scholarly journals Code of practice for medical autopsies: a minimum standard position paper for pathology departments performing medical (hospital) autopsies in adults

2021 ◽  
Author(s):  
G. Cecilie Alfsen ◽  
Jacek Gulczyński ◽  
Ivana Kholová ◽  
Bart Latten ◽  
Javier Martinez ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Good Practice ◽  
Turnaround Time ◽  
Medical Procedure ◽  
Minimum Standard ◽  
Code Of Practice ◽  
Standard Position ◽  
Minimum Number ◽  
Minimum Requirements ◽  
High Standards

AbstractThe medical autopsy (also called hospital or clinical autopsy) is a highly specialised medical procedure, which requires professional expertise and suitably equipped facilities. To ensure high standards of performance, the Working Group of Autopsy Pathology of the European Society of Pathology (ESP) suggests a code of practice as a minimum standard for centres performing medical autopsies. The proposed standards exclusively address autopsies in adults, and not forensic autopsies, perinatal/or paediatric examinations. Minimum standards for organisation, standard of premises, and staffing conditions, as well as minimum requirements for level of expertise of the postmortem performing specialists, documentation, and turnaround times of the medical procedure, are presented. Medical autopsies should be performed by specialists in pathology, or by trainees under the supervision of such specialists. To maintain the required level of expertise, autopsies should be performed regularly and in a number that ensures the maintenance of good practice of all participating physicians. A minimum number of autopsies per dedicated pathologist in a centre should be at least 50, or as an average, at least one autopsy per working week. Forensic autopsies, but not paediatric/perinatal autopsies may be included in this number. Turnaround time for final reports should not exceed 3 weeks (14 working days) for autopsies without fixation of brain/spinal cord or other time-consuming additional examinations, and 6 weeks (30 working days) for those with fixation of brain/spinal cord or additional examinations.

scholarly journals Residents' Procedural Experience Does Not Ensure Competence: A Research Synthesis

2017 ◽  
Vol 9 (2) ◽  
pp. 201-208 ◽  
Author(s):  
Jeffrey H. Barsuk ◽  
Elaine R. Cohen ◽  
Joe Feinglass ◽  
William C. McGaghie ◽  
Diane B. Wayne
Keyword(s):  
Venous Catheter ◽  
Research Synthesis ◽  
Medical Procedure ◽  
Clinical Procedures ◽  
Simulated Performance ◽  
Northwestern University ◽  
Minimum Number ◽  
Overall Performance ◽  
Using Data ◽  
The Relationship

ABSTRACT Background Many medical certifying bodies require that a minimum number of clinical procedures be completed during residency training to obtain board eligibility. However, little is known about the relationship between the number of procedures residents perform and their clinical competence. Objective This study evaluated associations between residents' medical procedure skills measured in a simulation laboratory and self-reported procedure experience and year of training. Methods This research synthesis extracted and summarized data from multiple cohorts of internal medicine, emergency medicine, anesthesiology, and neurology resident physicians who performed simulated clinical procedures. The procedures were central venous catheter insertion, lumbar puncture, paracentesis, and thoracentesis. We compared residents' baseline simulated performance to their self-reported procedure experience using data from 7 research reports written by Northwestern University investigators between 2006 and 2016. We also evaluated how performance differed by postgraduate year (PGY). Results A total of 588 simulated procedures were performed during the study period. We found significant associations between passing the skills examinations and higher number of self-reported procedures performed (P = .011) and higher PGY (P < .001). However, performance for all procedures was poor, as only 10% of residents passed the assessments with a mean of 48% of checklist items correct (SD = 24.2). The association between passing the skills examination and year of training was mostly due to differences between PGY-1 and subsequent years of training. Conclusions Despite positive associations between self-reported experience and simulated procedure performance, overall performance was poor. Residents' clinical experience is not a proxy for skill.

scholarly journals The protection of consumers in rest homes - time for a change?

