnering in daily care and support groups were perceived as the most beneficial strategies for improving difficult interactions. This study delineates what staff perceive as challenging interactions and provides support for an educational and interventional role that incorporates mental health professionals. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

The effects of a non-smoking policy on nursing staff smoking behaviour and attitudes in a psychiatric hospital.

Science.gov (United States)

Bloor, R N; Meeson, L; Crome, I B

2006-04-01

The UK Department of Health required that by April 2001, all NHS bodies would have implemented a smoking policy. It has been suggested that the best demonstration a hospital can make of its commitment to health is to ban smoking on its premises. This paper reports on an evaluation of the effectiveness of a non-smoking policy in a newly opened NHS psychiatric hospital. Questionnaires were sent to all 156 nursing staff in a psychiatric hospital to assess the effectiveness of the policy in terms of staff smoking behaviour, attitudes to the restriction and compliance with the policy. Of the 156 questionnaires distributed, 92 (58%) were returned; smokers, former smokers and those who have never smoked were quite evenly represented at 34.78%, 34.78% and 30.43%, respectively. Of eight critical success factors for the policy, only one, staff not smoking in Trust public areas, had been achieved. A non-smoking policy was generally accepted as necessary by nursing staff working in a mental health setting. Staff felt that the policy was not effective in motivating smoking nurses to stop and that insufficient support was given to these nurses. The study highlights the importance of introducing staff support systems as an integral part of smoking policies and the role of counterintuitive behaviour in the effectiveness of smoking policy introduction in healthcare settings.

75 FR 14342 - Market-Based Rates for Wholesale Sales of Electric Energy, Capacity and Ancillary Services by...

Science.gov (United States)

2010-03-25

...; Order No. 697-D] Market-Based Rates for Wholesale Sales of Electric Energy, Capacity and Ancillary... affiliates.\\3\\ \\1\\ Market-Based Rates for Wholesale Sales of Electric Energy, Capacity and Ancillary Services...\\ Market-Based Rates for Wholesale Sales of Electric Energy, Capacity and Ancillary Services by Public...

Fundamentals of Medical Ultrasonics

CERN Document Server

Postema, Michiel

2011-01-01

This book sets out the physical and engineering principles of acoustics and ultrasound as used for medical applications. It covers the basics of linear acoustics, wave propagation, non-linear acoustics, acoustic properties of tissue, transducer components, and ultrasonic imaging modes, as well as the most common diagnostic and therapeutic applications. It offers students and professionals in medical physics and engineering a detailed overview of the technical aspects of medical ultrasonic imaging, whilst serving as a reference for clinical and research staff.

Motivation and job satisfaction among medical and nursing staff in a Cyprus public general hospital

OpenAIRE

Lambrou, Persefoni; Kontodimopoulos, Nick; Niakas, Dimitris

2010-01-01

Abstract Background The objective of this study was to investigate how medical and nursing staff of the Nicosia General Hospital is affected by specific motivation factors, and the association between job satisfaction and motivation. Furthermore, to determine the motivational drive of socio-demographic and job related factors in terms of improving work performance. Methods A previously developed and validated instrument addressing four work-related motivators (job attributes, remuneration, co...

Surveying the factor structure and reliability of the Persian version of the Jefferson Scale of Physician Lifelong Learning (JeffSPLL) in staff of medical sciences.

Science.gov (United States)

Karimi, Fatemeh Zahra; Alesheikh, Aytay; Pakravan, Soheila; Abdollahi, Mahbubeh; Damough, Mozhdeh; Anbaran, Zahra Khosravi; Farahani, Leila Amiri

2017-10-01

In medical sciences, commitment to lifelong learning has been expressed as an important element. Today, due to the rapid development of medical information and technology, lifelong learning is critical for safe medical care and development in medical research. JeffSPLL is one of the scales for measuring lifelong learning among the staff of medical sciences that has never been used in Iran. The aim of the present study was to determine the factor structure and reliability of the Persian version of JeffSPLL among Persian-speaking staff of universities of medical sciences in Iran. This study was a cross-sectional study, methodologically, that was conducted in 2012-2013. In this study, 210 staff members of Birjand University of Medical Sciences were selected. Data collection tool was the Persian version of JeffSPLL. To investigate the factor structure of this tool, confirmatory factor analysis was used and to evaluate the model fit, goodness-of-fit indices, root mean square error of approximation (RMSEA), the ratio of chi-square to the degree of freedom associated with it, comparative fit index (CFI), and root mean square residual (RMR) were used. To investigate the reliability of tool, Cronbach's alpha was employed. Data analysis was conducted using LISREL8.8 and SPSS 20 software. Confirmatory factor analysis showed that RMSEA was close to 0.1, and CFI and GFI were close to one. Therefore, four-factor model was appropriate. Cronbach's alpha was 0.92 for the whole tool and it was between 0.82 and 0.89 for subscales. The present study verified the four-factor structure of the 19-item Persian version of JeffSPLL that included professional learning beliefs and motivation, scholarly activities, attention to learning opportunities, and technical skills in information seeking among the staff. In addition, this tool has acceptable reliability. Therefore, it was appropriate to assess lifelong learning in the Persian-speaking staff population.

Motivation and job satisfaction among medical and nursing staff in a Cyprus public general hospital

Directory of Open Access Journals (Sweden)

Kontodimopoulos Nick

2010-11-01

Full Text Available Abstract Background The objective of this study was to investigate how medical and nursing staff of the Nicosia General Hospital is affected by specific motivation factors, and the association between job satisfaction and motivation. Furthermore, to determine the motivational drive of socio-demographic and job related factors in terms of improving work performance. Methods A previously developed and validated instrument addressing four work-related motivators (job attributes, remuneration, co-workers and achievements was used. Two categories of health care professionals, medical doctors and dentists (N = 67 and nurses (N = 219 participated and motivation and job satisfaction was compared across socio-demographic and occupational variables. Results The survey revealed that achievements was ranked first among the four main motivators, followed by remuneration, co-workers and job attributes. The factor remuneration revealed statistically significant differences according to gender, and hospital sector, with female doctors and nurses and accident and emergency (A+E outpatient doctors reporting greater mean scores (p 55 years of age reported higher job satisfaction when compared to the other groups. Conclusions The results are in agreement with the literature which focuses attention to management approaches employing both monetary and non-monetary incentives to motivate health care professionals. Health care professionals tend to be motivated more by intrinsic factors, implying that this should be a target for effective employee motivation. Strategies based on the survey's results to enhance employee motivation are suggested.

A before and after study of medical students' and house staff members' knowledge of ACOVE quality of pharmacologic care standards on an acute care for elders unit.

Science.gov (United States)

Jellinek, Samantha P; Cohen, Victor; Nelson, Marcia; Likourezos, Antonios; Goldman, William; Paris, Barbara

2008-06-01

The Assessing Care of Vulnerable Elders (ACOVE) comprehensive set of quality assessment tools for ill older persons is a standard designed to measure overall care delivered to vulnerable elders (ie, those aged > or =65 years) at the level of a health care system or plan. The goal of this research was to quantify the pretest and posttest results of medical students and house staff participating in a pharmacotherapist-led educational intervention that focused on the ACOVE quality of pharmacologic care standards. This was a before and after study assessing the knowledge ofACOVE standards following exposure to an educational intervention led by a pharmacotherapist. It was conducted at the 29-bed Acute Care for Elders (ACE) unit of Maimonides Medical Center, a 705-bed, independent teaching hospital located in Brooklyn, New York. Participants included all medical students and house staff completing a rotation on the ACE unit from August 2004 through May 2005 who completed both the pre-and posttests. A pharmacotherapist provided a 1-hour active learning session reviewing the evidence supporting the quality indicators and reviewed case-based questions with the medical students and house staff. Educational interventions also occurred daily through pharmacotherapeutic consultations and during work rounds. Medical students and house staff were administered the same 15-question, patient-specific, case-based, multiple-choice pre-and posttest to assess knowledge of the standards before and after receiving the intervention. A total of 54 medical students and house staff (median age, 28.58 years; 40 men, 14 women) completed the study. Significantly higher median scores were achieved on the multiple-choice test after the intervention than before (median scores, 14/15 [93.3%] vs 12/15 [80.0%], respectively; P = 0.001). A pharmacotherapist-led educational intervention improved the scores of medical students and house staff on a test evaluating knowledge of evidence

Possibilities of utilizing blended-learning in the area of language education of medical staff

Directory of Open Access Journals (Sweden)

Radka Šulistová

2014-11-01

Full Text Available This contribution deals with the presentation of teaching materials created within the IMED-KOMM-EU "Intercultural medical communication inEurope" internet project, having taken place under the leadership of the Institute for Intercultural Communication inGermany(Ansbach,Berlin,Jena,Erfurt. Project target was creating, testing, valorisation and permanent extending of the mentioned teaching materials, testing and certification technologies (ECL for intercultural professional communication of foreign physicians and other medical staff. The target groups involving the already practising professionals, as well as students, should be able to utilize the existing possibilities of communication withinEuropeand to perform their professional activity or studies in the languages, in which the materials are elaborated. As a result, five complete courses of blended-learning were created, which are generally easily accessible at mutually connected web sites in Czech, Slovak, German, Bulgarian and Hungarian. Their core are modules orientated on practice with complex exercises online and offline focused on the medical communication, including the manuals for teachers.

Role of Religiosity in Psychological Well-Being Among Medical and Non-medical Students.

Science.gov (United States)

Saleem, Shemaila; Saleem, Tamkeen

2017-08-01

Religion has been generally considered as a protective factor for the psychological health of the people. As many studies have publicized a high prevalence of psychological morbidities among the medical students during their academic stages of medical schools, it is significant to investigate whether religiosity functions as a protective factor, to explore religiosity as a predictor of psychological well-being in a sample of medical students, and to compare the results of medical students as well as non-medical students with respect to religiosity and psychological well-being. The study is carried out in Federal Medical and Dental College and International Islamic University, Islamabad. The present study examined a sample of 120 medical students from Federal Medical and Dental College and 120 non-medical students from International Islamic University, Islamabad. Purposive sampling was used. The respondents completed religious orientation scale and scale of psychological well-being scale along with a demographic data sheet. In order to measure the study variables, linear regression and t test were used. The findings revealed that religiosity is a strong predictor of psychological well-being. Extrinsic and intrinsic religiosity predicts psychological well-being among the students. The results indicated a significant difference in psychological well-being between medical and non-medical students. No significant difference was found in religiosity of medical and non-medical students. The gender differences in religiosity and psychological well-being were found to be insignificant. The results emphasize that psychological well-being is prophesied by religiosity. The present research suggests further investigations and also endows with trends for psychological evaluation, development of religious beliefs, and interventions for augmenting psychological well-being among the medical students.

Pattern of non-communicable diseases among medical admissions ...

African Journals Online (AJOL)

Medical admissions due to non-communicable diseases were carefully selected and analyzed. There were 1853 cases of various non-communicable diseases out of a total medical admission of 3294 constituting 56.2% of total medical admissions. Diseases of the cardiovascular, endocrine and renal systems were the most ...

VOLTTRON-Based System for Providing Ancillary Services with Residential Building Loads

Energy Technology Data Exchange (ETDEWEB)

Jin, Xin

2016-07-01

Ancillary services entail controlled modulation of building equipment to maintain a stable balance of generation and load in the power system. Ancillary services include frequency regulation and contingency reserves, whose acting time ranges from several seconds to several minutes. Many pilot studies have been implemented to use industrial loads to provide ancillary services, and some have explored services from commercial building loads or electric vehicle charging loads. Residential loads, such as space conditioning and water heating, represent a largely untapped resource for providing ancillary services. The residential building sector accounts for a significant fraction of the total electricity use in the United States. Many loads in residential buildings are flexible and could potentially be curtailed or shifted at the request of the grid. However, there are many barriers that prevent residential loads being widely used for ancillary services. One of the major technical barriers is the lack of communication capabilities between end-use devices and the grid. End-use devices need to be able to receive the automatic generation control (AGC) signal from the grid operator and supply certain types of telemetry to verify response. With the advance of consumer electronics, communication-enabled, or 'connected,' residential equipment has emerged to overcome the communication barrier. However, these end-use devices have introduced a new interoperability challenge due to the existence of numerous standards and communication protocols among different end devices. In this paper, we present a VOLTTRON-based system that overcomes these technical challenges and provides ancillary services with residential loads. VOLTTRON is an open-source control and sensing platform for building energy management, facilitating interoperability solutions for end devices. We have developed drivers to communicate and control different types of end devices through standard

78 FR 102 - Guidance for Industry and Food and Drug Administration Staff; eCopy Program for Medical Device...

Science.gov (United States)

2013-01-02

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-D-1056] Guidance for Industry and Food and Drug Administration Staff; eCopy Program for Medical Device Submissions; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug...

77 FR 63837 - Draft Guidance for Industry and Food and Drug Administration Staff; eCopy Program for Medical...

Science.gov (United States)

2012-10-17

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2012-D-1056] Draft Guidance for Industry and Food and Drug Administration Staff; eCopy Program for Medical Device Submissions; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and...

[Association between occupational stress and presenteeism among medical staff at grade A tertiary hospitals in Shanghai, China].

Science.gov (United States)

Dai, Junming; Hua, Yujie; Zhang, Hao; Huang, Li; Fu, Hua

2015-10-01

To investigate the current status of occupational stress and presenteeism among medical staff at grade A tertiary hospitals in Shanghai, China, and to analyze the association between occupational stress and presenteeism. A total of 2356 healthcare workers from eight grade A tertiary hospitals in Shanghai were investigated by stratified random sampling. All the subjects were asked to complete self-administered questionnaires with informed consent. The occupational stress was assessed by the occupational stress core questionnaire. The presenteeism was evaluated by the Stanford Presenteeism Scale. In all subjects, the average score of presenteeism was 15.23 ± 3.89, and 72.5% felt occupational stress in self-evaluation. There were significant differences in the score of presenteeism between subjects with different ages, education levels, occupations, lengths of service, job titles, and shifts (all Poccupational stress, including job demand, control, social support, and demand-control ratio (Poccupational stress in medical staff from grade A tertiary hospitals is positively correlated with the level of presenteeism. It is important to promote social support to reduce the loss of work efficiency due to presenteeism.

Exposure doses of the patient and the medical staff during urological X-ray examens

International Nuclear Information System (INIS)

Vogel, H.; Loehr, H.; Haug, P.; Schuett, B.

1977-01-01

During 32 intravenous urografies and 48 angiografies of the kidney and the suprarenal glands the X-ray doses at the patient's skin and gonades were determined. During the angiografies the doses were mesured at the hands. the gonades and the front (eyes) of the medical staff. The results are discussed. Because the X-ray doses are relatively high, the number of the pictures and the exposure time is to be reduced to the minimum. Clinical experience and special knowledge is the best X-ray protection. (orig.) [de

The Use of Communication Apps by Medical Staff in the Australian Health Care System: Survey Study on Prevalence and Use.

Science.gov (United States)

Nikolic, Amanda; Wickramasinghe, Nilmini; Claydon-Platt, Damian; Balakrishnan, Vikram; Smart, Philip

2018-02-09

The use of communication apps on mobile phones offers an efficient, unobtrusive, and portable mode of communication for medical staff. The potential enhancements in patient care and education appear significant, with clinical details able to be shared quickly within multidisciplinary teams, supporting rapid integration of disparate information, and more efficient patient care. However, sharing patient data in this way also raises legal and ethical issues. No data is currently available demonstrating how widespread the use of these apps are, doctor's attitudes towards them, or what guides clinician choice of app. The objective of this study was to quantify and qualify the use of communication apps among medical staff in clinical situations, their role in patient care, and knowledge and attitudes towards safety, key benefits, potential disadvantages, and policy implications. Medical staff in hospitals across Victoria (Australia) were invited to participate in an anonymous 33-question survey. The survey collected data on respondent's demographics, their use of communication apps in clinical settings, attitudes towards communication apps, perceptions of data "safety," and why one communication app was chosen over others. Communication apps in Victorian hospitals are in widespread use from students to consultants, with WhatsApp being the primary app used. The median number of messages shared per day was 12, encompassing a range of patient information. All respondents viewed these apps positively in quickly communicating patient information in a clinical setting; however, all had concerns about the privacy implications arising from sharing patient information in this way. In total, 67% (60/90) considered patient data "moderately safe" on these apps, and 50% (46/90) were concerned the use of these apps was inconsistent with current legislation and policy. Apps were more likely to be used if they were fast, easy to use, had an easy login process, and were already in

Removal Action Workplan for the 105-DR and 105-F Building Interim Safe Storage Projects and Ancillary Buildings

International Nuclear Information System (INIS)

Rodovsky, T. J.

1999-01-01

This document is the removal action workplan (RAW) for the 105-DR and 105-F Reactor Buildings and ancillary facilities. These buildings and facilities are located in the 100-D/DR and 100-F Areas of the Hanford Site in Benton County, Washington, which is owned and operated by the U.S. Department of Energy (DOE). The 100 Areas (including 100-D/DR and 100-F Areas) of the Hanford Site were placed on the U.S. Environmental Protection Agency's (EPA) National Priorities List under the Comprehensive Environmental Response, Compensation,and Liability Act of 1980 (CERCLA). DOE has determined that hazardous substances in the 105-DR and 105-F Reactor Buildings and four ancillary facilities present a potential threat to human health or the environment DOE has also determined that a non-time critical removal action is warranted at these facilities

Greater gains from smoke-free legislation for non-smoking bar staff in Belfast.

Science.gov (United States)

Bannon, Finian; Devlin, Anne; McElwee, Gerry; Gavin, Anna

2009-12-01

In April 2007, smoke-free legislation was enacted in workplaces throughout N. Ireland. The effects of this legislation on bar workers' health and their exposure to second-hand smoke at home, work and social environment, and their attitudes to the legislation before and after its implementation remain to be documented. A self-completed questionnaire of bar staff in 35 Belfast bars, before (March 2007, n = 110) and after the legislation (July 2007, n = 110). Smokers (excluding 'social smokers') made up 41.6% of respondents. After the introduction of the smoke-free legislation, the reductions in the proportion of bar workers reporting various respiratory symptoms ranged from 1.3% to 18.6% for smokers and from 21.9% to 33.2% for non-smokers. Likewise, the reductions for various sensory symptoms ranged from 7.3% to 17.7% for smokers and from 29.6% to 46.8% for non-smokers. Reduction in wheeze, cough and throat symptoms after the legislation were much greater for non-smokers than smokers. The proportion of bar staff who reported satisfaction with the legislation remained unchanged across the surveys. Decreases in perceived exposure to second-hand smoke occurred at work, home and in social settings. After the legislation's enactment, a majority of bar workers felt the workplace was healthier (98%). These first findings show reduced reported symptoms among bar workers, both smokers and non-smokers, after the introduction of smoke-free legislation in N. Ireland, though greater among non-smokers. There was also a reported fall in the hours of second-hand smoke exposure in the home for this group of workers which has a high prevalence of smokers.

Exogam with Vamos, Tiara and other ancillary detectors

International Nuclear Information System (INIS)

Lewitowicz, M.; Olivier, L.; Savajols, H.; Catford, W.; Raine, B.; Oliveira, F. de; Perru, O.; Podolyak, Z.; Redon, N.; Bouchez, E.; Simenel, C.; Stanoiu, M.; Lemmon, R.; Rubio, B.; Obertelli, A.; Cederwall, B.; Chapman, R.; Korten, W.; Rubio Barroso, B.

2003-01-01

The aim of this workshop was to discuss the status of experiments at GANIL facility using Exogam with Vamos, Tiara and other ancillary detectors. This document gathers most of the slides that were presented at the workshop, it concerns 8 presentations: 1) the status of Spiral and Spiral-II, 2) the status of Tiara (Tiara array is used for the study of nuclear transfer reactions with radioactive beams in inverse kinematics), 3) data acquisition for the ancillary detectors, 4) the identification of gamma-ray in nuclei around Sm 130 : probing the maximally deformed light rare earth region, 5) the Coulomb excitation of radioactive krypton beams (Kr 76 , Kr 74 ), 6) the influence of weakly bound neutrons on fusion around the Coulomb barrier, 7) single particle transfer on doubly-magic Ni 56 , and 8) the study of N=16 for neutron rich nuclei with Ne 26 (d,p)Ne 27 transfer reaction

Power system studies of new ancillary services

DEFF Research Database (Denmark)

Hansen, Anca Daniela; Altin, Müfit

The objective of this report is to illustrate and analyse, by means of simulation test cases, the impact of wind power advanced ancillary services, like inertial response (IR), power oscillation damping (POD) and synchronising power (SP) on the power system. Generic models for wind turbine, wind...... power plant and power system are used in the investigation....

DELIRIUM RELATED DISTRESS EXPERIENCED BY PATIENTS, CAREGIVERS AND NURSING STAFF IN A MEDICAL INTENSIVE CARE UNIT (ICU

Directory of Open Access Journals (Sweden)

Ayush Kumar Jayaswal

2018-03-01

Full Text Available BACKGROUND Delirium, a common neuropsychiatric syndrome in intensive care settings is a distressing experience for the patient, caregivers and nursing staff. Research on delirium experience has been scant and unsystematic. We set out to explore the extent of recall of delirium, differential distress it had on patients, caregivers and nursing staff and the extent to which it impacted recognition across the motoric subtypes. MATERIALS AND METHODS A prospective study was carried out on all consecutively admitted patients in the medical ICU of a tertiary care teaching hospital. Patients diagnosed with delirium using Confusion Assessment Method for ICU (CAM-ICU were administered the Richmond Agitation Sedation Scale (RASS for differentiating the motor subtypes (hypoactive, hyperactive, mixed. Distress was assessed using the Delirium Experience Questionnaire (DEQ. RESULTS Of the 88 patients (31.43% who developed delirium, 60.2% recalled their experience. Recall was highest in the hyperactive subtype. 76% of patients, 94.3% of caregivers and 31.8% of nursing staff reported severe levels of distress. Motoric subtypes did not impact on the distress levels experienced by the patients or their caregivers, but influenced it significantly in the nursing staff (highest in hyperactive, least in hypoactive. Identification of delirium by nursing staff (13.4% was significantly influenced by the motor subtypes (highest in hyperactive, least in hypoactive. Linear regression analysis revealed that distress of ICU staff (F=1.36, p=0.018 and not the motoric subtypes (F=1.36, p=0.262 significantly predicted recognition of delirium. CONCLUSIONS Most patients who develop delirium and their caregivers experience high levels of distress. Under-recognition is significantly influenced by the distress it causes the ICU staff than the motor subtype of delirium.

Radiant Ceiling Panels Combined with Localized Methods for Improved Thermal Comfort of Both Patient and Medical Staff in Patient Room

DEFF Research Database (Denmark)

Mori, Sakura; Barova, Mariya; Bolashikov, Zhecho Dimitrov

2012-01-01

The objectives were to identify whether ceiling installed radiant heating panels can provide thermal comfort to the occupants in a patient room, and to determine a method for optimal thermal environment to both patient and medical staff simultaneously. The experiments were performed in a climate...... mattress were used to provide local heating for the patient. The effects of the methods were identified by comparing the manikin based equivalent temperatures. The optimal thermal comfort level for both patient and medical staff would obtained when two conventional cotton blankets were used with extra...... chamber resembling a single-bed patient room under convective air conditioning alone or combined with the ceiling installed radiant heating panels. Two thermal manikins simulated a patient lying in the bed and a doctor standing next to the patient. Conventional cotton blanket, electric blanket, electric...

Initial Management of Poisoned Patients in Emergency Medical Services and Non-poisoning Hospitals in Tehran: The Comparison between Expected and Performed Managements

Directory of Open Access Journals (Sweden)

Hossein Hassanian-Moghadam

2014-06-01

Full Text Available Background: There is no clear data on the adherence of emergency medical services (EMS paramedics and hospital staff rather than those working in poisoning centers to the guidelines for managing acutely poisoned patients in developing countries. Methods: During a 6-month period, all EMS-managed poisoned patients along with those initially managed in a non-poisoning center before being referred to a poisoning hospital in Tehran, Iran, were instructed. Then the indications for administrating the activated charcoal (AC as well as performing gastric lavage (GL and tracheal intubation were studied and compared to the recommended guidelines. Results: A total of 3347 cases, including 1859 males (55.6%, were evaluated. There were significant differences between expected and performed endotracheal intubations in both EMS and other medical centers (P-value = 0.002 and 0.001, respectively as well as the administration of GL and AC in other medical centers (P-values= 0.003 and 0.03, respectively. Conclusion: More extensive educational programs should be established to improve the preliminary management of poisoned patients performed by EMS paramedics and staff of hospitals other than poisoning centers.

Training and Practices of Cannabis Dispensary Staff.

Science.gov (United States)

Haug, Nancy A; Kieschnick, Dustin; Sottile, James E; Babson, Kimberly A; Vandrey, Ryan; Bonn-Miller, Marcel O

2016-01-01

Introduction: The proliferation of cannabis dispensaries within the United States has emerged from patient demand for the legalization of cannabis as an alternative treatment for a number of conditions and symptoms. Unfortunately, nothing is known about the practices of dispensary staff with respect to recommendation of cannabis strains/concentrations for specific patient ailments. To address this limitation, the present study assessed the training and practices of cannabis dispensary staff. Materials and Methods: Medical and nonmedical dispensary staff ( n =55) were recruited via e-mail and social media to complete an online survey assessing their demographic characteristics, dispensary features, patient characteristics, formal training, and cannabis recommendation practices. Results: Fifty-five percent of dispensary staff reported some formal training for their position, with 20% reporting medical/scientific training. A majority (94%) indicated that they provide specific cannabis advice to patients. In terms of strains, dispensary staff trended toward recommendations of Indica for anxiety, chronic pain, insomnia, nightmares, and Tourette's syndrome. They were more likely to recommend Indica and hybrid plants for post-traumatic stress disorder (PTSD)/trauma and muscle spasms. In contrast, staff were less likely to recommend Indica for depression; hybrid strains were most often recommended for amyotrophic lateral sclerosis (ALS). In terms of cannabinoid concentrations, dispensary staff were most likely to recommend a 1:1 ratio of delta-9-tetrahydrocannabinol (THC):cannabidiol (CBD) for patients suffering from anxiety, Crohn's disease, hepatitis C, and PTSD/trauma, while patients seeking appetite stimulation were most likely to be recommended THC. Staff recommended high CBD for arthritis and Alzheimer's disease and a high CBD or 1:1 ratio for ALS, epilepsy, and muscle spasms. Conclusions: Although many dispensary staff are making recommendations consistent with

Pattern of leisure-time physical activity involvement of Academic and non-Academic staff in tertiary Institutions in Ondo State, Nigeria

OpenAIRE

Ajibua M.A.; Alla J.B

2012-01-01

Leisure signifies individual’s choice to spend his/her discretionary time fulfilling certain interest or needs or performing a gratifying experience for the sake of wellness or personal development. The aim of this study was to look into the pattern of leisure-time physical activity involvement among academic and non-academic staff in tertiary institution in Ondo State. For the purpose of the study, 40 academic and 40 non-academic staff were selected from the five Government-owned tertiary in...

Medical Decision-Making Processes and Online Behaviors Among Cannabis Dispensary Staff

Directory of Open Access Journals (Sweden)

Nicholas C Peiper

2017-08-01

Full Text Available Background: Most cannabis patients engage with dispensary staff, like budtenders, for medical advice on cannabis. Yet, little is known about these interactions and how the characteristics of budtenders affect these interactions. This study investigated demographics, workplace characteristics, medical decision-making, and online behaviors among a sample of budtenders. Methods: Between June and September 2016, a cross-sectional Internet survey was administered to budtenders in the San Francisco Bay Area and Greater Los Angeles. A total of 158 budtenders fully responded to the survey. A series of comparisons were conducted to determine differences between trained and untrained budtenders. Results: Among the 158 budtenders, 56% had received formal training to become a budtender. Several demographic differences were found between trained and untrained budtenders. For workplace characteristics, trained budtenders were more likely to report budtender as their primary job (74% vs 53%, practice more than 5 years (34% vs 11%, and receive sales commission (57% vs 16%. Trained budtenders were significantly less likely to perceive medical decision-making as very important (47% vs 68% and have a patient-centered philosophy (77% vs 89%. Although trained budtenders had significantly lower Internet usage, they were significantly more likely to exchange information with patients through e-mail (58% vs 39%, text message (46% vs 30%, mobile app (33% vs 11%, video call (26% vs 3%, and social media (51% vs 23%. Conclusions: Budtenders who are formally trained exhibit significantly different patterns of interaction with medical cannabis patients. Future studies will use multivariate methods to better determine which factors independently influence interactions and how budtenders operate after the introduction of regulations under the newly passed Proposition 64 that permits recreational cannabis use in California.

Ethical analysis of non-medical fetal ultrasound.

Science.gov (United States)

Leung, John Lai Yin; Pang, Samantha Mei Che

2009-09-01

Obstetric ultrasound is the well-recognized prenatal test used to visualize and determine the condition of a pregnant woman and her fetus. Apart from the clinical application, some businesses have started promoting the use of fetal ultrasound machines for nonmedical reasons. Non-medical fetal ultrasound (also known as 'keepsake' ultrasound) is defined as using ultrasound to view, take a picture, or determine the sex of a fetus without a medical indication. Notwithstanding the guidelines and warnings regarding ultrasound safety issued by governments and professional bodies, the absence of scientifically proven physical harm to fetuses from this procedure seems to provide these businesses with grounds for rapid expansion. However, this argument is too simplistic because current epidemiological evidence is not synchronous with advancing ultrasound technology. As non-medical fetal ultrasound has aroused very significant public attention, a thorough ethical analysis of this topic is essential. Using a multifaceted approach, we analyse the ethical perspective of non-medical fetal ultrasound in terms of the expectant mother, the fetus and health professionals. After applying four major theories of ethics and principles (the precautionary principle; theories of consequentialism and impartiality; duty-based theory; and rights-based theories), we conclude that obstetric ultrasound practice is ethically justifiable only if the indication for its use is based on medical evidence. Non-medical fetal ultrasound can be considered ethically unjustifiable. Nevertheless, the ethical analysis of this issue is time dependent owing to rapid advancements in ultrasound technology and the safety issue. The role of health professionals in ensuring that obstetric ultrasound is an ethically justifiable practice is also discussed.

"Will they just pack up and leave?" – attitudes and intended behaviour of hospital health care workers during an influenza pandemic

Directory of Open Access Journals (Sweden)

Po Kieren

2009-02-01

Full Text Available Abstract Background There is a general consensus that another influenza pandemic is inevitable. Although health care workers (HCWs are essential to the health system response, there are few studies exploring HCW attitudes to pandemic influenza. The aim of this study was to explore HCWs knowledge, attitudes and intended behaviour towards pandemic influenza. Methods Cross-sectional investigation of a convenience sample of clinical and non-clinical HCWs from two tertiary-referral teaching hospitals in Sydney, Australia was conducted between June 4 and October 19, 2007. The self-administered questionnaire was distributed to hospital personal from 40 different wards and departments. The main outcome measures were intentions regarding work attendance and quarantine, antiviral use and perceived preparation. Results Respondents were categorized into four main groups by occupation: Nursing (47.5%, Medical (26.0%, Allied (15.3% and Ancillary (11.2%. Our study found that most HCWs perceived pandemic influenza to be very serious (80.9%, n = 873 but less than half were able to correctly define it (43.9%, n = 473. Only 24.8% of respondents believed their department to be prepared for a pandemic, but nonetheless most were willing to work during a pandemic if a patient or colleague had influenza. The main determinants of variation in our study were occupational factors, demographics and health beliefs. Non-clinical staff were significantly most likely to be unsure of their intentions (OR 1.43, p Conclusion We identified two issues that could undermine the best of pandemic plans – the first, a low level of confidence in antivirals as an effective measure; secondly, that non-clinical workers are an overlooked group whose lack of knowledge and awareness could undermine pandemic plans. Other issues included a high level of confidence in dietary measures to protect against influenza, and a belief among ancillary workers that antibiotics would be protective. All

Toxic effects of formalin-treated cadaver on medical students, staff ...

African Journals Online (AJOL)

Noha Selim Mohamed Elshaer

2017-01-02

Jan 2, 2017 ... Formalin-exposed staff reported symptoms of skin disorders as drying (75%), ..... rent research, 6.2% of the formalin-exposed staff had abnormal ..... Khaliq F, Tripathi P. Acute effects of formalin on pulmonary functions in gross.

The Use of Communication Apps by Medical Staff in the Australian Health Care System: Survey Study on Prevalence and Use

Science.gov (United States)

Wickramasinghe, Nilmini; Claydon-Platt, Damian; Balakrishnan, Vikram; Smart, Philip

2018-01-01

Background The use of communication apps on mobile phones offers an efficient, unobtrusive, and portable mode of communication for medical staff. The potential enhancements in patient care and education appear significant, with clinical details able to be shared quickly within multidisciplinary teams, supporting rapid integration of disparate information, and more efficient patient care. However, sharing patient data in this way also raises legal and ethical issues. No data is currently available demonstrating how widespread the use of these apps are, doctor’s attitudes towards them, or what guides clinician choice of app. Objective The objective of this study was to quantify and qualify the use of communication apps among medical staff in clinical situations, their role in patient care, and knowledge and attitudes towards safety, key benefits, potential disadvantages, and policy implications. Methods Medical staff in hospitals across Victoria (Australia) were invited to participate in an anonymous 33-question survey. The survey collected data on respondent’s demographics, their use of communication apps in clinical settings, attitudes towards communication apps, perceptions of data “safety,” and why one communication app was chosen over others. Results Communication apps in Victorian hospitals are in widespread use from students to consultants, with WhatsApp being the primary app used. The median number of messages shared per day was 12, encompassing a range of patient information. All respondents viewed these apps positively in quickly communicating patient information in a clinical setting; however, all had concerns about the privacy implications arising from sharing patient information in this way. In total, 67% (60/90) considered patient data “moderately safe” on these apps, and 50% (46/90) were concerned the use of these apps was inconsistent with current legislation and policy. Apps were more likely to be used if they were fast, easy to use, had

The Relation between Perceived Organizational Justice and Job Satisfaction among the Staff of Birjand University of Medical Sciences

Directory of Open Access Journals (Sweden)

Yahya Mohammadi

2017-01-01

Full Text Available Background: Perceived organizational justice refers to the staffs' feelings and perceptions concerning the justice and equity in behaviors and working relations. The aim of this study was to investigate the relation between perceived organizational justice and job satisfaction. Methods: This descriptive analytical study was conducted in 2015 in Birjand University of Medical Sciences. The population included all the staff of Birjand University of Medical Sciences. A total of 205 individuals were selected using stratified random sampling method. To collect the data, Niehoff and Moorman’s Organizational Justice Questionnaire (1993 and Kendall Smith Job Satisfaction (1969 were used. The collected data were analyzed in SPSS 16 using Pearson correlation test. Results: In this study, 83 people (40.5 % were male and 122 of them (59.5 % were female. The results showed that organizational justice and its dimensions (distributive, procedural, and interactive justice were significantly correlated with job satisfaction (p < 0.05. Conclusion: According to the results, considering perceived organizational justice by academic leaders can lead to improve employees' job satisfaction.

