Facility Personnel Research Articles

Examining the Relationship Between Environmental Factors and Inpatient Hospital Falls: Protocol for a Mixed Methods Study.

BackgroundPatient falls are the most common adverse events reported in hospitals. Although it is well understood that the physical hospital environment contributes to nearly 40% of severe or fatal hospital falls, there are significant gaps in the knowledge about the relationship between inpatient unit design and fall rates. The few studies that have examined unit design have been conducted in a single hospital (non-Veterans Health Administration [VHA]) or a small number of inpatient units, limiting generalizability. The goal of this study is to identify unit design factors contributing to inpatient falls in the VHA.ObjectiveThe first aim of the study is to investigate frontline and management perceptions of and experiences with veteran falls as they pertain to inpatient environmental factors. An iterative rapid assessment process will be used to analyze the data. Interview findings will directly inform the development of an environmental assessment survey to be conducted as part of aim 2 and to contribute to interpretation of aim 2. The second aim of this study is to quantify unit design factors and compare spatial and environmental factors of units with higher- versus lower-than-expected fall rates.MethodsWe will first conduct walk-through interviews with facility personnel in 10 medical/surgical units at 3 VHA medical centers to identify environmental fall risk factors. Data will be used to finalize an environmental assessment survey for nurse managers and facilities managers. We will then use fall data from the VA Inpatient Evaluation Center and patient data from additional sources to identify 50 medical/surgical nursing units with higher- and lower-than-expected fall rates. We will measure spatial factors by analyzing computer-aided design files of unit floorplans and environmental factors from the environmental assessment survey. Statistical tests will be performed to identify design factors that distinguish high and low outliers.ResultsThe VA Health Services Research and Development Service approved funding for the study. The research protocol was approved by institutional review boards and VA research committees at both sites. Data collection started in February 2018. Results of the data analysis are expected by February 2022. Data collection and analysis was completed for aim 1 with a manuscript of results in progress. For aim 2, the medical/surgical units were categorized into higher- and lower-than-expected fall categories, the environmental assessment surveys were distributed to facility managers and nurse managers. Data to measure spatial characteristics are being compiled.ConclusionsTo our knowledge, this study is the first to objectively identify spatial risks for falls in hospitals within in a large multihospital system. Findings can contribute to evidence-based design guidelines for hospitals such as those of the Facility Guidelines Institute and the Department of Veterans Affairs. The metrics for characterizing spatial features are quantitative indices that could be incorporated in larger scale contextual studies examining contributors to falls, which to date often exclude physical environmental factors at the unit level. Space syntax measures could be used as physical environmental factors in future research examining a range of contextual factors—social, personal, organizational, and environmental—that contribute to patient falls.International Registered Report Identifier (IRRID)DERR1-10.2196/24974

Medical evacuation of remote industrial sites personnel. Fundamental problems and methods of its solving

Introduction. The organization of medical assistance for employees of remote industrial facilities is a highly pressing task, and the role of medical evacuation in the health care system can hardly be overestimated. There is currently no unified medical evacuation system. There is no data on the structure of the reasons for evacuations and economic justification for the required amount of funding for this area in Russia. Purpose. The assessment of the structure of the reasons for medical evacuations of the personnel from remote industrial facilities and their possible relationship to seasonality, the profile of the enterprises, and the age of workers. Material and methods. Considering that men constitute most industrial facilities’ personnel, the analysis of 1,823 evacuations among male personnel (1,159 planned and 664 emergencies) was carried out. The structure of the reasons for evacuations was studied depending on the age, season, and industrial enterprise profile. The χ2 Pearson criterion (significance level p <0.05) was used to assess the significance of differences between analyzed indices. Results. In the structure of all evacuations of the personnel of remote industrial facilities, diseases of the circulatory system are the leading reason for evacuations, followed by injuries and poisoning, diseases of the digestive system and respiratory diseases. The main reason for emergency evacuations is injuries and poisoning. In the group of workers under 39 years old, injuries and poisoning, diseases of the digestive system and diseases of the circulatory system take the first three positions. In the more senior age groups, diseases of the circulatory system prevail, injuries and poisoning take second place, and digestive diseases take third place. Conclusion. The main directions in improving the health care system and maintaining the health of the personnel of remote industrial facilities include the development of the legal framework for activities in the field of remote health care, the organization of the unified state system of medical evacuations, the development and the implementation of telemedicine technologies, the organization of educational courses and training programs for medical professionals in the field of remote health care.

