ارائه یک الگو برای سیستم ملی طبقه بندی اقدامات پزشکی ایران

مقدمه:مدیران اطلاعات بهداشتی، اطلاعات مربوط به مراقبت و درمان را بر اساس سیستم های طبقه بندی اقدامات پزشکی طبقه بندی نموده و براساس اطلاعات طبقه بندی شده گزارشات آماری را تهیه و تحلیل می نمایند . امروزه مراقبت بهداشتی با کیفیت مطلوب بدون وجود یک سیستم طبقه بندی اقدامات پزشکی کامل و کارآمد امکانپذیر نخواهد بود . با استفادهد از این سیستم نتایج عملیات مراقبت در پرونده بیمار به صورت کدهای استاندارد ثبت می شود . این کدها اساس تحلیل اطلاعات برای پرسنل درمانی ، پژوهشگران ، سیاستگذاران و برنامه ریزان بهداشتی است. با توجه به اینکه در حال حاضر در کشور ما یک سیتم طبقه بندی اقدامات که بتواند نیازهای کدگذاران را برآورده کند وجود ندارد، ضرورت ارائه یک الگو مناسب احساس گردیده است. روش بررسی : این تحقیق به صورت یک مطالعه مقطعی ـ مقایسه ای در سال های 82-1381 به منظور ارائه یک الگوی مناسب برای سیستم ملی طبقه بندی اقداماتی پزشکی کشورمان انجام شده است . ابزار گردآوری داده های این پژوهش کتاب ها ، نشریات ، پایان نامه های موجود در کتابخانه ، اینترنت و پست الکترونیکی بوده است . در این پژوهش با مطالعه سیر پیدایش و تکامل ، ساختار ، سازمان ایجادکننده ، مزایا و محدودیت ها و استانداردهای به کار رفته در طراحی سیستم های طبقه بندی اقدامات به زبان انگلیسی و یک الگو برای سیستم ملی طبقه بندی اقدامات پزشکی کشورمان پیشنهاد شد. الگوی پیشنهادی طی دو مرحله به روش دلفی آزمون شده است . سرانجام پس از تحلیل نتایج آزمون ، الگویی مناسب برای سیستم ملی طبقه بندی اقدامات کشورمان ارائه گردیده است . یافته ها : نتایج مطالعه سیستم های ملی طبقه بندی اقدامات نگاشته شده به زبان انگلیسی همراه سیستم های موجود در کشورمان به طور مقایسه ای آورده شده است . همچنین الگوی نهایی در پنج محور اصلی به طور مبسوط تشریح گردیده است. به طور خلاصه می توان چند محوری بودن ، امکان گسترش سیستم بدون تغییر در ساختار آن ، وسعت بیشتر ، در نظر گرفتن راهنمای فارسی کدگذاری اقدامات ، وجود توصیف گرهای مورد نیاز ، استاندارد بودن و تنظیم فصول بر اساس نوع اقدام یا مداخله از مزیت های الگوی ارائه شده در مقایسه با سیستم های اقدامات موجود کشور دانست : نتیجه گیری : الگوی ارائه شده برای سیتسم ملی طبقه بندی اقدامات کشورمان در مقایسه با سیستم ملی طبقه بندی کشورهای انگلیسی زبان بیانگر آن است که این الگو بیشتر منطبق بر سیستم ملی طبقه بندی اقدامات کشورهای اروپای شمالی است. به دلیل نوپا بودن سیستم ملی طبقه بندی اقدامات پزشکی کشورمان و امکان نادیده گرفتن برخی اقدامات ، کدهایی برای موارد طبقه بندی نشده پیش بینی گردید