Comparison research on stakeholders analysis of disposition of medical dispute between China and abroad

Directory of Open Access Journals (Sweden)

Qin Chen

2015-01-01

Full Text Available Objective: We learn about the methods, process, effects of each stakeholder and the principles of the disposition of medical dispute home and abroad through stakeholder analysis. Methods: We investigate the methods, process and the principles of the disposition of medical dispute home and abroad by literature retrieval, key informant interview and depth interview. Results: The stakeholders of medical disputes mainly include patients and families, medical staff and hospitals, pharmaceutical companies, governments, laws, non-government organizations and media. They play different roles in medical disputes and have different effects. Over all, patients and families, medical staff and hospitals have the greatest effect and then laws, media, government, non-government organizations and pharmaceutical companies. Conclusion: Different stakeholders affect the disposition of medical disputes differently. It is crucial to establish harmonious relationship between patients and doctors and to build harmonious society by untangling the responsibility between all the stakeholders and dispose medical disputes quickly and effectively.

Improving the non-technical skills of hospital medical emergency teams: The Team Emergency Assessment Measure (TEAM™).

Science.gov (United States)

Cant, Robyn P; Porter, Joanne E; Cooper, Simon J; Roberts, Kate; Wilson, Ian; Gartside, Christopher

2016-12-01

This prospective descriptive study aimed to test the validity and feasibility of the Team Emergency Assessment Measure (TEAM™) for assessing real-world medical emergency teams' non-technical skills. Second, the present study aimed to explore the instrument's contribution to practice regarding teamwork and learning outcomes. Registered nurses (RNs) and medical staff (n = 104) in two hospital EDs in rural Victoria, Australia, participated. Over a 10 month period, the (TEAM™) instrument was completed by multiple clinicians at medical emergency episodes. In 80 real-world medical emergency team resuscitation episodes (283 clinician assessments), non-technical skills ratings averaged 89% per episode (39 of a possible 44 points). Twenty-one episodes were rated in the lowest quartile (i.e. ≤37 points out of 44). Ratings differed by discipline, with significantly higher scores given by medical raters (mean: 41.1 ± 4.4) than RNs (38.7 ± 5.4) (P = 0.001). This difference occurred in the Leadership domain. The tool was reliable with Cronbach's alpha 0.78, high uni-dimensional validity and mean inter-item correlation of 0.45. Concurrent validity was confirmed by strong correlation between TEAM™ score and the awarded Global Rating (P technical skills of medical emergency teams are known to often be suboptimal; however, average ratings of 89% were achieved in this real-world study. TEAM™ is a valid, reliable and easy to use tool, for both training and clinical settings, with benefits for team performance when used as an assessment and/or debriefing tool. © 2016 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Implementation and Evaluation of a Pilot Training to Improve Transgender Competency Among Medical Staff in an Urban Clinic.

Science.gov (United States)

Lelutiu-Weinberger, Corina; Pollard-Thomas, Paula; Pagano, William; Levitt, Nathan; Lopez, Evelyn I; Golub, Sarit A; Radix, Asa E

2016-01-01

Purpose: Transgender individuals (TGI), who identify their gender as different from their sex assigned at birth, continue facing widespread discrimination and mistreatment within the healthcare system. Providers often lack expertise in adequate transgender (TG) care due to limited specialized training. In response to these inadequacies, and to increase evidence-based interventions effecting TG-affirmative healthcare, we implemented and evaluated a structural-level intervention in the form of a comprehensive Provider Training Program (PTP) in TG health within a New York City-based outpatient clinic serving primarily individuals of color and of low socioeconomic status. This pilot intervention aimed to increase medical staff knowledge of TG health and needs, and to support positive attitudes toward TGI. Methods: Three 2-h training sessions were delivered to 35 clinic staff across 4 months by two of the authors experienced in TG competency training; the training sessions included TG-related identity and barriers to healthcare issues, TG-specialized care, and creating TG-affirmative environments, medical forms, and billing procedures. We evaluated changes through pre-post intervention surveys by trainees. Results: Compared to pre-training scores, post-training scores indicated significant (1) decreases in negative attitudes toward TGI and increases in TG-related clinical skills, (2) increases in staff's awareness of transphobic practices, and (3) increases in self-reported readiness to serve TGI. The clinic increased its representation of general LGBT-related images in the waiting areas, and the staff provided highly positive training evaluations. Conclusion: This PTP in TG health shows promise in leading to changes in provider attitudes and competence, as well as clinic systems, especially with its incorporation in continuing education endeavors, which can, in turn, contribute to health disparities reductions among TG groups.

Predictors of medication non-adherence for vasculitis patients

Science.gov (United States)

Hogan, Susan L.; DeVellis, Robert F.

2013-01-01

The primary purpose of this article is to document whether demographic, clinical, regimen-related, intrapersonal, and interpersonal factors predict medication non-adherence for vasculitis patients. A secondary purpose is to explore whether adherence varies by medication type and whether patients experienced drug-related side effects. Vasculitis patients (n=228) completed online baseline and 3-month follow-up surveys. Demographic (age, gender, education, race, marital status, and insurance status), clinical (perceived vasculitis severity, disease duration, vasculitis type, and relapse/remission status), regimen-related (experience of side effects), intrapersonal (depressive symptoms), and interpersonal (adherence-related support from family and friends) factors were measured at baseline. Medication non-adherence was assessed at follow-up using the Vasculitis Self-Management Survey medication adherence sub-scale (α=0.89). Variables that significantly correlated (pvasculitis medication types, patients who experienced side effects were less adherent than patients who did not experience side effects. Multiple factors are associated with medication non-adherence for vasculitis patients. Providers should discuss medication adherence and drug-related side effects with vasculitis patients. Providers may want to particularly target younger patients and patients with clinical signs of depression. PMID:23314654

Capabilities and costs for ancillary services provision by wind power plants. Deliverable D 3.1

DEFF Research Database (Denmark)

Faiella, Mariano; Hennig, Tobias; Cutululis, Nicolaos Antonio

This report is the deliverable of the third work package of the REserviceS project and describes the technical options and related costs for the provision of ancillary services specifically from wind energy technologies. It is focused on the set of ancillary services defined in the previous work...

Patients' Non-Medical Characteristics Contribute to Collective Medical Decision-Making at Multidisciplinary Oncological Team Meetings.

Science.gov (United States)

Restivo, Léa; Apostolidis, Thémis; Bouhnik, Anne-Déborah; Garciaz, Sylvain; Aurran, Thérèse; Julian-Reynier, Claire

2016-01-01

The contribution of patients' non-medical characteristics to individual physicians' decision-making has attracted considerable attention, but little information is available on this topic in the context of collective decision-making. Medical decision-making at cancer centres is currently carried out using a collective approach, at MultiDisciplinary Team (MDT) meetings. The aim of this study was to determine how patients' non-medical characteristics are presented at MDT meetings and how this information may affect the team's final medical decisions. Observations were conducted at a French Cancer Centre during MDT meetings at which non-standard cases involving some uncertainty were discussed from March to May 2014. Physicians' verbal statements and predefined contextual parameters were collected with a non-participant observational approach. Non numerical data collected in the form of open notes were then coded for quantitative analysis. Univariate and multivariate statistical analyses were performed. In the final sample of patients' records included and discussed (N = 290), non-medical characteristics were mentioned in 32.8% (n = 95) of the cases. These characteristics corresponded to demographics in 22.8% (n = 66) of the cases, psychological data in 11.7% (n = 34), and relational data in 6.2% (n = 18). The patient's age and his/her "likeability" were the most frequently mentioned characteristics. In 17.9% of the cases discussed, the final decision was deferred: this outcome was positively associated with the patients' non-medical characteristics and with uncertainty about the outcome of the therapeutic options available. The design of the study made it difficult to draw definite cause-and-effect conclusions. The Social Representations approach suggests that patients' non-medical characteristics constitute a kind of tacit professional knowledge that may be frequently mobilised in physicians' everyday professional practice. The links observed between patients

Technical and economic aspects of ancillary services markets in the electric power industry: an international comparison

International Nuclear Information System (INIS)

Raineri, R.; Rios, S.; Schiele, D.

2006-01-01

We present a comparative analysis of technical and economic aspects of ancillary services on the markets of England and Wales, Nordic Countries, California, Argentina, Australia and Spain, comparing the services of voltage control, frequency regulation and system restoration. All the analyzed markets rely on the existence of an administrator of ancillary services, function that leads to the figure of the system operator. Among the services analyzed, the mandatory nature of voltage control and primary frequency regulation stands out, being both the ancillary services with the higher market price and the shortest period of time requirements. In general, the recognized costs of the services correspond to investments operation, maintenance, and opportunity costs. In the provision of these ancillary services, there are no clear preferences for a particular resource allocation mechanism, where mandatory provision, auctions, competitive offers and different time length bilateral contracts are combined

Is 'gut feeling' by medical staff better than validated scores in estimation of mortality in a medical intensive care unit? - The prospective FEELING-ON-ICU study.

Science.gov (United States)

Radtke, Anne; Pfister, Roman; Kuhr, Kathrin; Kochanek, Matthias; Michels, Guido

2017-10-01

The aim of the FEELING-ON-ICU study was to compare mortality estimations of critically ill patients based on 'gut feeling' of medical staff and by Acute Physiology And Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) II and Sequential Organ Failure Assessment (SOFA). Medical staff estimated patients' mortality risks via questionnaires. APACHE II, SAPS II and SOFA were calculated retrospectively from records. Estimations were compared with actual in-hospital mortality using receiver operating characteristic (ROC) curves and the area under the ROC curve (AUC). 66 critically ill patients (60.6% male, mean age 63±15years (range 30-86)) were evaluated each by a nurse (n=66, male 32.4%) and a physician (n=66, male 67.6%). 15 (22.7%) patients died on the intensive care unit. AUC was largest for estimations by physicians (AUC 0.814 (95% CI 0.705-0.923)), followed by SOFA (AUC 0.749 (95% CI 0.629-0.868)), SAPS II (AUC 0.723 (95% CI 0.597-0.849)), APACHE II (AUC 0.721 (95% CI 0.595-0.847)) and nursing staff (AUC 0.669 (95% CI 0.529-0.810)) (p<0.05 for all results). The concept of physicians' 'gut feeling' was comparable to classical objective scores in mortality estimations of critically ill patients. Concerning practicability physicians' evaluations were advantageous to complex score calculation. Copyright © 2017 Elsevier Inc. All rights reserved.

Outbreak of Mysterious Illness Among Hospital Staff

DEFF Research Database (Denmark)

Jacobsen, Peter; Ebbehøj, Niels Erik

2016-01-01

BACKGROUND: Hospitals are rarely reported as settings for mass psychogenic illness (MPI). The present report scrutinizes an outbreak of probable MPI among hospital staff, with medical intervention reinforcing the course of the illness. CASE REPORT: Four of seven staff members in an emergency...

Does non-medical prescribing make a difference to patients?

Science.gov (United States)

Carey, Nicola; Stenner, Karen

This article examines the literature on non-medical prescribing to establish its impact on UK healthcare. It discusses how better access to medication through non-medical prescribing can improve patient safety and patient-centred care, and how nurse prescribing can help ensure quality of care in the NHS during the current financial crisis.

Attitude of staff of Kashan university of medical sciences concerning their annual performance

Directory of Open Access Journals (Sweden)

Seyed Ahmad Hosseini Golafshani

2018-01-01

Full Text Available Background: Performance assessment in organizations can lead to healthy relationships in the workplace, and it also pays grounds for intellectual growth and improvement of staff performance. This study examines the attitudes of Staff of Kashan University of Medical Sciences and Health Services about their annual performance. Materials and Methods: In this descriptive study, 714 staff were randomly selected. The data of this study were collected by a questionnaire, whose validity and credit were tested. Then, in two stages, samples of 52 and 56 persons were taken and by two-half method and calculating the homogeneity coefficient and the Cronbach's coefficient alpha and Kuder-Richardson coefficients in the second step get to the Cronbach's coefficient alpha 93% that final validity was acceptable. The collected data were analyzed using the SPSS Inc. Released 2007. SPSS for Windows, Version 16.0. (Chicago, SPSS Inc.. Results: The results of this study showed that the mean and standard deviation of age of the employees were 37.16 ± 7.1 years and their working history was 12.4 ± 7.7 years. A total of 256 participants (35.8% considered the current evaluation as inappropriate or completely inappropriate performance assessment, 303 participants (42.4% almost appropriate, 155 participants (21.7% suitable or perfectly suitable. About 47.9% of participants rated the best period of evaluation yearly, and 552 participants (77.3% of the statistical society were considered assessment in the presence of the employee appropriate. Conclusion: The results of this study indicate that the attitude of more than 50% of employees was positive about the annual performance assessment.

Application of microgrids in providing ancillary services to the utility grid

International Nuclear Information System (INIS)

Majzoobi, Alireza; Khodaei, Amin

2017-01-01

A microgrid optimal scheduling model is developed in this paper to demonstrate microgrid's capability in offering ancillary services to the utility grid. The application of localized ancillary services is of significant importance to grid operators as the growing proliferation of distributed renewable energy resources, mainly solar generation, is causing major technical challenges in supply-load balance. The proposed microgrid optimal scheduling model coordinates the microgrid net load with the aggregated consumers/prosumers net load in its connected distribution feeder to capture both inter-hour and intra-hour net load variations. In particular, net load variations for three various time resolutions are considered, including hourly ramping, 10-min based load following, and 1-min based frequency regulation. Numerical simulations on a test distribution feeder with one microgrid and several consumers/prosumers indicate the effectiveness of the proposed model and the viability of the microgrid application in supporting grid operation. - Highlights: • Microgrid optimal scheduling for providing ancillary services to the utility grid. • Local management and mitigation of distribution net load variations. • Offering various support services: ramping, load following, frequency regulation. • Proven effectiveness and accuracy in capturing net load variations.

Effectiveness of an e-Learning Platform for Image Interpretation Education of Medical Staff and Students.

Science.gov (United States)

Ogura, Akio; Hayashi, Norio; Negishi, Tohru; Watanabe, Haruyuki

2018-05-09

Medical staff must be able to perform accurate initial interpretations of radiography to prevent diagnostic errors. Education in medical image interpretation is an ongoing need that is addressed by text-based and e-learning platforms. The effectiveness of these methods has been previously reported. Here, we describe the effectiveness of an e-learning platform used for medical image interpretation education. Ten third-year medical students without previous experience in chest radiography interpretation were provided with e-learning instructions. Accuracy of diagnosis using chest radiography was provided before and after e-learning education. We measured detection accuracy for two image groups: nodular shadow and ground-glass shadow. We also distributed the e-learning system to the two groups and analyzed the effectiveness of education for both types of image shadow. The mean correct answer rate after the 2-week e-learning period increased from 34.5 to 72.7%. Diagnosis of the ground glass shadow improved significantly more than that of the mass shadow. Education using the e-leaning platform is effective for interpretation of chest radiography results. E-learning is particularly effective for the interpretation of chest radiography images containing ground glass shadow.

Psychosocial work environment and burnout among emergency medical and nursing staff.

Science.gov (United States)

Escribà-Agüir, V; Martín-Baena, D; Pérez-Hoyos, S

2006-11-01

The prevalence of burnout syndrome is increasing among doctors and nurses. The aim of this study was to analyse the relationship between the psychosocial work environment and burnout syndrome among emergency medical and nursing staff in Spain. A secondary aim was to determine if the effect of this psychosocial work environment on burnout was different for doctors and nurses. A cross-sectional survey was carried out by means of a mail questionnaire among 945 emergency doctors and nursing staff of Spain. The outcome variable was three dimensions of burnout syndrome [emotional exhaustion (EE), personal accomplishment (PA), depersonalisation (DP)]. The explanatory variable was that psychosocial work environment evaluated according to Karasek and Johnson's demand-control model. The adjusted odds ratios (OR) and their 95% confidence intervals were calculated by logistical regression. The probability of high EE was greater among those exposed to high psychological demands, OR 4.66 (2.75-7.90), low job control, OR 1.65 (1.04-2.63), and low supervisors' social support, OR 1.64 (1.01-2.59). Emotional exhaustion dimension was negatively influenced by low control only among doctors. Those exposed to low job control had a higher risk of low PA, OR 2.55 (1.66-3.94). There was no evidence of negative effect of psychosocial risk factors on the DP. Prevalence of EE and PA was higher among doctors and nurses. The presence of risk factors derived from work organisation within the work place (psychosocial risk factors) increases the probability of presenting burnout syndrome and, above all, EE.

Non-medical use of methylphenidate among medical students of the University of the Free State

OpenAIRE

Jain, Roshini; Chang, Chiech; Koto, Mpho; Geldenhuys, Alden; Nichol, Richard; Joubert, Gina

2017-01-01

Background: Faced with demanding training programmes, medical students may be more prone to use methylphenidate for non-medical purposes in order to improve concentration, alertness and academic performance. Aim: The study aimed to investigate the prevalence of the non-medical use of methylphenidate and knowledge of this drug among undergraduate medical students of the University of the Free State. Methods: This was a cross-sectional study. A self-administered, anonymous questionnaire...

Energy and ancillary service dispatch through dynamic optimal power flow

International Nuclear Information System (INIS)

Costa, A.L.; Costa, A. Simoes

2007-01-01

This paper presents an approach based on dynamic optimal power flow (DOPF) to clear both energy and spinning reserve day-ahead markets. A competitive environment is assumed, where agents can offer active power for both demand supply and ancillary services. The DOPF jointly determines the optimal solutions for both energy dispatch and reserve allocation. A non-linear representation for the electrical network is employed, which is able to take transmission losses and power flow limits into account. An attractive feature of the proposed approach is that the final optimal solution will automatically meet physical constraints such as generating limits and ramp rate restrictions. In addition, the proposed framework allows the definition of multiple zones in the network for each time interval, in order to ensure a more adequate distribution of reserves throughout the power system. (author)

78 FR 46177 - Third-Party Provision of Ancillary Services; Accounting and Financial Reporting for New Electric...

Science.gov (United States)

2013-07-30

...-Party Provision of Ancillary Services; Accounting and Financial Reporting for New Electric Storage... Financial Reporting for New Electric Storage Technologies, Notice of Proposed Rulemaking, FERC Stats. & Regs... Commission 18 CFR Parts 35 and 101 Third-Party Provision of Ancillary Services; Accounting and Financial...

Ból głowy wśród personelu medycznego = Headache among medical Staff

Directory of Open Access Journals (Sweden)

Dorota Kozak-Putowska

2016-06-01

3.       Katedra Onkologii i Środowiskowej Opieki Zdrowotnej, Uniwersytet Medyczny w Lublinie, Polska     Adres do korespondencji: Prof. dr hab. med. Joanna Iłżecka Samodzielna Pracownia Rehabilitacji Neurologicznej UM w Lublinie 20-081 Lublin ul. S. Staszica 4/6 tel. 505569275 e-mail: joanna.ilzecka@umlub.pl   Abstrakt Wprowadzenie. Ból głowy jest powszechną dolegliwością mogącą wynikać z procesu chorobowego toczącego się w organizmie, jak też być skutkiem negatywnych zachowań zdrowotnych, nieprawidłowego stylu życia lub szkodliwych warunków pracy. Cel pracy. Analiza częstości i przyczyn występowania bólu głowy wśród personelu medycznego i jego wpływ na funkcjonowanie w pracy i wypełnianie obowiązków zawodowych. Materiał i metody. Badaniami objęto 145 osób, pracujących w szpitalach w Lublinie oraz Warszawie. Narzędziem badawczym był anonimowy kwestionariusz ankiety. Wyniki i wnioski. Stwierdzono, że średnio połowa badanego personelu medycznego jest zdania, że praca zawodowa, którą wykonują jest przyczyną bólu głowy. Wynika to z sytuacji stresowych mających związek ze specyfiką pracy oraz szkodliwych warunków pracy. Główna przyczyna bólu głowy wśród personelu medycznego to kontakt ze środkami do dezynfekcji powierzchni i skóry oraz kontakt z różnorodnymi środkami medycznymi i lekami.   Słowa kluczowe: ból głowy, kadry medyczne szpitala, praca zawodowa.   Abstract Introduction. Headache is a common condition that may result from an ongoing disease process in the body as well as be the result of negative health behaviors, improper lifestyle or harmful working conditions. Purpose. The aim of the work was the analysis of the frequency and the causes of headache among medical staff and its impact on the functioning of the working and professional duties. Material and methodology. The study group consisted of 145 people, chosen randomly,  working in hospitals in Lublin and Warsaw. The study was

Reduced risks and improved economic operation of ancillary services

NARCIS (Netherlands)

Bosch, van den P.P.J.; Jokic, A.; Hermans, R.M.; Frunt, J.; Kling, W.L.; Nobel, Frank; Boonekamp, P.; Boer, de W.W.

2010-01-01

Present arrangements and regulation for ancillary services for power balance in power systems cannot cope with future developments in power systems as the participants do not receive proper incentives for required behaviour. This paper analyzes the consequences of current arrangements for system

Radiation protection of medical staff: a coordinated action by EURADOS on extremely dosimetry and the use of active personnel dosemeters (CONRAD)

International Nuclear Information System (INIS)

Struelens, L.; Vanhavere, F.

2009-01-01

Monitoring of workers constitutes an integral part of any radiological protection program. However, unresolved issues in radiation protection of medical staff still remain. Research and establishment of guidelines are necessary on a variety of issues such as extremity dosimetry (fingers, eye lenses, etc), the use of double dosimetry above and below lead aprons, or the use of electronic personal dosimeters in interventional procedures. Medical practices are also evolving fast, and new techniques with ionising radiation emerge very regularly, thus implying the need of radiation protection measures for medical staff, and the implementation of new monitoring programs. In some medical applications of radiation there is an increased risk of high local exposures because of direct handling of sources or the use of beta-emitters. However, despite the large number of workers that are exposed in the medical field worldwide, only few measurements of extremity doses have been reported in the literature. Some activities of EURADOS Working Group 9 (WG9) were sponsored by the European Commission in the CONRAD project. This CONRAD project was aiming at the coordination of research on radiation protection at the workplace. Working group 9 has been involved in the coordination and promotion of European research in the field of Radiation Protection Dosimetry for Medical Staff. One of the objectives of this working group was to formulate the state of the art and to identify areas in which improvements were needed. For some of these medical applications the skin of the fingers is the limiting organ from the point of view of individual monitoring of external radiation. The wide variety of radiation field characteristics in a medical environment, and the difficulty of measuring a local dose that is representative for the maximum skin dose (usually with one single detector), makes it difficult to perform extremity dosimetry with an accuracy similar to whole-body dosimetry. Therefore a

24/7 Presence of Medical Staff in the Labor Ward; No Day-Night Differences in Perinatal and Maternal Outcomes.

Science.gov (United States)

Tavares, Sara; Cavaco-Gomes, João; Moucho, Marina; Severo, Milton; Mateus, Mário; Ramalho, Carla; Visser, Gerard H A; Montenegro, Nuno

2017-05-01

Objective  The objective of this study was to assess possible day-night differences in perinatal and maternal labor outcomes in a hospital setting with no day-night differences in the presence of experienced medical staff. Design  This was a retrospective study conducted over 5 years between 2008 and 2012. Setting  This study was set at the obstetric delivery unit in a tertiary hospital. Population  A total of 9,143 singleton deliveries were assessed after 34 weeks of gestation and after exclusion of major congenital malformations, inductions of labor, and elective cesarean sections. Materials and Methods  Data were collected using the hospital electronic medical records. Time periods of 8 hours were defined (daytime between 8 am and 4 pm, evening time between 4 pm and 12 pm, and nighttime between 12 pm and 8 am). Differences between the three time periods were assessed using software R Core Team (2013). Main outcome measures were neonatal birth asphyxia, neonatal intensive care unit admission, and neonatal death. Results  There were no differences in perinatal and maternal outcomes in the course of the day, apart from a higher incidence of third- and fourth-degree tears during the evening. Neonatal outcome after obstetric emergencies (uterine rupture, partial placental abruption, and cord prolapse) also showed no day-night differences. Conclusion  Adverse nighttime-related outcomes may be avoided by the 24/7 presence of experienced medical staff. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Non-medical use of methylphenidate among medical students of the University of the Free State

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Roshini Jain

2017-01-01

Full Text Available Background: Faced with demanding training programmes, medical students may be more prone to use methylphenidate for non-medical purposes in order to improve concentration, alertness and academic performance. Aim: The study aimed to investigate the prevalence of the non-medical use of methylphenidate and knowledge of this drug among undergraduate medical students of the University of the Free State. Methods: This was a cross-sectional study. A self-administered, anonymous questionnaire was distributed during lectures to all students in the five year groups of the undergraduate medical programme. Results: Of the 643 undergraduate medical students, 541 completed the questionnaire (response rate: 84.1%. Approximately 11.0% of surveyed students were using methylphenidate at the time of the study, of which the majority (67.9% used it for academic purposes and 70.6% received it from a medical health professional. Less than a third of users had been diagnosed with Attention-Deficit/Hyperactivity Disorder. Methylphenidate users’ median knowledge was greater than non-users, and methylphenidate knowledge increased from first-year and second-year students to third-year to fifth-year students. Median knowledge scores per year group ranged from 52.0% to 60.0%. Conclusion: Methylphenidate is mainly used for non-medical purposes by medical students. Students generally have a low level of knowledge on methylphenidate. Specific information on methylphenidate should be included in lectures on stress management and study methods during the course of the medical curriculum.

Increasing awareness of age-related fertility and elective fertility preservation among medical students and house staff: a pre- and post-intervention analysis.

Science.gov (United States)

Anspach Will, Erica; Maslow, Bat-Sheva; Kaye, Leah; Nulsen, John

2017-05-01

To assess medical students' and house staff's knowledge and personal and professional perceptions of age-related fertility and fertility preservation before and after an educational intervention. Pre-/post intervention survey. University-based medical center. Medical students and house staff. An educational session on age-related fertility decline and elective fertility preservation. Knowledge scores and perceptions assessed immediately before and after the intervention. Sixty-five surveys were administered. Of the 53 respondents, 71.7% were married or in a committed relationship; 89.4% reported that they were delaying childbearing, with career and/or education being the most frequently listed reason (85.7%); 39.5% indicated that they had both personal and professional interest in fertility preservation but identified finances (62.5%) and time (59.4%) as barriers; 86.9% indicated previous exposure, with formal education (80.0%) and social media (40.0%) being the most common sources. Mean scores on a six-question knowledge-based assessment improved significantly following the presentation (54.6 ± 19.0% vs. 78.1 ± 16.0%), as did the number of participants who indicated that they might now recommend elective oocyte cryopreservation to others (71.1% vs. 54.3%). After the intervention, 97.8% thought that it was important for medical professionals to be informed about age-related fertility decline and elective oocyte cryopreservation. Despite professional and personal interest, knowledge of age-related fertility decline and elective fertility preservation is limited among medical students and house staff. This study highlights the need for formal education across all levels of training and specialties, with even brief interventions being of potential benefit. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Professional Ethics and Organizational Commitment Among the Education Department Staff of Tabriz University of Medical Sciences

Directory of Open Access Journals (Sweden)

Ali Imani

2017-06-01

Full Text Available Background: Concepts such as organizational commitment and employees’ and managers’ ethics provide decision-makers and policy makers with potentially useful information which can result in increasing organizational efficiency and effectiveness. This study aimed to explore the relationship between professional ethics and organizational commitment among the staff working in the education departments of Tabriz University of Medical Sciences. Methods: This cross-sectional study was conducted in 2015. The study population consisted of all staff working as educational experts in the education departments of Tabriz University of Medical Sciences (N = 65. Data collection instruments used in this study were two standard questionnaires on professional ethics and organizational commitment. SPSS software version 21 was used to analyze the data. Results: According to the results, mean scores obtained for professional ethics and organizational commitment were (91.57± 9.13 (95% CI, 89.23-93.91 and (64.89 ± 10.37 (95% CI, 62.2367.54, respectively. A significant relationship was observed between professional ethics and organizational commitment among the educational experts working in Tabriz University of Medical Sciences (correlation coefficient = 0.405 (P = 0.001 (at 95% confidence level. Furthermore, there was a significant relationship between professional ethics and work experience (P = 0.043. The highest level of professional ethics observed was associated with those participants having a work experience of ranging from 6 to 10 years. Individuals with fulltime employment scored the highest in organizational commitment. Conclusion: Educational experts possessed a high level of professional ethics. The finding provides the grounds for promoting organizational commitment, which will lead to higher levels of organizational effectiveness.

Regulatory issues associated with closure of the Hanford AX Tank Farm ancillary equipment

International Nuclear Information System (INIS)

Becker, D.L.

1998-01-01

Liquid mixed, high-level radioactive waste has been stored in underground single-shell tanks at the US Department of Energy's (DOE's) Hanford Site. After retrieval of the waste from the single-shell tanks, the DOE will proceed with closure of the tank farm. The 241-AX Tank Farm includes four one-million gallon single-shell tanks in addition to sluice lines, transfer lines, ventilation headers, risers, pits, cribs, catch tanks, buildings, well and associated buried piping. This equipment is classified as ancillary equipment. This document addresses the requirements for regulatory close of the ancillary equipment in the Hanford Site 241-AX Tank Farm. The options identified for physical closure of the ancillary equipment include disposal in place, disposal in place after treatment, excavation and disposal on site in an empty single-shell tank, and excavation and disposal outside the AX Tank Farm. The document addresses the background of the Hanford Site and ancillary equipment in the AX Tank Farm, regulations for decontamination and decommissioning of radioactively contaminated equipment, requirements for the cleanup and disposal of radioactive wastes, cleanup and disposal requirements governing hazardous and mixed waste, and regulatory requirements and issues associated with each of the four physical closure options. This investigation was conducted by the Sandia National Laboratories, Albuquerque, New Mexico, during Fiscal Year 1998 for the Hanford Tanks Initiative Project

Association between Secondhand Smoke in Hospitality Venues and Urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol Concentrations in Non-Smoking Staff.

Science.gov (United States)

Kim, Jeonghoon; Lee, Kiyoung; Kwon, Ho-Jang; Lee, Do Hoon; Kim, KyooSang

2016-11-08

The purpose of this study was to determine the relationship between urinary cotinine and total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) concentrations in non-smoking staff and the indoor levels of fine particles (PM 2.5 ) in hospitality venues that allow smoking, with respect to demographic and indoor environmental factors. We evaluated 62 hospitality venues that allowed smoking in Seoul, Korea. A real-time aerosol monitor was used to measure indoor PM 2.5 concentrations. Field technicians recorded indoor environmental characteristics. One non-smoking staff member in each hospitality venue was tested for urinary cotinine and total NNAL concentrations. Demographic characteristics were obtained from self-reported staff questionnaires. Natural-log (ln)-transformed PM 2.5 concentrations were significantly correlated with the ln-transformed cotinine ( r = 0.31) and the total NNAL concentrations ( r = 0.32). In multivariable regression analysis, the urinary cotinine concentrations of the staff members were significantly correlated with indoor PM 2.5 concentrations; those with the highest concentrations were more likely to be women or staff members that worked in venues with a volume hospitality venues that allow smoking.

A New Approach to Identify High Burnout Medical Staffs by Kernel K-Means Cluster Analysis in a Regional Teaching Hospital in Taiwan

Directory of Open Access Journals (Sweden)

Yii-Ching Lee PhD

2016-11-01

Full Text Available This study uses kernel k-means cluster analysis to identify medical staffs with high burnout. The data collected in October to November 2014 are from the emotional exhaustion dimension of the Chinese version of Safety Attitudes Questionnaire in a regional teaching hospital in Taiwan. The number of effective questionnaires including the entire staffs such as physicians, nurses, technicians, pharmacists, medical administrators, and respiratory therapists is 680. The results show that 8 clusters are generated by kernel k-means method. Employees in clusters 1, 4, and 5 are relatively in good conditions, whereas employees in clusters 2, 3, 6, 7, and 8 need to be closely monitored from time to time because they have relatively higher degree of burnout. When employees with higher degree of burnout are identified, the hospital management can take actions to improve the resilience, reduce the potential medical errors, and, eventually, enhance the patient safety. This study also suggests that the hospital management needs to keep track of medical staffs’ fatigue conditions and provide timely assistance for burnout recovery through employee assistance programs, mindfulness-based stress reduction programs, positivity currency buildup, and forming appreciative inquiry groups.

Profesional medical library education in the United States in relation to the qualifications of medical library manpower in Ohio.

Science.gov (United States)

Rees, A M; Rothenberg, L; Denison, B

1968-10-01

THE PRESENT SYSTEM OF EDUCATION FOR MEDICAL LIBRARY PRACTICE IN THE UNITED STATES CONSISTS OF FOUR MAJOR COMPONENTS: graduate degree programs in library science with specialization in medical librarianship; graduate degree programs in library science with no such specialization; postgraduate internships in medical libraries; continuing education programs. Data are presented illustrating the flow of graduates along these several educational pathways into medical library practice.The relevance of these educational components to the current medical library work force is discussed with reference to manpower data compiled for Ohio. The total number of medical library personnel in Ohio in 1968 is 316. Of this total, only forty-two (approximately 14 percent) have received any formal library training. Seventy persons have only a high school education. From these figures, it is concluded that there is no standard or essential qualification which is universally accepted as educational preparation for work in medical libraries; that the comparative sophistication of the educational programs in medical librarianship has yet to be reflected widely in general medical library practice; that an increasingly large number of non-professional or ancillary personnel are being, and will continue to be, utilized in medical libraries; that large numbers of untrained persons have sole responsibility for medical libraries; and that appropriate educational programs will have to be designed specifically for this type of personnel.

Occupational exposure of medical staff due to diagnostic X-ray examinations in veterinary medicine

International Nuclear Information System (INIS)

Mergel, E.; Feige, S.; Haeusler, U.

2007-01-01

The implementation of the Council directive 96/29 EURATOM and the corresponding national Radiation Protection Ordinance and the X-ray Protection Ordinance coming subsequently into effect led to a changed situation regarding the occupational radiation protection in the medical sector. To reduce the occupational exposure of veterinarians and assisting staff in veterinary radiography is particularly challenging as, in opposite to human radiological examination, the presence of staff is indispensable to restrain the patient. Beyond that the relevant literature reports about too high and/or about unnecessary radiation exposures. To gain a comprehensive knowledge upon the possible exposure of involved staff, the variety of typical examination methods in veterinary clinics and at practitioners had been investigated during the daily routine. Dose measurements were performed for different employees during the examinations taking into account several places of exposure (lens, thyroid, chest, hand, gonad, and feet). Veterinary X-ray diagnostic examinations for pets as well as in equine radiography had been accounted for this study. In total, 101 examination methods, 4.484 accompanied examinations and 53.892 single dose readings resulted in a reliable statistical base to set up a 'Job-Exposure-Matrix' allowing the dose assessment for a variable number and kind of examinations. The 'Job-Exposure-Matrix' is believed to be a useful tool for optimization of occupational radiation exposure of veterinarians by appraising the height of a possible dose, forcing a review of the status quo and triggering the improvement of personal protection by establishing adequate measures. (orig.)

