Audit of the management of convulsive status epilepticus in children: the need for a uniform treatment strategy

We conducted a two-year prospective audit to review the paediatric management of Convulsive Status Epilepticus (CSE) in Ireland. Our audit showed that there is considerable variability in the management of CSE in this country. In order to provide optimum care for this potentially life-threatening condition a uniform management strategy is required. We propose a protocol for the treatment of CSE, which should ensure uniform management and optimum care and also provide a template for further study and audit of this important disorder.     

The management of nonconformities in blood establishments

With the introduction of quality management system as either a voluntary activity or based on legal regulation, a transfusion establishment is committed to consistent use of nonconformity management in all its activities. Nonconformities are mostly detected in blood products, in all steps of the manufacturing process. A product in broad sense also refers to the services offered. Nonconformities may be found in input materials, devices and equipment as well. Efficient management of these nonconformities is one of the key elements of the materiovigilance system. A special category are the nonconformities that need not be identified directly in the products, materials or equipment, but their occurrence may have adverse effects on the product and service quality, safety of those involved in the transfusion chain, user confidence, or transfusion establishment economy. Nonconformities may be detected in regular work process, or during internal and external quality assessment, inspections, evaluation of the quality system by the managing board, management of complaints, etc. Each blood establishment should have written procedure describing nonconformity management, while the personnel should undergo continuous education on all aspects of this segment of quality management. Along with making proper decision on the nonconforming product/nonconformity, in the procedure of nonconformity management it is of great importance to assess the potential impact of this nonconformity on other products or processes, and to prevent the possible additional damage on time. As the management of nonconformities has a critical role for the quality and safety of transfusion treatment and is involved in all transfusion service activities, it is no surprise that an array of quality indicators that serve as a basis for corrective measures and continuous quality improvement derive from this segment of quality management.     

Health care engineering management

Today, health care engineering management is merely a concept of dreamers, with most engineering decisions in health care being made by nonengineers. It is the purpose of this paper to present a rationale for an integrated hospital engineering group, and to acquaint the clinical engineer with some of the salient features of management concepts. Included are general management concepts, organization, personnel management, and hospital engineering systems.     

Social support among African-American adults with diabetes, Part 2: A review.

Diabetes mellitus affects African Americans in disproportionate numbers relative to whites. Proper management of this disease is critical because of the increased morbidity and mortality associated with poor diabetes management. The role of social support in promoting diabetes management and improved glycemic control among African Americans is a little-explored area. This review, the second in a two-part series, examines the relationship between social support and glycemic control among African-American adults with diabetes. The main findings of the study are that African Americans tend to rely more heavily than whites on their informal social networks to meet their disease management needs and that social support is significantly associated with improved diabetes management among members of this population. However, there remains a critical need to systematically include substantial numbers of African-American respondents in studies examining the relationship between social support and glycemic control. Only then can the effects of age, gender, socioeconomic status, and other variables on this relationship in African Americans become clear and interventions incorporating relevant aspects of social support be developed.     

医学影像设备管理系统的设计与开发

目的：设计和开发出一套功能全面、操作简便而又实用的放射科设备管理信息系统。方法：本论文从软件工程的角度出发进行分析和设计,采用J2EE、SPRING、HIBERNATE等先进流行的Web框架技术,对一款医学影像设备管理维护系统进行初步设计和开发。结果：根据对现有医院影像设备管理的需求分析和实地调研,完成了一款医学影像设备管理维护系统的具体开发,系统主要功能模块包括系统管理、采购管理、设备信息管理、故障信息管理、设备维护管理、设备说明书管理等等。结论：该医学影像设备管理系统总体来说,功能全面、操作简便而又实用,能够满足医院影像设备管理的大部分需求,极大的提高了医学影像设备的管理效率。     

Issues in mental health management and administration

Administrators and middle managers from six CMHCs in Tennessee and Alabama were interviewed during site visits for the purpose of determining the main issues in mental health management. A step-by-step conceptual methodology was followed to process the field notes and interview responses. The views of a senior-level management professor specializing in mental health management and a senior-level professor in community psychology were used to further interpret and refine the results of this investigation. Although many diverse issues surfaced, an integrating theme emerged in the form of a need for management to motivate and inspire CMHC staff to a sense of mission.     

