WorldWideScience

Sample records for staffed medical contact

  1. Managerial implications of calculating optimal nurse staffing in medical units.

    Science.gov (United States)

    Bordoloi, S K; Weatherby, E J

    2000-07-01

    A critical managerial decision in health care organizations is the staffing decision. We offer a model to derive an optimum mix of different staff categories that minimizes total cost subject to constraints imposed by the patient acuity system and minimum staffing policies in a medical unit of Fairbanks Memorial Hospital, Alaska. We also indicate several managerial implications on how our results and their sensitivity analyses can be used effectively in decision making in a variety of categories.

  2. Managerial implications of calculating optimum nurse staffing in medical units.

    Science.gov (United States)

    Bordoloi, S K; Weatherby, E J

    1999-01-01

    A critical managerial decision in health care organizations is the staffing decision. We offer a model to derive an optimum mix of different staff categories that minimizes total cost subject to constraints imposed by the patient acuity system and minimum staffing policies in a medical unit of Fairbanks Memorial Hospital, Alaska. We also indicate several managerial implications on how our results and their sensitivity analyses can be used effectively in decision making in a variety of categories.

  3. Impact of nonphysician staffing on outcomes in a medical ICU.

    Science.gov (United States)

    Gershengorn, Hayley B; Wunsch, Hannah; Wahab, Romina; Leaf, David; Brodie, Daniel; Li, Guohua; Factor, Phillip

    2011-06-01

    As the number of ICU beds and demand for intensivists increase, alternative solutions are needed to provide coverage for critically ill patients. The impact of different staffing models on the outcomes of patients in the medical ICU (MICU) remains unknown. In our study, we compare outcomes of nonphysician provider-based teams to those of medical house staff-based teams in the MICU. We conducted a retrospective review of 590 daytime (7:00 am-7:00 pm) admissions to two MICUs at one hospital. In one MICU staffed by nurse practitioners and physician assistants (MICU-NP/PA) there were nonphysicians (nurse practitioners and physicians assistants) during the day (7:00 am-7:00 pm) with attending physician coverage overnight. In the other MICU, there were medicine residents (MICU-RES) (24 h/d). The outcomes investigated were hospital mortality, length of stay (LOS) (ICU, hospital), and posthospital discharge destination. Three hundred two patients were admitted to the MICU-NP/PA and 288 to the MICU-RES. Mortality probability model III (MPM(0)-III) predicted mortality was similar (P = .14). There was no significant difference in hospital mortality (32.1% for MICU-NP/PA vs 32.3% for MICU-RES, P = .96), MICU LOS (4.22 ± 2.51 days for MICU-NP/PA vs 4.44 ± 3.10 days for MICU-RES, P = .59), or hospital LOS (14.01 ± 2.92 days for MICU-NP/PA vs 13.74 ± 2.94 days for MICU-RES, P = .86). Discharge to a skilled care facility (vs home) was similar (37.1% for MICU-NP/PA vs 32.5% for MICU-RES, P = .34). After multivariate adjustment, MICU staffing type was not associated with hospital mortality (P = .26), MICU LOS (P = .29), hospital LOS (P = .19), or posthospital discharge destination (P = .90). Staffing models including daytime use of nonphysician providers appear to be a safe and effective alternative to the traditional house staff-based team in a high-acuity, adult ICU.

  4. Medical physics personnel for medical imaging: requirements, conditions of involvement and staffing levels-French recommendations.

    Science.gov (United States)

    Isambert, Aurélie; Le Du, Dominique; Valéro, Marc; Guilhem, Marie-Thérèse; Rousse, Carole; Dieudonné, Arnaud; Blanchard, Vincent; Pierrat, Noëlle; Salvat, Cécile

    2015-04-01

    The French regulations concerning the involvement of medical physicists in medical imaging procedures are relatively vague. In May 2013, the ASN and the SFPM issued recommendations regarding Medical Physics Personnel for Medical Imaging: Requirements, Conditions of Involvement and Staffing Levels. In these recommendations, the various areas of activity of medical physicists in radiology and nuclear medicine have been identified and described, and the time required to perform each task has been evaluated. Criteria for defining medical physics staffing levels are thus proposed. These criteria are defined according to the technical platform, the procedures and techniques practised on it, the number of patients treated and the number of persons in the medical and paramedical teams requiring periodic training. The result of this work is an aid available to each medical establishment to determine their own needs in terms of medical physics. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  5. Development of Staffing Patterns in Six New Medical Schools Established 1952-1960.

    Science.gov (United States)

    National Institutes of Health (DHEW), Bethesda, MD. Resources Analysis Branch.

    This summary report of staffing patterns in 6 medical schools established between 1952 and 1960 is the first phase of a proposed study of biomedical staffing requirements in institutions of higher education, 1965-1975. The 6 schools are: the University of Miami, Albert Einstein College of medicine at Yeshiva University, the University of Florida,…

  6. Medical physics staffing for radiation oncology: a decade of experience in Ontario, Canada

    Science.gov (United States)

    Battista, Jerry J.; Patterson, Michael S.; Beaulieu, Luc; Sharpe, Michael B.; Schreiner, L. John; MacPherson, Miller S.; Van Dyk, Jacob

    2012-01-01

    The January 2010 articles in The New York Times generated intense focus on patient safety in radiation treatment, with physics staffing identified frequently as a critical factor for consistent quality assurance. The purpose of this work is to review our experience with medical physics staffing, and to propose a transparent and flexible staffing algorithm for general use. Guided by documented times required per routine procedure, we have developed a robust algorithm to estimate physics staffing needs according to center‐specific workload for medical physicists and associated support staff, in a manner we believe is adaptable to an evolving radiotherapy practice. We calculate requirements for each staffing type based on caseload, equipment inventory, quality assurance, educational programs, and administration. Average per‐case staffing ratios were also determined for larger‐scale human resource planning and used to model staffing needs for Ontario, Canada over the next 10 years. The workload specific algorithm was tested through a survey of Canadian cancer centers. For center‐specific human resource planning, we propose a grid of coefficients addressing specific workload factors for each staff group. For larger scale forecasting of human resource requirements, values of 260, 700, 300, 600, 1200, and 2000 treated cases per full‐time equivalent (FTE) were determined for medical physicists, physics assistants, dosimetrists, electronics technologists, mechanical technologists, and information technology specialists, respectively. PACS numbers: 87.55.N‐, 87.55.Qr PMID:22231223

  7. Medical physics staffing for radiation oncology: a decade of experience in Ontario, Canada.

    Science.gov (United States)

    Battista, Jerry J; Clark, Brenda G; Patterson, Michael S; Beaulieu, Luc; Sharpe, Michael B; Schreiner, L John; MacPherson, Miller S; Van Dyk, Jacob

    2012-01-05

    The January 2010 articles in The New York Times generated intense focus on patient safety in radiation treatment, with physics staffing identified frequently as a critical factor for consistent quality assurance. The purpose of this work is to review our experience with medical physics staffing, and to propose a transparent and flexible staffing algorithm for general use. Guided by documented times required per routine procedure, we have developed a robust algorithm to estimate physics staffing needs according to center-specific workload for medical physicists and associated support staff, in a manner we believe is adaptable to an evolving radiotherapy practice. We calculate requirements for each staffing type based on caseload, equipment inventory, quality assurance, educational programs, and administration. Average per-case staffing ratios were also determined for larger-scale human resource planning and used to model staffing needs for Ontario, Canada over the next 10 years. The workload specific algorithm was tested through a survey of Canadian cancer centers. For center-specific human resource planning, we propose a grid of coefficients addressing specific workload factors for each staff group. For larger scale forecasting of human resource requirements, values of 260, 700, 300, 600, 1200, and 2000 treated cases per full-time equivalent (FTE) were determined for medical physicists, physics assistants, dosimetrists, electronics technologists, mechanical technologists, and information technology specialists, respectively.

  8. Community health centers employ diverse staffing patterns, which can provide productivity lessons for medical practices.

    Science.gov (United States)

    Ku, Leighton; Frogner, Bianca K; Steinmetz, Erika; Pittman, Patricia

    2015-01-01

    Community health centers are at the forefront of ambulatory care practices in their use of nonphysician clinicians and team-based primary care. We examined medical staffing patterns, the contributions of different types of staff to productivity, and the factors associated with staffing at community health centers across the United States. We identified four different staffing patterns: typical, high advanced-practice staff, high nursing staff, and high other medical staff. Overall, productivity per staff person was similar across the four staffing patterns. We found that physicians make the greatest contributions to productivity, but advanced-practice staff, nurses, and other medical staff also contribute. Patterns of community health center staffing are driven by numerous factors, including the concentration of clinicians in communities, nurse practitioner scope-of-practice laws, and patient characteristics such as insurance status. Our findings suggest that other group medical practices could incorporate more nonphysician staff without sacrificing productivity and thus profitability. However, the new staffing patterns that evolve may be affected by characteristics of the practice location or the types of patients served. Project HOPE—The People-to-People Health Foundation, Inc.

  9. Pharmacist Staffing, Technology Use, and Implementation of Medication Safety Practices in Rural Hospitals

    Science.gov (United States)

    Casey, Michelle M.; Moscovice, Ira S.; Davidson, Gestur

    2006-01-01

    Context: Medication safety is clearly an important quality issue for rural hospitals. However, rural hospitals face special challenges implementing medication safety practices in terms of their staffing and financial and technical resources. Purpose: This study assessed the capacity of small rural hospitals to implement medication safety…

  10. Pan African Medical Journal: Contact

    African Journals Online (AJOL)

    Principal Contact. Dr Raoul Kamadjeu Editor-in-Chief The Pan African Medical Journal Phone: +254 714 606 223. Email: raoul.kamadjeu@gmail.com. Support Contact. Editor Email: editor@panafrican-med-journal.com. ISSN: 1937-8688. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians ...

  11. Guam Medical Staffing Plan Needs Improvement to Ensure Eligible Beneficiaries Will Have Adequate Access to Health Care

    Science.gov (United States)

    2012-05-16

    Commandant of the Marine Corps submits updated force projections and the Secretary of Defense submits a master plan to Congress. Guam Realignment...are responsible for medical personnel assets. 5 NMW personnel used the following formula to determine physician staffing requirements...Okinawa discussed staffing requirements for multiple specialties, including pediatrics , psychiatry, psychology, and emergency room care. NMW

  12. Egyptian Journal of Medical Laboratory Sciences: Contact

    African Journals Online (AJOL)

    Principal Contact. Prof.Ossama Rasslan Editor Egyptian Journal of Medical Laboratory Sciences Cairo Medical Syndicate Dar El-Hekma, 42 Kasr El-Aini Street. Cairo EGYPT Email: orasslaneg@hotmail.com ...

  13. Pre-hospital severe traumatic brain injury - comparison of outcome in paramedic versus physician staffed emergency medical services.

    Science.gov (United States)

    Pakkanen, Toni; Virkkunen, Ilkka; Kämäräinen, Antti; Huhtala, Heini; Silfvast, Tom; Virta, Janne; Randell, Tarja; Yli-Hankala, Arvi

    2016-04-29

    Traumatic brain injury (TBI) is one of the leading causes of death and permanent disability. Emergency Medical Services (EMS) personnel are often the first healthcare providers attending patients with TBI. The level of available care varies, which may have an impact on the patient's outcome. The aim of this study was to evaluate mortality and neurological outcome of TBI patients in two regions with differently structured EMS systems. A 6-year period (2005 - 2010) observational data on pre-hospital TBI management in paramedic-staffed EMS and physician-staffed EMS systems were retrospectively analysed. Inclusion criteria for the study were severe isolated TBI presenting with unconsciousness defined as Glasgow coma scale (GCS) score ≤ 8 occurring either on-scene, during transportation or verified by an on-call neurosurgeon at admission to the hospital. For assessment of one-year neurological outcome, a modified Glasgow Outcome Score (GOS) was used. During the 6-year study period a total of 458 patients met the inclusion criteria. One-year mortality was higher in the paramedic-staffed EMS group: 57 % vs. 42 %. Also good neurological outcome was less common in patients treated in the paramedic-staffed EMS group. We found no significant difference between the study groups when considering the secondary brain injury associated vital signs on-scene. Also on arrival to ED, the proportion of hypotensive patients was similar in both groups. However, hypoxia was common in the patients treated by the paramedic-staffed EMS on arrival to the ED, while in the physician-staffed EMS almost none of the patients were hypoxic. Pre-hospital intubation by EMS physicians probably explains this finding. The results suggest to an outcome benefit from physician-staffed EMS treating TBI patients. ClinicalTrials.gov ID NCT01454648.

  14. Quality assurance in radiotherapy: the importance of medical physics staffing levels. Recommendations from an ESTRO/EFOMP joint task group.

    Science.gov (United States)

    Belletti, S; Dutreix, A; Garavaglia, G; Gfirtner, H; Haywood, J; Jessen, K A; Lamm, I L; Mijnheer, B; Noël, A; Nüsslin, F; Rosenow, U; Schneider, P; Seelentag, W; Sheriff, S; Svensson, H; Thwaites, D

    1996-10-01

    The safe application of ionising radiation for diagnosis and therapy requires a high level of knowledge of the underlying processes and of quality assurance. Sophisticated modern equipment can be used effectively for complicated diagnostic and therapeutic techniques only with adequate physics support. In the light of recent analyses and recommendations by national and international societies a joint working group of representatives from ESTRO (European Society for Therapeutic Radiology and Oncology) and from EFOMP (European Federation of Organisations for Medical Physics) was set up to assess the necessary staffing levels for physics support to radiotherapy. The method used to assess the staffing levels, the resulting recommendations and examples of their practical application are described.

  15. Effects of learning climate and registered nurse staffing on medication errors.

    Science.gov (United States)

    Chang, YunKyung; Mark, Barbara

    2011-01-01

    Despite increasing recognition of the significance of learning from errors, little is known about how learning climate contributes to error reduction. The purpose of this study was to investigate whether learning climate moderates the relationship between error-producing conditions and medication errors. A cross-sectional descriptive study was done using data from 279 nursing units in 146 randomly selected hospitals in the United States. Error-producing conditions included work environment factors (work dynamics and nurse mix), team factors (communication with physicians and nurses' expertise), personal factors (nurses' education and experience), patient factors (age, health status, and previous hospitalization), and medication-related support services. Poisson models with random effects were used with the nursing unit as the unit of analysis. A significant negative relationship was found between learning climate and medication errors. It also moderated the relationship between nurse mix and medication errors: When learning climate was negative, having more registered nurses was associated with fewer medication errors. However, no relationship was found between nurse mix and medication errors at either positive or average levels of learning climate. Learning climate did not moderate the relationship between work dynamics and medication errors. The way nurse mix affects medication errors depends on the level of learning climate. Nursing units with fewer registered nurses and frequent medication errors should examine their learning climate. Future research should be focused on the role of learning climate as related to the relationships between nurse mix and medication errors.

  16. External validation of the ROSC after cardiac arrest (RACA) score in a physician staffed emergency medical service system.

    Science.gov (United States)

    Kupari, Petteri; Skrifvars, Markus; Kuisma, Markku

    2017-03-29

    The return of spontaneous circulation (ROSC) after cardiac arrest (RACA) score may have implications as a quality indicator for the emergency medical services (EMS) system. We aimed to validate this score externally in a physician staffed urban EMS system. We conducted a retrospective cohort study. Data on resuscitation attempts from the Helsinki EMS cardiac arrest registry from 1.1.2008 to 31.12.2010 were collected and analyzed. For each attempted resuscitation the RACA score variables were collected and the score calculated. The endpoint was ROSC defined as palpable pulse over 30 s. Calibration was assessed by comparing predicted and observed ROSC rates in the whole sample, separately for shockable and non-shockable rhythm, and separately for resuscitations lead by a specialist, registrar or medical supervisor (i.e., senior paramedic). Data are presented as medians and interquartile ranges. Statistical testing included chi-square test, the Mann-Whitney U test, Hosmer-Lemeshow goodness of fit test and calculation of 95% confidence intervals (CI) for proportions. A total of 680 patients were included of whom 340 attained ROSC. The RACA score was higher in patients with ROSC (0.62 [0.46-0.69] than in those without (0.46 [0.36-0.57]) (p system for out-of-hospital cardiac arrest patients would allow patient heterogeneity adjustment and measurement of quality of care in analogy to commoly used severity-of-illness- scores developed for the similar purposes for the general intensive care unit population. However, transferring RACA score to another country with different population and EMS system might affect the performance and generalizability of the score. This study found a good overall calibration and moderate discrimination of the RACA score in a physician staffed urban EMS system which suggests external validity of the score. Calibration was suboptimal in patients with a non-shockable rhythm which may due to a local do-not-attempt-resuscitation policy. The lower

  17. Journal of Medical Laboratory Science: Contact

    African Journals Online (AJOL)

    Principal Contact. Prof. Francis Useh Editor. National Open University of Nigeria. 14/16 Ahmadu Bello Way. Victoria. Lagos. Nigeria. Additional Contact: Prof. Okoronkwo (Editor-in-Chief): okoronkwo@gmail.com. Phone: +2348035925974. Email: francisuse@yahoo.co.uk ...

  18. Ten-year trends in family medicine residency productivity and staffing: impact of electronic health records, resident duty hours, and the medical home.

    Science.gov (United States)

    Lesko, Sarah; Hughes, Lauren; Fitch, Wes; Pauwels, Judith

    2012-02-01

    Electronic health records (EHRs), resident duty hour restrictions, and Patient-centered Medical Home (PCMH) innovations have all impacted the clinical practices of residency programs over the past decade. The University of Washington Family Medicine Network (UWFMN) residencies have collaborated for 10 years in collecting and comparing data regarding the productivity and operations of their training programs to identify the program-level effects of such changes. Based on five survey results from 2000 to 2010, this study examines changes in faculty and resident productivity and staffing models of UWFMN residency training clinics using a standardized methodology, specifically describing the productivity impact of EHR changes and duty hour restrictions and the implementation of the PCMH by residencies. Data were systematically collected via standardized questionnaire, evaluated for quality, clarified, and then analyzed. Resident productivity decreased over the 10-year interval, with resident total yearly patient visits down 17.2%. Core family medicine faculty productivity was highly variable among programs, and nonphysician provider visits increased. Faculty part-time status increased. Front office, medical assistant, and nursing staffing grew significantly, but other administrative staff decreased, resulting in minimal change in total non-provider staffing. A majority of programs engaged in PCMH initiatives in 2010 and had implemented an EHR. Physician productivity in UWFMN residency programs decreased for all resident physicians from 2000 to 2010, likely due to a combination of decreased resident duty hours and other clinical practice changes. Productivity trends have implications for the structure and training requirements for family medicine residency programs.

  19. Improving Staffing and Nurse Engagement in a Neuroscience Intermediate Unit.

    Science.gov (United States)

    Nadolski, Charles; Britt, Pheraby; Ramos, Leah C

    2017-06-01

    The neuroscience intermediate unit is a 23-bed unit that was initially staffed with a nurse-to-patient ratio of 1:4 to 1:5. In time, the unit's capacity to care for the exceeding number of progressively acute patients fell short of the desired goals in the staff affecting the nurse satisfaction. The clinical nurses desired a lower nurse-patient ratio. The purpose of this project was to justify a staffing increase through a return on investment and increased quality metrics. This initiative used mixed methodology to determine the ideal staffing for a neuroscience intermediate unit. The quantitative section focused on a review of the acuity of the patients. The qualitative section was based on descriptive interviews with University Healthcare Consortium nurse managers from similar units. The study reviewed the acuity of 9,832 patient days to determine the accurate acuity of neuroscience intermediate unit patients. Nurse managers at 12 University Healthcare Consortium hospitals and 8 units at the Medical University of South Carolina were contacted to compare staffing levels. The increase in nurse staffing contributed to an increase in many quality metrics. There were an 80% decrease in controllable nurse turnover and a 75% reduction in falls with injury after the lowered nurse-patient ratio. These 2 metrics established a return on investment for the staffing increase. In addition, the staffing satisfaction question on the Press Ganey employee engagement survey increased from 2.44 in 2013 to 3.72 in 2015 in response to the advocacy of the bedside nurses.

  20. Potential benefit of physician-staffed helicopter emergency medical service for regional trauma care system activation: An observational study in rural Japan.

    Science.gov (United States)

    Abe, Tomohiro; Nagano, Takehiko; Ochiai, Hidenobu

    2017-05-01

    Objective: Involvement of all regional medical facilities in a trauma system is challenging in rural regions. We hypothesized that the physician-staffed helicopter emergency medical service potentially encouraged local facilities to participate in trauma systems by providing the transport of patients with trauma to those facilities in a rural setting. Materials and Methods: We performed two retrospective observational studies. First, yearly changes in the numbers of patients with trauma and destination facilities were surveyed using records from the Miyazaki physician-staffed helicopter emergency medical service from April 2012 to March 2014. Second, we obtained data from medical records regarding the mechanism of injury, severity of injury, resuscitative interventions performed within 24 h after admission, secondary transports owing to undertriage by attending physicians, and deaths resulting from potentially preventable causes. Data from patients transported to the designated trauma center and those transported to non-designated trauma centers in Miyazaki were compared. Results: In total, 524 patients were included. The number of patients transported to non-designated trauma centers and the number of non-designated trauma centers receiving patients increased after the second year. We surveyed 469 patient medical records (90%). There were 194 patients with major injuries (41%) and 104 patients with multiple injuries (22%), and 185 patients (39%) received resuscitative interventions. The designated trauma centers received many more patients with trauma (366 vs. 103), including many more patients with major injuries (47% vs. 21%, p service potentially encouraged non-designated trauma centers to participate in trauma systems while maintaining patient safety.

  1. Microscopic contact area and friction between medical textiles and skin.

    Science.gov (United States)

    Derler, S; Rotaru, G-M; Ke, W; El Issawi-Frischknecht, L; Kellenberger, P; Scheel-Sailer, A; Rossi, R M

    2014-10-01

    The mechanical contact between medical textiles and skin is relevant in the health care for patients with vulnerable skin or chronic wounds. In order to gain new insights into the skin-textile contact on the microscopic level, the 3D surface topography of a normal and a new hospital bed sheet with a regular surface structure was measured using a digital microscope. The topographic data was analysed concerning material distribution and real contact area against smooth surfaces as a function of surface deformations. For contact conditions that are relevant for the skin of patients lying in a hospital bed it was found that the order of magnitude of the ratio of real and apparent contact area between textiles and skin or a mechanical skin model lies between 0.02 and 0.1 and that surface deformations, i.e. penetration of the textile surface asperities into skin or a mechanical skin model, range from 10 to 50µm. The performed analyses of textile 3D surface topographies and comparisons with previous friction measurement results provided information on the relationship between microscopic surface properties and macroscopic friction behaviour of medical textiles. In particular, the new bed sheet was found to be characterised by a trend towards a smaller microscopic contact area (up to a factor of two) and by a larger free interfacial volume (more than a factor of two) in addition to a 1.5 times lower shear strength when in contact with counter-surfaces. The applied methods can be useful to develop improved and skin-adapted materials and surfaces for medical applications. Copyright © 2014 Elsevier Ltd. All rights reserved.

  2. The Accreditation Council for Graduate Medical Education resident duty hour new standards: history, changes, and impact on staffing of intensive care units.

    Science.gov (United States)

    Pastores, Stephen M; O'Connor, Michael F; Kleinpell, Ruth M; Napolitano, Lena; Ward, Nicholas; Bailey, Heatherlee; Mollenkopf, Fred P; Coopersmith, Craig M

    2011-11-01

    The Accreditation Council for Graduate Medical Education recently released new standards for supervision and duty hours for residency programs. These new standards, which will affect over 100,000 residents, take effect in July 2011. In response to these new guidelines, the Society of Critical Care Medicine convened a task force to develop a white paper on the impact of changes in resident duty hours on the critical care workforce and staffing of intensive care units. A multidisciplinary group of professionals with expertise in critical care education and clinical practice. Relevant medical literature was accessed through a systematic MEDLINE search and by requesting references from all task force members. Material published by the Accreditation Council for Graduate Medical Education and other specialty organizations was also reviewed. Collaboratively and iteratively, the task force corresponded by electronic mail and held several conference calls to finalize this report. The new rules mandate that all first-year residents work no more than 16 hrs continuously, preserving the 80-hr limit on the resident workweek and 10-hr period between duty periods. More senior trainees may work a maximum of 24 hrs continuously, with an additional 4 hrs permitted for handoffs. Strategic napping is strongly suggested for trainees working longer shifts. Compliance with the new Accreditation Council for Graduate Medical Education duty-hour standards will compel workflow restructuring in intensive care units, which depend on residents to provide a substantial portion of care. Potential solutions include expanded utilization of nurse practitioners and physician assistants, telemedicine, offering critical care training positions to emergency medicine residents, and partnerships with hospitalists. Additional research will be necessary to evaluate the impact of the new standards on patient safety, continuity of care, resident learning, and staffing in the intensive care unit.

  3. The Impact of an Electronic Medication Administration Record (eMAR) and Computerized Physician Order Entry (CPOE) on Nurse Extender and Unit Clerk Staffing.

    Science.gov (United States)

    Robinson, Edmondo J; Bergey, Meredith R; Brady, Elizabeth; Mapp, Alexandra M; Goldsack, Jennifer C

    2017-12-01

    The aim of this study is to describe the impact of the introduction of health information technology (HIT) on the utilization and payroll costs of nurse extenders and unit clerks in medicine and surgery units in a large regional health system. Long-term policy goals of HIT implementation are reported to include system-level reductions in labor costs, achieved through improved efficiency. Using a retrospective cohort model, we analyzed how hours worked per patient day and staffing costs per patient day varied with the implementation of HIT over time at 2 different hospitals within a health system. Implementation of electronic medication administration records was not associated with significant changes in staffing or labor costs. Both labor hours and costs associated with nurse extenders and unit clerks were significantly reduced after the subsequent addition of computerized provider order entry. Simultaneously, units that did not implement any HIT experienced a significant increase in both labor hours and costs. Health information technology implementation in the inpatient setting is associated with significant savings in labor hours and costs in non-registered nursing roles.

  4. Physician staffed helicopter emergency medical service dispatch via centralised control or directly by crew - case identification rates and effect on the Sydney paediatric trauma system.

    Science.gov (United States)

    Garner, Alan A; Lee, Anna; Weatherall, Andrew

    2012-12-18

    Severe paediatric trauma patients benefit from direct transport to dedicated Paediatric Trauma Centres (PTC). Parallel case identification systems utilising paramedics from a centralised dispatch centre versus the crew of a physician staffed Helicopter Emergency Medical Service (HEMS) allowed comparison of the two systems for case identification rates and subsequent timeliness of direct transfer to a PTC. Paediatric trauma patients over a two year period from the Sydney region with an Injury Severity Score (ISS) > 15 were retrospectively identified from a state wide trauma registry. Overall paediatric trauma system performance was assessed by comparisons of the availability of the physician staffed HEMS for patient characteristics, transport mode (direct versus indirect) and the times required for the patient to arrive at the paediatric trauma centre. The proportion of patients transported directly to a PTC was compared between the times that the HEMS service was available versus the time that it was unavailable to determine if the HEMS system altered the rate of direct transport to a PTC. Analysis of variance was used to compare the identifying systems for various patient characteristics when the HEMS was available. Ninety nine cases met the inclusion criteria, 44 when the HEMS system was operational. Patients identified for physician response by the HEMS system were significantly different to those that were not identified with higher median ISS (25 vs 18, p = 0.011), and shorter times to PTC (67 vs 261mins, p = 0.015) and length of intensive care unit stays (2 vs 0 days, p = 0.045). Of the 44 cases, 21 were not identified, 3 were identified by the paramedic system and 20 were identified by the HEMS system, (P system was available (RR 1.81, 95% CI 1.20-2.73). The median time (minutes) to arrival at the PTC was shorter when HEMS available (HEMS available 92, IQR 50-261 versus HEMS unavailable 296, IQR 84-583, P < 0.01). Physician staffed

  5. Staffing in Radiotherapy: An Activity Based Approach

    International Nuclear Information System (INIS)

    2015-01-01

    Radiotherapy requires competent professional staff to ensure safe and effective patient treatment and management. There is a need to provide guidelines that recommend appropriate staffing levels to support the initiation of new services as well as the expansion or upgrade of existing services as even simple upgrades or replacement of existing equipment may have a significant impact on staffing needs. Similarly, the introduction of education and training programmes will require staffing adjustments. A calculation algorithm was developed to predict staffing levels based on the inputs that are known or can be easily estimated. This publication complements other IAEA publications used to support the initiation of basic radiation medicine services including Setting up a Radiotherapy Programme: Clinical, Medical Physics, Radiation Protection and Safety Aspects, published in 2008

  6. Contact allergy to ingredients of topical medications : results of the European Surveillance System on Contact Allergies (ESSCA), 2009-2012

    NARCIS (Netherlands)

    Uter, Wolfgang; Spiewak, Radoslaw; Cooper, Susan M.; Wilkinson, Mark; Sanchez Perez, Javier; Schnuch, Axel; Schuttelaar, Marie-Louise

    2016-01-01

    PurposeThe aim of this study was to give an overview of the prevalence of contact allergy to active ingredients and excipients of topical medications across Europe. MethodsRetrospective analysis of data collected by the European Surveillance System on Contact Allergies () with substances applied to

  7. Objective and subjective evaluation of the performance of medical contact lenses fitted using a contact lens selection algorithm

    NARCIS (Netherlands)

    Visser, Esther-Simone; Wisse, Robert P L; Soeters, Nienke; Imhof, Saskia M; van der Lelij, Allegonda

    PURPOSE: To evaluate the performance of medical contact lenses (CLs) for a wide range of clinical indications. DESIGN: Prospective cross-sectional study. METHODS: A total of 281 eyes were evaluated in 281 consecutive patients (≥18 years of age; CL use ≥3 months) who visited the contact lens service

  8. Medical marijuana: time to contact your U.S. representative.

    Science.gov (United States)

    James, J S

    1998-04-03

    Advocates for legalizing marijuana for medicinal use are encouraged to contact their U.S. representatives. The first congressional vote on medicinal use of marijuana, House Resolution 372 (the anti-medicinal-marijuana resolution), takes place on April 21. H. Res. 372 states that marijuana is a dangerous and addictive drug. Nine Democrats on the House Judiciary Committee strongly disagreed with the statement and supported State initiatives to legalize marijuana for medicinal purposes. The Marijuana Policy Project offers a script to use when contacting representatives. Contact information is provided.

  9. Allergic Contact Dermatitis to Ophthalmic Medications: Relevant Allergens and Alternative Testing Methods.

    Science.gov (United States)

    Grey, Katherine R; Warshaw, Erin M

    Allergic contact dermatitis is an important cause of periorbital dermatitis. Topical ophthalmic agents are relevant sensitizers. Contact dermatitis to ophthalmic medications can be challenging to diagnose and manage given the numerous possible offending agents, including both active and inactive ingredients. Furthermore, a substantial body of literature reports false-negative patch test results to ophthalmic agents. Subsequently, numerous alternative testing methods have been described. This review outlines the periorbital manifestations, causative agents, and alternative testing methods of allergic contact dermatitis to ophthalmic medications.

  10. The European Federation of Organisations for Medical Physics. Policy Statement No. 7.1: The roles, responsibilities and status of the medical physicist including the criteria for the staffing levels in a Medical Physics Department approved by EFOMP Council on 5th February 2016.

    Science.gov (United States)

    Evans, Stephen; Christofides, Stelios; Brambilla, Marco

    2016-04-01

    This EFOMP Policy Statement is an amalgamation and an update of the EFOMP Policy Statements No. 2, 4 and 7. It presents guidelines for the roles, responsibilities and status of the medical physicist together with recommended minimum staffing levels. These recommendations take into account the ever-increasing demands for competence, patient safety, specialisation and cost effectiveness of modern healthcare services, the requirements of the European Union Council Directive 2013/59/Euratom laying down the basic safety standards for protection against the dangers arising from exposure to ionising radiation, the European Commission's Radiation Protection Report No. 174: "Guidelines on medical physics expert", as well as the relevant publications of the International Atomic Energy Agency. The provided recommendations on minimum staffing levels are in very good agreement with those provided by both the European Commission and the International Atomic Energy Agency. Copyright © 2016. Published by Elsevier Ltd.

  11. Integrative Review of Mobile Phone Contacts and Medication Adherence in Severe Mental Illness.

    Science.gov (United States)

    Bright, Cordellia E

    2018-02-01

    Poor medication adherence is a significant problem in individuals with severe mental illness (SMI). About 50% of people with SMI become nonadherent to treatment in the first month following discharge from the hospital. This study examined literature in the past decade (2006-2016) on the use of mobile phone contacts in individuals with SMI to improve medication adherence post hospital discharge. This integrative review used the search terms texting, text messaging, SMS, cell/mobile phone, medication adherence, medication compliance, and mental illness. Databases (CINAHL, PubMed, PsycINFO, and Scopus) and manual searching of reference lists were done. The main inclusion criteria were the use of mobile phone contacts on medication adherence in individuals with SMI. Adults 18 years and older, studies conducted from 2006 to 2016, and studies conducted in English were also criteria for inclusion. Only five studies met criteria for inclusion. Outcomes from the review showed that mobile phone contacts have been used to improve medication adherence in individuals with SMI and able to provide the four types of social support (instrumental, informational, emotional, and, appraisal). When phone contacts especially text messaging was used as an adjunct to other interventions, it yielded better medication adherence than when used alone. However, results on medication adherence rates were mixed in participants on both psychiatric and nonpsychiatric medications. Although mobile phone contacts are a promising tool to enhance medication adherence after hospital discharge, its effectiveness to increase medication adherence in this population remains inconclusive.

  12. Savannah Journal of Medical Research and Practice: Contact

    African Journals Online (AJOL)

    Dr Habeeb Omokanye (Journal Secretary) Phone: 234-803-501-2930. Email: habeebomokanye@yahoo.com. ISSN: 2276-6839. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use · Contact AJOL ...

  13. 77 FR 14832 - Plumchoice, Inc., Including On-Site Leased Workers From Balance Staffing, Insight Global Staffing...

    Science.gov (United States)

    2012-03-13

    ... Staffing, Insight Global Staffing, and Technisource, Scarborough, ME; Amended Certification Regarding..., Inc., including on-site leased workers from Balance Staffing, Insight Global Staffing, and... from Balance Staffing, Insight Global Staffing, and Technisource, Scarborough, Maine, who became...

  14. Effective Staffing Takes a Village: Creating the Staffing Ecosystem.

    Science.gov (United States)

    Gavigan, Margaret; Fitzpatrick, Therese A; Miserendino, Carole

    2016-01-01

    The traditional approaches to staffing and scheduling are often ineffective in assuring sufficient budgeting and deployment of staff to assure the right nurse at the right time for the right cost. As hospital merger activity increases, this exercise is further complicated by the need to rationalize staffing across multiple enterprises and standardize systems and processes. This Midwest hospital system successfully optimized staffing at the unit and enterprise levels by utilizing operations research methodologies. Savings were reinvested to improve staffing models which provided sufficient nonproductive coverage and patient-driven ratios. Over/under-staffing was eliminated in support of the system's recognition that adequate resource planning and deployment are critical to the culture of safety.

  15. Objective and subjective evaluation of the performance of medical contact lenses fitted using a contact lens selection algorithm.

    Science.gov (United States)

    Visser, Esther-Simone; Wisse, Robert P L; Soeters, Nienke; Imhof, Saskia M; Van der Lelij, Allegonda

    2016-08-01

    To evaluate the performance of medical contact lenses (CLs) for a wide range of clinical indications. Prospective cross-sectional study. A total of 281 eyes were evaluated in 281 consecutive patients (≥18 years of age; CL use ≥3 months) who visited the contact lens service in a tertiary academic clinic for a scheduled follow-up visit. The main outcome measured were clinical indications for CL wear; CL type; change in corrected distance visual acuity (CDVA) with CL use; CL wearing duration; CL wearing time; subjective performance measured using a visual analog scale (VAS) questionnaire (score range: 0-100); and effectiveness of the lens-selection algorithm. Wearing CLs significantly improved CDVA compared to wearing spectacles (median change: -0.15 logMAR, range: 1.00 to -2.10; Pscleral lens and soft lens groups. The medical CL fitting was found to be generally effective (the overall satisfaction rating was ≥70 for 81% of patients). Fitting CLs based on the lens-selection algorithm yielded positive clinical results, including improved visual acuity, satisfactory wearing time, and high overall subjective performance. Moreover, subjective performance was similar between users of scleral lenses and users of soft lenses. These results underscore the importance of prescribing scleral lenses and the need for tertiary eye clinics to offer patients a variety of CL types. Copyright © 2016 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  16. How easy is it to contact the duty medical doctor responsible for acute admissions?

    OpenAIRE

    Bakhai, A; Goodman, F; Juchniewichz, H; Martin, A; Porter, G; White, C; Williams, L; Hopkins, A

    1990-01-01

    OBJECTIVE--To ascertain ease or difficulty of contacting duty junior doctors responsible for acute medical admissions by telephone. DESIGN--Telephone survey of hospitals in six health regions in England and Wales. SETTING--70 Randomly selected hospitals, 15 of which were excluded because of non-acceptance of acute medical admissions. PARTICIPANTS--71 Duty doctors (duty house physicians, senior house officers, or registrars responsible for acute medical admissions) in 48 hospitals; seven duty ...

  17. Fabulous award for staffing app.

    Science.gov (United States)

    2015-12-02

    A safe staffing app giving up-to-date information on the number of nurses on the wards at Nottingham University Hospitals NHS Trust scooped top prize at the inaugural Academy of Fabulous NHS Stuffawards in London last week.

  18. KNOWLEDGE, ATTITUDE AND PRACTICE OF CONTACT LENS USERS AMONG MEDICAL COLLEGE STUDENTS IN BANGALORE

    OpenAIRE

    Sujatha; Pandu

    2015-01-01

    INTRODUCTION: The use of contact lens (CL) for the correction of refractive errors, cosmetic use and their usage as a therapeutic modality for corneal pathologies has increased many fold over the years. The present study was conducted with the aim to find the knowledge , attitude and pattern of CL use amongst medical college student...

  19. Observance of hand washing procedures performed by the medical personnel before patient contact. Part I

    Directory of Open Access Journals (Sweden)

    Anna Garus-Pakowska

    2013-02-01

    Full Text Available Introduction: According to the Centers for Disease Control and Prevention (CDC as well as the World Health Organization (WHO recommendations, medical staff are obliged to decontaminate the skin of the hands before every single patient contact. Materials and Methods: The study was performed by quasi-observation among the group of 188 medical staff (nurses and physicians working in three selected hospitals of the Łódź province. The procedure of hand washing and disinfection performed directly before the patient contact according to the CDC and WHO recommendations were observed. The results was subject to statistical analysis (p < 0.05. Results: During 1544 hours of observation 4101 activities requiring hand washing were recorded. The medical staff obeyed the hand washing procedure before the patient contact only in 5.2% of the situations. There was no activity observed before which hand hygiene was maintained in 100% of cases. Observance of hand hygiene depended signifi cantly on the type of the performed activity, the professional group, and the workload index. A decrease in percentage observance of hand hygiene according to the time of the day was found to be of statistical signifi cance. The mean time of hand washing was 8.5 s for physicians and 6.6 s for nurses. Conclusion: The level of observance of hand washing procedures among the medical staff prior to the patient contact appears to be alarmingly below the expectations.

  20. How easy is it to contact the duty medical doctor responsible for acute admissions?

    Science.gov (United States)

    Bakhai, A; Goodman, F; Juchniewichz, H; Martin, A; Porter, G; White, C; Williams, L; Hopkins, A

    1990-09-15

    To ascertain ease or difficulty of contacting duty junior doctors responsible for acute medical admissions by telephone. Telephone survey of hospitals in six health regions in England and Wales. 70 Randomly selected hospitals, 15 of which were excluded because of non-acceptance of acute medical admissions. 71 Duty doctors (duty house physicians, senior house officers, or registrars responsible for acute medical admissions) in 48 hospitals; seven duty doctors in seven hospitals were excluded (four declined to participate and three required a written explanation of the survey). 67 Doctors gave full information to all questions. Time taken for hospital switchboards and duty doctors to reply to telephone call, diagnoses of patients recently admitted, and on call rotas and hours of sleep of duty doctors. Hospital switchboards responded within 30 seconds in 87 (74%) calls, and in 76 calls (64%) the duty doctor requested was contacted within a further two minutes. Chest pain, possibly due to myocardial infarction, was the most common reason for acute medical admissions. Nearly half (48%) of the duty doctors in larger hospitals reported having 4-5 hours sleep or less on their nights on call. Most (30) were on a one in three rota; two were on a one in two rota. Despite impressions to the contrary contacting the duty medical team by telephone seemed fairly easy. Although most junior doctors were on a rota of one in three or better, insufficient recognition may be given to their deprivation of sleep during nights on duty.

  1. Staffing Up for Technology Support.

    Science.gov (United States)

    Carter, Kim

    2000-01-01

    Examines current technology staffing in school districts and compares technology-related roles with a similar study conducted in 1997. Discusses job titles; responsibilities; career paths; lack of technology support in schools; district-level support; teacher training; peer assistance; student roles; collaboration with library media specialists;…

  2. When Contact Is Not Enough: Affecting First Year Medical Students' Image towards Older Persons.

    Science.gov (United States)

    Kusumastuti, Sasmita; van Fenema, Esther; Polman-van Stratum, Eugenie C F; Achterberg, Wilco; Lindenberg, Jolanda; Westendorp, Rudi G J

    2017-01-01

    Many medical schools have initiated care internships to familiarize their students with older persons and to instil a professional attitude. To examine the impact of care internships on the image that first-year medical students have of older persons and to explore the underlying concepts that may play a role in shaping this image. Survey before and after a two-week compulsory care internship using the Aging Semantic Differential (ASD; 32 adjectives) and the Attitudes toward Old People (AOP; 34 positions) questionnaires. Before and after a care internship involving interpersonal contact, 252 and 244 first-year medical students at the Leiden University Medical Centre (LUMC) in the academic year 2012-2013 participated. Descriptive statistics, analyses of variance, and principal component analysis were used; clusters of adjectives and positions were reduced into concepts to examine dominant patterns of views. Changes in image were investigated as mean differences of the total and concept scores. Both the ASD and the AOP questionnaires showed a poor general image of older persons that significantly worsened after the care internship (p < 0.01). The percentage of students considering over 75 years as being old increased from 17.2% to 31.2% (p < 0.01) and those who thought they would find as much satisfaction in care for older as for younger patients decreased from 78.5% to 62.1% (p < 0.001). Exploratory principal component analysis showed particularly low scores on 'comportment' and 'pleasurable interaction' whereas the scores on 'personality traits' and 'habitual behaviour' significantly deteriorated (both p < 0.001). These patterns were irrespective of the student's gender and previous contact experience. Medical schools should carefully consider care internships to ensure that students do not worsen their views on older patients, which may occur due to inadequate contact depth and quality within a rather unsupportive context.

  3. When Contact Is Not Enough: Affecting First Year Medical Students’ Image towards Older Persons

    Science.gov (United States)

    van Fenema, Esther; Polman-van Stratum, Eugenie C. F.; Achterberg, Wilco; Westendorp, Rudi G. J.

    2017-01-01

    Context Many medical schools have initiated care internships to familiarize their students with older persons and to instil a professional attitude. Objective To examine the impact of care internships on the image that first-year medical students have of older persons and to explore the underlying concepts that may play a role in shaping this image. Design Survey before and after a two-week compulsory care internship using the Aging Semantic Differential (ASD; 32 adjectives) and the Attitudes toward Old People (AOP; 34 positions) questionnaires. Participants Before and after a care internship involving interpersonal contact, 252 and 244 first-year medical students at the Leiden University Medical Centre (LUMC) in the academic year 2012–2013 participated. Method Descriptive statistics, analyses of variance, and principal component analysis were used; clusters of adjectives and positions were reduced into concepts to examine dominant patterns of views. Changes in image were investigated as mean differences of the total and concept scores. Results Both the ASD and the AOP questionnaires showed a poor general image of older persons that significantly worsened after the care internship (p < 0.01). The percentage of students considering over 75 years as being old increased from 17.2% to 31.2% (p < 0.01) and those who thought they would find as much satisfaction in care for older as for younger patients decreased from 78.5% to 62.1% (p < 0.001). Exploratory principal component analysis showed particularly low scores on ‘comportment’ and ‘pleasurable interaction’ whereas the scores on ‘personality traits’ and ‘habitual behaviour’ significantly deteriorated (both p < 0.001). These patterns were irrespective of the student’s gender and previous contact experience. Conclusion Medical schools should carefully consider care internships to ensure that students do not worsen their views on older patients, which may occur due to inadequate contact depth and

  4. When Contact Is Not Enough: Affecting First Year Medical Students' Image towards Older Persons.

    Directory of Open Access Journals (Sweden)

    Sasmita Kusumastuti

    Full Text Available Many medical schools have initiated care internships to familiarize their students with older persons and to instil a professional attitude.To examine the impact of care internships on the image that first-year medical students have of older persons and to explore the underlying concepts that may play a role in shaping this image.Survey before and after a two-week compulsory care internship using the Aging Semantic Differential (ASD; 32 adjectives and the Attitudes toward Old People (AOP; 34 positions questionnaires.Before and after a care internship involving interpersonal contact, 252 and 244 first-year medical students at the Leiden University Medical Centre (LUMC in the academic year 2012-2013 participated.Descriptive statistics, analyses of variance, and principal component analysis were used; clusters of adjectives and positions were reduced into concepts to examine dominant patterns of views. Changes in image were investigated as mean differences of the total and concept scores.Both the ASD and the AOP questionnaires showed a poor general image of older persons that significantly worsened after the care internship (p < 0.01. The percentage of students considering over 75 years as being old increased from 17.2% to 31.2% (p < 0.01 and those who thought they would find as much satisfaction in care for older as for younger patients decreased from 78.5% to 62.1% (p < 0.001. Exploratory principal component analysis showed particularly low scores on 'comportment' and 'pleasurable interaction' whereas the scores on 'personality traits' and 'habitual behaviour' significantly deteriorated (both p < 0.001. These patterns were irrespective of the student's gender and previous contact experience.Medical schools should carefully consider care internships to ensure that students do not worsen their views on older patients, which may occur due to inadequate contact depth and quality within a rather unsupportive context.

  5. Raising the Bar with Trades Staffing Guidelines.

    Science.gov (United States)

    Weidner, Theodore J.

    2000-01-01

    Examines the APPA's Trades Staffing Guidelines Task Force for college campus building maintenance and presents descriptions of the proposed guideline levels and a matrix of indicators for the Trades Staffing Guidelines. The levels and matrix are intended to mimic features of the custodial staffing guidelines. (GR)

  6. [Medical emergency care and patient contact at the Quart Rock Festival in Norway].

    Science.gov (United States)

    Skjeie, Holgeir; Nygaard, Siv; Li, Henrik Stenwig; Gardasevic, Bozidar; Fetveit, Arne; Brekke, Mette

    2008-06-26

    The annual Quart Rock Festival (1991-2007) was the largest rock festival in Norway. During festivals in 2004-06, a daily average of 3 000 personnel, guests and artists, and 10,000 visitors, 13,000 people, were present daily. The festival had a medical care organization recruited from primary care personnel. The team consisted of one general practitioner, one physiotherapist, two nurses from the municipality outpatient service, and lay personnel trained in first aid. We recorded all patient contacts at the festival in 2004, 2005, and 2006 in order to describe injuries requiring medical attention and the need for referrals. The total number of festival participants, including personnel, was 208,000 during the registration period. Of totally 1,349 patient contacts, 254 required consultation with a nurse and 191 with the attending physician. There were no deaths, cardiac or respiratory arrests or serious penetrating trauma. 33 contacts were related to intoxication: 24 due to alcohol, five to illegal drugs and four to unknown substances. Violence-related injuries were the cause of 18 contacts, of which none were serious. 49 patients were referred for follow-up, mostly to the municipality outpatient service or their own physician, and five patients were admitted to hospital. The transport-to-hospital-ratio was 0.24 per 10,000 participants. The results are similar to those in studies of rock festivals in other countries. The need for referrals was equal to or lower than in other studies. This indicates that the primary care-based medical organization at the Quart Festival was adequate.

  7. Physician Contacts and Their Influence on the Appropriateness of Pain Medication in Nursing Home Residents: A Cross-Sectional Study.

    Science.gov (United States)

    Flaig, Tanja Maria; Budnick, Andrea; Kuhnert, Ronny; Kreutz, Reinhold; Dräger, Dagmar

    2016-09-01

    This study assessed the frequency of physician contacts for individual nursing home residents (NHRs) and investigated whether the frequency of contacts influences the appropriateness of pain medication in NHRs. Observational cross-sectional study conducted between March 2009 and April 2010. Forty nursing homes in Berlin and Brandenburg, Germany. A total of 560 NHRs. The number and type of NHR physician contacts were obtained by face-to-face interviews. To assess the appropriateness of pain medication, the German version of the Pain Medication Appropriateness Scale (PMASD) was used. The influence of physician contacts on the appropriateness of pain medication was calculated with a linear mixed-effect model. The proportions of NHRs with at least 1 contact with their attending physicians were 61.8% (primary care physicians), 55.2% (general practitioners), 9.6% (neurologists), 9.4% (other), 5.4% (internists), 2.2% (orthopedic surgeons), and 0.7% (psychiatrists). The number of all physician contacts correlated weakly with the appropriateness of pain medication (r = 0.166, P = .039). With every physician contact, the PMASD score rose by about 2 points (P = .056). Physician care in German nursing homes is mainly provided by primary care physicians. A higher number of physician contacts had a modest impact on more appropriate pain medication use. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  8. Level of compliance in contact lens wearing medical doctors in Nepal.

    Science.gov (United States)

    Sapkota, Kishor

    2015-12-01

    To determine the level of compliance and major non-compliant behaviors in contact lens (CL) wearing medical doctors (MDs) and to compare it with age matched CL wearing normal subjects with no medical background (NS). Thirty-nine current CL wearing MDs, who were prescribed CLs in Nepal Eye Hospital, Kathmandu, Nepal, between 2007 and 2011, were interviewed on ten modifiable compliant behaviors regarding lens care and maintenance. The level of compliance and the rate of non-compliance for each behavior were determined and compared with NS. Level of compliance was good, average and poor in 35.9%, 48.7% and 15.4% of MDs, respectively. There was no significant difference in compliance between MDs and NS (p=0.209). Level of compliance was not associated with age, gender and duration of lens wear (p>0.05). Compliance rate varied according to different behaviors, achieving a good compliance level of 95% for hand hygiene, avoidance of water contact and not sleeping with lenses. There was poor compliance for topping up solution (53.8%) and lens case replacement (15.4%). About one third of MDs had a good level of compliance. Level of compliance and compliance rate of different behaviors were similar in MDs and NS. Periodic lens case replacement was the most neglected behavior in CL wearers for this region. Copyright © 2015 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  9. Comparative Analysis of the Main Indicators of Population Health and Staffing for Diabetes Care in the Kyiv Region in the Conditions of Implementation of Medical and Technological Documents (2010–2012 and 2012–2014

    Directory of Open Access Journals (Sweden)

    V.I. Tkachenko

    2015-08-01

    Full Text Available Analysis of the results of medical and technological documents implementation remains an urgent problem in different countries of the world. The objective — to carry out a comparative analysis of the main indicators of population health and staffing for diabetes care in 2010–2012 and 2012–2014 in the conditions of implementation of unified clinical protocol of medical care to the patients with diabetes mellitus (DM type 2 (Order of the Ministry of Healthcare of Ukraine dated December 21, 2012 № 1118 in the Kyiv region and Ukraine. Materials and methods. Analysis of data from statistical reports of medical institutions, by reporting forms in accordance with the law. Statistical analysis was performed using Excel 2007, SPSS. Results. Availability of endocrinologists per 10,000 adult population in the Kyiv region for 2012–2014 has changed statistically insignificantly (by 7.5 % from 0.40 to 0.43 per 10,000 adult population, while the total number of general practitioners — family physicians significantly increased by 140.57 % from 1.06 to 2.55 0/000 (p < 0.01. Prevalence of DM in general increased significantly, but in 2012–2014 in the Kyiv region growth rate of morbidity has stabilized (in 2012 — 27.39 0/000; in 2014 — 27.06 0/000, growth of –1.2 %, reaching the level of all-Ukrainian index. When analyzing the incidence rate of DM complications in the Kyiv region, there was its probable decrease by 5.02 % over 2012–2014 (from 9.17 to 8.71 0/000, p < 0.01, as well as in Ukraine — by 12.09 % (from 8.6 to 7.56 0/000, p < 0.01. The percentage of hospitalized patients with DM in the Kyiv region for the 2012–2014 significantly decreased (p < 0.01, primary disability tended to decrease, mortality significantly decreased by 8.33 % (p < 0.01. Conclusion. Implementation of medical and technological documents on providing medical care to the patients with DM type 2 had a positive effect.

