Monthly Archive: October 2017

MDLinx reader survey responses: The opioid crisis in the United States

MDLinx reader survey responses

MDLinx reader survey responses: The opioid crisis in the United States

 

Experts from the Department of Health and Human Services and the US National Institutes of Health have developed strategies to deal with this crisis.

MDLinx editors took this latest survey to the readers to better evaluate the impact of opioid readers’ crisis, practices and prescription patterns, and determine their views on possible solutions.

In general, responses indicate that the opioid crisis affected the way most opioid prescribers prescribe, and personally in their own practices. Most doctors, however, are not convinced that government intervention will help alleviate the opioid crisis. Finally, three-quarters of them favored a registry of national or state opioid use within the electronic health records of patients (EHR).

Here is a breakdown of what the readers’ responses revealed:

Immediate effects in practice. Most medical respondents (60.10%) reported that the opioid epidemic had an impact on their practice, with adverse effects due to concomitant use of other prescription products, or overdose of opiate abuse. A smaller percentage (27.40%), however, said that it had no effect on their practices, while 12.50% said they did not know whether it was or not.

The comments to this question vary considerably, from “I work in an emergency room. I see this problem every day.” “I am a radiologist, and I do not care about patients directly.”

Effects on prescription patterns. When asked if the opioid crisis changed the way they prescribe opioids, most doctors (66.50%) said they prescribed fewer pills and / or for a shorter duration or a lower dose.

This was followed by 25% who reported that the prescription of opioids was not applicable to their practices and 8.5% who responded that they have not changed the way they prescribe opioids because “they rely on their patients to regulate themselves .

Nine Ways Diagnostic Medical Sonographer Jobs are Growing

Nine Ways Diagnostic Medical

 

Nine Ways Diagnostic Medical Sonographer Jobs are Growing

 

When people think about ultrasound, they usually think of ultrasounds on pregnant women. But as applications develop Ultrasound, new and emerging roles are developing for associated health professionals. Today, the ultrasonic medical diagnostic system is one of the fastest growing employment types in the United States, providing a critical diagnosis for all kinds of medical conditions.

The field is booming, to employment for ultrasonography technician jobs is expected to grow by 26% 2014-2024, according to the Bureau of Labor Statistics

What is driving the demand? Some of the growth is due to the aging baby boomers who rely on ultrasound technology to diagnose blood clots and heart disease. Imaging technology also improves. Ultrasound is increasingly cheaper than cheaper than other imaging technologies more invasive procedures, and often.

Here are nine types of ultrasound technologists, according to the BLS and the Ultrasound Technician Center:

1. Ultrasound (OB / GYN) obstetrics and gynecology focusing on the female reproductive system. Evaluate the health of the fetus and pelvic organs. In non-pregnant women, their images are used to assess problems such as endometriosis, ovarian cysts and cancer.
2. Abdominal sonographers are specialized in the image of the abdominal cavity, including organs such as the gall bladder, kidney, liver, pancreas, or spleen. Ultrasound is used to diagnose the cause of abdominal pain and swelling, such as cysts and tumors, and to see blockages and blood clots.
3. Bestial sonographers typically represent the breast in a woman after a mammogram. Ultrasound can more easily confirm the presence of cysts in dense breast tissue. Also the difference between cysts filled with liquid and hard masses
4. Pediatric sonographers represent children and infants whose conditions are often associated with premature birth or congenital malformations.
5. Musculoskeletal sonographers focus on muscles, ligaments, tendons, joints and soft tissues. They picture patients who may suffer from bruising, rotator cuff torn, muscle tears or the early stages of rheumatoid arthritis. They also work with children to confirm pieces of soft tissue or hip dislocations.
6. Surgeons identify ophthalmologic abnormalities in the eye, including cataract and vitreous hemorrhage, in which the blood escapes from the back of the eye.
7.Escopi├│grafos the vascular image of the blood vessels to help evaluate blood flow to the tissues and organs.
8. Known as echocardiograms, cardiac sonographers represent the heart of the patient, including heart valves, chambers and vessels. Cardiac sonographers may specialize in three subareas: fetal echocardiography, pediatric echocardiography and adult echocardiography.
9. Neuroson├│grafos specializing in the nervous system, helping to evaluate problems that affect the brain and spinal cord, such as strokes, brain tumors and aneurysms. They also image patients with disorders include paralysis, herniated discs and multiple sclerosis.