Occupational exposure of medical staff due to diagnostic X-ray examinations in veterinary medicine

Energy Technology Data Exchange (ETDEWEB)

Mergel, E.; Feige, S. [Gesellschaft fuer Anlagen- und Reaktorsicherheit mbH (GRS) (Germany); Haeusler, U. [Bundesamt fuer Strahlenschutz (BfS), Salzgitter (Germany)

2007-07-01

The implementation of the Council directive 96/29 EURATOM and the corresponding national Radiation Protection Ordinance and the X-ray Protection Ordinance coming subsequently into effect led to a changed situation regarding the occupational radiation protection in the medical sector. To reduce the occupational exposure of veterinarians and assisting staff in veterinary radiography is particularly challenging as, in opposite to human radiological examination, the presence of staff is indispensable to restrain the patient. Beyond that the relevant literature reports about too high and/or about unnecessary radiation exposures. To gain a comprehensive knowledge upon the possible exposure of involved staff, the variety of typical examination methods in veterinary clinics and at practitioners had been investigated during the daily routine. Dose measurements were performed for different employees during the examinations taking into account several places of exposure (lens, thyroid, chest, hand, gonad, and feet). Veterinary X-ray diagnostic examinations for pets as well as in equine radiography had been accounted for this study. In total, 101 examination methods, 4.484 accompanied examinations and 53.892 single dose readings resulted in a reliable statistical base to set up a 'Job-Exposure-Matrix' allowing the dose assessment for a variable number and kind of examinations. The 'Job-Exposure-Matrix' is believed to be a useful tool for optimization of occupational radiation exposure of veterinarians by appraising the height of a possible dose, forcing a review of the status quo and triggering the improvement of personal protection by establishing adequate measures. (orig.)

Evaluating the attendance of medical staff and room occupancy during palliative radiotherapy

Energy Technology Data Exchange (ETDEWEB)

Adamietz, Irenaeus A. [University of Bochum, Department of Radiation Oncology, Bochum (Germany); Marienhospital Herne, Department of Radiotherapy and Radiation Oncology, Herne (Germany); Micke, Oliver [Franziskus-Hospital, Department of Radiation Oncology, Bielefeld (Germany); Popp, Wolfgang [Prime Networks AG, Basel (Switzerland); Sack, Horst [DEGRO, Berlin (Germany)

2014-09-15

Attendance of staff and use of resources during treatment have an impact on costs. For palliative radiotherapy, no reliable data are available on the subject. Therefore, the measurement of selected variables (staff absorbance and room occupancy) based on daily palliative irradiation was the aim of our prospective study. The analysis is part of a larger study conducted by the German Society of Radiation Oncology (DEGRO). A total of 172 palliative radiation treatments were followed up prospectively between October 2009 and March 2010. The study was performed at two experienced radiotherapy departments (Herne and Bielefeld) and evaluated the attendance of medical personnel and room occupancy related to the selected steps of the treatment procedure: treatment planning and daily application of radiation dose. Computed tomography for treatment planning engaged the unit for 19 min (range: 17-22 min). The localization of target volume required on average 28 min of a technician's working time. The mean attendance of the entire staff (radiation oncologist, physicist, technician) for treatment planning was 159 min, while the total room occupancy was 140 min. Depending on the type of treatment, the overall duration of a radiotherapy session varied on average between 8 and 18 min. The staff was absorbed by the first treatment session (including portal imaging) for 8-27 min. Mean room occupancy was 18 min (range: 6-65 min). The longest medical staff attendance was observed during an initial irradiation session (mean: 11 min). Radiotherapy sessions with weekly performed field verifications occupied the rooms slightly longer (mean: 10 min, range: 4-25 min) than daily radiotherapy sessions (mean: 9 min, range: 3-29 min). We observed that the patients' symptoms, their condition, and their social environment confounded the time schedule. Target localization, treatment planning, and performance of palliative radiotherapy absorb resources to an extent comparable to

Mental strain among staff at medical rehabilitation clinics in Germany.

Science.gov (United States)

Koerner, Mirjam

2011-01-20

The aim of the study is to compare the frequency of mental strain effects on employees in somatic and psychosomatic rehabilitation clinics as well as between the different occupational groups. Associations between mental strain effects and working conditions, cooperation in the team and employee satisfaction are also investigated. The present study is cross-sectional with a descriptive-explorative design. It is composed of a survey with standardized questionnaires (Human Service Workload, Questionnaire on Teamwork and Questionnaire on Staff Satisfaction in Medical Rehabilitation) and global items, and was conducted among all employees of twelve rehabilitation teams (five somatic and seven psychosomatic rehabilitation clinics (n=549)). The response rate of the survey averaged 45% (n=252). One in four participants reported being emotionally exhausted. There were significantly more emotionally exhausted employees working in the psychosomatic (31%) than in the somatic rehabilitation clinics (16%) (X(2)=7.403, df=1, pemployee satisfaction (r=-.38 to r=-.50, pintrinsic motivation, dissatisfaction). The results clearly show that the employees in medical rehabilitation clinics have a high stress level at work, a situation which is also known in other health care organizations. Observations of strong associations between cooperation in the team and strain effects confirm the positive impact of social support in the daily work routine. Correlation between the subjective appraisal of working conditions and the impact of strain is mostly high. It can be assumed that the strain effects can be influenced positively with supportive team and human resource development (person-related interventions) and interventions that enhance working conditions (condition-related interventions).

Industrial Demand Management Providing Ancillary Services to the Distribution Grid

DEFF Research Database (Denmark)

Rahnama, Samira; Green, Torben; Lyhne, Casper

2017-01-01

A prominent feature of the future smart grid is the active participation of the consumer side in ancillary service provision. Grid operators procure ancillary services, including regulating power, voltage control, frequency control, and so on, to ensure safe, reliable, and high-quality electricity...... delivery. Consumers' involvement requires new entities and infrastructure. A so-called aggregator has been introduced as a new player to manage the services that are offered by the consumption units. This paper describes an industrial scale experimental setup for evaluating a particular type of aggregator....... The aggregator aims to provide a distribution grid service from industrial thermal loads through a direct control policy. Our specific case studies are a supermarket refrigeration system and an HVac chiller in conjunction with an ice storage, which are virtually connected to the aggregator. Practical results...

The Teamwork Study: enhancing the role of non-GP staff in chronic disease management in general practice.

Science.gov (United States)

Black, D A; Taggart, J; Jayasinghe, U W; Proudfoot, J; Crookes, P; Beilby, J; Powell-Davis, G; Wilson, L A; Harris, M F

2013-01-01

There is evidence for a team-based approach in the management of chronic disease in primary health care. However, the standard of care is variable, probably reflecting the limited organisational capacity of health services to provide the necessary structured and organised care for this group of patients. This study aimed to evaluate the impact of a structured intervention involving non-GP staff in GP practices on the quality of care for patients with diabetes or cardiovascular disease. A cluster randomised trial was undertaken across 60 GP practices. The intervention was implemented in 30 practices with staff and patients interviewed at baseline and at 12-15 months follow up. The change in team roles was evaluated using a questionnaire completed by practice staff. The quality of care was evaluated using the Patient Assessment of Chronic Illness Care questionnaire. We found that although the team roles of staff improved in the intervention practices and there were significant differences between practices, there was no significant difference between those in the intervention and control groups in patient-assessed quality of care after adjusting for baseline-level score and covariates at the 12-month follow up. Practice team roles were not significantly associated with change in Patient Assessment of Chronic Illness Care scores. Patients with multiple conditions were more likely to assess their quality of care to be better. Thus, although previous research has shown a cross-sectional association between team work and quality of care, we were unable to replicate these findings in the present study. These results may be indicative of insufficient time for organisational change to result in improved patient-assessed quality of care, or because non-GP staff roles were not sufficiently focussed on the aspects of care assessed. The findings provide important information for researchers when designing similar studies.

Perceived need to take medication is associated with medication non-adherence in patients with rheumatoid arthritis

Directory of Open Access Journals (Sweden)

Zwikker HE

2014-11-01

Full Text Available Hanneke E Zwikker,1,2 Sandra van Dulmen,3–5 Alfons A den Broeder,1,2 Bart J van den Bemt,1,2,6 Cornelia H van den Ende1,2 1Department of Rheumatology, 2Department of Pharmacy, Sint Maartenskliniek, Nijmegen, the Netherlands; 3Department of Primary and Community Care, Radboud University Medical Centre, Nijmegen, the Netherlands; 4NIVEL (Netherlands Institute for Health Services Research, Utrecht, the Netherlands; 5Department of Health Science, Buskerud and Vestfold University College, Drammen, Norway; 6Department of Pharmacy, Radboud University Medical Centre, Nijmegen, the Netherlands Background: This is the first cross-sectional study that aims to examine associations between beliefs about medication and non-adherence in patients with rheumatoid arthritis (RA using disease-modifying antirheumatic drugs, taking potential psychological confounders into account.Methods: Eligible patients (diagnosed with RA for ≥1 year or ≥18 years, using greater than or equal to one disease-modifying antirheumatic drug were included by their rheumatologist during regular outpatient visits between September 2009 and September 2010. Included patients received questionnaires. The Beliefs about Medicines Questionnaire was used to measure the perceived need to take medication (necessity beliefs, the concerns about taking medication (concern beliefs, general medication beliefs, and attitudes toward taking medication. Medication non-adherence (no/yes was measured using the Compliance Questionnaire Rheumatology (CQR. Associations between beliefs and non-adherence, and the influence of demographical, clinical, and psychological factors (symptoms of anxiety/depression, illness cognitions, self-efficacy were assessed using logistic regression.Results: A total of 580 of the 820 eligible patients willing to participate were included in the analyses (68% female, mean age 63 years, 30% non-adherent to their medication. Weaker necessity beliefs (OR [odds ratio]: 0.8, 95% CI

Loads Providing Ancillary Services: Review of InternationalExperience-- Technical Appendix: Market Descriptions

Energy Technology Data Exchange (ETDEWEB)

Grayson Heffner, Charles Goldman, Kintner-Meyer, M; Kirby, Brendan

2007-05-01

In this study, we examine the arrangements for andexperiences of end-use loads providing ancillary services (AS) in fiveelectricity markets: Australia, the United Kingdom (UK), the Nordicmarket, and the ERCOT and PJM markets in the United States. Our objectivein undertaking this review of international experience was to identifyspecific approaches or market designs that have enabled customer loads toeffectively deliver various ancillary services (AS) products. We hopethat this report will contribute to the ongoing discussion in the U.S.and elsewhere regarding what institutional and technical developments areneeded to ensure that customer loads can meaningfully participate in allwholesale electricity markets.

Shift Work and Related Health Problems among Medical and Diagnostic Staff of the General Teaching Hospitals Affiliated to Shiraz University of Medical Sciences, 2012

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Zahra Sajjadnia

2015-07-01

Full Text Available Introduction:Today, shift work is considered as a necessity in many jobs and for some 24-hour services the use of shift-work is growing. However, shift work can lead to physiological and psycho-social problems for shift workers. This study aimed to determine the effects of shift work on the associated health problems, together with the demographic and job characteristics underlying the problems, among the medical and diagnostic staff of the general teaching hospitals affiliated to Shiraz University of Medical Sciences in 2012. Method:This study was an applied, cross-sectional and descriptive-analytical one. The study employed a sample of 205 employees from the medical and diagnostic staff using stratified sampling proportional to the size and simple random sampling methods. Data were collected using the Survey of Shift workers (SOS questionnaire, validity and reliability of which have already been confirmed. Finally, the collected data were analyzed using SPSS 16.0 software through ANOVA, Chi-square, Independent-Samples T-Test, as well as Pearson Correlation Coefficient. A P<0.05 was considered statistically significant. Results: The results showed that among the demographic and job characteristics studied, the individual, family and social problems had significant associations with work schedules, shift work and job satisfaction. In addition, there were significant associations between musculoskeletal disorders and the satisfaction of shift work; cardiovascular disorders and marital status and occupation; digestive disorders and the work schedules; sleep disorders and the satisfaction of shift work; musculoskeletal disorders, cardiovascular disorders and sleep disorders and age, job experience and shift work experience. And finally, there were significant associations among sleep disorders and age, job experience and the shift work experience. Conclusion: Based on the findings of this study, demographic characteristics such as age, marital

Non-prescription medications: considerations for the dental practitioner.

Science.gov (United States)

Kingon, Angus

2012-04-01

The widespread availability of non-prescription medications has a significant potential impact on dental practice. Dentists are trained to provide scientifically-based advice on the appropriate use of medications, but it is not uncommon for patients to take matters into their own hands, especially if it is felt that the treatment provided is not solving a specific problem, or is insufficient. Well-meaning but often ill-informed family and friends frequently have an opinion as to what should be done. Not only may the suggested treatment not be effective, it may also be harmful. Over-the-counter medications can easily be obtained, and there is nothing to stop individuals exceeding recommended doses, and if this occurs, there could be adverse medical sequelae. Patient compliance in taking prescription medications is known to be problematic, and when combined with the ready availability of complementary medications, probiotics and illicit drugs, the risk of self-harm can be seen to be a distinct possibility. To compound the position, sometimes there seems to be, in a practical sense, little regulation on the advertising and marketing of non-prescription medications, which can leave consumers not only confused but potentially vulnerable. While complementary medicines may not have a significant role in dental practice in 2012, that may not always be the case as research continues, and reference is made to some aspects of ongoing work. Non-prescription medications are discussed, and some effects on oral health are considered.

Resident and Staff Satisfaction of Pediatric Graduate Medical Education Training on Transition to Adult Care of Medically Complex Patients.

Science.gov (United States)

Weeks, Matthew; Cole, Brandon; Flake, Eric; Roy, Daniel

2018-04-11

This study aims to describe the quantity and satisfaction current residents and experienced pediatricians have with graduate medical education on transitioning medically complex patients to adult care. There is an increasing need for transitioning medically complex adolescents to adult care. Over 90% now live into adulthood and require transition to adult healthcare providers. The 2010 National Survey of Children with Special Health Care Needs found that only 40% of youth 12-17 yr receive the necessary services to appropriately transition to adult care. Prospective, descriptive, anonymous, web-based survey of pediatric residents and staff pediatricians at Army pediatric residency training programs was sent in March 2017. Questions focused on assessing knowledge of transition of care, satisfaction with transition training, and amount of education on transition received during graduate medical education training. Of the 145 responders (310 potential responders, 47% response rate), transition was deemed important with a score of 4.3 out of 5. The comfort level with transition was rated 2.6/5 with only 4.2% of participants receiving formal education during residency. The most commonly perceived barriers to implementing a curriculum were time constraints and available resources. Of the five knowledge assessment questions, three had a correct response rate of less than 1/3. The findings show the disparity between the presence of and perceived need for a formal curriculum on transitioning complex pediatric patients to adult care. This study also highlighted the knowledge gap of the transition process for novice and experienced pediatricians alike.

Non medical factors associated with psychological disorders in cancer patients

International Nuclear Information System (INIS)

Iqbal, A.; Intikhab, K.; Saeed, K.

2002-01-01

Objective: To find out major non-medial factors associated with psychological disorders in cancer patients. Design: An observational study conducted on adult cancer patients. Place and Duration of Study: The study was conducted at Shaukat Khanum Memorial Cancer Hospital and Research Center Lahore Pakistan from January 1999. Patients and Methods: Two hundred and twenty-four newly-diagnosed adult cancer patients were interviewed by the clinical psychologist and data was collected regarding non-medical causal factors, patients age, gender family support system, general home atmosphere and marital status. Collected data was analyzed by utilizing. SPSS for windows version 10.0. Results: Of the 224 patients 142 (63.4%) reported non-medical factors causing psychological distress and 82 (36.6%) reported that medical sources are the most distressing. Ten most common non-medical sources of developing psychological disorders were identified. It was observed that family support system and general home atmosphere were significantly associated with the development of psychological disorders whereas the other variables such as age, gender and marital status had no significant relationship with the non Medical factors. Conclusion: It was concluded that non-medical factors causing psychological problems are significant in cancer patients. The results suggest that we should identify these factors and target psychosocial intervention for those patients most at risk. (author)

Factors Affecting Communication Patterns between Oncology Staff and Family Members of Deceased Patients: A Cross-Sectional Study.

Directory of Open Access Journals (Sweden)

Tal Granot

Full Text Available Perceptions of the role of oncology medical staff in supporting bereaved families have evolved with the transition to interdisciplinary cancer care. We investigated the interactions between oncology professionals and bereaved families.This cross-sectional study involved all oncology medical staff at the Davidoff Center. Participants were given a questionnaire relating to bereavement follow-up. Responses were measured using a 5-point Likert scale.Of 155 staff members, 107 filled questionnaires with 50% of the families of their deceased patients. Contacting bereaved families was considered the responsibility of the physicians (90%, nurses (84%, or social workers (89%. The main barriers to contacting bereaved families were emotional overload (68% and lack of time (63%; 60% indicated a need for additional communication tools for bereavement follow-up. In a multivariate analysis, profession (physician vs. nurse, primary workplace (outpatient setting vs. other, and self-defined religion were significant variables with respect to the perceived importance of contacting bereaved families and to actually contacting them. Other factors (e.g., age, gender were non-significant.Perspectives regarding bereavement actions differ significantly across medical professions, work settings, and self-defined religions. Additional guidance and education regarding bereavement actions is warranted.

Convergence and translation: attitudes to inter-professional learning and teaching of creative problem-solving among medical and engineering students and staff.

Science.gov (United States)

Spoelstra, Howard; Stoyanov, Slavi; Burgoyne, Louise; Bennett, Deirdre; Sweeney, Catherine; Drachsler, Hendrik; Vanderperren, Katrien; Van Huffel, Sabine; McSweeney, John; Shorten, George; O'Flynn, Siun; Cantillon-Murphy, Padraig; O'Tuathaigh, Colm

2014-01-22

Healthcare worldwide needs translation of basic ideas from engineering into the clinic. Consequently, there is increasing demand for graduates equipped with the knowledge and skills to apply interdisciplinary medicine/engineering approaches to the development of novel solutions for healthcare. The literature provides little guidance regarding barriers to, and facilitators of, effective interdisciplinary learning for engineering and medical students in a team-based project context. A quantitative survey was distributed to engineering and medical students and staff in two universities, one in Ireland and one in Belgium, to chart knowledge and practice in interdisciplinary learning and teaching, and of the teaching of innovation. We report important differences for staff and students between the disciplines regarding attitudes towards, and perceptions of, the relevance of interdisciplinary learning opportunities, and the role of creativity and innovation. There was agreement across groups concerning preferred learning, instructional styles, and module content. Medical students showed greater resistance to the use of structured creativity tools and interdisciplinary teams. The results of this international survey will help to define the optimal learning conditions under which undergraduate engineering and medicine students can learn to consider the diverse factors which determine the success or failure of a healthcare engineering solution.

Medication non-adherence in the homeless population in an Intermountain West city

Directory of Open Access Journals (Sweden)

Elizabeth J. Unni

2014-01-01

Full Text Available Background: Homelessness happens when people or household are unable to acquire and/or maintain housing they can afford. Approximately 17% of homeless individuals are also chronically ill. Studies have often not objectively measured medication non- adherence among the homeless population, probably due to lack of consistent pharmacy records. This study proposed to objectively estimate medication non-adherence to chronic medications among the homeless population in Salt Lake City, Utah. Methods: A retrospective study design was used based on the pharmacy records from the Fourth Street Pharmacy based on four classes of chronic medications - asthma, diabetes, statins, and psychiatric medications. Data was collected between November 1, 2010 and February 28, 2011 on the variables: date of original prescription, number of refills on the original prescription, date of 1st, 2nd, 3rd, and 4th fills, age, gender, and race. Primary non-adherence and medication refill non-adherence based on Continuous Measure of Medication Gaps were calculated. Results: The medication refill non-adherence rate was 38.8% with asthma medications, 38.5% with diabetic medications, 27.2% with statins, and 47.1% with psychiatric medications. The primary non-adherence rate varied from zero percent to 20%. Conclusion: The study concluded that this population has comparable non-adherence rates with asthma, diabetes, cholesterol lowering, and certain psychiatric medications than the general population.   Type: Original Research

Perceptions of personal health risks by medical and non-medical workers in a university medical center: a survey study

Directory of Open Access Journals (Sweden)

Nap Raoul E

2010-11-01

Full Text Available Abstract Background Health care workers (HCWs are faced with many work-related choices which may depend on how they perceive risk, such as whether or not to comply with safety regulations. Little research has investigated risk perception in medical workers in comparison with non-medical workers and the extent to which risk perception differs in these groups. The current study thus investigates risk perception of medical and non-medical workers to inform and complement future research on safety compliance. The study has implications for the design of intervention programmes to increase the level of compliance of HCWs. Methods A survey study was conducted in which questionnaires were distributed to 6380 HCWs. The questionnaire asked for ratings of risk perception for cold, annual influenza, pandemic influenza, cancer, heart attack and food poisoning. Of 2495 returned questionnaires (response rate: 39%, 61.40% were from medical workers (24.1% of these were from physicians, 39.7% from nurses and 36.2% from paramedics and 38.60% were from non-medical workers. Results Medical workers gave lower risk perception ratings than did non-medical workers for cancer, but not for other health risks. Within the medical workers, physicians rated the risk of getting a cold as higher, but of having a heart attack as lower than did nurses and paramedics; physicians also rated their risk of getting cancer as lower than did nurses. Perceived risk was higher as a function of age for pandemic influenza, cancer and heart attack, but lower for cold and annual influenza. HCWs who lived with a partner and children rated the risk of getting a cold or annual influenza higher than those who lived alone or with a partner only. Full-time HCWs gave lower ratings for annual influenza than did part-time HCWs. Conclusions Different base levels of risk perception between medical and non-medical workers need to be taken into account for successful implementation of safety regulations

Readiness for organisational change among general practice staff.

Science.gov (United States)

Christl, B; Harris, M F; Jayasinghe, U W; Proudfoot, J; Taggart, J; Tan, J

2010-10-01

Increasing demands on general practice to manage chronic disease may warrant organisational change at the practice level. Staff's readiness for organisational change can act as a facilitator or barrier to implementing interventions aimed at organisational change. To explore general practice staff readiness for organisational change and its association with staff and practices characteristics. This is a cross-sectional study of practices in three Australian states involved in a randomised control trial on the effectiveness of an intervention to enhance the role of non-general practitioner staff in chronic disease management. Readiness for organisational change, job satisfaction and practice characteristics were assessed using questionnaires. 502 staff from 58 practices completed questionnaires. Practice characteristics were not associated with staff readiness for change. A multilevel regression analysis showed statistically significant associations between staff readiness for organisational change (range 1 to 5) and having a non-clinical staff role (vs general practitioner; B=-0.315; 95% CI -0.47 to -0.16; pchange which addresses the mix of practice staff. Moderately low job satisfaction may be an opportunity for organisational change.

Translating staff experience into organisational improvement: the HEADS-UP stepped wedge, cluster controlled, non-randomised trial

Science.gov (United States)

Athanasiou, Thanos; Long, Susannah J; Beveridge, Iain; Sevdalis, Nick

2017-01-01

Objectives Frontline insights into care delivery correlate with patients’ clinical outcomes. These outcomes might be improved through near-real time identification and mitigation of staff concerns. We evaluated the effects of a prospective frontline surveillance system on patient and team outcomes. Design Prospective, stepped wedge, non-randomised, cluster controlled trial; prespecified per protocol analysis for high-fidelity intervention delivery. Participants Seven interdisciplinary medical ward teams from two hospitals in the UK. Intervention Prospective clinical team surveillance (PCTS): structured daily interdisciplinary briefings to capture staff concerns, with organisational facilitation and feedback. Main measures The primary outcome was excess length of stay (eLOS): an admission more than 24 hours above the local average for comparable patients. Secondary outcomes included safety and teamwork climates, and incident reporting. Mixed-effects models adjusted for time effects, age, comorbidity, palliation status and ward admissions. Safety and teamwork climates were measured with the Safety Attitudes Questionnaire. High-fidelity PCTS delivery comprised high engagement and high briefing frequency. Results Implementation fidelity was variable, both in briefing frequency (median 80% working days/month, IQR 65%–90%) and engagement (median 70 issues/ward/month, IQR 34–113). 1714/6518 (26.3%) intervention admissions had eLOS versus 1279/4927 (26.0%) control admissions, an absolute risk increase of 0.3%. PCTS increased eLOS in the adjusted intention-to-treat model (OR 1.32, 95% CI 1.10 to 1.58, p=0.003). Conversely, high-fidelity PCTS reduced eLOS (OR 0.79, 95% CI 0.67 to 0.94, p=0.006). High-fidelity PCTS also increased total, high-yield and non-nurse incident reports (incidence rate ratios 1.28–1.79, all p<0.002). Sustained PCTS significantly improved safety and teamwork climates over time. Conclusions This study highlighted the potential benefits and

Transactive Control and Coordination of Distributed Assets for Ancillary Services

Energy Technology Data Exchange (ETDEWEB)

Subbarao, Krishnappa [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Fuller, Jason C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Kalsi, Karanjit [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Somani, Abhishek [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Pratt, Robert G. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Widergren, Steven E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Chassin, David P. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2013-09-18

The need to diversify energy supplies, the need to mitigate energy-related environmental impact, and the entry of electric vehicles in large numbers present challenges and opportunities to power system professionals. Wind and solar power provide many benefits, and to reap the benefits the resulting increased variability—forecasted as well as unforecasted—should be addressed. A majority of states and the District of Columbia, representing over half of the total load, have passed renewable portfolio standards. California’s plans call for 33% renewable energy by 2020. For grid balancing and for meeting reliability standards, ancillary services are needed. The needs for these services are poised to increase significantly. Demand resources are receiving increasing attention as one means of providing the ancillary services. Control and coordination of a large number (~millions) of distributed smart grid assets requires innovative approaches. One such approach is transactive control and coordination (TC2)—a distributed, hierarchical, agent-based incentive and control system. The TC2 paradigm is to create a market-like control system in which participation is voluntary and the participant sets the price for participation. For transactions that are frequent, automation of bids and responses is necessary. Such an approach has been developed and demonstrated at the Pacific Northwest National Laboratory. The devices, typically thermostatically controlled heating, ventilating, and air conditioning (HVAC) loads, send their bids—the quantity of energy they need and, based on the consumer preferences encoded in a simple user interface, the price they are willing to pay. The typical bid period is 5 minutes. By aggregating all the bids, a demand curve is generated by the aggregating entity, and matched with a supply curve or supply constraint. The aggregator transmits the clearing price to the devices. The winning devices proceed to consume the energy they bid for and won

Evaluation of the Program in Medical Education for the Urban Underserved (PRIME-US) at the UC Berkeley-UCSF Joint Medical Program (JMP): The First 4 Years.

Science.gov (United States)

Sokal-Gutierrez, Karen; Ivey, Susan L; Garcia, Roxanna M; Azzam, Amin

2015-01-01

Medical educators, clinicians, and health policy experts widely acknowledge the need to increase the diversity of our healthcare workforce and build our capacity to care for medically underserved populations and reduce health disparities. The Program in Medical Education for the Urban Underserved (PRIME-US) is part of a family of programs across the University of California (UC) medical schools aiming to recruit and train physicians to care for underserved populations, expand the healthcare workforce to serve diverse populations, and promote health equity. PRIME-US selects medical students from diverse backgrounds who are committed to caring for underserved populations and provides a 5-year curriculum including a summer orientation, a longitudinal seminar series with community engagement and leadership-development activities, preclerkship clinical immersion in an underserved setting, a master's degree, and a capstone rotation in the final year of medical school. This is a mixed-methods evaluation of the first 4 years of the PRIME-US at the UC Berkeley-UC San Francisco Joint Medical Program (JMP). From 2006 to 2010, focus groups were conducted each year with classes of JMP PRIME-US students, for a total of 11 focus groups; major themes were identified using content analysis. In addition, 4 yearly anonymous, online surveys of all JMP students, faculty and staff were conducted and analyzed. Most PRIME-US students came from socioeconomically disadvantaged backgrounds and ethnic backgrounds underrepresented in medicine, and all were committed to caring for underserved populations. The PRIME-US students experienced many program benefits including peer support, professional role models and mentorship, and curricular enrichment activities that developed their knowledge, skills, and sustained commitment to care for underserved populations. Non-PRIME students, faculty, and staff also benefited from participating in PRIME-sponsored seminars and community-based activities

Evaluation of the occupational X-rays dose of the medical staff in a cardiac catheterization laboratory using an acrylic phantom and semiconductor dosimeter.

Science.gov (United States)

Pan, Lung Fa; Kittipayak, Samrit; Yen, Shan Lin; Pan, Lung Kwang; Lin, Cheng Hsun

2016-01-01

The occupational X-rays doses of medical staff in a cardiac catheterization laboratory were evaluated. Four customized acrylic phantoms were used to simulate a patient, medical doctor, assistant, and radiologist to evaluate the in-situ X-rays exposure dose using semiconductor dosimeters. The exposure dose was measured under three scenarios that were preset to imply: no shielding, moderate shielding and complete shielding for the medical staff in the laboratory. The doses were applied by changing the dose area product (DAP) from 11,000 to 500,000mGy·cm(2) in 14 increments. The estimated annual occupational doses for doctors, assistants and radiologists in scenarios I, II, and III were: I) 35.03, 7.78, 1.95; II) 1.95, 0.78, 0.06; and III) 0.19, 0.10, 0.05cSv, respectively. The derived linear regression line of the exposure dose with respect to the DAP were extrapolated to obtain the minimum detectable level (MDL) of DAP for triggering the staff dosimeters. Accordingly, the minimum annual dose was estimated as 0.05cSv. Additional shielding provided measurable protection to the staff. The protective clothing used in scenarios II and III can reduce the original dose from scenario I to ∼3% (scenario II) and ∼0.5% (scenario III). The annual occupational dose also changed with the various X-rays energy settings. The annual dose increased to 126% when the preset X-rays energy was changed from 70 to 100kVp. The semiconductor dosimeter proved to be an adequate tool for measuring low doses and low dose rates under these circumstances. The dose can be reduce of I) 35.03, 7.78, 1.95; to II) 1.95, 0.78, 0.06 (∼3%); or III) 0.19, 0.10, 0.05 (∼0.5%)cSv, respectively according to different protective scenarios.

Exploring Factors Affecting Emergency Medical Services Staffs’ Decision about Transporting Medical Patients to Medical Facilities

Directory of Open Access Journals (Sweden)

Abbasali Ebrahimian

2014-01-01

Full Text Available Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS staffs. So this study was performed to explore affecting factors in EMS staffs’ decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: “degree of perceived risk in EMS staffs and their patients.” This theme consisted of two main categories: (1 patient’s condition’ and (2 the context of the EMS mission’. The patent’s condition category emerged from “physical health statuses,” “socioeconomic statuses,” and “cultural background” subcategories. The context of the EMS mission also emerged from two subcategories of “characteristics of the mission” and EMS staffs characteristics’. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients’ needs for transportation in a prehospital situation.

Assess the Relationship between Workplace Spirituality and Organizational Commitment of Administrative Staff of Zahedan University of Medical Sciences

Directory of Open Access Journals (Sweden)

2015-07-01

Full Text Available Introduction: One of the hidden factors, however, influences the behavior of employees, their commitment to the organization and their jobs. Thus, identifying factors affecting the organizational commitment is an important task of managers that in this study, the role of workplace spirituality in its occurrence are discussed. Methods: The present study was conducted to assess the relationship between workplace spirituality and organizational commitment. This is a descriptive - correlation study that 151 Administrative Staff of Zahedan University of Medical Sciences was selected by random sampling method in December. The study instruments included workplace spirituality Questionnaire (Milliman et al. 2003 and organizational commitment (Linz, 2003. The scores were analyzed using the Spearman correlation coefficient and multiple regression by Software SPSS17. Results: between workplace spirituality and its three components (meaningful work, a sense of solidarity and alignment values there was a significant positive correlation with the organizational commitment staff (p<0/01. Also, all three components of spirituality at work ability to predict organizational commitment staff (p<0/05. Conclusion: With the development of workplace spirituality, meaningful work, a sense of solidarity and alignment values in organizations, Can be accepted that organizational commitment of employees increases.

The business of medicine: how to overcome financial obstacles and secure financing for your private practice and ancillary services business.

Science.gov (United States)

Nayor, David

2012-01-01

Doctors across the country who operate private medical practices are facing increasing financial obstacles, namely shrinking income as a result of rising costs and lower reimbursements. In addition, as hospitals have become overburdened many physicians have opened up private surgical centers; magnetic resonance imaging and computed tomography and positron emission tomography scanning facilities; pathology labs; colonoscopy/endoscopy suites; lithotripsy centers; and other medical businesses typically performed within the hospital. Moreover, many doctors seek loans to purchase existing practices or for their capital contribution in medical partnerships. The past decade has thus seen a significant increase in the number of doctors taking out small business loans. Indeed, banks view the healthcare industry as a large growth market. This article includes practical information, advice, and resources to help doctors to secure bank financing for their practices, ancillary services business, real estate, and equipment on the best possible market terms.

Exploring the ancillary benefits of the Kyoto Protocol for air pollution in Europe

International Nuclear Information System (INIS)

Vuuren, D.P. van; Cofala, J.; Eerens, H.E.; Oostenrijk, R.; Heyes, C.; Klimont, Z.; Elzen, M.G.J. den; Amann, M.

2006-01-01

An integrated approach to climate change and regional air pollution can harvest considerable ancillary benefits in terms of environmental impacts and costs. This is because both problems are caused to a large extent by the same activity (fossil fuel combustion). Substantial ancillary benefits were found for regional air pollution (SO 2 , NO x , VOC and particulate matter) of implementing the Kyoto Protocol (intended to control greenhouse gas emissions) in Europe. For instance, while three different scenarios on Kyoto implementation were found to reduce European CO 2 emissions by 4-7%, they also reduced European emissions of SO 2 by 5-14% compared with a no Kyoto policies case. The magnitude of ancillary benefits depends on how flexible mechanisms and surplus emission allowances are used in meeting the Kyoto targets. The total cost savings for implementing current policies for regional air pollution of the Kyoto Protocol are of an order of 2.5-7 billion Euro. In all cases, this is in the order of half the costs of the climate policy (4-12 billion Euro). Using flexible mechanisms reduces emissions of air pollutants for Europe as a whole even further than domestic implementation (e.g. 10-14% versus 5% for SO 2 emissions), but the reductions are shifted from Western Europe to Central and Eastern Europe and Russia. The use of surplus emission allowances to achieve the Kyoto targets decreases the ancillary benefits, in particular for the latter group of countries (e.g. unprotected area against acidification increases from 1.3 to 1.7 million ha)

Aggression-impulsivity, mental pain, and communication difficulties in medically serious and medically non-serious suicide attempters.

