Hutchisonbrinch1034

This study qualitatively explores differences in psychological contract (PC) content between Belgian and Chinese employees, while attempting to understand these differences from the perspective of cultural values. We build on theory concerning horizontal and vertical individualism/collectivism to interpret differences in PC content. 21 Chinese and 20 Belgian employees were interviewed, with results indicating that Belgian interviewees' PCs tend to be balanced with an emphasis on egalitarian interpersonal relationships, reflecting a horizontal collectivist culture. We propose that a "culture of compromise" forms a fitting description for Belgian interviewees' PCs. For Chinese interviewees, the PC was characterized by mixed contracts aligning with the ideology of 'Utilitarianistic Guanxi', which forms a Chinese philosophy that combines the pursuit of profit with objective goods, reflecting a culture of vertical collectivism.Purpose of program This paper will provide guidance on how to best manage patients with end-stage kidney disease who will be or are being treated with home dialysis during the COVID-19 pandemic. Sources of information Program-specific documents, pre-existing, and related to COVID-19; documents from national and international kidney agencies; national and international webinars, including webinars that we hosted for input and feedback; with additional information from formal and informal review of published academic literature. Methods Members of the Canadian Society of Nephrology (CSN) Board of Directors solicited a team of clinicians and administrators with expertise in home dialysis. Specific COVID-19-related themes in home dialysis were determined by the Canadian senior renal leaders community of practice, a group compromising medical and administrative leaders of provincial and health authority renal programs. We then developed consensus-based recommendations virtually by the CSN work-group with input frorallel review process was created that may not be as robust as standard arms' length peer-review processes. Implications These recommendations are intended to provide the best care possible during a time of altered priorities and reduced resources.Rationale Crystalglobulinemia is a rare complication of monoclonal gammopathy wherein crystallized immunoglobulins deposit in various organs causing occlusive vasculopathy, endothelial damage, and thrombosis. It should be differentiated from light chain cast nephropathy without crystalline nephropathy through timely diagnosis with a kidney biopsy. Presenting concerns of the patient We report a case of a 74-year-old female with polyarthralgia, chest pain, petechial rash, and acute kidney injury. Diagnoses Kidney biopsy revealed eosinophilic casts in the tubular lumen and similar occlusive crystalline deposits within the glomerular vasculature and interlobular arteries. Bone marrow biopsy and serum electrophoresis confirmed immunoglobulin G (IgG) κ multiple myeloma. Interventions Dialysis was initiated for severe oligoanuric acute kidney injury. The patient was treated with 5 sessions of plasmapheresis and 11 cycles of clone reduction chemotherapy with CyBorD (cyclophosphamide, bortezomib, and dexamethasone). Outcomes This patient achieved excellent kidney recovery and is no longer dialysis dependent. Teaching points Crystalglobulinemia should be suspected in patients with rapidly progressive acute kidney injury and monoclonal gammopathy. Timely investigation with kidney biopsy to differentiate this condition from light chain cast nephropathy and initiation of appropriate treatment can lead to remission of disease and excellent recovery of kidney function.Background Chronic kidney disease (CKD) is a condition presenting with long-term slow progression of structural and/or functional damage to the kidneys. Early detection is key to preventing complications and improving outcomes. Point-of-care estimated glomerular filtration rate (eGFR) screening technology allows for detection of abnormal kidney function in the community pharmacy setting. Objective To evaluate the effectiveness of a community pharmacist-directed point-of-care screening program and to identify the prevalence of CKD in high-risk patients. Design Quantitative observational. Setting Four community pharmacies in British Columbia over a 6-month period. Patients In all, 642 participants with at least one CKD risk factor were identified and screened. Mean age was 60 years and females accounted for 55% of the study population. Measurements Serum creatinine was measured from peripheral blood using the HeathTab® screening system (Piccolo® Renal Function Panel with the Piccolo® blood chemistry analyzer). nd risk factors (89%), medication review (72%), and physician follow-up (38%). Limitations included lack of follow-up beyond the 3-month study period prevented medical confirmation of CKD and limited the ability to quantify the impact of pharmacist interventions on the clinical outcomes of patients with low eGFR. Conclusion These results illustrate the prevalence of abnormal renal function among undiagnosed, high-risk patients in the community. Pharmacists, as the most accessible healthcare practitioners, are ideally positioned to utilize novel point-of care technologies to improve access to CKD screening, facilitate follow-up, and increase awareness around the importance of early detection.Objectives To compare elective hip arthroplasty rates funded by the public sector in Brazil and Scotland. Design Ecological study, 2009-13, of crude and directly standardised rates of elective primary hip arthroplasty rates (per 100,000) funded by the public sector at national and