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Doig, Alan. „Advice, Guidance and Control: Non-Departmental Public Bodies and Standards of Conduct“. Teaching Public Administration 8, Nr. 2 (September 1988): 1–23. http://dx.doi.org/10.1177/014473948800800202.
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Marleau, Justin N., und Kimberly D. Girling. „Keeping science’s seat at the decision-making table: Mechanisms to motivate policy-makers to keep using scientific information in the age of disinformation“. FACETS 2, Nr. 2 (01.09.2017): 1045–64. http://dx.doi.org/10.1139/facets-2017-0087.
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Policy-makers are confronted with complex problems that require evaluating multiple streams of evidence and weighing competing interests to develop and implement solutions. However, the policy interventions available to resolve these problems have different levels of supporting scientific evidence. Decision-makers, who are not necessarily scientifically trained, may favour policies with limited scientific backing to obtain public support. We illustrate these tensions with two case studies where the scientific consensus went up against the governing parties’ chosen policy. What mechanisms exist to keep the weight of scientific evidence at the forefront of decision-making at the highest levels of government? In this paper, we propose that Canada create “Departmental Chief Science Advisors” (DCSAs), based on a program in the UK, to help complement and extend the reach of the newly created Chief Science Advisor position. DCSAs would provide advice to ministers and senior civil servants, critically evaluate scientific work in their host department, and provide public outreach for the department’s science. We show how the DCSAs could be integrated into their departments and illustrate their potential benefits to the policy making process and the scientific community.
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Carey, Gemma, Fiona Buick, Melanie Pescud und Eleanor Malbon. „Preventing Dysfunction and Improving Policy Advice: The Role of Intra-Departmental Boundary Spanners“. Australian Journal of Public Administration 76, Nr. 2 (12.09.2016): 176–86. http://dx.doi.org/10.1111/1467-8500.12213.
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Hannah, Romanie, Richard Chavasses, James Paton, Emily Walton, Damian Roland, Steven Foster und Mark Lyttle. „1804 Survey of discharge practice and review of safety-netting instructions for children attending Emergency Departments in the UK & Ireland with acute wheeze or asthma: a PERUKI study“. Emergency Medicine Journal 39, Nr. 12 (22.11.2022): A980.2—A981. http://dx.doi.org/10.1136/emermed-2022-rcem2.33.
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Aims, Objectives and BackgroundAcute wheeze is one of the commonest reasons for childhood Emergency Department (ED) attendances. Ongoing recovery following discharge should be supported with robust safety-netting advice including advice for ongoing bronchodilator use. Evidence for recovery bronchodilator dosing is lacking, likely leading to variation in advice across the UK and Ireland.This study aimed to describe discharge practices, examining consistency and quality of safety-netting advice (including bronchodilator plans) when discharging children with wheeze or asthma, and identify opportunities for improvementsMethod and DesignThis two-phase study was conducted across PERUKI registered sites between June 2020 – September 2021. Phase 1 consisted of single site survey responses regarding departmental discharge practices for acute wheezy presentations. During phase 2, discharge instructions provided for caregivers underwent formal review. Data abstraction tools were developed based upon existing literature regarding written wheeze safety-netting information, BTS/SIGN 2019 asthma guidelines, NICE safety-netting recommendations and the BTS Asthma Discharge Bundle.Abstract 1804 Table 1Analysis of written safety-netting information (n=61)Type of leaflet1. Discharge – Normal (expected) recovery path50 (81.9)2. Combined discharge and AAP33 (54.1) - Combined discharge (normal & abnormal) and AAP17 (27.9) - Combined discharge (normal recovery) and AAP16 (26.2)3. Discharge – with a Normal (expected) path AND abnormal (unexpected/deterioration) recovery path31 (50.8)4. PAAP/ plan for future episodes only11 (18.0)General Information provided to caregivers*Inhaler and Spacer technique33 (54.1)Overview of information about wheeze23 (37.7)How inhalers work19 (31.1)Expected time course for recovery18 (29.5)Advice on what to do overnight:16 (26.2) - Do not wake to give inhalers overnight9 (56.3) - Continue to administer overnight including waking if sleeping6 (37.5) - Administer only if felt required1 (1.6)Signs of improvement7 (11.5)Inhaler side effects3 (4.9)Red Flags *Unable to speak52 (85.2)Respiratory distress51 (83.6)Inhalers not lasting 4 hours49 (80.3)Audible wheeze40 (65.6)Coughing37 (60.7)Fast breathing or short of breath36 (59.0)Poor feeding or drinking32 (52.5)Looks pale31 (50.8)Not improving after specified period26 (42.6)Drowsiness25 (40.9)Caregiver is worried8 (13.1)Escalation- how to seek help*Contact GP47 (77.1)Call 99945 (73.7)Call / reattend hospital25 (40.9)Call 11119 (31.1)No advice given7 (11.5)Where is red flag and escalation advice describedWithin PAAP/future episodes information only31 (52.5)Within discharge recovery information28 (47.5)None described2 (3.3)GP Follow-up recommendedGP Follow-up (any)38 (62.3)Within 48hr28 (45.9)Within 1 week4 (6.6)Within 72 hr3 (4.9)Other timeframe2 (3.3)Within 2 weeks1 (1.6)Other support*Smoking cessation support offered15 (24.6)Specialist Nurse8 (13.1)Asthma Clinic4 (6.6)Open access (OA)3 (4.9)Community Nursing Team (CNT)3 (4.9)General Paediatric Clinic1 (1.6)* Percentages may be greater than 100% as more than one could be selectedResults and ConclusionThis two-phase study was conducted across PERUKI registered sites between June 2020 – September 2021. Phase 1 consisted of single site survey responses regarding departmental discharge practices for acute wheezy presentations. During phase 2, discharge instructions provided for caregivers underwent formal review. Data abstraction tools were developed based upon existing literature regarding written wheeze safety-netting information, BTS/SIGN 2019 asthma guidelines, NICE safety-netting recommendations and the BTS Asthma Discharge Bundle.National comparison of discharge practices and written safety-netting information for wheezy children attending EDs showed wide variation. This highlights the need for evidence-based guidance to improve and standardise care, providing consistent discharge and safety-netting advice for carers.
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Sanfilippo, Fred, Priscilla Markwood und David N. Bailey. „Retaining the Value of Former Department Chairs: The Association of Pathology Chairs Experience“. Academic Pathology 7 (01.01.2020): 237428952098168. http://dx.doi.org/10.1177/2374289520981685.
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Serving as a clinical department chair in an academic health center is an increasingly complex and difficult position. In 2014, the Association of Pathology Chairs engaged former chairs to assist its members by establishing an ad hoc committee of “Senior Fellows,” which then became a permanent Senior Fellows Group. The Senior Fellows Group currently includes more than 50 former chairs, many of whom subsequently served as deans, medical center executives, and in other leadership roles. The primary mission of the Senior Fellows Group has been to provide advice, consultation, and mentoring to members of the Association of Pathology Chairs, especially new chairs and faculty interested in leadership roles. All new chairs are asked if they wish to select or be assigned a Senior Fellow advisor. Each Senior Fellow is listed on the Association of Pathology Chairs website with the areas of advice they are willing to provide, which include: “on-boarding” issues and opportunities facing a new chair; strategy (eg, departmental priorities, mission balance); administration (eg, financial, operational); institutional reviews of chairs/departments; interaction with institutional leaders (eg, other chairs, deans, hospital leadership); fundraising; faculty management (eg, recruitment, retention, annual evaluations, productivity, dismissal); and personal issues (eg, work–life balance, stepping down, retirement). The Senior Fellows Group also has participated actively in essentially all Association of Pathology Chairs programs, committees, fundraising, and projects. The organized structure and function of the Senior Fellows Group has been of significant value to the membership of the Association of Pathology Chairs, as well as to the participating former chairs, and may provide a model for other academic organizations to utilize this important resource.