Science.gov (United States)

Gvion, Yari; Horresh, Netta; Levi-Belz, Yossi; Fischel, Tsvi; Treves, Ilan; Weiser, Mark; David, Haim Shem; Stein-Reizer, Orit; Apter, Alan

2014-01-01

Unbearable mental pain, depression, and hopelessness have been associated with suicidal behavior in general, while difficulties with social communication and loneliness have been associated with highly lethal suicide attempts in particular. The literature also links aggression and impulsivity with suicidal behavior but raises questions about their influence on the lethality and outcome of the suicide attempt. To evaluate the relative effects of aggression and impulsivity on the lethality of suicide attempts we hypothesized that impulsivity and aggression differentiate between suicide attempters and non-attempters and between medically serious and medically non-serious suicide attempters. The study group included 196 participants divided into four groups: 43 medically serious suicide attempters; 49 medically non-serious suicide attempters, 47 psychiatric patients who had never attempted suicide; and 57 healthy control subjects. Data on sociodemographic parameters, clinical history, and details of the suicide attempts were collected. Participants completed a battery of instruments for assessment of aggression-impulsivity, mental pain, and communication difficulties. The medically serious and medically non-serious suicide attempters scored significantly higher than both control groups on mental pain, depression, and hopelessness (pimpulsivity (psuicide attempter groups. Medically serious suicide attempters had significantly lower self-disclosure (psuicide attempters and nonsuicidal psychiatric patients (pimpulsivity, mental pain, and communication variables with suicide lethality yielded significant correlations for self-disclosure, schizoid tendency, and loneliness. The interaction between mental pain and schizoid traits explained some of the variance in suicide lethality, over and above the contribution of each component alone. Aggression-impulsivity and mental pain are risk factors for suicide attempts. However, only difficulties in communication differentiate

Pattern of leisure-time physical activity involvement of Academic and non-Academic staff in tertiary Institutions in Ondo State, Nigeria

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Ajibua M.A.

2012-01-01

Full Text Available Leisure signifies individual’s choice to spend his/her discretionary time fulfilling certain interest or needs or performing a gratifying experience for the sake of wellness or personal development. The aim of this study was to look into the pattern of leisure-time physical activity involvement among academic and non-academic staff in tertiary institution in Ondo State. For the purpose of the study, 40 academic and 40 non-academic staff were selected from the five Government-owned tertiary institutions in the state using convenience sampling techniques. Thus, total respondents were 400. The instrument employed in the study was a structured and validated questionnaire, Pattern of Leisure Involvement Questionnaire (PLIQ to collect information on the pattern of leisure-time physical activity involvement among staff. The reliability test of the instrument was carried out by obtaining Cronbach’s Alpha statistic which is a measure of how reliable and consistent the instrument was. The result showed that Cronbach’s Alpha was 0.896. Since the value was above 0.5 which was the average, it showed that the research instrument was reliable and consistent. The information gathered from the subjects through the questionnaire was analyzedusing descriptive (mean, standard deviation and standard error and inferential statistics (t-test. The findings showed that academic and non-academic staff in tertiary institutions in Ondo State participate in leisure-time physical activity differently. It thus suggested that variety of leisure-time physical activities must be provided for members of tertiary institutions so that some groups will not be taken care of, while others will be isolated.

The State of Cell Blocks and Ancillary Testing: Past, Present, and Future.

Science.gov (United States)

Saqi, Anjali

2016-12-01

Cell blocks are an integral part of cytology, but their utility is recognized probably more now than ever before, largely owing to the significant role they play in ancillary testing, particularly molecular diagnostics. Modifications to improve the cell block method initially introduced more than a century ago have been made over the years. Though their value is acknowledged and they are widely used across laboratories, cell block preparations are not standardized and results of ancillary testing performed on them are inconsistent. This article reviews the state of cell blocks-summarizes the more common, currently available and used methods and their corresponding advantages and shortcomings, outlines the role of alternative techniques (eg, smears), and proposes methods to optimize results.

Data on motivational factors of the medical and nursing staff of a Greek Public Regional General Hospital during the economic crisis.

Science.gov (United States)

Charalambous, Marianna; Konstantinos, Mitosis; Talias, Michael A

2017-04-01

In this article, we present the data related to motivational factors given by the medical (n=118) and nursing (n=217) staff, of a Greek Public General Hospital during a period of financial austerity. The data collection has been based on a structured self-administrable questionnaire which was used in a previous survey in Cyprus (Chatzicharalambous, 2015) [1]. The incentives-rewards included amount in a total to 11 (both financial and non-financial). The data contains 4 parts: (1) demographics, (2) assessment of the degree to which this hospital provided such incentives-rewards, (3) personal assessment of the participants about the significance of these incentive-rewards and (4) to what extent these incentives-rewards have increased or decreased over the last five years due to the economic crisis. The sample was analyzed as a whole on demographics and by a professional subgroup (doctors and nurses) for the other three parts. The data include quantitative tables for all parts. Finally include three tables contain multilevel models.

Qualitative Literature Review of the Prevalence of Depression in Medical Students Compared to Students in Non-medical Degrees.

Science.gov (United States)

Bacchi, Stephen; Licinio, Julio

2015-06-01

The purpose of this study is to review studies published in English between 1 January 2000 and 16 June 2014, in peer-reviewed journals, that have assessed the prevalence of depression, comparing medical students and non-medical students with a single evaluation method. The databases PubMed, Medline, EMBASE, PsycINFO, and Scopus were searched for eligible articles. Searches used combinations of the Medical Subject Headings medical student and depression. Titles and abstracts were reviewed to determine eligibility before full-text articles were retrieved, which were then also reviewed. Twelve studies met eligibility criteria. Non-medical groups surveyed included dentistry, business, humanities, nursing, pharmacy, and architecture students. One study found statistically significant results suggesting that medical students had a higher prevalence of depression than groups of non-medical students; five studies found statistically significant results indicating that the prevalence of depression in medical students was less than that in groups of non-medical students; four studies found no statistically significant difference, and two studies did not report on the statistical significance of their findings. One study was longitudinal, and 11 studies were cross-sectional. While there are limitations to these comparisons, in the main, the reviewed literature suggests that medical students have similar or lower rates of depression compared to certain groups of non-medical students. A lack of longitudinal studies meant that potential common underlying causes could not be discerned, highlighting the need for further research in this area. The high rates of depression among medical students indicate the continuing need for interventions to reduce depression.

Comparison of Smoking and Khat Chewing Habits between Medical and Non-Medical Female Students at UST, Sana'a, Yemen.

Science.gov (United States)

Kubas, Mohammed Abdullah; Wadi, Majed

2015-01-01

Smoking is a worldwide problem that kills millions of people. Women smoke much lower than males but the numbers of smoker women are growing up. The objectives of this study were to assess the prevalence of smoking and khat chewing in medical and non-medical female students at University of Science and Technology (UST), Sana'a, Yemen. We used self-administrated questionnaire to collect cross-sectional data from a randomly selected sample of medical and non-medical female students of UST in 2012-2013. Overall, 480 students completed and returned the questionnaire, of them medical students represented 50% of them. The prevalence of smoking was significantly low among female medical students (P=0.045), however, not significantly difference was found between medical and non-medical female students in khat chewing habits (P=0.083). Non-smoker medical female students who tried smoking (45.6%) were significantly lower than non-medical students (54.4%), and curiosity was the main reason for trying smoking. Water pipe was the most common type of smoking among smoker students (78.6%). Out of 26 female students who smoke and chew khat, 18 students reported that they smoke more while they chew khat. Our study highlights the need for increased health education, awareness, and knowledge of the risks of smoking and particularly khat chewing to reduce these habits among female university students especially in non-medical female students.

An assessment of market and policy barriers for demand response providing ancillary services in U.S. electricity markets

International Nuclear Information System (INIS)

Cappers, Peter; MacDonald, Jason; Goldman, Charles; Ma, Ookie

2013-01-01

An impact of increased variable renewable generation is the need for balancing authorities to procure more ancillary services. While demand response resources are technically capable of providing these services, current experience across the U.S. illustrates they are relatively minor players in most regions. Accessing demand response resources for ancillary services may require a number of changes to policies and common practices at multiple levels. Regional reliability councils must first define ancillary services such that demand response resources may provide them. Once the opportunity exists, balancing authorities define and promulgate rules that set the infrastructure investments and performance attributes of a resource wishing to provide such services. These rules also dictate expected revenue streams which reveal the cost effectiveness of these resources. The regulatory compact between utility and state regulators, along with other statutes and decisions by state policymakers, may impact the interest of demand response program providers to pursue these resources as ancillary service providers. This paper identifies within these broad categories specific market and policy barriers to demand response providing ancillary services in different wholesale and retail environments, with emphasis on smaller customers who must be aggregated through a program provider to meet minimum size requirements for wholesale transactions. - Highlights: • We identify barriers keeping demand response from providing ancillary services. • Institutional, financial and program provider business model barriers exist. • Product definitions and rules do not always accommodate demand response well. • Expected revenues are uncertain and may not exceed required investments costs. • Regulatory compact and state statutes limit opportunities for program providers

Convergence and translation: attitudes to inter-professional learning and teaching of creative problem-solving among medical and engineering students and staff

Science.gov (United States)

2014-01-01

Background Healthcare worldwide needs translation of basic ideas from engineering into the clinic. Consequently, there is increasing demand for graduates equipped with the knowledge and skills to apply interdisciplinary medicine/engineering approaches to the development of novel solutions for healthcare. The literature provides little guidance regarding barriers to, and facilitators of, effective interdisciplinary learning for engineering and medical students in a team-based project context. Methods A quantitative survey was distributed to engineering and medical students and staff in two universities, one in Ireland and one in Belgium, to chart knowledge and practice in interdisciplinary learning and teaching, and of the teaching of innovation. Results We report important differences for staff and students between the disciplines regarding attitudes towards, and perceptions of, the relevance of interdisciplinary learning opportunities, and the role of creativity and innovation. There was agreement across groups concerning preferred learning, instructional styles, and module content. Medical students showed greater resistance to the use of structured creativity tools and interdisciplinary teams. Conclusions The results of this international survey will help to define the optimal learning conditions under which undergraduate engineering and medicine students can learn to consider the diverse factors which determine the success or failure of a healthcare engineering solution. PMID:24450310

The relationship between knowledge of ergonomic science and the occupational health among nursing staff affiliated to Golestan University of Medical Sciences

Science.gov (United States)

Juibari, Leila; Sanagu, Akram; Farrokhi, Nafiseh

2010-01-01

BACKGROUND: Occupational hazards are much higher for nurses than many other jobs and neglecting this fact may reduce the quality of nursing services. The aim of this study was to investigate the relationship between knowledge of ergonomics and occupational health among the nursing staff affiliated to Golestan University of Medical Sciences. METHODS: It was a cross-sectional analytical study on 423 nursing staff working in various medical centers affiliated to Golestan University of Medical Sciences in 2008, selected by quota randomized sampling. Data collection instrument was Ergonomics Questionnaire, which consisted of 72 questions. Cronbach’s alpha for main sections of the questionnaire was 0.8, 0.8 and 0.9. Descriptive and analytical tests were used for data analysis and an alpha error of 5% was considered. RESULTS: Of all the subjects, 36.1% had 5-10 years of work experience, 61.9% had a good knowledge of ergonomic principles, and 83% were exposed to a mild level of occupational hazards. There was no significant relationship between knowledge of ergonomics and occupational health (p = 0.08). The relationships between knowledge of ergonomics and age, gender, marital status, work experience, the type, and the location of service were significant (p ergonomics can provide a healthier work environment for nurses and optimize human resource efficiency. PMID:21589793

Ancillary services provided by PV power plants

Directory of Open Access Journals (Sweden)

Antonio PIERNO

2016-07-01

Full Text Available Renewable energy sources are widely utilized in distributed generation systems, and, recently, they are also considered for providing ancillary services. The paper is focused on PV plants, a survey of the most interesting papers published in the literature in the last decade is reported and the main characteristics of the technical proposals, with their advantages and limits, are evidenced. The results are schematically shown in a table that immediately gives the opportunity to be aware of what was already done, representing a reference tool.

Ancillary testing, diagnostic/classification criteria and severity grading in Behçet disease.

Science.gov (United States)

Okada, Annabelle A; Stanford, Miles; Tabbara, Khalid

2012-12-01

Since there is no pathognomonic clinical sign or laboratory test to distinguish Behçet disease from other uveitic entities, the diagnosis must be made based on characteristic ocular and systemic findings in the absence of evidence of other disease that can explain the findings. Ancillary tests, including ocular and brain imaging studies, are used to assess the severity of intraocular inflammation and systemic manifestations of Behçet disease, to identify latent infections and other medical conditions that might worsen with systemic treatment, and to monitor for adverse effects of drugs used. There are two diagnostic or classification criteria in general use by the uveitis community, one from Japan and one from an international group; both rely on a minimum number and/or combination of clinical findings to identify Behçet disease. Finally, several grading schemes have been proposed to assess severity of ocular disease and response to treatment.

Factors Affecting Communication Patterns between Oncology Staff and Family Members of Deceased Patients: A Cross-Sectional Study.

Science.gov (United States)

Granot, Tal; Gordon, Noa; Perry, Shlomit; Rizel, Shulamith; Stemmer, Salomon M

Perceptions of the role of oncology medical staff in supporting bereaved families have evolved with the transition to interdisciplinary cancer care. We investigated the interactions between oncology professionals and bereaved families. This cross-sectional study involved all oncology medical staff at the Davidoff Center. Participants were given a questionnaire relating to bereavement follow-up. Responses were measured using a 5-point Likert scale. Of 155 staff members, 107 filled questionnaires with social workers (7%), psychologists (4%), or unspecified (8%); 85% were Jewish, and 60% had ≥10 years of oncology experience. Most respondents thought that contacting bereaved families was important (73%), and that it provided closure for staff (79%); 41% indicated that they contacted >50% of the families of their deceased patients. Contacting bereaved families was considered the responsibility of the physicians (90%), nurses (84%), or social workers (89%). The main barriers to contacting bereaved families were emotional overload (68%) and lack of time (63%); 60% indicated a need for additional communication tools for bereavement follow-up. In a multivariate analysis, profession (physician vs. nurse), primary workplace (outpatient setting vs. other), and self-defined religion were significant variables with respect to the perceived importance of contacting bereaved families and to actually contacting them. Other factors (e.g., age, gender) were non-significant. Perspectives regarding bereavement actions differ significantly across medical professions, work settings, and self-defined religions. Additional guidance and education regarding bereavement actions is warranted.

30 CFR 250.207 - What ancillary activities may I conduct?

Science.gov (United States)

2010-07-01

... surveys; or (c) Studies that model potential oil and hazardous substance spills, drilling muds and... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What ancillary activities may I conduct? 250.207 Section 250.207 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR OFFSHORE...

Attitudes toward inter-hospital electronic patient record exchange: discrepancies among physicians, medical record staff, and patients.

Science.gov (United States)

Wang, Jong-Yi; Ho, Hsiao-Yun; Chen, Jen-De; Chai, Sinkuo; Tai, Chih-Jaan; Chen, Yung-Fu

2015-07-12

In this era of ubiquitous information, patient record exchange among hospitals still has technological and individual barriers including resistance to information sharing. Most research on user attitudes has been limited to one type of user or aspect. Because few analyses of attitudes toward electronic patient records (EPRs) have been conducted, understanding the attitudes among different users in multiple aspects is crucial to user acceptance. This proof-of-concept study investigated the attitudes of users toward the inter-hospital EPR exchange system implemented nationwide and focused on discrepant behavioral intentions among three user groups. The system was designed by combining a Health Level 7-based protocol, object-relational mapping, and other medical informatics techniques to ensure interoperability in realizing patient-centered practices. After implementation, three user-specific questionnaires for physicians, medical record staff, and patients were administered, with a 70 % response rate. The instrument showed favorable convergent construct validity and internal consistency reliability. Two dependent variables were applied: the attitudes toward privacy and support. Independent variables comprised personal characteristics, work characteristics, human aspects, and technology aspects. Major statistical methods included exploratory factor analysis and general linear model. The results from 379 respondents indicated that the patients highly agreed with privacy protection by their consent and support for EPRs, whereas the physicians remained conservative toward both. Medical record staff was ranked in the middle among the three groups. The three user groups demonstrated discrepant intentions toward privacy protection and support. Experience of computer use, level of concerns, usefulness of functions, and specifically, reason to use electronic medical records and number of outpatient visits were significantly associated with the perceptions. Overall, four

Reproductive experiences of women who cryopreserved oocytes for non-medical reasons.

Science.gov (United States)

Hammarberg, Karin; Kirkman, Maggie; Pritchard, Natasha; Hickey, Martha; Peate, Michelle; McBain, John; Agresta, Franca; Bayly, Chris; Fisher, Jane

2017-03-01

What are the reproductive experiences of women who cryopreserve oocytes for non-medical reasons? One in three women had been pregnant at some stage in their lives and while most still wanted to have a child or another child, very few had used their stored oocytes, predominantly because they did not want to be single parents. The number of healthy women who freeze oocytes to avoid age-related infertility is increasing. Evidence about reproductive outcomes after oocyte cryopreservation for non-medical reasons is needed to help women make informed decisions. A cross-sectional survey was carried out. Study packs which included a self-administered questionnaire were mailed by clinic staff to 193 eligible women. Women who had stored oocytes for non-medical reasons at Melbourne IVF, a private ART clinic, between 1999 and 2014 were identified from medical records and invited to complete an anonymous questionnaire about their reproductive histories and experience of oocyte cryopreservation. A total of 10 survey packs were returned to the clinic marked 'address unknown'. Of the 183 potential respondents, 96 (53%) returned the questionnaire. One respondent provided only free-text comments, thus data from 95 respondents were compiled. The mean age at the time of freezing oocytes was 37.1 years (SD ± 2.6, range: 27-42) and the average number of oocytes stored was 14.2 (SD ± 7.9, range: 0-42); 2% had attempted to store oocytes but had none suitable for freezing, 24% had stored 23 oocytes. About one-third of respondents (34%) had been pregnant at some point in their lives. Six women (6%) had used their stored oocytes and three of them had given birth as a result. The main reason for not using stored oocytes was not wanting to be a single parent. Of the 87 (91%) women who still had oocytes stored, 21% intended to use them while 69% indicated that their circumstances would determine usage. The mean number of children respondents would ideally have liked to have was significantly

Analysis of the Impact of Wind Power Participating in Both Energy and Ancillary Services Markets – The Danish Case

DEFF Research Database (Denmark)

Soares, Tiago; Morais, Hugo; Pinson, Pierre

2014-01-01

The impact of a high penetration of wind power generation in power systems motivates need for an assessment of its inte raction with electricity markets. With the continuous evolution of wind turbines technology, wind farms have today the ability to provide certain ancillary services...... with appropriate levels of security and reliability . The participation of wind f arms i n ancillary service market s ought to rely on market designs and offering strategies that satisfy power system needs, as well as their operating characteristics . Here we evaluate the system impact of different offering...... strategies that wind farms employ on ene rgy and ancillary service market. A lready proposed Proportional Wind Reserve Strategy (PWRS) and a Continuo us Wind Reserve Strategy (CWRS) are used to determine the amount of available power for ancillary services. A case study based on real and recent dat...

Evaluating the implementation of a multicomponent asthma education program for Head Start staff.

Science.gov (United States)

Ruvalcaba, Elizabeth; Chung, Shang-En; Rand, Cynthia; Riekert, Kristin A; Eakin, Michelle

2018-03-15

Asthma disproportionately affects minority groups, low income populations, and young children under 5. Head Start (HS) programs predominantly serve this high-risk population, yet staff are not trained on asthma management. The objective of this study was to assess a 5-year, multicomponent HS staff asthma education program in Baltimore City HS programs. All HS programs were offered annual staff asthma education by a medical research team that included didactic lectures and hands-on training. Attendees received continuing education credits. HS staff were anonymously surveyed on asthma knowledge and skills and asthma medication management practices in Year 1 (preimplementation) and Year 5. There was an estimated response rate of 94% for Year 1 and 82% for Year 5. Compared to staff in Year 1, Year 5 staff were significantly more likely to report they had very good knowledge and skills related to asthma [odds ratio (OR) 1.63; p staff reported higher self-assessed knowledge and skills, self-reports of asthma medication management practices, and self-reports of asthma activities compared to Year 1 staff. HS serves high-risk children with asthma, and a multicomponent program can adequately prepare staff to manage asthma in the child care setting. Our results indicate the feasibility of providing efficacious health skill education into child care provider training to reduce asthma knowledge gaps.

Technique for determining training staff size

International Nuclear Information System (INIS)

Frye, S.R.

1985-01-01

Determining an adequate training staff size is a vital function of a training manager. Today's training requirements and standards have dictated a more stringent work load than ever before. A trainer's role is more than just providing classroom lectures. In most organizations the instructor must develop programs, lesson plans, exercise guides, objectives, test questions, etc. The tasks of a training organization are never ending and the appropriate resources must be determined and allotted to do the total job. A simple method exists for determining an adequate staff. Although not perfect, this method will provide a realistic approach for determining the needed training staff size. This method considers three major factors: instructional man-hours; non-instructional man-hours; and instructor availability. By determining and adding instructional man-hours and non-instructional man-hours a total man-hour distribution can be obtained. By dividing this by instructor availability a staff size can be determined

38 CFR 17.96 - Medication prescribed by non-VA physicians.

Science.gov (United States)

2010-07-01

... AFFAIRS MEDICAL Outpatient Treatment § 17.96 Medication prescribed by non-VA physicians. Any prescription... and medicines ordered by a private or non-Department of Veterans Affairs doctor of medicine or doctor of osteopathy duly licensed to practice in the jurisdiction where the prescription is written, shall...

Comparison of knowledge non-medical and medical students about the sport of people with disabilities

Directory of Open Access Journals (Sweden)

Agnieszka Jacykowska

2018-01-01

Full Text Available Introduction and aim: Physical activity is a very important part of everyone's life. It has positive effect on the functioning of the body of both healthy people and people with disabilities. Many disabled people take competitive sports with very good results. These individuals can find support in a number of organizations cooperating with disabled athletes. The main aim of this article is to compare the knowledge of students of medical and non-medical universities about sport of disabled people. Material and methods: Research was carried out among students of medical and non-medical universities. Tested 152 people - 93  women and 59 men. Diagnostic survey questionnaire method was used during the test. The questionnaire consisted of 17 questions and specifications relating to sport for the disabled. Results: The definition of a disabled person were able to identify by 70% of the surveyed students. 42% of respondents could not indicate the names of the disabled athlete. The majority of respondents (medical and non-medical professions have seen competition of disabled people on television or the Internet. Rehabilitation and improvement of mental health, were indicated by respondents as the most important benefits of doing sport for disabled. Conclusions: The level of knowledge of students about sport for the disabled can be considered as satisfying.

Medical futility and end-of-life care | Sidler | South African Medical ...

African Journals Online (AJOL)

treating physician is responsible for guiding this process by demonstrating sensitivity and compassion, respecting the values of patients, their families and the medical staff. The need for training to equip medical staff to take responsibility as empathetic participants in end-of-life decision-making is underscored. South African ...

The Staff of Life.

Science.gov (United States)

Jones, Rebecca

1994-01-01

Some children have chronic illnesses that require diet modifications as part of their medical treatment. Advises school districts to hire a registered dietitian or look for resources at a local hospital or public health office. In addition, schools should work with parents, improve staff training, and conduct spot checks of school cafeterias. (MLF)

Teamwork and delegation in medical homes: primary care staff perspectives in the Veterans Health Administration.

Science.gov (United States)

True, Gala; Stewart, Greg L; Lampman, Michelle; Pelak, Mary; Solimeo, Samantha L

2014-07-01

The patient-centered medical home (PCMH) relies on a team approach to patient care. For organizations engaged in transitioning to a PCMH model, identifying and providing the resources needed to promote team functioning is essential. To describe team-level resources required to support PCMH team functioning within the Veterans Health Administration (VHA), and provide insight into how the presence or absence of these resources facilitates or impedes within-team delegation. Semi-structured interviews with members of pilot teams engaged in PCMH implementation in 77 primary care clinics serving over 300,000 patients across two VHA regions covering the Mid-Atlantic and Midwest United States. A purposive sample of 101 core members of pilot teams, including 32 primary care providers, 42 registered nurse care managers, 15 clinical associates, and 12 clerical associates. Investigators from two evaluation sites interviewed frontline primary care staff separately, and then collaborated on joint analysis of parallel data to develop a broad, comprehensive understanding of global themes impacting team functioning and within-team delegation. We describe four themes key to understanding how resources at the team level supported ability of primary care staff to work as effective, engaged teams. Team-based task delegation was facilitated by demarcated boundaries and collective identity; shared goals and sense of purpose; mature and open communication characterized by psychological safety; and ongoing, intentional role negotiation. Our findings provide a framework for organizations to identify assets already in place to support team functioning, as well as areas in need of improvement. For teams struggling to make practice changes, our results indicate key areas where they may benefit from future support. In addition, this research sheds light on how variation in medical home implementation and outcomes may be associated with variation in team-based task delegation.

Medication details documented on hospital discharge: cross-sectional observational study of factors associated with medication non-reconciliation.

LENUS (Irish Health Repository)

Grimes, Tamasine C

2012-02-01

AIMS: Movement into or out of hospital is a vulnerable period for medication safety. Reconciling the medication a patient is using before admission with the medication prescribed on discharge, and documenting any changes (medication reconciliation) is recommended to improve safety. The aims of the study were to investigate the factors contributing to medication reconciliation on discharge, and identify the prevalence of non-reconciliation. METHODS: The study was a cross-sectional, observational survey using consecutive discharges from purposively selected services in two acute public hospitals in Ireland. Medication reconciliation, potential for harm and unplanned re-admission were investigated. RESULTS: Medication non-reconciliation was identified in 50% of 1245 inpatient episodes, involving 16% of 9569 medications. The majority of non-reconciled episodes had potential to result in moderate (63%) or severe (2%) harm. Handwritten rather than computerized discharges (adjusted odds ratio (adjusted OR) 1.60, 95% CI 1.11, 2.99), increasing number of medications (adjusted OR 1.26, 95% CI 1.21, 1.31) or chronic illness (adjusted OR 2.08, 95% CI 1.33, 3.24) were associated with non-reconciliation. Omission of endocrine, central nervous system and nutrition and blood drugs was more likely on discharge, whilst omission on admission and throughout inpatient care, without documentation, was more likely for obstetric, gynaecology and urinary tract (OGU) or respiratory drugs. Documentation in the discharge communication that medication was intentionally stopped during inpatient care was less likely for cardiovascular, musculoskeletal and OGU drugs. Errors involving the dose were most likely for respiratory drugs. CONCLUSIONS: The findings inform strategies to facilitate medication reconciliation on discharge from acute hospital care.

Prolonged Cardiopulmonary Resuscitation Process and Lower Frequency of Medical Staff Visit Predicts Independently In-hospital Resuscitation Success in the Elderly Population

Directory of Open Access Journals (Sweden)

Jui-Chen Tsai

2012-09-01

Conclusion: Although the initial resuscitation success rate was not affected by age, a longer time interval between the last medical staffs’ visit and the onset of resuscitation did result in a worse success rate in elderly patients. Our data suggest that more frequent staff visits to the elderly population during hospitalization could alter initial resuscitation results.

29 CFR 2550.408b-6 - Statutory exemption for ancillary services by a bank or similar financial institution.

Science.gov (United States)

2010-07-01

....408b-6 Statutory exemption for ancillary services by a bank or similar financial institution. (a) In... service is consistent with sound banking and financial practice, as determined by Federal or State... 29 Labor 9 2010-07-01 2010-07-01 false Statutory exemption for ancillary services by a bank or...

ٍEffective factors on the Incidence of medication errors from the nursing staff perspective in various department of Fasa Hospital

Directory of Open Access Journals (Sweden)

Mostafa Bizhani

2013-06-01

Full Text Available  Background and Objective: The incidence of medical errors is deemed one of the unavoidable cases of serious threats to the health and safety of patients. This study aimed to determine the factors influencing medication errors from the perspective of the nursing staff. Materials and Methods: This descriptive -analytic study recruited 80 nurses working in various wards in Fasa Hospital. The nurses were selected via the availability sampling method, and their perspective on factors affecting medication errors was gathered using a questionnaire designed for this study. The data were analyzed with SPSS-15 software.   Results: The most important causes of medication errors were work fatigue, low nurse-to-patient ratio, long working hours, high density of work in units, and doing other tasks. Other variables such as age and gender as well as factors effective on the incidence of medication errors are mentioned in the full text. Conclusion: From the nurses’ standpoint, workload and the patient-to-nurse ratio were the most significant factors leading to medication errors.

Perception of electronic medical records (EMRs by nursing staff in a teaching hospital in India

Directory of Open Access Journals (Sweden)

Naveen Kumar Pera

2014-01-01

Full Text Available Background: Currently, in India, many healthcare organizations and their managements appreciate the advantages of electronic medical records, but they often use them. The current push for universal health coverage in India with National Rural Health Mission (NRHM and National Urban Health Mission (NUHM helping toward healthcare reforms highlights the importance of implementing information technology as a means of cutting costs and improving efficiency in healthcare field. The quality of documentation of patient care rendered at healthcare destinations is very important to showcase the growing stature of healthcare in India. Aims: As maintaining the medical records is very important, storage and retrieval of the information is also important for future patient care. In this regard, implementation of electronic medical records in hospitals is essential. Through this study, we wanted to highlight the perceptions of healthcare personnel, who are in the core team of delivering healthcare, toward implementation of electronic medical records. Methods: A cross-sectional study was carried out among doctors (post-graduates and staff nurses. The sample size for post-graduate students and nurses was 164 and 296, respectively, in this study. The study was carried out during the period from January to June 2013, and a survey was conducted with the help of a validated, pre-tested questionnaire in a tertiary care medical college hospital in India. Results: The results showed that 75% of the study population are comfortable working with electronic medical records. They mentioned that display of diagnosis, medications, and allergies of patients on the records was most important. Their perception was that electronic medical records improve timely decision-making and patient care due to immediate access to the patient′s disease history. Conclusion: The major problems faced by nurses, as per our study, are delay in services due to dispersion of records

Validity of the SMS, Phone, and medical staff Examination sports injury surveillance system for time-loss and medical attention injuries in sports.

Science.gov (United States)

Møller, M; Wedderkopp, N; Myklebust, G; Lind, M; Sørensen, H; Hebert, J J; Emery, C A; Attermann, J

2018-01-01

The accurate measurement of sport exposure time and injury occurrence is key to effective injury prevention and management. Current measures are limited by their inability to identify all types of sport-related injury, narrow scope of injury information, or lack the perspective of the injured athlete. The aims of the study were to evaluate the proportion of injuries and the agreement between sport exposures reported by the SMS messaging and follow-up telephone part of the SMS, Phone, and medical staff Examination (SPEx) sports injury surveillance system when compared to measures obtained by trained on-field observers and medical staff (comparison method). We followed 24 elite adolescent handball players over 12 consecutive weeks. Eighty-six injury registrations were obtained by the SPEx and comparison methods. Of them, 35 injury registrations (41%) were captured by SPEx only, 10 injury registrations (12%) by the comparison method only, and 41 injury registrations (48%) by both methods. Weekly exposure time differences (95% limits of agreement) between SPEx and the comparison method ranged from -4.2 to 6.3 hours (training) and -1.5 to 1.0 hours (match) with systematic differences being 1.1 hours (95% CI 0.7 to 1.4) and -0.2 (95% CI -0.3 to -0.2), respectively. These results support the ability of the SPEx system to measure training and match exposures and injury occurrence among young athletes. High weekly response proportions (mean 83%) indicate that SMS messaging can be used for player measures of injury consequences beyond time-loss from sport. However, this needs to be further evaluated in large-scale studies. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Aligning institutional priorities: engaging house staff in a quality improvement and safety initiative to fulfill Clinical Learning Environment Review objectives and electronic medical record Meaningful Use requirements.

Science.gov (United States)

Flanagan, Meghan R; Foster, Carolyn C; Schleyer, Anneliese; Peterson, Gene N; Mandell, Samuel P; Rudd, Kristina E; Joyner, Byron D; Payne, Thomas H

2016-02-01

House staff quality improvement projects are often not aligned with training institution priorities. House staff are the primary users of inpatient problem lists in academic medical centers, and list maintenance has significant patient safety and financial implications. Improvement of the problem list is an important objective for hospitals with electronic health records under the Meaningful Use program. House staff surveys were used to create an electronic problem list manager (PLM) tool enabling efficient problem list updating. Number of new problems added and house staff perceptions of the problem list were compared before and after PLM intervention. The PLM was used by 654 house staff after release. Surveys demonstrated increased problem list updating (P = .002; response rate 47%). Mean new problems added per day increased from 64 pre-PLM to 125 post-PLM (P house staff in institutional quality and safety initiatives with tangible institutional benefits. Copyright © 2016 Elsevier Inc. All rights reserved.

Medical faculty opinions of peer tutoring.

Science.gov (United States)

Rudland, Joy R; Rennie, Sarah C

2014-01-01

Peer tutoring is a well-researched and established method of learning defined as 'a medical student facilitating the learning of another medical student'. While it has been adopted in many medical schools, other schools may be reluctant to embrace this approach. The attitude of the teaching staff, responsible for organizing and or teaching students in an undergraduate medical course to formal peer teaching will affect how it is introduced and operationalized. This study elicits faculty opinions on how best to introduce peer tutoring for medical students. Structured telephone interviews were recorded, transcribed and analyzed using thematic analysis. The interviews were with medically qualified staff responsible for organizing or teaching undergraduate medical students at a New Zealand medical school. Six questions were posed regarding perceived advantages and disadvantages of peer tutoring and how the school and staff could support a peer-tutoring scheme if one was introduced. Staff generally supported the peer tutoring concept, offering a safe environment for learning with its teachers being so close in career stage to the learners. They also say disadvantages when the student-teachers imparted wrong information and when schools used peer tutoring to justify a reduction in teaching staff. Subjects felt that faculty would be more accepting of peer tutoring if efforts were made to build staff 'buy in' and empowerment, train peer tutors and introduce a solid evaluation process. Staff of our school expressed some concerns about peer tutoring that are not supported in the literature, signaling a need for better communication about the benefits and disadvantages of peer tutoring.

Perceptions and attitudes of hospital staff toward paging system and the use of mobile phones.

Science.gov (United States)

Haroon, Muhammad; Yasin, Faiza; Eckel, Rachael; Walker, Frank

2010-10-01

Our objective was to document the pattern of mobile phone usage by medical staff in a hospital setting, and to explore any perceived benefits (such as improved communications) associated with mobile phones. This cross-sectional survey was conducted in Waterford Regional Hospital, Ireland, where bleep is the official system of communication. All non-consultant hospital doctors, of medical disciplines only, were asked to participate. The questionnaire was designed to explore the pattern and different aspects of mobile phone usage. At the time of study, there were sixty medical junior doctors, and the response rate was 100 percent. All participants used mobile phones while at work, and also for hospital-related work. For 98.3 percent the mobile phone was their main mode of communication while in the hospital. Sixty-two percent (n = 37) made 6-10 calls daily purely for work-related business, and this comprised of ≥ 80 percent of their daily usage of mobile phones. For 98 percent of participants, most phone calls were work-related. Regarding reasons for using mobile phones, all reported that using mobile phone is quicker for communication. Mobile phone usage is very common among the medical personnel, and this is regarded as a more efficient means of communication for mobile staff than the hospital paging system.