2021 ◽  
Author(s):  
◽  
Frederik Martell
Keyword(s):  
Consumer Protection ◽  
The Elderly ◽  
Access To Justice ◽  
Protection Measures ◽  
Code Of Practice ◽  
Rest Home ◽  
Statutory Protection ◽  
Minimum Requirements ◽  
Legal Position ◽  
Elderly Consumers

<p>This dissertation examines the statutory protection of elderly consumers in rest homes and makes several proposals of how to improve their protection. The dissertation compares New Zealand’s legislation with the existing rest home related legislation in Australia and Germany to improve New Zealand’s regulations.  At first, the dissertation characterises elderly consumers as a consumer group with special vulnerabilities. According to the dissertation several reasons can be identified, which justify regulatory intervention in favour of the elderly. Secondly, the dissertation gives an overview of the relevant rest home legislation in New Zealand, Australia and Germany.  In the later chapters the dissertation examines the existing information obligations, and the statutory protection of elderly consumers during the implementation and at the time of the termination of a rest home contract. The author argues that many of the existing consumer protection measures are not specifically tailored for consumers in rest homes and, therefore, do not ensure comprehensive protection. Furthermore, the author identifies several gaps in protection and proposes to introduce targeted new protection measures to close these gaps. Subsequently, the dissertation considers the access to justice for elderly consumers. The author states that the existing system offers some advantages but is far from being perfect. He speaks in favour of establishing a new Commissioner who is responsible for the issues of elderly consumers and the enhancement of their legal position.  Lastly and on the basis of the previous outcomes, the author recommends creating a new piece of legislation specifically tailored for the protection of elderly consumers in rest homes to implement all the proposed changes. In the author’s opinion a new Act could build on the existing consumer protection measures but should also improve them to ensure the best protection possible. The author also outlines how a code of practice should be put in place, which sets out minimum requirements.</p>

scholarly journals Assessment of mental capacity: a flow chart guide

2007 ◽  
Vol 31 (8) ◽  
pp. 304-307 ◽  
Author(s):  
Michael Church ◽  
Sarah Watts
Keyword(s):  
Good Practice ◽  
Good Clinical Practice ◽  
Legal Framework ◽  
Mental Capacity ◽  
Flow Chart ◽  
Code Of Practice ◽  
Health And Social Care ◽  
Mental Capacity Act 2005 ◽  
Informal Carers ◽  
Mental Capacity Act

The Mental Capacity Act 2005 provides a new legal framework within which health and social care professionals (as well as informal carers) must act when providing care and treatment for the estimated 2 million people in England, Wales and Northern Ireland who lack the capacity to make certain decisions for themselves. Although the Mental Capacity Act 2005 Code of Practice provides comprehensive advice on good practice in assessing capacity, it does not identify a specific process to be used. Good clinical practice depends on the exercise of clinical judgement within a valid and contestable process. This article outlines a flow chart (Fig. 1) that can be used to guide the process of capacity assessments in more complex cases, in line with the Mental Capacity Act 2005 and the Code of Practice.

Floating Hose Behavior During Different Scenarios of an Offloading Operation

2020 ◽  
Author(s):  
Nathalia Paruolo ◽  
Thalita Mello ◽  
Leonardo Brandão
Keyword(s):  
Numerical Model ◽  
Bending Strength ◽  
Full Time ◽  
Coupled Numerical Model ◽  
Oil Exploitation ◽  
Environmental Criteria ◽  
Oil Pipelines ◽  
Minimum Number ◽  
Minimum Requirements ◽  
Minimum Distances

Abstract Considering the deep water oil exploitation in remote fields far away from the coast, the use of shuttle tankers connected to FPSOs (Floating, Production, Storage and Offloading) for offloading and oil transporting shows to be a preferred alternative compared to constructing oil pipelines considering technic and economic matters, even if offshore offloading operation is still considered one of the riskiest operations in the offshore environment. From the concerns about hazards of an offloading operation, one is related to hose failure during oil transferring and the consequences on the environment. Different aspects of FPSO and shuttle tanker influence floating hose behavior during offloading operation as environmental condition, ships loading conditions, ships distance, heading, FPSO offloading station position and number of hose sections. The different aspects may be combined in several scenarios, in which integrity of floating hoses in terms of tension and bending strength shall be guaranteed. In the present paper, global numerical analyses of offloading operation considering a spread moored FPSO and a typical dynamic positioning shuttle tanker (DPST) moored in tandem are carried out. The analyses are based on a coupled numerical model of FPSO, DPST and floating hose [2]. Covering a wide combination of the scenarios considering the aspects listed above, full time domain simulation is used to estimate hose sections force and moments during the operation. Numerical model results are validated for a couple of scenarios against field data. With focus on floating hose integrity, the main objective is to define minimum requirements for a safe offloading operation, as environmental criteria, maximum and minimum distances between FPSO and DPST, limit operating sectors and minimum number of hose sections. The results can be used as reference to offloading procedures and manuals of owners and operators in combination with recommendations of international organizations.

