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Results for “Technology--changes”

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PubMed1976

Occupational health hazards resulting from elevated work rate situations.

Some occupational health hazards resulting from an elevated rate of work due to recent mechanization and automatization are discussed on the basis of results of health examinations. A rapid increase of a cervicobrachial disorder among young cash register and packing machine operators has been observed. Switching to the use of electronic cash registers has been shown to have only limited efficacy due to increased operation speed, and high-speed complex finger and hand movements of packer operators have also proven to be as hazardous as key-board operations. The high incidence of low-back pain, in particular gradually developing pain, among workers in electric power supply work has been suggested to be the result of quick and intensified work to meet increasing supply demand. Likewise, the workload of electric locomotive and bullet train drivers has increased in accordance with increased train speeds, and has been shown to have had significant effects on their health particularly in regards to neural strain, intra-cab environment such as air pressure change, vibration, and noise, and rotation on irregular shifts. New steps seem required therefore to meet the new health problems arising from a combination of modern technological changes and elevated working speeds.

Atmospheric Pressure↗

PubMed1992

[Results of testing well water from an area influenced by the chemical plant "Police"].

The subject of this study was the determination of the correlation between the operation of Chemical Plant "Police" and contamination of underground waters. The waters from ten wells in 16 localities were tested in 1982, 1987 and 1990. The indicators of contaminations emitted in different form by Chemical Plant "Police" as fluorides, ammonia and its derivatives nitrites and nitrates, sulphates, phosphates and also chlorides were tested. Bacteriological examinations of water also were performed. Investigations performed in 1987, confronted to 1982, showed development concentration of ammonia and minor as depends fluorides and sulphates. In 1990 lowering of average level of all chemical indicators were obtained. Presumable the introduction of technological changes in Plant determined the reduction of contaminations of underground water in this area.

Chemical Industry↗

PubMed1991

Strategic planning: a biomedical communications model.

This article describes a biomedical communications approach to strategic planning. This model produces a short-term plan that allows a department to take the competitive advantage, react to technological change, and make timely decisions on new courses of action. The model calls for self-study, involving staff in brainstorming sessions where options are identified and ideas are prioritized into possible strategies for success. The article recommends that an evaluation and monitoring schedule be implemented after decisions have been made.

Communication↗

PubMed1991

Knowledge growth. A challenge to administrators.

The rapid scientific and technological changes in patient care practically mandate structural changes to accommodate to the means of effective patient care. The phenomenal growth of science will not wait for individual nurses or whole professions to adjust. The growth of science, along with a cybernated system, will be relentless and will require rapid adjustment. Personal power will be defined in terms of how effectively knowledge is acquired, used, and expanded.

Diffusion of Innovation↗

PubMedDate not supplied

Collaborative practice between Ontario nurses and physicians: is it possible?

Numerous historical, psychological, social and cultural factors have caused the development and endurance of an unequal relationship pattern between the physician and the nurse. Nurses have assumed a position of lower status and dependency on physicians, and have been viewed as physicians' helpers or "handmaidens". However, with today's rapid technological changes, ethical and moral dilemmas, and cost constraints, high quality patient care cannot occur without equal contribution of both nursing and medicine. A shift from the traditional physician dominated relationship to a more balanced nurse-physician collaboration is needed. In a collaborative relationship, the physician and nurse jointly assume responsibility and accountability for patient care. This paper addresses the barriers to establishing a nurse-physician collaborative practice in Ontario and how they may be overcome.

Communication↗

PubMed1990

The impact of diagnosis-related groups on patient acuity, quality of care, and length of stay.

The consequences of the implementation of diagnosis-related groups (DRGs) include increased patient acuity level, shortened length of stay, and decreased quality of nursing care. The findings of this study did not support the expected changes in patient acuity level or quality of nursing care. In this study, technological changes and organizational variables may have buffered the expected negative consequences of the implementation of DRGs in a group of cardiovascular surgery patients.

Cardiovascular Surgical Procedures↗

PubMed1990

[Occupational rehabilitation yesterday, today and tomorrow as exemplified by the vocational retraining centers].

Developed in the 1960s, the concept for vocational rehabilitation in the vocational retraining centres has proven its worth also in the face of the great challenges of the 80s. Not all of the partly profound changes which have taken place in the environs of vocational rehabilitation over the last few years had been positive ones. Before this background, it must therefore be asked how the standard attained by the vocational retraining centres is to be viewed and which route the vocational rehabilitation field is going to take in the 90s. The process of societal and technological change over recent years is likely to further accelerate in the 90s, with numerous implications for vocational education and disability policies. Even more so than in the past, this process will require adjustments to be made, but equally give rise to innovative efforts and developments. The demands to be faced by the facilities are therefore going to increase, and major re-structuring processes will have to take place also in the vocational retraining centres.

Germany, West↗

PubMed1990

Renal failure in pregnancy.