Preconception sex selection for non-medical and intermediate reasons: ethical reflections

OpenAIRE

de Wert, G.; Dondorp, W.

2010-01-01

Sex selection for non-medical reasons is forbidden in many countries. Focusing on preconception sex selection, the authors first observe that it is unclear what should count as a ‘medical reason’ in this context and argue for the existence of ‘intermediate reasons’ that do not fit well within the rigid distinction between ‘medical’and ‘non-medical’. The article further provides a critical review of the arguments for the prohibition of sex selection for non-medical reasons and finds that none ...

Ocean Surface Topography Mission (OSTM) /Jason-2: Ancillary Files (NODC Accession 0044982)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — This accession contains the data descriptions for the OSTM/Jason-2 Ancillary data files, which is served through the NOAA/NESDIS Comprehensive Large Array-data...

Trust and Work Place Spirituality on Knowledge Sharing Behaviour: Perspective from Non-Academic Staff of Higher Learning Institutions

Science.gov (United States)

Rahman, Muhammad Sabbir; Osmangani, Aahad M; Daud, Nuraihan Mat; Chowdhury, Abdul Hannan; Hassan, Hasliza

2015-01-01

Purpose: This empirical research aims to add value in the existing research on knowledge sharing, investigate the antecedents of knowledge-sharing behaviour by embedding trust and workplace spirituality variable on non-academic staff from higher learning institution in Malaysia. The role of trust, perceived risk and workplace spirituality towards…

Ancillary Frequency Control of Direct Drive Full-Scale Converter Based Wind Power Plants

DEFF Research Database (Denmark)

Hu, Weihao; Su, Chi; Fang, Jiakun

2013-01-01

This paper presents a simulation model of a wind power plant based on a MW-level variable speed wind turbine with a full-scale back-to-back power converter developed in the simulation tool of DIgSILENT Power Factory. Three different kinds of ancillary frequency control strategies, namely inertia...... control strategies are effective means for providing ancillary frequency control of variable speed wind turbines with full-scale back-to-back power converters....... emulation, primary frequency control and secondary frequency control, are proposed in order to improve the frequency stability of power systems. The modified IEEE 39-bus test system with a large-scale wind power penetration is chosen as the studied power system. Simulation results show that the proposed...

Medical Care Expenditure in Suicides From Non-illness-related Causes

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Jungwoo Sohn

2014-11-01

Full Text Available Objectives: Several epidemiological studies on medical care utilization prior to suicide have considered the motivation of suicide, but focused on the influence of physical illnesses. Medical care expenditure in suicide completers with non-illness-related causes has not been investigated. Methods: Suicides motivated by non-illness-related factors were identified using the investigator’s note from the National Police Agency, which was then linked to the Health Insurance Review and Assessment data. We investigated the medical care expenditures of cases one year prior to committing suicide and conducted a case-control study using conditional logistic regression analysis after adjusting for age, gender, area of residence, and socioeconomic status. Results: Among the 4515 suicides motivated by non-illness-related causes, medical care expenditures increased in only the last 3 months prior to suicide in the adolescent group. In the younger group, the proportion of total medical expenditure for external injuries was higher than that in the older groups. Conditional logistic regression analysis showed significant associations with being a suicide completer and having a rural residence, low socioeconomic status, and high medical care expenditure. After stratification into the four age groups, a significant positive association with medical care expenditures and being a suicide completer was found in the adolescent and young adult groups, but no significant results were found in the elderly groups for both men and women. Conclusions: Younger adults who committed suicide motivated by non-illness-related causes had a higher proportion of external injuries and more medical care expenditures than their controls did. This reinforces the notion that suicide prevention strategies for young people with suicidal risk factors are needed.

Ancillary services and optimal household energy management with photovoltaic production

International Nuclear Information System (INIS)

Clastres, C.; Ha Pham, T.T.; Wurtz, F.; Bacha, S.

2010-01-01

This article presents a project designed to increase the monetary value of photovoltaic (PV) solar production for residential applications. To contribute to developing new functionalities for this type of PV system and an efficient control system for optimising its operation, this article explains how the proposed system could contract to provide ancillary services, particularly the supply of active power services. This provision of service by a PV-based system for domestic applications, not currently available, has prompted a market design proposal related to the distribution system. The mathematical model for calculating the system's optimal operation (sources, load and exchanges of power with the grid) results in a linear mix integer optimisation problem in which the objective is to maximise the profits achieved by taking part in the electricity market. Our approach is illustrated in a case study. PV producers could gain by taking part in the markets for balancing power or ancillary services despite the negative impact on profit of several types of uncertainty, notably the intermittent nature of the PV source.

Porters, watchmen, and the crime of William Sayers: the non-scientific staff of the Royal Observatory, Greenwich, in Victorian times

Science.gov (United States)

Chapman, Allan

2003-06-01

A careful study of the detailed archives of the Victorian Royal Observatory makes it possible to build up a picture of the employment and working conditions not only of the astronomical staff who worked at Greenwich, but also of the labourers, watchmen, and gate porters. Indeed, the archives open up a window on to how the Observatory was run on a daily basis: how its non-scientific staff were recruited and paid, and what were their terms of employment. They also say a great deal about how Sir George Biddell Airy directed and controlled every aspect of the Observatory's life. Yet while Airy was a strict employer, he emerges as a man who was undoubtedly fair-minded and sometimes even generous to his non-scientific work-force. A study of the Observatory staff files also reveals the relationship between the Observatory labouring staff and the Airy family's domestic servants. And of especial interest is the robbery committed by William Sayers, the Airy family footman in 1868, bringing to light as it does Sir George and Lady Richarda Airy's views on crime and its social causes and consequences, the prison rehabilitation service in 1868, and their opinions on the reform of offenders. Though this paper is not about astronomy as such, it illuminates a fascinating interface where the world of astronomical science met and worked alongside the world of ordinary Victorian people within the walls of one of the nineteenth century's most illustrious astronomical institutions.

Primary non-adherence to prescribed medication in general practice

DEFF Research Database (Denmark)

Linnet, Kristján; Halldórsson, Matthías; Thengilsdóttir, Gudrún

2013-01-01

Primary non-adherence refers to the patient not redeeming a prescribed medication at some point during drug therapy. Research has mainly focused on secondary non-adherence. Prior to this study, the overall rate of primary non-adherence in general practice in Iceland was not known....

Staff rules and regulations

CERN Multimedia

HR Department

2007-01-01

The 11th edition of the Staff Rules and Regulations, dated 1 January 2007, adopted by the Council and the Finance Committee in December 2006, is currently being distributed to departmental secretariats. The Staff Rules and Regulations, together with a summary of the main modifications made, will be available, as from next week, on the Human Resources Department's intranet site: http://cern.ch/hr-web/internal/admin_services/rules/default.asp The main changes made to the Staff Rules and Regulations stem from the five-yearly review of employment conditions of members of the personnel. The changes notably relate to: the categories of members of the personnel (e.g. removal of the local staff category); the careers structure and the merit recognition system; the non-residence, installation and re-installation allowances; the definition of family, family allowances and family-related leave; recognition of partnerships; education fees. The administrative circulars, some of which are being revised following the m...

Staff rules and regulations

CERN Multimedia

HR Department

2007-01-01

The 11th edition of the Staff Rules and Regulations, dated 1 January 2007, adopted by the Council and the Finance Committee in December 2006, is currently being distributed to departmental secretariats. The Staff Rules and Regulations, together with a summary of the main modifications made, will be available, as from next week, on the Human Resources Department's intranet site: http://cern.ch/hr-web/internal/admin_services/rules/default.asp The main changes made to the Staff Rules and Regulations stem from the five-yearly review of employment conditions of members of the personnel. The changes notably relate to: the categories of members of the personnel (e.g. removal of the local staff category); the careers structure and the merit recognition system; the non-residence, installation and re-installation allowances; the definition of family, family allowances and family-related leave; recognition of partnerships; education fees. The administrative circulars, some of which are being revised following the ...

High beta radiation exposure of medical staff measures for optimisation of radiation protection

International Nuclear Information System (INIS)

Barth, I.; Rimpler, A.

2006-01-01

Full text of publication follows: New therapies applying beta radionuclides have been introduced in medicine in recent years, especially in nuclear medicine, e. g. radio-synoviorthesis, radioimmunotherapy and palliative pain therapy. The preparation of radiopharmaceuticals, their dispensary as well as injection require the handling of vials and syringes with high activities of beta emitters at small distances to the skin. Thus the medical staff may be exposed to a high level of beta radiation. Hence the local skin dose, Hp(0,07), was measured at these workplaces with thin-layer thermoluminescent dosemeters TLD (LiF:Mg,P,Cu) fixed to the tip of the fingers at both hands of the personnel. In addition, official beta/photon ring dosemeters were worn at the first knuckle of the index finger. Very high local skin doses were measured at the tip of index finger and thumb. The findings indicate that the exposure of the staff can exceed the annual dose limit for skin of 500 mSv when working at a low protection standard. By the use of appropriate shieldings and tools (e.g. tweezers or forceps) the exposure was reduced of more than one order of magnitude. The German dosimetry services provide official beta/photon ring dosemeters for routine monitoring of the extremity exposure of occupationally exposed persons. But even monitoring with these official dosemeters does not provide suitable results to control compliance with the dose limit in the majority of cases because they can mostly not be worn at the spot of highest beta exposure (finger tip). Therefore, a study was performed to identify the difference of readings of official ring dosemeters and the maximum local skin dose at the finger tips. At workplaces of radio-synoviorthesis a correction factor of 3 was determined provided that the staff worked at high radiation protection standard and the ring dosemeters were worn at the first knuckle of the index finger. The correction factor increases significantly when the radiation

Impact of advanced wind power ancillary services on power system

DEFF Research Database (Denmark)

Hansen, Anca Daniela; Altin, Müfit

The objective of this report is to illustrate and analyse, by means of simulation test cases, the impact of wind power advanced ancillary services, like inertial response (IR), power oscillation damping (POD) and synchronising power (SP) on the power system. Generic models for wind turbine, wind...... power plant and power system are used in the investigation....

Psychosocial Variables Associated with Immunosuppressive Medication Non-Adherence after Renal Transplantation

Directory of Open Access Journals (Sweden)

Jennifer Felicia Scheel

2018-02-01

Full Text Available IntroductionNon-adherence to immunosuppressive medication is regarded as an important factor for graft rejection and loss after successful renal transplantation. Yet, results on prevalence and relationship with psychosocial parameters are heterogeneous. The main aim of this study was to investigate the association of immunosuppressive medication non-adherence and psychosocial factors.MethodsIn 330 adult renal transplant recipients (≥12 months posttransplantation, health-related quality of life, depression, anxiety, social support, and subjective medication experiences were assessed, and their associations with patient-reported non-adherence was evaluated.Results33.6% of the patients admitted to be partially non-adherent. Non-adherence was associated with younger age, poorer social support, lower mental, but higher physical health-related quality of life. There was no association with depression and anxiety. However, high proportions of clinically relevant depression and anxiety symptoms were apparent in both adherent and non-adherent patients.ConclusionIn the posttransplant follow-up, kidney recipients with lower perceived social support, lower mental and higher physical health-related quality of life, and younger age can be regarded as a risk group for immunosuppressive medication non-adherence. In follow-up contacts with kidney transplant patients, physicians may pay attention to these factors. Furthermore, psychosocial interventions to optimize immunosuppressive medication adherence can be designed on the basis of this information, especially including subjectively perceived physical health-related quality of life and fostering social support seems to be of importance.

What are incident reports telling us? A comparative study at two Australian hospitals of medication errors identified at audit, detected by staff and reported to an incident system.

Science.gov (United States)

Westbrook, Johanna I; Li, Ling; Lehnbom, Elin C; Baysari, Melissa T; Braithwaite, Jeffrey; Burke, Rosemary; Conn, Chris; Day, Richard O

2015-02-01

To (i) compare medication errors identified at audit and observation with medication incident reports; (ii) identify differences between two hospitals in incident report frequency and medication error rates; (iii) identify prescribing error detection rates by staff. Audit of 3291 patient records at two hospitals to identify prescribing errors and evidence of their detection by staff. Medication administration errors were identified from a direct observational study of 180 nurses administering 7451 medications. Severity of errors was classified. Those likely to lead to patient harm were categorized as 'clinically important'. Two major academic teaching hospitals in Sydney, Australia. Rates of medication errors identified from audit and from direct observation were compared with reported medication incident reports. A total of 12 567 prescribing errors were identified at audit. Of these 1.2/1000 errors (95% CI: 0.6-1.8) had incident reports. Clinically important prescribing errors (n = 539) were detected by staff at a rate of 218.9/1000 (95% CI: 184.0-253.8), but only 13.0/1000 (95% CI: 3.4-22.5) were reported. 78.1% (n = 421) of clinically important prescribing errors were not detected. A total of 2043 drug administrations (27.4%; 95% CI: 26.4-28.4%) contained ≥ 1 errors; none had an incident report. Hospital A had a higher frequency of incident reports than Hospital B, but a lower rate of errors at audit. Prescribing errors with the potential to cause harm frequently go undetected. Reported incidents do not reflect the profile of medication errors which occur in hospitals or the underlying rates. This demonstrates the inaccuracy of using incident frequency to compare patient risk or quality performance within or across hospitals. New approaches including data mining of electronic clinical information systems are required to support more effective medication error detection and mitigation. © The Author 2015. Published by Oxford University Press in association

Staff eye doses in a large medical centre in Saudi Arabia: are they meeting the new ICRP recommendations?

International Nuclear Information System (INIS)

Al-Haj, Abdalla N.; Al-Gain, Ibrahim; Lobriguito, Aida M.

2015-01-01

A 5-y retrospective analysis of the cardiology staff eye doses was performed on 34 staff from different categories (cardiologists, nurses and technologists) at King Faisal Specialist Hospital and Research Centre (KFSHRC) in Riyadh, Saudi Arabia. KFSHRC is a tertiary medical centre with 800-bed capacity having more than 5000 cardiac catheterisation procedures performed annually. The aim of the study is to derive staff doses to the lens of the eyes using the personal dose equivalent Hp(0.07) values from the annual TLD dose report for the years 2008-2012 and determine the category of staff with high estimated eye doses. The study also aims to investigate the causes for high doses and recommend dose-reduction techniques. The dose to the lens of the eye was estimated by using the ratio Hp(0.07) slab /H lens of 1.1 where Hp(0.07) values are the reported doses read from TLD badge worn at the collar level. The average annual eye dose of each category for the 5-y monitoring period was determined. Cardiologists tend to receive higher doses than the nurses by a factor of 2-4 and can exceed 5 mSv y -1 . No correlation exists between the eye doses of nurses and the cardiologists. There is a need to use a conversion coefficient in terms of eye lens dose per dose-area product for faster estimation of eye lens doses. However, there is a limitation on the use of the conversion coefficient because it will depend on the clinical procedure and the X-ray tube angulation. Further investigation on this limitation is needed. (authors)

ESHRE guideline: routine psychosocial care in infertility and medically assisted reproduction-a guide for fertility staff.

Science.gov (United States)

Gameiro, S; Boivin, J; Dancet, E; de Klerk, C; Emery, M; Lewis-Jones, C; Thorn, P; Van den Broeck, U; Venetis, C; Verhaak, C M; Wischmann, T; Vermeulen, N

2015-11-01

Based on the best available evidence in the literature, what is the optimal management of routine psychosocial care at infertility and medically assisted reproduction (MAR) clinics? Using the structured methodology of the Manual for the European Society of Human Reproduction and Embryology (ESHRE) Guideline Development, 120 recommendations were formulated that answered the 12 key questions on optimal management of routine psychosocial care by all fertility staff. The 2002 ESHRE Guidelines for counselling in infertility has been a reference point for best psychosocial care in infertility for years, but this guideline needed updating and did not focus on routine psychosocial care that can be delivered by all fertility staff. This guideline was produced by a group of experts in the field according to the 12-step process described in the ESHRE Manual for Guideline Development. After scoping the guideline and listing a set of 12 key questions in PICO (Patient, Intervention, Comparison and Outcome) format, thorough systematic searches of the literature were conducted; evidence from papers published until April 2014 was collected, evaluated for quality and analysed. A summary of evidence was written in a reply to each of the key questions and used as the basis for recommendations, which were defined by consensus within the guideline development group (GDG). Patient and additional clinical input was collected during the scoping and the review phase of the guideline development. The guideline group, comprising psychologists, two medical doctors, a midwife, a patient representative and a methodological expert, met three times to discuss evidence and reach consensus on the recommendations. 120 recommendations that aim at guiding fertility clinic staff in providing optimal evidence-based routine psychosocial care to patients dealing with infertility and MAR. The guideline is written in two sections. The first section describes patients' preferences regarding the psychosocial

Data on motivational factors of the medical and nursing staff of a Greek Public Regional General Hospital during the economic crisis

Directory of Open Access Journals (Sweden)

Marianna Charalambous

2017-04-01

Full Text Available In this article, we present the data related to motivational factors given by the medical (n=118 and nursing (n=217 staff, of a Greek Public General Hospital during a period of financial austerity. The data collection has been based on a structured self-administrable questionnaire which was used in a previous survey in Cyprus (Chatzicharalambous, 2015 [1]. The incentives-rewards included amount in a total to 11 (both financial and non-financial. The data contains 4 parts: (1 demographics, (2 assessment of the degree to which this hospital provided such incentives-rewards, (3 personal assessment of the participants about the significance of these incentive-rewards and (4 to what extent these incentives-rewards have increased or decreased over the last five years due to the economic crisis. The sample was analyzed as a whole on demographics and by a professional subgroup (doctors and nurses for the other three parts. The data include quantitative tables for all parts. Finally include three tables contain multilevel models.

FREQUENCY AND PATTERN OF HEADACHE IN MEDICAL RESIDENTS AND NON-MEDICAL STUDENTS IN A TERTIARY CARE TEACHING HOSPITAL IN NORTH INDIA

Directory of Open Access Journals (Sweden)

Ruchika Tandon

2018-02-01

Full Text Available BACKGROUND Headache is quite prevalent in general population. Few studies have been done on medical residents and comparison between headache prevalence and types in medical and non-medical student groups is quite lacking. This institute having medical residents as well as non-medical students, provides an opportunity to study and compare frequency and pattern of headache in these student groups. The study was aimed at finding out the type and frequency of headache, disability due to headache and treatment practices followed by these two student groups and the effect on the quality of life of our work force resulting from headache. MATERIALS AND METHODS Headache characteristics were studied in 200 medical residents and non-medical students who had at least one episode of headache of at least moderate intensity in the last 1 year using structured questionnaire. RESULTS Headache occurred in 81% students (79.9% of males and 83.9% of females, of whom, 81.82% were medical, 77.14% were non-medical, 79.65% were married and 82.76% were unmarried. Episodic tension-type headache (TTH was most frequent headache type and migraine without aura was uncommon. More males had TTH than females (55.6% versus 39.3% and migraine was more common in females (39.3% versus 20.1%. Common triggers for headache in medical students were stress, lack of sleep and in non-medical students were stress, sunshine and loud noise. Only 10.5% students were on prescription drugs while 69.8% were self-medicating. CONCLUSION Headache is almost as frequent in medical as in non-medical students and it affects the quality of life of our work force

Benefits and Barriers of E-Learning for Staff Training in a Medical University.

Science.gov (United States)

Franz, Stefan; Behrends, Marianne; Haack, Claudia; Marschollek, Michael

2015-01-01

Learning Management Systems (LMS) are a feasible solution to fulfill the various requirements for e-learning based training in a medical university. Using the LMS ILIAS, the Institute of Diagnostic and Interventional Radiology has designed an e-learning unit about data protection, which has been used by 73% of the department's employees in the first three months. To increase the use of e-learning for staff training, it is necessary to identify barriers and benefits, which encourage the use of e-learning. Therefore, we started an online survey to examine how the employees evaluate this learning opportunity. The results show that 87% of the employees had no technical problems and also competence of Information and Communication Technology (ICT) was no barrier. If anything, reported issues were time shortages and tight schedules. Therefore, short learning modules (less than 20 minutes) are preferred. Furthermore, temporal flexibility for learning is important for 83% of employees.

Building a medical system for nuclear facilities

International Nuclear Information System (INIS)

Maeda, Mitsuya

2016-01-01

To build a medical system for nuclear facilities, I explained what kinds of actions were performed with the TEPCO Fukushima Daiichi Nuclear Power Plant Accident and what kinds of actions are going to be performed in the future. We examined the health and medical care of the emergency workers in nuclear facilities including TEPCO Fukushima Daiichi Nuclear Power Plant from 2014 to 2015 in the Ministry of Health, Labour and Welfare (MHLW). We carried out a detailed hearing from stakeholders of electric companies and medical institutions about the medical system in nuclear facilities carrying out urgent activities. It has been said that the electric company is responsible to maintain the medical system for affected workers in nuclear facilities. However, TEPCO could not find the medical staff, such as doctors, by their own effort at the TEPCO Fukushima Daiichi Nuclear Power Plant Accident. The network of doctors familiar with emergency medical care support dispatched the medical staff after July of 2011. The stakeholders indicated that the following six tasks must be resolved: (1) the fact that no electric company performs the action of bringing up medical staff who can be dispatched into nuclear facilities in emergencies in 2015; (2) bringing up personnel in charge of radiation management and logistics other than the medical staff, such as doctors; (3) cooperation with the community medicine system given the light and shade by nuclear facilities; (4) performing training for the many concurrent wounded based on the scenario of a severe accident; (5) indicating both the condition of the contract and the guarantee of status that is appropriate for dispatched medical staffs; and (6) clarifying the organization of the network of stakeholders. The stakeholders showed the future directionality as follows: (1) To recruit the medical staff expected to be dispatched into nuclear facilities, (2) to carry out the discussion and conveyance training to strengthen cooperation with

Provision of enhanced ancillary services from wind power plants - Examples and challenges

DEFF Research Database (Denmark)

Hansen, Anca Daniela; Altin, Müfit; Iov, Florin

2016-01-01

Emphasis in this article is on the power system impact of wind power plants capability to provide enhanced ancillary services, i.e. temporary frequency response (TFR) and power oscillation damping (POD). The main objective of the article is to analyze and justify the challenges in the use of TFR...... and POD from wind power plants (WPPs). The study is conducted with an aggregated wind power plant model which is integrated into a generic power system model, specifically designed to assess the targeted ancillary services in a relatively simple, but still relevant environment. Various case studies...... with different wind power penetration levels are considered. The study shows that WPPs can provide additional control features such as TFR and POD to enhance the stability of power systems with large share of wind power. Nevertheless, the results illustrate that the power system stability can be potentially...

Non-medical use of psychoactive prescription drugs is associated with fatal poisoning.

Science.gov (United States)

Haukka, Jari; Kriikku, Pirkko; Mariottini, Claudia; Partonen, Timo; Ojanperä, Ilkka

2018-03-01

The aims of this study were to estimate the prevalence and predictors of non-medical substance use, and to assess the association between non-medical substance use and fatal poisoning or history of drug abuse in Finland. Retrospective cohort study of all medico-legally investigated death cases in Finland. The postmortem toxicology database was linked together with the register on reimbursed prescription medicines. All postmortem cases between 2011 and 2013 positive for one or more of the following drugs: oxycodone, fentanyl, tramadol, clonazepam, gabapentin, pregabalin, tizanidine, olanzapine, quetiapine, risperidone, alprazolam, zolpidem, mirtazapine and bupropion, n = 2974. Non-medical use of substance was the outcome variable. Predictors were the following: gender, residence at the time of death, place of death, blood alcohol concentration, age, drug abuse, number of prescriptions of any psychoactive drugs in last year and proportion of prescriptions issued by psychiatrist in last year. In 50.4% of the studied cases, at least one drug was detected without a prescription. Clonazepam, alprazolam and tramadol were the most prevalent non-medical findings in these cases (6.6, 6.1 and 5.6%, respectively). The risk of non-medical use of prescription drugs was especially high in cases with history of drug abuse (88.5%) and in fatal poisonings (71.0%). The proportion of non-medical use of the studied substances varied between 5.9% [95% confidence interval (CI) = 3.1-10.1%)] for risperidone and 55.7% for fentanyl (95% CI = 44.1-66.9%). Valid prescription for one or more of any psychoactive drug was associated with lower odds for non-medical use of the studied substances. Additionally, the higher the proportion of psychoactive drugs prescribed by a psychiatrist, the lower the probability of non-medical use. Non-prescribed psychoactive drugs are found commonly at postmortem in drug poisoning deaths in Finland, with history of drug abuse being a major contributing

The TIGRESS Integrated Plunger ancillary systems for electromagnetic transition rate studies at TRIUMF

International Nuclear Information System (INIS)

Voss, P.; Henderson, R.; Andreoiu, C.; Ashley, R.; Austin, R.A.E.; Ball, G.C.; Bender, P.C.; Bey, A.; Cheeseman, A.; Chester, A.; Cross, D.S.; Drake, T.E.; Garnsworthy, A.B.; Hackman, G.; Holland, R.; Ketelhut, S.; Kowalski, P.; Krücken, R.; Laffoley, A.T.; Leach, K.G.

2014-01-01

The TIGRESS Integrated Plunger device is a new experimental tool for nuclear structure investigations via gamma-ray spectroscopy with post-accelerated beams from the ISAC-II facility at TRIUMF. Several ancillary detection systems integral to the device's capabilities for charged-particle tagging and light-ion identification following a variety of nuclear reaction mechanisms have been constructed and characterized. In particular, a silicon PIN diode wall, an annular silicon segmented detector, and a CsI(Tl) scintillator wall have together enabled particle-gamma correlations for reaction channel selectivity and precision kinematic reconstruction in recent measurements. We highlight the construction, characteristics, and implementation of the device's ancillary detectors as they enable a rich set of electromagnetic transition rate measurements via Doppler-shift lifetime techniques and low-energy Coulomb excitation

A systematic review of medication non-adherence in persons with dementia or cognitive impairment.

Directory of Open Access Journals (Sweden)

Daisy Smith

Full Text Available Adherence to medication is vital for disease management while simultaneously reducing healthcare expenditure. Older persons with cognitive impairment (CI are at risk for non-adherence as cognitive processes are needed to manage medications. This systematic review focuses on the relationship between medication non-adherence and specific cognitive domains in persons with CI, and explores determinants of medication non-adherence. When available, relationships and factors are compared with cognitively intact populations.A seven database systematic search of studies published between 1 January 1949-31 December 2015 examining medication non-adherence in community dwelling persons with CI or dementia was conducted. Articles reporting medication non-adherence in people with CI or dementia in the community, with or without caregiver supports were eligible for inclusion. Papers reporting adherence to treatments in cognitively intact populations, populations from hospital or institutional settings, for non-prescribed medication or those describing dementia as a factor predicting medication non-adherence were excluded. Data on study and population characteristics, research design, data sources and analysis, specific cognitive domains, non-adherence prevalence, measurement of adherence, salient findings, factors associated with adherence and strategies to improve medication adherence were extracted. Study limitations included inconsistencies between data sources and definitions, resulting in a loss of fidelity in the value and comprehensiveness of data, as well as exclusion of non-pharmacological treatments and regimens.Fifteen studies met inclusion criteria. Adherence among CI subjects ranged from 10.7%-38% with better rates of adherence in non-CI individuals. Medication non-adherence definitions varied considerably. New-learning, memory and executive functioning were associated with improved adherence and formed the focus of most studies. Multiple factors

A Survey of Job Satisfaction among Staff of Jundishapur Medical Teaching Hospitals in Ahvaz; Based on Herzberg's Two-Factor Model

Directory of Open Access Journals (Sweden)

Elham Amiri

2017-06-01

Full Text Available Background and Objectives: Job satisfaction is the most important factor affecting the performance and productivity of the organization. The purpose of this study was to assess job satisfaction among staff of Jundishapur medical teaching hospitals; based on Herzberg's      two-factor model. Material and Methods: This was a cross-sectional study. The sample size of 147 was calculated. Stratified sampling method was used. The questionnaire used to collect data consisted of demographic characteristics and job satisfaction in a Likert scale. Data were analyzed using descriptive statistics (mean score and standard deviation and analytical statistics (Parametric test in SPSS16 software. Results: In survival factors, the highest average belonged to salary subscale with mean score     (3.35 ± 1.05. The other subscales were estimated relatively inappropriate .Regarding motivational factors; all subscales were estimated relatively inappropriate. The recognition subscale showed a significant association with age (P Conclusion: In order to enhance the efficiency of hospital staff, in addition to the domains that prevent staff from quitting their job, it needs to emphasize on their motivation as well.

Engineering Evaluation/Cost Analysis for the 100-N Area Ancillary Facilities and Integration Plan

International Nuclear Information System (INIS)

Mukherjee, B.

1997-09-01

This document presents the results of an engineering evaluation/cost analysis (EE/CA) that was conducted to evaluate alternatives for addressing final disposition of contaminated buildings and structures in the 100-N Area of the Hanford Site. The Hanford Site is located in southeastern Washington State and is owned by the U.S. Government and operated by the U.S. Department of Energy, Richland Operations Office (RL). In November 1989, the 100 Area of the Hanford Site (as well as the 200, 300, and 1100 Areas) was placed on the U.S. Environmental Protection Agency's National Priorities List (NPL) under the Comprehensive Environmental Response, Compensation, and Liability Act of 1980. The 100 Area NPL includes the 100-N Area, which is in various stages of the remediation process. It has been determined by RL that hazardous substances in the 100-N Area ancillary facilities may present a potential threat to human health or the environment, and that a non-time critical removal action at these facilities is warranted. To help determine the most appropriate action, RL, in cooperation with the Washington State Department of Ecology (Ecology) and the EPA, has prepared this EE/CA. The scope of the evaluation includes the inactive contaminated ancillary facilities in the 100-N Area, the facilities residing in the buffer zone, and the Hanford Generating Plant (HGP) and the solid waste management units (SWMUs) inside HGP support facilities. The 105-N Reactor and 109-N Heat Exchange facilities are excluded from this EE/CA evaluation

Blood tests in tired elite athletes: expectations of athletes, coaches and sport science/sports medicine staff.

Science.gov (United States)

Fallon, K E

2007-01-01

The issue of the expectations of elite athletes, their coaches and non-medically qualified athlete support staff of consultations with sports physicians has not been previously dealt with in the sports medicine literature. As fulfillment of expectations of the content of a consultation may influence patient's satisfaction and clinical outcome, it is important to assess the expectations of athletes and, most importantly, coaches. To assess the expectations and beliefs about fatigue, particularly in relation to blood tests, of athletes, their coaches and support staff in the specific context of tiredness of sports science or non-medically qualified sports medicine staff, 22 elite coaches and 62 elite athletes from the Australian Institute of Sport were included in this study. A single questionnaire. The expectation for a blood test at the initial consultation for short-term fatigue was particularly high among athletes (81%) and coaches (91%). This expectation increased in athletes if their performance was worsening. All groups unanimously suggested that a blood test be performed in cases of more prolonged fatigue. Increase in total training load was perceived to be the most important cause of fatigue, but issues relating to sleep were also thought to be highly relevant. All groups suggested that blood tests provide some degree of reassurance, and all groups suggested that the most important blood tests that might be performed related to exclusion of iron deficiency, anaemia and infection. Athletes and their coaches generally expect that blood tests will be performed even when fatigue has been present for performed.

Non-medical use of psychoactive drugs in relation to suicide tendencies among Chinese adolescents.

Science.gov (United States)

Juan, Wang; Jian-Xiong, Deng; Lan, Guo; Yuan, He; Xue, Gao; Jing-Hui, Huang; Guo-Liang, Huang; Ci-Yong, Lu

2015-12-01

To investigate the prevalence of non-medical use of psychoactive prescription drug (NMUPD) among adolescents and to explore the associations between non-medical psychoactive prescription drug use and depressive symptoms, poor sleep quality, deliberate self-harm, and suicide. A two-stage stratified cluster sample design produced a representative sample of 12-19-year-old students in grades 1-6 who attended public middle schools in Guangdong province. Prevalence estimates (SE) of non-medical psychoactive prescription drug use were calculated, and logistic regression was used to examine its association with depressive symptoms, poor sleep quality, deliberate self-harm, and suicide. Overall, 7.5% of adolescents reported non-medical use of opioids, and 4.8% of adolescents reported non-medical use of sedatives. Lifetime, last-year, and last-month non-medical use of opioids and sedatives were positively associated with depressive symptoms, poor sleep quality, deliberate self-harm, suicidal ideation, and suicidal attempts among different gender and age-group adolescents. Those who reported last month non-medical use of opioids and sedatives had the greatest odds of reporting depressive symptoms, poor sleep quality, deliberate self-harm, suicidal ideation, and suicidal attempts. Males who were last month non-medical users of opioids or sedative had 8.9 or 10.7 times greater odds of reporting a suicidal attempt, and 8.8 or 9.8 times greater odds of reporting a suicidal attempt were observed among adolescents aged 16-19 who were last-month non-medical users of opioids or sedatives. These findings provide evidence for improving adolescents' suicide prevention strategy by targeting supervision on high risk current non-medical users of psychoactive drug. Copyright © 2015 Elsevier Ltd. All rights reserved.

An examination of ongoing trends in airline ancillary revenues

OpenAIRE

Warnock-Smith, David; O'Connell, John Frankie; Maleki, Mahnaz

2015-01-01

The airline industry seems permanently embedded in producing thin margins and continuously combatting downward pressure on yields. To perpetuate the problem, the industry remains eclipsed with high cost structures and low barriers to entry. However, a new sizzling concept continues to counterbalance these effects in the form of ancillary revenues. Globally, these revenues have increased by 121% from 2010 to 2014 – and the trend is set to continue as carriers are quickly implementing structura...

Perceptions of personal health risks by medical and non-medical workers in a university medical center : a survey study

NARCIS (Netherlands)

Listyowardojo, Tita Alissa; Nap, Raoul E.; Johnson, Addie

2010-01-01

Background: Health care workers (HCWs) are faced with many work-related choices which may depend on how they perceive risk, such as whether or not to comply with safety regulations. Little research has investigated risk perception in medical workers in comparison with non-medical workers and the

Characteristics of HIV-Positive Transgender Men Receiving Medical Care: United States, 2009-2014.

