DHQ hospital faisalabad

Offers DHQ hospital faisalabad with a product or service that delivers doctors association and education association. Eligible Employee: Non-exempt employees (employees eligible for premium overtime) are eligible if they have worked a total of at least 12 months and for at least 1,250 hours, including overtime hours for scheduled employees, during the 12 months prior to the start of the leave. Exempt employees (employees who are exempt from premium overtime) are eligible if they have worked a total of at least 12 months and for at least 1,250 hours during the 12 months prior to the start of the leave. Family Members: Parent: The biological, foster or adoptive parent, a stepparent or a legal guardian of an employee or an individual who stands or stood in loco parentis to an employee when the employee was a child. Parent does not include "parent-in-law". Child: Biological, adopted or foster child, stepchild, legal ward, or a child of an employee who is standing in loco parentis, who is either under 18 years of age or an adult dependent child. An adult dependent child is an individual who is 18 years of age or older and incapable of self-care because of a mental or physical disability. Incapable of self-care means that the individual requires active assistance or supervision to provide daily self-care in several of the "activities of daily living" (ADLs). ADLs include adaptive activities such as caring appropriately for one's grooming and hygiene, bathing, dressing, eating, cooking, cleaning, shopping, taking public transportation, paying bills, maintaining a residence, using telephones and directories, using a post office, etc. Spouse: A husband or wife as defined or recognized under State law for purposes of marriage, including common law marriage in States where it is recognized. Health Care Provider: A doctor of medicine or osteopathy who is authorized to practice medicine or surgery by the State in which the doctor practices; or Podiatrists, dentists, clinical psychologists, optometrists, and chiropractors (limited to treatment consisting of manual manipulation of the spine to correct a subluxation as demonstrated by X-ray to exist) authorized to practice in the State and performing within the scope of their practice as defined under State law; or Nurse Practitioners and nurse midwives who are authorized to practice under State law and who are performing within the scope of their practice as defined under State law; or Christian Science practitioners listed with the First Church of Christ Scientist in Boston, Massachusetts. Intermittent Leave: Leave taken in separate periods of time due to a single illness or injury as determined by the health care provider of the individual, rather than for one continuous period of time. Leave may include periods from an hour or more to several weeks. Examples of intermittent leave would include leave taken on an occasional basis for medical appointments, or leave taken several days at a time spread over a period of six months, such as for chemotherapy. Intermittent leave is to be reported to the nearest quarter hour for usage. Exempt employees may be included in the calculation of leave usage to the nearest quarter hour. If an employee does not have adequate leave accrual to cover the time taken during intermittent leave, that time will be without pay. FMLA/CFRA DEFINITIONS CONTINUED Parental Leave: Leave taken for the reason of the birth of the employee's child or the placement in the employee's home of an adopted or foster child. Parental leave is not required to be taken in one continuous period. Basic minimum duration of the leave shall be 2 weeks. However, leave may be granted for a duration of less than 2 weeks on any 2 occasions. Leave taken for parental leave shall be concluded within one year of the birth or placement in the employee's home of the child. Reduced Work Schedule: A reduced work schedule is one that reduces the usual number of hours per workweek, or hours per workday, of an employee for reasons outlined under intermittent leave. An employee may elect or be required to use accrued sick leave, vacation, compensatory time off or TRIP bonus time to cover the time off (see Combination of Paid and Unpaid Leave Usage statement on pg. 3). Exempt employees may be included in the calculation of leave usage to the nearest quarter hour on a reduced leave schedule. Serious Health Condition: An illness, injury (including on the job injury), impairment, or physical or mental condition that involves: 1. Any period of incapacity or treatment in connection with or consequent to inpatient care (i.e., an overnight stay) in a hospital, hospice, or residential medical care facility (covered under FMLA and CFRA): or 2. Any period of incapacity requiring absence from work, school or regular daily activities for more than three calendar days, that also involves continuing treatment (i.e.: physical therapy, chemotherapy) by (or under the supervision of) a health care provider (covered under FMLA and CFRA): or 3. Continuing treatment by (or under the supervision of) a health care provider for a chronic or long-term health condition that is incurable or so serious that, if not treated, would likely result in a period of incapacity of more than three calendar days (covered under FMLA and CFRA): or 4. For prenatal care (covered under FMLA only): or 5. Pregnancy disability leave meaning a leave taken for disability due to pregnancy, childbirth or related medical conditions (covered under FMLA only). . NOTE: Voluntary or cosmetic treatment (such as most treatment for orthodontia or acne) which are not medically necessary are not "serious health conditions", unless inpatient hospital care is required. Restorative dental surgery after an accident, or removal of cancerous growths are serious health conditions, provided all the other conditions of this regulation are met. Treatments for allergies or stress, or for substance abuse, are serious health conditions only if all the conditions of the regulation are met. Prenatal care is included as a serious health condition. Routine preventative physical examinations are excluded. SUPERVISOR'S SUMMARY -- FAMILY MEDICAL LEAVE ACT & CALIFORNIA FAMILY RIGHTS ACT The Family Medical Leave Act (FMLA) was enacted August 5, 1993. The California Family Rights Act (CFRA) was adopted as per the August 12, 1995 Amendment. These acts entitle eligible employees to 12 weeks of leave per rolling year for purposes of pregnancy leave, parental leave, personal medical leave, or family medical leave. Coverage by FMLA and CFRA will run concurrently, except in the case of a leave taken for disability due to pregnancy, childbirth or a related medical condition. ELIGIBLE EMPLOYEES Employees (exempt and non-exempt) are eligible if they have worked a total of at least 12 months and at least 1,250 hours, including overtime hours, during the 12 months prior to the start of the leave. CONDITIONS FOR LEAVE Leave must be granted for any of the following reasons: o Pregnancy leave (covered by FMLA only) or, o Parental leave to care for the employee's newborn child or the placement in the employee's home of an adopted or foster child (covered by FMLA and CFRA); or, o Personal medical leave due to the employee's own serious medical condition that requires the employee's absence from work (covered by FMLA and CFRA); or, o Family medical leave to care for a family member as defined by FMLA and CFRA (see definitions for specifics) who suffers from a serious medical condition that requires on site care or supervision by the employee (covered by FMLA and CFRA). For a normal medical leave, use the following chart to help determine application of leave. Maximum total leave shall not exceed six months. | 12 weeks | 12 weeks | | Disabled by a health care provider | Covered by disability | | | COVERED BY: FMLA and CFRA SUPPLEMENTAL LEAVE** CONCURRENTLY **Supplemental Leave is for non-represented employees only. For a normal pregnancy, use the following chart to help determine application of leave. Maximum total leave shall not exceed seven months. | 2 weeks | 6 weeks | 4 weeks | 12 weeks | 4 weeks | | delivery date | Covered by disability | | | | COVERED BY: FMLA CFRA SUPPLEMENTAL LEAVE** **Supplemental Leave is for non-represented employees only. COMBINATION OF PAID AND UNPAID LEAVE USAGE For pregnancy, parental, personal and family medical leaves, the employee may elect or be required to use a combination of applicable paid leave, (sick, vacation, compensatory time off, TRIP bonus) to the extent permitted by the applicable personnel program or contract articles. Note: If accrued compensatory time is used to cover all or a portion of a leave of absence, that portion of the leave of absence shall not be charged against the employee's entitlement under FMLA but may be charged against the employee's entitlement under CFRA. SUPERVISOR'S SUMMARY -- FAMILY MEDICAL LEAVE ACT & CALIFORNIA FAMILY RIGHTS ACT CONTINUED HEALTH INSURANCE COVERAGE The University will continue an eligible employee's existing employer-paid health insurance (medical, dental, vision) during periods of leave covered by these Acts - " up to a maximum of 12 weeks for pregnancy, parental or family medical leaves or " up to a maximum of 6 months for a personal medical leave. An employee must make arrangements to pay the employee's premium (if any) for the health insurance (medical, dental, vision) and may arrange to continue other employee-paid coverage they have enrolled in by contacting the Campus Benefits Office at 824-7135 or 824-5197. EMPLOYEE NOTIFICATION Supervisors are required to provide written notice to the employee that part or all of the requested leave may fall under the FMLA/CFRA Acts. Supervisors are to give the employee a copy of this packet which outlines the eligible requirements and benefits under the FMLA/CFRA Acts. MEDICAL DOCUMENTATION Medical documentation of the employee's need for pregnancy leave, personal medical leave or family medical leave due to a serious health condition shall be required. For parental leave, no documentation is required. Such requests must be coordinated closely with Human Resources, in order to ensure that the confidentiality requirement of the Americans with Disabilities Act are met. Such documentation shall be provided by the employee's health care provider thirty days prior to the start of a planned medical leave or as soon as it is known that a leave is required. If documentation is requested and not provided, the leave request may be denied or rescinded. A return to work certification is required prior to the employee returning to work. JOB PROTECTION For Pregnancy Disability Leaves: Reinstatement shall be to the same position provided that the employee returns to work within 4 months and immediately following termination of pregnancy disability leave. If the employee would have been laid off or terminated had the employee remained on pay status during the leave period, reinstatement shall be to a similar job at the same location. If a similar job is not available, the employee shall be afforded the same considerations afforded to other employees who are laid off or terminated pursuant to the provisions of Staff Policy 60, Layoff and Reduction in Time from Professional and Support Staff Positions; Staff Policy 64, Termination of Career Employees -- Professional and Support Staff; and Staff Policy 61, Release of Casual and Probationary Employees. For Family and Medical Leaves: Reinstatement shall be to the same position, or at the department's discretion, to an equivalent position with equivalent employment benefits, pay, and other terms and conditions of employment provided that the employee returns to work immediately following termination of the leave. If the employee would have been laid off or terminated had the employee remained on pay status during the leave period, the employee shall be afforded the same considerations afforded to other employees who are laid off or terminated pursuant to the provisions of Staff Policy 60, Layoff and Reduction in Time from Professional and Support Staff Positions; Staff Policy 64, Termination of Career Employees -- Professional and Support Staff; and Staff Policy 61, Release of Casual and Probationary Employees. For Supplemental Leaves (Applies only to non-represented employees): Reinstatement shall be to the same, or at the department's discretion, a similar position in the same department provided that the employee returns to work immediately following termination of the leave. If the employee would have been laid off or terminated had the employee remained on pay status during the leave period, the employee shall be afforded the same considerations afforded to other employees who are laid off or terminated pursuant to the provisions of Staff Policy 60, Layoff and Reduction in Time from Professional and Support Staff Positions; Staff Policy 64, Termination of Career Employees -- Professional and Support Staff; Staff Policy 65, Termination of Career Employees -- Managers and Senior Professionals: and Staff Policy 61, Release of Casual and Probationary Employees. FAMILY MEDICAL LEAVE ACT (FMLA)/ CALIFORNIA FAMILY RIGHTS ACT (CFRA) PROCESS 1. Employee asks supervisor for a leave of absence 30 days in advance of leave, if possible. It is preferable that the leave request be in writing, but not required. 2. Supervisor determines if the employee's employment service meets FMLA/CFRA eligibility criteria. Review of payroll records to determine hire date and hours worked during the previous 12 months. 3. For questions regarding the request for a leave of absence or the eligibility of the employee, the supervisor should call the department's Human Resource consultant for counseling. 4. Upon meeting criteria, supervisor reviews with and provides to the employee a copy of: a. FMLA/CFRA Rights and Obligations b. Notice to Health Care Provider/Medical Certification Form c. Return to Work Certification (for pregnancy leaves and personal medical leaves) d. Copy of employee's current Job Description 5. Supervisor refers employee to the Benefits Office for personal counseling. Benefits staff prepares benefits continuation form detailing all of the employees benefits. Employee is given form to sign and counseled on process to continue benefits. 6. Employee has attending health care provider complete the Medical Certification Form and returns it to the supervisor within two weeks upon commencement of leave. 7. When leave is approved, supervisor has department payroll/personnel coordinator complete the necessary documentation for input to the on-line payroll/personnel system. The department payroll/personnel coordinator should follow the on-line payroll manuals procedures for processing leaves of absences. (If the leave is extended beyond the original end date, another LOA will need to be submitted to indicate the extension.) 8. Employee goes on leave 9. Employee provides Return to Work Certification to supervisor upon returning to active status. 