WorldWideScience

Sample records for al hospital central

  1. Does Al Qaeda Central Still Matter?

    Directory of Open Access Journals (Sweden)

    Kangil Lee

    2015-01-01

    Full Text Available El artículo discute si Al Qaeda central es todavía relevante o no. Tras estudiar la actividades de Al Qaeda central cuyo objetivo es provocar la violencia en Afganistán y Pakistán, así como los planes continuos de ataques directos contra los Estados Unidos, el artículo muestra que la capacidad operativa de Al Qaeda es más sólida y fuerte que la que Estados Unidos y otros investigadores y eruditos han anticipado. Además, el apoyo virulento y la contribución Al Qaeda en la Península Arábiga a la red de Al Qaeda muestra que la longevidad de Al Qaeda depende de la relación con sus afiliados. El artículo concluye que, en estas condiciones, Al Qaeda central todavía ocupa un lugar en las discusiones de seguridad global.

  2. Lineamientos de un plan estratégico para el mejoramiento de la calidad del servicio brindado en el Hospital Militar Central de Lima

    OpenAIRE

    Cabrera Rioja, Luis Alberto

    2007-01-01

    El presente estudio, realizado en el Hospital Militar Central (HMC) de Lima, está dirigido al diseño de los lineamientos de un plan estratégico que permita formular la misión y visión del HMC, analizar el entorno e intorno organizacional y formular objetivos estratégicos orientados al mejoramiento continuo de la calidad del servicio. A fin de superar las dificultades económicas, logísticas y de personal que afronta actualmente el Hospital Militar Central, debido a los recortes presupuestales ...

  3. Prevalencia de displasia y cáncer cervicouterino y factores asociados en el Hospital Central de Chihuahua, México

    OpenAIRE

    Ivonne Salas-Urrutia; Eyra Alejandra Villalobos; Brenda Lizeth Ramírez-Vega

    2006-01-01

    Objetivos: Los objetivos del presente estudio fueron determinar la prevalencia y los factores de riesgo asociados a cáncer cervicouterino en; las mujeres que acuden al Hospital Central de Chihuahua en el 2004 ya que no se cuenta registros de esta entidad en la ciudad de Chihuahua.; Material y Métodos: Se realizó un estudio observacional, transversal, donde se incluyó a mujeres que demandaron realizarse la citología; cervical en el Hospital Central del Estado de Chihuahua, en el año 2...

  4. Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. II. - August of 2001; Asesoria especializada en seguridad radiologica al hospital central norte de alta especialidad, PEMEX II.- Agosto de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Rodriguez A, F.; Garcia A, J

    2001-10-15

    The north central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)0.

  5. Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. I. - July of 2001; Asesoria especializada en seguridad radiologica al hospital central norte de alta especialidad, PEMEX I.- Julio de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A

    2001-09-15

    The north central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  6. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. I. - July of 2001; Asesoria especializada en seguridad radiologica al hospital central sur de alta especialidad, PEMEX I.- Julio de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J

    2001-09-15

    The south central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  7. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. II.- August of 2001; Asesoria especializada en seguridad radiologica al hospital central sur de alta especialidad, PEMEX II.- Agosto de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Rodriguez A, F.; Garcia A, J

    2001-12-15

    The south central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  8. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. III.- September of 2001; Asesoria especializada en seguridad radiologica al hospital central sur de alta especialidad, PEMEX III.- Septiembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Rodriguez A, F.; Garcia A, J

    2001-12-15

    The south central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  9. Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. III. - September of 2001; Asesoria especializada en seguridad radiologica al hospital central norte de alta especialidad, PEMEX III.- Septiembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A; Vizuet G, J; Benitez S, J A; Rodriguez A, F; Garcia A, J

    2001-12-15

    The north central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  10. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. V. - November of 2001; Asesoria especializada en seguridad radiologica al hospital central sur de alta especialidad, PEMEX. V.- Noviembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A; Vizuet G, J; Benitez S, J A; Garcia A, J; Rodriguez A, F

    2002-01-15

    The south central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Autho000.

  11. Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. I. - May-June of 2003; Asesoria especializada en seguridad radiologica al hospital central norte de alta especialidad, PEMEX I.- Mayo-Junio de 2003

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Camacho V, B.; Rodriguez A, F

    2003-09-15

    The north central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  12. Impact of nationwide centralization of pancreaticoduodenectomy on hospital mortality

    NARCIS (Netherlands)

    de Wilde, R. F.; Besselink, M. G. H.; van der Tweel, I.; de Hingh, I. H. J. T.; van Eijck, C. H. J.; Dejong, C. H. C.; Porte, R. J.; Gouma, D. J.; Busch, O. R. C.; Molenaar, I. Q.

    Background: The impact of nationwide centralization of pancreaticoduodenectomy (PD) on mortality is largely unknown. The aim of this study was to analyse changes in hospital volumes and in-hospital mortality after PD in the Netherlands between 2004 and 2009. Methods: Nationwide data on International

  13. Impact of nationwide centralization of pancreaticoduodenectomy on hospital mortality

    NARCIS (Netherlands)

    de Wilde, R. F.; Besselink, M. G. H.; van der Tweel, I.; de Hingh, I. H. J. T.; van Eijck, C. H. J.; Dejong, C. H. C.; Porte, R. J.; Gouma, D. J.; Busch, O. R. C.; Molenaar, I. Q.

    2012-01-01

    Background: The impact of nationwide centralization of pancreaticoduodenectomy (PD) on mortality is largely unknown. The aim of this study was to analyse changes in hospital volumes and in-hospital mortality after PD in the Netherlands between 2004 and 2009. Methods: Nationwide data on International

  14. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. IV. - October of 2001; Asesoria especializada en seguridad radiologica a la clinica al hospital central sur de alta especialidad, PEMEX. IV.- Octubre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F

    2002-01-15

    The south central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  15. Violence Directed towards Nurses Working at Al-Medina Hospitals

    Directory of Open Access Journals (Sweden)

    Amar Alsheri

    2017-07-01

    Full Text Available Background: According to the recent studies, violence in health care is growing and it excessively affects the retention and recruitment of nurses. It also affects burnout levels and sick leave. Aims: To determine the physical and verbal abuse violence prevalence against nurses in Al-Medina hospitals. Methods: This a descriptive cross sectional study which was conducted in three community hospitals in Saudi Arabia in 2011 using a random sample of 288 nurses. Results: The prevalence of physical violence among the population of the study was 26%. Verbal abuse prevalence was 23.3%. Patients/clients were the major perpetrators of the violence (76.0% followed by patient’s family member(s (24.0%. Whereas 92.0% mentioned that the violence action was preventable. Gender was correlated significantly with verbal abuse violence. Conclusion: Our study manifested that the prevalence of physical violence and verbal abuse among nurses at Al-Medina hospitals was high.

  16. Evaluation of medical consultation letters at King Fahd Hospital, Al ...

    African Journals Online (AJOL)

    Evaluation of medical consultation letters at King Fahd Hospital, Al Hufuf, Saudi Arabia. Hamed Abd Allah Al Wadaani, Magdy Hassan Balaha. Abstract. Background: In surgical wards, it is of paramount importance to communicate with other health care providers, mostly physicians, referring patients to them for their ...

  17. Sympathetic dysfunction of central origin in patients with ALS

    DEFF Research Database (Denmark)

    Karlsborg, M; Andersen, E B; Wiinberg, N

    2003-01-01

    Amyotrophic lateral sclerosis (ALS) is a severe, progressive disease affecting both the central and peripheral parts of the motor nervous system. Some studies have shown unequivocal indications of a more disseminated disease also affecting the autonomic nervous system. We therefore evaluated...

  18. Bootstrapping data envelopment analysis of efficiency and productivity of county public hospitals in Eastern, Central, and Western China after the public hospital reform.

    Science.gov (United States)

    Wang, Man-Li; Fang, Hai-Qing; Tao, Hong-Bing; Cheng, Zhao-Hui; Lin, Xiao-Jun; Cai, Miao; Xu, Chang; Jiang, Shuai

    2017-10-01

    China implemented the public hospital reform in 2012. This study utilized bootstrapping data envelopment analysis (DEA) to evaluate the technical efficiency (TE) and productivity of county public hospitals in Eastern, Central, and Western China after the 2012 public hospital reform. Data from 127 county public hospitals (39, 45, and 43 in Eastern, Central, and Western China, respectively) were collected during 2012-2015. Changes of TE and productivity over time were estimated by bootstrapping DEA and bootstrapping Malmquist. The disparities in TE and productivity among public hospitals in the three regions of China were compared by Kruskal-Wallis H test and Mann-Whitney U test. The average bias-corrected TE values for the four-year period were 0.6442, 0.5785, 0.6099, and 0.6094 in Eastern, Central, and Western China, and the entire country respectively, with average non-technical efficiency, low pure technical efficiency (PTE), and high scale efficiency found. Productivity increased by 8.12%, 0.25%, 12.11%, and 11.58% in China and its three regions during 2012-2015, and such increase in productivity resulted from progressive technological changes by 16.42%, 6.32%, 21.08%, and 21.42%, respectively. The TE and PTE of the county hospitals significantly differed among the three regions of China. Eastern and Western China showed significantly higher TE and PTE than Central China. More than 60% of county public hospitals in China and its three areas operated at decreasing return scales. There was a considerable space for TE improvement in county hospitals in China and its three regions. During 2012-2015, the hospitals experienced progressive productivity; however, the PTE changed adversely. Moreover, Central China continuously achieved a significantly lower efficiency score than Eastern and Western China. Decision makers and administrators in China should identify the causes of the observed inefficiencies and take appropriate measures to increase the efficiency of county

  19. Endometrial pathology in a teaching hospital in North Central ...

    African Journals Online (AJOL)

    The study was a 5 year histopathological survey of endometrial biopsies seen at the University of Ilorin Teaching Hospital , Ilorin, North Central Nigeria from January 1st 1997 to December 31st 2001. It aimed at identifying the morphological patterns of endometrial disorders, prevalence of these disorders and the ...

  20. An integrated outsourcing solution at York Central Hospital.

    Science.gov (United States)

    Marr, Jo-Anne; Tam, Richard; Simms, Stephen; Bacchus, Feria

    2011-01-01

    Canadian hospitals struggle to balance the need to increase and improve operational services and quality with diminishing resources. Many realize that sustaining their organization depends on how well they focus their resources and talents on their core business, clinical care delivery. Outsourcing of non-core, non-clinical support services is a solution for many organizations. Most often, this is put into action one service provider at a time. In 2007, however, York Central Hospital (YCH) implemented Sodexo's integrated Comprehensive Service Solutions (CSS) for all its support service functions. In doing so, YCH achieved significant improvements in patient and staff satisfaction rates, substantial cost savings through improved operational efficiency from process improvements and leveraging technology investments, and increased retail food revenue.

  1. Prevalence of Neonatal Jaundice on Central Hospital, Warri, Delta ...

    African Journals Online (AJOL)

    Methods: 272 babies (aged 1 – 30 days) the Neonatal Clinic of the Department of Child Health, Central Hospital, Warri, Delta State between June 2009 and June 2010 were examined daily for evidence of jaundice. Those with serum bilirubin ³15mg/100ml were subjected to additional clinical and laboratory investigations to ...

  2. Central radiological department of the Jahn Ferenc hospital and medical center

    Energy Technology Data Exchange (ETDEWEB)

    Erdelyi, M Jr [Jahn Ferenc Korhaz-Rendeloeintezet, Budapest (Hungary). Koezponti Radiologia

    1982-01-01

    The design, organisation and functioning of the central X-ray diagnostical unit of the new hospital, inaugurated in December 1980 are reviewed. The experiences of the shortcomings of the planning are summerized, too.

  3. Diabetic retinopathy at the Yaoundé Central Hospital in Cameroon ...

    African Journals Online (AJOL)

    We carried out a cross-sectional analytical survey using data from patients who had done Fluorescein Angiography at the Yaounde Central Hospital Diabetic Retinopathy Prevention and Management Project between October 2007 and January 2010 to identify the risk factors, incidence and severity of different types of ...

  4. Circumstances surrounding death and nursing difficulties with end-of-life care for individuals with ALS in central Japan.

    Science.gov (United States)

    Ushikubo, Mitsuko; Okamoto, Koichi

    2012-11-01

    This study aimed to clarify the circumstances surrounding death for people with amyotrophic lateral sclerosis (ALS) in Japan and difficulties in providing home-care end-of-life nursing for these individuals. A questionnaire was mailed to the directors of 709 home-care nursing agencies located in central Japan. Of 232 questionnaires returned (response rate 32.8%), 49 reported treating someone with ALS. Overall, 31% of these patients died at home, whereas 63% were admitted to hospital from a few days to months preceding death. Respiratory insufficiency was identified as the cause of death in 73% of cases, 45% of the deaths were sudden, and 27% of the deaths involved CO2 narcosis. Analysis of the reported nursing difficulties resulted in five categories: lack of adaptation to the disease or disease progression by the patient and/or their family, involvement with family, how to select/deliver care, decision-making and communication, and poor collaboration with other practitioners. Family care and family education are important to supporting the end-of-life process for people with ALS. Use of advance directives and collaboration with other related practitioners are recommended to enhance communication linked to psychological care and informed consent.

  5. Preliminary report on theNeurology workload ina central hospital in ...

    African Journals Online (AJOL)

    Introduction: Identification of the local pattern of neurological diseases is expected to help setting the priorities for good planning of management and public education. Objectives: To identify the pattern of neurological disorders in a second biggest central hospital in Sudan. Methodology: Review of the diagnosis of 170 ...

  6. Inadequate ventilation for nosocomial tuberculosis prevention in public hospitals in Central Thailand.

    Science.gov (United States)

    Jiamjarasrangsi, W; Bualert, S; Chongthaleong, A; Chaindamporn, A; Udomsantisuk, N; Euasamarnjit, W

    2009-04-01

    Forty-two community and general hospitals in central Thailand. To examine the adequacy of indoor ventilation for nosocomial tuberculosis (TB) prevention in public hospitals in central Thailand. A cross-sectional survey was conducted among 323 patient care and ancillary areas in the target hospitals. Data on indoor ventilation rate were collected by the tracer gas method and reported as air changes per hour (ACH). The adequacy of the measured ventilation rates were then determined by comparison with the international recommended standard values. Indoor ventilation rates were inadequate in almost half of the studied areas (144/323, 44.6%). The inadequacy was particularly serious in the emergency rooms (ERs) and radiological areas, where 73.8% (31/42 each) of the rooms had ACH below the recommended standards. Detailed analysis showed that most of the rooms with natural ventilation had air exchange rates that exceeded the recommended standards, while the opposite was the case for rooms with air-conditioning, particularly the window or wall-mount type. Indoor ventilation in high-risk nosocomial TB areas in public hospitals in Thailand was inadequate due to the installation of air-conditioning systems in modern buildings.

  7. Decentralization and centralization of healthcare resources: investigating the associations of hospital competition and number of cardiologists per hospital with mortality and resource utilization in Japan.

    Science.gov (United States)

    Park, Sungchul; Lee, Jason; Ikai, Hiroshi; Otsubo, Tetsuya; Imanaka, Yuichi

    2013-11-01

    To investigate the associations of hospital competition and number of cardiologists per hospital (indicating the decentralization and centralization of healthcare resources, respectively) with 30-day in-hospital mortality, healthcare spending, and length of stay (LOS) among patients with acute myocardial infarction (AMI) in Japan. We collected data from 23,197 AMI patients admitted to 172 hospitals between 2008 and 2011. Hospital competition and number of cardiologists per hospital were analyzed as exposure variables in multilevel regression models for in-hospital mortality, healthcare spending, and LOS. Other covariates included patient, hospital, and regional variables; as well as the use of percutaneous coronary intervention (PCI). Hospitals in competitive regions and hospitals with a higher number of cardiologists were both associated lower in-hospital mortality. Additionally, hospitals in competition regions were also associated with longer LOS durations, whereas hospitals with more cardiologists had higher spending. The use of PCI was also associated with reduced mortality, increased spending and increased LOS. Centralization of cardiologists at the hospital level and decentralization of acute hospitals at the regional level may be contributing factors for improving the quality of care in Japan. Policymakers need to strike a balance between these two approaches to improve healthcare provision and quality. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  8. Granuloma central de células gigantes Giant cells central granuloma

    Directory of Open Access Journals (Sweden)

    Ayelén María Portelles Massó

    2011-03-01

    Full Text Available El granuloma reparativo central de células gigantes es una lesión proliferativa no neoplásica de etiología desconocida. Se presenta un paciente masculino de 40 años de edad, portador de prótesis parcial superior. Fue remitido al Servicio de Cirugía Maxilofacial del Hospital "V. I. Lenin" por presentar aumento de volumen en reborde alveolar superior, de color rojo grisáceo y que provocaba expansión de corticales óseas. Una vez analizados los exámenes clínicos, radiográficos e histopatológicos se diagnosticó un granuloma reparativo central de células gigantes Se realizó exéresis quirúrgica de la lesión y extracción de dientes adyacentes con una evolución satisfactoria sin señales de recidivas luego de tres años del tratamiento. El granuloma reparativo central de células gigantes se presentó como respuesta a un trauma. La correcta interpretación de los datos clínicos, radiográficos e histopatológicos nos permitió llegar al correcto diagnóstico y plan de tratamiento.Giant-cell central reparative granuloma is non neoplastic proliferative lesion of unknown etiology. We report a 40 years old male patient who was admitted at the Maxillofacial Service of the "V. I. Lenin" Hospital. The patient had partial upper prosthesis and was complaining of red-grey volume increase lesion in upper alveolar ridge which led to the expansion of cortical bone. Having analyzed clinical, radiographic and histopathological findings the case was concluded as a giant-cell central reparative granuloma. Surgical exeresis and adjunct tooth extraction were done. After three years of treatment, satisfactory follow up without recurrence is reported.

  9. Leukaemia at Queen Elizabeth Central Hospital in Blantyre, Malawi.

    Science.gov (United States)

    Mukiibi, J M; Nyirenda, C M; Adewuyi, J O; Mzula, E L; Magombo, E D; Mbvundula, E M

    2001-07-01

    To determine the patterns of leukaemias seen in Malawians at Queen Elizabeth Central Hospital (QECH) and to compare the findings with those from elsewhere. An overview of the problems encountered in the management of leukaemia in developing countries especially those in sub-Saharan Africa are highlighted. Retrospective descriptive analysis of consecutive leukaemia cases seen from January 1994 through December 1998. Of the 95 leukaemia patients diagnosed during the study period, childhood (0-15 years) leukaemia occurred in 27 (28.4%) patients while adulthood (above 15 years) leukaemia accounted for 68 (71.6%) patients. The main leukaemia types were: acute lymphoblastic leukaemia (ALL) 14 (14.7%), acute myeloblastic leukaemia (AML) 25 (26.3%), chronic myeloid (granulocytic) leukaemia (CML) 32 (33.7%), chronic lymphocytic (lymphatic) leukaemia (CLL) 22 (23.2%) and hairy cell leukaemia (HCL) two (2.1%) patients. Most of the acute leukaemia (AL) cases occurred in the six to 15 year age bracket with a male preponderance. In ALL, lymphadenopathy was the commonest presenting feature followed by pallor (92.9%) while in the AML group, pallor occurred in 80% of cases. Abdominal swelling (87.5%) due to splenomegaly (81.3%) were the main clinical features in the CML group whereas lymphadenopathy (63.6%) followed by splenomegaly (59.1%) were the dominant presenting features in CLL. Haematologically, although leucocytosis characterised both acute and chronic leukaemias, most cases of acute leukaemia presented with more severe anaemia (Hb charitable organisations.

  10. A 54 year analysis of articles from Mpilo Central Hospital, Bulawayo ...

    African Journals Online (AJOL)

    PubMed and Google Scholar were searched to obtain articles originating from Mpilo Central Hospital, Bulawayo, Zimbabwe - 1958 to August 2011 (54 years). 168 articles cited 999 times were retrieved giving about 6 citations per article. Analysis of publication trends over time as well as publication avenues is made.

  11. Specialized consulting in radiological safety to the North Central Hospital of high specialty, PEMEX. V. November of 2001; Asesoria especializada en seguridad radiologica al Hospital Central Norte de alta especialidad, PEMEX. V. Noviembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F. [ININ, 52045 Ocoyoacac, Estado de Mexico (Mexico)

    2002-01-15

    It is a report of a specialized consulting in radiological safety that to be carried the ININ to PEMEX for the North Central Hospital of High Specialty, to maintain the sanitary license for the use of X ray equipment of medical diagnostic, and guarantee these services with a program of quality assurance. To give fulfilment to that requests it is programmed a technical assistance monthly, with reports of results during the development of the service. In this document it is carried a report of the advances and results in the month of November of the 2001, where the following documents are analyzed: Manual of radiological safety, program of quality assurance, operation procedures, procedure of maintenance team, procedure of medical radiological control of the specialized personnel; also are annotate the obtained results and their observations. (Author)

  12. Specialized consulting in radiological safety to the south central hospital of high specialty, PEMEX. VI. December of 2001; Asesoria especializada en seguridad radiologica al hospital central sur de alta especialidad. PEMEX. VI. Diciembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J.A.; Garcia A, J.; Rodriguez A, F. [ININ, 52045 Ocoyoacac, Estado de Mexico (Mexico)

    2002-01-15

    It is a report of a specialized consulting in radiological safety that to be carried the ININ to PEMEX for the South Central Hospital of High Specialty, to maintain the sanitary license for the use of X-ray equipment of medical diagnostic, and guarantee these services with a program of quality assurance. To give fulfilment to that requests it is programmed a technical assistance monthly, with reports of results during the development of the service. In this document it is carried a report of the advances and results in the month of december of the 2001, where the following documents are analyzed: Manual of radiological safety, program of quality assurance, operation procedures, procedure of maintenance team, procedure of medical radiological control of the specialized personnel; also are annotate the obtained results and their observations. (Author)

  13. Risk Assessment of Physical Health Hazards in Al-Azhar University Hospital in New Damietta, Egypt

    OpenAIRE

    Mohammed El-Hady Imam*, Raed Mohammed Alazab**,

    2013-01-01

    Introduction: Personnel working in hospitals are exposed to many occupational hazards that may threaten their health and safety. Physical hazards that are encountered in hospital working environment include temperature, illumination, noise, electrical injuries, and radiation. Objectives: The objectives of this study were to identify physical health hazards in all departments of Al-Azhar University Hospital in new Damietta, to measure risk level of these hazards, and to recognize safety me...

  14. The relationship of centralization, organizational culture and performance indexes in teaching hospitals affiliated to Tehran University of Medical Sciences.

