检索结果-南通市图书馆

Challenges of a negative work load and implications on morale,productivity and quality of service delivered in nhs laboratories in england

引用

Asian Pacific Journal of Tropical Biomedicine 2014年第6期4卷 421-429页

作者： Erhabor Osaro Njemanze Chima Blood Sciences Department Royal Bolton Hospital NHS Foundation Trust

The National Health Service(nhs)is a term used to describe the publicly funded healthcare delivery system providing quality healthcare services in the United *** are several challenges militating against the effective laboratory service delivery in the nhs in *** scientists work in healthcare to diagnose disease and evaluate the effectiveness of treatment through the analysis of body fluids and tissue samples from *** provide the"engine room"of modern medicine with 70%of diagnosis based on the laboratory results generated by *** review involved the search of literature for information on working condition of biomedical scientist in the nhs in *** service delivery in the nhs in england faces numerous daunting challenges;staffing levels in the last few years have become dangerously low,less remunerated,relatively less experienced and predominantly band 5's,multidisciplinary rather than specialty based,associated with working more unsocial hours without adequate recovery time,de-banding of staff,high staff turnaround,profit and cost driven rather than *** factors has resulted in burn out,low morale,high sickness absences,increased error rate,poor team spirit,diminished productivity and suboptimal laboratory service *** is the urgent need to retract our steps on unpopular policies to ensure that patient care is not compromised by ensuring adequate staffing level and mix,ensuring adequate remuneralion of laboratory staff,implementing evidenced-based specialty oriented service,determining the root cause/s for the high staff turnover and implementing corrective action,identifying other potential sources of waste in the system rather than pruning the already dangerously low staffing levels and promoting a quality delivery side by side cost effectiveness.

关键词： Laboratory staffs National Health Service england Negative work load Morale Productivity Service delivery

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Post Mid-Staffordshire Inquiries Reaction, in and about the National Health Service (nhs), england. The Missing Pieces: Organizational, Care and Virtue Ethics Perspectives

引用

International Journal of Clinical Medicine 2014年第16期5卷 1009-1015页

作者： Albert Coleman Southern Health nhs Foundation Trust Hampshire UK

The release of the Mid Staffordshire hospital report otherwise called the Francis report once again ignited the debate about the issue of abuse of especially vulnerable patients, while navigating the care pathway as inpatients in hospitals;within the National health service (nhs), england. Once more the official reaction from the nhs directorate is more “standards” to monitor failed standards in patient care. Of interest in the official responses so far, are the unheard voices addressing the issue of healthcare and organizational ethics concerns that need revisiting. This article seeks to revisit practice, systems and care issues leading to incidents of the type of the Staffordshire abuses, and the important but yet unheralded place of organizational and care ethics in helping to curb such abuses from re-occurring.

关键词： Health Professionals Quality of Care Rights Health Care Ethics

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Prehospital transdermal glyceryl trinitrate for ultra- acute ischaemic stroke: data from the RIGHT- 2 randomised sham- controlled ambulance trial

引用

Stroke & Vascular Neurology 2024年第1期9卷 38-49,I0035-I0046页

作者： Jason Philip Appleton Lisa J Woodhouse Craig S Anderson Sandeep Ankolekar Lesley Cala Mark Dixon Timothy J england Kailash Krishnan Grant Mair Keith W Muir John Potter Christopher I Price Marc Randall Thompson G Robinson Christine Roffe Else C Sandset Jeffrey L Saver Angela Shone Aloysius Niroshan Siriwardena Joanna M Wardlaw Nikola Sprigg Philip M Bath Stroke University Hospitals Birmingham NHS Foundation TrustBirminghamUK Institute of Applied HealthResearch University of Birmingham College of Medical and Dental SciencesBirminghamUK Stroke Trials Unit Mental Health and Clinical NeurosciencesUniversity of NottinghamNottinghamUK Faculty of Medicine The George Institute for Global HealthSydneyNew South WalesAustralia The George Institute China at Peking University Health Science Center BeijingChina Neurology Royal Prince Alfred HospitalSydney Health PartnersSydneyNew South WalesAustralia Department of Neurology King's College Hospital NHS Foundation TrustLondonUK Faculty of Health and Medical Sciences University of Western AustraliaCrawleyWestern AustraliaAustralia East Midlands Ambulance Service nhs Trust NottinghamUK Stroke Queen's Medical CentreNottingham University Hospitals NHS TrustNottinghamUK Centre for Clinical Brain Sciences Dementia Research InstituteUniveristy of EdinburghEdinburghUK Institute of Neurology and Psychology University of GlasgowGlasgowUK Bob Champion Research and Education Building University of East AngliaNorwichUK Institute of Neuroscience Newcastle UniversityNewcastle upon TyneUK Department of Neurology Leeds Teaching Hospitals NHS TrustLeedsUK Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre University of LeicesterLeicesterUK Stroke Research in Stoke Institute for Science and Technology in MedicineKeele UniversityStoke-on TrentUK Department of Neurology Oslo University HospitalOsloNorway Research and Development Norwegian Air Ambulance FoundationOsloNorway Department of Neurology and Comprehensive Stroke Center David Geffen School of MedicineUCLALos AngelesCaliforniaUSA Research and Graduate Services University of NottinghamNottinghamUK Community and Health Research Unit University of LincolnLincolnUK