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Wilson, Donald O., und John E. Ettlie. „Boundary Spanning, Group Heterogeneity and Engineering Project Performance“. International Journal of Innovation and Technology Management 15, Nr. 06 (Dezember 2018): 1950005. http://dx.doi.org/10.1142/s0219877019500056.
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This study examines the concept of intra-organizational links as a way for boundary spanners to bring into the project group the information needed to deal with task uncertainty. Several studies have shown that heterogeneous groups are superior to homogeneous groups when novel or creative solutions need to be developed to deal with tasks characterized by high task uncertainty. For boundary spanners in engineering project groups, it is proposed that cross-departmental technical advice links are another source of the information needed to deal with task uncertainty. An empirical test supports the proposition that for high-performing project groups, boundary-spanning technical advice links may compensate for a lack of internal group heterogeneity and vice versa. This is not the case for low-performing project groups. Implications of these finding are presented, including the direction that the open innovation research stream might take to address the findings of this study.
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Gerhold, Henry, Kim Steiner und C. J. Sacksteder. „Management Information Systems for Urban Trees“. Arboriculture & Urban Forestry 13, Nr. 10 (01.10.1987): 243–49. http://dx.doi.org/10.48044/jauf.1987.051.
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The concept and applications of computerized information systems for the management of urban trees are reviewed. Among their uses are landscape planning, choosing species to be planted, organizing work on trees, departmental planning and evaluation, and public relations. Five types of data required for these purposes pertain to the location of trees, tree characteristics, site characteristics, actions recommended, and work completed. Methods for handling data are reviewed including collection, processing, storage retrieval, and updating. Computer equipment and software options are discussed, particularly microcomputers. Advice is offered on installing a management information system for urban trees and for using it effectively.
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Kennedy, Peter. „The Management of Deliberate Self-Harm“. Bulletin of the Royal College of Psychiatrists 9, Nr. 8 (August 1985): 152. http://dx.doi.org/10.1192/pb.9.8.152.
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These departmental guidelines at last revise advice of the 1968 vintage—that all parasuicides should be admitted to hospital and assessed by a psychiatrist. Of course this was never achieved, nor even attempted in many areas. It is a welcome set of new recommendations, therefore, which will help ensure that what actually happens is done well. It is great credit to undergraduate medical teachers that such confidence can now be expressed in newly qualified doctors carrying out these psychosocial assessments. It recognizes that suitably trained nurses and social workers can assess and manage aftercare of these patients quite competently.
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Sanji, Rajiv Ranganath, Narendranath V und Chandrakiran Channegowda. „Understanding and Analyzing Prescribing and Prescription Errors in Outpatient Setting of a Medical College Hospital ENT Department“. Bengal Journal of Otolaryngology and Head Neck Surgery 29, Nr. 1 (03.06.2021): 17–27. http://dx.doi.org/10.47210/bjohns.2021.v29i1.395.
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Introduction A medication error is a failure in the treatment process that leads to, or has the potential to lead to, harm to the patient. In the hospital OPD, errors can occur in deciding on the medication to be prescribed (prescribing error) or in writing the prescription (prescription error). Materials and Methods We analyzed 100 prescriptions and case sheets in the OPD of ENT department in a tertiary medical college hospital for a period of one week for errors and assessed the perceptions and attitudes of the residents of the department using a questionnaire. Result Several prescription writing errors were found, primarily failure to document non pharmaceutical patient advice and use of generic names. Four prescribing errors were noticed which did not need urgent intervention. Discussion Failure modes and effects analysis was done to rank the failures modes; and causes for failure were elucidated using Ishikawa Diagram. Recommendations for preventing errors were made based on these results. Conclusion This study illustrates the use of management techniques to identify errors and formulate appropriate preventive responses. Such techniques should be a part of ongoing departmental management; and they provide insights into improving resident training in an ENT residency program.
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Boyle, Douglas M., und Dana R. Hermanson. „Research Initiatives in Accounting Education: Developing and Utilizing Faculty“. Issues in Accounting Education 35, Nr. 4 (08.06.2020): 75–86. http://dx.doi.org/10.2308/issues-2020-015.
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ABSTRACT This essay addresses key needs for research in five areas related to developing and utilizing accounting faculty: faculty development (the backgrounds of who enters academia, how these individuals are trained in doctoral programs, and what advice is given to them), faculty management (the ongoing performance measurement and reward systems that are applied to individual faculty members), faculty portfolio (who provides administrative oversight, how workloads may vary across individuals, and how faculty are utilized), departmental culture (broader issues of culture), and academic freedom (the climate of academic freedom). Within each area, we pose research questions designed to provide faculty members and administrators with insights to enhance the development and utilization of accounting faculty.
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Seagger, R., T. Bunker und P. Hamer. „Surgeon-operated ultrasonography in a one-stop shoulder clinic“. Annals of The Royal College of Surgeons of England 93, Nr. 7 (Oktober 2011): 528–31. http://dx.doi.org/10.1308/147870811x13137608454939.
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INTRODUCTION Nearly 1 in 40 of the population seeks medical advice related to a shoulder problem every year. The majority pertain to rotator cuff pathology. Prior to intervention in such patients it is imperative to define whether the tendons are intact or torn. Ultrasonography has become an essential adjunct to clinical assessment in diagnosing rotator cuff tears. This study was designed to investigate if a surgeon using a portable ultrasonography machine in a one-stop shoulder clinic could significantly reduce the time a patient waited from initial outpatient presentation to the end of the treatment episode (be it surgery, injection or conservative management). METHODS A total of 77 patients were allocated to one of two groups: Group A, consisting of 37 patients who were assessed and had ultrasonography as outpatients, and Group B, consisting of 40 patients who were assessed and referred for departmental ultrasonography where appropriate. Three clear outcome groups were defined: those who required surgical repair, those who had irreparable tears and those who declined surgery. RESULTS For all outcomes (surgery, irreparable tears and conservative treatment), the patients in Group A all completed their clinical episodes significantly quicker than those in Group B (p<0.02). As well as the time saving benefits, there was a substantial financial saving for Group A. By performing ultrasonography in the outpatients department, those patients avoided the requirement of departmental imaging (£120) and subsequent follow-up appointments (£73) to discuss results and management, resulting in a saving of nearly £200 per patient. CONCLUSIONS The use of a portable ultrasonography machine by an orthopaedic surgeon can significantly reduce the time to treatment and the financial cost for patients with rotator cuff tears.
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Cohn, Helen M. „Watch Dog over the Herbarium: Alfred Ewart, Victorian Government Botanist 1906 - 1921“. Historical Records of Australian Science 16, Nr. 2 (2005): 139. http://dx.doi.org/10.1071/hr05009.
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Alfred Ewart was Government Botanist in the service of the Victorian Government from February 1906 to February 1921. He was concurrently foundation Professor of Botany at the University of Melbourne, both positions being part-time. As Government Botanist he was in charge of the National Herbarium of Victoria, which had fallen into a slump after the death of the first Government Botanist, Ferdinand von Mueller, in 1896. Ewart was determined to restore the Herbarium to its former position as a leading centre of research on the Victorian and indeed the Australian flora. In doing so he enlisted the aid of the many capable botanists who were members of the Field Naturalists' Club of Victoria. The Herbarium being in the Department of Agriculture, Ewart had duties in relation to the business of that Department. These had mainly to do with weeds, impure seeds and providing advice to departmental officers. Of particular importance was his taxonomic work as Government Botanist. He published a series of papers and books on the flora of Victoria and the Northern Territory, and engaged in debates with colleagues both interstate and overseas. Ewart ceased to be Government Botanist when the professorship was made a full-time appointment in response to increased teaching loads.
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Neville, Robert, James Williams und Caroline C. Hunt. „Faculty–Library Teamwork in Book Ordering“. College & Research Libraries 59, Nr. 6 (01.11.1998): 523–32. http://dx.doi.org/10.5860/crl.59.6.523.
