Provision of out-of-hours interventional radiology services in Scotland.

AIM: To evaluate the availability of out-of-hours (OOH) interventional radiology (IR) services in Scotland and discuss implications for service redesign. MATERIALS AND METHODS: Data were gathered via a survey conducted by telephone/e-mail interview. The setting was hospitals in Scotland with acute medical and/or surgical beds. The interviewees were consultant interventional radiologists representing each of the 14 geographical Health Boards in Scotland. RESULTS: Three of the 14 geographical Health Boards provided a formal, prospectively planned OOH IR service in at least one hospital. Fourteen of the 34 acute hospitals provided an in-hours IR service, which includes endovascular haemorrhage control. Eight of the 34 acute hospitals had formal, prospectively planned on-call IR arrangements, 12 had an ad-hoc service, and 20 transferred patients to other facilities. Thirty-eight of the 223 consultant radiologists in Scotland were able to perform endovascular haemorrhage control procedures: only 18 of these 38 (47%) were included in on-call rotas. A further 42 radiologists were able to perform nephrostomy and a further 61 were able to perform abscess drainage. Eighty-two radiologists did not perform any interventional procedures. CONCLUSIONS: The provision of OOH IR services in Scotland is limited and available resources, both skills and equipment, are being underutilized. These data will be used to inform a process of OOH IR service redesign in Scotland.

Genetic learning automata for function optimization.

Stochastic learning automata and genetic algorithms (GAs) have previously been shown to have valuable global optimization properties. Learning automata have, however, been criticized for having a relatively slow rate of convergence. In this paper, these two techniques are combined to provide an increase in the rate of convergence for the learning automata and also to improve the chances of escaping local optima. The technique separates the genotype and phenotype properties of the GA and has the advantage that the degree of convergence can be quickly ascertained. It also provides the GA with a stopping rule. If the technique is applied to real-valued function optimization problems, then bounds on the range of the values within which the global optima is expected can be determined throughout the search process. The technique is demonstrated through a number of bit-based and real-valued function optimization examples.

Parasitic disease control in a residential facility for the mentally retarded.

Asymptomatic infection with either Entameba histolytica or Giardia lamblia was found in 61 per cent of the residents of a dormitory in an institution for the mentally retarded; two other dormitories had rates of 20 per cent and 22 per cent. Drug therapy was successfully undertaken in all three dormitories, and environmental improvements were introduced in the heavily infected dormitory. A one-year follow-up showed a reduction in parasitic disease in two dormitories but, in the most heavily infected dormitory, infection had returned to pretreatment levels.

Environmental conditions of abortion clinics.

PIP: 9 out of 15 known free standing abortion clinics in the Washington, D.c. metro area were surveyed by a multidisciplinary team to determine whether prescribed health and safety standards for health care facilities are being adhered to. The minimum space requirements of 80 sq ft for medical examination and/or treatment rooms were not met by 4 clinics and inadequate lighting was found in 2 clinics. Although all facilities exhibited evidence of an effective housekeeping program, 8 clinics did not have effective preventive maintenance program for mechanical equipment and medical devices. 1 clinic had inadequate ventilation system and 6 had inadequate handwashing facilities. All had effective solid waste management systems. 6 clinics regularly conduct microbiological monitoring programs (eg, swabbing walls, doorknobs and heating units; sterilization of surgical instruments) but 3 lacked vigilant supervision of sterilizing equipment and procedures. 2 clinics did not have properly grounded or insulated electrical equipment for minimizing electrical shock. Insect and rodent control in all clinics was good. Overall, the housekeeping programs were considered to be constant, thorough, well-conceived and well executed. Implications of the findings were discussed.^ieng