Academic literature on the topic 'Medical personnel Health risk assessment'
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Journal articles on the topic "Medical personnel Health risk assessment"
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Priambodo, Raditya, Elsye Maria Rosa, and Sri Sundari. "Kepatuhan dan Ketepatan Tenaga Medis dalam Pengisian Assessment Pre Dialisis di Klinik Hemodialisis Nitipuran Health Center." Jurnal Ilmiah Universitas Batanghari Jambi 20, no. 1 (February 5, 2020): 268. http://dx.doi.org/10.33087/jiubj.v20i1.775.
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Background: The National Hospital Accreditation Standards (SNARS) state that one of the key indicators in patient-focused service standards is patient assessment. The purpose of this study was to analyze the level of compliance and accuracy of medical personnel in pre dialysis assessments at NHC. Subjects and Method: This study uses a mixed method with the Cohort Study approach. Research subjects were medical records for quantitative data and doctors, nurses and head nurses for qualitative data. Quantitative data analysis with descriptive analysis, and qualitative analysis with in-depth interviews. Result: The level of compliance and accuracy of medical personnel in filling the pre dialysis assessment at the Nitipuran Hemodialysis Clinic is not quite good. The implementation of pre dialysis assessment at the NHC includes physical status, medical history, history of drug allergy, assessment of pain, risk of falls, and educational needs. Constraints include time constraints, assessments are filled in immediately without checking in detailly, there are gaps in the hourly monitoring records. Conclusion: compliance and accuracy of medical personnel in filling out assessments must be improved.
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Smirnova, S. S., I. А. Egorov, N. N. Zhuikov, L. G. Vyatkina, А. N. Kharitonov, А. V. Semenov, and О. V. Morova. "Risks of becoming infected with SARS-CoV-2 for medical personnel in a large industrial city during the pandemic: comparative assessment." Health Risk Analysis, no. 2 (June 2022): 139–50. http://dx.doi.org/10.21668/health.risk/2022.2.13.
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The COVID-19 pandemic has produced its effects on functioning of all the state institutions, the public healthcare system being a peculiar one among them. Medical personnel have become an unprotected population group that was actively involved into the epidemic process. Results produced by several studies indicate that relative risks to become infected with COVID-19 are by up to 11.6 times higher for medical personnel than in population at large. A share of medical personnel among patients with COVID-19 varies in different countries, from 4.2 % in China to 17.8 % in the USA. According to official statistics, in 2020 a share of medical personnel who became infected with COVID-19 in in-hospital foci amounted to 68.6 % in the RF regions located in the Urals and Siberian Federal Districts. High epidemic potential of the virus and intensive mass contacts between medical personnel and their patients make for rapid SARS-CoV-2 spread and infection among them. It is vital to examine all the range of risk factors that cause SARS-CoV-2 infection among medical personnel. The present study involved using “The map of epidemiological investigation focused on the incidence of the new coronavirus infection (COVID-19) in medical personnel”. The map was located on Google Cloud Platform. Overall, 613 medical workers from different medical organizations took part in the research. We applied sociological, epidemiological and statistical research techniques. We established that work in an infectious diseases hospital increased a relative risk of SARS-CoV-2 infection by 1.8 times (RR = 1.78; 95 % CI [1.65–1.93]). The total risk of SARS-CoV-2 infection was insignificant for workers employed at a medical organization that provided scheduled medical assistance to population (RR = 1.02; 95 % CI [1.00–1.04]). However, certain factors created elevated risks of infection. Any contacts with COVID-19 patients who were close relatives, friends or neighbors were established to be significant (RR = 1.13; 95 % CI [1.04–1.228]). The research results should be used when organizing work procedures and anti-epidemic activities in infectious diseases hospitals and medical organizations providing scheduled assistance to population. The focus should be on providing medical personnel with personal protective equipment as well as on calculating relevant duration of a work shift relying on the risk-based approach.
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Smirnova, S. S., I. А. Egorov, N. N. Zhuikov, L. G. Vyatkina, А. N. Kharitonov, А. V. Semenov, and О. V. Morova. "Risks of becoming infected with SARS-CoV-2 for medical personnel in a large industrial city during the pandemic: comparative assessment." Health Risk Analysis, no. 2 (June 2022): 139–50. http://dx.doi.org/10.21668/health.risk/2022.2.13.eng.
Full textAbstract:
The COVID-19 pandemic has produced its effects on functioning of all the state institutions, the public healthcare system being a peculiar one among them. Medical personnel have become an unprotected population group that was actively involved into the epidemic process. Results produced by several studies indicate that relative risks to become infected with COVID-19 are by up to 11.6 times higher for medical personnel than in population at large. A share of medical personnel among patients with COVID-19 varies in different countries, from 4.2 % in China to 17.8 % in the USA. According to official statistics, in 2020 a share of medical personnel who became infected with COVID-19 in in-hospital foci amounted to 68.6 % in the RF regions located in the Urals and Siberian Federal Districts. High epidemic potential of the virus and intensive mass contacts between medical personnel and their patients make for rapid SARS-CoV-2 spread and infection among them. It is vital to examine all the range of risk factors that cause SARS-CoV-2 infection among medical personnel. The present study involved using “The map of epidemiological investigation focused on the incidence of the new coronavirus infection (COVID-19) in medical personnel”. The map was located on Google Cloud Platform. Overall, 613 medical workers from different medical organizations took part in the research. We applied sociological, epidemiological and statistical research techniques. We established that work in an infectious diseases hospital increased a relative risk of SARS-CoV-2 infection by 1.8 times (RR = 1.78; 95 % CI [1.65–1.93]). The total risk of SARS-CoV-2 infection was insignificant for workers employed at a medical organization that provided scheduled medical assistance to population (RR = 1.02; 95 % CI [1.00–1.04]). However, certain factors created elevated risks of infection. Any contacts with COVID-19 patients who were close relatives, friends or neighbors were established to be significant (RR = 1.13; 95 % CI [1.04–1.228]). The research results should be used when organizing work procedures and anti-epidemic activities in infectious diseases hospitals and medical organizations providing scheduled assistance to population. The focus should be on providing medical personnel with personal protective equipment as well as on calculating relevant duration of a work shift relying on the risk-based approach.
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Annenkova, E. A., O. A. Tikhonova, A. P. Biryukov, L. I. Baranov, I. G. Dibirgadzhiev, M. V. Sheyanov, O. A. Kasymova, and O. V. Parinov. "Risk-Based Causal Model of Risk Factors for Infection among Medical Personnel Involved in the Care Of Patients with the New COVID-19 Coronavirus Infection." Disaster Medicine, no. 3 (September 2021): 65–68. http://dx.doi.org/10.33266/2070-1004-2021-3-65-68.
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The aim of the study is to develop and apply a mathematical model for assessing the risks of contamination of medical personnel involved in providing medical care to patients with COVID-19 in a "red zone" environment. Materials and methods. Based on the analysis of informative signs and information on working conditions in the infectious disease department of the A.I. Burnazyan Federal Medical Biophysical Center of the Federal Medical and Biological Agency of Russia, a decision-making support system was developed to provide an objective assessment of the risks of infection for medical personnel when providing medical care in the "red zone". Results of the study and their analysis. The influence of various risk factors for infection of medical personnel involved in the provision of medical care to patients with new coronavirus infection COVID-19 was analyzed; the most significant risk factors were identified.
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Burtseva, T. I., V. A. Solopova, A. I. Baitelova, and N. N. Rakhimova. "Infection of personnel working in clinical and diagnostic laboratories: qualitative analysis and risk assessment." Health Risk Analysis, no. 2 (June 2022): 128–38. http://dx.doi.org/10.21668/health.risk/2022.2.12.
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Personnel who work in laboratories and directly deal with detecting and examining pathogenic biological agents (PBA) in human biomaterials have to face high risks of becoming infected. At present, working conditions at workplaces of personnel in such laboratories are to be analyzed and checked thoroughly with subsequent implementation of relevant correction measures. We performed qualitative analysis of infection risks in clinical and diagnostic laboratories using a reason tree and event tree analysis and determined a risk probability range for an ending event considering combined effects produced by preconditions. We revealed basic reasons why personnel in medical laboratories became infected when working with PBA. The events were considered at three levels and four directions in their development. We performed mathematical calculation of possible event combinations and determined the whole probability range for occurrence of the events. Quantitative risk analysis showed that a probability of a person becoming infected remained within 0.9∙10–4–0.9∙10–3 range even in case of the most unfavorable outcome. The study provides a well-substantiated conclusion about peculiarities of work tasks accomplished in laboratories; we established that laboratory personnel who were involved in determining drug resistance of microbacteria had the highest risks of infection. The most hazardous scenarios of emergencies were identified; they made the highest contribution to the analyzed risk. We established that a probability of personnel becoming infected that starts with the value being 1.3∙10–6 occurs when immune prevention is neglected and a disease is revealed too late. It is advisable to analyze ways how emergencies develop in medical laboratories since this helps to make necessary amendments in the system and influence factors of its functioning. This analysis procedure gives an opportunity to select the most relevant measures for protection and prevention of emergencies involving PBA leakage out of all the available ones. These measures can reduce risks of infection for personnel down to their acceptable levels.
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Burtseva, T. I., V. A. Solopova, A. I. Baitelova, and N. N. Rakhimova. "Infection of personnel working in clinical and diagnostic laboratories: qualitative analysis and risk assessment." Health Risk Analysis, no. 2 (June 2022): 128–38. http://dx.doi.org/10.21668/health.risk/2022.2.12.eng.
Full textAbstract:
Personnel who work in laboratories and directly deal with detecting and examining pathogenic biological agents (PBA) in human biomaterials have to face high risks of becoming infected. At present, working conditions at workplaces of personnel in such laboratories are to be analyzed and checked thoroughly with subsequent implementation of relevant correction measures. We performed qualitative analysis of infection risks in clinical and diagnostic laboratories using a reason tree and event tree analysis and determined a risk probability range for an ending event considering combined effects produced by preconditions. We revealed basic reasons why personnel in medical laboratories became infected when working with PBA. The events were considered at three levels and four directions in their development. We performed mathematical calculation of possible event combinations and determined the whole probability range for occurrence of the events. Quantitative risk analysis showed that a probability of a person becoming infected remained within 0.9∙10–4–0.9∙10–3 range even in case of the most unfavorable outcome. The study provides a well-substantiated conclusion about peculiarities of work tasks accomplished in laboratories; we established that laboratory personnel who were involved in determining drug resistance of microbacteria had the highest risks of infection. The most hazardous scenarios of emergencies were identified; they made the highest contribution to the analyzed risk. We established that a probability of personnel becoming infected that starts with the value being 1.3∙10–6 occurs when immune prevention is neglected and a disease is revealed too late. It is advisable to analyze ways how emergencies develop in medical laboratories since this helps to make necessary amendments in the system and influence factors of its functioning. This analysis procedure gives an opportunity to select the most relevant measures for protection and prevention of emergencies involving PBA leakage out of all the available ones. These measures can reduce risks of infection for personnel down to their acceptable levels.
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Bondareva, E. D., K. E. Borovkova, and M. N. Makarova. "Risk-Based Approach to the Assessment of Sanitary Safety of Vivariums and Breeding Facilities, and Health Status of Personnel and Laboratory Animals." Bulletin of the Scientific Centre for Expert Evaluation of Medicinal Products 10, no. 4 (December 11, 2020): 257–66. http://dx.doi.org/10.30895/1991-2919-2020-10-4-257-266.
