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Results for “Genetic workforce”

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At least 181 records · Page 10Linked to original sources
PubMed1993

[Preventive health examinations of pregnant women in Denmark. Anamnestic practice and discussion of prenatal diagnosis in early pregnancy examinations in general practice, birth clinics and birthing centers].

In Denmark, pregnant women are offered antenatal care in a nationwide programme. This programme is organized around health examinations in general practice, hospital outpatient departments and at midwives' centres. During winter 1986-1987, a nationwide investigation of antenatal care was carried out. A random sample of approximately 1/3 of the general practitioners, all of the midwives who had antenatal consultations and the medical staffs of 26 departments of obstetrics and gynaecology received a questionnaire about content of a definite antenatal examination. 62% of the general practitioners, 63% of the doctors at the place of delivery and 86% of the midwives replied. Among the pregnant women, 92% replied from general practice, 84% from hospital outpatient departments and 91% from midwives' centres. The interviews about date of delivery and genetic counselling at early visits in general practice, hospital outpatient departments and at midwives' centres were in agreement with the nationwide guidelines. Employment of routine ultrasound scanning was not associated with less detailed history taking by the doctors at hospital outpatient departments, where ultrasound scanning was employed only on special indications. It was concluded that there was a considerable overlap between the interview about the date of delivery and genetic counselling at early visits in general practice and in hospital outpatient departments and, to some extent, at the midwives' centres. The sharing of responsibility for care of pregnant women by three professional groups requires specification of the content of the consultation. Official guidelines should be more specific about this point.

Birthing Centers↗
PubMed2003

Risks associated with ionizing radiation.

This paper reviews current knowledge on the deterministic and stochastic risks (the latter including the risk of cancer and of hereditary disease) associated with exposure to ionizing radiation. Particular attention is paid to cancer risks following exposure to man-made low linear energy transfer radiation. Excess cancer risks have been observed in the Japanese atomic bomb survivors and in many medically and occupationally exposed groups. In general, the relative risks among Japanese survivors of atomic-bomb explosions are greater than those among comparable subsets in studies of medically exposed individuals. Cell sterilization largely accounts for the discrepancy in relative risks between these two populations, although other factors may contribute, such as the generally higher underlying cancer risks in the medical series than in the Japanese atomic bomb survivors. Risks among occupationally exposed groups such as nuclear workforces and underground miners are generally consistent with those observed in the Japanese atomic bomb survivors.

Adolescent↗
PubMed1985

Outline for a comprehensive classification of retinal dystrophy and its consequences.

Classification of all relevant factors is a prerequisite to the formulation of specific objectives to attain goals of prevention of retinal dystrophy (RD) and effective provision of services. National and international agreement on a classification is sought. This outline stresses the importance of a sound conceptual basis. The root meaning of dystrophy (difficult nourishment), and the concepts given in the World Organization's International Classification of Impairments, Disabilities and Handicaps are emphasized. The proposed classification is designed to be statistical as well as assisting diagnosis and case management. The scheme for RD entities takes into account special features, in contrast to most treatable eye diseases. Genetics is stressed because of the importance of genetic counseling and rapid research advances. Three appendices illustrate portions of a comprehensive classification already in operation at the Retinal Dystrophy Service of NSW.

Disability Evaluation↗
PubMed2000

Stroke therapy clinical guideline. South African Medical Association-- Neurological Association of South Africa Stroke Working Group.

OBJECTIVE: To describe the prevention, management and rehabilitation of stroke in South Africa as provided by a range of caregivers. OPTIONS: Emphasis should predominantly be on finding the cause, preventing, and treating stroke in the transient and mild stroke group. Moderate stroke patients require maximal rehabilitation and secondary prevention. Severe disabling stroke patients require home and community care. OUTCOMES: The most effective use of resources (personnel and facilities) in relation to the different types of stroke. These should be used to decrease stroke incidence, increase stroke awareness, improve acute stroke therapy, and improve access to rehabilitation. EVIDENCE: Based on international reports and research. Meta-analyses were used when the topic warranted such specific literature review. Stroke consensus has been achieved internationally and widely reported. A wide range of South African reviewers from various health fields, including representatives of local and national health groups, were consulted. Evidence-based documents were considered and incorporated. VALUES: As far as possible, cultural and economic preferences were given major emphasis. The aim of the guideline is to optimise stroke care from the point of view of individual patients, health practitioners, reimbursing agencies and society as a whole. Where possible, best-practice stroke care of international standard has been used in this document. However, at no stage has the Working Group deviated from the unique set of South African stroke problems, namely differing risk and preventive factors, multi-cultural, genetic and traditional practices and the problems of cost saving from best-practice funding for stroke care. BENEFITS, HARMS, COSTS: It is difficult to assess the local situation without prospective research. However, stroke causes the following in South Africa: between 8% and 10% of all reported deaths 7.5% of deaths in the workforce (25-64 years of age) age-standardised mortality rate of 125-175/100,000. More can be done to improve the cost-effectiveness of available resources by increasing education of health care professionals and patients. RECOMMENDATIONS: Assess and treat all cerebral vascular events within 6 hours if possible; categorize the stoke into mild, moderate or severe; transient ischaemic attack (TIA), minor or reversible stroke should be intensively investigated to find the cause and this should be treated vigorously; all risk factors should be treated; moderate strokes require active rehabilitation; secondary prevention is required to prevent another stroke; when vegetative symptoms persist after 7 days, therapy should be supportive. VALIDATION: This guideline is similar to others produced in other countries but with reference to South Africa, and has been developed in collaboration with the Neurological Association of South Africa. The initial document was developed in 1997 with a multidisciplinary group with special interest in the management of stroke. In July 1998 a nationally representative stroke consensus meeting was held and the document was widely scrutinised. The guideline is endorsed by the South African Medical Association.