Decreases in COVID-19 Cases, Emergency Department Visits, Hospital Admissions, and Deaths Among Older Adults Following the Introduction of COVID-19 Vaccine - United States, September 6, 2020-May 1, 2021.

Throughout the COVID-19 pandemic, older U.S. adults have been at increased risk for severe COVID-19-associated illness and death (1). On December 14, 2020, the United States began a nationwide vaccination campaign after the Food and Drug Administration's Emergency Use Authorization of Pfizer-BioNTech COVID-19 vaccine. The Advisory Committee on Immunization Practices (ACIP) recommended prioritizing health care personnel and residents of long-term care facilities, followed by essential workers and persons at risk for severe illness, including adults aged ≥65 years, in the early phases of the vaccination program (2). By May 1, 2021, 82%, 63%, and 42% of persons aged ≥65, 50-64, and 18-49 years, respectively, had received ≥1 COVID-19 vaccine dose. CDC calculated the rates of COVID-19 cases, emergency department (ED) visits, hospital admissions, and deaths by age group during November 29-December 12, 2020 (prevaccine) and April 18-May 1, 2021. The rate ratios comparing the oldest age groups (≥70 years for hospital admissions; ≥65 years for other measures) with adults aged 18-49 years were 40%, 59%, 65%, and 66% lower, respectively, in the latter period. These differential declines are likely due, in part, to higher COVID-19 vaccination coverage among older adults, highlighting the potential benefits of rapidly increasing vaccination coverage.

Expert advice on management of urban nucleic acid testing base

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA detection is the key link for the precise epidemic prevention and control, and the urban detection bases have been proved to be achieved great successes in increasing the regional nucleic acid detection ability and efficiency. This expert advice contains ten aspects: environment and facilities management, personnel management and training, equipment management, materials management, quality management, bio-safety management, medical waste management, information system management, result report, supervision and continuous improvement. This manual aims to provide standards and suggestions for the SARS-CoV-2 RNA detection base management for ensuring the standardized, safe and orderly operation of the base to complete large-scale nucleic acid screening with high efficiency and quality. It also could be used by other SARS-CoV-2 RNA detection laboratory as reference.

Assessment of the accuracy of malaria microscopy in private health facilities in Entebbe Municipality, Uganda: a cross-sectional study

BackgroundAlthough microscopy remains the gold standard for malaria diagnosis, little is known about its accuracy in the private health facilities in Uganda. This study evaluated the accuracy of malaria microscopy, and factors associated with inaccurate smear results at private health facilities in Entebbe Municipality, Uganda.MethodsBetween April and May 2018, all patients referred for a malaria smear in 16 private health facilities in Entebbe municipality were screened, and 321 patients were enrolled. A questionnaire was administered to collect demographic and clinical information, facility-based smear results were recorded from the participant’s consultation notes, and a research slide was obtained for expert microscopy during exit interview. A health facility assessment was conducted, and information on experience in performing malaria microscopy was collected from all facility personnel reading smears and the data was linked to the participant’s clinic visit.ResultsThe test positivity rate of malaria parasitaemia was 15.0% by expert microscopy. The sensitivity, specificity and negative predictive value of the facility-based microscopy were high (95.8%, 90.1 and 99.2%, respectively). However; the positive predictive value (PPV) was low with 27/73 (63%) patients diagnosed with malaria not having the disease. Majority of the inaccurate results were from 2 of the 23 laboratory personnel reading the smears. The factors associated with inaccurate smear readings included being read by a technician; (1) who had less than 5 years’ experience in reading malaria smears (adjusted Odds Ratio [aOR] = 9.74, 95% confidence interval [CI] (1.06–89.5), p-value = 0.04), and (2) who was examining less than 5 smears a day (aOR = 38.8, 95% CI 9.65–156, p-value < 0.001).ConclusionsThe accuracy of malaria microscopy in this setting was high, although one third of the patients diagnosed with malaria did not have the disease. Majority of the errors in smear readings were made by two laboratory personnel, with the main factor associated with inaccurate smear results being low experience in malaria microscopy. In-service training may be sufficient to eliminate inaccurate smear results in this setting, and these private facilities would be ideal model facilities to improve the quality of malaria microscopy in Uganda especially in the public sector where accuracy is still poor.