Nurse Licensure Compact Expands to 25 States: Is National Licensure on the Horizon?

Nurse Licensure Compact Expands to 25 States

Nurse Licensure Compact Expands to 25 States: Is National Licensure on the Horizon?

 

The movement to train nurses to practice in several licensed states continues to gain ground throughout the country, with 25 states now Nurse Licensure of the Compact (CNL).

Created by the National Council of State Councils of Nursing in 2000, Licensed Comprehensive Nursing gives nurses practical / licensed practical nurses the opportunity to practice in other compact nursing states without having to get a Additional license. Nursing license is Multistate issued by the state of residence of the nurse, which should be a compact state, and replaces the old system requiring that nurses are licensed in each state where they practice.

Expanding the compact nursing license has been good news for many in the industry, especially as the nursing shortage continues to grow.

Proponents of the pact argue that multistate nursing allowed patients better access to quality nursing care, allow the delivery of electronic services or telemedicine by competent nurses from a state to provide organizations and health a more Large number of qualified nurses.

The nation’s ongoing expansion NLC approaches the ultimate goal of national licensing of nursing, which is supported by many healthcare providers and nursing organizations.

National nursing license will ensure that all nurses practice under a set of rules as opposed to the current system in which individual states have their own scope of practice definitions for licenses. These differences may limit the ability of nurses to practice their education and training as much as possible. As stated in an article in the July 2012 issue of the American Journal of Critical Care “… a nurse who is competent to perform a particular procedure in a state in which it may be legally prohibited to do the same procedure in another ” .

Some states have been slow to adopt the license agreement cited differences in the background checks rules and other factors. In May 2015, the National Council of State Councils of Nursing RN adopted an “improved” agreement at higher levels, to address these concerns.

The pact includes enhanced state and federal criminal background check, restrictions on the purchase of a multi license if it has never been convicted of a crime, and a variety of requirements for a ” Uniform licensing, including renewal and reintegration.

It should result in a more compact improvement states to join the current state of the compact nursing movement towards national license.

Retirement plans vary by physician specialty

Retirement plans vary by physician specialty

Retirement plans vary by physician specialty

 

Among dermatologists (n = 8), 87.5% had been in practice for over 25 years, and 50.0% were between 56 and 70 years old. The majority (62.5%) reported that they did not plan to retire between the ages of 65 and 70, followed by 25% who said they planned to retire and 12.5% who planned to retire before the age of 65.

The reason for retirement cited by most dermatologists (75.0%) was that they were tired of ballot papers and political, regulatory and insurance situations. Health or family problems were cited by the remaining 12.5%, and financial security / without working at 12.5%.

Oncologists: Of the seven responding oncologists, 71.4% were between 56 and 70 years old, and 87.5% had been in practice for 25 years. Fifty percent reported that their retirement at age 65 to 70 years depended on the circumstances, while 16.7% planned to retire at that time, 16.7% planned to retire before the age of 65 and 16, 7% had no plans to retire. Responses were divided as to the reason for retiring at this age, with 42.9% citing that they were tired of paperwork and political, regulatory and insurance situations; And 42.9% cited financial security. Finally, 14.3% reported that health or family issues would make them consider retirement at this age.

Ophthalmologists: Among the 15 respondents who were ophthalmologists, 73.3% were between 56 and 70 years old, and 86.7% had been in practice for over 25 years. In total, 33.3% thought to retire between 65 and 70 years, 26.7% did not, 20.0% reported that it would depend on their circumstances at the time and 20.0% reported that they planned to retire before 65 years.

