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PubMed1991

Influencers of career choice among allied health students.

This study focused on the factors that influence students' choice of an allied health profession. A survey of 153 students in three allied health programs at the University of Connecticut revealed that "the need to help others," "prestige," "professional autonomy," "opportunities for advancement," "income potential," and "the effect of the specialty on family and personal life," were the major influencers of career choice among allied health students. Only a few students regarded malpractice suits and AIDS as negative influencers. While medical laboratory science majors regarded these as important factors, dietetics and physical therapy majors did not. The article suggests further use of these findings by program directors and career counselors.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Healthy workplace environments support a nurturing student educational climate.

Due to the shortage of medical laboratory scientist personnel in the United States, the successful integration of students into the Medical Laboratory Science (MLS) profession is vital. Education Facilitators are being used increasingly to assist clinical site managers in actively supporting and contributing to a healthier workplace environment, thereby inspiring students to become part of the organization. Education Facilitators associated with a single university-based MLS Program were the participant target group in a study. Face-to-face, in-depth, semi-structured interviews were conducted with five Education Facilitators at two clinical sites. The findings of this study suggest that organizational efforts to improve the learning environment for MLS students should focus on providing a supportive and nurturing educational climate. Education Facilitators' descriptions revealed an organizational leadership that communicated a commitment to provide people, space, and equipment in an effort to promote a positive clinical rotation experience. Additionally, the facilitators expressed a need to "pay more attention to students," be "willing to work with students," and make sure the students don't get "lost in the shuffle." They said that concern for a healthy work/life balance should be communicated to MLS students through day-to-day educational contact with bench technologists and Education Facilitators.

Data Collection↗
PubMed1992

Oncogenes in gynecological tumors.

Evidence is increasing that proto-oncogenes and cancer suppressor genes are involved in the development and/or progression of gynecological malignancies. While histopathologic examination remains an indispensable tool of the surgical pathologist in the diagnosis and evaluation of patients with gynecological malignancies, the advancement to technology and the development of new knowledge regarding neoplastic transformation are providing a basis for new opportunities to improve patients care. These new opportunities will depend on the use of the skills and reagents developed in the basic medical science laboratories. Thus, it is important for those in the field of diagnostic pathology to begin to acquire a knowledge of proto-oncogenes and cancer suppressor genes as well as a basic understanding of the techniques used to detect and evaluate them.

Cell Transformation, Neoplastic↗
PubMed1992

Audit of critical care: aims, uses, costs and limitations of a Canadian system.

We describe an audit system used in our Medical/Surgical Intensive Care Unit (ICU) during 1989-90. The system emphasizes the integration of data acquisition (database function) with the analysis and use of data (decision function). Resource input (human and technological) included patient demographics, diagnoses, complications, procedures, severity of illness (Apache II), therapeutic interventions (TISS), and nursing workload (GRASP and TISS). The output was assessed by survival, length of stay and ability to return home. The annual operating cost for 277 admissions (249 patients) to this ICU was $7,333. The implementation costs were $58,261 including program development and computer purchases. Non-survivors of ICU and hospital had higher Apache II scores on admission (P less than 0.0001) and longer ICU length of stay (P less than 0.05) than survivors. The nursing workload (both TISS and GRASP) on the day of admission and the last day in ICU were greater in non-survivors (P less than 0.0001) than survivors. Limitations of this audit system included the delay (6-9 mos) from ICU admission until data entry, the large number of diagnostic groups in the ICD.9.CM classification, and lack of a documented cause/effect relationship between interventions and complications. This audit system was more useful for utilization management than for quality assurance purposes.

Canada↗
PubMedDate not supplied

The impact of information technology on pediatric cardiology: present, past, and future.

Inexorable progress in information technology has been the driving force behind much of the progress that has been achieved in the fields of pediatric cardiology and cardiac surgery since the inception of these two subspecialities during the middle of the 20th century. This article outlines the influences of the digital age and speculates on likely future developments in these two subspecialities.

Cardiology↗
PubMed1984

Medical technology and professional dominance theory.

The expansion of medical technology in hospitals is commonly asserted to be a result of the preferences of medical doctors translated into organizational policies as a result of professional dominance in health care organizations. This paper examines the theoretical and empirical bases for hypotheses of professional dominance and the utility of these hypotheses in explaining hospital decisions to adopt new medical technologies. The analysis, which is based on 5 years of data collection including 378 personal interviews at 25 U.S. hospitals, indicates that appropriate application of the concept requires specification of the type of physician exercising influence and of the hospital decision systems within which it is exercised. Specification is needed because neither physicians nor hospitals are unitary categories when considered in relation to technology adoptions . In this paper, four categories of physicians are identified: community generalists, community specialists, referral specialists and hospital-based specialists. Members of these categories exhibit different skills and interests, different relationships to hospitals and hospital technologies, and differential access to the resources of organization influence including two unrelated to professional dominance. To understand the exercise of physician influence, it is further useful to differentiate three decision systems which review and pass judgement on different types of hospital technologies. They are: the medical-individualistic, the fiscal-managerial and the strategic-institutional. The three decision systems make decisions in accord with different values and goals and display different decision structures and dynamics. Ironically , the physicians who most clearly possess the resources of influence associated with professional dominance are centrally involved in only one of the three systems.(ABSTRACT TRUNCATED AT 250 WORDS)

Data Collection↗
PubMed1994

Task Force 1: The underserved.