10. IMPORTANT: Department records and monitors leave period. Department maintains FMLA/CFRA records in a confidential manner according to University Policy and Procedure #720-11. Upon request, makes records available for inspection, copying and transcription by representative of the Department of Labor. FAMILY AND MEDICAL LEAVE ACT (FMLA)/ CALIFORNIA FAMILY RIGHTS ACT (CFRA) DEPARTMENTAL RECORD Whether leave is approved or denied, all documents pertaining to FMLA/CFRA leaves are to be retained according to University Policies and Procedures. All medical records must be maintained in a confidential manner. This form shall be used to ensure proper information was distributed to and received by the employee and to monitor the FMLA/CFRA process. Employee's Name: I.D. # : Department: 1. VERIFIED EMPLOYEE'S ELIGIBILITY FOR FAMILY MEDICAL LEAVE ON: Read Supervisor's Summary to determine qualifications for leave. A total of 12 weeks in a 12 month rolling calendar is available to eligible employees. An employee will not have to requalify (work at least 1,250 hours) for more than one leave request within the 12 month period until all available FMLA/CFRA leave has been used. Date of Hire: # of hours worked in past 12 month period, including overtime hours, or from date of hire (whichever is less): Hours Worked: Information gathered by: 2. HOURS OF LEAVE AVAILABLE UNDER FMLA/CFRA: Balance Forward of FMLA/CFRA leave available: hours Less hours used during this leave: hours Ending Balance of FMLA/CFRA leave available: hours 3. INFORMATION PROVIDED TO EMPLOYEE: 0 Rights and Obligations under FMLA/CFRA (pages 6 & 7) 0 Notice to Health Care Provider/Medical Certification Form (pages 10 & 11) 0 Return to Work Certification (page 12) 0 Job Description (if applicable) 0 Benefits Checklist (provided by the Human Resources Benefits Office) The information, as indicated above, was provided to the employee on: Date: By: 4. DOCUMENTATION NEEDED TO INITIATE LEAVE: Request for Leave received on: (Date) Medical Certification Returned to Department on: (Date) FAMILY AND MEDICAL LEAVE ACT (FMLA)/ CALIFORNIA FAMILY RIGHTS ACT (CFRA) DEPARTMENTAL RECORD CONTINUED 5. PROCESSING " Leave of Absence (LOA) Form is completed. This form may be used as a data gathering tool for input to the on-line payroll/personnel system or the department may use their own data gathering form. No copies of the form need to be sent to the Human Resource, Benefits or Payroll Offices. (Date) " Approval for leave of absence obtained in department. (Date) " Approved leave of absence is input to the on-line payroll/personnel system by the department's payroll/personnel coordinator. See the on-line payroll/personnel manual for instructions on how to process a leave of absence. (Date) " Distribution of IDOC: Original with signatures is sent to the Payroll Department. (Date) Copy given to the employee. (Date) Copy placed in the employee's file within the department. (Date) 6. DOCUMENTATION NEEDED TO RETURN FROM LEAVE: The Return to Work Certification was submitted to Department on: (Date) 7. RECORD KEEPING Beginning Leave Date: Leave Extension Date(s): Date Employee Returned to Work: University of California, Irvine Page 8 Human Resources EMPLOYEE RIGHTS AND OBLIGATIONS UNDER THE FEDERAL FAMILY AND MEDICAL LEAVE ACT (FMLA) AND THE CALIFORNIA FAMILY RIGHTS ACT (CFRA) It is the policy of the University of California to provide family and medical leave to eligible employees in accordance with the Federal Family and Medical Leave Act (FMLA) of 1993 and the California Family Rights Act (CFRA) of 1991 as per the 1995 amendment. This notice sets forth your rights and obligations under FMLA and CFRA. If you are eligible, the family and medical leave you have requested pursuant to University policy will be counted against your annual entitlement of 12 workweeks in a 12-month period under FMLA and/or CFRA if it qualifies as FMLA and/or CFRA leave. Eligibility for Leave If you have at least 12 months of service (all prior University service counts) and if you have worked at least 1,250 hours during the 12 months immediately preceding the requested leave, you are covered by the provisions of FMLA and CFRA. If not eligible for FMLA and/or CFRA, employees may still be eligible for leaves of absence in accordance with collective bargaining agreements or staff personnel programs. Purpose of Leave o To care for your child after birth, or after placement in your home of an adopted or foster care child o To care for a family member who has a serious health condition (as described in Definitions, pages 1 & 2) o For your own serious health condition o Pregnancy Leave Length of Leave Under federal law (FMLA) and state law (CFRA), you are entitled to up to 12 weeks of family and medical leave during a 12-month period. Intermittent FMLA/CFRA leave may be requested for parental leave or when medically necessary for a serious health condition. When possible, you should attempt to schedule medical treatments to minimize disruption to your department. Additional leave beyond 12 weeks may be requested under other provisions of the University's leave policies and collective bargaining agreements. Pay Family and medical leave is normally unpaid leave. You may request or you may be required by your department to substitute paid leave (accrued sick leave, vacation, compensatory time off or TRIP bonus time) for all or a portion of the unpaid leave. Approval of the use of paid leave will be in accordance with the appropriate policies and collective bargaining agreements and with your department's approval. If you have requested family and medical leave for your own serious health condition, you may be eligible for temporary disability benefit payments during the unpaid portion of your leave under the University-Paid Temporary Disability Plan and/or the Employee-Paid Disability Plan. Please contact the Benefits Office for more information. Advance Notice 30 days advance notice is required if your need for family and medical leave is foreseeable (e.g. the birth of a child or a planned medical treatment). If you fail to provide 30 days notice for a foreseeable leave, your department may deny leave until 30 days after the date you provide notice. If your need for the leave is not foreseeable, you should provide as much advance notice as possible. Written notice from the employee is recommended. Written notice from the health care provider is required. Medical Certification Written certification from a health care provider is required for either your own serious health condition or the serious health condition of a family member. Failure to provide certification within 15 calendar days of the date you receive this notice may result in delay or denial of leave until the certification is provided. A medical certification form will be provided by your department. Under federal regulations, a "health care provider" is defined as: a doctor of medicine or osteopathy, podiatrist, dentist, chiropractor, clinical psychologist, optometrist, nurse practitioner or nurse-midwife who is authorized to practice by the State and performing within the scope of their practice as defined by State law, or a Christian Science practitioner. (See Definitions, page 1 for more details) Health Benefits Coverage under any group health plan (medical, dental, optical) will be maintained during any leave covered by FMLA and/or CFRA (up to a maximum of 12 weeks). You are responsible for arranging with the Benefits Office for the payment of the employee portion of any premiums that are not fully covered by a University contribution. Failure to pay the employee portion of any premiums within 30 days of the due date may result in cancellation of your enrollment in that plan. If you do not return to work at the conclusion of your approved family and medical leave, you will be liable for payment of the health plan premiums (medical, dental, optical) paid by the University during any unpaid portion of your leave. The University may recover its share of health plan premiums by taking deductions, to the extent permitted by law, from your unpaid wages, if any; from vacation pay; or from any other pay due you, or by initiating legal action. However, you will not be liable for the premiums if your failure to return to work is due to continuation of your own serious health condition or other reasons beyond your control. You will be considered to have returned to work if you work for at least 30 calendar days commencing with your scheduled return date. Reinstatement Under federal law (FMLA) and state law (CFRA), you must be reinstated to the same position you had prior to taking the leave, or to an equivalent position provided that you return to work immediately following the conclusion of family and medical leave. If your position is unavailable (due to, for example, a temporary or indefinite layoff), you have no greater right to reinstatement than had you been continually employed during the FMLA/CFRA leave period. You are not entitled to reinstatement if your appointment end date occurs before your scheduled return date from family and medical leave. The University's responsibility to continue your health plan coverage ends (except for COBRA continuation coverage) upon notice that you do not intend to return to work at the end of the approved leave, even though you are able to work at that time. See Health Benefits (paragraph 2) above regarding employee liability for premiums. If the FMLA/CFRA leave you have requested is for your own serious health condition, you shall be required to present medical certification upon your return stating that you are able to return to work to perform the functions of your job. University Designated FMLA/CFRA Leave The University may designate leave as FMLA and/or CFRA leave if the leave meets the requirements listed above, even when an employee does not specifically request FMLA, CFRA or family and medical leave. University Personnel Policies and Collective Bargaining Agreements For more information about family and medical leave and related leaves, please contact the Academic Personnel Office (Faculty) or Human Resources Office (Staff) at your location. Questions regarding employee benefits should be directed to the Benefits Office at your location. NOTICE TO HEALTH CARE PROVIDER Under Department of Labor regulations for the Family and Medical Leave Act and the State of California Family Rights Act, "health care provider" is defined as: a doctor of medicine or osteopathy, podiatrist, dentist, chiropractor, clinical psychologist, optometrist, nurse practitioner, nurse-midwife who is authorized to practice by the State and performing within the scope of their practice as defined by State law, or a Christian Science practitioner. Our employee has requested leave under the provisions of Federal and/or California family and medical leave statutes for: " his or her own serious health condition; or " for the purpose of caring for your patient who is a parent (biological, foster or adoptive parent; a stepparent; a legal guardian; or other person who stood in loco parentis to the employee when the employee was a child), child (biological, adopted or foster child; a stepchild; a legal ward; a child for whom the employee is standing in loco parentis to; or an adult dependent child), or spouse (a husband or wife as defined or recognized under State law for purposes of marriage, including common law marriage in states where it is recognized) of our employee. Please note the in-laws are not covered by this provision. In order for the University to determine whether this leave qualifies for family and medical leave under Federal and/or State law, please complete the brief Health Care provider section on the reverse side of this form and return it to our employee. A SERIOUS HEALTH CONDITION IS: Any illness, injury (including on the job), impairment or physical or mental condition that involves: " any period of incapacity or treatment in connection with or consequent to inpatient care (i.e., an overnight stay) in a hospital, hospice, or residential medical care facility; or " any period of incapacity requiring absence from work, school, or regular daily activities for more than three calendar days, that also involves continuing treatment by (or under the supervision of) a health care provider; or " continuing treatment by (or under the supervision of) a health care provider for a chronic or long-term health condition that is incurable or so serious that, if not treated, would likely result in a period of incapacity of more than three calendar days; or " prenatal care; or " Pregnancy disability leave meaning a leave taken for disability due to pregnancy, childbirth or related medical conditions. Examples: heart attacks, heart conditions requiring heart bypass or valve operations, most cancers, back conditions requiring extensive therapy or surgical procedures, strokes, severe respiratory conditions, spinal injuries, appendicitis, pneumonia, emphysema, severe arthritis, severe nervous disorders, and injuries caused by serious accidents on or off the job. A SERIOUS HEALTH CONDITION IS NOT: " allergies, stress, or substance abuse unless inpatient hospital care is required. " the patient is not incapacitated for more than three calendar days, is not under the continuing care of a health care provider, and/or the patient does not have a serious long-term health condition; or " voluntary treatment or surgery unless inpatient hospital care is required. DO NOT DISCLOSE THE UNDERLYING DIAGNOSIS WITHOUT CONSENT OF PATIENT. (CONFIDENTIAL) FOR DEPARTMENTAL RECORDKEEPING ONLY University of California, Irvine FAMILY AND MEDICAL LEAVE CERTIFICATION Employee Name: Patient (if other than employee): Relationship of employee to patient: Beginning date of leave: What is the employees anticipated return to work date? Medical Status and Recommendations from Health Care Provider Does this employee or patient have a serious health condition? (see definitions) 0 yes 0 no On what date did the serious health condition commence? If leave is for the employee: Is employee able to perform the functions of his/her job? (see job description) 0 yes 0 no Questions regarding the employee's job duties may be addressed to the employee's supervisor. Employee's Supervisor: ______________________ Phone: ____________________ Can the employee work a reduced work schedule or require other medical accommodation(s)? 0 yes 0 no If yes, describe: If leave is for employee's family member: Is the employee's presence necessary to provide on-site care for the patient? or 0 yes 0 no Is the employee's presence deemed beneficial to the welfare of the patient? 