    Science.gov (United States)

    Nasirpour, Amir Ashkan; Gohari, Mahmoud Reza; Moradi, Saied

    2010-01-01

    One of the main problems in the efficiency and efficacy of an organization is its structural issue. Organizational culture is also considered as an effective factor in the performance of many organizations. The main goal of the present study was to determine the relationship of Centralization and organizational culture and performance indexes in Teaching Hospitals affiliated to Tehran University of Medical Sciences. This correlation study was performed in the year 2007. The population studied consisted of 4408 personnel from 13 hospitals among whom 441 subjects were selected and studied via a class sampling method. Data was compiled using a check list concerning the evaluation status of Centralization and another form concerning performance indexes as well as Robbin's organizational culture questionnaire. Data were obtained from the subjects by self answering and analyzed by using descriptive statistical indexes, T- test and Fisher's exact tests. Among the organizational culture indexes of the hospitals studied, control and organizational identity was better as compared to others (mean=3.32 and 3.30). Concerning the extent of Centralization in the hospitals studied, 53.85 % and 46.15 % were reported to have upper and lower organizational Centralization, respectively. Mean ratio of surgical operations to inpatients was 40%, the mean rate of admissions per active bed was 60.83, mean bed occupancy coefficient was 70.79%, average length of stay was 6.96 days, and mean net death rate was 1.41%. No significant correlation was seen between Centralization degree, organizational culture and performance indexes in teaching hospitals Tehran university of medical sciences. (with 95% confidence interval). Due to the fact that first grade Teaching hospitals use board certified members, expert personnel, and advanced equipments and because of the limitation of patients choice and, the extent of Centralization and many organizational culture components have no significant

  15. Development of personnel radiation monitoring program for occupationally exposed workers in Malawian Hospitals : A case study of Kamuzu Central, Bwaila and Mtengo Wa Nthenga Hospitals

    International Nuclear Information System (INIS)

    Chinangwa, Getrude

    2016-07-01

    Malawi became an IAEA member state in 2006 and developed the Atomic Energy Act and Regulations in 2011 and 2012 respectively. However, regulatory authority and personnel monitoring services have not yet been established. As such, hospitals operating radiological services in Malawi do not have personnel monitoring programme. This study aimed at developing the personnel radiation monitoring program for three hospitals in Malawi namely; Kamuzu Central Hospital, Bwaila Hospital, and Mtengo wa Nthenga Hospital. A radiation protection questionnaire was administered to the X-ray Departments involved in the study to investigate radiation protection practices in the hospitals. Dose rate measurements in the facilities were taken using survey meters and doses to individuals were recorded using personal dosimeters. The results showed that the hospitals lack radiation protection program which covers the critical issues of quality assurance and control as well as the personnel dose monitoring. Average ambient dose rate values were 0.39 μSv/hr for Mtengo wa Nthenga Hospital, 5.03 μSv/hr for Bwaila Hospital and 4μSv/hr for Kamuzu Central Hospital. Average monthly dose for workers was 0.247 mSv. The study recommends the establishment of a regulatory authority, consistent dose assessment, quality control tests and structural shielding assessment in these and probably all the diagnostic facilities in Malawi. The personnel monitoring programme developed from this study is intended to guide diagnostic facilities and personnel monitoring service providers in Malawi in tracking and reporting exposure record for their occupationally exposed workers. (au)

  16. SWITCH: Al Wakra Hospital Journey to 90% Hand Hygiene Practice Compliance, 2011 – 2015

    Science.gov (United States)

    Visan, Feah Altura -; Zakaria, Almunzer; Castro, Jenalyn; Alhasanat, Omar; Ismail, Khalil Al; Ansari, Naser Al; Hamed, Manal

    2017-01-01

    Hand Hygiene is the cheapest and simplest way to prevent the spread of infection, however international compliance is below than 40% (WHO, 2009). In the experience of Al Wakra Hospital, the improvement in hand hygiene compliance highlighted not just interventions towards training and education but also behavioral motivation and physical allocations of hand hygiene appliances and equipment. Through motivating the behavioral, emotional, physical and intellectual dimensions of the different healthcare worker professions, hand hygiene compliance has increased from 60.78% in 2011 to 94.14% by the end of December 2015. It took 25 months of continuous and collaborative work with different healthcare workers to reach the 90% hand hygiene target. “Together, we have reached our goals and together we fight against infections! Because we always strive for excellence in everything we do – that is our vision here in Al Wakra Hospital.” PMID:28469905

  17. Parenteral Opioid Analgesics Utilization Pattern in Amir-al-Momenin Hospital, Zabol-IRAN

    Directory of Open Access Journals (Sweden)

    Hossein Vatanpour

    2016-08-01

    Full Text Available Opioids are the most available medicines to get rid of any general severe pain and avoiding of any deleterious sequential that can worsen patient outcomes. Rational prescription of opioid analgesics with respect to the possibility of abuse is a big concern in the medical care costs. Zabol, where is located in eastern part of Iran and has common border with Afghanistanhas the most opioid traffic in the region. In this study the rational prescription of parenteral opioid in Amir-al-Momenin general hospital was investigated. A retrospective drug utilization review was performed on 509 in-patients who received parenteral opioids including Morphine, Pethidin, Pentazocin, Fentanyl, Alfentanil, Sufentanil and Methadone from March 21sttoSeptember 23rd, 2011. Multivariate conditional regression modeling was used to determine independent predictors for daily parenteral opioid consumption. Total daily parenteral opioid consumption was 38.63 DDDs/100bed-days for Morphine, Pethidine and Pentazocin and 84564.78 PFEQs/100bed-days for Fentanyl, Alfentanil and Sufentanil and 766 mg for Methadone. Pethidine was the most frequently prescribed parenteral opioid. Most patients who were prescribed by the intramuscular routes, ordered PRN. Daily parenteral opioid consumption was the highest in the emergency ward whereas it was considered as the lowest in the intensive care unit[ICU]. According to our findings, total daily parenteral opioid consumption was almost high in Amir-al-Momenin Hospital. Unlike to some relevant factors that can effect on the consumption of analgesic opioids like gender, age, drug-drug interaction and etc, we found no rational prescription and consumption in the mentioned hospital.

  18. Propuesta de implementación de una guía de procedimientos para mejorar la eficiencia en los procesos de la Central de Esterilización del Hospital "Dr. Teodoro Maldonado Carbo" de la ciudad de Guayaquil.

    OpenAIRE

    Payez Freire, Eva Cristina

    2015-01-01

    La presente investigación se desarrolló en la central de esterilización del Hospital Teodoro Maldonado Carbo de la ciudad de Guayaquil, perteneciente al Instituto Ecuatoriano de Seguridad Social, con la finalidad de evaluar el nivel de aplicación de los procedimientos obligatorios de esterilización y su relación con el nivel de eficiencia en los resultados obtenidos. Para el logro de los objetivos planteados se desarrolló una investigación de campo aplicando encuestas y entrevistas al...

  19. Tri-Lateral Noor al Salaam High Concentration Solar Central Receiver Program

    Energy Technology Data Exchange (ETDEWEB)

    Blackmon, James B

    2008-03-31

    This report documents the efforts conducted primarily under the Noor al Salaam (“Light of Peace”) program under DOE GRANT NUMBER DE-FC36-02GO12030, together with relevant technical results from a closely related technology development effort, the U.S./Israel Science and Technology Foundation (USISTF) High Concentration Solar Central Receiver program. These efforts involved preliminary design, development, and test of selected prototype power production subsystems and documentation of an initial version of the system definition for a high concentration solar hybrid/gas electrical power plant to be built in Zaafarana, Egypt as a first step in planned commercialization. A major part of the planned work was halted in 2007 with an amendment in October 2007 requiring that we complete the technical effort by December 31, 2007 and provide a final report to DOE within the following 90 days. This document summarizes the work conducted. The USISTF program was a 50/50 cost-shared program supported by the Department of Commerce through the U.S./Israel Science and Technology Commission (USISTC). The USISTC was cooperatively developed by President Clinton and the late Prime Minister Rabin of Israel "to encourage technological collaboration" and "support peace in the Middle East through economic development". The program was conducted as a follow-on effort to Israel's Magnet/CONSOLAR Program, which was an advanced development effort to design, fabricate, and test a solar central receiver and secondary optics for a "beam down" central receiver concept. The status of these hardware development programs is reviewed, since they form the basis for the Noor al Salaam program. Descriptions are provided of the integrated system and the major subsystems, including the heliostat, the high temperature air receiver, the power conversion unit, tower and tower reflector, compound parabolic concentrator, and the master control system. One objective of the USISTF program was to conduct

  20. Hospital network performance: a survey of hospital stakeholders' perspectives.

    Science.gov (United States)

    Bravi, F; Gibertoni, D; Marcon, A; Sicotte, C; Minvielle, E; Rucci, P; Angelastro, A; Carradori, T; Fantini, M P

    2013-02-01

    Hospital networks are an emerging organizational form designed to face the new challenges of public health systems. Although the benefits introduced by network models in terms of rationalization of resources are known, evidence about stakeholders' perspectives on hospital network performance from the literature is scanty. Using the Competing Values Framework of organizational effectiveness and its subsequent adaptation by Minvielle et al., we conducted in 2009 a survey in five hospitals of an Italian network for oncological care to examine and compare the views on hospital network performance of internal stakeholders (physicians, nurses and the administrative staff). 329 questionnaires exploring stakeholders' perspectives were completed, with a response rate of 65.8%. Using exploratory factor analysis of the 66 items of the questionnaire, we identified 4 factors, i.e. Centrality of relationships, Quality of care, Attractiveness/Reputation and Staff empowerment and Protection of workers' rights. 42 items were retained in the analysis. Factor scores proved to be high (mean score>8 on a 10-item scale), except for Attractiveness/Reputation (mean score 6.79), indicating that stakeholders attach a higher importance to relational and health care aspects. Comparison of factor scores among stakeholders did not reveal significant differences, suggesting a broadly shared view on hospital network performance. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  1. Clinical risk management in hospitals: strategy, central coordination and dialogue as key enablers.

    Science.gov (United States)

    Briner, Matthias; Manser, Tanja; Kessler, Oliver

    2013-04-01

    The study aims to identify key enablers fostering clinical risk management (CRM) in hospitals to guide health care in this vital area of patient safety. A cross-sectional survey was conducted at the national level in 324 Swiss hospitals in 2007-2008 to assess the relationship between key elements and systematic CRM. Therefore, a comprehensive monitoring instrument for CRM was used for the first time. Organizational factors (e.g. strategy, coordination, resources) and structural conditions (e.g. hospital size) were tested as key elements. CRM was assessed by evaluating its maturity (i.e. the level of CRM development) by 12 theoretically derived indices joining together essential aspects of CRM at the hospital level and the service level. Chi-square measures were used to analyse the relationships between organizational factors or structural conditions and maturity of CRM. Participation in this voluntary survey was good, with CRM experts of 138 out of 324 hospitals responding (response rate 43%). Three key enablers for CRM were identified: implementing a function for central CRM coordination, assuring dialogue with and between the different hospital services, and developing strategic CRM objectives. This study offers, for the first time, an assessment of the maturity of hospitals' CRM and identifies key enablers related to CRM. This is a feasible first step in guiding hospitals to shape their CRM and presents a basis for future studies, for example, linking CRM to outcome data. © 2012 Blackwell Publishing Ltd.

  2. An examination of blood center structure and hospital customer satisfaction: what can centralized and decentralized blood centers learn from each other?

    Science.gov (United States)

    Carden, Robert; DelliFraine, Jami L

    2005-01-01

    The cost of blood and blood products has increased rapidly over the last several years while the supply of available blood donors has simultaneously decreased. Higher blood costs and donor shortages have put a strain on the relationship between blood suppliers and their hospital customers. This study examines the association between blood center centralization or decentralization and several aspects of hospital satisfaction. Centralized and decentralized blood centers have significant differences in various aspects of hospital customer satisfaction. Advantages and disadvantages of the two structures are discussed, as well as areas for future research.

  3. Two-tier charging in Maputo Central Hospital: costs, revenues and effects on equity of access to hospital services.

    Science.gov (United States)

    McPake, Barbara; Hongoro, Charles; Russo, Giuliano

    2011-06-02

    Special services within public hospitals are becoming increasingly common in low and middle income countries with the stated objective of providing higher comfort services to affluent customers and generating resources for under funded hospitals. In the present study expenditures, outputs and costs are analysed for the Maputo Central Hospital and its Special Clinic with the objective of identifying net resource flows between a system operating two-tier charging, and, ultimately, understanding whether public hospitals can somehow benefit from running Special Clinic operations. A combination of step-down and bottom-up costing strategies were used to calculate recurrent as well as capital expenses, apportion them to identified cost centres and link costs to selected output measures. The results show that cost differences between main hospital and clinic are marked and significant, with the Special Clinic's cost per patient and cost per outpatient visit respectively over four times and over thirteen times their equivalent in the main hospital. While the main hospital cost structure appeared in line with those from similar studies, salary expenditures were found to drive costs in the Special Clinic (73% of total), where capital and drug costs were surprisingly low (2 and 4% respectively). We attributed low capital and drug costs to underestimation by our study owing to difficulties in attributing the use of shared resources and to the Special Clinic's outsourcing policy. The large staff expenditure would be explained by higher physician time commitment, economic rents and subsidies to hospital staff. On the whole it was observed that: (a) the flow of capital and human resources was not fully captured by the financial systems in place and stayed largely unaccounted for; (b) because of the little consideration given to capital costs, the main hospital is more likely to be subsidising its Special Clinic operations, rather than the other way around. We conclude that the

  4. Two-tier charging in Maputo Central Hospital: Costs, revenues and effects on equity of access to hospital services

    Directory of Open Access Journals (Sweden)

    Russo Giuliano

    2011-06-01

    Full Text Available Abstract Background Special services within public hospitals are becoming increasingly common in low and middle income countries with the stated objective of providing higher comfort services to affluent customers and generating resources for under funded hospitals. In the present study expenditures, outputs and costs are analysed for the Maputo Central Hospital and its Special Clinic with the objective of identifying net resource flows between a system operating two-tier charging, and, ultimately, understanding whether public hospitals can somehow benefit from running Special Clinic operations. Methods A combination of step-down and bottom-up costing strategies were used to calculate recurrent as well as capital expenses, apportion them to identified cost centres and link costs to selected output measures. Results The results show that cost differences between main hospital and clinic are marked and significant, with the Special Clinic's cost per patient and cost per outpatient visit respectively over four times and over thirteen times their equivalent in the main hospital. Discussion While the main hospital cost structure appeared in line with those from similar studies, salary expenditures were found to drive costs in the Special Clinic (73% of total, where capital and drug costs were surprisingly low (2 and 4% respectively. We attributed low capital and drug costs to underestimation by our study owing to difficulties in attributing the use of shared resources and to the Special Clinic's outsourcing policy. The large staff expenditure would be explained by higher physician time commitment, economic rents and subsidies to hospital staff. On the whole it was observed that: (a the flow of capital and human resources was not fully captured by the financial systems in place and stayed largely unaccounted for; (b because of the little consideration given to capital costs, the main hospital is more likely to be subsidising its Special Clinic

  5. Riesgos ergonómicos que afecta al trabajo empresarial en el hospital civil de Chone

    OpenAIRE

    Velásquez Giler, César Augusto; Mendoza Cedeño, Álvaro Danny

    2017-01-01

      El presente estudio tiene como objetivo identificar los riesgos ergonómicos que afectan al trabajo empresarial, caso particular Hospital Civil de Chone, para determinar los factores ergonómicos y los índices de bienestar general como factores de riesgo laboral. Se incluyeron para el análisis a 40 profesionales de la salud que realizan atención directa al paciente internado. En cuanto a las técnicas, se hizo uso de la investigación de campo, descriptiva, documental y transversal, par...

  6. Beyond the bundle: a survey of central line-associated bloodstream infection prevention practices used in US and Canadian pediatric hospitals.

    Science.gov (United States)

    Klieger, Sarah B; Potter-Bynoe, Gail; Quach, Caroline; Sandora, Thomas J; Coffin, Susan E

    2013-11-01

    We surveyed US and Canadian pediatric hospitals about their use of central line-associated bloodstream infection (CLABSI) prevention strategies beyond typical insertion and maintenance bundles. We found wide variation in supplemental strategies across hospitals and in their penetration within hospitals. Future studies should assess specific adjunctive prevention strategies and CLABSI rates.

  7. FACTORES ASOCIADOS AL DESARROLLO DE PREECLAMPSIA EN UN HOSPITAL DE PIURA, PERÚ

    OpenAIRE

    Yamalí Benites-Cóndor; Susy Bazán-Ruiz; Danai Valladares-Garrido

    2011-01-01

    Introducción: La Organización Mundial de la Salud indica que diariamente fallecen alrededor de 800 mujeres por causas relacionadas al embarazo y parto, dentro de las cuales la preeclampsia ocupa el tercer lugar. Objetivo: identificar los factores asociados a preeclampsia en gestantes que fueron hospitalizadas en el Hospital de Apoyo II "Santa Rosa" de la ciudad de Piura durante el periodo junio 2010 - mayo 2011. Métodos: Se realizó un estudio descriptivo retrospectivo de casos y controles, e...

  8. The spectrum of central nervous system infections in an adult referral hospital in hanoi, Vietnam

    NARCIS (Netherlands)

    Taylor, Walter R.; Nguyen, Kinh; Nguyen, Duc; Nguyen, Huyen; Horby, Peter; Nguyen, Ha L.; Lien, Trinh; Tran, Giang; Tran, Ninh; Nguyen, Ha M.; Nguyen, Thai; Nguyen, Ha H.; Nguyen, Thanh; Tran, Giap; Farrar, Jeremy; de Jong, Menno; Schultsz, Constance; Tran, Huong; Nguyen, Diep; Vu, Bich; Le, Hoa; Dao, Trinh; Nguyen, Trung; Wertheim, Heiman

    2012-01-01

    To determine prospectively the causative pathogens of central nervous system (CNS) infections in patients admitted to a tertiary referral hospital in Hanoi, Vietnam. From May 2007 to December 2008, cerebrospinal fluid (CSF) samples from 352 adults with suspected meningitis or encephalitis underwent

  9. A multi-criteria assessment of scenarios on thermal processing of infectious hospital wastes: A case study for Central Macedonia

    International Nuclear Information System (INIS)

    Karagiannidis, A.; Papageorgiou, A.; Perkoulidis, G.; Sanida, G.; Samaras, P.

    2010-01-01

    In Greece more than 14,000 tonnes of infectious hospital waste are produced yearly; a significant part of it is still mismanaged. Only one off-site licensed incineration facility for hospital wastes is in operation, with the remaining of the market covered by various hydroclave and autoclave units, whereas numerous problems are still generally encountered regarding waste segregation, collection, transportation and management, as well as often excessive entailed costs. Everyday practices still include dumping the majority of solid hospital waste into household disposal sites and landfills after sterilization, still largely without any preceding recycling and separation steps. Discussed in the present paper are the implemented and future treatment practices of infectious hospital wastes in Central Macedonia; produced quantities are reviewed, actual treatment costs are addressed critically, whereas the overall situation in Greece is discussed. Moreover, thermal treatment processes that could be applied for the treatment of infectious hospital wastes in the region are assessed via the multi-criteria decision method Analytic Hierarchy Process. Furthermore, a sensitivity analysis was performed and the analysis demonstrated that a centralized autoclave or hydroclave plant near Thessaloniki is the best performing option, depending however on the selection and weighing of criteria of the multi-criteria process. Moreover the study found that a common treatment option for the treatment of all infectious hospital wastes produced in the Region of Central Macedonia, could offer cost and environmental benefits. In general the multi-criteria decision method, as well as the conclusions and remarks of this study can be used as a basis for future planning and anticipation of the needs for investments in the area of medical waste management.

  10. We are family? Spanish law and lesbian normalization in Hospital Central.

    Science.gov (United States)

    Calvo, Mónica; Escudero, Maite

    2009-01-01

    After four decades of a repressive dictatorial regime during which homosexuality was banned and punished with prison sentence and electroshock, Spain became a democratic country in 1978. The social, political, and legal debates previous to the passing of the law on same-sex marriage in June 2005 fueled lesbian visibility in the media. Considering that the emergence of lesbian representation has been linked to these social and political changes, our contribution centers on the ways in which the prime time TV series Hospital Central unravels as a vehicle for the normalization of lesbian relationships and families as addressed to a mostly heterosexual audience.

  11. Prescribing Albumin in a Central Hospital. New Standards versus Old Habits

    OpenAIRE

    Pasini, J; Marcelino, P

    2012-01-01

    O presente estudo teve como objectivo aferir a adequação da prescrição de albumina humana num hospital central à evidência científica nesta área actualmente disponível. O estudo foi retrospectivo e analisou os pedidos de albumina aos serviços farmacêuticos entre Setembro de 2007 e Agosto de 2008. Analisadas 761 requisições de 619 doentes com idade média de 58,1 +/- 14,7 anos, 510 (77%) dos quais do sexo masculino. Foram avaliados parâmetros analíticos globais (proteínas totais, album...

  12. Specialized consultant in radiological safety to the clinical north central hospital of high speciality, PEMEX. IV. - December of 2001; Asesoria especializada en seguridad radiologica a la clinica hospital central norte de alta especialidad, PEMEX. IV.- Diciembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F

    2002-01-15

    The clinical north central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  13. Aetiologies of central nervous system infection in Viet Nam: a prospective provincial hospital-based descriptive surveillance study.

    Directory of Open Access Journals (Sweden)

    Nghia Ho Dang Trung

    Full Text Available Infectious diseases of the central nervous system (CNS remain common and life-threatening, especially in developing countries. Knowledge of the aetiological agents responsible for these infections is essential to guide empiric therapy and develop a rational public health policy. To date most data has come from patients admitted to tertiary referral hospitals in Asia and there is limited aetiological data at the provincial hospital level where most patients are seen.We conducted a prospective Provincial Hospital-based descriptive surveillance study in adults and children at thirteen hospitals in central and southern Viet Nam between August 2007-April 2010. The pathogens of CNS infection were confirmed in CSF and blood samples by using classical microbiology, molecular diagnostics and serology.We recruited 1241 patients with clinically suspected infection of the CNS. An aetiological agent was identified in 640/1241 (52% of the patients. The most common pathogens were Streptococcus suis serotype 2 in patients older than 14 years of age (147/617, 24% and Japanese encephalitis virus in patients less than 14 years old (142/624, 23%. Mycobacterium tuberculosis was confirmed in 34/617 (6% adult patients and 11/624 (2% paediatric patients. The acute case fatality rate (CFR during hospital admission was 73/617 (12% in adults and to 42/624 (7% in children.Zoonotic bacterial and viral pathogens are the most common causes of CNS infection in adults and children in Viet Nam.

  14. Depression in chronic respiratory disorders in a tertiary rural hospital of Central India

    Institute of Scientific and Technical Information of China (English)

    Sameer singhal; Pankaj Banode; Nitish Baisakhiya

    2009-01-01

    Objective: To determine prevalence of depression in chronic respiratory disorders in a tertiary rural hospital of Central India. Various studies done in past have shown that prevalence of depression in diabetes and hypertension is around 40%-57%. Few studies have been done to screen depression in chronic respiratory disorders. This study was conducted in a tertiary rural hospital of Central India to find out prevalence of depression in indoor patients suffering from chronic respiratory disorders. Methods: Total 68 patients were evaluated for depression. Patients suffering from chronic respiratory disorders (total duration of illness >3 months) were evaluated using Prime MD Questionnaire. Patients suffering from diabetes, heart diseases, stroke, having past history of psychiatric illness, drug abusers, having lack of social support and suffering from chronic upper respiratory tract infections were excluded from this study. Questionnaire was asked when treatment for acute phase of illness is over. Results: Out of 68 patients evaluated, 36 (53%) were found out to be suffering from depression. Female gender (80%) was more prone to depression, inspite of the fact that all alcoholics were male. 39% of all chronic obstructive pulmonary disease (COPD) patients were suffering from depression in comparison to 65% for pulmonary tuberculosis and 44% for other chronic respiratory illness. 54% of patients suffering from depression are 60 yrs of age, suggesting that age has no relation with depression. No association was seen between alcoholism and depression. Conclusion: Prevalence of depression in patients of chronic respiratory illness is very high, like in cases of diabetes and hypertension. Further community and hospital based studies are needed to find out exact prevalence of depression in chronic respiratory illnesses.

