Abstract This paper describes the acquisition history and business approach of Quest Diagnostics, the nation's leading provider of diagnostic testing, information and services. This paper is written from the perspective of an independent consultant hired to resolve conflicts and analyze team dynamics in the company. Some areas considered include work-group productivity, an expanded discussion of social influence within the organization, and the role of the individual and diversity. Additionally, Steven Covey's "7 Habits of Highly Effective People" are integrated into this paper. The author concludes that everything comes back to the strength of the organization, and the organization must be maintained and promoted as an overall priority for any firm.
Organizational Behavior-Quest Diagnostics Overview of the Paper
Work-Group Productivity
Social Influence
Individual Differences and Personality
The Habits of Effective People
Perception, Attribution and Motivation
High Performance, Effective and Ineffective Teams
Quality Management and Teamwork
Conclusion
People
Process
Professionalism
From the Paper "When discussing the dynamic of Work-Group Productivity, there are multiple facets of the dynamic itself to consider. Of course, the success of any group is only as good as its weakest member, but from another point of view, the old adage that two heads, or perhaps twenty heads, is better than one. American businesses, Quest among them, have long ago reached the conclusion that the ability to make important decisions is greatly enhanced by having a group of decision makers involved as opposed to one individual (Robbins, 2005). By having a group involved in decision making, the stress of the decisions is spread among many, removing from the equation the possibility of one figure head melting down in the face of the stress of making decisions all on their own. Beyond this, of course, the group is able to provide a great deal of different perspectives, attitudes, and experiences to the table, making it possible for the decisions to not only be made in a time effective way, but also in such a way that allows for high quality decisions that remove much of the possibility of error and poor judgment."
Abstract This paper discusses the use of radio-diagnostic imagery instead of the more standard form of autopsy in forensic medicine. The paper examines the pros and cons of using images provided by machinery such as MRIs instead of the information provided by the more invasive autopsy procedure. The paper discusses the accuracy of radio-diagnostic imagery compared with its less technologically advanced counterpart in determining causes of death. The author concludes that while radio-diagnostic imaging can be useful in forensic medicine, it can not yet replace traditional autopsy.
Table of Contents:
Objective
Introduction
Negative Findings in the use of Radio-diagnostic Imaging in Forensic Medicine
Positive Findings in the use of Radio-diagnostic Imaging in Forensic Medicine
Discussion
Conclusion
From the Paper "There has been an increase in the use of MRI in forensics in making a diagnosis when death involved either injury or disease. Stated to be one of the: "main criticisms of the use of MRI as an alternative to conventional autopsy is the lack of validation of this imaging technique." This is due to the mixed results that have been reported related to MRI post mortem examinations in the fields of neuropathology and paediatrics."
Tags: MRI, forensic, medicine, Post, Mortem, Magnetic, Resonance, Imaging
Abstract This paper examines diagnostic x-ray imaging quality assurance (QA) and quality control (QC). It defines QA and QC for diagnostic x-ray imaging and then discusses how this occurs within all areas of a radiology department. Lastly, the paper discusses the growth of quality assurance in pediatric radiology. The paper contains tables and images.
Table of Contents:
Diagnostic X-Ray Imaging Quality Assurance (QA)
Diagnostic X-Ray Imaging Quality Control (QC)
Radiographic Unit Monitoring
Sensitometery and Darkroom Monitoring
Use of Technique Charts
Analysis of Repeat Rates
Continuing Education
Repeat Analysis
Timer Quality Control in Radiographic Equipment
Collimator Quality Control
Vertical Beam Alignment Quality Control
Collimation
Focal-spot Size
Fluoroscopy Quality Control
Automatic Exposure Systems
Tomography Quality Control
Ensuring QC in Conventional Radiographic Systems
Radiation Safety/QA Program
Test Frequency
Different Types of Tests and Duration
Growth of Quality Assurance in Pediatric Radiology
Exhibits
From the Paper "The various parameters to be checked under radiography are (i) assessment of the focal spot size which is the surface area of the anode which is bombarded by the electron beam. In case of radiography machine, it ranges from 0.1 to 1.2 mm or more than that. In case of mammo-machines the values are 0.3 to 0.6. The assessment of focal spot size is applied to get a X-ray image having the least blur. Small focal spot are likely to concentrate heat and emits load on focal spot areas. In case the quantity of heat emitted at the time of an individual exposure is more than the track capacity, the anode surface is liable to melt. Besides, the assessment of the focal spot size is necessary to compare it with the original focal spot size with that of the machine. Also spot size of any machine is stated on the top of the X-Ray tube. (Mukhtar, n. d.)"
