High Standards (high + standards)

Distribution by Scientific Domains
Distribution within Medical Sciences

Selected Abstracts

Living up to high standards and psychological distress

Nico W. Van Yperen
Abstract We argue and demonstrate that setting high standards, an essential aspect of perfectionism, is not associated with maladaptive responses in and of itself. Rather, our findings suggest that people's responses to their perceptions that they consistently fail to meet their own standards are maladaptive. More importantly, in the present survey study (n,=,293), we extend previous research by showing that low personal standards and the perception that others are imposing high standards on the self operate in concert to strengthen the link between perceived discrepancy and psychological distress. Furthermore, in support of our moderation-mediation model, regression analyses provided evidence for the mediating role of generalised self-efficacy beliefs. Copyright 2008 John Wiley & Sons, Ltd. [source]

Staunch protections: the ethics of haemophilia gene transfer research

HAEMOPHILIA, Issue 1 2008
Summary., Haemophilia has long been considered an ideal system for validating human gene transfer (GT). However, haemophilia GT trials present a particular ethical challenge because they involve subjects whose medical condition is stabilized by standard therapies. Below, I review the ethics and risks of haemophilia GT clinical research. I propose several conditions and practices that strengthen the ethical basis for such trials. These include consultation with haemophilia advocacy organizations as trials are designed and executed, high standards of supporting evidence before trials are initiated, pretrial publication of this evidence, and the offer of indemnification for participants. I further argue against the conduct of paediatric haemophilia GT studies at this time, and raise questions about the fairness of recruiting economically disadvantaged subjects into studies that are primarily directed towards the health needs of persons in the developed world. [source]

Rescue policy for discarded liver grafts: a single-centre experience of transplanting livers ,that nobody wants'

HPB, Issue 8 2010
Lucas McCormack
Abstract Background:, There is a worldwide need to expand the donor liver pool. We report a consecutive series of elective candidates for liver transplantation (LT) who received ,livers that nobody wants' (LNWs) in Argentina. Methods:, Between 2006 and 2009, outcomes for patients who received LNWs were analysed and compared with outcomes for a control group. To be defined as an LNW, an organ is required to fulfil two criteria. Firstly, each liver must be officially offered and refused more than 30 times; secondly, the liver must be refused by at least 50% of the LT programmes in our country before our programme can accept it. Principal endpoints were primary graft non-function (PNF), mortality, and graft and patient survival. Results:, We transplanted 26 LNWs that had been discarded by a median of 12 centres. A total of 2666 reasons for refusal had been registered. These included poor donor status (n= 1980), followed by LT centre (n= 398) or recipient (n= 288) conditions. Incidences of PNF (3.8% vs. 4.0%), in-hospital mortality (3.8% vs. 8.0%), 1-year patient (84% vs. 84%) and graft (84% vs. 80%) survival were equal in the LNW and control groups. Conclusions:, Transplantable livers are unnecessarily discarded by the transplant community. External and internal supervision of the activity of each LT programme is urgently needed to guarantee high standards of excellence. [source]

Restrictions to the use of cleanrooms for packaging pasteurised milk

The study evaluated the effect of packaging pasteurised milk inside an ISO Class 8 cleanroom and an external Class 7 antechamber. Chemical, microbiological and sensory analyses of three trials did not show evidence of improvements in the product shelf life, although the total airborne particle and the viable airborne counts were considerable higher outside the cleanroom than inside it. Post-pasteurisation contaminations inherent to the equipments should be considered in futures studies. Therefore, the use of cleanroom technology is an operational alternative to be taken into consideration, provided that the characteristics of the whole system is compatible with the high standards of the clean air. [source]

Asymmetric Synthesis with Silicon-Based Bulky Amino Organocatalysts

Li-Wen Xu
Abstract Recent years have witnessed an explosive growth in the field of amino organocatalysis, especially in asymmetric enamine and iminium catalysis. Except for the obvious interaction between organocatalyst and substrate, the impact of bulky side group ons stereoselectivity is not as simple as one could imagine. Within the development of bulky site-stereoselective organocatalysts, functional silyl organocatalysts with a bulky silicon group are promising and meet the high standards of modern synthetic methods. This review focuses on the recent advances in the synthetic applications of silicon-based, bulky amino organocatalysts in which catalysts containing an organosilicon moiety or group play a formative role in controlling both the course of the reaction as well as the stereoselectivity. [source]