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The paper discusses the system of managing risks arising during preclinical studies (risks for the health of personnel and laboratory animals, as well as risks associated with sanitation of premises) as a way to improve and control the efficiency of processes and the safety of facilities involved in preclinical studies.The aim of the study was to analyse the risk assessment system’s efficiency for improvement of drug safety assessment during preclinical studies in the context of animal care and use programmes.Materials and methods: the Failure Mode Effect Analysis (FMEA) method was used to assess the sanitary and hygienic conditions in laboratory animal facilities, as well as health status and welfare of laboratory animals and the attending personnel. The study checked the presence of pathogenic and opportunistic microflora as the main potential inconsistencies.Results: the risk assessment performed during monitoring of laboratory animal health, monitoring of surface cleanliness, and assessment of personnel health, helped to establish a list of the most dangerous pathogens that require stricter control. In order to reduce risks arising during preclinical studies, the following set of measures was proposed: monitoring of the living environment and health of laboratory animals, revision of therapeutic and preventive measures for laboratory animals (including adjustment of antibiotic treatment depending on antimicrobial resistance of microorganisms), monitoring of the personnel health status, taking measures to enhance the personnel vigilance with respect to their own health, prohibition to work at the premises for employees showing symptoms, control of how the employees showing symptoms observe the prohibition to work at the premises, organisation of periodic medical examinations for personnel having contact with laboratory animals.Conclusions: the risk-based assessment helped to identify the most dangerous potential inconsistencies (pathogenic and opportunistic microflora) and the necessary preventive measures to control and manage potential risk consequences.
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Blokh, A. I., I. I. Panyushkina, P. O. Pakhtusova, I. V. Sergeeva, L. I. Levahina, I. P. Burashnikova, N. G. Anpilova, N. A. Penyevskaya, O. A. Pasechnik, and N. V. Rudakov. "Assessment of Seroconversion to SARS-CoV-2 in Health Care Unitunit Personnel." Epidemiology and Vaccinal Prevention 20, no. 5 (November 5, 2021): 32–38. http://dx.doi.org/10.31631/2073-3046-2021-20-5-32-38.
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Relevance. The novel coronavirus pandemic is a major burden on public health and healthcare professionals. The study of the prevalence of antibodies among medical workers provides an understanding of the potential risk of transmission of the infectious agent, the level of herd immunity, the introduction of specific immunization and risk stratification in various areas of professional activities.The purpose of this study was to assess the level of specific antibodies to SARS-CoV-2 in the personnel of the medical and sanitary unit, providing the population with outpatient and inpatient medical care.Materials and methods. A study to assess seroprevalence to the SARS-CoV-2 virus was carried out in the Omsk region from September 2020 to December 2020. The study included 2 groups of employees of continuously operating organizations – the main group – employees of the medical and sanitary unit of the city of Omsk (n = 631), the control group consisted of employees of two industrial enterprises in the city of Omsk (n = 1696). The level of class G immunoglobulins to the SARS-CoV-2 virus was determined by enzyme-linked immunosorbent assay.Results. Among medical workers, the proportion of people with a positive reaction to IgG was 73.1% (n = 461; 95% CI 69.5–76.4%). In the control group, the proportion of those who were seropositive was 3.9 times less than that – 18.6% (n = 315; 95% CI 16.8–20.5). Significant differences in seroprevalence in men and women were revealed in medical workers (χ2 = 4.164; p = 0.0413). The highest proportion of seroconversion was found in nursing staff – 85,4% (95% CI 71.6 – 93.1), in doctors – 63.3% (95% CI 55.0–70.9). The highest rate of seroprevalence was found among hospital medical workers – 81.9%, the lowest among employees of the administrative and economic service – 51,8%.Conclusions. The level of specific antibodies to SARS-CoV-2 among medical workers significantly exceeded that of other professional groups, and there was a high proportion of seroconversion among junior medical personnel and in-patient medical unit workers.
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Batov, V. E., S. M. Kuznetsov, and S. M. Logatkin. "Assessment of risk factors for COVID-19 infection in personnel of military medical organizations." Medicо-Biological and Socio-Psychological Problems of Safety in Emergency Situations, no. 3 (January 5, 2023): 13–20. http://dx.doi.org/10.25016/2541-7487-2022-0-3-13-20.
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Relevance. Workers in medical organizations are at risk of developing occupational diseases, including coronavirus infection through frequent contacts with patients and colleagues in the course of their professional activities. Analysis of the causes of infection associated with the pathogen SARS-CoV-2 is the basis for development of preventive measures aimed at minimizing the risk of infection. Intention – development of the main directions for the prevention of COVID-19 morbidity among medical personnel based on a hygienic assessment of occupational risk factors. Methodology. An analysis of cases of a new coronavirus infection among employees of a military medical organization was carried out. An assessment was made of the factors that increase the risk of personnel infection, based on the study of materials from epidemiological investigations and the results of a survey. Results and Discussion. Research has identified factors that increase the risk of COVID-19. An analysis of the causes of the disease showed that in 60 % of cases, infection of personnel is associated with infection at the workplace (contacts with patients – 53.1 %, contacts personnel – 6.9 %), in 38.7 % of cases the cause was not established, in 1.3 % – contacts with sick relatives were registered. A number of specialists from certain professional groups have a higher incidence rate (traumatologists, surgeons, urologists, specialists who carry out sanitary and epidemiological surveillance). It was found that, regardless of the category of work and specialty, during the pandemic, the staff had contacts with sick patients – 78.2 %, contacts with sick colleagues – 53.7 %. Contacts with sick patients increased the risk of developing the disease (RR 1.26; 95 % CI: 1.02–1.55; p = 0.01). The required degree of personnel protection was not provided in this case, which affected the significance of the factor of violation of the rules for the use of PPE (RR 1.66; 95 % CI: 1.11–2.48; p = 0.006) in the risk of developing disease. At the same time, the involvement of personnel to the work in the “red zone” increased the likelihood of the disease (RR 2.98; 95 % CI: 1.24–7.17; p = 0.005). Conclusion. The conducted studies made it possible to establish differences in the level of potential risk for certain categories of medical specialists in non-infectious departments (traumatologists, surgeons, urologists; specialists in charge of sanitary and epidemiological surveillance) and to develop directions for preventive measures based on their analysis.
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Kondashov, A. A., E. Yu Udavtsova, V. A. Mashtakov, E. V. Bobrinev, A. A. Vetoshkin, and T. A. Shavyrina. "Assessment of the acceptable risk of injury in employees of the Federal Fire Service of EMERCOM of Russia." Medicо-Biological and Socio-Psychological Problems of Safety in Emergency Situations, no. 1 (April 2, 2021): 40–49. http://dx.doi.org/10.25016/2541-7487-2021-0-1-40-49.
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Relevance. Occupational Safety and Health Management System (OSHMS) should be improved and regularly adjusted based on continuous analysis of hazards and current risks.Intention. Development of approaches to determining the permissible level of risks to the personnel of the Federal Fire Service (FPS) of the EMERCOM of Russia when performing occupational duties.Methodology. Cases of injuries were analyzed in the staff of the FPS when performing occupational duties. Relative frequencies of injuries were calculated in the personnel of the FPS as follows: light damage (the number of days of temporary disability ≤ 3), moderate damage (the number of days of temporary disability from 4 to 30) and severe damage (the number of days of temporary disability more than 30, the onset of disability or death). Associations between injuries in the personnel of the FPS and the complexity of fires were assessed, including amount of the fire extinguishers used.Results and Discussion. It is proposed to allocate two levels of acceptable risk of injury for the personnel of the FPS when performing official duties: the maximum risk and acceptable risk. Estimates of acceptable and maximum risks of injury to personnel of the FPS were obtained using the relative index of the frequency of injuries to personnel: acceptable risk estimates R acceptable = (5 ± 1) • 10–5 and maximum risk estimates Rmaximum = (4,4 ± 0,3) • 10–4. It is proposed to use the values of acceptable risks of personal injury adjusted for the complexity of fires extinguished to assess the effectiveness of the OSHMS in fire protection units. Options for decision-making in the framework of the Occupational Safety and Health Management Systems, depending on the actual level of injury to personnel in the performance of official duties, are considered.Conclusion. The proposed model for assessing the effectiveness of the OSHMS is based on the planning of OSHMS activities depending on the degree of implementation of the OSHMS procedures and the risk of injury to the personnel of the FPS of EMERCOM of Russia in the performance of official activities.
Dissertations / Theses on the topic "Medical personnel Health risk assessment"
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Ndlebe, Lusanda. "Occupational exposure to tuberculosis: knowledge and practices of employees at specialised tuberculosis hospitals." Thesis, Nelson Mandela University, 2017. http://hdl.handle.net/10948/14245.
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Knowledge and safer practices regarding occupational exposure are crucial to all employees working in healthcare facilities, especially Tuberculosis (TB) hospitals. This study aimed to explore and describe the knowledge and practices of employees working in three specialised TB hospitals regarding occupational exposure to TB. The results of the study will be used to make recommendations to the Eastern Cape Department of Health (ECDOH) and hospital managers that could assist in reducing the prevalence of occupational TB. This quantitative, descriptive and contextual study was conducted in three specialised TB hospitals in the Nelson Mandela Bay Health District (NMBHD). Convenience sampling was used to select the research participants. The knowledge and practices of 181 employees towards occupational exposure to TB and infection control was measured through a self-administered questionnaire. The questionnaire covered areas such as the knowledge of TB and infection control, the infection control policy, infrastructure as well as patient transportation. The whole population was targeted and out of a potential 253 employees, 181 were on duty during the stage of data collection and agreed to willingly participate in the study. The data was analysed descriptively using MS excel and MS word. This study revealed that 69% (n=124/181) of employees in the three specialised TB hospitals in the NMBHD have adequate knowledge of infection control. However, only 10% (n=18/181) of employees reported appropriate infection control practices, while almost half of the participants 42% (n=76) apparently practice infection control poorly. The majority (78%, n=141) of the employees in the three specialised TB hospitals in the NMBHD reported knowing about the availability of an infection control policy in their respective hospitals, however only 42 % (n=76) have reportedly read the policy. In conclusion, knowledge and practices regarding occupational exposure in specialised TB hospitals in the NMBHD is not optimal. It is however, important to note that the majority of employees have knowledge about the TB disease itself and its symptoms. Recommendations were made in order to improve infection control knowledge and practices. These include the development of a plan for purchasing of equipment to address infection control, development of a curriculum specific for non-nursing personnel and the establishment of a plan to ensure the availability of patient consultation rooms and dining halls. A further recommendation deemed important by the researcher was isolation glass as a compulsory specification when purchasing patient transportation vehicles, in order to provide protection for the drivers transporting patients to and from the hospital.
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Santos, Felipe Amorim. "Avaliação da exposição do público e médica em um cenário típico de exames que utilizam equipamento móvel de raios X através do método Monte Carlo." Pós-Graduação em Física, 2014. https://ri.ufs.br/handle/riufs/5302.