  10. KNOWLEDGE, ATTITUDE AND PRACTICE OF CONTACT LENS USERS AMONG MEDICAL COLLEGE STUDENTS IN BANGALORE

    Directory of Open Access Journals (Sweden)

    Sujatha

    2015-09-01

    Full Text Available INTRODUCTION: The use of contact lens (CL for the correction of refractive errors, cosmetic use and their usage as a therapeutic modality for corneal pathologies has increased many fold over the years. The present study was conducted with the aim to find the knowledge , attitude and pattern of CL use amongst medical college students and to highlight the complications and the correct method to be followed. MATERIALS AND METHODS: This study included 520college students out of which 114 students who have worn contact lens for any period were included for the study. RESULTS: Results showed that 94.7% of the CL users use the daily wear soft contact lens’ most quoted reasons of usage were comfort and convenience (59.6% with cosmetic benefit (29.8% as the next most common reply. Common complaints were that of general discomfort (foreign body sensation, dry eyes and watering eyes. With the advent of e commerce 26.3% of students are buying lenses are online. CONCLUSION: Educated use of CLs amongst its users is advised in view of the symptoms and associated complications that may occur. Electronic media is playing a commendable role in the sales and educating the buyers about do’s and don’t’s of contact lens use

  11. Homeless Caseload is Associated with Behavioral Health and Case Management Staffing in Health Centers.

    Science.gov (United States)

    Jones, Emily B; Zur, Julia; Rosenbaum, Sara

    2017-07-01

    Community health centers provide co-located medical, behavioral, and case management services to meet the unique and complex needs of the underserved, including homeless individuals. Multivariate analysis of staffing patterns in health centers serving high homeless caseloads highlights above-average behavioral and case management staffing, regardless of Health Care for the Homeless funding status. Rural health centers and those in the South had lower behavioral health and enabling services staffing. Implications include the need to monitor disparities, link health centers with available technical assistance, and emphasize integrating co-located behavioral health, enabling, and medical services through grant oversight mechanisms.

  12. The labor market effects of California's minimum nurse staffing law.

    Science.gov (United States)

    Munnich, Elizabeth L

    2014-08-01

    In 2004, California became the first state to implement statewide minimum nurse-to-patient ratios in general hospitals. In spite of years of work to establish statewide staffing regulations, there is little evidence that the law was effective in attracting more nurses to the hospital workforce or improving patient outcomes. This paper examines the effects of this legislation on employment and wages of registered nurses. By using annual financial data from California hospitals, I show that nurse-to-patient ratios in medical/surgical units increased substantially following the staffing mandate. However, survey data from two nationally representative datasets indicate that the law had no effect on the aggregate number of registered nurses or the hours they worked in California hospitals, and at most a modest effect on wages. My findings suggest that offsetting changes in labor demand due to hospital closures, combined with reclassification of workers within hospitals, and mitigated the employment effects of California's staffing regulation. This paper cautions that California's experience with minimum nurse staffing legislation may not be generalizable to states considering similar policies in very different hospital markets. Copyright © 2013 John Wiley & Sons, Ltd.

  13. Health Promotion and Wellness Staffing Methods

    National Research Council Canada - National Science Library

    Thomsen, Kim

    1999-01-01

    ... injuries, and decrease the number of hospital visits. The Army does not have standardized staffing guidelines or models while the mechanisms to determine requirements are fragmented and inconsistent...

  14. Twenty years and twenty thousand contact lens patients.

    Science.gov (United States)

    Dixon, J M

    1981-01-01

    A self contained non commercial private office laboratory staffed by office personnel has been used to prepare contact lenses for private office patients. These lenses include hard contact lenses of various materials and various designs. During the past ten years extended wear hydrophilic soft lenses have been prepared in the same manner as hard lenses, all custom made with lens powers, base curves, diameters, and thickness designed according to the needs of each patient. This has provided strict medical supervision and lens maintenance with maximum convenience for patients and the ophthalmologist.

  15. Texas Nurse Staffing Trends Before and After Mandated Nurse Staffing Committees.

    Science.gov (United States)

    Jones, Terry; Heui Bae, Sung; Murry, Nicole; Hamilton, Patti

    2015-08-01

    This article describes the evolution of mandated nurse staffing committees in Texas from 2002 to 2009 and presents a study that analyzed nurse staffing trends in Texas using a secondary analysis of hospital staffing data (N = 313 hospitals) from 2000 to 2012 obtained from the American Hospital Association Annual Survey. Nurse staffing patterns based on three staffing variables for registered nurses (RNs), licensed vocational nurses (LVNs), and total licensed nurses were identified: full-time equivalents per 1,000 adjusted patient days, productive hours per adjusted patient day, and RN skill mix. Similar to national trends between 2000 and 2012, most Texas hospitals experienced an increase in RN and total nurse staffing, decrease in LVN staffing, and an increase in RN skill mix. The magnitude of total nurse staffing changes in Texas (5% increase) was smaller than national trends (13.6% increase). Texas's small, rural, government hospitals and those with the highest preregulation staffing levels experienced the least change in staffing between 2000 and 2012: median change of 0 to .13 full-time equivalents per 1,000 adjusted patient days and median change in productive hours per patient day of 0 to .23. The varying effects of staffing committees in different organizational contexts should be considered in future staffing legislative proposals and other policy initiatives. © The Author(s) 2015.

  16. Medical and psychosocial outcome of patients with occupational contact dermatitis in Israel.

    Science.gov (United States)

    Lazarov, A; Rabin, B; Fraidlin, N; Abraham, D

    2006-10-01

    Although the medical, financial and prognostic factors of occupational contact dermatitis (OCD) have been addressed, studies on the social outcome of OCD are sparse. To define the medical and psychosocial outcome of patients with OCD. Workers with OCD were interviewed by telephone using a questionnaire that included questions about the occupation, dermatological disease, sick leave, present working status and disability claims, and questions related to the subjective perceptions of OCD in all areas of psychosocial functioning and quality of life. Seventy workers (64.3% males and 35.7% females) were interviewed. Forty per cent had stopped working and one-third had taken sick leave because of OCD. Forty-seven (67.1%) were currently working while 23 (32.8%) were unemployed. Disability compensation was claimed by only 41.4% and was received by 24.3%. Eight workers (11.4%) had persistent postoccupational dermatitis (PPOD). Loss of employment affected the occupational area of the workers' lives (100%), and also interpersonal relationships (45.7%), relationships within the family (18.6%), daily functioning (45.7%) and mental health (24.3%). Considerable working time is lost because of unemployment or sick leave due to OCD. Only a small proportion of eligible patients with OCD apply for disability compensation and an even smaller proportion receive it. Our study demonstrates the significance of OCD to the psychosocial aspects of workers' lives and emphasizes that the assessment of OCD outcome should relate not only to the medical but also to the psychosocial aspect of the disease.

  17. First Contact: interprofessional education based on medical students' experiences from their nursing internship

    Directory of Open Access Journals (Sweden)

    Eich-Krohm, Astrid

    2016-04-01

    Full Text Available Goal: The aim of the course “interprofessional communication and nursing” is to reflect medical students’ experiences from the nursing internship. The content of the course focuses on barriers and support of interprofessional communication as a foundation for teamwork between nursing professionals and physicians. The nursing internship is for most medical students the first contact with nursing professionals and can lead to perceptions about the other group that might hinder interprofessional teamwork and consequently harm patients. To meet the demographic challenges ahead it is important to emphasize interprofessional education in the study of medicine and better prepare future physicians for interprofessional collaboration. Method: The design of the course includes an assessment of a change in the students’ perceptions about nursing and interprofessional communication. The first class meeting presents the starting point of the assessment and visualizes students’ perceptions of nursing and medicine. The content of the following class meetings serve to enhance the students’ knowledge about nursing as a profession with its own theories, science and scholarship. In addition, all students have to write a research paper that entails to interview one nursing professional and one physician about their ideas of interprofessional communication and to compare the interviews with their own experiences from the nursing internship. To access what students learned during the course a reflective discussion takes place at the last meeting combined with an analysis of the students’ research papers. Results: The assessment of the students’ perceptions about the nursing profession and the importance of successful interprofessional communication showed a new and deeper understanding of the topic. They were able to identify barriers and support measures of interprofessional communication and their own responsibilities as part of a team

  18. First Contact: interprofessional education based on medical students' experiences from their nursing internship.

    Science.gov (United States)

    Eich-Krohm, Astrid; Kaufmann, Alexandra; Winkler-Stuck, Kirstin; Werwick, Katrin; Spura, Anke; Robra, Bernt-Peter

    2016-01-01

    The aim of the course "interprofessional communication and nursing" is to reflect medical students' experiences from the nursing internship. The content of the course focuses on barriers and support of interprofessional communication as a foundation for teamwork between nursing professionals and physicians. The nursing internship is for most medical students the first contact with nursing professionals and can lead to perceptions about the other group that might hinder interprofessional teamwork and consequently harm patients. To meet the demographic challenges ahead it is important to emphasize interprofessional education in the study of medicine and better prepare future physicians for interprofessional collaboration. The design of the course includes an assessment of a change in the students' perceptions about nursing and interprofessional communication. The first class meeting presents the starting point of the assessment and visualizes students' perceptions of nursing and medicine. The content of the following class meetings serve to enhance the students' knowledge about nursing as a profession with its own theories, science and scholarship. In addition, all students have to write a research paper that entails to interview one nursing professional and one physician about their ideas of interprofessional communication and to compare the interviews with their own experiences from the nursing internship. To access what students learned during the course a reflective discussion takes place at the last meeting combined with an analysis of the students' research papers. The assessment of the students' perceptions about the nursing profession and the importance of successful interprofessional communication showed a new and deeper understanding of the topic. They were able to identify barriers and support measures of interprofessional communication and their own responsibilities as part of a team. Interprofessional education is an important part of medical education

  19. Novel non-contact control system of electric bed for medical healthcare.

    Science.gov (United States)

    Lo, Chi-Chun; Tsai, Shang-Ho; Lin, Bor-Shyh

    2017-03-01

    A novel non-contact controller of the electric bed for medical healthcare was proposed in this study. Nowadays, the electric beds are widely used for hospitals and home-care, and the conventional control method of the electric beds usually involves in the manual operation. However, it is more difficult for the disabled and bedridden patients, who might totally depend on others, to operate the conventional electric beds by themselves. Different from the current controlling method, the proposed system provides a new concept of controlling the electric bed via visual stimuli, without manual operation. The disabled patients could operate the electric bed by focusing on the control icons of a visual stimulus tablet in the proposed system. Besides, a wearable and wireless EEG acquisition module was also implemented to monitor the EEG signals of patients. The experimental results showed that the proposed system successfully measured and extracted the EEG features related to visual stimuli, and the disabled patients could operate the adjustable function of the electric bed by themselves to effectively reduce the long-term care burden.

  20. NATURE OF THE LAST CONTACT WITH A MEDICAL DOCTOR BEFORE SUICIDE

    Directory of Open Access Journals (Sweden)

    Urša Mars Bitenc

    2018-01-01

    Full Text Available A relevant number of suicide decedents visit medical doctors (MDs in a short period before death. This study aimed to learn about MDs’ attitudes towards suicide prevention, their previous education on suicide, the experience with suicide, and eventually the nature of the last visit with a patient that died by suicide. 159 Slovenian MDs participated in an online survey covering previously mentioned topics. More than a third of MDs have never been trained on suicide prevention and reported lack of knowledge in this area. More than half experienced suicide of a patient or close one. During the last contact before suicide, MDs frequently noticed symptoms of mental health problems, hopelessness, sleep problems, somatic pain and suicidal ideation. More seldom they observed stocking pills, giving away values, gaining access to firearms, and changing a will. At the time of the last visit, main diagnoses were depression (54.5%, schizophrenia (22.7%, bipolar disorder (12.5%, alcohol use disorder (9.6%, and dementia (4.5%. To improve risk assessment and suicide prevention in health-care settings, a specific training would be a highly desirable option for educating MD's.

  1. Staffing for Cyberspace Operations: Summary of Analysis

    Science.gov (United States)

    2016-08-01

    I N S T I T U T E F O R D E F E N S E A N A L Y S E S Staffing for Cyberspace Operations: Summary of Analysis Thomas H. Barth Jerome J. Burke...7013 (a)(16) [Jun 2013]. Staffing for Cyberspace Operations: Summary of Analysis Thomas H. Barth Jerome J. Burke Stanley A. Horowitz Mark F. Kaye...civilian employment. 1 Thomas H. Barth et al., “(U) Staffing for Cyberspace Operations,” IDA Paper P

  2. How Book Publishers are Staffing for Multimedia.

    Science.gov (United States)

    Protsik, Ralph

    1995-01-01

    Examines how book publishers are staffing for multimedia developments. Discussion includes competition from software developers, costs, partnerships, professional organizations as the most innovative electronic publishers, cultural problems, human resource polices, hiring, conflict between print and technology staff, marketing, outside…

  3. Nursing teamwork, staff characteristics, work schedules, and staffing.

    Science.gov (United States)

    Kalisch, Beatrice J; Lee, Hyunhwa

    2009-01-01

    This study aimed to explore whether and how staff characteristics, staffing, and scheduling variables are associated with the level of teamwork in nursing staff on acute care hospital patient units. This was a cross-sectional study with a sample of 1,758 nursing staff members from two different hospitals on 38 patient care units who completed the Nursing Teamwork Survey in 2008. This study focused on nursing teams who are stationed on a particular patient care unit (as opposed to visitors to the units). The return rate was 56.9%. The sample was made up of 77.4% nurses (registered nurses and licensed practical nurses), 11.9% assistive personnel, and 7.9% unit secretaries. Teamwork varied by unit and service type, with the highest scores occurring in pediatrics and maternity and the lowest scores on the medical-surgical and emergency units. Staff with less than 6 months of experience, those working 8- or 10-hour shifts (as opposed to 12 hours or a combination of 8 and 12 hours), part-time staff (as opposed to full time), and those working on night shift had higher teamwork scores. The higher teamwork scores were also associated with no or little overtime. The higher perception of the adequacy of staffing and the fewer patients cared for on a previous shift, the higher the teamwork scores. There is a relationship between selected staff characteristics, aspects of work schedules, staffing, and teamwork. Nursing staff want to work where teamwork is high, and perceptions of good staffing lead to higher teamwork. Higher teamwork scores correlated with those who worked less overtime.

  4. Human Resources Staffing Plan for the Tank Farm Contractor

    International Nuclear Information System (INIS)

    BOSLEY, J.W.

    2000-01-01

    The Human Resources Staffing Plan quantified the equivalent staffing needs required for the Tank Farm Contractor (TFC) and its subcontractors to execute the readiness to proceed baseline between FY 2000-2008. The TFC staffing needs were assessed along with the staffings needs of Fluor Hanford and the privatization contractor. The plan then addressed the staffing needs and recruitment strategies required to execute the baseline

  5. Human Resources Staffing Plan for the Tank Farm Contractor

    Energy Technology Data Exchange (ETDEWEB)

    BOSLEY, J.W.

    2000-04-22

    The Human Resources Staffing Plan quantified the equivalent staffing needs required for the Tank Farm Contractor (TFC) and its subcontractors to execute the readiness to proceed baseline between FY 2000-2008. The TFC staffing needs were assessed along with the staffings needs of Fluor Hanford and the privatization contractor. The plan then addressed the staffing needs and recruitment strategies required to execute the baseline.

  6. Simultaneous Soft Sensing of Tissue Contact Angle and Force for Millimeter-scale Medical Robots.

    Science.gov (United States)

    Arabagi, Veaceslav; Gosline, Andrew; Wood, Robert J; Dupont, Pierre E

    2013-01-01

    A novel robotic sensor is proposed to measure both the contact angle and the force acting between the tip of a surgical robot and soft tissue. The sensor is manufactured using a planar lithography process that generates microchannels that are subsequently filled with a conductive liquid. The planar geometry is then molded onto a hemispherical plastic scaffolding in a geometric configuration enabling estimation of the contact angle (angle between robot tip tangent and tissue surface normal) by the rotation of the sensor around its roll axis. Contact force can also be estimated by monitoring the changes in resistance in each microchannel. Bench top experimental results indicate that, on average, the sensor can estimate the angle of contact to within ±2° and the contact force to within ±5.3 g.

  7. Minimum Nurse Staffing Legislation and the Financial Performance of California Hospitals

    Science.gov (United States)

    Reiter, Kristin L; Harless, David W; Pink, George H; Mark, Barbara A

    2012-01-01

    Objective To estimate the effect of minimum nurse staffing ratios on California acute care hospitals’ financial performance. Data Sources/Study Setting Secondary data from Medicare cost reports, the American Hospital Association's (AHA) Annual Survey, and the California Office of Statewide Health Planning and Development (OSHPD) are combined from 2000 to 2006 for 203 hospitals in California and 407 hospitals in 12 comparison states. Study Design The study employs a difference-in-difference analytical approach. Hospitals are grouped into quartiles based on pre-regulation nurse staffing levels in adult medical-surgical and pediatric units (quartile 1 = lowest staffing). Differences in operating margin, operating expenses per day, and inpatient operating expenses per discharge for California hospitals within a staffing quartile during the period of regulation are compared to differences at hospitals in comparison states during the same period. Data Collection/Extraction Methods Hospital data from Medicare cost reports are merged with nurse staffing measures obtained from AHA and from OSPHD. Principal Findings Relative to hospitals in comparison states, operating margins declined significantly for California hospitals in quartiles 2 and 3. Operating expenses increased significantly in quartiles 1, 2, and 3. Conclusions Implementation of minimum nurse staffing legislation in California put substantial financial pressure on some hospitals. PMID:22150627

  8. Minimum nurse staffing legislation and the financial performance of California hospitals.

    Science.gov (United States)

    Reiter, Kristin L; Harless, David W; Pink, George H; Mark, Barbara A

    2012-06-01

    To estimate the effect of minimum nurse staffing ratios on California acute care hospitals' financial performance. Secondary data from Medicare cost reports, the American Hospital Association's (AHA) Annual Survey, and the California Office of Statewide Health Planning and Development (OSHPD) are combined from 2000 to 2006 for 203 hospitals in California and 407 hospitals in 12 comparison states. The study employs a difference-in-difference analytical approach. Hospitals are grouped into quartiles based on pre-regulation nurse staffing levels in adult medical-surgical and pediatric units (quartile 1=lowest staffing). Differences in operating margin, operating expenses per day, and inpatient operating expenses per discharge for California hospitals within a staffing quartile during the period of regulation are compared to differences at hospitals in comparison states during the same period. Hospital data from Medicare cost reports are merged with nurse staffing measures obtained from AHA and from OSPHD. Relative to hospitals in comparison states, operating margins declined significantly for California hospitals in quartiles 2 and 3. Operating expenses increased significantly in quartiles 1, 2, and 3. Implementation of minimum nurse staffing legislation in California put substantial financial pressure on some hospitals. © Health Research and Educational Trust.

  9. A grid to facilitate physics staffing justification.

    Science.gov (United States)

    Klein, Eric E

    2009-12-03

    Justification of clinical physics staffing levels is difficult due to the lack of direction as how to equate clinical needs with the staffing levels and competency required. When a physicist negotiates staffing requests to administration, she/he often refers to American College of Radiology staffing level suggestions, and resources such as the Abt studies. This approach is often met with questions as to how to fairly derive the time it takes to perform tasks. The result is often insufficient and/or inexperienced staff handling complex and cumbersome tasks. We undertook development of a staffing justification grid to equate the clinical needs to the quantity and quality of staffing required. The first step is using the Abt study, customized to the clinical setting, to derive time per task multiplied by the anticipated number of such tasks. Inclusion of vacation, meeting, and developmental time may be incorporated along with allocated time for education and administration. This is followed by mapping the tasks to the level of competency/experience needed. For example, in an academic setting the faculty appointment levels correlate with experience. Non-staff personnel, such as IMRT QA technicians or clerical staff, should also be part of the equation. By using the staffing justification grid, we derived strong documentation to justify a substantial budget increase. The grid also proved useful when our clinical demands changed. Justification for physics staffing can be significantly strengthened with a properly developed data-based time and work analysis. A staffing grid is presented, along with a development methodology that facilitated our justification. Though our grid is for a large academic facility, the methodology can be extended to a non-academic setting, and to a smaller scale. This grid method not only equates the clinical needs with the quantity of staffing, but can also help generate the personnel budget, based on the type of staff and personnel required

  10. Simultaneous soft sensing of tissue contact angle and force for millimeter-scale medical robots

    OpenAIRE

    Arabagi, Veaceslav; Gosline, Andrew; Wood, Robert J.; Dupont, Pierre E

    2013-01-01

    A novel robotic sensor is proposed to measure both the contact angle and the force acting between the tip of a surgical robot and soft tissue. The sensor is manufactured using a planar lithography process that generates microchannels that are subsequently filled with a conductive liquid. The planar geometry is then molded onto a hemispherical plastic scaffolding in a geometric configuration enabling estimation of the contact angle (angle between robot tip tangent and tissue surface normal) by...

  11. Why people do, or do not, immediately contact emergency medical services following the onset of acute stroke: qualitative interview study.

    Directory of Open Access Journals (Sweden)

    Joan E Mackintosh

    Full Text Available To identify the reasons why individuals contact, or delay contacting, emergency medical services in response to stroke symptoms.Qualitative interview study with a purposive sample of stroke patients and witnesses, selected according to method of accessing medical care and the time taken to do so. Data were analysed using the Framework approach.Area covered by three acute stroke units in the north east of England.Nineteen stroke patients and 26 witnesses who had called for help following the onset of stroke symptoms.Factors influencing who called emergency medical services and when they called included stroke severity, how people made sense of symptoms and their level of motivation to seek help. Fear of the consequences of stroke, including future dependence or disruption to family life, previous negative experience of hospitals, or involving a friend or relations in the decision to access medical services, all resulted in delayed admission. Lack of knowledge of stroke symptoms was also an important determinant. Perceptions of the remit of medical services were a major cause of delays in admission, with many people believing the most appropriate action was to telephone their GP. Variations in the response of primary care teams to acute stroke symptoms were also evident.The factors influencing help-seeking decisions are complex. There remains a need to improve recognition by patients, witnesses and health care staff of the need to treat stroke as a medical emergency by calling emergency medical services, as well as increasing knowledge of symptoms of stroke among patients and potential witnesses. Fear, denial and reticence to impose on others hinders the process of seeking help and will need addressing specifically with appropriate interventions. Variability in how primary care services respond to stroke needs further investigation to inform interventions to promote best practice.UK Clinical Research Network UKCRN 6590.

  12. Selection and development of international indicators on staffing

    NARCIS (Netherlands)

    van Amelsvoort, H.W.C.H.; Hendriks, Maria A.; Scheerens, Jaap

    2000-01-01

    International comparisons of indicators on staffing are regarded as a useful information base to policymakers. Politically relevant staffing indicators in relation to the costs, planning and quality of education deal with training, working conditions, staff characteristics, and stability and

  13. 42 CFR 9.9 - Facility staffing.

    Science.gov (United States)

    2010-10-01

    ... PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS STANDARDS OF CARE FOR... of the activities and chimpanzee population of the sanctuary. The level of staffing shall be adequate... issues related to captive nonhuman primates. Experience in these areas dealing specifically with...

  14. Staffing the Global Organization: "Cultural Nomads"

    Science.gov (United States)

    McPhail, Ruth; Fisher, Ron; Harvey, Michael; Moeller, Miriam

    2012-01-01

    This article explores the evolution of international staffing in an increasingly globalized and hypercompetitive marketplace. As the issue of staff retention becomes critical in global organizations, it is important to understand the types of managers that may be on or assigned to overseas assignments. The purpose of this article is to present a…

  15. Staffing Policy for Solving the Information Security

    Directory of Open Access Journals (Sweden)

    A. I. Tolstoy

    2012-06-01

    Full Text Available Determining staffing policy implementation of information security tasks is given. The basic requirements that must be taken into account when developing policies are defined. The policy framework is determined and recommendations for the design of such policies are formulated. Requirements for the implementation of the policy are defined.

  16. Physician staffing for the practice of psychosomatic medicine in general hospitals: a pilot study.

    Science.gov (United States)

    Kunkel, Elisabeth J S; Del Busto, Elena; Kathol, Roger; Stern, Theodore A; Wise, Thomas N; Stoddard, Frederick R; Straus, Joshua; Saravay, Stephen M; Muskin, Philip R; Dresner, Nehama; Harrington, Colin J; Weiner, Joseph; Barnhill, John; Becker, Madeleine; Joseph, Robert C; Oyesanmi, Olugbenga; Fann, Jesse R; Colon, Eduardo; Epstein, Steven; Weinrieb, Robert

    2010-01-01

    The treatment of psychiatric illnesses, prevalent in the general hospital, requires broadly trained providers with expertise at the interface of psychiatry and medicine. Since each hospital operates under different economic constraints, it is difficult to establish an appropriate ratio of such providers to patients. The authors sought to determine the current staffing patterns and ratios of Psychosomatic Medicine practitioners in general hospitals, to better align manpower with clinical service and educational requirements on consultation-liaison psychiatry services. Program directors of seven academic Psychosomatic Medicine (PM) programs in the Northeast were surveyed to establish current staffing patterns and patient volumes. Survey data were reviewed and analyzed along with data from the literature and The Academy of Psychosomatic Medicine (APM) fellowship directory. Staffing patterns varied widely, both in terms of the number and disciplines of staff providing care for medical and surgical inpatients. The ratio of initial consultations performed per hospital bed varied from 1.6 to 4.6. Although staffing patterns vary, below a minimum staffing level, there is likely to be significant human and financial cost. Efficient sizing of a PM staff must be accomplished in the context of a given institution's patient population, the experience of providers, the presence/absence and needs of trainees, and the financial constraints of the department and institution. National survey data are needed to provide benchmarks for both academic and nonacademic PM services.

  17. Improved release of triamcinolone acetonide from medicated soft contact lenses loaded with drug nanosuspensions.

    Science.gov (United States)

    García-Millán, Eva; Quintáns-Carballo, Mónica; Otero-Espinar, Francisco Javier

    2017-06-15

    Drug nanosuspensions (NSs) show a significant potential to improve loading and release properties of the poorly water soluble drug triamcinolone acetonide (TA) from poly(hydroxyethyl methacrylate) (pHEMA) soft contact lenses. In this work, TA NSs were developed by a controlled precipitation method using a fractional factorial Plackett-Burmann design. Poloxamer 407 (PL) and polyvinyl alcohol (PVA) as stabilizing agents were selected. NSs were characterized in terms of their drug content, particle size and morphology. Results indicate that all studied factors, except homogenization speed and sonication, have significant influence on the drug incorporation yield into NSs. Drug nanoparticles showed an interesting size that may be suitable for their incorporation into topical ocular drug delivery systems, as hydrogels. pHEMA hydrogels and daily-wear Hilafilcon B commercial contact lenses (SCLs) were employed to study TA loading capacity and drug release properties using NSs as loading system. Hydrogels have been synthesised by copolymerization of 2-hydroxyethyl methacrylate (HEMA) with methacrylic acid (MA) in accordance with a previous work (García-Millán et al., 2015). Both synthesised hydrogels and SCLs were characterized in terms of their mechanical and physical properties and TA loading and release properties. Selected TA NS was further characterized by studying its physical-chemical stability during the loading process. Results show that the use of TA NSs as loading medium significantly increases drug loading capacity and release of soft contact lenses in comparison with drug saturated solution. Synthesised pHEMA hydrogels and SCLs lenses have good properties as ophthalmic drug delivery systems, but SCLs load higher quantities of drug and release TA in shorter time periods than synthesised pHEMA hydrogel. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. "It's making contacts": notions of social capital and implications for widening access to medical education.

    Science.gov (United States)

    Nicholson, S; Cleland, J A

    2017-05-01

    In the UK widening access (WA) activities and policies aim to increase the representation from lower socio-economic groups into Higher Education. Whilst linked to a political rhetoric of inclusive education such initiatives have however failed to significantly increase the number of such students entering medicine. This is compounded by a discourse that portrays WA applicants and students as lacking the essential skills or attributes to be successful in medical education. Much of the research in this area to date has been weak and it is critical to better understand how WA applicants and students negotiate medical admissions and education to inform change. To address this gap we amalgamated a larger dataset from three qualitative studies of student experiences of WA to medicine (48 participants in total). Inductively analysing the findings using social capital as a theoretical lens we created and clustered codes into categories, informed by the concepts of "weak ties" and "bridging and linking capital", terms used by previous workers in this field, to better understand student journeys in medical education. Successful applicants from lower socio-economic groups recognise and mobilise weak ties to create linking capital. However once in medical school these students seem less aware of the need for, or how to create, capital effectively. We argue WA activities should support increasing the social capital of under-represented applicants and students, and future selection policy needs to take into account the varying social capital of students, so as to not overtly disadvantage some social groups.

  19. Alternative staffing services. Contract transcription.

    Science.gov (United States)

    Tessier, C

    1992-03-01

    Contract medical transcription services can be of great assistance in meeting the demands for transcription, without jeopardizing patient, physician, or institutional confidentiality. You simply must require the contract service to provide at least the same degree of protection and preservation of confidentiality that you should require inhouse. To achieve this you must make these requirements explicit, comprehensive, comprehensible, believable, and enforceable. Discuss the requirements with prospective contractors. Review them at least annually with existing contractors and when contracts are due for renewal. Be sure to specify the consequence of breaching confidentiality, and if there are breaches, enforce the terms of the contract. Consult your institution's legal counsel both in developing the contract and in enforcing its provisions. Take into consideration your department's and institution's policies, AHIMA's statement on confidentiality, as well as local, state, and federal laws. Above all, never lose sight of the patient. Ultimately, it is not patient information that you are obligated to protect. It is the patient.

  20. Radiotherapy facilities, equipment, and staffing in Poland: 2005–2011

    Science.gov (United States)

    Reinfuss, Marian; Byrski, Edward; Malicki, Julian

    2013-01-01

    Background and purpose To evaluate the current status of radiotherapy facilities, staffing, and equipment, treatment and patients in Poland for the years 2005–2011 following implementation of the National Cancer Programme. Methods A survey was sent to the radiotherapy centres in Poland to collect data on available equipment, staffing, and treatments in the years 2005–2011. Results In 2011, 76,000 patients were treated with radiotherapy at 32 centres vs. 63,000 patients at 23 centres in 2005. Number of patients increased by 21%. In 2011, there were 453 radiation oncologists – specialists (1 in 168 patients), 325 medical physicists (1 in 215 patients), and 883 radiotherapy technicians (1 in 86 patients) vs. 320, 188, and 652, respectively, in 2005. The number of linear accelerators increased by 60%, from 70 units in 2005 to 112 in 2011. The current linac/patient ratio in Poland is 1 linac per 678 patients. Waiting times from diagnosis to the start of treatment has decreased. Conclusion Compared to 2005, there are more treatment facilities, more and better equipment (linacs), and more cancer care specialists. There are still large differences between the 16 Polish provinces in terms of equipment availability and ease of access to treatment. However, radiotherapy services in Poland have improved dramatically since the year 2005. PMID:24416548

  1. Computerized nursing staffing: a software evaluation.

    Science.gov (United States)

    Pereira, Irene Mari; Gaidzinski, Raquel Rapone; Fugulin, Fernanda Maria Togeiro; Peres, Heloísa Helena Ciqueto; Lima, Antônio Fernandes Costa; Castilho, Valéria; Mira, Vera Lúcia; Massarollo, Maria Cristina Komatsu Braga

    2011-12-01

    The complexity involved in operationalizing the method for nursing staffing, in view of the uncountable variable related to identifying the workload, the effective working time of the staff, and the Technical Security Index (TSI) revealed the need to develop a software program named: Computerized Nursing Staffing (DIPE, in Portuguese acronyms). This exploratory, descriptive study was performed with the objective to evaluate the technical quality and functional performance of DIPE. Participants were eighteen evaluators, ten of whom where nurse faculty or nurse hospital unit managers, and eight health informatics experts. The software evaluation was performed according to norm NBR ISO/IEC 9126-1, considering the features functionality, reliability, usability, efficiency, and maintainability. The software evaluation reached positive results and agreement among the evaluators for all the evaluated features. The reported suggestions are important for proposing further improving and enhancing the DIPE.

  2. Impact of staffing parameters on operational reliability

    International Nuclear Information System (INIS)

    Hahn, H.A.; Houghton, F.K.

    1993-01-01

    This paper reports on a project related to human resource management of the Department of Energy's (DOE's) High-Level Waste (HLW) Tank program. Safety and reliability of waste tank operations is impacted by several issues, including not only the design of the tanks themselves, but also how operations and operational personnel are managed. As demonstrated by management assessments performed by the Tiger Teams, DOE believes that the effective use of human resources impacts environment safety, and health concerns. For the of the current paper, human resource management activities are identified as ''Staffing'' and include the of developing the functional responsibilities and qualifications of technical and administrative personnel. This paper discusses the importance of staff plans and management in the overall view of safety and reliability. The work activities and procedures associated with the project, a review of the results of these activities, including a summary of the literature and a preliminary analysis of the data. We conclude that although identification of staffing issues and the development of staffing plans contributes to the overall reliability and safety of the HLW tanks, the relationship is not well understood and is in need of further development

  3. Spent Nuclear Fuel Project operational staffing plan

    International Nuclear Information System (INIS)

    Debban, B.L.

    1996-03-01

    Using the Spent Nuclear Fuel (SNF) Project's current process flow concepts and knowledge from cognizant engineering and operational personnel, an initial assessment of the SNF Project radiological exposure and resource requirements was completed. A small project team completed a step by step analysis of fuel movement in the K Basins to the new interim storage location, the Canister Storage Building (CSB). This analysis looked at fuel retrieval, conditioning of the fuel, and transportation of the fuel. This plan describes the staffing structure for fuel processing, fuel movement, and the maintenance and operation (M ampersand O) staffing requirements of the facilities. This initial draft does not identify the support function resources required for M ampersand O, i.e., administrative and engineering (technical support). These will be included in future revisions to the plan. This plan looks at the resource requirements for the SNF subprojects, specifically, the operations of the facilities, balances resources where applicable, rotates crews where applicable, and attempts to use individuals in multi-task assignments. This plan does not apply to the construction phase of planned projects that affect staffing levels of K Basins

  4. Impact of staffing parameters on operational reliability

    International Nuclear Information System (INIS)

    Hahn, H.A.; Houghton, F.K.

    1993-01-01

    This paper reports on a project related to human resource management of the Department of Energy (DOEs) High-Level Waste (HLW) Tank program. Safety and reliability of waste tank operations is impacted by several issues, including not only the design of the tanks themselves, but also how operations and operational personnel are managed. As demonstrated by management assessments performed by the Tiger Teams, DOE believes that the effective use of human resources impacts environment, safety, and health concerns. For the purposes of the current paper, human resource management activities are identified as 'Staffing' and include the process of developing the functional responsibilities and qualifications of technical and administrative personnel. This paper discusses the importance of staff plans and management in the overall view of safety and reliability, the work activities and procedures associated with the project, a review of the results of these activities, including a summary of the literature and a preliminary analysis of the data. We conclude that, although identification of staffing issues and the development of staffing plans contributes to the overall reliability and safety of the HLW tanks, the relationship is not well understood and is in need of further development

  5. Medical students' and facilitators' experiences of an Early Professional Contact course: Active and motivated students, strained facilitators

    Directory of Open Access Journals (Sweden)

    Gunnarsson Ronny

    2008-12-01

    Full Text Available Abstract Background Today, medical students are introduced to patient contact, communication skills, and clinical examination in the preclinical years of the curriculum with the purpose of gaining clinical experience. These courses are often evaluated from the student perspective. Reports with an additional emphasis on the facilitator perspective are scarce. According to constructive alignment, an influential concept from research in higher education, the learning climate between students and teachers is also of great importance. In this paper, we approach the learning climate by studying both students' and facilitators' course experiences. In 2001, a new "Early Professional Contact" longitudinal strand through term 1–4, was introduced at the Sahlgrenska Academy, University of Gothenburg, Sweden. General practitioners and hospital specialists were facilitators. The aim of this study was to assess and analyse students' and clinical facilitators' experiences of the Early Professional Contact course and to illuminate facilitators' working conditions. Methods Inspired by a Swedish adaptation of the Course Experience Questionnaire, an Early Professional Contact Questionnaire was constructed. In 2003, on the completion of the first longitudinal strand, a student and facilitator version was distributed to 86 students and 21 facilitators. In the analysis, both Chi-square and the Mann-Whitney tests were used. Results Sixty students (70% and 15 facilitators (71% completed the questionnaire. Both students and facilitators were satisfied with the course. Students reported gaining iiration for their future work as doctors along with increased confidence in meeting patients. They also reported increased motivation for biomedical studies. Differences in attitudes between facilitators and students were found. Facilitators experienced a greater workload, less reasonable demands and less support, than students. Conclusion In this project, a new Early

  6. Contradictions in the medical encounter: female sexual dysfunction in primary care contacts.

    Science.gov (United States)

    Sarkadi, A; Rosenqvist, U

    2001-04-01

    Over the past two decades, primary care physicians have been encouraged to participate in the management of sexual disturbances. Women with type 2 diabetes, often treated by GPs, are at high risk of experiencing sexual dysfunction. Very few qualitative studies have described the impact of sexual dysfunction on the diabetic women experiencing it. Our aim was, therefore, to explore the effects, if any, of type 2 diabetes on "womanhood and intimacy" and investigate whether women wish to receive medical attention for their sexual disturbances. We used a purposeful sample of middle-aged and older women (44-80 years) diagnosed with type 2 diabetes (n = 33). Methods triangulation was employed: focus group interviews were combined with observer data and a structured, anonymous questionnaire. We performed content analysis, with co-researcher control for systematic bias during the coding process. Personal characteristics, such as age, sex, experience and attitude of the doctor, the specialty considered to be appropriate (GP versus gynaecologist) and circumstances (time and privacy) in the primary care setting appeared to significantly influence women's willingness to discuss--if at all--sexual matters with physicians. GPs should aim to create an open atmosphere to encourage discussion of female sexual dysfunction in the consultation room. However, women with sexual problems might benefit more from peer help through patient or women's organizations. The role of GPs might therefore consist of supporting these services and identifying female sexual dysfunction in type 2 diabetes, a problem that middle-aged and older women have difficulty communicating.

  7. Contacto precoz con la realidad asistencial: una experiencia piloto en medicina Early contact with medical practice: a pilot experience in medical students

    Directory of Open Access Journals (Sweden)

    J.E. Baños

    2011-03-01

    Full Text Available Introducción: Varios estudios han sugerido que el contacto precoz del estudiante de medicina con la realidad asistencial puede tener unos efectos beneficiosos sobre su motivación, el conocimiento de la relación médico-paciente y la aceptación de la importancia de las materias médicas básicas. En el nuevo grado conjunto de Medicina de la Universitat Autònoma de Barcelona y la Universitat Pompeu Fabra se ha incorporado una asignatura denominada 'Prácticas de Grado' que se imparte durante los tres primeros años, destinada a permitir el contacto de los estudiantes con la asistencia primaria, los equipos de enfermería y los centros sociosanitarios. El presente artículo describe la experiencia y la opinión de los estudiantes que la cursaron durante el primer año. Materiales y métodos: El artículo describe las características académicas de la asignatura. Se realizó una encuesta a los estudiantes al finalizar la asignatura para evaluar su grado de satisfacción y su percepción sobre el cumplimiento de los objetivos y las competencias que debían alcanzarse. Resultados: Existió una elevada satisfacción con la nueva actividad y una percepción entre los estudiantes de que las competencias preestablecidas se habían alcanzado en su mayor parte. Conclusión: El contacto precoz con la realidad asistencial es un elemento esencial para la comprensión de la actividad médica por los estudiantes de medicina de primer año.Introduction: Several studies have suggested that early contact of medical students with medical care may have beneficial effects on their motivation, knowledge of doctor-patient relationship and acceptance of the interest of biomedical sciences. In the new joint degree of Medicine of Autonomous University of Barcelona and Pompeu Fabra University we have incorporated the subject 'Prácticas de Grado' during the first three years. It is devoted to permit the early contact of medical students with primary care, nursing

  8. Avoiding crisis: right-sizing staffing for the future.

    Science.gov (United States)

    Best, Michele L

    2002-01-01

    Workforce issues, especially recruitment and retention of qualified laboratory staff, are major strategic issues that will continue to face laboratory managers over the next 10 years. Major factors affecting the laboratory labor market in the next decade include increased health-care and laboratory testing needs of an aging population, the graying of the laboratory workforce as baby boomers retire, and new technology development. At least two of these factors will increase the demand for qualified laboratory professionals. Vacancy rates for laboratory professionals are increasing at a significant rate and will continue over the next 10 years. Planning will require creativity in staff recruitment and retention strategies and in human resources. Laboratorians no longer will have the luxury of using medical technologists for nonspecialized testing assignments and will need to develop more creative recruiting approaches using fewer highly qualified testing personnel. This article proposes a staffing deployment model that will use medical technologist education and skills more appropriately, will improve retention of medical technologists, and will alleviate the shortage of medical technologists by reducing dependence on them as routine laboratory testing personnel.

  9. Brown & Smith Communication Solutions: A Staffing System Simulation

    Science.gov (United States)

    Small, Erika E.; Doll, Jessica L.; Bergman, Shawn M.; Heggestad, Eric D.

    2018-01-01

    Developing students' practical skills in strategic staffing and selection within the classroom can be challenging. This article describes a staffing system simulation designed to engage students and develop applied skills in strategic recruiting, assessment, and evaluation of job applicants. Instructors looking for a multifaceted team project…

  10. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... One Use Facts About Colored Contacts and Halloween Safety Colored Contact Lens Facts Over-the-Counter Costume ... Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of Service For ...

  11. Colored Contact Lens Dangers

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    Full Text Available ... Costume Contacts May Contain Chemicals Harmful to Eyes Four Ways Over-the-Counter Costume Contact Lenses Can ... was in severe pain and on medication for four weeks, and couldn't see well enough to ...

  12. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... One Use Facts About Colored Contacts and Halloween Safety Colored Contact Lens Facts Over-the-Counter Costume ... an ophthalmologist — an eye medical doctor — who will measure each eye and talk to you about proper ...

  13. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... prescription. Follow the contact lens care directions for cleaning, disinfecting, and wearing the lenses. Never share contact ... with Industry Medical Disclaimer Privacy Policy Terms of Service For Advertisers For Media Ophthalmology Job Center © American ...

  14. [Correct contact lens hygiene].

    Science.gov (United States)

    Blümle, S; Kaercher, T; Khaireddin, R

    2013-06-01

    Although contact lenses have long been established in ophthalmology, practical aspects of handling contact lenses is becoming increasingly less important in the clinical training as specialist for ophthalmology. Simultaneously, for many reasons injuries due to wearing contact lenses are increasing. In order to correct this discrepancy, information on contact lenses and practical experience with them must be substantially increased from a medical perspective. This review article deals with the most important aspects for prevention of complications, i.e. contact lens hygiene.

  15. Guidelines for equipment and staffing of radiotherapy facilities in the European countries

    DEFF Research Database (Denmark)

    Dunscombe, Peter; Grau, Cai; Defourny, Noémie

    2014-01-01

    BACKGROUND AND PURPOSE: In planning to meet evidence based needs for radiotherapy, guidelines for the provision of capital and human resources are central if access, quality and safety are not to be compromised. A component of the ESTRO-HERO (Health Economics in Radiation Oncology) project...... changes in the availability or specifics of guidelines over the ten-year period since the QUARTS study with the exception of the recent expansion of RTT staffing models. Where comparison is possible it appears that staffing for radiation oncologists, medical physicists and particularly RTTs tend to exceed...... guidelines suggesting developments in clinical radiotherapy are moving faster than guideline updating. CONCLUSION: The efficient provision of safe, high quality radiotherapy services would benefit from the availability of well-structured guidelines for capital and human resources, based on agreed upon...

  16. Staffing and job satisfaction: nurses and nursing assistants.

    Science.gov (United States)

    Kalisch, Beatrice; Lee, Kyung Hee

    2014-05-01

    The aim of this study was to examine the relationship between staffing and job satisfaction of registered nurses (RNs) and nursing assistants (NAs). Although a number of previous studies have demonstrated the link between the numbers of patients cared for on the last shift and/or perceptions of staffing adequacy, we could find only one study that utilized a measure of actual staffing (opposed to perceptions of staffing adequacy) and correlated it with job satisfaction of registered nurses. This cross-sectional study included 3523 RNs and 1012 NAs in 131 patient care units. Staff were surveyed to determine job satisfaction and demographic variables. In addition, actual staffing data were collected from each of the study units. Hours per patient day was a significant positive predictor for registered nurse job satisfaction after controlling for covariates. For NAs, a lower skill mix was marginally significant with higher job satisfaction. In addition, the more work experience the NAs reported, the lower their job satisfaction. Adequate staffing levels are essential for RN job satisfaction whereas NA job satisfaction depends on the number of assistive personnel in the mix of nursing staff. Two implications are (1) providing adequate staffing is critical to maintain RN job satisfaction and (2) the NA job needs to be re-engineered to make it a more attractive and satisfying career. © 2012 John Wiley & Sons Ltd.

  17. Staffing Levels at National Collegiate Athletic Association Football Bowl Subdivision-Level Institutions.

    Science.gov (United States)

    Ms, Suzie Aparicio; Welch Bacon, Cailee E; Parsons, John T; Bay, R Curtis; Cohen, Randy P; DeZeeuw, Terry; McLeod, Tamara C Valovich

    2015-12-01

    The "Appropriate Medical Coverage for Intercollegiate Athletics" (AMCIA) document was created to support assessment and calculation of athletic training personnel requirements. However, little is known regarding disparities between current and recommended staffing practices. To identify the staffing and employment characteristics of athletic health care services at Football Bowl Subdivision-level institutions. Cross-sectional study. Web-based survey. Head athletic trainers and athletic training staff members who were knowledgeable about budget and staff. The survey, Assessment of Staffing Levels at National Collegiate Athletic Association Football Bowl Subdivision-Level Institutions, was used to evaluate personal, university, and staff demographics; staffing and employment topics; and AMCIA variables and use. The survey was accessed and partially completed by 104 individuals (response rate = 84.6%). A total of 79 athletic trainers (response rate = 76%) completed the entire survey. One-third of the respondents (34.2%, n = 26) met the recommended number of full-time equivalents (FTEs) for football, two-thirds of the respondents (65.7%, n = 50) failed to meet the recommendation, and 26.2% (n = 27) were missing data needed for FTE calculation. Among those who did not meet the recommended FTEs (n = 50), 38.0% (n = 19) were within 1 FTE of being compliant, 26.0% (n = 13) were within 2 FTEs, and 24.0% (n = 12) were within 3 FTEs. About one-third of respondents (35.9%, n = 37) reported not using the AMCIA, citing lack of funding (29.7%, n = 11), lack of administrative support (21.6%, n = 8), and other reasons (37.8%, n = 14). The majority of institutions that used the AMCIA were able to provide justification for staffing. For most of the institutions that failed to meet their recommendation, adding 1-3 FTE athletic trainers for football would change their compliance status. A uniform definition of the term FTE within collegiate athletics is needed to allow for structured

  18. Staffing Levels at National Collegiate Athletic Association Football Bowl Subdivision-Level Institutions

    Science.gov (United States)

    MS, Suzie Aparicio; Welch Bacon, Cailee E.; Parsons, John T.; Bay, R. Curtis; Cohen, Randy P.; DeZeeuw, Terry; McLeod, Tamara C. Valovich

    2015-01-01

    Context The “Appropriate Medical Coverage for Intercollegiate Athletics” (AMCIA) document was created to support assessment and calculation of athletic training personnel requirements. However, little is known regarding disparities between current and recommended staffing practices. Objective To identify the staffing and employment characteristics of athletic health care services at Football Bowl Subdivision-level institutions. Design Cross-sectional study. Setting Web-based survey. Patients or Other Participants Head athletic trainers and athletic training staff members who were knowledgeable about budget and staff. Main Outcome Measure(s) The survey, Assessment of Staffing Levels at National Collegiate Athletic Association Football Bowl Subdivision-Level Institutions, was used to evaluate personal, university, and staff demographics; staffing and employment topics; and AMCIA variables and use. Results The survey was accessed and partially completed by 104 individuals (response rate = 84.6%). A total of 79 athletic trainers (response rate = 76%) completed the entire survey. One-third of the respondents (34.2%, n = 26) met the recommended number of full-time equivalents (FTEs) for football, two-thirds of the respondents (65.7%, n = 50) failed to meet the recommendation, and 26.2% (n = 27) were missing data needed for FTE calculation. Among those who did not meet the recommended FTEs (n = 50), 38.0% (n = 19) were within 1 FTE of being compliant, 26.0% (n = 13) were within 2 FTEs, and 24.0% (n = 12) were within 3 FTEs. About one-third of respondents (35.9%, n = 37) reported not using the AMCIA, citing lack of funding (29.7%, n = 11), lack of administrative support (21.6%, n = 8), and other reasons (37.8%, n = 14). Conclusions The majority of institutions that used the AMCIA were able to provide justification for staffing. For most of the institutions that failed to meet their recommendation, adding 1–3 FTE athletic trainers for football would change their

  19. Retrospective Chart Review of Skin-to-Skin Contact in the Operating Room and Administration of Analgesic and Anxiolytic Medication to Women After Cesarean Birth.

    Science.gov (United States)

    Wagner, Debra L; Lawrence, Stephen; Xu, Jing; Melsom, Janice

    2018-04-01

    Transporting a newborn out of the operating room after cesarean birth can contribute to maternal awareness of discomfort, anxiety, and the need for administration of analgesics and anxiolytics for relief. This retrospective study analyzed the association between skin-to-skin contact in the operating room and administration of analgesics and anxiolytics to women in the operating and recovery rooms after cesarean birth. Our results indicated a trend toward decreased medication administration for women who experienced skin-to-skin contact and add to evidence supporting the incorporation of skin-to-skin contact in the operating room as the standard of care for cesarean birth. This practice has the potential to enhance the birth experience, promote breastfeeding, and provide greater safety with less exposure to opioids and benzodiazepines for women and their newborns. © 2018 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

  20. Provider staffing effect on a decision aid intervention.

    Science.gov (United States)

    Ersek, Mary; Sefcik, Justine S; Lin, Feng-Chang; Lee, Tae Joon; Gilliam, Robin; Hanson, Laura C

    2014-02-01

    This study examined the association between Nurse Practitioner (NP) and Physician Assistant (PA) staffing in nursing homes and the effect of a decision aid regarding feeding options in dementia on the frequency of surrogate-provider discussions and on surrogates' decisional conflict. We compared these outcomes for facilities that had no NPs/PAs, part-time-only NP/PA staffing, and full-time NP/PA staffing. The sample included 256 surrogate decision makers from 24 nursing homes. The decision aid was associated with significant increases in discussion rates in facilities with part-time or no NP/PA staffing (26% vs. 51%, p vs. 41%, p vs. -0.047, p = .008, and -0.30 vs. -0.68, p = .014, respectively). Sites with full-time NP/PA staffing had high baseline rates of discussions (41%). These findings suggest that the decision aid and full-time NP/PA staffing can enhance surrogate decision making in nursing homes.

  1. Association between Nurse Staffing and In-Hospital Bone Fractures: A Retrospective Cohort Study.

    Science.gov (United States)

    Morita, Kojiro; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo

    2017-06-01

    To determine if sufficient nurse staffing reduced in-hospital fractures in acute care hospitals. The Japanese Diagnosis Procedure Combination inpatient (DPC) database from July 2010 to March 2014 linked with the Surveys for Medical Institutions. We conducted a retrospective cohort study to examine the association of inpatient nurse-to-occupied bed ratio (NBR) with in-hospital fractures. Multivariable logistic regression with generalized estimating equations was performed, adjusting for patient characteristics and hospital characteristics. We identified 770,373 patients aged 50 years or older who underwent planned major surgery for some forms of cancer or cardiovascular diseases. We used ICD-10 codes and postoperative procedure codes to identify patients with in-hospital fractures. Hospital characteristics were obtained from the "Survey of Medical Institutions and Hospital Report" and "Annual Report for Functions of Medical Institutions." Overall, 662 (0.09 percent) in-hospital fractures were identified. Logistic regression analysis showed that the proportion of in-hospital fractures in the group with the highest NBR was significantly lower than that in the group with the lowest NBR (adjusted odd ratios, 0.67; 95 percent confidence interval, 0.44-0.99; p = .048). Sufficient nurse staffing may be important to reduce postsurgical in-hospital fractures in acute care hospitals. © Health Research and Educational Trust.