Factors Affecting Australia's Refugee Policy: The Case of the Kosovars

Jackie King
This article seeks to explain Australia's refugee policy and to identify the various objectives and factors that influence the development of that policy. Australia's refugee programme seeks to: provide a humanitarian response and protection to individual refugees; participate responsibly in the international community; honour its Convention obligations; further the interests of the people of Australia; meet high standards of administration and; acknowledge as much as possible changes in refugee populations. In fulfilling these objectives, Australian governments must weigh and balance various competing factors. These include: humanitarian responsibility, international obligations, social, political, economic and foreign policy factors, as well as efficient administration. In balancing the relative importance of these factors, the Federal government hopes to fulfil all its refugee and humanitarian objectives. However, the pluralistic nature of Australian society and the often conflicting ideals associated with protection of Australia's interests and the preservation of the rights of refugees, means that fulfilment of these objectives is difficult. This article examines the Australian government's response to the Kosovar conflict, to assess the relative success Australia had in fulfilling its refugee policy objectives and identifying the various factors that produced the final result. [source]

A New Information Exchange System for Nursing Professionals to Enhance Patient Safety Across Europe

Dr. Alessandro Stievano RN
Abstract Purpose: Ensuring safe healthcare services is one of today's most challenging issues, especially in light of the increasing mobility of health professionals and patients. In the last few years, nursing research has contributed to the creation of a culture of safety that is an integral part of clinical care and a cornerstone of healthcare systems. Organizing Constructs: European institutions continue to discuss methods and tools that would best contribute to ensuring safe and high-quality care, as well as ensuring access to healthcare services. According to the European Commission between 8% and 12% of patients admitted to hospitals in the European Union member states suffer from adverse events while receiving care, although some of these events are part of the intrinsic risk linked to receiving care. However, most of these adverse events are caused by such avoidable healthcare errors as, for instance, diagnosis mistakes, inability to act on the results of tests, medication errors, failures of healthcare equipment and hospital infections. Nosocomial infections alone are estimated to affect 4.1 million inpatients, that is, about 1 of every 20 inpatients, causing avoidable suffering and mortality, as well as an enormous loss of financial resources (at least ,5.48 billion a year). Conclusions: The Internal Market Information (IMI) System, developed by the European Commission, aims at contributing to patient safety by means of a timely and updated exchange of information among nursing regulatory bodies on the good standing and scope of practice of their registrants. Through the IMI System, the European Federation of Nursing Regulators will improve its electronic database on nurses to allow national nursing regulatory bodies to exchange the information needed to recognize the nurses' educational and professional qualifications and competencies. This process both facilitates the mobility of professionals and ensures high-quality nursing practice in an even and consistent way across the European Union. Clinical Relevance: On a national basis, nursing regulatory bodies play an important role in ensuring patient safety through high standards of nursing education and competence, whereas on an international basis, patient safety can assured by a better exchange of information between national regulatory bodies on the good professional standing of nurses. [source]

Clinical governance in practice: closing the loop with integrated audit systems

L. TAYLOR ba hons rmn
Clinical governance has been acknowledged as the driving force behind National Health Service (NHS) reform since the government white paper outlined a new style of NHS in the UK in 1997. The framework of clinical governance ensures that NHS organizations are accountable for continually improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will develop. A major component of a clinical governance framework requires utilizing audit procedures, which assess the effectiveness of current systems and ultimately direct continual quality improvement. This paper describes the audit component of a local clinical governance framework designed for a unit based within an NHS trust, which has utilized a multidisciplinary approach to assess the effectiveness of a newly commissioned service and its impact on the residents and staff. The unit is a 12-bedded, low-secure-intensive rehabilitation unit for clients with severe and enduring mental illness. Using recognized and standardized psychometric outcome measures, information was collected on clinical symptoms, social functioning, social behaviour, quality of life, relationship quality with named nurses and medication side-effects. Additionally, confidential staff measures were included to assess levels of burnout, identify expressed emotion and assess staff perception of models of illness. The paper includes a comprehensive account of how managerial commitment, teaching processes and application of technology ensured prompt data collection and maintained the momentum through the audit timescale. Data analysis and presentation of data in both clinical reviews and in senior management meetings within the unit are discussed. Findings highlight the full integration of the audit system into the processes of the unit. Clinically, the paper highlights the enhancement of the knowledge base of the client group and the influence on clinical decision-making processes and care delivery as a result of the audit. Brief clinical examples are given. In conclusion, the impact of the audit on unit strategy and organizational efficiency are discussed to highlight the importance of closing the audit loop and completing the cycle of clinical governance. The audit system has positive implications for replication in other services. [source]

What Determines Buyer-Seller Relationship Quality?

