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At least 487 records · Page 27Linked to original sources
PubMed2003

Superiority of minipool nucleic acid amplification technology for hepatitis B virus over chemiluminescence immunoassay for hepatitis B surface antigen screening.

BACKGROUND AND OBJECTIVES: The Japanese Red Cross (JRC) have developed a fully automated multiplex (MPX) nucleic acid amplification technology (NAT) system for hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus 1 (HIV-1). This is used to test serologically negative blood units from volunteer, non-remunerated donors. The system utilizes a 50-sample pool for NAT screening with an input volume of each pool. This results in a significantly higher sensitivity for hepatitis B than that seen with highly sensitive hepatitis B surface antigen (HBsAg) testing. MATERIALS AND METHODS: From 1 February 2000 to 15 October 2001, over 11 million donations, which were serologically negative, were tested using the MPX NAT system. Donations found to be HBV DNA positive were further tested by using the chemiluminescence immunoassay (CLIA). RESULTS: Out of 181 HBV DNA-positive donations, 96 (53%) and 76 (42%) were negative by individual enzyme immunoassay (EIA) and CLIA testing, respectively. CONCLUSIONS: The sensitivity of the 50-sample pool MPX NAT system was higher than that of individual HBsAg screening by CLIA. By adopting this NAT-screening system, the JRC has improved the safety of the blood supply and maintained supply across Japan.

Blood Donors↗
PubMed2003

Hemodialysis: management problems in developing countries, with Nigeria as a surrogate.

The incidence of end-stage renal failure is increasing worldwide at an annual growth rate of 8%. Data for much of the developing world are often unavailable, but given the prevalence of poor socioeconomic factors, the incidence is likely to be greater. In Sub-Saharan Africa, economic and manpower factors dictate a conservative approach to therapy in most instances. The majority of those with end-stage renal disease (ESRD) perish because of the lack of funds, as very few can afford regular maintenance dialysis and renal transplantation is often not available. Hemodialysis (HD) remains the most common modality of management, with a very few units offering peritoneal dialysis (PD). Limitations to regular maintenance HD include the paucity of dialysis units, restriction of those units to urban centers, and the absence of government funding or subsidy and health insurance to cover the relatively high costs of dialysis. The few available units are bedeviled with multiple problems: old machines frequently break down, absence of adequate maintenance technical support and spare parts, and frequent power outages. Staff motivation and remuneration are equally poor with consequent disruption of services due to industrial action and emigration of trained staff to the Middle East and Western world. Present avenues for improvements include: focusing on prevention to stem the high prevalence of ESRD, greater government involvement to better fund units and thus enhance the quality of services rendered, and the wider availability of transplantation.

Developing Countries↗
PubMedDate not supplied

A Dutch blood bank and its donors.

Through the aid of a questionnaire, a group of prospective donors, donors and ex-donors was studied. The most important incentive to become a donor was the direct approach by another donor. The most important motives were altruistic in nature and the medical check-up which is a part of donation. The complaints and objections of donors related to the medical check-up, the distance traveled to the site of the medical examination and blood collection and the rather impersonal way donors were treated. The most important reasons why ex-donors had stopped giving blood referred to medical complaints, practical inconveniences, physical reactions to the giving of blood, the impersonal approach and the fear of detrimental side-effects of the giving of blood. The Dutch system, whereby no financial remuneration is offered for the donation of blood, appears to function satisfactorily. The survey justifies future research aimed to a greater degree on the connection between the motives of the donor and the way the blood bank functions.

Blood Banks↗
PubMed1999

Factors influencing recruitment and retention of academic staff in South-East Asia.

South-East Asia has a number of developing and developed countries. The economic standings of these countries are different and influence the number of staff in each academic department. The quantum of clinical work they are expected to perform and the remuneration vary enormously. The retirement age, facilities for research and criteria for promotion are different. The health care delivery system, the financial status and outlook of the universities also differ. These factors operate differently in the South-East Asian countries and determine the recruitment and retention of academic staff.

Asia, Southeastern↗
PubMed1999

Profile and recruitment in Australasia.

There are 12 medical schools in Australia and New Zealand producing a total of 1600 graduates per year. Academic recruitment is poor as a result of lack of career paths, poor financial remuneration, problems with lack of research funding and the small size of departments. Increased demands from the clinical service and lack of 'start-up' research funds act as a deterrent to recruitment of junior academics. Clinical academics need to convince governments that, without strong and continuing academic leadership, there will be a deterioration in patient care, teaching and research in obstetrics and gynaecology.