Background The effect of transdermal glyceryl trinitrate(GTN,a nitrovasodilator)on clinical outcome when administered before hospital admission in suspected stroke patients is ***,we assess the safety and efficacy of GTN in the prespecified subgroup of patients who had an ischaemic stroke within the Rapid Intervention with Glyceryl trinitrate in Hypertensive stroke Trial-2(RIGHT-2).Methods RIGHT-2 was an ambulance-based multicentre sham-controlled blinded-endpoint study with patients randomised within 4hours of *** primary outcome was a shift in scores on the modified Rankin scale(mRS)at day *** outcomes included death;a global analysis(Wei-Lachin test)containing Barthel Index,EuroQol-5D,mRS,telephone interview for cognitive status-modified and Zung depression scale;and neuroimaging-determined‘brain frailty’*** were reported as n(%),mean(SD),median[IQR],adjusted common OR(acOR),mean difference or Mann-Whitney difference(MWD)with 95%*** 597 of 1149(52%)patients had a final diagnosis of ischaemic stroke;age 75(12)years,premorbid mRS>2107(18%),Glasgow Coma Scale 14(2)and time from onset to randomisation 67[45,108]***‘brain frailty’was common:median score 2[2,3](range 0–3).At day 90,GTN did not influence the primary outcome(acOR for increased disability 1.15,95%CI 0.85 to 1.54),death or global analysis(MWD 0.00,95%CI-0.10 to 0.09).In subgroup analyses,there were non-significant interactions suggesting GTN may be associated with more death and dependency in participants randomised within 1hour of symptom onset and in those with more severe *** In patients who had an ischaemic stroke,ultra-acute administration of transdermal GTN in the ambulance did not improve clinical outcomes in a population with more clinical and radiological frailty than seen in previous in-hospital *** IS ALREADY KNOWN ON THIS TOPIC⇒Transdermal glyceryl trinitrate(GTN)was associat-ed with less death and dependency in those w

关键词： Glasgow nitrate random

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Understanding the Underlying Mechanisms of Action for Successful Implementation of Social Prescribing

引用

Open Journal of Preventive Medicine 2023年第2期13卷 41-56页

作者： Kate Walker Chris Griffiths Harmony Jiang Northamptonshire Healthcare nhs Foundation Trust Berrywood Hospital Northampton England

There is growing evidence for the use of social prescribing as a means of facilitating healthy lifestyle behavior changes by linking patients to sources of support in the community. However, there are gaps in understanding about what works to facilitate and enable this behavior change i.e. , the mechanisms of actions underpinning social prescribing delivery. This study used a qualitative approach involving interviews with 18 Social Prescription Link Workers (SPLWs). Reflective thematic analysis was used to analyze the data. Through this, an overall theme of “Theoretical underpinning: Solution-focused and strengths-based” was identified. This was made up of sub-themes relating to mechanisms underpinning: the SPLWs’ role (comprising asking questions, motivational interviewing and the therapeutic alliance);the patients’ role, (empowerment and active engagement);and the approach adopted (solution building, goal and action orientated). To formalize this, a framework could be developed for SPLWs that encapsulates the solution-focused strengths-based approach for application within social prescribing. This framework can then be embedded into practice facilitating more successful healthy lifestyle behavior change for social prescribing patients.