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Faculty liaisons help to select books and other materials in many libraries, especially those without specialized bibliographers. To get the best results from a faculty liaison system, library staff must take into account the varied nature of academic collections and the uneven pricing of materials, respect departmental cultures and be willing to make adjustments for them, and frequently reassess and fine-tune the system. Using these principles, the College of Charleston has developed a liaison system that permits a range of practices. Two examples, the computer science collection and the English collection, illustrate this range: the former requires the most recent information available and uses relatively little faculty input; the latter seeks to balance primary and secondary materials and benefits from extensive faculty advice. In conclusion, the authors suggest how the institution might further improve its system in the next few years.
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Haikal Nur Rachmanrachim Achaqie. „Pemanfaatan Social Network Analysis (SNA) Untuk Analisis Pemetaan Komunikasi Pada Pegawai Bank Syariah di Jawa Tengah“. Jurnal Teknik Mesin, Elektro dan Ilmu Komputer 2, Nr. 1 (04.03.2022): 42–49. http://dx.doi.org/10.55606/teknik.v2i1.179.
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Bank Syariah Mandiri is one of the sharia business units which is a work unit of the main office (parent) of conventional commercial banks which has a function as the main office of the sharia unit office or sharia branch. So far, the performance of Islamic banks is only seen from the number of assets and customers, but very rarely describes the internal conditions related to the performance of their employees. Good communication and coordination between departments is very important so that the company can run effectively and efficiently. The purpose of this research is that the company is expected to be able to analyze employee interactions through communication patterns and become policy advice in decision making, especially related to HR development. This study involved approximately 20 employees at a branch of Bank Syariah Mandiri in Central Java Province which used a social network analysis (SNA) approach. In the SNA approach, the values of density, degree centrality, closeness centrality, betweenness centrality, clicks, and visualization of relationships using a sociogram will be sought. As a result, all inter-departmental employees have good communication relationships. Based on these findings, it is necessary to solve the problem by making actors or employees who have high indegree scores to be more proactive in providing information to their colleagues so that coordination can be smooth.
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Auberger, Elise, Jean-Pierre Gély und Didier Merle. „New regulatory tool for the conservation of the geological heritage in France: the Prefectural Decree of the Protection of the Geotope (APPG). Application and feedback in the Yvelines department (Paris basin, Île-de-France)“. BSGF - Earth Sciences Bulletin 189, Nr. 1 (2018): 3. http://dx.doi.org/10.1051/bsgf/2018002.
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In France, the conservation of geological heritage has a complex history that dates back to the middle of the 19th century. Two regulatory tools, “Site Classé”, established in 1906, and Natural Reserves, created in 1976, have served to protect geological sites in the past. Nonetheless, these tools are long to implement vis-à-vis to the rapid destruction of geological objects in the French territory. Due to this juridical void, the state created in 2015 two prefectural decrees for the protection of geological sites of interest. These tools allow the Prefect to: (i) determine a departmental list of geological sites of importance; (ii) define appropriate regulations for their conservation through the Prefectural Decree of the Protection of the Geotope (APPG). Their decentralised legal proceedings appear to be easy to administer, as they only require the advice of regional and departmental commissions as well as some local stakeholders. Our article reports the first enactment of the APPG in France, in a peri-urban to urban area, the Yvelines department. By relying on the programmes of Strategy of Creation of Protected metropolitan Areas (SCAP) and the National Inventory of the Geological Heritage (INPG), two geological sites of international value threatened by anthropic activities were selected for the APPG: the Lutetian fossil sites of Grignon and the Ferme de l’Orme. If successfully enacted, the APPG could prove advantageous because it is a tool adapted to the protection of geological objects and to its socio-economic and environmental context. However, after almost two years, the proceedings of the APPG have not been finalised. Optional yet beneficial steps, as well as unforeseen requests, delayed the process considerably. Given that the APPG do not confer protection to the geological sites during this period, their efficacy must be questioned in a fast-evolving region where land pressure is high and geological sites disappear quickly. However, the French juridical system has improved in the recent years in that it encourages Earth Sciences specialists to form part of local consultative instances (CSRPN, CDNPS) and thereby influence the decisions concerning the protection of these highly threatened sites.
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Fraser, Lauren, und Ayia Al-Asadi. „366 The ED young person’s wellbeing guide – a novel approach to psychosocial risk assessing children and young people in the emergency department“. Emergency Medicine Journal 37, Nr. 12 (23.11.2020): 850.1–850. http://dx.doi.org/10.1136/emj-2020-rcemabstracts.50.
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Aims/Objectives/BackgroundThe 2019/20 RCEM National QIP ‘Care of Children in the ED’ recommends use of a recognised tool (eg HEEADSSS) to psychosocial risk assess 12–17 year olds seen in the ED. Northwick Park’s ED team collaborated with the Young Harrow Foundation (YHF), a local charitable organisation, to coproduce the ED Young Person’s Wellbeing Guide with the aim of addressing this standard whilst also meeting the needs of ED staff and the children and young people (CYP) that we care for.Methods/DesignYHF’s Change Champions, a dynamic group of local 15–25 year olds with lived experience of areas such as youth violence and mental health, worked with the ED team and fed back that they wouldn’t necessarily expect (or welcome) ED staff enquiring about such personal topics (particularly if presenting with an unrelated issue) but valued access to reliable support and advice for themselves or their peers. ED staff, similarly, often felt awkward approaching such sensitive subjects with CYP if the presentation was with a seemingly unrelated complaint or when departmental pressures prohibited development of a meaningful doctor-patient rapport. The Wellbeing Guide was therefore coproduced to provide CYP with links to trusted sources of support (based on the HEEADSSS categories) as well as allowing the ED clinician to broach such conversations by asking whether any issues raised in the Guide resonated with the young person and whether further support or advice was required.Abstract 366 Figure 1Results/ConclusionsThe Wellbeing Guide will be piloted, and offered to all 12–17yo’s attending the ED, in the next few weeks. Using an iterative approach the document will be further developed through feedback from CYP. We are also developing a complementary document containing links to resources for parents concerned about their child. We aspire to an online version of both documents, accessible via the Trust’s website, in the next few months.
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Rose, Katy, Silvia Bressan, Kate Honeyford, Zsolt Bognar, Danilo Buonsenso, Liviana Da Dalt, Tisham De et al. „Responses of paediatric emergency departments to the first wave of the COVID-19 pandemic in Europe: a cross-sectional survey study“. BMJ Paediatrics Open 5, Nr. 1 (Dezember 2021): e001269. http://dx.doi.org/10.1136/bmjpo-2021-001269.
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ObjectiveUnderstanding how paediatric emergency departments (PEDs) across Europe adapted their healthcare pathways in response to COVID-19 will help guide responses to ongoing waves of COVID-19 and potential future pandemics. This study aimed to evaluate service reconfiguration across European PEDs during the initial COVID-19 wave.DesignThis cross-sectional survey included 39 PEDs in 17 countries. The online questionnaire captured (1) study site characteristics, (2) departmental changes and (3) pathways for children with acute illness pre and during the first wave of COVID-19 pandemic (January–May 2020). Number of changes to health services, as a percentage of total possible changes encompassed by the survey, was compared with peak national SARS-CoV-2 incidence rates, and for both mixed and standalone paediatric centres.ResultsOverall, 97% (n=38) of centres remained open as usual during the pandemic. The capacity of 18 out of 28 (68%) short-stay units decreased; in contrast, 2 units (7%) increased their capacity. In 12 (31%) PEDs, they reported acting as receiving centres for diverted children during the pandemic.There was minimal change to the availability of paediatric consultant telephone advice services, consultant supervision of juniors or presence of responsible specialists within the PEDs.There was no relationship between percentage of possible change at each site and the peak national SARS-CoV-2 incidence rate. Mixed paediatric and adult hospitals made 8% of possible changes and standalone paediatric centres made 6% of possible changes (p=0.086).ConclusionOverall, there was limited change to the organisation or delivery of services across surveyed PEDs during the first wave of the COVID-19 pandemic.
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Stephenson, Maxine, und Nane Rio. „Signing Off the Standards, Making the Disciplines Mandatory“. Teachers' Work 20, Nr. 1 (30.06.2023): 139–50. http://dx.doi.org/10.24135/teacherswork.v20i1.443.
