Experience Of Departments Research Articles

Ten things your emergency department should consider to prepare for pandemic influenza

Pandemic influenza remains a potential major threat to global public health. It is essential for emergency departments to be involved in planning for the management of such a major event....

Die Überwachung von Trinkwasseranlagen auf Märkten und in Fahrzeugen

The new German Drinking Water Ordinance (TrinkwV 2001) demands that the requirements of water intended for human consumption be met up to the intrinsic tap, at which the water is used. This also applies to water supply systems for food trade aboard non-stationary facilities and in vehicles for commercial purposes. In contrast to stationary units for drinking water supply, the nonstationary units relocate and the responsibility changes with each public health authority agent. Therefore, a coordinated action between the federal states is desirable and necessary. The experience of the public health departments presents many non-compliant parameters of microbiology in water supply systems on markets and in vehicles. The development of practical and consistent recommendations for the surveillance of non-stationary units is required to give consistent standards to the users. The article gives a review about legal foundations and technical rules in order to define the drinking water supply systems on markets and in vehicles in compliance with the German Drinking Water Ordinance. Examples of laboratory results from different monitoring episodes from three federal states are shown.

Day-to-Day Challenges of a Shipping Company From the Technical Department’s Point of View: Lessons Learned

Working for one of the largest shipping companies in Greece is not an easy task. The challenges from the day-to-day vessel operation never stop and the maritime environment, which grows more challenging by the day, demands that the technical department is on a constant state of alert. The paper discusses the lessons learned from the many years of the authors' combined experience in the technical departments of a bulk carrier operator and of its tanker counterpart. The most interesting and diverse cases are outlined together with the conclusions and the necessary alterations to the procedures and work practices established as a result of the experiences gained. The following cases are examined:propeller damage on a Capesize bulk carrier from inherent casting defects,main engine camshaft problems originating from initial poor design,cracking of main engine bedplate bearing girders on a very large crude carrier (VLCC) attributed to unauthorized repairs and casting defects,failure cases of fitted bolts in marine applications,premature failure of main engine piston crowns, andsea chest ballast valve problems on a VLCC attributed to poor detail design.

Freedom or coercion?: NPM incentives in New Zealand central government departments

Incentives have a major presence in the language of new public management (NPM) which seeks to apply agency theory concepts and market sector practices to government. This article examines the experience of New Zealand central government departments with a series of financial management incentives built on an accrual accounting base centred on outputs. These incentives included a capital charge, the treatment of departmental surpluses and interest earned on cash balances, and performance-based rewards for chief executives. How well these operated is examined in light of avowed principles of managerial freedom and competition with alternative providers. The incentives, and the rules accompanying them, are found to have been developed in a fashion that has eroded the resources of departments, and their ability to deliver services over the longer term, and constrains managerial freedom. Accordingly, claims about the applicability of private sector models, managerial freedom and transparency needed to be treated with caution.

Freedom or coercion?NPM incentives in New Zealand central government departments

Abstract Incentives have a major presence in the language of new public management (NPM) which seeks to apply agency theory concepts and market sector practices to government. This article examines the experience of New Zealand central government departments with a series of financial management incentives built on an accrual accounting base centred on outputs. These incentives included a capital charge, the treatment of departmental surpluses and interest earned on cash balances, and performance-based rewards for chief executives. How well these operated is examined in light of avowed principles of managerial freedom and competition with alternative providers. The incentives, and the rules accompanying them, are found to have been developed in a fashion that has eroded the resources of departments, and their ability to deliver services over the longer term, and constrains managerial freedom. Accordingly, claims about the applicability of private sector models, managerial freedom and transparency needed to be treated with caution.

The patient experience in emergency departments: a review of the literature

This paper analyses the literature on the patient experience within emergency departments. We identify six themes within the literature: waiting times, communication, cultural aspects of care, pain, the environment and dilemas in accessing the patient experience. Overall, the literature has a North American bias and is largely quantitative in approach. Although levels of patient satisfaction are high, a number of issues arise within the review, which suggest areas where quality of care could improve. We also identify the problematic nature of accessing the patient experience and suggest future areas for researchers to explore.