0 yes 0 no Does the patient require full time care? 0 yes 0 no If no, describe: Health Care Provider Information Health Care Provider Signature Date Type of Health Care Provider (see definition): Address Phone Retention period 5 years University of California, Irvine Page 12 (CONFIDENTIAL) FOR DEPARTMENTAL RECORDKEEPING ONLY FAMILY AND MEDICAL LEAVE RETURN TO WORK CERTIFICATION Under Department of Labor regulations for the Family and Medical Leave Act and the State of California Family Rights Act, "health care provider" is defined as: a doctor of medicine or osteopathy, podiatrist, dentist, chiropractor, clinical psychologist, optometrist, nurse practitioner, nurse-midwife who is authorized to practice by the State and performing within the scope of their practice as defined by State law, or a Christian Science practitioner. Employee Name: The following information is to be completed by your health care provider. Return this form to your supervisor prior to your return to work date. Employee is released to return to work effective (date): Is employee able to perform the functions of his/her job? (see attached job description) 0 yes 0 yes, with restrictions/accommodations 0 no Questions regarding the employee's job duties may be addressed to the employee's supervisor. Employee's Supervisor: _________________________ Phone: _____________________ Please list any restrictions/accommodations the department should consider: Are the restrictions/accommodations: 0 permanent 0 temporary, until (date):_________________ Comments: Health Care Provider Information Health Care Provider Signature Date Type of Health Care Provider (see definition): Address Phone Retention period 5 years FAMILY MEDICAL LEAVE ACT (FMLA) and CALIFORNIA FAMILY RIGHTS ACT QUESTIONS AND ANSWERS 1. Q: What is the differences between the Federal Family Medical Leave Act (FMLA) and the California Family Rights Act (CFRA)? A: FMLA is a federal law while CFRA is a state law. Provisions under both are basically the same except that CFRA does not apply to pregnancy leaves. CFRA does apply as parental leave after the FMLA pregnancy leave allowances have been completed. Parental leave is for the care of the child. 2. Q: Under what types of circumstances are employers required to grant family or medical leave? A: An eligible employee is entitled to FMLA and/or a CFRA covered leave for : 1) pregnancy leave (under FMLA); 2) the birth of a child (under FMLA) and to care for the child (under FMLA and/or CFRA) immediately after birth; 3) for the placement in the employee's home of a child for adoption or foster care (under FMLA and/or CFRA); 4) to care for the employee's seriously-ill spouse, child, or parent as defined by FMLA and CFRA (see Definitions, page 1) (under FMLA and/or CFRA); and/or 5) because of a serious health condition that makes the employee unable to perform his or her job functions (under FMLA and/or CFRA). 3. Q: Which employees are "eligible" to take leave under the FMLA/CFRA? A: Employees are eligible for FMLA and/or CFRA covered leave provided they have worked for the University for a total of at least 12 months and for at least 1,250 hours during the 12 months preceding the start of the leave. (Note: Out of state employees may not be eligible for CFRA. If information is needing regarding an out of state employee, please contact your Human Resources coordinator) 4. Q: How are the 1,250 hours counted? A: In determining whether an employee has 1,250 hours of service, the FMLA/CFRA acts require that all hours worked by the employee be counted as under the Fair Labor Standards Act, including overtime hours worked by non-exempt employees. 5. Q: For the 1,250 hours, is overtime counted as straight hours worked, or credited at the 1-1/2 rate? A: Overtime is counted as actual straight time hours worked. 6. Q: Is a probationary employee eligible for FMLA and/or CFRA covered leave? A: The FMLA/CFRA acts do not differentiate between probationary and permanent employees. However, the employee must meet the requirement to have worked for at least 12 months and at least 1,250 hours worked during the prior 12 months. But newly hired probationary employees are unlikely to meet the required length and hours of employment criteria. 7. Q: What if the new employee had worked in another capacity (hourly, professional staff, etc.)? A: FMLA/CFRA acts do not distinguish between the kind of work or job titles that must comprise the 12 months and 1,250 hours of employment. FMLA states "all hours which an employer...permits an employee to work are counted towards hours of service". FMLA --- QUESTIONS AND ANSWERS CONTINUED 8. Q: The American With Disabilities Act requires that medical statements regarding an employee or an employee's related medical conditions be considered confidential. How will medical documentation needed for family or personal medical leave requests be handled? A: Any medical information related to requests for leaves of absence or reasonable accommodation will be maintained in the department and treated as confidential information. Departments shall exercise discretion in permitting access these files. 9. Q. What constitutes "foster care"? A. Foster care is defined to require formal State recognition. It does not include informal arrangement to take care of another person's child. 10. Q. Does FMLA and/or CFRA covered leave have to be taken all at once, or can it be taken in parts? A: For parental leave, the employer may require the leave to be taken all at once, but the employee may request and the employer has the option to approve an employee's request to take parental FMLA and/or CFRA covered leave intermittently or by working a reduced work schedule. Basic duration of the leave shall be 2 weeks. However, leave may be granted for a duration of less than 2 weeks on any 2 occasions. Leave taken for parental leave shall be concluded within one year of the birth or placement in the employee's home of the child. For family or personal medical leave due to a serious health condition, FMLA/CFRA covered leave may be taken whenever "medically necessary". This can include requirements to take intermittent periods of leave, as well as, to work a reduced work schedule. 11. Q. What is the minimum FTE required in order to meet the 1,250 hour threshold in a 9, 10, 11, or 12 month appointment? How are the hours counted? A. The actual hours worked are used to determine employee coverage by FMLA/CFRA requirements. Based on 2,088 hours in a work year equaling full time employment, the table below shows the minimum FTE appointment/hours worked to meet the hour threshold: 9 month appointment (80% FTE = 1,250) 10 month appointment (72% FTE = 1,250) 11 month appointment (65.3% FTE = 1,250) 12 month appointment (60% FTE = 1,250) Keep in mind the requirements that an employee must work the 12 months prior to the request for leave. 12. Q. What does it mean that an employee is "needed to care for" a family member? A. An eligible employee may take FMLA and/or CFRA covered leave in order to care for the employee's spouse, child, or parent as defined by FMLA and CFRA (see Definitions, page 1) with a serious health condition. The health care provider must either certify that third party care is required or that the employee's presence would be beneficial to the patient. Certification will be sufficient to satisfy this requirement and entitle the employee to FMLA and/or CFRA covered leave. This provision is intended to accommodate needs for leave to provide psychological comfort for a seriously ill eligible family member, and to arrange "third party" care for an eligible family member. FMLA --- QUESTIONS AND ANSWERS CONTINUED 13. Q. What level of health insurance benefits is the employer required to provide during the 12 weeks of FMLA and/or CFRA covered leave? A. The University is required to maintain the employee's existing employer-paid health insurance coverage (medical, dental, optical) during the period of leave covered by FMLA and/or CFRA, with no change in cost to the employee. The combined obligation due to FMLA and CFRA extends to a maximum of 12 weeks of coverage in a 12 month period. If the employee did not qualify for health insurance coverage prior to the FMLA/CFRA request, no new benefits would be established. 14. Q. Who would not be considered a family member for purposes of a leave? A. Grandparents, grandchildren, in-laws or other persons that are not related but that are residing in the employee's household are not covered by FMLA and/or CFRA. There may be provisions in the various personnel program's Sick Leave policies which allow for use of sick leave to provide care for these persons, but they are not covered by the FMLA/CFRA acts. Check the policy governing the personnel program you are covered by. A "Serious Health Condition" means an illness, injury, impairment or physical or mental condition that involves one of the following: 1. Hospital Care inpatient care (i.e., an overnight stay) in a hospital, hospice or residential medical care facility, including any period of incapacity2 or subsequent treatment in connection with or consequent to such inpatient care 2. Absence Plus Treatment a period of incapacity2 of more than three consecutive calendar days (including any subsequent treatment or period of incapacity2 relating to the same condition), that also involves: (a) treatment3 two or more times by a health care provider, by a nurse of physician's assistant under direct supervision of a health care provider, or by a provider of health care services (e.g., physical therapist) under orders of, or on referral by, a health care provider; or (b) treatment by a health care provider on at least one occasion that results in a regimen of continuing treatment4 under the supervision of the health care provider 3. Pregnancy any period of incapacity2 due to pregnancy, or for prenatal care 4. Chronic Conditions Requiring Treatments a chronic condition that: (a) requires periodic visits for treatment by a health care provider, or by a nurse or physician's assistant under direct supervision of a health care provider (b) continues over an extended period of time (including recurring episodes of a single underlying condition); and (c) may cause episodic rather than a continuing period of incapacity2 (e.g., asthma, diabetes, epilepsy, etc.) 5. Permanent/Long-term Conditions Requiring Supervision a period of incapacity2 which is permanent or long-term due to a condition for which treatment may not be effective; the employee or family member must be under the continuing supervision of, but need not be receiving active treatment by, a health care provider (e.g., Alzheimer's, a severe stroke or the terminal stages of a disease) 6. Multiple Treatments (Non-Chronic Conditions) any period of absence to receive multiple treatments (including any period of recovery from) by a health care provider or by a provider of health care services under orders of, or on referral by, a health care provider, either for restorative surgery after an accident or other injury, or for a condition that would likely result in a period of incapacity2 of more than three consecutive calendar days in the absence of medical intervention or treatment, such as cancer (chemotherapy, radiation, etc.), severe arthritis (physical therapy), kidney disease (dialysis) ________________________________ 2incapacity for purposes of FMLA means the inability to work, attend school or perform other regular daily activities due to the serious health condition, treatment for, or recovery from 3treatment includes examinations to determine if a serious health condition exists and evaluations of the condition; treatment does not include routine physical examinations, eye examinations or dental examinations 4a regimen of continuing treatment includes, for example, a course of prescription medication (e.g., an antibiotic) or therapy requiring special equipment to resolve or alleviate the health condition; a regimen of treatment does not include the taking of over-the-counter medications such as aspirin, antihistamines or salves; or bed-rest, drinking fluids, exercise and other similar activities that can be initiated without a visit to a health care provider Monday 2 June 2003 TREAT MEDICAL SCIENCE AS ONE OF OUR MAJOR ICONS - EXPERT CALL Internationally acclaimed Australian medical researcher, Professor Terry Dwyer, today called on the Federal and State Governments to rally behind health and medical research to preserve a national icon. Known for his ground-breaking research into Sudden Infant Death Syndrome and other important epidemiological research, Professor Dwyer has been awarded the prestigious Australian Society for Medical Research National Medal for 2003. Director of the Menzies Centre for Population Health Research at the University of Tasmania in Hobart, Professor Dwyer said medical research is like sport, one of Australia's national icons. "The achievements of medical research rival those that Australians are more familiar with in the sporting sphere; however, the current level of achievement is not guaranteed," said Professor Dwyer. "Just as Australia's competitiveness in the Olympics fell dramatically in the 1970's and took almost two decades to retrieve, our medical research team needs a level of continuing support that will ensure its competitiveness," he said. "Australia truly boxes above its weight in world medical research. For example, Australian patents in the US in recent years increased by almost 250%, more than twice the rate for all US patents. "This is an outstanding performance which should be more widely recognised and further developed," he said. Professor Dwyer directed Australia's internationally recognised scientific research into the cause of sudden deaths in infants during the 1980s and 1990s. His research findings - which contributed to a revolution of parents putting their infants to sleep in the non-prone position - have saved thousands of babies' lives all over the world. In Australia, his research has translated into 400 babies' lives saved every year and has been cited by the National Health and Medical Research Council as one of Australia's most significant medical achievements of the 20th Century. Professor Dwyer said Australia, with only 0.3% of the world's population, had established 10 times the number of World Health Organisation 'collaborating centres' than would be expected for our population size and was contributing to 3% of global medical research publications each year. "The numbers tell the story. The potential for Australian medical research is huge. However, the system needs continual fostering and renewing, otherwise the medical research momentum will fade the way it did in the Olympic sports field in the 1970's where Australia fell from the world's top 10 to 32nd." …2/ -2- "Medical research is perhaps one of the most important fields for this country. Medical research will find ways of preventing diseases and produce new treatments for illness and disease that will be critical for our aging population," he said. Professor Dwyer says that without maintenance and expansion of government funds, Australia will not be able to meet the new global conditions and the increasing investment of our competitors. "Total R&D expenditure in Australia is only 1.5% of GDP, compared to 2.8% of GDP in the US and 3.1% in Sweden. Our relative deficiency is greatest in the non-government and business sector, but this makes the government contribution in this country all the more important. "It will matter to us if members of our families can't have access to the new gene-based cancer drug that stops the spread of an otherwise lethal tumour, or if the progress of Alzheimer's disease in our elderly patients cannot be stopped when an effective drug is readily available in North America. "And we will not have the human resources to tackle the problems that remain important to our population like neurodegenerative diseases, such as multiple sclerosis and Parkinson's disease, many cancers and disabling conditions of the bones and joints, such as arthritis," he said. "By investing now in medical research we are investing in our very own future. Following the Wills Report in 1999, we got off to a very good start with an historic doubling of the National Health and Medical Research Council budget. The challenge as we head into the mid 2000s is to further boost this funding and this environment of scientific breakthrough." Professor Dwyer said the majority of the commercial patents are based on research findings from the public sector. 