An Investigation from the Buyer's Perspective
SUMMARY In today's environment, businesses are increasingly dependent on the relationships they have with their suppliers and are demanding that they adhere to high standards. It is increasingly important that buyers have strong relationships with their suppliers to stay ahead of competition. The establishment, development, and maintenance of relationships between exchange partners is crucial to achieving success (Morgan and Hunt 1994). The goal of this research is to further investigate the nature of buyer-seller relationships from the buyer's perspective and to address the question , what determines the quality of buyer-seller relationships? Many factors may contribute to the quality of a buyer-seller relationship. Quality may depend on the nature of the organizations involved, the individuals in the organizations, and the nature of the situation. This study considers two main sets of variables, interpersonal and aspects of the relationship. Interpersonal variables describe the characteristics of individual company representatives, while aspects of the relationship variables describe the situations buyers and sellers face. A unique aspect of this study is that it considers the role both of individuals and of the organizations they represent. [source]

Small-gap insertion-device development at the National Synchrotron Light Source , performance of the new X13 mini-gap undulator

J. M. Ablett
The National Synchrotron Light Source (NSLS) 2.8,GeV electron storage ring continues to set high standards in insertion-device research and development. The Chasman,Green NSLS lattice design provides for dispersion-free long straight sections in addition to a very small vertical , function. As the electron beam size is proportional to the square root of this function, a program to exploit this feature was undertaken more than a decade ago by implementing short-period small-gap insertion devices in the NSLS storage ring. The possibility of utilizing existing moderate-energy synchrotron radiation electron storage rings to produce high-brightness photon beams into the harder X-ray region have been realised using in-vacuum undulators. In this article the operation of a 1.25,cm-period mini-gap undulator, operating down to a gap of 3.3,mm within the NSLS X13 straight section, is reported. It is the brightest source of hard X-rays in the energy range ,3.7,16,keV at the NSLS, and replaces an in-vacuum undulator which had a more limited tunability. [source]

,You're judged all the time!' Students' views on professionalism: a multicentre study

Gabrielle Finn
Medical Education 2010: 44: 814,825 Objectives, This study describes how medical students perceive professionalism and the context in which it is relevant to them. An understanding of how Phase 1 students perceive professionalism will help us to teach this subject more effectively. Phase 1 medical students are those in the first 2 years of a 5-year medical degree. Methods, Seventy-two undergraduate students from two UK medical schools participated in 13 semi-structured focus groups. Focus groups, carried out until thematic saturation occurred, were recorded and transcribed verbatim. Data were analysed and coded using NVivo 8, using a grounded theory approach with constant comparison. Results, From the analysis, seven themes regarding professionalism emerged: the context of professionalism; role-modelling; scrutiny of behaviour; professional identity; ,switching on' professionalism; leniency (for students with regard to professional standards), and sacrifice (of freedom as an individual). Students regarded professionalism as being relevant in three contexts: the clinical, the university and the virtual. Students called for leniency during their undergraduate course, opposing the guidance from Good Medical Practice. Unique findings were the impact of clothing and the online social networking site Facebook on professional behaviour and identity. Changing clothing was described as a mechanism by which students ,switch on' their professional identity. Students perceived society to be struggling with the distinction between doctors as individuals and professionals. This extended to the students' online identities on Facebook. Institutions' expectations of high standards of professionalism were associated with a feeling of sacrifice by students caused by the perception of constantly ,being watched'; this perception was coupled with resentment of this intrusion. Students described the significant impact that role-modelling had on their professional attitudes. Conclusions, This research offers valuable insight into how Phase 1 medical students construct their personal and professional identities in both the offline and online environments. Acknowledging these learning mechanisms will enhance the development of a genuinely student-focused professionalism curriculum. [source]

Educational Standards in Private and Public Schools,

Giorgio Brunello
When school quality increases with the educational standard set by schools, education before college need not be a hierarchy with private schools offering better quality than public schools. In our model, private schools can offer a lower educational standard at a positive price because they attract students with a relatively high cost of effort, who would find the high standards of public schools excessively demanding. We estimate the key parameters of the model and show that majority voting supports a system where private schools have higher quality in the US and public schools have higher quality in Italy. [source]

Musculoskeletal tissue banking in Western Australia: review of the first ten years

