Individual Departments Research Articles

ENT Mentorship Program for Preclinical Medical Students.

To provide preclinical medical students early access to otolaryngologists to learn about the specialty, facilitate acquisition of clinical skills, and provide one-on-one mentorship. Students are matched with a single otolaryngology faculty mentor from The Ohio State University/Nationwide Children's Hospital and attend 8 hours per month in the clinic or operating room, monthly lectures, and rounds, and they give a final presentation. Mentors complete performance evaluations, and surveys are administered longitudinally until Match Day. Thirty-five students and 17 faculty members have participated in the program since 2015. All mentors and students found the program to be a valuable experience. When compared to nonparticipating students, participants had significantly higher confidence scores for clinical performance, knowledge of anatomy, and familiarity with the department of interest. All students felt the program prepared them well for third and fourth years, and all 8 of the initial program participants successfully matched into residency with 4 entering otolaryngology. Medical students face a competitive residency application process in otolaryngology with limited exposure, which creates an opportunity for guidance in the pursuit of matching into this field. This novel preclinical mentorship program prepares students for their clinical years and residency by facilitating acquisition of various competencies. Students gain hands-on clinical exposure in a field of interest and support for navigating the application process. The structure of this program can be applied to other medical schools or specialties if the individual departments contain adequate resources of teaching faculty willing to participate.

Study of referrals to department of psychiatry in tertiary care general hospital setting

Background: Study of referral pattern to psychiatry helps us to understand the type of patients and the rate of referral from individual departments. It also helps us to understand the need for consultation liaison services (CLP) thereby strengthening the General Hospital Psychiatric Units (GHPU). Aim: To study the referral pattern to psychiatry in a tertiary care teaching hospital. Materials and Methods: All referrals to the department of psychiatry for a period of two months were included in the study. Sociodemographic details, reasons for referral and the department from which referred were noted. The Psychiatric diagnosis was made according to the ICD -10 criteria. The overall referral rate to psychiatry and referral from individual departments was noted and descriptive statistics was applied to represent the same. Results: The overall referral rate to psychiatry was found to be 1.17% with majority being from medical specialities (62%). The most common reasons for referral have been suicidal attempts and most common psychiatric disorder diagnosed among referred has been delirium. Conclusion: The low levels of referrals to psychiatry emphasize the need for better consultation liaison services. Keywords: Referrals, Consulatation-liasion, General hospital psychiatric units.

Determining the Smart University Infrastructure Development Level Based on Data Models

The paper presents applied research in the framework of solving determining the smart university infrastructure development level problem. Today, all digital transformation and transition to the digital economy concept and smart society development issues are very important. Education is the intellectual core of the digital transformation, the knowledge base, and the training center for the digital economy. Therefore, more attention should be paid to the creation and development of the smart university infrastructure. The purpose of the study is to develop criteria and models for determining the level of smart university infrastructure development. To describe the management of infrastructure level assessment, we propose to use adapted mathematical methods, structural analysis, and mathematical statistics methods. The study examines trends in the development of smart education, highlights the main elements of the smart university infrastructure (technological and organizational), and examines approaches to determining the level of its development based on data models. Taking into account the diversity and volume of quantitative and qualitative indicators of the smart university infrastructure, we propose to measure the level of the infrastructure using data models and Educational Data Mining tools. Universities can use got models when forming a development strategy or selecting funding directions, to reduce the time of digital transformation and transition to the optimal state of a smart university, to prepare for accreditation or to align the smart infrastructure of individual departments.