91% of the country's patents were based on research from publicly funded institutions. "The challenge is for private industry, individuals and philanthropic trusts to really focus on this sector and pitch in. If they do, the benefits will be there for generations. "We see some of this when we look at the statistics that show in 2001-2002 more than 30 new biotechnology companies started up in Australia," he said. "We are an audacious people. That's great in sport and it's even better in the blue-sky world of medical research. The self-belief that Australian scientists show is a wonderful national asset. It needs further support to ensure the community gets a tangible benefit from that belief and endeavour. "We can't afford not to hang on to our leading position in this sector. It is our major chance to be a contributor to the global new economy and we must maintain the momentum," Professor Dwyer said. For media interviews with Professor Terry Dwyer contact: Dr Moira Clay on 0417 863 688 Niall Byrne on 0417 131 977 Anne Hayward on 0419 893 922 REGISTRATION OF MEDICAL FACILITIES: GENERAL INFORMATION 1. BACKGROUND INFORMATION 38 M.R.S.A. _ 1319-0(3) requires the Board of Environmental Protection to adopt rules governing the management of biomedical waste, including registration of biomedical waste generators, to protect public health, safety and welfare and the environment. The Biomedical Waste Management Rules (Chapter 900 of the Department's rules) were adopted to implement the intent of the Legislature. The effective date of most provisions of the rule was January 1, 1991. 2. WHAT TYPES OF WASTE DOES THE RULE COVER? 38 M.R.S.A. _ 1303 C(1 A) defines biomedical waste as follows: "Biomedical waste" means waste that may contain human pathogens of sufficient virulence and in sufficient concentrations that exposure to it by a susceptible human host could result in disease or that may contain cytotoxic chemicals used in medical treatment. Section 7 of the rules identifies the following categories of waste subject to regulation: 1. Discarded human blood, blood products and body fluids; 2. Waste saturated with human blood, blood products, or body fluids; 3. Pathological waste; 4. Discarded sharps used in patient, animal or cadaver care or in medical and biomedical research laboratories; 5. Discarded cultures and stocks of infectious agents and the culture dishes and devices used to transfer, inoculate and mix cultures; discarded clinical specimens and the associated containers or vials; discarded biologicals; and waste from the production of biologicals and recombinant DNA research; 6. Discarded carcasses, body parts, bedding and other waste generated by research facilities from animals containing organisms or agents not usual to the normal animal environment and which are pathogenic or hazardous to humans; 7. Cytotoxic (Antineoplastic) drugs not identified as hazardous waste in Chapter 850 of the Department's Regulations; 8. Chemotherapy Waste All materials that have come in contact with, and have no more than trace amounts of, cytotoxic (antineoplastic) agents. 3. WHO MUST REGISTER? Each medical facility that generates any amount of biomedical waste is required to register with the Department. Section 6(Y) of the rule defines medical facility as follows: "Medical facility" means any place where biomedical waste is generated, including, but not limited to: hospitals, ambulatory surgical centers, emergency medical service providers, offices and mobile units of health care providers including doctors and dentists, nursing homes, medical diagnostic laboratories, blood centers, pharmaceutical companies, research laboratories, health agencies, diet or health care clinics, offices of veterinarians, veterinary hospitals, and funeral homes and mortuaries. Registration is by facility location. In instances where a medical practice has satellite offices, each location (address) must be registered. In the case of a group practice at a single location, the group practice must register (not each practitioner). In instances where separate medical practices are located within an office building, each practice must register. Household generators of biomedical waste are not required to register with the Department. Section 5(U) of the rule defines household as follows: "Household" means single and multiple residential dwellings and includes hotels, motels and boarding homes. 4. IS A BIOMEDICAL WASTE MANAGEMENT PLAN REQUIRED? A medical facility which generates less than 50 pounds per month of biomedical waste is not required to prepare a written biomedical waste management plan. All other medical facilities are required to prepare such a plan. Plans need not be submitted to the Department but shall be available for inspection by a public safety officer or authorized representative of the Department. 5. WHERE DOES ONE REGISTER? Medical facilities must register with: Maine Department of Environmental Protection Bureau of Remediation and Waste Management 17 State House Station Augusta, Maine 04333-0017 6. WHAT IS THE REGISTRATION FEE? The registration fee is fifty dollars ($50.00) per facility. Checks should be made payable to: Hazardous Waste Fund - Biomedical Waste Account. NOTE: A medical facility must notify the Department in writing of a change in majority ownership, name, location, or operational status of a facility. 7. QUESTIONS AND ASSISTANCE For assistance in answering questions regarding the Biomedical Waste Management Rules, call (207) 287-2651. Customer Service Specialist The Customer Service Specialist is a link between you and the medical center. If you have a problem, please ask for help immediately. The Customer Service Specialist is here to assist you and can be reached at 750-6650. Do not hesitate to express dissatisfaction if you are not pleased with services provided. When you assist in identifying problems, you give us the opportunity to improve patient services to all veterans. If you contact your Customer Service Specialist with a complaint, it will be addressed within 24 hours, and a response will be given to you within within three working days. The presentation of a complaint will not compromise future access to quality care. Your suggestions for improved care and service are always welcomed. Social Workers Social Workers are available in both the inpatient and outpatient settings to help you and your family with problems caused by your illness or hospitalization or with problems that may delay your recovery. Social Workers provide information and assistance with discharge planning, rehabilitation, hospice care, and community services you may need as an outpatient. Social Workers provide counseling about financial benefits and vocational rehabilitation. In addition, they provide therapy/counseling for psychiatric issues such as post-traumatic stress disorder, depression, substance abuse, marital and family problems, and adjustment to illness and disability. You can contact a Social Worker by asking your inpatient or clinic doctor or nurse to make a referral, by calling 750-2044, or by stopping by the Social Work Service office in Building 2, Room 161. Chaplain There is Chaplain coverage at the medical center 24 hours a day, 7 days a week. Please let us know if you need a Clergyman at any time. The Chapel and the Chaplain's offices are located in Building 7 on the second floor. There is easy access by elevator and stairs from the lower floors to the Chapel area. The Protestant Services are held each Sunday morning in the Chapel at 10:30 a.m. The Catholic Services are held each Sunday morning at 9:00 a.m. in the Chapel. There are also Catholic Masses each day of the work week at 11:30 a.m. Jewish Services are held individually and upon request from the patient to the Jewish Chaplain. SPECIAL CONSIDERATION REGULATIONS As approved by Academic Senate on 25 October 1995 (AS 95/219, 220) and 11 December 1996 (AS 96/318) and amended on 11 December 1996 (AS 96/319), 25 June 1997 (AS 97/127), 16 December 1998 (AS 98/295-296) and 19 September 2001 (AS 01/140). 1. Application of These Regulations The Special Consideration Regulations apply in all cases where the other Academic Regulations provide for a student to seek some entitlement on the grounds of misadventure or extenuating circumstances. 2. Student Obligations Students are expected to complete all compulsory assessment tasks, tests and examinations at an acceptable standard and to meet all compulsory assessment deadlines to meet course requirements. Students who suffer misadventure as described in sections 3 and 3.1 below, or are affected by extenuating circumstances as described in sections 3 and 3.2 below, which prevents them from meeting acceptable standards or deadlines may apply for special consideration. Students who experience circumstances which adversely affect their studies but which are not such as to be deemed misadventure or extenuating circumstances as defined in section 3 below, are nevertheless advised to inform their subject coordinator or course coordinator of those circumstances as they occur. 3. Misadventure and Extenuating Circumstances As a general guide misadventure or extenuating circumstances are circumstances which are: " beyond the student's control (ie they could not have reasonably been anticipated, avoided or guarded against); " sufficiently grave or of a nature or duration to have caused considerable disruption to the student's capacity to study effectively or to complete subject requirements; and " have interfered with the otherwise satisfactory fulfilment of the subject requirements. 3.1 Misadventure Circumstances contributing to misadventure can include: " medical reasons; " family/personal reasons - including death or severe medical or personal problems; " employment related reasons - such as a substantial change to routine employment arrangements or status. The following circumstances would not be considered misadventure: " routine demands of employment; " difficulties adjusting to University life, to the self discipline needed to study effectively, and to the demands of academic work; " stress or anxiety normally associated with examinations, required assessment tasks or any aspect of course work; " routine need for financial support; " lack of knowledge of requirements of academic work. 3.2 Extenuating Circumstances Circumstances which can be deemed to be extenuating include: " administrative problems - such as the late receipt of teaching materials, enrolment errors or delays; " sporting or cultural commitments - where a student has been selected to participate in a state, national or international sporting or cultural event; " military commitments - where a student is a member of the armed forces involved in a compulsory exercise; " legal commitments - where a student is called for jury duty or is subpoenaed to attend a court, tribunal, etc; or " other events that pose a major obstacle to the student proceeding satisfactorily with his or her studies. The following would not be regarded as extenuating circumstances: " demands of sport, clubs, and social or extra-curricular activity (other than selection for state, national or international sporting or cultural events); " difficulties with the English language during examinations. 4. Requests for Special Consideration Requests for special consideration may be lodged for the purposes given below. The type of application, the office with which it should be lodged and the deadline for lodging it are specified in each case. 4.1 An Extension of Time to Submit Assessment Tasks Applications for an extension of time to submit assessment tasks are the subject of policies specified in subject outlines. Such applications may be received and approved verbally. Where a written application is required, the following applies: " Applications should be in the form of a letter to the subject coordinator and should be supported by appropriate documentation. The application should be lodged as soon as it becomes apparent that the submission deadline cannot be met. 4.2 Approved Withdrawal from a Subject (AW Grade) After the HECS Census Date Applications must be in the form of a letter to the Student Administration Office. The application must be lodged as soon as possible and preferably before the last four weeks of session (counting the examination weeks). Refer to Enrolment Regulation 13. 4.3 Refund of HECS-HELP Payments Following Withdrawal from a Subject/s Applications must be in the form of a letter to the HECS-HELP/FEE HELP Coordinator in the Student Administration Office. The application must be lodged within one year of the notification of the granting of an AW grade. Refer to Enrolment Regulation 13.4.4. 4.4 Extended Leave of Absence Applications for leave of absence which do not exceed the maximum leave permitted (two sessions of leave in any four consecutive calendar years) are normally automatically granted. All applications for leave must be in writing but applications for leave beyond the maximum permitted must be on the grounds of misadventure or extenuating circumstances. Applications for extended leave should be lodged with the Student Administration Office by 5:00 pm on the census date of the session in which leave is sought. Refer to Enrolment Regulation 14. 4.5 An Extension of Time to Complete a Subject (Grade Pending GP) Applications must be lodged in writing with the Student Administration Office by the Friday before the commencement of examinations for the session. Late applications may be accepted if the misadventure or extenuating circumstances prevented the student from lodging the application on time. Refer to Assessment Regulation 7. 4.6 Permission to Sit for a Supplementary Examination 4.6.1 Due to Inability to Sit for the Final Examination Applications must be lodged in writing with the Student Administration Office (Examinations Office in Bathurst) by the Friday before the commencement of examinations for the session. Late applications may be accepted if the misadventure or extenuating circumstances prevented the student from lodging the application on time. Refer to Assessment Regulation 7. 