АКТУАЛЬНЫЕ ВОПРОСЫ ОБЕСПЕЧЕНИЯ РАБОТНИКОВ РАДИАЦИОННО ОПАСНЫХ ПРОИЗВОДСТВ СРЕДСТВАМИ ИНДИВИДУАЛЬНОЙ ЗАЩИТЫ

Purpose: The article covers issues related to the providing personal protection for the personnel of radiation hazardous facilities. Specific character of working conditions at the enterprises in the field of atomic energy use is caused by extremely high toxic level of radioactive substances and the fact that there is no human sense organ which can identify dangerous levels of radiation exposure. Establishment of mandatory requirements for manufacturing, identification and verification of personal protection equipment (PPE) in the field of atomic energy use is needed because using of low-quality PPE and PPE not complying with working conditions poses a risk for the health of workers. The article provides results of analysis of the regulatory frameworks, both current and under development, which set the requirements for PPE.&#x0D; Results: Since 2017 Rosatom is executing plans for development of series of industry standards specifying requirements for PPE in the field of atomic energy use and methods of their testing. More than 25 interstate and national standards on PPE were included in the Summary list of standardization documents in the field of atomic energy use. PPE was included in the list of products subject to mandatory certification and having requirements for safety assurance in the field of atomic energy use specified.&#x0D; Industry and national standards establishing requirements for PPE protecting from tritium, radioactive noble gases, radioactive iodine, high-toxic alpha-emitting radionuclides, as well as standards on methods of their testing are planned to be developed soon.&#x0D; Conclusion: The system of standardizing requirements for PPE in the field of atomic energy use being created, together with existing system of certification of PPE in the field of atomic energy use will help to increase effectiveness of personal protection of the personnel at radiation and chemical hazardous facilities in nuclear industry.

Responses to Fatwas of Islamic Religious Leaders and Institutions during the Coronavirus Disease (COVID-19) in the Philippines: Looking at How Guidance Was Provided to Muslim Communities in the Philippines.

The Philippine constitution guarantees the free exercise of religion and religious worship. The law forbids public officials from interrupting religious activities. However, with the sharp rise of Coronavirus (COVID-2019) infection all over the world, the Inter-Agency Task Force (AITF) on Emerging Infections Disease created resolutions to assess, monitor, contain and prevent the spread of the pandemic. Religious leaders and Islamic institutions are no exceptions and they must abide to these resolutions including mass gatherings, safety procedures on burials, and strict observance of social distancing.&#x0D; Muslims strictly perform five times a day prayer, Friday Jamaah prayer, and bury the dead in accordance to Islamic practices mentioned in the Quran. Therefore, the study focus on how Islamic leaders and institutions responded to AITF resolutions to prevent the spread of the pandemic.&#x0D; The data were collected from mixed sources: from official announcements, social media accounts, and by phone interviews. Meaningful central themes were derived from the data.&#x0D; Findings noted responses of Muslim communities focused on (1) suspension of collective religious activities and programs until the pandemic is over; (2) abide by government directives on how to be safe from the threat of COVID-19; (3) institutionalization of positive sanitation practices of their facilities personnel and families; (4) cancellation of classes and their religious learning institutions; and (5) public interest and dharurah (possibility of harm or injury).&#x0D; In conclusion, the concept of collective duty (farḍ kifāya) as a basic of principle of Islam was practiced by Islamic religious leaders and institutions. Hence, maintaining social

Priority vaccination for mental illness, developmental or intellectual disability

Coronavirus vaccines have made their debut. Now, allocation practices have stepped into the spotlight. Following Centers for Disease Control and Prevention guidelines, states and healthcare institutions initially prioritised healthcare personnel...

