scholarly journals Acute hospital medical staffing during the night shift

1998 ◽  
Vol 21 (4) ◽  
pp. 163 ◽  
Author(s):  
Ken Hillman ◽  
Sean Beehan
Keyword(s):  
Night Shift ◽  
Acute Hospital ◽  
Junior Doctors ◽  
Great Cost ◽  
Acute Medicine ◽  
Acute Hospitals ◽  
High Level ◽  
General Wards ◽  
Cost Implications

There has been little or no attempt to define the need for 24-hour medical cover, norits appropriateness in acute hospitals, despite the great cost implications and thequestion of the quality of that care. This study examined the medical activity duringthe ?night shift? in an acute hospital. There were an average of 2.59 calls per night,most from the emergency department (247/475) and general wards (108/475). Manycalls were related to active resuscitation (88/475) and immediate treatment (83/475).Over 40% (81/286) of patients had to be transferred to a higher level of care, suchas an intensive care unit within the hospital. By collecting data on the demands ofhealth care during what amounts to over a third of the hospital?s time, it wasestablished that a high level of medical care was required. Appropriate levels ofstaffing, using junior doctors trained in acute medicine, was able to be provided tomatch need as determined by these data, and extra staff at higher costs were avoided.

Editorial

2005 ◽  
Vol 4 (3) ◽  
Author(s):  
Chris Roseveare ◽  
Keyword(s):  
Night Shift ◽  
Hospital Medicine ◽  
Phone Call ◽  
Junior Doctors ◽  
Exact Nature ◽  
Text Book ◽  
Acute Medicine ◽  
Junior Staff ◽  
Training Programmes ◽  
The Uk

The challenges and uncertainties of working in the developing field of Acute Medicine have been a regular theme for editorial comment in this journal since I took the helm in 2002. Almost four years on, with sub-specialty status confirmed, over 200 consultants and many SpRs enrolled in higher specialist training programmes throughout the UK, Acute Medicine finds itself in a much stronger position than any could have predicted at that time. Enthusiasm for the field is clear from the numbers of applicants for training programmes at SpR level, as well as the dramatic rise in attendances at acute medicine meetings across the country in the last year. However, on-going challenges remain. Eighteen months from now, Modernising Medical Careers will send shockwaves throughout hospital medicine. The exact nature of the change to our training programmes remains unclear, and will probably have changed again between my writing this and its publication. However it is essential that Acute Medicine is ready for whatever comes our way. We must work closely with our colleagues in Emergency Medicine and Critical Care to develop common stem training schemes which allow doctors to choose the area of ‘front door’ medicine which suits them best. Where possible we should seek to encourage dual accreditation in two or more of these areas. But most of all we need to maintain the momentum which has carried us so far in such a short space of time, and which has the potential to make Acute Medicine one of the largest hospital specialties. This edition’s review articles cover a varied mix of common and less common conditions on the acute medical ‘take’. Most medical admission units will be faced with at least one patient presenting with a seizure in each 24 hour period. Dr Kinton emphasises the importance of a good history in the management of this problem, but also provides some useful tips to help distinguish seizures from other causes of blackout. Distinction from syncope can be a particular challenge, not least because of the differing implications for driving, the loss of which can have devastating consequences. Acute ischaemic stroke is another common problem, the management of which is comprehensively reviewed by David Jarrett and Hemang Dave. As well as summarising some of the major trial data for thrombolytic and antiplatelet therapy, this review includes some advice on some of the common clinical challenges which don’t usually feature in text book descriptions of this condition. Less common, but no less important, Acute liver failure must be distinguished from decompensated chronic liver disease – the former often requiring discussion with a regional liver unit. Phil Berry has included a useful checklist to have to hand before making this phone call. Headache, palpitations and sweating is a common problem on the post-take ward round – particularly amongst the junior staff completing a night shift. Fortunately most junior doctors do not have a phaeochromocytoma – in common with every patient for whom I have ever requested 24 hour urinary catecholamine measurement. Having read Dr Solomon’s thorough review of the acute management of this condition I will now feel equipped to manage this condition when I finally get a positive result back from the laboratory! Apologies that this edition has been a little delayed – I hope you consider it to have been worth waiting for….

scholarly journals Response to winter pressures in acute services: analysis from the Winter Society for Acute Medicine Benchmarking Audit

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Catherine Atkin ◽  
Thomas Knight ◽  
Chris Subbe ◽  
Mark Holland ◽  
Tim Cooksley ◽  
...  
Keyword(s):  
Acute Hospital ◽  
Hospital Services ◽  
Acute Medicine ◽  
Medicine Department ◽  
Delivery Of Care ◽  
The United Kingdom ◽  
National Guidance ◽  
Acute Hospitals ◽  
Emergency Medicine Department ◽  
Increased Pressure