4.6.2 Due to Misadventure at an Examination Applications may be made on an Incident Report form available from the examination supervisor. The completed Incident Report form must be lodged with the examination supervisor. Alternatively, application may be made in writing and must be lodged in person, by facsimile or by email with the Student Administration Office (Examinations Office in Bathurst) within three working days of the examination. Refer to Assessment Regulations 17.8 and 17.9. 4.7 Exemption from Attendance at a Compulsory Residential School Applications must be made in writing to Student Services and be lodged prior to the commencement of the residential school. Refer to Assessment Regulation 15. 4.8 To Avoid Failing a Subject for Not Attending a Compulsory Residential School Students who do not attend a compulsory residential school and who were not granted an exemption from attendance will be asked by Student Services to show cause why they should not be failed in the subject. Refer to Assessment Regulation 15.3. 5. Supporting Documentary Evidence 5.1 Medical Certificates and Reports 5.1.1 Medical Certificates A medical certificate will normally be submitted by a student who has suffered an acute (ie. brief) illness when seeking special consideration. A medical certificate is a signed statement from a qualified and registered health practitioner which explains the debilitating nature of the condition from which the student is or was suffering and the period during which the condition has or will affect the student, so that the University can decide on the basis of that information and any other information provided by the student, whether to grant the special consideration sought. The certificate should also specify the precise nature of the medical condition, unless to do so would result in a breach of patient confidentiality. 5.1.2 Medical Reports A medical report will normally be submitted by a student when seeking to explain poor academic performance over an extended period of time as in the case of an exclusion appeal. A medical report is a signed statement from a qualified and registered health practitioner which explains the debilitating nature of the chronic (ie ongoing) medical condition from which the student is or was suffering and the likely duration of the condition, so that the University can decide on the basis of that information and any other information provided by the student, whether to grant the special consideration sought. The report should also specify the precise nature of the medical condition, unless to do so would result in a breach of patient confidentiality. 5.1.3 Conditions Relating to the Use of Medical Reports and Certificates " Medical certificates and medical reports will only be accepted when given by qualified and registered health practitioners. " Medical certificates and medical reports must be legible; documents, signed by the practitioner and, preferably be on letterhead stationery; they must indicate the date/s on which attention was sought; and meet the other requirements specified in 5.1.1 and 5.1.2 above. " A student shall submit a medical certificate or medical report when seeking special consideration in relation to an illness, disability or medical condition. " When assessing a request for special consideration, the University will take into account all matters relevant to the request. A medical certificate or medical report, in itself, does not guarantee that special consideration will be granted. 5.1.4 Registered Health Practitioners Medical reports and certificates will be accepted from the following categories of registered health practitioners: " registered medical practitioners; " registered dentists. 5.2 Family/Personal For family/personal reasons - a statement from a registered health care practitioner, a recognised mental health professional, or a person who knows the student, who is not related to the student and who is independent of the University stating: " the date the student's personal circumstances began or changed; and " how these circumstances affected the student's ability to study. 5.3 Employment For employment related reasons - a statement from the student's employer stating: " the date employment arrangements or status changed; and " the nature of the changes. 5.4 Sporting/Cultural/Military/Legal For sporting, cultural, military or legal commitments - a statement from the relevant authority advising: " details of the event; and " the period during which the student's study will be interrupted Multiple prescriptions can be confusing: knowing which pill is which, when to take what medication and what pills have special instructions. A Medical College of Georgia physical therapist and associate dean wants to reduce consumer confusion with software that creates a calendar-like printout every time a prescription is filled. "The idea came to me when a relative who was taking multiple medications for asthma came to stay with me," says Dr. W. Kent Guion, associate dean for academic affairs in the School of Allied Health Sciences. "She was often confused about which pills she had to take in the morning and which pills she had to take at night. Many of her medications also looked the same and it was easy for her to get one confused with the other." Medication errors lead to an increase in doctor's visits and hospitalizations, which drive up health care costs. With $25,000 in VentureLab funding from the Georgia Research Alliance, Dr. Guion is working with an independent consultant to test and market a program that allows patients to print out a "calendar-type" listing of their current medications. The goal is to help them remember often-complicated prescription schedules. "The printout also shows warnings about similar-looking pills to protect patients from taking the wrong medication," he says. The computer program interfaces with computer software at major pharmacies. "The idea is that pharmacists won't have to do any extra work," Dr. Guion says. "When the prescription comes in, they can scan it and the calendar printout will automatically generate. It won't require any extra keystrokes." He is testing an early version of the program in an independent North Carolina pharmacy. Dr. Guion hopes the program eventually will serve as the centerpiece for developing a software company to maintain it. That company will administer and update software, maintain data about medications in the software library and collaborate with pharmacies to implement the software and improve patient safety and compliance with medications. Eventually, Dr. Guion says, the program could be tailored to online pharmacies where 20 percent of Americans now fill their prescriptions, or targeted toward individuals who could use the program on their home computers. "While I am excited about the potential, I completely understand that this process is in the very early stages," he says. "The first round of funding is used to evaluate the market potential and to establish the most appropriate path to commercialization. Fortunately I've been working side-by-side with Dr. Michael Gabridge, MCG associate vice president for technology transfer and economic development, and experienced programmers and pharmacists. They've all provided first-rate support throughout the process Offers DHQ hospital faisalabad with a product or service that delivers doctors association and education association.

doctors association
education association
DHQ hospital faisalabad
hospital doctors
medical college
medical associations
medical alumni
medical college in pakistan
medical doctor association
medical doctor

education association

This is simply amazing. Offers DHQ hospital faisalabad with a product or service that delivers doctors association and education association. Low Salt Diet A Danger For Elderly, Says Salt Manufacturers' Association, UK Squash Slug, Says UK Salt Industry The World's Healthiest Foods List Good Diet and Atherosclerosis How safe are medicinal herbs? Find out New blood test predicts heart disease risk for diabetics VCJD: Further precautionary measures announced to groups of patients, UK Health experts stress importance of jointly tackling TB and HIV, WHO Revised drinking water guidelines to help prevent water-related outbreaks and disease, WHO Long term eradication of brain tumor in lab model holds promise for treatment in humans Emotional intelligence used as skill to build relationships, New book goes beyond hype Research suggests new avenue for stopping, preventing colon cancer Scientists explore genome of methane-breathing microbe Scientists decipher genetic code of biothreat pathogen Pill patch 'safe to use', say UK experts New Web Based System Provides Mental Welfare for Scotland with Paperless Solution Hospitals failing older people, UK Disabled people receiving inadequate healthcare, UK The Benefits of Physical Activity Vitamin D Is Good for Your Gums? Fracture risk based on many factors, not just bone density score American Medical Student Association response to Sullivan Commission report APHA Supports Sullivan Commission's Blueprint to Address USA's Shortage of Minority Health Professionals Key recommendations to improve healthcare for patients put to Select Committee, UK Regulatory Update on MacugenTM (pegaptanib sodium injection) New Imigran Formulation Shown to Start Working in as Fast as 20 Minutes Release of the Half Body Bathing Refreshment Drink (Soft Drink) YUAMI, Japan Aranesp, Approved for Extended Dosing (Europe) Anemia Associated With Cancer Chemotherap Positive preliminary results from 2nd pivotal CDP870 Phase III Trial in rheumatoid arthritis 'No safe level of fluoride' in water, Liberal Democrat Conference, UK HHS Awards 91 Grants Worth $11 Million to Improve Health Center Services, USA Ministers of Health Meet to Analyze Situation, Set New Health Policies, The Americas Action needed to counter sharp rise in rubella cases, Japan More frequent monitoring advised for people with diabetes I and 2 A Shift of Focus in Oral Health, Europe The unkept promises of wonder diets EPA Makes Passenger Aircraft Water Testing Information Available, USA Targeted therapy knocks out pediatric brain cancer in mice Key stimulator of colorectal cancer identified Binocular rivalry: Fulfilling visual expectations Loss of the neuronal adhesion protein d-catenin leads to severe cognitive dysfunction The terms 'plastic surgery' and 'cosmetic surgery' are perceived differently Obese trauma patients more likely to die of their injuries Immediate breast reconstruction after mastectomy does not delay chemotherapy Combination laser and ointment therapy effective in treating vitiligo Intravenous line placement for minor ear surgery in children appears to offer no added benefit Strep bacteria uses a sword and shield to win battle against immune system Double dealing receptor protein on tumors promotes cancer development in cell nucleus Targeting stress response proteins on breast, prostate tumor cells shows promise Talking to your dying child Androgen Therapy for Women: A Critical Look at the data and the Issues Earth Institute Supports Accelerated Expansion of Health System for Ethiopia University of Pittsburgh Cancer Institute forms center for environmental oncology HIV Dementia Mechanism Discovered, Finding may lead to new therapies Researchers eliminate leukemia in mice Mayo Clinic first in USA to scan with new computed tomography (CT) system Stimulating the production of utrophin protects muscular dystrophy mice from muscle wasting Vanilla may have a future in sickle cell treatment Fibromyalgia prohibits sufferers from breast feeding Circulating Mononuclear Cells in the Obese in Proinflammatory State, Contributing to Diabetes and Heart Disease Fractures mean broken lives in developing world, Initial treatment would make a huge difference Yale digital diagnostic technology is basis of new company, HistoRx Inc 20 Sep 2004 Farm to Table Shell Egg Safety FDA Proposes Further Action New agreement between NHS and voluntary sector, UK September is Gynecologic Cancer Awareness Month Moffitt Fact Sheet Moffitt Announces Second Annual Florida Melanoma Symposium Royal Society study on pharmacogenetics, UK Son's memory spurs leukemia fight, Donors needed for marrow transplants, Japan Millions offered private surgery on the NHS, UK Royal Society investigates personalised medicine, UK Patients taught to manage condition, UK Overweight children warned of heart disease Syndrome X, Lifestyle strikes again Dementia, An Emerging Major Health Challenge,Australian Medical Association Significant Survival Benefit for Drug Tarceva in Advanced Pancreatic Cancer Bonviva, monthly osteoporosis tablet, submitted for authorisation in Europe Bayer BNP assay receives FDA clearance for two additional heart failure claims Recognition of Movement Disorders: Extrapyramidal Side Effects and Tardive Dyskinesia Hurricane Victims Struggling in Ivan's Aftermath Animal to Human Transplantation (Xenotransplantation), Australia Helping others raises quality of life and happiness Are processed foods not as nutritious as fresh foods? Orthorexia nervosa - obsessed with eating to improve your health The Highs and Lows of carbohydrates. How do foods affect blood sugar levels? What kind of foods are carbohydrate free? Oral Health Alliance documents, material to assist you during the federal election campaign, Australia Researchers Identify the Genome's Controlling Elements Intellectural Property Used to Create Scientific Software to Aid in Drug Design Ecotoxicologist Identifies Drugs in Texas Waters, Fish Complex Cells Likely Arose from Bacterial, Extreme microbe Genomes New Scientist Magazine Issue 18 Sep 2004 Tallow Magic Ingredient in Promising Cholesterol Fighter ORNL Microscope Pushes Back Barrier of How Small Genes expose secrets of sex on the side 19 Sep 2004 Confusion for parents and doctors regarding FDA antidepressant warning Combating emerging zoonoses: challenges and prospects at community level, Europe Doctor jailed for 6 years for indecent assault, 23 counts, showed no remorse World's Most Powerful MRI for Decoding the Human Brain Less Pain and Quicker Recovery with Coblation Assisted Tonsillectomy Ear, Nose, and Throat Specialists Offer Primer on West Nile Virus Pediatric Head and Neck Abscesses and Group Strep A Organism Use of Mitomycin C to Lessen Unsightly Scarring Questioned Less Patient Bleeding with Coblation Assisted Tonsillectomy Microdebrider More Effective Treating Airway Obstruction Sleep Apnea Associated with Stomach Acid Backflow into Throat Palatal Implants Provide Effective Snoring Relief Severe Complications from Acute Sinusitis Will Affect Young Males in Late Winter MRI Identifies Causes of Sudden Deafness At Home Diagnostic Test for Obstructive Sleep Apnea Dental Appliances Effective in Treating Obstructive Sleep Apnea 1 in 6 Combat Wounded in Iraq, Afghanistan Need Treatment by Otolaryngologists Gastroeosphageal Reflux, Middle Ear Infection Associated in Children Asthmatic Patients with Sinusitis More Likely to Have Nasal Polyps Cochlear Implantation in the Elderly Enhances Quality of Life Adenotonsillectomy Resolves Obstructive Sleep Apnea for Children Vitamin E May be Effective in Sudden Hearing Loss Reading not Imparied after Recovery from Hearing Loss Nasal Ointment Reduces Allergic Rhinitis Symptoms Sushi Eaters Should Not Count on Wasabi to Clear the Nose Sinusitis Patients' Voice Resonance following Endoscopic Surgery Red Baron's Prior Head Injury Led to Being Shot Down HFES 48th annual meeting papers feature work on critical health and safety issues Central corneal thickness significantly impacts glaucoma treatment Positive Trial Of Neurodex For Uncontrollable Laughing And Crying In MS 18 Sep 2004 Increased incidence of MS associated with Hepatitis B Vaccination FDA Offers Food Safety Information for Expected Power Outages and Flooding Due to Hurricanes HIV AIDS, EU and neighbouring countries pledge common action to counter resurgent epidemic Nutritional Aspects of Cereals Outbreak of Cyclosporiasis Associated with Snow Peas, Pennsylvania, 2004 Live Web Chat on CAM and Cancer, September 20 Do you want to become a doctor? 