Outcomes beyond phenylalanine: An international perspective

Control of blood phenylalanine (Phe) levels throughout the life of a person diagnosed with phenylketonuria (PKU) is the biochemical management strategy necessary to provide the best potential for optimal outcome. Psychosocial support mechanisms comprise the other aspects of PKU management that are necessary to overcome the hurdles of living with this chronic disease and to adhere to the rigors of its management. Additional psychosocial support may be required, in light of increasing evidence that control of blood Phe levels in PKU can still lead to subtle but measurable cognitive function deficits as well as a predisposition to certain psychiatric symptoms and disorders. An all encompassing PKU management strategy that goes beyond simply treating blood Phe levels can empower and enable people born with PKU to achieve similar life goals as those born without PKU. This review looks at PKU management strategies that go beyond treating Phe levels, specifically (1) the roles psychologists play in managing PKU from infancy through adulthood and how they help PKU families and caregivers deal with the disease and the burden of its management; (2) understanding the challenges of transitioning into adulthood as an individual with PKU and addressing unmet needs in this population; (3) how non-traditional practices can be utilized in PKU. The objective is to emphasize that management of PKU goes well beyond addressing the biochemical nature of this disease in order to achieve optimal patient outcomes.     

医院制剂生产管理系统的设计与实现

目的设计开发完整的医院制剂生产管理系统，使其满足物资的入出存管理和生产管理的需求。方法在细致分析医院制剂生产的管理流程的基础上，结合企业资源规划系统，采用客户端，服务器模式，应用SQL Server数据库管理系统和PowerBuilder开发工具设计、开发了该系统，主要由库存管理模块和生产管理模块组成，同时具有综合查询、报表输出和系统维护等功能。结果该系统能够与HIS连接，根据HIS销售情况制定生产计划，通过生产计划和现有库存快速制定采购计划．理顺了医院制剂室的工作流程，能够准确、快捷地输出相应的报表。结论该系统设计方案可行，系统操作简单．提高了工作效率，加强了医院的管理工作。     

Knowledge management system for laboratory work and clinical decision support

This paper discusses a knowledge management system for clinical laboratories. In the clinical laboratory of Toranomon Hospital, we receive about 20 questions relevant to laboratory tests per day from medical doctors or co-medical staff. These questions mostly involve the essence to appropriately accomplish laboratory tests. We have to answer them carefully and suitably because an incorrect answer may cause a medical accident. Up to now, no method has been in place to achieve a rapid response and standardized answers. For this reason, the laboratory staff have responded to various questions based on their individual knowledge. We began to develop a knowledge management system to promote the knowledge of staff working for the laboratory. This system is a type of knowledge base for assisting the work, such as inquiry management, laboratory consultation, process management, and clinical support. It consists of several functions: guiding laboratory test information, managing inquiries from medical staff, reporting results of patient consultation, distributing laboratory staffs notes, and recording guidelines for laboratory medicine. The laboratory test information guide has 2,000 records of medical test information registered in the database with flexible retrieval. The inquiry management tool provides a methos to record all questions, answer easily, and retrieve cases. It helps staff to respond appropriately in a short period of time. The consulting report system treats patients' claims regarding medical tests. The laboratory staffs notes enter a file management system so they can be accessed to aid in clinical support. Knowledge sharing using this function can achieve the transition from individual to organizational learning. Storing guidelines for laboratory medicine will support EBM. Finally, it is expected that this system will support intellectual activity concerning laboratory work and contribute to the practice of knowledge management for clinical work support.     

Defining Competency to Empower Blood and Marrow Transplant and Cellular Immunotherapy Quality Management Professionals in Healthcare

Blood and marrow transplant (BMT) programs worldwide frequently employ a quality management professional who is charged with securing quality and maintaining regulatory requirements. Although many BMT programs employ an individual to oversee quality management, there are no standard definitions of the education, training, and core competencies needed to successfully perform this role. The goal of this article is to propose the required qualifications and responsibilities of the BMT professional who oversees quality management and to elicit discussion to standardize such a role in BMT and cellular immunotherapy programs. Our results could serve as a model for quality managers in other complex healthcare environments. The recommendation and findings are primarily limited to cell therapy centers in North America.     

Pelvic floor exercise for urinary incontinence: A systematic literature review

Urinary incontinence is a common problem among adults and conservative management is recommended as the first-line treatment. Physical therapies, particularly pelvic floor muscle exercise, are the mainstay of such conservative management. The purpose of this review is to summarise current literature and describe trends in the use of pelvic floor muscle exercise in the management of urinary incontinence in women.     