The outcome for pregnancies in women with renal pathology has improved markedly as a result of many new technological changes. The kidney plays a critical role in both normal and complicated pregnancy. Only by understanding these various adaptations can one correctly manage patients whose pregnancies are complicated by some degree of renal impairment and achieve a safe and successful outcome for both mother and baby.

Acute Kidney Injury↗

PubMed1990

Strategic change in hospitals: an examination of the response of the acute care hospital to the turbulent environment of the 1980s.

Changes in strategies of hospitals responding to the turbulent health care environment of the 1980s are examined both in the aggregate and from the perspective of the individual hospital. The Miles and Snow typology is used to determine strategy type. Both investor-owned and not-for-profit hospitals were well represented in the broad mix of hospital types sampled. In addition, freestanding hospitals and members of multihospital systems were present in the sample. Last, hospitals of all sizes were included. Strategic change was evaluated by classifying hospitals by strategy type in each of two consecutive five-year time periods (1976 through 1980 and 1981 through 1985). Changes in reimbursement policies, the emergence of new technologies, changing consumer expectations, and new sources of competition made the environment for hospitals progressively more turbulent in the latter period and provided an opportune setting to evaluate strategic change. Results showed that a significant number of hospitals did change strategy as the environment changed, and in the direction anticipated. Logistic regression was used to determine whether prior strategy, type of ownership, system membership, or size would predict which hospitals would change strategy as the environment changed: only prior strategy was found to be a predictor of strategy change.

Economic Competition↗

PubMed1990

No evidence of an emerging physician surplus. An analysis of change in physicians' work load and income.

Analysis of physicians' work patterns and income between 1982 and 1987 provides strong evidence that the demand for physicians' services has risen at least as quickly as physician supply. Aggregate hours spent by US physicians who provide patient care rose by 21%, and aggregate real net income rose by more than 30% during a period in which the supply of physicians grew by only 16%. The aggregate number of visits rose by only 9%, indicating that the time spent per patient encounter rose sharply, presumably as a result of technological change and the increased complexity of care. Recently released data for 1988 are consistent with these trends. Our findings are inconsistent with the prediction by the Graduate Medical Education National Advisory Committee that there would be a large physician surplus by the year 1990. Moreover, if the upward trend in demand for physicians' services continues, as seems probable, a physician surplus should not develop in the foreseeable future. Only extensive rationing of beneficial services would be expected to alter this projection.

Data Collection↗

PubMed1990

Continuing education/beyond higher education.

Publicly funded institutions, such as NIH, NLM, and state-supported universities, have explicit public service missions that extend beyond the walls of a single institution. During the past few years, national organizations, such as NLM and AAMC, have funded studies and projects to measure how well universities are adapting to technological change and educational reform. The IAIMS models are evidence of universities fostering cooperative rather than duplicative effort. Opportunities and problems facing universities extending systems and services to the private practice setting, to community-based health care HMO's, and to state and local health care agencies are discussed in terms of political, economic, and geographic realities. Instilling lifelong learning concepts begins before the health professional enters practice and is dependent on the emphasis universities place on "excellence in teaching." Without cooperation among core facilities, such as libraries, computer centers, and excellent instructors, continuing education will remain a parochial issue instead of a national thrust toward the continuum of the learning process. If continuing education is to become a high priority for universities and take its place on the education spectrum, flexible policies must be established to accommodate individual practitioners' expectations and interests.

Computers↗

PubMed1990

[Conclusions from field studies of stress on miners caused by dry-hot climate conditions].

The physical strain of miners in hot salt mines based on analyses of heart-rates, deep body temperatures, and sweat-rates during real work was studied. Based on these results changes in the working conditions have been realized (air-conditioning of cabins or ambient air, technological changes, workpause-regimes). Cooling-wastes are not sufficient to reduce the thermal strain in hot-dry climate in normal work of salt-mines, independent of the principle of cooling. During fire-fighters work the physical work is the more dominating stressor in relation to the thermal strain.

Climate↗

PubMed1985

Update on laboratory studies and relationship to rheumatic and allergic diseases.

Guidelines have been presented for the optimal selection and interpretation of various laboratory tests related to rheumatologic, immunologic, and allergic disorders. The last decade has witnessed many technologic changes in the performance of screening tests for autoantibodies, and an expeditious approach to the detection of the clinically useful autoantibody system has been outlined. When both an immunofluorescent assay using an actively dividing substrate such as HEp-2 and an immunodiffusion test for precipitin autoantibodies are performed on patient sera, it is likely that most of the significant diagnostic and prognostic systems will be detected. Although exact pathogenetic roles have not been defined for all autoantibodies, it is apparent that highly specific markers for certain rheumatic diseases exist and the pertinent clinical aspects of each individual autoantibody-autoantigen system has been summarized. Why so many autoantibodies are cross-reactive with seemingly unrelated antigens is a perplexing aspect of autoimmunity, a disease process for which the necessary and sufficient conditions of development have not been defined even after decades of research. One recent hypothesis regarding the generation of diverse autoantibodies is the tenet that production is interrelated in an auto-anti-idiotypic network. Support for this hypothesis comes from the recent successful use of anti-idiotypes to DNA autoantibodies in an attempt to abrogate pathogenetic effects of target organ damage in murine models of SLE. A similar approach might be undertaken with some of the other autoantibody systems in an attempt at a novel therapy for disorders of immunoregulation.