60% of chronically ill who cannot afford medications do not tell doctor, USA Why and how men and women often misjudge sexual signals Coronary angioplasty soon after medical therapy best treatment for heart attack patients Potential Link Between Schizophrenia and Suicide in China Younger drinkers more likely to have a drinking problem later in life UNICEF relief supplies arrive in post Ivan Jamaica Botox May Smooth Your Wrinkles and Stop the Ringing in Your Ears Folic acid vitamin use by women reaches all-time high, March of Dimes survey finds Historical increases in life span to lower childhood exposure to infection Information system to help scientists analyze mechanisms of social behavior Humans not irrational, just wary Family predictors of girls' sex typed activities Is home visiting an effective strategy for families with young children? Middle childhood development and later adult outcomes Chemical genetics identifies SARS inhibitors Resveratrol synthase uncovered: Cyclization specificity of type III polyketide synthases Therapy for Alzheimer's? Promising pilot study Opening Dialogues in Healthcare Communication HIV AIDS Care in the Developing World: Lessons Learned and The Way Forward Aeras Receives CDC Funding to Develop TB Vaccine Trial Sites in India Joslin researchers clarify mechanisms for beta-cell formation 22nd Amino Acid Synthesized And Added To Genetic Code Of E. coli Bacteria Scientists shed light on mechanism behind beneficial effects of red wine Researchers develop fast track way to discover how cells are regulated Genetic modification of linseed produces healthier omega 3 and 6 fatty acids New technique for thyroid cancer therapy eliminates many side effects New Asian-American tobacco use and diet findings 17 Sep 2004 New study validates benefits of a low glycemic diet Medicare To Expand Coverage For Pet Scans For Alzheimer's Disease, USA Pharmaceutical Price Regulation Scheme (PPRS), UK Statins, the emerging indications Is this a cure for the common cold? Double barrelled syringe combats contamination Reports of Mortality Associated with Hurricane Charley, Florida, 2004 RCGP welcomes Government's new sugar campaign, UK Sumitomo Pharma, Novo Nordisk Conclude Licensing Agreement for Repaglinide Researchers Develop Fast Track Way to Discover How Cells are Regulated Call for new NHS charges, UK Children's health at crisis point, UK NPSA advises on spinal injury patients, UK Patients put in the driving seat, UK FDA Clears Over the Counter Sale of Automatic External Defibrillator FDA Statement on Recommendations of the Psychopharmacologic Drugs and Pediatric Advisory Committees HIV AIDS, EU and neighbouring countries pledge common action to counter resurgent epidemic Soft drinks overtaking milk as calorie source in USA Sit-in forces hospital to reopen rest rooms for doctors, UK Public Hospitals Policy, "More Beds, Less Desks", Australian Medical Association says Global study shows nine factors identify majority of heart attack risk CDC Recommends Return to Full Four-Dose Series of Prevnar Oxford Biomedica Signs License Agreement with Massachusetts General Hospital & Dana-Farber Cancer Institute GSK gets EU CHMP positive opinion for new once daily HIV drug, 2 antiretrovirals in 1 tablet EU Scientific Committee recommends approval of Cymbalta® and Xeristar® for treatment of major depressive episodes Statistics on alcohol, England, 2004 Osaka Univ restores eyesight by grafting cultivated cornea, Japan MediBic to Launch Proteome Analysis Service for Drug Development Preferential parental treatment of siblings. Effect on children Increased impulsivity, or a lack of impulse control, is a key characteristic of many psychiatric disorders, including alcohol dependence. Recent studies suggest that increased impulsivity is involved in a predisposition to developing these disorders. A new study of brain processes provides support for this theory. Results are published in the January issue of Alcoholism: Clinical & Experimental Research. "Altered impulsivity is a prominent manifestation in many disinhibitory psychiatric disorders, such as alcohol- or substance-related disorders, conduct disorder, attention-deficit hyperactive disorder (ADHD), antisocial personality disorder (ASP), bipolar disorder, impulse control disorders, and so on," said Bernice Porjesz, professor and director of the Henri Begleiter Neurodynamics Laboratory at SUNY Downstate Medical Center. "Individuals suffering with these disorders may frequently and unpredictably act without planning in advance or without regard to the negative consequences of their behaviors, which in turn can result in serious aftermath. In severe cases, it may lead to danger to the patient or to others." Porjesz added that the majority of psychiatric diseases are "complex diseases," meaning that their development is influenced by an underlying biological susceptibility of genetic factors, environmental factors, and interactions among multiple genes and the environment. "Disinhibitory disorders share many similar clinical presentations as well as similar neurobiological abnormalities such as brain waves," said Porjesz. "This suggests that this group of disorders may have some underlying genetic vulnerabilities in common that contribute to the disorders. One recent study of genetic and environmental contributions to internalizing and externalizing disorders determined that the single most important factor underlying externalizing disorders is a genetic liability involving impulse control." For this study, researchers recruited 57 alcohol-dependent individuals and 58 healthy adult "controls" from the New York City area. All participants were assessed with a standard visual oddball task, where the subject presses a button only to rarely occurring target stimuli (the letter "X") embedded in a series of frequent non-target stimuli. Meanwhile, brain waves or event-related potentials (ERPs) were recorded with a non-invasive technique using 61 scalp electrodes to measure P3 amplitudes. (P3 amplitudes reflect level of neural inhibition in the central nervous system - the larger the P3, the more the inhibition.) Levels of impulsivity were also measured through a standardized self-report scale, the Barratt Impulsiveness Scale. Self-reported measures of impulsivity were also gathered through questionnaires. Furthermore, source localization of brain sources contributing to P3s was computed through a recently developed method of low-resolution electromagnetic tomography called LORETA. Results showed that the alcohol-dependent subjects, as well as those individuals with high impulsivity, had significantly lower P3 amplitudes and reduced frontal-lobe activity while processing the visual target signals. "This is the first study to demonstrate that reduced brain activity in the frontal lobe during processing of target visual stimuli is highly related to impulsivity, regardless of a clinical diagnosis such as alcoholism," said Porjesz. "Genetically influenced underlying factors, such as neural disinhibition and impulsivity, involve frontal-lobe function and influence a wide range of clinical outcomes. Thus, the low P3 amplitude and reduced frontal activation that we found reflect risk for the development of many externalizing disorders, not just specifically alcohol dependence." Porjesz noted that impulsivity as a behavioral process is essential for normal and socially relevant functioning. "However," she added, "an increased level of impulsiveness may indicate that an individual is more vulnerable than others to behaviors such as excessive drinking, abuse of illicit drugs, and perhaps the development of other disinhibitory disorders. Awareness of this increased vulnerability can aid in better prevention strategies, and early identification of individuals manifesting high impulsivity may prevent more serious clinical outcomes." Porjesz and her colleagues plan to continue with their research, and will next examine the relationship between impulsivity and ERPs in the offspring of alcoholics. As part of a large nine-center collaborative study known as COGA (Collaborative Study on the Genetics of Alcoholism), they are also trying to identify genes associated with impulsivity, and the underlying predisposition involved in disinhibitory disorders, by following young offspring of alcoholics with "risk genes" as they go though the age of risk and respond to their environmental factors. New River Pharmaceuticals And Shire Receive Approvable Letter For VYVANSE™ (lisdexamfetamine Dimesylate) For The Treatment Of ADHD Main Category: ADHD News Article Date: 04 Jan 2007 - 11:00 PST | email this article | printer friendly | view or write opinions | Article Also Appears In Mental HealthPsychology / PsychiatryPediatrics Useful Article? Digg It Del.icio.us NewsVine Reddit New River Pharmaceuticals Inc. (NASDAQ: NRPH) and its collaborative partner Shire plc (LSE: SHP, NASDAQ: SHPGY, TSX: SHQ) announced today that the U.S. Food and Drug Administration (FDA) has issued a second approvable letter for VYVANSE (lisdexamfetamine dimesylate, formerly known as NRP104) for the treatment of Attention Deficit Hyperactivity Disorder (ADHD). On October 6, 2006 the FDA issued an approvable letter for VYVANSE and New River Pharmaceuticals submitted a complete response to the FDA on October 24, 2006. No additional studies have been requested by the FDA as a condition for approval of VYVANSE. The companies will work together to provide full and timely responses to the agency’s request. The data requested are routine, and their provision to the FDA is not expected to delay a launch of VYVANSE in the second quarter of 2007. The U.S. Drug Enforcement Administration’s parallel review of VYVANSE’s scheduling assignment is expected within three months. The FDA has proposed that VYVANSE be classified as a Schedule II controlled substance. This proposal has been submitted to the U.S. Drug Enforcement Administration (DEA). Once VYVANSE is approved by the FDA and receives final scheduling designation by DEA, VYVANSE will be available in three dosage strengths: 30 mg, 50 mg and 70 mg, all indicated for once-daily dosing. For more information about ADHD, please visit: www.ShireADHDTreatments.com. The Collaboration Agreement In January 2005, New River Pharmaceuticals signed a collaborative agreement with Shire to develop and commercialize VYVANSE. Details on the collaboration agreement are available in previous filings with the U.S. Securities and Exchange Commission. New River New River Pharmaceuticals Inc. is a specialty pharmaceutical company developing novel pharmaceuticals that are generational improvements of widely prescribed drugs in large and growing markets. For further information on New River, please visit the Company's Web site at www.nrpharma.com. Shire plc Shire’s strategic goal is to become the leading specialty pharmaceutical company that focuses on meeting the needs of the specialist physician. Shire focuses its business on attention deficit and hyperactivity disorder (ADHD), human genetic therapies (HGT), gastrointestinal (GI) and renal diseases. The structure is sufficiently flexible to allow Shire to target new therapeutic areas to the extent opportunities arise through acquisitions. Shire believes that a carefully selected portfolio of products with a strategically aligned and relatively small-scale sales force will deliver strong results. Shire’s focused strategy is to develop and market products for specialty physicians. Shire’s in-licensing, merger and acquisition efforts are focused on products in niche markets with strong intellectual property protection either in the US or Europe. For further information on Shire, please visit the Company’s website: http://www.shire.com. "SAFE HARBOR" STATEMENT UNDER THE PRIVATE SECURITIES LITIGATION REFORM ACT OF 1995 Statements included herein that are not historical facts are forward-looking statements. Such forward-looking statements involve a number of risks and uncertainties and are subject to change at any time. In the event such risks or uncertainties materialize, Shire's results could be materially affected. The risks and uncertainties include, but are not limited to, risks associated with: the inherent uncertainty of pharmaceutical research, product development, manufacturing and commercialization; the impact of competitive products, including, but not limited to the impact of those on Shire's Attention Deficit and Hyperactivity Disorder (ADHD) franchise; patents, including but not limited to, legal challenges relating to Shire's ADHD franchise; government regulation and approval, including but not limited to the expected product approval dates of SPD503 (guanfacine extended release) (ADHD), SPD465 (extended release of mixed amphetamine salts) (ADHD), MESAVANCE (mesalamine) with MMX technology (SPD 476) (ulcerative colitis), ELAPRASE (idursulfase) (Hunter Syndrome) and NRP104 (lisdexamfetamine dimesylate) (ADHD), including its scheduling classification by the Drug Enforcement Administration in the United States; Shire's ability to secure new products for commercialization and/or development; and other risks and uncertainties detailed from time to time in Shire's and its predecessor registrant Shire Pharmaceuticals Group plc's filings with the Securities and Exchange Commission, particularly Shire plc's Annual Report on Form 10-K for the year ended December 31, 2005. An editorial written by Professor Philip Asherson, a leading psychiatrist in adult ADHD (Attention Deficit Hyperactivity Disorder), at the Institute of Psychiatry, King’s College London strongly recommends that general adult psychiatrists should diagnose ADHD in adults appropriately with stimulant drugs. It is published in the January issue of the British Journal of Psychiatry. Although ADHD can be effectively treated with