The ACC has affirmed its commitment to universal access to health care. Underserved populations exist in urban and rural centers. Common to each is a paucity of personnel trained in cardiovascular care and a lack of access to preventive and highly technologic services. These factors contribute to a poor health outcome (75). Part of the rural problem can be corrected by the transfer of information to local providers by the use of new information systems. Included would be real-time electronic consultation, on-site subspecialty visits and the appropriate use of nonphysician providers (15). The urban problem requires changes in priorities and responsibilities of the academic health centers toward the communities they serve. Curricula changes of cardiovascular specialists, internists, generalists and nonphysician health care personnel must include diversity in training, physician training of ethnically matched providers in addition to technical excellence and research into methods of patient education and motivation for a healthier life-style (51). Reimbursement must appropriately reward those caring for underserved patients and those providing evaluation and management services (43,52).

Academic Medical Centers↗
PubMed2004

Achieving appropriate design and widespread use of health care technologies in the developing world. Overcoming obstacles that impede the adaptation and diffusion of priority technologies for primary health care.

OBJECTIVES: To identify and describe constraints facing the development and dissemination of technologies appropriate for public health care challenges and solutions in the developing world. METHODS: Review of lessons learned in development and introduction of numerous health technologies as experienced by a non-profit organization working on technologies for 25 years. RESULTS: Many obstacles prevent appropriate technologies from reaching widespread use and acceptance. These include low profit margins in developing world markets, regulatory constraints, and the need for systems changes. Strong public/private-sector partnerships and realistic approaches to working in these environments make a difference. CONCLUSIONS: There is a growing awareness of the need for new technologies and experience with strategies that can make them happen. Some technologies with documented value for maternal care in developing world settings appear to be stuck short of widespread acceptance and use. Understanding the factors impeding their progress can enable the public sector and its collaborators to organize and facilitate their progress more effectively.

Developing Countries↗
PubMed2004

Auxiliary technologies related to transport and communication for obstetric emergencies.

OBJECTIVES: To review the evidence on appropriate transport and communications technologies for obstetrical referrals in developing countries. METHODS: Review of articles published in peer-reviewed journals and gray literature, supplemented by email and telephone consultations with key informants and field programmers. RESULTS: A wide range of transportation options have been attempted. Initial approaches--such as those relying on ambulances owned and operated by health systems--have evolved into recommendations that emphasize community-based solutions. There are fewer options within the realm of communications technologies, and the recommendations are more consistent. Public health researchers are only beginning to evaluate the cost and effectiveness of different options. CONCLUSIONS: One of the greatest barriers to effective use of transport and communications for obstetric emergencies is the short time interval necessary for action, which limits options for obstetric referrals more than for other medical referrals. Although evidence is still scarce, experience suggests that motorized transport is likely to be the most acceptable and effective transportation option. More sophisticated communications technologies such as cell phones are both practical and effective, and are increasingly becoming the technologies of choice for low-resource settings.

Communication↗
PubMed2004

Improving technologies to reduce abortion-related morbidity and mortality.

This article reviews the technologies used to diagnose pregnancy and manage abortion in developing countries. The author discusses methods of diagnosing pregnancy--including physical examination, laboratory and home testing, and ultrasound--as well as methods for performing safe abortions. Due to manual vacuum aspiration (MVA) advances, vacuum aspiration has become safer and more feasible in low-resource settings. The discussion of medical abortion includes the advantages and limitations of mifepristone, misoprostol-only regimens, methotrexate, and other methods. The author stresses the importance of post-abortion care and post-abortion contraception and, in the conclusion, identifies six areas in which technology can reduce abortion-related morbidity and mortality: pregnancy prevention, early diagnosis of pregnancy, accurate assessment of gestation, standardization and supply of MVA technology, and simple and affordable regimens for medical abortion.

Abortion, Induced↗
PubMed2004

New and underutilized technologies to reduce maternal mortality: call to action from a Bellagio workshop.

Little progress has been made in preventing the more than 500,000 maternal deaths that occur each year. Many new and underutilized technologies can be used to reduce these deaths. In July 2003, maternal health experts from around the world gathered in Bellagio, Italy, to develop a set of priority actions for reducing maternal mortality using proven and promising technologies. To reduce maternal mortality, immediate efforts are needed to accelerate the appropriate use of technologies and to reduce their inequitable distribution. Organizations are called on to commit the necessary human and financial resources to evaluate and document the effectiveness of promising technologies and to scale up and put proven technologies into widespread use to save women's lives.

Developing Countries↗