Joyleen M. Winter
Background: Musculoskeletal tissue allotransplantation has been used as a standard approach for reconstructive surgery. The present study has reviewed the banking of musculoskeletal tissue at the Perth Bone and Tissue Bank (PBTB) and provided evidence of quality assurance on musculoskeletal tissue allotransplantation. Methods: All donor tissues were processed in accordance with the Therapeutic Goods Administration's relevant codes of good manufacturing practices. Microbiological monitoring at each step of manufacture and postoperative surveying of the musculoskeletal allotransplantations were both conducted. The possible contribution of contaminants in allografts to postoperative infections was also assessed. Results: Of the 5276 donors obtained over the last 10 years, 1672 were rejected, giving an overall donor rejection rate of 32%. Milled femoral heads were the most frequently implanted allografts, followed by whole femoral heads. In the postoperative survey an infection rate of 4.9% was found (113/2321 recipients). The infectious agents were identified in 65 cases but for 60 of these there were no correlations with the positive culture test results for the allografts. The organism most commonly identified in postoperative infections was Staphylococcus species. Conclusions: The present study shows evidence that musculoskeletal tissue allotransplantation is a safe procedure when accompanied by high standards of quality assurance. [source]

Falkland Islands cruise ship tourism: an overview of the 1999,2000 season and the way forward

Rebecca J. Ingham
Abstract 1.Falkland Islands' tourism is evolving at an increasing pace. A record number of passengers, 23 497, visited the Islands during the 1999,2000 season. This rise was due to an increase in both the frequency of vessel visits and the average passenger capacity of vessels, with the number of luxury cruise ships of >1000 passengers steadily increasing. The Falklands' industry is made up of three types of vessel: the expedition cruise vessels (ca. 100,200 passengers); larger cruise vessels (ca. 400 passengers), and the luxury cruise vessels (ca. 1000 passengers). 2.The cruise ship industry has seen a diversification within the market, with cruises now available to a wider audience thus increasing the need for new experiences and landing sites. A similar diversification is being seen within the Islands themselves as the capacity to take larger vessels at remote sites is being developed. Whilst the expedition cruise vessels visiting the Islands are operating to high environmental standards as members of the International Association of Antarctic Tour Operators (IAATO), vessels with 400+ passengers may not become members of IAATO, due to Article III of the organization's Bylaws which limits the number of passengers. These larger capacity vessels are therefore not subject to the same self-regulating guidelines. The implications of increasing passenger numbers in the islands are discussed with regard to pressures on both the wildlife and vegetation. 3.This study outlines the need for an island-wide approach and a legislative framework to ensure high standards of operation are adhered to within the Islands from all visiting vessels and that accurate information is provided to all visitors along with a suitable code of conduct. The collection, collation and analysis of visitor data to identify trends and implement appropriate management strategies, and further research into the potential impacts of tourism on wildlife in the Falklands are also recommended. Copyright 2002 John Wiley & Sons, Ltd. [source]

Virtue in Emergency Medicine

Gregory Luke Larkin MD
Abstract At a time in which the integrity of the medical profession is perceptibly challenged, emergency physicians (EPs) have an opportunity to reaffirm their commitment to both their patients and their practice through acceptance of a virtue-based ethic. The virtue-based ethic transcends legalistic rule following and the blind application of principles. Instead, virtue honors the humanity of patients and the high standards of the profession. Recognizing historical roots that are relevant to the modern context, this article describes 10 core virtues important for EPs. In addition to the long-recognized virtues of prudence, courage, temperance, and justice, 6 additional virtues are offered unconditional positive regard, charity, compassion, trustworthiness, vigilance, and agility. These virtues might serve as ideals to which all EPs can strive. Through these, the honor of the profession will be maintained, the trust of patients will be preserved, and the integrity of the specialty will be promoted. [source]

Use of inhaled nitric oxide in the new born period: results from the European inhaled nitric oxide registry

Chris Dewhurst
Abstract Aims:, The aim of this study was to present data relating to the use of inhaled nitric oxide (iNO) in newborn infants included in the European Inhaled Nitric Oxide Registry. Methods:, Demographic, clinical and therapeutic data from seven European centres are reported. Univariate analyses were performed to identify factors associated with acute response to iNO and survival without extra corporeal membrane oxygenation (ECMO). Results:, A total of 112 newborn infants received iNO, with 40% being less than 34 weeks gestational age. The commonest indication for iNO was secondary pulmonary hypertension. Acute response to iNO was more common in infants with a higher oxygenation index (median OI 32.7 vs 22.6, p = 0.040), although acute response did not predict survival without ECMO. Infants who survived without ECMO had a lower OI prior to therapy (median OI 24 vs 43, p = 0.009), were commenced on a higher starting dose (median dose 20 ppm vs 10 ppm p = 0.013) and received a lower maintenance dose (median dose 10 vs 17 ppm, p = 0.027) than those who died or received ECMO. Conclusion:, Collating and reporting data about iNO therapy in neonates across a number of European centres using a web-based system is feasible. These data may be used to monitor the clinical use of iNO, identify adverse effects, generate research hypotheses and promote high standards in the clinical use of iNO. [source]