stimulant medication, and such treatment is widespread in the young, general adult psychiatry has not yet followed suit in identifying and treating substantial numbers of affected people. ADHD is a common disorder affecting children and adults, and is a predictor of adult mental health problems. Symptoms include high levels of inattentiveness, impulsiveness and restless over activity, and are regarded as a source of disability in children and adolescents, as well as a risk to adult psychological adjustment. Young people are entering adult life whilst still receiving medication for ADHD, and adult psychiatrists are needed to take over treatment when symptoms persist. Moreover, some adult patients with ADHD may be misdiagnosed and ineffectively treated for other disorders, such as depression and personality disorder. Research suggests that between 15% and 65% of children diagnosed with ADHD still have symptoms of the disorder in adulthood. However, many children with ADHD go unrecognised, and may be diagnosed in adulthood for the first time. A survey of schoolchildren with ADHD in the London Borough of Newham found that although levels of restless activity diminished between the ages of 7 and 17, the 17-year-olds showed a level of hyperactivity similar to that found in a group of normal 7-year-olds. When the same people were followed up at the age of 26, they were found to have disabilities associated with high levels of psychiatric disorder, which were all the more significant because of increasing demands in adult life for self-organisation and the ability to plan ahead. Adult behaviours linked to ADHD are associated with the childhood symptoms of motor hyperactivity, attention deficit, unfocused thinking, mood changes, disorganisation and impulsiveness. They include - at the severe end of the spectrum - feelings of restlessness, difficulty in relaxing, feeling depressed when inactive, lack of concentration on detail, depression or excitability, poor time management, difficulties sustaining relationships and a tendency to make rapid and facile decisions without full analysis of the situation. Psychiatrists diagnosing ADHD in adults need to be aware of the fact that people with this disorder often show decreased symptoms in a novel situation like a psychiatric evaluation. It is therefore important to base mental state evaluations on a typical week and a variety of normal situations. Mood instability is very common in adult ADHD, and can lead to diagnoses of depression or personality disorder. Many adults with ADHD also have other problems, such as antisocial personality, alcohol and drug misuse, anxiety disorders and learning difficulties. ADHD in childhood may also lead to the development of antisocial behaviour. Some symptoms of adult ADHD are similar to those of bipolar disorder, but ADHD tends to show a persisting trait of irritability and volatility, very different from the grandiose and euphoric symptoms of mania and the depression found in bipolar disorder. Professor Philip Asherson comments: "Adults with untreated ADHD use more healthcare resources because of smoking-related disorders, increased rates of serious accidents, and alcohol and drug misuse. Further research is needed to quantify the contribution of ADHD to psychiatric disorders in adulthood." Professor Asherson’s editorial is published in the British Journal of Psychiatry, January 2007. Main Category: ADHD News Article Date: 19 Dec 2006 - 18:00 PST | email this article | printer friendly | view or write opinions | Article Also Appears In Neurology / NeurosciencePediatrics Useful Article? Digg It Del.icio.us NewsVine Reddit Social stigma and feeling lifeless and/or alienated from one's peers are some of the reasons why children and adolescents stop taking prescription stimulant medications used to treat attention deficit-hyperactivity disorder (ADHD), according to a new study published in the Journal for Specialists in Pediatric Nursing. ADHD is a common neurobehavioral disorder, affecting 4.4 million children in the United States between the ages of 4 and 17. Following diagnosis, 56% are treated with prescription stimulant medications. According to the study, many stop using these medications even while they are still exhibiting symptoms of the disorder, despite research indicating these medications are effectively reducing hyperactivity, impulsivity and inattention. The study also found that while ADHD is a chronic disorder, none of the adolescents interviewed had received ongoing education about their condition. As college students, many used the medications irregularly, sometimes in doses exceeding the prescribed amount, and often at night - factors that may exacerbate the side effects. Julie B. Meaux, PhD, RNC, lead author of the study, suggests that "dialogue between the child, parents and healthcare provider about the general effects, side effects and potential abuse of prescribed stimulant medications is essential," adding "careful administration of dosages, based on input from the child, is exceedingly important." ### This study is published in the current issue of the Journal for Specialists in Pediatric Nursing. Julie B. Meaux, PhD, RNC is an Assistant Professor in the Department of Nursing at University of Central Arkansas. The Journal for Specialists in Pediatric Nursing bridges the gap between research and practice by publishing peer-reviewed reliable, clinically relevant, and readily applicable evidence. The journal integrates the best evidence with pediatric nurses' passion for achieving the best outcomes. For more information, please visit www.blackwellnursing.com/jspn. Blackwell Publishing is the world's leading society publisher, partnering with 665 medical, academic, and professional societies. Blackwell publishes over 800 journals and has over 6,000 books in print. The company employs over 1,000 staff members in offices in the US, UK, Australia, China, Singapore, Denmark, Germany, and Japan. Blackwell's mission as an expert publisher is to create long-term partnerships with our clients that enhance learning, disseminate research, and improve the quality of professional practice. For more information on Blackwell Publishing, please visit Blackwell PublishingLong-Term Narcotics Use For Back Pain May Be Ineffective And Lead To Abuse Main Category: Pain / Anesthetics News Article Date: 20 Jan 2007 - 1:00 PST | email this article | printer friendly | view or write opinions | Article Also Appears In Body AchesAlcohol / Addiction / Illegal Drugs Useful Article? Digg It Del.icio.us NewsVine Reddit Narcotic drugs (opioids) are commonly prescribed for short-term relief of chronic back pain, but their effectiveness long-term has been questioned in a review article by researchers at Yale School of Medicine, who also found that behaviors consistent with opioid abuse was reported in 24 percent of cases. "Patients with chronic back pain commonly request pain medication, and opioid medications are used despite the concerns clinicians have with patients developing an addiction to these medications," said first author Bridget Martell, M.D., assistant clinical professor of general internal medicine at Yale School of Medicine. "Our findings suggest that clinicians should consider other treatments with similar benefits but fewer long-term adverse effects." Published in the January 16 Annals of Internal Medicine, Martell and co-authors conducted a systematic literature review and meta-analysis that addressed the prevalence and effectiveness of opioid prescriptions for patients with chronic back pain, and the incidence of substance abuse disorders among patients receiving opioid medications for chronic back pain. The study populations consisted of non-obstetric patients over age 18 with non-malignant chronic back pain lasting for at least three months. The research focused on efficacy of oral, transdermal, or topical opioids, where there was no pre-existing diagnosis of opioid dependence. According to the report, opioids may be effective for the short-term (less than four months) treatment of chronic low back pain, but long-term effectiveness was not conclusive. "Our results also demonstrate that the quality of the literature on these topics is generally weak and more studies need to be done before firm conclusions can be made," said Martell. ### In addition to Martell and corresponding author David Fiellin, M.D., associate professor of general internal medicine at Yale, other authors on the study included Patrick G. O'Connor, M.D., Robert D. Kerns, William C. Becker, M.D., Knashawn H. Morales and Thomas R. Kosten, M.D. What is High Blood Pressure? High blood pressure, sometimes called hypertension, means high pressure (tension) in the arteries. It does not mean excess emotional stress, though doctors’ believe that stress might contribute to high blood pressure over a longer period of time. Your blood pressure rises and falls with each heartbeat, even normal blood pressure does this. These levels can change with everyday activity, for example, during exercise or when you are asleep and this is also normal. However, in some people, and as we get older, these changes in blood pressure start to happen at higher pressure levels than normal and this is what high blood pressure means. Your blood pressure is usually measured with a blood pressure cuff placed around the upper arm that registers the pressure in units called millimetres of mercury (or mm Hg). Your blood pressure is usually considered to be high when it is at a level exceeding 140/90 mm Hg (“140 over 90”) on several readings under various conditions. However, defining normal and abnormal is not always so clear-cut and your doctor or healthcare professional will make the necessary recommendations. Blood pressure rises and falls with each heartbeat. Systolic blood pressure, the higher number, represents the pressure in the arteries as the heart contracts and sends blood into the circulation. Diastolic pressure, the lower number, occurs as the heart relaxes following a beat. It represents the lowest pressure to which the arteries are exposed between heartbeats. How do you get High Blood Pressure? No specific cause is found in 95% of patients with hypertension – this is called primary hypertension or sometimes essential hypertension. Most patients have primary, or essential hypertension. Most cases of primary hypertension are due to increased stiffness and narrowing of the smaller (peripheral) arteries. This results in increased resistance to the flow of blood and is what makes the blood pressure go up. Increased peripheral artery resistance is associated with genetics (family history), obesity, lack of exercise, over use of salt, and the natural ageing process. A few patients have high blood pressure with a known cause (secondary hypertension). Long-lasting (chronic) kidney disease accounts for most of these patients where there is excessive fluid accumulation in the body that raises blood pressure. Hypertension can also occur during some pregnancies. How serious is High Blood Pressure? It is rare these days for blood pressure to be so high as to pose an immediate threat to life. In almost all cases, the problem with blood pressure is that over time it can cause damage to the tiny blood vessels and this may affect the function of the heart, eyes, and kidney. Again, over time it can affect the larger arteries as well and contribute to hardening of the arteries. This explains why people with untreated high blood pressure have a higher risk of suffering from a stroke, heart attack, heart failure, hardening of the arteries, eye and kidney problems. For this reason it is important that treatment with a blood pressure lowering medicine is given for a long period of time, which in most cases is for life. And, because blood pressure tends to go up as you get older anyway, it means we should have our blood pressure checked regularly, even if our blood pressure is ‘normal’. How long does High Blood Pressure last? High blood pressure may be present for several years before it is detected and is often found during a routine check-up, for example, for insurance purposes. Usually there are no symptoms and consequences may only become apparent after many years. How is High Blood Pressure treated? Doctors know that there is a benefit from treating high blood pressure at any age, even in older patients of 65 years and over. Depending on the level of the blood pressure, different things are recommended. In some people with only mild elevations in blood pressure a change in diet and adopting a more healthy lifestyle may reduce the blood pressure to normal. Your healthcare professional will provide you with the right diet for you. Its not just lowering the amount of salt you eat, although this is important: there are other things you can change in your diet that can help. Also, if you are overweight, getting slimmer may help. If necessary, high blood pressure can be treated with a range of different medicines, including: Beta-blockers, which make the heart beat more slowly and less strongly. They work by blocking the action of nerves supplying the heart that release a chemical called noradrenaline. This helps to control the rhythm and force of heart muscle movement. They also block a hormone called adrenaline (a chemical carried in the blood) which is similar to noradrenaline. Diuretics, which work in the kidneys to make you pass urine more often and get rid of excess fluid. Calcium-channel blockers, which relax arterial blood vessels making them less narrow. These lower the resistance to blood flow, allowing blood to flow more easily. They work by preventing calcium from entering the muscles in blood vessels because calcium is important in narrowing down blood vessels. ACE inhibitors and angiotensin II antagonists, which in general relax the blood vessels. They do this by preventing a hormone called angiotensin II from working, either by preventing its production or blocking its action. Like other hormones, angiotensin II is an active chemical signal in the blood. It controls the function of many organs or systems including the narrowing of blood vessels and prevents the kidneys from getting rid of excess fluid. Doctors believe that angiotensin II is involved as one of the causes of high blood pressure. It is also important to follow any lifestyle instructions that your doctor has given to you, like trying to give up smoking, reducing your weight, doing more exercise and eating a healthy diet. When these and other risk factors are present together with high blood pressure, then this means there is even higher risk of serious disease. It is also important to continue taking any medications you have been given, even if you feel normal. Breast cancer What is Breast Cancer? Cancers occur when abnormal cells grow in an uncontrolled way. Almost all breast cancers occur in women - very few occur in men. The cancer usually begins as a small lump in a breast and then grows, either slowly or quickly. Breast cancer News Facts and figures Treatment Hormonal therapy Interactive