Abstract The paper shows that diagnostic imaging is a rapidly growing healthcare industry that involves the application of electromagnetic radiation to create images of internal structures of the human body with the goal of providing an accurate diagnosis of the patient's condition. It points out that a common theme in the literature review is the need for an increased receptiveness on the part of all healthcare practitioners, both senior clinicians as well as those in training, to improve interdisciplinary activities, as well as more effective communications and collaboration among the various imaging subspecialties. Regrettably, the same market forces that have driven the rapid growth of diagnostic imaging for the benefit of the healthcare consumer are the same forces that are fueling the growing tendency to use these techniques unnecessarily or for inappropriate purposes. The writer points out, however, that there are a lot of imaging machines out there that are going to require skilled and competent technicians to operate them.
Introduction
Review and Discussion
Background and Overview
Diagnostic Imaging Today
Identifying Effective Supervisory Techniques in Support of a Constructive Clinical Learning Experience
Current and Future Trends
Bibliography
From the Paper " According to Anreson and Carroll, "These external accrediting agencies for specialized services provide a means to legitimate the organization. Internal participants also make legitimacy evaluations that can affect their own levels of involvement and motivation" (p. 36). Just as the Holy Bible points out that "No man can serve two masters: for either he will hate the one, and love the other, or else he will hold to the one, and despise the other" (Matthew 6:24, KJV), Anreson and Carroll note that one or another of these internal or external assessments may represent the most important at any given time within certain areas of the organization and different sources of legitimacy may conflict with one another.
A fundamental consideration in this regard concerns the need for changing an organizational component that is not going to be easily changed. According to Amy C. Edmondson's essay, "Framing for Learning: Lessons in Successful Technology Implementation" (2003), "The decision to bring a new, innovative technology into a complex organization is only the first step in an implementation journey. Many new technologies disrupt existing organizational routines and relationships, requiring potential users to re-learn how to work together--a challenge that usually proves more difficult than anticipated" (p. 34). As a result, any type of new technology will cause the subsequent implementation process to take place along a variety of paths that are determined less by the unique qualities of the technology itself than by a complex interaction between the technology and the adopting organization. Edmonson suggests that "Those participating in an implementation effort may have considerable leeway in how to interpret the technology's benefits and challenges, and so the same technology can be seen differently and can elicit different responses, even in organizations that may appear quite similar (p. 35)."
Abstract This paper explores the chemical structure and clinical uses of technetium-based radio-pharmaceuticals which have since the 1970s, served as the mainstay for every hospital's nuclear medicine department. Today, fully 85% of all diagnostic scans in American hospitals use 99mTc in some chemical form. It includes a brief overview of several "technetium-essential" and "technetium-tagged" radio-pharmaceuticals, as well as a discussion of current areas of research and development for new technetium drugs.
From the Paper "Technetium-99m has several physical properties that make it ideal for use in nuclear medicine. Foremost among these is that Tc-99m generally emits only gamma rays. These gamma ray photons are of a high enough energy (140,000 eV) that they can easily pass through dense tissue and exit the body, but can be effectively stopped and detected by a special gamma camera. Other radionuclides generate alpha and/or beta particles, which are diagnostically useless since they lack the penetrating ability to exit the human body. Worse, the ionizing ability of these decay products can damage tissue."
Abstract This paper presents a diagnostic assessment of Hannibal Lecter as a patient. It first describes his presenting problem and social history. The paper then discusses the diagnosis of dissociative disorder for Lecter and describes the treatment options that are available. It specifically focuses on a combination of imagery-based techniques, cognitive restructuring, self-control procedures and real-life performance-based techniques.