scholarly journals Opportunities for Refinement of Non-Human Primate Vaccine Studies

Vaccines ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 284
Author(s):  
Mark J. Prescott ◽  
Carolyn Clark ◽  
William E. Dowling ◽  
Amy C. Shurtleff
Keyword(s):  
Social Housing ◽  
Environmental Enrichment ◽  
International Workshop ◽  
Good Practice ◽  
High Quality ◽  
National Centre ◽  
High Standards ◽  
High Level ◽  
Scientific Value ◽  
Human Primate

Non-human primates (NHPs) are used extensively in the development of vaccines and therapeutics for human disease. High standards in the design, conduct, and reporting of NHP vaccine studies are crucial for maximizing their scientific value and translation, and for making efficient use of precious resources. A key aspect is consideration of the 3Rs principles of replacement, reduction, and refinement. Funders of NHP research are placing increasing emphasis on the 3Rs, helping to ensure such studies are legitimate, ethical, and high-quality. The UK’s National Centre for the 3Rs (NC3Rs) and the Coalition for Epidemic Preparedness Innovations (CEPI) have collaborated on a range of initiatives to support vaccine developers to implement the 3Rs, including hosting an international workshop in 2019. The workshop identified opportunities to refine NHP vaccine studies to minimize harm and improve welfare, which can yield better quality, more reproducible data. Careful animal selection, social housing, extensive environmental enrichment, training for cooperation with husbandry and procedures, provision of supportive care, and implementation of early humane endpoints are features of contemporary good practice that should and can be adopted more widely. The requirement for high-level biocontainment for some pathogens imposes challenges to implementing refinement but these are not insurmountable.

scholarly journals Setting Up and Providing Telepsychiatry Services in India

2020 ◽  
Vol 42 (5_suppl) ◽  
pp. 4S-10S
Author(s):  
Furkhan Ali ◽  
Vachana Kamila ◽  
Mahesh R Gowda ◽  
Preeti Srinivasa ◽  
Guru S Gowda ◽  
...  
Keyword(s):  
Practice Guidelines ◽  
Good Practice ◽  
Legal Aspects ◽  
Healthcare Sector ◽  
Medical Council ◽  
The Past ◽  
Indian Medical ◽  
Minimum Requirements ◽  
Set Up ◽  
The Needy

The exponential growth of technology in the past few decades has benefitted the healthcare sector. Telemedicine is a newer advancement which is making healthcare affordable and more accessible to the needy in recent times. This article discusses how to set up telepsychiatry services, the procedure of telepsychiatry consultation, how to record and maintain the electronic health records, the potential challenges, ethical and legal aspects concerning telepsychiatry while ensuring the good practice guidelines, medical ethics, patient rights, and the minimum requirements as established by the Information Technology Act and the telemedicine practice guidelines (TPG) 2020 issued by the Indian Medical Council.

The Connor-Davidson Resilience Scale as a Positive Psychology Measure for People With Spinal Cord Injuries

2013 ◽  
Vol 27 (3) ◽  
pp. 213-222 ◽  
Author(s):  
Mayu Fujikawa ◽  
Eun-Jeong Lee ◽  
Fong Chan ◽  
Denise Catalano ◽  
Celeste Hunter ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Factor Analysis ◽  
Positive Psychology ◽  
General Population ◽  
Spinal Cord Injuries ◽  
Rehabilitation Counseling ◽  
Research And Practice ◽  
Resilience Scale ◽  
Confirmatory Factor ◽  
High Standards