Abstract Background There is increased demand for urgent and acute services during the winter months, placing pressure on acute medicine services caring for emergency medical admissions. Hospital services adopt measures aiming to compensate for the effects of this increased pressure. This study aimed to describe the measures adopted by acute medicine services to address service pressures during winter. Methods A survey of acute hospitals was conducted during the Society for Acute Medicine Benchmarking Audit, a national day-of-care audit, on 30th January 2020. Survey questions were derived from national guidance. Acute medicine services at 93 hospitals in the United Kingdom completed the survey, evaluating service measures implemented to mitigate increased demand, as well as markers of increased pressure on services. Results All acute internal medicine services had undertaken measures to prepare for increased demand, however there was marked variation in the combination of measures adopted. 81.7% of hospitals had expanded the number of medical inpatient beds available. 80.4% had added extra clinical staff. The specialty of the physicians assigned to provide care for extra inpatient beds varied. A quarter of units had reduced beds available for providing Same Day Emergency Care on the day of the survey. Patients had been waiting in corridors within the emergency medicine department in 56.3% of units. Conclusion Winter pressure places considerable demand on acute services, and impacts the delivery of care. Although increased pressure on acute hospital services during winter is widely recognised, there is considerable variation in the approach to planning for these periods of increased demand.

Heart Rate Recovery Changes during Competition Period in High-Level Basketball Players

2018 ◽  
Vol 1 (80) ◽  
Author(s):  
Audrius Gocentas ◽  
Anatoli Landõr ◽  
Aleksandras Kriščiūnas
Keyword(s):  
Heart Rate ◽  
Heart Rate Recovery ◽  
Team Sports ◽  
Basketball Players ◽  
Coeffi Cients ◽  
Competition Period ◽  
Monitoring Training ◽  
Intense Training ◽  
High Level

Research background and hypothesis. Replete schedule of competitions and intense training are features of contemporary team sports. Athletes, especially the most involved ones, may not have enough time to recover. As a consequence, aggregated fatigue can manifest in some undesirable form and affect athlete’s performance and health.Research aim. The aim of this study was to evaluate the changes in heart rate recovery (HRR) and investigate possible relations with sport-specifi c measures of effi cacy in professional basketball players during competition season.Research methods. Eight male high-level basketball players (mean ± SD, body mass, 97.3 ± 11.33 kg; height 2.02 ± 0.067 m, and age 23 ± 3.12 years) were investigated. The same basketball specifi c exercise was replicated several times from September till April during the practice sessions in order to assess the personal trends of HRR. Heart rate monitoring was performed using POLAR TEAM SYSTEM. Investigated athletes were ranked retrospectively according to the total amount of minutes played and the coeffi cients of effi cacy. Research results. There were signifi cant differences in the trends of HRR between the investigated players. The most effective players showed decreasing trends of HRR in all cases of ranking.Discussion and conclusions. Research fi ndings have shown that the quality of heart rate recovery differs between basketball players of the same team and could be associated with sport-specifi c effi cacy and competition playing time.Keywords: adaptation, autonomic control, monitoring training.

About Innovative Content of Subject-Oriented Pedagogical Education

2019 ◽  
Vol 28 (10) ◽  
pp. 106-117
Author(s):  
R. M. Asadullin
Keyword(s):  
Teacher Education ◽  
Teacher Training ◽  
Educational Process ◽  
Professional Activity ◽  
Subject Knowledge ◽  
Technological Structure ◽  
State Pedagogical ◽  
High Level ◽  
Competencies Development

The continuous modernization of the education system makes the problems of the quality of teacher training increasingly relevant. Moreover, the measures taken to improve the system of teacher education are largely confined to the introduction of new organizational and managerial mechanisms and practically do not affect the internal content and technological structure of the teacher training process.Modern pedagogical universities are constantly looking for innovative models of training teachers that will be able to solve non-standard social and professional tasks. However, recent studies in this area do not fully take into account the nature of pedagogical activity and conditions of its formation. Thus, the need arises for a special study of the processes and means of updating the content and technologies of teacher training in order to control the level of students’ professional competencies development, as required by educational and professional standards. This means the creation of a special educational system in a pedagogical university, which can provide a harmonious and synchronous mastering by future specialists of both subject knowledge and methods of pedagogical activity.The article provides a theoretical study aimed at identifying key patterns of designing a new content for teacher education, the basis of which is the formation of a future teacher as a subject of his own professional activity. The author describes the experience of using a subject-oriented model of education, implemented at Bashkir State Pedagogical University n.a. M. Akmulla. The effectiveness of this model is confirmed by the high level of students’ mastery of designing methods and constructing the educational process, as well as their positive experience in the implementation of educational activities.