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The place of the foundational disciplines in teacher education has long been an issue of on-going debate amongst programme developers, teacher educators and students. In 1951 a departmental report on the recruitment, education and training of teachers acknowledged that the work of practising teachers, academics and research students in a number of disciplinary areas had resulted in ‘an immense growth of knowledge relevant to the business of education’ (Campbell, 1951, p.2). Concerned educators, who have been aware of the limitations of our educational system in providing equitable outcomes for all students, have seized the opportunities such knowledges have provided to inform their practice. Others have remained sceptical and chosen to ignore the possibilities that attention to such insights may offer. However, with the introduction of the Graduating Teacher Standards (New Zealand Teachers Council [NZTC], 2008) and the imperative for students to demonstrate critical engagement with contextual factors, courses drawing on disciplinary perspectives have become mandatory. It is no longer possible for graduating teachers to accept the advice of less critical and more sceptical colleagues to forget the theory of education since they are about to go into the real world.
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Nielsen, Brian D. „245 Equine research programs: Where are they going?“ Journal of Animal Science 98, Supplement_3 (02.11.2020): 21–22. http://dx.doi.org/10.1093/jas/skaa054.037.
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Abstract Those in the equine community have a strong desire for knowledge in the quest to provide the best care for their horses. Unfortunately, they often seek out advice through on-line sources and are quick to take anecdotal evidence or testimonials as fact. While those in the scientific community would encourage decisions to be made based upon quality research, often there are insufficient data available to answer questions posed by the industry. One of the reasons for this is limited resources. In the past it was common to have departmental-funded assistantships for graduate students. However, those assistantships have disappeared in many departments and now students are often supported through grants. Likewise, there is additional pressure by administrators for federal funding though “horse research” is often considered less important to such funding agencies as horses are viewed as recreational animals as opposed to being a food-producing animals. Hence, much funded equine research would fall under the category of product-testing. While somewhat limited in scope, such research may provide the opportunity to answer other research questions if projects are appropriately planned. However, such “side-projects” are only useful if adequate subject numbers and controls are in place. Reduced animal availability and increased costs of utilizing horses in research may necessitate using other animal models for horses to answer fundamental questions and, if appropriately designed, may allow projects to be competitive for federal funding. Especially as it pertains to junior faculty, collaborative research utilizing colleagues with specialized skills can be important in terms of promoting competitive and fundamental research proposals. While limited resources may increase the appeal for low-cost studies, there is still a need for well-designed studies that answer questions critical to the horse industry and doing quality research is important to enhance the reputation of equine research.
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Sidiq, Mohammad, Aksh Chahal, Nitesh Bansal, Sajjad Alam, Rituraj Verma, Krishna Reddy Vajrala, Jyoti Sharma et al. „Effect of blood flow restriction training on pressure pain threshold and hand function among adults with persistent neck pain: A study protocol for a randomized controlled trial“. F1000Research 12 (31.08.2023): 1076. http://dx.doi.org/10.12688/f1000research.140084.1.
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Background: Persistent neck pain is a prevalent musculoskeletal condition that affects the quality of life and functional abilities of individuals. Blood Flow Restriction Training (BFRT) is a novel therapeutic approach that involves restricting blood flow to exercising muscles to enhance strength and function. However, limited research has been conducted on the effects of BFRT on pressure pain threshold and hand function in adults with persistent neck pain. This randomized controlled trial aims to investigate the potential benefits of BFRT as a treatment intervention for this population. Methods: This study will be a prospective parallel group active controlled trail done at Physiotherapy Department, Galgotias University. Ethical clearance has been obtained from Departmental Ethics Committee on 19/05/2023 with reference number DEC/PT/GU/2023 and the Trial has been registered with Clinical Trial Registry India CTRI/2023/06/053439. Informed consent will be obtained from all the participants who are eligible to be included in the study. 110 patients with persistent neck pain will be randomly allocated into two groups. The BFRT group will receive supervised training sessions three times a week for eight weeks, performing low-load resistance exercises with blood flow restriction applied using personalized cuff pressure. The control group will receive standard care for neck pain, which may include general advice, manual therapy, and/or home exercises without BFRT. The primary outcome measures will be the pressure pain threshold, assessed using a pressure Algometer, and hand function, evaluated using standardized tests such as Hand Grip Strength and Purdue Peg board Test. Results: The data obtained will be analyzed using appropriate statistical methods, and the significance level will be set at p<0.05. Conclusion: This trial will contribute valuable contribution highlighting the potential benefits of BFR training in improving pressure pain threshold and hand function in adults with persistent neck pain.
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Garthwaite, Mary AE, G. Johnson, S. Lloyd und I. Eardley. „The Implementation of European Association of Urology Guidelines in the Management of Acute Epididymo-Orchitis“. Annals of The Royal College of Surgeons of England 89, Nr. 8 (November 2007): 799–803. http://dx.doi.org/10.1308/003588407x232026.
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INTRODUCTION Acute epididymo-orchitis is a common and increasing problem. This retrospective study reviewed whether the European Association of Urology guidelines for the management of acute epididymo-orchitis, which form the basis of this Trust's present inter-departmental guidelines, are being effectively implemented. PATIENTS AND METHODS Case notes of 53 patients attending the emergency department with acute epididymo-orchitis over a 6-month period were reviewed retrospectively. The hospital results' database was used to confirm the diagnostic tests requested on patients at the time of their initial presentation. RESULTS Of the study cohort, 26 patients were aged ≤ 35 years and 27 patients were aged > 35 years. The results demonstrated that a sexual history was documented in only 43.4% of cases. A mid-stream urine sample was sent for routine culture in 54.7% of cases whilst urine for the Chlamydia polymerase chain reaction (PCR) test was obtained in 17% and a urethral swab performed in 5.6%. Antibiotics were prescribed in 81% of cases. Of these patients, 46.5% received ciprofloxacin alone (mean age, 52 years; range, 18–87 years), 25.5% received doxycycline alone (mean age, 30 years; range, 18–45 years) and 21% received both ciprofloxacin and doxycycline (mean age, 33 years; range 18–49 years). In 26.4% of cases, verbal advice to attend a genito-urinary medicine clinic was given, whilst a formal telephone referral was made in only one case. Formal urological follow-up was arranged for only three out of 11 patients aged > 50 years. CONCLUSIONS Although a joint emergency department/urology clinical protocol for the investigation and treatment of acute epididymo-orchitis already exists within the Trust, our current management conforms to this in only a minority of cases. Many different strategies can be employed in the implementation of clinical practice guidelines and all are associated with variable degrees of success. The regular movement of junior staff through each department necessitates that the distribution of management protocols and guidelines occurs at frequent intervals throughout the year and that their implementation is continuously monitored so that, if necessary, further implementation strategies can be employed.
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Fatovich, Daniel, und Ian Jacobs. „Emergency department telephone advice: a survey of Australian emergency departments“. Emergency Medicine 10, Nr. 2 (26.08.2009): 117–21. http://dx.doi.org/10.1111/j.1442-2026.1998.tb00668.x.
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Belyakov, Alexander, und Anna Tsvetkova. „Investigators’ Mistakes in the Appointment of Forensic Examinations“. Academic Law Journal 25, Nr. 1 (15.04.2024): 124–32. http://dx.doi.org/10.17150/1819-0928.2024.25(1).124-132.
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The paper investigates the problem of mistakes and violations made by investigators when appointing forensic examinations. Among the reasons studied are the imperfection of curricula, the constant emergence of new research objects, as well as genera and types of examinations, the inconsistency of departmental acts fixing the lists of forensic examinations, and their specifics, etc. As part of the study, the authors rely on the position that the mistake is involuntary and unintentional, and the investigator acts in good faith and is ready to do everything to avoid the appearance of an mistake in the actions when appointing examinations. Typical mistakes and violations are considered: non-appointment or untimely appointment of expert studies, appointment of examinations when there is no such need, appointment of studies to the wrong body, erroneous sequence of appointment of examinations, errors in setting questions and handling of objects submitted for research. For each mistake, the authors suggest the best methods to prevent it, which, in general, include the following: increasing the number of training hours allocated to forensic science courses, disseminating digital reference systems to assist in assigning forensic examinations (Digital Forensic Science Guide and mobile application “CrimLib – Investigator’s Reference Guide”), seeking preliminary advice from a specialist, careful planning when determining sequences of forensic examinations, etc. As a result of the study, the authors conclude that today there is an urgent need to implement all of the proposed measures, as it directly affects the effectiveness of crime detection and investigation.