Social work students on the island of Ireland: a cross-sectional survey

Understanding the characteristics, motivations, and experiences of student social workers is important to inform their professional education and support needs. To date, there has been relatively little research about social work students in Ireland, both North and South. This study reports on an all-Ireland survey of students beginning their social work course in Autumn 2018 in the six Universities delivering social work education. It describes the characteristics of the student cohort, examines the motivations behind choosing this career, and highlights some of the potentially relevant life experiences and beliefs which may have contributed to their ambition to join the social work profession. Implications for social work education, recommendations for curriculum development, workforce planning, and the provision of appropriate support for students are discussed

Plasma-photonic spatiotemporal synchronization of relativistic electron and laser beams

Modern particle accelerators and their applications increasingly rely on precisely coordinated interactions of intense charged particle and laser beams. Femtosecond-scale synchronization alongside micrometre-scale spatial precision are essential e.g. for pump-probe experiments, seeding and diagnostics of advanced light sources and for plasma-based accelerators. State-of-the-art temporal or spatial diagnostics typically operate with low-intensity beams to avoid material damage at high intensity. As such, we present a plasma-based approach, which allows measurement of both temporal and spatial overlap of high-intensity beams directly at their interaction point. It exploits amplification of plasma afterglow arising from the passage of an electron beam through a laser-generated plasma filament. The corresponding photon yield carries the spatiotemporal signature of the femtosecond-scale dynamics, yet can be observed as a visible light signal on microsecond-millimetre scales

The mental health needs of social work students: findings from an Irish survey

It is important to consider the mental health of social work students to promote their wellbeing and to ensure they are prepared for the potential stressors of practice. This cross-sectional survey of social work students (n = 240), the first of its kind on the island of Ireland, provides findings on mental health and a range of associated issues which can help to improve student welfare; the content of social work courses; social work practice; and so, outcomes for service users. The article discusses implications for the delivery of social work education internationally

Professional identity formation within longitudinal integrated clerkships: A scoping review

ContextAlthough the uptake of Longitudinal Integrated Clerkships (LICs) is increasing worldwide, and there are documented benefits to participation, there is a lack of conceptual evidence regarding how LICs exert many of their benefits, including their influence on the recruitment and retention of practitioners to underserved areas or specialties. Whilst career choice and professional identity development have been previously connected within medicine, what is known about the ways in which LICs influence identity remains unclear. A scoping review was conducted to explore current knowledge and map directions for future research.MethodIn 2020, the authors searched nine bibliographic databases for articles discussing identity within the context of LICs using a systematic search strategy. Two reviewers independently screened all articles against eligibility criteria and charted the data. Eligible articles were analysed by quantitative and qualitative thematic analysis.Results849 articles were identified following an extensive search. 131 articles were selected for full-text review, with 27 eligible for inclusion. Over half of all articles originated from the United States or Canada, and research most frequently explored identity development from sociocultural orientations. Qualitatively, four themes were identified: (a) The importance of contextual continuities; (b) Symbiotic relationship of responsibility and identity development; (c) Becoming a competent carer; and (d) Influence of LICs on career identity.ConclusionsThis scoping review adds weight to the supposition that participation in LICs facilitates identity development, namely through contextual continuities and the responsibility students assume as they become co-providers of patient care. There are suggestions that LICs encourage the development of an ‘ethic of caring’. As little research compares comprehensive LICs with other clerkship models, it remains difficult to say to what degree identity formation is facilitated above and beyond other models. Future comparative research, and research exploring identity formation from diverse theoretical perspectives would add depth

Soil properties at the UCD geotechnical research site at Blessington

Bridge and Concrete Research in Ireland 2012, Dublin, Ireland, 6-7 September, 2012Over the past ten years, the Geotechnical Research Group (GRG) at University College Dublin have developed a research site at Blessington, County Wicklow, for the purpose of testing foundation systems. This paper presents the results of field and laboratory tests conducted to obtain the geotechnical parameters of Blessington sand. The in-situ tests included cone penetration and dilatometer tests. Sonic coring was performed in three boreholes at the site and complete recovery was obtained in boreholes up to 14 m deep. Additional disturbed samples were taken from trial pits which were up to 6 m deep. The classification tests performed on samples compared favourably with those inferred from correlations with in-situ test data. The strength, stiffness and mineralogy were also determined by a suite of laboratory tests including SEM imagery, triaxial tests and ring shear testing. The accuracy of conventional correlations in predicting the laboratory measured parameters is discussed.Author has checked copyright19/8/2013. SB