The main objective of this study is to evaluate the measurement structure of the Connor-Davidson Resilience Scale (CD-RISC) as a positive psychology measure for people with spinal cord injuries (SCIs) using confirmatory factor analysis. The participants consisted of 274 Canadians with SCI living in the community. The result indicated that the 5-factor intercorrelated model fits the data reasonably well (χ2 = 635.20; p value < .001; χ2/df = 2.40; CFI = .90; RMSEA = 0.07). These 5 factors (personal competence, high standards, and tenacity; trust in one’s instincts, tolerance of negative affect, and strengthening effects of stress; positive acceptance of change and secure relationships; control; and spiritual influence) correlated positively with disability acceptance and happiness, and inversely related to depression. The reliability of the 5 subscales was good ranging from .65 to .92. In conclusion, the results of this study confirmed that the 5-factor structure of the CD-RISC observed in the general population can be replicated in a sample of Canadians with SCI. This resilience scale can be used as a positive psychology measure in rehabilitation counseling research and practice.

scholarly journals Model systems to elucidate minimum requirements for protected areas networks

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Yolanda F. Wiersma ◽  
R. Troy McMullin ◽  
Darren J. H. Sleep
Keyword(s):  
Conservation Biology ◽  
Simulation Models ◽  
Model System ◽  
Model Systems ◽  
Gamma Diversity ◽  
Birch Trees ◽  
Minimum Number ◽  
Minimum Requirements ◽  
Support Software ◽  
Novel Model

AbstractIn conservation biology there have been varying answers to the question of “How much land to protect?” Simulation models using decision-support software such as Marxan show that the answer is sensitive to target type and amount, and issues of scale. We used a novel model system for landscape ecology to test empirically whether the minimum conservation requirements to represent all species at least once are consistent across replicate landscapes, and if not, whether these minimum conservation requirements are linked to biodiversity patterns. Our model system of replicated microcosms could be scaled to larger systems once patterns and mechanisms are better understood. We found that the minimum representation requirements for lichen species along the microlandscapes of tree trunks were remarkably consistent (4–6 planning units) across 24 balsam fir trees in a single stand, as well as for 21 more widely dispersed fir and yellow birch trees. Variation in minimum number of planning units required correlated positively with gamma diversity. Our results demonstrate that model landscapes are useful to determine whether minimum representation requirements are consistent across different landscapes, as well as what factors (life history, diversity patterns, dispersal strategies) affect variation in these conservation requirements. This system holds promise for further investigation into factors that should be considered when developing conservation designs, thus yielding scientifically-defensible requirements that can be applied more broadly.

Increasing pharmacy productivity and reducing medication turnaround times in an Italian comprehensive cancer center by implementing robotic chemotherapy drugs compounding

2021 ◽  
pp. 107815522199285
Author(s):  
Martina Capilli ◽  
Fiorenza Enrico ◽  
Matteo Federici ◽  
Tiziana Comandone
Keyword(s):  
Workflow Management ◽  
Turnaround Time ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Antineoplastic Drugs ◽  
Chemotherapy Drugs ◽  
Accuracy And Precision ◽  
Number Of Patients ◽  
High Standards ◽  
The Impact

Introduction The management of antineoplastic drugs used for chemotherapy is widely recognized as a high-risk activity. In 2018, our oncology pharmacy implemented workflow improvements to manage the growing workload due to the centralisation of activities from a hospital’s satellite pharmacy, moving towards automated compounding of antineoplastic drugs. The aim of this study was to determine the impact of the centralization on the productivity of the pharmacy department and evaluate the performances of the robotic chemotherapy drugs compounding. Material and methods Data were collected from the hospital information system and the workflow management software, and examined over a 3-year period (2017–2019). The total annual throughput in terms of doses prepared and patients treated and the Medication Turnaround Time (MTAT) were determined. Productivity and dosage accuracy were calculated for the robotic system. Results In 2018, the number of patients treated increased by 16.6%, consequently, the overall number of intravenous preparations compounded in the pharmacy increased by 17.2%. Regarding manual compounding, the total number of antineoplastic preparations decreased by about 2%. Investigational treatments manually compounded increased by about 27%, in contrast to the non-investigational treatments, which decreased by 9.4%. Regarding robotic compounding, the annual production increased by 50.4%. In 2018, the MTAT decreased about 24%. The dosage accuracy and precision of the total amount of doses were -1.1% and 1.2%, respectively. Conclusion This study indicates that in the effort to satisfy an ever-increasing workload, computerization and automation are essential instruments to maintain and ensuring high standards of quality.

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