Table of Contents:
Presenting Problem
Social History
Diagnosis
Treatment
From the Paper "Real-life performance-based techniques are frequently used in settings such as institutions and prisons (Mandery, 2005), therefore this treatment, combined with the above will probably be very successful with the patient. Dr. Chilton appears to have used a form of this therapy on the patient, however in the negative sense: Dr. Chilton dealt punishment for bad behavior, however, good behavior or cooperation was not rewarded. The reverse of Dr. Chilton's approach will likely be successful treatment with Dr. Lecter. If he cooperates and shows improvement in his behavior, he will be rewarded with a small token such as a new book, special meal, etc. will rely on a psychiatric aide to ensure that the patient's behavior and rewards are monitored, to ensure direct contact with the patient. Although Dr. Lecter may attempt to manipulate the situation to get rewards, the fact that through manipulation he is changing his behavior is positive because his behavior permanently change in the process."
Abstract This research paper examines the different diagnostic labels for autism that are in current use, to consider how far they are applied with any consistency, how far they overlap, and whether existing terminology is adequate to account for the range of disorders encountered. The paper explains that Professor D.V.M. Bishop's work is highlighted in the research because the author feels that to even attempt to comprehend what is the 'best practice' in the case of educating the autistic individual is to first identify, define and characterize what 'autism' is actually comprised of in terms of its needs, its abilities, and the practices that negatively impact the autistic learner as well. Bishop informs the research at hand of some key factors in considering education of the autistic child.
Table of Contents:
Background of the Study
Diagnostic Criteria in 'Autism'
Revised Definition and Diagnostic Criteria in Autism 'Spectrum' Disorder
Research Questions
Nature and Purpose of the Diagnostic Exercise
Special Education and General Education Overview
Purpose of the Study
Definitions
Autism Spectrum Disorder
Social Skills
Inclusion
Self-Contained
Special Education
General Education
Literature Review
Historical Overview of Education and Autism
Complaints of the Special Education Inclusion Program
Autism Continuum Two-Dimensional Model
Conner (1989) Guidelines for Mainstream Practice
Nine Diagnostic Points Identified (Creak 1961; as cited in Conner, 1999)
Diagnostic Criteria: Asperger Syndrome
Screening Tools Identified
Autistic Behavior 'Rating Scales'
Classroom Strategies
Behavioral and Social Management
Scholastic Management
Limitations of the Research
Summary of Literature Review
Recommendations for Future Research
Methodology
Questions of the Research
Method of Collection of Primary Studies for Review
Designation of Criteria for Inclusion
Designation of Criteria for Exclusion
Delineation of the Characteristics and Findings of the Studies
Analysis of the Data
Interpretation of the Results
From the Paper "While Christopher may well master the production of "long and complicated sentences" simultaneously Christopher's responses "are often inappropriate, and he often asks questions of others while disregarding the answers he receives." Bishop goes on and explains by asking the reader to suppose that in this fictional yet realistic situation that: "The psychiatrist suggests a diagnosis of Asperger syndrome. The speech therapist states that an analysis of Christopher's language shows that it is phonologically and grammatically normal.""
Tags: asperger, diagnostic labels, obsessive subtypes, best practice
Abstract This paper presents a brief history of W. Edward Deming and total quality management (TQM). It presents a review of quality and standard development and requirements, both nationally and internationally. The paper then discusses the implementation of TQM and Deming's fourteen guiding principles in the diagnostic medical environment. It hypothesizes that Deming's guiding principles can be effectively applied to the diagnostic medical laboratory environment. Finally, the paper examines International Standards Organization (ISO) standards used in the diagnostic laboratory setting and surveys from laboratories currently or recently implementing TQM into their environment.
