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991.
M. Elisabeth Paté-Cornell Linda M. Lakats Dean M. Murphy David M. Gaba 《Risk analysis》1997,17(4):511-523
The risk of death or brain damage to anesthesia patients is relatively low, particularly for healthy patients in modern hospitals. When an accident does occur, its cause is usually an error made by the anesthesiologist, either in triggering the accident sequence, or failing to take timely corrective measures. This paper presents a pilot study which explores the feasibility of extending probabilistic risk analysis (PRA) of anesthesia accidents to assess the effects of human and management components on the patient risk. We develop first a classic PRA model for the patient risk per operation. We then link the probabilities of the different accident types to their root causes using a probabilistic analysis of the performance shaping factors. These factors are described here as the "state of the anesthesiologist" characterized both in terms of alertness and competence. We then analyze the effects of different management factors that affect the state of the anesthesiologist and we compute the risk reduction benefits of several risk management policies. Our data sources include the published version of the Australian Incident Monitoring Study as well as expert opinions. We conclude that patient risk could be reduced substantially by closer supervision of residents, the use of anesthesia simulators both in training and for periodic recertification, and regular medical examinations for all anesthesiologists. 相似文献
992.
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994.
The authors measured the impact of educational efforts on the number of college students who received meningococcal vaccine. First-year Brown University students from the classes of 2004 (n = 1,562) and 2005 (n = 1,518) received educational vaccine materials before they arrived on campus, whereas students from the class of 2003 (n = 1.441) did not. Students in the class of 2003, 13% (n = 184) of whom had received vaccine before their arrival on campus, served as the baseline. These educational efforts by the college health services before students arrived on campus increased the number of students immunized before campus arrival to 46% (n = 724) for the class of 2004, and 60% (n = 913) for the class of 2005. Education about the benefits of meningococcal vaccine before students' arrival on campus increased both the number of immunized students and the overall immunization rate among students. 相似文献
995.
The current study examined the differences between three types of violent men based on Holtzworth-Munroe and Stuart's (1994) tripartite typology and a group of non-intimate violent men. First, a cluster analysis was conducted on a sample of 91 domestically violent men, resulting in three clusters that approximated the tripartite model for psychopathology as measured by the MMPI-2, that is, non-pathological, borderline/dysphoric, and antisocial. Based on the violence variables (i.e., severity of violence, family-only violence, and exposure to family of origin violence) only severity of violence approximated what would be expected across the three clusters, that is, the less the psychopathology, the less severe the violence. The other two violence variables had approximate frequencies/percentages of occurrence that would be expected for individual typologies with some but not all three typologies. In comparing the three intimate violent typologies to the non-intimate violent group, the non-intimate and non-pathological groups were within normal limits and did not differ significantly on any of the MMPI-2 scales. These non-intimate and non-pathological groups differed significantly from the antisocial and borderline/dysphoric groups on all the scales that defined the psychopathology of these two groups. On the violence variables, the non-intimate groups reported significantly less severe violence than the borderline/dysphoric and antisocial groups. 相似文献
996.
Current treatment of generalized anxiety disorder 总被引:1,自引:0,他引:1
Generalized anxiety disorder is the most common anxiety disorder and is second only to depression as the most common disorder diagnosed in primary care. Because it is potentially disabling due to its high comorbidity with other psychiatric conditions, psychiatric nurses must accurately diagnose GAD and formulate individualized treatment plans that promote positive outcomes for clients with this disorder. 相似文献
997.
998.
The incidence of various stressors at work and outside work was examined in a group of public service workers with a large Canadian federal government department. Workers were either in clerical, technical and supervisory ('officers'), or management positions. Measures of work stress included role stressors (load, insufficiency, conflict ambiguity and responsibility), as well as stress due to the physical environment. Both life events and daily hassles were included as measures of non-work stress. The consequences of stress were considered in terms of vocational, psychological, interpersonal, and physical strain, as well as in terms of job satisfaction and organizational commitment. Potential moderators of stress included social support and self-esteem. Among work stressors conflict, ambiguity and insufficiency were the more closely associated with vocational outcomes. MANCOVA followed by discriminant function analysis showed that clerical workers were distinguished by higher levels of insufficiency, officers by higher levels of conflict and the lowest levels of job satisfaction and organizational commitment, and managers by higher levels of perceived responsibility for others. The results are discussed in terms of social role theory. 相似文献
999.
This article presents findings from a study of the attitudes and beliefs of social security claimants engaged in benefit fraud. The basis for a taxonomy of such claimants is outlined, drawing upon concepts of reflexivity and anxiety. This is compared and contrasted with other theoretically-drawn taxonomies, one relating to workplace crime, the other to the consumption of social care services. Finally, the article considers whether benefit fraud is intelligible as resistance to social control. It is argued that benefit fraud represents a conservative form of resistance. Benefit fraud does not signify a "culture" of resistance, so much as a "manageable" form of rule-breaking. 相似文献
1000.
SUMMARY. This paper explores the relationship between the reading attainment of a group of 8–14 year olds in long-term foster care and factors in their histories and current home environments. The findings suggest that children's early histories before entry to care may have an effect on their educational attainment in middle childhood. Some amelioration of early childhood experience may be found in a stable foster home placement which has an expectation of permanence. The type of permanent placement seems less important than the expectation of stability. There was no difference in progress between children where the eventual outcome might be adoption or custodianship and those who would remain foster children. Of especial interest was the fact that the foster children's educational attainment was not related either positively or negatively to contact with their birth parents. 相似文献