The functional cost analysis as a method of analysis of personnel management system at domestic enterprises

The article deals with the peculiarities of application of functional-cost analysis of the personnel management system, including the identification of unnecessary or duplicate management functions; functions that have not been performed for any reasons; the degree of centralization and decentralization of management functions has been determined. The main difficulties which specialists are facing in conducting FСA have been revealed. The advantages and disadvantages of this method have been identified. The experience of foreign countries in using of functional-cost analysis, as well as practical application in the enterprises of Ukraine has been analysed. The authors propose an approach by which the efficiency of personnel management at the enterprise will be considered comprehensively and systematically, using such basic structural elements as a system with an arbitrary number of elements and connections, its subsystem, the beneficial effect of their function by appointment. The article proposes an evaluation method that reflects the efficiency and productivity of staff. The status of the activity of an individual department or employee has been suggested to be described as a set of functions and the cost of providing them. The importance of each individual function in the value expression for the general financial condition of the enterprise has been emphasized in order to supplement the previously formed functional structure for finding alternative solutions. It has been determined that the existing experience in the application of functional cost analysis in the field of personnel management is imperfect. Therefore, it requires further elaboration in the form of methodological and practical recommendations, taking into account foreign experience. The conclusion has been made about the necessity of wider application of functional-cost analysis, creation of special services of enterprises, as well as strengthening of functional relations of such services with managers and other departments at the enterprise.

Innovativeness of Polish manufacturing enterprises in 2008-2015

Purpose – The aim of the article is an attempt to estimate the level of innovativeness of Polish manufacturing enterprises conducting their activity in the years 2008-2015. Research method – The study was divided into three stages. First stage – estimation of synthetic innovativeness indicators of manufacturing enterprises operating in Poland (2008 – 2015) – general and broken down into individual departments of the manufacturing sector. Second stage – estimation of the main descriptive statistics of the synthetic innovativeness indicator of Polish manufacturing enterprises (2008–2015) – average, standard deviation, coefficient of variation, median, minimum value, maximum value. Third stage – creating a ranking of innovativeness of Polish manufacturing enterprises representing individual departments of sector C and conducting their activity in 2015. The ranking was based on a synthetic innovativeness indicator of Polish manufacturing enterprises for 2015. Results – The study shows that the synthetic index of innovativeness of Polish enterprises in the manufacturing sector in 2009–2015 is characterized by an upward trend. Department C20 came first in the ranking of innovativeness of Polish manufacturing enterprises by individual departments of sector C (manufacturing) operating in 2015, whereas department C13-15 ranked last. Originality – Estimation, statistical evaluation of the synthetic innovativeness indicator of Polish manufacturing enterprises and creating a ranking of innovativeness of Polish manufacturing enterprises by individual departments of sector C conducting their activity in 2015.

Расовое профилирование: история и современное состояние исследований

Немногочисленные исследования расового профилирования в России подтвердили существование этой проблемы. Однако её разработка, начатая в середине 2000-х годов, до настоящего времени продвинулась незначительно. Русскоязычный читатель практически не знаком с теоретическими и методологическими подходами к изучению расового профилирования, разработанными за рубежом. Эта статья призвана восполнить недостаток информации о зарубежных исследованиях расового профилирования и является первым обзором литературы по этой теме на русском языке. В статье рассматривается история изучения расовой дискриминации в системе уголовного правосудия в англоязычном научном мире, анализируется выделение расового профилирования в отдельную область исследований в начале 1990-х годов и ее дальнейшее развитие в 2000-х годах. Представлены основные методологические подходы к изучению расового профилирования, их возможности и ограничения. Рассмотрены ключевые теоретические подходы к пониманию расового неравенства в правоохранительной деятельности. В заключение с учетом накопленного опыта приводится ряд рекомендаций по планированию будущих исследований. Обращается внимание на необходимость более четкого разграничения между преднамеренным расовым профилированием, санкционированным государством; политикой отдельных полицейских управлений; личной инициативой сотрудников полиции и статистической дискриминацией, отражающей социальное неравенство. При проведении количественных исследований рекомендуется использовать несколько источников данных и несколько аналитических методов. Подчеркивается необходимость избегать поспешности и предвзятости в выводах. При интерпретации полученных эмпирических данных рекомендуется учитывать все возможные концептуальные объяснения, включая расово нейтральные.