  15. Characteristics and visual outcomes of patients hospitalized for ocular trauma in central China:2006-2011

    Directory of Open Access Journals (Sweden)

    Ying Qi

    2015-05-01

    Full Text Available AIM: To complete the data of ocular trauma in central China, as a well-known tertiary referral center for ocular trauma, we documented the epidemiological characteristics and visual outcomes of patients hospitalized for ocular trauma in this region. METHODS: A retrospective study of patients hospitalized for ocular trauma in central China from 2006 to 2011 was performed. RESULTS: This study included 5964 eyes of 5799 patients. The average age was 35.5±21.8y with a male-to-female ratio of 2.8:1. The most common age was 45-59y age group. Most patients were farmers and workers (51.9%. The most common injuries were firework related (24.5%, road traffic related (24.2%, and work related (15.0%. Among the most common causative agents were firecrackers (24.5%, followed by metal/knife/scissors (21.4%. Most injuries occurred in January (14.2%, February (27.0%, and August (10.0%. There were 8.5% patients with ocular injuries combined with other injuries. The incidence of open ocular injuries (4585 eyes, 76.9% was higher than closed ocular injuries (939 eyes, 15.7%. The incidences of chemical and thermal ocular injuries were 1.2% and 0.6%. Ocular trauma score (OTS predicted final visual acuity at non light perception (NLP, 20/200-20/50 and 20/40 with a sensitivity of 100%, and light perception (LP/hand motion (HM and 1/200-19/200 with a specificity of 100%. CONCLUSIONS: This study provides recent epidemiological data of patients hospitalized for ocular trauma in central China. Some factors influencing the visual outcome include time interval between injury and visit to the clinic, wound location, open or closed globe injury, initial visual acuity, and OTS.

  16. The effectiveness of ERC advanced life support (ALS) provider courses for the retention of ALS knowledge.

    Science.gov (United States)

    Fischer, Henrik; Strunk, Guido; Neuhold, Stephanie; Kiblböck, Daniel; Trimmel, Helmut; Baubin, Michael; Domanovits, Hans; Maurer, Claudia; Greif, Robert

    2012-02-01

    Out-of-hospital emergency physicians in Austria need mandatory emergency physician training, followed by biennial refresher courses. Currently, both standardized ERC advanced life support (ALS) provider courses and conventional refresher courses are offered. This study aimed to compare the retention of ALS-knowledge of out-of-hospital emergency physicians depending on whether they had or had not participated in an ERC-ALS provider course since 2005. Participants (n=807) from 19 refresher courses for out-of-hospital emergency physicians answered eight multiple-choice questions (MCQ) about ALS based on the 2005 ERC guidelines. The pass score was 75% correct answers. A multivariate logistic regression analyzed differences in passing scores between those who had previously participated in an ERC-ALS provider course and those who had not. Age, gender, regularity of working as an out-of-hospital emergency physician and the self-reported number of real resuscitation efforts within the last 6months were entered as control variables. Out-of-hospital emergency physicians who had previously attended an ERC-ALS provider course had a significantly higher chance of passing the MCQ test (OR=1.60, p=0.015). Younger age (OR=0.95, pERC-ALS provider course since 2005 had a higher retention of ALS knowledge compared to non-ERC-ALS course participants. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  17. Correspondence: risk factors of acute respiratory infection in under-fives in a rural hospital of Central India – Authors’ reply

    Directory of Open Access Journals (Sweden)

    Amar Taksande

    2016-07-01

    Full Text Available Dear Editor,We thank the authors for their interest and comments on our paper. They have raised some very valid points. This corrispondence refers to the following article:Taksande AM, Yeole M. Risk factors of Acute Respiratory Infection (ARI in under-fives in a rural hospital of Central India. J Pediatr Neonat Individual Med. 2016;5(1:e050105. doi: 10.7363/050105 br />Comments can be found in the following article:Mandal A, Sahi PK. Correspondence: risk factors of acute respiratory infection in under-fives in a rural hospital of Central India. J Pediatr Neonat Individual Med. 2016;5(2:e050207. doi: 10.7363/050207

  18. Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. III. - September of 2001

    International Nuclear Information System (INIS)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Rodriguez A, F.; Garcia A, J.

    2001-12-01

    The north central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  19. Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. II. - August of 2001

    International Nuclear Information System (INIS)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Rodriguez A, F.; Garcia A, J.

    2001-10-01

    The north central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  20. Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. I. - July of 2001

    International Nuclear Information System (INIS)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.

    2001-09-01

    The north central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  1. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. II.- August of 2001

    International Nuclear Information System (INIS)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Rodriguez A, F.; Garcia A, J.

    2001-12-01

    The south central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  2. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. III.- September of 2001

    International Nuclear Information System (INIS)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Rodriguez A, F.; Garcia A, J.

    2001-12-01

    The south central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  3. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. IV. - October of 2001

    International Nuclear Information System (INIS)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F.

    2002-01-01

    The south central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  4. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. I. - July of 2001

    International Nuclear Information System (INIS)

    Angeles C, A.; Vizuet G, J.

    2001-09-01

    The south central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  5. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. V. - November of 2001

    International Nuclear Information System (INIS)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F.

    2002-01-01

    The south central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  6. Diagnostic, evaluation and handling of the tumors of soft tissues. Experience in the Central Military Hospital

    International Nuclear Information System (INIS)

    Pineda Acero, Gustavo Adolfo; Torres Quintero, Pio

    2001-01-01

    With the purpose of analyzing the experience of the orthopedics service and traumatology of the central military hospital in the treatment of the tumors of soft tissues, it carries out a descriptive observational study, type series of cases and retrospective. The incidence of the tumors of soft tissues compared with carcinomas and other neoplasia, constitutes less than 1% of all cancerous and the benign ones are more common than the wicked ones in a range of 100:1. The knowledge of the classification, stadification, evaluation strategies, previous biopsy, surgical treatment, radiotherapy y/o chemotherapy is vital for a good final result. 29 clinical histories were included of patient with tumoral lesions in the soft tissues, valued in the central military hospital between March of 1996 and March of 2001. The age average was of 39 years and the pursuit of 24 months. In most of the cases the anatomical commitment belonged to the inferior members (93%), 79% for benign tumors and 21% for wicked tumors. To avoid incorrect diagnoses and inappropriate treatments it is necessary the coordinated evaluation of all multidisciplinary team

  7. Riesgos ergonómicos que afecta al trabajo empresarial en el hospital civil de Chone

    Directory of Open Access Journals (Sweden)

    César Augusto Velásquez Giler

    2017-07-01

    Full Text Available El presente estudio tiene como objetivo identificar los riesgos ergonómicos que afectan al trabajo empresarial, caso particular Hospital Civil de Chone, para determinar los factores ergonómicos y los índices de bienestar general como factores de riesgo laboral. Se incluyeron para el análisis a 40 profesionales de la salud que realizan atención directa al paciente internado. En cuanto a las técnicas, se hizo uso de la investigación de campo, descriptiva, documental y transversal, para la obtención de información específica del tema propuesto, de igual manera se utilizó el método inductivo-deductivo, mientras que el instrumento para la recolección de datos se manejó una matriz de evaluación de riesgos para registrar los factores ergonómicos, se tomó las siguientes áreas ocupacionales como muestra: enfermeros, auxiliares de enfermería, secretarias, identificando los principales factores de riesgos ergonómicos que se expone el capital humano del hospital en condiciones de trabajo no recomendables, disminuyendo la productividad del trabajo   Palabras clave: salud, bienestar, condiciones de trabajo, capital humano, productividad del trabajo.

  8. Neonatal screening for sickle cell disease, Glucose-6-PhosphateDehydrogenase deficiency and Alpha-Thalassemia in Qatif and Al-Hasa

    International Nuclear Information System (INIS)

    Nasserullah, Z.; Srair, Hussain Abu; Al-Jame, A.; Mokhtar, M.; Al-Qatari, G.; Al-Naim, S.; Al-Aqib, A.

    1998-01-01

    Screening programs to determine the frequency of sickle cell,glucose-6-phosphate dehydrogenase deficiency and alpha-thalassemia gene areavailable in Saudi Arabia, although not used frequently. Greater use of theseprograms will decrease the morbidity and mortality of Saudi children affectedby these disorders. Neonatal hemoglobin electrophoresis andglucose-6-dehydrogenase fluorescent spot tests were performed on new bornbabies delivered between December 1992 and December 1993 at the Qatif CentralHospital and at the King Fahd Hospital in Al-Hasa. Cord blood samples werecollected from babies born in these two hospitals. Babies born in otherhospitals had blood collected in their first visit to Qatif primary carecenters at the time of vaccination. All specimens were sent to Dammam CentralLaboratory. The diagnosis of sickle cell and alpha-thalassemia was based oncellulose acetate electrophoresis and confirmed by agar gel electrophoresisand glucose-6-phosphate dehydrgenase was confirmed by fluorescent spot test.A total of 12,220 infants, including 11,313 Saudis (92.6%), were screenedover a 12-month period. The common phenotype detected in these infantsincluded AF, SFA, SFA Bart's, FS and FS Bart's. In Saudi infants, homozygoussickle cell disease was detected in 2.35% and 1.08% in Qatif and Al-Hasa,respectively. The frequencies of sickle cell gene were 0.1545% and 0.1109% inQatif and Al-Hasa. Alpha-thalassemia genes based on an elevated level of HbBart's were 28% and 16.3% in Qatif and Al-Hasa. The screening for G6PDdeficiency revealed a high prevalence of 30.6% and 14.7% in Qatif andAl-Hasa. In the non-Saudi infants the frequencies were low. The outcome ofthis study indicates that the Saudi populations in Qatif and Al-Hasa are atrisk for hemoglobinopathies and G6PD. Neonatal screening programs areessential and cost effective and should be maintained as a routine practice.(author)

  9. [Primary lymphoma of the central nervous system: 20 years' experience in a referral hospital].

    Science.gov (United States)

    Calderón-Garcidueñas, A L; Pacheco-Calleros, J; Castelán-Maldonado, E; Nocedal-Rustrián, F C

    Primary central nervous system lymphomas (PCNSL) are rare neoplasms. AIM. To study the clinical aspects and the immuno-phenotype of all cases of PCNSL in a 20 years lapse in a referral hospital in Northeastern Mexico. From January 1986 to December 2005 all PCNSL histologically confirmed were studied. The primary lymphomas were 1% of malignant central nervous system neoplasms. 21 cases were studied (ages from 9-70 years) with male predominance (2:1). 24% patients had immuno-suppression. The more frequent clinical data were: papilledema (71%), headache (62%), paresis (48%) and seizures (33%). 33% of patients died during the first six months after diagnosis. The T lymphomas were 19% of cases and corresponded to small cell type. PCNSL are still a diagnostic challenge. Multicenter studies are required in order to determine the best treatment protocol.

  10. Profile of Epilepsy in a Regional Hospital in Al Qassim, Saudi Arabia

    Science.gov (United States)

    Hamdy, Nermin A; Alamgir, Mohammad Jawad; Mohammad, El Gamri E; Khedr, Mahmoud H; Fazili, Shafat

    2014-01-01

    Introduction Epilepsy is a diverse set of chronic neurological disorders characterized by seizures. It is one of the most common of the serious neurological disorders. About 3% of people will be diagnosed with epilepsy at some time in their lives. Objectives We aimed to address the commonest types of seizures, their aetiologies, EEG and neuroimaging results and prognosis of patients presented to neurology services of the King Fahad Specialist Hospital- AlQassim (KFSH). Methodology In this retrospective epidemiological study we investigated the medical records of patients with epilepsy, who attended the neurology services of KFSH, during the study period (26/10/2011–26/4/2012). Results The study included 341 patients; 189 (55.4%) males and 152 (44.6%) females. Their ages ranged between 12 and 85 years (mean ± SD = 31±16.9). The majority of patients had Generalised Tonic Clonic Seizures (76.2%), followed by Complex Partial Seizures (7.6%). 73% of our patients had idiopathic epilepsy. The commonest causes for symptomatic epilepsy were Cerebro Vascular Accidents and Head trauma. Hemiplegia, mental retardation and psychiatric illness were the commonest comorbidity. 69.3% of patients had controlled seizures. Patients with idiopathic epilepsy were significantly controlled than patients with symptomatic epilepsy (P=0.01), and those using one Anti Epileptic Drug were significantly controlled compared to patients using polytherapy (P=0.0001) there was no significant relation between controlled seizure and duration of illness or hospitalization or EEG changes. Conclusion Seizure types, aetiology, drug therapy, Comorbidities and outcome in a tertiary care hospital in Saudi Arabia are similar to previous local and international studies. 35.3% of patients were hospitalized, higher rates than previous studies. Seizure control was better in generalized seizures and idiopathic epilepsy compared to complex partial seizures or partial seizures with secondary generalization and

  11. Evaluación del espesor corneal central y su influencia en la presión intraocular en pacientes del Hospital "Dr. Miguel Enríquez" Evaluation of the central corneal thickness and its impact on the intraocular pressure of patients in "Dr. Miguel Enriquez" hospital

    Directory of Open Access Journals (Sweden)

    María Teresa Arrronte Alarcón

    2012-01-01

    Full Text Available Objetivo: evaluar el espesor corneal central en sujetos sanos, hipertensos oculares, sospechosos de glaucoma y glaucomatosos, y su influencia en la presión intraocular. Métodos: se realizó un estudio descriptivo y transversal que incluyó 708 ojos de 356 sujetos que acudieron al servicio de oftalmología del Hospital Universitario "Dr. Miguel Enríquez" entre enero y diciembre de 2010. A los pacientes se les midió el espesor corneal central con paquimetría ultrasónica (paquímetro US 4000. El resto de la información se obtuvo a partir de las historias clínicas de los pacientes. Resultados: Los hipertensos oculares presentaron córneas gruesas (p=0,07; el mayor número de casos que tenían diagnóstico de sospecha de glaucoma y de glaucoma primario de ángulo abierto presentaron un grosor corneal delgado (p=0,62 y p=0,08 respectivamente. Si no se hubiese tenido en cuenta el factor de corrección para evaluar la presión intraocular se encontraría 48,1 % de los glaucomatosos y 31,5 % de los hipertensos oculares con diagnóstico inadecuado (pObjective: to evaluate the central corneal thickness in healthy individuals, in persons with ocular hypertension, and in suspected glaucoma and glaucomatous people, and its influence in intraocular pressure. Methods: a cross-sectional and descriptive study was performed in 708 eyes from 356 people who had been seen at ophthalmology service of “Dr. Miguel Enríquez”, university hospital from January to December, 2010. Their central corneal thickness was measured with ultrasonic pachymetry (pachymeter US 4000. The rest of the information came from the clinical histories of the patients. Results: Most of the ocular hypertensives presented thick corneas (p=0,07; a high number of cases that had diagnosis of glaucoma suspicion and primary open-angle glaucoma showed thin corneas (p=0,62 and (p=0,08 respectively. If the correction factor to evaluate the IOP had not been considered, then 48,1 % of the

  12. NIVEL DE SATISFACCIÓN DEL PACIENTE ADULTO POSTOPERADO RESPECTO AL CUIDADO DE ENFERMERÍA EN SERVICIO DE CIRUGÌA DEL HOSPITAL REGIONAL DE LAMBAYEQUE

    OpenAIRE

    Oliva Ramos, Pamela; Universidad Señor de Sipán

    2014-01-01

     El presente estudio Nivel de Satisfacción del Paciente Adulto Postoperado Respecto al Cuidado de Enfermería en Servicio de Cirugía del Hospital Regional de Lambayeque Chiclayo 2013, tuvo como objetivo: Determinar el nivel de satisfacción en el paciente adulto postoperado respecto al cuidado de enfermería en servicio de cirugía del Hospital Regional de Lambayeque Chiclayo 2013. El diseño metodológico fue de tipo cuantitativo descriptivo simple, se utilizó como instrumento el cuestionario tipo...

  13. Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. I. - May-June of 2003

    International Nuclear Information System (INIS)

    Angeles C, A.; Camacho V, B.; Rodriguez A, F.

    2003-09-01

    The north central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  14. Specialized consultant in radiological safety to the clinical north central hospital of high speciality, PEMEX. IV. - December of 2001

    International Nuclear Information System (INIS)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F.

    2002-01-01

    The clinical north central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  15. Reacciones Adversas al Tratamiento Antirretroviral de Gran Actividad Inicial en el Hospital Santa Rosa - Piura.

    Directory of Open Access Journals (Sweden)

    Jiovany Jhan Carlos Saldaña-Gastulo

    2009-01-01

    Full Text Available Objetivo, Determinar la incidencia y factores asociados a reacciones adversas medicamentosas (RAM al TARGA inicial durante el periodo enero 2006 - diciembre 2007 en el Hospital de Apoyo Santa Rosa-Piura. Diseño, Se realizó un estudio analítico de cohorte retrospectiva. Lugar, Hospital de Apoyo Santa Rosa-Piura. Participantes, 107 historias clínicas de pacientes VIH positivos mayores de 18 años que recibieron TARGA y fueron atendidos durante este periodo en el consultorio de infectología. Intervenciones, Se analizaron retrospectivamente las historias clínicas que fueron pertinentes para la recolección de datos. Principales medidas de resultado, Analisis Univariado, Bivariado (t de Student, y Riesgo Relativo, multivariado (Regresión logística con 95% de confianza (p<0.05. Resultados, En 107 pacientes se encontró una incidencia acumulada de 66,35% de RAM al TARGA inicial. Las RAM experimentadas con mayor frecuencia fueron anemia (35,2%, rash (16,9% y vómitos (9,9%. Se encontró diferencias significativas entre la media de edad y la presencia de RAM con la prueba de t de student (p < 0.05 Conclusiones, Existe una alta incidenica de RAM en pacientes incluidos en TARGA, siendo la más frecuente la anemia en 25 pacientes (35,2%. La media de edad es mayor en pacientes con RAM.

  16. Factores de riesgo de bajo peso al nacer en un hospital cubano, 1997-2000

    Directory of Open Access Journals (Sweden)

    Escobar José Andrés Cabrales

    2002-01-01

    Full Text Available Objetivo. Identificar qué factores de riesgo materno durante el embarazo se asocian a la incidencia de bajo peso al nacer (menos de 2 500 g. Métodos. Se diseñó un estudio de casos y testigos con 764 casos de nacimiento simple con un peso al nacer de menos de 2 500 g, y 1 437 testigos del Hospital Gineco-Obstétrico Provincial de Sancti Spíritus, Cuba, durante el cuatrienio de 1997-2000. Los datos se obtuvieron de historias clínicas, registros de partos y entrevistas personales con las madres. Se realizó un análisis con dos variables y se controlaron los posibles factores de confusión mediante regresión logística dicotómica con el programa SPSS. Se usó un modelo final de múltiples variables para identificar los factores de riesgo maternos asociados con el bajo peso al nacer. Resultados. El análisis con múltiples variables mostró una asociación significativa del bajo peso al nacer con la presencia de anemia en la madre cuando se detectó el embarazo, la sepsis urinaria durante el embarazo, el asma bronquial, un aumento de peso materno menor de 8 kg durante todo el embarazo, el hábito de fumar durante el mismo, antecedentes de bajo peso al nacer en partos anteriores, la presencia de hipertensión arterial desde antes de la gestación y la consulta prenatal extemporánea. Conclusiones. A partir de estos resultados se concluyó que, independientemente de la medida de impacto utilizada, es importante tratar de disminuir los factores de riesgo identificados a fin de reducir la incidencia del bajo peso al nacer en la provincia de Sancti Spíritus.

  17. Factores de riesgo de bajo peso al nacer en un hospital cubano, 1997-2000

    Directory of Open Access Journals (Sweden)

    José Andrés Cabrales Escobar

    2002-09-01

    Full Text Available Objetivo. Identificar qué factores de riesgo materno durante el embarazo se asocian a la incidencia de bajo peso al nacer (menos de 2 500 g. Métodos. Se diseñó un estudio de casos y testigos con 764 casos de nacimiento simple con un peso al nacer de menos de 2 500 g, y 1 437 testigos del Hospital Gineco-Obstétrico Provincial de Sancti Spíritus, Cuba, durante el cuatrienio de 1997-2000. Los datos se obtuvieron de historias clínicas, registros de partos y entrevistas personales con las madres. Se realizó un análisis con dos variables y se controlaron los posibles factores de confusión mediante regresión logística dicotómica con el programa SPSS. Se usó un modelo final de múltiples variables para identificar los factores de riesgo maternos asociados con el bajo peso al nacer. Resultados. El análisis con múltiples variables mostró una asociación significativa del bajo peso al nacer con la presencia de anemia en la madre cuando se detectó el embarazo, la sepsis urinaria durante el embarazo, el asma bronquial, un aumento de peso materno menor de 8 kg durante todo el embarazo, el hábito de fumar durante el mismo, antecedentes de bajo peso al nacer en partos anteriores, la presencia de hipertensión arterial desde antes de la gestación y la consulta prenatal extemporánea. Conclusiones. A partir de estos resultados se concluyó que, independientemente de la medida de impacto utilizada, es importante tratar de disminuir los factores de riesgo identificados a fin de reducir la incidencia del bajo peso al nacer en la provincia de Sancti Spíritus.

  18. Variation of central corneal thickness in patients with diabetic retinopathy as detected by ultrasonic pachymetry in patients presenting to a tertiary care hospital

    International Nuclear Information System (INIS)

    Khan, S.A.

    2017-01-01

    To compare the central corneal thickness between patients with diabetic retinopathy and non diabetics. Study Design: A cross sectional study. Place and Duration of Study: Lahore General Hospital Lahore, from 1st Dec 2015 to 31st May 2016. Material and Methods: A cross-sectional study was conducted in the ophthalmology outpatient department of Lahore General Hospital. A total of one hundred and fifty subjects from different age groups were selected for the study. An ultrasound pachymeter was used to measure CCT. There were two groups for sample, 75 were patients with diabetic retinopathy and 75 of them were non-diabetic subjects. Results: The diabetic patients had average central corneal thickness of value 554.93 +- 33.73 microns. The average central corneal thickness found in non-diabetic patients was 520.41 +- 26.06 microns. The diabetic patients showed an increased central corneal thickness as compared to non-diabetics. The result of this study was statistically significant (p=0.001). Conclusion: The diabetic patients showed an increased central corneal thickness as compared to non-diabetic patients. (author)

  19. Ischaemic stroke management at Al-Shifa Hospital in the Gaza Strip: a clinical audit.

    Science.gov (United States)

    Abukaresh, Amir; Al-Abadlah, Rami; Böttcher, Bettina; El-Essi, Khamis

    2018-02-21

    In the 2014 Palestinian annual health report, cerebrovascular accident was ranked as the third leading cause of death in the occupied Palestinian territory. Cerebrovascular accident is also one the most common causes of disability worldwide. Good management decreases mortality and morbidity. The aim of this study was to assess the current management of patients with ischaemic stroke at the Al-Shifa Hospital and to compare this with international guidelines. For this clinical audit, we used simple random sampling to select files of patients admitted with the diagnosis of ischaemic stroke to the Al-Shifa Hospital. Data collection sheets were completed, and clinical practice was compared with the 2013 American Stroke Association guidelines. Between January and June, 2016, 254 patients were admitted with ischaemic stroke, haemorrhagic stroke, or transient ischaemic attack. We selected 55 patient files. The International Classification of Diseases coding for cerebral infarction in patient files was relatively good, with 92% of files correctly coded. However, we found a substantial weakness in the documentation of duration, progression of symptoms (documented in 20% of files only), and physiotherapy assessment. Most essential acute investigations were done on time (for all [100%] patients needing blood count, renal function tests, and CT scan and for 42 [76%] patients needing ECG). However, thrombolytic drugs were not used because they were not available. Long-term antiplatelet therapy was provided properly to 51 (92%) patients discharged from hospital. However, the initial doses of antiplatelet therapy were generally lower than the international recommendations. Findings also showed a marked inconformity of blood pressure management, especially with respect to the treatment decision and the choice of antihypertensive drug. No local guidelines exist. Furthermore, the lack of availability of thrombolysis medication and the poor deviation in blood pressure management show

  20. L'escriptura i el llibre a la Catalunya Central als segles XIII i XIV

    OpenAIRE

    Torras i Cortina, Miquel

    2004-01-01

    Consultable des del TDX Títol obtingut de la portada digitalitzada Aquesta investigació reconstrueix la vida cultural de la ciutat de Manresa, a la Catalunya Central, al llarg dels segles XIII i XIV, amb el còdex baixmedieval com a fil conductor. L'estudi es basa en l'anàlisi de 305 documents amb mencions libràries (editats conjuntament), pràcticament tots ells inèdits, que procedeixen d'un buidatge exhaustiu dels fons notarials que custodien l'Arxiu Històric Comarcal de Manresa i l'Arx...