关键词： Social Prescribing Behaviour Change Solution-Focused Goal and Action Orientation

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Medium-term mortality after hip fractures and COVID-19:A prospective multicentre UK study

引用

Chinese Journal of Traumatology 2022年第3期25卷 161-165页

作者： Gareth Chan Ashish Narang Arash Aframian Zaid Ali Joseph Bridgeman Alastair Carr Laura Chapman Henry Goodier Catrin Morgan Chang Park Sarah Sexton Kapil Sugand Thomas Walton Michael Wilson Ajay Belgaumkar Kieran Gallagher Koushik Ghosh Charles Gibbons Joshua Jacob Andrew Keightley Zuhair Nawaz Khaled Sarraf Christopher Wakeling William Kieffer Benedict Rogers Brighton&Sussex University Hospitals nhs Trust Brighton&Sussex Medical SchoolFainter CampusBrighton UK Surrey&Sussex Healthcare nhs Trust Canada&venueRedhillUK Chelsea&Westminster Hospital nhs Foundation Trust LondonUK Ashford&St frier's Hospital NHS Foundation TrustChertseyUK Western Sussex Hospitals nhs Foundation Trust(Sr Richard's Hospital)ChichesterUK Poole General Hospital&the Royal Bournemouth Hospital froleUK Imperial College Healthcare nhs Trust LondonUK Western Sussex Hospitals nhs Foundation Trust(Worthing Hospital) WorthingUK Royal Surrey Hospital nhs Foundation Trust GuildfordUK Frimley Health nhs Foundation Trust FrimleyUK

Purpose:The COVID-19 pandemic has caused 1.4 million deaths globally and is associated with a 3-4 times increase in 30-day mortality after a fragility hip fracture with concurrent COVID-19 ***,death from COVID-19 infection occurs between 15 and 22 days after the onset of symptoms,but this period can extend up to 8 *** study aimed to assess the impact of concurrent COVID-19 infection on 120-day mortality after a fragility hip ***:A multi-centre prospective study across 10 hospitals treating 8%of the annual burden of hip fractures in england between 1st March and 30th April,2020 was *** whose surgical treatment was payable through the National Health Service Best Practice Tariff mechanism for"fragility hip fractures"were included in the ***'120-day mortality was assessed relative to their perioperative COVID-19 *** analysis was performed using SPSS version ***:A total of 746 patients were included in this study,of which 87(11.7%)were COVID-19 *** rates at 30-and 120-day were significantly higher for COVID-19 positive patients relative to COVID-19 negative patients(p<0.001).However,mortality rates between 31 and 120-day were not significantly different(p=0.107),16.1%and 9.4%respectively for COVID-19 positive and negative patients,odds ratio 1.855(95%CI 0.865-3.978).Conclusion:Hip fracture patients with concurrent COVID-19 infection,provided that they are alive at day-31 after injury,have no significant difference in 120-day *** the growing awareness and concern of "long-COVID"and its widespread prevalence,this does not appear to increase mediumterm mortality rates after a hip fracture.

关键词： Hip fractures Femoral fractures COVID-19 Coronavirus Mortality

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

To bridge or not to bridge:summary of the new evidence in endovascular stroke treatment

引用

Stroke & Vascular Neurology 2022年第3期7卷 179-181页

作者： Anna Podlasek Permesh Singh Dhillon Waleed Butt Iris Q Grunwald Timothy J england Tayside Innovation MedTech Ecosystem(TIME) University of DundeeDundeeUK NIHR Nottingham Biomedical Research Centre University of NottinghamNottinghamUK Interventional Neuroradiology Nottingham University Hospitals NHS TrustNottinghamUK Interventional Neuroradiology University Hospitals Birmingham NHS TrustBirminghamUK Stroke Division of Mental Health and Clinical NeurosciencesSchool of MedicineUniversity of NottinghamNottinghamUK Stroke University Hospitals of Derby and Burton NHS Foundation TrustDerbyUK

WHAT IS ALREADY KNOWN Recently published summaries and meta-analyses of four randomised controlled trials(RCTs)1-5 comparing direct mechan-ical thrombectomy(dMT)and bridging therapy with intravenous(IV)thrombolytics(alteplase)suggested that dMT is non-inferior to bridging therapy to achieve good functional outcome 3 months after stroke(modified Rankin Score 0-2)with the non-inferiority margin(NIM)<−5%.

