Electronic surveillance in hospitals: A review

This paper focuses on the increasing use of electronic surveillance systems in hospitals and the apparent lack of awareness of the implications of these systems for privacy of the individual. The systems are used for identification and tracking of equipment, staff and patients. There has been little public comment or analysis of these systems with regard to privacy as their implementation has been driven by security issues. The systems that gather this information include video, smart card and more recently RFID systems. The system applications include tracking of vital equipment, labelling of blood and other samples, tracking of patients, new born babies and staff. These applications generate a vast amount of digital information that needs to be correctly secured to protect the privacy of the individual. Separately each type of information has value, but if this information were analysed together then the intelligence that can be gleaned from this could become a major threat to privacy and security. There are various standards and legislation that cover healthcare information, such as CCTV, but are these known and what are the compliance levels? RFID use is increasing in the hospital sector and this is being linked with the patient medical record as it is becoming core to treatment in some hospitals. The indications are that this will become normal practice which means that surveillance information from RFID systems will be linked much more closely to a patient’s medical record. Managers, owners and custodians of information within hospitals need to be aware of the issues and take steps to ensure that staff are fully aware and trained in information handling practices. They also need to ensure that external parties who handle surveillance information are compliant with standards and good practice

The effect of maternal HIV status on perinatal outcome at Mowbray Maternity Hospital and referring midwife obstetric units Cape Town

Objectives. To study the effect of maternal HIV status on perinatal outcome at Mowbray Maternity Hospital (a secondary-level hospital in Cape Town) and its satellite community midwife obstetric units. Design. A retrospective descriptive and comparative study.Setting. Public sector maternity facilities serving historically disadvantaged populations. Subjects. All deliveries at Mowbray Maternity Hospital and its referral midwife obstetric units from January to December 2008. Outcome measures. Stillbirth, early neonatal death, perinatal mortality and neonatal encephalopathy rates in HIV-positive and HIVnegative subjects. Results. There was a total of 18 870 deliveries at the units studied, 3 259 (17.2%) of them to HIV-positive mothers. The stillbirth rate in the HIV-positive population was 17.1/1 000 births, compared with 8.3/1 000 in the HIV-negative population (odds ratio (OR), 2.07, 95% confidence interval (CI) 1.5 - 2.8). The early neonatal death rate in the HIV-positive population was 4.6/1 000 live births, compared with 3.1/1 000 in the HIV-negative population (OR 1.46, 95% CI 0.8 - 2.6). The perinatal mortality rate in the HIV-positive population was 21.7/1 000 births, compared with 11.7 in the HIV-negative population (OR 1.91, 95% CI 1.4 - 2.5). A comparison of the pattern of primary obstetric causes of perinatal mortality showed that infection, intra-uterine growth restriction (IUGR) and antepartum haemorrhage (APH) were significantly more common as causes for perinatal death in the HIV-positive population. The risk of neonatal encephalopathy in the HIV-exposed population was 4.9/1 000 live births compared with 2.07 in the HIV-negative group (OR 2.36, 95% CI 1.28 - 4.35). The 1 643 women (8.7% of total deliveries) who were not tested for HIV were at particularly high risk of adverse perinatal outcome. This group included women who had either declined testing or not attended for antenatal care. Conclusion. The perinatal mortality rate in the group of HIV-exposed mothers was significantly higher than that in the HIV-negative group due to a higher stillbirth rate. Infection, IUGR and APH were significantly more common obstetric causes for mortality in the HIV-infected population. The risk of neonatal encephalopathy was also significantly higher in the HIV-positive population

Intergenerational and Peer Communication in the Workplace: An Analysis of Satisfaction and Dissatisfaction

This research used an on-line survey to examine intergenerational communication in the workplace. Respondents were 165 young, middle-aged, and older working adults randomly assigned to report on workplace communication with either peer or intergenerational co-workers. All completed a questionnaire assessing satisfaction with communication with coworkers in the target group, and 134 respondents also provided descriptions of a satisfactory and a dissatisfactory work conversation with a member of the target group, following Williams and Giles (1996). Young and older respondents reported greater satisfaction with peer than intergenerational coworker communication on the questionnaire as predicted, but middle-aged respondents indicated equivalent satisfaction with peer and older coworker communication. Emergent theme analysis of the conversational descriptions revealed that, consistent with communication accommodation theory (Giles, Coupland, & Coupland, 1991), satisfactory conversations were characterized by accommodative communication behaviors, positive feelings, and goal accomplishment, whereas dissatisfactory conversations were associated with underaccommodative communication behaviors, negative feelings, and goal non-accomplishment. Although the forms of accommodation and underaccommodation varied in emphasis across age groups and descriptions of peer and intergenerational conversations, more similarities than differences were noted. The ways in which the work context shapes conceptions of age were also identified. Together, these results provide evidence that the work context may foster a shared identity that serves to reduce the salience of age in workplace interactions, consistent with the common ingroup identity model (Dovidio & Gaertner, 2000), but that shared identity at the interpersonal level does not necessarily lead to general communication satisfaction with intergenerational coworkers

Voices at the Table: Collaboration and Intertextuality

While we often associate reading aloud with children and particularly younger children, the practice of reading aloud has historically been a way for a community to share texts for information and enjoyment. Findings from a year-long study of a school librarian collaborating with a team of second grade teachers demonstrates the value of reading aloud in building background knowledge and vocabulary, modeling, understanding curriculum, creating common texts, and reading for enjoyment. Reading aloud brought other voices to the table in a clear example of intertextuality. Implications are shared for school librarians interested in similar practices as well as future research related to the impact of the school librarian on classroom instruction and student learning