Examining the use of evidence-based and social media supported tools in freely accessible physical activity intervention websites

Background: It has been shown that physical activity is more likely to increase if web-based interventions apply evidence-based components (e.g. self-monitoring) and incorporate interactive social media applications (e.g. social networking), but it is unclear to what extent these are being utilized in the publicly available web-based physical activity interventions. The purpose of this study was to evaluate whether freely accessible websites delivering physical activity interventions use evidence-based behavior change techniques and provide social media applications. Methods: In 2013, a systematic search strategy examined 750 websites. Data was extracted on a wide range of variables (e.g. self-monitoring, goal setting, and social media applications). To evaluate website quality a new tool, comprising three sub-scores (Behavioral Components, Interactivity and User Generated Content), was developed to assess implementation of behavior change techniques and social media applications. An overall website quality scored was obtained by summing the three sub-scores. Results: Forty-six publicly available websites were included in the study. The use of self-monitoring (54.3%), goal setting (41.3%) and provision of feedback (46%) was relatively low given the amount of evidence supporting these features. Whereas the presence of features allowing users to generate content (73.9%), and social media components (Facebook (65.2%), Twitter (47.8%), YouTube (48.7%), smartphone applications (34.8%)) was relatively high considering their innovative and untested nature. Nearly all websites applied some behavioral and social media applications. The average Behavioral Components score was 3.45 (±2.53) out of 10. The average Interactivity score was 3.57 (±2.16) out of 10. The average User Generated Content Score was 4.02 (±2.77) out of 10. The average overall website quality score was 1.04 (±6.92) out of 30. Four websites (8.7%) were classified as high quality, 12 websites (26.1%) were classified as moderate quality, and 30 websites (65.2%) were classified as low quality. Conclusions: Despite large developments in Internet technology and growth in the knowledge of how to develop more effective web-based interventions, overall website quality was low and the majority of freely available physical activity websites lack the components associated with behavior change. However, the results show that website quality can be improved by taking a number of simple steps, and the presence of social media applications in most websitesis encouraging

A nurse-led intervention improves detection and management of AKI in Malawi

BACKGROUND: Acute kidney injury is common and has significant impact on mortality and morbidity. There is a global drive to improve the lack of knowledge and understanding surrounding the recognition, diagnosis and management of patients with AKI in resource poor healthcare systems. OBJECTIVES: We propose a nurse‐led education programme to medical and nursing staff of the Queen Elizabeth Central Hospital (QECH) in Blantyre, Malawi, will improve the overall care and understanding of patients with AKI that will still be effective 3 months later. METHODS: This was a three phase, prospective interventional pilot study which evaluated base line knowledge and clinical practice amongst healthcare workers, provided a comprehensive combination nurse‐led class room and ward based teaching programme and evaluated the change in knowledge and clinical management of patients in the high dependency areas of the hospital immediately, and 3 months, after the teaching intervention. RESULTS: The nurse‐led intervention significantly improved the healthcare workers attitudes towards detecting or managing patients with suspected AKI (p < 0.0001). There were also significant improvements in the completion of fluid charts and recording of urine output (p < 0.0001), corner stones of AKI management. Knowledge and clinical intervention was still present three months later. There was however little change in the understanding that AKI could be a significant clinical problem in QECH and that it may have a major impact on mortality and working practice and this needs to be addressed in future teaching programmes. CONCLUSIONS: A low cost, nurse‐led AKI educational intervention improved the knowledge and management of AKI at QECH, which was still evident 3 months later