关键词： intravenous bridging treatment

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Clinical and mechanical outcomes in isolated anterior cruciate ligament reconstruction vs additional lateral extra-articular tenodesis or anterolateral ligament reconstruction

引用

World Journal of Orthopedics 2022年第7期13卷 662-675页

作者： Nikhil Agarwal Jaibaji Monketh Andrea Volpin Department of Trauma and Orthopaedics University of AberdeenAberdeen AB243FXUnited Kingdom Health Education england North East Newcastle Upon Tyne NE158NYUnited Kingdom Department of Trauma and Orthopaedics NHS GrampianElgin IV301SNUnited Kingdom

BACKGROUND Anterior cruciate ligament(ACL) reconstruction has been a successful treatment for ACL *** ongoing rotational instability can be an *** surgical techniques have been recommended to overcome this including lateral extra-articular tenodesis(LET) and more recently anterolateral ligament reconstruction(ALLR).AIM To compare the clinical outcomes following ACL reconstruction(ACLR) alone or ACLR with either LET or *** A systematic review was conducted by means of four databases(MEDLINE,EMBASE,Cochrane and ***),and the Reference Citaion Analysis(https://***/) to identify all studies investigating either or both of LET and *** Critical Appraisal Skills Programme checklist for cohort studies was employed for critical appraisal and evaluation of all twenty-four studies which met the inclusion *** Pooled meta-analyses illustrated that ACLR with additional LET or ALLR results in improved pivot shift test scores,compared to isolated *** was no statistically significant difference in International Knee Documentation Committee(IKDC) clinical scores with addition of either LET or *** re-rupture rates were compared between LET and ALLR *** was a statistically significant difference between techniques,with a 1.14% rupture rate in ACLR +ALLR,and 4.03% rupture rate in ACLR + *** ACLR re-rupture rates were 12.59%,significantly higher than when augmented with either ALLR or LET(P < 0.0001 for both groups).There were no statistical differences in pivot shift test or IKDC scores between LET and ALLR *** This meta-analysis has found that use of either LET or ALLR in addition to ACLR results in improved mechanical outcomes suggesting surgeons should consider augmenting ACLR with an extra-articular procedure in patients with rotatory ***,both anterolateral extra articular procedures in addition to ACLR lead to reduced

关键词： Anterior cruciate ligament Knee Systematic review Lateral extra tenodesis Anterolateral ligament Knee surgery

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Statin, testosterone and phosphodiesterase 5-inhibitor treatments and age related mortality in diabetes

引用

World Journal of Diabetes 2017年第3期8卷 104-111页

作者： Geoffrey Hackett Peter W Jones Richard C Strange Sudarshan Ramachandran Department of Urology University of Bed-fordshire Department of Urology Heart of England NHS Foundation Trust Metabolic Research Group Institute of Science and Technology in Medicine Keele University Department of Clinical Biochemistry Heart of England NHS Foundation Trust Department of Clinical Biochemistry University Hospitals of North Midlands/Faculty of Health Sciences Staffordshire University

AIM To determine how statins, testosterone(T) replacement therapy(TRT) and phosphodiesterase 5-inhibitors(PDE5I) influence age related mortality in diabetic *** We studied 857 diabetic men screened for the BLAST study, stratifying them(mean follow-up = 3.8 years) into:(1) Normal T levels/untreated(total T > 12 nmol/L and free T > 0.25 nmol/L), Low T/untreated and Low T/treated;(2) PDE5I/untreated and PDE5I/treated; and(3) statin/untreated and statin/treated groups. The relationship between age and mortality, alone and with T/TRT, statin and PDE5 I treatment was studied using logistic regression. Mortality probability and 95%CI were calculated from the above models for each individual. RESULTS Age was associated with mortality(logistic regression, OR = 1.10, 95%CI: 1.08-1.13, P < 0.001). With all factors included, age(OR = 1.08, 95%CI: 1.06-1.11, P < 0.001), Low T/treated(OR = 0.38, 95%CI: 0.15-0.92, P = 0.033), PDE5I/treated(OR = 0.17, 95%CI: 0.053-0.56, P = 0.004) and statin/treated(OR = 0.59, 95%CI: 0.36-0.97, P = 0.038) were associated with lower mortality. Age related mortality was as described by Gompertz, r2 = 0.881 when Ln(mortality) was plotted against age. The probability of mortality and 95%CI(from logistic regression) of individuals, treated/untreated with the drugs, alone and in combination was plotted against age. Overlap of 95%CI lines was evident with statins and TRT. No overlap was evident with PDE5 I alone and with statins and TRT, this suggesting a change in the relationship between age and mortality. CONCLUSION We show that statins, PDE5 I and TRT reduce mortality in diabetes. PDE5 I, alone and with the other treatments significantly alter age related mortality in diabetic men.