  1. [A Survey of the Perception of Nurses Toward the Practice Environment at a Regional Teaching Hospital in Central Taiwan].

    Science.gov (United States)

    Hung, Jui-Tai; Lin, Ching-Wen; Wen, Wei-Chun; Lin, Esther Ching-Lan

    2015-08-01

    The nursing practice environment has been shown to wield significant influence on nursing retention and nursing quality of care. Because a large percentage of Taiwan nurses currently work at regional teaching hospitals, exploring the perception toward the practice environment of nurses working at this type of hospital is important. This study explored the perception of nurses working at a regional teaching hospital in central Taiwan toward their practice environment. A cross-sectional research design with a sample of 474 nurses from a regional hospital in central Taiwan was conducted. Instruments including the demographic data and the Chinese-version Practice Environment Scale-Nursing Work Index (CPES-NWI) were anonymously self-administered. Overall, participants were moderately satisfied with their practice environment, with the greatest dissatisfaction focused on staffing and resource adequacy. Work unit and nursing level, respectively, had significant impacts on perceptions regarding the practice environment. Furthermore, discriminant analysis identified two new compound variables: 1) adequate staffing resources and partnership in the workplace and 2) supportive administrative management environment. Participants who worked in medical and surgical units were significantly more dissatisfied with the adequacy of staffing resources and partnership in the workplace than participants who worked in acute/intensive and special units. Participants at the N2 level were significantly more dissatisfied with the supportive nature of the administrative management environment. These findings support that the nursing practice environment of regional hospitals may be improved using several measures, including: modifying the staffing and resource adequacy of nurses, fostering collaborative nurse-physician relationships, and further involving nurses in administrative management and decision-making.

  2. Infective endocarditis in children: A 5 year experience from Al-Zahra Hospital, Isfahan, Iran

    Directory of Open Access Journals (Sweden)

    Alireza Ahmadi

    2014-01-01

    Full Text Available Background: Considering that there are no regional published data regarding the epidemiologic findings of infective endocarditis (IE in children, in this study we reviewed the epidemiologic and clinical features and treatment and outcome of children diagnosed with IE at Al-Zahra hospital over a 5-year period. Materials and Methods: In this retrospective study, medical records of patients (<18 years old admitted from March 2006 to March 2011 in Al-Zahra Hospital (Pediatrics Infectious or Cardiology Departments reviewed. The medical files reviewed regarding demographic, clinical, diagnostic (laboratory, microbiological and echocardiographic details and treatment and outcome details. Obtained data were recorded in a questionnaire. The diagnosis of IE was determined based on Duke criteria. Results: In this study, 17 patients fulfill the Duke criteria for definite or the possible IE. The most common causes of IE was non-cyanotic heart disease (ventricular septal defect and AS; 64.8%. From cyanotic hearth disease,   Tetralogy of Fallot (TOF was the most frequent causes (11.8%. In this study, 41% of patients with IE aged < 2 years and 70% aged < 6 years. In this study, 76.5% of patients had a history of congenital heart disease or cardiac surgery. Blood cultures were positive in 10 patients (58.8%. Coagulase-negative staphylococci (23.5% and Staphylococcus aureus (11.7% were the most common organisms that cause IE. Conclusion: It seems that in order to provide a regional comprehensive guideline for appropriate management and prevention of IE related complications further advanced studies with larger sample size and evaluation is recommended.

  3. Seroprevalence of toxoplasma gondii infection among patients admitted to al-zahra hospital, isfahan, iran

    International Nuclear Information System (INIS)

    Mohaghegh, M.A.; Yazdani, H.; Hadipour, M.; Namdar, F.

    2015-01-01

    Toxoplasma gondii (T. gondii) infection is one of the most common parasitic infections among humans and other warm-blooded animals worldwide. The aim of this study was to evaluate toxoplasmosis status in patients admitted to Al-Zahra hospital, Isfahan, Iran. Methods: This cross-sectional study was conducted from October 2012 to January 2015. During this period, 716 patients referred to Al-Zahra hospital in Isfahan city, Iran, were studied to investigate the IgG and IgM antibodies against T. gondii using ELISA kit. The data were analysed by Chi-square and Fishers exact tests. In addition, the relation of data with age and sex were also examined. Results: Among 716 patients, 21 patients (2.9%) had positive IgM and 288 patients (40.2%) had positive IgG titer against T. gondii. Data analysis by Chi-square and Fishers exact tests revealed that there was no significant relationship between IgG titer and age (p>0.05). Additionally, there was no relationship between IgM titer and age (p>0.05). The data showed that there was no relationship between IgG and IgM antibody titer and sex (p>0.05). Conclusion: The prevalence of toxoplasmosis in Isfahan inhabitants seems fairly high but it can be concluded that the rate of seropositive patient is moderate comparing to other regions of country. Accordingly, the authors propose that all sensitive patients have to be tested for T. gondii antibody in order to prevent the consequences of disease. (author)

  4. Comparison of sexual dysfunction in women with infertility and without infertility referred to Al-Zahra Hospital in 2013-2014

    Directory of Open Access Journals (Sweden)

    Fariba Mirblouk

    2016-02-01

    Full Text Available Background: One of the affected aspects in infertile women that have not been given sufficient attention is sexual function. Sexual function is a key factor in physical and marital health, and sexual dysfunction could significantly lower the quality of life. Aim of this study was to assess the comparison sexual dysfunction in women with infertility and without infertility, admitted to Al- Zahra Hospital. Objective: We decided to assess the prevalence of women sexual disorders in fertile and infertile subjects, admitted to Al-Zahra Hospital. Materials and Methods: 149 fertile and 147 infertile women who referred to infertility clinic of Al-Zahra Hospital during 2013-2014 were entered this crosssectional study and Female Sexual Function Index questionnaire (FSFI had been filled by all the cases. Most of women were married for 6-10 years (35.5% and mean marriage time in participants was 9.55±6.07 years. Data were analyzed using SPSS software Ver. 18 and χP 2 P test and logistic regression model has been used for analysis. Results: Results showed significant differences between desire (p=0.004, arousal (p=0.001, satisfaction (p=0.022 and total sexual dysfunction (p=0.011 in both groups but in lubrication (p=0.266, orgasm (p=0.61 and pain (p=0.793 difference were not significant. Conclusion: Some of sexual dysfunction indices are high in all infertile women. Our findings suggest that infertility impacts on women’s sexual function in desire, arousal, satisfaction and total sexual dysfunction. Health care professional should be sensitive to impact that diagnosis of infertility can have on women’s sexuality.

  5. Etiologic Agents of Central Nervous System Infections among Febrile Hospitalized Patients in the Country of Georgia

    OpenAIRE

    Akhvlediani, Tamar; Bautista, Christian T.; Shakarishvili, Roman; Tsertsvadze, Tengiz; Imnadze, Paata; Tatishvili, Nana; Davitashvili, Tamar; Samkharadze, Tamar; Chlikadze, Rusudan; Dvali, Natia; Dzigua, Lela; Karchava, Mariam; Gatserelia, Lana; Macharashvili, Nino; Kvirkvelia, Nana

    2014-01-01

    OBJECTIVES: There is a large spectrum of viral, bacterial, fungal, and prion pathogens that cause central nervous system (CNS) infections. As such, identification of the etiological agent requires multiple laboratory tests and accurate diagnosis requires clinical and epidemiological information. This hospital-based study aimed to determine the main causes of acute meningitis and encephalitis and enhance laboratory capacity for CNS infection diagnosis. METHODS: Children and adults patients cli...

  6. Effects of Implemented Initiatives on Patient Safety Culture in Fateme Al-zahra Hospital in Najafabad

    Directory of Open Access Journals (Sweden)

    Ahmadreza Izadi

    2015-01-01

    Full Text Available Introduction: Patient safety improvement requires ongoing culture. This cultural change is the most important challenge that managers are faced with in creation of a safe system. This study aims to show the results of initiatives to improvement in patient safety culture in Fateme Al-zahra hospital. Method: In the quasi-experimental research, patient safety culture was measured using the Persian questionnaire on adaptation of the hospital survey on patient safety culture in 12 dimensions. The research was conducted before (January 2010 and after (September 2012 the improvement initiatives. In this study, all units were determined and no sampling method was used. Reliability of the questionnaire was tested by Alpha Chronbakh (0.83. Data were analyzed using descriptive statistics indices and Independent T-Test by SPSS Software (version 18. Results: 350 questionnaires were distributed in each phaseand overall response rate was 58 and 56 percent, respectively. According to Independent T-test, Management expectations and actions, Organizational learning, Management support, Feedback and communication about error, Communication openness, Overall Perceptions of Safety, Non-punitive Response to Error, Frequency of Event Reporting, and Patient safety culture showed significant differences (P-value0.05. The mean score of Patient safety culture was 2.27 (from 5 and it was increased to 2.46 after initiatives that showed a significant difference (P-value<0.05. Conclusion: Although, improvement in patient safety culture needs teamwork and continuous attempts, the study showed that initiatives implemented in the case hospital had been effective in some dimensions. However, Teamwork within hospital units, Teamwork across units, Hospital handoffs and transitions, and Staffing dimensions were recognized for further intervention. Hospital could improve the patient safety culture with planning and measures in these dimensions.

  7. Study of the central collisions in the reactions Ni + Al and Ni + Ni at 28 A.MeV; Etude des collisions centrales dans les reactions Ni + Al et Ni + Ni a 28 A.MeV

    Energy Technology Data Exchange (ETDEWEB)

    Lebreton, L.

    1995-12-01

    The work is in characterisation of mechanisms in the energy range of onset of multifragmentation (excitation energy of composed nucleus around 4 - 5 AMeV). This work focused on an experiment performed at the SARA facility, in Grenoble, using the AMPHORA multi detection array. I have been particularly interested in central collisions in the Ni + Al and Ni + Ni systems. The possibility to detect complete events for Ni + Al, and quasi-complete events for the Ni + Ni case, is the reason of this choice. Furthermore Ni + Ni presents the interest of a symmetrical system, for which the excitation energy per nucleon is maximum. The study of these reactions has been focused on the quasi-complete events (events for which at least 80 % of the total charge has been detected). Heavy ions produced in peripheral collisions are very likely emitted along the beam line or stopped in the plastic detectors, energy thresholds are too high for the quasi-target products detection, consequently by requiring complete or quasi-complete measurement of the total charge, we are able to detect mostly central events. The knowledge of informations like charge, energy or detection angles allows to isolate the source(s) and to reconstruct the size and the excitation energy of the source(s). Comparisons with simulations like sequential emission (GEMINI code), very deep inelastic collision or instantaneous emission (Berliner code) allows to characterise the first stage of the collision (binary collisions or central collisions) and the type of deexcitation of the source(s). Some calculations was also performed with the statistical model code MODGAN. Indeed azimuthal correlations seem to be a good tool in getting more information about involved reaction mechanisms. Comparisons with MODGAN provide information about angular momentum of the source and time delay between emissions of the two particles (separation between sequential or instantaneous process). (author). 69 refs.

  8. Implementing health care reform: implications for performance of public hospitals in central Ethiopia.

    Science.gov (United States)

    Manyazewal, Tsegahun; Matlakala, Mokgadi C

    2018-06-01

    Understanding the way health care reforms have succeeded or failed thus far would help policy makers cater continued reform efforts in the future and provides insight into possible levels of improvement in the health care system. This work aims to assess and describe the implications of health care reform on the performance of public hospitals in central Ethiopia. A facility-based, cross-sectional study was carried out in five public hospitals with different operational characteristics that have been implementing health care reform in central Ethiopia. The reform documents were reviewed to assess the nature and targets of the reform for interpretive analysis. Adopting dimensions of health system performance as the theoretical framework, a self-administered questionnaire was developed. Consenting health care professionals who have been involved in the reform from inception to implementation filled the questionnaire. Cronbach's alpha was measured to ensure internal consistency of the instrument. Descriptive statistics, weighted median score, χ 2 , and Mann-Whitney U and Kruskal-Wallis tests were used for data analysis. s Despite implementation of the reform, the health care system in public hospitals was still fragmented as confirmed by 50% of respondents. Limited effects were reported in favour of quality (48%), access (50%), efficiency (51%), sustainability (53%), and equity (61%) of care, while poor effects were reported in patient-provider (41%) and provider-management (32%) interactions. Though there was substantial gain in infrastructure and workspace, stewardship of health care resources was less benefited. The predominant hindrances of the reform were the working environment (adjusted Odds Ratio (aOR) = 2.27, 95% confidence interval (CI): 1.15-4.47), financial resources (aOR = 3.54, 95%CI = 1.97-6.33), management (aOR = 2.27, 95% CI = 1.15-4.47), and information technology system (aOR = 3.15, 95% CI = 1.57-6.32). s The Ethiopian

  9. Reply to Comment by Xu et al. on "Sr-Nd isotope composition and clay mineral assemblages in eolian dust from the central Philippine Sea over the last 600 kyr: Implications for the transport mechanism of Asian dust" by Seo et al.

    Science.gov (United States)

    Seo, Inah; Lee, Yong Il; Yoo, Chan Min; Kim, Hyung Jeek; Hyeong, Kiseong

    2016-12-01

    Against Xu et al. (2016), who argued that East Asian Desert (EAD) dust that traveled on East Asian Winter Monsoon winds dominates over Central Asian Desert (CAD) dust in the Philippine Sea with presentation of additional data, we reconfirm Seo et al.'s (2014) conclusion that CAD dust carried on the Prevailing Westerlies and Trade Winds dominates over EAD dust in overall dust budget of the central Philippine Sea. The relative contribution of dust from EADs and CADs using clay mineral composition should be evaluated with elimination of mineralogical contribution from the volcanic end-member which is enriched in kaolinite and overestimate the contribution of EAD dust.

  10. Recentralization within decentralization: County hospital autonomy under devolution in Kenya

    Science.gov (United States)

    Manyara, Anthony M.; Molyneux, Sassy; Tsofa, Benjamin

    2017-01-01

    Background In 2013, Kenya transitioned into a devolved system of government with a central government and 47 semi-autonomous county governments. In this paper, we report early experiences of devolution in the Kenyan health sector, with a focus on public county hospitals. Specifically, we examine changes in hospital autonomy as a result of devolution, and how these have affected hospital functioning. Methods We used a qualitative case study approach to examine the level of autonomy that hospitals had over key management functions and how this had affected hospital functioning in three county hospitals in coastal Kenya. We collected data by in-depth interviews of county health managers and hospital managers in the case study hospitals (n = 21). We adopted the framework proposed by Chawla et al (1995) to examine the autonomy that hospitals had over five management domains (strategic management, finance, procurement, human resource, and administration), and how these influenced hospital functioning. Findings Devolution had resulted in a substantial reduction in the autonomy of county hospitals over the five key functions examined. This resulted in weakened hospital management and leadership, reduced community participation in hospital affairs, compromised quality of services, reduced motivation among hospital staff, non-alignment of county and hospital priorities, staff insubordination, and compromised quality of care. Conclusion Increasing the autonomy of county hospitals in Kenya will improve their functioning. County governments should develop legislation that give hospitals greater control over resources and key management functions. PMID:28771558

  11. Una frontera casi invisible: los territorios al norte del Sistema Central en la Alta Edad Media (siglos VIII-XI

    Directory of Open Access Journals (Sweden)

    Iñaki MARTÍN VISO

    2009-12-01

    Full Text Available RESUMEN: Los territorios al norte del Sistema Central no estuvieron sujetos a un dominio por parte de una autoridad centralizada entre los siglos VIII a XI. Los instrumentos del poder central, en especial la tributación y la organización episcopal, se descompusieron tras el siglo VIII y asumieron un papel determinante las estructuras de poder local, las cuales deben ser el principal objeto de estudio. A partir de su análisis, se descubre un espacio fronterizo abierto, con un dominio político informal, que es invisible para los poderes centrales. Palabras clave: Poderes Locales. Sitios de Altura. Necrópolis. Frontera. Tributación. Mozárabes.ABSTRACT: The territories at the North of the Iberian Central System were not ruled by any central authority between eighth and eleventh centuries. The main tools of the central power, especially the tribute and the episcopal organization, were broken down after the 8th century and the structures of local power, which must be studied particularly, got a very influential role. The analysis discover an opened frontier area, with an informal political control, that is invisible from the perspective of the central power

  12. Preliminary Characterization of the Liquid Discharge of the Mexico Hospital; Caracterizacion Preliminar de la Descarga Liquida del Hospital Mexico

    Energy Technology Data Exchange (ETDEWEB)

    Hernandez Rojas, A

    2001-07-01

    constituye un grave problema a nivel nacional. En este trabajo se realiza una caracterizacion preliminar de la descarga liquida del Hospital Mexico. Para ello se analizaron diferentes puntos de vertido dentro de la institucion, ellos son : Lavanderia, cocina central, Laboratorio Clinico, Rayos X, Laboratorio de Biomasa, Morgue y la descarga final del hospital. Esto con el fin de conocer el manejo de los desechos liquidos en el centro de salud, la calidad sanitaria de estos vertidos y su influencia en las aguas crudas del Hospital Mexico en el cuerpo receptor. Para este estudio primero se coordino con el personal de cada departamento para conocer sobre el manejo y tipo de residuos liquidos que son descargados al sistema de tuberias. Posteriormente se realizaron las pruebas fisico-quimicas y biologicas con base en dos muestreos compuestos realizados los dias 26 de octubre y 4 de noviembre de 1998. Entre las pruebas realizadas se tienen: pH, DBO, DQO, SAAM, Grasas y Aceites, Temperatura, Nitrogeno y Coliformes Fecales, dependiendo de las caracteristicas de su punto de procedencia. Al final del estudio, se evaluaron los resultados obtenidos para cada punto de vertido estudiado y luego se analizo la influencia de estos focos sobre la calidad de las aguas crudas del hospital, las cuales descargan en una quebrada localizada al costado noroeste de las instalaciones. Los resultados obtenidos permiten conocer preliminarmente la caracterizacion de la descarga liquida del Hospital Mexico y lo catalogan como una fuente de contaminacion. El Hospital requiere de una planta de tratamiento biologica para aquellos vertidos biodegradables, y de un sistema de tratamiento quimico para tratar ese tipo de productos, que son utilizados en los procesos propios de cada departamento; ademas se requiere tomar en cuenta medidas de reduccion de contaminacion que disminuyan la cantidad de desechos desde la fuente. (Author)

  13. Cuidado humanizado al neonato prematuro y familia: una perspectiva de enfermería. Unidad de cuidado intensivo neonatal. Hospital San Bartolomé. 2015.

    OpenAIRE

    Broncano Vargas, Yrma Nilda

    2016-01-01

    El objeto de estudio es el cuidado humanizado de enfermería al neonato prematuro y familia, desde la perspectiva de enfermería en la Unidad de Cuidados Intensivos Neonatal (UCIN) del Hospital San Bartolomé, Lima Perú. Objetivos: Describir y caracterizar el cuidado humanizado que brinda la enfermera al neonato prematuro y familia en la UCIN, analizar las implicancias del cuidado humanizado al recién nacido prematuro y familia en la salud neonatal. Estudio de naturaleza cualitativa, método desc...

  14. Allogenic bone grafts used at Central Hospital during June 1995 to July 1998

    International Nuclear Information System (INIS)

    Yolchai Jongjirasiri; Yongyudh Vajaradul

    1999-01-01

    Producing and using allogenic bone graft in Thailand began ten years ago. There are approximately 1,000 cases a year on orthopaedic surgery at Central Hospital. For using allogenic bone graft from the Bangkok Biomaterial Center, 66 cases were operated since June 1995. This was generated by 30 in males, 36 in females and by ages between 12-81 years old. After the operation, 43 cases had bone gap from injuries and 19 cases, fusion of spondylolisthesis and scoliosis were done. Four cases had tumor surgery, and 59 out of 66 cases had good bone union that is 89%. Delayed union happened in 6 cases only. Immune response to allogenic bone graft has not been found yet

  15. Reacciones adversas al tratamiento antirretroviral de gran actividad inicial en el hospital Santa Rosa – Piura.

    Directory of Open Access Journals (Sweden)

    Jiovany Jahn Carlos Saldaña-Gastulo

    2011-01-01

    Full Text Available Objetivo: Determinar la incidencia y factores asociados a reacciones adversas medicamentosas (RAM al TARGA inicial durante el periodo enero 2006 – diciembre 2007 en el Hospital de Apoyo Santa Rosa-Piura. Diseño: Se realizó un estudio analítico de cohorte retrospectiva. Lugar: Hospital de Apoyo Santa Rosa-Piura. Participantes: 107 historias clínicas de pacientes VIH positivos mayores de 18 años que recibieron TARGA y fueron atendidos durante este periodo en el consultorio de infectología. Intervenciones: Se analizaron retrospectivamente las historias clínicas que fueron pertinentes para la recolección de datos. Principales medidas de resultado: Analisis Univariado, Bivariado (t de Student, y Riesgo Relativo, multivariado (Regresión logística con 95% de confianza (p<0.05. Resultados: En 107 pacientes se encontró una incidencia acumulada de 66,35% de RAM al TARGA inicial. Las RAM experimentadas con mayor frecuencia fueron anemia (35,2%, rash (16,9% y vómitos (9,9%. Se encontró diferencias significativas entre la media de edad y la presencia de RAM con la prueba de t de student (p < 0.05 Conclusiones: Existe una alta incidenica de RAM en pacientes incluidos en TARGA, siendo la más frecuente la anemia en 25 pacientes (35,2%. La media de edad es mayor en pacientes con RAM. Palabras Claves: VIH/SIDA, Terapia de alta actividad antirretroviral, Reacciones adversas a medicamentos.

  16. Performance evaluation of nonhomogeneous hospitals: the case of Hong Kong hospitals.

    Science.gov (United States)

    Li, Yongjun; Lei, Xiyang; Morton, Alec

    2018-02-14

    Throughout the world, hospitals are under increasing pressure to become more efficient. Efficiency analysis tools can play a role in giving policymakers insight into which units are less efficient and why. Many researchers have studied efficiencies of hospitals using data envelopment analysis (DEA) as an efficiency analysis tool. However, in the existing literature on DEA-based performance evaluation, a standard assumption of the constant returns to scale (CRS) or the variable returns to scale (VRS) DEA models is that decision-making units (DMUs) use a similar mix of inputs to produce a similar set of outputs. In fact, hospitals with different primary goals supply different services and provide different outputs. That is, hospitals are nonhomogeneous and the standard assumption of the DEA model is not applicable to the performance evaluation of nonhomogeneous hospitals. This paper considers the nonhomogeneity among hospitals in the performance evaluation and takes hospitals in Hong Kong as a case study. An extension of Cook et al. (2013) [1] based on the VRS assumption is developed to evaluated nonhomogeneous hospitals' efficiencies since inputs of hospitals vary greatly. Following the philosophy of Cook et al. (2013) [1], hospitals are divided into homogeneous groups and the product process of each hospital is divided into subunits. The performance of hospitals is measured on the basis of subunits. The proposed approach can be applied to measure the performance of other nonhomogeneous entities that exhibit variable return to scale.