Investigation of the mechanisms of the electromagnetic wave effect on the diffusion flame torch

New socio-economic conditions for the development of Russia dictate new requirements for the protection of buildings, equipment and personnel of various facilities from fires and their consequences. In complex fire extinguishing systems, the timeliness of fire detection and the effectiveness of extinguishing is the key to preserving material values and human lives. An urgent task is not only the improvement of existing fire extinguishing systems, but also the development of new systems, the basis of which is based on previously unused approaches. These approaches are based both on the previously known physical and chemical methods of extinguishing fires, and on the methods being investigated and studied at present. One of the promising methods of extinguishing fires is the technology of extinguishing fires using the effect of an electromagnetic field on the diffusion flame. The study of this method involves the analysis of physical processes that are electromagnetic in nature of interaction occurring in the system “diffusion flame torch - electromagnetic wave”. In this work, a quantitative analysis of the parameters affecting the possible mechanisms of interaction of the elements of this system is carried out. A mathematical model of the considered physical processes is presented.

The psychological burden of long-term care facilities personnel during the SARS-COV-2 pandemic – a national survey in poland

IntroductionThe high COVID-19 morbidity and mortality are observed among residents in long-term care facilities (LTCF) worldwide. Employees of LTCF, who are facing a critical epidemiological situation endangering the vulnerable residents, are exposed to pandemic’s psychological consequences daily.Objectives The main aim of this study was to assess psychological consequences (somatic symptoms, anxiety and insomnia, social dysfunction, and depression) among LTCF employees exposed to the SARS-CoV-2 pandemic crisis. Moreover, we investigated if factors such as: personal protective equipment (PPE) availability, safety guidelines or access to psychiatric and psychological support at the workplace, correlated with the level of psychological distress experienced by personnel.MethodsA cross-sectional study was conducted among personnel of LTCF in Poland. The survey consisted of the sociodemographic section, the authors’ questionnaire with questions related to COVID-19 exposure, working conditions, access to PPE and mental health services, GHQ Questionnaire-28.Results show that access to PPE (P= .018), to workplace safety guidelines (P= .031), psychological support at workplace (P&lt;0.01), fixed shift schedule (P= .05) and feeling that the right number of staff are employed in the workplace (P= .009), were related to the lower severity of psychopathological symptoms evaluated with the GHQ-28.Conclusions The study indicates an evidence that LTCF personnel are susceptible to the development of anxiety, depression, insomnia and social dysfunction during the pandemic crisis. However, these can be modified by: access to PPE, safety guidelines and psychological support. Findings from this study lay a basis for effective interventions aiming to support psychological health within this group.

Humanitarian led community-based surveillance: case study in Ekondo-titi, Cameroon

BackgroundCommunity-based surveillance (CBS) has been used successfully in many situations to strengthen existing health systems as well as in humanitarian crises. The Anglophone crisis of Northwest Southwest Cameroon, led to burning of villages, targeting of health personnel and destruction of health facilities which, in combination with distrust for the government services led to a collapse of surveillance for outbreak prone diseases.MethodsWe evaluated the ability of the CBS system to identify suspected cases of outbreak prone diseases (OPD) as compared to the facility-based surveillance, evaluated the timeliness of the CBS system in identifying an OPD, reporting of OPD to District Health Service (DHS) and timeliness in outbreak response. The paper also assessed the collaboration with the DHS and contribution of the CBS system with regards to strengthening the overall surveillance of the health district and also determine the interventions undertaken to contain suspected/confirmed outbreaks.ResultsIn total 9 alerts of suspected OPDs were generated by the CBS system as compared to 0 by the DHS, with 8 investigated, 5 responses and 3 confirmed outbreaks. Average time from first symptoms to alert generation by the CBS system was 7.3 days. Average time lag from alert generation from the CBS to the DHS was 0.3 days which was essentially within 24 h. There was extensive and synergistic collaboration with the DHS.DiscussionCBS generated a higher number of alerts than traditional outbreak reported used in the region, and had timely investigations and if appropriate, responses. Careful selection of CHWs with strong community engagement led to the success of the project, and the use of the mobile health team in situ allowed for rapid responses to potential outbreaks, as well as for feedback to CHWs and communities. CBS was also well utilized for identification of other events, such as displacement and malnutrition.ConclusionIn conflict settings, CBS can help in outbreak identification as well as other events, and a mobile health team is crucial to the success of the CBS due to the ability to rapidly response to generated alerts. The mobile health team provided timely investigation of 8 of 9 alerts generated. Collaboration with existing DHS structures is important for systems strengthening in such settings.