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Coordenação de Aperfeiçoamento de Pessoal de Nível SuperiorDetriments caused by ionizing radiation are the reason of many studies in medical physics. Both in experimental and computational fields, many studies seek to limit the risks involved in the practice with ionizing radiation. Accordingly, the field of computational simulation seeks to create scenarios in the most realistic way in order to measure with the greatest precision the radiation doses deposited in organs and tissues of patients, workers and the public. In this study, we generated scenarios that simulate exams involving mobile radiography equipment in beds of clinics and hospital. Through a pair of computational phantons, these scenarios allow the calculation of effective dose values and the conversion coefficients for individuals from the public and pacient based on the physical quantity absorbed dose. One of the simulators were irradiated with the direct beam (patient) simulating examinations of thorax and abdomen, each one with two fields of irradiation. For each of these situations, the X rays spectra were varied from 60 to 80 keV. The other simulator was positioned by the side of the patient simulator (individual from the public) from different distances for the assessment of the effective dose generated by the scattered beam and the subsequent calculation of the conversion coefficients. Regarding the effective dose measured in the patient, we obtained the maximum increase between the irradiation fields of 53,1% for thorax examination with 80 kVp. For abdomen examination, we obtained a maximum increase between the fields of irradiation of 6,4% to the beam of 80 kVp. For the radiation doses in the individual from the public, coming from the scattered beam, the maximum percentage difference between the ideal field and the extrapolated field was 76,1% when the beam was positioned at 50 cm away from the patient in a abdomen exam with 60 kVp. For the pacient, the greatest risk of cancer was 43,46.10-6 mGy-1 for extrapolated field with 80 kVp for abdomen examinations. For the individuals from the public, positioned at 200 cm, the risk of cancer decreases 83,0%, when it was positioned at 50 cm. Finally, radiation doses evaluated for a typical scenario in a hospital or clinic that provides services through mobile X ray equipment allows the measurement of possible damages related to this practice, both for the patient as for the individual from the public.
Os detrimentos causados pela radiação ionizante são a razão de diversos estudos na área da física médica. Tanto na área experimental quanto no campo computacional, diversos estudos buscam limitar os riscos que envolvem a prática com radiação ionizante. Nesse sentido, a área da simulação computacional busca criar cenários da forma mais real possível para mensurar com maior precisão as doses de radiação depositadas em cada órgão e tecido dos pacientes, trabalhadores e do público. Neste trabalho foram gerados cenários que simularam exames envolvendo equipamento de radiografia móvel em leitos de clínicas e hospitais. Através de uma dupla de simuladores computacionais, estes cenários permitem calcular os valores de dose efetiva bem como os coeficientes de conversão para indivíduos do público e pacientes baseados na grandeza física dose absorvida. Um dos simuladores foi irradiado com o feixe direto (paciente) simulando exames de tórax e abdômen, cada um com dois campos de irradiação. Para cada uma destas situações os espectros do feixe foram variados de 60 a 80 keV. O outro simulador foi posicionado ao lado (indivíduo do público) em diferentes distâncias para a avaliação da dose efetiva gerada pelo feixe espalhado e posterior cálculo dos coeficientes de conversão. Em relação à dose efetiva medida no paciente, foi obtido um aumento máximo entre os campos de irradiação de 53,1% para o exame de tórax com 80 kVp. Para o exame de abdômen foi obtido um aumento máximo entre os campos de irradiação de 6,4% para o feixe de 80 kVp. Para as doses de radiação, no indivíduo do público, proveniente do feixe espalhado, a diferença percentual máxima entre o campo ideal e o campo extrapolado foi de 76,1% quando o mesmo foi posicionado a 50 cm em um exame de abdômen com 60 kVp. Para o paciente, o maior risco de câncer foi de 43,46.10-6 mGy-1. para campo extrapolado a 80 kVp para exames de abdômen. Para um indivíduo do público posicionado a 200 cm, o risco de câncer diminui 83,0% quando o mesmo estava posicionado a 50 cm. Por fim, as doses de radiação avaliadas para um cenário típico em clínica e hospitais que prestam serviço com equipamento móvel de raios X permitem mensurar os possíveis danos relacionados a esta prática, tanto para o paciente quanto para o indivíduo do público.
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Rutledge, Thomas. "Psychological response styles and cardiovascular health : confound or independent risk factor?" Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1998. http://www.collectionscanada.ca/obj/s4/f2/dsk2/tape15/PQDD_0002/NQ34622.pdf.
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Kling, Michael Patrick. "Needs Assessment for Mental Health Support Towards Emergency Medical Service (EMS) Personnel." Thesis, Regent University, 2021. http://pqdtopen.proquest.com/#viewpdf?dispub=27961789.
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Understanding and assessing the needs of Emergency Medical Service (EMS) personnel and other first responders is crucial for providing these individuals with the resources needed within their community. The literature discusses how EMS personnel are at risk for psychological impairment due to routine exposure to traumatic events and occupational stressors within EMS organizations. Additionally, the research has supported the importance of positive coping abilities, organizational belongingness, and social support within the lives of EMS personnel to enable them to resiliently handle the occupational stress of their job. This study investigated the occupational needs of EMS providers to determine if they are receiving resources within their organization to cope with occupational stressors. Participants for this study comprised (n=153) paramedics and fire-fighters from the Tidewater EMS Council organization. A needs assessment was conducted to explore correlations between quality of life, resiliency, years of service, level of education, burnout, secondary traumatic stress, interpersonal support, positive and negative religious coping, and the occupational needs of EMS personnel. The results revealed that burnout (r=4.27**) and secondary traumatic stress (r.215*) were important factors for determining occupational turnover among EMS personnel. Furthermore, EMS providers reported occupational needs such as easier access to mental health, improved staff relations, adequate staffing, and improved shift hours are needed within their organization. Future research should explore differences in occupational needs with EMS providers among EMS organizations in metropolitan and rural communities. Keywords: Emergency Medical Services (EMS), Burnout, Occupational Stress, Traumatic Critical Incidents
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Chanza, Alfred Witness Dzanja. "An assessment of the motivational value of rewards among health professionals in Malawi's Ministry of Health." Thesis, Nelson Mandela Metropolitan University, 2012. http://hdl.handle.net/10948/d1020330.
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The assessment of the motivational value of rewards in the world of work is interesting but difficult to understand. Variations in research reports and inadequate comprehension of the efficiency and motivational value of rewards have brought about confusions, controversies and contradictions among authors, researchers, consultants and practitioners in the field of Industrial and Organisational Psychology (Mangham, 2007; Muula, 2006; Muula & Maseko, 2005; Palmer, 2006; World Bank, 2004). As a consequence, organisations are applying theories and models of motivation selectively depending on their beliefs, ideological framework of values and assumptions (Dzimbiri, 2009). The study was therefore carried out as a positive contribution to the existing knowledge and debate on the motivational value of rewards for health professionals in the public health sectors of the developing countries. Through a systematic sampling method, 571 health professionals were sampled for the study. Data were collected through the use of a self-administered questionnaire which was composed based on the data collected from desk research/literature review, focus group discussions and interviews. The findings of the study revealed that the Malawi‟s Ministry of Health (MoH) is failing to attract, motivate and retain health professionals; there is perception of inequity of the rewards among the health professionals; health professionals develop coping strategies to supplement their monthly financial rewards; health professionals engage in corrupt practices to supplement their monthly financial rewards; and there is erosion of industrial democracy in the Malawi‟s Public Health Sector. While the statistical testing of the hypothesized model proved a lack of fit between the variables, the statistical testing of the re-specified model suggests that there is a positive relationship between financial rewards and reward-related problems being faced by health professionals in the Malawi‟s MoH. Through the Structural Equation Modeling (SEM) exercise, an inverse (negative) relationship between financial and non-financial rewards was deduced, and scientifically and graphically demonstrated. Both the re-specified and graphical models symbolize a pragmatic departure from the theoretical model whose authors (Franco, Bennett, Kanfer & Stubblebine, 2004) are largely inclined to the use of non-financial rewards and suggest that financial rewards should be used with caution. These findings also reject the Herzberg‟s two factor theory (Herzberg, 1960) which claims that financial rewards (salaries) are not a motivator. The major recommendations of the study are that the Franco et al.‟s (2004) model should be adopted and adapted in the Malawi‟s MoH with the view that the value of both financial and non-financial rewards (as motivators) varies from individual to individual due to individual differences and prevailing factors/forces in both the work environment and wider society in which the MoH operates; a hybrid reward system combining the strengths of time-based, performance-based and competence-based reward systems should be developed and implemented; the results of scientifically testing the re-specified model and the inverse (causal) relationship established between financial and non-financial rewards (as demonstrated in a graphic model) should be re-tested with other samples in the public health sectors of the developing countries; and the motivational value of non-financial rewards should be scientifically established and compared with the motivational value of financial rewards used independent of each other in business organisations to make an objective conclusion on the rewards-motivation debate.
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Win, Khin Than. "The application of the FMEA risk assessment technique to electronic health record systems." Access electronically, 2005. http://www.library.uow.edu.au/adt-NWU/public/adt-NWU20050822.093730/index.html.
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Roberts, Craig Brendan. "The judgement of risk in traumatised and non-traumatised emergency medical service personnel." Thesis, Stellenbosch : Stellenbosch University, 2000. http://hdl.handle.net/10019.1/51990.
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Thesis (MA) -- University of Stellenbosch, 2000.ENGLISH ABSTRACT: Judgement of risk for negative events in certain situations was investigated in a group of emergency medical service (EMS) personnel with a diagnosis of posttraumatic stress disorder (PTSD; n = 27) and a group without PTSD (n = 74). Participants completed the PTSD Symptom Scale: Self-Report version (Faa, Riggs, Dancu, & Rothbaum, 1993), an EMS work experiences questionnaire, the Beck Depression Inventory (Beck, Rush, Shaw, & Emery, 1979), and an event probability questionnaire designed to assess judgement of risk. Participants with PTSD overestimated amount of risk involved in comparison to participants without PTSD, thereby demonstrating a judgement bias for risk related events. The present study found that the judgement bias in PTSD participants extended to include not just external harm related events but also general negative events (without potential threatening/harmful consequences), negative social events, and negative workrelated events. Of the posttraumatic symptomatology assessed, avoidance symptomatology was found to be the best predictor of judgement bias. The results of the present study are discussed in terms of the cognitive clinical psychology theories of PTSD, which predict the manifestation of judgement bias in PTSD, and cognitive experimental psychology explanations of the effect of negative emotional states on judgement processes.
AFRIKAANSE OPSOMMING: Oordeeloor risiko vir negatiewe gebeurtenisse in sekere situasies is ondersoek by "n groep mediese nooddienspersoneel met "n diagnose van posttraumatiese stresversteuring (PTSV; n = 27) en "n groep sonder PTSV (n = 74). Deelnemers het die PTSD Symptom Scale: Self-Report version (Foa, Riggs, Dancu, & Rothbaum, 1993), "n mediese nooddiens werkservaringe-vraelys, die Beck Depression Inventory (Beck, Rush, Shaw, & Emery, 1979), en "n gebeurtenis-waarskynlikheidsvraelys wat opgestel is om oordeeloor risiko te meet, voltooi. Deelnemers met PTSV het die mate van risiko betrokke oorskat in vergelyking met deelnemers sonder PTSVen sodoende "n beoordelingsydigheid vir risiko-verbandhoudende situasies gedemonstreer. In die huidige studie is gevind dat beoordelingsydigheid by PTSV deelnemers nie beperk was tot eksterne skade-verbandhoudende gebeurtenisse nie, maar dat dit ook veralgemeen het na algemene negatiewe gebeurtenisse (sonder potensieel skadelike gevolge), negatiewe sosiale gebeurtenisse, en negatiewe werksverwante gebeurtenisse. Daar is gevind dat, wat PTSV-simptomatologie betref, vermyding die beste voorspeller van beoordelingsydigheid was. Die resultate van die huidige studie word bespreek in terme van kognitiewe klinies-sielkundige teorieë van PTSV, wat die aanwesigheid van beoordelingsydigheid voorspel, en kognitiewe eksperimentele-sielkunde verklarings van die effek van negatiewe emosionele toestande op beoordelingsprosesse.