Table of Contents:
Abstract
Key Words
Body of paper
Methodology
Literature Review
Deming and TQM
History
TQM
14 principles
Uniqueness of Diagnostic Laboratory Setting
Deming Applied to the Diagnostic Laboratory
Conclusion
From the Paper "Libeer (13) tells us that as far back as 1981 Shewhart's control chart and TQM principles were used in clinical chemistry by Levey and Jennings, incorporating internal quality control and TQM principles from industry to the diagnostic medical laboratory. Libeer researched diagnostic medical laboratories on an international basis and found that in addition to ISO standards, most have their own proposed quality standards for medical laboratories but in order to compare them, using Deming's 'Plan-Do-Check-Adjust' approach is appropriate to assure quality elements are included, such as reagent and standards requirements."
Abstract This paper considers the diagnostic validity of post traumatic stress disorder (PTSD). The evolution of the current diagnostic category, its reliability and validity,and points of controversy are discussed. Particular attention is given to the high degree of co morbidity observed in individuals diagnosed with PTSD and the implications of co morbidity for diagnosis and conceptualisation.
Outline
The Evolution of the PTSD Diagnosis
Diagnostic Reliability
Co morbidity
Conclusion
From the Paper "During the late 1800s and early 1900s, investigations among combat veterans, the bereaved, and survivors of natural disasters, described a range of trauma-related conditions such as 'combat neurosis', 'post-traumatic mental complications', and 'fright neurosis' (Saigh, & Bremner, 1999). These early investigation described various types of trauma reactions including heightened levels of anxiety and physiological arousal, sleep disturbance, recurrent experiences of reliving the event, somatic complaints, mood disturbance and changes in personality."
Abstract The paper explains that multislice CT angiography is a potentially useful and cost-effective, non-invasive diagnostic modality. The paper discusses multislice angiography's diagnostic accuracy in different diseases, including cerebral vascular disease, aneurysms, pulmonary embolism, coronary artery disease and peripheral vascular disease. The paper also points out that multislice CT angiography's technology is quickly outpacing the conventional angiography. The paper notes, however, that some surgeons still prefer the time-tested angiography in spite of its invasive nature, discomfort to the patient and potential risk for hemorrhage.
Outline:
Introduction
Diagnostic Accuracy in Different Diseases
Future Developments of Multislice CT Angiography
From the Paper "Conventional angiography is considered as the golden standard technique in vascular imaging. Its main attributes include real-time visualization of target vessels, which makes it ideal not only for direct visualization of the vasculature of any accessible organ, but also for conducting therapeutic procedures. This provides angiography procedures with the distinct advantage of being able to diagnose and treat vascular diseases with one procedure. This comes at a cost. Another main attribute of angiography is its invasive nature. Most procedures involve gaining vascular access through the femoral artery, which presents as a potential problem post-procedure. While local pressure and close post-procedure monitoring can prevent life-threatening hemorrhaging, subjecting patients to seemingly unnecessary invasive procedures has prompted the development of other imaging modalities to match the real-time precision of angiographic imaging as well as remain non-invasive."
Abstract Analysis of the Diagnostic and Statistical Manual of Mental Disorders (DSM) as it relates to women. Contends that certain personality traits of women (dependent persoanlity, emotionalism) are labled as psychiatric disorders by the white male mental health community. Cites several articles discussing the issue. Historical bias against women. Suggestion for a better diagnostic system.
From the Paper "Introduction
Perceptions of gender and gender roles have been constantly readjusting over the last few decades, resulting in a plethora of written material about the societal disadvantages experienced by women, as well as their emotional costs (Halgin, 2001, p. 14). Although researchers and clinicians have attempted to keep the Diagnostic and Statistical Manual of Mental Disorders (DSM) up to date, "psychiatric diagnosis and help-seeking behavior are multifaceted, and sometimes they involve subtle bias" (p. 14). Halgin presents Terry A. Kupers' article, "The Politics of Psychiatry: Gender and Sexual Preference in DSM-IV" in contrast to "Gender Issues in DSM-IV" by Ruth Ross, Allen Frances, and Thomas A. Widiger, as examples of this ongoing discussion."