  17. A Proposed Solution for Managing Doctor's Smart Cards in Hospitals Using a Single Sign-On Central Architecture

    OpenAIRE

    Mauro, Christian;Sunyaev, Ali;Leimeister, Jan Marco;Schweiger, Andreas;Krcmar, Helmut

    2014-01-01

    This paper describes a single sign-on solution for the central management of health care provider?s smart cards in hospitals. The proposed approach which is expected to be an improvement over current methods is made possible through the introduction of a national healthcare telematics infrastructure in Germany where every physician and every patient will automatically be given an electronic health smart card (for patients) and a corresponding health professional card (for health care provider...

  18. Adherence to hand hygiene protocol by clinicians and medical students at Queen Elizabeth Central Hospital, Blantyre-Malawi.

    Science.gov (United States)

    Kalata, N L; Kamange, L; Muula, A S

    2013-06-01

    While communicable diseases are the leading causes of morbidity and mortality in Malawi, the contribution of nosocomial or hospital-acquired infections (HAIs) is unknown but could be substantial. The single most important method of preventing nosocomial infections is hand hygiene. We report a study which was conducted in 2011 to investigate adherence to hand hygiene protocols by clinicians and medical students working at Queen Elizabeth Central Hospital in Blantyre, Malawi. There were two parts to the study: a single blinded arm in which participants were observed without their knowledge by trained nurses; and a second arm which included self-completion of questionnaire after participant consent was obtained. The 2009 World Health Organization hand hygiene technique and recommendations which were adopted by Queen Elizabeth Central Hospital were used to define an opportunity for hand washing and effectiveness of hand washing. Hand hygiene effectiveness was defined as adherence to at least 6 out of 7 steps (80%) of the hand hygiene technique when using alcohol-based formulation or at least 8 out of 10 steps (80%) of the hand hygiene technique when using water and soap formulation before and after having direct contact with patients or their immediate surroundings. Clinicians were found to have disinfected their hands more than medical students (phand sanitizer and hand hygiene practice (p=0.3). Adherence to hand hygiene was found to be 23%. Most of the participants mentioned infection transmission prevention as a reason for disinfecting their hands. Other reasons mentioned included: a routine personal hand hygiene behaviour and discomfort if not washing hands. The top three reasons why they did not disinfect hands were forgetfulness, unavailability of sanitizers and negligence. Adherence to hand hygiene practice was found to be low, with forgetfulness and negligence being the major contributing factors. A hospital-wide multifaceted program aiming at clinicians and

  19. Anemia intrahospitalaria y descenso de hemoglobina en pacientes internados Hospital-acquired anemia and decrease of hemoglobin levels in hospitalized patients

    Directory of Open Access Journals (Sweden)

    Carina V. Gianserra

    2011-06-01

    Full Text Available Es frecuente observar el desarrollo de anemia durante la internación, especialmente en pacientes graves. Esto se ha relacionado a extracciones de laboratorio. Pocos estudios evaluaron su prevalencia y factores asociados en pacientes internados en sala general. El objetivo fue determinar la prevalencia, características y factores clínicos asociados a anemia intrahospitalaria y descenso de hemoglobina en pacientes internados. Se efectuó un estudio transversal, prospectivo, descriptivo. Se analizaron 192 internaciones consecutivas en sala general. Se determinó aquellas que presentaron un descenso del valor de hemoglobina = 2 g/dl y se analizaron factores de riesgo asociados. Presentaron anemia 139 pacientes (72.4%, 89 (46.4% al ingreso y 50 (26% durante la internación. Se presentaron 47 casos de descenso de hemoglobina = 2 g/dl (24.47%, en los que se observaron los valores más bajos de hematocrito y hemoglobina al alta (p = 0.01, hidratación parenteral con mayor volumen (p = 0.01 y estadías hospitalarias más prolongadas (p = 0.0001. En el análisis univariado las variables leucocitosis = 11 000mm³ (OR; IC95%: 2.02; 1.03-4; p = 0.01, días de internación = 7 (OR; IC95%: 3.39; 1.62-7.09; p = 0.0006, hidratación parenteral = 1500 ml/día (OR; IC95%: 2.47; 1.06-6.4; p = 0.01, vía central (OR; IC95%: 10.29; 1.75-108.07, p = 0.003 y anemia intrahospitalaria (OR; IC95%: 7.06; 3.41-15.83; p = 0.00000004 fueron estadísticamente significativos como factores de riesgo para descenso de hemoglobina = 2 g/dl. En el análisis multivariado las variables leucocitosis = 11 000 mm³ (OR; IC95%:2.45; 1.14-5.27; p = 0.02; días de internación = 7 (OR; IC95%: 5.15; 2.19-12.07; p = 0.0002; hidratación parenteral = 1500 ml/día (OR; IC95%: 2.95; 1.13-7.72; p = 0.02 y vía central (OR; IC95%:8.82; 1.37-56.82; p = 0.02 fueron factores predictivos independientes de descenso de hemoglobina = 2 g/dl. La anemia intrahospitalaria tuvo una elevada prevalencia. La

  20. Legitimacy of hospital reconfiguration: the controversial downsizing of Kidderminster hospital.

    Science.gov (United States)

    Oborn, Eivor

    2008-04-01

    This paper examines the contested organizational legitimacy of hospital reconfiguration, which continues to be a central issue in health care management. A qualitative study which focuses on the controversial downsizing of Kidderminster Hospital, a highly publicized landmark case of district general hospital closure. Rhetorical strategies are analysed to examine how legitimacy was constructed by stakeholder groups and how these strategies were used to support or resist change. Stakeholders promoting change legitimized re-organization pragmatically and morally arguing the need for centralization as a rational necessity. Stakeholders resisting change argued for cognitive and moral legitimacy in current service arrangements, contrasting local versus regionalized aspects of safety and provision. Groups managed to talk past each other, failing to establish a dialogue, which led to significant conflict and political upheaval. Stakeholders value hospitals in different ways and argue for diverse accounts of legitimacy. Broader discourses of medical science and democratic participation were drawn into rhetorical texts concerning regionalization to render them more powerful.

  1. Rifampicin resistance in mycobacterium tuberculosis patients using GeneXpert at Livingstone Central Hospital for the year 2015: a cross sectional explorative study.

    Science.gov (United States)

    Masenga, Sepiso K; Mubila, Harrison; Hamooya, Benson M

    2017-09-22

    Since the recent introduction of GeneXepert for the detection of Tuberculosis (TB) drug resistance mutations in both primary resistance and acquired resistance in Zambia, little has been documented in literature on the issue of rifampicin resistance especially in the face of a high National TB burden. The study aimed to determine the prevalence of rifampicin resistance in tuberculosis patients at Livingstone Central Hospital for the year 2015. This was a cross sectional study conducted at Livingstone Central Hospital where we reviewed 152 records (from January 1, 2015 to 31st December, 2015) involving patients who presented with clinically suspected TB or documented TB, whose samples were sent to the laboratory for GeneXpert Mycobacterium tuberculosis/rifampicin testing. Statistical evaluations used a one-sample test of proportion and Fisher's exact test. The age of participants ranged from 8 months to 73 years old (median = 34). Of the participants with complete data on gender, 99 (66%) and 52 (34%) were males and females respectively. The TB co-infection with HIV prevalence was 98.3% (p < 0.001). Prevalence of rifampicin resistance was 5.9% and there was no statistical significant difference between being male or female (p = 0.721). We were able to show from our study, evidence of rifampicin resistance at Livingstone Central Hospital. Hence, there was need for further in-depth research and appropriate interventions (i.e close follow-up and patient care for drug resistance positive patients).

  2. Major Differences in Advanced Life Support Training Strategies Among Danish Hospitals - A Nationwide Study

    DEFF Research Database (Denmark)

    Glerup Lauridsen, Kasper; Mygind-Klausen, Troels; Stærk, Mathilde

    2017-01-01

    Introduction: Advanced life support (ALS) training may increase survival from in-hospital cardiac arrest. Efficient ALS training includes practice of both technical and non-technical skills in a realistic setting with frequent retraining to avoid decay in ALS skills. ALS training strategies among...... hospitals are currently unknown. This study aimed to investigate ALS training strategies in Danish hospitals.Methods: We included all public, somatic hospitals in Denmark with a cardiac arrest team (n=46). Online questionnaires were distributed to resuscitation officers in each hospital. Questionnaires...... inquired information on: A) Course duration and retraining interval, B) Training methods and setting, C) Scenario training and practicing non-technical skills.Results: In total, 44 hospitals replied (response rate: 96%). ALS training was conducted in 43 hospitals (98%). Median (range) ALS course duration...

  3. Evaluation of Antimicrobial Susceptibility Among Acintobacter baumannii by E-Test Method at Khatam-Al-Anbia Hospital During 2013 - 2015

    Directory of Open Access Journals (Sweden)

    Hadi Kazemi

    2017-01-01

    Full Text Available Background Nosocomial infections are one of the health problems of modern societies, which are rising with unusual organisms. Acintobacter, which is the main cause of nosocomial infections such as pneumonia and nosocomial pneumonia, is caused by mechanical ventilation. Acinetobacter species are becoming resistant to antibiotics. One the most important agent of nosocomial infections with high mortality is infections by Acinetobacter baumannii which is Gram- negative opportunistic Coccobacilli. Treatment in these infections is difficult and sometimes impossible, due to multidrug resistance in strains isolated from nosocomial infections. Objectives The aim of the current study was to evaluate antibiotic resistance in A. baumannii isolates Khatam-Al-Anbia Hospital, Tehran, Iran. Methods In this cross-sectional study 100 of Acintobacter baumannii were isolated from hospitalized patients during 2013-2015 in Khatam-Al-Anbia hospital in Tehran. In this study samples of A. baumannii isolated from trachea, blood, urine, sputum and wound samples of patients bedridden in Intensive care unit (ICU wards. Antimicrobial susceptibility and minimum inhibitory concentration (MIC were determined by E-test methods. We used descriptive statistics to analyze the data by using SPSS 21 software. Results A total of 100 A. baumannii were isolated from clinical samples. The organism was resistant to rifampicin (46%, gentamicin (67%, meropenem (100%, piperacilin (98%, colistin (0%, and ceftazidin (96%. Conclusions The antibiotic resistance against most of the antibiotics especially meropenem is very high in this study. Moreover, colistin was most effective antibiotic to be used in A. baumannii infections. Colistin is the best choices for treatment of Acinetobacter.

  4. Concentraciones de aminoácidos maternos secundarias al uso de betametasona para la

    OpenAIRE

    Keibis Jiménez-Castillejo; Eduardo Reyna-Villasmil; Duly Torres- Cepeda; Joel Santos-Bolívar; Jorly Mejia-Montilla

    2016-01-01

    El objetivo de la investigación fue determinar las concentraciones plasmáticas de aminoácidos maternos secundarias al uso de betametasona para la maduración pulmonar fetal. Se realizó una investigación con un diseño tipo cuasi-experimental y una muestra no probabilística intencional de 106 pacientes que acudieron a la Consulta Pe-Natal de Alto Riesgo del Hospital Central “Dr. Urquinaona". A las pacientes seleccionadas se les administró betametasona intramuscular (12 mg) por dos dí...

  5. Arthroplasty of hip resection, handling with external fixation - Experience in the central military hospital

    International Nuclear Information System (INIS)

    Satizabal Azuero, Carlos E; Calderon Uribe, Oscar; Naquira Escobar, Luis F

    2006-01-01

    This is an observational retrospective study series of cases carried out between January 1998 and July 2004 in the central military hospital, 13 patients were treated with Girdlestone arthroplasty with external fixation, with a pursuit average of 53 months. Function, return to the daily activities and associate complications was evaluated. They were as complication; pain in the fixator site, osteitis, and fixator broke. All patients report at the end of the treatment no pain in the hip. Shortening in the patient without lenghting was 3,5 cm and in the group with lenghting was 1.5 cm. the obtained results demonstrate that Girdlestone arthroplasty with external fixation, is option, to improve the patient's pain and function of the hip

  6. The saw-tooth sign as a clinical clue for intrathoracic central airway obstruction

    Directory of Open Access Journals (Sweden)

    Nakajima Akira

    2012-07-01

    Full Text Available Abstract Background The saw-tooth sign was first described by Sanders et al in patients with obstructive sleep apnea syndrome as one cause of extrathoracic central airway obstruction. The mechanism of the saw-tooth sign has not been conclusively clarified. The sign has also been described in various extrathoracic central airway diseases, such as in burn victims with thermal injury to the upper airways, Parkinson’s disease, tracheobronchomalacia, laryngeal dyskinesia, and pedunculated tumors of the upper airway. Case presentation A 61-year-old man was referred to our hospital with a two-month history of persistent dry cough and dyspnea. He was diagnosed with lung cancer located in an intrathoracic central airway, which was accompanied by the saw-tooth sign on flow-volume loops. This peculiar sign repeatedly improved and deteriorated, in accordance with the waxing and waning of central airway stenosis by anti-cancer treatments. Conclusion This report suggests that the so-called saw-tooth sign may be found even in intrathoracic central airway obstruction due to lung cancer.

  7. Propuesta de mejora para el Complejo Hospitalario de Navarra, Hospital D: manual de procedimientos para la Central de Esterilización

    OpenAIRE

    Garde Sesma, Idoia

    2014-01-01

    La esterilización es una ciencia en la que se emplean tecnologías muy variadas con el fin de lograr la destrucción de todos los microorganismos. Una vez que se ha esterilizado todo el material, debe mantenerse esa condición hasta el momento de “uso” de los equipos. La central de esterilización (en adelante CE o Central), es una unidad de vital importancia dentro de la estructura de un hospital. Recibe una enorme cantidad y variedad de instrumental quirúrgico que debe ser recogido, limpiad...

  8. [Introduction of the psychoprophylactic method and its influence on the prenatal care program for institutional parturition in Japan: the practice in the Central Hospital of Maternity of the Japanese Red Cross Society and Oomori Red Cross Hospital, 1953-1964].

    Science.gov (United States)

    Fujihara, Satoko; Tsukisawa, Miyoko

    2014-03-01

    The psychoprophylactic method is one of the methods for providing 'painless childbirth without drugs' and was invented by applying I. Pavlov's theory of higher nervous activity. In 1951, it was adopted as a national policy in the Union of Soviet Socialist Republics. This method was then introduced in the People's Republic of China in 1952. In 1953, it was brought to Japan by Masatomo SUGAI, an obstetrician, and was introduced into the Central Hospital of Maternity of the Japanese Red Cross Society with the support of the director, Naotarou KUJI. The practice of this method by the research team, which consisted of the obstetricians and midwives of the Central Hospital of Maternity of the Japanese Red Cross Society and Oomori Red Cross Hospital, resulted in the initiation and characterization of the prenatal care program to encourage the autonomy of the pregnant women for normal parturition in the institutions of Japan.

  9. Using In-Hospital Mortality as an Indicator of Quality Care and Hospital Performance

    Directory of Open Access Journals (Sweden)

    Badia BISBIS

    2016-06-01

    Full Text Available The in-hospital mortality (MIH is used as a performance indicator and quality healthcare in hospital. However, the majority of deaths resulted from an inevitable disease process (severity of cases and / or co-morbidity, and not medical errors or changes in the quality of care. This work aims to make a distribution of deaths in the Regional Hospital of Eastern, Al Farabi hospital and to highlight that more studies on the MIH are required consistently with detailed clinical data at the admission. The MIH showed its limitation as a health care  indicator. The overall rate of in-hospital deaths within the Al Farabi hospital has averaged 2.4%, with 8.4% in the emergency unit, 28% in intensive care unit, 22% Neonatology unit, 1.6% in pediatric unit. The MIH may depend, firstly, on the condition of patients before hospitalization and secondly, on the conditions of their transfer from one institution to another that supports them as a last resort. Al Farabi hospital supports patients transferred from the provinces of the eastern region. Thus, 6% of patients who died in 2014 come from Berkane, 2% from  Nador, 2% from Bouarfa, 4% from  Taourirt and 2% from Jerrada. One might question about  the procedures and the conditions of such transfers. In conclusion, the overall MIH measured from routine data do not allow proper comparison between hospitals or the assessment of the quality of care and patient safety in the hospital. To do so, we should ideally have detailed clinical data on admission (e.g. type of admission, age of patient, sex, comorbidity, .... The MIH is however an important indicator to consider as a tool to detect potential  problems related to admission procedures and to suspect an area of "non-quality" in healthcare . The MIH is interesting for the patient and for the hospital because it serves the improvement of quality healthcare.

  10. Stepwise introduction of the 'Best Care Always' central-line-associated bloodstream infection prevention bundle in a network of South African hospitals.

    Science.gov (United States)

    Richards, G A; Brink, A J; Messina, A P; Feldman, C; Swart, K; van den Bergh, D

    2017-09-01

    Healthcare-associated infection (HCAI) remains a major international problem. The 'Best Care Always!' (BCA) campaign was launched in South Africa to reduce preventable HCAI, including central-line-associated bloodstream infection (CLABSI). The intervention took place in 43 Netcare Private Hospitals, increasing later to 49 with 958 intensive care units (ICUs) and 439 high-care (HC) beds and 1207 ICUs and 493 HC beds, respectively. Phase 1, April 2010 to March 2011, ICU infection prevention and control (IPC) nurse-driven change: commitment from management and doctors and training of IPC nurses. Bundle compliance and infections per 1000 central-line-days were incorporated as standard IPC measures and captured monthly. Phase 2, April 2011 to March 2012, breakthrough collaborative method: multiple regional learning sessions for nursing leaders, IPC nurses and unit managers. Phase 3, April 2012 to May 2016: sustained goal-setting, benchmarks, ongoing audits. A total of 1,119,558 central-line-days were recorded. Bundle compliance improved significantly from a mean of 73.1% [standard deviation (SD): 11.2; range: 40.6-81.7%] in Phase 1 to a mean of 90.5% (SD: 4.7; range: 76.5-97.2%) in Phase 3 (P = 0.0004). The CLABSI rate declined significantly from a mean of 3.55 (SD: 0.82; range: 2.54-5.78) per 1000 central-line-days in Phase 1 to a mean of 0.13 (SD: 0.09; range: 0-0.33) (P hospitals resulted in significant decreases in CLABSI. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  11. Tracking the 10Be-26Al source-area signal in sediment-routing systems of arid central Australia

    Science.gov (United States)

    Struck, Martin; Jansen, John D.; Fujioka, Toshiyuki; Codilean, Alexandru T.; Fink, David; Fülöp, Réka-Hajnalka; Wilcken, Klaus M.; Price, David M.; Kotevski, Steven; Fifield, L. Keith; Chappell, John

    2018-05-01

    Sediment-routing systems continuously transfer information and mass from eroding source areas to depositional sinks. Understanding how these systems alter environmental signals is critical when it comes to inferring source-area properties from the sedimentary record. We measure cosmogenic 10Be and 26Al along three large sediment-routing systems ( ˜ 100 000 km2) in central Australia with the aim of tracking downstream variations in 10Be-26Al inventories and identifying the factors responsible for these variations. By comparing 56 new cosmogenic 10Be and 26Al measurements in stream sediments with matching data (n = 55) from source areas, we show that 10Be-26Al inventories in hillslope bedrock and soils set the benchmark for relative downstream modifications. Lithology is the primary determinant of erosion-rate variations in source areas and despite sediment mixing over hundreds of kilometres downstream, a distinct lithological signal is retained. Post-orogenic ranges yield catchment erosion rates of ˜ 6-11 m Myr-1 and silcrete-dominant areas erode as slow as ˜ 0.2 m Myr-1. 10Be-26Al inventories in stream sediments indicate that cumulative-burial terms increase downstream to mostly ˜ 400-800 kyr and up to ˜ 1.1 Myr. The magnitude of the burial signal correlates with increasing sediment cover downstream and reflects assimilation from storages with long exposure histories, such as alluvial fans, desert pavements, alluvial plains, and aeolian dunes. We propose that the tendency for large alluvial rivers to mask their 10Be-26Al source-area signal differs according to geomorphic setting. Signal preservation is favoured by (i) high sediment supply rates, (ii) high mean runoff, and (iii) a thick sedimentary basin pile. Conversely, signal masking prevails in landscapes of (i) low sediment supply and (ii) juxtaposition of sediment storages with notably different exposure histories.

  12. Analysis and Description of Suicidal Burns Admitted to Al-Fayhaa General Hospital in Basra, Iraq

    Directory of Open Access Journals (Sweden)

    Mustafa Al-Shamsi

    2018-05-01

    Full Text Available Suicide by self-burning remains a common method of suicide amongst women in Iraq and some neighboring countries. This study aimed to describe the problem of self-burning in Basra province and investigate the associated factors. A prospective study was undertaken between October 2016 and May 2017 in Al-Fayhaa Burn Center. Data were collected from all patients admitted to the center for a self-inflicted burn. Sociodemographic information and cause of suicide were obtained using an interviewer-administered questionnaire, and clinical data were transcribed from hospital records. There were 62 cases (females 74%, males 26% of self-burning during the 6 months data collection accounting for 22% of all burn admission. The age ranged from 9-56 years (mean 25.3, SD 10.8 year. The vast majority had no or only basic education (92%, 55% were married, 60% were from outside Basra city and 53% considered themselves from a poor socioeconomic background. The incident mostly occurred at home (84% while the person was alone (91% using kerosene as the burning material (82%. The total burn surface area ranged from 20-100% with a median of 80% (IQR 60-95. The median hospital stay was 5 days (IQR 1-12 days. In-hospital mortality rate was 72.6%. Suicide by self-burning seems not to be uncommon in Basra and require more attention from public health and social services. More research is required to provide a better estimation of the problem and in-depth understanding of the factors that contribute to the problem.

  13. Transfusion practice in Helsinki University Central Hospital: an analysis of diagnosis-related groups (DRG).

    Science.gov (United States)

    Syrjälä, M T; Kytöniemi, I; Mikkolainen, K; Ranimo, J; Lauharanta, J

    2001-12-01

    Transfusion data combined with data automatically recorded in hospital databases provides an outstanding tool for blood utilization reporting. When the reporting is performed with an online analytical processing (OLAP) tool, real time reporting can be provided to blood subscribers. When this data is combined with a common patient classification system, Diagnosis-Related Groups (DRG), it is possible to produce statistical results, that are similar in different institutions and may provide a means for international transfusion bench-marking and cost comparison. We use a DRG classification to describe the transfusion practice in Helsinki University Central Hospital. The key indicators include the percentage of transfused patients, the number of transfused units and costs in different DRG groups, as well as transfusion rates per DRG weighted treatment episodes. Ninety-three per cent of all transfusions could be classified into different DRGs. The largest blood-using DRG group was acute adult leukaemia (DRG 473), which accounted for 10.4% of all transfusion costs. The 13 largest blood consuming DRGs accounted for half the total costs in 1998. Currently, there is a lack of an internationally accepted standardized way to report institutional or national transfusion practices. DRG-based transfusion reporting might serve as a means for transfusion benchmarking and thus aid studies of variations in transfusion practice.