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Till, Anne. "Dietary risk assessment of Discovery Health Medical Aid’s vitality members in South Afric." Thesis, Stellenbosch : Stellenbosch University, 2014. http://hdl.handle.net/10019.1/86308.
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Thesis ( Mnutr)--Stellenbosch University, 2014.ENGLISH ABSTRACT: Background: The rising prevalence of non-communicable diseases (NCD) is cause for concern. Improving dietary quality is a key health promotion strategy aimed at reducing NCD morbidity and mortality. Assessments that quantify “risky” dietary behaviours are worthwhile, and may help to identify high risk individuals, that would benefit from targeted interventions. Purpose: Discovery Vitality is a wellness incentive business associated with Discovery Health medical aid in South Africa. This study developed a Dietary Behaviour Score (DBSPHR) that measured degrees of compliance of Discovery Vitality members with the “spirit of dietary guidance”. It further categorized scores and identified members who may be at risk for developing NCDs due to poor dietary compliance. Methods: The DBSPHR included proportionally weighted components related to the consumption of fruit, vegetables, low fat dairy, whole-grain foods, lean meat, chicken and discretionary fat. The study population included adult South African members of Discovery Vitality, who had completed the programme’s on-line health risk assessment (PHR) between the 1st February 2010 and 31st January 2011. Stratified random sampling was used (n=1600). Half the sample included members who participated in Vitality’s HealthyFoodTM benefit (HFB) programme. The different Vitality Status groups were equally represented, and reflect degrees of engagement with the programme. Genders were equally represented. DBSPHR data were categorized as: Poor (Score 0-18), Inadequate (18.5-22.5), Fair (23-26), Good (26.5-29), Excellent (29.5-36). DBSPHR data was analyzed for variables: Vitality status, HFB participation, smoking, physical activity, alcohol consumption, body mass index (BMI), age and gender. The relationships between continuous response variables and nominal input variables were analysed using analysis of variance (ANOVA). When ordinal response variables were compared versus a nominal input variable, non-parametric ANOVA methods were used. Further, the Mann-Whitney test or the Kruskal-Wallis test was used. A p-value of p < 0.05 was considered to represent statistical significance, and 95% confidence intervals were used to describe the estimation of unknown parameters. Results: Of the sample, 67.13% of members had DBSPHRs that were considered “poor” or “inadequate”. The mean DBSPHR of the sample was 20.47 points. Women achieved better DBSPHRs than men (p<0.01). Greater engagement with the Vitality programme was associated with better DBSPHRs (p<0.01). There was no significant difference between the mean DBSPHR of members participating in the HFB and Non-HFB members, however the HFB was not assessed as an intervention. Members with “risky” lifestyle behaviours such as; inactivity, smoking and consuming alcohol excessively, demonstrated lower DBSPHR than members without these risks. Obese members achieved significantly lower DBSPHRs than normal weight and overweight members (p<0.01). Conclusions: It is concerning that Discovery Vitality members did not perform better than the general global standard of inadequate compliance with the “spirit of dietary guidance”. Engagement with the Vitality programme seems to positively impact on dietary compliance. Members at an increased risk for NCD morbidity and mortality due to; aging, obesity, smoking, inactivity or non-compliance with alcohol consumption guidelines, demonstrated lower DBSPHRs compared to members without these risks. Targeted interventions aimed at addressing “risky” dietary and lifestyle behaviours may benefit these members.
AFRIKAANSE OPSOMMING: Agtergrond: Die styging in voorkoms van nie-oordraagbare siektes (NOS) is rede tot kommer. Verbetering van dieetkwaliteit is ‘n sleutel gesondheidsbevordering strategie gemik daarop om NOS morbiditeit en mortaliteit te verminder. Assesserings wat “riskante” dieetgedrag kwantifiseer is waardevol en mag help om hoë risiko individue te identifiseer wat sal baatvind by geteikende intervensies. Doel: Discovery Vitality is ‘n welwees motiveringsbesigheid wat geassosieer is met Discovery Health mediese fonds in Suid-Afrika. Hierdie studie het ‘n dieet-gedragstelling (“Dietary Behaviour Score - DBSPHR”) ontwikkel wat die graad van nakoming van Discovery Vitality lede gemeet het aan die “gees van leiding oor dieet”. Dit het verder tellings gekategoriseer en lede geïdentifiseer wat ‘n verhoogde risiko vir die ontwikkeling van NOS mag hê as gevolg van swak nakoming van dieet. Metodes: Die DBSPHR het proporsioneel geweegde komponente bevat, verwant aan die inname van vrugte en groente, laevet suiwelprodukte, volgraan voedsels, maer vleis, hoender en diskresionêre vet. Die studiepopulasie het volwasse Suid-Afrikaners ingesluit wat lede van die Discovery Vitality program was en wat die program se aanlyn gesondheidsrisiko assessering tussen 1 Februarie 2010 en 31 Januarie 2011 voltooi het. Gestratifiseerde, ewekansige steekproeftrekking was gebruik (n=1600). Helfte van die steekproef het lede ingesluit wat aan Vitality se HealthyFoodTM voordeel program deelgeneem het. Die verskillende Vitality Status groepe was gelyk verteenwoordig en reflekteer verskillende grade van interaksie met die program. Geslagte was gelyk verteenwoordig. DBSPHRs data was gekategoriseer as: Swak (Telling 0-18), Onvoldoende (18.5-22.5), Matig (23-26), Goed (26.5-29), Uitstekend (29.5-36). DBSPHR data was vir die volgende veranderlikes geanaliseer: Vitality status, deelname aan die HealthyFoodTM voordeel, rook, fisiese aktiwiteit, alkohol inname, liggaamsmassa indeks (LMI), ouderdom en geslag. Die verhouding tussen aaneenlopende reaksie veranderlikes en nominale inset veranderlikes was geanaliseer deur die gebruik van analise van variansies (ANOVA). Wanneer ordinale reaksie veranderlikes vergelyk was teenoor ‘n nominale inset variansie, was nie-parametriese ANOVA metodes gebruik. Verder was die Mann-Whitney toets of die Kruskal-Wallis toets gebruik. ‘n P-waarde van p < 0.05 was gesien as verteenwoordigend van statistiese beduidendheid en 95% sekerheidsintervalle was gebruik om die skatting van onbekende parameters te beskryf.Resultate: Van die studie monster het 67.13% van die lede DBSPHRs getoon wat gereken was as “swak” of “onvoldoende”. Die gemiddelde DBSPHR van die steekfproef was 20.47 punte. Vroue het beter DBSPHR as mans behaal (p<0.01). Meer interaksie met die Vitality program was geassosieer met beter DBSPHRs (p<0.01). Daar was geen beduidende verskille tussen die gemiddelde DBSPHR van lede wat aan die HealthyFoodTM voordeel program deelneem en die lede wat nie aan die program deelneem nie, alhoewel die HealthyFoodTM voordeel nie geëvalueer was as ‘n intervensie nie. Lede met “riskante” lewenstyl gedrag soos onaktiwiteit, rook en hewige alkoholinname het laer DBSPHR getoon as lede sonder hierdie risiko’s. Vetsugtige lede het laer DBSPHR behaal as normale gewig en oorgewig lede (p<0.01). Gevolgtrekking: Dit is ‘n bron van kommer dat Discovery Vitality lede nie beter vertoon het as wat blyk ‘n algemene globale standaard van gebrekkige nakoming van die “gees van leiding oor dieet” te wees nie. Interaksie met die Vitality program blyk ‘n positiewe impak te hê op dieet nakoming. Lede wat ‘n verhoogde risiko gehad het vir NOS morbiditeit en mortaliteit as gevolg van veroudering, vetsugtigheid, rook, onaktiwiteit of verontagsaming van alkohol inname riglyne het ook laer DBSPHRs getoon in vergelyking met lede sonder hierdie risiko’s. Geteikende intervensies gemik op die aanspreek van riskante dieet en lewenstyl gedrag mag tot voordeel van hierdie lede wees.
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Stuart, Rhonda Lee 1963. "Nosocomial tuberculous infection : assessing the risk among health care workers." Monash University, Dept. of Epidemiology and Preventive Medicine, 2000. http://arrow.monash.edu.au/hdl/1959.1/9004.
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McLernon, Michelle Yvonne. "Risk Propensity, Self-Efficacy and Driving Behaviors Among Rural, Off-Duty Emergency Services Personnel." OpenSIUC, 2014. https://opensiuc.lib.siu.edu/dissertations/837.
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Emergency medical services personnel work in a fast-paced, stressful environment requiring rapid, efficient response to critical situations, creating unique safety considerations within the workforce. With an occupational fatality rate notably higher than average, most of which are attributed to vehicular crashes, compounded by risks faced on rural roadways, rural EMS personnel face unique driving challenges that may be exacerbated by the very traits, self-efficacy and risk propensity, that may have initially drawn them to the profession. The purpose of this study was to identify the extent to which rural EMS personnel engage in off-duty, risky driving behaviors and to examine the relationship between these behaviors and their levels of risk propensity as well as their self-efficacy relative to driving. A cross-sectional, quantitative study was conducted to explore the relationship between the variables. A 63-item survey was completed by 227 rural EMS personnel. The statistical model resulting from this study identifies risky-driving self-efficacy and risk propensity as significant predictors of engaging in risky driving behaviors, with self-efficacy emerging as the strongest predictor. The predictive model fit well within the Social Cognitive Theory construct of triadic reciprocity, providing a platform from which to develop mitigating strategies to foster systemic as well as behavioral changes, while tailoring interventions to highly self-efficacious, risk-taking individuals who gravitate toward risky professions, including rural EMS personnel.
Books on the topic "Medical personnel Health risk assessment"
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Hazan, Maurizio. Assicurazione obbligatoria del medico e responsabilità sanitaria. Milano: Giuffrè editore, 2013.
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Minnesota. Dept. of Health. The Commissioner of Health's report and recommendations to the Governor on HIV infection and health care workers. [Minneapolis (P.O. Box 9441, Minneapolis 55440): The Dept., 1991.
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Julia, Ostrowsky, and United States. Congress. Office of Technology Assessment., eds. HIV in the health care workplace. Washington, D.C: Congress of the U.S., Office of Technology Assessment, 1991.
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1963-, LaTourrette Tom, and National Institute for Occupational Safety and Health, eds. Protecting emergency responders, volume 2: Community views of safety and health risks and personal protection needs. Santa Monica, CA: Rand, 2003.
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1962-, Peters David H., ed. Better health systems for India's poor: Findings, analysis, and options. Washington, D.C: World Bank, 2002.
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E, McKone Thomas, and National Academy of Sciences (U.S.), eds. Strategies to protect the health of deployed U.S. forces: Detecting, characterizing, and documenting exposures. Washington, D.C: National Academy Press, 2000.
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Institute of Medicine (U.S.). Committee to Review the CDC Centers for Research and Demonstration of Health Promotion and Disease Prevention. Linking research and public health practice: A review of CDC's program of centers for research and demonstration of health promotion and disease prevention. Edited by Stoto Michael A, Green Lawrence W, and Bailey Linda A. Washington, D.C: National Academy Press, 1997.
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The Association of Schools of Public Health (ASPH). Risk Assessment for Environmental Health. New York: John Wiley & Sons, Ltd., 2007.
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I, Iezzoni Lisa, ed. Risk adjustment for measuring health care outcomes. 3rd ed. Chicago, Ill: Health Administration Press, 2003.
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I, Johannessen S., ed. Medical risks in epilepsy. Petersfield, UK: Wrightson Biomedical Pub., 2001.