Computers and undergraduate mathematics 2: on the desktop

This, the second of a series of papers [two of which appeared in the issue 35 (2000) of this journal Computers and Education 35 (2000) 95, 123] focuses our analysis of the use of computers for undergraduate mathematics on the ‘stand alone’ scenario. The taxonomy outlined in the first paper is developed to classify the types of software in common use, and analyse the various ways in which the computer can empower the student and broaden the learning process. We report on the experience of some important math departments in the US, UK and Australia: detailed evaluations however are disappointingly hard to find.

The Application of Rubber Dams for Water Supply in Hong Kong

ABSTRACTThere is a long history of the use of inflatable dams (rubber dams) in Hong Kong. Three inflatable dams were constructed in the 1960s as an integral part of the Plover Cove water supply scheme which was the largest project in Hong Kong at that time. However, because most civil‐engineering structures are constructed from steel, concrete, soil and rock, the use of rubber as a construction material is subject to much scepticism. The problems and counter‐measures associated with the use of rubber are discussed, based upon the experience of several departments which have used the dams in Hong Kong, and in other parts of the world.

The Polish Experience with Bank and Enterprise Restructuring

Poland's program tackled simultaneously bank and enterprise restructuring and dealt decisively with the bad debt stock and flow problem with measures to improve incentives and institutional skills. Among transition economies, Poland was a pioneer in bank and enterprise restructuring. The main tool it used to implement the restructuring program was the 1993 law on financial restructuring of enterprises and banks, in an approach that encouraged banks to play a central role in enterprise restructuring. Bank recapitalization was linked to improvements in the banks' operating systems aimed at increasing efficiency and loan recovery. Poland's program to restructure banks and enterprises was successful because it was comprehensive. It tackled banks and enterprises at the same time, dealing both with the bad debt stock problem and the associated flow problem. It made assistance on the stock problem contingent on concrete actions to improve lending practices, with the prospect of possible privatization or liquidation. The lesson Poland's experience offers is that solving the stock problem through bank recapitalization is necessary but not sufficient. Bank recapitalization without measures to improve performance incentives and bank skills is likely to fail. Poland was also realistic about isolating too important to fail enterprises, providing special temporary budget support (after progress in key areas) that gave the program political viability. Poland took steps to modernize bank supervision and adopted measures to privatize banks and set up workout units showing genuine interest in changing banking practices. Poland's banking sector now resembles a modern market economy in structure. Commercial banks have a more than adequate capital base. Banking competition has increased and the sector seems relatively efficient and profitable. The experience of the workout departments has strengthened the skills needed for credit allocation and monitoring. Some positive results in enterprising restructuring have been linked to the banks' central role in enterprise governance, maintaining incentives to avoid unloading debt on the government, resolving conflicts between creditors to avoid triggering unnecessary liquidations, and preventing unnecessary bankruptcies. But it is unclear whether enterprises are on a healthy path or whether a second wave of bad loans may emerge, especially after a downswing in the business cycle. This paper - a product of the Financial Sector Development Department - is based in part on the findings of a broader study for the Operations Evaluation Department.

A major outbreak of asthma associated with a thunderstorm: experience of accident and emergency departments and patients' characteristics

To investigate the time course of an epidemic of asthma after a thunderstorm, characteristics of patients affected, and the demand on emergency medical resources. Study of registers and records in accident and emergency departments and questionnaire to staff. London area. All patients presenting at 12 accident and emergency departments with asthma or other airway disease. Numbers of patients, clinical features, information on shortage of resources--equipment, drugs and staff. The epidemic had a sudden onset on 24 June 1994; 640 patients with asthma or other airways disease attended during 30 hours from 1800 on 24 June, nearly 10 times the expected number. Over half (365) the patients were aged 21 to 40 years. A history of hay fever was recorded in 403 patients; for 283 patients this was the first known attack of asthma; a history of chronic obstructive airways disease was recorded in 12 patients. In all, 104 patients were admitted (including five to an intensive care unit). Several departments ran out of equipment or drugs, called in additional doctors, or both. This study supports the view that this epidemic was larger than previously reported epidemics and the hypothesis that "thunderstorm associated asthma' is related to aeroallergens. Demands on resources were considerable; a larger proportion of patients needing intensive care would have caused greater problems.