Reducing carbon emissions in business through Responsible Management Education: Influence at the micro-, meso- and macro-levels

There has long been an understanding that to achieve meaningful progress against sustainability challenges, action is required at multiple levels. With regards to education initiatives, these levels range from macro-level international agreements and activities such as the United Nations Sustainable Development Goals (SDGs) and the United Nations Principles of Responsible Management Education, meso-level influences such as the role of national bodies supporting sustainability in higher education, and micro-level influences such as the commitment of individual universities or departments. However, decision makers are individuals and the development and delivery of such initiatives requires action at the level of the individual. This paper explores the impact of working within and across these different levels and how jointly they help to work towards addressing carbon reductions in a partnership setting between a business school and various organisations. In its centre is an educational initiative carried out in the United Kingdom in the core curriculum of Nottingham Business School where students conduct a carbon footprint of an organisation and recommend measures to reduce the company's greenhouse gas emissions. The total recommended greenhouse gas emissions savings from two years of the project were 507, 435 kg CO2e, averaging over 10 tonnes per organisation and 2 tonnes per student. If this project was extended over 5 years and taken on by an additional educator, the potential reductions increase to 2,562,418 kg CO2e. It demonstrates that action undertaken at the micro-level can result in significant impact at the macro-level when scaled up and provide significant benefits to actors across all levels from individuals though to all participating organisations. This initiative has proven very successful in delivering SDG 7, SDG 13 and SDG17; if taken up by more business schools the impacts on the targets of these SDGs and the climate change agreements could be significant.

Opioid Use During the Six Months After an Emergency Department Visit for Acute Pain: A Prospective Cohort Study

Despite the frequent use of opioids to treat acute pain, the long-term risks and analgesic benefits of an opioid prescription for an individual emergency department (ED) patient with acute pain are still poorly understood and inadequately quantified. Our objective was to determine the frequency of recurrent or persistent opioid use during the 6 months after the ED visit METHODS: This was a prospective, observational cohort study of opioid-naive patients presenting to 2 EDs for acute pain who were prescribed an opioid at discharge. Patients were followed by telephone 6 months after the ED visit. Additionally, we reviewed the statewide prescription monitoring program database. Outcomes included frequency of recurrent and persistent opioid use and frequency of persistent moderate or severe pain 6 months after the ED visit. Persistent opioid use was defined as filling greater than or equal to 6 prescriptions during the 6-month study period. During 9 months beginning in November 2017, 733 patients were approached for participation. Four hundred eighty-four met inclusion criteria and consented to participate. Four hundred ten patients (85%) provided 6-month telephone data. The prescription monitoring database was reviewed for all 484 patients (100%). Most patients (317/484, 66%; 95% confidence interval 61% to 70%) filled only the initial prescription they received in the ED. One in 5 patients (102/484, 21%; 95% confidence interval 18% to 25%) filled at least 2 prescriptions within the 6-month period. Five patients (1%; 95% confidence interval 0% to 2%) met criteria for persistent opioid use. Of these 5 patients, all but 1 reported moderate or severe pain in the affected body part 6 months later. Although 1 in 5 opioid-naive ED patients who received an opioid prescription for acute pain on ED discharge filled at least 2 opioid prescriptions in 6 months, only 1% had persistent opioid use. These patients with persistent opioid use were likely to report moderate or severe pain 6 months after the ED visit.

Clinician's opinion about critical risk results proposed by the Croatian Chamber of Medical Biochemists: a survey in one Croatian tertiary hospital.