Abstract This paper illustrates the current developments in the diagnostic imaging of malignant pleural mesothelioma, an aggressive form of malignancy in the pleura that often leads to death. Because of its gravity, there is a need for an effective imaging tool to help determine the tumor stage and extent, and to predict the prognostic outcomes of a chosen treatment . The author describes the disease and its histologic traits and also discusses past and current practices on diagnostic imaging such as the chest x-ray, computed tomographic scan, magnetic resonance imaging, and positron emission tomography scan. The potential and limitations of these technologies are also analyzed. This paper includes an annotated bibliography.
Outline:
Abstract
Introduction
A Look into Malignant Pleural Mesothelioma
Recent Advances in Medical Imaging in the Diagnosis of Malignant Pleural Mesothelioma
Computed Tomography Scan
Magnetic Resonance Imaging
Positron Emission Tomography
Molecular Imaging
Conclusion
From the Paper "The search for the most efficient, cost-effective imaging modality is still ongoing. Current modalities, CT Scan, MRI, and FDG-PET, have their own limitations as well as their advantages. It is only through research that the medical field may be able to utilize these existing technologies. The importance of early diagnosis through non-invasive means can not be emphasized enough. Because of the aggressive nature of malignant pleural mesothelioma, the use of these current modalities must be utilized as early as possible especially by people who are high risk."
Abstract This paper introduces the general study of sound, and, specifically, ultrasonic phenomena. Human versus animal perception of sound is discussed. The use of ultrasound as a diagnostic tool in humans is outlined.
From the Paper "One of the greatest tools that man has ever had in the drive to preserve his own body is that of understanding. Particularly, through greater comprehension of the processes and logistics that facilitate our body functions, we can make further gains in aiding them where need exists. Sonic study is indicative of that very fact and, specifically, with the inception of sound exploration into the canon of physics came evidence that sound is more than just what human beings can hear. Rather, we now understand sound as acoustic energy existing in amplitudes of widely varying sizes and intensities. Further, the human ear perceives these amplitudes by translating their frequency. This frequency, a measure of the quantity of sound waves an object (i.e. vocal chords, drum skin, etc.) produces per second, may occur across an infinite range of measurements, expressed in hertz. The human ear, however, has a decidedly finite capacity for sound comprehension that falls somewhere between 20 and 20,000 Hz. Any sound occurring above that frequency is defined as ultrasonic. That is, ultrasonic phenomena are those sounds that exceed "normal" human hearing capabilities, normal being defined as that hearing which falls within the aforementioned frequency comprehension range."
From the Paper "The issue of psychiatric diagnosis, strictly avoided during the golden years of psychoanalysis in the 1940's and 1950's, rose to prominence in the early 1960's in conjunction with the "neoKraepelinian" school of thought. The neo-Kraepelinians sought to revive interest in the objective-descriptive approach to psychiatry; this approach involved classifying the signs, symptoms, course, and prognosis of mental illnesses through observation of phenomenological events rather than through etiological theories. The American Psychiatric Association published their first Diagnostic and Statistical Manual (DSM-I) in 1952, followed in 1968 by the DSM-II. However, neither document was as heavily influenced by the neo-Kraepelians and other proponents of descriptive
Describes the symptomology, current etiology, diagnostic tools and current treatments with some evaluation of treatment methods for this sleep disorder.
Abstract Narcolepsy is a chronic, debilitating sleep disorder affecting nearly one percent of the North American population. This paper discusses the history and symptoms of narcolepsy and provides an in depth analysis of the diagnostic tools, both objective and subjective. Issues surrounding diagnosis are given, as well as treatment options such as lifestyle changes and pharmacotherapy.
From the Paper "Cataplexy, sleep paralysis, and hypnagogic hallucinations are usually further controlled by tricyclic antidepressants such as Prozac, Triptil, and Anafranil (Daniels, King, Smith & Shneerson, 2001). Medically formulated gamma-hydroxybutyrate (GHB) have shown beneficial effects in control of cataplexy in some patients (Thorpy, 2001). GHB stabilizes nocturnal REM sleep by increasing sleep continuity, and decreases cataplexy attacks, but does not significantly affect daytime sleep attacks or sleep latency (Fry, 1998). Because of GHB's recognition as a date-rape drug and the high instances of personal and social abuse, the drug is highly regulated and hard to receive prescriptions (Fry, 1998)."