Possible Causes of and Measures to Minimise Risks of Abscesses Following DTP Vaccination

Registration and analysis of adverse events following immunisation (AEFIs) allow for objective assessment and systematisation of AEFI causes, and promotion of vaccination safety. Development of abscesses after DTP vaccination is a fairly common AEFI, however, they are not included in the “Side effects” part of the patient information leaflet of the vaccine. The aim of the study was to analyse reasons for abscess development after DTP vaccination and to elaborate recommendations on enhancing the vaccine safety. The review of literature data, solicited reports on AEFIs, and AEFI investigation reports submitted to the Scientific Centre for Expert Evaluation of Medicinal Products during 2014–2018 suggests that abscesses associated with DTP vaccination may be caused by the vaccine reactogenicity, quality defects arising during production or distribution, and vaccine administration errors by healthcare personnel. Lack of information in the documents submitted by medical institutions does not allow to rule out any of the identified reasons. The minimisation of risks of abscesses requires quality control of DTP vaccines, maintenance of the cold chain during transportation and storage, and compliance with aseptic regulations during administration. Additional pharmacovigilance measures will also help enhance vaccination safety: improvement and standardisation of data collection during investigation of abscess development in the post-vaccination period, obligatory inclusion of data on the thickness of children’s subcutaneous adipose tissue (weight, body mass index) and the length of the needle used for vaccination in AEFI investigation reports. It is advisable to add information on abscess risk in the “Side effects” part of the patient information leaflet of the DTP vaccine, and to update the “Dosage regimen and administration route” and “Precautions” parts in order to minimise the risk. Personnel of healthcare facilities performing vaccination should be made aware of the importance of providing detailed data on AEFIs for subsequent objective analysis.

Концепция психофизиологического обследования персонала объектов использования атомной энергии в медицинских организациях

Ensuring safety of the facilities employing radiation and nuclear hazardous technologies is a priority task for medical organizations serving these facilities. To perform safely at their jobs, it is important for the personnel of nuclear facilities (NF) to have their central nervous systems functioning flawlessly. Certain categories of nuclear industry workers are required to undergo compulsory annual medical examinations (ME) and psychophysiological examinations. This study aimed to develop a concept of psychophysiological examination of NF personnel allowing to assess the central nervous system's functional status. The study involved three groups of nuclear corporation employees (male) counting 720, 364 and 24 people aged from 46 ± 5.3 to 49 ± 6.1 years. The report describes the suggested concept of psychophysiological examination of the specified category of workers, discusses goals, objectives and the procedure of such an examination at all stages of compulsory ME, covers the developed hardware and software sets. The proposed methodological approach is evaluated through consideration of the results of psychophysiological examination of the specified category of workers.

Characteristics of Nursing Homes by COVID-19 Cases Among Staff: March to August 2020