  14. Infecciones del sistema nervioso central por enterovirus en niños atendidos en un hospital de Lima, Perú Enteroviral central nervous system infections in children treated at a hospital in Lima, Peru

    Directory of Open Access Journals (Sweden)

    Iván O Espinoza

    2011-12-01

    Full Text Available Objetivos. Determinar la frecuencia y las características clínicas de las infecciones del sistema nervioso central por enterovirus en niños atendidos en el Hospital Nacional Cayetano Heredia de Lima, Perú. Materiales y métodos. Se realizó un estudio prospectivo y descriptivo desde abril 2008 hasta marzo 2010. Se enrolaron pacientes de un mes a 14 años con diagnóstico clínico de encefalitis o meningitis asépticas. Se investigó la presencia de enterovirus, virus herpes simple 1 (VHS-1, virus herpes simple 2 (VHS-2 y virus varicela-zoster (VZV mediante reacción en cadena de polimerasa (PCR. Resultados. Se enrolaron 97 pacientes de los cuales 69 % presentaron encefalitis aguda y 31 % meningitis aguda. Se identificó enterovirus en 52,6 % del total de infecciones agudas no bacterianas del sistema nervioso central; encontrándose en 83,3 % de las meningitis y en 38,8 % de las encefalitis. No hubo casos de infección por VHS-1, VHS-2 ni VZV. Las infecciones por enterovirus alcanzaron el 82,9 % en los meses cálidos de noviembre a enero y el 28,6 % en los meses fríos de mayo a julio. Conclusiones. Los enterovirus fueron los principales agentes etiológicos en las encefalitis y meningitis asépticas agudas en pacientes pediátricos de Lima, Perú. Los enterovirus tienen un comportamiento epidemiológico estacional con un claro aumento del número de casos en los meses de verano. Resulta útil tener disponible un método de diagnóstico rápido, como una ayuda para el manejo de las infecciones agudas del sistema nervioso.Objectives. To determine the frequency and clinical features of central nervous system infections caused by enterovirus in children treated at the Hospital Nacional Cayetano Heredia in Lima, Peru. Materials and methods. A prospective, descriptive study was performed from April 2008 to March 2010. Patients aged 1 month - 14 years with clinical diagnosis of encephalitis or aseptic meningitis were included. We investigated the

  15. Geoarchaeological investigation at Al-Khiday (central Sudan): late Quaternary palaeoenvironment and site formation

    Science.gov (United States)

    Zerboni, Andrea; Usai, Donatella; Salvatori, Sandro

    2010-05-01

    The micromorphological investigation on several pluristratified archaeological sites in central Sudan (Al-Khiday, left bank of the White Nile, Khartoum region, Sudan) permitted to elucidate depositional and post-depositional processes playing a role in the formation and preservation of the archaeological record. At Al-Khiday sites are located at the top of small mounds, representing the remains of Pleistocene sandy fluvial bars, and were attended since the beginning of the Holocene. The first occupation of the area corresponds to a pre-Mesolithic cemetery; than Mesolithic groups lived upon the mounds and their occupation is testified by several archaeological features: pits filled by ash and bones and living floors. Preserved Neolithic features are scarce and limited to few graves (V millennium BC). After this phase, a long gap in human attendance is registered, during which wind continued to dismantling the mounds and the sites; at ca. 2000 years BP Meroitic/Post-Meroitic groups built their tombs at the top of the archaeological sequences and altered most of the stratigraphic record. Thanks to micromorphology, it was possible to distinguish between archaeological strata still in situ and those disturbed by natural and anthropic processes; furthermore, this approach allowed to interpret the significance of several archaeological features (living floors, fireplaces, and garbage pits). In this case micromorphology of archaeological deposits was a key tool to reconstruct the depositional and post-depositional processes that contributed to the formation and preservation of the archaeological record.

  16. ARTRODESIS TIBIOTALOCALCANEA CON PLACA PHILOS: EXPERIENCIA EN EL HOSPITAL MILITAR CENTRAL. ENERO 2007 A DICIEMBRE DE 2009

    OpenAIRE

    MUÑOZ FALLA, GERARDO ALEXI; DELGADO NEIRA, ALEJANDRO; ENRIQUE GAMBA, CESAR; HERNÁNDEZ PERDOMO, EDGAR

    2011-01-01

    Estudio descriptivo observacional, retrospectivo tipo serie de casos, realizado entre enero de 2007 y diciembre de 2009 en el Hospital Militar Central. Fueron tratados 21 pacientes con artrosis de la articulación tibio talar y subtalar de etiología diversa, con seguimiento mínimo de 6 meses. Se evaluó; la función pre operatoria y post operatoria por medio de la escala AOFAS, el dolor mediante la escala visual análoga, el tiempo de consolidación con controles radiográficos, el tipo de injerto ...

  17. Neurocognitive sequelae of cerebral malaria in adults: a pilot study in Benguela Central Hospital, Angola.

    Science.gov (United States)

    Peixoto, Bruno; Kalei, Isabel

    2013-07-01

    To characterize the neurocognitive sequelae of cerebral malaria (CM) in an adult sample of the city of Benguela, Angola. A neuropsychological assessment was carried out in 22 subjects with prior history of CM ranging from 6 to 12 months after the infection. The obtained results were compared to a control group with no previous history of cerebral malaria. The study was conducted in Benguela Central Hospital, Angola in 2011. CM group obtained lower results on the two last trials of a verbal learning task and on an abstract reasoning test. CM is associated to a slower verbal learning rate and to difficulties in the ability to discriminate and perceive relations between new elements.

  18. Lucha tras las rejas franquistas. La prisión central de mujeres de Segovia

    OpenAIRE

    Santiago VEGA SOMBRÍA; Juan Carlos GARCÍA FUNES

    2012-01-01

    Edificio de tipo panóptico inaugurado en 1924 como Reformatorio de Mujeres, posteriormente sería Hospital Asilo Penitenciario para ancianos y enfermos de tuberculosis. Con la guerra civil se vio abarrotado de presos políticos, que ya no abandonarían el edificio durante toda la dictadura. En 1946 se transformó en Prisión Central de Mujeres y, durante sus diez años de existencia, albergó al mayor contingente de luchadoras antifranquistas españolas, que convirtieron esta prisión en un centro de ...

  19. Dizziness in a community hospital: central neurological causes, clinical predictors, and diagnostic yield and cost of neuroimaging studies.

    Science.gov (United States)

    Ammar, Hussam; Govindu, Rukma; Fouda, Ragai; Zohdy, Wael; Supsupin, Emilio

    2017-03-01

    Objectives : Neuroimaging is contributing to the rising costs of dizziness evaluation. This study examined the rate of central neurological causes of dizziness, relevant clinical predictors, and the costs and diagnostic yields of neuroimaging in dizziness assessment. Methods : We retrospectively reviewed the records of 521 adult patients who visited the hospital during a 12-month period with dizziness as the chief complaint. Clinical findings were analyzed using Fisher's exact test to determine how they correlated with central neurological causes of dizziness identified by neuroimaging. Costs and diagnostic yields of neuroimaging were calculated. Results : Of the 521 patients, 1.5% had dizziness produced by central neurological causes. Gait abnormalities, limb ataxia, diabetes mellitus, and the existence of multiple neurological findings predicted central causes. Cases were associated with gait abnormalities, limb ataxia, diabetes mellitus, and the existence of multiple neurological findings . Brain computed tomography (CT) and magnetic resonance imaging (MRI) were performed in 42% and 9.5% of the examined cases, respectively, with diagnostic yields of 3.6% and 12%, respectively. Nine cases of dizziness were diagnosed from 269 brain scans, costing $607 914. Conclusion : Clinical evaluation can predict the presence of central neurological causes of dizziness, whereas neuroimaging is a costly and low-yield approach. Guidelines are needed for physicians, regarding the appropriateness of ordering neuroimaging studies. Abbreviations : OR: odds ratio; CI: confidence interval; ED: emergency department; CT: computed tomography; MRI: magnetic resonance imaging; HINTS: Head impulse, Nystagmus, Test of skew.

  20. Central Diabetes Insipidus, Central Hypothyroidism, Renal Tubular ...

    African Journals Online (AJOL)

    readmitted to the hospital because of jaundice and failure to thrive, for which he was investigated and diagnosed to have central congenital hypothyroidism. Shortly thereafter, he was admitted to our institute with a history of vomiting, decreased oral intake, polyuria, and dehydration having lasted 5 days. He was investigated ...

  1. Effects of dietary pattern and education on glycemic control in patients with type 2 diabetes mellitus at Dr. Sardjito Central General Hospital, Yogyakarta.

    Science.gov (United States)

    Sinorita, Hemi; Saádah; Jazakillah, Setyowati

    2008-04-01

    to recognize the effect of education and diet on glycemic control in patients with type 2 diabetes mellitus at Dr. Sardjito Central General Hospital, Jogjakarta. a cross-sectional study was conducted in 88 patients with type 2 DM who had routine visit to the outpatient clinic in Endocrinology Division of Dr. Sardjito Central General Hospital, Jogjakarta. As inclusion criteria, patients who had routine visit in 3 month continuously with fasting plasma glucose (GDN) 126 mg/dl as poor glycemic control group. Data were recorded which included age, sex, period of DM, daily diet pattern, and education received. we found that glycemic control was not affected by sex (p=0.52) and age (p=0.38), but it was affected by period of DM (p=0.02). Glycemic control in the present study was affected by dietary pattern (p=0.01), but not by education (p=1.00). the present study has found significant correlation between regulation of dietary pattern and glycemic control (p=0.01).

  2. Clinical and endoscopic profile of the patients with upper gastrointestinal bleeding in central rural India: A hospital-based cross-sectional study

    Directory of Open Access Journals (Sweden)

    Jyoti Jain

    2018-01-01

    Full Text Available Introduction: Acute Upper Gastrointestinal bleeding (UGIB is one of the common causes with which the patients present to emergency. The upper gastrointestinal (UGI endoscopy remains a crucial tool in identification of UGIB. The aim of the present study was to determine the endoscopic profile of UGIB in adult population of rural central India admitted with history of UGIB (hemetemesis and/or malena. Methods: This prospective, cross sectional study was conducted in rural hospital in central India and we enrolled all consecutive patients aged 18 years and above who were admitted in the hospital ward with the history of UGIB. After obtaining the demographic data, all patients underwent clinical examination, laboratory investigations and video-endoscopy. We used Student's t test to compare means, Chi-square test to compare proportions and Mann-Whitney test to compare medians. P value <0.05 will be considered significant. Results: The mean age of our study population (N = 118 was 46.2 years. Among 118 patients who underwent endoscopy, 47.4% had esophageal varices, 27.1% had portal hypertensive gastropathy, 14.4% had gastric erosions, 5.9% each had duodenal ulcers and esophagitis, 5% had gastric ulcer disease, 4.2% each had Mallory-Weiss tear and had gastric malignancy, 1.7% had esophageal malignancy and 16.1% had normal endoscopic findings. Conclusion: Esophageal varices were the most common cause of UGIB in the adult population of rural central India presenting with UGIB, when diagnosed by video-endoscopy.

  3. Tracking the 10Be–26Al source-area signal in sediment-routing systems of arid central Australia

    Directory of Open Access Journals (Sweden)

    M. Struck

    2018-05-01

    Full Text Available Sediment-routing systems continuously transfer information and mass from eroding source areas to depositional sinks. Understanding how these systems alter environmental signals is critical when it comes to inferring source-area properties from the sedimentary record. We measure cosmogenic 10Be and 26Al along three large sediment-routing systems ( ∼  100 000 km2 in central Australia with the aim of tracking downstream variations in 10Be–26Al inventories and identifying the factors responsible for these variations. By comparing 56 new cosmogenic 10Be and 26Al measurements in stream sediments with matching data (n =  55 from source areas, we show that 10Be–26Al inventories in hillslope bedrock and soils set the benchmark for relative downstream modifications. Lithology is the primary determinant of erosion-rate variations in source areas and despite sediment mixing over hundreds of kilometres downstream, a distinct lithological signal is retained. Post-orogenic ranges yield catchment erosion rates of  ∼  6–11 m Myr−1 and silcrete-dominant areas erode as slow as  ∼  0.2 m Myr−1. 10Be–26Al inventories in stream sediments indicate that cumulative-burial terms increase downstream to mostly  ∼  400–800 kyr and up to  ∼  1.1 Myr. The magnitude of the burial signal correlates with increasing sediment cover downstream and reflects assimilation from storages with long exposure histories, such as alluvial fans, desert pavements, alluvial plains, and aeolian dunes. We propose that the tendency for large alluvial rivers to mask their 10Be–26Al source-area signal differs according to geomorphic setting. Signal preservation is favoured by (i high sediment supply rates, (ii high mean runoff, and (iii a thick sedimentary basin pile. Conversely, signal masking prevails in landscapes of (i low sediment supply and (ii juxtaposition of sediment storages with notably different exposure

  4. Comparision between bed side testing of blood glucose by glucometer vs centralized testing in a tertiary care hospital.

    Science.gov (United States)

    Baig, Ayaz; Siddiqui, Imran; Jabbar, Abdul; Azam, Syed Iqbal; Sabir, Salman; Alam, Shahryar; Ghani, Farooq

    2007-01-01

    To determine the accuracy, turnaround time and cost effectiveness of bedside monitoring of blood glucose levels by non-laboratory health care workers and centralized testing of blood glucose by automated analyzer in a tertiary care hospital. The study was conducted in Section of Chemical Pathology, Department of Pathology and Microbiology and Section of Endocrinology Department of Medicine, Aga Khan University and Hospital Karachi, from April 2005 to March 2006. One hundred and ten patients were included in the study. The blood glucose levels were analyzed on glucometer (Precision Abbott) by finger stick, using Biosensor Technology. At the same time venous blood was obtained to analyze glucose in clinical laboratory on automated analyzer (SYNCHRON CX7) by glucose oxidase method. We observed good correlation between bed side glucometer and laboratory automated analyzer for glucose values between 3.3 mmol/L (60 mg/dl) and 16.7 (300 mg/dl). A significant difference was observed for glucose values less than 3.3 mmol/L (p = 0.002) and glucose values more than 16.67 mmol/l (p = 0.049). Mean Turnaround time for glucometer and automated analyzer were 0.08 hours and 2.49 hours respectively. The cost of glucose testing with glucometer was 48.8% lower than centralized lab based testing. Bedside glucometer testing, though less expensive does not have good accuracy in acutely ill patient with either very high or very low blood glucose levels.

  5. A Ten Year Descriptive Study of Adult Leukaemia at Al-Jomhori Teaching Hospital in Sana'a, Yemen

    Directory of Open Access Journals (Sweden)

    Jameel Al-Ghazaly

    2014-12-01

    Full Text Available Background: There is scarcity of data of the epidemiology of leukaemia in Arab countries including Yemen. Understanding patterns of leukaemia underpins epidemiology and can provide insight into disease etiology. The aim of this research is to determine the epidemiologic pattern of adult leukaemia in Yemen. Methods: The research is a descriptive cross-sectional study. We analyzed the data of 702 adult patients with leukaemia, who were newly diagnosed over a ten-year period between October 1999 and October 2009 at the referral haematology centre in Sana’a at Al-Jomhori Teaching Hospital, according to type of leukaemia, age, sex, geographic distribution and time of diagnosis. Results: Acute Myeloid Leukaemia (AML was found to be the most common (45.1% followed by Chronic Myeloid Leukaemia (CML (26.5%, Acute Lymphoid Leukaemia (ALL (17.7% and Chronic Lymphoid Leukaemia (CLL (10.7%, respectively. There was an almost equal prevalence of AML and CML for males and females but males had significantly more cases of ALL and CLL (p =0.008. A significant variation in geographic pattern showed that the highest number of cases is seen the Central mountainous region and the least number of cases in the South-eastern region which is coastal and lowland (p<0.001. The seasonal variation showed that higher number of ALL cases was seen in the summer months (33% compared with other seasons (21% in the spring, 24.2% in autumn and 21.8% in winter. Conclusions: The pattern of adult leukaemia in Yemen is different from that seen in western countries which could be attributed to different environmental exposure. The geographic pattern indicates a possible role of certain environmental factors which warrant further investigations. The pattern of seasonal variation needs further studies for evaluating the seasonality.

  6. Towards a smoke-free hospital: how the smoking status of health professionals influences their knowledge, attitude and clinical activity. Results from a hospital in central Italy.

    Science.gov (United States)

    Giorgi, E; Marani, A; Salvati, O; Mangiaracina, G; Prestigiacomo, C; Osborn, J F; Cattaruzza, M S

    2015-01-01

    In Italy, the prevalence of smoking among health professionals is higher than in the general population and this might hamper their role in the promotion of health. This study aimed to investigate how the smoking status of healthcare professionals might influence knowledge, attitudes and clinical practice in a hospital in central Italy in order to enforce effective tobacco control measures. Physicians and professionals of the hospital were asked to complete an anonymous questionnaire which yielded epidemiological and environmental information on knowledge, attitude, clinical practice and quality of the hospital environments, in relation to smoking. Overall, among the employees of the hospital, the smoking prevalence was 47%, (42% among physicians and 43% among nurses); 30% admitted smoking in the hospital and three quarters of the smokers would like to quit. Some knowledge, opinions and attitudes differ statistically among the smoking categories. For example, only 35% of the smokers admitted that smoking is more dangerous to health than atmospheric and car pollution compared with 60% of the ex or never smokers (p=0.04). Fewer smokers realize that their behavior is seen as a role model by patients. A greater percentage of smokers state that patients (34%) and visitors (43%) often smoke in hospital and these percentages are significantly higher than those reported by ex or never smokers (p≤0.05). All smokers claim that they never smoke in patient rooms, infirmaries and clinics, whereas over 20% of ex or never smokers report that smoking sometimes occurs in these places (p=0.015). The mean concentration of PM 2.5 in the 25 rooms was 2.4 μg/m3 with a range from 1 to 7 μg/m3. This study implies that the prevalence of smoking among health professionals may be very high, and might be twice the rate observed in the general population. Generally, smokers report less knowledge compared with ex and never-smokers and it seems that they systematically underestimate the

  7. Outcomes after out-of-hospital cardiac arrest treated by basic vs advanced life support.

    Science.gov (United States)

    Sanghavi, Prachi; Jena, Anupam B; Newhouse, Joseph P; Zaslavsky, Alan M

    2015-02-01

    Most out-of-hospital cardiac arrests receiving emergency medical services in the United States are treated by ambulance service providers trained in advanced life support (ALS), but supporting evidence for the use of ALS over basic life support (BLS) is limited. To compare the effects of BLS and ALS on outcomes after out-of-hospital cardiac arrest. Observational cohort study of a nationally representative sample of traditional Medicare beneficiaries from nonrural counties who experienced out-of-hospital cardiac arrest between January 1, 2009, and October 2, 2011, and for whom ALS or BLS ambulance services were billed to Medicare (31,292 ALS cases and 1643 BLS cases). Propensity score methods were used to compare the effects of ALS and BLS on patient survival, neurological performance, and medical spending after cardiac arrest. Survival to hospital discharge, to 30 days, and to 90 days; neurological performance; and incremental medical spending per additional survivor to 1 year. Survival to hospital discharge was greater among patients receiving BLS (13.1% vs 9.2% for ALS; 4.0 [95% CI, 2.3-5.7] percentage point difference), as was survival to 90 days (8.0% vs 5.4% for ALS; 2.6 [95% CI, 1.2-4.0] percentage point difference). Basic life support was associated with better neurological functioning among hospitalized patients (21.8% vs 44.8% with poor neurological functioning for ALS; 23.0 [95% CI, 18.6-27.4] percentage point difference). Incremental medical spending per additional survivor to 1 year for BLS relative to ALS was $154,333. Patients with out-of-hospital cardiac arrest who received BLS had higher survival at hospital discharge and at 90 days compared with those who received ALS and were less likely to experience poor neurological functioning.

  8. ÁCAROS ASOCIADOS AL CULTIVO DEL AGUACATE (Persea americana Mill EN LA COSTA CENTRAL DE PERÚ

    Directory of Open Access Journals (Sweden)

    Jorge Luis Muñoz Marticorena

    2014-01-01

    Full Text Available En la costa central de Perú (Lima e Ica, se cultiva el aguacate con fines de exportación, especialmente la variedad Hass. Con el objetivo de conocer la diversidad de ácaros depredadores en huertos comerciales de aguacate, se realizaron recolectas en 6 lugares de la costa central, duran - te el 2010 al 2012. Se registraron 12 especies de la familia Phytoseiidae, de los cuales algunos tendrían potencial como depredadores eficien - tes de Oligonychus sp . (Guanilo et ál. 2012; estos son: Amblyseius aerialis (Muma, Ambly - seius chungas (Demmark y Muma, Amblyseiella setosa (Muma, Euseius emanus (El–Banhawy, Euseius concordis (Chant, Euseius stipulatus (Athias–Henriot, Phytoseiulus persimilis (Athias Henriot, Phytoseiulus macropilis (Banks, Neo - seiulus californicus (McGregor, Typhlodromina subtropica (Chant, Typhlodromus ( Antoseius evectus (Schusters y Aristadromips n.sp. Se con - firmó que la vegetación espontánea cumple un rol importante en la conservación de las especies halladas en este cultivo y que además la intro - ducción de un ácaro depredador exótico, como Euseius stipulatus, contribuyó significativamente con el control de la plaga durante la temporada de invierno.

  9. Hospital Presbiteriano Valley

    Directory of Open Access Journals (Sweden)

    Luckman, Charles

    1964-12-01

    Full Text Available This hospital is built on the circular system. This arrangement has economic and functional advantages. The nurses walk 40 % less distance than in a hospital of similar size, of conventional layout. The rooms are situated along the external perimeter and the beds are orientated towards the corridor, rather than towards the window. However, the patients can see out of doors by turning on their side. The hospital is most carefully fitted out, and is very comfortable. There is air conditioning, and patients can control their own TV sets. There are also curtains separating each bed form the rest, thus providing maximum independence. Warm colours have been adopted in the decoration of rooms facing north, whilst those facing south are painted in cooler tones. The circular design arrangement makes the distribution far more flexible, and it will be easier to include further units later on; by adding small adjustments to the central building. To reduce external noise, and to improve the surrounding landscape, small sand hills have been provided in the garden, and the parking site also serves to partially absorb the noise.Presenta esta solución de unidades circulares numerosas ventajas de tipo económico, ahorra espacio y da eficiencia a la circulación— las enfermeras recorren un 40 por 100 menos de camino que en otro hospital de dimensiones similares—. Las habitaciones están distribuidas a lo largo del perímetro exterior y tienen las camas orientadas hacia los corredores, en lugar de hacia las ventanas, pero de tal modo que los pacientes puedan contemplar el exterior al volverse sobre uno de sus costados. Están cuidadosamente diseñadas y dotadas de las máximas comodidades: aire acondicionado y aparatos de televisión controlados por el paciente; así como cortinas divisorias que le proporcionan el grado de aislamiento deseado.

  10. Peripherally Inserted Central Catheters (PICCs) and Potential Cost Savings and Shortened Bed Stays In an Acute Hospital Setting.