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Savoskin, A. V. „Review of the Monograph by S. S. Burynin, S. V. Valov, Yu. A. Tsvetkov, T. V. Cheremisina "Appointment of Citizens and Consideration of Applications in Investigative Bodies". Moscow: Moscow Academy of the Investigative Committee of Russia, 2020.“ Actual Problems of Russian Law 15, Nr. 12 (30.12.2020): 200–208. http://dx.doi.org/10.17803/1994-1471.2020.121.12.200-208.
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The paper presents a detailed analysis of the book "Appointment of Citizens and Consideration of Applications in Investigative Bodies". The emphasis is placed on such issues raised in the book as the interpretation of the term "citizens’ application", the system of legislation on citizens’ applications, the system of citizens’ applications and the system of their consideration. Special attention is given to the right of the heads of the Investigative Committee of the Russian Federation, the Ministry of Internal Affairs of the Russian Federation and the Federal Security Service of the Russian Federation to regulate issues related to citizens’ applications; differentiation of citizens’ applications based on the basic interest of the applicant; functional subsystem for considering citizens’ applications; the passage of time when considering citizens’ applications; termination of correspondence (including the priority of the legal fact of receipt of the application to the final addressee, and not the legal fact of filing an application); the rules for organizing a personal reception (including psychological advice) and the analysis of judicial practice. The following things are being criticized in the review: author’s definition of the category "citizen application"; classifying the right to apply as political; referring requests of authorities and their officials to the number of applications; redundancy of the approach to respond to electronic appeals. It is proposed to continue research in terms of establishing the concept and characteristics of an organization performing public functions (as a recipient of citizens’ applications); improving the departmental procedure for registering applications and reports of crimes; improvement of legislation on electronic and collective applications.
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Pelitari, Stavroula, Charlotte Hathaway, Dean Gritton, Andrea Smith, David Bush, Shyam Menon und Brian McKaig. „Impact and cost-effectiveness of formal gastroenterology outpatient referral Clinical Assessment Service“. Frontline Gastroenterology 9, Nr. 2 (23.09.2017): 159–65. http://dx.doi.org/10.1136/flgastro-2017-100853.
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ObjectiveThe aim was to assess the financial and operational impact of our new gastroenterology referral pathway model on our services.DesignAn electronic ‘Clinical Assessment Service’ (CAS) proforma and an information platform were developed, and all data were analysed retrospectively.SettingRoyal Wolverhampton NHS Trust.Patients14 245 general practitioner (GP) referrals were received during January 2014–December 2016 with 9773 of them being triaged via our CAS.Main outcome measuresWe looked into patients’ clinical outcome along with departmental performance and finances.ResultsA new outpatient appointment was offered to 60.1% (n=5873) of the CAS referred patients. Endoscopic or radiological investigations were requested for 29.2% (n=2854) of patients prior to deciding on further management plan. Out of those, 27% (n=765) went on to receive another gastroenterology (GI) clinic appointment. The remaining 21.3% (n=2089) of the CAS patients were discharged back to their GP following initial investigations. 5.5% (n=538) were discharged back to primary care with a letter of advice, whereas 5.2% (n=509) were deemed inappropriate for GI clinic and were redirected to other specialists. Overall, 32% (n=3127) of patients were managed without a face to face consultation in the GI clinic. This corresponds to 3136 less outpatient appointments with estimated reduced expenditure by the Clinical Commissioning Group (CCG) of £481K. The 18-week performance and waiting times remained stable despite the increasing referral population. The DNA rate dropped from 14% pre to 8.5%.ConclusionsOur clinical assessment model has, in addition to the clinical benefits, a considerable positive financial impact to the health economy.
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Fatovich, Daniel M., Jill P. McCance, Kerry L. Sidney, Rod J. White und Ian G. Jacobs. „Emergency department telephone advice“. Medical Journal of Australia 169, Nr. 3 (August 1998): 143–46. http://dx.doi.org/10.5694/j.1326-5377.1998.tb116015.x.
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George, James E., Madelyn S. Quattrone und Marc Goldstone. „Emergency department telephone advice“. Journal of Emergency Nursing 21, Nr. 5 (Oktober 1995): 450–51. http://dx.doi.org/10.1016/s0099-1767(05)80125-4.
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Verdile, Vincent P., Paul M. Paris, Ronald D. Stewart und Louise A. Verdile. „Emergency department telephone advice“. Annals of Emergency Medicine 18, Nr. 3 (März 1989): 278–82. http://dx.doi.org/10.1016/s0196-0644(89)80414-7.
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Tolan, M., J. Nartey, M. Dattoo, D. King und S. de Silva. „P741 Do gastroenterology services need published standards for provision of antenatal care in patients with Inflammatory Bowel Disease? A local evaluation of UK practice“. Journal of Crohn's and Colitis 17, Supplement_1 (30.01.2023): i871—i872. http://dx.doi.org/10.1093/ecco-jcc/jjac190.0871.
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Abstract Background Inflammatory bowel disease (IBD) is common with 0.5-1% of the UK living with the disease. Poor disease control can result in adverse pregnancy outcomes including low birth weight and preterm labour. It is essential that pregnant patients with IBD receive care from physicians experienced in management of antenatal IBD. Furthermore patients must be equipped with the knowledge to make decisions on their care and the care of their new-born. Audit standards by Selinger et al 20201 for the British Society of Gastroenterology (endorsed by the British Maternal and Fetal Medicine Society) have been published for UK practice but local service standards are unknown. Methods Pregnant patients with Crohn’s disease (CD) and Ulcerative Colitis (UC) between 2017-2020 were identified with ICD-10 and OPSC-4 codes for a hospital with 650 inpatient beds and a catchment area of 450,000 with around 4,600 births per annum. The service was assessed against a 90% compliance standard for documentation of: a decision on biological therapy during pregnancy; discussion on mode of delivery (MoD); antenatal live vaccine counselling; and breast-feeding advice. Results 48 eligible patients were identified. Mean birth weight and delivery date were in line with the national average with no preterm births. 41 of 48 patients (85%) were in remission at the time of conception. 9 of 25 CD pregnancies were on biologics at conception and 7 of 9 (78%) discontinued this by 24-weeks gestation; one continued vedolizumab to 30-weeks and received antenatal vaccine counselling; one continued ustekinumab to 34-weeks. 4 out of 23 UC pregnancies were on biologics at conception; all ceased biologics by 24-weeks and vaccine counselling was not indicated. Only one published standard was achieved, with decision on biologics in pregnancy discussed in 100% (13/13). 3 standards were not met; MoD discussion (23%, 11/48); antenatal vaccine counselling (50%, 1/2); and breast-feeding advice (4%, 2/48). Conclusion Our service did not meet new standards for antenatal IBD care, demonstrating a need for improvement. We recommend that all IBD teams understand the expected service standards, perform a baseline service evaluation and develop clear patient pathways and departmental guidelines to identify pregnant patients with IBD. Clear patient information and close collaboration between obstetricians and gastroenterologists is essential to optimise the outcome for mother and baby. 1) Selinger C et al Standards for the provision of antenatal care for patients with inflammatory bowel disease: guidance endorsed by the British Society of Gastroenterology and the British Maternal and Fetal Medicine Society. Frontline Gastroenterology 2021;12:182-187 BMJ 2020
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Cotton, Rebecca, Richard Drew, Matthew Douma, Domhnall O'Dochartaigh, Candice Keddie, Karen Muncaster und Christopher Picard. „An analysis of individual and department triage variances to identify, quantify, and improve markers of triage nurse accuracy“. Canadian Journal of Emergency Nursing 44, Nr. 2 (20.07.2021): 19–20. http://dx.doi.org/10.29173/cjen130.