  2. [Children from the GAZEL cohort: II--motive for contact with the medical-educational system by age and sex].

    Science.gov (United States)

    Fombonne, E; Vermeersch, S

    1997-04-01

    An epidemiological survey of 2582 French children aged 4 to 16 has been conducted to assess patterns of service use in relation to psychological disturbances. Details on the design, sample, survey instruments, response rate, and 12-months prevalence rates of contacts with a range of different professionals were presented in a previous article. In this second article, the psychological motives leading to contact with family doctors, school-based professionals, speech and language therapists, and mental health specialists are analyzed. The age and gender effects are assessed for each motives. On the whole, consistent sex differences were found for the types of complaints presented by service users, with emotional symptoms being more frequent amongst girls, and behavioural, developmental and learning difficulties being more frequent amongst boys. Mental health specialists were attended for a variety of reasons. Family doctors were contacted for minor emotional difficulties. Because family doctors were consulted by a high proportion of children and adolescents of our sample, the role of this professionals in the detection and management of minor psychological morbidity is emphasized.

  3. Excellence and evidence in staffing: a data-driven model for excellence in staffing (2nd edition).

    Science.gov (United States)

    Baggett, Margarita; Batcheller, Joyce; Blouin, Ann Scott; Behrens, Elizabeth; Bradley, Carol; Brown, Mary J; Brown, Diane Storer; Bolton, Linda Burnes; Borromeo, Annabelle R; Burtson, Paige; Caramanica, Laura; Caspers, Barbara A; Chow, Marilyn; Christopher, Mary Ann; Clarke, Sean P; Delucas, Christine; Dent, Robert L; Disser, Tony; Eliopoulos, Charlotte; Everett, Linda Q; Garcia, Amy; Glassman, Kimberly; Goodwin, Susan; Haagenson, Deb; Harper, Ellen; Harris, Kathy; Hoying, Cheryl L; Hughes-Rease, Marsha; Kelly, Lesly; Kiger, Anna J; Kobs-Abbott, Ann; Krueger, Janelle; Larson, Jackie; March, Connie; Martin, Deborah Maust; Mazyck, Donna; Meenan, Penny; McGaffigan, Patricia; Myers, Karen K; Nell, Kate; Newcomer, Britta; Cathy, Rick; O'Rourke, Maria; Rosa, Billy; Rose, Robert; Rudisill, Pamela; Sanford, Kathy; Simpson, Roy L; Snowden, Tami; Strickland, Bob; Strohecker, Sharon; Weems, Roger B; Welton, John; Weston, Marla; Valentine, Nancy M; Vento, Laura; Yendro, Susan

    2014-01-01

    The Patient Protection and Affordable Care Act (PPACA, 2010) and the Institute of Medicine's (IOM, 2011) Future of Nursing report have prompted changes in the U.S. health care system. This has also stimulated a new direction of thinking for the profession of nursing. New payment and priority structures, where value is placed ahead of volume in care, will start to define our health system in new and unknown ways for years. One thing we all know for sure: we cannot afford the same inefficient models and systems of care of yesterday any longer. The Data-Driven Model for Excellence in Staffing was created as the organizing framework to lead the development of best practices for nurse staffing across the continuum through research and innovation. Regardless of the setting, nurses must integrate multiple concepts with the value of professional nursing to create new care and staffing models. Traditional models demonstrate that nurses are a commodity. If the profession is to make any significant changes in nurse staffing, it is through the articulation of the value of our professional practice within the overall health care environment. This position paper is organized around the concepts from the Data-Driven Model for Excellence in Staffing. The main concepts are: Core Concept 1: Users and Patients of Health Care, Core Concept 2: Providers of Health Care, Core Concept 3: Environment of Care, Core Concept 4: Delivery of Care, Core Concept 5: Quality, Safety, and Outcomes of Care. This position paper provides a comprehensive view of those concepts and components, why those concepts and components are important in this new era of nurse staffing, and a 3-year challenge that will push the nursing profession forward in all settings across the care continuum. There are decades of research supporting various changes to nurse staffing. Yet little has been done to move that research into practice and operations. While the primary goal of this position paper is to generate research

  4. Organization and staffing practices in US cardiac intensive care units: a survey on behalf of the American Heart Association Writing Group on the Evolution of Critical Care Cardiology.

    Science.gov (United States)

    O'Malley, Ryan G; Olenchock, Benjamin; Bohula-May, Erin; Barnett, Christopher; Fintel, Dan J; Granger, Christopher B; Katz, Jason N; Kontos, Michael C; Kuvin, Jeffrey T; Murphy, Sabina A; Parrillo, Joseph E; Morrow, David A

    2013-03-01

    The cardiac intensive care unit (CICU) has evolved into a complex patient-care environment with escalating acuity and increasing utilization of advanced technologies. These changing demographics of care may require greater clinical expertise among physician providers. Despite these changes, little is known about present-day staffing practices in US CICUs. We conducted a survey of 178 medical directors of ICUs caring for cardiac patients to assess unit structure and physician staffing practices. Data were obtained from 123 CICUs (69% response rate) that were mostly from academic medical centres. A majority of hospitals utilized a dedicated CICU (68%) and approximately half of those hospitals employed a 'closed' unit model. In 46% of CICUs, an intensivist consult was available, but not routinely involved in care of critically ill cardiovascular patients, while 11% did not have a board-certified intensivist available for consultation. Most CICU directors (87%) surveyed agreed that a closed ICU structure provided better care than an open ICU and 81% of respondents identified an unmet need for cardiologists with critical care training. We report contemporary structural models and staffing practices in a sample of US ICUs caring for critically ill cardiovascular patients. Although most hospitals surveyed had dedicated CICUs, a minority of CICUs employed a 'closed' CICU model and few had routine intensivist staffing. Most CICU directors agree that there is a need for cardiologists with intensivist training and expertise. These survey data reveal potential areas for continued improvement in US CICU organizational structure and physician staffing.

  5. Restrictions of the sale of pharmaceuticals and medical devices such as contact lenses over the internet and the free movement of goods.

    Science.gov (United States)

    de Sadeleer, Nicolas

    2012-03-01

    In the light of new case law development, this article examines whether national restrictions on the online sale of pharmaceuticals and medical devices such as contact lenses are consistent either with EU secondary law, either with Article 34 TFEU that prohibits measures having equivalent effect to quantitative restrictions on imports. In particular, this article focuses on an analysis of two judgments on this important issue delivered by the Court of Justice of the European Union in 2003 and 2010, namely the Deutscher Apothekerverband decision and the Ker-Optika decision.

  6. Variation Across U.S. Assisted Living Facilities: Admissions, Resident Care Needs, and Staffing.

    Science.gov (United States)

    Han, Kihye; Trinkoff, Alison M; Storr, Carla L; Lerner, Nancy; Yang, Bo Kyum

    2017-01-01

    Though more people in the United States currently reside in assisted living facilities (ALFs) than nursing homes, little is known about ALF admission policies, resident care needs, and staffing characteristics. We therefore conducted this study using a nationwide sample of ALFs to examine these factors, along with comparison of ALFs by size. Cross-sectional secondary data analysis using data from the 2010 National Survey of Residential Care Facilities. Measures included nine admission policy items, seven items on the proportion of residents with selected conditions or care needs, and six items on staffing characteristics (e.g., access to licensed nurse, aide training). Facilities (n = 2,301) were divided into three categories by size: small, 4 to 10 beds; medium, 11 to 25 beds; and large, 26 or more beds. Analyses took complex sampling design effects into account to project national U.S. estimates. More than half of ALFs admitted residents with considerable healthcare needs and served populations that required nursing care, such as for transfers, medications, and eating or dressing. Staffing was largely composed of patient care aides, and fewer than half of ALFs had licensed care provider (registered nurse, licensed practical nurse) hours. Smaller facilities tended to have more inclusive admission policies and residents with more complex care needs (more mobility, eating and medication assistance required, short-term memory issues, p < .01) and less access to licensed nurses than larger ALFs (p < .01). This study suggests ALFs are caring for and admitting residents with considerable care needs, indicating potential overlap with nursing home populations. Despite this finding, ALF regulations lag far behind those in effect for nursing homes. In addition, measurement of care outcomes is critically needed to ensure appropriate ALF care quality. As more people choose ALFs, outcome measures for ALFs, which are now unavailable, should be developed to allow for oversight

  7. Nurse dose: linking staffing variables to adverse patient outcomes.

    Science.gov (United States)

    Manojlovich, Milisa; Sidani, Souraya; Covell, Christine L; Antonakos, Cathy L

    2011-01-01

    Inconsistent findings in more than 100 studies have made it difficult to explain how variation in nurse staffing affects patient outcomes. Nurse dose, defined as the level of nurses required to provide patient care in hospital settings, draws on variables used in staffing studies to describe the influence of many staffing variables on outcomes. The aim of this study was to examine the construct validity of nurse dose by determining its association with methicillin-resistant Staphylococcus aureus (MRSA) infections and reported patient falls on a sample of inpatient adult acute care units. Staffing data came from 26 units in Ontario, Canada, and Michigan. Financial and human resource data were data sources for staffing variables. Sources of data for MRSA came from infection control departments. Incident reports were the data source for patient falls. Data analysis consisted of bivariate correlations and Poisson regression. Bivariate correlations revealed that nurse dose attributes (active ingredient and intensity) were associated significantly with both outcomes. Active ingredient (education, experience, skill mix) and intensity (full-time employees, registered nurse [RN]:patient ratio, RN hours per patient day) were significant predictors of MRSA. Coefficients for both attributes were negative and almost identical. Both attributes were significant predictors of reported patient falls, and coefficients were again negative, but coefficient sizes differed. By conceptualizing nurse and staffing variables (education, experience, skill mix, full-time employees, RN:patient ratio, RN hours per patient day) as attributes of nurse dose and by including these in the same analysis, it is possible to determine their relative influence on MRSA infections and reported patient falls.

  8. Medication Information Seeking Behavior in a Social Context: The Role of Lay and Professional Social Network Contacts

    Directory of Open Access Journals (Sweden)

    Andrea L. Kjos, Pharm.D., Ph.D.

    2011-01-01

    Full Text Available This study provided a view of the social context of medication information seeking from a patient’s perspective.This was an exploratory qualitative study with 40 adults to determine how patients communicate within social networks to seek medication information. Semi-structured interviews were used to determine the structure (who, the content provided (what, and the function of social sources of information (how/why. Data underwent ethnographic content analysis using theory and prior research driven themes. Coding matrices were created to identify emerging patterns for who supplied what information and how the information was used. Participants described seeking medication information from health professional or lay social network sources. Health professional sources’ strongest role was to provide factual information. In contrast, lay sources provided factual information and affective information such as personal experiences and beliefs or attitudes. Information sought from social sources displayed similar functioning roles in terms of how the information was used by the participants seeking the information. The study concluded that medication information is sought from social sources both inside and outside of healthcare. Emerging patterns found that lay sources may provide patients more than affective information about medications. Further, patients may be receiving factually based information other than from health professionals. By coming to a more complete understanding of the social nature of the information environment, health professionals can better understand information needs from a patient’s perspective.

  9. Medication Information Seeking Behavior in a Social Context: The Role of Lay and Professional Social Network Contacts

    Directory of Open Access Journals (Sweden)

    Andrea L. Kjos

    2011-01-01

    Full Text Available This study provided a view of the social context of medication information seeking from a patient's perspective.This was an exploratory qualitative study with 40 adults to determine how patients communicate within social networks to seek medication information. Semi-structured interviews were used to determine the structure (who, the content provided (what, and the function of social sources of information (how/why. Data underwent ethnographic content analysis using theory and prior research driven themes. Coding matrices were created to identify emerging patterns for who supplied what information and how the information was used. Participants described seeking medication information from health professional or lay social network sources. Health professional sources' strongest role was to provide factual information. In contrast, lay sources provided factual information and affective information such as personal experiences and beliefs or attitudes. Information sought from social sources displayed similar functioning roles in terms of how the information was used by the participants seeking the information. The study concluded that medication information is sought from social sources both inside and outside of healthcare. Emerging patterns found that lay sources may provide patients more than affective information about medications. Further, patients may be receiving factually based information other than from health professionals. By coming to a more complete understanding of the social nature of the information environment, health professionals can better understand information needs from a patient's perspective.   Type: Original Research

  10. Cluster approach to staffing in the agricultural sector

    Directory of Open Access Journals (Sweden)

    Belaia Nataliia Vladimirovna

    2013-08-01

    Full Text Available The state of agricultural sector influences every person, determines the potential of national economy and politics. That is why the development of agricultural sector has always been one of the most urgent tasks for Russia and its regions. For the last few years the large-scale government support of the agricultural sector has been maintained which made the problem of peopleware of agricultural sector to be very significant. Staffing is known as fundamental principle of peopleware. Altai region is one of the farm production leaders, and problems of agricultural staffing are becoming more and more important.

  11. 77 FR 40638 - Syniverse Technologies, Inc., Including On-Site Leased Workers From Insight Global Stone Staffing...

    Science.gov (United States)

    2012-07-10

    ... Insight Global Stone Staffing, and Randstad Formerly Known as Sapphire Technologies, Watertown, MA... workers from Insight Global, Stone Staffing, Randstad formerly known as Sapphire Technologies, Watertown... telecommunication services. The company reports that workers leased from Insight Global, Stone Staffing, Randstad...

  12. Colored Contact Lens Dangers

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    Full Text Available ... also available in Spanish . Follow The Academy Professionals: Education Guidelines News Multimedia Public & Patients: Contact Us About the Academy Jobs at the Academy Financial Relationships with Industry Medical ...

  13. Colored Contact Lens Dangers

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    Full Text Available ... seek immediate medical attention from an ophthalmologist. Related resources: Learn how to properly care for contact lenses . ... woman from Oregon made history as the first human host for an eye worm that previously had ...

  14. Colored Contact Lens Dangers

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    Full Text Available ... people with high myopia? Mar 29, 2017 New Technology Helps the Legally Blind Be More Independent Oct ... Multimedia Public & Patients: Contact Us About the Academy Jobs at the Academy Financial Relationships with Industry Medical ...

  15. Colored Contact Lens Dangers

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    Full Text Available ... Cleveland. "This is far from the truth." Real People, Real Problems with Colored Contact Lenses Julian: Teenager ... About the Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of ...

  16. Colored Contact Lens Dangers

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    Full Text Available ... Follow The Academy Professionals: Education Guidelines News Multimedia Public & Patients: Contact Us About the Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of Service For Advertisers For Media Ophthalmology ...

  17. Colored Contact Lens Dangers

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    Full Text Available ... about the members of the eye-care team . Consumer warning about the improper use of colored contact ... About the Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of ...

  18. Colored Contact Lens Dangers

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    Full Text Available ... medical attention from an ophthalmologist. Related resources: Learn how to properly care for contact lenses . Learn about ... Shape of the Eclipse Itself Dec 08, 2017 How long does it take the eye to go ...

  19. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... also available in Spanish . Follow The Academy Professionals: Education Guidelines News Multimedia Public & Patients: Contact Us About the Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms ...

  20. Relationship Between Staffing and Utilization of Special Collections ...

    African Journals Online (AJOL)

    Findings showed that, there was a gross under-utilization of special collections by users in the libraries studied. A further analysis revealed that significant relationships between staffing with utilization of special collections information resources existed. Based on the findings, the study concluded that, there was gross ...

  1. 5 CFR 9701.363 - Special staffing payments.

    Science.gov (United States)

    2010-01-01

    ... HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Special Payments § 9701.363 Special... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Special staffing payments. 9701.363 Section 9701.363 Administrative Personnel DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT...

  2. Staffing UK University Campuses Overseas: Lessons from MNE Practice

    Science.gov (United States)

    Salt, John; Wood, Peter

    2014-01-01

    This article suggests that as their internal labor markets become more multinational in scope, UK universities may acquire similar staffing characteristics to commercial multinational enterprises (MNEs). Comparing evidence from four UK universities with several surveys of MNEs it concludes that, although there are broad similarities in the…

  3. Healthcare security staffing for smaller facilities: where science meets art.

    Science.gov (United States)

    Warren, Bryan

    2013-01-01

    Obtaining effective security resourcing and staffing for smaller healthcare facilities presents many difficulties, according to the author In this article, he provides guidance to security practitioners on taking existing data and translating it into a language that administration will understand and appreciate.

  4. Flexible nurse staffing based on hourly bed census predictions

    NARCIS (Netherlands)

    Kortbeek, Nikky; Braaksma, Aleida; Burger, C.A.J.; Bakker, P.J.M; Boucherie, Richardus J.

    2012-01-01

    Workload on nursing wards depends highly on patient arrivals and patient lengths of stay, which are both inherently variable. Predicting this workload and staffing nurses accordingly is essential for guaranteeing quality of care in a cost effective manner. This paper introduces a stochastic method

  5. Flexible nurse staffing based on hourly bed census predictions

    NARCIS (Netherlands)

    Kortbeek, Nikky; Braaksma, Aleida; Burger, C.A.J.; Bakker, P.J.M; Boucherie, Richardus J.

    Workloads in nursing wards depend highly on patient arrivals and lengths of stay, both of which are inherently variable. Predicting these workloads and staffing nurses accordingly are essential for guaranteeing quality of care in a cost-effective manner. This paper introduces a stochastic method

  6. African Health Sciences: Contact

    African Journals Online (AJOL)

    Principal Contact. Dr James Tumwine Editor-in-Chief. Makerere University Medical School P. O. Box 7072 Kampala Uganda. Phone: 256-41-530020/1. Email: kabaleimc@gmail.com. Support Contact. Pauline Salamula Email: paulinesalamula@gmail.com. ISSN: 1680-6905. AJOL African Journals Online. HOW TO USE ...

  7. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Get follow up exams with your eye care provider. If you notice redness, swelling, excessive discharge, pain or discomfort from wearing contact lenses, remove the lenses and seek immediate medical attention from an ophthalmologist. Related resources: Learn how to properly care for contact lenses . ...

  8. Leadership, staffing and quality of care in nursing homes

    Directory of Open Access Journals (Sweden)

    Havig Anders

    2011-11-01

    Full Text Available Abstract Background Leadership and staffing are recognised as important factors for quality of care. This study examines the effects of ward leaders' task- and relationship-oriented leadership styles, staffing levels, ratio of registered nurses and ratio of unlicensed staff on three independent measures of quality of care. Methods A cross-sectional survey of forty nursing home wards throughout Norway was used to collect the data. Five sources of data were utilised: self-report questionnaires to 444 employees, interviews with and questionnaires to 13 nursing home directors and 40 ward managers, telephone interviews with 378 relatives and 900 hours of field observations. Separate multi-level analyses were conducted for quality of care assessed by relatives, staff and field observations respectively. Results Task-oriented leadership style had a significant positive relationship with two of the three quality of care indexes. In contrast, relationship-oriented leadership style was not significantly related to any of the indexes. The lack of significant effect for relationship-oriented leadership style was due to a strong correlation between the two leadership styles (r = 0.78. Staffing levels and ratio of registered nurses were not significantly related to any of the quality of care indexes. The ratio of unlicensed staff, however, showed a significant negative relationship to quality as assessed by relatives and field observations, but not to quality as assessed by staff. Conclusions Leaders in nursing homes should focus on active leadership and particularly task-oriented behaviour like structure, coordination, clarifying of staff roles and monitoring of operations to increase quality of care. Furthermore, nursing homes should minimize use of unlicensed staff and address factors related to high ratios of unlicensed staff, like low staff stability. The study indicates, however, that the relationship between staffing levels, ratio of registered nurses

  9. Leadership, staffing and quality of care in nursing homes

    Science.gov (United States)

    2011-01-01

    Background Leadership and staffing are recognised as important factors for quality of care. This study examines the effects of ward leaders' task- and relationship-oriented leadership styles, staffing levels, ratio of registered nurses and ratio of unlicensed staff on three independent measures of quality of care. Methods A cross-sectional survey of forty nursing home wards throughout Norway was used to collect the data. Five sources of data were utilised: self-report questionnaires to 444 employees, interviews with and questionnaires to 13 nursing home directors and 40 ward managers, telephone interviews with 378 relatives and 900 hours of field observations. Separate multi-level analyses were conducted for quality of care assessed by relatives, staff and field observations respectively. Results Task-oriented leadership style had a significant positive relationship with two of the three quality of care indexes. In contrast, relationship-oriented leadership style was not significantly related to any of the indexes. The lack of significant effect for relationship-oriented leadership style was due to a strong correlation between the two leadership styles (r = 0.78). Staffing levels and ratio of registered nurses were not significantly related to any of the quality of care indexes. The ratio of unlicensed staff, however, showed a significant negative relationship to quality as assessed by relatives and field observations, but not to quality as assessed by staff. Conclusions Leaders in nursing homes should focus on active leadership and particularly task-oriented behaviour like structure, coordination, clarifying of staff roles and monitoring of operations to increase quality of care. Furthermore, nursing homes should minimize use of unlicensed staff and address factors related to high ratios of unlicensed staff, like low staff stability. The study indicates, however, that the relationship between staffing levels, ratio of registered nurses and quality of care is

  10. Staff Assist: A Resource to Improve Nursing Home Quality and Staffing

    Science.gov (United States)

    Castle, Nicholas G.

    2011-01-01

    Purpose: This study describes the creation and use of a web-based resource, designed to help nursing homes implement quality improvements through changes in staffing characteristics. Design and Methods: Information on staffing characteristics (i.e., staffing levels, turnover, stability, and use of agency staff), facility characteristics (e.g.,…

  11. Nurse staffing issues are just the tip of the iceberg: a qualitative study about nurses' perceptions of nurse staffing

    NARCIS (Netherlands)

    van Oostveen, Catharina J.; Mathijssen, Elke; Vermeulen, Hester

    2015-01-01

    To obtain in-depth insight into the perceptions of nurses in the Netherlands regarding current nurse staffing levels and use of nurse-to-patient-ratios (NPR) and patient classification systems (PCS). In response to rising health care demands due to ageing of the patient population and increasing

  12. Physician staffing needs in critical care departments.

    Science.gov (United States)

    Gómez Tello, V; Ruiz Moreno, J; Weiss, M; González Marín, E; Merino de Cos, P; Franco Garrobo, N; Alonso Ovies, A; Montejo González, J C; Iber, T; Marx, G; Córcoles González, V; Gordo Vidal, F; Palencia Herrejón, E; Roca Guiseris, J

    Departments of Critical Care Medicine are characterized by high medical assistance costs and great complexity. Published recommendations on determining the needs of medical staff in the DCCM are based on low levels of evidence and attribute excessive significance to the structural/welfare approach (physician-to-beds ratio), thus generating incomplete and minimalistic information. The Spanish Society of Intensive Care Medicine and Coronary Units established a Technical Committee of experts, the purpose of which was to draft recommendations regarding requirements for medical professionals in the ICU. The Technical Committee defined the following categories: 1) Patient care-related aspects; 2) Activities outside the ICU; 3) Patient safety and clinical management aspects; 4) Teaching; and 5) Research. A subcommittee was established with experts pertaining to each activity category, defining criteria for quantifying the percentage time of the intensivists dedicated to each task, and taking into account occupational category. A quantitative method was applied, the parameters of which were the number of procedures or tasks and the respective estimated indicative times for patient care-related activities within or outside the context of the DCCM, as well as for teaching and research activities. Regarding non-instrumental activities, which are more difficult to evaluate in real time, a matrix of range versus productivity was applied, defining approximate percentages according to occupational category. All activities and indicative times were tabulated, and a spreadsheet was created that modified a previously designed model in order to perform calculations according to the total sum of hours worked and the hours stipulated in the respective work contract. The competencies needed and the tasks which a Department of Critical Care Medicine professional must perform far exceed those of a purely patient care-related character, and cannot be quantified using structural criteria

  13. Less Contact Ballistogram Recording during Sleep as a Perspective Technology for the Medical Monitoring System in a Mission to Mars

    Science.gov (United States)

    Baevsky, R. M.; Bogomolov, V. V.; Funtova, I. I.

    strong argument for success of a future Martian mission is absence of pathologies developed in cosmonauts following one-year or longer space flights that might forbid further gradual extension of piloted missions. However, functional shifts in the neurohormonal regulation revealed during the long-term Mir missions suggest that homeostasis of the vital important body systems is maintained owing to active functioning of the regulatory mechanisms (Grigoriev A.I. et al., 1998). Since overstrain of these mechanisms constitutes one of the main factors of risk of diseases, it is important to provide unfailing and systematic monitoring of the body regulation functional reserves. night ballistocardiography, made it possible to obtain data on super-slow heart rhythm fluctuations reflective of activation of the neurohormonal regulation (Baevsky R.M. et al., 1999). Analysis of the data showed that on a background of extended exposure of the human organism to various stressful factors the cardiovascular homeostasis is maintained through consecutive recruitment in adaptation of higher levels of regulation of the physiological systems (Grigoriev A.I., Baevsky R.M., 2001). This validates the hypothesis concerning the role of the higher autonomous centers in long-term adaptation to the spaceflight factors and opens up the new way to diagnosis and prediction of the human body functional reserves. It was first demonstrated in space during the Mir primary mission 9 in 1991. Sensor-accelerometer secured to cosmonaut's sleeping bag registered micromovements conditioned by the heart, respiratory and motor activities of a sleeping cosmonaut. The joint Russian-Austrian space investigations in 1992-1995 resulted in technology refinement and enhancement. Advantages of medical monitoring during sleep are obvious not only because of the time saving and opportunity to receive systematically information pertaining to the crew health. Records allow, to begin with, evaluate the functional state in

  14. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... A medical degree and many more years of training, for starters. A recent article from U.S. News and World Report explains what ophthalmologists are and how they can help you look after ... Contact Us About the Academy Jobs at the Academy Financial Relationships with Industry Medical ...

  15. Nursing home staffing requirements and input substitution: effects on housekeeping, food service, and activities staff.

    Science.gov (United States)

    Bowblis, John R; Hyer, Kathryn

    2013-08-01

    To study the effect of minimum nurse staffing requirements on the subsequent employment of nursing home support staff. Nursing home data from the Online Survey Certification and Reporting (OSCAR) System merged with state nurse staffing requirements. Facility-level housekeeping, food service, and activities staff levels are regressed on nurse staffing requirements and other controls using fixed effect panel regression. OSCAR surveys from 1999 to 2004. Increases in state direct care and licensed nurse staffing requirements are associated with decreases in the staffing levels of all types of support staff. Increased nursing home nurse staffing requirements lead to input substitution in the form of reduced support staffing levels. © Health Research and Educational Trust.

  16. Twenty years and twenty thousand contact lens patients.

    OpenAIRE

    Dixon, J M

    1981-01-01

    A self contained non commercial private office laboratory staffed by office personnel has been used to prepare contact lenses for private office patients. These lenses include hard contact lenses of various materials and various designs. During the past ten years extended wear hydrophilic soft lenses have been prepared in the same manner as hard lenses, all custom made with lens powers, base curves, diameters, and thickness designed according to the needs of each patient. This has provided st...

  17. Health Care Evolution Is Driving Staffing Industry Transformation.

    Science.gov (United States)

    Faller, Marcia; Gogek, Jim

    2016-01-01

    The powerful transformation in the health care industry is reshaping not only patient care delivery and the business of health care but also demanding new strategies from vendors who support the health care system. These new strategies may be most evident in workforce solutions and health care staffing services. Consolidation of the health care industry has created increased demand for these types of services. Accommodating a changing workforce and related pressures resulting from health care industry transformation has produced major change within the workforce solutions and staffing services sector. The effect of the growth strategy of mergers, acquisitions, and organic development has revealed organizational opportunities such as expanding capacity for placing physicians, nurses, and allied professionals, among other workforce solutions. This article shares insights into workforce challenges and solutions throughout the health care industry.

  18. Comparing the staffing models of outsourcing in selected companies

    OpenAIRE

    Chaloupková, Věra

    2010-01-01

    This thesis deals with problems of takeover of employees in outsourcing. The capital purpose is to compare the staffing model of outsourcing in selected companies. To compare in selected companies I chose multi-criteria analysis. This thesis is dividend into six chapters. The first charter is devoted to the theoretical part. In this charter describes the basic concepts as outsourcing, personal aspects, phase of the outsourcing projects, communications and culture. The rest of thesis is devote...

  19. Analysis of patients with decompression illness transported via physician-staffed emergency helicopters

    Directory of Open Access Journals (Sweden)

    Yasumasa Oode

    2015-01-01

    Full Text Available Context: There have been few reports investigating the effects of air transportation on patients with decompression illness (DCI. Aims: To investigate the influence of air transportation on patients with DCI transported via physician-staffed emergency helicopters (HEMS: Emergency medical system of physician-staffed emergency helicopters. Settings and Design: A retrospective medical chart review in a single hospital. Materials and Methods: A medical chart review was retrospectively performed in all patients with DCI transported via HEMS between July 2009 and June 2013. The exclusion criteria included cardiopulmonary arrest on surfacing. Statistical analysis used: The paired Student′s t-test. Results: A total of 28 patients were treated as subjects. Male and middle-aged subjects were predominant. The number of patients who suddenly surfaced was 15/28. All patients underwent oxygen therapy during flight, and all but one patient received the administration of lactate Ringer fluid. The subjective symptoms of eight of 28 subjects improved after the flight. The range of all flights under 300 m above sea level. There were no significant differences between the values obtained before and after the flight for Glasgow coma scale, blood pressure, and heart rate. Concerning the SpO 2 , statistically significant improvements were noted after the flight (96.2 ± 0.9% versus 97.3 ± 0.7%. There were no relationships between an improvement in subjective symptoms and the SpO 2 . Conclusion: Improvements in the subjective symptoms and/or SpO 2 of patients with DCI may be observed when the patient is transported via HEMS under flights less than 300 m in height with the administration of oxygen and fluids.

  20. NURSE STAFFING AND RENAL ANAEMIA OUTCOMES IN HAEMODIALYSIS CARE.

    Science.gov (United States)

    Erlingmark, Julia; Hedström, Mariann; Lindberg, Magnus

    2016-09-01

    Current trends in renal anaemia management place greater emphasis, and thus increased workload, on the role of the nurse in haemodialysis settings. However, there is little evidence that demonstrates the relationship between nurse staffing and patient outcomes. To describe nurse staffing in haemodialysis settings, its relationship with target levels of renal anaemia management and to describe target level achievement for different ways of organising anaemia management. Cross-sectional audit. Forty (out of 78) haemodialysis centres in Sweden reported quality assurance data. The numbers of bedside registered nurses, licensed nurse assistants and patients undergoing haemodialysis during a predefined morning shift; type of anaemia management and achieved target levels of anaemia management. The mean patient:registered nurse ratio was 2.4 and the mean patient:nurse assistant ratio was 12.8. There were no significant relationships between registered nurse staffing and target level achievement. On average, 45.6% of the patients had haemoglobin within the target levels at centres applying nurse-driven anaemia management, compared with 47.3% at physician-driven centres. These cross-sectional data suggest that renal anaemia outcomes are unrelated to the patient:registered nurse ratio. There is, however, room for improvement in renal anaemia management in the units included in this study, particularly the achievement of target levels of haemoglobin and transferrin saturation. © 2016 European Dialysis and Transplant Nurses Association/European Renal Care Association.

  1. STAFFING DALAM ALQURAN DAN HADIS DITINJAU DARI MANAJEMEN PENDIDIKAN

    Directory of Open Access Journals (Sweden)

    Tuti Andriani

    2016-08-01

    Full Text Available Staffing in an organization can be defined as a series of processes and efforts to acquire, develop, motivate, and evaluate the overall human resources. It is required within the organization in achieving its goals. In staffing, putting a person in a work should be in accordance with his capabilities and expertise so that all are expected to be achieved. Job placement principle is the principle of humanity, democracy, the right man on the right place, equal pay for equal work, unity of direction, the principle of unity of purpose, unity of command, Efficiency and Productivity Work. The concept is the placement, promotion, transfer and demotion. Staffing in the Qur'an and Hadith seen from education management is an employee must complete properly, responsibility, trust, has the capability and expertise, serve, work ethic, strong and trustworthy, honest, sincere, true and trustful, physical and mental strength, and high manners. Professionalism in view of sharia is characterized by three things, namely ahliyah (expertise, himmatul 'charity (high work ethic, trustworthy (reliable.

  2. Differences in symptoms, first medical contact and pre-hospital delay times between patients with ST- and non-ST-elevation myocardial infarction.

    Science.gov (United States)

    Ängerud, Karin H; Sederholm Lawesson, Sofia; Isaksson, Rose-Marie; Thylén, Ingela; Swahn, Eva

    2017-11-01

    In ST-elevation myocardial infarction, time to reperfusion is crucial for the prognosis. Symptom presentation in myocardial infarction influences pre-hospital delay times but studies about differences in symptoms between patients with ST-elevation myocardial infarction and non-ST-elevation myocardial infarction are sparse and inconclusive. The aim was to compare symptoms, first medical contact and pre-hospital delay times in patients with ST-elevation myocardial infarction and non-ST-elevation myocardial infarction. This multicentre, observational study included 694 myocardial infarction patients from five hospitals. The patients filled in a questionnaire about their pre-hospital experiences within 24 h of hospital admittance. Chest pain was the most common symptom in ST-elevation myocardial infarction and non-ST-elevation myocardial infarction (88.7 vs 87.0%, p=0.56). Patients with cold sweat (odds ratio 3.61, 95% confidence interval 2.29-5.70), jaw pain (odds ratio 2.41, 95% confidence interval 1.04-5.58), and nausea (odds ratio 1.70, 95% confidence interval 1.01-2.87) were more likely to present with ST-elevation myocardial infarction, whereas the opposite was true for symptoms that come and go (odds ratio 0.58, 95% confidence interval 0.38-0.90) or anxiety (odds ratio 0.52, 95% confidence interval 0.29-0.92). Use of emergency medical services was higher among patients admitted with ST-elevation myocardial infarction. The pre-hospital delay time from symptom onset to first medical contact was significantly longer in non-ST-elevation myocardial infarction (2:05 h vs 1:10 h, p=0.001). Patients with ST-elevation myocardial infarction differed from those with non-ST-elevation myocardial infarction regarding symptom presentation, ambulance utilisation and pre-hospital delay times. This knowledge is important to be aware of for all healthcare personnel and the general public especially in order to recognise symptoms suggestive of ST-elevation myocardial infarction and

  3. Guidelines for equipment and staffing of radiotherapy facilities in the European countries: Final results of the ESTRO-HERO survey

    International Nuclear Information System (INIS)

    Dunscombe, Peter; Grau, Cai; Defourny, Noémie; Malicki, Julian; Borras, Josep M.; Coffey, Mary; Bogusz, Marta; Gasparotto, Chiara; Slotman, Ben; Lievens, Yolande; Kokobobo, Arianit; Sedlmayer, Felix; Slobina, Elena; De Hertogh, Olivier; Hadjieva, Tatiana; Petera, Jiri; Eriksen, Jesper Grau; Jaal, Jana; Bly, Ritva; Azria, David

    2014-01-01

    Background and purpose: In planning to meet evidence based needs for radiotherapy, guidelines for the provision of capital and human resources are central if access, quality and safety are not to be compromised. A component of the ESTRO-HERO (Health Economics in Radiation Oncology) project is to document the current availability and content of guidelines for radiotherapy in Europe. Materials and methods: An 84 part questionnaire was distributed to the European countries through their national scientific and professional radiotherapy societies with 30 items relating to the availability of guidelines for equipment and staffing and selected operational issues. Twenty-nine countries provided full or partial evaluable responses. Results: The availability of guidelines across Europe is far from uniform. The metrics used for capital and human resources are variable. There seem to have been no major changes in the availability or specifics of guidelines over the ten-year period since the QUARTS study with the exception of the recent expansion of RTT staffing models. Where comparison is possible it appears that staffing for radiation oncologists, medical physicists and particularly RTTs tend to exceed guidelines suggesting developments in clinical radiotherapy are moving faster than guideline updating. Conclusion: The efficient provision of safe, high quality radiotherapy services would benefit from the availability of well-structured guidelines for capital and human resources, based on agreed upon metrics, which could be linked to detailed estimates of need

  4. Impact of an electronic health record operating room management system in ophthalmology on documentation time, surgical volume, and staffing.

    Science.gov (United States)

    Sanders, David S; Read-Brown, Sarah; Tu, Daniel C; Lambert, William E; Choi, Dongseok; Almario, Bella M; Yackel, Thomas R; Brown, Anna S; Chiang, Michael F

    2014-05-01

    Although electronic health record (EHR) systems have potential benefits, such as improved safety and quality of care, most ophthalmology practices in the United States have not adopted these systems. Concerns persist regarding potential negative impacts on clinical workflow. In particular, the impact of EHR operating room (OR) management systems on clinical efficiency in the ophthalmic surgery setting is unknown. To determine the impact of an EHR OR management system on intraoperative nursing documentation time, surgical volume, and staffing requirements. For documentation time and circulating nurses per procedure, a prospective cohort design was used between January 10, 2012, and January 10, 2013. For surgical volume and overall staffing requirements, a case series design was used between January 29, 2011, and January 28, 2013. This study involved ophthalmic OR nurses (n = 13) and surgeons (n = 25) at an academic medical center. Electronic health record OR management system implementation. (1) Documentation time (percentage of operating time documenting [POTD], absolute documentation time in minutes), (2) surgical volume (procedures/time), and (3) staffing requirements (full-time equivalents, circulating nurses/procedure). Outcomes were measured during a baseline period when paper documentation was used and during the early (first 3 months) and late (4-12 months) periods after EHR implementation. There was a worsening in total POTD in the early EHR period (83%) vs paper baseline (41%) (P system implementation was associated with worsening of intraoperative nursing documentation time especially in shorter procedures. However, it is possible to implement an EHR OR management system without serious negative impacts on surgical volume and staffing requirements.

  5. Nurse Staffing Patterns and Patient Experience of Care: An Empirical Analysis of U.S. Hospitals.

    Science.gov (United States)

    Oppel, Eva-Maria; Young, Gary J

    2017-08-14

    To examine the relationship between nurse staffing patterns and patients' experience of care in hospitals with a particular focus on staffing flexibility. The study sample comprised U.S. general hospitals between 2010 and 2012. Nurse staffing data came from the American Hospital Association Annual Survey, and patient experience data came from the Medicare Hospital Consumer Assessment of Healthcare Providers and Systems. An observational research design was used entailing a pooled, cross-sectional data set. Regression models were estimated using generalized estimating equation (GEE) and hospital fixed effects. Nurse staffing patterns were assessed based on both levels (i.e., ratio of full-time equivalent nurses per 1,000 patient days) and composition (i.e., skill mix-percentage of registered nurses; staffing flexibility-percentage of part-time nurses). All three staffing variables were significantly associated with patient experience in the GEE analysis, but only staffing flexibility was significant in the fixed-effects analysis. A higher percentage of part-time nurses was positively associated with patient experience. Multiplicative and nonlinear effects for the staffing variables were also observed. Among three staffing variables, flexibility was found to be the most important relative to patient experience. Unobserved hospital characteristics appear to underlie patient experience as well as certain nurse staffing patterns. © Health Research and Educational Trust.

  6. Consequences of Inadequate Staffing Include Missed Care, Potential Failure to Rescue, and Job Stress and Dissatisfaction.

    Science.gov (United States)

    Simpson, Kathleen Rice; Lyndon, Audrey; Ruhl, Catherine

    2016-01-01

    To evaluate responses of registered nurse members of the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) to a survey that sought their recommendations for staffing guidelines and their perceptions of the consequences of inadequate nurse staffing. The goal was to use these member data to inform the work of the AWHONN nurse staffing research team. Secondary analysis of responses to the 2010 AWHONN nurse staffing survey. Online. AWHONN members (N = 884). Review of data from an online survey of AWHONN members through the use of thematic analysis for descriptions of the consequences of inadequate nurse staffing during the childbirth process. Three main themes emerged as consequences of inadequate staffing or being short-staffed: Missed Care, Potential for Failure to Rescue, and Job-Related Stress and Dissatisfaction. These themes are consistent with those previously identified in the literature related to inadequate nurse staffing. Based on the responses from participants in the 2010 AWHONN nurse staffing survey, consequences of inadequate staffing can be quite serious and may put patients at risk for preventable harm. Copyright © 2016 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  7. Staffing in postnatal units: is it adequate for the provision of quality care? Staff perspectives from a state-wide review of postnatal care in Victoria, Australia

    Directory of Open Access Journals (Sweden)

    Lumley Judith

    2006-07-01

    Full Text Available Abstract Background State-wide surveys of recent mothers conducted over the past decade in Victoria, one state of Australia, have identified that women are consistently less satisfied with the care they received in hospital following birth compared with other aspects of maternity care. Little is known of caregivers' perspectives on the provision ofhospital postnatal care: how care is organised and provided in different hospitals; what constrains the provision of postnatal care (apart from funding and what initiatives are being undertaken to improve service delivery. A state-widereview of organisational structures and processes in relation to the provision of hospital postnatal care in Victoria was undertaken. This paper focuses on the impact of staffing issues on the provision of quality postnatal care from the perspective of care providers. Methods A study of care providers from Victorian public hospitals that provide maternity services was undertaken. Datawere collected in two stages. Stage one: a structured questionnaire was sent to all public hospitals in Victoria that provided postnatal care (n = 73, exploring the structure and organisation of care (e.g. staffing, routine observations, policy framework and discharge planning. Stage two: 14 maternity units were selected and invited to participate in a more in-depth exploration of postnatal care. Thirty-eight key informant interviews were undertaken with midwives (including unit managers, associate unit managers and clinical midwives and a medical practitioner from eachselected hospital. Results Staffing was highlighted as a major factor impacting on the provision of quality postnatal care. There were significant issues associated with inadequate staff/patient ratios; staffing mix; patient mix; prioritisation of birth suites over postnatal units; and the use of non-permanent staff. Forty-three percent of hospitals reported having only midwives (i.e. no non-midwives providing postnatal care

  8. When caring stops, staffing doesn't matter: part II.

    Science.gov (United States)

    Douglas, Kathy

    2011-01-01

    Response to a column on caring and staffing struck a cord with Nursing Economic$ readers worldwide. Measuring caring is complicated and a healthy debate exists over how exactly to do it. The extraordinary work of Dr. Jean Watson is an excellent resource for understanding how to measure and monitor caring. Beneath the instruments for measuring caring sits foundational work that can help us clarify and understand the topic of caring and just where it sits in our philosophies, intentions, patient care models, and care delivery systems.

  9. California's minimum-nurse-staffing legislation and nurses' wages.

    Science.gov (United States)

    Mark, Barbara; Harless, David W; Spetz, Joanne

    2009-01-01

    In 2004, California became the first state to implement minimum-nurse-staffing ratios in acute care hospitals. We examined the wages of registered nurses (RNs) before and after the legislation was enacted. Using four data sets-the National Sample Survey of Registered Nurses, the Current Population Survey, the National Compensation Survey, and the Occupational Employment Statistics Survey-we found that from 2000 through 2006, RNs in California metropolitan areas experienced real wage growth as much as twelve percentage points higher than the growth in the wages of nurses employed in metropolitan areas outside of California.

  10. Innovation: Contact

    African Journals Online (AJOL)

    Principal Contact. Ruth Hoskins Editor University of KwaZulu-Natal, Information Studies Programme Email: hoskinsr@ukzn.ac.za. Support Contact. Gita Ramdass Email: ramdass@ukzn.ac.za. ISSN: 1025-8892. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More ...

  11. Factor XII Contact Activation.

    Science.gov (United States)

    Naudin, Clément; Burillo, Elena; Blankenberg, Stefan; Butler, Lynn; Renné, Thomas

    2017-11-01

    Contact activation is the surface-induced conversion of factor XII (FXII) zymogen to the serine protease FXIIa. Blood-circulating FXII binds to negatively charged surfaces and this contact to surfaces triggers a conformational change in the zymogen inducing autoactivation. Several surfaces that have the capacity for initiating FXII contact activation have been identified, including misfolded protein aggregates, collagen, nucleic acids, and platelet and microbial polyphosphate. Activated FXII initiates the proinflammatory kallikrein-kinin system and the intrinsic coagulation pathway, leading to formation of bradykinin and thrombin, respectively. FXII contact activation is well characterized in vitro and provides the mechanistic basis for the diagnostic clotting assay, activated partial thromboplastin time. However, only in the past decade has the critical role of FXII contact activation in pathological thrombosis been appreciated. While defective FXII contact activation provides thromboprotection, excess activation underlies the swelling disorder hereditary angioedema type III. This review provides an overview of the molecular basis of FXII contact activation and FXII contact activation-associated disease states. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  12. Medical marijuana: largest provider closed, some alternatives available.

    Science.gov (United States)

    James, J S

    1998-06-05

    The Cannabis Healing Center, the largest of the medical marijuana buyers' clubs in San Francisco, was shut down on May 25 due to a court order obtained by State Attorney General Dan Lungren. The closure creates an emergency situation for thousands of persons who obtained the drug through the center. City officials are exploring ways to develop guidelines for the medical usage of marijuana that would be consistent with California Proposition 215. Proposition 215 does not nullify Federal laws against marijuana, however, Federal authorities usually allow State or local jurisdictions to handle marijuana enforcement. The three other buyers' clubs in the city are unable to meet the needs of everyone due to insufficient staffing. The closure also shut down the campaign office of Dennis Peron, who was the founder of the previous Cannabis Buyers' Club, and who was running for governor. Contact information and documentation requirements are included for the buyers' clubs.

  13. Business Case Analysis of the Walter Reed Army Medical Center Medical/Surgical Prime Vendor Generation III Service Level Electron Program

    National Research Council Canada - National Science Library

    Markot, Peter B

    2007-01-01

    ...) staffing and medical/surgical services offered under the Prime Vendor (PV) Generation III contract would provide the best supply chain management solution for Walter Reed Army Medical Center (WRAMC...

  14. Improvements in nuclear plant staffing resulting from the AP600 design programme

    International Nuclear Information System (INIS)

    Mycoff, C.

    2001-01-01

    The staffing for a single-unit AP600 is estimated to require a staff for operation and maintenance about 32% smaller than current generation power plants of similar size. These staffing reductions are driven primarily by various features incorporated into the AP600 plant design. (author)

  15. High School Administrative Staffing in Washington State: Principal Perspectives on Resource Needs and Utilization

    Science.gov (United States)

    Steach, John C.

    2011-01-01

    This mixed methods study explored how high school principals prioritize their work and utilize available human resources to adjust to inadequate administrative staffing. Analysis of staffing levels across the state of Washington and specifically inside two eastern Washington districts framed interview questions for central office administration…

  16. The Influence of Nurse Staffing Levels on Quality of Care in Nursing Homes

    Science.gov (United States)

    Hyer, Kathryn; Thomas, Kali S.; Branch, Laurence G.; Harman, Jeffrey S.; Johnson, Christopher E.; Weech-Maldonado, Robert

    2011-01-01

    Objective: This study examines the relationship between increasing certified nursing assistants (CNAs) and licensed nurse staffing ratios and deficiencies in Florida nursing homes over a 4-year period. Methods: Data from Florida staffing reports and the Online Survey Certification and Reporting database examine the relationship among staffing…

  17. Pre-hospital critical care by anaesthesiologist-staffed pre-hospital services in Scandinavia

    DEFF Research Database (Denmark)

    Krüger, A J; Lossius, H M; Mikkelsen, S

    2013-01-01

    All Scandinavian countries provide anaesthesiologist-staffed pre-hospital services. Little is known of the incidence of critical illness or injury attended by these services. We aimed to investigate anaesthesiologist-staffed pre-hospital services in Scandinavia with special emphasis on incidence...

  18. Preparing emergency personnel in dialysis: a just-in-time training program for additional staffing during disasters.

    Science.gov (United States)

    Stoler, Genevieve B; Johnston, James R; Stevenson, Judy A; Suyama, Joe

    2013-06-01

    There are 341 000 patients in the United States who are dependent on routine dialysis for survival. Recent large-scale disasters have emphasized the importance of disaster preparedness, including supporting dialysis units, for people with chronic disease. Contingency plans for staffing are important for providing continuity of care for a technically challenging procedure such as dialysis. PReparing Emergency Personnel in Dialysis (PREP-D) is a just-in-time training program designed to train individuals having minimum familiarity with the basic steps of dialysis to support routine dialysis staff during a disaster. A 5-module educational program was developed through a collaborative, multidisciplinary effort. A pilot study testing the program was performed using 20 nontechnician dialysis facility employees and 20 clinical-year medical students as subjects. When comparing pretest and posttest scores, the entire study population showed a mean improvement of 28.9%, with dialysis facility employees and medical students showing improvements of 21.8% and 36.4%, respectively (P just-in-time training format. The knowledge gained by using the PREP-D program during a staffing shortage may allow for continuity of care for critical services such as dialysis during a disaster.

  19. Risk-Adjusted Staffing to Improve Patient Value.

    Science.gov (United States)

    Pappas, Sharon; Davidson, Nan; Woodard, Jim; Davis, Jennifer; Welton, John M

    2015-01-01

    The presence of hospital-acquired conditions, infections, or other adverse events are a reflection of inadequate patient safety and can have short and long-term impacts of quality of life for patients as well as financial implications for the hospital. Using unit-level information to develop a tool, the Patient Risk Assessment Profile, nurses on an inpatient surgical unit proactively assessed patient risk to guide staffing decisions and nurse-patient assignment with the goal to improve patient value, reduce adverse events, and avoid unnecessary hospital costs. Findings showed decreased adverse event rates for patient falls, catheter-acquired urinary tract infection, central line-acquired blood stream infection, and pressure ulcer prevalence after the intervention was implemented. In addition, end-of-shift over-time and patient cost per case decreased as well yielding an operational impact in hospital financial performance.

  20. Staffing and Workflow of a Maturing Institutional Repository

    Directory of Open Access Journals (Sweden)

    Debora L. Madsen

    2013-02-01

    Full Text Available Institutional repositories (IRs have become established components of many academic libraries. As an IR matures it will face the challenge of how to scale up its operations to increase the amount and types of content archived. These challenges involve staffing, systems, workflows, and promotion. In the past eight years, Kansas State University's IR (K-REx has grown from a platform for student theses, dissertations, and reports to also include faculty works. The initial workforce of a single faculty member was expanded as a part of a library-wide reorganization, resulting in a cross-departmental team that is better able to accommodate the expansion of the IR. The resultant need to define staff responsibilities and develop resources to manage the workflows has led to the innovations described here, which may prove useful to the greater library community as other IRs mature.

  1. Managerial Ownership in Nursing Homes: Staffing, Quality, and Financial Performance.

    Science.gov (United States)

    Huang, Sean Shenghsiu; Bowblis, John R

    2017-06-20

    Ownership of nursing homes (NHs) has primarily focused broadly on differences between for-profit (FP), nonprofit (NFP), and government-operated facilities. Yet, among FPs, the understanding of detailed ownership structures at individual NHs is rather limited. Particularly, NH administrators may hold significant equity interests in their facilities, leading to heterogeneous financial incentives and NH outcomes. Through the principal-agent theory, this article studies how managerial ownership of individual facilities affects NH outcomes. We use a unique panel dataset of Ohio NHs (2005-2010) to empirically examine the relationship between managerial equity ownership and NH staffing, quality, and financial performance. We identify facility administrators as owner-managers if they have more than 5% of the equity stakes or are relatives of the owners. The statistical analysis is based on the pooled ordinary least squares and NH-fixed effect models. We find that owner-managed NHs are associated with higher nursing staff levels compared to other FP NHs. Surprisingly, despite higher staffing levels, owner-managed NHs are not associated with better quality and we find no statistically significant difference in financial performance between owner-managed and nonowner-managed FP NHs. Our results do not support the principal-agent model and we offer alternative explanations for future research. Our findings provide empirical evidence that NH ownership structures are more nuanced than simply broadly categorizing facilities as FP or NFP, and our results do not fully align with the standard principal-agent model. The role of managerial ownership should be considered in future NH research and policy discussions. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  2. Analysis of patients with bodyboarding injuries transported by physician-staffed emergency helicopter

    Directory of Open Access Journals (Sweden)

    Kazuhiko Omori

    2015-01-01

    Full Text Available Context: There have been no reports that have studied the characteristics specific to bodyboard injuries. Aims: To clarify characteristics to bodyboard injuries. Settings and Design: A retrospective medical chart review. Materials and Methods: A medical chart review was retrospectively performed for all patients with spinal cord injuries transported via physician-staffed emergency helicopters between January 2009 and October 2013. The subjects were divided into two groups based on whether they had a spinal cord injury induced by bodyboarding (Bodyboard group, n = 14 or not (Control group, n = 14. Statistical Analysis Used: Using a χ2 -test, Mann-Whitney U-test and non-paired Student′s t-test. Results: All but one of the subjects had spinal canal stenosis. The age of the patients in the Bodyboard group was younger than that of the Control group. The ratio of males and Glasgow Coma Scale of the Bodyboard group were higher than those on the Control group. The spinal cord injury induced by bodyboarding typically occurred after impacts of the head or face with the sea bottom while the subject was being buffeted by the waves. The severity of the spinal cord injury in the Bodyboard group was lower than that in the Control group. Conclusion: Bodyboarding tended to induce spinal cord injuries after the head or face collided with the sea bottom, and was more common in middle-aged males during the summer season, and was associated with a favorable outcome.