Science.gov (United States)

Lemons, Ansley; Beer, Linda; Finlayson, Teresa; McCree, Donna Hubbard; Lentine, Daniel; Shouse, R Luke

2018-01-01

To present the first national estimate of the sociodemographic, clinical, and behavioral characteristics of HIV-positive transgender men receiving medical care in the United States. This analysis included pooled interview and medical record data from the 2009 to 2014 cycles of the Medical Monitoring Project, which used a 3-stage, probability-proportional-to-size sampling methodology. Transgender men accounted for 0.16% of all adults and 11% of all transgender adults receiving HIV medical care in the United States from 2009 to 2014. Of these HIV-positive transgender men receiving medical care, approximately 47% lived in poverty, 69% had at least 1 unmet ancillary service need, 23% met criteria for depression, 69% were virally suppressed at their last test, and 60% had sustained viral suppression over the previous 12 months. Although they constitute a small proportion of all HIV-positive patients, more than 1 in 10 transgender HIV-positive patients were transgender men. Many experienced socioeconomic challenges, unmet needs for ancillary services, and suboptimal health outcomes. Attention to the challenges facing HIV-positive transgender men may be necessary to achieve the National HIV/AIDS Strategy goals of decreasing disparities and improving health outcomes among transgender persons.

Non-adherence to immunosuppressive medications in kidney transplantation: intent vs. forgetfulness and clinical markers of medication intake.

Science.gov (United States)

Griva, Konstadina; Davenport, Andrew; Harrison, Michael; Newman, Stanton P

2012-08-01

Although adherence to immunosupressive medication after transplantation is important to maximize good clinical outcomes it remains suboptimal and not well-understood. The purpose of this study was to examine intentional and unintentional non-adherence to immunosuppression medication in kidney transplant patients. A cross-sectional sample of N=218 patients [49.6 ± 12.3 years] recruited in London, UK (1999-2002) completed measures of medication beliefs, quality-of-life, depression, and transplantation-specific emotions. Adherence was measured with self-report and serial immunosuppressive assays. Intentional non-adherence was low (13.8 %) yet 62.4 % admitted unintentional non-adherence and 25.4 % had sub-target immunosuppressive levels. The risk of sub-target serum immunosuppressive levels was greater for patients admitting unintentional non-adherence (OR=8.4; p=0.004). Dialysis vintage, doubts about necessity, and lower worry about viability of graft explained R(2)=16.1 to 36 % of self-report non-adherence. Depression was related only to intentional non-adherence. Non-adherence is common in kidney transplantation. Efforts to increase adherence should be implemented by targeting necessity beliefs, monitoring depression, and promoting strategies to decrease forgetfulness.

A risk stratification model for antihypertensive medication non-adherence among Chinese immigrants

Directory of Open Access Journals (Sweden)

Wen-Wen Li

2016-12-01

Full Text Available The purpose of this study was to establish a risk stratification model for identifying Chinese immigrants at risk for non-adherence to antihypertensive medications. Questionnaires were self-administered to 200 Chinese immigrants in San Francisco, USA. Questionnaires included demographics, culture factors (e.g., Perceived Susceptibility in General, Perceived Benefits of Western Medication, Perceived Benefits of Chinese Herbs, and Health-Related Social Support, and medications adherence. Participants' mean age was 70.6 (±10.3 years. Three stratification factors were identified for non-adherence: Lower Perceived Susceptibility in General, lower Perceived Benefit of Western Medications, and longer Length of Stay in the United States. The probability of non-adherence was 77%, 62%, and 57% for lower perceived susceptibility, longer stay in the United States, and lower perceived benefits of Western medications, respectively. A combination of lower perceived susceptibility and lower perceived benefits of medication predicted 81% non-adherence and lower perceived susceptibility with longer stay in the United States predicted at 84%. All three factors combined predicted nearly 90%. Patients with all three factors had the highest risk for non-adherence. The second priority groups are patients with lower perceived susceptibility and those with lower perceived susceptibility combined with any of the other two factors. In the clinical setting, these three groups are a high priority for education on the importance of medication adherence.

Medication details documented on hospital discharge: cross-sectional observational study of factors associated with medication non-reconciliation.

LENUS (Irish Health Repository)

Grimes, Tamasine C

2011-03-01

Movement into or out of hospital is a vulnerable period for medication safety. Reconciling the medication a patient is using before admission with the medication prescribed on discharge, and documenting any changes (medication reconciliation) is recommended to improve safety. The aims of the study were to investigate the factors contributing to medication reconciliation on discharge, and identify the prevalence of non-reconciliation.

CO{sub 2} mitigation costs and ancillary benefits in the Nordic countries, the UK and Ireland: A survey

Energy Technology Data Exchange (ETDEWEB)

Kverndokk, Snorre; Rosendahl, Knut Einar

2000-07-01

This paper provides a survey of top-down modelling studies on mitigation costs and ancillary benefits in the Nordic countries, the UK and Ireland. Special emphasis is put on results concerning revenue recycling, double dividend, distributional effects and ancillary benefits. According to the papers surveyed, modest emissions restrictions as those given by the Kyoto Protocol, can be met without substantial costs for the countries studied. (Author)

Preconception sex selection for non-medical and intermediate reasons: ethical reflections.

Science.gov (United States)

de Wert, G; Dondorp, W

2010-01-01

Sex selection for non-medical reasons is forbidden in many countries. Focusing on preconception sex selection, the authors first observe that it is unclear what should count as a 'medical reason' in this context and argue for the existence of 'intermediate reasons' that do not fit well within the rigid distinction between 'medical'and 'non-medical'. The article further provides a critical review of the arguments for the prohibition of sex selection for non-medical reasons and finds that none of these are conclusive. The authors conclude that the ban should be reconsidered, but also that existing-- societal concerns about possible harmful effects should be taken seriously. Measures to this effect may include limiting the practice to couples who already have at least one child of the sex opposite to that which they now want to select ('family balancing'). Finally, a difficult set of questions is raised by concerns about the reliability and unproven (long-term) safety of the only technology (flow cytometry) proven to work.

Direct costs of emergency medical care: a diagnosis-based case-mix classification system.

Science.gov (United States)

Baraff, L J; Cameron, J M; Sekhon, R

1991-01-01

To develop a diagnosis-based case mix classification system for emergency department patient visits based on direct costs of care designed for an outpatient setting. Prospective provider time study with collection of financial data from each hospital's accounts receivable system and medical information, including discharge diagnosis, from hospital medical records. Three community hospital EDs in Los Angeles County during selected times in 1984. Only direct costs of care were included: health care provider time, ED management and clerical personnel excluding registration, nonlabor ED expense including supplies, and ancillary hospital services. Indirect costs for hospitals and physicians, including depreciation and amortization, debt service, utilities, malpractice insurance, administration, billing, registration, and medical records were not included. Costs were derived by valuing provider time based on a formula using annual income or salary and fringe benefits, productivity and direct care factors, and using hospital direct cost to charge ratios. Physician costs were based on a national study of emergency physician income and excluded practice costs. Patients were classified into one of 216 emergency department groups (EDGs) on the basis of the discharge diagnosis, patient disposition, age, and the presence of a limited number of physician procedures. Total mean direct costs ranged from $23 for follow-up visit to $936 for trauma, admitted, with critical care procedure. The mean total direct costs for the 16,771 nonadmitted patients was $69. Of this, 34% was for ED costs, 45% was for ancillary service costs, and 21% was for physician costs. The mean total direct costs for the 1,955 admitted patients was $259. Of this, 23% was for ED costs, 63% was for ancillary service costs, and 14% was for physician costs. Laboratory and radiographic services accounted for approximately 85% of all ancillary service costs and 38% of total direct costs for nonadmitted patients

Predictive Psychiatric Genetic Testing in Minors: An Exploration of the Non-Medical Benefits.

Science.gov (United States)

Manzini, Arianna; Vears, Danya F

2018-03-01

Predictive genetic testing for susceptibility to psychiatric conditions is likely to become part of standard practice. Because the onset of most psychiatric diseases is in late adolescence or early adulthood, testing minors could lead to early identification that may prevent or delay the development of these disorders. However, due to their complex aetiology, psychiatric genetic testing does not provide the immediate medical benefits that current guidelines require for testing minors. While several authors have argued non-medical benefits may play a crucial role in favour of predictive testing for other conditions, little research has explored such a role in psychiatric disorders. This paper outlines the potential non-medical benefits and harms of psychiatric genetic testing in minors in order to consider whether the non-medical benefits could ever make such testing appropriate. Five non-medical themes arise in the literature: psychological impacts, autonomy/self-determination, implications of the biomedical approach, use of financial and intellectual resources, and discrimination. Non-medical benefits were prominent in all of them, suggesting that psychiatric genetic testing in minors may be appropriate in some circumstances. Further research needs to empirically assess these potential non-medical benefits, incorporate minors in the debate, and include normative reflection to evaluate the very purposes and motivations of psychiatric genetic testing in minors.

Morphology combined with ancillary techniques: An algorithm approach for thyroid nodules.

Science.gov (United States)

Rossi, E D; Martini, M; Capodimonti, S; Cenci, T; Bilotta, M; Pierconti, F; Pontecorvi, A; Lombardi, C P; Fadda, G; Larocca, L M

2018-04-23

Several authors have underlined the limits of morphological analysis mostly in the diagnosis of follicular neoplasms (FN). The application of ancillary techniques, including immunocytochemistry (ICC) and molecular testing, contributes to a better definition of the risk of malignancy (ROM) and management of FN. According to literature, the application of models, including the evaluation of ICC, somatic mutations (ie, BRAF V 600E ), micro RNA analysis is proposed for FNs. This study discusses the validation of a diagnostic algorithm in FN with a special focus on the role of morphology then followed by ancillary techniques. From June 2014 to January 2016, we enrolled 37 FNs with histological follow-up. In the same reference period, 20 benign nodules and 20 positive for malignancy were selected as control. ICC, BRAF V 600E mutation and miR-375 were carried out on LBC. The 37 FNs included 14 atypia of undetermined significance/follicular lesion of undetermined significance and 23 FN. Specifically, atypia of undetermined significance/follicular lesion of undetermined significance resulted in three goitres, 10 follicular adenomas and one NIFTP whereas FN/suspicious for FN by seven follicular adenomas and 16 malignancies (nine non-invasive follicular thyroid neoplasms with papillary-like nuclear features, two invasive follicular variant of papillary thyroid carcinoma [PTC] and five PTC). The 20 positive for malignancy samples included two invasive follicular variant of PTC, 16 PTCs and two medullary carcinomas. The morphological features of BRAF V 600E mutation (nuclear features of PTC and moderate/abundant eosinophilic cytoplasms) were associated with 100% ROM. In the wild type cases, ROM was 83.3% in presence of a concordant positive ICC panel whilst significantly lower (10.5%) in a negative concordant ICC. High expression values of MirR-375 provided 100% ROM. The adoption of an algorithm might represent the best choice for the correct diagnosis of FNs. The morphological

Perceptions and attitudes of hospital staff toward paging system and the use of mobile phones.

LENUS (Irish Health Repository)

Haroon, Muhammad

2012-02-01

OBJECTIVES: Our objective was to document the pattern of mobile phone usage by medical staff in a hospital setting, and to explore any perceived benefits (such as improved communications) associated with mobile phones. METHODS: This cross-sectional survey was conducted in Waterford Regional Hospital, Ireland, where bleep is the official system of communication. All non-consultant hospital doctors, of medical disciplines only, were asked to participate. The questionnaire was designed to explore the pattern and different aspects of mobile phone usage. RESULTS: At the time of study, there were sixty medical junior doctors, and the response rate was 100 percent. All participants used mobile phones while at work, and also for hospital-related work. For 98.3 percent the mobile phone was their main mode of communication while in the hospital. Sixty-two percent (n = 37) made 6-10 calls daily purely for work-related business, and this comprised of >\\/= 80 percent of their daily usage of mobile phones. For 98 percent of participants, most phone calls were work-related. Regarding reasons for using mobile phones, all reported that using mobile phone is quicker for communication.Conclusions: Mobile phone usage is very common among the medical personnel, and this is regarded as a more efficient means of communication for mobile staff than the hospital paging system.

An integrated pan-European ancillary services market for frequency control

International Nuclear Information System (INIS)

Scherer, Marc; Zima, Marek; Andersson, Göran

2013-01-01

Real-time balancing of mismatches between consumption and production is one of the key elements for the secure operation of power systems. This takes place within the framework of ancillary services managed by respective national transmission system operating companies. The objective of this paper is to investigate the option of one integrated pan-European ancillary services market. Our contribution is twofold: quantifying the potential benefit of such an option and outlining a possible approach to such an option highlighting its positive properties as well as risks and challenges. In several recently published considerations of pan-European electricity supply models this topic has not been adequately addressed, but we believe it is one of the crucial subjects in shaping the future electricity supply in Europe. -- Author-Highlights: •We investigated the option of a one-area market for frequency control in Continental Europe. •For the current situation a centralised approach may lead to a significant reduction of control reserves. •In the long run it is a possibility to avoid a tremendous increase of needed control reserves. •The implementation of an integrated market is not to be underestimated

Influence of Wind Plant Ancillary Voltage Control on System Small Signal Stability

DEFF Research Database (Denmark)

Su, Chi; Chen, Zhe

2012-01-01

As a common tendency, large-scale wind farms are increasingly connected to the transmission system of modern power grids. This introduces some new challenges to the connected power systems, and the transmission system operators (TSOs) have to put some new requirements as part of the grid codes...... on the integration of wind farms. One common requirement to wind farms is the function of system voltage control which can be implemented in the grid-side convertor controller of a variable speed wind turbine. This ancillary voltage control provided by wind farms could have some influence on the system small signal...... stability. This paper implements an ancillary voltage control strategy on a direct-drive-full-convertor-based wind farm and studies its influence on the damping ratio values of the dominant oscillation mode within the connected power system. All the calculations and simulations are conducted in DIg...

Mesenteric vascular occlusion: Comparison of ancillary CT findings between arterial and venous occlusions and independent CT findings suggesting life-threatening events

International Nuclear Information System (INIS)

Wong, Yon Cheong; Wu, Cheng Hsien; Wang, Li Jen; Chen, Huan Wu; Lin, Being Chuan; Huang, Chen Chih

2013-01-01

To compare the ancillary CT findings between superior mesenteric artery thromboembolism (SMAT) and superior mesenteric vein thrombosis (SMVT), and to determine the independent CT findings of life-threatening mesenteric occlusion. Our study was approved by the institution review board. We included 43 patients (21 SMAT and 22 SMVT between 1999 and 2008) of their median age of 60.0 years, and retrospectively analyzed their CT scans. Medical records were reviewed for demographics, management, surgical pathology diagnosis, and outcome. We compared CT findings between SMAT and SMVT groups. Multivariate analysis was conducted to determine the independent CT findings of life-threatening mesenteric occlusion. Of 43 patients, 24 had life-threatening mesenteric occlusion. Death related to mesenteric occlusion was 32.6%. A thick bowel wall (p < 0.001), mesenteric edema (p < 0.001), and ascites (p = 0.009) were more frequently associated with SMVT, whereas diminished bowel enhancement (p = 0.003) and paralytic ileus (p = 0.039) were more frequent in SMAT. Diminished bowel enhancement (OR = 20; p = 0.007) and paralytic ileus (OR = 16; p = 0.033) were independent findings suggesting life-threatening mesenteric occlusion. The ancillary CT findings occur with different frequencies in SMAT and SMVT. However, the independent findings indicating life-threatening mesenteric occlusion are diminished bowel wall enhancement and paralytic ileus.

Simulated annealing to handle energy and ancillary services joint management considering electric vehicles

DEFF Research Database (Denmark)

Sousa, Tiago M; Soares, Tiago; Morais, Hugo

2016-01-01

The massive use of distributed generation and electric vehicles will lead to a more complex management of the power system, requiring new approaches to be used in the optimal resource scheduling field. Electric vehicles with vehicle-to-grid capability can be useful for the aggregator players...... in the mitigation of renewable sources intermittency and in the ancillary services procurement. In this paper, an energy and ancillary services joint management model is proposed. A simulated annealing approach is used to solve the joint management for the following day, considering the minimization...... of the aggregator total operation costs. The case study considers a distribution network with 33-bus, 66 distributed generation and 2000 electric vehicles. The proposed simulated annealing is matched with a deterministic approach allowing an effective and efficient comparison. The simulated annealing presents...

Reduction of levels of radiation exposure over patients and medical staff by using additional filters of copper and aluminum on the outputs of X-ray tubes in hemodynamic equipment

International Nuclear Information System (INIS)

Weis, Guilherme L.; Müller, Felipe M.; Schuch, Luiz A.

2013-01-01

Radioprotection in hemodynamic services is extremely important. Decrease of total exposition time, better positioning of medical staff in the room, use of individual and collective protection equipment and shorter distance between the patient and the image intensifier tube are, among others, some ways to reduce the levels of radiation. It is noted that these possible forms of reducing the radiation exposition varies depending on the medical staff. Hence, the purpose of the present paper is to reduce such levels of radiation exposition in a way apart from medical staffs. It is proposed, therefore, the use of additional filters on the output of the X-ray tube in three hemodynamic equipment from different generations: detector with a flat panel of amorphous selenium, image intensifier tube with charge coupled device, and image intensifier tube with video camera. In order to quantify the quality of the images generated, a simulator made of aluminum plates and other devices was set up, so it was possible to measure and compare the acquired images. Methods of images analysis (threshold, histogram, 3D surface) were used to measure the signal/noise ratio, the spatial resolution, the contrast and the definition of the signal area, thus doubts regarding the analysis of the images among observers (inter-observers) and even for a single observer (intra-observer) can be avoided. Ionization chambers were also used in order to quantify the doses of radiation that penetrated the skin of the patients with and without the use of the filters. In all cases was found an arrangement of filters that combines quality of the images with a significant reduction of the levels of exposure to ionizing radiation, concerning both the patient and the medical staff. (author)

Facilitators and barriers to non-medical prescribing - A systematic review and thematic synthesis.

Science.gov (United States)

Graham-Clarke, Emma; Rushton, Alison; Noblet, Timothy; Marriott, John

2018-01-01

Non-medical prescribing has the potential to deliver innovative healthcare within limited finances. However, uptake has been slow, and a proportion of non-medical prescribers do not use the qualification. This systematic review aimed to describe the facilitators and barriers to non-medical prescribing in the United Kingdom. The systematic review and thematic analysis included qualitative and mixed methods papers reporting facilitators and barriers to independent non-medical prescribing in the United Kingdom. The following databases were searched to identify relevant papers: AMED, ASSIA, BNI, CINAHL, EMBASE, ERIC, MEDLINE, Open Grey, Open access theses and dissertations, and Web of Science. Papers published between 2006 and March 2017 were included. Studies were quality assessed using a validated tool (QATSDD), then underwent thematic analysis. The protocol was registered with PROSPERO (CRD42015019786). Of 3991 potentially relevant identified studies, 42 were eligible for inclusion. The studies were generally of moderate quality (83%), and most (71%) were published 2007-2012. The nursing profession dominated the studies (30/42). Thematic analysis identified three overarching themes: non-medical prescriber, human factors, and organisational aspects. Each theme consisted of several sub-themes; the four most highly mentioned were 'medical professionals', 'area of competence', 'impact on time' and 'service'. Sub-themes were frequently interdependent on each other, having the potential to act as a barrier or facilitator depending on circumstances. Addressing the identified themes and subthemes enables strategies to be developed to support and optimise non-medical prescribing. Further research is required to identify if similar themes are encountered by other non-medical prescribing groups than nurses and pharmacists.

Coordinated Control Scheme for Ancillary Services from Offshore Wind Power Plants to AC and DC Grids

DEFF Research Database (Denmark)

Sakamuri, Jayachandra N.; Altin, Müfit; Hansen, Anca Daniela

2016-01-01

This paper proposes a new approach of providing ancillary services to AC and DC grids from offshore wind power plants (OWPPs), connected through multi-terminal HVDC network. A coordinated control scheme where OWPP’s AC grid frequency modulated according to DC grid voltage variations is used...... to detect and provide the ancillary service requirements of both AC and DC grids, is proposed in this paper. In particular, control strategies for onshore frequency control, fault ridethrough support in the onshore grid, and DC grid voltage control are considered. The proposed control scheme involves only...

Comparing the effect of non-medical mechanical restraint preventive factors between psychiatric units in Denmark and Norway

DEFF Research Database (Denmark)

Bak, Jesper; Zoffmann, V.; Sestoft, D.M.

2015-01-01

was not supported by earlier research, the identification of the patient's crisis triggers; therefore, more research on the mechanisms involved is needed. CLINICAL IMPLICATIONS: None of the six MR preventive factors presents any adverse effects; therefore, units in Denmark and Norway may consider investigating......-medical origin may explain the differing number of MR episodes between Denmark and Norway. METHODS: This study is a cross-sectional survey of psychiatric units. Linear regression was used to assess the confounding effects of the MR preventive factors, i.e. whether a difference in the impact of these factors...... the effect of implementing, the identification of the patient's crisis triggers, an increased number of staff per patient, increased staff education, a better work environment and reduced use of substitute staff in practice....

EX1606 Dive05 Ancillary Data Collection including reports, kmls, spreadsheets, and data

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Standard suite of ancillary data files generated through a scripting process following an ROV dive on NOAA Ship Okeanos Explorer during EX1606: CAPSTONE Wake Island...

EX1606 Dive04 Ancillary Data Collection including reports, kmls, spreadsheets, and data

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Standard suite of ancillary data files generated through a scripting process following an ROV dive on NOAA Ship Okeanos Explorer during EX1606: CAPSTONE Wake Island...

EX1606 Dive13 Ancillary Data Collection including reports, kmls, spreadsheets, and data

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Standard suite of ancillary data files generated through a scripting process following an ROV dive on NOAA Ship Okeanos Explorer during EX1606: CAPSTONE Wake Island...

EX1606 Dive09 Ancillary Data Collection including reports, kmls, spreadsheets, and data

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Standard suite of ancillary data files generated through a scripting process following an ROV dive on NOAA Ship Okeanos Explorer during EX1606: CAPSTONE Wake Island...

EX1606 Dive10 Ancillary Data Collection including reports, kmls, spreadsheets, and data

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — Standard suite of ancillary data files generated through a scripting process following an ROV dive on NOAA Ship Okeanos Explorer during EX1606: CAPSTONE Wake Island...

Burnout and Sleep Quality: A Cross-Sectional Questionnaire-Based Study of Medical and Non-Medical Students in India.

Science.gov (United States)

Shad, Rohan; Thawani, Rajat; Goel, Ashish

2015-10-21

Introduction It is well documented that on entering college, students experience a multitude of changes in sleep habits. Very few studies have been conducted that explore sleep quality in Indian undergraduate students; fewer still study the effects of burnout in the same population. Medical students, in particular, are believed to be more stressed, sleep deprived, and burnt out than their non-medical peers. Methods A cross-sectional study was conducted to study sleep disturbances and burnout in a sample of 214 Indian undergraduate students (112 medical, 102 non-medical). The instruments used to measure the sleep quality and burnout were the PSQI (Pittsburgh Sleep Quality Index) and OLBI (Oldenburg Burnout Inventory), respectively. Differences between continuous variables were analysed using Wilcox Mann Whitney U-tests. Bivariate Spearman's rho correlations were done to identify correlations between the individual burnout components and the PSQI sleep quality components. Results Of the students surveyed, 62.6% were found to be poor sleepers with an average score of 6.45 ± 2.85. It was seen that 20% of the students (n = 43) slept less than five hours a day. Medical students, in particular, were found to have more poor sleep (72.9%) than their non-medical peers (51.9%; p sleep scores (Rho 0.21, p 0.001) and (Rho = 0.18, p = 0.008), respectively. The exhaustion dimension of burnout was higher in medical students (2.46 ± 0.55) than in non-medical students (2.38 ± 0.59), but was seen to correlate more with the PSQI sleep score in the non-medical group (Rho = 0.62, p sleep scores, the burnout dimensions did not correlate well with the academic year. Conclusions Burnout and sleep quality are both uncommonly studied topics in India. Fostering a healthier and more proactive approach to tackling burnout and poor sleep quality may help unearth culture specific causes for some of the results we have demonstrated.

Socioeconomic disadvantage and primary non-adherence with medication in Sweden.

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Wamala, Sarah; Merlo, Juan; Bostrom, Gunnel; Hogstedt, Christer; Agren, Gunner

2007-06-01

Lack of adherence with pharmacological therapy is a public health concern that compels tremendous costs for the health care system and the community. To analyse the association between socioeconomic disadvantage and primary non-adherence with medication, and to explore possible mediating effects of trust in health care and lifestyle profile. Cross-sectional population-based study based on data from the Swedish national public health surveys 2004-2005. The study comprised 13603 men and 18292 women aged 21-84 years who had any contact with a physician at a hospital or primary care centre. Measures Primary non-adherence with medication based on whether respondents reported that they refrained from purchasing at the pharmacy prescribed medication. Socioeconomic Disadvantage Index was based on four different indicators of economic deprivation. Socioeconomic disadvantage was associated with primary non-adherence with medication independent of long-term illness, risky lifestyle, low education, living alone and low trust for health care. This association increased with older age, particularly among women. Among individuals aged 21-34 years, severe compared with no socioeconomic disadvantage, was associated with two-fold increased odds for non-adherence with medication. The corresponding odds among individuals aged 65-84 years were three-fold increase among elderly men (OR=3.3, 95% CI: 1.4-7.8) and six-fold increase among elderly women (OR=6.2, 95% CI: 2.5-15.3). Yet every seventh elderly woman aged 65-84 years suffered from long-term illness. Results indicate that health policies for 'care on equal terms' in Sweden have been less successful in relation to equitable access to prescribed medication, especially among the elderly.

The use of prescription medications obtained from non-medical sources among immigrant Latinos in the rural southeastern U.S.

Science.gov (United States)

Song, Eun-Young; Leichliter, Jami S; Bloom, Frederick R; Vissman, Aaron T; O'Brien, Mary Claire; Rhodes, Scott D

2012-05-01

We explored the relationships between behavioral, socio-cultural, and psychological characteristics and the use of prescription medications obtained from non-medical sources among predominantly Spanish-speaking Latinos in the rural southeastern U.S. Respondent-driven sampling (RDS) was used to identify, recruit, and enroll immigrant Latinos to participate in an interviewer-administered assessment. A total of 164 respondents were interviewed in 2009. Average age was 34 years old, 64% of respondents were female, and nearly 85% reported being from Mexico. Unweighted and RDS-weighted prevalence estimates of any non-medical source of prescription medications were 22.6% and 15.1%, respectively. In multivariable modeling, respondents who perceived their documentation status as a barrier to health care and those with higher educational attainment were significantly more likely to report use of non-medical sources. Interventions are needed to increase knowledge of eligibility to sources of medical care and treatment and ensure culturally congruent services for immigrant communities in the U.S.

Acceptability of medical male circumcision among traidtionally non ...

African Journals Online (AJOL)

IMTU Medical Journal ... Background: Male circumcision (MC) can reduce men's risk of contracting Sexually Transmitted Infections (STIs) ... non-circumcising males accessing health care in Makambako Hospital, Njombe Region, Tanzania.

Cognition of and Demand for Education and Teaching in Medical Statistics in China: A Systematic Review and Meta-Analysis

Science.gov (United States)

Li, Gaoming; Yi, Dali; Wu, Xiaojiao; Liu, Xiaoyu; Zhang, Yanqi; Liu, Ling; Yi, Dong

2015-01-01

Background Although a substantial number of studies focus on the teaching and application of medical statistics in China, few studies comprehensively evaluate the recognition of and demand for medical statistics. In addition, the results of these various studies differ and are insufficiently comprehensive and systematic. Objectives This investigation aimed to evaluate the general cognition of and demand for medical statistics by undergraduates, graduates, and medical staff in China. Methods We performed a comprehensive database search related to the cognition of and demand for medical statistics from January 2007 to July 2014 and conducted a meta-analysis of non-controlled studies with sub-group analysis for undergraduates, graduates, and medical staff. Results There are substantial differences with respect to the cognition of theory in medical statistics among undergraduates (73.5%), graduates (60.7%), and medical staff (39.6%). The demand for theory in medical statistics is high among graduates (94.6%), undergraduates (86.1%), and medical staff (88.3%). Regarding specific statistical methods, the cognition of basic statistical methods is higher than of advanced statistical methods. The demand for certain advanced statistical methods, including (but not limited to) multiple analysis of variance (ANOVA), multiple linear regression, and logistic regression, is higher than that for basic statistical methods. The use rates of the Statistical Package for the Social Sciences (SPSS) software and statistical analysis software (SAS) are only 55% and 15%, respectively. Conclusion The overall statistical competence of undergraduates, graduates, and medical staff is insufficient, and their ability to practically apply their statistical knowledge is limited, which constitutes an unsatisfactory state of affairs for medical statistics education. Because the demand for skills in this area is increasing, the need to reform medical statistics education in China has become urgent

The Modern Technologies to Reduce Turnover of Company Staff

Directory of Open Access Journals (Sweden)

Zaiko Tetiana O.

2017-12-01

Full Text Available The article is aimed at analyzing and substantiating the use in practice of modern technologies to reduce turnover of staff, which do not bear significant financial costs for the company. The authors have proved that non-material measures to reduce staff turnover in companies are becoming predominant nowadays. Among them as the most important are indicated: introduction of flexible schedule (mode of work, transition to the remote form of employment, and distribution of internal shares, in particular related to the strengthening of cohesion of staff, its team spirit. Also the reasons of transition from material to intangible factors of influence on conduct of workers have been disclosed. The advantages of non-material measures of the staff turnover reduction for both employees and employers were analyzed. For the first ones the most important are motivation and job satisfaction, while for the others it is reduction of staff turnover, formation of the responsible worker, improvement of quality and productivity of work.

Prevalence of Sharing Access Credentials in Electronic Medical Records

Science.gov (United States)

Korach, Tzfania; Shreberk-Hassidim, Rony; Thomaidou, Elena; Uzefovsky, Florina; Ayal, Shahar; Ariely, Dan

2017-01-01

Objectives Confidentiality of health information is an important aspect of the physician patient relationship. The use of digital medical records has made data much more accessible. To prevent data leakage, many countries have created regulations regarding medical data accessibility. These regulations require a unique user ID for each medical staff member, and this must be protected by a password, which should be kept undisclosed by all means. Methods We performed a four-question Google Forms-based survey of medical staff. In the survey, each participant was asked if he/she ever obtained the password of another medical staff member. Then, we asked how many times such an episode occurred and the reason for it. Results A total of 299 surveys were gathered. The responses showed that 220 (73.6%) participants reported that they had obtained the password of another medical staff member. Only 171 (57.2%) estimated how many time it happened, with an average estimation of 4.75 episodes. All the residents that took part in the study (45, 15%) had obtained the password of another medical staff member, while only 57.5% (38/66) of the nurses reported this. Conclusions The use of unique user IDs and passwords to defend the privacy of medical data is a common requirement in medical organizations. Unfortunately, the use of passwords is doomed because medical staff members share their passwords with one another. Strict regulations requiring each staff member to have it's a unique user ID might lead to password sharing and to a decrease in data safety. PMID:28875052

Shadowing emergency medicine residents by medical education specialists to provide feedback on non-medical knowledge-based ACGME sub-competencies.

Science.gov (United States)

Waterbrook, Anna L; Spear Ellinwood, Karen C; Pritchard, T Gail; Bertels, Karen; Johnson, Ariel C; Min, Alice; Stoneking, Lisa R

2018-01-01

Non-medical knowledge-based sub-competencies (multitasking, professionalism, accountability, patient-centered communication, and team management) are challenging for a supervising emergency medicine (EM) physician to evaluate in real-time on shift while also managing a busy emergency department (ED). This study examines residents' perceptions of having a medical education specialist shadow and evaluate their nonmedical knowledge skills. Medical education specialists shadowed postgraduate year 1 and postgraduate year 2 EM residents during an ED shift once per academic year. In an attempt to increase meaningful feedback to the residents, these specialists evaluated resident performance in selected non-medical knowledge-based Accreditation Council of Graduate Medical Education (ACGME) sub-competencies and provided residents with direct, real-time feedback, followed by a written evaluation sent via email. Evaluations provided specific references to examples of behaviors observed during the shift and connected these back to ACGME competencies and milestones. Twelve residents participated in this shadow experience (six post graduate year 1 and six postgraduate year 2). Two residents emailed the medical education specialists ahead of the scheduled shadow shift requesting specific feedback. When queried, five residents voluntarily requested their feedback to be included in their formal biannual review. Residents received milestone scores and narrative feedback on the non-medical knowledge-based ACGME sub-competencies and indicated the shadow experience and subsequent feedback were valuable. Medical education specialists who observe residents over the course of an entire shift and evaluate non-medical knowledge-based skills are perceived by EM residents to provide meaningful feedback and add valuable information for the biannual review process.

Chat reference service in medical libraries: part 2--Trends in medical school libraries.

Science.gov (United States)

Dee, Cheryl R

2003-01-01

An increasing number of medical school libraries offer chat service to provide immediate, high quality information at the time and point of need to students, faculty, staff, and health care professionals. Part 2 of Chat Reference Service in Medical Libraries presents a snapshot of the current trends in chat reference service in medical school libraries. In late 2002, 25 (21%) medical school libraries provided chat reference. Trends in chat reference services in medical school libraries were compiled from an exploration of medical school library Web sites and informal correspondence from medical school library personnel. Many medical libraries are actively investigating and planning new chat reference services, while others have decided not to pursue chat reference at this time. Anecdotal comments from medical school library staff provide insights into chat reference service.

Diabetes, obesity and non-optimum blood pressure levels in a group of employees of the University of Puerto Rico, Medical Sciences Campus, 2003.

Science.gov (United States)

Disdier-Flores, Orville M; Rodríguez-Lugo, Luis A

2005-06-01

To estimate the proportion of diabetes, obesity and non-optimum blood pressure levels in a group of employees of the University of Puerto Rico Medical Sciences Campus that participated in a diabetes health fair at the "Centro de Diabetes para Puerto Rico". A total of 113 participants of the diabetes health fair completed a questionnaire to obtain demographic characteristics and the frequency of self-reported diabetes. The nursing staff examined the participants in order to obtain the following clinical characteristics: body mass index, blood pressure and blood glucose levels. The proportion of self-reported diabetes, obesity (> or = 30 kg/m2) and non-optimum blood pressure levels (systolic > or = 20 mm/Hg or diastolic > or = 80 mm/Hg) were 15.4% (95% CI: 8.5% - 25.7%), 80.0% (95% CI: 70.8%-86.9%) and 70.5% (95% CI: 61.1%-78.6%), respectively. Although it was not statistically significant, diabetes was higher among females (15.4%) compared to males (12.0%). All participants with self-reported diabetes were overweight or obese, and 91.7% showed non-optimum blood pressure levels. A significant positive correlation (p diabetes, obesity, and non-optimum blood pressure levels in this sample of Medical Sciences Campus employees underscores the need for confirming these results in a larger study and developing strategies focused on reducing health risks in this population.

Trace Metal and Ancillary Data in Puget Sound, 1980 - 1986 (NODC Accession 9100153)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — In first of three data reports on the trace metal and ancillary data in Puget Sound and its watershed (Paulson et al., 1991a), all water column, sediment, and...