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An analysis of individual and department triage variances to identify, quantify, and improve markers of nurse triage accuracy. Rebecca Cotton, Richard Drew, Matthew Douma, Domhnall O’Dochartaigh, Candice Keddie, Karen Muncaster, Christopher Picard Background: Canadian Emergency Departments (ED) use the five-point Canadian Triage Acuity Scale (CTAS) to sort and prioritize patients according to acuity. CTAS scores are used to make decisions on patient flow, staffing complement, and funding. Despite this, there is a paucity of literature describing how CTAS data can be audited, and how the data can inform quality improvement/assurance (QI/QA). Implementation: Triage data downloaded from Tableau were analyzed using Microsoft Excel and IBM SPSS 26. Staff were informed of the audit using email and social media, and invited to discuss the results with educators and administrators. Staff identified for intervention were approached individually with the administrative plan. Anonymized versions of the work plan were posted on the departmental audit board. Nurses triaging greater than 50% department average were offered the option to triage less frequently, while nurses triaging less than 50% the department average were preferentially placed in triage. Nurses triaging fewer than 100 patients per year were informed they would be relieved of triage responsibility unless their rates increased above threshold. Nurses “down-triaging” patients at rates greater than 2 SD were informed that if their practice remained outside 2 SD at repeat audit they would be relieved of triage responsibility until they voluntarily completed CTAS refresher training. Nurses with average assigned CTAS scores > 2 SD department average had 20 visits randomly audited per month for error/appropriateness. Evaluation Method: Computer-assisted analysis of complete triage records was conducted for August 2019 to August 2020 at the Misericordia Hospital Emergency. Complete triage entries of every patient triaged by all triage trained nurses in the department were examined. Nurse’s with practice variation two deviations from department mean were identified and received additional detailed audits. Items examined for error were: FTE adjusted triage frequency; average CTAS score assigned; triage score manual override “down/up-triage” rate; proportion of absent Numeric Pain Scores (NPS) for patients with primary presenting complaints of pain; and vital signs modifier error rates. Initial department averages were used for benchmarking individual nurses; zone averages were used to benchmark department performance. Nurses were interviewed, audit results and action plans were posted. Repeat audits were performed on a three-month basis and benchmarked to initial measures, and a staff awareness campaign was enacted to improve NPS scoring. Data were extracted using text-parsing algorithms programmed into Microsoft Excel and analyzed using IBM SPSS 26. Data were normally distributed and descriptive statistics were calculated using means and standard deviations. T-testing was used for comparisons, and all testing was two-tailed with a pre-defined significance set at 0.05. Results: After the 3rd quarterly audit and associated interventions, global improvements were appreciated in triage nurse practice. There was a 68% reduction in the need for administrative action (n=51, n=18) with reduced variance in individual nurse triage rates and a 50% reduction in nurses who triaged >50% more patients than their peers. 50% fewer nurses had a mean triage rate >.02 above or below department average, there was an 86% reduction in high risk vital sign error rates, a 78% reduction in ”down-triage” rates, and a 6.5% improvement in documentation of numerical pain scores. Advice and Lessons Learned:1) Triage data analytics can rapidly identify staff with significant deviations from the average,making auditing and QI/QA activities more efficient and effective. 2) Having a concrete performance management framework and dissemination plan in place areessential for auditing to have a significant impact on triage consistency and quality over time. 3) Future QI/QA work should consider expanding computer-assisted text parsing to identifypatients at risk for mis-triage for reasons other than vital sign derangement, which will allowfor broader ED rollout across the Edmonton Zone and beyond.
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Digarse, Rohan Dilip, Bal Krishna Ojha, Anil Chandra, Chhitij Srivastava und Sunil Kumar Singh. „Outcome of “DESTITUTE” Head Injury Patients at a Tertiary Care Neurosurgical Centre: A KGMU Experience of 10 Years“. Indian Journal of Neurotrauma 16, Nr. 01 (April 2019): 67–70. http://dx.doi.org/10.1055/s-0039-1700314.
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Abstract Introduction Many patients are admitted to hospitals as destitute or unknown, after having met with accidents. What happens to these patients after admission is not much reported in world literature. With the ever increasing number of road traffic accidents (RTAs), a significant number of such patients are reported worldwide. Material and Methods We conducted a retrospective analysis of the departmental case records of destitute patients from January 2009 till December 2018 in our institute. The mode of presentation, demographic profile, computed tomography scan findings, hospital course, and outcome at discharge were analyzed. Results Out of 128 patients, there were 114 (89.1%) male patients, maximum being in the 21 to 30 years age group. The mean age was 36.4 years with ages ranging from 10 to 70 years. The average length of stay in hospital was of approximately 6 days with maximum being 37 days. The main cause of head injury was RTA in 66 patients (51.5%). Majority, that is, 84 patients, had a Glasgow Coma Scale score of < 8 at admission. Forty-two head injury patients were operated in all, while the rest were managed conservatively. Forty-nine (38.2%) patients died in hospital, and 44 (34.3%) patients had good recovery. During treatment, 16 (12.5%) patients took discharge against medical advice, while identity of 63 (49.2%) patients could be established out of which 5 (3.9%) patients were either discharged to home while 51 (39.8%) patients were referred to their district hospital. Two patients (1.5%) remained unknown and were sent to destitute homes for rehabilitation. Conclusion Unknown head injury patients are usually neglected and their outcome is poorer in comparison to other patients. Their management is fraught with challenges. They need special care for which staff should be well trained and hospital must have economic resources and a good network of social workers.
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Khyzhnyy, B. V. „The use of special knowledge during the investigation of forgery of documents that are submitted for state registration of a legal entity and individual entrepreneurs“. Analytical and Comparative Jurisprudence, Nr. 2 (11.05.2024): 737–42. http://dx.doi.org/10.24144/2788-6018.2024.02.121.
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In the scientific article, scientific publications on the specified issues were analyzed and it was established that special knowledge in the investigation of criminal proceedings under Art. 205-1 of the Criminal Code of Ukraine, are used for the purpose of: 1) identifying traces of this type of crime: (for example, identifying signs of making changes to documents that are the subject of a crime; identifying the person who entered false information into the document; the original content of the document, etc.); 2) application of methods of studying documents within the scope of their review (non-destructive methods and technical means); 3) fixation of S(R) D using technical means; 4) seizure of material evidence (computer equipment, documents and other traces, things or other objects); 5) obtaining advice on the preparation of materials for expert research (for example, determining the types of forensic examinations that should be assigned for the study of seized documents and other objects, formulating expert tasks, selecting samples for comparative research, etc.); 6) modeling the mechanism of the crime in order to propose versions and plan the next stage of the investigation; 7) conducting expert research; 8) obtaining data during the interrogation of an expert as a witness regarding the research he conducted, etc. It was established that the use of special knowledge during a pre-trial investigation into the forgery of documents that are submitted for state registration of a legal entity and individual entrepreneurs takes place in two forms: 1) procedural: involving a specialist to participate in the pre-trial investigation, appointing forensic experts, obtaining a written explanation of a specialist, questioning as witnesses of specialists or forensic experts who participated in conducting forensic examinations; 2) non-procedural: advisory assistance of specialists on matters requiring special knowledge, departmental documentary audits and checks.
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陳璿羽, 陳璿羽. „急診病患不遵醫囑自動出院之法律關係與醫學倫理爭議“. 月旦醫事法報告 57, Nr. 57 (Juli 2021): 153–68. http://dx.doi.org/10.53106/241553062021070057012.
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Gomes, Paula Azambuja, und José Roberto Goldim. „Directivas anticipadas de voluntad en una unidad de emergencia hospitalaria“. Revista Bioética 30, Nr. 1 (März 2022): 106–15. http://dx.doi.org/10.1590/1983-80422022301511es.