IntroductionIt has been recommended that each laboratory modify their critical result reporting practices to reflect the clinical needs of their patient populations. The aim of this survey was to assess how well critical laboratory values defined by the Croatian Chamber of Medical Biochemists (CCMB) correspond to the needs of the physicians at University hospital “Sveti Duh” (Zagreb, Croatia).Materials and methodsWe conducted a survey among physicians from five departments in our hospital. Physicians were asked general questions about critical risk results (if and how they want to be informed). A list of critical risk results defined by the CCMB was offered and physicians were asked to revise the existing critical risk results and suggest adding new parameters. Obtained data were presented as numbers. Where the number of observations was low, ratios were used.ResultsSurvey response rate was 43% (52/121). Majority (48/52) wants to be informed of critical risk results, either personally (31/48) or through a colleague (32/48). They prefer to be informed about critical risk results of prothrombin time, platelet count, haemoglobin, glucose, creatinine, sodium and potassium. Revisions in the CCMB critical risk result list are proposed by 13 out of 48 physicians. Neonatologists approved the CCMB’s list.ConclusionsAlthough most critical risk results defined by the CCMB correspond well to the needs of the physicians in our hospital, some revisions are necessary to meet the particular needs of individual departments. Communication of critical risk results to those who have requested laboratory testing is highly appreciated practice.

THE DEVELOPMENT OF SOVIET STATE SYSTEM IN 1918-1940 (AS IN THE CASE OF INDIVIDUAL POWER STRUCTURES)

Purpose: This paper examines the problems of changing the systems of the structures of governance in the first years of the existence of Soviet rule using the example of the armed forces, the redistribution of powers between them, the strengthening of the administrative influence of individual departments on the most important decisions in this area. Methodology: The basis of scientific research is the dialectical materialist method, which allows revealing the patterns of development of the relevant legal industry and suggesting the most likely options for the development of legislation and law enforcement practice. In addition, the authors use the historical-chronological method, the historical-systemic method, the formal-logical method, the method of comparative law, the system-structural method, the technical-legal method, etc. Result: a dramatic change in internal political line with the advent of the Bolsheviks predetermined the sweeping changes in the approaches to public administration. Having no experience in organizing public authority, the leaders of the revolutionary movement proposed and approved numerous ideas related to improving the efficiency of the management of uniformed services, which was very important in the conditions of the civil war and foreign intervention. Applications: This research can be used for universities, teachers, and students. Novelty/Originality: In this research, the model of the development of the Soviet state system in 1918-1940 is presented in a comprehensive and complete manner.

Pandemic influenza and major disease outbreak preparedness in US emergency departments: A survey of medical directors and department chairs.

To quantify the readiness of individual academic emergency departments (EDs) in the United States for an outbreak of pandemic influenza. Methods, design, and setting: Cross-sectional assessment of influenza pandemic preparedness level of EDs in the United States via survey of medical directors and department chairs from the 135 academic emergency medicine departments in the United States. Preparedness assessed using a novel score of 15 critical preparedness indicators. Data analysis consisted of summary statistics, χ2, and ANOVA. ED medical directors and department chairs. One hundred and thirty academic emergency medicine departments contacted; 66 (50.4 percent) responded. Approximately half (56.0 percent) stated their ED had a written plan for pandemic influenza response. Mean preparedness score was 7.2 (SD = 4.0) out of 15 (48.0 percent); only one program (1.5 percent) achieved a perfect score. Respondents from programs with larger EDs (=30 beds) were more likely to have a higher preparedness score (p < 0.035), an ED pandemic preparedness plan (p = 0.004) and a hospital pandemic preparedness plan (p = 0.007). Respondents from programs with larger EDs were more likely to feel that their ED was prepared for a pandemic or other major disease outbreak (p = 0.01). Only one-third (34.0 percent) felt their ED was prepared for a major disease outbreak, and only 27 percent felt their hospital was prepared to respond to a major disease outbreak. Significant deficits in preparedness for pandemic influenza and other disease outbreaks exist in US EDs, relative to HHS guidelines, which appear to be related in part to ED size. Further study should be undertaken to determine the barriers to appropriate pandemic preparedness, as well as to develop and validate preparedness metrics.

Parathyroid scintigraphy.

The purpose of this guideline is to assist specialists in Nuclear Medicine and Radionuclide Radiology in recommending, performing, interpreting and reporting the results of Parathyroid Scintigraphy. This guideline will assist individual departments to formulate their own local protocols. This does not aim to be prescriptive regarding technical aspects of individual camera acquisitions which need to be developed in conjunction with the local medical physics expert. These guidelines pertain only to adult patients. There are numerous techniques for localizing Parathyroid adenomas. This guideline will describe the use of 99mTc-sestamibi dual phase imaging which may be used alone or in combination with other modalities.