  3. How Does Rurality Influence the Staffing of Social Service Departments in Nursing Homes?

    Science.gov (United States)

    Roberts, Amy Restorick; Bowblis, John R

    2017-01-09

    Social service departments in nursing homes (NHs) are staffed by qualified social workers (QSWs) and paraprofessionals. Due to greater workforce challenges in rural areas, this article aims to describe the staffing levels and composition of these departments by rurality. Certification and Survey Provider Enhanced Reports data from 2009 to 2015 are used to examine the effect of rurality on social service staffing using random-effects linear panel regressions. The average NH employed 1.8 full-time equivalents (FTEs), with approximately two thirds of social services staffed by QSWs. Large NHs had more staff, but employed fewer staff hours per resident day. Staffing levels were lower and QSWs made up a smaller percentage of staff in rural areas. National trends indicate variability in staffing by NH size and degree of rurality. Very low staffing within rural NHs is a concern, as staff may have less time to respond to residents' needs and these NHs may utilize fewer QSWs. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. The relationship of California's Medicaid reimbursement system to nurse staffing levels.

    Science.gov (United States)

    Mukamel, Dana B; Kang, Taewoon; Collier, Eric; Harrington, Charlene

    2012-10-01

    Policy initiatives at the Federal and state level are aimed at increasing staffing in nursing homes. These include direct staffing standards, public reporting, and financial incentives. To examine the impact of California's Medicaid reimbursement for nursing homes which includes incentives directed at staffing. Two-stage limited-information maximum-likelihood regressions were used to model the relationship between staffing [registered nurses (RNs), licensed practical nurses, and certified nursing assistants hours per resident day] and the Medicaid payment rate, accounting for the specific structure of the payment system, endogeneity of payment and case-mix, and controlling for facility and market characteristics. A total of 927 California free-standing nursing homes in 2006. The model included facility characteristics (case-mix, size, ownership, and chain affiliation), market competition and excess demand, labor supply and wages, unemployment, and female employment. The instrumental variable for Medicaid reimbursement was the peer group payment rate for 7 geographical market areas, and the instrumental variables for resident case-mix were the average county revenues for professional therapy establishments and the percent of county population aged 65 and over. Consistent with the rate incentives and rational expectation behavior, expected nursing home reimbursement rates in 2008 were associated with increased RN staffing levels in 2006 but had no relationship with licensed practical nurse and certified nursing assistant staffing. The effect was estimated at 2 minutes per $10 increase in rate. The incentives in the Medicaid system impacted only RN staffing suggesting the need to improve the state's rate setting methodology.

  5. [Impact of Increased Supply of Newly Licensed Nurses on Hospital Nurse Staffing and Policy Implications].

    Science.gov (United States)

    Kim, Yunmi; You, Sunju; Kim, Jinhyun

    2017-12-01

    This study aimed to analyze the impact of increasing the supply of newly licensed nurses on improving the hospital nurse staffing grades for the period of 2009~2014. Using public administrative data, we analyzed the effect of newly licensed nurses on staffing in 1,594 hospitals using Generalized Estimating Equation (GEE) ordered logistic regression, and of supply variation on improving staffing grades in 1,042 hospitals using GEE logistic regression. An increase of one newly licensed nurse per 100 beds in general units had significantly lower odds of improving staffing grades (grades 6~0 vs. 7) (odds ratio=0.95, p=.005). The supply of newly licensed nurses increased by 32% from 2009 to 2014, and proportion of hospitals whose staffing grade had improved, not changed, and worsened was 19.1%, 70.1%, and 10.8% respectively. Compared to 2009, the supply variation of newly licensed nurses in 2014 was not significantly related to the increased odds of improving staffing grades in the region (OR=1.02, p=.870). To achieve a balance in the regional supply and demand for hospital nurses, compliance with nurse staffing legislation and revisions in the nursing fee differentiation policy are needed. Rather than relying on increasing nurse supply, retention policies for new graduate nurses are required to build and sustain competent nurse workforce in the future. © 2017 Korean Society of Nursing Science

  6. Staffing decision processes and issues: Case studies of seven US Nuclear Power Plants

    International Nuclear Information System (INIS)

    Melber, B.; Roussel, A.; Baker, K.; Durbin, N.; Hunt, P.; Hauth, J.; Forslund, C.; Terrill, E.; Gore, B.

    1994-03-01

    The objective of this report is to identify how decisions are made regarding staffing levels and positions for a sample of U.S. nuclear power plants. In this report, a framework is provided for understanding the major forces driving staffing and the implications of staffing decisions for plant safety. The focus of this report is on driving forces that have led to changes in staffing levels and to the establishment of new positions between the mid-1980s and the early 1990s. Processes used at utilities and nuclear power plants to make and implement these staffing decisions are also discussed in the report. While general trends affecting the plant as a whole are presented, the major emphasis of this report is on staffing changes and practices in the operations department, including the operations shift crew. The findings in this report are based on interviews conducted at seven nuclear power plants and their parent utilities. A discussion of the key findings is followed by a summary of the implications of staffing issues for plant safety

  7. Contact hysteroscopy.

    Science.gov (United States)

    Baggish, M S; Barbot, J

    1983-06-01

    In 1907 innovations in optics and illumination made by Maximilian Nitze were applied to hysteroscopy by Charles David, who wrote a treatise of hysteroscopy. David improved illumination by placing an electric incandescent bulb at the intrauterine end of his endoscope and also sealed the distal end of the tube with a piece of glass. The history of the contact endoscope that the authors personally used is connected to the invention by Vulmiere (1952) of a revolutionary illumination process in endoscopy--the "cold light" process. The components of cold light consist of a powerful external light source that is transmitted via a special optical guide into the endometrial cavity. The 1st application of his principle (1963) was an optical trochar contained in a metallic sheath. This simple endoscope was perfected, and in 1973 Barbot and Parent, in France, began to use it to examine the uterine cavity. Discussion focuses on methods, instrumentation, method for examination (grasping the instrument, setup, light source, anesthesia, dilatation, technique, and normal endometrium); cervical neoplasia; nonneoplastic lesions of the endometrium (endometrial polyp, submucous myoma, endometrial hyperplasia); intrauterine device localization; neoplastic lesions of the endometrium; precursors (adenocarcinoma); hysteroscopy in pregnancy (embryoscopy, hydatidiform mole, postpartum hemorrhage, incomplete abortion, spontaneous abortion, induced abortions, and amnioscopy); and examinations of children and infants. The contact endoscope must make light contact with the structure to be viewed. The principles of contact endoscopy depend on an interpretation of color, contour, vascular pattern, and a sense of touch. These are computed together and a diagnosis is made on the basis of previously learned clinical pathologic correlations. The contact endoscope is composed of 3 parts: an optical guide; a cylindric chamber that collects and traps ambient light; and a magnifying eyepiece. The phase of

  8. Optimizing staffing, quality, and cost in home healthcare nursing: theory synthesis.

    Science.gov (United States)

    Park, Claire Su-Yeon

    2017-08-01

    To propose a new theory pinpointing the optimal nurse staffing threshold delivering the maximum quality of care relative to attendant costs in home health care. Little knowledge exists on the theoretical foundation addressing the inter-relationship among quality of care, nurse staffing, and cost. Theory synthesis. Cochrane Library, PubMed, CINAHL, EBSCOhost Web and Web of Science (25 February - 26 April 2013; 20 January - 22 March 2015). Most of the existing theories/models lacked the detail necessary to explain the relationship among quality of care, nurse staffing and cost. Two notable exceptions are: 'Production Function for Staffing and Quality in Nursing Homes,' which describes an S-shaped trajectory between quality of care and nurse staffing and 'Thirty-day Survival Isoquant and Estimated Costs According to the Nurse Staff Mix,' which depicts a positive quadric relationship between nurse staffing and cost according to quality of care. A synthesis of these theories led to an innovative multi-dimensional econometric theory helping to determine the maximum quality of care for patients while simultaneously delivering nurse staffing in the most cost-effective way. The theory-driven threshold, navigated by Mathematical Programming based on the Duality Theorem in Mathematical Economics, will help nurse executives defend sufficient nurse staffing with scientific justification to ensure optimal patient care; help stakeholders set an evidence-based reasonable economical goal; and facilitate patient-centred decision-making in choosing the institution which delivers the best quality of care. A new theory to determine the optimum nurse staffing maximizing quality of care relative to cost was proposed. © 2017 The Author. Journal of Advanced Nursing © John Wiley & Sons Ltd.

  9. Variation in cancer surgical outcomes associated with physician and nurse staffing: a retrospective observational study using the Japanese Diagnosis Procedure Combination Database

    Directory of Open Access Journals (Sweden)

    Yasunaga Hideo

    2012-05-01

    Full Text Available Abstract Background Little is known about the effects of professional staffing on cancer surgical outcomes. The present study aimed to investigate the association between cancer surgical outcomes and physician/nurse staffing in relation to hospital volume. Methods We analyzed 131,394 patients undergoing lung lobectomy, esophagectomy, gastrectomy, colorectal surgery, hepatectomy or pancreatectomy for cancer between July and December, 2007–2008, using the Japanese Diagnosis Procedure Combination database linked to the Survey of Medical Institutions data. Physician-to-bed ratio (PBR and nurse-to-bed ratio (NBR were determined for each hospital. Hospital volume was categorized into low, medium and high for each of six cancer surgeries. Failure to rescue (FTR was defined as a proportion of inhospital deaths among those with postoperative complications. Multi-level logistic regression analysis was performed to examine the association between physician/nurse staffing and FTR, adjusting for patient characteristics and hospital volume. Results Overall inhospital mortality was 1.8%, postoperative complication rate was 15.2%, and FTR rate was 11.9%. After adjustment for hospital volume, FTR rate in the group with high PBR (≥19.7 physicians per 100 beds and high NBR (≥77.0 nurses per 100 beds was significantly lower than that in the group with low PBR ( Conclusions Well-staffed hospitals confer a benefit for cancer surgical patients regarding reduced FTR, irrespective of hospital volume. These results suggest that consolidation of surgical centers linked with migration of medical professionals may improve the quality of cancer surgical management.

  10. Does safety climate moderate the influence of staffing adequacy and work conditions on nurse injuries?

    Science.gov (United States)

    Mark, Barbara A; Hughes, Linda C; Belyea, Michael; Chang, Yunkyung; Hofmann, David; Jones, Cheryl B; Bacon, Cynthia T

    2007-01-01

    Hospital nurses have one of the highest work-related injury rates in the United States. Yet, approaches to improving employee safety have generally focused on attempts to modify individual behavior through enforced compliance with safety rules and mandatory participation in safety training. We examined a theoretical model that investigated the impact on nurse injuries (back injuries and needlesticks) of critical structural variables (staffing adequacy, work engagement, and work conditions) and further tested whether safety climate moderated these effects. A longitudinal, non-experimental, organizational study, conducted in 281 medical-surgical units in 143 general acute care hospitals in the United States. Work engagement and work conditions were positively related to safety climate, but not directly to nurse back injuries or needlesticks. Safety climate moderated the relationship between work engagement and needlesticks, while safety climate moderated the effect of work conditions on both needlesticks and back injuries, although in unexpected ways. DISCUSSION AND IMPACT ON INDUSTRY: Our findings suggest that positive work engagement and work conditions contribute to enhanced safety climate and can reduce nurse injuries.

  11. Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study.

    Science.gov (United States)

    Aiken, Linda H; Sloane, Douglas M; Bruyneel, Luk; Van den Heede, Koen; Griffiths, Peter; Busse, Reinhard; Diomidous, Marianna; Kinnunen, Juha; Kózka, Maria; Lesaffre, Emmanuel; McHugh, Matthew D; Moreno-Casbas, M T; Rafferty, Anne Marie; Schwendimann, Rene; Scott, P Anne; Tishelman, Carol; van Achterberg, Theo; Sermeus, Walter

    2014-05-24

    for an average of eight patients. Nurse staffing cuts to save money might adversely affect patient outcomes. An increased emphasis on bachelor's education for nurses could reduce preventable hospital deaths. European Union's Seventh Framework Programme, National Institute of Nursing Research, National Institutes of Health, the Norwegian Nurses Organisation and the Norwegian Knowledge Centre for the Health Services, Swedish Association of Health Professionals, the regional agreement on medical training and clinical research between Stockholm County Council and Karolinska Institutet, Committee for Health and Caring Sciences and Strategic Research Program in Care Sciences at Karolinska Institutet, Spanish Ministry of Science and Innovation. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Comparison of physician staffed emergency teams with paramedic teams assisted by telemedicine--a randomized, controlled simulation study.

    Science.gov (United States)

    Rörtgen, Daniel; Bergrath, Sebastian; Rossaint, Rolf; Beckers, Stefan K; Fischermann, Harold; Na, In-Sik; Peters, David; Fitzner, Christina; Skorning, Max

    2013-01-01

    Emergency medical services (EMSs) vary considerably. While some are physician staffed, most systems are run by paramedics. The objective of this randomized, controlled simulation study was to compare the emergency care between physician staffed EMS teams (control group) and paramedic teams that were supported telemedically by an EMS physician (telemedicine group). Overall 16 teams (1 EMS physician, 2 paramedics) were randomized to the control group or the telemedicine group. Telemedical functionalities included two-way audio communication, transmission of vital data (numerical values and curves) and video streaming from the scenario room to the remotely located EMS physician. After a run-in scenario all teams completed four standardized scenarios, in which no highly invasive procedures (e.g. thoracic drain) were required, two using high-fidelity simulation (burn trauma, intoxication) and two using standardized patients (renal colic, barotrauma). All scenarios were videotaped and analyzed by two investigators using predefined scoring items. Non case-specific items (31 vs. 31 scenarios): obtaining of 'symptoms', 'past medical history' and 'events' were carried out comparably, but in the telemedicine group 'allergies' (17 vs. 28, OR 7.69, CI 2.1-27.9, p=0.002) and 'medications' (17 vs. 27, OR 5.55, CI 1.7-18.0, p=0.004) were inquired more frequently. No significant differences were found regarding the case-specific items and in both groups no potentially dangerous mistreatments were observed. Telemedically assisted paramedic care was feasible and at least not inferior compared to standard EMS teams with a physician on-scene in these scenarios. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  13. Extension Staffing Models to Serve 4-H Clientele in Changing Times

    Directory of Open Access Journals (Sweden)

    Donna R. Gillespie

    2010-03-01

    Full Text Available In response to budget cuts in 2002, 4-H staffing models were restructured. The response by University of Idaho Extension was intended to continue meeting the needs of Idaho’s citizens with fewer UI Extension faculty. This staffing reorganization led to the formation of the District III 4-H Team who united to bring stronger 4-H programs to south central Idaho and expand programs to underserved audiences. Information from surveys and interviews over the past seven years reflects the effectiveness, challenges and successes of the District III 4-H Team. In Making the Best Better: 4-H Staffing Patterns and Trends in the Largest Professional Network in the Nation (2007, author Kirk A. Astroth notes a nationwide change in 4-H leadership at the county level from 4-H faculty to program assistants or coordinators. The information gathered in our research may help other states determine staffing models to meet the needs of clientele in these changing times.

  14. Synthesis of the project leadership staffing needs for successful development of alternative delivery programs.

    Science.gov (United States)

    2017-08-01

    This research provides a synthesis of practices in organizational structuring and professional staffing of the innovative delivery units in several state DOTs across the nation that are actively utilizing alternative project delivery. Several major c...

  15. Optimizing Fire Department Operations Through Work Schedule Analysis, Alternative Staffing, and Nonproductive Time Reduction

    Science.gov (United States)

    2014-09-01

    fatigue attributed to work-related stressors .19 On the other hand, research has shown that the 48/96 schedule exacerbates sleep deprivation issues...health and wellness initiatives, brown-out, fire department funding, peak-usage staffing, four-person staffing, schedule modification, sleep deprivation ...to a significant sleep deprivation risk that impacts the employee’s ability to function at peak levels.7 The 10/14-hour schedule produces better

  16. Medications (for IBS)

    Medline Plus

    Full Text Available ... Month IBS Awareness Month Tips of the Day Art of IBS Gallery Contact Us About IBS Twitter ... Month IBS Awareness Month Tips of the Day Art of IBS Gallery Contact Us Medications Details Medications ...

  17. Medications (for IBS)

    Medline Plus

    Full Text Available ... Gallery Contact Us About IBS Twitter Facebook YouTube Search Search ... About Us What is IBS? What is IBS? ... the Day Art of IBS Gallery Contact Us Search Medications Details Medications Last Updated: 01 July 2017 ...

  18. Medications (for IBS)

    Medline Plus

    Full Text Available ... Month Tips of the Day Art of IBS Gallery Contact Us About IBS Twitter Facebook YouTube Search ... Month Tips of the Day Art of IBS Gallery Contact Us Medications Details Medications Last Updated: 01 ...

  19. Prioritized Contact Transport Stream

    Science.gov (United States)

    Hunt, Walter Lee, Jr. (Inventor)

    2015-01-01

    A detection process, contact recognition process, classification process, and identification process are applied to raw sensor data to produce an identified contact record set containing one or more identified contact records. A prioritization process is applied to the identified contact record set to assign a contact priority to each contact record in the identified contact record set. Data are removed from the contact records in the identified contact record set based on the contact priorities assigned to those contact records. A first contact stream is produced from the resulting contact records. The first contact stream is streamed in a contact transport stream. The contact transport stream may include and stream additional contact streams. The contact transport stream may be varied dynamically over time based on parameters such as available bandwidth, contact priority, presence/absence of contacts, system state, and configuration parameters.

  20. Association between patient classification systems and nurse staffing costs in intensive care units: An exploratory study.

    Science.gov (United States)

    Stafseth, Siv K; Tønnessen, Tor Inge; Fagerström, Lisbeth

    2018-04-01

    Nurse staffing costs represent approximately 60% of total intensive care unit costs. In order to analyse resource allocation in intensive care, we examined the association between nurse staffing costs and two patient classification systems: the nursing activities score (NAS) and nine equivalents of nursing manpower use score (NEMS). A retrospective descriptive correlational analysis of nurse staffing costs and data of 6390 patients extracted from a data warehouse. Three intensive care units in a university hospital and one in a regional hospital in Norway. Nurse staffing costs, NAS and NEMS. For merged data from all units, the NAS was more strongly correlated with monthly nurse staffing costs than was the NEMS. On separate analyses of each ICU, correlations were present for the NAS on basic costs and external overtime costs but were not significant. The annual mean nurse staffing cost for 1% of NAS was 20.9-23.1 euros in the units, which was comparable to 53.3-81.5 euros for 1 NEMS point. A significant association was found between monthly costs, NAS, and NEMS. Cost of care should be based on individual patients' nursing care needs. The NAS makes nurses' workload visible and may be a helpful classification system in future planning and budgeting of intensive care resources. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. [Structure of nurse labor market and determinants of hospital nurse staffing levels].

    Science.gov (United States)

    Park, Bohyun; Seo, Sukyung; Lee, Taejin

    2013-02-01

    To analyze the structure of Korean nurse labor market and examine its effect on hospital nurse staffing. Secondary data were obtained from Statistics Korea, Education Statistics, and Health Insurance Review & Assessment Service and Patient Survey. Intensity of monopsony in the nurse labor market was measured by Herfindahl Hirshman Index (HHI). Hospital nurse staffing level was divided into high and low. While controlling for confounding factors such as inpatient days and severity mix of patients, effects of characteristics of nurse labor markets on nurse staffing levels were examined using multi-level logistic regressions. For characteristics of nurse labor markets, metropolitan areas had high intensity of monopsony, while the capital area had competitive labor market and the unemployed nurse rate was higher than other areas. Among hospital characteristics, bed occupancy rate was significantly associated with nurse staffing levels. Among characteristics of nurse labor markets, the effect of HHI was indeterminable. The Korean nurse labor market has different structure between the capital and other metropolitan areas. But the effect of the structure of nurse labor market on nurse staffing levels is indeterminable. Characteristics such as occupancy rate and number of beds are significantly associated with nurse staffing levels. Further study in support of the effect of nurse labor market is needed.

  2. Nurse burnout in China: a questionnaire survey on staffing, job satisfaction, and quality of care.

    Science.gov (United States)

    Lu, Minmin; Ruan, Hui; Xing, Weijie; Hu, Yan

    2015-05-01

    The investigators examined how nurse staffing affects nurse job satisfaction and quality of care. Inadequate nurse staffing is a worldwide issue with profound effects on nurse job satisfaction and quality of care. Few studies have examined the relationship between nurse staffing and job satisfaction and quality of care in China. A cross-sectional design was adopted, wherein 873 nurses were surveyed on demographics, nurse staffing, job-related burnout, job dissatisfaction, intent to leave, and quality of care. The median patient-nurse ratio was five; 45.1% nurses reported high levels of job-related burnout, and 55.6%, job dissatisfaction. In adjusted regression models, patient-nurse ratios of four or less were related to a decrease in the odds of job dissatisfaction (odds ratio 0.55, 95% confidence interval 0.36-0.85) and increase in the odds of quality of care (odds ratio 1.78, 95% confidence interval 1.02-2.82). Nurse staffing is associated with job dissatisfaction and quality of care. Nurse managers should maintain an adequate level of nurse staffing, referring to the patient-nurse ratio. They should create new initiatives to increase job satisfaction among nurses and to evaluate their effects. © 2013 John Wiley & Sons Ltd.

  3. The effects of nurse staffing on hospital financial performance: competitive versus less competitive markets.

    Science.gov (United States)

    Everhart, Damian; Neff, Donna; Al-Amin, Mona; Nogle, June; Weech-Maldonado, Robert

    2013-01-01

    Hospitals facing financial uncertainty have sought to reduce nurse staffing as a way to increase profitability. However, nurse staffing has been found to be important in terms of quality of patient care and nursing-related outcomes. Nurse staffing can provide a competitive advantage to hospitals and as a result of better financial performance, particularly in more competitive markets. In this study, we build on the Resource-Based View of the Firm to determine the effect of nurse staffing on total profit margin in more competitive and less competitive hospital markets in Florida. By combining a Florida statewide nursing survey with the American Hospital Association Annual Survey and the Area Resource File, three separate multivariate linear regression models were conducted to determine the effect of nurse staffing on financial performance while accounting for market competitiveness. The analysis was limited to acute care hospitals. Nurse staffing levels had a positive association with financial performance (β = 3.3, p = .02) in competitive hospital markets, but no significant association was found in less competitive hospital markets. Hospitals in more competitive hospital markets should reconsider reducing nursing staff, as these cost-cutting measures may be inefficient and negatively affect financial performance.

  4. [Computers and contact dermatitis].

    Science.gov (United States)

    Dooms-Goossens, A

    1989-01-01

    A computerized database with the complete composition of pharmaceutical products and some cosmetics helps the patient with an allergic contact dermatitis reaction to avoid his specific allergens. Together with a database with patient information (12000 cases) this product, file serves as the basis for an expert system that assists the dermatologist during his every day clinical practice. The use of the computer in the field of contact dermatitis has gained much interest in the course of the last decade. In fact, the computer can be a particularly helpful tool in: 1. The storage of large amounts of data that can help to identify the patient's allergen microenvironment: --literature: articles related to contact dermatitis problems; --product information such as, for example, the composition of pharmaceutical, cosmetics, and industrial materials; --the dermatologist: the filling in of a standardized anamnesis from also helps to assure that relevant clinical data is not overlooked. 2. The diagnosis of allergic contact dermatitis: on the basis of all these data stored, an expert system can be developed to provide targeted information to assist the physician with the anamnesis of a new patient. Depending on the profile of the patient, several factors that could be at the source of the contact dermatitis, such as the patient's profession, hobbies, and use of pharmaceutical products and cosmetics, can be considered, thus increasing the efficiency of the allergological examination considerably. 3. Research in contact dermatitis: --The data can be used for epidemiological analyses in behalf of the patients, the medical profession, the industry, and the authorities.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. Staffing requirements for future small and medium reactors

    International Nuclear Information System (INIS)

    McQuade, D.

    2001-01-01

    As power generators around the world grapple with the challenges of the environment, deregulation, competitions and changing prices of fuels, the economics of running a future power plant are influenced significantly by the component of labour costs. These costs, from plant staff, corporate support and purchased services, will affect the overall plant economics. To achieve improved efficiency and effectiveness of organization structures and staff, vendors and utilities are working jointly to apply lessons learned for future designs. This paper will examine the experience gained to date with Canadian CANDU 6 type reactors both in Canada and abroad. The strategies which have been very successful will be reviewed, together with the results of collaboration between Atomic Energy of Canada and the utilities. An assessment of the staffing numbers is provided as a comparison between current number at a Canadian utility and the projected number from a future plant with the improvements in the design. The influence to the overall plant economics are discussed with some broad generalities that look at the effects of increasing and reducing staff levels showing the probable impact on capacity factor. The lessons from other plants can contribute significantly to the performance improvement process. The paper points to the need for a balanced approach in the future for the distribution of operating maintenance and administration (OM and A) cost between nuclear safety studies; maintenance programs and staff training. In the future, utilities, together with the designers, will have to greatly improve plant maintenance and training. The improved design features detailed in the paper will support this strategy by utilizing operational experience. (author)

  6. The association between nurse staffing and omissions in nursing care: a systematic review.

    Science.gov (United States)

    Griffiths, Peter; Recio-Saucedo, Alejandra; Dall'Ora, Chiara; Briggs, Jim; Maruotti, Antonello; Meredith, Paul; Smith, Gary B; Ball, Jane

    2018-03-08

    To identify nursing care most frequently missed in acute adult inpatient wards and determine evidence for the association of missed care with nurse staffing. Research has established associations between nurse staffing levels and adverse patient outcomes including in-hospital mortality. However, the causal nature of this relationship is uncertain and omissions of nursing care (referred as missed care, care left undone or rationed care) have been proposed as a factor which may provide a more direct indicator of nurse staffing adequacy. Systematic review. We searched the Cochrane Library, CINAHL, Embase and Medline (2006-2016) for quantitative studies of associations between staffing and missed care. We searched key journals, personal libraries and reference lists of articles. Two reviewers independently selected studies. Quality appraisal was based on the National Institute for Health and Care Excellence quality appraisal checklist for studies reporting correlations and associations. Data were abstracted on study design, missed care prevalence and measures of association. Synthesis was narrative. Eighteen studies gave subjective reports of missed care. 75% or more nurses reported omitting some care. Fourteen studies found low nurse staffing levels were significantly associated with higher reports of missed care. There was little evidence that adding support workers to the team reduced missed care. Low Registered Nurse staffing is associated with reports of missed nursing care in hospitals. Missed care is a promising indicator of nurse staffing adequacy. The extent to which the relationships observed represent actual failures is yet to be investigated. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  7. EDITORIAL: Close contact Close contact

    Science.gov (United States)

    Demming, Anna

    2010-07-01

    The development of scanning probe techniques, such as scanning tunnelling microscopy [1], has often been touted as the catalyst for the surge in activity and progress in nanoscale science and technology. Images of nanoscale structural detail have served as an invaluable investigative resource and continue to fascinate with the fantastical reality of an intricate nether world existing all around us, but hidden from view of the naked eye by a disparity in scale. As is so often the case, the invention of the scanning tunnelling microscope heralded far more than just a useful new apparatus, it demonstrated the scope for exploiting the subtleties of electronic contact. The shrinking of electronic devices has been a driving force for research into molecular electronics, in which an understanding of the nature of electronic contact at junctions is crucial. In response, the number of experimental techniques in molecular electronics has increased rapidly in recent years. Scanning tunnelling microscopes have been used to study electron transfer through molecular films on a conducting substrate, and the need to monitor the contact force of scanning tunnelling electrodes led to the use of atomic force microscopy probes coated in a conducting layer as studied by Cui and colleagues in Arizona [2]. In this issue a collaboration of researchers at Delft University and Leiden University in the Netherlands report a new device architecture for the independent mechanical and electrostatic tuning of nanoscale charge transport, which will enable thorough studies of molecular transport in the future [3]. Scanning probes can also be used to pattern surfaces, such as through spatially-localized Suzuki and Heck reactions in chemical scanning probe lithography. Mechanistic aspects of spatially confined Suzuki and Heck chemistry are also reported in this issue by researchers in Oxford [4]. All these developments in molecular electronics fabrication and characterization provide alternative

  8. Examining the value of inpatient nurse staffing: an assessment of quality and patient care costs.

    Science.gov (United States)

    Martsolf, Grant R; Auerbach, David; Benevent, Richele; Stocks, Carol; Jiang, H Joanna; Pearson, Marjorie L; Ehrlich, Emily D; Gibson, Teresa B

    2014-11-01

    Inpatient quality deficits have important implications for the health and well-being of patients. They also have important financial implications for payers and hospitals by leading to longer lengths of stay and higher intensity of treatment. Many of these costly quality deficits are particularly sensitive to nursing care. To assess the effect of nurse staffing on quality of care and inpatient care costs. Longitudinal analysis using hospital nurse staffing data and the Healthcare Cost and Utilization Project State Inpatient Databases from 2008 through 2011. Hospital discharges from California, Nevada, and Maryland (n=18,474,860). A longitudinal, hospital-fixed effect model was estimated to assess the effect of nurse staffing levels and skill mix on patient care costs, length of stay, and adverse events, adjusting for patient clinical and demographic characteristics. Increases in nurse staffing levels were associated with reductions in nursing-sensitive adverse events and length of stay, but did not lead to increases in patient care costs. Changing skill mix by increasing the number of registered nurses, as a proportion of licensed nursing staff, led to reductions in costs. The study findings provide support for the value of inpatient nurse staffing as it contributes to improvements in inpatient care; increases in staff number and skill mix can lead to improved quality and reduced length of stay at no additional cost.

  9. Toward cost-effective staffing mixes for Veterans Affairs substance use disorder treatment programs.

    Science.gov (United States)

    Im, Jinwoo J; Shachter, Ross D; Finney, John W; Trafton, Jodie A

    2015-11-23

    In fiscal year (FY) 2008, 133,658 patients were provided services within substance use disorders treatment programs (SUDTPs) in the U.S. Department of Veterans Affairs (VA) health care system. To improve the effectiveness and cost-effectiveness of SUDTPs, we analyze the impacts of staffing mix on the benefits and costs of specialty SUD services. This study demonstrates how cost-effective staffing mixes for each type of VA SUDTPs can be defined empirically. We used a stepwise method to derive prediction functions for benefits and costs based on patients' treatment outcomes at VA SUDTPs nationally from 2001 to 2003, and used them to formulate optimization problems to determine recommended staffing mixes that maximize net benefits per patient for four types of SUDTPs by using the solver function with the Generalized Reduced Gradient algorithm in Microsoft Excel 2010 while conforming to limits of current practice. We conducted sensitivity analyses by varying the baseline severity of addiction problems between lower (2.5 %) and higher (97.5 %) values derived from bootstrapping. Compared to the actual staffing mixes in FY01-FY03, the recommended staffing mixes would lower treatment costs while improving patients' outcomes, and improved net benefits are estimated from $1472 to $17,743 per patient.

  10. The relationship of staffing and work environment with implicit rationing of nursing care in Swiss nursing homes--A cross-sectional study.

    Science.gov (United States)

    Zúñiga, Franziska; Ausserhofer, Dietmar; Hamers, Jan P H; Engberg, Sandra; Simon, Michael; Schwendimann, René

    2015-09-01

    Implicit rationing of nursing care refers to the withdrawal of or failure to carry out necessary nursing care activities due to lack of resources, in the literature also described as missed care, omitted care, or nursing care left undone. Under time constraints, nurses give priority to activities related to vital medical needs and the safety of the patient, leaving out documentation, rehabilitation, or emotional support of patients. In nursing homes, little is known about the occurrence of implicit rationing of nursing care and possible contributing factors. The purpose of this study was (1) to describe levels and patterns of self-reported implicit rationing of nursing care in Swiss nursing homes and (2) to explore the relationship between staffing level, turnover, and work environment factors and implicit rationing of nursing care. Cross-sectional, multi-center sub-study of the Swiss Nursing Home Human Resources Project (SHURP). Nursing homes from all three language regions of Switzerland. A random selection of 156 facilities with 402 units and 4307 direct care workers from all educational levels (including 25% registered nurses). We utilized data from established scales to measure implicit rationing of nursing care (Basel Extent of Rationing of Nursing Care), perceptions of leadership ability and staffing resources (Practice Environment Scale of the Nursing Work Index), teamwork and safety climate (Safety Attitudes Questionnaire), and work stressors (Health Professions Stress Inventory). Staffing level and turnover at the unit level were measured with self-developed questions. Multilevel linear regression models were used to explore the proposed relationships. Implicit rationing of nursing care does not occur frequently in Swiss nursing homes. Care workers ration support in activities of daily living, such as eating, drinking, elimination and mobilization less often than documentation of care and the social care of nursing homes residents. Statistically

  11. Perceptions of Risk and Safety in the ICU: A Qualitative Study of Cognitive Processes Relating to Staffing.

    Science.gov (United States)

    D'Lima, Danielle M; Murray, Eleanor J; Brett, Stephen J

    2018-01-01

    The aims of this study were to 1) examine individual professionals' perceptions of staffing risks and safe staffing in intensive care and 2) identify and examine the cognitive processes that underlie these perceptions. Qualitative case study methodology with nurses, doctors, and physiotherapists. Three mixed medical and surgical adult ICUs, each on a separate hospital site within a 1,200-bed academic, tertiary London hospital group. Forty-four ICU team members of diverse professional backgrounds and seniority. None. Four themes (individual, team, unit, and organizational) were identified. Individual care provision was influenced by the pragmatist versus perfectionist stance of individuals and team dynamics by the concept of an "A" team and interdisciplinary tensions. Perceptions of safety hinged around the importance of achieving a "dynamic balance" influenced by the burden of prevailing circumstances and the clinical status of patients. Organizationally, professionals' risk perceptions affected their willingness to take personal responsibility for interactions beyond the unit. This study drew on cognitive research, specifically theories of cognitive dissonance, psychological safety, and situational awareness to explain how professionals' cognitive processes impacted on ICU behaviors. Our results may have implications for relationships, management, and leadership in ICU. First, patient care delivery may be affected by professionals' perfectionist or pragmatic approach. Perfectionists' team role may be compromised and they may experience cognitive dissonance and subsequent isolation/stress. Second, psychological safety in a team may be improved within the confines of a perceived "A" team but diminished by interdisciplinary tensions. Third, counter intuitively, higher "situational" awareness for some individuals increased their stress and anxiety. Finally, our results suggest that professionals have varying concepts of where their personal responsibility to minimize

  12. An international comparison of commercial nuclear power plant staffing regulations and practice, 1980--1990

    International Nuclear Information System (INIS)

    Melber, B.; Hauth, J.; Terrill, E.; Berk, B.; Gore, B.

    1994-03-01

    In this report an international review of regulatory and industry practices is provided in the area of nuclear power plant staffing during the 1980s in Canada, France, Germany, Japan, Sweden, and the United Kingdom. The objective of this review is to highlight trends in staffing regulatory approaches, industry practices, and issues of concern in other countries that have potential relevance to nuclear power plant staffing issues in the United States. The decade of the 1980s was marked by a great deal of growth in nuclear power operations internationally; however, growth of nuclear power is not expected to continue in the 1990s except in France and Japan. A continuum of regulatory approaches to staffing was identified, ranging from prescribed regulations that are applied to all licensees (Germany is most similar to the United States in this regard), to indirect staffing regulations where the regulatory authority oversees plant operating practices that are agreed to in the plant operating license (most notably, France and the United Kingdom). Most of the changes observed in staffing regulations and practices in the early 1980s were made in response to the accident at the Three Mile Island Unit 2 nuclear power plant (TMI) in 1979. These changes included the widespread issuance of new operator and licensing requirements and the establishment of national training centers. After the post-TMI changes were implemented, a period of relative stability followed. Changes in the latter half of the 1980s have focused on continuing improvements and additions to training curricula and methods, most notably increased reliance on simulator training

  13. The significance of staffing and work environment for quality of care and the recruitment and retention of care workers. Perspectives from the Swiss Nursing Homes Human Resources Project (SHURP)

    OpenAIRE

    Zúñiga, Franziska

    2015-01-01

    While the demand for high quality of care in nursing homes is rising, recruiting and retaining qualified staff is becoming increasingly difficult. Burgeoning chronic illness rates, complex medical and psychosocial situations, and the rising challenge of mental health disorders such as dementia compound the problem. Current research shows a tendency for higher staffing levels to correlate with higher quality care; however, the results are inconclusive. Further, while work environment factors s...

  14. Implementing an inclusive staffing model for today's reference services a practical guide for librarians

    CERN Document Server

    Nims, Julia K; Stevens, Robert

    2013-01-01

    Reference service remains a core function of modern libraries. However, how and where we provide assistance has evolved with changing technologies and the shifting habits and preferences of our users. One way libraries can provide the on-demand, in-person assistance while managing and developing new services and resources that will benefit current and future users is to reconsider how their reference points and services are staffed and adopt a staff-based reference model. In Implementing an Inclusive Staffing Model for Today's Reference Services, Nims, Storm, and Stevens describe step-by-step

  15. Organization and staffing of the regulatory body for nuclear facilities. Safety guide

    International Nuclear Information System (INIS)

    2005-01-01

    The purpose of this safety guide is to provide recommendations for national authorities on the appropriate management system, organization and staffing for the regulatory body responsible for the regulation of nuclear facilities in order to achieve compliance with the applicable safety requirements. This safety guide covers the organization and staffing in relation to nuclear facilities such as: enrichment and fuel manufacturing plants. Nuclear power plants. Other reactors such as research reactors and critical assemblies. Spent fuel reprocessing plants. And radioactive waste management facilities such as treatment, storage and disposal facilities. This safety guide also covers issues related to the decommissioning of nuclear facilities, the closure of waste disposal facilities and site rehabilitation

  16. Determinants and Effects of Nurse Staffing Intensity and Skill Mix in Residential Care/Assisted Living Settings

    Science.gov (United States)

    Stearns, Sally C.; Park, Jeongyoung; Zimmerman, Sheryl; Gruber-Baldini, Ann L.; Konrad, Thomas R.; Sloane, Philip D.

    2007-01-01

    Purpose: Residential care/assisted living facilities have become an alternative to nursing homes for many individuals, yet little information exists about staffing in these settings and the effect of staffing. This study analyzed the intensity and skill mix of nursing staff using data from a four-state study, and their relationship to outcomes.…

  17. 75 FR 45166 - Jeld-Wen, Inc., Hawkins Window Division, Including On-Site Leased Workers of Nicolet Staffing...

    Science.gov (United States)

    2010-08-02

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-71,014] Jeld-Wen, Inc., Hawkins Window Division, Including On-Site Leased Workers of Nicolet Staffing, Hawkins, WI; Notice of Negative...., Hawkins Window Division, including on-site leased workers of Nicolet Staffing, Hawkins, Wisconsin. Signed...

  18. 45 CFR 1336.65 - Staffing and organization of the Revolving Loan Fund: Responsibilities of the Loan Administrator.

    Science.gov (United States)

    2010-10-01

    ... organization table, including: (a) The structure and composition of the Board of Directors of the RLF; (b) The... 45 Public Welfare 4 2010-10-01 2010-10-01 false Staffing and organization of the Revolving Loan... Hawaiian Revolving Loan Fund Demonstration Project § 1336.65 Staffing and organization of the Revolving...

  19. 42 CFR 432.50 - FFP: Staffing and training costs.

    Science.gov (United States)

    2010-10-01

    ... organization or a degree in a medical field issued by a college or university certified by a professional... salary or other compensation, fringe benefits, travel, per diem, and training, at rates determined on the... education and training” means the completion of a 2-year or longer program leading to an academic degree or...

  20. 21 CFR 800.10 - Contact lens solutions; sterility.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Contact lens solutions; sterility. 800.10 Section...) MEDICAL DEVICES GENERAL Requirements for Specific Medical Devices § 800.10 Contact lens solutions... ophthalmic use, including contact lens solutions, should be sterile. It is further evident that such...

  1. A Functional Model of Quality Assurance for Psychiatric Hospitals and Corresponding Staffing Requirements.

    Science.gov (United States)

    Kamis-Gould, Edna; And Others

    1991-01-01

    A model for quality assurance (QA) in psychiatric hospitals is described. Its functions (general QA, utilization review, clinical records, evaluation, management information systems, risk management, and infection control), subfunctions, and corresponding staffing requirements are reviewed. This model was designed to foster standardization in QA…

  2. Library/Media Centers in U.S. Public Schools: Growth, Staffing, and Resources. Executive Summary

    Science.gov (United States)

    Tuck, Kathy D.; Holmes, Dwight R.

    2016-01-01

    This study analyzes data collected between 2000 and 2013 from the annual National Center for Education Statistics (NCES) Common Core of Data (CCD) Local Education Agency (School District) Universe Survey; the NCES Schools and Staffing Survey (SASS); and the U.S. Census Bureau Small Area Income and Poverty Estimates Survey (SAIPE). The findings…

  3. Survey of foreign reactor operator qualifications, training, and staffing requirements. Final report

    International Nuclear Information System (INIS)

    Au, M.L.; DiSalvo, R.; Merschoff, E.

    1982-05-01

    The report is a compilation of the data obtained from a survey of foreign nuclear power plant operator requirements. Included among the considerations are: (1) shift staffing; (2) operator eligibility; (3) operator training programs; (4) operator licensing or certification; and (5) operator retraining. The data obtained from this survey are presented in matrix form and contrasted with U.S. requirements

  4. 76 FR 14101 - Commercial Furniture Group, Inc., Including On-Site Leased Workers From Staffing Solutions...

    Science.gov (United States)

    2011-03-15

    ... Furniture Group, Inc., Including On-Site Leased Workers From Staffing Solutions; Morristown, TN; Commercial Furniture Group, Inc., Chicago, IL; Amended Certification Regarding Eligibility To Apply for Worker... Adjustment Assistance on May 5, 2010, applicable to workers of Commercial Furniture Group, Inc., including on...

  5. Physical Attacks: An Analysis of Teacher Characteristics Using the Schools and Staffing Survey

    Science.gov (United States)

    Williams, Thomas O., Jr.; Ernst, Jeremy V.

    2016-01-01

    This study investigated physical attacks as reported by public school teachers on the most recent Schools and Staffing Survey (SASS) from the National Center for Education Statistics administered by the Institute of Educational Sciences. For this study, characteristics of teachers who responded affirmatively to having been physically attacked in…

  6. Outcomes and Costs of Community Living: Semi-Independent Living and Fully Staffed Group Homes

    Science.gov (United States)

    Felce, David; Perry, Jonathan; Romeo, Renee; Robertson, Janet; Meek, Andrea; Emerson, Eric; Knapp, Martin

    2008-01-01

    In a matched-groups design, costs and quality of life outcomes for adults with intellectual disabilities with relatively low support needs were compared between those in fully staffed group homes (n = 35) and in semi-independent living (n = 35). Data were collected on participant characteristics, setting organization, various lifestyle outcomes,…

  7. A Staffing Profile of United States Online Database Producers: A Model and Discussion of Educational Implications.

    Science.gov (United States)

    Lowry, Glenn R.

    1983-01-01

    Reports results of survey of United States online database producers designed to determine number of personnel employed in intellectual production of databases and provide basis for generation of people employed in frequently recurring staff categories. Implications for education based on needs suggested by staffing patterns are examined.…

  8. 76 FR 73683 - Whirlpool Corporation, Including On-Site Leased Workers From Career Solutions TEC Staffing...

    Science.gov (United States)

    2011-11-29

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,593] Whirlpool Corporation, Including On-Site Leased Workers From Career Solutions TEC Staffing, Andrews International, IBM Corporation... refrigerators and trash compactors. The notice was published in the Federal Register on October 25, 2010 (75 FR...

  9. 76 FR 72978 - Whirlpool Corporation Including On-Site Leased Workers From Career Solutions TEC Staffing...

    Science.gov (United States)

    2011-11-28

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,593] Whirlpool Corporation Including On-Site Leased Workers From Career Solutions TEC Staffing, Andrews International, IBM Corporation... workers are engaged in the production of refrigerators and trash compactors. The notice was published in...

  10. 75 FR 16512 - Willstaff Staffing Agency, Willstaff Crystal, Inc., and MDS Industrial Resources, Inc., Working...

    Science.gov (United States)

    2010-04-01

    ... Agency, Willstaff Crystal, Inc., and MDS Industrial Resources, Inc., Working On-Site at Tyler Pipe... MDS Industrial Resources, Inc., working on-site at Tyler Pipe Company, Waterworks Division, South... Staffing Agency, Willstaff Crystal, Inc., and MDS Industrial Resources, Inc., working on-site at Tyler Pipe...

  11. Library/Media Centers in U.S. Public Schools: Growth, Staffing, and Resources. Full Report

    Science.gov (United States)

    Tuck, Kathy D.; Holmes, Dwight R.

    2016-01-01

    At the request of New Business Item: 89 (NBI: 89) adopted at the 2015 NEA Representative Assembly, this study examines the extent to which students have access to public school library/media centers with qualified staff and up-to-date resources. The study explores trends in library/media center openings and closings as well as staffing patterns…

  12. Registered Nurse Staffing Mix and Quality of Care in Nursing Homes: A Longitudinal Analysis

    Science.gov (United States)

    Kim, Hongsoo; Harrington, Charlene; Greene, William H.

    2009-01-01

    Purpose: To examine the relationship between registered nurse (RN) staffing mix and quality of nursing home care measured by regulatory violations. Design and Methods: A retrospective panel data study (1999-2003) of 2 groups of California freestanding nursing homes. One group was 201 nursing homes that consistently met the state's minimum standard…

  13. Successful Implementation of Six Sigma to Schedule Student Staffing for Circulation Service Desks

    Science.gov (United States)

    Jankowski, Janiece

    2013-01-01

    In fall of 2011 the University at Buffalo Libraries circulation department undertook Six Sigma training for the purpose of overhauling its student scheduling process. The department was able to mitigate significant staffing budgetary reductions and resource reallocations and to overcome the unique challenges of scheduling student labor for a…

  14. Nuclear power plant organization and staffing for improved performance: Lessons learned

    International Nuclear Information System (INIS)

    1998-11-01

    Experience from well operated nuclear power plants (NPPs) around the world indicates that an organizational structure which efficiently supports plant operation is essential in economically achieving both high level of safety and operational performance. At the same time energy markets are being opened to competition in many Member States. It is in consideration of this new competitive energy market that the overall objective of this document is to provide NPP managers information on lessons learned on improving the organization and staffing of NPP activities. Within this overall objective, specific objectives are to: Identify organisational design and staffing principles, Provide examples of how NPPs implement these principles, Identify typical NPP staffing levels, Factors affecting these levels, and staffing trends among various NPP types. Although it is not expected that any particular utility or NPP manager would consider all of the suggestions provided here to be appropriate, it is anticipated that nearly every NPP manager in IAEA Member States would find some ideas useful in improving the efficiency and effectiveness of NPP activities

  15. 38 CFR 58.10 - VA Form 10-3567-State Home Inspection Staffing Profile.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false VA Form 10-3567-State Home Inspection Staffing Profile. 58.10 Section 58.10 Pensions, Bonuses, and Veterans' Relief... Profile. ER06JA00.000 ER06JA00.001 ER06JA00.002 ...

  16. 45 CFR 1321.9 - Organization and staffing of the State agency.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Organization and staffing of the State agency. 1321.9 Section 1321.9 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN... PROGRAMS GRANTS TO STATE AND COMMUNITY PROGRAMS ON AGING State Agency Responsibilities § 1321.9...

  17. Reversing Course: The Troubled State of Academic Staffing and a Path Forward

    Science.gov (United States)

    American Federation of Teachers (NJ), 2008

    2008-01-01

    Over the last generation, the instructional staffing system in American higher education has experienced a significant reduction in the proportion of jobs for full-time tenured and tenure-track faculty members and a dramatic growth in fixed-term full- and part-time instructional jobs without tenure. About 70 percent of the people teaching in…

  18. A social network of hospital acquired infection built from electronic medical record data.

    Science.gov (United States)

    Cusumano-Towner, Marco; Li, Daniel Y; Tuo, Shanshan; Krishnan, Gomathi; Maslove, David M

    2013-05-01

    Social networks have been used in the study of outbreaks of infectious diseases, including in small group settings such as individual hospitals. Collecting the data needed to create such networks, however, can be time consuming, costly, and error prone. We sought to create a social network of hospital inpatients using electronic medical record (EMR) data already collected for other purposes, for use in simulating outbreaks of nosocomial infections. We used the EMR data warehouse of a tertiary academic hospital to model contact among inpatients. Patient-to-patient contact due to shared rooms was inferred from admission-discharge-transfer data, and contact with healthcare workers was inferred from clinical documents. Contacts were used to generate a social network, which was then used to conduct probabilistic simulations of nosocomial outbreaks of methicillin-resistant Staphylococcus aureus and influenza. Simulations of infection transmission across the network reflected the staffing and patient flow practices of the hospital. Simulations modeling patient isolation, increased hand hygiene, and staff vaccination showed a decrease in the spread of infection. We developed a method of generating a social network of hospital inpatients from EMR data. This method allows the derivation of networks that reflect the local hospital environment, obviate the need for simulated or manually collected data, and can be updated in near real time. Inpatient social networks represent a novel secondary use of EMR data, and can be used to simulate nosocomial infections. Future work should focus on prospective validation of the simulations, and adapting such networks to other tasks.

  19. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... One Use Facts About Colored Contacts and Halloween Safety Colored Contact Lens Facts Over-the-Counter Costume ... Costume Contact Lenses Can Ruin Vision Eye Makeup Safety In fact, it is illegal to sell colored ...

  20. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... with Colored Contact Lenses Julian: Teenager Blinded In One Eye By Non-Prescription Contact Lens Laura: Vision ... Robyn: Blurry Vision and Daily Eye Drops After One Use Facts About Colored Contacts and Halloween Safety ...

  1. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... One Use Facts About Colored Contacts and Halloween Safety Colored Contact Lens Facts Over-the-Counter Costume ... use of colored contact lenses , from the U.S. Food and Drug Administration (FDA). Are the colored lenses ...

  2. Medications (for IBS)

    Medline Plus

    Full Text Available ... Awareness Month IBS Awareness Month Tips of the Day Art of IBS Gallery Contact Us About IBS ... Awareness Month IBS Awareness Month Tips of the Day Art of IBS Gallery Contact Us Medications Details ...

  3. Medications (for IBS)

    Medline Plus

    Full Text Available ... Month IBS Awareness Month Tips of the Day Art of IBS Gallery Contact Us About IBS Twitter ... Month IBS Awareness Month Tips of the Day Art of IBS Gallery Contact Us Search Medications Details ...

  4. International Journal of Community Research: Contact

    African Journals Online (AJOL)

    Principal Contact. Nwaopara Anthony Obioma (Dr) Managing Editor. University of Medical Sciences,. Laje Road, Ondo City. Ondo State. Nigeria. Alternative email address: nwaoparaao@yahoo.com. Phone: +2348037441401. Email: anthoservpub@yahoo.com ...

  5. African Journal of Health Professions Education: Contact

    African Journals Online (AJOL)

    Principal Contact. Claudia Naidu Managing Editor Health and Medical Publishing Group Private Bag X1 Pinelands 7430 Cape Town South Africa Phone: + 27 (21) 532 1281. Email: claudian@hmpg.co.za. Support Contact. Getrude Fani Phone: +27 (21) 532 1281. Email: publishing@hmpg.co.za · AJOL African Journals ...

  6. Medical abortion service delivery.

    Science.gov (United States)

    Breitbart, V; Rogers, M K; Vanderhei, D

    2000-08-01

    Medical abortion with mifepristone and methotrexate regimens may be offered in a variety of American medical practice settings. In this article the new provider will find information on all aspects of the patient care delivery system for medical abortion, including physical space requirements, staffing and training, patient flow, cost, security, marketing, and quality assurance. Because of the limited published data available regarding logistic issues surrounding abortion care, the information in this article derives largely from the experiences of providers who have established medical abortion practices in their offices or clinics. Its goals are to help make the initial start-up phase briefer and more rewarding for new providers, to offer helpful guidelines for incorporation of medical abortion into practice, and to encourage more practitioners to see the benefits of adding this option to their practices.