Attitudes toward depression among Japanese non-psychiatric medical doctors: a cross-sectional study

Directory of Open Access Journals (Sweden)

Ohtsuki Tsuyuka

2012-08-01

Full Text Available Abstract Background Under-recognition of depression is common in many countries. Education of medical staff, focusing on their attitudes towards depression, may be necessary to change their behavior and enhance recognition of depression. Several studies have previously reported on attitudes toward depression among general physicians. However, little is known about attitudes of non-psychiatric doctors in Japan. In the present study, we surveyed non-psychiatric doctors’ attitude toward depression. Methods The inclusion criteria of participants in the present study were as follows: 1 Japanese non-psychiatric doctors and 2 attendees in educational opportunities regarding depression care. We conveniently approached two populations: 1 a workshop to depression care for non-psychiatric doctors and 2 a general physician-psychiatrist (G-P network group. We contacted 367 subjects. Attitudes toward depression were measured using the Depression Attitude Questionnaire (DAQ, a 20-item self-report questionnaire developed for general physicians. We report scores of each DAQ item and factors derived from exploratory factor analysis. Results We received responses from 230 subjects, and we used DAQ data from 187 non-psychiatric doctors who met the inclusion criteria. All non-psychiatric doctors (n = 187 disagreed with "I feel comfortable in dealing with depressed patients' needs," while 60 % (n = 112 agreed with "Working with depressed patients is heavy going." Factor analysis indicated these items comprised a factor termed "Depression should be treated by psychiatrists" - to which 54 % of doctors (n = 101 agreed. Meanwhile, 67 % of doctors (n = 126 thought that nurses could be useful in depressed patient support. The three factors derived from the Japanese DAQ differed from models previously derived from British GP samples. The attitude of Japanese non-psychiatric doctors concerning whether depression should be treated by psychiatrists was markedly

Attitudes toward depression among Japanese non-psychiatric medical doctors: a cross-sectional study.

Science.gov (United States)

Ohtsuki, Tsuyuka; Kodaka, Manami; Sakai, Rumi; Ishikura, Fuminobu; Watanabe, Yoichiro; Mann, Anthony; Haddad, Mark; Yamada, Mitsuhiko; Inagaki, Masatoshi

2012-08-16

Under-recognition of depression is common in many countries. Education of medical staff, focusing on their attitudes towards depression, may be necessary to change their behavior and enhance recognition of depression. Several studies have previously reported on attitudes toward depression among general physicians. However, little is known about attitudes of non-psychiatric doctors in Japan. In the present study, we surveyed non-psychiatric doctors' attitude toward depression. The inclusion criteria of participants in the present study were as follows: 1) Japanese non-psychiatric doctors and 2) attendees in educational opportunities regarding depression care. We conveniently approached two populations: 1) a workshop to depression care for non-psychiatric doctors and 2) a general physician-psychiatrist (G-P) network group. We contacted 367 subjects. Attitudes toward depression were measured using the Depression Attitude Questionnaire (DAQ), a 20-item self-report questionnaire developed for general physicians. We report scores of each DAQ item and factors derived from exploratory factor analysis. We received responses from 230 subjects, and we used DAQ data from 187 non-psychiatric doctors who met the inclusion criteria. All non-psychiatric doctors (n = 187) disagreed with "I feel comfortable in dealing with depressed patients' needs," while 60 % (n = 112) agreed with "Working with depressed patients is heavy going." Factor analysis indicated these items comprised a factor termed "Depression should be treated by psychiatrists" - to which 54 % of doctors (n = 101) agreed. Meanwhile, 67 % of doctors (n = 126) thought that nurses could be useful in depressed patient support. The three factors derived from the Japanese DAQ differed from models previously derived from British GP samples. The attitude of Japanese non-psychiatric doctors concerning whether depression should be treated by psychiatrists was markedly different to that of British GPs. Japanese non

Factors Enhancing Manpower Efficiency from the Viewpoint of Clinical and Non-clinical Faculty Members at Guilan University of Medical Sciences in 2011

Directory of Open Access Journals (Sweden)

Fardin Mehrabian

2012-11-01

Full Text Available Introduction: There are various factors that affect manpower efficiency. Identification of the most important and influential factors on efficiency is quite essential. Analysis of factors affecting manpower efficiency from the viewpoint of clinical and non-clinical faculty members at Guilan University of Medical Sciences in 2011.Methods: This descriptive, analytical, cross-sectional study was performed in October and November in 2011. The study sample consisted of 186 faculty members, including 128 clinical and 58 non-clinical. Instruments used to collect library data were questionnaire and field studies. Exploratory factor analysis with Varimax rotation was utilized to determine the factors influencing manpower efficiency as well as loading level of each of the variables. Results: Among clinical faculty members, 70.66% of changes in manpower efficiency, and among non-clinical faculty members, 79.57% of changes in manpower efficiency were explained by 9 and 8 factors, respectivelyConclusion: Staff empowerment and organizational culture were recognized as the most important factors enhancing manpower efficiency from the viewpoint of clinical and non-clinical faculty members, respectively.

Adolescents Who Self-Harm: Professional Staff Knowledge, Attitudes and Training Needs

Science.gov (United States)

Timson, Debbie; Priest, Helena; Clark-Carter, David

2012-01-01

This study aimed to investigate professional staff attitudes and knowledge about adolescents who engage in self-harming behaviour and to identify training needs. Previous research has suggested that medical and health care staff perceptions may reinforce the stigma associated with such behaviour and therefore jeopardise the effectiveness of…

The Role of Liquid Based Cytology and Ancillary Techniques in the Peritoneal Washing Analysis: Our Institutional Experience

Science.gov (United States)

Rossi, Esther; Bizzarro, Tommaso; Martini, Maurizio; Longatto-Filho, Adhemar; Schmitt, Fernando; Fagotti, Anna; Scambia, Giovanni; Zannoni, Gian Franco

2017-01-01

Background The cytological analysis of peritoneal effusions serves as a diagnostic and prognostic aid for either primary or metastatic diseases. Among the different cytological preparations, liquid based cytology (LBC) represents a feasible and reliable method ensuring also the application of ancillary techniques (i.e immunocytochemistry-ICC and molecular testing). Methods We recorded 10348 LBC peritoneal effusions between January 2000 and December 2014. They were classified as non-diagnostic (ND), negative for malignancy-NM, atypical-suspicious for malignancy-SM and positive for malignancy-PM. Results The cytological diagnosis included 218 ND, 9.035 NM, 213 SM and 882 PM. A total of 8048 (7228 NM, 115SM, 705 PM) cases with histological follow-up were included. Our NM included 21 malignant and 7207 benign histological diagnoses. Our 820 SMs+PMs were diagnosed as 107 unknown malignancies (30SM and 77PM), 691 metastatic lesions (81SM and 610PM), 9 lymphomas (2SM and 7PM), 9 mesotheliomas (1SM and 8SM), 4 sarcomas (1SM and 3PM). Primary gynecological cancers contributed with 64% of the cases. We documented 97.4% sensitivity, 99.9% specificity, 98% diagnostic accuracy, 99.7% negative predictive value (NPV) and 99.7% positive predictive value (PPV). Furthermore, the morphological diagnoses were supported by either 173 conclusive ICC results or 50 molecular analyses. Specifically the molecular testing was performed for the EGFR and KRAS mutational analysis based on the previous or contemporary diagnoses of Non Small Cell Lung Cancer (NSCLC) and colon carcinomas. We identified 10 EGFR in NSCCL and 7 KRAS mutations on LBC stored material. Conclusions Peritoneal cytology is an adjunctive tool in the surgical management of tumors mostly gynecological cancers. LBC maximizes the application of ancillary techniques such as ICC and molecular analysis with feasible diagnostic and predictive yields also in controversial cases. PMID:28099523

Training for staff who support students.

Science.gov (United States)

Flynn, Eleanor; Woodward-Kron, Robyn; Hu, Wendy

2016-02-01

Front-line administrative, academic and clinical teaching staff often find themselves providing pastoral and learning support to students, but they are often not trained for this role, and this aspect of their work is under-acknowledged. Staff participating in an action research study at two medical schools identified common concerns about the personal impact of providing student support, and of the need for professional development to carry out this responsibility. This need is magnified in clinical placement settings that are remote from on-campus services. Informed by participatory action research, brief interactive workshops with multimedia training resources were developed, conducted and evaluated at eight health professional student training sites. These workshops were designed to: (1) be delivered in busy clinical placement and university settings; (2) provide a safe and inclusive environment for administrative, academic and clinical teaching staff to share experiences and learn from each other; (3) be publicly accessible; and (4) promote continued development and roll-out of staff training, adapted to each workplace (see http://www.uws.edu.au/meusupport). The workshops were positively evaluated by 97 participants, with both teaching and administrative staff welcoming the opportunity to discuss and share experiences. Staff supporting health professional students have shared, often unmet, needs for support themselves Staff supporting health professional students have shared, often unmet, needs for support themselves. Participatory action research can be a means for producing and maintaining effective training resources as well as the conditions for change in practice. In our workshops, staff particularly valued opportunities for guided discussion using videos of authentic cases to trigger reflection, and to collaboratively formulate student support guidelines, customised to each site. © 2015 John Wiley & Sons Ltd.

Hospital reform and staff morale in South Africa: a case study of Dr ...

African Journals Online (AJOL)

Objectives: This study explored major factors that influenced staff motivation at a ... Settings and subjects: This study included all medical and nursing staff working at the ... transformation in terms of implementation of National Health Insurance.

Staff perceptions of community health centre team function in Ontario.

Science.gov (United States)

Rayner, Jennifer; Muldoon, Laura

2017-07-01

To examine perceptions of different staff groups about team functioning in mature, community-governed, interprofessional primary health care practices. Cross-sectional online survey. The 75 community health centres (CHCs) in Ontario at the time of the study, which have cared for people with barriers to access to traditional health services in community-governed, interprofessional settings, providing medical, social, and community services since the 1970s. Managers and staff of primary care teams in the CHCs. Scores on the short version of the Team Climate Inventory (with subscales addressing vision, task orientation, support for innovation, and participative safety), the Organizational Justice Scale (with subscales addressing procedural justice and interactional justice), and the Organizational Citizenship Behavior Scale, stratified by staff group (clinical manager, FP, nurse practitioner [NP], registered nurse, medical secretary, social worker, allied health provider, counselor, outreach worker, and administrative assistant). A total of 674 staff members in 58 of 75 (77%) CHCs completed surveys. All staff groups generally reported positive perceptions of team function. The procedural justice subscale showed the greatest variation between groups. Family physicians and NPs rated procedural justice much lower than nurses and administrators did. This study provides a unique view of the perceptions of different groups of staff in a long-standing interprofessional practice model. Future research is needed to understand why FPs and NPs perceive procedural justice more negatively than other team members do, and whether such perceptions affect outcomes such as staff turnover and health outcomes for patients. Copyright© the College of Family Physicians of Canada.

Evaluation of three ancillary treatments in the management of equine grass sickness.

Science.gov (United States)

Fintl, C; McGorum, B C

2002-09-28

Brotizolam, acetylcysteine and aloe vera gel were evaluated as ancillary treatments for 29 cases of equine grass sickness. None of the treatments had any significant beneficial effect on the survival of the horses. However, 11 of 13 horses with mild chronic grass sickness survived solely with intensive nursing care.

[The influence of the pre-hospital application of non-invasive measurements of carboxyhemoglobin in the practice of emergency medical services in multiple and mass casualty incidents (MCI)--a case report].

Science.gov (United States)

Gałazkowski, Robert; Wejnarski, Arkadiusz; Baumberg, Ignacy; Świeżewski, Stanisław; Timler, Dariusz

2014-01-01

In 2013 a fire broke out in the Nursing Home (NH) in the Henryszew village 5 km away from the district hospital in Zyrardów. At the time of the incident 52 residents and 16 staff members were present in the building. Due to a large number of casualties, the occurrence was classified as a potentially mass casualty incident (MCI). Troops of the State Fire Brigade, Paramedic Rescue Squads, choppers of the Helicopter Emergency Medical Service, the Police, and the NH staff took part in the rescue operation. The priority was given to the evacuation of the NH residents carried out by the NH staff and firefighters, extinguishing the fire, as well as to primary and secondary survey triage. Due to the pre-accident health state of the victims, the latter posed a considerable difficulty. A decisive role was played by the need to conduct non-invasive measurements of carboxyhemoglobin in all the casualties, which then made it possible to adequately diagnose the patients and implement proper procedures. The rescue operation was correctly followed although it proved to be a serious logistical and technical undertaking for the participating emergency services. The residents were not found to be suffering from carbon monoxide poisoning, therefore 46 of the residents safely returned to the building. The fact that all the Paramedic Rescue Squads were equipped with medical triage sets and were able to conduct non-invasive measurements of carboxyhemoglobin made it possible to introduce effective procedures in the cases of suspected carbon monoxide poisoning and abandon costly and complicated organisational procedures when they proved to be unnecessary.

Could non-grade based selection improve medical student socio-demographic diversity?

DEFF Research Database (Denmark)

O'Neill, Lotte Dyhrberg

2013-01-01

selected with a non-grade-based or ’non-cognitive’ admission program. The two admission groups were compared on seven social indices (doctor parent, ethnic origin, father’s education, mother’s education, parenthood, parents live together, parent on benefit). Result: Selection strategy made no difference...... to the social diversity of admitted medical students. The non-cognitive admission program studied was not a useful initiative for improving medical student diversity nor did it further disadvantaged educationally vulnerable population groups in these cohorts. Discussion: The social heritage and general...

Medical practice in organized settings. Redefining medical autonomy.

Science.gov (United States)

Astrachan, J H; Astrachan, B M

1989-07-01

Physicians are perplexed by the ongoing erosion of their individual professional autonomy. While the economic forces underlying such change have received much attention, the evolution of new organizational forms that modify and often diminish medical autonomy is less well understood. The practice of medicine is becoming more organized and more hierarchical. We emphasize the importance of organized medical groups, including the medical staff organization, as structures for appropriate peer monitoring, and for counterbalancing the burgeoning influence of governance and administrative constraints on practice. There is an ongoing tension within organizations between management, governance, and physicians. Over time one or another of these groups achieves some measure of dominance, but good management requires a balance of power. The role of the medical staff, which is poorly represented in some health care institutions and under threat in others, is considered. In general, we find that medical work is becoming more hierarchical, and that physician "leaders" do not substitute for collegial processes.

Hospital reform and staff morale in South Africa: a case study of Dr ...

African Journals Online (AJOL)

2012-02-16

Feb 16, 2012 ... Settings and subjects: This study included all medical and nursing staff working at ... Keywords: hospital reform, staff morale, quality of care, healthcare resources ..... of healthcare workers' goals to cure patients.3 This differs.

[Delegation of medical activities in acute pain therapy].

Science.gov (United States)

Erlenwein, J; Moroder, A; Biermann, E; Petzke, F; Ehlers, A P F; Bitter, H; Pogatzki-Zahn, E

2018-01-01

Acute pain management is an interprofessional and interdisciplinary task and requires a good and trustful cooperation between stakeholders. Despite provisions in Germany according to which medical treatment can only be rendered by a formally qualified physician ("Arztvorbehalt"), a physician does not have to carry out every medical activity in person. Under certain conditions, some medical activities can be delegated to medical auxiliary personnel but they need to be (1) instructed, (2) supervised and (3) checked by the physician himself; however, medical history, diagnostic assessment and evaluation, indications, therapy planning (e.g. selection, dosage), therapeutic decisions (e. g. modification or termination of therapy) and obtaining informed consent cannot be delegated. With respect to drug therapy, monitoring of the therapy remains the personal responsibility of the physician, while the actual application of medication can be delegated. From a legal perspective, the current practice needs to be stressed about what is within the mandatory requirements and what is not when medical activities are delegated to non-medical staff. The use of standards of care improves treatment quality but like any medical treatment it must be based on the physician's individual assessment and indications for each patient and requires personal contact between physician and patient. Delegation on the ward and in acute pain therapy requires the authorization of the delegator to give instructions in the respective setting. The transfer of non-delegable duties to non-medical personnel is regarded as medical malpractice.

Consumers and Carers Versus Pharmacy Staff: Do Their Priorities for Australian Pharmacy Services Align?

Science.gov (United States)

McMillan, Sara S; Kelly, Fiona; Sav, Adem; Kendall, Elizabeth; King, Michelle A; Whitty, Jennifer A; Wheeler, Amanda J

2015-10-01

Health professionals, including pharmacists, are encouraged to meet the needs of their consumers in an efficient and patient-centred manner. Yet, there is limited information as to what consumers with chronic conditions need from pharmacy as a healthcare destination or how well pharmacy staff understand these needs. The aim of this study was to identify service user priorities for ideal community pharmacy services for consumers with chronic conditions and their carers, and compare these priorities with what pharmacy staff think these groups want. The nominal group technique was undertaken with pharmacist, pharmacy support staff, consumer and carer groups in four Australian regions between December 2012 and April 2013. Participant ideas and priorities for ideal services or care were identified, and contextual insight was obtained by thematic analysis. Twenty-one nominal group sessions are accepted, including 15 consumer and carer, four pharmacist and two pharmacy support staff groups. Pharmacy staff views generally aligned with consumer priorities, such as access, affordability, patient-centred care and continuity and coordinated care, yet diverged with respect to consumer information or education on medication and services. Fundamentally, consumers and carers sought streamlined access to information and medication, in a coordinated, patient-centred approach. Alleviating financial burden was a key consumer priority, with a call for the continuation and extension of medication subsidies. Overall, pharmacy staff had a reasonable understanding of what consumers would prioritise, but further emphasis on the importance, delivery, or both, of consumer information is needed. Greater consideration is needed from policy makers regarding the financial barriers to accessing medication for consumers with chronic conditions.

Evaluation of job satisfaction of practice staff and general practitioners: an exploratory study

Directory of Open Access Journals (Sweden)

Goetz Katja

2011-12-01

Full Text Available Abstract Background Primary care teams' job satisfaction is an important issue in quality of care. The purpose of our study was to evaluate the job satisfaction of general practitioners (GPs and non-physician staff and to explore the elements that may impact on overall job satisfaction for GPs and non-physician staff separately. Methods The study was based on data from the European Practice Assessment and used an observational design. Job satisfaction was measured with the 10-items Warr-Cook-Wall questionnaire with 7-point-Likert scales. Job satisfaction of GPs and non-physician staff was compared and impact on overall job satisfaction was analysed with stepwise linear regression analyses for both samples separately. Results The study population consisted of 2878 non-physician staff (mean age: 38 years and 676 GPs (mean age: 50 years. The actual mean working time per week of GPs was 50.0 hours and of practice staff 26.0 hours. Both were satisfied with colleagues and fellow workers (mean = 5.99 and mean = 6.18 respectively and mostly dissatisfied with their income (mean = 4.40 and mean = 4.79 respectively. For GPs the opportunity to use their abilities (β = 0.638 and for non-physician staff recognition for their work (β = 0.691 showed the highest scores of explained variance (R2 = 0.406 and R2 = 0.477 respectively regarding overall job satisfaction. Conclusions Non-physician staff evaluate their job satisfaction higher than GPs except recognition for work. Job satisfaction of members of primary care teams is important because poor satisfaction is associated with suboptimal healthcare delivery, poor clinical outcomes and higher turnover of staff.

Personal and social factors regarding medical non-compliance in cardiac failure patients

International Nuclear Information System (INIS)

Mujtaba, S.F.; Masood, T.; Khalid, D.

2011-01-01

Objective: To determine the frequency and association of various personal and social factors with medical non-compliance in cardiac failure patients. Study Design: Cross-sectional, observational study. Place and Duration of Study: National Institute of Cardiovascular Diseases (NICVD), Karachi from January to August 2010. Methodology: Patients admitted in the medical wards of NICVD, who were being treated for cardiac failure, were included. Information regarding basic demographics, education level, self engagement in therapy and status of compliance was obtained by questionnaire. Statistical analysis was carried out by using Fisher's exact test and chi-square. Level of significance was < 0.05. Data was analyzed using SPSS V-15. Out of 267 patients, 73 (27.3%) were compliant while 194 (72.7%) were non-compliant. Educated, self caring patient, and those who knew names of their medications were more compliant than the rest. Conclusion: Medical non-compliance is very common in heart failure patients. Illiteracy and no self engagement in therapy are associated with non-compliance. (author)

Non-Medical Prescription Stimulant Use in Graduate Students: Relationship With Academic Self-Efficacy and Psychological Variables.

Science.gov (United States)

Verdi, Genevieve; Weyandt, Lisa L; Zavras, Brynheld Martinez

2016-09-01

The objective of this study was to examine graduate students' non-medical use of prescription stimulant medication, and the relationship between non-medical use of prescription stimulants with academic self-efficacy, psychological factors (i.e., anxiety, depression, and stress), and internal restlessness. The sample consisted of 807 graduate students from universities located in five geographic regions of the United States. Past-year rates of self-reported non-medical use were determined to be 5.9%, with overall lifetime prevalence of 17.5%. Observed self-reported non-medical use of prescription stimulant medications was significantly correlated with self-reported levels of anxiety and stress, various aspects of internal restlessness, and perceived safety of the medications. Findings support graduate students' motivations of non-medical prescription stimulant use to be both academic and social in nature. Effective prevention and education efforts are needed to help address the non-medical use of prescription stimulants by graduate students on university campuses. © The Author(s) 2014.

Computer-Based Training at a Military Medical Center: Understanding Decreased Participation in Training among Staff and Ways to Improve Completion Rates

Science.gov (United States)

Lavender, Julie

2013-01-01

Military health care facilities make extensive use of computer-based training (CBT) for both clinical and non-clinical staff. Despite evidence identifying various factors that may impact CBT, the problem is unclear as to what factors specifically influence employee participation in computer-based training. The purpose of this mixed method case…

Management of Ovarian Cysts by Laparoscopic Extracorporeal Approach Using Single Ancillary Trocar

Directory of Open Access Journals (Sweden)

Metin Capar

2009-12-01

Conclusion: This technique does not require the use of two or more ancillary trocars or widening of the trocar incision. The duration of surgery can be shortened considerably and complete excision of the cystic capsule can be performed. Homeostasis was achieved using 3-0 polyglactin sutures. No electrocoagulation was required.

An antenatal prediction model for adverse birth outcomes in an urban population: The contribution of medical and non-medical risks.

Science.gov (United States)

Posthumus, A G; Birnie, E; van Veen, M J; Steegers, E A P; Bonsel, G J

2016-07-01

in the Netherlands the perinatal mortality rate is high compared to other European countries. Around eighty percent of perinatal mortality cases is preceded by being small for gestational age (SGA), preterm birth and/or having a low Apgar-score at 5 minutes after birth. Current risk detection in pregnancy focusses primarily on medical risks. However, non-medical risk factors may be relevant too. Both non-medical and medical risk factors are incorporated in the Rotterdam Reproductive Risk Reduction (R4U) scorecard. We investigated the associations between R4U risk factors and preterm birth, SGA and a low Apgar score. a prospective cohort study under routine practice conditions. six midwifery practices and two hospitals in Rotterdam, the Netherlands. 836 pregnant women. the R4U scorecard was filled out at the booking visit. after birth, the follow-up data on pregnancy outcomes were collected. Multivariate logistic regression was used to fit models for the prediction of any adverse outcome (preterm birth, SGA and/or a low Apgar score), stratified for ethnicity and socio-economic status (SES). factors predicting any adverse outcome for Western women were smoking during the first trimester and over-the-counter medication. For non-Western women risk factors were teenage pregnancy, advanced maternal age and an obstetric history of SGA. Risk factors for high SES women were low family income, no daily intake of vegetables and a history of preterm birth. For low SES women risk factors appeared to be low family income, non-Western ethnicity, smoking during the first trimester and a history of SGA. the presence of both medical and non-medical risk factors early in pregnancy predict the occurrence of adverse outcomes at birth. Furthermore the risk profiles for adverse outcomes differed according to SES and ethnicity. to optimise effective risk selection, both medical and non-medical risk factors should be taken into account in midwifery and obstetric care at the booking visit

The SPICE concept - An approach to providing geometric and other ancillary information needed for interpretation of data returned from space science instruments

Science.gov (United States)

Acton, Charles H., Jr.

1990-01-01

The Navigation Ancillary Information Facility (NAIF), acting under the direction of NASA's Office of Space Science and Applications, and with substantial participation of the planetary science community, is designing and implementing an ancillary data system - called SPICE - to assist scientists in planning and interpreting scientific observations taken from spaceborne instruments. The principal objective of the implemented SPICE system is that it will hold the essential geometric and related ancillary information needed to recover the full value of science instrument data, and that it will facilitate correlations of individual instrument datasets with data obtained from other instruments on the same or other spacecraft.

Staff rotation: implications for occupational therapy.

Science.gov (United States)

Taylor, A; Andriuk, M L; Langlois, P; Provost, E

1995-10-01

Occupational therapy departments of tertiary care hospitals can provide staff with opportunities to gain diverse clinical experience if they rotate through the various services such as surgery, medicine, geriatrics, plastic surgery and orthopaedics. The system of rotation offers both advantages and disadvantages for the staff and the institution. The Royal Victoria Hospital in Montreal, a large university teaching hospital, had traditionally offered staff the opportunity to rotate. Changes in staffing and their needs however, resulted in rotation becoming an important issue within the department. This article presents the pros and the cons of rotation and non-rotation systems as identified by therapists and administrators across Canada. Staff rotation was found to have an effect on job satisfaction and a therapist's career orientation. Given these findings, administrators may want to reconsider the role of the generalist and specialist in their facilities.

Engaging Frontline Leaders and Staff in Real-Time Improvement.

Science.gov (United States)

Phillips, Jennifer; Hebish, Linda J; Mann, Sharon; Ching, Joan M; Blackmore, C Craig

2016-04-01

The relationship of staff satisfaction and engagement to organizational success, along with the integral influence of frontline managers on this dimension, is well established in health care and other industries. To specifically address staff engagement, Virginia Mason Medical Center, an integrated, single-hospital health system, developed an approach that involved leaders, through the daily use of standard work for leaders, as well as staff, through a Lean-inspired staff idea system. Kaizen Promotion Office (KPO) staff members established three guiding principles: (1) Staff engagement begins with leader engagement; (2) Integrate daily improve- ment (kaizen) as a habitual way of life not as an add-on; and (3) Create an environment in which staff feel psycho- logically safe and valued. Two design elements--Standard Work for Leaders (SWL) and Everyday Lean Ideas (ELIs) were implemented. For the emergency department (ED), an early adopter of the staff engagement work, the challenge was to apply the guiding principles to improve staff engagement while improving quality and patient and staff satisfaction, even as patient volumes were increasing. Daily huddles for the KPO staff members and weekly leader rounds are used to elicit staff ideas and foster ELIs in real time. Overall progress to date has been tracked in terms of staff satisfaction surveys, voluntary staff turnover, adoption of SWL, and testing and implementation of staff ideas. For example, voluntary turnover of ED staff decreased from 14.6% in 2011 to 7.5% in 2012, and 2.0% in 2013. Organizationwide, at least 800 staff ideas are in motion at any given time, with finished ones posted in an idea supermarket website. A leadership and staff engagement approach that focuses on SWL and on capturing staff ideas for daily problem solving and improvement can contribute to organization success and improve the quality of health care delivery.

Factors related to medication non-adherence for patients with hypertension in Taiwan.

Science.gov (United States)

Li, Wen-Wen; Kuo, Chi-Tai; Hwang, Shiow-Li; Hsu, Hsin-Tien

2012-07-01

To characterise a Taiwanese population and to examine the prevalence of antihypertensive medication non-adherence and how the cultural/clinical factors were associated with non-adherence in Taiwan. Antihypertensive medication non-adherence is a significant clinical issue in the United States. However, little is known about hypertension (HTN) control and cultural/clinical factors related to non-adherence in Taiwan. A convenience sample survey design was used. Data were gathered from a convenience sample of 200 subjects recruited from a large teaching hospital. Medication non-adherence and cultural/clinical factors were recorded using various self-administered questionnaires, and blood pressure was taken twice for each participant. The mean age of the participants was 60.4 (SD 11.5 years) including 62% men. Two-thirds had less than a high school education (64.5%), and the majority of them were married (86·0%) and lived with family or close friends (93.5%). The average length of HTN diagnosis was 8.6 years (SD 9.0 years). Medication non-adherence rate was 47·5%, and uncontrolled HTN rate was 49.0%. Some participants (17.0%) used Chinese herbs for treating their disease (e.g. cough) and promoting health in addition to their regular antihypertensive medications. Two factors were found to be statistically significant for predicting medication non-adherence: Lower Perceived Susceptibility to Specific Diseases [OR = 1.15 (95%CI, 1.01-1.31)] and Longer Length of HTN Diagnosis [OR = 1.06 (95%CI, 1.01-1.12)]. Taiwanese at risk of non-adherence included those who perceived lower susceptibility to specific diseases and had been diagnosed with HTN for a longer time. Those using herbs need to be studied for an impact of herbs on their adherence behaviour. These findings can help guide the development of culturally sensitive and clinically appropriate nursing interventions for HTN management in Taiwan. © 2012 Blackwell Publishing Ltd.

The Perspective of the Staff Regarding Facility Revitalization at Walter Reed Army Medical Center

National Research Council Canada - National Science Library

Baker, Jimmy G

2004-01-01

...). The response rate for the questionnaire was 40.69%, Analysis of collected data revealed that most respondents believe major facility revitalization must occur at WRAMC, staff awareness of the Master Facility Plan is lacking and staff education...

Physicians’ leadership styles in rural primary medical care: How are they perceived by staff?

Science.gov (United States)

Kirkhaug, Rudi

2014-01-01

Abstract Aim. This study investigates which leadership styles can be identified among general practice lead physicians and how they are associated with and predicted by staff and context characteristics like profession, gender, age, work experience, and team size. Method/material. In a cross-sectional study self-administered questionnaires were distributed to staff physicians (42% females) and support staff (98% females) at 101 primary health care centres in North Norway. A total of 127 and 222, respectively, responded (response rate 59%). Items were ranked on Likert scales (range 1–5). Results. Analysis revealed three significantly different styles (mean scores/Cronbach's alpha): change style (3.36/0.898), task style (3.17/0.885), and relation style (2.88/0.900). The lead physicians were perceived as practising change style the most and relation style the least. Males experienced significantly more of all three styles. Support staff scored lowest for all styles. Age was negatively correlated with relation style and change style, while work experience was negatively correlated with change style. No significant association was found between styles and team size. Conclusion. Leadership in rural general practice can be identified in terms of task, relation, and change styles. Change style is the most perceived style. Males seem to be most attentive to leadership styles. However, within the staff physician group, there is less difference between genders. Support staff scores lowest for all styles; this might indicate either less need for leadership or dissatisfaction with leadership. Age and work experience seem to reduce employees’ attention to relation and change styles, indicating that maturity reduces needs for these leadership styles. Due to growing demands for leaders to take care of efficiency and change in general practice, more young female physicians, and more diverse staff groups, these findings may be useful to understand leadership and leadership

Physicians' leadership styles in rural primary medical care: how are they perceived by staff?

Science.gov (United States)

Hana, Jan; Kirkhaug, Rudi

2014-03-01

This study investigates which leadership styles can be identified among general practice lead physicians and how they are associated with and predicted by staff and context characteristics like profession, gender, age, work experience, and team size. METHOD/MATERIAL: In a cross-sectional study self-administered questionnaires were distributed to staff physicians (42% females) and support staff (98% females) at 101 primary health care centres in North Norway. A total of 127 and 222, respectively, responded (response rate 59%). Items were ranked on Likert scales (range 1-5). Analysis revealed three significantly different styles (mean scores/Cronbach's alpha): change style (3.36/0.898), task style (3.17/0.885), and relation style (2.88/0.900). The lead physicians were perceived as practising change style the most and relation style the least. Males experienced significantly more of all three styles. Support staff scored lowest for all styles. Age was negatively correlated with relation style and change style, while work experience was negatively correlated with change style. No significant association was found between styles and team size. Leadership in rural general practice can be identified in terms of task, relation, and change styles. Change style is the most perceived style. Males seem to be most attentive to leadership styles. However, within the staff physician group, there is less difference between genders. Support staff scores lowest for all styles; this might indicate either less need for leadership or dissatisfaction with leadership. Age and work experience seem to reduce employees' attention to relation and change styles, indicating that maturity reduces needs for these leadership styles. Due to growing demands for leaders to take care of efficiency and change in general practice, more young female physicians, and more diverse staff groups, these findings may be useful to understand leadership and leadership training for general practice.

The influence of the pre-hospital application of non-invasive measurements of carboxyhemoglobin in the practice of emergency medical services in multiple and mass casualty incidents (MCI – A case report

Directory of Open Access Journals (Sweden)

Robert Gałązkowski

2014-04-01

Full Text Available In 2013 a fire broke out in the Nursing Home (NH in the Henryszew village 5 km away from the district hospital in Żyrardów. At the time of the incident 52 residents and 16 staff members were present in the building. Due to a large number of casualties, the occurrence was classified as a potentially mass casualty incident (MCI. Troops of the State Fire Brigade, Paramedic Rescue Squads, choppers of the Helicopter Emergency Medical Service, the Police, and the NH staff took part in the rescue operation. The priority was given to the evacuation of the NH residents carried out by the NH staff and firefighters, extinguishing the fire, as well as to primary and secondary survey triage. Due to the pre-accident health state of the victims, the latter posed a considerable difficulty. A decisive role was played by the need to conduct non-invasive measurements of carboxyhemoglobin in all the casualties, which then made it possible to adequately diagnose the patients and implement proper procedures. The rescue operation was correctly followed although it proved to be a serious logistical and technical undertaking for the participating emergency services. The residents were not found to be suffering from carbon monoxide poisoning, therefore 46 of the residents safely returned to the building. The fact that all the Paramedic Rescue Squads were equipped with medical triage sets and were able to conduct non-invasive measurements of carboxyhemoglobin made it possible to introduce effective procedures in the cases of suspected carbon monoxide poisoning and abandon costly and complicated organisational procedures when they proved to be unnecessary. Med Pr 2014;65(2:289–295

[Non-medical applications for brain MRI: Ethical considerations].