Find full textBook chapters on the topic "Medical personnel Health risk assessment"
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Draper, Heather. "Risk and Infectious Disease Outbreaks: Should Military Medical Personnel Be Willing to Accept Greater Risks Than Civilian Medical Workers?" In Military and Humanitarian Health Ethics, 201–18. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-80443-5_13.
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Irony, Telba, and Martin Ho. "Benefit–Risk Determinations at the FDA Center for Devices and Radiological Health." In Benefit-Risk Assessment Methods in Medical Product Development, 53–67. Boca Raton : Taylor & Francis, 2016. | Series: Chapman & Hall/CRC biostatistics series: Chapman and Hall/CRC, 2017. http://dx.doi.org/10.1201/b20302-3.
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Alotaibi, Manal, Khaled Albazli, Lina Bissar, and Hani Almoallim. "Perioperative Management of Patients with Rheumatic Diseases." In Skills in Rheumatology, 407–17. Singapore: Springer Singapore, 2021. http://dx.doi.org/10.1007/978-981-15-8323-0_18.
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AbstractThe aim of this chapter is to present a simple approach to the assessment of patients with different rheumatologic diseases, especially rheumatoid arthritis (RA), before undergoing orthopedic surgery. Perioperative assessment confirms an early diagnosis of the patient’s medical condition and comorbidities, overall health, and the assessment of the risk factors associated with the proposed interventions. Perioperative assessment allows for proper postoperative management of complications. It can also aid in the management of high-risk drugs used by rheumatologic patients such as disease-modifying antirheumatic drugs (DMARD), antiplatelets, and corticosteroids. The assessment also supports postoperative plans and patient education [1–3].
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Trocin, Cristina, Jan Gunnar Skogås, Thomas Langø, and Gabriel Hanssen Kiss. "Operating Room of the Future (FOR) Digital Healthcare Transformation in the Age of Artificial Intelligence." In Digital Transformation in Norwegian Enterprises, 151–72. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-031-05276-7_9.
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AbstractNew technologies are emerging under the umbrella of digital transformation in healthcare such as artificial intelligence (AI) and medical analytics to provide insights beyond the abilities of human experts. Because AI is increasingly used to support doctors in decision-making, pattern recognition, and risk assessment, it will most likely transform healthcare services and the way doctors deliver those services. However, little is known about what triggers such transformation and how the European Union (EU) and Norway launch new initiatives to foster the development of such technologies. We present the case of Operating Room of the Future (FOR), a research infrastructure and an integrated university clinic which investigates most modern technologies such as artificial intelligence (AI), machine learning (ML), and deep learning (DL) to support the analysis of medical images. Practitioners can benefit from strategies related to AI development in multiple health fields to best combine medical expertise with AI-enabled computational rationality.
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Saccardi, Riccardo, and Fermin Sanchez-Guijo. "How Can Accreditation Bodies, Such as JACIE or FACT, Support Centres in Getting Qualified?" In The EBMT/EHA CAR-T Cell Handbook, 199–201. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-94353-0_38.
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AbstractThe FACT-JACIE accreditation system is based on a standard-driven process covering all the steps of HSC transplant activity, from donor selection to clinical care. Since the first approval of the First Edition of the Standards in 1998, over 360 HSCT programmes or facilities have been accredited at least once, most of them achieving subsequent re-accreditations (Snowden et al. 2017). The positive impact of the accreditation process in the EBMT Registry has been well established (Gratwohl et al. 2014). Starting with version 6.1, the standards include new items specifically developed for other cellular therapy products, with special reference to immune effector cells (IECs). This reflects the rapid evolution of the field of cellular therapy, primarily (but not exclusively) through the use of genetically modified cells, such as CAR-T cells. FACT-JACIE standards cover a wide range of important aspects that can be of use for centres that aim to be accredited in their countries to provide IEC therapy. Notably, FACT-JACIE accreditation itself is a key (or even a prerequisite) condition in some countries for approval by health authorities to provide commercial CAR-T cell therapy and is also valued by pharmaceutical companies (both those developing clinical trials and those manufacturing commercial products), which also inspect the cell therapy programmes and facilities established at each centre (Yakoub-Agha et al. 2020). Interest in applying for FACT-JACIE accreditation that includes IEC therapeutic programmes is clearly increasing, from four applications in 2017 to 36 applications approved in 2019. The standards do not cover the manufacturing of such cells but include the chain of responsibilities when the product is provided by a third party (Maus and Nikiforow 2017). In any case, all the steps in the process in which the centre is involved (e.g., patient or donor evaluations, cell collection, cell reception, and storage) are covered by the standards, including the appropriate agreements with the internal partners, including the pharmacy department. In addition, from a clinical perspective, IECs may require special safety monitoring systems due to the high frequency of acute adverse events related to the massive immunological reaction against the tumour. Although examples and explanations are found in the standard manual, here, the special importance of identifying and managing cytokine release syndrome (CRS) should be emphasized, and the standards focus not on specific therapeutic algorithms but on ensuring that medical and nursing teams are sufficiently trained in the early detection of this and other potential complications (e.g., neurological complications). They also pay attention to the full-time availability within the institution and its pharmacy of the necessary medication to address complications and the capacitation and involvement of Intensive Care and Neurology Department professionals to provide urgent care if needed. Forthcoming cellular therapy products, currently under investigation, will show a wider range of risk profiles, therefore requiring product-specific risk assessment and consequent adaptation of the clinical procedures for different classes of products. The FACT-JACIE standards will continue to adapt to these future needs to assist centres in their achievement of optimal clinical outcomes.
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Pirelli, Gianni, and Sarah DeMarco. "Forensic Mental Health Assessment and Firearm-Specific Evaluations." In Firearms and Clinical Practice, 115—C5S23. Oxford University PressNew York, 2023. http://dx.doi.org/10.1093/med-psych/9780190923211.003.0005.
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Abstract In this chapter, medical and mental health professionals are provided with an overview of forensic mental health assessment principles as well as a framework for conducting firearm-specific evaluations. The section addressing firearm-specific evaluations is divided into subsections addressing scenarios involving gun applicants; mental health expungements; and gun rights restoration matters, including forfeiture, reinstatement, “red flag,” and related scenarios. The following part of this chapter is an overview of violence and suicide risk assessment models and approaches. The last section pertains to firearm-specific assessment. Two formal, published frameworks are reviewed—Relief from Disability and Pirelli Firearm-10—followed by considerations for conducting evaluations with law enforcement, corrections, and military personnel.
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Giannakopoulou, Olympia, Petros Toumpaniaris, Ioannis Kouris, Konstantia Moirogiorgou, Nansy Karanasiou, Vasiliki Aisopou, George Matsopoulos, et al. "A Platform for Health Record Management of the Conscripts in the Hellenic Navy." In Studies in Health Technology and Informatics. IOS Press, 2021. http://dx.doi.org/10.3233/shti210181.
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eMass project aims to digitalize the medical examination procedure of recruitment phase of conscripts in the Hellenic Navy. eMass integrates recruits’ Electronic Health Record (EHR), while allows a pre-screening test, through portable telemedicine equipment. The data will be exploited to assess the individual’s cardiovascular risk through appropriate digital tools and algorithms. The eMass digital platform, will be accessible to health experts involved in the recruitment procedure for further assessment and processing. Recruits’ personal data is stored in the database encrypted using Advanced Encryption Standard (AES). eMass solution contributes to beneficial management and medical data analysis, preventing inessential physical or medical examinations minimizing danger of possible errors and reducing time-consuming processes. Moreover, eMass exploits Electronic Health Record data through a machine-learning based cardiovascular risk assessment tool.
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Hutanu, Delia, and Ioana Rugescu. "Quality Management System in Medical Assisted Reproductive Technology (MART)." In Assisted Reproductive Technologies - Current Practices and New Perspectives [Working Title]. IntechOpen, 2022. http://dx.doi.org/10.5772/intechopen.106172.
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A quality management system (QMS) refers to an organization’s broader approach to minimize deficiencies and errors, to meet regulatory compliance standards, and to satisfy a specified set of inherent characteristics during the health care services provided to patients. According to the European directives and recommendations (European Commission, 2006a, c, 2012; Council of Europe, 2013), working in compliance with a QMS is mandatory. The requirements cover the organization, management, personnel, equipment and materials, facilities/premises, documentation, records, and quality review. The IVF clinics should consider total quality management (TQM) as an option, especially in these days when escalating regulatory scrutiny increases the pressure for professional accreditation. TQM is an integrative philosophy of management for continuously improving the quality of services and processes and includes quality assurance (QA), quality control (QC), quality improvement (QI), and risk assessment and risk management. QMS must become an essential topic for those who are working in MART.
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Zarkogianni, Konstantia, and Konstantina S. Nikita. "Personal Health Systems for Diabetes Management, Early Diagnosis and Prevention." In Handbook of Research on Trends in the Diagnosis and Treatment of Chronic Conditions, 465–92. IGI Global, 2016. http://dx.doi.org/10.4018/978-1-4666-8828-5.ch022.
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This chapter aims at the presentation and comparative assessment of tools and methodologies used for the development of Personal Health Systems (PHSs) for diabetes management, early diagnosis and prevention. Medical decision support systems such as glucose prediction models, risk assessment models for long-term diabetes complications, models for early diagnosis of diabetes and closed-loop glucose controllers along with integrated systems for diabetes management are described. The outcomes of a wide range of research studies demonstrate the feasibility of providing safe, reliable and cost-effective solutions towards improving patients' quality of life through the application of PHSs. Specific limitations that prevent these systems from being fully adopted in clinical practice are highlighted, while challenges and future research directions are summarized.
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Zarkogianni, Konstantia, and Konstantina S. Nikita. "Personal Health Systems for Diabetes Management, Early Diagnosis and Prevention." In Consumer-Driven Technologies in Healthcare, 191–218. IGI Global, 2019. http://dx.doi.org/10.4018/978-1-5225-6198-9.ch012.
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This chapter aims at the presentation and comparative assessment of tools and methodologies used for the development of Personal Health Systems (PHSs) for diabetes management, early diagnosis and prevention. Medical decision support systems such as glucose prediction models, risk assessment models for long-term diabetes complications, models for early diagnosis of diabetes and closed-loop glucose controllers along with integrated systems for diabetes management are described. The outcomes of a wide range of research studies demonstrate the feasibility of providing safe, reliable and cost-effective solutions towards improving patients' quality of life through the application of PHSs. Specific limitations that prevent these systems from being fully adopted in clinical practice are highlighted, while challenges and future research directions are summarized.
Conference papers on the topic "Medical personnel Health risk assessment"
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Logunov, Konstantin Valerievich, Sergei Anatolievich Antipov, and Andrey Borisovich Karpov. "Offshore Health Innovations." In Abu Dhabi International Petroleum Exhibition & Conference. SPE, 2021. http://dx.doi.org/10.2118/207945-ms.
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Objectives/Scope Analysis of 15 years results of remote occupational health care in oil and gas production industries. Methods, Procedures, Process Continuous observation, statistical analysis of morbidity, mortality, and treatment results in industrial personnel at different endpoints depending on the variability of care models. Cost-efficacy analysis of several occupational health interventions. Targeted polls of Customers. Dynamics of new Customers. Results, Observations, Conclusions The best practices which provide the maximum efficacy include risk assessment and risk management, action planning for emergencies, telemedicine, education, registry maintenance. Each of all these gave a 10-100-fold rise in Customer satisfaction, seriously improved medical statistics. Telemedicine implies both: the delivery of highly specialized diagnostic technologies directly to the industrial production site, where a GP or paramedic is present, and it implements the direct replacement of medics with gadgets at the patient's bedside. Education involves hands-on training for both industrial personnel at remote sites and for medical professionals who provide care. The 2020-21 COVID19 pandemic was a great real stress test for remote health models when systemic integrated management procedures played a pivotal role in ensuring smooth industry operation due to the high quality of back medical services. Novel/Additive Information Modern efficient models of medical care for remote industries are necessarily comprehensive, modular, adaptive, and rely on personnel health registers. Remote health practices gain a 5-15% rise in price every year, but it pays off in greater labor productivity and in improving the health of industry personnel.