Reasons cited by ophthalmologists for retirement included being tired of paperwork and political, regulatory and insurance situations (33.3%), followed by 46.7% who were financially secure and did not need to work, 13.5% reported health problems Or relatives and 6.7% said they would never retire because they love their work.

Pediatricians: Of the 32 patients who responded to the pediatrician, the majority (56.3%) were between 56 and 70 years old, and 78.1% were in practice for 25 years. A 34.4% plan to retire between 65 and 70 years, followed by 34.4% who did not, 18.8% before age 65 and 12.5% perhaps, depending on the circumstances.

The majority (37.5%) mentioned being tired of paperwork, political regulation and insurance situations as their reason for retirement; 31.3% cited financial security, 15.6% health or family problems, 12.5% said they would never retire, and 3.1% cited too many CME requirements and recertification to stay on top of their field.

Obstetricians / gynecologists: Of the 21 respondents specializing in Ob / Gyn, 66.7% were between 56 and 70 years old, and 85.7% had been in practice for 25 years. Respondents were square divided into four equal factions with respect to their plans to retire: 25.0% reported that they wanted to retire between 65 and 70 years, 25% wanted to retire before age 65, 25.0% said that retirement would depend on their Circumstances and 25.0% did not want to retire.

Again, the majority (40.0%) were tired of paperwork and the political, regulatory and insurance situation, 30.0% cited financial stability and 15.0% of health or family problems as a reason for their retirement. In addition, 15.0% reported that they would never retire because they love their job.

Pulmonologists: Of the four responding pulmonologists, 50% were between 56 and 70 years old, and all (100%) had been in practice for more than 25 years. In total, 50% planned to retire between 65 and 70 years, 25% did not plan to retire and 25% responded “maybe”, depending on the circumstances. Reasons for retirement were divided equally between the tiredness of paperwork and the political, regulatory and insurance situation; Health or family problems, too much CME and recertification required; And financial security, to 25% each.

Gastroenterologists: Of the three gastroenterologists who responded, all were between 56 and 70 years old, and 50% had been in practice for 25 years. One (33.3%) plans to retire between 65 and 70 years, one (33.3%) never plans to retire and one (33.3%) can retire according to the circumstances. Two of the three physicians (66.7%) were tired of paperwork and regulatory insurance policy situations, and one did not report plans to retire.

Birds’ ability to fly could determine the shape of their eggs

Birds' ability to fly

Birds’ ability to fly could determine the shape of their eggs

 

We all know what an egg looks like, right? Well, we might know less than we think: birds’ eggs can be spheres, tears, and caplets all the rest. An interdisciplinary group of scientists may have advanced into the mystery of how these different forms.
A new science study shows that differences in flight capacity could really begin from the egg: birds that take the sky are more elliptical and asymmetric eggs, while land birds (ostriches) are more eggs spherical.
“My colleagues and I were really impressed by the egg-shaped diversity,” says Mary Stoddard, the paper’s first author and an assistant professor at Princeton. “All bird eggs perform a similar function. Feeding and protecting the growing chicken, but in spite of their shared function, developed different forms “.
All eggs are like a supermarket; The vast landscape of bird eggs actually covers a much wider range of means. Brown hawk-egg falcon, for example, is almost a perfect sphere, while the launderer has an egg shaped like a drop of water.
The first step was to characterize the researchers this diversity with two measures. First of all, the ellipticity: begins with a sphere, and to stretch it becomes more elliptical. On the other hand, the asymmetry: sometimes, one end of an egg is sharper than the other. Each of these measurements is one of the continuous values – they can be in the middle and combination, can describe almost all the eggs. ┬┐Asymmetric elliptical? Like a tear. With spherical symmetry? It’s a sphere, duh.