ObjectiveTo measure the association between nursing home (NH) characteristics and Coronavirus Disease 2019 (COVID-19) prevalence among NH staff. DesignRetrospective cross-sectional study. Setting and ParticipantsCenters for Disease Control and Prevention COVID-19 database for US NHs between March and August 2020, linked to NH facility characteristics (LTCFocus database) and local COVID-19 prevalence (USA Facts). MethodsWe estimated the associations between NH characteristics, local infection rates, and other regional characteristics and COVID-19 cases among NH staff (nursing staff, clinical staff, aides, and other facility personnel) measured per 100 beds, controlling for the hospital referral regions in which NHs were located to account for local infection control practices and other unobserved characteristics. ResultsOf the 11,858 NHs in our sample, 78.6% reported at least 1 staff case of COVID-19. After accounting for local COVID-19 prevalence, NHs in the highest quartile of confirmed resident cases (413.5 to 920.0 cases per 1000 residents) reported 18.9 more staff cases per 100 beds compared with NHs that had no resident cases. Large NHs (150 or more beds) reported 2.6 fewer staff cases per 100 beds compared with small NHs (<50 beds) and for-profit NHs reported 0.8 fewer staff cases per 100 beds compared with nonprofit NHs. Higher occupancy and more direct-care hours per day were associated with more staff cases (0.4 more cases per 100 beds for a 10% increase in occupancy, and 0.7 more cases per 100 beds for an increase in direct-care staffing of 1 hour per resident day, respectively). Estimates associated with resident demographics, payer mix, or regional socioeconomic characteristics were not statistically significant. Conclusions and ImplicationsThese findings highlight the urgent need to support facilities with emergency resources such as back-up staff and protocols to reduce resident density within the facility, which may help stem outbreaks.

What Gastroenterologists Should Know About COVID-19 Vaccines

What Gastroenterologists Should Know About COVID-19 Vaccines

RESOURCE MANAGEMENT VARIABLES AS CORRELATE OF COMMUNITY SPORTS DEVELOPMENT AMONG PUBLIC TERTIARY INSTITUTIONS IN KWARA STATE

Community sports bind families and communities through shared experienced which also empowers, inspires, and motivates individuals . The purpose of this study was to examine resource management variables including funding, facilities, equipment and sports personnel related to the development of community sports development in public tertiary institutions in Kwara State. Purposive sampling technique was used to select seventy-two (72) respondents in all public tertiary institutions in Kwara State. Self-developed, Structured and validated questionnaire was used with test-retest method of reliability and 0.75r was obtained. Data were analyzed using inferential statistic of PPMC and the findings revealed that three (3) hypotheses tested were significant. This implies that funding, facilities, equipment and sports personnel highly contribute to community sports development. Based on the findings the following conclusion was drawn that resources management variables (funding, facility, equipment and sports personnel) were significantly correlate to community sports development. Based on the conclusion the recommendation was made: that governing council in Public Tertiary Institutions in Kwara State should made sufficient fund, adequate number of sports personnel and provision of standard sports facilities and equipment to Sports Unit (Sports Council) for the development of community sports in tertiary institution in Kwara state. Keywords : Management resources; funding; facilities; sport personnel

СИСТЕМА КОНТРОЛЯ ПЕРСОНАЛА ОБЪЕКТА ЭНЕРГЕТИКИ ПО ПРИНЦИПУ РАДИОЧАСТОТНОЙ ИДЕНТИФИКАЦИИ

Purpose. The article is devoted to the development of a power facility personnel control system using radio frequency identification technology (RFID). The main components of this system are RFID readers and RFID tags attached to personnel's clothing. The process involves video surveillance, monitoring and access control systems at a power facility. The alert and information control system at a power facility under normal operating conditions can improve the quality of production and technological process management through the use of a video surveillance system and access control, and in case of a fire or emergency it plots a safe route to the emergency exit and provides information about the presence of people in the room. Methods. Based on calculations, the dependence of the values of energy and modulating range parameters on the choice of RFID tags and readers for various conditions of use is obtained. Findings. Calculation, using formulas (1) and (2) for the values of the stationary reader parameters in the 900 MHz range (P = 1 W, GR = 4, λ = 30 cm, SR = –100 dBW, kE = 0.5) and tags with antennas in the form of half-wave dipoles (Ae = 0.01 m2, Δσ = 0.06 m2, S = 30 μW) allows obtaining the energy range RE ≈ 7 m, and the modulation range RM ≈ 25 m. In the design process the use of formulas (1) – (5) allows determining the RFID equipment technical parameters, which provide the required coverage range. Research application field. It is advisable to include the results of the study in the research and development work of the research organizations of EMERCOM of Russia and other ministries and departments. Conclusions. The development of the system for personnel warning and access control at a power facility using radio frequency identification will make it possible not only to ensure production and technological process control, having information about the exact people's location, but also to evacuate personnel to a safe area in case of a fire or emergency.