Analisis Soal Matematika Tipe Higher Order Thinking Skills (HOTS) Tingkat SMP

2020 ◽  
Vol 2 (2) ◽  
pp. 112-129
Author(s):  
Lelly Oktafiana ◽  
Iis Holisin ◽  
Himmatul Mursyidah
Keyword(s):  
Power Level ◽  
Thinking Skills ◽  
Higher Order Thinking Skills ◽  
National Examination ◽  
Class Viii ◽  
Valid Test ◽  
Grade Material ◽  
Data Collection Technique ◽  
High Level

This study aims to describe the quality of the 2018 Mathematics National Examination (UN) in the HOTS types at the junior high level in terms of the level of validity, reliability, problem differentiation power, level of difficulty and distractor. This type of research is a descriptive study. The research was conducted at SMP Muhammadiyah 4 Surabaya and SMP Negeri 13 Surabaya for students in class VIII. The data collection technique used is a test. The test was taken from the 2018 math UN questions in odd semester VIII grade material including HOTS type. The number of UN mathematics questions in 2018 in the odd semester VIII class material consisted of 12 questions with 25% including LOTS types and 75% including HOTS types. The results showed: (1) 100% valid test questions, (2) high question reliability, (3) good problem differentiation power, (4) the difficuly level of the question 77,77% categorized as moderate and 2 question 22,23% are categorized as difficult, (5) there are 2 questions with one of the answer options do not work.

scholarly journals Evaluation of Physiological and Quality Parameters of Green Asparagus Spears Subjected to Three Treatments against the Decline Syndrome

Agronomy ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 937
Author(s):  
Francisco Javier López-Moreno ◽  
Santiago Atero-Calvo ◽  
Eloy Navarro-León ◽  
Begoña Blasco ◽  
Teresa Soriano ◽  
...  
Keyword(s):  
Early Death ◽  
Amino Acid Profile ◽  
Quality Parameters ◽  
Asparagus Officinalis ◽  
Chicken Manure ◽  
Economic Losses ◽  
Whole Plants ◽  
High Level ◽  
Green Asparagus

Green asparagus (Asparagus officinalis L.) is a widely grown and consumed crop which provides high-level nutritional interest. In recent years, the decline syndrome in asparagus plantations has been rapidly augmenting. This syndrome causes the early death of whole plants, also negatively affecting the new replanting. Decline causes notable economic losses in the sector. The objective of this work was to verify the effect of different treatments against asparagus decline syndrome on the physiological parameters and nutritional quality of the spears. To meet the objective, four different treatments were applied to asparagus plots strongly affected by decline syndrome: (T1) untreated control soil, (T2) biofumigation with Brassica pellets, (T3) biofumigation with chicken manure pellets, and (T4) disinfestation of the soil with Dazomet. The cumulative yield and physiological and quality parameters of green asparagus spears were studied. Thus, malondialdehyde (MDA), photosynthetic pigments, glutathione (GSH), ascorbate (AsA), total phenols, flavonoids, anthocyanin, antioxidant test, mineral nutrients, and the amino acid profile were measured on asparagus spears. The results showed that the Brassica pellets and Dazomet treatments were the most effective against the damage caused by the decline syndrome. However, it would be necessary to monitor the evolution in the following years.

scholarly journals AI-based localization and classification of skin disease with erythema

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ha Min Son ◽  
Wooho Jeon ◽  
Jinhyun Kim ◽  
Chan Yeong Heo ◽  
Hye Jin Yoon ◽  
...  
Keyword(s):  
Neural Network ◽  
Skin Diseases ◽  
Classification Model ◽  
Screening Tests ◽  
Sensitivity Score ◽  
Common Skin ◽  
Novel Method ◽  
Improved Performance ◽  
High Level

AbstractAlthough computer-aided diagnosis (CAD) is used to improve the quality of diagnosis in various medical fields such as mammography and colonography, it is not used in dermatology, where noninvasive screening tests are performed only with the naked eye, and avoidable inaccuracies may exist. This study shows that CAD may also be a viable option in dermatology by presenting a novel method to sequentially combine accurate segmentation and classification models. Given an image of the skin, we decompose the image to normalize and extract high-level features. Using a neural network-based segmentation model to create a segmented map of the image, we then cluster sections of abnormal skin and pass this information to a classification model. We classify each cluster into different common skin diseases using another neural network model. Our segmentation model achieves better performance compared to previous studies, and also achieves a near-perfect sensitivity score in unfavorable conditions. Our classification model is more accurate than a baseline model trained without segmentation, while also being able to classify multiple diseases within a single image. This improved performance may be sufficient to use CAD in the field of dermatology.

scholarly journals Comparing quality of life between patients undergoing trans-areola endoscopic thyroid surgery and trans-oral endoscopic thyroid surgery