regional level for age (30 + years) and gender in Brazil and Scotland. Setting National Health Service Scotland and Unified Health System in Brazil. Participants Over 30 s who had undergone an elective hip arthroplasty funded by the public sector. Main outcome measures Publicly funded standardised elective hip arthroplasty rates in Brazil and Scotland. Results Between 2009 and 2013, there was a seven-fold difference in treatment rates between Brazil and Scotland, and an eight-fold regional difference in Brazil; Brazil (7.8-8.3/100,000, increase of 0.5 per 100,000, 95% confidence interval (CI) (0.3, 0.7) from 2009/10 to 2012/13) and Scotland (from 61.1 to 57.7/100,000, decrease of 3.4 per 100,000, 95% confidence interval (1.4, 5.8) per 100,000); a two-fold difference in number of public beds per head of population (Brazil 158.3/100,000 vs. Scotland 305.1/100,000) and general medical workforce (Brazil 198.8/100,000 vs. Scotland 327.4/100,000); numbers of orthopaedic surgeons per head of population in the two countries were similar in 2013 (Brazil 5.2/100,000 vs. selleck compound Scotland 4.3/100,000). Conclusion Although the 'inverse care law' is seen in both countries, access to publicly funded hip arthroplasties in Brazil is worse than in Scotland; the distribution of specialists and higher treatment rates in Brazil is highly skewed towards wealthier areas, perpetuating historical regional inequalities.Stress fracture of the clavicle is a rare injury usually occurring in high-level athletes. It is typically a result of repetitive sporting activity or unusual strain. We present the first case of an occupational clavicle stress fracture in a young female barista. The patient initially presented with insidious onset clavicular pain. There was no history of trauma, and an undisplaced fracture was present on the plain radiograph but overlooked by the emergency physicians. Two weeks later, the patient presented again with worsening symptoms, and a displaced fracture of the clavicle was diagnosed on plain radiograph. A thorough occupational history revealed the cause of her pain, which was the mechanical activity of coffee tamping and the fracture went on to unite with no further complications. No other cause was found on investigations including magnetic resonance imaging. The fracture healed with cessation of coffee tamping. This case highlights a previously unrecognised occupational hazard of coffee tamping as a potential cause of stress fracture of clavicle.Objectives To establish whether blood samples taken from used peripheral intravenous cannulae are clinically interchangeable with venepuncture. Design Systematic review. PubMed, Web of Science and Embase were searched for relevant trials. Setting Trials which compared blood samples from used peripheral intravenous cannulae to venepuncture and provided limits of agreement or data which allowed calculation of limits of agreement. Participants Seven trials with 746 participants. Blood tests included 13 commonly ordered biochemistry, haematology and blood gas measurements. Main outcome measures 95% limits of agreement. Data were pooled using inverse variance weighting and compared to a clinically acceptable range estimated by expert opinion from previous trials. Results Limits of agreement for blood samples from used peripheral intravenous cannulae were within the clinically acceptable range for sodium, chloride, urea, creatinine and haematology samples. Limits of agreement for potassium were ±0.47 mmol/L which exceeded the clinically acceptable range. Peripheral intravenous cannula samples for blood gas analysis gave limits of agreement which far exceeded the clinically acceptable range. Conclusions Blood sampling from used peripheral intravenous cannulae is a reasonable clinical practice for haematology and biochemistry samples. Potassium samples from used peripheral intravenous cannulae can be used in situations where error up to ±0.47 mmol/L is acceptable. Peripheral intravenous cannula samples should not be used for blood gas analysis.Objective Using data from 40 years of national surveys of UK medical graduates, we report on ophthalmology as a career choice. Design setting and participants Self-administered questionnaire surveys of all graduates from all UK medical schools in selected years of qualification between 1974 and 2015. Main outcome measures Career specialty preferences of doctors one, three, and five years after graduation; career specialty destinations 10 years after graduation. Results One year after graduation, ophthalmology was the first career preference of 1.6% of the qualifiers of 1974-83, 2.2% of 1993-2002, and 1.8% of 2005-15. The corresponding percentages three years after graduation were 1.5, 1.8, and 1.2%. Men were more likely than women to choose ophthalmology among graduates of 2005-15, 2.4% of men and 1.4% of women did so at one year, as did 1.7% of men and 0.7% of women at five years. Seventy per cent of doctors practising as ophthalmologists 10 years after qualification had told us in their first post-qualification year that ophthalmology was their first choice of career. Conclusions There has been no systematic change in recent years in the proportion of recent medical graduates intending to have a career in ophthalmology when surveyed one year after graduation. However, the proportion at three and five years after graduation was lower than that at year 1. Suggestions for maintaining interest in the specialty include improved career advice, greater early clinical exposure to ophthalmology, and improved access to flexible training. Most practising ophthalmologists had made early decisions that this was their intended career.