Bier's block — the experience of Australian emergency departments

To describe the current use, effectiveness and safety of Bier's block within Australian emergency departments. A review of clinical practice based on an opinion survey of directors of emergency departments. Directors of 120 private and public hospital emergency departments. A response rate of 97% was achieved. Bier's block was used in 67% of Australian emergency departments. Emergency department medical staff performed the procedure in 83% of these hospitals. It was estimated that 7500 emergency department Bier's blocks were performed each year. Ninety-six per cent of respondents found Bier's block to produce adequate regional anaesthesia. Reported complications or adverse reactions were extremely rare. A wide variation in procedural approach was evident. Bier's block is a popular, reliable and relatively safe anaesthetic technique for use in emergency departments. Increased surveillance of local anaesthetic morbidity associated with the technique, as well as a standardisation of the procedure in the emergency department setting, are required.

Engineering, the Developing Career—A Personal View

The President refers to his early career in teaching and research and outlines some of the benefits. He identifies his involvement in offshore engineering as one major turning point in his career. It was a great opportunity for real collaboration between industry and higher education; progress usually required a multi-disciplinary approach and commitment from engineers, scientists and managers alike. Having added subsequently to his direct experience of industry, commerce and government departments and to his contacts with other professions in engineering and science he offers a few of his own thoughts on the health of smaller manufacturing companies, on the environment and on waste, each a matter critical in its own way to our future, nationally and globally.

A Survey of the Views of Elderly Out-patients on their Physiotherapy Treatment

A postal questionnaire was used to obtain the views of 100 patients on their physiotherapy treatment immediately after discharge from the Richmond Rehabilitation Unit for the Elderly. Factors associated with treatment were examined and particular attention was given to the outcome of treatment in terms of patients' initial problems. The standard of treatment was rated highly in closed items, sentence completion items and free comments. The most frequently reported problems were also those judged by patients to have the most successful outcomes. These comprised pain, stiffness, swelling, walking, getting comfortable in bed, weakness and managing household jobs. It was evident that treatment regarding common problems of daily living enabled many patients to improve or maintain their quality of life and level of independence. Attention is drawn to the economic implications and to the clear indication for increasing the provision of such services. A postal questionnaire was used to obtain the views of 100 patients on their physiotherapy treatment immediately after discharge from the Richmond Rehabilitation Unit for the Elderly. Factors associated with treatment were examined and particular attention was given to the outcome of treatment in terms of patients' initial problems. The standard of treatment was rated highly in closed items, sentence completion items and free comments. The most frequently reported problems were also those judged by patients to have the most successful outcomes. These comprised pain, stiffness, swelling, walking, getting comfortable in bed, weakness and managing household jobs. It was evident that treatment regarding common problems of daily living enabled many patients to improve or maintain their quality of life and level of independence. Attention is drawn to the economic implications and to the clear indication for increasing the provision of such services. Biography: Having gained general experience in out-patient departments, the author worked at a geriatric hospital for several years before taking up an appointment at Richmond Rehabilitation Unit for the Elderly where physiotherapy is available to patients aged 60 years and over on an out-patient basis.

BRITAIN'S ADMINISTRATIVE ELITE: PERMANENT SECRETARIES 1900–1986

This article is based upon analysis of biographical data of those men and women who reached the rank of Permanent Secretary in the career civil service between 1900 and 1986. Among other matters, the article gives details of the schools and universities attended by Permanent Secretaries, their age on, and mode of, entry to the civil service, and their career pattern within that service, including the number of departments served in, the age of appointment to the rank of Permanent Secretary, and the length of tenure in that role. The evidence shows that for the present cadre of Permanent Secretaries the route to the top has been characterized by inter‐departmental mobility, private office service, and experience in the key central departments of the Treasury and the Cabinet Office.

Contracting for Program Evaluation Resources

Abstract: A number of problems with balancing in-house and contract resources, and with the contracting process itself, prompted DSS to try to establish some “rules of thumb” for program evaluation, based on the experience of other government departments. Questions were asked of eleven departments and agencies on three main topics: the balance of in-house and contract resources, the process of selecting contractors, and the issue of costs and budgets. The resulting responses translate into a “pattern for success” for managing the evaluation function, in light of the current trend to increased use of contracting resources.