Animals↗

PubMedDate not supplied

Rural community hospitals and factors correlated with their risk of closing.

The issue of rural hospital closings in the United States in recent years has become of increasing concern to health care policy analysts. Rural communities face unique health needs, necessitating access to local health care. Much has been written about the social, economic, legislative, and technological changes that have increased the stress on rural hospitals in the 1980s. However, quantifiable models have been lacking with which to examine in detail factors associated with rural hospitals and to correlate such factors with individual hospitals' risks of closing. In this study, we identify variables correlated with rural community hospital closures in the period 1980-87. Using epidemiologic case-control methods, 161 closed rural hospitals were matched 1 to 3 with a control group of 483 rural hospitals which remained open during the same period. A series of hospital performance indicators and demographic, economic, and social community variables were entered into a multiple logistic regression model. Four variables were found to be positively correlated with risk of closure. They are for-profit ownership; nongovernment, not-for-profit ownership; presence of a skilled nursing or other longterm care unit; and the number of other hospitals in the county. Variables negatively correlated with risk of closure were accreditation by the Joint Commission on the Accreditation of Healthcare Organizations, the number of facilities and services, and membership in a multihospital system. Policy and research implications at the Federal, State, and local levels are discussed.

Accreditation↗

PubMed1989

Social well-being: the future of the social and health care systems.

There are signs that the American public is becoming more concerned than in the previous decade with issues of compassion such as helping the poor, giving families a better break, helping children and people of color. Concern about the nation's vulnerable groups is increasing at a time of particularly profound societal change. The nation is aging demographically, vast technologic changes have displaced masses of workers, there are sharper economic contrasts than ever between the "haves" and "have-nots," and family structure is changing dramatically. In this era of change there are increased pressures on health care professionals, particularly in terms of fiscal constraints and public demands for accountability. At this time, we recommend moving toward a unified social well-being system which incorporates medical care,health care, and social services in a manner that makes the most efficient use of limited resources.

Delivery of Health Care↗

PubMed1989

Emergence of rheumatic fever in the nineteenth century.

How do we make sense of the process of disease definition when the tools for "framing" a pathophysiologic reality and the reality to be framed may have both been changing? The sudden emergence of rheumatic fever at the end of the eighteenth century was the result of distinct biological changes that led to cardiac damage. But the identification of the disease also depended on the ability of clinicians to diagnose it in the absence of easily observable cardiac symptoms. Clinicians were able to appreciate the alteration of rheumatism into rheumatic fever through assimilation of technological changes (the stethoscope and autopsy), refinements in clinical thinking (the "typical case"), and the concentration of patients in hospitals where they were treated by physicians who were medical leaders and educators.

History, 18th Century↗

PubMedDate not supplied

[New problems in occupational medicine: findings on the risk of coronary heart disease in the services industry].

The distribution of the major coronary risk factors: total and HDL cholesterol, blood pressure, smoking and body mass index, was studied during the course of a routine screening of 1404 male bank employees in Northern Italy. The recent Italian and international consensus conferences and particularly the results from the Italian areas of the WHO-MONICA Project were taken as reference points. There was a widespread coronary risk in the bank employees who had a 5-10% excess of cholesterol, corresponding to a 10-20% increase in the theoretical risk of coronary heart disease. Compared to the data produced by the Lipid Research Clinics (USA), coronary risk appeared higher for all the surveyed factors in the Italian general population, and particularly in bank employees. Greater stress at home and at work and above all the change from the traditional, poor Mediterranean diet to a richer diet might provide an explanation for these results. A new perspective is thus opened for occupational health due to the new health problems produced by the cultural and technological changes occurring in the country.

Adult↗

PubMed1988

Using the microbiology laboratory in the diagnosis of pneumonia.

Pneumonia/influenza is one of the top ten leading causes of mortality in the United States each year. The identification of the etiologic agent responsible for lower respiratory tract infection plays an important role in the proper management of this clinical problem. The specimens submitted for evaluation are obtained in diverse ways and include expectorated sputum, material from transtracheal and bronchoscopic procedures, pleural fluid and lung aspirates, and biopsy of actual lung tissue. Processing of material can include stained smears, aerobic and anaerobic cultures, and special processing techniques for fungal, viral, Pneumocystis carinii, Legionella, mycobacterial, and mycoplasma identification. Modifications of smear preparation techniques and application of the new DNA probe technology are providing the opportunity for rapid microbiologic testing of clinical specimens with increased sensitivity and specificity, often obviating the need for invasive diagnostic procedures. Laboratory methodology is continually undergoing technological change, and optimal care of the patient with pneumonia requires close cooperation between the attending physician and the clinical laboratory.

Bacteriological Techniques↗