  7. Biological, epidemiological, sanitary-hygienic, medical and behavioral occupational health risk factors for stock-breeders, veterinaries and workers employed at meat-processing enterprises, contacting brucellar animals and infected meat

    Directory of Open Access Journals (Sweden)

    S.I. Ereniev

    2017-06-01

    Full Text Available We have studied sanitary-hygienic characteristics of working conditions, charts with results of sanitary-epidemiologic examination performed in a zoogenous nidus, outpatient clinic cards and questionnaires filled in by 202 patients living in Omsk region and suffering from occupational brucellosis. The disease usually prevails among stock-breeders, veterinaries and workers employed at meat-processing enterprises. Our goal was to detect risks of occupational, production-induced and general pathology evolvement. Working conditions which all the examined people had to work in corresponded to hazardous (3.3 or even dangerous (4 category as per occurrence of contacts with infectious agents and parasites (biological risk. Apart from biological factor, a number of workers were under complex exposure to ammonia concentrations (higher than MPC, noise higher than MPL, vibration, cooling microclimate, uncomfortable lighting environment, labor process hardness and intensity. There were several factors causing epidemiologic risks as well. Disinfectants were absent or their quantity was not sufficient; industrial and amenity rooms were not well-organized; there was no central hot water supply or shower rooms, separate rooms for meals, specialized implements for removing abortus and stillborn fetuses and afterbirths, correctly organized burial grounds, or first aid kits. Hygienic health risks were caused by insufficient cleaning agents supply, absence of centralized protecting clothing laundering, and insufficient provision with personal protection means. Occupational health risks resulted from absence of preliminary medical examinations in standard recruitment procedures, irregularity and low quality of periodical medical examinations. Our qualitative assessment of behavioral health risks revealed that a lot of workers tended to have irresponsible medical and hygienic behavior, there were disorders in their work and rest regime (shift work with shifts rotation

  8. The effects of staffing and training on firm productivity and profit growth before, during, and after the Great Recession.

    Science.gov (United States)

    Kim, Youngsang; Ployhart, Robert E

    2014-05-01

    This study integrates research from strategy, economics, and applied psychology to examine how organizations may leverage their human resources to enhance firm performance and competitive advantage. Staffing and training are key human resource management practices used to achieve firm performance through acquiring and developing human capital resources. However, little research has examined whether and why staffing and training influence firm-level financial performance (profit) growth under different environmental (economic) conditions. Using 359 firms with over 12 years of longitudinal firm-level profit data, we suggest that selective staffing and internal training directly and interactively influence firm profit growth through their effects on firm labor productivity, implying that staffing and training contribute to the generation of slack resources that help buffer and then recover from the effects of the Great Recession. Further, internal training that creates specific human capital resources is more beneficial for prerecession profitability, but staffing is more beneficial for postrecession recovery, apparently because staffing creates generic human capital resources that enable firm flexibility and adaptation. Thus, the theory and findings presented in this article have implications for the way staffing and training may be used strategically to weather economic uncertainty (recession effects). They also have important practical implications by demonstrating that firms that more effectively staff and train will outperform competitors throughout all pre- and postrecessionary periods, even after controlling for prior profitability. (c) 2014 APA, all rights reserved.

  9. The Size and Scope of Collegiate Athletic Training Facilities and Staffing.

    Science.gov (United States)

    Gallucci, Andrew R; Petersen, Jeffrey C

    2017-08-01

      Athletic training facilities have been described in terms of general design concepts and from operational perspectives. However, the size and scope of athletic training facilities, along with staffing at different levels of intercollegiate competition, have not been quantified.   To define the size and scope of athletic training facilities and staffing levels at various levels of intercollegiate competition. To determine if differences existed in facilities (eg, number of facilities, size of facilities) and staffing (eg, full time, part time) based on the level of intercollegiate competition.   Cross-sectional study.   Web-based survey.   Athletic trainers (ATs) who were knowledgeable about the size and scope of athletic training programs.   Athletic training facility size in square footage; the AT's overall facility satisfaction; athletic training facility component spaces, including satellite facilities, game-day facilities, offices, and storage areas; and staffing levels, including full-time ATs, part-time ATs, and undergraduate students.   The survey was completed by 478 ATs (response rate = 38.7%) from all levels of competition. Sample means for facilities were 3124.7 ± 4425 ft 2 (290.3 ± 411 m 2 ) for the central athletic training facility, 1013 ± 1521 ft 2 (94 ± 141 m 2 ) for satellite athletic training facilities, 1272 ± 1334 ft 2 (118 ± 124 m 2 ) for game-day athletic training facilities, 388 ± 575 ft 2 (36 ± 53 m 2 ) for athletic training offices, and 424 ± 884 ft 2 (39 ± 82 m 2 ) for storage space. Sample staffing means were 3.8 ± 2.5 full-time ATs, 1.6 ± 2.5 part-time ATs, 25 ± 17.6 athletic training students, and 6.8 ± 7.2 work-study students. Division I schools had greater resources in multiple categories (P training staffing and facilities. The results (1) suggest that the ATs were satisfied with their facilities and (2) highlight the differences in resources among competition levels.

  10. Expatriate clinics and medical evacuation companies are a growth industry worldwide.

    Science.gov (United States)

    Wilde, Henry; Roselieb, Marcus; Hanvesakul, Rekha; Phaosavasdi, Sukhit; Pruksapong, Chumsak

    2003-01-01

    Globalization and the growth of tourism, which now includes "adventure" visits to very remote regions, has created new employment but also new problems. For example, elderly tourists break their hips where there is no competent orthopedic surgeon, a traveler gets bitten by a cobra in rural Cambodia where there is not even an "Ambu" bag to keep him oxygenated, and a tour guide develops high-altitude cerebral edema on a remote Nepalese mountain. What would we do without organizations that are capable of removing such victims rapidly and safely to a place able to provide appropriate medical care? Fortunately, several well-staffed and well-equipped air ambulance companies stand ready almost worldwide to help 24 hours a day. Medical assistance firms, which sell their own travel insurance and/or act as agents of large insurance companies, are also at hand and have offices in major cities worldwide. They have 24-hour telephone numbers and are prepared to advise a sick or injured traveler where he or she should go to obtain competent medical care. Most of these firms have regional medical advisors in strategic locations who maintain a network of contacts. They can ensure that an ill traveler is receiving appropriate care and will act as quality controllers. They are also able to advise whether medical evacuation to a higher level of care is needed and where the traveler should be evacuated to.

  11. Effect of poly-hexamethylene biguanide hydrochloride (PHMB) treated non-sterile medical gloves upon the transmission of Streptococcus pyogenes, carbapenem-resistant E. coli, MRSA and Klebsiella pneumoniae from contact surfaces.

    Science.gov (United States)

    Ali, S; Wilson, A P R

    2017-08-17

    Reduction of accidental contamination of the near-patient environment has potential to reduce acquisition of healthcare-associated infection(s). Although medical gloves should be removed when soiled or touching the environment, compliance is variable. The use of antimicrobial-impregnated medical gloves could reduce the horizontal-transfer of bacterial contamination between surfaces. Determine the activity of antimicrobial-impregnated gloves against common hospital pathogens: Streptococcus pyogenes, carbapenem-resistant E.coli (CREC), MRSA and ESBL-producing Klebsiella pneumoniae. Fingerpads (~1cm 2 ) of PHMB-treated and untreated gloves were inoculated with 10 μL (~10 4 colony-forming-units [cfu]) of test-bacteria prepared in heavy-soiling (0.5%BSA), blood or distilled-water (no-soiling) and sampled after 0.25, 1, 10 or 15 min contact-time. Donor surfaces (~1cm 2 computer-keys) contaminated with wet/dry inoculum were touched with the fingerpad of treated/untreated gloves and subsequently pressed onto recipient (uncontaminated) computer-keys. Approximately 4.50log 10 cfu of all bacteria persisted after 15 min on untreated gloves regardless of soil-type. In the absence of soiling, PHMB-treated gloves reduced surface-contamination by ~4.5log 10 cfu (>99.99%) within 10 min of contact-time but only ~2.5log 10 (>99.9%) and ~1.0log 10 reduction respectively when heavy-soiling or blood was present. Gloves became highly-contaminated (~4.52log 10 -4.91log 10 cfu) when handling recently-contaminated computer-keys. Untreated gloves contaminated "recipient" surfaces (~4.5log 10 cfu) while PHMB-treated gloves transferred fewer bacteria (2.4-3.6log 10 cfu). When surface contamination was dry, PHMB gloves transferred fewer bacteria (0.3-0.6log 10 cfu) to "recipient" surfaces than untreated gloves (1.0-1.9log 10 ; P gloves may be useful in preventing dissemination of organisms in the near-patient environment during routine care. However they are not a substitute for

  12. Industrial Fuel Gas Demonstration Plant Program: staffing plan. Deliverable No. 34

    Energy Technology Data Exchange (ETDEWEB)

    None

    1980-05-01

    This report describes the staffing plans of each industrial team member during final design and construction of the IFGDP. The internal organization of each team member, including the delegation of authority and responsibility within the structure, is discussed. The primary function of the various organizational units are also identified. In addition, a brief summary of the Phase II role of each industrial partner is included. The overall Phase II organization chart is attached.

  13. Generalizable items and modular structure for computerised physician staffing calculation on intensive care units.

    Science.gov (United States)

    Weiss, Manfred; Marx, Gernot; Iber, Thomas

    2017-08-04

    Intensive care medicine remains one of the most cost-driving areas within hospitals with high personnel costs. Under the scope of limited budgets and reimbursement, realistic needs are essential to justify personnel staffing. Unfortunately, all existing staffing models are top-down calculations with a high variability in results. We present a workload-oriented model, integrating quality of care, efficiency of processes, legal, educational, controlling, local, organisational and economic aspects. In our model, the physician's workload solely related to the intensive care unit depends on three tasks: Patient-oriented tasks, divided in basic tasks (performed in every patient) and additional tasks (necessary in patients with specific diagnostic and therapeutic requirements depending on their specific illness, only), and non patient-oriented tasks. All three tasks have to be taken into account for calculating the required number of physicians. The calculation tool further allows to determine minimal personnel staffing, distribution of calculated personnel demand regarding type of employee due to working hours per year, shift work or standby duty. This model was introduced and described first by the German Board of Anesthesiologists and the German Society of Anesthesiology and Intensive Care Medicine in 2008 and since has been implemented and updated 2012 in Germany. The modular, flexible nature of the Excel-based calculation tool should allow adaption to the respective legal and organizational demands of different countries. After 8 years of experience with this calculation, we report the generalizable key aspects which may help physicians all around the world to justify realistic workload-oriented personnel staffing needs.

  14. A scientific model to determine the optimal radiographer staffing component in a nuclear medicine department

    International Nuclear Information System (INIS)

    Shipanga, A.N.; Ellmann, A.

    2004-01-01

    Full text: Introduction: Nuclear medicine in South Africa is developing fast. Much has changed since the constitution of a scientific model for determining an optimum number of radiographer posts in a Nuclear Medicine department in the late 1980's. Aim: The aim of this study was to ascertain whether the number of radiographers required by a Nuclear Medicine department can still be determined according to the norms established in 1988. Methods: A quantitative study using non-experimental evaluation design was conducted to determine the ratios between current radiographer workload and staffing norms. The workload ratios were analysed using the procedures statistics of the Nuclear Medicine department at Tygerberg Hospital. Radiographers provided data about their activities related to patient procedures, including information about the condition of the patients, activities in the radiopharmaceutical laboratory, and patient related administrative tasks. These were factored into an equation relating this data to working hours, including vacation and sick leave. The calculation of Activity Standards and an annual Standard Workload was used to finally calculate the staffing requirements for a Nuclear Medicine department. Results: Preliminary data confirmed that old staffing norms cannot be used in a modern Nuclear Medicine department. Protocols for several types of study have changed, including the additional acquisition of tomographic studies. Interest in the use of time-consuming non-imaging studies has been revived and should be factored Into the equation. Conclusions: All Nuclear Medicine departments In South Africa, where the types of studies performed have changed over the past years, should look carefully at their radiographer staffing ratio to ascertain whether the number of radiographers needed is adequate for the current workload. (author)

  15. Evaluation of a Peer-Staffed Hotline for Families Who Received Genetic Testing for Risk of Breast Cancer

    National Research Council Canada - National Science Library

    Coyne, James

    2004-01-01

    This project proposed to develop, implement, and evaluate a peer-staffed toll-free hotline for individuals at high risk of developing hereditary breast cancer, either through family history or known BRCA1/2 mutations...

  16. Strategies for using international domain standards within a national context: The case of the Dutch temporary staffing industry

    NARCIS (Netherlands)

    Folmer, Erwin Johan Albert; van Bekkum, Michael; Verhoosel, Jack

    2009-01-01

    This paper will discuss strategies for using international domain standards within a national context. The various strategies are illustrated by means of a case study of the temporary staffing industry.

  17. An Analysis of Peacetime Medical Workload and Staffing: Should Medical Readiness be Viewed Through a Peacetime Lens?

    Science.gov (United States)

    2003-03-01

    written word. Most importantly, it is to my family that I say thank you for sticking by me and for believing in me. Yes, kids , dad’s home work is...Supt Svcs - Funded/Reimbursable DH Rehabilitative Services EE Material Services DHA Inhalation/Respiratory Therapy EEA Material Services DHX

  18. [Relationship between nurse staffing and nursing outcomes: a narrative review of literature].

    Science.gov (United States)

    Petrucci, Cristina; Calandro, Maria Teresa; Tresulti, Federica; Baldacchini, Antonio; Lancia, Loreto

    2015-01-01

    The measurement of nursing sensitive outcomes represents a fundamental element in "Health Management" in order to assess the suitability and quality of care given, particoulaly in hospitals for the acutely ill. To highlight how some variables connected with nurse-staffing can determine the quality of processes and the care outcomes. A narrative review of international literature has been carried out on investigating possible correlation between nurse-staffing characteristics and care outcomes regarding patients, taking into account primary and secondary sources, written either in English or Italian, without time limits. The bibliographical research strategies used, have brought about the restitution of no. 4244 articles were retrived, of these 56 were analyzed. Articles were categorized into 3 specific areas: 1) Which aspects determine the efficacy and quality of nursing care; 2) The direct effects of nursing care on care outcomes; 3) The indirect effects of nursing care on care outcomes. Results confirm the existence of a noticeable relationship between the main components of nurse-staffing and the direct and indirect outcomes on patients health. Longitudinal studies shound be carried out highlighting the results obtained up till now even more and assist in accurately measuring the importance of possible predictive variables on care outcomes correlated to nursing care.

  19. Benefits of High-Intensity Intensive Care Unit Physician Staffing under the Affordable Care Act

    Directory of Open Access Journals (Sweden)

    Sachin Logani

    2011-01-01

    Full Text Available The Affordable Care Act signed into law by President Obama, with its value-based purchasing program, is designed to link payment to quality processes and outcomes. Treatment of critically ill patients represents nearly 1% of the gross domestic product and 25% of a typical hospital budget. Data suggest that high-intensity staffing patterns in the intensive care unit (ICU are associated with cost savings and improved outcomes. We evaluate the literature investigating the cost-effectiveness and clinical outcomes of high-intensity ICU physician staffing as recommended by The Leapfrog Group (a consortium of companies that purchase health care for their employees and identify ways to overcome barriers to nationwide implementation of these standards. Hospitals that have implemented the Leapfrog initiative have demonstrated reductions in mortality and length of stay and increased cost savings. High-intensity staffing models appear to be an immediate cost-effective way for hospitals to meet the challenges of health care reform.

  20. Hospital nurse staffing and patient mortality, emotional exhaustion, and job dissatisfaction.

    Science.gov (United States)

    Halm, Margo; Peterson, Michelle; Kandels, Mary; Sabo, Julie; Blalock, Miriam; Braden, Rebecca; Gryczman, Anna; Krisko-Hagel, Kathryn; Larson, Dave; Lemay, Diane; Sisler, Bette; Strom, Linda; Topham, Debra

    2005-01-01

    To conduct an investigation similar to a landmark study that investigated the association between nurse-to-patient ratio and patient mortality, failure-to-rescue, emotional exhaustion and job satisfaction of nurses. Cross-sectional analysis of 2709 general, orthopedic, and vascular surgery patients, and 140 staff nurses (42% response rate) caring for these patients in a large Midwestern institution. The main outcome measures were mortality, failure-to-rescue, emotional exhaustion, and job dissatisfaction. Staffing was not a significant predictor of mortality or failure-to-rescue, nor did clinical specialty predict emotional exhaustion or job dissatisfaction. Although these findings reinforce adequate staffing ratios at this institution, programs that support nurses in their daily practice and positively impact job satisfaction need to be explored. The Nursing Research Council not only has heightened awareness of how staffing ratios affect patient and nurse outcomes, but also a broader understanding of how the research process can be used to effectively shape nurse's practice and work environments.

  1. Staffing requirements for future small and medium reactors (SMRs) based on operating experience and projections

    International Nuclear Information System (INIS)

    2001-01-01

    At the time of this study there were about 160 small and medium sized nuclear power reactors (referred to as SMRs) in operation worldwide, and about 25 more under construction. Operation and maintenance costs for operating SMRs represent a substantial portion of the cost of electricity produced. Of these costs, the direct and indirect cost of staff represents the major cost component. In recent years, particularly since 1990, there has been increased interest in SMRs by many developing countries wishing to take advantage of nuclear power and several small and medium reactor designs are in various stages of development. To enhance the economic competitive position of SMRs relative to alternative methods of electricity generation, it is essential to ensure that new SMRs can be operated reliably and efficiently using the optimum number of staff. This publication reviews the lessons learned from the reactor operation, and the insights gained through the design of new SMRs, with a view to optimizing staffing in order to improve overall plant economics without compromising safety.This publication is intended to evaluate the estimated staffing size of various SMRs, the staff qualification and training required for the operation of future SMRs. and the key issues which impact the staffing requirements that should be considered in the development and deployment of future SMRs

  2. Implementation of a Team-based Physician Staffing Model at an Academic Emergency Department

    Directory of Open Access Journals (Sweden)

    Jose V. Nable

    2014-09-01

    Full Text Available Introduction: There is scant literature regarding the optimal resident physician staffing model of academic emergency departments (ED that maximizes learning opportunities. A department of emergency medicine at a large inner-city academic hospital initiated a team-based staffing model. Its pre-interventional staffing model consisted of residents and attending physicians being separately assigned patients, resulting in residents working with two different faculty providers in the same shift. This study aimed to determine if the post-interventional team-based system, in which residents were paired with a single attending on each shift, would result in improved residents’ learning and clinical experiences as manifested by resident evaluations and the number of patients seen. Methods: This retrospective before-and-after study at an academic ED with an annual volume of 52,000 patients examined the mean differences in five-point Likert-scale evaluations completed by residents assessing their ED rotation experiences in both the original and team-based staffing models. The residents were queried on their perceptions of feeling part of the team, decision-making autonomy, clinical experience, amount of supervision, quality of teaching, and overall rotational experience. We also analyzed the number of patients seen per hour by residents. Paired sample t-tests were performed. Residents who were in the program in the year preceding and proceeding the intervention were eligible for inclusion. Results: 34 of 38 eligible residents were included (4 excluded for lack of evaluations in either the pre- or post-intervention period. There was a statistically significant improvement in resident perception of the quality and amount of teaching, 4.03 to 4.27 (mean difference=0.24, p=0.03. There were non-statistically significant trends toward improved mean scores for all other queries. Residents also saw more patients following the initiation of the team-based model

  3. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... One Use Facts About Colored Contacts and Halloween Safety Colored Contact Lens Facts Over-the-Counter Costume ... new application of artificial intelligence shows whether a patient’s eyes point to high blood pressure or risk ...

  4. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... sell contacts without a prescription are breaking the law, and may be fined $11,000 per violation. " ... wear any kind of contact lens. In Butler's case, the lenses caused an infection and left her ...

  5. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... in a pair of colored contact lenses, Laura Butler of Parkersburg, W.Va., had "extreme pain in ... to wear any kind of contact lens. In Butler's case, the lenses caused an infection and left ...

  6. Contact Angle Goniometer

    Data.gov (United States)

    Federal Laboratory Consortium — Description:The FTA32 goniometer provides video-based contact angle and surface tension measurement. Contact angles are measured by fitting a mathematical expression...

  7. Multiple Josephson contact interferometer

    International Nuclear Information System (INIS)

    Zappe, H.H.

    1978-01-01

    The interferometer (quantum interference between two parallel contacts) displays a mid connector and contacts of the same size, or contacts at which the middle one is twice the size as the other two, or a double connector and three contacts by which the middle contact carries twice the current as the other two. Also there can be provided interferometers with three and four contacts as well as with symmetrical double current connectors and the same largest Josephson current through all contacts. Because all contacts display the same phase state in the voltage free switching state, the amplification property can be increased and current dissipation can be decreased in a way that logic circuits with high integration degree and high switching velocities can be designed. (DG) [de

  8. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Cleveland. "This is far from the truth." Real People, Real Problems with Colored Contact Lenses Julian: Teenager ... the lenses. Never share contact lenses with another person. Get follow up exams with your eye care ...

  9. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... popping touch. But colored contact lenses are popular year-round, not just at Halloween. But few know the ... also available in Spanish . Follow The Academy Professionals: Education Guidelines News Multimedia Public & Patients: Contact Us About ...

  10. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Contact Lens Facts Over-the-Counter Costume Contacts May Contain Chemicals Harmful to Eyes Four Ways Over- ... without a prescription are breaking the law, and may be fined $11,000 per violation. "Many of ...

  11. Corporate Consumer Contact API

    Data.gov (United States)

    General Services Administration — The data in the Corporate Consumer Contact API is based on the content you can find in the Corporate Consumer Contact listing in the Consumer Action Handbook (PDF)....

  12. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... not require the same level of care or consideration as a standard contact lens because they can ... sell contacts without a prescription are breaking the law, and may be fined $11,000 per violation. " ...

  13. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... lens because they can be purchased over-the-counter or on the Internet," says Thomas Steinemann, MD, ... Halloween Safety Colored Contact Lens Facts Over-the-Counter Costume Contacts May Contain Chemicals Harmful to Eyes ...

  14. Contact Us about Asbestos

    Science.gov (United States)

    How to contact EPA for more information on asbestos, including state and regional contacts, EPA’s Asbestos Abatement/Management Ombudsman and the Toxic Substances Control Act (TSCA) Assistance Information Service (TSCA Hotline).

  15. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... like a suction cup." Halloween is a popular time for people to use colored contact lenses to ... wear costume contact lenses for Halloween or any time of year, follow these guidelines: Get an eye ...

  16. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... contact lenses , from the U.S. Food and Drug Administration (FDA). Are the colored lenses you are considering ... Follow The Academy Professionals: Education Guidelines News Multimedia Public & Patients: Contact Us About the Academy Jobs at ...

  17. Contact lens in keratoconus

    OpenAIRE

    Rathi, Varsha M; Mandathara, Preeji S; Dumpati, Srikanth

    2013-01-01

    Contact lenses are required for the visual improvement in patients with keratoconus. Various contact lens options, such as rigid gas permeable (RGP) lenses, soft and soft toric lenses, piggy back contact lenses (PBCL), hybrid lenses and scleral lenses are availble. This article discusses about selection of a lens depending on the type of keratoconus and the fitting philosophies of various contact lenses including the starting trial lens. A Medline search was carried out for articles in the En...

  18. Contact dermatitis from Eriodictyon parryi: a novel cause of contact dermatitis in California.

    Science.gov (United States)

    Czaplicki, Christopher D

    2013-09-01

    Allergic contact dermatitis caused by Eriodictyon parryi, better known as poodle-dog bush, is a growing cause of contact dermatitis in California. Blooming after a large fire, E parryi is a threat to reforestation workers as well as countless outdoor enthusiasts across the state. This paper focuses on the epidemiology, identification, immunochemistry, pathophysiology, prevention, and treatment of contact dermatitis from this little-researched plant. Copyright © 2013 Wilderness Medical Society. Published by Elsevier Inc. All rights reserved.

  19. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Ophthalmologist Patient Stories Español Eye Health / News Halloween Hazard: The Hidden Dangers of Buying Decorative Contact Lenses ... One Use Facts About Colored Contacts and Halloween Safety Colored Contact Lens Facts Over-the-Counter Costume ...

  20. New Cosmetic Contact Allergens

    Directory of Open Access Journals (Sweden)

    An Goossens

    2015-02-01

    Full Text Available Allergic and photo-allergic contact dermatitis, and immunologic contact urticaria are potential immune-mediated adverse effects from cosmetics. Fragrance components and preservatives are certainly the most frequently observed allergens; however, all ingredients must be considered when investigating for contact allergy.

  1. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... an Ophthalmologist Patient Stories Español Eye Health / News Halloween Hazard: The Hidden Dangers of Buying Decorative Contact ... After One Use Facts About Colored Contacts and Halloween Safety Colored Contact Lens Facts Over-the-Counter ...

  2. Hydrogenation of passivated contacts

    Energy Technology Data Exchange (ETDEWEB)

    Nemeth, William; Yuan, Hao-Chih; LaSalvia, Vincenzo; Stradins, Pauls; Page, Matthew R.

    2018-03-06

    Methods of hydrogenation of passivated contacts using materials having hydrogen impurities are provided. An example method includes applying, to a passivated contact, a layer of a material, the material containing hydrogen impurities. The method further includes subsequently annealing the material and subsequently removing the material from the passivated contact.

  3. Organisational quality, nurse staffing and the quality of chronic disease management in primary care: observational study using routinely collected data.

    Science.gov (United States)

    Griffiths, Peter; Maben, Jill; Murrells, Trevor

    2011-10-01

    An association between quality of care and staffing levels, particularly registered nurses, has been established in acute hospitals. Recently an association between nurse staffing and quality of care for several chronic conditions has also been demonstrated for primary care in English general practice. A smaller body of literature identifies organisational factors, in particular issues of human resource management, as being a dominant factor. However the literature has tended to consider staffing and organisational factors separately. We aim to determine whether relationships between the quality of clinical care and nurse staffing in general practice are attenuated or enhanced when organisational factors associated with quality of care are considered. We further aim to determine the relative contribution and interaction between these factors. We used routinely collected data from 8409 English general practices. The data, on organisational factors and the quality of clinical care for a range of long term conditions, is gathered as part of "Quality and Outcomes Framework" pay for performance system. Regression models exploring the relationship of staffing and organisational factors with care quality were fitted using MPLUS statistical modelling software. Higher levels of nurse staffing, clinical recording, education and reflection on the results of patient surveys were significantly associated with improved clinical care for COPD, CHD, Diabetes and Hypothyroidism after controlling for organisational factors. There was some evidence of attenuation of the estimated nurse staffing effect when organisational factors were considered, but this was small. The effect of staffing interacted significantly with the effect of organisational factors. Overall however, the characteristics that emerged as the strongest predictors of quality of clinical care were not staffing levels but the organisational factors of clinical recording, education and training and use of patient

  4. Contact lens in keratoconus

    Directory of Open Access Journals (Sweden)

    Varsha M Rathi

    2013-01-01

    Full Text Available Contact lenses are required for the visual improvement in patients with keratoconus. Various contact lens options, such as rigid gas permeable (RGP lenses, soft and soft toric lenses, piggy back contact lenses (PBCL, hybrid lenses and scleral lenses are availble. This article discusses about selection of a lens depending on the type of keratoconus and the fitting philosophies of various contact lenses including the starting trial lens. A Medline search was carried out for articles in the English language with the keywords keratoconus and various contact lenses such as Rose k lens, RGP lens, hybrid lens, scleral lens and PBCL.

  5. Contact lens in keratoconus

    Science.gov (United States)

    Rathi, Varsha M; Mandathara, Preeji S; Dumpati, Srikanth

    2013-01-01

    Contact lenses are required for the visual improvement in patients with keratoconus. Various contact lens options, such as rigid gas permeable (RGP) lenses, soft and soft toric lenses, piggy back contact lenses (PBCL), hybrid lenses and scleral lenses are availble. This article discusses about selection of a lens depending on the type of keratoconus and the fitting philosophies of various contact lenses including the starting trial lens. A Medline search was carried out for articles in the English language with the keywords keratoconus and various contact lenses such as Rose k lens, RGP lens, hybrid lens, scleral lens and PBCL. PMID:23925325

  6. Development and application of an objective staffing calculator for antimicrobial stewardship programs in the Veterans Health Administration.

    Science.gov (United States)

    Echevarria, Kelly; Groppi, Julie; Kelly, Allison A; Morreale, Anthony P; Neuhauser, Melinda M; Roselle, Gary A

    2017-11-01

    The development and validation of a staffing calculator and its use in creating staffing guidance for antimicrobial stewardship programs (ASPs) in Veterans Health Administration (VHA) facilities are described. The Tools and Resources Work Group of the Antimicrobial Stewardship Task Force and PBM Clinical Pharmacy Practice Office of the Department of Veterans Affairs developed, tested, and validated a staffing calculator to track patient care and ASP management activities needed to maintain a comprehensive ASP. Time spent on activities was based on time-in-motion tracking studies and input from experienced antimicrobial stewards. The staffing calculator was validated across VHA facilities of varying sizes and complexities to determine the number of needed clinical pharmacist full-time equivalents (FTEs) to implement and maintain ASPs per 100 occupied beds. A total of 12 facilities completed the staffing calculator for 1 calendar week. The median number of occupied beds was 226. Most facilities had at least 100 occupied beds, and 6 of the 12 were considered high complexity facilities. The median calculated FTE personnel requirement was 2.62, or 1.01 per 100 occupied beds. The majority of FTE time (70%) was spent on patient care activities and 30% on program management activities, including infectious diseases or ASP rounds. The final recommendations indicated that in order to implement and manage a robust ASP, a pharmacist FTE investment of 1.0 per 100 occupied beds would be needed. A staffing calculator to account for the time needed to implement ASP activities and provide staffing guidance across a large health-care system was validated. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  7. The Association of Team-Specific Workload and Staffing with Odds of Burnout Among VA Primary Care Team Members.

    Science.gov (United States)

    Helfrich, Christian D; Simonetti, Joseph A; Clinton, Walter L; Wood, Gordon B; Taylor, Leslie; Schectman, Gordon; Stark, Richard; Rubenstein, Lisa V; Fihn, Stephan D; Nelson, Karin M

    2017-07-01

    Work-related burnout is common in primary care and is associated with worse patient safety, patient satisfaction, and employee mental health. Workload, staffing stability, and team completeness may be drivers of burnout. However, few studies have assessed these associations at the team level, and fewer still include members of the team beyond physicians. To study the associations of burnout among primary care providers (PCPs), nurse care managers, clinical associates (MAs, LPNs), and administrative clerks with the staffing and workload on their teams. We conducted an individual-level cross-sectional analysis of survey and administrative data in 2014. Primary care personnel at VA clinics responding to a national survey. Burnout was measured with a validated single-item survey measure dichotomized to indicate the presence of burnout. The independent variables were survey measures of team staffing (having a fully staffed team, serving on multiple teams, and turnover on the team), and workload both from survey items (working extended hours), and administrative data (patient panel overcapacity and average panel comorbidity). There were 4610 respondents (estimated response rate of 20.9%). The overall prevalence of burnout was 41%. In adjusted analyses, the strongest associations with burnout were having a fully staffed team (odds ratio [OR] = 0.55, 95% CI 0.47-0.65), having turnover on the team (OR = 1.67, 95% CI 1.43-1.94), and having patient panel overcapacity (OR = 1.19, 95% CI 1.01-1.40). The observed burnout prevalence was 30.1% lower (28.5% vs. 58.6%) for respondents working on fully staffed teams with no turnover and caring for a panel within capacity, relative to respondents in the inverse condition. Complete team staffing, turnover among team members, and panel overcapacity had strong, cumulative associations with burnout. Further research is needed to understand whether improvements in these factors would lower burnout.

  8. Experiences and lessons learnt on staffing from the first Indian nuclear power plant (PHWR)

    International Nuclear Information System (INIS)

    Bhattacharya, A.S.

    2001-01-01

    Three decades of operating experience in India has led to sustained high performance of NPPs. The staffing modules and policies are standardised. The basic functions of operation, maintenance, technical support and quality assurance are carried out by a team of 727 in-plant persons (for a 2 x 220 MW PHWR station) organised at five levels, for fifty positions in ten job families. Specific qualification levels apply to each position - six at management positions, five licensed positions with the rest qualified through an equivalent training scheme. Practically all O and M activities are carried out on-site by the utility manpower with minimum involvement of contractors. The entire process of human resource development is in-house - with each NPP organisation comprised of 30% experienced staff transferred from older NPPs and 70% totally developed out of fresh recruits. Four to eight years lead time goes to qualify fresh recruits depending on the position. This optimisation of manpower is a result of continuous learning - through operating experience and regulatory feed back and self assessment for (i) optimising quantum of work load and (ii) improving productivity. For the first category, design improvements over older NPP's increased reliability, operability, maintainability and human factors are described separately in the companion paper. In this paper the organisation factors are discussed, starting with the initial lessons that demanded improved management and enhanced quality programmes and caused temporarily, high demand of staffing for bringing out new systems, e.g., (i) attaining maturity of units; (ii) standardising training, retraining and cross training and qualifications; (in) job rotations, (iv) in service inspection of reactor components; (v) quality audits. The experiences on subsequent optimisation of staffing levels are outlined. (author)

  9. Ontario: linking nursing outcomes, workload and staffing decisions in the workplace: the Dashboard Project.

    Science.gov (United States)

    Fram, Nancy; Morgan, Beverley

    2012-03-01

    Research shows that nurses want to provide more input into assessing patient acuity, changes in patient needs and staffing requirements. The Dashboard Project involved the further development and application of an electronic monitoring tool that offers a single source of nursing, patient and organizational information. It is designed to help inform nurse staffing decisions within a hospital setting. The Dashboard access link was installed in computers in eight nursing units within the Hamilton Health Sciences (HHS) network. The Dashboard indicators are populated from existing information/patient databases within the Decision Support Department at HHS. Committees composed of the unit manager, staff nurses, project coordinator, financial controller and an information controller met regularly to review the Dashboard indicators. Participants discussed the ability of the indicators to reflect their patients' needs and the feasibility of using the indicators to inform their clinical staffing plans. Project findings suggest that the Dashboard is a work in progress. Many of the indicators that had originally been incorporated were refined and will continue to be revised based on suggestions from project participants and further testing across HHS. Participants suggested the need for additional data, such as the time that nurses are off the unit (for code blue response, patient transfers and accompanying patients for tests); internal transfers/bed moves to accommodate patient-specific issues and particularly to address infection control issues; deaths and specific unit-centred data in addition to the generic indicators. The collaborative nature of the project enabled staff nurses and management to work together on a matter of high importance to both, providing valuable recommendations for shared nursing and interprofessional planning, further Dashboard development and project management.

  10. Determinants of hospital fall rate trajectory groups: a longitudinal assessment of nurse staffing and organizational characteristics.

    Science.gov (United States)

    Everhart, Damian; Schumacher, Jessica R; Duncan, R Paul; Hall, Allyson G; Neff, Donna F; Shorr, Ronald I

    2014-01-01

    Patient falls in acute care hospitals represent a significant patient safety concern. Although cross-sectional studies have shown that fall rates vary widely between acute care hospitals, it is not clear whether hospital fall rates remain consistent over time. The aim of this study was to determine whether hospitals can be categorized into fall rate trajectory groups over time and to identify nurse staffing and hospital characteristics associated with hospital fall rate trajectory groups. We conducted a 54-month (July 2006-December 2010) longitudinal study of U.S. acute care general hospitals participating in the National Database for Nursing Quality Indicators (2007). We used latent class growth modeling to categorize hospitals into groups based on their long-term fall rates. Nurse staffing and hospital characteristics associated with membership in the highest hospital fall rate group were identified using logistic regression. A sample of 1,529 hospitals (mean fall rate of 3.65 per 1,000 patient days) contributed data to the analysis. Latent class growth modeling findings classified hospital into three groups based on fall rate trajectories: consistently high (mean fall rate of 4.96 per 1,000 patient days), consistently medium (mean fall rate of 3.63 per 1,000 patient days), and consistently low (mean fall rate of 2.50 per 1,000 patient days). Hospitals with higher total nurse staffing (odds ratio [OR] = 0.92, 95% confidence interval [CI] [0.85, 0.99]), Magnet status (OR = 0.49, 95% CI [0.35, 0.70]), and bed size greater than 300 beds (OR = 0.70, 95% CI [0.51, 0.94]) were significantly less likely to be categorized in the "consistently high" fall rate group. Over this 54-month period, hospitals were categorized into three groups based on long-term fall rates. Hospital-level factors differed among these three groups. This suggests that there may be hospitals in which "best practices" for fall prevention might be identified. In addition, administrators may be able

  11. [Danish emergency departments are not staffed by consultants 24/7].

    Science.gov (United States)

    Mackenhauer, Julie; Møller, Cecilie; Fjældstad, Alexander; Østervig, Rebecca; Kole, Ayhan Al; Folkestad, Lars; Hallas, Peter; Brabrand, Mikkel; Møllekær, Anders; Kirkegaard, Hans

    2013-02-18

    The Danish health care system is undergoing a major reorganisation, resulting in fewer emergency departments (ED) with consultants in attendance 24/7. This questionnaire-based study evaluates the status of the reorganisation with emphasis on physician attendance and recruitment. 76% of the EDs are not staffed by consultants 24/7, 51% report difficulties in recruiting qualified personnel and 33% report problems connected to retaining them. 71% believe that a specialty in emergency medicine could help solve these problems. Danish EDs do not comply with the visions of the reorganisation plan.

  12. Using a nursing productivity committee to achieve cost savings and improve staffing levels and staff satisfaction.

    Science.gov (United States)

    McKenna, Erin; Clement, Kristina; Thompson, Elizabeth; Haas, Kathy; Weber, William; Wallace, Michelle; Stauffer, Cindy; Frailey, Jan; Anderson, Aimee; Deascenti, Missy; Hershiser, Lisa; Roda, Patricia Inama

    2011-12-01

    Challenged by rising costs, higher registered nurse vacancy rates and declining staff morale, a Nursing Productivity Committee was formed to analyze productive and nonproductive hours and seek improvements in our staffing models and scheduling processes. The changes implemented led to lower nurse to patient ratios, better control of labor costs, elimination of agency staff, greater staff satisfaction, and introduction of new technologies. Nurse managers, nursing supervisors, and frontline staff are now more knowledgeable and empowered to use creative solutions to manage their budgets and schedules in these times of fluctuating census and varying vacancy rates.

  13. Is Hypoxia common despite oxygen treatment in the Acute Medical ...

    African Journals Online (AJOL)

    The delivery of oxygen in an acute Admissions Unit is always (often) riddled with difficulties. While most patients do get oxygen at some point of time it is often uncontrolled and inappropriate. This reflects inadequate and untrained staffing in the very busy Medical Units. We did a small study on 30 random acute admissions ...

  14. Predicting future staffing needs at teaching hospitals: use of an analytical program with multiple variables.

    Science.gov (United States)

    Mitchell, Christine C; Ashley, Stanley W; Zinner, Michael J; Moore, Francis D

    2007-04-01

    To develop a model to predict future staffing for the surgery service at a teaching hospital. Tertiary hospital. A computer model with potential future variables was constructed. Some of the variables were distribution of resident staff, fellows, and physician extenders; salary/wages; work hours; educational value of rotations; work units, inpatient wards, and clinics; future volume growth; and efficiency savings. Outcomes Number of staff to be hired, staffing expense, and educational impact. On a busy general surgery service, we estimated the impact of changes in resident work hours, service growth, and workflow efficiency in the next 5 years. Projecting a reduction in resident duty hours to 60 hours per week will require the hiring of 10 physician assistants at a cost of $1 134 000, a cost that is increased by $441 000 when hiring hospitalists instead. Implementing a day of didactic and simulator time (10 hours) will further increase the costs by $568 000. A 10% improvement in the efficiency of floor care, as might be gained by advanced information technology capability or by regionalization of patients, can mitigate these expenses by as much as 21%. On the other hand, a modest annual growth of 2% will increase the costs by $715 000 to $2 417 000. To simply replace residents with alternative providers requires large amounts of human and fiscal capital. The potential for simple efficiencies to mitigate some of this expense suggests that traditional patterns of care in teaching hospitals will have to change in response to educational mandates.

  15. Lessons learned from Gen II NPP staffing approaches applicable to new reactors - 15003

    International Nuclear Information System (INIS)

    Goodnight, C.

    2015-01-01

    This paper discusses lessons learned from the operation of the Gen II fleet of existing nuclear power plants (NPPs), in terms of staffing, that can be applied to the final design, deployment, and operation of new reactor designs. The most significant of these lessons is the need to appropriately staff the facility, having the right number of people with the required skills and experience. This begs the question of how to identify those personnel requirements. For NPPs, there are five key factors that ultimately will determine the effectiveness and costs of operating nuclear power plants (NPPs): 1) The Nuclear Steam Supply System (NSSS) and the layout of the plant site; 2) The processes which the operating organization applies; 3) The organizational structure of the operating organization; 4) The organizational culture of the operating organization, and 5) The regulatory framework under which the licensee must operate. In summary, this paper identifies opportunities to minimize staffing and costs learned from Gen II NPPs that may be applicable for new nuclear plants. (author)

  16. [Model to predict staffing for anesthesiology and post-anesthesia intensive care units and pain clinics].

    Science.gov (United States)

    Canet, J; Moral, V; Villalonga, A; Pelegrí, D; Gomar, C; Montero, A

    2001-01-01

    Human resources account for a large part of the budgets of anesthesia and post-anesthesia intensive care units and pain clinics (A-PICU-PC). Adequate staffing is a key factor in providing for both effective care and professional staff development. Changes in professional responsibilities have rendered obsolete the concept of one anesthesiologist per operating room. Duties must be analyzed objectively to facilitate understanding between hospital administrators and A-PICU-PC chiefs of service when assigning human resources. The Catalan Society of Anesthesiology, Post-anesthesia Intensive Care and Pain Therapy has developed a model for estimating requirements for A-PICU-PC staffing based on three factors: 1) Definition of staff positions that must be filled and criteria for assigning human resources; 2) Estimation of non-care-related time required by the department for training, teaching, research and internal management, and 3) Estimation of staff required to cover absences from work for vacations, personal leave or illness. The model revealed that the ratio of number of staff positions to number of persons employed by an A-PICU-PC is approximately 1.3. Differences in the nature of services managed by an A-PICU-PC or the type of hospital might change the ratio slightly. The model can be applied universally, independently of differences that might exist among departments. Widespread application would allow adoption of a common language to be used by health care managers and A-PICU-PC departments when discussing a basis for consensus about our specialty.

  17. Influence of design improvements in optimising staffing of NPPs - an Indian experience

    International Nuclear Information System (INIS)

    Bhattacharya, A.S.

    2001-01-01

    Three decades of operating experience in India has led to sustained high performance of NPP's. The staffing modules and policies are standardised. The basic functions of operation, maintenance, technical support and quality assurance are carried out by a team of 727 in-plant persons (for a 2 x 220 MW PHWR station) organised at five levels, for fifty positions in ten job families. The organisational factors that led to optimising of staff are described in the companion paper. This optimisation of manpower is a result of continuous learning - for (i) optimising quantum of workload and (ii) improving productivity. For the first category, design improvements over older Indian NPP's have increased reliability, operability, maintainability and human factors. Few examples: (i) improved man-machine interface in plant controls and on-power refuelling system with operator guidance, logging as well as diagnostic/health monitoring features; (ii) spread out layout for better access and ease of maintenance, separation of plant services for unit-1 from unit-2 and, removal of reactor auxiliaries out to separate buildings; (iii) reduction of maintenance tasks through redesigned equipment and improved condition monitoring means. However, design and procedural improvements also include additional equipment for upgradation of safety measures, e.g. larger number of safety related pumps separate switchyard control room and increased service system equipment. This paper outlines experience of design improvements in optimising staffing and uses a specific case illustration to establish the findings for better use of staff. (author)

  18. [Effects of cost saving strategies and staffing levels on patient and nurse outcomes. A literature review].

    Science.gov (United States)

    Schubert, Maria; Schaffert-Witvliet, Bianca; De Geest, Sabina

    2005-10-01

    The effects of cost saving strategies and changes in staffing levels and skill mix in the inpatient care setting on patient and nurse outcomes have not yet been examined in Switzerland. In 2002 the Swiss Federal Office of Health mandated the Institute of Nursing Science at the University of Basel to conduct a literature review to examine the evidence available on this topic. The literature research and analysis cover the period from 1991 to 2003. Sixty publications out of a total of 260 reviewed abstracts were included and analyzed. The results show that in the inpatient care settings in Switzerland as well as in other countries positions for registered nurses have been reduced and/or the qualification and skill mix in care teams have been downgraded. Given the present health care situation where the intensity and complexity of caring for hospitalized patients is increasing, an imbalance occurs between the need for high quality care and the possibilities to offer this care. This affects patients' and nurses outcomes. The international results show a significant relationship between lower staffing levels and skill mix in care teams and higher complication, "failure-to-rescue", and mortality rates in patients, as well as a lower job satisfaction, and higher fluctuation, burnout and work-related injury rates in nursing personnel. Thus, nursing care within hospitals represents not only a cost factor but also an important quality factor which is essential in order to be able to realize good patient's outcomes.

  19. Enhancing Nursing Staffing Forecasting With Safety Stock Over Lead Time Modeling.

    Science.gov (United States)

    McNair, Douglas S

    2015-01-01

    In balancing competing priorities, it is essential that nursing staffing provide enough nurses to safely and effectively care for the patients. Mathematical models to predict optimal "safety stocks" have been routine in supply chain management for many years but have up to now not been applied in nursing workforce management. There are various aspects that exhibit similarities between the 2 disciplines, such as an evolving demand forecast according to acuity and the fact that provisioning "stock" to meet demand in a future period has nonzero variable lead time. Under assumptions about the forecasts (eg, the demand process is well fit as an autoregressive process) and about the labor supply process (≥1 shifts' lead time), we show that safety stock over lead time for such systems is effectively equivalent to the corresponding well-studied problem for systems with stationary demand bounds and base stock policies. Hence, we can apply existing models from supply chain analytics to find the optimal safety levels of nurse staffing. We use a case study with real data to demonstrate that there are significant benefits from the inclusion of the forecast process when determining the optimal safety stocks.

  20. Animal Research International: Contact

    African Journals Online (AJOL)

    Principal Contact. Dr. J. E. Eyo Dr. Department of Zoology, University of Nig Department of Zoology, POBox 3146, University of Nigeria, Nsukka, Enugu State, Nigeria. Phone: 234 42 308030. Email: joseph.eyo@unn.edu.ng. Support Contact. N. S. Oluah Phone: +234-83732127. Email: ndubusioluah@yahoo.com.

  1. Contact Hamiltonian mechanics

    Energy Technology Data Exchange (ETDEWEB)

    Bravetti, Alessandro, E-mail: alessandro.bravetti@iimas.unam.mx [Instituto de Investigaciones en Matemáticas Aplicadas y en Sistemas, Universidad Nacional Autónoma de México, A. P. 70543, México, DF 04510 (Mexico); Cruz, Hans, E-mail: hans@ciencias.unam.mx [Instituto de Ciencias Nucleares, Universidad Nacional Autónoma de México, A. P. 70543, México, DF 04510 (Mexico); Tapias, Diego, E-mail: diego.tapias@nucleares.unam.mx [Facultad de Ciencias, Universidad Nacional Autónoma de México, A.P. 70543, México, DF 04510 (Mexico)

    2017-01-15

    In this work we introduce contact Hamiltonian mechanics, an extension of symplectic Hamiltonian mechanics, and show that it is a natural candidate for a geometric description of non-dissipative and dissipative systems. For this purpose we review in detail the major features of standard symplectic Hamiltonian dynamics and show that all of them can be generalized to the contact case.

  2. Discovery and Innovation: Contact

    African Journals Online (AJOL)

    Principal Contact. Prof. Keto Mshigeni Editor-in-Chief Academy Science Publishers. PO Box 14798-00200. Nairobi. Kenya. Phone: 254 (20) 884401-5. Fax: 254 (20) 884406. Email: aas@aasciences.org. Support Contact. Prof. Keto Mshigeni Email: aas@aasciences.org. ISSN: 1015-079X. AJOL African Journals Online.

  3. LBS Management Review: Contact

    African Journals Online (AJOL)

    Principal Contact. Dr Obinna Muogboh Managing Editor Lagos Business School Pan African University 2 Ahmed Onibudo Street, P.O. Box 73688, Victoria Island, Lagos, NIGERIA Email: omuogboh@lbs.edu.ng. Support Contact. Editor Email: omuogboh@lbs.edu.ng. ISSN: 1118-3713. AJOL African Journals Online.

  4. Contact Quality in Participation

    DEFF Research Database (Denmark)

    Simonsen, Jesper; Jensen, Olav Storm

    2016-01-01

    We investigate the concept of participation from the perspective of quality of the contact in the communicative interactions between participants. We argue for the need for an academic-personal competence that qualifies the human contact central in all Participatory Design (PD) activities as a wa...

  5. Electric contact arcing

    International Nuclear Information System (INIS)

    Cuthrell, R.E.

    1976-01-01

    Electrical contacts must function properly in many types of components used in nuclear weapon systems. Design, application, and testing of these components require detailed knowledge of chemical and physical phenomena associated with stockpile storage, stockpile testing, and operation. In the past, investigation of these phenomena has led to significant discoveries on the effects of surface contaminants, friction and wear, and the mechanics of closure on contact performance. A recent investigation of contact arcing phenomena which revealed that, preceding contact closure, arcs may occur at voltages lower than had been previously known is described. This discovery is important, since arcing may damage contacts, and repetitive testing of contacts performed as part of a quality assurance program might produce cumulative damage that would yield misleading life-test data and could prevent proper operation of the contacts at some time in the future. This damage can be avoided by determining the conditions under which arcing occurs, and ensuring that these conditions are avoided in contact testing

  6. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Eye Health A-Z Symptoms Glasses & Contacts Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye ... colored contact lenses , from the U.S. Food and Drug Administration (FDA). Are the colored lenses you are ...

  7. Sciences & Nature: Contact

    African Journals Online (AJOL)

    Principal Contact. Ehouan Etienne Ehile Professor University of Abobo-Adjamé 02 BP 801 Abidjan 02. Phone: (+225) 2030 4201. Fax: (+225) 2030 4203. Email: eh_ehile@yahoo.fr. Support Contact. Irie Zoro Bi Email: banhiakalou@yahoo.fr. ISSN: 1812-0741. AJOL African Journals Online. HOW TO USE AJOL.

  8. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... in Cleveland. "This is far from the truth." Real People, Real Problems with Colored Contact Lenses Julian: Teenager Blinded ... use of colored contact lenses , from the U.S. Food and Drug Administration (FDA). Are the colored lenses ...

  9. African Zoology: Contact

    African Journals Online (AJOL)

    Principal Contact. Lester Isaacs Phone: +27466229698. Fax: +2746 622 9550. Email: lester@nisc.co.za. Support Contact. NISC office. Email: info@nisc.co.za. ISSN: 2224-073X. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners ...

  10. Afrika Statistika: Contact

    African Journals Online (AJOL)

    Principal Contact. Prof. Gane Samb Lo Editor Université Gaston Berger BP 234, Université Saint-Louis Sénégal Phone: 221 961 23 40. Fax: 221 961 53 38. Email: ganesamblo@yahoo.com. Support Contact. Mamadou Camara Email: mdoucamara@gmail.com. ISSN: 2316-090X. AJOL African Journals Online. HOW TO ...

  11. Nigerian Food Journal: Contact

    African Journals Online (AJOL)

    Nigerian Food Journal. ... Nigerian Food Journal: Contact. Journal Home > About the Journal > Nigerian Food Journal: Contact. Log in or Register to get access to full text downloads. ... Mailing Address. Department of Food Science and Technology University of Agriculture, Makurdi, Nigeria ...

  12. Lettuce contact allergy

    DEFF Research Database (Denmark)

    Paulsen, Evy; Andersen, Klaus E

    2016-01-01

    degradability of lettuce allergens, it is recommended to patch test with freshly cut lettuce stem and supplement this with Compositae mix. As contact urticaria and protein contact dermatitis may present as dermatitis, it is important to perform prick-prick tests, and possibly scratch patch tests as well. Any...