The researchers attracted 50,000 different forms of eggs 1400 species along these two axes and incredible variety were surprised, more than in other vertebrates that lay eggs. They found that most eggs fell somewhere in the middle, like a chicken egg: a little more elliptical than a sphere, and a little asymmetrical. But how do these forms arise?
Previous research has shown that the shape is determined by the flexible membrane of the egg, a protective layer under the hard shell. This study goes even further to suggest how the shape of the membrane is first determined. Suggests that the properties of the membrane in different parts of the thickness and elasticity of the egg, for example, determine how the shape of the membrane in response to pressure changes. The researchers created a computer model to show how the properties of the membrane in some parts of the egg can affect the overall shape.

Digital Camera Cleaning and Maintenance

Digital Camera Cleaning and Maintenance

 

Digital Camera Cleaning and Maintenance

 

It’s too easy to go home after a day of shooting, remove the memory card, play with new images and forget about the maintenance of your equipment.

If you are like me, something new to save time (car, motorcycle, watch, glasses, etc.), impeccably cleaned at least once a day. Then, after a few weeks, falling to once a week and then just “occasionally strange” or when they are really dirty.

Because photography is my livelihood, I have to physically grab my camera bag, go sit in a quiet place and take a good half hour to an hour after filming to clean each piece of equipment I used.

This kit has thousands of costs and cleanliness has a direct relationship with the quality of my images and longevity of use. Not only that, but upgrading my computer, you can sell my old devices at the best price.

These are the checks I make;

Cleaning and Care of Digital Cameras – Objectives

Obviously, being very careful when cleaning the glass is what makes lenses so expensive and expensive to repair or replace. Use only fine solutions of paper and alcohol that are designed for the camera lens. Clean first front and rear elements with a first blower brush to remove dust particles.

The last thing you want to do is scrape off the smallest piece of dust through your lens.

Also use the bristles of a blower to clean the moving parts of the outer cylinder brush. This prevents the accumulation of dirt over time and maintains proper functioning, helping to prevent dust from entering the internal optical system.

Make sure to clean the brush or replace too often otherwise simply spread small particles of grease and dirt onto the lens.

Cleaning and Care of Digital Cameras – Camera Sensor

The more talked about and questioned the problem with maintaining digital SLR is the sensor and the accumulation of dust. If you are not sure how to do, wait until the dust sensor is at a point where it is unbearable (most specifications are easily and quickly removed in the editing), then a professional cleaning.

Damage a sensor is expensive …

If you intend to do it yourself, just be careful. Set the camera to manual 30 second exposure. It takes time to clean the sensor, but using the bulb setting (“B”) could be an error.

If you accidentally, the trigger is in danger of damaging the mirror, shutter, sensor or three closed while cleaning the sensor. Even if you use a remote control set “B” on the remote control batteries could sell and close the shutter prematurely.

With a fully charged battery in your camera and a delay of 30 seconds, you know where it is.

Once the shutter is open, hold the camera so that the sensor is down and use the fan (without brush) to blow up the dust sensor.

NB The chamber is thus maintained to allow the dust to fall from the chamber and the brush is removed if the touch sensor and adds grease stains or dust rather than removing it.

If the sensor is very dirty, you can purchase cleaning kits with tampons where the physical touch the sensor to “clean” dirt. Again, you need a small hand and a great care to do so, so if you are not sure, seek professional help.

Cleaning and Care of Digital Cameras – Mirror Screen / Focus

Unless you can barely see through the viewfinder (exaggeration), I tend to leave the mirror and the screen focusing other than a single quick shot / shot with a blower brush. The only time I would give more attention is whether the risk of dust sensor transfer is running.

Dust on the mirror or screen does not change the final image, so that the dust you see in the viewfinder does not affect the image (although excessive dust on the screen may affect the accuracy Of the approach).

Again, be careful because the mirror in particular is extremely sensitive and easily scratched.