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1.
Urol Clin North Am ; 48(2): 203-213, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33795054

RESUMO

The nation's undersupply of urology services disproportionately affects Medicare beneficiaries compared to the general population. Advanced Practice Providers (APPs), most commonly nurse practitioners and physician assistants may be a vehicle to meet this need. The increased use of APPs in urology is hampered by physician discomfort with delegating responsibility to APPs. This discomfort may be compounded by complexities with billing issues and interstate variation in scope of practice regulations. To expand access to urological services while simultaneously ensuring service quality, it is imperative that urologists engage with APPs individually and as a specialty.


Assuntos
Profissionais de Enfermagem , Assistentes Médicos , Papel Profissional , Urologistas/provisão & distribução , Urologia , Humanos , Licenciamento , Profissionais de Enfermagem/economia , Profissionais de Enfermagem/provisão & distribução , Assistentes Médicos/economia , Assistentes Médicos/provisão & distribução , Âmbito da Prática , Estados Unidos
3.
Med Care ; 59(4): 283-287, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33704102

RESUMO

BACKGROUND: While optimal utilization of the nurse practitioner (NP) workforce is an increasingly popular proposal to alleviate the growing primary care shortage, federal, state, and organizational scope of practice policies inhibit NPs from practicing to the full extent of their license and training. In March of 2020, NP state-specific supervisory requirements were temporarily waived to meet the demands of the coronavirus disease 2019 (COVID-19) pandemic in Massachusetts. OBJECTIVE: The objective of this study was to examine the impact of temporarily waived state practice restrictions on NP perception of care delivery during the initial surge of the COVID-19 pandemic in Massachusetts. RESEARCH DESIGN: Mixed methods descriptive analysis of a web-based survey of Massachusetts NPs (N=391), conducted in May and June 2020. RESULTS: The vast majority (75%) of NPs believed the temporary removal of practice restriction did not perceptibly improve clinical work. Psychiatric mental health NPs were significantly more likely than other NP specialties to believe the waiver improved clinical work (odds ratio=6.68, P=0.001). NPs that experienced an increase in working hours during the pandemic surge were also more likely to report a positive effect of the waiver (odds ratio=2.56, P=0.000). CONCLUSIONS: Temporary removal of state-level practice barriers alone is not sufficient to achieve immediate full scope of practice for NPs. The successful implementation of modernized scope of practice laws may require a collective effort to revise organizational and payer policies accordingly.


Assuntos
/terapia , Profissionais de Enfermagem/organização & administração , Pandemias/prevenção & controle , Padrões de Prática em Enfermagem/organização & administração , Atenção Primária à Saúde/organização & administração , /diagnóstico , Certificação , Implementação de Plano de Saúde , Humanos , Licenciamento , Massachusetts/epidemiologia , Profissionais de Enfermagem/legislação & jurisprudência , Padrões de Prática em Enfermagem/legislação & jurisprudência , Atenção Primária à Saúde/legislação & jurisprudência , Autonomia Profissional , Inquéritos e Questionários/estatística & dados numéricos , Recursos Humanos/legislação & jurisprudência , Recursos Humanos/organização & administração
7.
Am Psychol ; 76(1): 165-166, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33475390

RESUMO

Callahan et al. (2020) asserted that the Examination for Professional Practice in Psychology (Part 2-Skills) has not undergone appropriate validation. Although they recognized that content validity is the foundation of licensure examinations, they suggested additional validational strategies that are not recommended for licensure examination development. This response clarifies the appropriate validation standards for the examination. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Assuntos
Licenciamento , Prática Profissional , Humanos , Padrões de Referência
11.
12.
Lab Anim (NY) ; 50(1): 5, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33339990
14.
Lab Anim (NY) ; 50(1): 4, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33339992
16.
Biomed Eng Online ; 19(1): 75, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008462

RESUMO

BACKGROUND: The world is facing an unprecedented outbreak affecting all aspects of human lives which is caused by the COVID-19 pandemic. Due to the virus novelty, healthcare systems are challenged by a high rate of patients and the shortage of medical products. To address an increased need for essential medical products, national authorities, worldwide, made various legislative concessions. This has led to essential medical products being produced by automotive, textile and other companies from various industries and approved under the emergency use authorizations or legal concessions of national regulatory bodies. This paper presents a narrative commentary of the available documentation on emergency use authorizations and legal concessions for medical products during COVID-19 pandemic. METHODOLOGY: The basis for narrative commentary includes scientific articles published in Web of Science, Scopus, PubMed and Embase databases, official publications of international organizations: Food and Drug Agency (FDA), World Health Organisation (WHO), World Bank and United Nations (UN), and national regulatory agency reports in native languages (English, German, Bosnian, and Croatian) published from November 1, 2019 to May 1, 2020. This paper focuses on three types of essential medical products: mechanical ventilators, personal protective equipment (PPE) and diagnostic tests. Evidence-informed commentary of available data and potential identified risks of emergency use authorizations and legal concessions is presented. DISCUSSION: It is recognized that now more than ever, raising global awareness and knowledge about the importance of respecting the essential requirements is needed to guarantee the appropriate quality, performance and safety of medical products, especially during outbreak situation, such as the COVID-19 pandemic. Emergency use authorizations for production, import and approval of medical products should be strictly specified and clearly targeted from case to case and should not be general or universal for all medical products, because all of them are associated with different risk level. CONCLUSION: Presented considerations and experiences should be taken as a guide for all possible future outbreak situations to prevent improvised reactions of national regulatory bodies.