Initial experiences with a formalised teaching programme in diagnostic radiology during the clinical undergraduate course

The initial experiences of a four-week clinical undergraduate attachment in diagnostic radiology are described. The course is divided into (1) a series of prepared lecture programmes which cover aspects of diagnostic radiology in a systematic manner, (2) experience in hospital X-ray departments, observing special investigations and routine reporting, attending clinicoradiological conferences and receiving informal and formal tuition from radiologists, and (3) visits to specialised radiological and other imaging departments, namely ultrasound, nuclear medicine, neuroradiology and paediatrics. The aims of the courses are: (i) to provide a means of teaching clinical subjects and pathology in a dimension which crosses the tightly compartmentalised undergraduate curriculum; (ii) to instil basic principles of radiological interpretation, (iii) to teach undergraduates how to use the facilities of diagnostic imaging departments effectively and efficiently when they have qualified; (iv) to increase interest in the specialty, and insight into student opinion. There are difficulties involved in this large teaching commitment, for instance, understaffing, and the development of the course has been geared to counteracting these problems.

Emergency medical technician-paramedic training

With a nationally standardized emergency medical technician-paramedic training program soon to be adopted, certain factors in the planning of training programs should be emphasized. (1) The facilities should provide an opportunity for the paramedics to gain clinical experience in intensive care units and emergency departments. Teaching must be appropriate to the students' educational background. (2) The course content should include advanced life-support. (3) Full-time and part-time programs must be developed, possibly using a modular format. (4) The operating procedure should conform to local medical and legal practice. (5) Mechanisms for evaluation and recertification must be developed. (6) Continuing education, as important or more important than the original training, should be included in program planning.

Manufacture of lead shields

I was most interested to read a description by Mr. Douglas Jones (Jones, 1971) of an elegant method for the accurate manufacture of lead shields, using the modern plastic equivalent of the ancient “cire perdu” casting process. The foundry work involved, although simple, is probably outside the experience of many radiotherapy departments. In acquiring the necessary skill three mistakes are liable to be made. The sand may be too dry or too loosely packed, and as a result, the casting will be ragged or even unusable. On the other hand the sand may be too moist, and in consequence picturesque mayhem arises in the casting room as steam is generated during pouring, and molten lead is blown back through the sprue hole.

Management improvement in the federal government: An inside view

Our mammoth federal bureaucracy, set up to handle growing numbers of programs and budgets, offers the greatest management challenge in history. Drawing on his experience in various federal departments, the author describes some of the major problems facing managers in federal government: lack of expertise, divided loyalties, the separation of management from policy development, neglect of less visible tasks, inability to measure results, and cumbersome administrative mechanisms. Using several examples, he shows how a practical approach, utilizing basic management principles, has helped to solve some of these problems. The quality of top managers has been improved, management planning and control improved, and programs simplified and decentralized.

Internationalizing Colleges and Universities

Dean Cordier has cautioned wisely that centers of international studies should concentrate on excellence rather than on universality of coverage and should not expand beyond the limits of their expertise. I shall develop a complementary theme, asserting that within any college or university a number of departments and professional schools have responsibility for international studies. Centers of international studies cannot reach their maximum potential if these responsibilities are not carried out. The first portion of my comments will be concerned with international relations but later discussion will be broadened to include other aspects of international studies. Over the past two decades the experience of university departments and centers traditionally concerned with international relations has been rather similar to that of foreign offices in national governments. Until recently the foreign office served as the agent of government through which most foreign affairs were conducted. As a variety of economic, social, cultural, and scientific problems were added to the agendas of intergovernmental dialogue, other departments of government became increasingly involved in international relations. Foreign offices have attempted to control, or at least coordinate, the foreign relations of their sister departments of government but with limited success. As each department of government becomes involved directly in international relations there are wider and wider areas of international activity in which the foreign office is involved only marginally. Similarly, departments and professional schools of colleges and universities heretofore uninterested in international relations now are increasingly involved. This includes direct participation in international relations through expanding activities of international pro-