    LENUS (Irish Health Repository)

    O’Brien, C

    2018-01-01

    Peripheral inserted central catheters (PICCs) have increasingly become the mainstay of patients requiring prolonged treatment with antibiotics, transfusions, oncologic IV therapy and total parental nutrition. They may also be used in delivering a number of other medications to patients. In recent years, bed occupancy rates have become hugely pressurized in many hospitals and any potential solutions to free up beds is welcome. Recent introductions of doctor or nurse led intravenous (IV) outpatient based treatment teams has been having a direct effect on early discharge of patients and in some cases avoiding admission completely. The ability to deliver outpatient intravenous treatment is facilitated by the placement of PICCs allowing safe and targeted treatment of patients over a prolonged period of time. We carried out a retrospective study of 2,404 patients referred for PICCs from 2009 to 2015 in a university teaching hospital. There was an exponential increase in the number of PICCs requested from 2011 to 2015 with a 64% increase from 2012 to 2013. The clear increase in demand for PICCs in our institution is directly linked to the advent of outpatient intravenous antibiotic services. In this paper, we assess the impact that the use of PICCs combined with intravenous outpatient treatment may have on cost and hospital bed demand. We advocate that a more widespread implementation of this service throughout Ireland may result in significant cost savings as well as decreasing the number of patients on hospital trollies.

  11. Hospital Geriátrico Ellesmere Gran Bretaña

    Directory of Open Access Journals (Sweden)

    Stow, Derek

    1980-11-01

    Full Text Available This center was designed to serve as a prototype for geriatric hospitals, in accordance with the program drawn up by the health authorities of the southeast area of the Thames; for this reason, its design had to be such that it could be reused in different hospital complexes. It consists of a pavilion with an infirmary equipped with different clinical, therapeutical and social services for senior citizens. In order to render possible the realization of the prototype on locations with different conditioning factors —in this case the unit was built on the grounds of an important medical center—, the auxiliary and service premises were designed separately, thus facilitating a different implementation with respect to the central nucleus, in accordance with varying circumstances

    Este centro se concibió para que sirviera como prototipo de hospital geriátrico, de acuerdo con el programa confeccionado por las autoridades sanitarias del suroeste del Támesis; por ello su diseño debía hacerle capaz de ser reutilizado en distintos complejos hospitalarios. Consta de un pabellón con ambulatorio equipado con distintos servicios clínicos, terapéuticos y de tipo social dirigidos a la tercera edad. Con el fin de posibilitar la realización del prototipo en parcelas sometidas a distintos condicionantes —en este caso, la unidad se construyó en los terrenos de un importante centro médico—, los locales auxiliares y de servicio fueron objeto de un diseño independiente facilitando, por tanto, su distinta implantación respecto al núcleo central, de acuerdo con las diferentes circunstancias.

  12. Benefiting from networks by occupying central positions: an empirical study of the Taiwan health care industry.

    Science.gov (United States)

    Peng, Tzu-Ju Ann; Lo, Fang-Yi; Lin, Chin-Shien; Yu, Chwo-Ming Joseph

    2006-01-01

    At issue is whether network resources imply some resources available to all members in networks or available only to those occupying structurally central positions in networks. In this article, two conceptual models, the additive and interaction models of the firm, are empirically tested regarding the impact of hospital resources, network resources, and centrality on hospital performance in the Taiwan health care industry. The results demonstrate that: (1) in the additive model, hospital resources and centrality independently affect performance, whereas network resources do not; and (2) no evidence supports the interaction effect of centrality and resources on performance. Based on our findings in Taiwanese practices, the extent to which the resources are acquired externally from networks, we suggest that while adopting interorganizational strategies, hospitals should clearly identify those important resources that reside in-house and those transferred from network partners. How hospitals access resources from central positions is more important than what network resources can hospitals acquire from networks. Hospitals should improve performance by exploiting its in-house resources rather than obtaining network resources externally. In addition, hospitals should not only invest in hospital resources for better performance but should also move to central positions in networks to benefit from collaborations.

  13. Comparability of Point-of-Care versus Central Laboratory Hemoglobin Determination in Emergency Patients at a Supra-Maximal Care Hospital.

    Science.gov (United States)

    Dolscheid-Pommerich, Ramona C; Dolscheid, Sarah; Grigutsch, Daniel; Stoffel-Wagner, Birgit; Graeff, Ingo

    2016-01-01

    Fulfilling the requirements of point-of-care testing (POCT) training regarding proper execution of measurements and compliance with internal and external quality control specifications is a great challenge. Our aim was to compare the values of the highly critical parameter hemoglobin (Hb) determined with POCT devices and central laboratory analyzer in the highly vulnerable setting of an emergency department in a supra maximal care hospital to assess the quality of POCT performance. In 2548 patients, Hb measurements using POCT devices (POCT-Hb) were compared with Hb measurements performed at the central laboratory (Hb-ZL). Additionally, sub collectives (WHO anemia classification, patients with Hb 85y.) were analyzed. Overall, the correlation between POCT-Hb and Hb-ZL was highly significant (r = 0.96, p2.5g/dl occurred. McNemar´s test revealed significant differences regarding anemia diagnosis according to WHO definition for male, female and total patients (♂ phemoglobin concentration measurement methods, i.e. POCT devices and at the central laboratory. The results confirm the successful implementation of the presented POCT concept. Nevertheless some limitations could be identified in anemic patients stressing the importance of carefully examining clinically implausible results.

  14. Aspergilosis cervical con diseminaci?n al sistema nervioso central. Presentaci?n de un caso y revisi?n de bibliograf?a

    OpenAIRE

    Vergara, Guillermo Enrique; Roura, Natalia; del Castillo, Marcelo; Mora, Andrea; Alcorta, Santiago Condomi; Mormandi, Rub?n; Cervio, Andr?s; Salvat, Jorge

    2015-01-01

    Introducci?n: la Aspergilosis Invasiva (AI) del Sistema Nervioso Central (SNC) es infrecuente y ocurre generalmente en pacientes inmunocomprometidos. Puede presentarse con cuadros de meningitis, aneurismas mic?ticos, infartos o abscesos. Es una infecci?n con pron?stico reservado y puede afectar el SNC de forma primaria o secundaria a partir de un foco que se disemina por v?a hemat?gena. Presentamos el caso de un paciente con AI con invasi?n primaria a nivel ?seo y diseminaci?n posterior al ce...

  15. Los fines de la presencia de la Orden del Hospital en Castilla (Siglos XII y XIII = The objectives of the presence of the Order of the Hospital in Castile during the 12th and 13th Centuries

    Directory of Open Access Journals (Sweden)

    Carlos Barquero Goñi

    2015-06-01

    Full Text Available Las fuentes nos informan muy poco acerca de la suerte que tenían los recursos obtenidos por la Orden del Hospital de sus posesiones en la Corona de Castilla durante los siglos XII y XIII. Con toda seguridad lo primero en que debían utilizarse estas sumas era en el mantenimiento de todas las instalaciones y miembros de la Orden en Castilla y León. Lo que sobrase después de esto se habría de emplear en cuatro partidas distintas: aportaciones al convento central del Hospital en Oriente, actividad militar en la propia Corona de Castilla, desempeño de funciones asistenciales y propiamente hospitalarias, y soporte para algunas operaciones financieras.The sources provide us with scarce information on the use of resources obtained by the Order of the Hospital from its possessions in the Crown of Castile during the twelfth and thirteenth centuries. There is no doubt that this wealth was destined in the first place for the maintenance of all the facilities and members of the Order in Castile and Leon. What remained thereafter would be allocated to four different areas: Contributions to the central convent of the Hospital in the East; military activity within the Crown of Castile itself; coverage of welfare and specifically hospitaller functions; and support for certain financial operations.

  16. Tuberculosis patients hospitalized in the Albert Schweitzer Hospital, Lambaréné, Gabon-a retrospective observational study

    NARCIS (Netherlands)

    Stolp, S. M.; Huson, M. A. M.; Janssen, S.; Beyeme, J. O.; Grobusch, M. P.

    2013-01-01

    Epidemiological data on tuberculosis in Central Africa are limited. We performed a retrospective observational study on clinical characteristics of 719 hospitalized tuberculosis patients in Lambaréné, Gabon. Human immunodeficiency virus (HIV) co-infection rate was high (34%) and in-hospital

  17. Decentralization or centralization: striking a balance.

    Science.gov (United States)

    Dirschel, K M

    1994-09-01

    An Executive Vice President for Nursing can provide the necessary link to meet diverse clinical demands when encountering centralization--decentralization decisions. Centralized communication links hospital departments giving nurses a unified voice. Decentralization acknowledges the need for diversity and achieves the right balance of uniformity through a responsive communications network.

  18. Perceptions of the hospital ethical environment among hospital social workers in the United States.

    Science.gov (United States)

    Pugh, Greg L

    2015-01-01

    Hospital social workers are in a unique context of practice, and one where the ethical environment has a profound influence on the ethical behavior. This study determined the ratings of ethical environment by hospital social workers in large nationwide sample. Correlates suggest by and compared to studies of ethical environment with nurses are explored. Positive ratings of the ethical environment are primarily associated with job satisfaction, as well as working in a centralized social work department and for a non-profit hospital. Religiosity and MSW education were not predictive. Implications and suggestions for managing the hospital ethical environment are provided.

  19. The application of hospitality elements in hospitals.

    Science.gov (United States)

    Wu, Ziqi; Robson, Stephani; Hollis, Brooke

    2013-01-01

    In the last decade, many hospital designs have taken inspiration from hotels, spurred by factors such as increased patient and family expectations and regulatory or financial incentives. Increasingly, research evidence suggests the value of enhancing the physical environment to foster healing and drive consumer decisions and perceptions of service quality. Although interest is increasing in the broader applicability of numerous hospitality concepts to the healthcare field, the focus of this article is design innovations, and the services that such innovations support, from the hospitality industry. To identify physical hotel design elements and associated operational features that have been used in the healthcare arena, a series of interviews with hospital and hotel design experts were conducted. Current examples and suggestions for future hospitality elements were also sought from the experts, academic journals, and news articles. Hospitality elements applied in existing hospitals that are addressed in this article include hotel-like rooms and decor; actual hotels incorporated into medical centers; hotel-quality food, room service, and dining facilities for families; welcoming lobbies and common spaces; hospitality-oriented customer service training; enhanced service offerings, including concierges; spas or therapy centers; hotel-style signage and way-finding tools; and entertainment features. Selected elements that have potential for future incorporation include executive lounges and/or communal lobbies with complimentary wireless Internet and refreshments, centralized controls for patients, and flexible furniture. Although the findings from this study underscore the need for more hospitality-like environments in hospitals, the investment decisions made by healthcare executives must be balanced with cost-effectiveness and the assurance that clinical excellence remains the top priority.

  20. Del Horizonte Medio al Horizonte Tardío en la Costa Sur Central: el caso del valle de Asia

    Directory of Open Access Journals (Sweden)

    2004-01-01

    Full Text Available DE L’HORIZON MOYEN A L’HORIZON RECENT SUR LA COTE CENTRALE : LE CAS DE LA VALLEE DE ASIA. La vallée de Asia, située à quelque 100 km au sud de Lima, a joué un rôle important durant l’Horizon moyen. En effet, les contextes funéraires de la Huaca Malena et les textiles élaborés qui en sont issus, suggèrent d’étroites relations avec Huari, Pachacamac, et les côtes centrale et nord. L’étude des textiles nous permet de voir que la transition de l’Horizon moyen à la période Intermédiaire récent se marque par une croissance des relations avec la côte centrale. Selon les données ethnohistoriques, la vallée de Asia était durant la période Intermédiaire récent habitée par les Coyallo, qui versaient tribut à Pachacamac. À l’Horizon récent, les Incas construisirent d’importants centres administratifs dans la vallée, et durant cette période le matériel céramique montre de fortes relations avec les styles des vallées voisines au nord, comme Mala, Chilca, et la côte aux alentours de Lima. El valle de Asia, situado a 100 kilómetros al sur de Lima, jugó un rol de importancia durante el Horizonte Medio. En efecto, los contextos funerarios de Huaca Malena, así como los finos textiles que los acompañan indican una fuerte relación con Wari, Pachacamac, la Costa Central y la Costa Norte. De acuerdo con la evidencia textil, el tránsito del Horizonte Medio al periodo Intermedio Tardío incrementó las relaciones con la costa central. Para el periodo Intermedio Tardío, de acuerdo a la información etnohistórica, el valle estuvo habitado por los coayllo, quienes tributaban a Pachacamac. Durante el Horizonte Tardío, los incas construyen importantes centros administrativos en el valle, y la cerámica durante este periodo se relacionó fuertemente con los estilos propios de los vecinos valles norteños de Mala, Chilca y la costa de Lima. FROM THE MIDDLE HORIZON TO THE LATE HORIZON ON THE SOUTH CENTRAL COAST: THE CASE OF THE

  1. American Hospital Association

    Science.gov (United States)

    ... Central Office-Coding Resources AHA Team Training Health Career Center Health Forum Connect More Regulatory Relief The regulatory burden faced by hospitals is substantial and unsustainable. Read the report . More AHA Opioid Toolkit Stem the Tide: Addressing the Opioid Epidemic More ...

  2. Evaluación de las causas de los eventos adversos o incidentes que afectan la seguridad del paciente, en el hospital central de la policía de enero 2012 a diciembre 2013

    OpenAIRE

    Alarcon Ruiz, Diego Jesus; Gil Vargas, Luis Fabio

    2016-01-01

    TITULO DEL TRABAJO: Evaluación de las causas de los eventos adversos o incidentes que afectan la seguridad del paciente, en el hospital central de la policía de enero 2012 a diciembre 2013. OBJETIVO: Determinar y analizar la causa raíz de los principales factores de riesgo que afectan la seguridad del paciente que puedan ocasionar eventos adversos en la atención de los pacientes, con el uso de la teoría de restricciones TOC en el Hospital Central de la Policía HOCEN. MATERIALES Y METODO: Se r...

  3. Hospital implementation of resuscitation guidelines and review of CPR training programmes: a nationwide study.

    Science.gov (United States)

    Schmidt, Anders S; Lauridsen, Kasper G; Adelborg, Kasper; Løfgren, Bo

    2016-06-01

    This study aimed to investigate cardiopulmonary resuscitation (CPR) guideline implementation and CPR training in hospitals. This nationwide study included mandatory resuscitation protocols from each Danish hospital. Protocols were systematically reviewed for adherence to the European Resuscitation Council (ERC) 2010 guidelines and CPR training in each hospital. Data were included from 45 of 47 hospitals. Adherence to the ERC basic life support (BLS) algorithm was 49%, whereas 63 and 58% of hospitals adhered to the recommended chest compression depth and rate. Adherence to the ERC advanced life support (ALS) algorithm was 81%. Hospital BLS course duration was [median (interquartile range)] 2.3 (1.5-2.5) h, whereas ALS course duration was 4.0 (2.5-8.0) h. Implementation of ERC 2010 guidelines on BLS is limited in Danish hospitals 2 years after guideline publication, whereas the majority of hospitals adhere to the ALS algorithm. CPR training differs among hospitals.

  4. Compliance with the guidelines of prescription writing in a central hospital in the West Bank.

    Science.gov (United States)

    Tayem, Y I; Ibrahim, M A; Qubaja, M M; Shraim, R K; Taha, O B; Abu Shkhedem, E

    2013-09-01

    This retrospective, cross-sectional study was carried out to evaluate the quality of 2208 outpatient prescriptions in a central hospital in the West Bank, Palestine. The physicians' handwriting was poorly readable or illegible in one-third of the prescriptions. The prescriber's name and signature and patient's name were mentioned in almost all orders whereas the patient's age was stated in 54.9%. The vast majority of physicians (95.5%) prescribed drugs using their trade (brand) names. Drug strength, quantity and dose/frequency were stated in 61.1%, 76% and 73.8% of prescriptions respectively. Only 33 prescriptions (1.5%) contained full directions for use for all drugs. Correlation analysis revealed that the presence of certain prescription elements was statistically significantly associated with the clinic of origin and the number of drugs prescribed. The overall poor legibility and incompleteness of the prescriptions is of concern.

  5. FACTORES ASOCIADOS AL DESARROLLO DE PREECLAMPSIA EN UN HOSPITAL DE PIURA, PERÚ

    Directory of Open Access Journals (Sweden)

    Yamalí Benites-Cóndor

    2011-01-01

    Full Text Available Introducción: La Organización Mundial de la Salud indica que diariamente fallecen alrededor de 800 mujeres por causas relacionadas al embarazo y parto, dentro de las cuales la preeclampsia ocupa el tercer lugar. Objetivo: identificar los factores asociados a preeclampsia en gestantes que fueron hospitalizadas en el Hospital de Apoyo II "Santa Rosa" de la ciudad de Piura durante el periodo junio 2010 - mayo 2011. Métodos: Se realizó un estudio descriptivo retrospectivo de casos y controles, en gestantes hospitalizadas entre junio del 2010 y mayo del 2011. Mediante un muestreo aleatorio se obtuvieron 39 casos de preeclampsia y 78 controles sin preeclampsia. Los datos fueron analizados con el paquete estadístico SPSS v19.0, en el cual se ejecutó un análisis de casos y controles no pareados aplicando la prueba Chi cuadrado. Resultados: Fueron variables significativamente asociadas con la preeclampsia: Edad 35 años (p=0,021, y número de controles prenatales mayor o igual a siete (p= 0,049. No resultaron significativos la primiparidad ni el sobrepeso. Interpretación: Se debe promover un control prenatal adecuado (traducido como siete o más controles durante la gestación, especialmente en aquellas mujeres que se encuentran en los extremos de la vida fértil.

  6. Okusanya et al (5)

    African Journals Online (AJOL)

    DELL

    rainfall and number of days with rain per month were obtained from Meteorological Institute, Oshodi, Lagos- ... Central and South America, Australia, West. Indies, Africa, (Orwa et al., 2009) and in Florida .... dominant forest tree species. In this ...

  7. Hospital costs of central line-associated bloodstream infections and cost-effectiveness of closed vs. open infusion containers. The case of Intensive Care Units in Italy

    Directory of Open Access Journals (Sweden)

    Torbica Aleksandra

    2010-05-01

    Full Text Available Abstract Objectives The aim was to evaluate direct health care costs of central line-associated bloodstream infections (CLABSI and to calculate the cost-effectiveness ratio of closed fully collapsible plastic intravenous infusion containers vs. open (glass infusion containers. Methods A two-year, prospective case-control study was undertaken in four intensive care units in an Italian teaching hospital. Patients with CLABSI (cases and patients without CLABSI (controls were matched for admission departments, gender, age, and average severity of illness score. Costs were estimated according to micro-costing approach. In the cost effectiveness analysis, the cost component was assessed as the difference between production costs while effectiveness was measured by CLABSI rate (number of CLABSI per 1000 central line days associated with the two infusion containers. Results A total of 43 cases of CLABSI were compared with 97 matched controls. The mean age of cases and controls was 62.1 and 66.6 years, respectively (p = 0.143; 56% of the cases and 57% of the controls were females (p = 0.922. The mean length of stay of cases and controls was 17.41 and 8.55 days, respectively (p Conclusions CLABSI results in considerable and significant increase in utilization of hospital resources. Use of innovative technologies such as closed infusion containers can significantly reduce the incidence of healthcare acquired infection without posing additional burden on hospital budgets.

  8. Factores biosocioculturales y uso de métodos anticonceptivos en mujeres que acuden al hospital Elpidio Berovidez Pérez, Otuzco 2014.

    OpenAIRE

    Campos Jara, Clara Luz

    2015-01-01

    La investigación tuvo como objetivo general, determinar la relación entre los factores biosocioculturales: edad, estado civil, religión, escolaridad, rol de género con el uso de métodos anticonceptivos en mujeres que acuden al consultorio de obstetricia del Hospital Elpidio Berovidez Pérez, Otuzco 2014, fue de tipo cuantitativo–prospectivo, la muestra estuvo constituida por 115 mujeres de una población de 390, los datos se obtuvieron con la técnica de la entrevista. Obteniéndose los siguiente...

  9. Factores biosocioculturales y uso de métodos anticonceptivos en mujeres que acuden al Hospital Elpidio Berovidez Pérez, Otuzco 2014

    OpenAIRE

    Campos Jara, Clara Luz

    2016-01-01

    La investigación tuvo como objetivo general, determinar la relación entre los factores biosocioculturales: edad, estado civil, religión, escolaridad, rol de género con el uso de métodos anticonceptivos en mujeres que acuden al consultorio de obstetricia del Hospital Elpidio Berovidez Pérez, Otuzco 2014, fue de tipo cuantitativo–prospectivo, la muestra estuvo constituida por 115 mujeres de una población de 390, los datos se obtuvieron con la técnica de la entrevista. Obteniéndose los siguiente...

  10. Original Article Hospital Acquired Infection in Obafemi Awolowo ...

    African Journals Online (AJOL)

    2011-08-07

    Aug 7, 2011 ... This study assesses the pattern of hospital acquired infections. (HAIs) and state of hygiene ... Unfortunately, due to inadequate resources and commitment to ... Turkey, India and Mexico (Rosenthal et al., 2005;. Salomao et al.

  11. A Computerized Hospital Patient Information Management System

    Science.gov (United States)

    Wig, Eldon D.

    1982-01-01

    The information processing needs of a hospital are many, with varying degrees of complexity. The prime concern in providing an integrated hospital information management system lies in the ability to process the data relating to the single entity for which every hospital functions - the patient. This paper examines the PRIMIS computer system developed to accommodate hospital needs with respect to a central patient registry, inpatients (i.e., Admission/Transfer/Discharge), and out-patients. Finally, the potential for expansion to permit the incorporation of more hospital functions within PRIMIS is examined.

  12. Orden monetario y bancos centrales Monetary order and Central Banks

    Directory of Open Access Journals (Sweden)

    Aglietta Michel

    1996-06-01

    Full Text Available Con el enfoque evolucionista e institucionalista de la economía de las convenciones francesa, este trabajo analiza el surgimiento histórico de la banca central y la creación institucional del 'arte de la banca central'. El artículo estudia los modelos formales del orden monetario, la banca libre y la banca central, y analiza los eventos históricos que llevaron a que el Banco de Inglaterra inventara el arte de manejar los bancos centrales en conjunción con el aprendizaje colectivo e institucional que lo hizo posible. Aglietta muestra que la banca central no es una creación del Estado sino una creación institucional endógena al sistema de mercado.With the evolutionist and institutionalist focus of the economics of the French conventions, this paper analyzes the historical rise of the central bank and the institutional creation of the 'art of the central bank'. The article studies formal models of the monetary order, free banking and the central bank, and analyzes the historie events that led to the Bank of England inventing the art of managing the central banks, in conjunction with the collective and institutional learning that made it possible. Aglietta shows that the central bank is not a creation of the State, but rather aninstitutional creation endogenous to the market system.

  13. The effects of hospital reforms on the management of public hospitals in Tanzania: Challenges and lessons learnt.

    Science.gov (United States)

    Shwekerela, Byera

    2014-01-01

    Although hospital reforms are being advocated internationally as part of a solution to hospital management problems in developing countries, studies have shown that they do give rise to some challenges. A study was undertaken that used in-depth interviews, focus group discussion and document review to examine hospital reforms. The article examines the effects of reforms on the management of Level II public hospitals in Tanzania and documents the related challenges and lessons Learnt. It is shown that hospital reforms have mixed effects in resource-strained hospitals, and that hospital reform actions may have replaced the bureaucratic inefficiencies associated with hospitals being managed from the central level (MoHSW) with the equally bureaucratic inefficiencies that characterize the management of these hospitals from a supposedly local level, the office of the Regional Administrative Secretary (RAS). Managing hospitals from this level seems to cause many hospital management problems to be left unattended.

  14. Incidence of thrombosis in children with tunneled central venous access devices versus peripherally inserted central catheters (PICCs).