Rationalizing Health Personnel Financing Schemes for Evidence-informed Policy Reforms: Policy Analysis

Background. The Universal Health Care Law seeks to optimize financing of personnel costs without compromising quality and equitable health care among the health care facilities. This position statement aimed to identify strategies and policy recommendations for the cost-effective financing of health personnel in public healthcare facilities.&#x0D; Methods. A systematic review of literature was done to generate policy brief and key points for roundtable discussion in collaboration with the Department of Health (DOH). The discussion was guided by the three health financing options of DOH: (a) retain Personnel Services (PS) as DOH budget but shift Maintenance and Other Operating Expenses (MOOE) to PhilHealth; (b) shift PS and MOOE to PhilHealth, and (c) rationalize part-time status in government hospitals.&#x0D; Results. The pros and cons of financing options were cross-examined. In Option 1, physicians in government hospitals would receive fixed salaries from DOH / Local Government Units. In Option 2, there would be a monopsony between PhilHealth and provincial power. Payment will be performance-driven, and balance billing will be eliminated. Option 3 would be a set up of retaining part-time positions for physicians.&#x0D; Conclusion and Recommendation. Participants deduced that for Option 1, provision of salary augmentation sources and ensuring adequate plantilla items and level of remuneration in government hospitals should be considered, in order to sufficiently compete with physicians’ income from private practice. For Option 2, the PhilHealth reimbursement system should ensure timely reimbursement so as not to subject care providers to financial instabilities. For Option 3, rationalizing part-time status should be flexible and can be applied regardless of how physicians are paid, as this would incentivize caregivers to work harder and smarter.

Становление атомной промышленности на Урале в аспекте радиационной безопасности

This study examines the formation of the nuclear industry in the Urals from the perspective of radiation safety, identifies objective and subjective factors that led to problems in the field of radiation protection of nuclear facility personnel in the process of developing nuclear production, an assessment of the level and extent of radiation exposure to operating personnel. The author notes that the creation of the domestic nuclear industry took place in extremely difficult conditions of the post-war period and was fraught with many difficulties, especially at the initial stage of the formation of the nuclear industrial complex. During the years of commissioning and development of the first nuclear facilities, first of all, the industry pioneer the Mayak chemical plant, production personnel had to work under conditions of increased radioactive radiation. The experimental nature of plutonium production in the Urals, the novelty of the problem, the miscalculations and mistakes of designers and scientists, the extremely small amount of knowledge about the effects of radiation on a living organism, the secrecy regime and a number of other reasons led to the emergence of an emergency radiation situation at all main production facilities of the chemical plant, which entailed a significant re-irradiation of nuclear facility personnel. However, at that time, the problems of radiation protection of personnel did not have priority for the country's top political leadership. The main thing was to get plutonium for the first Soviet atomic bomb in the shortest possible time, regardless of the cost.

Statewide Implementation of the Music & Memory Program: Facilitators, Barriers, and Lessons Learned

The movement of evidence-based interventions into routine institutional settings like nursing homes is challenging. Among non-pharmacological interventions to address behavioral problems of residents with dementia, Music and Memory (M&M), a popular individualized music listening program, has been shown to have potential to improve quality of life among residents. To examine facilitators and barriers to implementation and sustainability of the M&M program in nursing facilities, a statewide (online and mail) survey of nursing homes was conducted in Wisconsin where the statewide implementation of the program occurred. The response rate was 41% (N=161). Descriptive statistics and content analysis were conducted. Over 80% of facilities provided the M&M program, and 86% of them planned to continue the program. The majority of respondents found the M&M to be beneficial to residents but also reported that the program was not equally effective for everyone, and M&M was time and labor intensive. Barriers to sustainability were: lack of buy-in by direct care staff, use of technology, costs of equipment, inconsistent volunteers, and families not supportive or helpful. Facilitators were: support of facility personnel, family, and volunteers; observing positive effects of program, M&M training provision and support, family involvement, and accessibility of equipment. Targeted resident selection is needed to identify the residents most likely to benefit from the program to avoid possibility of increased agitation or discomfort. Careful consideration is needed for facilities to identify realistic costs, labor, and staff buy-in to promote success.