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Guillen, Alejandra, Javier Colas, and German Gutierrez. "Risk assessment and patient stratification using implantable medical devices. The funding for personal health programs." In 2011 33rd Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE, 2011. http://dx.doi.org/10.1109/iembs.2011.6090197.
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Hernowo, Widi, Rosif Ridho, and Sunarto Sunarto. "Health Management Challenges of the Pandemic - A Case Study from Recent Pipeline Repair Campaign." In Abu Dhabi International Petroleum Exhibition & Conference. SPE, 2021. http://dx.doi.org/10.2118/207324-ms.
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Abstract Avoiding an offshore COVID-19 outbreak while executing an urgent and intricate pipeline repair campaign is a significant challenge, especially in a country that is experiencing a COVID-19 positivity rate of more than 20% on daily basis. Any minor mismanagement of health management on the DSV (diving support vessel) may lead to a COVID-19 outbreak with the risk of shutting down the campaign and significantly impacting the business continuity objectives. Therefore, the major health management challenge is to avoid a COVID-19 outbreak on the DSV to ensure the well-being of personnel during campaign and to achieve the necessary pipeline repair. The approach taken was to deploy the DSV with team and tools/equipment as soon as possible to avoid a prolonged platform shutdown due to the pipeline leak event. In order to carry out the project, a detailed risk assessment taking account of medical, logistics and security considerations was undertaken in order avoid a COVID-19 outbreak on the vessel. The risk assessment enabled an adjustment to the quarantine requirements for the pipeline repair team before departure to the work location. A contingency plan was also developed to manage a scenario in which a member of the offshore team was infected with COVID-19, and in order to comply with applicable government regulation. Through the effective implementation of a detailed risk assessment, the company was able to complete the pipeline repair campaign without any offshore COVID-19 outbreaks. On the DSV there were 65 personnel working on multiple activities to execute the pipeline repair works on time and on budget. The site team made a diligent effort to follow the mitigations identified in the risk assessment, under the direction of company Business Continuity Management Team (BCMT). As a result of this effort, the company was able to resume production from the offshore platform in a timely manner. This paper discusses the effective implementation of detailed risk assessment on a DSV as part of company business continuity management amid COVID-19 pandemic in the country, including medical, logistics and security considerations. This project was implemented in a year-end period, beyond normal conditions and in a tight schedule.
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Nugraha, Tommy, Widi Hernowo, Mohammad Alfianto, and Muhammad Djabbar Yulianto. "Managing 4 (Four) Major Offshore Projects Amid COVID 19 Pandemic - A Case Study from Health & Safety (H&S) and Quarantine Management." In ADIPEC. SPE, 2022. http://dx.doi.org/10.2118/210941-ms.
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Abstract For an upstream oil and gas company, avoiding an offshore COVID-19 outbreak while executing four different offshore projects poses a huge challenge, particularly in a country experiencing a daily COVID-19 test positivity rate over 20%. Even minor mismanagement of the quarantine process can lead to an offshore COVID-19 outbreak, with the risk of shutting down campaigns and severely impacting business objectives. The challenge is therefore to avoid an offshore COVID-19 outbreak, ensuring well-being of personnel during the quarantine period and managing quarantine related costs, including COVID-19 test costs. To ensure effective quarantine management, a new approach was created that applied a combination of medical assessments, Health & Safety (H&S) and security measures. Quarantine management was led by a special task force responsible for ensuring the readiness of transportations, rooms, PCR tests, as well as overall compliance to quarantine rules. In compliance with government regulations and WHO recommendations, another complimentary approach was applied that sequestered personnel who tested positive in an isolation room. Effective quarantine management was established with the assistance of the company Business Continuity Management Team (BCMT). The company was able to complete four different major offshore projects with no offshore COVID-19 outbreaks. During these operations, over 1,000 personnel were quarantined and tested with a 5.37% positivity rate at the pre-work quarantine site. Confirmed cases were managed in full compliance with government regulations. The result of this effective quarantine management system, has allowed the company to achieve scorecard performance goals while delivering all four of the major offshore work-scopes, as per the original business plan. This paper discusses quarantine management as part of business continuity management covering medical assessment, H&S and security measures amidst a national COVID-19 pandemic. These programs were applied in an adaptive method-based risk assessment, which based on evidence base approaches, during frequently changing government regulations.
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Zaitseva, A. V., V. V. Serikov, and H. T. Oniani. "PSYCHOPHYSIOLOGICAL ASSESSMENT OF THE LABOR OF MEDICAL WORKERS IN ORGANIZATIONS WITH COVID-19." In The 16th «OCCUPATION and HEALTH» Russian National Congress with International Participation (OHRNC-2021). FSBSI “IRIOH”, 2021. http://dx.doi.org/10.31089/978-5-6042929-2-1-2021-1-212-216.
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Abstract. Introduction. High neuro-emotional stress among medical workers in organizations with the leading harmfulness of Covid-19 contributes to the formation of an unfavorable functional state, increases the risks of health disorders. The study of the characteristics of the psychophysiological reactions of the body will allow to substantiate the timing of work in a pandemic, which is quite relevant at the present time. The purpose of the research was, on the basis of comprehensive psychophysiological studies, to study the features of the formation of a functional state in medical personnel working in organizations with COVID-19 under the influence of stress factors of the labor process. Materials and methods. A physiological and hygienic assessment of the intensity of the labor process was carried out, psychophysiological changes were studied during 3 months of work in the «dangerous» zone. Statistical processing of the obtained data was carried out using the statistical programs Statistika 10, Microsoft Excel 2010. Results. The formation of neuropsychic stress in medical workers is reflected in changes in ECG indicators (prolongation of the QT interval, decrease in the voltage of the P and T waves) and systemic arterial pressure, an increase in the endurance coefficient (an indicator of detraining of the cardiovascular system), positive values of the Kerdo autonomic index (predominance of sympathetic influences) after 3 months of work in medical organizations with Covid-19. Conclusions. Nervous and emotional tension at work is the leading professional factor among nurses and doctors working in medical institutions with Covid-19 (hazard class 3, grade 3). Indicators of the cardiovascular system, reflecting the degree of adaptation of the body of medical workers to production activities, can be used to justify different periods of work in organizations with Covid-19.
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Amin Zada, Sayamak. "COVID-19 Health Management and Business Continuity." In SPE Annual Caspian Technical Conference. SPE, 2021. http://dx.doi.org/10.2118/207050-ms.
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Abstract Considering the world faces an unprecedented challenge with economies everywhere affected by the COVID-19 pandemic there was an extreme need for coming together to combat the COVID-19 pandemic bringing governments, organizations from across industries and individuals together to manage this global outbreak. From the early stages of pandemic escalation, SOCAR AQS realized that only diversified measures would minimize risks, fulfil the duty of care responsibilities and promote workforce resilience. The establishment of the COVID-19 crisis management team ensured the continuous application of a proactive risk-based approach aligned with governmental regulations on the ground of the most up to date local and international information including the industry best practices. Access to the offices for all relevant staff and visitors was minimized, and the specific procedure for work from home was developed. A combination of preventive measures at all worksites and transportation facilities is held through regular effective disinfection, health checks, continuous access to the required personal protection and hygiene facilities, maintaining social distancing, and careful tracing close contacts for all suspected cases. Health promotion to all staff is conducted through various communication means. Two-stage pre-mobilization COVID-19 screening was implemented through a comprehensive health questionnaire prior to commuting at the entrance of quarantine facilities. There was a week of individual isolation in the designated controlled quarantine facilities with optimal detectability of the virus by the fifth day followed by highly-specific PCR testing before entering operational worksites enables early revealing of an infection prior to its manifestation in the human body. Specific post-illness medical assessment is a key for individual healthy return to work is carried out. Considering vaccines as a critical new tool in the battle against COVID-19, vaccination of all offshore personnel is implemented. As an outcome, the entire process provided a prudent way to ensure the continuation of uninterrupted operations resulted in zero COVID-19 detection at the quarantine worksites by follow-up of suspected cases during first eight months of the pandemic fight in Azerbaijan. In conclusion, the abovementioned statement provides the guidelines for the workforce working on worksites or in offices, and clear expectations of the measures to be taken to ensure COVID-19 health management and smooth business continuity are maintained.
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Amin Zada, Sayamak. "COVID-19 Health Management and Business Continuity." In SPE Annual Caspian Technical Conference. SPE, 2021. http://dx.doi.org/10.2118/207050-ms.
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Abstract Considering the world faces an unprecedented challenge with economies everywhere affected by the COVID-19 pandemic there was an extreme need for coming together to combat the COVID-19 pandemic bringing governments, organizations from across industries and individuals together to manage this global outbreak. From the early stages of pandemic escalation, SOCAR AQS realized that only diversified measures would minimize risks, fulfil the duty of care responsibilities and promote workforce resilience. The establishment of the COVID-19 crisis management team ensured the continuous application of a proactive risk-based approach aligned with governmental regulations on the ground of the most up to date local and international information including the industry best practices. Access to the offices for all relevant staff and visitors was minimized, and the specific procedure for work from home was developed. A combination of preventive measures at all worksites and transportation facilities is held through regular effective disinfection, health checks, continuous access to the required personal protection and hygiene facilities, maintaining social distancing, and careful tracing close contacts for all suspected cases. Health promotion to all staff is conducted through various communication means. Two-stage pre-mobilization COVID-19 screening was implemented through a comprehensive health questionnaire prior to commuting at the entrance of quarantine facilities. There was a week of individual isolation in the designated controlled quarantine facilities with optimal detectability of the virus by the fifth day followed by highly-specific PCR testing before entering operational worksites enables early revealing of an infection prior to its manifestation in the human body. Specific post-illness medical assessment is a key for individual healthy return to work is carried out. Considering vaccines as a critical new tool in the battle against COVID-19, vaccination of all offshore personnel is implemented. As an outcome, the entire process provided a prudent way to ensure the continuation of uninterrupted operations resulted in zero COVID-19 detection at the quarantine worksites by follow-up of suspected cases during first eight months of the pandemic fight in Azerbaijan. In conclusion, the abovementioned statement provides the guidelines for the workforce working on worksites or in offices, and clear expectations of the measures to be taken to ensure COVID-19 health management and smooth business continuity are maintained.
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D’Souza, Gavin A., Suvajyoti Guha, Matthew R. Myers, and Prasanna Hariharan. "Evaluation of Aerosol Leakage Sites Through Respirators Using Image-Based Modeling." In 2017 Design of Medical Devices Conference. American Society of Mechanical Engineers, 2017. http://dx.doi.org/10.1115/dmd2017-3446.