Assuntos
Betacoronavirus , Comércio/legislação & jurisprudência , Infecções por Coronavirus , Licenciamento/legislação & jurisprudência , Indústria Manufatureira/legislação & jurisprudência , Pandemias , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral , Kit de Reagentes para Diagnóstico/provisão & distribução , Ventiladores Mecânicos/provisão & distribução , Técnicas de Laboratório Clínico/normas , Infecções por Coronavirus/diagnóstico , Falha de Equipamento , União Europeia , Saúde Global , Humanos , Equipamento de Proteção Individual/normas , Kit de Reagentes para Diagnóstico/normas , Medição de Risco , Estados Unidos , United States Food and Drug Administration , Ventiladores Mecânicos/normas
17.
PLoS One ; 15(10): e0226397, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33001977

RESUMO

State fish and wildlife agencies rely on hunters and anglers (i.e., sportspersons) to fund management actions through revenue generated from license sales and excise taxes on hunting and fishing equipment. There is a need to develop new techniques that bridge the information gap on participation and provide agencies with an understanding of sportspersons at a resolution that can more directly inform efforts to engage sportspersons. Monitoring sportsperson participation using information about their license-purchasing behavior has the potential to reveal important patterns in recruitment (first-time purchase of a hunting or fishing license), retention (continued purchase of licenses across multiple years), and reactivation (purchase a license after several years with no purchases). Providing up-to-date information on what licenses are purchased, when and by whom may prove invaluable to managers and policy makers. We present a customizable, open-source, web-based application-huntfishapp-that allows the user to query and interact with a structured query language (SQL) hunting and fishing license database. The huntfishapp serves as an informational resource and tool that provides a framework to share information on license sales across an agency, with intent of increasing understanding of (a) sportspersons and (b) how management decisions affect sportspersons. Data dashboards, like the huntfishapp, allow agencies and non-governmental organizations to become more knowledgeable of their customer base and provide a greater understanding of management-decision effects on hunting and fishing participation.


Assuntos
Comportamento do Consumidor/economia , Licenciamento , Software , Comércio , Conservação dos Recursos Naturais/economia , Pesqueiros/economia , Humanos , Recreação/economia
18.
Vet Rec ; 187(8): 323, 2020 10 17.
Artigo em Inglês | MEDLINE | ID: mdl-33060234
19.
Health Aff (Millwood) ; 39(10): 1792-1798, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33017232

RESUMO

Motor vehicle crashes remain the leading cause of adolescent mortality and injury in the United States. For young drivers, crash risk peaks immediately after licensure and declines during the next two years, making the point of licensure an important safety intervention opportunity. Legislation in Ohio established a unique health-transportation partnership among the State of Ohio, Children's Hospital of Philadelphia, and Diagnostic Driving, Inc., to identify underprepared driver license applicants through a virtual driving assessment system. The system, a computer-based virtual driving test, exposes drivers to common serious crash scenarios to identify critical skill deficits and is delivered in testing centers immediately before the on-road examination. A pilot study of license applicants who completed it showed that the virtual driving assessment system accurately predicted which drivers would fail the on-road examination and provided automated feedback that informed drivers on their skill deficits. At this time, the partnership's work is informing policy changes around integrating the virtual driving assessment system into licensing and driver training with the aim of reducing crashes in the first months of independent driving. The system can be developed to identify deficits in safety-critical skills that lead to crashes in new drivers and to address challenges that the coronavirus disease 2019 pandemic has introduced to driver testing and training.


Assuntos
Condução de Veículo/legislação & jurisprudência , Infecções por Coronavirus/prevenção & controle , Licenciamento/legislação & jurisprudência , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Gestão da Segurança/organização & administração , Interface Usuário-Computador , Adolescente , Infecções por Coronavirus/epidemiologia , Estudos de Viabilidade , Feminino , Humanos , Masculino , Veículos Automotores/estatística & dados numéricos , Ohio , Pandemias/estatística & dados numéricos , Philadelphia , Projetos Piloto , Pneumonia Viral/epidemiologia , Transportes/métodos , Adulto Jovem
20.
Annu Int Conf IEEE Eng Med Biol Soc ; 2020: 3212-3215, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-33018688

RESUMO

A mobility scooter is a major assistive technology that replaces human ambulatory functions for people with disabilities. A license is often not required for driving a mobility scooter; therefore, less skilled drivers might create safety concerns. An effective way of reducing these safety risks is by assessing the driving skills of users. The existing assessment measures mostly score the task performance using manual observations. In this study, we have developed a novel assessment system that logs the driving operations by using add-on sensors. This system can monitor the operations of a mobility scooter including the angles of the throttle lever and the steering tiller. The subjects were seven older adults who participated in the driving test involving six tasks; the driver performances were video recorded, and the vehicle operation data were logged. The video analysis showed that two subjects crashed their scooters into objects or made contact with objects during the test course. To extract the characteristic patterns of the operations from the logs, 2D histograms of the operational status durations were investigated for each subject and task. Subsequent analysis of the operation logs identified the two subjects who had crashed their vehicles during the test drive. Our results proved that the driving operation logs could be used complementarily as a simple and low-cost tool for assessing a person's driving skills.


Assuntos
Condução de Veículo , Pessoas com Deficiência , Equipamentos de Autoajuda , Idoso , Humanos , Licenciamento , Amplitude de Movimento Articular
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