learning Support services Feature articles It can also spread to other parts of the body after a period of time. Early diagnosis is the key to survival. In fact, most lumps in the breast are not cancers, they are benign and don't spread to other parts of the body. However, every lump in the breast needs careful checking by a healthcare professional. Tumours can therefore be described as benign or malignant. Benign tumours do not spread, but malignant tumours, as in breast cancer, are made up of cells that can spread to and damage other parts of the body. How do you get Breast Cancer? Although the exact causes of breast cancer have yet to be identified, the risk increases gradually with age and for certain people there may be a family hereditary (genetic) component. Doctors know that 1 in 10 women will develop breast cancer at some point in their lives. Three-quarters of women who develop it do so after the menopause. Some other things are known to increase the risk such as early puberty/late menopause, not having children or having a first child after the age of 30 years. The risk can actually be lower if you have a short menstrual life, large family or first child before age 18 years. How serious is Breast Cancer? Breast cancer is potentially a very serious condition and can be life-threatening. Early detection of breast cancer is therefore vital as it increases the chances of successful treatment. Community screening programmes and mammograms are key to early detection and are integral tools in the fight against breast cancer. Self-examination is also important and women should check their breasts regularly. If there are any changes in size or shape, lumps, tenderness or nipple discharge then a healthcare professional should be consulted. How long does Breast Cancer last? Doctors know that breast cancer develops in phases from early to advanced stages (when it has spread to other organs). The earliest stage may have taken only a few weeks to develop before it is detected. Early treatment, possibly involving surgery and radiation combined with drug treatment, is very important and will probably take several months. Hormone therapy may then be continued for a longer period. If a tumour is malignant this can form new tumours that doctors call a recurrence, secondaries or metastases. The common places for breast cancer to spread are the bones (back or hips), the lungs, the liver and sometimes the brain Recurrences do not occur in every woman who has had breast cancer and they do not occur in all of the places mentioned, usually only one place is affected. How is Breast Cancer treated? Typically, treatment of breast cancer will involve surgery followed by a combination of chemotherapy, hormonal therapy and radiation. However, treatment can vary greatly from patient to patient depending on the stage of the cancer and whether recurrence has occurred. Surgery: Removal of the lump (called a lumpectomy) is the preferred technique. Removal of lymph nodes in the armpit may be undertaken as well. Removal of the breast (called a mastectomy) is only performed if absolutely necessary. Chemotherapy: Medicines that interfere with cancer cell growth and division are administered to reduce the size of tumours or kill them. Hormonal therapy: Hormones are chemical signals which are released by different parts of the body and can carried in the blood to some other area to have an effect. Oestrogen is a sex hormone that promotes the growth of some breast cancers. Hormonal treatments, such as anti-oestrogens, aromatase inhibitors or LHRH analogues, are designed to block the effects of oestrogen or its production, which stops or slows the growth of cancer cells. Radiation therapy: X-rays or other high-energy rays are applied to the tumour and surrounding areas to destroy cancer cells. White Blood Cells In Lung Produce Histamine Seen In Allergies Main Category: Blood / Hematology News Article Date: 17 Jan 2007 - 3:00 PST | email this article | printer friendly | view or write opinions | Article Also Appears In AllergyRespiratory / AsthmaCystic Fibrosis Useful Article? Digg It Del.icio.us NewsVine Reddit In a surprise finding, scientists have discovered that histamine, the inflammatory compound released during allergic reactions that causes runny nose, watery eyes, and wheezing, can be produced in large amounts in the lung by neutrophils, the white blood cells that are the major component of pus. Pus, a fluid found in infected tissue, is produced as a result of inflammation. The study in mice is the first to show that lung neutrophils can produce histamine in significant quantities, according to principal investigator George Caughey, MD, chief of pulmonary/critical care medicine at the San Francisco VA Medical Center. "Previously it was thought that the primary sources of lung histamine, in health as well as disease, was mast cells, which are classically associated with allergy," notes Caughey, who is also a professor of medicine at the University of California, San Francisco. Caughey says the result could mean that histamine acts as a link between airway infections and asthma and bronchitis, which are associated with allergy. "In both, we observe inflammation - swelling, blood vessel leak, and muscle contraction that narrows the airway." The study appears in the January 2007 issue of the Journal of Experimental Medicine. Caughey was investigating the well-known fact that upper respiratory infections often trigger acute asthma attacks. "We hypothesized that an infection in the airway would release histamine from mast cells, and that would be one of the reasons," he explains. To test the hypothesis, Caughey and his team exposed two different populations of mice to mycoplasma, a common respiratory infection in rodents and humans. One population had a genetic abnormality that causes a total lack of mast cells; the other population was made up of normal, wild-type mice. Both populations of infected mice developed pneumonia. "We thought the mice without mast cells would do better than the wild-type mice, because the infection wouldn't be provoking mast cells to release histamine," recalls Caughey. "In fact, they did much worse. Even though there were no mast cells, histamine levels rose up to 50 times normal." The reason was straightforward, Caughey says. Neutrophil numbers increased in response to infection, and neutrophils in turn produced histamine. "It's a direct effect of the mycoplasma bacteria on neutrophils. They induce neutrophils to produce the enzyme that produces histamine." Individual neutrophils produce much less histamine than individual mast cells, says Caughey, but "because pus contains millions if not billions of neutrophils, the overall amount they make is very considerable." The neutrophil-histamine effect was similar in the wild-type mice, reports Caughey: "Histamine levels from neutrophils blew right past the histamine levels contributed by mast cells." The wild-type mice suffered less severe infections overall because "as a number of recent studies, including ours, have shown, mast cells actually play a role in protecting against bacteria," Caughey explains. "For example, a mouse without mast cells with the equivalent of a ruptured appendix will die of the resulting infection, while a mouse with mast cells can survive." When the infected mice without mast cells were given antihistamines, the level of histamine, and therefore the severity of the pneumonia, dropped in proportion to the amount of antihistamine given. "This is a study in mice, so we cannot freely extrapolate the results to human beings," cautions Caughey. "Nonetheless, antihistamines may deserve more of a look as therapeutic options in lung and airway infection." He says the study also has implications for other types of airway infection "in which there are a lot of white blood cells -cystic fibrosis, for example, which can be associated with asthma-like airway contraction." The next steps for Caughey and his research team are to investigate "how general this result might be. Does only one type of bacteria cause the effect, or do others, also? Is it limited to rodents, or does it carry forward to humans? And if it does, is the amount of histamine produced by neutrophils enough to make a clinical difference?" ### Co-authors of the study were Xiang Xu, MD, PhD, Dongji Zhang, MD, PhD, Hong Zhang, PhD, Paul J. Wolters, MD, Nigel P. Killeen, PhD, Brandon M. Sullivan, Richard M. Locksley, MD, and Clifford A. Lowell, MD, PhD, of UCSF. The study was supported by funds from the National Institutes of Health, the Diamond Family Foundation, and an Elizabeth Nash memorial fellowship from Cystic Fibrosis Research, Inc. A part of the NIH funds was administered by the Northern California Institute for Research and Education. NCIRE is the largest research institute associated with a VA medical center. Its mission is to improve the health and well-being of veterans and the general public by supporting a world-class biomedical research program conducted by the UCSF faculty at SFVAMC. SFVAMC has the largest medical research program in the national VA system, with more than 200 research scientists, all of whom are faculty members at UCSF. UCSF is a leading university that advances health worldwide by conducting advanced biomedical research, educating graduate students in the life sciences and health professions, and providing complex patient care. Studies Examine Allergies And Contraceptive Use, Maternal Mortality Disparity, Cervical Treatments And Preterm Births, Condom Use Prevalence Main Category: Sexual Health / STDs News Article Date: 09 Jan 2007 - 15:00 PST | email this article | printer friendly | view or write opinions | Article Also Appears In AllergyPregnancyWomen's Health / OBGYN Useful Article? Digg It Del.icio.us NewsVine Reddit The following highlights recently released journal articles on women's health issues. Pregnancy & Childbirth "Does the Pill Make a Difference? Previous Maternal Use of Contraceptive Pills and Allergic Diseases Among Offspring," Allergy: Leea Keski-Nisula of Kuopio University and colleagues compared 618 asthmatic children ages five to six with 564 children in the same age group who were not asthmatic to determine if the mother's use of oral contraception increased the likelihood of the children having allergic rhinitis, or nasal allergy, Reuters Health reports. The study found that children whose mothers used oral contraceptives within one year of becoming pregnant were 67% more likely to have nasal allergies than the children whose mothers did not use oral contraceptives. The association was common in families where the parents had allergies and was strongest among boys, the study found. Researchers found no association between oral contraceptive use and the likelihood of the pregnant woman's child having asthma or eczema. The researchers wrote that the results are "tentative and possibly provocative," and they suggest that an allergy study of oral contraceptives might be valuable (Reuters Health, 12/29/06). "The Black-White Disparity in Pregnancy-Related Mortality From Five Conditions: Differences in Prevalence and Case-Fatality Rates," American Journal of Public Health: Myra Tucker, a physician at CDC, and colleagues looked at data collected between 1988 and 1999 collected from the National Hospital Discharge Survey and from the Pregnancy Mortality Surveillance System. Researchers calculated prevalence and case-related fatality rates for preeclampsia, eclampsia, abruptio placentae, placenta previa and postpartum hemorrhage -- which together account for 26% of all pregnancy-related deaths. The study found that the fatality rate among black women with the conditions were two to three times higher than that of white women (United Press International, 12/29/06). For every 100,000 women who developed preeclampsia, about 27 white women died, compared with about 73 black women, according to the study. For every 100,000 women who develop postpartum hemorrhage, 21 white women died, compared with 68 black women. Researchers concluded that a "complex interaction of biological and health services factors must be untangled" in order to determine reasons behind the disparity in pregnancy-related deaths (Reuters Health, 12/29/06). "Precancerous Changes in the Cervix and Risk of Subsequent Preterm Birth," BJOG: An International Journal of Obstetrics & Gynaecology: Researchers from Melbourne University and Royal Women's Hospital in Australia looked at the records of about 5,000 women who had undergone treatments to remove precancerous cells between 1982 and 2000. The researchers compared four common treatments of the cervix: loop excision, where an electrical current is passed around a wire in order to remove a tissue sample; cone biopsy, where tissue is removed with a cone-shaped blade; diathermy, where an electrical current is used directly on the tissue; and laser ablation, where the tissue is destroyed by a laser beam (Kirby, Press Association/Daily Mail, 1/2). The study found that all the treatments except laser ablation were associated with an increased of preterm birth later in life (Ricks, Long Island Newsday, 1/4). The study also found that both treated and untreated women who had precancerous cells were at increased risk of preterm birth, compared with women who did not have precancerous cells, which suggests that treatment was not the only risk factor. The authors write, "While we acknowledge that there are clinical scenarios where excisional treatment is necessary, we believe that treatment programs that have adopted a 'see and treat' policy for the management of abnormal Pap smears need to be re-evaluated in the light of these findings ... Furthermore, the use of precise ablative techniques such as laser ablation need revisiting" (Press Association/Daily Mail, 1/2). Public Health "Who Uses Condoms With Whom? Evidence From National Probability Sample Surveys," Sexually Transmitted Infections: Jackie Cassell of the University of Brighton and colleagues studied trends in condom use using data of 13,765 British residents ages 16 to 44 surveyed in 1990 and 11,161 similarly aged individuals surveyed in 2000. According to the study, about 82% of sexually active men ages 16 to 24 surveyed in 2000 said they used condoms, compared with 61% of such men in 1990. Condom use among women in the same age group increased from 42% in 1990 to more than 63% in 2000, the study found (Rauscher, Reuters Health, 1/3). Among people reporting at least two partners in the previous four weeks, 63.1% of the men and 68.5% of the women reported inconsistent or no condom use (Cassell et al., Sexually Transmitted Infections, 12/1/06). The data also suggested that younger people are more likely to report using condoms in part to prevent transmission of STIs, including HIV, researchers said (Reuters Health, 1/3). "Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved Offers DHQ hospital faisalabad with a product or service that delivers doctors association and education association. You will want to find out more information.