  13. Medication management roles in assisted living.

    Science.gov (United States)

    Sikma, Suzanne K; Young, Heather M; Reinhard, Susan C; Munroe, Donna J; Cartwright, Juliana; McKenzie, Glenise

    2014-06-01

    Residents in assisted living (AL) frequently need assistance with medication management. Rooted in a social model, AL serves people facing increasing health management challenges as they "age in place." This study explored roles in AL medication management and satisfaction with unlicensed assistive personnel (UAP) as medication aides, a cost-effective staffing approach that is used frequently. The sample included 112 participants representing all parties involved in medication administration (residents, medication aides, administrators, RNs and licensed practical nurses, pharmacists, and primary care providers) in 15 AL settings in four states. Results include description of medication management roles; empirical validation of existing AL nursing professional standards; and satisfaction with the role of UAP as medication aide from all perspectives. Clinical implications include creating a supportive environment for medication aides (i.e., UAPs); the importance of the RN role as facilitator of AL medication management; and the need for collaboration and interprofessional team development across disparate settings. Copyright 2014, SLACK Incorporated.

  14. Contact materials for nanoelectronics

    KAUST Repository

    Alshareef, Husam N.

    2011-02-01

    In this article, we review current research activities in contact material development for electronic and nanoelectronic devices. A fundamental issue in contact materials research is to understand and control interfacial reactions and phenomena that modify the expected device performance. These reactions have become more challenging and more difficult to control as new materials have been introduced and as device sizes have entered the deep nanoscale. To provide an overview of this field of inquiry, this issue of MRS Bulletin includes articles on gate and contact materials for Si-based devices, junction contact materials for Si-based devices, and contact materials for alternate channel substrates (Ge and III-V), nanodevices. © 2011 Materials Research Society.

  15. Contact with hospital syringes containing body fluids: implications for medical waste management regulation Jeringas en contacto con sangre y fluidos corporales utilizadas en el hospital: implicaciones para el manejo de desechos hospitalarios

    Directory of Open Access Journals (Sweden)

    Patricia Volkow

    2003-04-01

    Full Text Available OBJECTIVE: To determine amount of syringes used in the hospital and extent of contact with blood and body fluids of these syringes. MATERIAL AND METHODS: Syringe use was surveyed at a tertiary care center for one week; syringes were classified into the following four categories according to use: a contained blood; b contained other body fluids (urine, gastric secretion, cerebrospinal fluid, wound drainage; c used exclusively for drug dilution and application in plastic intravenous (IV tubes, and d for intramuscular (IM, subcutaneous (SC, or intradermic (ID injections. RESULTS: A total of 7 157 plastic disposable syringes was used; 1 227 (17% contained blood during use, 346 (4.8%, other body fluids, 5 257 (73% were used exclusively for drug dilution and application in plastic IV lines, and 327 (4.5% were utilized for IM, SC, or ID injections. An estimated 369 140 syringes used annually, or eight syringes per patient per in-hospital day. All syringes were disposed of as regulated medical waste, in observance of the law. CONCLUSIONS: There is an urgent need to review recommendations for medical waste management by both international agencies and local governments, based on scientific data and a cost-benefit analysis, to prevent resource waste and further environmental damage.OBJETIVO: Cuantificar el número de jeringas que se utilizan en el hospital y calcular cuántas de éstas entran en contacto con sangre o fluidos corporales. MATERIAL Y MÉTODOS: Se hizo una encuesta del uso de jeringas en un hospital de tercer nivel de atención durante toda una semana. Se clasificaron, de acuerdo con el uso que se les dio, en cuatro categorías: a aspiración de sangre, b otros fluidos corporales (orina, secreción gástrica, líquido cefalorraquídeo, drenaje de herida, etcétera, c uso exclusivo para diluir medicamentos y administrarlos a través de tubos de terapia intravenosa, d para aplicación de inyecciones intramusculares (IM, subcutáneas (SC o

  16. A consensus-based template for documenting and reporting in physician-staffed pre-hospital services

    DEFF Research Database (Denmark)

    Kruger, Andreas J; Lockey, David; Kurola, Jouni

    2011-01-01

    -staffed pre-hospital services in Europe. METHODS: Using predefined criteria, we recruited sixteen European experts in the field of pre-hospital care. These experts were guided through a four-step modified nominal group technique. The process was carried out using both e-mail-based communication and a plenary...... have established a core data set for documenting and reporting in physician-staffed pre-hospital services. We believe that this template could facilitate future studies within the field and facilitate standardised reporting and future shared research efforts in advanced pre-hospital care....

  17. [Personnel requirements of medical radiation physics in radiotherapy in comparison to the current guidelines "radiation protection in medicine" : Special consideration of intensity-modulated radiation therapy].

    Science.gov (United States)

    Leetz, H-K; Eipper, H H; Gfirtner, H; Schneider, P; Welker, K

    2014-08-01

    In 1994 and 1998 reports on staffing levels in medical radiation physics for radiation therapy were published by the "Deutsche Gesellschaft für Medizinische Physik" (DGMP, German Society for Medical Physics). Because of the technical and methodological progress, changes in recommended qualifications of staff and new governmental regulations, it was necessary to establish new staffing levels. The data were derived from a new survey in clinics. Some of the previously established results from the old reports were adapted to the new conditions by conversion.The staffing requirements were normalized to main components as in the earlier reports resulting in a simple method for calculation of staffing levels. The results were compared with the requirements in the "Richtlinie Strahlenschutz in der Medizin" (guidelines on radiation protection in medicine) and showed satisfactory agreement.

  18. Contacts to semiconductors

    International Nuclear Information System (INIS)

    Tove, P.A.

    1975-08-01

    Contacts to semiconductors play an important role in most semiconductor devices. These devices range from microelectronics to power components, from high-sensitivity light or radiation detectors to light-emitting of microwave-generating components. Silicon is the dominating material but compound semiconductors are increasing in importance. The following survey is an attempt to classify contact properties and the physical mechanisms involved, as well as fabrication methods and methods of investigation. The main interest is in metal-semiconductor type contacts where a few basic concepts are dealt with in some detail. (Auth.)

  19. Colored Contact Lens Dangers

    Medline Plus

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  20. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... colored contact lenses to enhance their costumes. From blood-drenched vampire eyes to glow-in-the-dark ... properly fitted may scratch the eye or cause blood vessels to grow into the cornea. Even if ...

  1. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... had not been properly fitted by an eye care professional, the lenses stuck to my eye like ... lenses do not require the same level of care or consideration as a standard contact lens because ...

  2. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... use of colored contact lenses , from the U.S. Food and Drug Administration (FDA). Are the colored lenses ... 2018 By Dan T. Gudgel Do you know what the difference is between ophthalmologists and optometrists? A ...

  3. Ergonomics SA: Contact

    African Journals Online (AJOL)

    Principal Contact. Mrs June McDougall. Rhodes University. Department of Human Kinetics and Ergonomics. P.O. Box 94. Rhodes University. Grahamstown. 6140. Phone: +27 46 6038471. Email: j.mcdougall@ru.ac.za ...

  4. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... sell contacts without a prescription are breaking the law, and may be fined $11,000 per violation. " ... 13, 2017 Histoplasmosis Diagnosis Sep 01, 2017 How common is retinal detachment for people with high myopia? ...

  5. Tomato contact dermatitis

    DEFF Research Database (Denmark)

    Paulsen, Evy; Christensen, Lars P; Andersen, Klaus Ejner

    2012-01-01

    The tomato plant (Solanum lycopersicum) is an important crop worldwide. Whereas immediate-type reactions to tomato fruits are well known, contact dermatitis caused by tomatoes or tomato plants is rarely reported. The aims of this study were to present new data on contact sensitization to tomato...... plants and review the literature on contact dermatitis caused by both plants and fruits. An ether extract of tomato plants made as the original oleoresin plant extracts, was used in aimed patch testing, and between 2005 and 2011. 8 of 93 patients (9%) tested positive to the oleoresin extracts....... This prevalence is in accordance with the older literature that reports tomato plants as occasional sensitizers. The same applies to tomato fruits, which, in addition, may cause protein contact dermatitis. The allergens of the plant are unknown, but both heat-stable and heat-labile constituents seem...

  6. Fragrance allergic contact dermatitis.

    Science.gov (United States)

    Cheng, Judy; Zug, Kathryn A

    2014-01-01

    Fragrances are a common cause of allergic contact dermatitis in Europe and in North America. They can affect individuals at any age and elicit a spectrum of reactions from contact urticaria to systemic contact dermatitis. Growing recognition of the widespread use of fragrances in modern society has fueled attempts to prevent sensitization through improved allergen identification, labeling, and consumer education. This review provides an overview and update on fragrance allergy. Part 1 discusses the epidemiology and evaluation of suspected fragrance allergy. Part 2 reviews screening methods, emerging fragrance allergens, and management of patients with fragrance contact allergy. This review concludes by examining recent legislation on fragrances and suggesting potential additions to screening series to help prevent and detect fragrance allergy.

  7. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... an impulsive buy from a souvenir shop, but 10 hours after she first put in a pair ... Prescription Contact Lens Laura: Vision Loss After Just 10 Hours Robyn: Blurry Vision and Daily Eye Drops ...

  8. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... in beauty salons, novelty shops or in pop-up Halloween stores are not FDA-approved and are ... share contact lenses with another person. Get follow up exams with your eye care provider. If you ...

  9. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... videos on your website Promotional materials for eye health observances EyeSmart resources are also available in Spanish . Follow The Academy Professionals: Education Guidelines News Multimedia Public & Patients: Contact Us About the Academy Jobs at ...

  10. GAS-FOVEAL CONTACT

    DEFF Research Database (Denmark)

    Alberti, Mark; la Cour, Morten

    2018-01-01

    PURPOSE: To compare gas-foveal contact in face-down positioning (FDP) and nonsupine positioning (NSP), to analyze causes of gas-foveal separation and to determine how gas-foveal contact affects clinical outcome after idiopathic macular hole repair. METHODS: Single center, randomized controlled...... study. Participants with an idiopathic macular hole were allocated to either FDP or NSP. Primary outcome was gas-foveal contact, calculated by analyzing positioning in relation to intraocular gas fill. Positioning was measured with an electronic device recording positioning for 72 hours postoperatively....... RESULTS: Positioning data were available for 33/35 in the FDP group and 35/37 in the NSP group, thus results are based on 68 analyzed participants. Median gas-foveal contact was 99.82% (range 73.6-100.0) in the FDP group and 99.57% (range 85.3-100.0) in the NSP group (P = 0.22). In a statistical model...

  11. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Health A-Z Symptoms Glasses & Contacts Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye Health / News Halloween Hazard: The Hidden Dangers of Buying Decorative ...

  12. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... to the journals may be interrupted during this time. We are working to resolve the issue quickly ... like a suction cup." Halloween is a popular time for people to use colored contact lenses to ...

  13. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Purchase the colored contact lenses from an eye product retailer who asks for a prescription. Follow the ... for people with high myopia? Mar 29, 2017 New Technology Helps the Legally Blind Be More Independent ...

  14. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Hidden Dangers of Buying Decorative Contact Lenses Without a Prescription Leer en Español: Peligros asociados con los ... contacto de color Sep. 26, 2013 It started as an impulsive buy from a souvenir shop, but ...

  15. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... sell contacts without a prescription are breaking the law, and may be fined $11,000 per violation. " ... American Academy of Ophthalmology 2018 Our Sites EyeWiki International Society of Refractive Surgery * Required * First Name: * Last ...

  16. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... be purchased over-the-counter or on the Internet," says Thomas Steinemann, MD, professor of ophthalmology at ... are being sold illegally," Dr. Steinemann said. Never buy colored contact lenses from a retailer that does ...

  17. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Patient Stories Español Eye Health / News Halloween Hazard: The Hidden Dangers of Buying Decorative Contact Lenses Without ... been properly fitted by an eye care professional, the lenses stuck to my eye like a suction ...

  18. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Español Eye Health / News Halloween Hazard: The Hidden Dangers of Buying Decorative Contact Lenses Without a Prescription ... people with high myopia? Mar 29, 2017 New Technology Helps the Legally Blind Be More Independent Oct ...

  19. Contact Lens Risks

    Science.gov (United States)

    ... Tap and distilled water have been associated with Acanthamoeba keratitis, a corneal infection that is resistant to ... to: Advice for Patients With Soft Contact Lenses: Acanthamoeba Keratitis Infections Related to Complete® MoisturePlus Multi Purpose ...

  20. Contact Heat Exchanger

    Science.gov (United States)

    Fleming, M. L.; Stalmach, D. D.; Cox, R. L.

    1985-01-01

    Fluid pressure controls contact between heat pipe and heat exchanger. Heat exchanger system in cross section provides contact interface between fluid system and heat pipe with easy assembly/disassembly of heat-pipe/ pumped-liquid system. Originally developed for use in space, new device applicable on Earth where fluid system is linked with heat pipe, where rapid assembly/disassembly required, or where high pressures or corrosive fluids used.

  1. The relationship between UK hospital nurse staffing and emotional exhaustion and job dissatisfaction.

    Science.gov (United States)

    Sheward, Louisa; Hunt, Jennifer; Hagen, Suzanne; Macleod, Margaret; Ball, Jane

    2005-01-01

    To explore the relationship between nurse outcomes (dissatisfaction and emotional exhaustion) and nurse workload, nurse characteristics and hospital variables. Concern about the impact of restructuring of nurse staffing, and reports of nurse shortages, on nurse and patient outcomes led to the research being reported on in this article. A questionnaire survey of registered nurses in Scotland and England. A questionnaire survey of the hospitals in which these nurses worked. Respondents in the two countries were similar in terms of demographic, work and employment characteristics. Significant relationships were found using the combined English and Scottish data between nurse patient ratios and (1) emotional exhaustion and (2) dissatisfaction with current job reported by nurses. Increasing numbers of patients to nurses was associated with increasing risk of emotional exhaustion and dissatisfaction with current job.

  2. Strategic foresight, leadership, and the future of rural healthcare staffing in the United States.

    Science.gov (United States)

    Reimers-Hild, Connie

    2018-04-10

    This article uses a strategic foresight tool, megatrends, to examine forces influencing long-term healthcare staffing in the rural United States. Two megatrends-exponential advances in science and technology and the continued evolution of the decentralized global marketplace-will influence and ultimately help shape the future of rural healthcare. Successful health ecosystems of the future will need to be customer-driven, more affordable, and tech-savvy. Successful evolution in an era of continuous change will require a blend of intentional engagement with stakeholders, strategic foresight, and future-focused leadership. More research is needed to fully understand not only the challenges of rural healthcare but also the emerging opportunities.

  3. An Innovative Approach to Staffing a Simulation Center in a College of Health Professions.

    Science.gov (United States)

    Berro, Elizabeth A; Knoesel, Joanne M

    2016-01-01

    The current limited number of nurse faculty and available clinical sites requires innovative strategies to provide education to current and future nurses. Simulation centers and clinical education laboratories can meet this need, but staffing issues can be problematic. This article describes how an urban university developed a cost-effective model to staff its clinical education laboratory. After two faculty members proposed a pilot program to fully integrate simulation into both the accelerated and traditional undergraduate nursing programs on two campuses, a need was identified for more nursing staff dedicated to the simulation program. Knowing that many recent nurse graduates were available while waiting to obtain their first nursing position, these new nurses were recruited to serve in a volunteer capacity, supporting nursing faculty in the simulation program. The new nurse graduate volunteer position quickly evolved into a paid nurse intern position and has proven to benefit students, faculty, and new nurse graduates. Copyright 2016, SLACK Incorporated.

  4. Analysis and practical use: the Abt Study of Medical Physicist Work Values for Radiation Oncology Physics Services--round II.

    Science.gov (United States)

    Mills, Michael D

    2005-09-01

    The initial Abt Study of Medical Physicist Work Values for Radiation Oncology Physics Services was published in October 1995. That study measured qualified medical physicist (QMP) work associated only with routine radiation oncology procedures. In the intervening years, medical physics practice has changed dramatically. Three-dimensional treatment planning, once considered a special procedure, is the standard of care for many patient presentations. Prostate seed brachytherapy, stereotactic procedures, and intensity-modulated radiation therapy now constitute a large portion of the time medical physicists devote to clinical duties. Special procedures now dominate radiation oncology, leading to the request for an updated work and staffing study for qualified medical physicists. The updated Abt Study of Medical Physicist Work Values for Radiation Oncology Physics Services: Round II was published in June 2003. Round II measures and reports QMP work associated with both routine and most contemporary special procedures. Additionally, staffing patterns are reported for a variety of practice settings. A work model is created to allow medical physicists to defend QMP work on the basis of both routine and special procedures service mix. The work model can be used to develop a cost justification report for setting charges for radiation oncology physics services. The work and cost justification models may in turn be used to defend medical physicist staffing and compensation. The updated Abt study empowers medical physicists to negotiate service or employment contracts with providers on the basis of measured national QMP work force and staffing data.

  5. Factors that guide nurse managers regarding the staffing of agency nurses in intensive care units at private hospitals in Pretoria

    Directory of Open Access Journals (Sweden)

    Karien Jooste

    2013-01-01

    Full Text Available Staffing needs affect the nursing department’s budget, staff productivity, the quality of care provided to patients and even the retention of nurses. It is unclear how the role players (the nursing agency manager, the nurse manager and the agency nurse perceive the staffing of agency nurses in intensive care units (ICUs. The purpose of this study was to explore and describe the factors that guide nurse managers regarding the staffing of agency nurses in ICUs at private hospitals in Pretoria. A quantitative exploratory and descriptive design was used. A survey by means of a structured questionnaire was carried out. Probability sampling was implemented to obtain a study sample (n = 124. One similar self-administered 5-point scale instrument was completed by the participants. Data was analysed by means of descriptive and inferential statistics. The principles of validity and reliability were adhered to and ethical considerations were also taken into account. The results indicated limitations in the determining of posts, recruitment and advertising, as well as the selection and appointment of agency nurses in ICUs at private hospitals in Pretoria. Recommendations on staffing are made to nurse managers in ICUs.

  6. Determinants and effects of nurse staffing intensity and skill mix in residential care/assisted living settings.

    Science.gov (United States)

    Stearns, Sally C; Park, Jeongyoung; Zimmerman, Sheryl; Gruber-Baldini, Ann L; Konrad, Thomas R; Sloane, Philip D

    2007-10-01

    Residential care/assisted living facilities have become an alternative to nursing homes for many individuals, yet little information exists about staffing in these settings and the effect of staffing. This study analyzed the intensity and skill mix of nursing staff using data from a four-state study, and their relationship to outcomes. We obtained longitudinal data for 1,894 residents of 170 residential care/assisted living facilities participating in the Collaborative Studies of Long-Term Care. Descriptive statistics assessed the levels of direct care staff (registered nurse, licensed practical nurse, personal care aide). Regression analyses evaluated the relationship between two staffing measures (intensity measured as care hours per resident and skill mix measured as the percentage of total care hours by licensed nurses), facility characteristics, and four health outcomes (mortality, nursing home transfer, hospitalization, and incident morbidity). Care hours per resident decreased with facility size (economies of scale) only for very small facilities and increased with dementia prevalence (case-mix effect). Licensed staff accounted for a greater proportion of total hours in nonprofit settings. Health outcomes did not vary by total care hours per resident, but hospitalization rates were significantly lower in facilities with higher proportions of skilled staff hours; this effect was stronger as dementia case mix increased. Current staffing levels for the outcomes analyzed meet most residents' needs. Reduced hospitalization in relation to greater use of licensed staff suggests that increased use of these workers might result in reductions in acute care expenditures.

  7. 9 CFR 310.1 - Extent and time of post-mortem inspection; post-mortem inspection staffing standards.

    Science.gov (United States)

    2010-01-01

    ... 288 4 4 2 289 to 316 5 4 2 317 to 343 5 5 2 (3) Swine Inspection. The following inspection staffing standards are applicable to swine slaughter configurations. The inspection standards for all slaughter lines..., liver, heart, lungs, and mediastinal lymph nodes. In addition, for one- and two-inspector lines, the...

  8. 75 FR 69468 - Progressive Furniture, Inc., Including On-Site Leased Workers From Onin Staffing, a Subsidiary of...

    Science.gov (United States)

    2010-11-12

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-73,756] Progressive Furniture, Inc., Including On-Site Leased Workers From Onin Staffing, a Subsidiary of Sauder Furniture, Claremont, NC; Notice of Affirmative Determination Regarding Application for Reconsideration On July 19, 2010...

  9. 77 FR 63873 - Johnson Controls, Inc. Including On-Site Leased Workers of Valley Staffing and AZ Quality Hudson...

    Science.gov (United States)

    2012-10-17

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-81,067] Johnson Controls, Inc... workers of Johnson Controls, Inc., including on-site leased workers from Valley Staffing, Hudson... subject firm. The company reports that workers leased from AZ Quality were employed on-site at the Hudson...

  10. 77 FR 19719 - Whirlpool Corporation Including On-Site Leased Workers From Career Solutions TEC Staffing, IBM...

    Science.gov (United States)

    2012-04-02

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,593] Whirlpool Corporation... Staffing, Fort Smith, Arkansas. The workers are engaged in the production of refrigerators and trash... trash compactors to Mexico. The amended notice applicable to TA-W-74,593 is hereby issued as follows...

  11. 75 FR 77665 - Whirlpool Corporation, Including On-Site Leased Workers From Career Solutions TEC Staffing and...

    Science.gov (United States)

    2010-12-13

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,593] Whirlpool Corporation, Including On-Site Leased Workers From Career Solutions TEC Staffing and Andrews International, Fort Smith... subject firm. The workers are engaged in the production of refrigerators and trash compactors. The company...

  12. Design Effects and Generalized Variance Functions for the 1990-91 Schools and Staffing Survey (SASS). Volume I. User's Manual.

    Science.gov (United States)

    Salvucci, Sameena; And Others

    This user's manual summarizes the results and use of design effects and generalized variance functions (GVF) to approximate standard errors for the 1990-91 Schools and Staffing Survey (SASS). It is Volume I of a two-volume publication that is part of the Technical Report series of the National Center for Education Statistics (NCES). The SASS is a…

  13. The Impact of Office Automation on the Roles and Staffing Patterns of Office Employees: A Case Study.

    Science.gov (United States)

    Goodrich, Elizabeth A.

    1989-01-01

    The study examined impact of office automation on the roles and staffing patterns of office employees at the National Institute of Neurological and Communicative Disorders and Stroke. Results of an interview study indicate that automation has had a favorable impact on the way work is accomplished and on the work environment. (Author/CH)

  14. The effects of ownership, staffing level and organisational justice on nurse commitment, involvement, and satisfaction: a questionnaire study.

    Science.gov (United States)

    Heponiemi, Tarja; Elovainio, Marko; Kouvonen, Anne; Kuusio, Hannamaria; Noro, Anja; Finne-Soveri, Harriet; Sinervo, Timo

    2011-12-01

    Elderly care systems have undergone a lot of changes in many European countries, including Finland. Most notably, the number of private for-profit firms has increased. Previous studies suggest that employee well-being and the quality of care might differ according to the ownership type. The present study examined whether the ownership type and the staffing level were associated with organisational commitment, job involvement, and job satisfaction. In addition, we examined the potential moderating effect of organisational justice on these associations. Cross-sectional questionnaire study. 1047 Finnish female staff members aged 18-69 years working in sheltered housing or nursing homes (units n=179). The relationships were studied with analyses of covariance (ANCOVA), adjusting for the effects of age and case-mix. Organisational commitment and job satisfaction levels were low in for-profit sheltered homes when justice levels were low, but when justice levels were high, for-profit sheltered homes did not differ from other ownership types. Similarly, organisational justice acted as a buffer against low commitment resulting from low staffing levels. Staffing levels were lowest in public sheltered homes and highest in not-for-profit sheltered homes. The results show that organisational justice can act as a buffer against low organisational commitment that results from low staffing levels and working in for-profit sheltered homes. Increasing justice in regard to the management, outcomes, and procedures in the organisation would thus be important. 2011 Elsevier Ltd. All rights reserved.

  15. Applying cost accounting to operating room staffing in otolaryngology: time-driven activity-based costing and outpatient adenotonsillectomy.

    Science.gov (United States)

    Balakrishnan, Karthik; Goico, Brian; Arjmand, Ellis M

    2015-04-01

    (1) To describe the application of a detailed cost-accounting method (time-driven activity-cased costing) to operating room personnel costs, avoiding the proxy use of hospital and provider charges. (2) To model potential cost efficiencies using different staffing models with the case study of outpatient adenotonsillectomy. Prospective cost analysis case study. Tertiary pediatric hospital. All otolaryngology providers and otolaryngology operating room staff at our institution. Time-driven activity-based costing demonstrated precise per-case and per-minute calculation of personnel costs. We identified several areas of unused personnel capacity in a basic staffing model. Per-case personnel costs decreased by 23.2% by allowing a surgeon to run 2 operating rooms, despite doubling all other staff. Further cost reductions up to a total of 26.4% were predicted with additional staffing rearrangements. Time-driven activity-based costing allows detailed understanding of not only personnel costs but also how personnel time is used. This in turn allows testing of alternative staffing models to decrease unused personnel capacity and increase efficiency. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  16. 77 FR 29362 - Kohler Company, Malvern Division, Including On-Site Leased Workers From Manpower Staffing and Dow...

    Science.gov (United States)

    2012-05-17

    ... Division, Including On-Site Leased Workers From Manpower Staffing and Dow Cleaning Services, Malvern, AR..., and components. The company reports that workers from Dow Cleaning Services were employed on-site at... leased from Dow Cleaning Services working on-site at the Malvern, Arkansas location of Kohler Company...

  17. Patients with multiple contact allergies

    DEFF Research Database (Denmark)

    Carlsen, Berit Christina; Andersen, Klaus Ejner; Menné, Torkil

    2008-01-01

    Patients with multiple contact allergies, also referred to as polysensitized, are more frequent than predicted from prevalence of single sensitivities. The understanding of why some people develop multiple contact allergies, and characterization of patients with multiple contact allergies...... of developing multiple contact allergies. Evidence of allergen clusters among polysensitized individuals is also reviewed. The literature supports the idea that patients with multiple contact allergies constitute a special entity within the field of contact allergy. There is no generally accepted definition...... of patients with multiple contact allergies. We suggest that contact allergy to 3 or more allergens are defined as multiple contact allergies....

  18. Trauma Center Staffing, Infrastructure, and Patient Characteristics that Influence Trauma Center Need

    Directory of Open Access Journals (Sweden)

    Faul, Mark

    2014-11-01

    Full Text Available Introduction: The most effective use of trauma center resources helps reduce morbidity and mortality, while saving costs. Identifying critical infrastructure characteristics, patient characteristics and staffing components of a trauma center associated with the proportion of patients needing major trauma care will help planners create better systems for patient care.   Methods: We used the 2009 National Trauma Data Bank-Research Dataset to determine the proportion of critically injured patients requiring the resources of a trauma center within each Level I-IV trauma center (n=443. The outcome variable was defined as the portion of treated patients who were critically injured. We defined the need for critical trauma resources and interventions (“trauma center need” as death prior to hospital discharge, admission to the intensive care unit, or admission to the operating room from the emergency department as a result of acute traumatic injury. Generalized Linear Modeling (GLM was used to determine how hospital infrastructure, staffing Levels, and patient characteristics contributed to trauma center need.     Results: Nonprofit Level I and II trauma centers were significantly associated with higher levels of trauma center need. Trauma centers that had a higher percentage of transferred patients or a lower percentage of insured patients were associated with a higher proportion of trauma center need.  Hospital infrastructure characteristics, such as bed capacity and intensive care unit capacity, were not associated with trauma center need. A GLM for Level III and IV trauma centers showed that the number of trauma surgeons on staff was associated with trauma center need. Conclusion: Because the proportion of trauma center need is predominantly influenced by hospital type, transfer frequency, and insurance status, it is important for administrators to consider patient population characteristics of the catchment area when planning the

  19. Does mental health staffing level affect antipsychotic prescribing? Analysis of Italian national statistics.

    Science.gov (United States)

    Starace, Fabrizio; Mungai, Francesco; Barbui, Corrado

    2018-01-01

    In mental healthcare, one area of major concern identified by health information systems is variability in antipsychotic prescribing. While most studies have investigated patient- and prescriber-related factors as possible reasons for such variability, no studies have investigated facility-level characteristics. The present study ascertained whether staffing level is associated with antipsychotic prescribing in community mental healthcare. A cross-sectional analysis of data extracted from the Italian national mental health information system was carried out. For each Italian region, it collects data on the availability and use of mental health facilities. The rate of individuals exposed to antipsychotic drugs was tested for evidence of association with the rate of mental health staff availability by means of univariate and multivariate analyses. In Italy there were on average nearly 60 mental health professionals per 100,000 inhabitants, with wide regional variations (range 21 to 100). The average rate of individuals prescribed antipsychotic drugs was 2.33%, with wide regional variations (1.04% to 4.01%). Univariate analysis showed that the rate of individuals prescribed antipsychotic drugs was inversely associated with the rate of mental health professionals available in Italian regions (Kendall's tau -0.438, p = 0.006), with lower rates of antipsychotic prescriptions in regions with higher rates of mental health professionals. After adjustment for possible confounders, the total availability of mental health professionals was still inversely associated with the rate of individuals exposed to antipsychotic drugs. The evidence that staffing level was inversely associated with antipsychotic prescribing indicates that any actions aimed at decreasing variability in antipsychotic prescribing need to take into account aspects related to the organization of the mental health system.

  20. Metal-Semiconductor Contacts

    Science.gov (United States)

    Pugh, D. I.

    Metal-semiconductor contacts display a range of electrical characteristics from strongly rectifying to ohmic, each having its own applications. The rectifying properties of metal points on metallic sulphides were used extensively as detectors in early radio experiments, while during the second world war the rectifying point contact diode became important as a frequency detector and low level microwave radar detector [1]. Since 1945 the development of metal semiconductor contacts has been stimulated by the intense activity in the field of semiconductor physics and has remained vital in the ohmic connection of semiconductor devices with the outside world. The developments in surface science and the increased use of Schottky barriers in microelectronics has lead to much research with the aim of obtaining a full understanding of the physics of barrier formation and of current transport across the metal-semiconductor interface. Large gain spin electronic devices are possible with appropriate designs by incorporating ferromagnetic layers with semiconductors such as silicon [2]. This inevitably leads to metal-semiconductor contacts, and the impact of such junctions on the device must be considered. In this section we aim to look simply at the physical models that can be used to understand the electrical properties that can arise from these contacts, and then briefly discuss how deviations of these models can occur in practical junctions.

  1. Treat Medication Samples with Respect

    Science.gov (United States)

    Home Support ISMP Newsletters Webinars Report Errors Educational Store Consulting FAQ Tools About Us Contact Us Treat Medication Samples with Respect A physician may give you samples of a particular medication at the time of your office or clinic visit. ...

  2. Surface coating for blood-contacting devices

    Science.gov (United States)

    Nair, Ajit Kumar Balakrishnan

    The major problems always encountered with the blood-contacting surfaces are their compatibility, contact blood damage, and thrombogenicity. Titanium nitride (TiN) is a hard, inert, ceramic material that is widely used in the engineering industry. TiN has been proven to be a good biomaterial in its crystalline form, in orthopedic, and in tissue implant applications. This dissertation describes a method to coat amorphous TiN on the blood-contacting surfaces of certain medical devices using the room-temperature sputtering process and to characterize, to test, and to evaluate the coating for a reliable, durable, and compatible blood-contacting surface The blood-compatibility aspects were evaluated with standard, established protocols and procedures to prove the feasibility. An amorphous TiN coating is developed, characterized, tested, and blood compatibility evaluated by applying to the blood-contacting surfaces of stainless steel, catheters, and blood filters. The flexibility characteristics were proven by applying it to the diaphragms of the pulsatile pneumatic ventricular assist device. The results show that amorphous titanium nitride is flexible and adherent to polymeric substrates like polyurethane and polyester. Blood compatibility evaluation showed comparable results with catheters and superior behavior with stainless steel and polyester filters. It is concluded that amorphous titanium nitride can be considered to be applied to the surfaces of some of the medical devices in order to improve blood compatibility.

  3. ALLERGIC CONTACT DERMATITIS

    Directory of Open Access Journals (Sweden)

    Trisna Yuliharti Tersinanda

    2013-07-01

    Full Text Available Normal 0 false false false EN-US X-NONE X-NONE Allergic contact dermatitis is an immunologic reaction that tends to involve the surrounding skin and may even spread beyond affected sites. This skin disease is one of the more frequent, and costly dermatologic problems. Recent data from United Kingdom and United States suggest that the percentage of occupational contact dermatitis due to allergy may be much higher, thus raising the economic impact of occupational allergic contact dermatitis. There is not enough data about the epidemiology of allergic contact dermatitis in Indonesia, however based on research that include beautician in Denpasar, about 27,6 percent had side effect of cosmetics, which is 25,4 percent of it manifested as allergic contact dermatitis. Diagnosis of allergic contact dermatitis is based on anamnesis, physical examination, patch test, and this disease should be distinguished from other eczematous skin disease. The management is prevention of allergen exposure, symptomatic treatment, and physicochemical barrier /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin-top:0in; mso-para-margin-right:0in; mso-para-margin-bottom:10.0pt; mso-para-margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}

  4. Contact dermatitis from a prosthesis.

    Science.gov (United States)

    Munoz, Carla A; Gaspari, Anthony; Goldner, Ronald

    2008-01-01

    Patients wearing a prosthesis face a wide variety of medical problems. Skin complications have long been recognized, but their prevalence is still unknown. The most frequently reported disorders are allergic contact dermatitis (ACD), acroangiodermatitis, epidermoid cysts, epidermal hyperplasia, follicular hyperkeratosis, verrucous hyperplasia, bullous diseases, hyperhidrosis, infections, malignancies, and ulcerations. Contact dermatitis represents one-third of the dermatoses in amputees wearing prostheses. All patients who are suspected of having ACD should be patch tested with standard allergen series as well as materials from the patient's own prosthesis, topical medicaments, moisturizers, and cosmetics. We report a patient with an ACD to mixed dialkyl thiourea present in the rubber parts of his below-the-knee prosthesis. Thiourea derivates are used as accelerators in the manufacture of chloroprene rubber and as fixatives in photography and photocopy paper. Allergy to thiourea is relatively uncommon; different studies have shown a prevalence of 0.7% up to 2.4% in patch-tested patients. Thiourea derivates are often the allergic sources in ACD involving high-grade rubber products made of neoprene such as diving suits, protective goggles, knee braces, and continuous positive airway pressure masks. They are also present in the rubber material of prostheses, as in the case of our patient.

  5. Clinical Study of Focus NIGHT &DAY® contact lenses | Aldebasi ...

    African Journals Online (AJOL)

    wear contact lenses for up to 3 weeks without ocular complications. Visual acuity, tear functions or corneal structure are not altered. Keywords: optometry, silicone hydrogel materials, resolution, ocular. Sudan Journal of Medical Sciences Vol.

  6. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Academy Publications EyeNet Ophthalmology Ophthalmology Retina Information for: International Ophthalmologists Media Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists ...

  7. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of Service For Advertisers For Media Ophthalmology Job Center © American ...

  8. Contact with hospital syringes containing body fluids: implications for medical waste management regulation Jeringas en contacto con sangre y fluidos corporales utilizadas en el hospital: implicaciones para el manejo de desechos hospitalarios

    OpenAIRE

    Patricia Volkow; Bénédicte Jacquemin; Diana Vilar-Compte; José Ramón Castillo

    2003-01-01

    OBJECTIVE: To determine amount of syringes used in the hospital and extent of contact with blood and body fluids of these syringes. MATERIAL AND METHODS: Syringe use was surveyed at a tertiary care center for one week; syringes were classified into the following four categories according to use: a) contained blood; b) contained other body fluids (urine, gastric secretion, cerebrospinal fluid, wound drainage); c) used exclusively for drug dilution and application in plastic intravenous (IV) tu...

  9. Nigeria Agricultural Journal: Contact

    African Journals Online (AJOL)

    Principal Contact. Prof. J.A. Mbanasor Editor in Chief Head of Department, Agribusiness and Management College of Agribusiness and Financial Management Michael Okpara University of Agriculture Office of the Head of Department. Agribusiness and Management. College of Agribusiness and Financial Management.

  10. Language Contact and Bilingualism

    NARCIS (Netherlands)

    Appel, René; Muysken, Pieter

    2006-01-01

    What happens - sociologically, linguistically, educationally, politically - when more than one language is in regular use in a community? How do speakers handle these languages simultaneously, and what influence does this language contact have on the languages involved? Although most people in the

  11. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... prescription. There is no such thing as a "one size fits all" contact lens. Lenses that are not properly fitted may scratch the eye or cause blood vessels to grow into the cornea. Even if you have perfect vision, you need to get an eye exam and a prescription ...

  12. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... contact lenses , from the U.S. Food and Drug Administration (FDA). Are the colored lenses you are considering ... woman from Oregon made history as the first human host for an eye worm that previously had been reported only in cattle. ... Policy Free EyeSmart Resources for Professionals Link your website to EyeSmart Embed ...

  13. Mathematics Connection: Contact

    African Journals Online (AJOL)

    Principal Contact. Dr. Kofi Mereku Executive Editor Department of Mathematics Education, UCE Mathematical Association of Ghana, C/o Department of Mathematics Education University College of Education of Winneba P. O. Box 25, Winneba, Ghana Phone: +233244961318. Email: dkmereku@uew.edu.gh ...

  14. Contact: Releasing the news

    Science.gov (United States)

    Pinotti, Roberto

    The problem of mass behavior after man's future contacts with other intelligences in the universe is not only a challenge for social scientists and political leaders all over the world, but also a cultural time bomb as well. In fact, since the impact of CETI (Contact with Extraterrestrial Intelligence) on human civilization, with its different cultures, might cause a serious socio-anthropological shock, a common and predetermined worldwide strategy is necessary in releasing the news after the contact, in order to keep possible manifestations of fear, panic and hysteria under control. An analysis of past studies in this field and of parallel historical situations as analogs suggests a definite "authority crisis" in the public as a direct consequence of an unexpected release of the news, involving a devastating "chain reaction" process (from both the psychological and sociological viewpoints) of anomie and maybe the collapse of today's society. The only way to prevent all this is to prepare the world's public opinion concerning contact before releasing the news, and to develop a long-term strategy through the combined efforts of scientists, political leaders, intelligence agencies and the mass media, in order to create the cultural conditions in which a confrontation with ETI won't affect mankind in a traumatic way. Definite roles and tasks in this multi-level model are suggested.

  15. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... wear any kind of contact lens. In Butler's case, the lenses caused an infection and left her with a corneal ... A recent article from U.S. News and World Report explains what ophthalmologists are and how they can ...

  16. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Health / News Halloween Hazard: The Hidden Dangers of Buying Decorative Contact Lenses Without a Prescription Leer en Español: Peligros asociados con los lentes de contacto de color Sep. 26, 2013 It started as an impulsive buy from a souvenir shop, but 10 hours ...

  17. Zoologist (The): Contact

    African Journals Online (AJOL)

    Principal Contact. Prof. A.B. Odaibo Editor-in-Chief University of Ibadan, Ibadan. Nigeria. Hydrobiology & Fisheries Unit, Department of Zoology, University of Ibadan, Ibadan. Oyo State. Nigeria. West Africa. Alternative Email Address: adebakar19@yahoo.com. Phone: +234-(0)- 803-049-74. Fax: +234-02-8103043

  18. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Tips & Prevention News Ask an Ophthalmologist Patient Stories Español Eye Health / News Halloween Hazard: The Hidden Dangers ... Decorative Contact Lenses Without a Prescription Leer en Español: Peligros asociados con los lentes de contacto de ...

  19. Open Veterinary Journal: Contact

    African Journals Online (AJOL)

    Principal Contact. Dr. Ibrahim Eldaghayes Faculty of Veterinary Medicine, University of Tripoli Faculty of Veterinary Medicine, University of Tripoli, P. O. Box 13662, Tripoli, Libya Phone: +218 21 462 8422. Fax: +218 21 462 8421. Email: ibrahim.eldaghayes@vetmed.edu.ly ...

  20. Have Confidence in Contact

    Science.gov (United States)

    Crisp, Richard J.; Turner, Rhiannon N.

    2010-01-01

    In an article in the May-June 2009 "American Psychologist," we discussed a new approach to reducing prejudice and encouraging more positive intergroup relations (Crisp & Turner, 2009). We named the approach imagined intergroup contact and defined it as "the mental simulation of a social interaction with a member or members of an outgroup category"…

  1. Disproportionate Minority Contact.

    Science.gov (United States)

    Fix, Rebecca L; Cyperski, Melissa A; Burkhart, Barry R

    2017-04-01

    The overrepresentation of racial/ethnic minorities within the criminal justice system relative to their population percentage, a phenomenon termed disproportionate minority contact, has been examined within general adult and adolescent offender populations; yet few studies have tested whether this phenomenon extends to juvenile sexual offenders (JSOs). In addition, few studies have examined whether offender race/ethnicity influences registration and notification requirements, which JSOs are subject to in some U.S. states. The present study assessed for disproportionate minority contact among general delinquent offenders and JSOs, meaning it aimed to test whether the criminal justice system treats those accused of sexual and non-sexual offenses differently by racial/ethnic group. Furthermore, racial/ethnic group differences in risk, legal classification, and sexual offending were examined for JSOs. Results indicated disproportionate minority contact was present among juveniles with non-sexual offenses and JSOs in Alabama. In addition, offense category and risk scores differed between African American and European American JSOs. Finally, registration classifications were predicted by offending characteristics, but not race/ethnicity. Implications and future directions regarding disproportionate minority contact among JSOs and social and legal policy affecting JSOs are discussed.

  2. Lubrication Of Nonconformal Contacts

    Science.gov (United States)

    Jeng, Yeau-Ren

    1991-01-01

    Report discusses advances in knowledge of lubrication of nonconformal contacts in bearings and other machine elements. Reviews previous developments in theory of lubrication, presents advances in theory of lubrication to determine minimum film thickness, and describes experiments designed to investigate one of regimes of lubrication for ball bearings.

  3. CODESRIA Bulletin: Contact

    African Journals Online (AJOL)

    Principal Contact. Francis B. Nyamnjoh Editor-in-Chief CODESRIA Avenue Cheikh Anta Diop x Canal 4. BP 3304. Dakar SENEGAL. ISSN: 0850-8712. AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's Partners · Terms and Conditions of Use ...

  4. Ghana Mining Journal: Contact

    African Journals Online (AJOL)

    Principal Contact. Professor Daniel Mireku-Gyimah Editor-in-Chief University of Mines & Technology Ghana Mining Journal University of Mines & Technology P. O. BOX 237 Tarkwa Ghana Phone: +233 362 20280/20324. Fax: +233 362 20306. Email: dm.gyimah@umat.edu.gh ...

  5. Contact allergy to spices

    NARCIS (Netherlands)

    W. Van den Akker Th. (W.); I.D. Roesyanto-Mahadi (I.); A.W. van Toorenenbergen (Albert); Th. van Joost (Theo)

    1990-01-01

    textabstractA group of 103 patients suspected of contact allergy was tested with the European standard series, wood tars and spices; paprika, cinnamon, laurel, celery seed, nutmeg, curry, black pepper, cloves, while pepper, coriander, cacao and garlic. 32 patients (Group I) were selected on the

  6. Metadata Quality in Institutional Repositories May be Improved by Addressing Staffing Issues

    Directory of Open Access Journals (Sweden)

    Elizabeth Stovold

    2016-09-01

    Full Text Available A Review of: Moulaison, S. H., & Dykas, F. (2016. High-quality metadata and repository staffing: Perceptions of United States–based OpenDOAR participants. Cataloging & Classification Quarterly, 54(2, 101-116. http://dx.doi.org/10.1080/01639374.2015.1116480 Objective – To investigate the quality of institutional repository metadata, metadata practices, and identify barriers to quality. Design – Survey questionnaire. Setting – The OpenDOAR online registry of worldwide repositories. Subjects – A random sample of 50 from 358 administrators of institutional repositories in the United States of America listed in the OpenDOAR registry. Methods – The authors surveyed a random sample of administrators of American institutional repositories included in the OpenDOAR registry. The survey was distributed electronically. Recipients were asked to forward the email if they felt someone else was better suited to respond. There were questions about the demographics of the repository, the metadata creation environment, metadata quality, standards and practices, and obstacles to quality. Results were analyzed in Excel, and qualitative responses were coded by two researchers together. Main results – There was a 42% (n=21 response rate to the section on metadata quality, a 40% (n=20 response rate to the metadata creation section, and 40% (n=20 to the section on obstacles to quality. The majority of respondents rated their metadata quality as average (65%, n=13 or above average (30%, n=5. No one rated the quality as high or poor, while 10% (n=2 rated the quality as below average. The survey found that the majority of descriptive metadata was created by professional (84%, n=16 or paraprofessional (53%, n=10 library staff. Professional staff were commonly involved in creating administrative metadata, reviewing the metadata, and selecting standards and documentation. Department heads and advisory committees were also involved in standards and documentation

  7. Identifying nurse staffing research in Medline: development and testing of empirically derived search strategies with the PubMed interface.

    Science.gov (United States)

    Simon, Michael; Hausner, Elke; Klaus, Susan F; Dunton, Nancy E

    2010-08-23

    The identification of health services research in databases such as PubMed/Medline is a cumbersome task. This task becomes even more difficult if the field of interest involves the use of diverse methods and data sources, as is the case with nurse staffing research. This type of research investigates the association between nurse staffing parameters and nursing and patient outcomes. A comprehensively developed search strategy may help identify nurse staffing research in PubMed/Medline. A set of relevant references in PubMed/Medline was identified by means of three systematic reviews. This development set was used to detect candidate free-text and MeSH terms. The frequency of these terms was compared to a random sample from PubMed/Medline in order to identify terms specific to nurse staffing research, which were then used to develop a sensitive, precise and balanced search strategy. To determine their precision, the newly developed search strategies were tested against a) the pool of relevant references extracted from the systematic reviews, b) a reference set identified from an electronic journal screening, and c) a sample from PubMed/Medline. Finally, all newly developed strategies were compared to PubMed's Health Services Research Queries (PubMed's HSR Queries). The sensitivities of the newly developed search strategies were almost 100% in all of the three test sets applied; precision ranged from 6.1% to 32.0%. PubMed's HSR queries were less sensitive (83.3% to 88.2%) than the new search strategies. Only minor differences in precision were found (5.0% to 32.0%). As with other literature on health services research, nurse staffing studies are difficult to identify in PubMed/Medline. Depending on the purpose of the search, researchers can choose between high sensitivity and retrieval of a large number of references or high precision, i.e. and an increased risk of missing relevant references, respectively. More standardized terminology (e.g. by consistent use of the

  8. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare America ... Medical Students Patients and Public Technicians and Nurses Senior Ophthalmologists Young Ophthalmologists Tools and Services EyeCare America ...

  9. The global assessment of medical radiation exposures

    International Nuclear Information System (INIS)

    Shannoun, F.

    2010-01-01

    evidence on equipment and staffing levels. Main difficulties of UNSCEAR medical surveys: Very poor response from countries of health care level II, III and IV; Complexity on patient age and sex distribution might have hindered submission of other important data and information; Confusion due to different interpretations of dosimetric approaches; Lack of clarity affects the quality and consistency of data submitted; Health care levels classifications do not allow comparison with WHO and World Bank data. - Language difficulties to interpret the requested information; Long verification and publishing process. Key elements of improving strategy: Simplify current questionnaire; Target specific countries; Create small expert group; Establish national contact points; Develop electronic solutions for data collection and Dissemination; Collaborate with other networks (IAEA, WHO etc.)

  10. Duality based contact shape optimization

    DEFF Research Database (Denmark)

    Vondrák, Vít; Dostal, Zdenek; Rasmussen, John

    2001-01-01

    An implementation of semi-analytic method for the sensitivity analysis in contact shape optimization without friction is described. This method is then applied to the contact shape optimization.......An implementation of semi-analytic method for the sensitivity analysis in contact shape optimization without friction is described. This method is then applied to the contact shape optimization....

  11. Electrical contacts principles and applications

    CERN Document Server

    Slade, Paul G

    2013-01-01

    Covering the theory, application, and testing of contact materials, Electrical Contacts: Principles and Applications, Second Edition introduces a thorough discussion on making electric contact and contact interface conduction; presents a general outline of, and measurement techniques for, important corrosion mechanisms; considers the results of contact wear when plug-in connections are made and broken; investigates the effect of thin noble metal plating on electronic connections; and relates crucial considerations for making high- and low-power contact joints. It examines contact use in switch

  12. Contact Graph Routing

    Science.gov (United States)

    Burleigh, Scott C.

    2011-01-01

    Contact Graph Routing (CGR) is a dynamic routing system that computes routes through a time-varying topology of scheduled communication contacts in a network based on the DTN (Delay-Tolerant Networking) architecture. It is designed to enable dynamic selection of data transmission routes in a space network based on DTN. This dynamic responsiveness in route computation should be significantly more effective and less expensive than static routing, increasing total data return while at the same time reducing mission operations cost and risk. The basic strategy of CGR is to take advantage of the fact that, since flight mission communication operations are planned in detail, the communication routes between any pair of bundle agents in a population of nodes that have all been informed of one another's plans can be inferred from those plans rather than discovered via dialogue (which is impractical over long one-way-light-time space links). Messages that convey this planning information are used to construct contact graphs (time-varying models of network connectivity) from which CGR automatically computes efficient routes for bundles. Automatic route selection increases the flexibility and resilience of the space network, simplifying cross-support and reducing mission management costs. Note that there are no routing tables in Contact Graph Routing. The best route for a bundle destined for a given node may routinely be different from the best route for a different bundle destined for the same node, depending on bundle priority, bundle expiration time, and changes in the current lengths of transmission queues for neighboring nodes; routes must be computed individually for each bundle, from the Bundle Protocol agent's current network connectivity model for the bundle s destination node (the contact graph). Clearly this places a premium on optimizing the implementation of the route computation algorithm. The scalability of CGR to very large networks remains a research topic

  13. HTSC-Josephson step contacts

    International Nuclear Information System (INIS)

    Herrmann, K.

    1994-03-01

    In this work the properties of josephson step contacts are investigated. After a short introduction into Josephson step contacts the structure, properties and the Josphson contacts of YBa 2 Cu 3 O 7-x high-T c superconductors is presented. The fabrication of HTSC step contacts and the microstructure is discussed. The electric properties of these contacts are measured together with the Josephson emission and the magnetic field dependence. The temperature dependence of the stationary transport properties is given. (WL)

  14. Contact dynamics math model

    Science.gov (United States)

    Glaese, John R.; Tobbe, Patrick A.

    1986-01-01

    The Space Station Mechanism Test Bed consists of a hydraulically driven, computer controlled six degree of freedom (DOF) motion system with which docking, berthing, and other mechanisms can be evaluated. Measured contact forces and moments are provided to the simulation host computer to enable representation of orbital contact dynamics. This report describes the development of a generalized math model which represents the relative motion between two rigid orbiting vehicles. The model allows motion in six DOF for each body, with no vehicle size limitation. The rotational and translational equations of motion are derived. The method used to transform the forces and moments from the sensor location to the vehicles' centers of mass is also explained. Two math models of docking mechanisms, a simple translational spring and the Remote Manipulator System end effector, are presented along with simulation results. The translational spring model is used in an attempt to verify the simulation with compensated hardware in the loop results.

  15. Contact allergy to cosmetics

    DEFF Research Database (Denmark)

    Held, E; Johansen, J D; Agner, T

    1999-01-01

    .4%) had doubtfully positive reaction(s) and 31 (5.8%) had irritant reaction(s). Skin-care products were tested most frequently and were also found to cause most positive, doubtfully positive and irritant reactions, 80% of the patients with positive reactions to their own products had no history of contact......In a 2-year period, 1527 patients with contact dermatitis were investigated in the patch-test clinic. In 531 patients, allergy to cosmetics was suspected from the history and they were tested with their own cosmetic products. 40 (7.5%) (of the 531 patients) had 1 or more positive reactions, 82 (15...... of common cosmetic ingredients. Fragrance mix and formaldehyde were found to be the ingredients most often responsible and were significantly more frequent in patients with positive reactions to their own products, compared to a control group of eczema patients also seen in the patch-test clinic....