Algorithms↗
PubMed1991

Autopsy rates in medical schools and hospitals in Japan.

The autopsy rates in Japanese medical schools and hospitals were reviewed. Although moderate autopsy levels have been maintained in medical schools (50%) and large training hospitals (30%), a slight tendency towards a decrease was demonstrated recently. Since autopsy is important in education, research and the quality control of medicine, it is essential to keep the autopsy rate high. Our analyses indicate that autopsy gives satisfaction to clinicians if clinical data are correlated in detail with pathological findings. Thus, efforts should be directed to strengthening the training of pathologists in the analysis of clinical data, which are essential for correct pathological diagnoses. In order to cope with the rapid progress in all fields of medicine, pathologists must collaborate with clinical staff to obtain all the information necessary for interpretation of autopsy data. This action also helps to keep the autopsy rate high. No international guidelines are available on autopsy. Autopsies are carried out for different purposes at different levels. An internationally agreed set of rules would allow efficient use of autopsy data for epidemiological studies. Genetic analysis of autopsy material is now feasible, and this may be useful in tracing etiological factors, such as infections and genetic predisposition. Various aspects of autopsy must be reconsidered in the light of modern science.

Autopsy↗
PubMedDate not supplied

Diagnosis of inborn errors of metabolism.

Systematic detection of inborn errors of metabolism (IEM) has usually encountered difficulties in developing countries. We present our experience in a high-risk population in Mexico between 1973 and 1998 with particular reference to the last 10 years, during which time infrastructure and support were considerably improved. Only disorders of intermediary metabolism were sought. The total number of patients studied is not available, but in the last 10 years, patients numbered 5,186. Routine metabolic screening was performed on all patients, with additional tests according to the clinical picture and screening results. The referral criteria have increasingly diversified, one-third being neurological conditions. Of the referrals, 33.8% were from pediatricians (31.1% of whom were at critical medicine departments) and the remainder from specialists. The number of diagnosed patients has increased to 1 per 43.9 patients studied. Amino acid defects have been the most prevalent, the proportion of organic acid and carbohydrate disorders having increased in the last 10 years, associated with improved diagnostic facilities. The most frequently diagnosed diseases were PKU, type 1a glycogen storage, and maple syrup urine disease (MSUD), their frequency apparently varying among different regions of Mexico. Other results of our program include training of specialists and technicians, development of the Latin American Metabolic Information Network, a procedure to locally prepare a special food product low in phenylalanine for the treatment of PKU patients, and extension of approaches for these disorders to the investigation metabolic derangements of infant malnutrition. This work demonstrates that inherited metabolic diseases constitute a significant load in pediatric pathology and that their study can and should be pursued in developing nations.

Allied Health Personnel↗
PubMed1992

Genetics in the reformed health service. Changes for the better?

The practical value of medical genetics, in particular the development of molecular genetics complemented by clinical diagnosis and counselling, is widely recognised. There is strong independent support from government and patient organisations for augmenting genetics services in all health regions; this support gives much reason for optimism. But there appears to be a hiatus following the reform of the Health Service: no genetics centre has, as yet, adequate resources and there has been no increase in clinical genetic manpower in the last two years. Even worse, Wales and at least one English region have devolved genetic services to districts, which appears to be contrary to government policy for genetic services. These factors have inevitably limited the implementation of many opportunities for improved patient care and the prevention of genetic disease. However, medical geneticists, assisted by the Royal College of Physicians and others, want to respond positively to the changes in the Health Service. Recommendations are made for strategies which promise to maintain integrated regional clinical and laboratory services and to achieve well evaluated developments.

Career Mobility↗
PubMed2001

Genetic algorithm for scheduling of laboratory personnel.

BACKGROUND: Staffing core laboratories with appropriate skilled workers requires a process to schedule these individuals so that all workstations are appropriately filled and all the skills of each worker are exercised periodically to maintain competence. METHODS: We applied a genetic algorithm to scheduling laboratory personnel. Our program, developed in Visual Basic 4.0, maximizes the value of a fitness function that measures how well a given scheduling of individuals and their skills matches a set of work tasks for a given work shift. The user provides in an Excel spreadsheet the work tasks, individuals available to work on any given date, and skills each individual possesses. The user also specifies the work shift to be scheduled, the range of dates to be scheduled, the number of days that an individual stays on a given workstation before rotating, and various parameters for the genetic algorithm if they differ from the default values. RESULTS: For >22 months, the program matched individuals to those tasks for which they were qualified and maintained personnel skills by rotating job duties. The schedules generated by the program allowed supervisory personnel to anticipate dates far in advance of when worker availability would be limited, so staffing could be adjusted. In addition, the program helped to identify skills for which too few individuals had been trained. This program has been well accepted by the staff in the clinical laboratories of a 670-bed university medical center, saving 37 h of labor per month, or approximately $11,000 per year, in time that supervisory personnel have spent developing work schedules. CONCLUSIONS: The genetic algorithm approach appears to be useful for scheduling in highly technical work environments that employ multiskilled workers.

Algorithms↗