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Personal protective equipment (PPE) such as respirators will form the first line of defense in the event of a public health emergency including an airborne pandemic or a bio-terror attack. The two major pathways by which virus-carrying aerosols can reach the human lungs through these PPEs are: a) the intrinsic penetration through porous layers of the PPE and b) the leakage through gaps between the PPE and a person’s face [1, 2]. The contribution from the second pathway can be significantly reduced using fit-testing i.e. by choosing the appropriately sized respirator for a specific face. Unfortunately, in case of an emergency, it would not be possible to fit-test the entire US population. In this scenario, excessive leakage can occur through the gaps. [1]. Hence, it is critical to identify the potential anatomical leak sites (gaps) and quantify the amount of aerosol leakage through surgical respirators for the average US population. At the behest of Office of Counterterrorism and Emerging Threats, the Center for Devices and Radiological Health, US Food and Drug Administration (FDA), has been developing a comprehensive risk assessment model for determining the risk to different populations in case of an “off-label” use of such PPEs, i.e. for public emergency scenarios for which these FDA cleared respirators were not intended to be used. In order to develop the risk assessment model, establishing a correlation between the respirator gaps and aerosol leakage between the face and the respirator is critical. A previous study [3] identified the gaps of N95 surgical respirators for a large population and quantified the aerosol leak using computational fluid dynamics. However, the gap surface area, which is a key parameter required for establishing the gap-aerosol leak correlation, has not been quantified before. In this study, gaps were identified and the gap surface areas were quantified for multiple head-respirator combinations under realistic conditions using imaging coupled with computer-aided design and modeling.
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Rebegea, Laura, Camelia Tarlungianu, Rodica Anghel, Dorel Firescu, Nadejda Corobcean, and Laurentia Gales. "BURNOUT RISK EVALUATION IN MEDICAL ONCOLOGY – RADIOTHERAPY PERSONNEL." In The European Conference of Psychiatry and Mental Health "Galatia". Archiv Euromedica, 2023. http://dx.doi.org/10.35630/2022/12/psy.ro.5.
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Europäische Wissenschaftliche Gesellschaft Home About the Journal Peer Review Editorial Board For Authors Reviewer Recognition Archiv Kontakt Impressum EWG e.V. indexing in the Clarivate Analytics indexing in the Emerging Sources Citation Index Crossref Member Badge Erfolgreich durch internationale Zusammenarbeit PUBLIC HEALTH DOI 10.35630/2022/12/psy.ro.5 Received 14 December 2022; Published 6 January 2023 BURNOUT RISK EVALUATION IN MEDICAL ONCOLOGY – RADIOTHERAPY PERSONNEL Laura Rebegea1,2 orcid id logo, Camelia Tarlungianu1 , Rodica Anghel3 orcid id logo , Dorel Firescu4,5, Nadejda Corobcean1,6, Laurentia Gales3 orcid id logo 1 Department of Medical Oncology - Radiotherapy, „Sf. Ap. Andrei” Emergency Clinical Hospital, Galati, Romania 2 Medical Clinical Department, Faculty of Medicine, „Dunarea de Jos” University of Galati, Romania 3 „Carol Davila” University of Medicine and Pharmacy”, Bucharest, Romania 4 IInd Clinic of Surgery, „Sf. Apostol Andrei” Emergency Clinical Hospital, Galati, Romania 5 Surgical Clinical Department, „Dunarea de Jos” University, Faculty of Medicine and Pharmacy, Galati, Romania 6 „Nicolae Testemitanu”State University of Medicine and Pharmacy. Chisinau, Moldova download article (pdf) laura_rebegea@yahoo.com, tarlungianucamelia@yahoo.com ABSTRACT Introduction: Even if, all studies evidenced that Burnout syndrome affects medical personnel from all medical specialties, the highest prevalence is in surgical, oncological and emergency medical specialties. Scope: Burnout syndrome evaluation in Medical Oncology and Radiotherapy personnel. Method and material: This study has involved 50 persons employee in Medical Oncology and Radiotherapy Department, from all categories: 11 superiors personal (medical doctors, physicists, psychologist), 31 nurses, and 8 auxiliary personnel (stretcher-bearer). The following questionnaires were used: professional exhaustion level questionnaire (with 25 items), questionnaire for attitude and adaptation in stressed and difficulties situations, BRIEF COPE and SES scale. Results: After professional exhaustion level questionnaire for superior personnel, emotional exhaustion prevalence, followed by reduced personal achievement and an accentuated increasing of affecting grade after first year of activity, with a pick around 10 years of activity were revealed. For nurses, share of depersonalization is relative homogenous, in moderate - low limits. The results revealed that 56% of personnel from this study have risk for burnout syndrome developing, without any prevention methods and 12% has already burnout syndrome. Conclusions: In general, this syndrome is under-evaluated and under-diagnosed, and its incidence can be diminishing by using the techniques of stress resistance, psychological counseling, cresting a friendly and tolerant professional climate.
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Granger, Alfred, Paul R. Garrett, and Gary Dalmadge. "Medical device software risk assessment requires cross functional personnel." In 2013 IEEE International Symposium on Software Reliability Engineering Workshops (ISSREW). IEEE, 2013. http://dx.doi.org/10.1109/issrew.2013.6688899.
Full textReports on the topic "Medical personnel Health risk assessment"
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Weld, Konstantine K. An Assessment of Health Literacy Rates in a Sample of Active-Duty Military Personnel at a Major Medical Center. Fort Belvoir, VA: Defense Technical Information Center, January 2008. http://dx.doi.org/10.21236/ad1013790.
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Rankin, Nicole, Deborah McGregor, Candice Donnelly, Bethany Van Dort, Richard De Abreu Lourenco, Anne Cust, and Emily Stone. Lung cancer screening using low-dose computed tomography for high risk populations: Investigating effectiveness and screening program implementation considerations: An Evidence Check rapid review brokered by the Sax Institute (www.saxinstitute.org.au) for the Cancer Institute NSW. The Sax Institute, October 2019. http://dx.doi.org/10.57022/clzt5093.
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Background Lung cancer is the number one cause of cancer death worldwide.(1) It is the fifth most commonly diagnosed cancer in Australia (12,741 cases diagnosed in 2018) and the leading cause of cancer death.(2) The number of years of potential life lost to lung cancer in Australia is estimated to be 58,450, similar to that of colorectal and breast cancer combined.(3) While tobacco control strategies are most effective for disease prevention in the general population, early detection via low dose computed tomography (LDCT) screening in high-risk populations is a viable option for detecting asymptomatic disease in current (13%) and former (24%) Australian smokers.(4) The purpose of this Evidence Check review is to identify and analyse existing and emerging evidence for LDCT lung cancer screening in high-risk individuals to guide future program and policy planning. Evidence Check questions This review aimed to address the following questions: 1. What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? 2. What is the evidence of potential harms from lung cancer screening for higher-risk individuals? 3. What are the main components of recent major lung cancer screening programs or trials? 4. What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Summary of methods The authors searched the peer-reviewed literature across three databases (MEDLINE, PsycINFO and Embase) for existing systematic reviews and original studies published between 1 January 2009 and 8 August 2019. Fifteen systematic reviews (of which 8 were contemporary) and 64 original publications met the inclusion criteria set across the four questions. Key findings Question 1: What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? There is sufficient evidence from systematic reviews and meta-analyses of combined (pooled) data from screening trials (of high-risk individuals) to indicate that LDCT examination is clinically effective in reducing lung cancer mortality. In 2011, the landmark National Lung Cancer Screening Trial (NLST, a large-scale randomised controlled trial [RCT] conducted in the US) reported a 20% (95% CI 6.8% – 26.7%; P=0.004) relative reduction in mortality among long-term heavy smokers over three rounds of annual screening. High-risk eligibility criteria was defined as people aged 55–74 years with a smoking history of ≥30 pack-years (years in which a smoker has consumed 20-plus cigarettes each day) and, for former smokers, ≥30 pack-years and have quit within the past 15 years.(5) All-cause mortality was reduced by 6.7% (95% CI, 1.2% – 13.6%; P=0.02). Initial data from the second landmark RCT, the NEderlands-Leuvens Longkanker Screenings ONderzoek (known as the NELSON trial), have found an even greater reduction of 26% (95% CI, 9% – 41%) in lung cancer mortality, with full trial results yet to be published.(6, 7) Pooled analyses, including several smaller-scale European LDCT screening trials insufficiently powered in their own right, collectively demonstrate a statistically significant reduction in lung cancer mortality (RR 0.82, 95% CI 0.73–0.91).(8) Despite the reduction in all-cause mortality found in the NLST, pooled analyses of seven trials found no statistically significant difference in all-cause mortality (RR 0.95, 95% CI 0.90–1.00).(8) However, cancer-specific mortality is currently the most relevant outcome in cancer screening trials. These seven trials demonstrated a significantly greater proportion of early stage cancers in LDCT groups compared with controls (RR 2.08, 95% CI 1.43–3.03). Thus, when considering results across mortality outcomes and early stage cancers diagnosed, LDCT screening is considered to be clinically effective. Question 2: What is the evidence of potential harms from lung cancer screening for higher-risk individuals? The harms of LDCT lung cancer screening include false positive tests and the consequences of unnecessary invasive follow-up procedures for conditions that are eventually diagnosed as benign. While LDCT screening leads to an increased frequency of invasive procedures, it does not result in greater mortality soon after an invasive procedure (in trial settings when compared with the control arm).(8) Overdiagnosis, exposure to radiation, psychological distress and an impact on quality of life are other known harms. Systematic review evidence indicates the benefits of LDCT screening are likely to outweigh the harms. The potential harms are likely to be reduced as refinements are made to LDCT screening protocols through: i) the application of risk predication models (e.g. the PLCOm2012), which enable a more accurate selection of the high-risk population through the use of specific criteria (beyond age and smoking history); ii) the use of nodule management algorithms (e.g. Lung-RADS, PanCan), which assist in the diagnostic evaluation of screen-detected nodules and cancers (e.g. more precise volumetric assessment of nodules); and, iii) more judicious selection of patients for invasive procedures. Recent evidence suggests a positive LDCT result may transiently increase psychological distress but does not have long-term adverse effects on psychological distress or health-related quality of life (HRQoL). With regards to smoking cessation, there is no evidence to suggest screening participation invokes a false sense of assurance in smokers, nor a reduction in motivation to quit. The NELSON and Danish trials found no difference in smoking cessation rates between LDCT screening and control groups. Higher net cessation rates, compared with general population, suggest those who participate in screening trials may already be motivated to quit. Question 3: What are the main components of recent major lung cancer screening programs or trials? There are no systematic reviews that capture the main components of recent major lung cancer screening trials and programs. We extracted evidence from original studies and clinical guidance documents and organised this into key groups to form a concise set of components for potential implementation of a national lung cancer screening program in Australia: 1. Identifying the high-risk population: recruitment, eligibility, selection and referral 2. Educating the public, people at high risk and healthcare providers; this includes creating awareness of lung cancer, the benefits and harms of LDCT screening, and shared decision-making 3. Components necessary for health services to deliver a screening program: a. Planning phase: e.g. human resources to coordinate the program, electronic data systems that integrate medical records information and link to an established national registry b. Implementation phase: e.g. human and technological resources required to conduct LDCT examinations, interpretation of reports and communication of results to participants c. Monitoring and evaluation phase: e.g. monitoring outcomes across patients, radiological reporting, compliance with established standards and a quality assurance program 4. Data reporting and research, e.g. audit and feedback to multidisciplinary teams, reporting outcomes to enhance international research into LDCT screening 5. Incorporation of smoking cessation interventions, e.g. specific programs designed for LDCT screening or referral to existing community or hospital-based services that deliver cessation interventions. Most original studies are single-institution evaluations that contain descriptive data about the processes required to establish and implement a high-risk population-based screening program. Across all studies there is a consistent message as to the challenges and complexities of establishing LDCT screening programs to attract people at high risk who will receive the greatest benefits from participation. With regards to smoking cessation, evidence from one systematic review indicates the optimal strategy for incorporating smoking cessation interventions into a LDCT screening program is unclear. There is widespread agreement that LDCT screening attendance presents a ‘teachable moment’ for cessation advice, especially among those people who receive a positive scan result. Smoking cessation is an area of significant research investment; for instance, eight US-based clinical trials are now underway that aim to address how best to design and deliver cessation programs within large-scale LDCT screening programs.(9) Question 4: What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Assessing the value or cost-effectiveness of LDCT screening involves a complex interplay of factors including data on effectiveness and costs, and institutional context. A key input is data about the effectiveness of potential and current screening programs with respect to case detection, and the likely outcomes of treating those cases sooner (in the presence of LDCT screening) as opposed to later (in the absence of LDCT screening). Evidence about the cost-effectiveness of LDCT screening programs has been summarised in two systematic reviews. We identified a further 13 studies—five modelling studies, one discrete choice experiment and seven articles—that used a variety of methods to assess cost-effectiveness. Three modelling studies indicated LDCT screening was cost-effective in the settings of the US and Europe. Two studies—one from Australia and one from New Zealand—reported LDCT screening would not be cost-effective using NLST-like protocols. We anticipate that, following the full publication of the NELSON trial, cost-effectiveness studies will likely be updated with new data that reduce uncertainty about factors that influence modelling outcomes, including the findings of indeterminate nodules. Gaps in the evidence There is a large and accessible body of evidence as to the effectiveness (Q1) and harms (Q2) of LDCT screening for lung cancer. Nevertheless, there are significant gaps in the evidence about the program components that are required to implement an effective LDCT screening program (Q3). Questions about LDCT screening acceptability and feasibility were not explicitly included in the scope. However, as the evidence is based primarily on US programs and UK pilot studies, the relevance to the local setting requires careful consideration. The Queensland Lung Cancer Screening Study provides feasibility data about clinical aspects of LDCT screening but little about program design. The International Lung Screening Trial is still in the recruitment phase and findings are not yet available for inclusion in this Evidence Check. The Australian Population Based Screening Framework was developed to “inform decision-makers on the key issues to be considered when assessing potential screening programs in Australia”.(10) As the Framework is specific to population-based, rather than high-risk, screening programs, there is a lack of clarity about transferability of criteria. However, the Framework criteria do stipulate that a screening program must be acceptable to “important subgroups such as target participants who are from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islander people, people from disadvantaged groups and people with a disability”.(10) An extensive search of the literature highlighted that there is very little information about the acceptability of LDCT screening to these population groups in Australia. Yet they are part of the high-risk population.(10) There are also considerable gaps in the evidence about the cost-effectiveness of LDCT screening in different settings, including Australia. The evidence base in this area is rapidly evolving and is likely to include new data from the NELSON trial and incorporate data about the costs of targeted- and immuno-therapies as these treatments become more widely available in Australia.