关键词：打 2 糖尿病死亡 Gompertz-Makeham 方程 Phosphodiesterase 5 禁止者男性腺机能减退 Statins 睾丸激素代替治疗

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Sensitivity and Specificity of Pre-Operative Staging of the Axilla When Using OSNA in Breast Cancer Patients

引用

Advances in Breast Cancer Research 2016年第3期5卷 103-110页

作者： Jonathan D. Horsnell Kashif Choudhry Daniel Urriza-Rodriguez Alex Valencia Zenon Rayter Department of Breast Surgery North Bristol NHS Trust Bristol England Department of Radiology North Bristol NHS Trust Bristol England

Introduction: All patients with a new diagnosis of breast cancer undergo pre-operative axillary ultrasound (US) and biopsy to identify axillary metastases. The efficacy of this approach at identifying metastatic disease is particularly important if an intra-operative technique of assessment is used. This paper is the first to report the sensitivity and specificity of pre-operative axillary ultrasound within the context of the routine use of OSNA (one step nucleic acid amplification) (Sysmex, Japan), a molecular assay technique for the intra-operative analysis of axillary lymph nodes. This knowledge will help counsel patients prior to the procedure and inform economic analysis of the implications of this approach. Method: Consecutive patients diagnosed with invasive breast cancer between July 2009 and February 2012 at a single centre were identified by interrogation of MDT (multi disciplinary team) and surgical databases and a prospective database of all patients undergoing OSNA analysis. A standardised data collection sheet was used to record tumour characteristics and the nodal stage for each patient. These results were used to document the efficacy of preoperative US and biopsy of the axilla in comparison to intraoperative OSNA analysis. The data were then compared between two groups of patients, those whose nodes had been assessed using OSNA (the OSNA group) and those nodes had been tested using standard histopathological examination (the non-OSNA group). Results: A total of 377 eligible patients were identified. Within the OSNA group (n = 240) the sensitivity of pre-operative axillary US was 29% which rose to 41% when micro-metastases were excluded. A specificity and positive predictive value of 100% was recorded. The negative predictive value was 74%. There were no significant differences to the efficacy when the nodes were assessed with standard histopathology. The detection rate of micro-metastases was significantly higher in the OSNA group (P = 0.001), but t

关键词： Breast Cancer Axillary Metastases Ultrasound OSNA

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

A Calcified Artery of Drummond, Could It Be a Sentinel Sign of Further Complications?

引用

Surgical Science 2012年第9期3卷 460-462页

作者： Shahe Boghossian Arpan Banerjee Heart of england nhs Trust Birmingham UK

Objective: To understand the role of the artery of Drummond in the elderly population. The artery plays a crucial role in the anastamosis between the inferior mesenteric artery and superior mesenteric artery. Its maintenance is particularly important for the survivability of the bowel in events of stenosis of either one of the native arteries;SMA or IMA. Method: A 94 year old lady presents with post-prandial abdominal pain and significant emaciation. The patient undergoes clinical and radiological investigations to find out the cause of her ailments. Results: Abdominal X-ray revealed a serpentine structure that was later defined as the artery of Drummond, CT scan revealed a calcified and enlarged artery of Drummond in addition to an occluded origin of SMA and celiac artery as well as a severe stenosis origin of IMA. Conclusion: The artery of Drummond was immensely hypertrophied and was supplying the entire bowel through the native IMA;subsequent occlusion of the IMA was the main cause that caused the demise of the patient.

关键词： Artery of Drummond Mesenteric Ischeamia Refeeding Syndrome

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：