Improving the Performance of Procurement and Inventory Management of Hospital Materials (Case of a Taiwanese Medical Centre)

Within healthcare organization, the main goal of material procurement and inventory management is to reduce the cost associated with supplies without sacrificing the quality of patient care. In general, there are two ways to maintain supply level, i.e., joint procurement and direct purchase from the point-of-use location. For joint procurement, the demand of the associated point-of-use will place order to central warehouse. The other way is the order is directly place to the supplier by the individual department. The focus of this study is to examine the current procurement and inventory management and improve the inventory policies for central storeroom and induvial department. To maintain the service by setting new order policies. In this study, we define a performance indicator, supply-demand ratio to measure the improvement of the operation of procurement and inventory management. With new policy, holding cost and idle stock, and usage of space can be reduced meanwhile it can maintain its service level.

River Chief System (RCS): An experiment on cross-sectoral coordination of watershed governance

The trans-regional characteristics of watershed governance produce more problems beyond the capacity of each individual water-related department, leading to the fragmentation of watershed management. The River Chief System (RCS) has experienced swift developments over the past decade in China by appointing the local government heads as river chiefs. RCS works efficiently in the short-term due to its superiority in the inclusion of clear responsibility, authority, and multi-sectoral collaboration. However, the characteristics of the authority-based vertical coordination of the hierarchical system remain unchanged, and therefore the problems of organizational logic and the responsibility dilemma still exist. Tasks including perfecting of laws, integrated watershed management, and public participation still need to be completed. RCS reflects the routine and characteristics of the migration of national governance, and as such provides new insights for other developing countries in the design of river management systems.

From Selma to Ferguson: The Voting Rights Act as a Blueprint for Police Reform

The Voting Rights Act of 1965 revolutionized access to the voting booth. Rather than responding to claims of voter suppression through litigation against individual states or counties, the Voting Rights Act introduced a coverage formula that preemptively regulated a large number of localities across the country. In doing so, the Voting Rights Act replaced reactive, piecemeal litigation with a proactive structure of continual federal oversight. As the most successful civil rights law in the nation’s history, the Voting Rights Act provides a blueprint for responding to one of the most pressing civil rights problems the country faces today: police misconduct. As with voter suppression in the mid-twentieth century, abusive police conduct against minority citizens is a national problem perpetrated by thousands of localities. Federal efforts to cure the problem through litigation against individual police departments have failed to produce widespread reform. This Article applies the lessons of the Voting Rights Act in proposing the use of a coverage formula to identify and regulate local police departments engaged in a pattern of unconstitutional misconduct. While this proposal would significantly enhance federal power over police departments, such a change is both necessary to curb police misconduct and constitutionally permissible.

UK guidelines on 18F-fluciclovine PET/CT in prostate cancer imaging.

The purpose of these guidelines is to assist specialists in Nuclear Medicine and Radionuclide Radiology in recommending, performing, interpreting and reporting F-fluciclovine PET/computed tomography. It should be recognised that adherence to the guidance in this document will not assure an accurate diagnosis or a successful outcome. These guidelines will assist individual departments in the formulation of their own local protocols. The guidelines apply to studies on adults. All that should be expected is that the practitioner will follow a reasonable course of action based on current knowledge, available resources and the needs of the patient in order to deliver effective and safe medical care.

“In somno securitas?” Is it time for anaesthetists to train in patient safety?

“<i>In somno securitas</i>?” Is it time for anaesthetists to train in patient safety?