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shuang Shen ◽  
Xiaochi Hu ◽  
Rui Qu ◽  
Youming Guo ◽  
Libo Luo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Thyroid Surgery ◽  
Short Form ◽  
Endoscopic Thyroidectomy ◽  
Operation Time ◽  
Endoscopic Thyroid Surgery ◽  
Sf 36 ◽  
Areola Approach ◽  
High Level

Abstract Background Compared with conventional open surgery, endoscopic thyroidectomy via the oral vestibular approach (ETVOA) and endoscopic thyroidectomy via the areola approach (ETAA) avoided scarring of the skin, which may help patients achieve a better quality of life (QOL). However, the benefit of the QOL from this technique has not been adequately investigated, therefore this study compared the QOL outcomes between ETVOA and ETAA. Methods 131 patients were enrolled in this study. ETAA surgery and ETVOA surgery were performed in 74 patients and 57 patients, respectively. These patients were followed up at 2 weeks, 4 weeks, and 8 weeks, and their QOL was evaluated using a thyroid surgery-specific questionnaire and a short-form health survey (SF-36). Results There were no differences in clinical characteristics such as gender, age, body mass index (BMI), and tumor size between the two groups. The volume of intraoperative blood loss, cost of hospitalization, and complications between the two procedures showed no differences. Compared with ETAA, ETVOA has a longer operation time, no drainage, and shorter hospital stay. In the QOL questionnaire, several parameters in ETVOA were better. The satisfaction scores of patients undergoing ETVOA were higher. In addition, the cosmetic satisfaction in patients who received ETOVA was significantly better than that of patients who underwent ETAA. The degree of neck movement disorder in patients with ETVOA was milder. Patients who received ETVOA had higher score on the SF-36. Conclusions The trans-oral endoscopic approach can acquire better cosmetic results and achieved high-level QOL.

Changes in alcohol history taking by psychiatric junior doctors: an audit

1995 ◽  
Vol 12 (1) ◽  
pp. 37-39 ◽  
Author(s):  
Simon J Taylor
Keyword(s):  
Illicit Drug ◽  
Statistical Significance ◽  
Inpatient Admission ◽  
Junior Doctors ◽  
History Taking ◽  
Drug Usage ◽  
Acute Psychiatric Wards ◽  
First Time

AbstractObjective: In recent years a number of articles have highlighted deficiencies in drinking histories taken by junior doctors. This study examines whether standards have improved as a result. It also examines for the first time: 1. the quality of drinking histories taken from patients following parasuicide; and 2. the quality of illicit drug usage histories.Method: An audit of case notes was undertaken of 114 patients admitted to a district hospital's acute psychiatric wards or assessed following overdose. Two periods were considered; one preceding many of the articles, and the second four years later.Results: There was an overall improvement from 58% of histories in 1988 having no mention of alcohol usage to 25% in 1992. (X2MH=10.57, p<0.01). There was, however, insufficient improvement of quantitative histories to reach statistical significance. Histories taken as part of an overdose assessment were not significantly different from those taken for inpatient admission. In 1992, 27% of patients had any illicit drug usage history recorded which represented a statistically significant improvement (X2MH=5.91, p<0.02) compared with four years earlier.Conclusions: Although improvements have been noted, alcohol and drug histories remain inadequate.

scholarly journals Mobile Networks and Internet of Things Infrastructures to Characterize Smart Human Mobility

Smart Cities ◽  
2021 ◽  
Vol 4 (2) ◽  
pp. 894-918
Author(s):  
Luís Rosa ◽  
Fábio Silva ◽  
Cesar Analide
Keyword(s):  
Internet Of Things ◽  
Mobile Networks ◽  
Smart Cities ◽  
Human Mobility ◽  
Rapid Development ◽  
Disruptive Technology ◽  
New Paradigm ◽  
Design And Optimization ◽  
High Level

The evolution of Mobile Networks and Internet of Things (IoT) architectures allows one to rethink the way smart cities infrastructures are designed and managed, and solve a number of problems in terms of human mobility. The territories that adopt the sensoring era can take advantage of this disruptive technology to improve the quality of mobility of their citizens and the rationalization of their resources. However, with this rapid development of smart terminals and infrastructures, as well as the proliferation of diversified applications, even current networks may not be able to completely meet quickly rising human mobility demands. Thus, they are facing many challenges and to cope with these challenges, different standards and projects have been proposed so far. Accordingly, Artificial Intelligence (AI) has been utilized as a new paradigm for the design and optimization of mobile networks with a high level of intelligence. The objective of this work is to identify and discuss the challenges of mobile networks, alongside IoT and AI, to characterize smart human mobility and to discuss some workable solutions to these challenges. Finally, based on this discussion, we propose paths for future smart human mobility researches.

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