Risk management program in a health facility using a project approach: transfusion risk management]

Risk management in the hospital, which is one of the referentiels of the ANAES accreditation manual, may be considered on two levels. Firstly, risk management may be approached globally, in the same way as it is tackled in the accreditation process. Secondly, risk management may be more definite. A specific risk chosen in accordance with the priorities of a particular plan may be dealt with individually. In this respect, the tranfusion process allows the risk management method to be tested and developed. f1     

Nonoperative trauma management: has the pendulum swung too far? The distinguished Dr. William Matory lecture.

Over the last decade, the role of nonoperative management has revolutionized the specialty of trauma. However, this management paradigm has generated substantial controversy in several areas, including penetrating neck and abdominal trauma. Evidence-based analysis will be the ultimate guideline to determine what is optimal management. To prevent the pendulum from swinging too far, there should always exist a high index of suspicion to possible complications associated with the nonoperative approach. Also, the specific choice of management should be institution- and resource dependent.     

Rol de la gestión educativa estratégica en la gestión del conocimiento,la ciencia,la tecnología y la innovación en la educación superior

The integration of knowledge management, science, technology and innovation as an educational management strategy at the university level has removed the old boundaries between research, post-graduate studies and university extension courses. The aim of this study is present the harmonisation of strategic educational management practices in the integration of knowledge management, science, technology and innovation in higher education.This strategic approach is currently being introduced into the management of many Ecuadorian universities. As it is continually gaining strength, it also requires continuous improvement. To meet these new requirements demands promoting knowledge generation, increasing scientific leadership of the country and its institutions, and encouraging the generation of new opportunities for university management or strategic direction that gives prominence to one of its main components: strategic planning. Harmonising strategic educational management practices in the integration of knowledge management, science, technology and innovation, due to current international requirements arising from UNESCO guidelines. These have a strong influence in higher education and call for the resolution of problems which still persist and become distant from the developing of a strategic culture.     

Clinical considerations in gastroschisis: incremental advances against a congenital anomaly with severe secondary effects

Gastroschisis is one of the most challenging congenital anomalies that physicians treat in the first 2 months of life. Over the last 40 years, tremendous progress has been made in the management of this defect. Survival has increased significantly during this period as well. However, gastroschisis still presents the clinician with a unique set of challenges as a result of secondary effects on intestinal development. These challenges or clinical considerations are discussed in this review including a history of the management of the defect, prenatal counseling, prenatal intervention, postnatal and surgical management, complications and long-term outcomes.     

Social support among African-American adults with diabetes. Part 1: Theoretical framework.

Diabetes mellitus affects African Americans in disproportionate numbers relative to whites. Proper management of this disease is critical because of the increased morbidity and mortality associated with poor diabetes management. The role of social support in promoting diabetes management and improved glycemic control among African Americans is a little-explored area. This article, the first in a two-part series, provides a theoretical framework for examining the relationship between social support and glycemic control among African-American adults.     

住院流程标准化管理系统的应用及体会

HRP(Health Resource Plan)即医院资源管理平台,该平台是在提高医院服务质量的基础上实现以"结构化电子病历、质量管理、成本管理和医患关系管理"为特点的新一代医院管理系统,"住院流程标准化系统"就是HRP的一部分,文章介绍了该系统的主要模块和成效。     

Education in laboratory management for pathology residents

In addition to clinical expertise, pathologists are required to have a background in areas of management, administration, and computer operations. During their training, it is imperative that pathology residents have exposure to the subject of modern laboratory management. The authors feel that a rotation in administration is not adequate to give the necessary training but that a formal program is needed to achieve this goal. They have developed a course in laboratory management that uses the available resources of their own department and hospital to meet these needs.     

The future of clinical laboratory database management system]

To assess the present status of the clinical laboratory database management system, the difference between the Clinical Laboratory Information System and Clinical Laboratory System was explained in this study. Although three kinds of database management systems (DBMS) were shown including the relational model, tree model and network model, the relational model was found to be the best DBMS for the clinical laboratory database based on our experience and developments of some clinical laboratory expert systems. As a future clinical laboratory database management system, the IC card system connected to an automatic chemical analyzer was proposed for personal health data management and a microscope/video system was proposed for dynamic data management of leukocytes or bacteria.