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Selected AbstractsSpindle-cell lesions of the liver: Diagnosis by fine-needle aspiration biopsyDIAGNOSTIC CYTOPATHOLOGY, Issue 2 2001Cynthia D. Guy M.D. Abstract Rarely, spindle-cell lesions in liver fine-needle aspiration biopsies (FNABs) are encountered. A retrospective review of our experience with lesions that are mesenchymal in origin or appearance was undertaken to elucidate the frequency and spectrum of these lesions. Image-guided liver FNABs performed over a 3-year period (n = 585) at our institution (1996,1998) were retrospectively evaluated. Cytologic smears, cell block preparations, and clinical follow-up of lesions with spindle-cell morphology were reviewed. Twenty-nine of 585 cases were of spindle-cell morphology (5%). Hemangiomas (n = 12, 41%) and metastatic sarcomas (n = 6, 21%) comprised the largest categories, followed by granulomatous inflammation (n = 3, 10%). Other cases included primary angiosarcoma and fibrolamellar hepatocellular carcinoma. The most frequent spindle-cell liver lesion encountered is hemangioma, followed by metastatic leiomyosarcoma and granulomatous hepatitis. Awareness of diagnostic possibilities, special attention to specimen adequacy, and use of ancillary procedures can maximize diagnostic yield. Diagn. Cytopathol. 2001;25:94,100. © 2001 Wiley-Liss, Inc. [source] Support staff in community pharmacy: who are they and what do they want?INTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 2 2008Dr. Ellen I Schafheutle research fellow Objective To collect information on different categories of support staff, their deployment in community pharmacy, their levels of experience and qualifications, and their opinions on a number of topical issues, such as training and regulation. Method Two ,snapshot' surveys, one of community pharmacists, another of support staff employed by them. Three focus groups with support staff. Setting The surveys were conducted in community pharmacies in two primary care trusts (PCTs) in England. Two focus groups were conducted in one of the PCTs with respondents who had taken part in the survey; a third took place in a third PCT during the design phase. Key findings Medicines counter assistants (MCAs) formed the largest category of support staff (56%); 21% were dispensing assistants (DAs); 17% were pharmacy technicians (PTs). All community pharmacies employed at least one (60%), and often more than one MCA, but 20% had no DAs and 40% operated without a PT. Nearly all (93%) support staff were women, and about one-third worked part-time. More mature (40+ years) staff commonly only held an MCA qualification and were often not keen on further training. Younger staff held higher qualifications and were interested in further training and career progression. The majority of all categories of staff showed high levels of job satisfaction and loyalty to their employer. Most held positive views towards the regulation of support staff. Poor salaries were identified as potential barriers to further training and regulation, and pharmacists identified problems recruiting support staff. Conclusion Many different categories of support staff are employed in community pharmacies, although some operated without DAs or a PT. Support staff were generally satisfied with their jobs, but increasing requirements for formal qualifications and regulation of support staff, if not accompanied by adequate recognition and remuneration, may worsen recruitment problems. [source] Barriers to Neglect and Self-Neglect ResearchJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2008Terry Fulmer PhD Neglect is proportionally the largest category for adult protective services referrals, yet there is a dearth of science that generates appropriate guidelines for the detection and intervention of neglect cases. Despite implementation of mandatory reporting laws and models for appropriate responding to elder neglect, there remain challenges to research in this field. These challenges include diagnosis, recruitment, retention, attrition, research language, obtaining informed consent, and many other obstacles that impede the progression of research in elder self-neglect. Despite these impediments, much-needed research continues, and new ways of addressing these challenges are being developed. [source] Skills under threat: the case of HIV/AIDS in the mining industry in ZimbabweJOURNAL OF INTERNATIONAL DEVELOPMENT, Issue 5 2006Caroline N. Matangi Abstract The Zimbabwe mining industry is currently battling to arrest further spread of the HIV/AIDS crisis in workplaces, especially its impact on labour productivity. Labour in the closed community of mines has been greatly susceptible to HIV/AIDS infection. The current AIDS incidence in the mine sites is estimated at a weighted average of 15,per,cent amongst miners, with the largest category of workers,the 30,39 years age group,also constituting the worst affected category. Given the current state of the country's economy and consequently its adverse impact on the lifestyle of miners, the pandemic is expected to increase. This paper builds on the work of the ILO (1995) involving a survey of 18 various firms/institutions. The survey was carried out in Zambia in order to assess the impact of HIV/AIDS on the productive labour force. The survey revealed that many of the firms are experiencing irregular work attendance, ,wasted' training as some of the trained workers are constantly ill or die, high medical bills, funeral costs and reduced productivity and profits. An analysis of data on the main causes of death in 1993 shows that at least 61.8,per,cent of deaths could be attributed to causes that are very closely related to HIV/AIDS complications. Based on points highlighted by respondents and analysis of symptoms suffered, it was observed that HIV/AIDS tended to affect most general workers (36.8,per,cent), followed by the lower management (30.9,per,cent) and the middle management (20.6,per,cent). Comparatively, 11.8,per,cent of the deaths in 1993 belonged to the top management. Although it is hard to appreciate the meaning of the figures without knowledge of the number of people in each category, it nevertheless helps to form a clear picture of the impact of HIV/AIDS on industry. This paper seeks to further investigate the impact of HIV/AIDS on the productive labour force, by focusing on one particular industry,mining,using a blend of research methods to collect the data. This paper examines the impact of HIV/AIDS on the productive labour force and management responses. It forms part of the findings of data gathered in 2001 in the mining industry in Zimbabwe, to examine factors affecting management responses to HIV/AIDS in the mine sites. Zimbabwe is a country with a complex historical legacy of mine labour. This phenomenon can largely be attributed to the production oriented nature of the mining industry. Mines focus mainly on mineral extraction and as a result the bulk of mine workers tend to be production workers whose skills have developed over long periods of time. Production workers on mines have a tradition of long-term employment. This phenomenon has meant that labour in the mines is hard to replace as a result of skills, especially tacit knowledge, acquired over many years. Thus while the recent closure of some gold mines, largely due to low commodity prices, has meant that more miners are available in the labour market, this situation has not necessarily eased the process of replacing labour lost to the HIV/AIDS epidemic, as certain skills are firm specific. Production workers are predominantly male with the bulk falling in the 35,39 years age group. Most mine workers reside in mine villages, a colonial legacy that ensured miners were close to the workplace. The village system is a system of housing labourers, which demonstrates capitalistic methods of controlling labour and minimising costs. Of significance in this study's background is how the village system has come to be viewed as a factor in the spread of HIV/AIDS in the mining communities, because of its ,closed' nature. It is against this complex historical backdrop that the paper turns to examine the impact of the HIV/AIDS pandemic on production workers and management responses to the crisis using the Resource Based View of the Firm model (RBV), one of the theories in the Strategic Human Resource Management (SHRM) tradition. RBV was chosen for this study out of many HRM models that exist, because this theory, in particular, explains why it is advantageous for sites to use their ,unique' firm based resources in order to achieve sustainable competitive advantage. Given this rationale it was, therefore, presumed that this theory would best apply in mines battling with the adverse impact of HIV/AIDS on productivity, especially in the light of the harsh national economic climate, which would likely place limitations on response mechanisms. Further, the issue of firm-specific skills was also taken into consideration as an important factor in the mines, limiting their ability to resort to external solutions. Thus, given these factors, RBV was deemed the most appropriate model. The study finds that the pandemic depresses labour productivity through a number of significant ways: increased rate of HIV/AIDS induced absenteeism gradual labour turnover as a result of AIDS induced morbidity; and consequently declining skills availability, particularly firm-specific skills. Maintaining labour productivity in the face of gradually diminishing skills and indisposed labour will be key to softening the adverse economic consequences of the pandemic in the mines. To reduce the threat to labour productivity, mines must find ways of utilising, to the maximum extent practicable, existing skills. Results indicate that a move towards the utilisation of existing miners is the most favoured response mechanism in most mines. Utilising existing miners enables mines from spending financial resources on avoidable recruitment and training and quite often mechanisation, which may not necessarily be compatible with the old infrastructure in certain mines. Copyright © 2006 John Wiley & Sons, Ltd. [source] A Work Sampling Study of Provider Activities in School-Based Health CentersJOURNAL OF SCHOOL HEALTH, Issue 6 2009Brian Mavis PhD ABSTRACT Background:, The purpose of this study was to describe provider activities in a convenience sample of School-Based Health Centers (SBHCs). The goal was to determine the relative proportion of time that clinic staff engaged in various patient care and non-patient care activities. Methods:, All provider staff at 4 urban SBHCs participated in this study; 2 were in elementary schools, 1 in a middle school, and 1 in a school with kindergarten through grade 8. The study examined provider activity from 6 days sampled at random from the school year. Participants were asked to document their activities in 15-minute intervals from 8:00 a.m. to 5:00 p.m. A structured recording form was used that included 35 activity categories. Results:, Overall, 1492 records were completed, accounting for 2708 coded activities. Almost half (48%) of all staff activities were coded as direct patient contact, with clinic operations the second largest category. Limited variations in activities were found across clinic sites and according to season. Conclusions:, A significant amount of provider activity was directed at the delivery of health care; direct patient care and clinic operations combined accounted for approximately 75% of clinic activity. Patient, classroom, and group education activities, as well as contacts with parents and school staff accounted for 20% of all clinic activity and represent important SBHC functions that other productivity measures such as billing data might not consistently track. Overall, the method was acceptable to professional staff as a means of tracking activity and was adaptable to meet their needs. [source] | ||||||||||