  16. Critical Points of Contact

    DEFF Research Database (Denmark)

    Jensen, Ole B.; Morelli, Nicola

    2011-01-01

    In contemporary urban societies multiple networks and systems interact, overlap, exist in parallel, converge, conflict etc. creating unforeseen complexity and less transparency. By exploring how layered networks of physical movement, service information, goods delivery, commercial communication etc....... are connected (and disconnected) we get a much better understanding of how to design and intervene regardless if we are thinking about public spaces in the city or new systems of service design. The many networks orchestrating and facilitating contemporary everyday life are dependent on the strategic sites...... where the networks meet and establish contact. Thus we argue for the usefulness of the notion of Critical Point of Contact (CPC) to deepen our understanding of the actual life within networks. En route to this notion we draw upon theories within as diverse realms such as interaction design, service...

  17. Contact allergy to lanolin

    DEFF Research Database (Denmark)

    Fransen, Marloes; Overgaard, Line E K; Johansen, Jeanne D

    2018-01-01

    BACKGROUND: Lanolin has been tested as lanolin alcohols (30% pet.) in baseline patch test series since 1969, and this has shown clinically relevant allergic contact dermatitis cases. OBJECTIVES: To investigate the temporal development of lanolin allergy (i.e. positive reaction to lanolin alcohols...... and/or Amerchol™ L-101), and the association between contact allergy to lanolin and patient characteristics from the MOAHLFA index. METHODS: A retrospective observational study of consecutively patch tested dermatitis patients (n = 9577) between 1 January 2004 and 31 December 2015 with lanolin...... alcohols 30% pet. and Amerchol™ L-101 50% pet. was performed. RESULTS: The prevalence of lanolin allergy increased from 0.45% in 2004 to 1.81% in 2015. In age-adjusted and sex-adjusted analyses, weak, significant associations were found between atopic dermatitis and lanolin and lanolin alcohols allergy...

  18. The Navy Medical Department’s Workload Management System for Nursing (Patient Classification and Staffing Allocation). Self-Instructional Workbook

    Science.gov (United States)

    1986-01-01

    NEW PROTHESIS , ALTERATION OF BODY IMAGE) Modification of Lifestyle: Includes time to provide indi- vidual support regarding limitations and...restrictions of a new prothesis , the necessary alteration of lifestyle, and coping with a body image change or illness. * (6) SENSORY DEPRIVATION Sensor

  19. Prehospital thoracostomy in patients with traumatic circulatory arrest: results from a physician-staffed Helicopter Emergency Medical Service

    NARCIS (Netherlands)

    Peters, J.H.; Ketelaars, R.; Wageningen, B. van; Biert, J.; Hoogerwerf, N.

    2017-01-01

    OBJECTIVE: Until recently, traumatic cardiac arrest (tCA) was believed to be associated with high mortality and low survival rates. New data suggest better outcomes. The most common error in tCA management is failing to treat a tension pneumothorax (TP). In the prehospital setting, we prefer

  20. Evaluation of the performance of French physician-staffed emergency medical service in the triage of major trauma patients.

    Science.gov (United States)

    Hamada, Sophie Rym; Gauss, Tobias; Duchateau, François-Xavier; Truchot, Jennifer; Harrois, Anatole; Raux, Mathieu; Duranteau, Jacques; Mantz, Jean; Paugam-Burtz, Catherine

    2014-06-01

    Proper prehospital triage of trauma patients is a cornerstone for the process of care of trauma patients. In France, emergency physicians perform this process according to a national triage algorithm called Vittel Triage Criteria (VTC), introduced in 2002 to help the triage decision-making process. The aim of this two-center study was to evaluate the performance of the triage process based on the VTC to identify major trauma patients in the Paris area. This was a retrospective analysis of two cohorts. The first cohort consisted of all patients admitted between January 2011 and September 2012 in two trauma referral centers in the region of Paris (Ile de France) and allowed estimation of overtriage. Undertriage was assessed in a second cohort made up of all prehospital trauma interventions from one emergency medicine sector during the same period. Adequate triage was defined by a direct admission of patients with an Injury Severity Score (ISS) greater than 15 into one of the regional trauma centers, and undertriage was defined as an initial nonadmission to a trauma center. Overtriage was defined by an admission of patients with an ISS of 15 or lower to a trauma center. The performance of the VTC was evaluated according to a strict to-the-letter application of the VTC and termed as theoretical triage. Logistic regression was performed to identify VTC criteria able to predict major trauma. Among 998 admitted patients of the first cohort, 173 patients (17%) were excluded because they were not directly admitted in the first 24 hours. In the first cohort (n = 825), adequate triage was 58% and overtriage was 42%. In the second cohort (n = 190), adequate triage was 40%, overtriage was 60%, and undertriage was less than 1%. Theoretical triage generated a nonsignificantly lower overtriage and a higher undertriage compared with observed triage. The most powerful predictors of major trauma were paralysis (odds ratio [OR,] 0.09; 95% confidence interval [CI], 0.03-0.22), flail chest (OR, 0.1; 95% CI, 0.01-0.03), and Glasgow Coma Scale (GCS) score of less than 13 (OR, 0.28; 95% CI, 0.17-0.45), whereas global assessments of speed and mechanism alone were poor predictors (positive likelihood ratio, 0.92-1.4). In the Paris area, the French physician-based prehospital triage system for patients with suspicion of major trauma showed a high rate of overtriage and a low rate of undertriage. Criteria of global assessment of speed and mechanism alone were poor predictors of major trauma.

  1. Contact stress sensor

    Science.gov (United States)

    Kotovsky, Jack [Oakland, CA

    2012-02-07

    A contact stress sensor includes one or more MEMS fabricated sensor elements, where each sensor element of includes a thin non-recessed portion, a recessed portion and a pressure sensitive element adjacent to the recessed portion. An electric circuit is connected to the pressure sensitive element. The circuit includes a thermal compensator and a pressure signal circuit element configured to provide a signal upon movement of the pressure sensitive element.

  2. Paraben Contact Hypersensitivity

    Directory of Open Access Journals (Sweden)

    A K Bajaj

    1985-01-01

    Full Text Available One hundred patients suspected to be having contact hypersensitivity to topical medicaments were patch tested with methly and propyl parabens along with commercially available topical medicaments. Six patients showed positive reactions to parabens. Two patients each were positive to methyl paraben and propyl paraben and two showed positive reactions to both of these. Three patients each showed positive reactions to soframycin, econazole and nitrofurazone also.

  3. Preparedness for epidemic disease or bioterrorism: minimum cost planning for the location and staffing of urban point-of-dispensing centers.

    Science.gov (United States)

    Bowen, William M; Chen, Jen-Yi; Tukel, Oya I

    2014-01-01

    Urban health authorities in the United States have been charged with developing plans for providing the infrastructure necessary to dispense prophylactic medications to their populations in the case of epidemic disease outbreak or bioterrorist attack. However, no specific method for such plans has been prescribed. This article formulates and demonstrates the use of an integer programming technique for helping to solve a part of the dispensing problem faced by cities, namely that of providing the federally required infrastructure at minimum cost, using their limited time and resources. Specifically, the technique minimizes the number of point-of-dispensing (POD) centers while covering every resident in all the census tracts within the city's jurisdiction. It also determines the optimal staffing requirement in terms of the number of nurses at each POD. This article includes a demonstration of the model using real data from Cleveland, OH, a mid-sized US city. Examples are provided of data and computational results for a variety of input parameter values such as population throughput rate, POD capacities, and distance limitations. The technique can be readily adapted to a wide range of urban areas.

  4. Customer Perception of a Supermarket Nutrition Centre Staffed by a Registered Dietitian.

    Science.gov (United States)

    Evans, KATE; Taper, JANETTE; Quintal, DEBORAH

    2000-01-01

    The purpose of this study was to examine consumers' attitudes toward a supermarket nutrition centre staffed full time by a registered dietitian. A questionnaire was administered over three consecutive days in that store and in a control store that was similar to the experimental site in every way, except for the absence of a nutrition centre. Participants were chosen randomly at timed intervals in specific areas of the store. Of 428 customers approached, 232 agreed to participate in the survey. At the experimental site, 75% of the participants were extremely satisfied with the registered dietitian's services and 69% ranked having a registered dietitian on staff in any store as extremely important, compared to 31% at the control site (p importance of 13 required and optional services offered by the supermarkets, 15% of participants at the experimental site ranked having a registered dietitian on staff in the top five, compared with 4% at the control site (p service. There may therefore be an expanded role for registered dietitians in the supermarket setting.

  5. The Nuclear Education and Staffing Challenge: Rebuilding Critical Skills in Nuclear Science and Technology

    International Nuclear Information System (INIS)

    Wogman, Ned A.; Bond, Leonard J.; Waltar, Alan E.; Leber, R E.

    2005-01-01

    The United States, the Department of Energy (DOE) and its National Laboratories, including the Pacific Northwest National Laboratory (PNNL), are facing a serious attrition of nuclear scientists and engineers and their capabilities through the effects of aging staff. Within the DOE laboratories, 75% of nuclear personnel will be eligible to retire by 2010. It is expected that there will be a significant loss of senior nuclear science and technology staff at PNNL within five years. PNNL's nuclear legacy is firmly rooted in the DOE Hanford site, the World War II Manhattan Project, and subsequent programs. Historically, PNNL was a laboratory where 70% of its activities were nuclear/radiological, and now just under 50% of its current business science and technology are nuclear and radiologically oriented. Programs in the areas of Nuclear Legacies, Global Security, Nonproliferation, Homeland Security and National Defense, Radiobiology and Nuclear Energy still involve more than 1,000 of the 3,800 current laboratory staff, and these include more than 420 staff who are certified as nuclear/radiological scientists and engineers. This paper presents the current challenges faced by PNNL that require an emerging strategy to solve the nuclear staffing issues through the maintenance and replenishment of the human nuclear capital needed to support PNNL nuclear science and technology programs

  6. Costs, Staffing, and Services of Assisted Living in the United States: A Literature Review.

    Science.gov (United States)

    Kisling-Rundgren, Amy; Paul, David P; Coustasse, Alberto

    2016-01-01

    Assisted-living facilities (ALFs), which provide a community for residents who require assistance throughout their day, are an important part of the long-term-care system in the United States. The costs of ALFs are paid either out of pocket, by Medicaid, or by long-term-care insurance. Monthly costs of ALFs have increased over the past 5 years on an average of 4.1%. The purpose of this research was to examine the future trends in ALFs in the United States to determine the impact of health care on costs. The methodology for this study was a literature review, and a total of 32 sources were referenced. Trends in monthly costs of ALFs have increased from 2004 to 2014. Within the past 5 years, there has been an increase on average of 4.1% in assisted-living costs. Medicaid is one payer for residents of ALFs, whereas another alternative is the use of long-term-care insurance. Unfortunately, Medicare does not pay for ALFs. Staffing concerns in ALFs are limited because of each state having different rules and regulations. Turnover and retention rates of nurses in ALFs are suggested to be high, whereas vacancy rate for nurses is suggested to be lower. The baby-boomer generation can be one contribution to the increase in costs. Over the years, there has been an increase in Alzheimer disease, which has had also an effect on cost in ALFs.

  7. The Nuclear Education and Staffing Challenge: Rebuilding Critical Skills in Nuclear Science and Technology

    International Nuclear Information System (INIS)

    Wogman, Ned A.; Bond, Leonard J.; Waltar, Alan E.; Leber, R E.

    2005-01-01

    The United States, the Department of Energy (DOE) and its National Laboratories, including the Pacific Northwest National Laboratory (PNNL), are facing a serious attrition of nuclear scientists and engineers and their capabilities through the effects of aging staff. Within the DOE laboratories, 75% of nuclear personnel will be eligible to retire by 2010. It is expected that there will be a significant loss of senior nuclear science and technology staff at PNNL within five years. PNNL's nuclear legacy is firmly rooted in the DOE Hanford site, the World War II Manhattan Project, and subsequent programs. Historically, PNNL was a laboratory were 70% of its activities were nuclear/radiological, and now just under 50% of its current business science and technology are nuclear and radiologically oriented. Programs in the areas of Nuclear Legacies, Global Security, Nonproliferation, Homeland Security and National Defense, Radiobiology and Nuclear Energy still involve more than 1,000 of the 3,800 current laboratory staff, and these include more than 420 staff who are certified as nuclear/radiological scientists and engineers. This paper presents the current challenges faced by PNNL that require an emerging strategy to solve the nuclear staffing issues through the maintenance and replenishment of the human nuclear capital needed to support PNNL nuclear science and technology programs

  8. The nuclear education and staffing challenge: Rebuilding critical skills in nuclear science and technology

    International Nuclear Information System (INIS)

    Wogman, N.A.; Bond, L.J.; Waltar, A.E.; Leber, R.E.

    2005-01-01

    The United States, the Department of Energy (DOE) and its National Laboratories, including the Pacific Northwest National Laboratory (PNNL), are facing a serious attrition of nuclear scientists and engineers and their capabilities through the effects of aging staff. Within the DOE laboratories, 75% of nuclear personnel will be eligible to retire by 2010. It is expected that there will be a significant loss of senior nuclear science and technology staff at PNNL within five years. PNNL's nuclear legacy is firmly rooted in the DOE Hanford site, the World War II Manhattan Project, and subsequent programs. Historically, PNNL was a laboratory where 70% of its activities were nuclear/radiological, and now just under 50% of its current business science and technology are nuclear and radiologically oriented. Programs in the areas of nuclear legacies, global security, nonproliferation, homeland security and national defense, radiobiology and nuclear energy still involve more than 1,000 of the 3,800 current laboratory staff, and these include more than 420 staff who are certified as nuclear/radiological scientists and engineers. Current challenges faced by PNNL that require an emerging strategy to solve the nuclear staffing issues through the maintenance and replenishment of the human nuclear capital needed to support PNNL nuclear science and technology programs are presented. (author)

  9. The influence of staffing and timetabling on achieving competence in surgical extractions.

    Science.gov (United States)

    Moore, U; Durham, J; Corbett, I; Thomson, P

    2009-02-01

    Competence based education is becoming more important in dentistry and medicine. In dentistry clinical skills are assessed using longitudinal assessments or structured objective clinical tests. We have previously presented the assessment of competence in surgical extractions however the success rate for this was poor. The opportunity to alter staffing levels and timetabling arose and we present the influence of this on the achievement of competence. The competence assessments and portfolios of two consecutive years of dental undergraduates were examined after completing their surgical extraction course. The first cohort received 9 sessions of teaching spread over 2 years with one staff supervisor per session. The second cohort received 10 sessions with varying numbers of staff supervisors. The first cohort required 210 staff sessions and performed 275 surgical extractions (mean 4), and 23% achieved competence. The second cohort required 240 staff sessions and performed 403 surgical extractions (mean 6), and 66% achieved competence. Thirty six extra sessions were provided for students in the second cohort who failed to complete their competence during the allocated blocks and following this 99% of the second cohort achieved competence. These differences are significant (P timetabling changes which focus student experience and learning.

  10. PROBLEMS OF TRANSPORT COMPLEX STAFFING OF UKRAINIAN SSR IN 1960-1980

    Directory of Open Access Journals (Sweden)

    Anatoliy Gorban

    2016-11-01

    Full Text Available In the article the staffing problems of transport complex in the period of its fundamental technical change and intensive development of 1960–1980-ies are described. The main purpose of this article is to analyze the peculiarities of personnel potential development of transport complex of the Ukrainian SSR in the years of the intensive development of transport sectors, figure out the social component of the measures to improve the efficiency of transport networks. Methodology. In this article we used the method of analysis. The qualitative personnel structure, training of skilled workers in the educational institutions and other forms of improvement of personal skills of transport workers are analyzed. The causes of staff turnover and low labour discipline are studied. Practical implementation. This article shows the possible opportunities for the modern transport complex of Ukraine, how to be successful and competitive in the market. The historical background of this article can be very useful for present managers of the transport complex. Results. The author makes a general conclusion that the main causes of personnel fluctuation in transport brunches are low wages, pour conditions of work and lack of accomodations for the staff. The social and practical measures to improve effectiveness of work with personnel of all brunches of transport system are characterized.

  11. Ant colony optimization and event-based dynamic task scheduling and staffing for software projects

    Science.gov (United States)

    Ellappan, Vijayan; Ashwini, J.

    2017-11-01

    In programming change organizations from medium to inconceivable scale broadens, the issue of wander orchestrating is amazingly unusual and testing undertaking despite considering it a manual system. Programming wander-organizing requirements to deal with the issue of undertaking arranging and in addition the issue of human resource portion (also called staffing) in light of the way that most of the advantages in programming ventures are individuals. We propose a machine learning approach with finds respond in due order regarding booking by taking in the present arranging courses of action and an event based scheduler revives the endeavour arranging system moulded by the learning computation in perspective of the conformity in event like the begin with the Ander, the instant at what time possessions be free starting to ended errands, and the time when delegates stick together otherwise depart the wander inside the item change plan. The route toward invigorating the timetable structure by the even based scheduler makes the arranging method dynamic. It uses structure components to exhibit the interrelated surges of endeavours, slip-ups and singular all through different progression organizes and is adjusted to mechanical data. It increases past programming wander movement ask about by taking a gander at a survey based process with a one of a kind model, organizing it with the data based system for peril assessment and cost estimation, and using a choice showing stage.

  12. Acanthamoeba keratitis and contact lens wear.

    Science.gov (United States)

    Lindsay, Richard G; Watters, Grant; Johnson, Richard; Ormonde, Susan E; Snibson, Grant R

    2007-09-01

    Acanthamoeba keratitis is a rare but serious complication of contact lens wear that may cause severe visual loss. The clinical picture is usually characterised by severe pain, sometimes disproportionate to the signs, with an early superficial keratitis that is often misdiagnosed as herpes simplex virus (HSV) keratitis. Advanced stages of the infection are usually characterised by central corneal epithelial loss and marked stromal opacification with subsequent loss of vision. In this paper, six cases of contact lens-related Acanthamoeba keratitis that occurred in Australia and New Zealand over a three-year period are described. Three of the patients were disposable soft lens wearers, two were hybrid lens wearers and one was a rigid gas permeable lens wearer. For all six cases, the risk factors for Acanthamoeba keratitis were contact lens wear with inappropriate or ineffective lens maintenance and exposure of the contact lenses to tap or other sources of water. All six patients responded well to medical therapy that involved topical use of appropriate therapeutic agents, most commonly polyhexamethylene biguanide and propamidine isethionate, although two of the patients also subsequently underwent deep lamellar keratoplasty due to residual corneal surface irregularity and stromal scarring. Despite the significant advances that have been made in the medical therapy of Acanthamoeba keratitis over the past 10 years, prevention remains the best treatment and patients who wear contact lenses must be thoroughly educated about the proper use and care of the lenses. In particular, exposure of the contact lenses to tap water or other sources of water should be avoided.

  13. Pediatric contact dermatitis

    Directory of Open Access Journals (Sweden)

    Sharma Vinod

    2010-01-01

    Full Text Available Allergic contact dermatitis (ACD in children, until recently, was considered rare. ACD was considered as a disorder of the adult population and children were thought to be spared due to a lack of exposure to potential allergens and an immature immune system. Prevalence of ACD to even the most common allergens in children, like poison ivy and parthenium, is relatively rare as compared to adults. However, there is now growing evidence of contact sensitization of the pediatric population, and it begins right from early childhood, including 1-week-old neonates. Vaccinations, piercing, topical medicaments and cosmetics in younger patients are potential exposures for sensitization. Nickel is the most common sensitizer in almost all studies pertaining to pediatric contact dermatitis. Other common allergens reported are cobalt, fragrance mix, rubber, lanolin, thiomersol, neomycin, gold, mercapto mix, balsum of Peru and colophony. Different factors like age, sex, atopy, social and cultural practices, habit of parents and caregivers and geographic changes affect the patterns of ACD and their variable clinical presentation. Patch testing should be considered not only in children with lesions of a morphology suggestive of ACD, but in any child with dermatitis that is difficult to control.

  14. Nurse staffing and system integration and change indicators in acute care hospitals: evidence from a balanced scorecard.

    Science.gov (United States)

    McGillis Hall, Linda; Peterson, Jessica; Baker, G Ross; Brown, Adalsteinn D; Pink, George H; McKillop, Ian; Daniel, Imtiaz; Pedersen, Cheryl

    2008-01-01

    This study examined relationships between financial indicators for nurse staffing and organizational system integration and change indicators. These indicators, along with hospital location and type, were examined in relation to the nursing financial indicators. Results showed that different indicators predicted each of the outcome variables. Nursing care hours were predicted by the hospital type, geographic location, and the system. Both nursing and patient care hours were significantly related to dissemination and benchmarking of clinical data.

  15. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Researchers at Google say a new application of artificial intelligence shows whether a patient’s eyes point to high ... Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of Service For ...

  16. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Many of the lenses found online or in beauty salons, novelty shops or in pop-up Halloween ... Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of Service For ...

  17. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... be purchased over-the-counter or on the Internet," says Thomas Steinemann, MD, professor of ophthalmology at ... Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of Service For ...

  18. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... about eye health and preserving your vision. Privacy Policy Free EyeSmart Resources for Professionals Link your website ... Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of Service For Advertisers For Media Ophthalmology ...

  19. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Eye Health Home Annual Meeting Clinical Education Practice Management Member Services Advocacy Foundation About Subspecialties & More Academy Publications EyeNet Ophthalmology Ophthalmology Retina Information for: International Ophthalmologists Media Medical Students Patients and Public Technicians ...

  20. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... information about eye health and preserving your vision. Privacy Policy Free EyeSmart Resources for Professionals Link your ... the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of Service For Advertisers For Media ...

  1. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... lenses, remove the lenses and seek immediate medical attention from an ophthalmologist. Related resources: Learn how to ... Be More Independent Oct 31, 2016 More Eye Health News The Mystery of the Ghostly White Ring ...

  2. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... website Promotional materials for eye health observances EyeSmart resources are also available in Spanish . ... Us About the Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms ...

  3. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Answers Free Newsletter Get ophthalmologist-reviewed tips and information about eye health and preserving your ... the Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms ...

  4. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global Ophthalmology Guide Academy Publications EyeNet Ophthalmology Ophthalmology Retina Information for: International Ophthalmologists Media Medical Students Patients and Public Technicians ...

  5. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Laura Butler of Parkersburg, W.Va., had "extreme pain in both eyes," she said. "Because I had ... with a corneal abrasion. "I was in severe pain and on medication for four weeks, and couldn' ...

  6. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Annual Meeting Clinical Education Practice Management Member Services Advocacy Foundation About Subspecialties & More Academy Publications EyeNet Ophthalmology Ophthalmology Retina Information for: International Ophthalmologists Media Medical Students Patients and Public Technicians ...

  7. Colored Contact Lens Dangers

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    Full Text Available ... Us About the Academy Jobs at the Academy Financial Relationships with Industry Medical Disclaimer Privacy Policy Terms of Service For Advertisers For Media Ophthalmology Job Center © American ...

  8. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... lenses, remove the lenses and seek immediate medical attention from an ophthalmologist. Related resources: Learn how to ... Eye Health News Ocular Melanoma Cases Getting Nationwide Attention MAY 03, 2018 By Dan T. Gudgel News ...

  9. Colored Contact Lens Dangers

    Medline Plus

    Full Text Available ... Eye Health Home Annual Meeting Clinical Education Practice Management Member Services Advocacy Foundation About Subspecialties & More Academy Publications EyeNet Ophthalmology Ophthalmology Retina Information for: International Ophthalmologists Media Medical Students Patients and ...

  10. Potentially pathogenic free-living amoebae in contact lenses of the asymptomatic contact lens wearers.

    Directory of Open Access Journals (Sweden)

    Maryam Niyyati

    2014-03-01

    Full Text Available Free-living amoebae (FLA including Acanthamoeba spp. and Hartmannella spp. are the causative agents of serious corneal infection especially within contact lens wearers. Thus contact lenses and their storage case could be a suitable niche for potentially pathogenic amoebae. The main objective of the present study was to evaluate the contamination of contact lenses to free living amoebae using morphological and sequencing based methods.Overall, 90 volunteers provided their contact lenses. All volunteers wore soft contact lenses. Both lenses were cultured in the same plate. Forty-eight of the volunteers were medical and dentistry student and 42 were ophthalmology attendees of hospitals in Tehran, Iran. All of the samples were inoculated to non-nutrient medium and monitored daily for the outgrowth of the amoebae. PCR and sequencing were performed using various primer pairs.Of the 90 volunteers, 9 (10% were positive for free-living amoebae outgrowth. Morphological analysis revealed that 3 isolates were belonged to Hartmannella genus according to small round cysts and 6 isolates were belonged to Acanthamoeba genus based on the star shape of endocysts. Sequencing revealed that Acanthamoeba belonged to T4, T3 and T5 genotype. Hartmannella were also belonged to vermiformis species.The presence of potentially pathogenic free living amoebae including Acanthamoeba and Hartmannella could be a high risk for people using soft contact lenses. These results revealed that improved clarification and professional recommendations for contact lens wearers is of utmost importance.

  11. Decline in Reference Transactions with Few Questions Referred to Librarian when the Reference Desk is Staffed by a Paraprofessional. A Review of: Dinkins, D., & Ryan, S. M. (2010. Measuring referrals: The use of paraprofessionals at the reference desk. The Journal of Academic Librarianship, 36(4, 279-286.

    Directory of Open Access Journals (Sweden)

    Diana K. Wakimoto

    2011-03-01

    Full Text Available Objective — To determine the type and percentage of questions referred to a librarian by a paraprofessional (i.e., an individual without an MLIS staffing the reference desk, whether the percentage of referrals would decrease over time, and any consequences from having a paraprofessional rather than a librarian staffing the desk.Design — Quantitative analysis of reference desk transaction statistics.Setting — Reference desk at the main library of Stetson University, a private university in the United States of America with approximately 2,500 FTE (full-time equivalent students.Subjects — A total of 486 reference desk transactions recorded by a paraprofessional staffing the reference desk during the Fall and Spring semesters of the 2008-2009 academic year.Methods — The first year that he worked in the Library at Stetson University, a paraprofessional recorded all reference desk transactions during his shift from 10:00am to 12:00pm, four days a week, for the Fall and Spring semesters of the 2008-2009 academic year. This paraprofessional, with computer expertise, received "relatively minimal" (p. 281 training on "reference desk policies and procedures… the use of the catalogue and the subscription databases" (p. 281. For each transaction, the paraprofessional categorized the question as "direction, " "reference, " or "machine. " He was instructed to contact a librarian if he could not answer a reference question. The paraprofessional also completed a questionnaire regarding his level of comfort answering questions and his thoughts on the training at the end of his first year of staffing the reference desk.Main Results — In the Fall semester, 9.5% of all reference desk transactions were referred to a librarian. This decreased to 4.2% of the total transactions during the Spring semester. The percentage of reference questions referred to a librarian in the Fall semester was 21.9% and only 5.0% in the Spring semester. There was a 49

  12. Prolonging contact lens wear and making contact lens wear safer.

    Science.gov (United States)

    Foulks, Gary N

    2006-02-01

    To summarize the present status of safety and efficacy of contact lens wear. Literature review. Ovid Medline searches were performed on records from 1966 through 2005 using keywords: keratitis, contact lens complications, extended-wear contact lenses, and silicone-hydrogel contact lenses. Patients desire comfort, clarity of vision, and prolonged contact lens wear when contact lenses are used to correct refractive error. Practitioners desire patient satisfaction but also require maintenance of the integrity of the eye and no complications that jeopardize vision or health of the eye. Improvements in the oxygen permeability of the contact lens materials, design of the contact lens and its surface, and solutions for the maintenance of the lens have reduced but not eliminated the risks of infection, inflammation, and conjunctival papillary reaction associated with contact lens wear. The lessons of past and recent history suggest that patient education and practitioner participation in the management of contact lens wear continue to be critical factors for patient satisfaction and safety in the extended wear of contact lenses. The availability of highly oxygen permeable contact lenses has increased the tolerance and safety of extended contact lens wear, but patient instruction and education in proper use and care of lenses is required and caution is advised.

  13. Mechanical Contact Experiments and Simulations

    DEFF Research Database (Denmark)

    Nielsen, Chris Valentin; Martins, P; Zhang, W.

    2011-01-01

    . The overall investigation serves for testing and validating the numerical implementation of the mechanical contact, which is one of the main contributions to a system intended for 3D simulation of resistance welding. Correct modelling of contact between parts to be welded, as well as contact with electrodes...... geometries and different materials are analyzed including contact between dissimilar materials. The numerical implementation is performed with a finite element computer program based on the irreducible flow formulation, and contact between deformable objects is modelled by applying the penalty method......, is crucial for satisfactory modelling of the resistance welding process. The resistance heating at the contact interfaces depends on both contact area and pressure, and as the contact areas develop dynamically, the presented tests are relevant for assessing the validity and accuracy of the mechanical contact...

  14. Mechanical Contact Experiments and Simulations

    DEFF Research Database (Denmark)

    Nielsen, Chris Valentin; Martins, P; Zhang, W.

    2011-01-01

    Mechanical contact is studied under dynamic development by means of a combined numerical and experimental investigation. The experiments are designed to allow dynamical development of non-planar contact areas with significant expansion in all three directions as the load is increased. Different....... The overall investigation serves for testing and validating the numerical implementation of the mechanical contact, which is one of the main contributions to a system intended for 3D simulation of resistance welding. Correct modelling of contact between parts to be welded, as well as contact with electrodes......, is crucial for satisfactory modelling of the resistance welding process. The resistance heating at the contact interfaces depends on both contact area and pressure, and as the contact areas develop dynamically, the presented tests are relevant for assessing the validity and accuracy of the mechanical contact...

  15. Prosthetic soft contact lenses in Japan.

    Science.gov (United States)

    Kanemoto, Masumi; Toshida, Hiroshi; Takahiro, Itagaki; Murakami, Akira

    2007-11-01

    To investigate the use of the prosthetic iris-tinted soft contact lens, the SEED Opaque, during the past 5 years. The records of 42 outpatients (48 eyes) for whom the prosthetic soft contact lens was prescribed in the contact lens clinic of Juntendo University Hospital from July 2001 to June 2005 were investigated. An investigation was conducted in regard to the tint patterns of the prosthetic soft contact lens and the presence or absence of a transparent part in the middle, as a brown iris with a clear pupil or a solid pupil. The diagnosis, purpose of prescription, age when that lens was prescribed, complications, and changes in corrected visual acuities were analyzed retrospectively from the medical records. The mean age at the first prescription, total number of years of wearing prosthetic contact lenses, total number of prescriptions, and mean period to use each SEED Opaque lens were compared. The mean age at the first prescription of solid-pupil lens wearers was significantly younger than that for clear-pupil lens wearers (Ppossible to adjust the color and size of the cosmetic part and the pupil diameter. Further, corrected visual acuities could improve with the clear-pupil type for patients who had prescribed for improvement of visual function.

  16. Physician medical oversight in emergency medical services: where are we?

    Science.gov (United States)

    Studnek, Jonathan R; Fernandez, Antonio R; Margolis, Gregg S; O'Connor, Robert E

    2009-01-01

    The objective of this study was to quantify the amount of direct contact with medical direction that nationally registered emergency medical services (EMS) professionals receive. The secondary objective was to determine whether differences in medical director contact were associated with work-related characteristics. As part of biennial reregistration paperwork, nationally registered EMS professionals reregistering in 2004 were asked to complete a survey regarding medical direction. There were three survey questions asking participants to indicate, on a five-point scale, how often they interacted with their medical director in specific situations (whether the medical director participated in continuing education, met personally to discuss an EMS issue, and was seen at the scene of an EMS call). Individuals were categorized as having limited contact if they had not observed their medical director in any of the above situations for more than six months. All others where categorized as having recent contact. Demographic characteristics were collected and statistical analysis was performed using chi-square. In 2004, 45,173 individuals reregistered, with 28,647 (63%) returning surveys. A complete case analysis was performed, leaving 22,026 (49%) individuals. There were 13,756 (62.5%) individuals who reported having recent medical director contact. A stepwise increase in the percentage of those reporting recent contact was present when comparing the providers' certification levels (emergency medical technician EMT-Basic 47.6%, EMT-Intermediate 62.3%, and EMT-Paramedic 78.5%, p medical director. Nearly one-third of participants in this study reported having limited medical director contact. Certification level, service type, and community size were significantly associated with the amount of contact with medical direction.

  17. Multiscale electrical contact resistance in clustered contact distribution

    Science.gov (United States)

    Lee, Sangyoung; Cho, Hyun; Jang, Yong Hoon

    2009-08-01

    For contact between rough surfaces of conductors in which a clustered contact spot distribution is dominant through a multiscale process, electrical contact resistance (ECR) is analysed using a smoothed version of Greenwood's model (Jang and Barber 2003 J. Appl. Phys. 94 7215), which is extended to estimate the statistical distribution of contact spots considering the size and the location simultaneously. The application of this statistical method to a contact spot distribution, generated by the finite element method using a fractal surface defined by the random midpoint displacement algorithm, identifies the effect of the clustered contact distribution on ECR, showing that including a finer scale in the fractal contact surface causes the predicted resistance to approach a finite limit. It is also confirmed that the results are close to that of Barber's analogy (Barber 2003 Proc. R. Soc. Lond. A 459 53) regarding incremental stiffness and conductance for elastic contact.

  18. Contact-induced doping in aluminum-contacted molybdenum disulfide

    Science.gov (United States)

    Shimazu, Yoshihiro; Arai, Kensuke; Iwabuchi, Tatsuya

    2018-01-01

    The interface between two-dimensional semiconductors and metal contacts is an important topic of research of nanoelectronic devices based on two-dimensional semiconducting materials such as molybdenum disulfide (MoS2). We report transport properties of thin MoS2 flakes in a field-effect transistor geometry with Ti/Au and Al contacts. In contrast to widely used Ti/Au contacts, the conductance of flakes with Al contacts exhibits a smaller gate-voltage dependence, which is consistent with a substantial electron doping effect of the Al contacts. The temperature dependence of two-terminal conductance for the Al contacts is also considerably smaller than for the Ti/Au contacts, in which thermionic emission and thermally assisted tunneling play a dominant role. This result is explained in terms of the assumption that the carrier injection mechanism at an Al contact is dominated by tunneling that is not thermally activated.

  19. Contextualizing Intergroup Contact: Do Political Party Cues Enhance Contact Effects?

    DEFF Research Database (Denmark)

    Sønderskov, Kim Mannemar; Thomsen, Jens Peter Frølund

    2015-01-01

    This article examines intergroup contact effects in different political contexts. We expand on previous efforts of social psychologists by incorporating the messages of political parties as a contextual trigger of group membership awareness in contact situations. We argue that the focus among......,000 individuals confirms that the ability of intergroup contact to reduce antiforeigner sentiment increases when political parties focus intensively on immigration issues and cultural differences. Specifically, both workplace contact and interethnic friendship become more effective in reducing antiforeigner...

  20. Contact Control, Version 1

    Energy Technology Data Exchange (ETDEWEB)

    2016-07-21

    The contact control code is a generalized force control scheme meant to interface with a robotic arm being controlled using the Robot Operating System (ROS). The code allows the user to specify a control scheme for each control dimension in a way that many different control task controllers could be built from the same generalized controller. The input to the code includes maximum velocity, maximum force, maximum displacement, and a control law assigned to each direction and the output is a 6 degree of freedom velocity command that is sent to the robot controller.

  1. Thermal contact conductance

    CERN Document Server

    Madhusudana, Chakravarti V

    2013-01-01

    The work covers both theoretical and practical aspects of thermal contact conductance. The theoretical discussion focuses on heat transfer through spots, joints, and surfaces, as well as the role of interstitial materials (both planned and inadvertent). The practical discussion includes formulae and data that can be used in designing heat-transfer equipment for a variety of joints, including special geometries and configurations. All of the material has been updated to reflect the latest advances in the field.

  2. Contact ionization ion source

    International Nuclear Information System (INIS)

    Hashmi, N.; Van Der Houven Van Oordt, A.J.

    1975-01-01

    An ion source in which an apertured or foraminous electrode having a multiplicity of openings is spaced from one or more active surfaces of an ionisation electrode, the active surfaces comprising a material capable of ionising by contact ionization a substance to be ionized supplied during operation to the active surface or surfaces comprises means for producing during operation a magnetic field which enables a stable plasma to be formed in the space between the active surface or surfaces and the apertured electrode, the field strength of the magnetic field being preferably in the range between 2 and 8 kilogauss. (U.S.)

  3. Precision contact level gauge

    International Nuclear Information System (INIS)

    Krejci, M.; Pilat, M.; Stulik, P.

    1977-01-01

    Equipment was developed measuring the heavy water level in the TR-0 reactor core within an accuracy of several hundredths of a millimeter in a range of around 3.5 m and at a temperature of up to 90 degC. The equipment uses a vibrating needle contact as a high sensitivity level gauge and a servomechanical system with a motion screw carrying the gauge for monitoring and measuring the level in the desired range. The advantage of the unique level gauge consists in that that the transducer converts the measured level position to an electric signal, ie., pulse width, with high sensitivity and without hysteresis. (Kr)

  4. Contact dermatitis to methylisothiazolinone*

    Science.gov (United States)

    Scherrer, Maria Antonieta Rios; Rocha, Vanessa Barreto; Andrade, Ana Regina Coelho

    2015-01-01

    Methylisothiazolinone (MI) is a preservative found in cosmetic and industrial products. Contact dermatitis caused by either methylchloroisothiazolinone/methylisothiazolinone (MCI/MI or Kathon CG) or MI has shown increasing frequency. The latter is preferably detected through epicutaneous testing with aqueous MI 2000 ppm, which is not included in the Brazilian standard tray. We describe a series of 23 patients tested using it and our standard tray. A case with negative reaction to MCI/MI and positive to MI is emphasized. PMID:26734880

  5. Optimal contact definition for reconstruction of Contact Maps

    Directory of Open Access Journals (Sweden)

    Stehr Henning

    2010-05-01

    Full Text Available Abstract Background Contact maps have been extensively used as a simplified representation of protein structures. They capture most important features of a protein's fold, being preferred by a number of researchers for the description and study of protein structures. Inspired by the model's simplicity many groups have dedicated a considerable amount of effort towards contact prediction as a proxy for protein structure prediction. However a contact map's biological interest is subject to the availability of reliable methods for the 3-dimensional reconstruction of the structure. Results We use an implementation of the well-known distance geometry protocol to build realistic protein 3-dimensional models from contact maps, performing an extensive exploration of many of the parameters involved in the reconstruction process. We try to address the questions: a to what accuracy does a contact map represent its corresponding 3D structure, b what is the best contact map representation with regard to reconstructability and c what is the effect of partial or inaccurate contact information on the 3D structure recovery. Our results suggest that contact maps derived from the application of a distance cutoff of 9 to 11Å around the Cβ atoms constitute the most accurate representation of the 3D structure. The reconstruction process does not provide a single solution to the problem but rather an ensemble of conformations that are within 2Å RMSD of the crystal structure and with lower values for the pairwise average ensemble RMSD. Interestingly it is still possible to recover a structure with partial contact information, although wrong contacts can lead to dramatic loss in reconstruction fidelity. Conclusions Thus contact maps represent a valid approximation to the structures with an accuracy comparable to that of experimental methods. The optimal contact definitions constitute key guidelines for methods based on contact maps such as structure prediction through

  6. Managing Person-Centered Dementia Care in an Assisted Living Facility: Staffing and Time Considerations.

    Science.gov (United States)

    Simmons, Sandra F; Coelho, Chris S; Sandler, Andrew; Shah, Avantika S; Schnelle, John F

    2017-06-02

    To describe (a) the unlicensed staff time necessary to provide quality activities of daily living (ADL) care to residents receiving dementia care within an assisted living facility and (b) a staff management approach to maintain quality ADL care. Supervisory staff used a standardized observational method to measure ADL care quality and the staff time to provide care during the morning and evening across 12 consecutive months. Staff were given individual feedback about the quality of their care provision following each observation. The average staff time to provide ADL care averaged 35 (± 11) minutes per resident per care episode with bathing and 18 (± 6) minutes/resident/care episode without bathing. Morning ADL care required significantly more staff time than evening care. There was not a significant relationship between residents' levels of cognitive impairment or ADL dependency and the staff time to provide ADL care. Quality ADL care was maintained for 12 months. This study provides novel data related to the amount of staff time necessary to provide quality ADL care for persons with dementia in an assisted living care setting. This study also describes a standardized approach to staff management that was effective in maintaining quality ADL care provision. Assisted living facilities should consider these data when determining the necessary unlicensed staffing level to provide person-centered ADL care and how to effectively manage direct care providers. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Neuroscience Intermediate-Level Care Units Staffed by Intensivists: Clinical Outcomes and Cost Analysis.

    Science.gov (United States)

    Kyeremanteng, Kwadwo; Hendin, Ariel; Bhardwaj, Kalpana; Thavorn, Kednapa; Neilipovitz, Dave; Kubelik, Dalibour; D'Egidio, Gianni; Stotts, Grant; Rosenberg, Erin

    2017-01-01

    With an aging population and increasing numbers of intensive care unit admissions, novel ways of providing quality care at reduced cost are required. Closed neurointensive care units improve outcomes for patients with critical neurological conditions, including decreased mortality and length of stay (LOS). Small studies have demonstrated the safety of intermediate-level units for selected patient populations. However, few studies analyze both cost and safety outcomes of these units. This retrospective study assessed clinical and cost-related outcomes in an intermediate-level neurosciences acute care unit (NACU) before and after the addition of an intensivist to the unit's care team. Starting in October 2011, an intensivist-led model was adopted in a 16-bed NACU unit, including daytime coverage by a dedicated intensivist. Data were obtained from all patients admitted 1 year prior to and 2 years after this intervention. Primary outcomes were LOS and hospital costs. Safety outcomes included mortality and readmissions. Descriptive and analytic statistics were calculated. Individual and total patient costs were calculated based on per-day NACU and ward cost estimates and significance measured using bootstrapping. A total of 2931 patients were included over the study period. Patients were on average 59.5 years and 53% male. The most common reasons for admission were central nervous system (CNS) tumor (27.6%), ischemic stroke (27%), and subarachnoid hemorrhage (11%). Following the introduction of an intensivist, there was a significant reduction in NACU and hospital LOS, by 1 day and 3 days, respectively. There were no differences in readmissions or mortality. Adding an intensivist produced an individual cost savings of US$963 in NACU and US$2687 per patient total hospital stay. An intensivist-led model of intermediate-level neurointensive care staffed by intensivists is safe, decreases LOS, and produces cost savings in a system increasingly strained to provide quality

  8. A survey of nurse staffing levels in interventional radiology units throughout the UK

    International Nuclear Information System (INIS)

    Christie, A.; Robertson, I.

    2016-01-01

    Aim: To supplement previous surveys analysing provision of interventional radiology (IR), in-hours (IH) and out-of-hours (OOH), by specifically surveying the level of nursing support provided. Materials and methods: A web-based questionnaire was distributed to all British Society of Interventional Radiology (BSIR) members. This addressed several aspects of radiology nursing support for IR procedures, both IH and OOH. Results: Sixty percent of respondents indicated that they have a formal OOH service. Of these, all have a dedicated nursing rota, with the vast majority operating with one nurse. IH, 77% of respondents always have a scrubbed nurse assistant, but this reduces to 40% OOH. IH, 4% never have a scrubbed radiology nurse assistant, which rises to 25% OOH. IH, 75% of respondents always have a radiology nurse dedicated to patient monitoring, but this reduces to 20% OOH. IH, 3% never have a radiology nurse dedicated to patient monitoring, which rises to 42% OOH. Conclusion: A significant disparity exists in the level of IR nursing support between IH and OOH. The majority of sites provide a single nurse with ad hoc additional support. This is potentially putting patients at increased risk. Radiology nurses are integral to the safe and sustainable provision of IR OOH services and a greater focus is required to ensure adequate and safe staffing levels for 24/7 IR services. - Highlights: • A significant disparity exists between the level of nursing support provided in-hours and OOH. • This applies to both the availability of a nurse to scrub and to monitor the patient. • Having a dedicated 24/7 nursing rota is mandatory to providing a deliverable OOH service.

  9. Systemic contact dermatitis

    Directory of Open Access Journals (Sweden)

    Daria Nowak

    2016-02-01

    Full Text Available Systemic contact dermatitis (SCD is a skin inflammation occurring in a patient after systemic administration of a hapten, which previously caused an allergic contact skin reaction in the same person. Most frequently, hypersensitivity reactions typical for SCD occur after absorption of haptens with food or inhalation. Haptens occur mainly in the forms of metals and compounds present in natural resins, preservatives, food thickeners, flavorings and medicines. For many years, several studies have been conducted on understanding the pathogenesis of SCD in which both delayed type hypersensitivity (type IV and immediate type I are observed. Components of the complement system are also suspected to attend there. Helper T cells (Th (Th1 and Th2, cytotoxic T lymphocytes (Tc, and NK cells play a crucial role in the pathogenesis of SCD. They secrete a number of pro-inflammatory cytokines. In addition, regulatory T cells (Tregs have an important role. They control and inhibit activity of the immune system during inflammation. Tregs release suppressor cytokines and interact directly with a target cell through presentation of immunosuppressive particles at the cell surface. Diagnostic methods are generally the patch test, oral provocation test, elimination diet and lymphocyte stimulation test. There are many kinds of inflammatory skin reactions caused by systemic haptens’ distribution. They are manifested in a variety of clinical phenotypes of the disease.

  10. The importance of contact quality

    DEFF Research Database (Denmark)

    van Bakel, Marian; Gerritsen, Marinel; van Oudenhoven, Jan Pieter

    Establishing contact between expatriates and a local host has been found to reap benefits with regard to Interaction Adjustment, Host National Social Support, Open-mindedness, and Social Initiative. This longitudinal study examines the role of the quality of contact for these four aspects. Expatr......, the more benefit the expatriate experienced. Moreover, expatriates with low-quality contact did not experience a detrimental effect.......Establishing contact between expatriates and a local host has been found to reap benefits with regard to Interaction Adjustment, Host National Social Support, Open-mindedness, and Social Initiative. This longitudinal study examines the role of the quality of contact for these four aspects....... Expatriates in the Netherlands were randomly divided into an experimental group (n = 33) of which 21 developed high-quality contact with their host, and a control group (n = 32) without host. The results show that contact quality plays an important role and suggest that the higher the quality of the contact...

  11. Contact Center Manager Administration (CCMA)

    Data.gov (United States)

    Social Security Administration — CCMA is the server that provides a browser-based tool for contact center administrators and supervisors. It is used to manage and configure contact center resources...

  12. [The adaptation to contact lenses].

    Science.gov (United States)

    Koos, D; Koos, M J

    1992-01-01

    The indications of contact lens adaptation in optical purpose are widely large, starting, with refractive errors [correction of vices], unilateral and bilateral aphakia, myopia, anisometropia and astigmatism, together with the use of contact lens in esthetic purpose. We have been presented the adaptation techniques, the supervise, and maintenance of contact lens.

  13. Contact Binary Asteroids

    Science.gov (United States)

    Rieger, Samantha

    2015-05-01

    Recent observations have found that some contact binaries are oriented such that the secondary impacts with the primary at a high inclination. This research investigates the evolution of how such contact binaries came to exist. This process begins with an asteroid pair, where the secondary lies on the Laplace plane. The Laplace plane is a plane normal to the axis about which the pole of a satellites orbit precesses, causing a near constant inclination for such an orbit. For the study of the classical Laplace plane, the secondary asteroid is in circular orbit around an oblate primary with axial tilt. This system is also orbiting the Sun. Thus, there are two perturbations on the secondarys orbit: J2 and third body Sun perturbations. The Laplace surface is defined as the group of orbits that lie on the Laplace plane at varying distances from the primary. If the secondary is very close to the primary, the inclination of the Laplace plane will be near the equator of the asteroid, while further from the primary the inclination will be similar to the asteroid-Sun plane. The secondary will lie on the Laplace plane because near the asteroid the Laplace plane is stable to large deviations in motion, causing the asteroid to come to rest in this orbit. Assuming the secondary is asymmetrical in shape and the bodys rotation is synchronous with its orbit, the secondary will experience the BYORP effect. BYORP can cause secular motion such as the semi-major axis of the secondary expanding or contracting. Assuming the secondary expands due to BYORP, the secondary will eventually reach the unstable region of the Laplace plane. The unstable region exists if the primary has an obliquity of 68.875 degrees or greater. The unstable region exists at 0.9 Laplace radius to 1.25 Laplace radius, where the Laplace radius is defined as the distance from the central body where the inclination of the Laplace plane orbit is half the obliquity. In the unstable region, the eccentricity of the orbit

  14. Teaching skills training for medical students.

    Science.gov (United States)

    Shariq, Omair; Alexopoulos, Anastasia-Stefania; Razik, Fathima; Currie, Jane; Salooja, Nina

    2013-06-01

      The UK General Medical Council has recommended that medical students be taught how to teach; however, the current state of teaching skills training in England has not yet been investigated.   To explore the current state of undergraduate teaching skills training at medical schools in England.   A questionnaire survey was sent to all 24 medical schools in England, enquiring about the basic structure, content areas, staffing, delivery and assessment methods of compulsory courses.   A response rate of 22/24 (92%) was achieved, and 18/22 (82%) of the responding institutions offered some form of teaching skills training. The most frequently covered content areas were small group facilitation skills, large group teaching skills and use of effective feedback. Teaching was delivered by a combination of hospital doctors, non-physician educators or general practitioner educators in the majority of courses. Six of the nine (67%) compulsory courses featured student assessments. The main barriers to implementing these courses were staffing limitations, insufficient time and lack of student engagement.   Our study demonstrates both the similarities and variation between undergraduate teaching skills courses across England. However, further research will be necessary to determine whether the long-term impact of such training will result in better educators, and ultimately in improved patient care. © 2013 John Wiley & Sons Ltd.

  15. Fragrance contact allergy

    DEFF Research Database (Denmark)

    Johansen, Jeanne D

    2003-01-01

    typically have a history of rash to a fine fragrance or scented deodorants. Chemical analysis has revealed that well known allergens from the fragrance mix are present in 15-100% of cosmetic products, including deodorants and fine fragrances, and most often in combinations of three to four allergens......Most people in modern society are exposed daily to fragrance ingredients from one or more sources. Fragrance ingredients are also one of the most frequent causes of contact allergic reactions. The diagnosis is made by patch testing with a mixture of fragrance ingredients, the fragrance mix....... This gives a positive patch-test reaction in about 10% of tested patients with eczema, and the most recent estimates show that 1.7-4.1% of the general population are sensitized to ingredients of the fragrance mix. Fragrance allergy occurs predominantly in women with facial or hand eczema. These women...

  16. Fragrance contact allergy

    DEFF Research Database (Denmark)

    Johansen, Jeanne D

    2003-01-01

    Most people in modern society are exposed daily to fragrance ingredients from one or more sources. Fragrance ingredients are also one of the most frequent causes of contact allergic reactions. The diagnosis is made by patch testing with a mixture of fragrance ingredients, the fragrance mix....... This gives a positive patch-test reaction in about 10% of tested patients with eczema, and the most recent estimates show that 1.7-4.1% of the general population are sensitized to ingredients of the fragrance mix. Fragrance allergy occurs predominantly in women with facial or hand eczema. These women...... typically have a history of rash to a fine fragrance or scented deodorants. Chemical analysis has revealed that well known allergens from the fragrance mix are present in 15-100% of cosmetic products, including deodorants and fine fragrances, and most often in combinations of three to four allergens...

  17. Cosmetic Contact Allergens

    Directory of Open Access Journals (Sweden)

    An Goossens

    2016-02-01

    Full Text Available This article presents trends in the frequency of cosmetics as causal factors of allergic contact dermatitis during a 26-year period in 14,911 patients patch-tested between 1990 and 2014, and discusses the cosmetic allergens identified during the last six years (2010–2015 in 603 patients out of 3105 tested. The data were retrieved from, and evaluated with, a patient database developed in-house. The results show the increasing importance of cosmetic allergies, up to 25% of the patients tested during the last five-year period. As expected, fragrance materials, preservatives, and hair dyes were the most frequent culprits, but a great variety of other allergenic ingredients were involved as well. This underlines the need of additional and extensive patch testing with the patient’s products used and their ingredients.

  18. Fragrance contact allergy

    DEFF Research Database (Denmark)

    Johansen, Jeanne D

    2003-01-01

    in the same products. This means that it is difficult to avoid exposure, as products labelled as 'fragrance free' have also been shown to contain fragrance ingredients, either because of the use of fragrance ingredients as preservatives or masking perfumes, or the use of botanicals. About 2500 different...... fragrance ingredients are currently used in the composition of perfumes and at least 100 of these are known contact allergens. Therefore, it is advisable to supplement standard patch testing with the patient's own stay-on cosmetic products, as well as the fragrance chemical hydroxyisohexyl-3-cyclohexane...... carboxaldehyde, which on its own gives responses in 1-3% of tested patients. The focus in recent years on the ingredients of the fragrance mix will probably result in the fragrance industry changing the composition of perfumes, and thus make the current diagnostic test less useful. New diagnostic tests are under...