A bottom up approach to evaluate the carbon footprints of a higher educational institute in India for sustainable existence

Carbon footprints (CFs) are the measure of extent of green house gases (GHGs) emitted from any organization or activity. Reporting of extent of CFs in terms of CO2e from educational campus may be considered as a first step towards sustainable educational practices. The present study employs a bottom up approach where CFs due to consumption of resources from each academic department is evaluated separately and net is obtained by adding contributions from individual departments. This method has the advantage of avoiding the potential overlaps in the calculation. Hence this approach to calculate carbon footprints can lead to their precise CF evaluation. In order to justify above hypothesis, CF evaluation was carried out at Shikshana Prasarak Mandali's Sir Parashurambhau College, Pune for three consecutive years starting from 2015 to 2016. The average carbon footprints over the study period were 3630.57 ± 296.79 tones CO2e per year with per capita emission of 0.81 ± 0.06 tones CO2e. The emission density determined from the average value was found to be 0.0361 ± 0.0029 tCO2e m−2 of the campus. It was observed that emission sources classified as scope-1, scope-2 and scope-3 contribute 28%, 48% and 25% respectively to total emission. Out of all the emission sources identified, apart from human contribution through respiration, electricity (35%), biodegradable and non-biodegradable waste, stationary paper, 7%, use of chemicals in the laboratories (5%), paper for official purpose (12%), LPG (3%) and transport (27%) were main contributors. As this is a multi faculty college, science faculty contributes almost 62%, commerce 9% and arts 11% of the total emission.

Retrospective analysis of breast radiotherapy treatment plans: Curating the 'non-curated'.

This paper provides a demonstration of how non-curated data can be retrospectively cleaned, so that existing repositories of radiotherapy treatment planning data can be used to complete bulk retrospective analyses of dosimetric trends and other plan characteristics. A non curated archive of 1137 radiotherapy treatment plans accumulated over a 12-month period, from five radiotherapy centres operated by one institution, was used to investigate and demonstrate a process of clinical data cleansing, by: identifying and translating inconsistent structure names; correcting inconsistent lung contouring; excluding plans for treatments other than breast tangents and plans without identifiable PTV, lung and heart structures; and identifying but not excluding plans that deviated from the local planning protocol. PTV, heart and lung dose-volume metrics were evaluated, in addition to a sample of personnel and linac load indicators. Data cleansing reduced the number of treatment plans in the sample by 35.7%. Inconsistent structure names were successfully identified and translated (e.g. 35 different names for lung). Automatically separating whole lung structures into left and right lung structures allowed the effect of contralateral and ipsilateral lung dose to be evaluated, while introducing some small uncertainties, compared to manual contouring. PTV doses were indicative of prescription doses. Breast treatment work was unevenly distributed between oncologists and between metropolitan and regional centres. This paper exemplifies the data cleansing and data analysis steps that may be completed using existing treatment planning data, to provide individual radiation oncology departments with access to information on their own patient populations. Clearly, the well-planned and systematic recording of new, high quality data is the preferred solution, but the retrospective curation of non-curated data may be a useful interim solution, for radiation oncology departments where the systems for recording of new data have yet to be designed and agreed.

Policy perceptions of US state public health and child and family services regarding maternal opioid use and neonatal exposure

ObjectiveTo explore how state legislatures and departments of health are responding to the public health and economic issues of increases in opioid use disorder and the impact on pregnant women and infants. DesignThe design was a non-experimental descriptive study using a mixed methods survey research approach. SettingElectronic and telephone survey of individuals from state departments of health associated with departments of behavioral health and substance use, or child and family services. ParticipantsFifty-two respondents employed by individual state departments of health and child and family services. MethodsUnivariate analysis and frequency distribution of ordinal variables was completed. Thematic analysis was used to analyze free text questions and identify themes. ResultsAll states reported recent changes or plans to address the problem of opioid misuse in their state. Many respondents feel their state continues to lack adequate services for treatment. Some states are exploring unique methods for addressing this in a safe and timely fashion, such as moving medication-assisted treatment to primary care and expanding licensure to Primary Care Physicians (PCPs) and nurse practitioners. ConclusionsOur findings demonstrate an increased commitment throughout the United States to enhance access to clinically appropriate treatment of substance use disorder particularly during pregnancy, consider unique methods for addressing the problem of opioid dependency, and increase education and primary prevention programs.