Australia↗
PubMed2001

The extent and nature of emergency nurse practitioner services in Scotland.

Emergency Nurse Practitioners (ENPs) are being used in an increasing proportion of A&E departments across England and Wales. This paper reports the findings of a postal survey sent to all (94) A&E departments in Scotland including the smaller GP run units. The aim of the study was to document the extent and nature of ENP services in Scotland. Nurses were found to be practising as ENPs in 47% of Scottish A&E departments. The majority (70%) of nurses practising as ENPs had been educated for the role on courses for ENPs. Nurses working as ENPs were being paid at all grades ranging from the lowest grade for a staff nurse (D-grade) through to H-grade. ENPs are practising in all types of A&E department. Most ENPs have been formally trained for the role, however huge variation exists in educational preparation and in remuneration for this expanded nursing role.

Emergency Nursing↗
PubMed2002

Benefits and barriers for registered nurses undertaking post-graduate diplomas in paediatric nursing.

This paper presents one aspect of a larger study identifying key influences on curriculum redesign and development of a post-graduate diploma in advanced clinical nursing. The focus is on paediatric intensive care and general paediatric streams. Data presented here relate to registered nurses' perceptions of benefits and barriers when undertaking this post-graduate diploma. As well as interviews and focus group discussions with a number of nurses, data were collected through a self-administered questionnaire, A total of 885 surveys were distributed to nurses working in paediatric areas in five hospitals in Victoria, Australia. Of these, 391 were completed (response rate 44%). One hundred and thirty (33%) had post-registration or post-graduate paediatric qualifications. Perceived benefits of undertaking the post-graduate diploma mainly related to an increase in knowledge and experience and improvement of employment opportunities. Perceived barriers mainly related to financial and professional issues such as cost of the course, loss of salary, the lack of direct remuneration on completion of the course and a lack of promotional opportunities. It was of concern that several nurses expressed a belief that paediatric qualifications were unnecessary and that many believed their employers did not value the qualification. Several recommendations are suggested to address the main barriers. These include more flexibility in the provision of such courses and opportunities for financial assistance.

Attitude of Health Personnel↗
PubMed2006

[Quality Assurance in Rehabilitation under the German Pension Insurance Scheme].

Ten years after its introduction, the German Pension Insurance's quality assurance programme is firmly established within the rehabilitation system. Regular, substantive reporting to rehabilitation centres and pension insurance organisations has contributed to improving the quality of rehabilitation. Legal codification of quality assurance stipulations has existed since 2001. The programme is in constant development, e. g. by optimization of patient interviewing and inclusion of evidence-based clinical practice guidelines. New programmes, e. g. in inpatient rehabilitation of children and youths or in outpatient rehabilitation, are being developed together with the German health care organizations. In the field of vocational rehabilitation quality assurance had started out with a conceptual study followed by projects concerning client interviewing, evaluation of documentation instruments, and analyses relative to the most important outcome factor, namely the vocational reintegration results achieved. External quality assurance is a mayor input factor for the rehabilitation centres' internal quality management. In future, rehabilitation centres will be asked to demonstrate the appropriate use of this information. It will remain the centres' decision which method of quality management system implementation they choose. Quality assurance results of every centre are planned to be made publicly accessible in the medium term, in particular to the insureds. Moreover, the results of the quality assurance programmes are intended to clearly impact the allocation of patients as well as the remuneration of the rehabilitation centres concerned. Quality assurance and quality management will continue to play a major role in the political discussion of health care.

Germany↗
PubMed2006

[Obstetrical care in the future -- expertise and structure].

The hospital remuneration act, the call for minimum amount regulations and the necessities of the specialization education rules will lead to considerable changes in obstetrical care in Germany in the future. It will develop into a two-stage structure in which the level I care takes place in houses with more than 700 deliveries and the maximum care with more than 1,500 deliveries (perinatal centres).

Delivery, Obstetric↗
PubMed1987

Community leadership and participation in the Saradidi, Kenya, rural health development programme.