  19. Hair dye contact allergy

    DEFF Research Database (Denmark)

    Søsted, Heidi; Rastogi, Suresh Chandra; Andersen, Klaus Ejner

    2004-01-01

    Colouring of hair can cause severe allergic contact dermatitis. The most frequently reported hair dye allergens are p-phenylenediamine (PPD) and toluene-2,5-diamine, which are included in, respectively, the patch test standard series and the hairdressers series. The aim of the present study...... was to identify dye precursors and couplers in hair dyeing products causing clinical hair dye dermatitis and to compare the data with the contents of these compounds in a randomly selected set of similar products. The patient material comprised 9 cases of characteristic clinical allergic hair dye reaction, where...... exposure history and patch testing had identified a specific hair dye product as the cause of the reaction. The 9 products used by the patients were subjected to chemical analysis. 8 hair dye products contained toluene-2,5-diamine (0.18 to 0.98%). PPD (0.27%) was found in 1 product, and m-aminophenol (0...

  20. Mechanoluminescent Contact Type Sensor

    Directory of Open Access Journals (Sweden)

    A. K. Yefremov

    2017-01-01

    Full Text Available Mechanoluminescent sensing elements convert mechanical stress into optical radiation. Advantages of such sensors are the ability to generate an optical signal, solid-state, simple structure, and resistance to electromagnetic interference. Mechanoluminescent sensor implementations can possess the concentrated and distributed sensitivity, thereby allowing us to detect the field of mechanical stresses distributed across the area and in volume. Most modern semiconductor photo-detectors can detect mechanoluminescent radiation, so there are no difficulties to provide its detection when designing the mechanoluminescent sensing devices. Mechanoluminescent substances have especial sensitivity to shock loads, and this effect can be used to create a fuse the structure of which includes a target contact type sensor with a photosensitive actuator. The paper briefly describes the theoretical basics of mechanoluminiscence: a light signal emerges from the interaction of crystalline phosphor luminescence centers with electrically charged dislocations, moving due to the deformation of the crystal. A mathematical model of the mechanoluminescent conversion is represented as a functional interaction between parameters of the mechanical shock excitation and the sensor light emission. Examples of computing the optical mechanoluminescent output signal depending on the duration and peak level of impulse load are given. It is shown that the luminous flux, generated by mechanoluminescent sensing element when there is an ammunition-target collision causes the current emerging in photo-detector (photodiode that is sufficient for a typical actuator of the fuse train to operate. The potential possibility to create a contact target type sensor based on the light-sensitive mechanoluminescent sensor was proved by the calculation and simulation results.

  1. The Moses Mabhida Medical Plan: medical care planning and execution at a FIFA2010 stadium; the Durban experience

    Science.gov (United States)

    Hardcastle, Timothy C; Naidoo, Mergan; Samlal, Sanjay; Naidoo, Morgambery; Larsen, Timothy; Mabasu, Muzi; Ngema, Sibongiseni

    2010-01-01

    Aim This paper aims to outline the medical services provided at the Moses Mabhida Stadium, Durban, South Africa for the Fédération Internationale de Football Association (FIFA) 2010 Soccer World Cup and audit the clinical services delivered to persons seeking medical assistance. Methods Descriptive report of the medical facilities at the Moses Mabhida Stadium including the staff deployment. Retrospective data review of medical incident reports from the Stadium Medical Team. Results Medical staffing exceeded the local norms and was satisfactory to provide rapid intervention for all incoming patients. Senior medical presence decreased the transport to hospital rate (TTHR). A total of 316 spectators or support staff were treated during the seven matches played at the stadium. The majority of patients were male (60%), mostly of local origin, with mostly minor complaints that were treated and discharged (88.2% Green codes). The most common complaints were headache, abdominal disorders, and soft-tissue injuries. One fatality was recorded. The patient presentation rate (PPR) was 0.66/10,000 and the TTHR was overall 4.1% of all treated patients (0.027/10,000 spectators). Conclusion There was little evidence to guide medical planning for staffing from the FIFA governing body. Most patients are treated and released in accordance with international literature, leading to low TTHR rates, while PPR was in line with international experience. Headache was the most common medical complaint. The blowing of Vuvuzelas® may have influenced the high headache rate. PMID:27147844

  2. Do staffing and workload levels influence the risk of new acquisitions of meticillin-resistant Staphylococcus aureus in a well-resourced intensive care unit?

    Science.gov (United States)

    Kong, F; Cook, D; Paterson, D L; Whitby, M; Clements, A C A

    2012-04-01

    Staffing deficits and workload have may a bearing on transmission of meticillin-resistant Staphylococcus aureus (MRSA) within intensive care units (ICUs). New MRSA acquistions may provide a clearer picture of the relationship between MRSA acquisition and staffing in the ICU setting. To determine whether staffing and bed occupancy rates had an immediate or delayed impact on the number of new MRSA acquisitions in a well-staffed ICU, and whether these variables could be used as predictors of future MRSA acquisitions. Data on new MRSA acquisitions in the ICU of a 796-bed metropolitan Australian hospital between January 2003 and December 2006 were used to build a model to predict the probabilility of actual new MRSA acquisitions in 2007. Cross validation was performed using receiver operator characteristic analysis. Sixty-one new MRSA acquisitions (21 infections, 40 colonizations) were identified in 51 individual weeks over the study period. The number of non-permanent staffing hours was relatively small. The area under the curve in the cross-validation analysis was 0.46 [95% CI 0.25-0.67] which suggests that the model, built on data from 2003-2006, was not able to predict weeks in which new MRSA acquisitions occurred in 2007. The risks posed by high workloads may have been mitigated by good compliance with infection control measures, nurse training and adequate staffing ratios in the ICU. Consequently, staffing policies and the infection control practices in the ICU do not need to be modified to address the rate of new MRSA acquisitions. Copyright © 2011 The Healthcare Infection Society. All rights reserved.

  3. Medical Libraries and Problem Based Learning: New Challenges and Opportunities

    Directory of Open Access Journals (Sweden)

    Kuan-nien Chen

    2004-06-01

    Full Text Available This article explores the changing role of the medical library and librarians in the context of problem-based learning in terms of fives aspects - impacts on medical libraries, library instruction, technology, the collection, and the new role of the librarians. For the libraries, the role change process is ongoing rather than a single event. The medical school and the library must collaborate and interact in the areas of curriculum design, communications, and library user education. In addition, administrative supports such as budgets, staffing, and the building space of the library are always in demand. [Article content in Chinese

  4. Health Physics and Medical Services report for 1986

    International Nuclear Information System (INIS)

    Burt, A.K.; Bird, R.W.

    1987-09-01

    A Health Physics and Medical Services report is presented for Harwell Laboratory for 1986. Health physics aspects covered include safety policy and organisation, monitoring results for the working environment and personnel, an analysis of radiological incidents and radioactive waste disposal, and protection of the public. Other non-radiological aspects of health and safety are briefly considered. The section on Medical Services contains details of the staffing, the types of medical examinations performed, the treatments received, work on the safety of asbestos and manmade mineral fibres and training and education programmes. (UK)

  5. Contact and Non-contact Measurements of Grinding Pins

    Directory of Open Access Journals (Sweden)

    Magdziak Marek

    2015-01-01

    Full Text Available The paper presents the results of contact and non-contact measurements of external profiles of selected grinding pins. The measurements were conducted in order to choose the appropriate measuring technique in the case of the considered measurement task. In the case of contact measurements the coordinate measuring machine ACCURA II was applied. The used coordinate measuring machine was equipped with the contact scanning probe VAST XT and the Calypso inspection software. Contact coordinate measurements were performed by using of different measurement strategies. The applied strategies included different scanning velocities and distances between measured points. Non-contact measurements were conducted by means of the tool presetter produced by the Mahr company. On the basis of gained results the guidelines concerning measurements of grinding pins were formulated. The measurements of analyzed grinding pins performed by means of the non-contact measuring system are characterized by higher reproducibility than the contact measurements. The low reproducibility of contact measurements may be connected with the inaccuracy of the selected coordinate measuring machine and the measuring probe, the measurement parameters and environmental conditions in the laboratory where the coordinate measuring machine is located. Moreover, the paper presents the possible application of results of conducted investigations. The results of non-contact measurements can be used in the simulation studies of grinding processes. The simulations may reduce the costs of machining processes.

  6. Meeting human resources for health staffing goals by 2018: a quantitative analysis of policy options in Zambia

    Directory of Open Access Journals (Sweden)

    Schroder Kate

    2010-06-01

    Full Text Available Abstract Background The Ministry of Health (MOH in Zambia is currently operating with fewer than half of the health workers required to deliver basic health services. The MOH has developed a human resources for health (HRH strategic plan to address the crisis through improved training, hiring, and retention. However, the projected success of each strategy or combination of strategies is unclear. Methods We developed a model to forecast the size of the public sector health workforce in Zambia over the next ten years to identify a combination of interventions that would expand the workforce to meet staffing targets. The key forecasting variables are training enrolment, graduation rates, public sector entry rates for graduates, and attrition of workforce staff. We model, using Excel (Office, Microsoft; 2007, the effects of changes in these variables on the projected number of doctors, clinical officers, nurses and midwives in the public sector workforce in 2018. Results With no changes to current training, hiring, and attrition conditions, the total number of doctors, clinical officers, nurses, and midwives will increase from 44% to 59% of the minimum necessary staff by 2018. No combination of changes in staff retention, graduation rates, and public sector entry rates of graduates by 2010, without including training expansion, is sufficient to meet staffing targets by 2018 for any cadre except midwives. Training enrolment needs to increase by a factor of between three and thirteen for doctors, three and four for clinical officers, two and three for nurses, and one and two for midwives by 2010 to reach staffing targets by 2018. Necessary enrolment increases can be held to a minimum if the rates of retention, graduation, and public sector entry increase to 100% by 2010, but will need to increase if these rates remain at 2008 levels. Conclusions Meeting the minimum need for health workers in Zambia this decade will require an increase in health

  7. To Meet the Needs of the Nations: Staffing the U.S. Civil Service and the Public Service of Canada

    Science.gov (United States)

    1992-01-01

    the Civil Service Reform Act of 1978, it is my honor to submit the U.S. Merit Systems Protection Board report titled "To Meet the Needs of the...Representatives Washington, DC 2 05 027 92-02948 "IuIII II IIIh I A Spedal Study TO MEET THE NEEDS OF THE NATIONS: STAFFING THE U.S. CiVIL SERVICE AND THE PUBLIC...ing close scutiny in appeals, inc flg ones that am a useful way to meet the needs of rapidly chang- reach the Fdu comt. As oe depotinental Ing Izadons

  8. Homotopy classification of contact foliations on open contact manifolds

    Indian Academy of Sciences (India)

    64

    Abstract. We give a homotopy classification of foliations on open contact manifolds whose leaves are contact ... The inverse images of FN under an f ∈ Trα(M, FN ), namely f−1FN , is a contact foliation on (M,α). ..... Let Γ be the graph of H; then the image of ϕ is contained in Γ. By Lemma 3.2 there exists a diffeomorphism Φ ...

  9. Acanthamoeba keratitis in patients wearing scleral contact lenses.

    Science.gov (United States)

    Sticca, Matheus Porto; Carrijo-Carvalho, Linda C; Silva, Isa M B; Vieira, Luiz A; Souza, Luciene B; Junior, Rubens Belfort; Carvalho, Fábio Ramos S; Freitas, Denise

    2017-12-05

    To report a series of cases of Acanthamoeba keratitis (AK) in scleral lens wearers with keratoconus to determine whether this type of contact lens presents a greater risk for development of infection. This study reports three patients who wore scleral contact lenses to correct keratoconus and developed AK. The diagnoses of AK were established based on cultures of the cornea, scleral contact lenses, and contact lens paraphernalia. This study investigated the risk factors for infections. The possible risks for AK in scleral contact lens wearers are hypoxic changes in the corneal epithelium because of the large diameter and minimal tear exchange, use of large amounts of saline solution necessary for scleral lens fitting, storing the scleral lens overnight in saline solution rather than contact lens multipurpose solutions, not rubbing the contact lens during cleaning, and the space between the cornea and the back surface of the scleral lens that might serve as a fluid reservoir and environment for Acanthamoeba multiplication. Two patients responded well to medical treatment of AK; one is still being treated. The recommendations for use and care of scleral contact lenses should be emphasized, especially regarding use of sterile saline (preferably single use), attention to rubbing the lens during cleaning, cleaning of the plunger, and overnight storage in fresh contact lens multipurpose solutions without topping off the lens solution in the case. Copyright © 2017. Published by Elsevier Ltd.

  10. [Vital contact with reality].

    Science.gov (United States)

    Ravagnan, L M

    1976-12-01

    From the standpoint of existential phenomenology, the contact with reality lies in the very phocus of theory, being closely related to another basic conception: that of being-in-the-world. In order to ratify those conceptions, the author reviews some concepts imported from Kurt Lewin's Field Theory, among which: a) vital psychological space, embedding the subject and in close interchange with him; b) intrapsychic regions, having, to a certain extent, autonomous functions, but being related to each other and integrated into the higher unity of the subject. As both systems are interdependent, any modification of the equilibrium of one of them reverberates into the other's, and changes the general conditions of both of them. Reviewing, at the same time, Minkowski's views on schizophrenia, the author sets forth the production of an inner world that becomes autonomous and possesses a degree of reality that overwhelms the true outer world. There is not only the splitting from reality, but the creation of a whole fantastic field, in which the individual participates with all his vital availability. Both views lead to a similar contention: that in some pathological states, the primal link man-real world, is replaced by a new inner correspondence, focused on the imaginary and having effects similar to those of the real world.

  11. Contact sport and osteoarthritis.

    LENUS (Irish Health Repository)

    Molloy, Michael G

    2011-04-01

    Osteoarthritis (OA) is the most common joint disease in the world and the single largest cause of disability for those over 18 years. It affects more than twice as many people as does cardiac disease, and increases in incidence and prevalence with age. Animal and human studies have shown no evidence of increased risk of hip or knee OA with moderate exercise and in the absence of traumatic injury, sporting activity has a protective effect. One age-matched case control study found recreational runners who ran 12-14 miles per week for up to 40 years had no increase in radiological or symptomatic hip or knee OA. However, higher rates of hip OA occur in contact sports than in age-matched controls, with the highest rate in professional players. Soccer players with torn anterior cruciate ligaments (ACL) are more likely to develop knee OA than those with intact ACL. Early ACL repair reduces the risk of knee OA, but does not prevent it. Established injury prevention programmes have been refined to prevent injuries such as ACL rupture.

  12. Comprehensive evaluation of contemporary assisted reproduction technology laboratory operations to determine staffing levels that promote patient safety and quality care.

    Science.gov (United States)

    Alikani, Mina; Go, Kathryn J; McCaffrey, Caroline; McCulloh, David H

    2014-11-01

    To consider how staffing requirements have changed with evolving and increasingly more complex assisted reproduction technology (ART) laboratory practice. Analysis by four laboratory directors from three different ART programs of the level of complexity and time requirements for contemporary ART laboratory activities to determine adequate staffing levels. University-based and private ART programs. None. None. Human resource requirements for ART procedures. Both complexity and time required for completion of a contemporary ART cycle have increased significantly compared with the same requirements for the "traditional cycle" of the past. The latter required roughly 9 personnel hours, but a contemporary cycle can require up to 20 hours for completion. Consistent with this increase, a quantitative analysis shows that the number of embryologists required for safe and efficient operation of the ART laboratory has also increased. This number depends on not only the volume but also the types of procedures performed: the higher the number of complex procedures, the more personnel required. An interactive Personnel Calculator is introduced that can help determine staffing needs. The increased complexity of the contemporary ART laboratory requires a new look at the allocation of human resources. Our work provides laboratory directors with a practical, individualized tool to determine their staffing requirements with a view to increasing the safety and efficiency of operations. The work could serve as the basis for revision of the 2008 American Society for Reproductive Medicine (ASRM) staffing guidelines. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  13. Contact Lens Related Corneal Ulcer

    OpenAIRE

    Loh, KY; Agarwal, P

    2010-01-01

    A corneal ulcer caused by infection is one of the major causes of blindness worldwide. One of the recent health concerns is the increasing incidence of corneal ulcers associated with contact lens user especially if the users fail to follow specific instruction in using their contact lenses. Risk factors associated with increased risk of contact lens related corneal ulcers are: overnight wear, long duration of continuous wear, lower socio-economic classes, smoking, dry eye and poor hygiene. Th...

  14. Emotional Satisfaction of Customer Contacts

    OpenAIRE

    Güngör, Hüseyin

    2007-01-01

    For marketing and customer services researchers and professionals who are interested in customer contacts, customer satisfaction and loyalty issues. Contact centers are playing a pivotal role in customer services of the 21st century. Nevertheless, despite their growing importance and presence, contact centers are increasingly becoming the center for customer frustration, and frequently associated with negative comments in the media. Therefore, this research explores the Emotional, Cognitive, ...

  15. Endoscopic Solution to Rhinogenic Contact Headaches

    Directory of Open Access Journals (Sweden)

    Hasan Abdul Cader Segana

    2016-08-01

    Full Text Available Introduction Headache is a common complaint that brings patients to multidisciplinary clinics. It is utmost important to have meticulous clinical diagnosis of patients with rhinogenic and non sinusogenic headaches. The diagnosis has become easier with the advent of modern endoscopy and endoscopic sinus surgical techniques. This study aims to investigate the role of some anatomical nasal abnormalities in rhinogenic contact headache and to evaluate response to endoscopic surgery.   Materials and Method A prospective study was conducted at a secondary level regional referral Hospital in the Sultanate of Oman. Patients with long-lasting, frequent, severe headaches not amenable to medical treatment, above 20 years of age were taken into consideration. Routine nasal endoscopy, Computerized tomography scan of the paranasal sinuses, Nasal decongestion and various surgical techniques to correct the anatomical abnormalities were included in our study and results were correlated statistically.   Result There was a male predominance in our study with duration of headache ranging from 2 weeks to 5 years. There was a preponderance of headache in frontal region in our study group. Diagnostic nasal endoscopy and CT scan of PNS revealed Deviated nasal septum / septal spur, concha bullosa, Haller cell, pneumatised uncinate process and agar nasi cells. The overall success rate of the surgery in relieving headaches, measured by the MIDAS- VAS score, was approximately 75 %. The non-parametric Wilcoxon signed rank test, Chi square and paired T tests shows that the following study has rejected the null hypothesis as statistically significant where the P value <0.05.   Discussion Researchers have examined the contact points as a source of rhinogenic / contact headache. Intranasal mucosal contact released substance P, causing pain and headache, Substance P has a potent vasodilator effect. Vasodilatation and perivascular inflammation are the final common pathways in

  16. African Journal of Psychiatry: Contact

    African Journals Online (AJOL)

    Principal Contact. Andrew Thomas Division of Psychiatry, Department of Neurosciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, SOUTH AFRICA Email: inhouse@iafrica.com ...

  17. Mitigation of epidemics in contact networks through optimal contact adaptation *

    Science.gov (United States)

    Youssef, Mina; Scoglio, Caterina

    2013-01-01

    This paper presents an optimal control problem formulation to minimize the total number of infection cases during the spread of susceptible-infected-recovered SIR epidemics in contact networks. In the new approach, contact weighted are reduced among nodes and a global minimum contact level is preserved in the network. In addition, the infection cost and the cost associated with the contact reduction are linearly combined in a single objective function. Hence, the optimal control formulation addresses the tradeoff between minimization of total infection cases and minimization of contact weights reduction. Using Pontryagin theorem, the obtained solution is a unique candidate representing the dynamical weighted contact network. To find the near-optimal solution in a decentralized way, we propose two heuristics based on Bang-Bang control function and on a piecewise nonlinear control function, respectively. We perform extensive simulations to evaluate the two heuristics on different networks. Our results show that the piecewise nonlinear control function outperforms the well-known Bang-Bang control function in minimizing both the total number of infection cases and the reduction of contact weights. Finally, our results show awareness of the infection level at which the mitigation strategies are effectively applied to the contact weights. PMID:23906209

  18. Mitigation of epidemics in contact networks through optimal contact adaptation.

    Science.gov (United States)

    Youssef, Mina; Scoglio, Caterina

    2013-08-01

    This paper presents an optimal control problem formulation to minimize the total number of infection cases during the spread of susceptible-infected-recovered SIR epidemics in contact networks. In the new approach, contact weighted are reduced among nodes and a global minimum contact level is preserved in the network. In addition, the infection cost and the cost associated with the contact reduction are linearly combined in a single objective function. Hence, the optimal control formulation addresses the tradeoff between minimization of total infection cases and minimization of contact weights reduction. Using Pontryagin theorem, the obtained solution is a unique candidate representing the dynamical weighted contact network. To find the near-optimal solution in a decentralized way, we propose two heuristics based on Bang-Bang control function and on a piecewise nonlinear control function, respectively. We perform extensive simulations to evaluate the two heuristics on different networks. Our results show that the piecewise nonlinear control function outperforms the well-known Bang-Bang control function in minimizing both the total number of infection cases and the reduction of contact weights. Finally, our results show awareness of the infection level at which the mitigation strategies are effectively applied to the contact weights.

  19. [Contact lens-associated Paecilomyces lilacinus keratitis].

    Science.gov (United States)

    Mihailovic, N; Alnawaiseh, M; Zumhagen, L; Eter, N

    2017-01-01

    We present the case of a 23-year-old otherwise healthy female patient with contact lens-associated Paecilomyces lilacinus keratitis. The clinical findings stabilized after initial local antimycotic and antibacterial treatment; however, in the further course of local therapy an extensive relapse occurred which required treatment by perforating keratoplasty à chaud due to a penetrating corneal ulcer. The patient responded well to subsequent treatment with systemic and local antimycotic medication. After a few months HLA-matched keratoplasty was performed. During the follow-up time of 14 months there were no signs of recurrence of the infection.

  20. African Crop Science Journal: Contact

    African Journals Online (AJOL)

    Principal Contact. Dr. J.S. Tenywa Editor-in-Chief Faculty of Agriculture. Makerere University PO Box 7062 Kampala Uganda. Alternative email address: acsj@caes.mak.ac.ug. Email: acss@caes.mak.ac.ug. Support Contact. Editor Email: johntenywa@gmail.com. ISSN: 2072-6589. AJOL African Journals Online. HOW TO ...

  1. Focusing on Contact Lens Safety

    Science.gov (United States)

    ... their practices. Decorative contacts (also called “costume,” colored,” “fashion,” or “plano” contacts). The FDA has often warned ... State & Local Officials Consumers Health Professionals Science & Research Industry Scroll back to top Popular Content Home Latest ...

  2. Journal of Business Research: Contact

    African Journals Online (AJOL)

    Principal Contact. Goski Alabi Mrs Institute of Professional Studies (IPS) P. 0 Box 149 Institute Of Professional Studies (IPS) Legon, Accra Ghana Phone: +233 24 64 52798. Fax: +233 21 513539. Email: goskia@yahoo.com. Support Contact. Anthony Afeadie. Phone: +233 21 500171. Email: ipsjournal@yahoo.com.

  3. Contacts between grandparents and grandchildren

    NARCIS (Netherlands)

    J. Oppelaar (Janneke); P.A. Dykstra (Pearl)

    2004-01-01

    textabstractHow much contact do Dutch grandparents have with their grandchildren, and how can differences in contact frequency by explained? In the 1992 NESTOR-LSN survey of 'Older adults living arrangements and social networks', a random group of 976 grandparents answered questions on the frequency

  4. Aluminum break-point contacts

    NARCIS (Netherlands)

    Heinemann, Martina; Groot, R.A. de

    1997-01-01

    Ab initio molecular dynamics is used to study the contribution of a single Al atom to an aluminum breakpoint contact during the final stages of breaking and the initial stages of the formation of such a contact. A hysteresis effect is found in excellent agreement with experiment and the form of the

  5. Contact Allergy to Neem Oil.

    NARCIS (Netherlands)

    de Groot, Anton; Jagtman, Berend A; Woutersen, Marjolijn

    2018-01-01

    A case of allergic contact dermatitis from neem oil is presented. Neem oil (synonyms: Melia azadirachta seed oil [INCI name], nim oil, margosa oil) is a vegetable (fixed) oil obtained from the seed of the neem tree Azadirachta indica by cold pressing. Contact allergy to neem oil has been described

  6. Emotional Satisfaction of Customer Contacts

    NARCIS (Netherlands)

    Güngör, Hüseyin

    2007-01-01

    For marketing and customer services researchers and professionals who are interested in customer contacts, customer satisfaction and loyalty issues. Contact centers are playing a pivotal role in customer services of the 21st century. Nevertheless, despite their growing importance and presence,

  7. Drops, contact lines, and electrowetting

    NARCIS (Netherlands)

    't Mannetje, Dieter

    2013-01-01

    In this work, we study the behaviour of drops and contact lines under the influence of electric fields, and how these can answer fundamental and industrial questions. Our focus is on studying the varying balance of the electric field, hysteresis forces and inertia as the speed of a contact line

  8. Archives of Ibadan Medicine: Contact

    African Journals Online (AJOL)

    Principal Contact. Editor BookBuilders Editions Africa 2, Awosika Avenue Bodija Estate Ibadan Nigeria Phone: +234 810 1113. Email: ibadanpgmed@yahoo.com. Support Contact. BookBuilders Editions Email: bookbuildersafrica@yahoo.com. ISSN: 1467-6958. AJOL African Journals Online. HOW TO USE AJOL.

  9. Contact Dermatitis of Hands in Chandigarh

    Directory of Open Access Journals (Sweden)

    Vinod K Sharma

    1987-01-01

    Full Text Available Sixty four patients (40 males, 24females of contact dermatitis of hands were patch tested. The patients included housewives (22, factory workers (16, office workers (8, medical and para - medical personnel (8, building workers (3, teachers (4, and photographer, farmer and student one each. The substances tested included battery of metals, rubber chemicals, common medicaments and suspected substances. Sensitivity to metals was found in 34 (53. 1% patients and nickel, cobalt and chromate in 40.6, 31.2 and 21.8% patients respectively. Medicament, rubber and vegetable sensitivity was found in 26 (40.6%, 13 (20.3% and 13 (20.3% patients respectively. The miscellaneous sensitizers were positive in 15 (23.4% patients. They included plants oils, file cover, currency notes, DDT (dichlorodiphenyltrichloroethane, PPD (paraphenylenediamine formaldehyde, mercuric chloride, film and paper developer.

  10. Whites but Not Blacks Gain Life Expectancy from Social Contacts.

    Science.gov (United States)

    Assari, Shervin

    2017-10-16

    Background . Recent research suggests that the health gain from economic resources and psychological assets may be systematically larger for Whites than Blacks. Aim . This study aimed to assess whether the life expectancy gain associated with social contacts over a long follow up differs for Blacks and Whites. Methods . Data came from the Americans' Changing Lives (ACL) Study, 1986-2011. The sample was a nationally representative sample of American adults 25 and older, who were followed for up to 25 years ( n = 3361). Outcome was all-cause mortality. The main predictor was social contacts defined as number of regular visits with friends, relatives, and neighbors. Baseline demographics (age and gender), socioeconomic status (education, income, and employment), health behaviors (smoking and drinking), and health (chronic medical conditions, obesity, and depressive symptoms) were controlled. Race was the focal moderator. Cox proportional hazard models were used in the pooled sample and based on race. Results . More social contacts predicted higher life expectancy in the pooled sample. A significant interaction was found between race and social contacts, suggesting that the protective effect of more social contacts is smaller for Blacks than Whites. In stratified models, more social contacts predicted an increased life expectancy for Whites but not Blacks. Conclusion . Social contacts increase life expectancy for White but not Black Americans. This study introduces social contacts as another social resource that differentially affects health of Whites and Blacks.

  11. Whites but Not Blacks Gain Life Expectancy from Social Contacts

    Directory of Open Access Journals (Sweden)

    Shervin Assari

    2017-10-01

    Full Text Available Background. Recent research suggests that the health gain from economic resources and psychological assets may be systematically larger for Whites than Blacks. Aim. This study aimed to assess whether the life expectancy gain associated with social contacts over a long follow up differs for Blacks and Whites. Methods. Data came from the Americans’ Changing Lives (ACL Study, 1986–2011. The sample was a nationally representative sample of American adults 25 and older, who were followed for up to 25 years (n = 3361. Outcome was all-cause mortality. The main predictor was social contacts defined as number of regular visits with friends, relatives, and neighbors. Baseline demographics (age and gender, socioeconomic status (education, income, and employment, health behaviors (smoking and drinking, and health (chronic medical conditions, obesity, and depressive symptoms were controlled. Race was the focal moderator. Cox proportional hazard models were used in the pooled sample and based on race. Results. More social contacts predicted higher life expectancy in the pooled sample. A significant interaction was found between race and social contacts, suggesting that the protective effect of more social contacts is smaller for Blacks than Whites. In stratified models, more social contacts predicted an increased life expectancy for Whites but not Blacks. Conclusion. Social contacts increase life expectancy for White but not Black Americans. This study introduces social contacts as another social resource that differentially affects health of Whites and Blacks.

  12. Reminder from Medical Service

    CERN Multimedia

    2003-01-01

    For medical problems, we would like to remind all personnel working on the CERN sites, staff members or from outside firms, that they are welcome at the Infirmary, building 57, ground floor. For information, contact the nurses on telephone: 73802 by e-mail: Service.Médical@cern.ch Francoise.Lebrun-Klauser@cern.ch Mireille.Vosdey@cern.ch Katie.Warrillow-Thomson@cern.ch Medical Service

  13. Army flight medic performance of paramedic level procedures: indicated vs. performed.

    Science.gov (United States)

    Bier, Scott A; Hermstad, Erik; Trollman, Christopher; Holt, Melinda

    2013-05-01

    There is great disparity in the education, experience, and staffing requirements for civilian and Army aeromedical transports (AMT). This study sought to determine if medical skills beyond the standard training for Army flight medics were indicated and being performed on Army AMT missions. As a secondary measure, the percentage of indicated interventions performed by basic Emergency Medical Technician (EMT-B) and paramedic (EMT-P) flight medics were compared. This was a retrospective review of Army AMT charts including patients transported by an EMT-B-staffed unit in Iraq and an EMT-P-staffed unit in Afghanistan from July 2008 to June 2009. Charts were reviewed independently by two Emergency Medicine board-certified Army flight surgeons. Of 984 interventions found to be indicated on the 406 charts that met inclusion criteria, 36% were rated as EMT-P level. Seventeen percent were indicated but not performed. EMT-Bs failed to perform indicated procedures 35% of the time vs. 3% in the EMT-P group (p Army flight medic training being required for Army AMT missions. It seems that when advance interventions are indicated, those trained to the EMT-P level perform them significantly more often than those trained to Army standard. Based on the findings of this study, the authors suggest the Army consider adopting the standards required for civilian AMT. Published by Elsevier Inc.

  14. Health Physics, Safety and Medical Services report for 1988

    International Nuclear Information System (INIS)

    Burt, A.K.; Bird, R.W.

    1989-08-01

    This annual report summarizes Health Physics and Medical Services activities at Harwell Laboratory. Topics covered include liaison with emergency authorities, organization, policy, training and staffing problems, major changes to plant and the decommissioning projects. Monitoring of the working environment and that surrounding the Laboratory are discussed, together with surface contamination and waste disposal. Summaries of doses for 1988, and cumulative doses in selected buildings for Harwell staff and contractors are presented in tabular form and a summary of attendance for medical treatment is also given. (UK)

  15. General practitioners' experiences as nursing home medical consultants.

    Science.gov (United States)

    Kirsebom, Marie; Hedström, Mariann; Pöder, Ulrika; Wadensten, Barbro

    2017-03-01

    To describe general practitioners' experiences of being the principal physician responsible for a nursing home. Fifteen general practitioners assigned to a nursing home participated in semi-structured qualitative interviews. Data were analysed using systematic text condensation. Medical assessment is the main duty of general practitioners. Advance care planning together with residents and family members facilitates future decisions on medical treatment and end-of-life care. Registered Nurses' continuity and competence are perceived as crucial to the quality of care, but inadequate staffing, lack of medical equipment and less-than-optimal IT systems for electronic healthcare records are impediments to patient safety. The study highlights the importance of advance care planning together with residents and family members in facilitating future decisions on medical treatment and end-of-life care. To meet the increasing demands for more complex medical treatment at nursing homes and to provide high-quality palliative care, there would seem to be a need to increase Registered Nurses' staffing and acquire more advanced medical equipment, as well as to create better possibilities for Registered Nurses and general practitioners to access each other's healthcare record systems. © 2016 Nordic College of Caring Science.

  16. The medical physics specialization system in Poland.

    Science.gov (United States)

    Bulski, Wojciech; Kukołowicz, Paweł; Skrzyński, Witold

    2016-07-01

    This paper presents the situation of the profession of medical physicists in Poland. The official recognition of the profession of medical physicist in Polish legislation was in 2002. In recent years, more and more Universities which have Physics Faculties introduce a medical physics specialty. At present, there are about 15 Universities which offer such programmes. These Universities are able to graduate about 150 medical physicists per year. In 2002, the Ministry of Health introduced a programme of postgraduate specialization in medical physics along the same rules employed in the specialization of physicians in various branches of medicine. Five institutions, mostly large oncology centres, were selected as teaching institutions, based on their experience, the quality of the medical physics professionals, staffing levels, equipment availability, lecture halls, etc. The first cycle of the specialization programme started in 2006, and the first candidates completed their training at the end of 2008, and passed their official state exams in May 2009. As of January 2016, there are 196 specialized medical physicists in Poland. Another about 120 medical physicists are undergoing specialization. The system of training of medical physics professionals in Poland is well established. The principles of postgraduate training and specialization are well defined and the curriculum of the training is very demanding. The programme of specialization was revised in 2011 and is in accordance with EC and EFOMP recommendations. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  17. Static friction of stainless steel wire rope–rubber contacts.

    NARCIS (Netherlands)

    Loeve, A.J.; Krijger, T.; Mugge, W.; Breedveld, P.; Dodou, D.; Dankelman, J.

    2014-01-01

    Little is known about static friction of stainless-steel wire ropes ('cables') in contact with soft rubbers, an interface of potential importance for rigidifiable medical instruments. Although friction theories imply that the size and profile of the cables affect static friction, there are no

  18. Ghana Journal of Geography: Contact

    African Journals Online (AJOL)

    Principal Contact. Joseph A. Yaro Professor University of Ghana, Legon. Department of Geography and Resource Development. P. O. Box LG 59. Legon. Ghana. Alternative email address: jayaro@ug.edu.gh. Phone: +233244038915. Email: jayaro@ug.edu.gh ...

  19. Nordic project food contact materials

    DEFF Research Database (Denmark)

    Li, Ågot; Tesdal Håland, Julie; Petersen, Jens Højslev

    countries have had a limited focus on the FCM area with the exception of Denmark and Finland. The aim of the project was therefore to control establishments producing, importing or using plastic food contact materials as well as to increase the knowledge of the inspectors performing these controls......Denmark, Finland, Faroe Islands, Iceland, Norway and Sweden have in 2013––2015 conducted a Nordic project on food contact materials. Food contact materials are used in all stages of food production and can be a general source of contamination. The food safety authorities in most of the Nordic....... The focus of the inspections was to control the declaration of compliance (DoC) for plastic food contact materials. The requirement for a Doc is mandatory in order to ensure that the FCM complies with the legislation. In addition some products were analyzed for phthalates....

  20. Animal Production Research Advances: Contact

    African Journals Online (AJOL)

    Principal Contact. Dr I Charles Okoli Editor-in-Chief Federal University of Technology Department of Animal Science and Technology PMB 1526 Owerri Nigeria Phone: +2348056647100. Email: dr_charleso@yahoo.com ...

  1. Scalable algorithms for contact problems

    CERN Document Server

    Dostál, Zdeněk; Sadowská, Marie; Vondrák, Vít

    2016-01-01

    This book presents a comprehensive and self-contained treatment of the authors’ newly developed scalable algorithms for the solutions of multibody contact problems of linear elasticity. The brand new feature of these algorithms is theoretically supported numerical scalability and parallel scalability demonstrated on problems discretized by billions of degrees of freedom. The theory supports solving multibody frictionless contact problems, contact problems with possibly orthotropic Tresca’s friction, and transient contact problems. It covers BEM discretization, jumping coefficients, floating bodies, mortar non-penetration conditions, etc. The exposition is divided into four parts, the first of which reviews appropriate facets of linear algebra, optimization, and analysis. The most important algorithms and optimality results are presented in the third part of the volume. The presentation is complete, including continuous formulation, discretization, decomposition, optimality results, and numerical experimen...

  2. Research in Hospitality Management: Contact

    African Journals Online (AJOL)

    Principal Contact. Dr Sjoerd A Gehrels Editor-in-Chief Stenden Hotel Management School, Academy of International Hospitality Research, Leeuwarden, The Netherlands Email: sjoerd.gehrels@stenden.com ...

  3. Transition metal contacts to graphene

    Energy Technology Data Exchange (ETDEWEB)

    Politou, Maria, E-mail: Maria.Politou@imec.be; De Gendt, Stefan; Heyns, Marc [KU Leuven, 3001 Leuven (Belgium); imec, Kapeldreef 75, 3001 Leuven (Belgium); Asselberghs, Inge; Radu, Iuliana; Conard, Thierry; Richard, Olivier; Martens, Koen; Huyghebaert, Cedric; Tokei, Zsolt [imec, Kapeldreef 75, 3001 Leuven (Belgium); Lee, Chang Seung [SAIT, Samsung Electronics Co., Suwon 443-803 (Korea, Republic of); Sayan, Safak [imec, Kapeldreef 75, 3001 Leuven (Belgium); Intel Corporation, 2200 Mission College Blvd, Santa Clara, California 95054 (United States)

    2015-10-12

    Achieving low resistance contacts to graphene is a common concern for graphene device performance and hybrid graphene/metal interconnects. In this work, we have used the circular Transfer Length Method (cTLM) to electrically characterize Ag, Au, Ni, Ti, and Pd as contact metals to graphene. The consistency of the obtained results was verified with the characterization of up to 72 cTLM structures per metal. Within our study, the noble metals Au, Ag and Pd, which form a weaker bond with graphene, are shown to result in lower contact resistance (Rc) values compared to the more reactive Ni and Ti. X-ray Photo Electron Spectroscopy and Transmission Electron Microscopy characterization for the latter have shown the formation of Ti and Ni carbides. Graphene/Pd contacts show a distinct intermediate behavior. The weak carbide formation signature and the low Rc values measured agree with theoretical predictions of an intermediate state of weak chemisorption of Pd on graphene.

  4. Allergic contact stomatitis from colophony.

    Science.gov (United States)

    Sharma, Paul R

    2006-09-01

    Colophony is an ubiquitous contact sensitizer which may be present in dental materials, such as periodontal dressings, impression materials, cements, fix adhesives and varnishes. Exposure to a sensitizer in a hypersensitive person may initiate an allergic contact dermatitis/stomatitis. This usually occurs after direct skin/mucosa contact with the sensitizer. This paper reports the case of a colophony hypersensitive male who developed contact stomatitis after dental treatment with a colophony-containing product. Sensitizing colophony is present in Duraphat 2.26%F varnish, a fluoride varnish used all over the world. A case of hypersensitivity to Duraphat 2.26%F varnish is presented in a patient who, at the initial visit, indicated only an allergy to sticking plasters.

  5. Different Levels of Leadership for Learning: Investigating Differences between Teachers Individually and Collectively Using Multilevel Factor Analysis of the 2011-2012 Schools and Staffing Survey

    Science.gov (United States)

    Boyce, Jared; Bowers, Alex J.

    2018-01-01

    This study investigated the differences between how individual teachers perceive leadership for learning and how teachers collectively perceive leadership for learning, using a large nationally generalizable data-set of 7070 schools from the National Center for Education Statistics 2011-2012 Schools and Staffing Survey. This study used…

  6. "Get a Blue and You Will See Your Money Back Again": Staffing and Marketing the English Prep School, 1890-1912

    Science.gov (United States)

    Benson, John

    2014-01-01

    This article explores the ways in which English prep schools were staffed and marketed in the years before the First World War. Its aim more specifically is to employ a biographical approach to consider the emphasis that the schools placed upon sport, and in particular the extent to which they recruited Oxford and Cambridge Blues as teachers…

  7. Metal semiconductor contacts and devices

    CERN Document Server

    Cohen, Simon S; Einspruch, Norman G

    1986-01-01

    VLSI Electronics Microstructure Science, Volume 13: Metal-Semiconductor Contacts and Devices presents the physics, technology, and applications of metal-semiconductor barriers in digital integrated circuits. The emphasis is placed on the interplay among the theory, processing, and characterization techniques in the development of practical metal-semiconductor contacts and devices.This volume contains chapters that are devoted to the discussion of the physics of metal-semiconductor interfaces and its basic phenomena; fabrication procedures; and interface characterization techniques, particularl

  8. Embodied Archives as Contact Zones

    Directory of Open Access Journals (Sweden)

    Judit Vidiella

    2015-02-01

    Full Text Available This article proposes a reflection about affective politics from locating some theoretical and conceptual genealogies like «emotion», «affection», «zones of contact»…, that understand them as action and force fields. These contributions allow us to rethink the relation of affects with politics and strategies of archive linked to performance, and understood as zones of friction, collision, circulation and contact: performative writing, repertoire, memes…

  9. Clinical update on contact allergy

    DEFF Research Database (Denmark)

    Uter, Wolfgang; Johansen, Jeanne Duus; Orton, David I

    2005-01-01

    PURPOSE OF REVIEW: The aim of this article is to review recent findings in contact allergy, regarding clinical research. RECENT FINDINGS: The biocide methyldibromo glutaronitrile was identified to be an important sensitizer. Subsequently, it was banned from leave-on cosmetics in the European Union...... studies have demonstrated broad individual variation of elicitation thresholds, dependent on the allergen concentration during induction, and other factors. Some unsuspected routes of exposure to allergens include oral, inhalational, connubial or airborne contact. Experimental studies provide...

  10. [Contact lens care and maintenance].

    Science.gov (United States)

    Bloise, L

    2017-04-01

    All contact lenses with replacement schedules longer than daily must be maintained. At each step of their use, the lenses may be contaminated. Contact lens solutions perform the essential functions of cleaning, decontaminating and preserving the lenses to prevent infectious problems and improve wearing comfort. Contact lens contamination essentially comes from hands, cleaning solutions, cases, water and the environment. The pathogenic microorganisms are mainly Gram-negative bacteria, fungi and amoebae. Contact lens deposits may or may not have an organic origin. Their presence increases the risk of infection because they serve as a nutrient matrix for microbes, and they are responsible for wearing discomfort. Contact lens solutions differ in their composition, their mechanism of action and the concentration of the various agents. To prescribe the best lens care system to each wearer and for each material, it is necessary to be very familiar with them. Maintenance is the main cause of discomfort with contact lenses, either through improper use, solution-material incompatibility, or a reaction of the wearer to the components. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  11. [Contact allergy to henna tattoos].

    Science.gov (United States)

    Steinkjer, Bjarte; Stangeland, Katarina Zak; Mikkelsen, Carsten Sauer

    2011-03-18

    Tattoos with henna colours have become very popular and the prevalence of contact allergy seems to increase. This is a short review article based on our own clinical experience and literature identified through a search in PubMed with the words "henna", "paraphenylendiamin" and "allergic contact dermatitis." A case report is included. It is well documented that many experience skin reactions after henna tattoos. The cause is almost always contact allergy to the azo compound paraphenylendiamin, which is added to speed up the process and make the colour darker. Most people, including children, get henna tattoos during vacations in Asia or the Mediterranean. Established contact allergy is permanent. Many hair-colour products contain paraphenylendiamin, and persons with contact allergy against the product may develop a very strong contact allergic eczema by use of such substances. Acute reactions are treated with local cortisone products, or with systemic steroids. Cross reaction to substances with a similar chemical structure may occur. Tattoos with paraphenylendiamin-containing henna colours should be avoided.

  12. The 2014 Academic College of Emergency Experts in India′s Education Development Committee (EDC White Paper on establishing an academic department of Emergency Medicine in India - Guidelines for Staffing, Infrastructure, Resources, Curriculum and Training

    Directory of Open Access Journals (Sweden)

    Praveen Aggarwal

    2014-01-01

    Full Text Available Emergency medicine services and training in Emergency Medicine (EM has developed to a large extent in developed countries but its establishment is far from optimal in developing countries. In India, Medical Council of India (MCI has taken great steps by notifying EM as a separate specialty and so far 20 medical colleges have already initiated 3-year training program in EM. However, there has been shortage of trained faculty, and ambiguity regarding curriculum, rotation policy, infrastructure, teachers′ eligibility qualifications and scheme of examination. Academic College of Emergency Experts in India (ACEE-India has been a powerful advocate for developing Academic EM in India. The ACEE′s Education Development Committee (EDC was created to chalk out guidelines for staffing, infrastructure, resources, curriculum, and training which may be of help to the MCI and the National Board of Examinations (NBE to set standards for starting 3-year training program in EM and develop the departments of EM as centers of quality education, research, and treatment across India. This paper has made an attempt to give recommendations so as to provide a uniform framework to the institutions, thus guiding them towards establishing an academic Department of EM for starting the 3-year training program in the specialty of EM.

  13. Non-medical triggers of patients' contacts to general practitioners

    DEFF Research Database (Denmark)

    Eriksson, Tina

    family practice, general practice, primary health care, health care services, health behaviour, mass media, reasons for encounter, case-crossover, time-selection bias, recall bias, bi-directional study......family practice, general practice, primary health care, health care services, health behaviour, mass media, reasons for encounter, case-crossover, time-selection bias, recall bias, bi-directional study...

  14. Crane-Load Contact Sensor

    Science.gov (United States)

    Youngquist, Robert; Mata, Carlos; Cox, Robert

    2005-01-01

    An electronic instrument has been developed as a prototype of a portable crane-load contact sensor. Such a sensor could be helpful in an application in which the load rests on a base in a horizontal position determined by vertical alignment pins (see Figure 1). If the crane is not positioned to lift the load precisely vertically, then the load can be expected to swing once it has been lifted clear of the pins. If the load is especially heavy, large, and/or fragile, it could hurt workers and/or damage itself and nearby objects. By indicating whether the load remains in contact with the pins when it has been lifted a fraction of the length of the pins, the crane-load contact sensor helps the crane operator determine whether it is safe to lift the load clear of the pins: If there is contact, then the load is resting against the sides of the pins and, hence, it may not be safe to lift; if contact is occasionally broken, then the load is probably not resting against the pins, so it should be safe to lift. It is assumed that the load and base, or at least the pins and the surfaces of the alignment holes in the load, are electrically conductive, so the instrument can use electrical contact to indicate mechanical contact. However, DC resistance cannot be used as an indicator of contact for the following reasons: The load and the base are both electrically grounded through cables (the load is grounded through the lifting cable of the crane) to prevent discharge of static electricity. In other words, the DC resistance between the load and the pins is always low, as though they were always in direct contact. Therefore, instead of DC resistance, the instrument utilizes the AC electrical impedance between the pins and the load. The signal frequency used in the measurement is high enough (.1 MHz) that the impedance contributed by the cables and the electrical ground network of the building in which the crane and the base are situated is significantly greater than the contact

  15. Quaternionic contact Einstein structures and the quaternionic contact Yamabe problem

    International Nuclear Information System (INIS)

    Ivanov, S.; Minchev, I.; Vassilev, D.

    2006-12-01

    The paper is a study of the conformal geometry of quaternionic contact manifolds with the associated Biquard connection. We give a partial solution of the quaternionic contact Yamabe problem on the quaternionic sphere. It is shown that the torsion of the Biquard connection vanishes exactly when the trace-free part of the horizontal Ricci tensor of the Biquard connection is zero and this occurs precisely on 3-Sasakian manifolds. In particular, the scalar curvature of the Biquard connection with vanishing torsion is a global constant. We consider interesting classes of functions on hypercomplex manifold and their restrictions to hypersurfaces. We show a '3-Hamiltonian form' of infinitesimal automorphisms of quaternionic contact structures and transformations preserving the trace-free part of the horizontal Ricci tensor of the Biquard connection. All conformal deformations sending the standard flat torsion-free quaternionic contact structure on the quaternionic Heisenberg group to a quaternionic contact structure with vanishing trace-free part of the horizontal Ricci tensor of the Biquard connection are explicitly described. (author)

  16. Contact investigation for active tuberculosis among child contacts in Uganda.

    Science.gov (United States)

    Jaganath, Devan; Zalwango, Sarah; Okware, Brenda; Nsereko, Mary; Kisingo, Hussein; Malone, LaShaunda; Lancioni, Christina; Okwera, Alphonse; Joloba, Moses; Mayanja-Kizza, Harriet; Boom, W Henry; Stein, Catherine; Mupere, Ezekiel

    2013-12-01

    Tuberculosis is a large source of morbidity and mortality among children. However, limited studies characterize childhood tuberculosis disease, and contact investigation is rarely implemented in high-burden settings. In one of the largest pediatric tuberculosis contact investigation studies in a resource-limited setting, we assessed the yield of contact tracing on childhood tuberculosis and indicators for disease progression in Uganda. Child contacts aged tuberculosis disease via clinical, radiographic, and laboratory methods for up to 24 months. Seven hundred sixty-one child contacts were included in the analysis. Prevalence of tuberculosis in our child population was 10%, of which 71% were culture-confirmed positive. There were no cases of disseminated tuberculosis, and 483 of 490 children (99%) started on isoniazid preventative therapy did not develop disease. Multivariable testing suggested risk factors including human immunodeficiency virus (HIV) status (odds ratio [OR], 7.90; P children aged ≤5 years (OR, 0.23; P children in high-burden settings is able to identify a large percentage of culture-confirmed positive tuberculosis cases before dissemination of disease, while suggesting factors for disease progression to identify who may benefit from targeted screening.

  17. Management of Medically Fragile Infants.

    Science.gov (United States)

    Ueda, Dawn; Caulfield, Rick

    2001-01-01

    Discusses the role of the Child Life Specialist in helping to meet the special needs of medically fragile children. Argues that since many child care professionals may come into contact with medically fragile children at some point in their careers, it is important to examine child life as a specialization in the health care profession. (SD)

  18. Solar cell with back side contacts

    Science.gov (United States)

    Nielson, Gregory N; Okandan, Murat; Cruz-Campa, Jose Luis; Resnick, Paul J; Wanlass, Mark Woodbury; Clews, Peggy J

    2013-12-24

    A III-V solar cell is described herein that includes all back side contacts. Additionally, the positive and negative electrical contacts contact compoud semiconductor layers of the solar cell other than the absorbing layer of the solar cell. That is, the positive and negative electrical contacts contact passivating layers of the solar cell.

  19. Reduced contact resistance in top-contact organic field-effect transistors by interface contact doping

    Science.gov (United States)

    Hou, Ji-Ling; Kasemann, Daniel; Widmer, Johannes; Günther, Alrun A.; Lüssem, Björn; Leo, Karl

    2016-03-01

    Emerging organic integrated electronics require capability of high speed and the compatibility with high-resolution structuring processes such as photolithography. When downscaling the channel length, the contact resistance is known to limit the performance of the short channel devices. In this report, orthogonal photolithography is used for the patterning of the source/drain electrodes of the organic field-effect transistors (OFETs) as well as the interface dopant insertion layers for further modifications of the contact resistance. Bottom-gate top-contact pentacene OFETs with different thicknesses of the p-dopant 2,2'-(perfluoronaphthalene-2,6-diylidene)dimalononitrile under the Au electrodes show a significant decrease in threshold voltage from -2.2 V to -0.8 V and in contact resistance from 55 k Ω cm to 10 k Ω cm by adding a 1 nm thin dopant interlayer. The influence of doping on charge carrier injection is directly visible in the temperature-dependent output characteristics and a charge-transfer activation energy of ˜20 meV is obtained. Our results provide a systematic study of interface contact doping and also show the connection between interface contact doping and improved charge carrier injection by the activation of charge transfer process.

  20. Voorbij de witte jas: over opkomst en ondergang van het placebo-effect in nieuwe vormen van arts-patiënt-contact.

    NARCIS (Netherlands)

    Dulmen, S. van

    2002-01-01

    Beyond the white-coat; the fall and rise of placebo effects in new types of medical visits. Within general practice, a doctor-patient contact can vary between a vis-à-vis contact and a more recently fashionable Internet contact. In between these two extremes, other types of contact are possible as