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Smit, Amelia, Kate Dunlop, Nehal Singh, Diona Damian, Kylie Vuong, and Anne Cust. Primary prevention of skin cancer in primary care settings. The Sax Institute, August 2022. http://dx.doi.org/10.57022/qpsm1481.
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Overview Skin cancer prevention is a component of the new Cancer Plan 2022–27, which guides the work of the Cancer Institute NSW. To lessen the impact of skin cancer on the community, the Cancer Institute NSW works closely with the NSW Skin Cancer Prevention Advisory Committee, comprising governmental and non-governmental organisation representatives, to develop and implement the NSW Skin Cancer Prevention Strategy. Primary Health Networks and primary care providers are seen as important stakeholders in this work. To guide improvements in skin cancer prevention and inform the development of the next NSW Skin Cancer Prevention Strategy, an up-to-date review of the evidence on the effectiveness and feasibility of skin cancer prevention activities in primary care is required. A research team led by the Daffodil Centre, a joint venture between the University of Sydney and Cancer Council NSW, was contracted to undertake an Evidence Check review to address the questions below. Evidence Check questions This Evidence Check aimed to address the following questions: Question 1: What skin cancer primary prevention activities can be effectively administered in primary care settings? As part of this, identify the key components of such messages, strategies, programs or initiatives that have been effectively implemented and their feasibility in the NSW/Australian context. Question 2: What are the main barriers and enablers for primary care providers in delivering skin cancer primary prevention activities within their setting? Summary of methods The research team conducted a detailed analysis of the published and grey literature, based on a comprehensive search. We developed the search strategy in consultation with a medical librarian at the University of Sydney and the Cancer Institute NSW team, and implemented it across the databases Embase, MEDLINE, PsycInfo, Scopus, Cochrane Central and CINAHL. Results were exported and uploaded to Covidence for screening and further selection. The search strategy was designed according to the SPIDER tool for Qualitative and Mixed-Methods Evidence Synthesis, which is a systematic strategy for searching qualitative and mixed-methods research studies. The SPIDER tool facilitates rigour in research by defining key elements of non-quantitative research questions. We included peer-reviewed and grey literature that included skin cancer primary prevention strategies/ interventions/ techniques/ programs within primary care settings, e.g. involving general practitioners and primary care nurses. The literature was limited to publications since 2014, and for studies or programs conducted in Australia, the UK, New Zealand, Canada, Ireland, Western Europe and Scandinavia. We also included relevant systematic reviews and evidence syntheses based on a range of international evidence where also relevant to the Australian context. To address Question 1, about the effectiveness of skin cancer prevention activities in primary care settings, we summarised findings from the Evidence Check according to different skin cancer prevention activities. To address Question 2, about the barriers and enablers of skin cancer prevention activities in primary care settings, we summarised findings according to the Consolidated Framework for Implementation Research (CFIR). The CFIR is a framework for identifying important implementation considerations for novel interventions in healthcare settings and provides a practical guide for systematically assessing potential barriers and facilitators in preparation for implementing a new activity or program. We assessed study quality using the National Health and Medical Research Council (NHMRC) levels of evidence. Key findings We identified 25 peer-reviewed journal articles that met the eligibility criteria and we included these in the Evidence Check. Eight of the studies were conducted in Australia, six in the UK, and the others elsewhere (mainly other European countries). In addition, the grey literature search identified four relevant guidelines, 12 education/training resources, two Cancer Care pathways, two position statements, three reports and five other resources that we included in the Evidence Check. Question 1 (related to effectiveness) We categorised the studies into different types of skin cancer prevention activities: behavioural counselling (n=3); risk assessment and delivering risk-tailored information (n=10); new technologies for early detection and accompanying prevention advice (n=4); and education and training programs for general practitioners (GPs) and primary care nurses regarding skin cancer prevention (n=3). There was good evidence that behavioural counselling interventions can result in a small improvement in sun protection behaviours among adults with fair skin types (defined as ivory or pale skin, light hair and eye colour, freckles, or those who sunburn easily), which would include the majority of Australians. It was found that clinicians play an important role in counselling patients about sun-protective behaviours, and recommended tailoring messages to the age and demographics of target groups (e.g. high-risk groups) to have maximal influence on behaviours. Several web-based melanoma risk prediction tools are now available in Australia, mainly designed for health professionals to identify patients’ risk of a new or subsequent primary melanoma and guide discussions with patients about primary prevention and early detection. Intervention studies have demonstrated that use of these melanoma risk prediction tools is feasible and acceptable to participants in primary care settings, and there is some evidence, including from Australian studies, that using these risk prediction tools to tailor primary prevention and early detection messages can improve sun-related behaviours. Some studies examined novel technologies, such as apps, to support early detection through skin examinations, including a very limited focus on the provision of preventive advice. These novel technologies are still largely in the research domain rather than recommended for routine use but provide a potential future opportunity to incorporate more primary prevention tailored advice. There are a number of online short courses available for primary healthcare professionals specifically focusing on skin cancer prevention. Most education and training programs for GPs and primary care nurses in the field of skin cancer focus on treatment and early detection, though some programs have specifically incorporated primary prevention education and training. A notable example is the Dermoscopy for Victorian General Practice Program, in which 93% of participating GPs reported that they had increased preventive information provided to high-risk patients and during skin examinations. Question 2 (related to barriers and enablers) Key enablers of performing skin cancer prevention activities in primary care settings included: • Easy access and availability of guidelines and point-of-care tools and resources • A fit with existing workflows and systems, so there is minimal disruption to flow of care • Easy-to-understand patient information • Using the waiting room for collection of risk assessment information on an electronic device such as an iPad/tablet where possible • Pairing with early detection activities • Sharing of successful programs across jurisdictions. Key barriers to performing skin cancer prevention activities in primary care settings included: • Unclear requirements and lack of confidence (self-efficacy) about prevention counselling • Limited availability of GP services especially in regional and remote areas • Competing demands, low priority, lack of time • Lack of incentives.
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Center for Plant Health Science and Technology Accomplishments, 2007. U.S. Department of Agriculture, Animal and Plant Health Inspection Service, December 2008. http://dx.doi.org/10.32747/2008.7296841.aphis.
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This past year’s hard work and significant changes have enabled CPHST—a division of the U.S. Department of Agriculture (USDA), APHIS Plant Protection and Quarantine (PPQ) program—to be an organization more capable and better aligned to support and focus on PPQ’s scientific needs. In 2007, CPHST developed the first PPQ strategic plan for CPHST. The plan shows where CPHST is going over the next 5 years, how it is going to get there, and how it will know if it got there or not. Moreover, CPHST plan identifies critical elements of PPQ’s overall strategic plan that must be supported by the science and technology services CPHST provides. The strategic plan was followed by an operational plan, which guarantees that the strategic plan is a living and breathing document. The operational plan identifies the responsibilities and resources needed to accomplish priorities in this fiscal year and measures our progress. CPHST identifies the pathways by which invasive plant pests and weeds can be introduced into the United States. CPHST develops, adapts, and supports technology to detect, identify, and mitigate the impact of invasive organisms. CPHST helps to ensure that the methods, protocols, and equipment used by PPQ field personnel are effective and efficient. All the work of CPHST is identified under one of the five program areas: Agricultural Quarantine Inspection and Port Technology, Molecular Diagnostics and Biotechnology, Response and Recovery Systems Technology, Risk and Pathway Analysis, and Survey Detection and Identification. CPHST scientists are leaders in various fields, including risk assessment, survey and detection, geographic information systems (GIS), molecular diagnostics, biocontrol techniques, methods and treatment, and mass rearing of insects. The following list outlines some of CPHST’s efforts in 2007: Responding to Emergencies, Developing and Supporting Technology for Treatments, Increasing Diagnostic Capacity, and Supporting Trade.
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Estimating the cost and effectiveness of different STI management strategies for sex workers in Madagascar. Population Council, 2002. http://dx.doi.org/10.31899/hiv2002.1002.
Full textAbstract:
In Madagascar, the prevalence of sexually transmitted infections (STIs) is a serious public health problem, particularly among sex workers. A Horizons study conducted in 2000 found approximately two-thirds of female sex workers had an STI, although few were infected with HIV. Since the link between STIs and transmission of HIV has been well established, affordable strategies to manage STIs among sex workers need to be developed. Study investigators also assessed STI management practices in health facilities in two urban areas of Madagascar. Health practitioners were using a syndromic approach, which may be appropriate for managing certain STIs in the general population but is less appropriate for sex workers who may have multiple, often asymptomatic infections. Diagnosing STIs with laboratory tests would make medical visits prohibitively expensive. Researchers developed a risk profile for various STIs based on characteristics of women that present with each STI, such as age, number of partners, symptoms. The investigators hypothesized that a risk assessment tool using these profiles would result in more appropriate and effective STI treatment for sex workers. This summary presents a cost-effectiveness analysis of different strategies to manage STIs among sex workers in Madagascar.