Community participation and leadership in initiating and implementing a health development programme in Saradidi, Kenya were examined. Organization of the area into villages had to be sensitive to existing community organizational structures such as geography, religion, kinship and administrative boundaries. The lowest level government leaders did not always have the support of the community. Some groups such as women and those who were not wealthy were not always included in leadership positions; these people, however, were often most aware of certain village problems. In Saradidi, women's groups were important for community development; they supported the volunteer community health workers and carried out many village health activities. Many village health committees did not function effectively. Village health workers were supported principally by the programme centre. Village income-generating activities were not very successful. Group involvement in income raising ventures proved to be inefficient; many ended up as income draining activities. Village group income projects must be well selected relative to the skills and resources available and the ability of the product to be marketed; only exceptional ones should be encouraged. Those based at the programme's centre were more successful perhaps because of a greater investment in skills, money and marketing. Age was an important factor in accepted leadership roles in Saradidi; most effective leaders were more than 45 years of age. Village health helpers volunteered a significant proportion of their time despite poor support by village health committees and no financial remuneration. The central project structure and the training they received compensated for the lack of guidance by village health committees.

Community Health Services↗
PubMed1997

Tropical trials: the problems of research in the tropics.

Eleven scientists who, like Herbert Gilles, have spent many years in the study of tropical disease, responded to an inquiry about the most problematic aspects of conducting intervention trials in the tropics. Areas of challenge or difficulty that figured most frequently in the replies were: (1) the proper interests, involvement and perceptions of the studied community; (2) maintaining a research team's standards and motivation over long periods; (3) good study design; (4) communications; and (5) the provision of adequate remuneration and incentives to local scientists. Other problems mentioned included the need to translate results into policy, the importance of a long-term view, the correct use of controls, the attitudes of donors, and the influences of national and local politics. Careful attention must be given to these aspects in the planning and conduct of international research.

Communication↗
PubMedDate not supplied

Night shift dose and stress at work.

In a new approach to the problem of night work and its consequences, an investigation of the relationships between shift variables, stress at work (environmental and psychosocial aspects), well-being and health, and lifestyle characteristics was carried out, taking into consideration the actual number of remunerated night shifts ('night shift dose' (NSD)). Out of the entire workforce (n = 173) of a manufacturing plant of the cement industry located in Lower Austria, a group of 31 shiftworkers, working approximately 44 night shifts per year on average was examined in detail. Between night shift dose and psychosocial stress, an important relationship was detected. Taking into account workers' well-being and health, the results suggest that psychosocial and environmental stress factors at work act independently from shift-related stress factors.

Adult↗
PubMed1998

The impact of perceptions and stereotypes on the managerial mobility of African Americans.

Although African Americans have made progress in reaching middle and upper management positions, a disproportionate number are stalled in lower levels of management where their remuneration often lags behind that of Whites in comparable positions. Further penetration into executive ranks may depend largely on the perceptions and attitudes of employers. Negative stereotypes held by top managers may have a deleterious effect on African American opportunities. Among a sample of White middle managers, Schein's (1973, 1975) descriptive index revealed a significant resemblance between ratings of Whites and ratings of managers (r' = .54), whereas the resemblance between ratings of Blacks and ratings of managers was nonsignificant (r' = .17). Managers were perceived to possess characteristics more commonly ascribed to Whites than to African Americans.

Administrative Personnel↗
PubMed2001

Determinants of mission house delivery among booked patients in a Nigerian teaching hospital.

This study examines the determinants of Mission House Delivery among booked patients in Ile-Ife, Nigeria. During the 12 months of the study (1 May 199930 April 2000) 196 booked patients at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife who delivered at mission houses were analysed. All ages and parity groups, educational level and social classes were involved. The majority (73%) were of low socio-economic class. The reasons for mission house delivery included financial constraints (41%), fear of possible caesarean section (46%), industrial action by health-care workers (39%), transport difficulty at night (26%), previous deliveries in mission houses (16%) and communal feud (12%). Four maternal deaths occurred (MMR 978/100 000 births) and 20 perinatal deaths (PNMR 118/1000 total births). Reduction of hospital user fees, provision of transportation and efficient telecommunication facilities at all times, conflict resolution and proper remuneration of health care workers are urgent needs to be addressed. Legislation against delivery in unsafe places and establishment of appropriate facilities by churches interested in maternity services is highly recommended.