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Resumen La participación del paciente en la planificación de su atención médica respeta su derecho a la autodeterminación. Así, esta investigación tuvo como objetivo evaluar el posicionamiento de médicos que actúan en el servicio de emergencia hospitalaria del Hospital de Clínicas de Porto Alegre en relación a las directivas anticipadas de voluntad de los pacientes. Se trata de un estudio transversal con 32 médicos. La mayoría de los participantes (81,3%) afirmó conocer las directivas anticipadas de voluntad, pero solo el 6,3% tenía conocimiento suficiente; el 87,5% se mostró a favor de su uso y la voluntad del paciente fue considerada determinante en tres de los cuatro escenarios presentados; y el 84,4% consideró necesaria una legislación específica además de la Resolución 1995/2012 del Consejo Federal de Medicina. Al final del estudio se concluyó que la mayoría de los médicos tenían conocimiento previo sobre directivas anticipadas de voluntad y se habían posicionado a favor de la utilización de este tipo de documentos en emergencias hospitalarias.
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Gomes, Paula Azambuja, und José Roberto Goldim. „Diretivas antecipadas de vontade em unidade de emergência hospitalar“. Revista Bioética 30, Nr. 1 (März 2022): 106–15. http://dx.doi.org/10.1590/1983-80422022301511pt.
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Resumo A participação do paciente no planejamento de seus cuidados de saúde respeita seu direito à autodeterminação. Com isso, esta pesquisa teve como objetivo avaliar o posicionamento de médicos que atuam no Serviço de Emergência Hospitalar do Hospital de Clínicas de Porto Alegre em relação às diretivas antecipadas de vontade de pacientes. Trata-se de estudo transversal com 32 médicos. A maioria dos participantes (81,3%) afirmou conhecer as diretivas antecipadas de vontade, mas apenas 6,3% tinham conhecimento suficiente; 87,5% foram favoráveis à sua utilização e a vontade do paciente foi considerada determinante em três dos quatro cenários apresentados; e 84,4% consideraram necessária legislação específica além da Resolução 1.995/2012 do Conselho Federal de Medicina. Ao final do estudo foi concluído que a maioria dos médicos tinha conhecimento prévio sobre diretivas antecipadas de vontade e se posicionara a favor da utilização deste tipo de documento em emergência hospitalar.
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Aangeenbrug, Robert T. „Getting It Together: Advice to Departments∗“. Professional Geographer 41, Nr. 4 (November 1989): 487–90. http://dx.doi.org/10.1111/j.0033-0124.1989.00487.x.
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Tonge, Xenia N., Henry Crouch-Smith, Vijay Bhalaik und William D. Harrison. „Do we achieve the Montgomery standard for consent in orthopaedic surgery?“ British Journal of Hospital Medicine 82, Nr. 4 (02.04.2021): 1–7. http://dx.doi.org/10.12968/hmed.2020.0504.
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Aims/Background The Montgomery v Lanarkshire Health Board (2015) case set a precedent that has driven the modernisation of consenting practice. Failure to demonstrate informed consent is a common source of litigation. This quality improvement project aimed to provide pragmatic guidance for surgeons on consent and to improve the patient experience during decision making. Methods Elective orthopaedic patients were assessed and the quality of documented consent was recorded. Data were collected over two discrete cycles, with cycle 1 used as a baseline in practice. The following criteria were reviewed: grade of consenting clinician, alternative treatment options, description of specific risks, place and timing of consent and whether the patient received written information or a copied clinic letter. Cycle 1 results were presented to clinicians; a teaching session was provided for clinicians on the standard of consent expected and implementation of a change in practice was established with a re-audit in cycle 2. Results There were 111 patients included in cycle 1, and 96 patients in cycle 2. Consent was undertaken mostly by consultants (54%). Specific patient risks were documented in 50% of patients in cycle 1 and 60% in cycle 2. Risks associated with a specific procedure were documented in 42% in cycle 1 and 76% in cycle 2, alternative options in 48% (cycle 1) and 66% (cycle 2). A total of 14% of patients in cycle 1 and 8% in cycle 2 had documented written information provision. Copied letters to patients was only seen in 12% of all cycles. Documentation from dedicated consenting clinics outperformed standard clinics. Conclusions Highlighting poor documentation habits and refining departmental education can lead to improvements in practice. The use of consenting clinics should be considered and clinicians should individually reflect on how to address their own shortcomings. Other units should strongly consider a similar audit. This article provides stepwise advice to improve consent and specifics from which to audit.
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Morley, Catherine, und Kathleen MacDonald. „Revalidation of the Client Perceptions of Nutrition Counselling (CPNC) Instrument“. Journal of Critical Dietetics 7, Nr. 1 (02.04.2024): 67–84. http://dx.doi.org/10.32920/jcd.v7i1.1720.
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The purpose of this project was to reassess the utility and content validity of the Client Perceptions of Nutrition Counselling (CPNC) instrument, originally developed in the early 1990s as a valid and reliable means to evaluate the effectiveness of nutrition counselling from the perspectives of those who consulted with a dietitian in an ambulatory care setting, while in hospital, or at a clinic. Outcomes assessed using the CPNC include trust in the dietitian per the Value of Nutrition Education conceptual framework (Hauchecorne et al., 1994), perceptions of and confidence in one’s ability to manage one’s health condition through diet, and comprehension of nutrition advice. These measures contrast with traditional outcome measures of weight and body composition, laboratory findings, clinical status, and dietary intake. A three-step progressive development design was used to assess and update the instrument: 1) a literature and report review; 2) an advisory panel (AP) consultation; and 3) based on Step 2, instrument revision if required. Findings from the literature review were that a more recent instrument based on user reflections on their nutrition counselling experiences was not available. The AP determined the CPNC remained relevant and updated the instrument. The revised CPNP 2.0 instrument is included in the article. Use of the CPNC 2.0 instrument makes it possible for people who have consulted with a dietitian to report on their perceptions of the service, and on personal outcomes related to using the service. These findings have implications at the unit/departmental level; dietitians and managers can consider how they might modify their services (for example, timing of consultations, virtual meetings rather than face to face, or integrating food skilling/culinary therapy into programs) to address service users’ needs and preferences. Findings can be used to advocate for nutrition counselling services to administrators, foundations, boards, health ministries, and others. Individually, and as a group, findings can inform dietitians’ decisions about professional development needs.
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Bhat, Rehana Kousar. „Working in Cardiac Cath Lab – a Nurse's Advice“. JMS SKIMS 15, Nr. 1 (11.06.2012): 84. http://dx.doi.org/10.33883/jms.v15i1.128.
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(THIS ARTICLE HAS NO ABSTRACT; THE FIRST 100 WORDS ARE DISPLAYED). I work in a multi-specialty hospital in Srinagar, Kashmir. During last 17 years, I have worked in several departments of my Institute and finally, I have been working in cardiac catheterization laboratory for last two years. I have learnt several essentials regarding working in a cardiac lab which I want to share with my colleagues who want to come and work in this department. Based on my long experience, I want to advise all interested colleagues on how to give one's best in cardiac cath laboratory. I want to give you an idea of what it is like working in... JMS 2012;15(1):84.
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Ng, Terence Bu-Peow, und Premila Gowri Shankar. „Effects of Technical Department’s Advice, Quality Assessment Standards, and Client Justifications on Auditors’ Propensity to Accept Client-Preferred Accounting Methods“. Accounting Review 85, Nr. 5 (01.09.2010): 1743–61. http://dx.doi.org/10.2308/accr.2010.85.5.1743.
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ABSTRACT: We conduct an experiment to investigate whether the effects of an SAS No. 90-like quality assessment standard (QAS) on auditors’ decision to accept a client-preferred accounting method is jointly moderated by the nature of advice from an audit firm’s technical department and the strength of the client’s justification. Results indicate that, in the absence of advice, the presence of QAS does not affect auditors’ decision, regardless of client justification strength. However, in the presence of advice from the technical department, the presence of QAS significantly reduces auditors’ propensity to accept the client-preferred method, but only when the advice explicitly recommends the use of the most appropriate method and the client’s justification is strong. These findings demonstrate the complementary roles that professional standards and audit firms’ technical departments play in enhancing the quality of auditors’ decisions, and indicate that the nature of advice matters.
