RESUMEN
While women continue to enter the American work force in record numbers; many experience difficulty in juggling career and family obligations. Flexible scheduling is one option used to ease work and family pressures. Women's changing work roles have potentially noteworthy implications for clinical nutrition management, a traditionally female-dominated profession where the recruitment and retention of valued, experienced registered dietitians can prove to be a human resources challenge. Job sharing, one type of flexible scheduling, is applicable to the nutrition management arena. This article describes and offers a plan for overcoming obstacles to job sharing, including determining feasibility, gaining support of top management, establishing program design, announcing the job share program, and using implementation, monitoring, and fine-tuning strategies. Benefits that can be derived from a successful job share are reduced absenteeism, decreased turnover, enhanced recruitment, improved morale, increased productivity, improved job coverage, and enhanced skills and knowledge base. A case study illustrates one method for achieving job sharing success in clinical nutrition management.
Asunto(s)
Servicios Dietéticos , Dietética , Admisión y Programación de Personal/organización & administración , Mujeres Trabajadoras , Femenino , Servicio de Alimentación en Hospital , Hospitales con más de 500 Camas , Humanos , Illinois , Modelos Organizacionales , Recursos HumanosRESUMEN
Digital subtraction angiography (DSA) was used in the investigation, by dynamic cavernosography, of 35 men with acquired erectile impotence. The benefits of using DSA included shorter examination times, lower contrast medium dosage and better definition of abnormal veins. In particular deep crural veins are more clearly seen than in conventional studies and these may be of more importance than was previously thought.
Asunto(s)
Angiografía/métodos , Pene/diagnóstico por imagen , Adulto , Anciano , Disfunción Eréctil/diagnóstico por imagen , Humanos , Masculino , Persona de Mediana Edad , Intensificación de Imagen Radiográfica , Técnica de SustracciónRESUMEN
Sixteen of 149 patients complaining of impotence of a non-neurogenic or endocrine aetiology and with a penile brachial index of greater than 0.7 failed to achieve an erection following intracavernosal injection of 30 mg papaverine and 1 mg phentolamine. All 16 were shown to have a significant venous leak using digital subtraction cavernosography. Nine of the 13 so far operated upon have had a full return of potency. Repeat cavernosography in three failures showed persistent leakage into crural veins in two and non-ligated superficial veins in one. Impotent men with a normal penile brachial index who fail to respond to papaverine and phentolamine have a venous leak, a curable cause of impotence. Surgical access should allow ligation of all identified leaking veins.
Asunto(s)
Disfunción Eréctil/cirugía , Pene/irrigación sanguínea , Adulto , Disfunción Eréctil/diagnóstico , Disfunción Eréctil/etiología , Humanos , Masculino , Persona de Mediana Edad , Papaverina , Erección Peniana/efectos de los fármacos , Pene/diagnóstico por imagen , Fentolamina , Flebografía , Flujo Sanguíneo Regional , Técnica de Sustracción , Venas/cirugíaRESUMEN
One hundred and twenty five men with psychogenic or organic impotence used autoinjection of the penile corpora cavernosa with either papaverine or papaverine and phentolamine for a mean period of 10.5 months (range 1-24 months) to achieve penile erection for sexual intercourse. Prolonged (over four hours) painless erection resulted from 34 of the 3513 self administered injections. This seems to be a highly effective approach to treating impotence irrespective of the aetiology.