Science.gov (United States)

Sarrazin, S; Fagot-Largeault, A; Leboyer, M; Houenou, J

2015-04-01

The recent neuroimaging techniques offer the possibility to better understand complex cognitive processes that are involved in mental disorders and thus have become cornerstone tools for research in psychiatry. The performances of functional magnetic resonance imaging are not limited to medical research and are used in non-medical fields. These recent applications represent new challenges for bioethics. In this article we aim at discussing the new ethical issues raised by the applications of the latest neuroimaging technologies to non-medical fields. We included a selection of peer-reviewed English medical articles after a search on NCBI Pubmed database and Google scholar from 2000 to 2013. We screened bibliographical tables for supplementary references. Websites of governmental French institutions implicated in ethical questions were also screened for governmental reports. Findings of brain areas supporting emotional responses and regulation have been used for marketing research, also called neuromarketing. The discovery of different brain activation patterns in antisocial disorder has led to changes in forensic psychiatry with the use of imaging techniques with unproven validity. Automated classification algorithms and multivariate statistical analyses of brain images have been applied to brain-reading techniques, aiming at predicting unconscious neural processes in humans. We finally report the current position of the French legislation recently revised and discuss the technical limits of such techniques. In the near future, brain imaging could find clinical applications in psychiatry as diagnostic or predictive tools. However, the latest advances in brain imaging are also used in non-scientific fields raising key ethical questions. Involvement of neuroscientists, psychiatrists, physicians but also of citizens in neuroethics discussions is crucial to challenge the risk of unregulated uses of brain imaging. Copyright © 2014 L’Encéphale, Paris. Published by

Effect of workload on quality of work life among staff of the teaching hospitals of Shahid Beheshti University of Medical Sciences (2014

Directory of Open Access Journals (Sweden)

S. Marzban

2016-04-01

Full Text Available Background: Quality of work life is the reaction of employees to their work specially the individual results at work and mental health that affects their personal experience and work results. Objective: The aim of this study was to determine the effect of workload on quality of work life in staff of the teaching hospitals affiliated to Shahid Beheshti University of Medical Sciences, Tehran. Methods: This analytical study was conducted in 530 staff of four hospitals affiliated to the Shahid Beheshti University of Medical Sciences that were selected by Cochrane sampling method during 2014. The measurement tools were demographic questionnaire, Walton's quality of work life questionnaire (including 32 questions and eight dimensions, and the NASA TLX workload scale. Data were analyzed using Pearson’s correlation coefficient. Findings: The mean scores of quality of work life and workload were 48.21±13.34 and 64.70±11.44, respectively. There was negative significant correlation between workload and quality of work life (r= -0.0161. Conclusion: With regards to the results, it seems that high workload is one of the most important factors of reduced quality of work life that can be reduced through proper organization and planning.

The use of prescribed and non-prescribed medication by Dutch children.

NARCIS (Netherlands)

Dijk, L. van; Lindert, H. van

2002-01-01

Background: Most research on the use of medication focuses on adults. Children, however, use medication too, most of which is prescribed by GP's. Children also use non-prescribed medication (f.e. bought in the drugstore), but the extent to which is not known. Moreover, it is not known to what extent

42 CFR 482.62 - Condition of participation: Special staff requirements for psychiatric hospitals.

Science.gov (United States)

2010-10-01

... requirements for psychiatric hospitals. 482.62 Section 482.62 Public Health CENTERS FOR MEDICARE & MEDICAID... staff requirements for psychiatric hospitals. The hospital must have adequate numbers of qualified...) Standard: Director of inpatient psychiatric services; medical staff. Inpatient psychiatric services must be...

Evaluation of an educational "toolbox" for improving nursing staff competence and psychosocial work environment in elderly care: results of a prospective, non-randomized controlled intervention.

Science.gov (United States)

Arnetz, J E; Hasson, H

2007-07-01

Lack of professional development opportunities among nursing staff is a major concern in elderly care and has been associated with work dissatisfaction and staff turnover. There is a lack of prospective, controlled studies evaluating the effects of educational interventions on nursing competence and work satisfaction. The aim of this study was to evaluate the possible effects of an educational "toolbox" intervention on nursing staff ratings of their competence, psychosocial work environment and overall work satisfaction. The study was a prospective, non-randomized, controlled intervention. Nursing staff in two municipal elderly care organizations in western Sweden. In an initial questionnaire survey, nursing staff in the intervention municipality described several areas in which they felt a need for competence development. Measurement instruments and educational materials for improving staff knowledge and work practices were then collated by researchers and managers in a "toolbox." Nursing staff ratings of their competence and work were measured pre and post-intervention by questionnaire. Staff ratings in the intervention municipality were compared to staff ratings in the reference municipality, where no toolbox was introduced. Nursing staff ratings of their competence and psychosocial work environment, including overall work satisfaction, improved significantly over time in the intervention municipality, compared to the reference group. Both competence and work environment ratings were largely unchanged among reference municipality staff. Multivariate analysis revealed a significant interaction effect between municipalities over time for nursing staff ratings of participation, leadership, performance feedback and skills' development. Staff ratings for these four scales improved significantly in the intervention municipality as compared to the reference municipality. Compared to a reference municipality, nursing staff ratings of their competence and the

Application countermeasures of non-incineration technologies for medical waste treatment in China.

Science.gov (United States)

Chen, Yang; Ding, Qiong; Yang, Xiaoling; Peng, Zhengyou; Xu, Diandou; Feng, Qinzhong

2013-12-01

By the end of 2012, there were 272 modern, high-standard, centralized medical waste disposal facilities operating in various cities in China. Among these facilities nearly 50% are non-incineration treatment facilities, including the technologies of high temperature steam, chemical disinfection and microwave. Each of the non-incineration technologies has its advantages and disadvantages, and any single technology cannot offer a panacea because of the complexity of medical waste disposal. Although non-incineration treatment of medical waste can avoid the release of polychlorinated dibenzo-p-dioxins/dibenzofurans, it is still necessary to decide how to best meet the local waste management needs while minimizing the impact on the environment and public health. There is still a long way to go to establish the sustainable application and management mode of non-incineration technologies. Based on the analysis of typical non-incineration process, pollutant release, and the current tendency for technology application and development at home and abroad, this article recommends the application countermeasures of non-incineration technologies as the best available techniques and best environmental practices in China.

Hospital accreditation: staff experiences and perceptions.

Science.gov (United States)

Bogh, Søren Bie; Blom, Ane; Raben, Ditte Caroline; Braithwaite, Jeffrey; Thude, Bettina; Hollnagel, Erik; Plessen, Christian von

2018-06-11

Purpose The purpose of this paper is to understand how staff at various levels perceive and understand hospital accreditation generally and in relation to quality improvement (QI) specifically. Design/methodology/approach In a newly accredited Danish hospital, the authors conducted semi-structured interviews to capture broad ranging experiences. Medical doctors, nurses, a quality coordinator and a quality department employee participated. Interviews were audio recorded and subjected to framework analysis. Findings Staff reported that The Danish Healthcare Quality Programme affected management priorities: office time and working on documentation, which reduced time with patients and on improvement activities. Organisational structures were improved during preparation for accreditation. Staff perceived that the hospital was better prepared for new QI initiatives after accreditation; staff found disease specific requirements unnecessary. Other areas benefited from accreditation. Interviewees expected that organisational changes, owing to accreditation, would be sustained and that the QI focus would continue. Practical implications Accreditation is a critical and complete hospital review, including areas that often are neglected. Accreditation dominates hospital agendas during preparation and surveyor visits, potentially reducing patient care and other QI initiatives. Improvements are less likely to occur in areas that other QI initiatives addressed. Yet, accreditation creates organisational foundations for future QI initiatives. Originality/value The authors study contributes new insights into how hospital staff at different organisational levels perceive and understand accreditation.

A Staff Education Consortium: One Model for Collaboration.

Science.gov (United States)

Stetler, Cheryl Beth; And Others

1983-01-01

Discusses the development, organization, activities, problems, and future of a staff education consortium of five medical center hospitals in Boston. The purposes of the consortium are mutual sharing, reduction in duplication, and cost containment of educational programing. (JOW)

Personality and medication non-adherence among older adults enrolled in a six-year trial

Science.gov (United States)

Jerant, Anthony; Chapman, Benjamin; Duberstein, Paul; Robbins, John; Franks, Peter

2011-01-01

Objectives Personality factors parsimoniously capture the variation in dispositional characteristics that affect behaviours, but their value in predicting medication non-adherence is unclear. We investigated the relationship between five-factor model personality factors (Conscientiousness, Neuroticism, Agreeableness, Extraversion, and Openness) and medication non-adherence among older participants during a six-year randomized placebo-controlled trial (RCT). Design Observational cohort data from 771 subjects aged ≥72 years enrolled in the Ginkgo Evaluation of Memory study, a RCT of Ginkgo biloba for prevention of dementia. Methods Random effects logistic regression analyses examined effects of NEO Five-Factor Inventory scores on medication non-adherence, determined via pill counts every 6 months (median follow-up 6.1 years) and defined as taking personality factor associated with non-adherence: a 1 SD increase was associated with a 3.8% increase in the probability of non-adherence (95% CI [0.4, 7.2]). Lower cognitive function was also associated with non-adherence: a 1 SD decrease in mental status exam score was associated with a 3.0% increase in the probability of non-adherence (95% CI [0.2, 5.9]). Conclusions Neuroticism was associated with medication non-adherence over 6 years of follow-up in a large sample of older RCT participants. Personality measurement in clinical and research settings might help to identify and guide interventions for older adults at risk for medication non-adherence. PMID:21226789

Student and staff experiences of attendance monitoring in undergraduate obstetrics and gynecology: a cross-sectional survey.

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Deane, Richard P; Murphy, Deirdre J

2016-01-01

Despite the widespread introduction of active learning strategies to engage students across modern medical curricula, student attendance and attendance monitoring remain a challenging issue for medical educators. In addition, there is little published evidence available to medical educators regarding the use of attendance monitoring systems. The aim of this study was to evaluate the opinions of students and staff about the use of a paper-based student logbook to record student attendance across all clinical and classroom-based learning activities within an undergraduate clinical rotation in obstetrics and gynecology (OBGYN). Each student undertaking the clinical rotation in OBGYN was required to complete a paper-based logbook in a booklet format that listed every clinical and classroom-based activity that the student was expected to attend. A cross-sectional survey evaluating the acceptability, practicality, and effect on access to learning opportunities of using the logbook was undertaken. The survey was conducted among all medical students who completed their OBGYN rotation over a full academic year and staff who taught on the program. The response rate was 87% (n=128/147) among students and 80% (n=8/10) among staff. Monitoring attendance was widely acceptable to students (n=107/128, 84%) and staff (n=8/8, 100%). Most students (n=95/128, 74%) and staff (n=7/8, 88%) recommended that attendance should be mandatory during rotations. Almost all staff felt that attendance should contribute toward academic credit (n=7/8, 88%), but students were divided (n=73/128, 57%). Students (n=94/128, 73%) and staff (n=6/8, 75%) reported that the use of the logbook to record attendance with tutor signatures was a satisfactory system, although students questioned the need for recording attendance at every classroom-based activity. Most students felt that the logbook facilitated access to learning experiences during the rotation (n=90/128, 71%). Staff felt that the process of signing

Student and staff experiences of attendance monitoring in undergraduate obstetrics and gynecology: a cross-sectional survey

Directory of Open Access Journals (Sweden)

Deane RP

2016-04-01

Full Text Available Richard P Deane, Deirdre J Murphy Department of Obstetrics and Gynaecology, Trinity College Dublin, The University of Dublin, Coombe Women & Infants University Hospital, Dublin, Republic of Ireland  Background: Despite the widespread introduction of active learning strategies to engage students across modern medical curricula, student attendance and attendance monitoring remain a challenging issue for medical educators. In addition, there is little published evidence available to medical educators regarding the use of attendance monitoring systems. The aim of this study was to evaluate the opinions of students and staff about the use of a paper-based student logbook to record student attendance across all clinical and classroom-based learning activities within an undergraduate clinical rotation in obstetrics and gynecology (OBGYN. Methods: Each student undertaking the clinical rotation in OBGYN was required to complete a paper-based logbook in a booklet format that listed every clinical and classroom-based activity that the student was expected to attend. A cross-sectional survey evaluating the acceptability, practicality, and effect on access to learning opportunities of using the logbook was undertaken. The survey was conducted among all medical students who completed their OBGYN rotation over a full academic year and staff who taught on the program. Results: The response rate was 87% (n=128/147 among students and 80% (n=8/10 among staff. Monitoring attendance was widely acceptable to students (n=107/128, 84% and staff (n=8/8, 100%. Most students (n=95/128, 74% and staff (n=7/8, 88% recommended that attendance should be mandatory during rotations. Almost all staff felt that attendance should contribute toward academic credit (n=7/8, 88%, but students were divided (n=73/128, 57%. Students (n=94/128, 73% and staff (n=6/8, 75% reported that the use of the logbook to record attendance with tutor signatures was a satisfactory system, although

Medication understanding, non-adherence, and clinical outcomes among adult kidney transplant recipients.

Science.gov (United States)

Patzer, Rachel E; Serper, Marina; Reese, Peter P; Przytula, Kamila; Koval, Rachel; Ladner, Daniela P; Levitsky, Josh M; Abecassis, Michael M; Wolf, Michael S

2016-10-01

We sought to evaluate the prevalence of medication understanding and non-adherence of entire drug regimens among kidney transplantation (KT) recipients and to examine associations of these exposures with clinical outcomes. Structured, in-person interviews were conducted with 99 adult KT recipients between 2011 and 2012 at two transplant centers in Chicago, IL; and Atlanta, GA. Nearly, one-quarter (24%) of participants had limited literacy as measured by the Rapid Estimate of Adult Literacy in Medicine test; patients took a mean of 10 (SD=4) medications and 32% had a medication change within the last month. On average, patients knew what 91% of their medications were for (self-report) and demonstrated proper dosing (via observed demonstration) for 83% of medications. Overall, 35% were non-adherent based on either self-report or tacrolimus level. In multivariable analyses, fewer months since transplant and limited literacy were associated with non-adherence (all Padherence, and hospitalization could help target appropriate self-care interventions. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Knowledge and training in paediatric medical traumatic stress and trauma-informed care among emergency medical professionals in low- and middle-income countries.

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Hoysted, Claire; Babl, Franz E; Kassam-Adams, Nancy; Landolt, Markus A; Jobson, Laura; Van Der Westhuizen, Claire; Curtis, Sarah; Kharbanda, Anupam B; Lyttle, Mark D; Parri, Niccolò; Stanley, Rachel; Alisic, Eva

2018-01-01

Background : Provision of psychosocial care, in particular trauma-informed care, in the immediate aftermath of paediatric injury is a recommended strategy to minimize the risk of paediatric medical traumatic stress. Objective : To examine the knowledge of paediatric medical traumatic stress and perspectives on providing trauma-informed care among emergency staff working in low- and middle-income countries (LMICs). Method : Training status, knowledge of paediatric medical traumatic stress, attitudes towards incorporating psychosocial care and barriers experienced were assessed using an online self-report questionnaire. Respondents included 320 emergency staff from 58 LMICs. Data analyses included descriptive statistics, t -tests and multiple regression. Results : Participating emergency staff working in LMICs had a low level of knowledge of paediatric medical traumatic stress. Ninety-one percent of respondents had not received any training or education in paediatric medical traumatic stress, or trauma-informed care for injured children, while 94% of respondents indicated they wanted training in this area. Conclusions : There appears to be a need for training and education of emergency staff in LMICs regarding paediatric medical traumatic stress and trauma-informed care, in particular among staff working in comparatively lower income countries.

Colleges Finding 'Wellness' Programs Cut Absenteeism, Boost Productivity and Morale of Their Staff Members.

Science.gov (United States)

McMillen, Liz

1986-01-01

Health-promotion programs provided for higher education staff are increasing. They draw on the expertise of physical education and athletic staff, counseling services, and medical centers to encourage employees to adopt lifetime regimens of healthy living. (MSE)

Radiation exposure of medical staff from interventional x-ray procedures: a multicentre study

International Nuclear Information System (INIS)

Haeusler, Uwe; Brix, Gunnar; Czarwinski, Renate

2009-01-01

The purpose of this study was to analyse the radiation exposure of medical staff from interventional x-ray procedures. Partial-body dose measurements were performed with thermoluminescent dosimeters (TLD) in 39 physicians and nine assistants conducting 73 interventional procedures of nine different types in 14 hospitals in Germany. Fluoroscopy time and the dose-area product (DAP) were recorded too. The median (maximum) equivalent body dose per procedure was 16 (2,500) μSv for an unshielded person; the partial-body dose per procedure was 2.8 (240) μSv to the eye lens, 4.1 (730) μSv to the thyroid, 44 (1,800) μSv to one of the feet and 75 (13,000) μSv to one of the hands. A weak correlation between fluoroscopy time or DAP and the mean TLD dose was observed. Generally, the doses were within an acceptable range from a radiation hygiene point of view. However, relatively high exposures were measured to the hand in some cases and could cause a partial-body dose above the annual dose limit of 500 mSv. Thus, the use of finger dosimeters is strongly recommended. (orig.)

Survey of Quality of Life and Influencing Factors in Alborz University of Medical Sciences Staff

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S. Amiri

2014-01-01

Full Text Available Background & Aims: Quality of life is a concept beyond the physical health. It is an important index in health research that its independent quantification as an important outcome is essential. Work environment consists of physical, mental and social stimuli and each of these factors can cause stress. These stresses and pressures have inappropriate effects on physical–emotional welfare, health and its function. Therefore, this study was performed on the Faculty of Medicine of Karaj staffs in 1390 to investigate their quality of life and the governing factors. Materials and Methods: In this descriptive and sectional study, a group of 100 of Faculty of Medicine and of Alborz University of Medical Sciences employees were participated. Sampling was done as census. Data collection was performed by means of the questionnaire of standard of quality of life (WHOQOL-BREF and the questionnaire of demographic information collected. Results: The results show that 51 percent of the employees have reported their quality of life in the average range and 6% in poor range. Furthermore, in the physical aspect of quality of life, 34% of the results are good, 59% moderate and the remaining 7% are poor. Likewise, in the quality of life from psychological aspect, 33% of the results are good, 64 percent moderate, and only 3% are poor. The data for the social relationships aspect are 28% good, 59% moderate, and 13% poor. Finally, in the quality of life from environmental health aspect, 36% of the staffs reported good, 55% moderate, and 9% poor condition. Pearson’s test results show that there is a meaningful correlation between the quality of life and the lower number of children, and also increasing years of service (P=0.00. However, the quality of life does not show any significant relationship with age and income. ANOVA test results indicate that there is a significant relationship between quality of life and the type of employment (P=0.017. Conclusion: Quality

Hospital Staff Shortage after the 2011 Triple Disaster in Fukushima, Japan-An Earthquake, Tsunamis, and Nuclear Power Plant Accident: A Case of the Soso District.

Science.gov (United States)

Ochi, Sae; Tsubokura, Masaharu; Kato, Shigeaki; Iwamoto, Shuichi; Ogata, Shinichi; Morita, Tomohiro; Hori, Arinobu; Oikawa, Tomoyoshi; Kikuchi, Antoku; Watanabe, Zenjiro; Kanazawa, Yukio; Kumakawa, Hiromi; Kuma, Yoshinobu; Kumakura, Tetsuo; Inomata, Yoshimitsu; Kami, Masahiro; Shineha, Ryuzaburo; Saito, Yasutoshi

2016-01-01

In 2011, Fukushima was struck by a triple disaster: an earthquake, tsunamis, and a nuclear accident. In the aftermath, there was much fear among hospital staff members about radiation exposure and many staff members failed to report to work. One objective is to measure this shortage in hospital staff and another is to compare the difference in recovery by hospital types and by categories of hospital staff. The monthly records of the number of staff members from May 2011 to September 2012 were extracted anonymously from the records of 7 local hospitals in the Soso district in Fukushima. Change in the number of staff was analyzed. Staff shortages at hospitals reached a maximum within one month after the disaster (47% reported to work). The shortage of clerks was the most severe (38% reported to work), followed by nurses (48% reported to work). The shortages remained even 18 months after the disaster. After a disaster in which the damage to hospital functions surpasses the structural damage, massive support of human resources in the acute phase and a smaller volume of support in the mid-term phase appear to be required, particularly for non-medical staff.

Introducing information technologies into medical education: activities of the AAMC.

Science.gov (United States)

Salas, A A; Anderson, M B

1997-03-01

Previous articles in this column have discussed how new information technologies are revolutionizing medical education. In this article, two staff members from the Association of American Medical College's Division of Medical Education discuss how the Association (the AAMC) is working both to support the introduction of new technologies into medical education and to facilitate dialogue on information technology and curriculum issues among AAMC constituents and staff. The authors describe six AAMC initiatives related to computing in medical education: the Medical School Objectives Project, the National Curriculum Database Project, the Information Technology and Medical Education Project, a professional development program for chief information officers, the AAMC ACCESS Data Collection and Dissemination System, and the internal Staff Interest Group on Medical Informatics and Medical Education.

Dosimetric evaluation of the staff working in a PET/CT department

International Nuclear Information System (INIS)

Dalianis, K.; Malamitsi, J.; Gogou, L.; Pagou, M.; Efthimiadou, R.; Andreou, J.; Louizi, A.; Georgiou, E.

2006-01-01

The dosimetric literature data concerning the medical personnel working in positron emission tomography/computed tomography (PET/CT) departments are limited. Therefore, we measured the radiation dose of the staff working in the first PET/CT department in Greece at the Diagnostic and Therapeutic Center of Athens HYGEIA-Harvard Medical International. As, for the time being, only 2-deoxy-2-[ 18 F]fluoro-d-glucose (FDG) PET studies are performed, radiation dose measurements concern those derived from dispensing of the radiopharmaceutical as well as from the patients undergoing FDG-PET imaging. Our aim is to develop more effective protective measures against radionuclide exposure. To estimate the effective dose from external exposure, all seven members of the staff (two nurses, two medical physicists, two technologists, one secretary) had TLD badges worn at the upper pocket of their overall, TLD rings on the right hand and digital dosimeters at their upper side pocket. In addition, isodose curves were measured with thermoluminescence detectors for distances of 20, 50, 70 and 100 cm away from patients who had been injected with 18 F-FDG. Dose values of the PET/CT staff were measured with digital detectors, TLD badges and TLD rings over the first 8 months for a total of 160 working days of the department's operation, consisting of a workload of about 10-15 patients/week who received 250-420 MBq of 18 F-FDG each. Whole - body collective doses and hand doses for the staff were the following: Nurse no. 1 received 1.6 mSv as a whole body dose and 2,1 as a hand dose, Nurse no. 2 received 1.9 and 2.4 mSv respectively. For medical physicist no. 1 the dose values were 1.45 mSv whole body and 1.7 mSv hand dose, for medical physicist no. 2 1.67 mSv wholebody dose and 1.55 mSv hand dose and for technologists no. 1 and no. 2 the whole body doses were 0.7 and 0.64 mSv respectively. Lastly, the secretary received 0.1 mSv whole body dose. These preliminary data have shown that the dose

Dosimetric evaluation of the staff working in a PET/CT department

Energy Technology Data Exchange (ETDEWEB)

Dalianis, K. [Department of PET/CT, Diagnostic and Therapeutic Center of Athens Hygeia-Harvard Medical International, Erythrau Stavrou 4, 5123 Athens (Greece)]. E-mail: k.dalianis@hygeia.gr; Malamitsi, J. [Department of PET/CT, Diagnostic and Therapeutic Center of Athens Hygeia-Harvard Medical International, Erythrau Stavrou 4, 5123 Athens (Greece); Gogou, L. [Department of PET/CT, Diagnostic and Therapeutic Center of Athens Hygeia-Harvard Medical International, Erythrau Stavrou 4, 5123 Athens (Greece); Pagou, M. [Department of PET/CT, Diagnostic and Therapeutic Center of Athens Hygeia-Harvard Medical International, Erythrau Stavrou 4, 5123 Athens (Greece); Efthimiadou, R. [Department of PET/CT, Diagnostic and Therapeutic Center of Athens Hygeia-Harvard Medical International, Erythrau Stavrou 4, 5123 Athens (Greece); Andreou, J. [Department of PET/CT, Diagnostic and Therapeutic Center of Athens Hygeia-Harvard Medical International, Erythrau Stavrou 4, 5123 Athens (Greece); Louizi, A. [Department of Medical Physics Medical School University of Athens, Athens (Greece); Georgiou, E. [Department of Medical Physics Medical School University of Athens, Athens (Greece)

2006-12-20

The dosimetric literature data concerning the medical personnel working in positron emission tomography/computed tomography (PET/CT) departments are limited. Therefore, we measured the radiation dose of the staff working in the first PET/CT department in Greece at the Diagnostic and Therapeutic Center of Athens HYGEIA-Harvard Medical International. As, for the time being, only 2-deoxy-2-[{sup 18}F]fluoro-d-glucose (FDG) PET studies are performed, radiation dose measurements concern those derived from dispensing of the radiopharmaceutical as well as from the patients undergoing FDG-PET imaging. Our aim is to develop more effective protective measures against radionuclide exposure. To estimate the effective dose from external exposure, all seven members of the staff (two nurses, two medical physicists, two technologists, one secretary) had TLD badges worn at the upper pocket of their overall, TLD rings on the right hand and digital dosimeters at their upper side pocket. In addition, isodose curves were measured with thermoluminescence detectors for distances of 20, 50, 70 and 100 cm away from patients who had been injected with {sup 18}F-FDG. Dose values of the PET/CT staff were measured with digital detectors, TLD badges and TLD rings over the first 8 months for a total of 160 working days of the department's operation, consisting of a workload of about 10-15 patients/week who received 250-420 MBq of {sup 18}F-FDG each. Whole - body collective doses and hand doses for the staff were the following: Nurse no. 1 received 1.6 mSv as a whole body dose and 2,1 as a hand dose, Nurse no. 2 received 1.9 and 2.4 mSv respectively. For medical physicist no. 1 the dose values were 1.45 mSv whole body and 1.7 mSv hand dose, for medical physicist no. 2 1.67 mSv wholebody dose and 1.55 mSv hand dose and for technologists no. 1 and no. 2 the whole body doses were 0.7 and 0.64 mSv respectively. Lastly, the secretary received 0.1 mSv whole body dose. These preliminary data have

Medication Adherence using Non-intrusive Wearable Sensors

Directory of Open Access Journals (Sweden)

T. H. Lim

2017-12-01

Full Text Available Activity recognition approaches have been applied in home ambient systems to monitor the status and well- being of occupant especially for home care systems. With the advancement of embedded wireless sensing devices, various applications have been proposed to monitor user´s activities and maintain a healthy lifestyle. In this paper, we propose and evaluate a Smart Medication Alert and Treatment Electronic Systems (SmartMATES using a non-intrusive wearable activity recognition sensing system to monitor and alert an user for missing medication prescription. Two sensors are used to collect data from the accelerometer and radio transceiver. Based on the data collected, SmartMATES processes the data and generate a model for the various actions including taking medication. We have evaluated the SmartMATES on 9 participants. The results show that the SmartMATES can identify and prevent missing dosage in a less intrusive way than existing mobile application and traditional approaches.

Preliminary Results of Ancillary Safety Analyses Supporting TREAT LEU Conversion Activities

Energy Technology Data Exchange (ETDEWEB)

Brunett, A. J. [Argonne National Lab. (ANL), Argonne, IL (United States); Fei, T. [Argonne National Lab. (ANL), Argonne, IL (United States); Strons, P. S. [Argonne National Lab. (ANL), Argonne, IL (United States); Papadias, D. D. [Argonne National Lab. (ANL), Argonne, IL (United States); Hoffman, E. A. [Argonne National Lab. (ANL), Argonne, IL (United States); Kontogeorgakos, D. C. [Argonne National Lab. (ANL), Argonne, IL (United States); Connaway, H. M. [Argonne National Lab. (ANL), Argonne, IL (United States); Wright, A. E. [Argonne National Lab. (ANL), Argonne, IL (United States)

2015-10-01

The Transient Reactor Test Facility (TREAT), located at Idaho National Laboratory (INL), is a test facility designed to evaluate the performance of reactor fuels and materials under transient accident conditions. The facility, an air-cooled, graphite-moderated reactor designed to utilize fuel containing high-enriched uranium (HEU), has been in non-operational standby status since 1994. Currently, in support of the missions of the Department of Energy (DOE) National Nuclear Security Administration (NNSA) Material Management and Minimization (M3) Reactor Conversion Program, a new core design is being developed for TREAT that will utilize low-enriched uranium (LEU). The primary objective of this conversion effort is to design an LEU core that is capable of meeting the performance characteristics of the existing HEU core. Minimal, if any, changes are anticipated for the supporting systems (e.g. reactor trip system, filtration/cooling system, etc.); therefore, the LEU core must also be able to function with the existing supporting systems, and must also satisfy acceptable safety limits. In support of the LEU conversion effort, a range of ancillary safety analyses are required to evaluate the LEU core operation relative to that of the existing facility. These analyses cover neutronics, shielding, and thermal hydraulic topics that have been identified as having the potential to have reduced safety margins due to conversion to LEU fuel, or are required to support the required safety analyses documentation. The majority of these ancillary tasks have been identified in [1] and [2]. The purpose of this report is to document the ancillary safety analyses that have been performed at Argonne National Laboratory during the early stages of the LEU design effort, and to describe ongoing and anticipated analyses. For all analyses presented in this report, methodologies are utilized that are consistent with, or improved from, those used in analyses for the HEU Final Safety Analysis

How many people in Canada use prescription opioids non-medically in general and street drug using populations?

Science.gov (United States)

Popova, Svetlana; Patra, Jayadeep; Mohapatra, Satya; Fischer, Benedikt; Rehm, Jürgen

2009-01-01

Medical prescriptions for opioids as well as their non-medical use have increased in Canada in recent years. This study aimed to estimate the number of non-medical prescription opioid (PO) users in the general and street drug using populations in Canada. The number of non-medical PO users among the general population and the number of non-medical PO users, heroin users, or both among the street drug using population was estimated for Canada and for the most populous Canadian provinces. Different estimation methods were used: 1) the number of non-medical PO users in the Canadian general population was estimated based on Canadian availability data, and the ratio of US availability to non-medical PO use from US survey data; 2) numbers within the street drug using population were indirectly estimated based on overdose death data, and a key informants survey. Distribution and trends by usage of opioids were determined by using the multi-site Canadian OPICAN cohort data. Between 321,000 to 914,000 non-medical PO users were estimated to exist among the general population in Canada in 2003. The estimated number of non-medical PO users, heroin users, or both among the street drug using population was about 72,000, with more individuals using nonmedical PO than heroin in 2003. Based on data from the OPICAN survey, in 2005 the majority of the street drug using population in main Canadian cities was non-medical PO users, with the exception of Vancouver and Montreal. A relative increase of 24% was observed from 2002 to 2005 in the proportion of the street drug using population who used non-medical POs only. There is an urgent need to further assess the extent and patterns of non-medical prescription opioid use, related problems and drug distribution channels in Canada.

76 FR 41726 - Reporting Ancillary Airline Passenger Revenues

Science.gov (United States)

2011-07-15

...., third checked bag or more) Overweight/Oversized Baggage/Sports Equipment Carry-On Baggage 4. In-Flight Medical Equipment 5. In-Flight Entertainment/Internet Access 6. Sleep Sets 7. In-Flight Food/Non Alcoholic... baggage performance is outdated. Airline passengers would [[Page 41728

Epistemology, culture, justice and power: non-bioscientific knowledge for medical training.

Science.gov (United States)

Kuper, Ayelet; Veinot, Paula; Leavitt, Jennifer; Levitt, Sarah; Li, Amanda; Goguen, Jeannette; Schreiber, Martin; Richardson, Lisa; Whitehead, Cynthia R

2017-02-01

While medical curricula were traditionally almost entirely comprised of bioscientific knowledge, widely accepted competency frameworks now make clear that physicians must be competent in far more than biomedical knowledge and technical skills. For example, of the influential CanMEDS roles, six are conceptually based in the social sciences and humanities (SSH). Educators frequently express uncertainty about what to teach in this area. This study concretely identifies the knowledge beyond bioscience needed to support the training of physicians competent in the six non-Medical Expert CanMEDS roles. We interviewed 58 non-clinician university faculty members with doctorates in over 20 SSH disciplines. We abstracted our transcripts (meaning condensation, direct quotations) resulting in approximately 300 pages of data which we coded using top-down (by CanMEDS role) and bottom-up (thematically) approaches and analysed within a critical constructivist framework. Participants and clinicians with SSH PhDs member-checked and refined our results. Twelve interrelated themes were evident in the data. An understanding of epistemology, including the constructed nature of social knowledge, was seen as the foundational theme without which the others could not be taught or understood. Our findings highlighted three anchoring themes (Justice, Power, Culture), all of which link to eight more specific themes concerning future physicians' relationships to the world and the self. All 12 themes were cross-cutting, in that each related to all six non-Medical Expert CanMEDS roles. The data also provided many concrete examples of potential curricular content. There is a definable body of SSH knowledge that forms the academic underpinning for important physician competencies and is outside the experience of most medical educators. Curricular change incorporating such content is necessary if we are to strengthen the non-Medical Expert physician competencies. Our findings, particularly our cross

Allocation of reactive power support, active loss balancing and demand interruption ancillary services in MicroGrids

Energy Technology Data Exchange (ETDEWEB)

Gomes, Mario Helder [Departamento de Engenharia Electrotecnica, Instituto Politecnico de Tomar, Quinta do Contador, Estrada da Serra, 2300 Tomar (Portugal); Saraiva, Joao Tome [INESC Porto and Faculdade de Engenharia da Universidade do Porto, Campus da FEUP, Rua Dr. Roberto Frias, 4200 - 465 Porto (Portugal)

2010-10-15

MicroGrids represent a new paradigm for the operation of distribution systems and there are several advantages as well as challenges regarding their development. One of the advantages is related with the participation of MicroGrid agents in electricity markets and in the provision of ancillary services. This paper describes two optimization models to allocate three ancillary services among MicroGrid agents - reactive power/voltage control, active loss balancing and demand interruption. These models assume that MicroGrid agents participate in the day-ahead market sending their bids to the MicroGrid Central Controller, MGCC, that acts as an interface with the Market Operator. Once the Market Operator returns the economic dispatch of the MicroGrid agents, the MGCC checks its technical feasibility (namely voltage magnitude and branch flow limits) and activates an adjustment market to change the initial schedule and to allocate these three ancillary services. One of the models has crisp nature considering that voltage and branch flow limits are rigid while the second one admits that voltage and branch flow limits are modeled in a soft way using Fuzzy Set concepts. Finally, the paper illustrates the application of these models with a Case Study using a 55 node MV/LV network. (author)

The Importance of Intangible Incentives to Increasing the Motivation of Enterprise Staff

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Kuchumova Iryna Yu.

2017-04-01

Full Text Available The article is aimed at studying different motivation systems that are used by the staff managers and considering recommendations for building an effective system to stimulate the professional development of staff at today’s enterprises. Impact of both the material and the non-material incentive systems on the staff performance was analyzed. It has been noted that, in the rapid development of the modern world, material motivation is no longer sufficient for the constant interest of workers and for their effective stimulation to productive work. Therefore, the main components of the system of non-material motivation of staff have been determined and analyzed. The most common methods of the non-material motivation used by contemporary companies together with the intangible incentives that workers want to receive were analyzed. Efficiency of the management practices associated with the evaluation of performance of each employee has been substantiated, and it has been specified that the effective staff incentives are one of the most significant factors in the competitiveness of today’s enterprises.

Staff and patient exposure to X-ray radiation during cardiac procedures

International Nuclear Information System (INIS)

Jankowski, J.; Papierz, D.; Domienik, J.; Kacprzyk, J.; Tybor-Czerwinska, M.; Werduch, A.

2008-01-01