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Wigder, Herbert N., Timothy Erickson, Thomas Morse und Victoria Saporta ‡. „Emergency Department Poison Advice Telephone Calls“. Annals of Emergency Medicine 25, Nr. 3 (März 1995): 349–52. http://dx.doi.org/10.1016/s0196-0644(95)70293-8.
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Genners, Kristy A. „Emergency department discharges against medical advice“. Annals of Emergency Medicine 21, Nr. 12 (Dezember 1992): 1521. http://dx.doi.org/10.1016/s0196-0644(05)80085-x.
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Dubow, David, Douglas Propp und Kris Narasimhan. „Emergency department discharges against medical advice“. Journal of Emergency Medicine 10, Nr. 4 (Juli 1992): 513–16. http://dx.doi.org/10.1016/0736-4679(92)90289-6.
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White-Lewis, Damani K. „Before the AD: How Departments Generate Hiring Priorities that Support or Avert Faculty Diversity“. Teachers College Record: The Voice of Scholarship in Education 123, Nr. 1 (Januar 2021): 1–36. http://dx.doi.org/10.1177/016146812112300109.
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Background/Context Although academic departments have more tools to advance faculty diversity than ever before, many still downplay their own responsibility throughout the hiring process. This results in a cycle of apathy that activates once searches are already under way, and structural change is out of reach. Yet few studies empirically outline what structural change entails so that departments can play a more active role in improving search processes before hiring begins. Purpose/Objective/Research Question/Focus of Study This study materializes the underlying mechanics of academic hiring by describing the process of departmental hiring priorities, and identifies how adjusting them can create the optimal conditions for supporting faculty diversity. Population/Participants/Subjects Participants were 23 academic personnel spanning four academic departments, including deans, department chairs, equity administrators, and faculty search committee members. Research Design This qualitative study uses a blend of multiple case study and grounded theory designs. The multiple case study method guided the site, case, participant selection, and data collection procedures. Grounded theory was employed primarily in the data coding and analysis phases. Data Collection and Analysis Data were collected from an institutional site fictitiously named Northfield University, a research-intensive four-year university located in the western region of the United States. Four departments were selected as case studies based on convenience sampling from four broader divisions: social sciences, life sciences, humanities, and physical sciences. Twenty-three participants spanning multiple positions and departments participated in a total of 31 semistructured interviews. These data were initially coded and analyzed using the constant comparative method and then further analyzed using cross-case analysis. Findings/Results Findings reveal the primary determinants of departmental hiring priorities that bred subfield conservatism, or the hesitancy to expand the department in new and different hiring directions based on resource constraint and subfield reproduction. This was a realistic yet troubling organizational response that inhibited opportunities for diversity before searches even began. Results also document the steps that departments took to thwart subfield conservatism in order to more aptly attract and elevate racially minoritized candidates. Conclusions/Recommendations This study highlights the untapped potential that hiring priorities hold for advancing faculty diversity. Department chairs and deans are uniquely positioned to implement initiatives that rearrange the structural conditions of faculty hiring that empower faculty to create equity-oriented positions beyond traditional departmental boundaries.
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Ramlakhan, Shammi, Kerry Nathan und Stanley Eferakeya. „Outcomes in children advised to attend the emergency department by a healthcare telephone advice service (NHS111)“. European Journal of Emergency Medicine 28, Nr. 4 (August 2021): 315–16. http://dx.doi.org/10.1097/mej.0000000000000799.
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Zahan, Sayeeda, Reghu KS, Parthasarathi Bhattachharyya, Manidipa Ghosh und Arpita Bhattacharyya. „Door-to-Needle Time for Administration of Antibiotic in Children with Cancer Within the Golden Hour- an Audit from a Tertiary Cancer Hospital in a Low-Middle Income Country“. Journal of the Pediatric Infectious Diseases Society 12, Supplement_1 (01.11.2023): S13—S14. http://dx.doi.org/10.1093/jpids/piad070.024.
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Abstract Background Fever neutropenia (FN) is the commonest complication during treatment in children with cancer. Most guidelines recommend administration of intravenous antibiotics within 60 minutes of presentation to the Emergency Room (ER) to minimize life threatening complications of FN(1). We performed a 3-month audit at our ER to see if this target was being met(2). The departmental FN management policy was revised and implemented from February 2021 based on the prevailing hospital antibiogram. All children undergoing treatment in the Paediatric Oncology Department are provided with written FN Alerts/Advice (Fig. 1). All patient prescriptions include instructions on antibiotic choice and dosage. Annual educational sessions are held with the ER staff and Paediatric Oncology Residents. A stock of essential antibiotics is maintained in the ER. Methods All children on chemotherapy or radiotherapy presenting to ER with fever (≥38°C) either at home or documented at ER had blood counts and blood cultures sent both from a peripheral vein and the indwelling central venous device (if present). The first dose of antibiotics as prescribed was administered without waiting for the blood count report or assessment by the Clinician. Time of patient’s arrival at ER and time of administration of the first antibiotic dose were obtained from ER nursing records and patient drug cards. Data was entered prospectively within 24 hours and tabulated for analysis on Microsoft Excel. Fig.1: Fever Neutropenia Sticker on Patient File Results Eighty-four children presented with 129 episodes of fever during the audit period (1st April 2022-30th June 2022). Median age was 6.4 years (IQR 3.1,12). Median time interval from last chemotherapy was 6 days (IQR 2,10). All children reporting to ER were seen by a Clinician, with 106 (82%) episodes seen within 30 minutes of reporting (median 15 minutes, IQR 5,21). All children received initial intravenous antibiotics after blood sampling. Median door-to-needle time was 45 minutes (IQR 35,60 minutes) There were 2 deaths in this cohort, one due to cancer progression and the other due to an unidentified infection of the central nervous system. Conclusions Over 80% children received the first dose of antibiotics within the target of <60 minutes. There were no deaths attributable to sepsis. Though the outcome was excellent in this cohort, we need to analyse the reasons for delay in administration of the first antibiotic dose and take remedial measures to improve compliance. References 1. Forde C, Scullin P. Chasing the Golden Hour – Lessons learned from improving initial neutropenic sepsis management. BMJ Open Qual. 2017 Mar 1;6(1):u204420.w6531. 2. Ali N, Baqir M, Hamid A, Khurshid M. Febrile neutropenia: median door-to-needle time - results of an initial audit. Hematol Amst Neth. 2015 Jan;20(1):26–30. Acknowledgement We would like to thank the LOTUS Network for technical support and funding to attend this conference. Contact Arpita Bhattacharyya Department of Paediatric Haematology Oncology Tata Medical Center, Kolkata, India arpita.bhattacharyya@tmckolkata.com
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AMERICANCOLLEGEOFEMERGENCYPHY. „Providing telephone advice from the emergency department“. Annals of Emergency Medicine 19, Nr. 5 (Mai 1990): 600. http://dx.doi.org/10.1016/s0196-0644(05)82201-2.
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Proctor, John H., Alan J. Hirshberg, A. Antoine Kazzi und Rebecca Bollinger Parker. „Providing telephone advice from the emergency department“. Annals of Emergency Medicine 40, Nr. 2 (August 2002): 217–19. http://dx.doi.org/10.1067/mem.2002.126398.
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Kurg, Steven E. „TELEPHONE ADVICE IN THE PEDIATRIC EMERGENCY DEPARTMENT“. Pediatric Emergency Care 4, Nr. 4 (Dezember 1988): 299. http://dx.doi.org/10.1097/00006565-198812000-00049.
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AVNER, JEFFREY R., DANIEL J. ISAACMAN, STEVEN M. SELBST und JAMES SEIDEL. „Telephone advice in the pediatric emergency department“. Pediatric Emergency Care 9, Nr. 5 (Oktober 1993): 300–306. http://dx.doi.org/10.1097/00006565-199310000-00010.
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