Improving trainee psychiatrist’s handover: standard setting and audit

Purpose – The 2006 Post Graduate Medical Education Trust Board (PMETB) trainees' survey indicated inadequacies in handover procedures amongst medical and psychiatry trainees nationwide; and in 2007 a local psychiatry trainees' survey found inadequate handover procedures. The purpose of this paper is to show how to improve handover practice through standard setting and sequential audit. Design/methodology/approach – A Trust wide Standard Operating Procedure (SOP) for handover was developed. Trainees were audited on perception of handover experiences (2008, 2009 and 2010). Findings – The audit revealed that the SOP was not consistently followed. Handing over “active problems” (AP) was perceived to occur frequently in 2008 (93.75 per cent), improved in 2009 (100 per cent for AP, 98 per cent for “problems which may arise”, (PA)); however deteriorated in 2010 (93 per cent for AP, 69 per cent for PA). Trainee satisfaction rates with handover improved each year (57 per cent in 2008, 75 per cent in 2009, 87 per cent in 2010, X2=3.7, df=2, p=0.16). Practical implications – SOP development, subsequent audits and sharing of results improved handover practice. This has implications for training and patient safety. This project demonstrates a method of improving handover practices in a large mental health trust. Originality/value – The work conducted is of interest to those working in psychiatry, not only from an education and training perspective, but also for clinical practice, in the UK as well as internationally. </jats:sec

Resilient design of recharging station networks for electric transportation vehicles

As societies shift to 'greener' means of transportation using electricity-driven vehicles one critical challenge we face is the creation of a robust and resilient infrastructure of recharging stations. A particular issue here is the optimal location of service stations. In this work, we consider the placement of battery replacing service station in a city network for which the normal traffic flow is known. For such known traffic flow, the service stations are placed such that the expected performance is maximized without changing the traffic flow. This is done for different scenarios in which roads, road junctions and service stations can fail with a given probability. To account for such failure probabilities, the previously developed facility interception model is extended. Results show that service station failures have a minimal impact on the performance following robust placement while road and road junction failures have larger impacts which are not mitigated easily by robust placement

Prostate Cancer—PET Imaging Update

Prostate cancer is the most common non-dermatologic cancer in men, and one of the leading causes of cancer-related mortality. The incidence of prostate cancer increases precipitously after the age of 65 and demonstrates variable aggressiveness, depending on its grade and stage at diagnosis. Despite recent advancements in prostate cancer treatment, recurrence is seen in 25% of patients. Advancements in prostate cancer Positron Emission Tomography (PET) molecular imaging and recent United States Food and Drug Administration (FDA) approvals have led to several new options for evaluating prostate cancer. This manuscript will review the commonly used molecular imaging agents, with an emphasis on Fluorine-18 fluciclovine (Axumin) and PSMA-ligand agents, including their protocols, imaging interpretation, and pitfalls