Journal Article↗
PubMed1993

Assessment of malingering after mild head trauma with the Portland Digit Recognition Test.

The Portland Digit Recognition Test (PDRT), a forced-choice measure of recognition memory designed for the purpose of assessing the possibility of malingering, was administered to two groups of clinically referred patients seeking financial compensation for injuries including a mild head trauma group and a brain dysfunction group and also to a third group with brain dysfunction not seeking compensation. The three groups were equated on verbal acquisition ability. The two groups seeking remuneration were impaired on the PDRT compared with the group not seeking compensation, and the brain dysfunction group seeking compensation was superior to the mild head trauma group. Cut-off scores were established for the group with brain dysfunction not seeking compensation, and 33% of the mild head trauma group and 18% of the brain dysfunction group seeking compensation fell below the cut-offs. Significantly below chance scores were found in 17% and 3% of the two groups seeking compensation, respectively. Difficult PDRT items were more sensitive than easy items to compensation-related deficit. The PDRT is recommended as a measure of exaggeration of memory deficits.

Adult↗
PubMed1996

Ethical considerations of industry-sponsored research: the use of human subjects.

This paper reviews the history and character of these research requirements, with special emphasis on questions concerning the role of industry in sponsored research. This discussion is becoming more vigorous with each passing year as private investment in research assumes greater importance in the scientific enterprise. I concentrate on issues of industry-supported human use that are on the "cutting edge" of contemporary biomedical ethics. Of special interest are questions about the disclosure of financial arrangements between industry and investigators, such as the nature and amount of capitated remuneration.

Clinical Trials as Topic↗
PubMed1998

Community pharmacist perspectives on HIV/AIDS and interventions for injection drug users in Canada.

In several countries, community pharmacies play a major role in the provision of HIV prevention services to injection drug users (IDUs). In this study, results from a national Canadian Survey of Community Pharmacies and HIV/AIDS Prevention are used to describe pharmacists' perspectives on HIV/AIDS and services to IDUs, and explore the relationship between personal and organizational characteristics and the level of support for HIV/AIDS prevention initiatives. A mailed questionnaire was directed to a random sample of 2,017 pharmacist owner-managers. The response rate was 84.6%. Results suggest that current services to IDUs primarily are limited to discretionary needle and syringe sales to non-diabetics, with almost three-quarters supportive. Staff safety was an important consideration in the provision of this service (77%), while remuneration was the lowest (27%). Community pharmacists were most comfortable with the provision of counselling, advice and literature (X = 2.6) and environmental and technological interventions (X = 2.4) and least supportive of provision of services as part of a programme (X = 1.6) and legalization of drugs or prescription of methadone (X = 1.9). Female pharmacists were more likely to support preventive measures such as the provision of counselling or advice, and males were more likely to promote legislative change. Pharmacists appear generally willing to expand their services in the fight against HIV/AIDS. However, it is not feasible to expect uniform programmes to be immediately introduced. While organizational, educational and policy changes may facilitate programme development, individual pharmacy and pharmacist discretion remains important.

Canada↗
PubMed2005

General practitioners' attitudes towards patients with disabilities: the need for training and support.

PURPOSE: Some general practitioners (GPs) report discomfort in caring for people with disabilities. These feelings may impede the provision of quality health care to these patients. METHOD: A cross-sectional survey interviewed 600 GPs in southeastern France and assessed their personal and professional characteristics, their attitudes and opinions towards people with disabilities, and their knowledge and practices in this field. RESULTS: 21.3% of the GP reported discomfort in treating people with mental impairments and 8.2% people with physical impairments. Discomfort with either type of impairment was more frequent among GPs who perceived frequent communication problems with persons with disabilities (p < 0.05) or who did not belong to a professional network (p < 0.10). GPs who reported less experience with the disabled patients (p < 0.05), no medical training about disabilities (p = 0.04), a lack of assistance during consultations (p = 0.02), and inadequate consultation time (p = 0.09) expressed more discomfort in caring for patients with mental impairments. GPs' discomfort was associated with their assessment of the patient's level of disability among patients with physical impairments (p = 0.01). CONCLUSION: This study suggests that substantial obstacles related to GPs' attitudes impede the delivery of quality health care to patients with disabilities and that GPs need more support and guidance in dealing with them. These results raise also the issue of adequate time and remuneration for consultations with these patients.

Adult↗