    Science.gov (United States)

    Kanin, Maralee; Young, Guy

    2013-11-01

    The recent proliferation of deep vein thrombosis in children has been attributed to the increased use of central venous catheters, specifically tunneled lines and peripherally inserted central catheters. A formal comparison of the incidence rate for deep vein thrombosis between tunneled lines and peripherally inserted central catheters has not been undertaken. Children inclusion. Data were extracted from the hospital discharge database which includes data on all procedures and up to 20 diagnoses per admission. Diagnoses and procedures were identified by International Classification of Disease, Ninth Revision coding. Patients were excluded if they received more than one central line. Data collected included type of central line, deep vein thrombosis event, and underlying medical illnesses classified according to chronic complex conditions. Over the seven year study period there was an overall rate of 73 deep vein thromboses per 10,000 hospital discharges. Of the 6915 eligible subjects, 181 had a deep vein thrombosis for an overall incidence rate of 2.6%. There were 152 thrombi (2.6%) in subjects with peripherally inserted central catheters and 29 thrombi (3.1%) in subjects with tunneled lines [OR=.83 (0.55, 1.29), p=0.38]. Despite the relative ease and simplicity of use of peripherally inserted central catheters leading to a substantial rise in their use, this study demonstrates that such lines pose a substantial risk for venous thrombosis and no difference in incidence was detected between such lines and tunneled lines. © 2013.

  15. Assessing the effectiveness of interpersonal communication skills training on job satisfaction among nurses in Al-Zahra Hospital of Isfahan, Iran.

    Science.gov (United States)

    Dehaghani, Abdollah Rezaei; Akhormeh, Kobra Ahmadi; Mehrabi, Tayyebeh

    2012-05-01

    The worldwide nursing shortage is threatening the quality of healthcare. The two most common causes in maintaining nurses are job satisfaction, a positive working environment, and good relationships among staff. This study aimed to determine the effect of interpersonal communication skills training on job satisfaction among the nurses working in Al-Zahra Hospital affiliated to Isfahan University of Medical Sciences, Isfahan, Iran, in 2011. This study was a quasi-experimental research with two groups and two phases, and was carried out on 70 nurses from Al-Zahra University Hospital. Only nurses who had been employed for more than one year were accepted into the study. There were 35 nurses in the test group and 35 nurses in the control group. The study questionnaire included personal details and job satisfaction scale by Smith and Kendall. Sampling was done randomly and nurses were divided into test and control groups. In the test group, the communication skills training program was done in 6 sessions, twice a week and each session was held for 2 hours. The questionnaire was completed in two stages; before, and two months after the study. Data were analyzed by descriptive and inferential statistics through SPSS Software version 18. Findings showed that pre-intervention mean score of job satisfaction of nurses in both groups had no significant difference (p = 0.92). After the communication skills training program in the experimental group, mean score of job satisfaction increased and it was significant compared to the control group (p interpersonal communication skills training program increased the mean score of job satisfaction in the test group. Therefore, it seems necessary that nursing managers design training programs for them.

  16. El hospital universitario

    Directory of Open Access Journals (Sweden)

    José Félix Patiño-Restrepo

    2016-10-01

    Full Text Available Según el Diccionario de la Real Academia Española (1, el vocablo hospital viene del latín hospitālis y en su primera acepción se define como: “1. m. Establecimiento destinado al diagnóstico y tratamiento de enfermos, donde a menudo se practican la investigación y la docencia”. Sin embargo, las otras acepciones se refieren a sus orígenes medievales: “2. m. Casa que servía para recoger pobres y peregrinos por tiempo limitado. 3. adj. ant. Afable y caritativo con los huéspedes. 4. adj. ant. Perteneciente o relativo al buen hospedaje”. El hospital moderno, en realidad, es la combinación de ciencia, tecnología, hospedaje y humanitarismo. ¿Cuándo nació el hospital y cuál es su historia? En la Edad Media temprana surgieron los xenodochia, albergues para pobres y peregrinos fundados por la iglesia católica en el marco del sentido humanitario del cristianismo. En los comienzos del siglo XIII, cuando las ciudades acumularon riqueza para sostener sus propios ejércitos, se presentó un fenómeno de crecimiento en el número de albergues y estos empezaron a caracterizarse por atender enfermos; ya para esta época no eran solo fundados por la iglesia, sino también por autoridades civiles. Aunque se siguió el modelo del Hospital del Santo Spirito de Roma, construido por orden del papa Inocencio III (1161-1216, en Francia se fundaron los Hôtel-Dieu, generalmente en la vecindad de las catedrales, que aún conservaban la característica de ser más bien albergues para los más necesitados y desamparados.

  17. Pattern of cardiovascular diseases in pilgrims admitted in Al-Noor hospital Makkah during hajj 1429 H

    International Nuclear Information System (INIS)

    Serafi, A.S.

    2010-01-01

    The number of Hajj pilgrims is increasing every year, and has crossed the huge figure of 2 million. During Hajj period of 1428H (2007G), cardiac problems have been reported as one of the commonest causes of admissions in hospitals. However, the data regarding their Nationalities, age and gender is not available in the literature. This study was carried out to identify the cardiovascular diseases in Hajj pilgrims for the year 1429 H (2008G) classified on geographical, age and gender basis, and to suggest pre-Hajj measures for their home countries and their handling by concerned Ministry during Hajj. Methods: On retrospective basis, data of all patients belonging to different Nationalities of various regions of the world, their age and gender, was analysed, who were admitted in the Coronary Care Unit (CCU) and cardiology wards at Al- Noor Specialist Hospital Makkah, over a period of 15 days in Hajj season 1429H (2008G). Results: Out of 203 patients hospitalised, the majority (94%) were older, i.e., >45 years. The patients suffering from various cardiac diseases were in the following order: heart failure cases 67%; ischemic heart disease 21.7%; and valvular heart disease 11.3%. As an outcome of total admissions (hospitalisation), 84% patients were discharged in stable condition, 9% were discharged against medical advice, 4.5% were unable to perform Hajj and 2.5% patients died. Most common cardiac diseases were found in hospitalized patients for Hajj 1429 H, which belongs to different countries over the globe. It indicate loop holes in the health services of their home countries not verifying the physical fitness of their pilgrims before allowing them to proceed for Hajj. This study will also serve as a helping tool for the Ministry of Hajj in Saudi Arabia to take appropriate measures for demanding strictness for the physical fitness of Hajj pilgrims and anticipated health services for them. (author)

  18. Japanese hospitals--culture and competition: a study of ten hospitals.

    Science.gov (United States)

    Anbäcken, O

    1994-01-01

    Japanese health care is characterized by a pluralistic system with a high degree of private producers. Central government regulates the prices and the financing system. All citizens are covered by a mandatory employment-based health insurance operating on a non-profit basis. The consumer has a free choice of physician and hospital. A comparison between Japan, Sweden and some other countries shows significant dissimilarities in the length of stay, number of treatments per hospital bed and year and the staffing of hospitals. About 80 per cent of the hospitals and 94 per cent of the clinics are privately owned. The typical private hospital owned by a physician has less than 100 beds. In this paper, data collected (1992/93) in an empirical study of Japanese hospitals and their leadership is presented. Also discussed are the hospitals' style of management, tools and strategies for competition and competences--personal and formal skills required of the leadership in the hospital. There follows a study of ten hospitals, among which hospital directors and chief physicians were interviewed. Interviews are also made with key persons in the Ministry of Health and Welfare and other organizations in the health care field. The result is also analysed from a cultural perspective--'what kind of impact does the Japanese culture have on the health care organization?' and/or 'what kind of sub-culture is developed in the Japanese hospitals'. Some comparisons are made with Sweden, USA, Canada and Germany. The different roles of the professions in the hospital are included in the study as well as the incentives for different kinds of strategies--specialization, growing in size, investments in new equipment, different kind of ownership and hospitals. Another issue discussed is the attempt to uncover whether there is an implicit distribution of specialties--silent agreements between hospitals, etc.

  19. Reply to the Letter of Terracini B. et al. “Comment on Piscitelli et al. Hospitalizations in Pediatric and Adult Patients for All Cancer Type in Italy: The EPIKIT Study under the E.U. COHEIRS Project on Environment and Health”. Int. J. Environ. Res. Public Health 2017, 14, 495

    Directory of Open Access Journals (Sweden)

    Prisco Piscitelli

    2017-10-01

    Full Text Available A letter to the IJERPH Editor was submitted by Terracini B. et al. as a comment to our latest paper “Hospitalizations in Pediatric and Adult Patients for all Cancer Type in Italy:[...

  20. Atitudes de enfermeiros de hospital geral frente ao uso do álcool e alcoolismo Actitudes de enfermeros de hospital general frente al uso de alcohol y al alcoholismo Clinical nurses' attitudes toward the use of alcohol and alcoholism

    Directory of Open Access Journals (Sweden)

    Divane Vargas

    2006-02-01

    Full Text Available Estudo psicométrico, utilizando a escala Seaman Mannello Nurse's attitudes toward alcohol and alcoholism, aplicou o instrumento a uma população de 196 enfermeiros de um macro-hospital, visando a mensurar as atitudes de enfermeiros de hospital geral no que se refere ao álcool e ao beber. Os dados apontaram que os enfermeiros consideram que as bebidas alcoólicas são prejudiciais (54,4%, beber com moderação não é inofensivo(57,1% e é errado (47,4%. Revelam dificuldade na aceitação do beber como um direito da pessoa, considerando as bebidas alcoólicas capazes de tornar pessoas saudáveis "débeis e loucas" (29,8%. O enfermeiro é um profissional indispensável para o tratamento e recuperação do alcoolista, suas atitudes podem influenciar no relacionamento com o paciente e conseqüentemente favorecer o tratamento.En este estudio psicométrico fue utilizada la escala Seaman Mannello Nurse's attitudes toward alcohol and alcoholism y aplicado un instrumento a una población de 196 enfermeros de un macro-hospital, con el objetivo de mensurar las actitudes de enfermeros de hospital general frente al alcohol y beber. Los datos mostraron que los enfermeros consideran que las bebidas alcohólicas son perjudiciales (54,4%, beber con moderación no es inofensivo (57,1% y es errado (47,4%, revelando dificultad en la aceptación del beber como un derecho de la persona. 29,8% consideraron las bebidas alcohólicas capaces de tornar las personas saludables en "locas y débiles". El enfermero es un profesional fundamental para el tratamiento y recuperación del alcoholista. Sus actitudes pueden influenciar el relacionamiento con el paciente y, así, favorecer el tratamiento.This psychometric study used the Seaman Mannello's scale of "nurse's attitudes toward alcohol and alcoholism". Authors applied an instrument to a population of 196 nurses from a general hospital with the aim to measure nurses'attitudes toward alcohol and drinking. Data showed that

  1. The cultural psychology endeavor to make culture central to psychology: Comment on Hall et al. (2016).

    Science.gov (United States)

    Dvorakova, Antonie

    2016-12-01

    When Hall, Yip, and Zárate (2016) suggested that cultural psychology focused on reporting differences between groups, they described comparative research conducted in other fields, including cross-cultural psychology. Cultural psychology is a different discipline with methodological approaches reflecting its dissimilar goal, which is to highlight the cultural grounding of human psychological characteristics, and ultimately make culture central to psychology in general. When multicultural psychology considers, according to Hall et al., the mechanisms of culture's influence on behavior, it treats culture the same way as cross-cultural psychology does. In contrast, cultural psychology goes beyond treating culture as an external variable when it proposes that culture and psyche are mutually constitutive. True psychology of the human experience must encompass world populations through research of the ways in which (a) historically grounded sociocultural contexts enable the distinct meaning systems that people construct, and (b) these systems simultaneously guide the human formation of the environments. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  2. Los palacios en la Costa Central durante los periodos Tardíos: de Pachacamac al Inca

    Directory of Open Access Journals (Sweden)

    2004-01-01

    tradición local como referentes del ordenamiento político de la llamada provincia inca de Pachacamac -al menos en la parte correspondiente al río Rímac- pone en evidencia un tema siempre actual en la discusión arqueológica: ¿cuáles fueron las características de la dominación política resultado de la ocupación inca de esta parte del Tahuantinsuyo? y ¿cuál fue la reacción de las elites locales ante el nuevo orden representado por este acontecimiento? El presente artículo desarrolla este tema a partir de la definición de los atributos formales de los palacios, la descripción y uso de los artefactos asociados a los mismos, así como del análisis de las fuentes históricas que dan cuenta de las características particulares de la sociedad prehispánica tardía de la Costa Central. PALACES ON THE CENTRAL COAST DURING THE LATE PERIODS: FROM PACHACAMAC TO THE INCA. Recent studies on the central coast of Peru have shown that during the Late Intermediate Period (11th to 15th centuries A.D. the architecture of power was closely linked to a certain type of building: an elite residence or palace. The evidence also indicates that after the Inca occupation of the above-mentioned region (15th century this kind of building retained its effectiveness as a distinctive symbol of the political power of the governing elites, i.e. the curacas. The fact that local-style palaces continued to exist as referents of the political ordering of the so-called Inca province of Pachacamac (at least in the Rimac area, throws light on a topic that is still current in archaeological debate: What were the characteristics of the political domination that resulted from the Inca occupation of this corner of Tawantinsuyu? And what was the reaction of the local elites when faced with the new order that arose from this event? The present article develops this topic via the definition of the formal attributes of palaces, their description and the use of artefacts associated with them, as well as

  3. Factores asociados al desarrollo de preeclampsia en un hospital de Piura, Perú

    Directory of Open Access Journals (Sweden)

    Yamalí Benites-Condor

    2012-09-01

    Full Text Available Introducción: La Organización Mundial de la Salud indica que diariamente fallecen alrededor de 800 mujeres por causas relacionadas al embarazo y parto, dentro de las cuales la preeclampsia ocupa el tercer lugar. Objetivo: identificar los factores asociados a preeclampsia en gestantes que fueron hospitalizadas en el Hospital de Apoyo II “Santa Rosa” de la ciudad de Piura durante el periodo junio 2010 - mayo 2011. Métodos: Se realizó un estudio descriptivo retrospectivo de casos y controles, en gestantes hospitalizadas entre junio del 2010 y mayo del 2011. Mediante un muestreo aleatorio se obtuvieron 39 casos de preeclampsia y 78 controles sin preeclampsia. Los datos fueron analizados con el paquete estadístico SPSS v19.0, en el cual se ejecutó un análisis de casos y controles no pareados aplicando la prueba Chi cuadrado. Resultados: Fueron variables significativamente asociadas con la preeclampsia: Edad 35 años  (p=0,021, y número de controles prenatales mayor o igual a siete (p= 0,049. No resultaron significativos la primiparidad ni el sobrepeso. Interpretación: Se debe promover un control prenatal adecuado (traducido como siete o más controles durante la gestación, especialmente en aquellas mujeres que se encuentran en los extremos de la vida fértil.

  4. L'autonomia della banca Centrale in Italia e in Europa. (Central bank independence in Italy and in Europe

    Directory of Open Access Journals (Sweden)

    A. JOZZO

    2013-12-01

    Full Text Available I problemi che riguardano il rapporto tra le autorità monetarie ,del potere  esecutivo e potere legislativo è attualmente al centro di un dibattito politico ed economico , sia a livello nazionale che a livello europeo . A livello europeo il progresso dell'integrazione economica e monetaria solleva la questione dell'autonomia delle autorità monetarie responsabili della gestione valutaria . A livello nazionale la necessità di migliorare l'economia in Italia e ridurre l'inflazione spiega la proposta di aumentare l'indipendenza della Banca d' Italia  rispetto al Tesoro . Questi due aspetti sono tuttavia interdipendenti . Il presente lavoro fa riferimento al dibattito del dopoguerra che ha avuto luogo in Germania per quanto riguarda la ricostruzione di una banca centrale , al fine di analizzare il presente questione dell'indipendenza della banca centrale in Italia e in Europa The problems concerning the relationship between monetary authorities, executive and legislative powers is currently at the centre of a political and economic debate, both at the national and at the European level. At the European level the progress of economic and monetary integration raises the issue of the autonomy of monetary authorities in charge of currency management. At the national level the need to improve Italy’s economy and reduce inflation explains the proposal to increase the Bank of Italy’s independence with respect to the Treasury. These two aspects are, however, interdependent. The present work makes reference to the post-war debate that took place in Germany regarding the reconstruction of a central bank, in order to analyse the present issue of central bank independence in Italy and Europe.JEL: E58, F36

  5. INFECCIONES OPORTUNISTAS EN INDIVIDUOS VIH + HOSPITALIZADOS. HOSPITAL VARGAS DE CARACAS. 2005- 2006.

    Directory of Open Access Journals (Sweden)

    Carolina Lissete Franco Ricart

    2012-02-01

    Full Text Available Objetivo: Describir la frecuencia de infecciones oportunistas y determinar cual es la más frecuente en pacientes VIH+ del Hospital Vargas de Caracas durante el período 2005 – 2006. Diseño: Estudio descriptivo, transversal, retrospectivo y observacional. Lugar: Hospital “José María Vargas” de Caracas, Venezuela. Participantes: Pacientes ingresados con historia de VIH+ e infección oportunista. Intervención: Revisión de Historias Clínicas de archivo entre los años 2005-2006. Principales medidas de Resultados: Porcentajes y Medidas de Tendencia Central, tabuladas en una base de datos con ayuda del programa Microsoft Excel 2003 para Windows ®. Resultados: Se revisaron 120 historias; 83 cumplían con los criterios de inclusión. El promedio de edad fue 36,87 años; 59,04% correspondían al sexo masculino y 40,96% al sexo femenino. El 44,4% fueron infecciones respiratorias, 31,88% infecciones del SNC. Las infecciones más frecuentes: 24,64% Mycobacterium tuberculosis, 19,87% Toxoplasma gondii, 15,94% Candida albicans y 10,14% Pneumocystis jiroveci. En el 63,86% de los casos se encontraron dos o más infecciones simultáneas. El 64% de estos pacientes recibía tratamiento y el 46% era heterosexual no promiscuo. Conclusiones: Las alteraciones respiratorias constituyen la infección oportunista más frecuente en pacientes VIH+.

  6. Infecciones oportunistas en individuos VIH + hospitalizados. Hospital Vargas de Caracas. 2005-2006.

    Directory of Open Access Journals (Sweden)

    Carolina Franco Ricart

    2008-01-01

    Full Text Available Objetivo: Describir la frecuencia de infecciones oportunistas y determinar cual es la más frecuente en pacientes VIH+ del Hospital Vargas de Caracas durante el período 2005 - 2006. Diseño: Estudio descriptivo, transversal, retrospectivo y observacional. Lugar: Hospital "José María Vargas" de Caracas, Venezuela. Participantes: Pacientes ingresados con historia de VIH+ e infección oportunista. Intervención: Revisión de Historias Clínicas de archivo entre los años 2005-2006. Principales medidas de Resultados : Porcentajes y Medidas de Tendencia Central, tabuladas en una base de datos con ayuda del programa Microsoft Excel 2003 para Windows ®. Resultados : Se revisaron 120 historias; 83 cumplían con los criterios de inclusión. El promedio de edad fue 36,87 años; 59,04% correspondían al sexo masculino y 40,96% al sexo femenino. El 44,4% fueron infecciones respiratorias, 31,88% infecciones del SNC. Las infecciones más frecuentes: 24,64% Mycobacterium tuberculosis, 19,87% Toxoplasma gondii, 15,94% Candida albicans y 10,14% Pneumocystis jiroveci. En el 63,86% de los casos se encontraron dos o más infecciones simultáneas. El 64% de estos pacientes recibía tratamiento y el 46% era heterosexual no promiscuo. Conclusiones : Las alteraciones respiratorias constituyen la infección oportunista más frecuente en pacientes VIH+.

  7. Teleradiology and PACS - strategy of the Innsbruck University Hospital

    International Nuclear Information System (INIS)

    Vogl, R.

    2005-01-01

    Systems for management of digital imaging data are very important and widespread at the Innsbruck University Hospital and constitute a central component of the IT strategies followed by the hospital operating company TILAK (Tyrolean public hospitals). The particular goal is to integrate all imaging data into the electronic medical records and make these available online to each of the approx. 2500 clinic workstations and ensure electronic data exchange with other healthcare services. Teleradiology connections have been established at the University Clinic for Radiology since 1995; these have been continually expanded and linked to the central PACS. An eHealth web portal was recently established to facilitate transfer of images and findings from TILAK hospitals to other healthcare organizations. Registered users can be cleared for a limited time to access all radiological imaging data via this web portal. (orig.) [de

  8. Comparison of Pre-operative Central Corneal Thickness in Pediatric Cataract Cases versus Normal

    International Nuclear Information System (INIS)

    Khan, S.; Ali, M.; Zaheer, N.

    2014-01-01

    Objective: To compare the pre-operative central corneal thickness (CCT) in paediatric cataract patients with reference to normal control group. Study Design: A case control study. Place and Duration of Study: Paediatric Ophthalmology Clinic of Al-Shifa Trust Eye Hospital (ASTEH), Rawalpindi, from November 2009 to May 2010. Methodology: The study included 116 subjects with equal number of cases and controls. Demographic profile of all the subjects was noted followed by history and detailed ophthalmic examination. CCT was measured using an ultrasonic pachymeter (model Pac Scan 300). The mean of three measurements from the central cornea were recorded in microns. Results were analyzed using SPSS version 17.0. Results: Mean CCT values of the cases was 566.83 +- 37.646 microns while the control group had a mean CCT of 535.81 +- 24.466 microns. Difference between the CCT values of the two groups was highly significant (p < 0.001). Conclusion: Eyes with congenital cataracts have greater CCT values as compared to normal paediatric population. This factor must be kept in mind while interpreting intra-ocular pressure in such patients. (author)

  9. Equidad de género en la adherencia al tratamiento de adicciones: Representaciones y prácticas de profesionales y pacientes en un servicio de internación de un hospital público Gender equity within adherence to treatment of addictions: Social representations and practices of professionals and patients in an inpatient service of a public hospital

    Directory of Open Access Journals (Sweden)

    Vanesa Jeifetz

    2010-12-01

    Full Text Available El objetivo central de este proyecto1 es explorar la equidad de género relativa a la adherencia al tratamiento en un servicio de internación de un hospital público, que atiende pacientes adictos/as a las drogas, así como identificar los modos en los cuales las diferencias entre los géneros se transforman en inequidad en salud. El propósito del proyecto es contribuir en el avance de la equidad de género en el tratamiento de las adicciones a las drogas, visibilizando las inequidades que se presenten, asi como las necesidades en la atención y los modos de enfermar de cada género. Del mismo modo, promoviendo la inclusión de la perspectiva de género en las prácticas de los profesionales, en aras de mejorar los modelos de atención. Se trata de una investigación de carácter exploratorio-descriptivo, en la que se utiliza metodología cualitativa para la recolección y el análisis de la información.The central objective of this project is to explore gender equity in adherence to treatment of an inpatient service of a public hospital, which serves patients addicted to drugs and to identify ways in which gender differences are transformed into health inequities. The project aim's is to contribute to gender equity in the treatment of addictions to drugs, make visible inequities that arise, promote the inclusion of gender in the practices of professionals and manifest the needs and modes of each gender in pursuit of improved models of care. It is an exploratory and descriptive research, which used qualitative methodology to collect and analyze information.

  10. Non-steroidal anti-inflammatory drugs and antibiotics prescription trends at a central west bank hospital.

    Science.gov (United States)

    Tayem, Yasin I; Qubaja, Marwan M; Shraim, Riyad K; Taha, Omar B; Abu Shkheidem, Imadeddin A; Ibrahim, Murad A

    2013-11-01

    We aimed to reliably describe the pattern of outpatient prescription of non-steroidal anti-inflammatory drugs (NSAIDs) and antibiotics (ATBs) at a central hospital in the West Bank, Palestine. This was a retrospective, cross-sectional study investigating a cohort of 2,208 prescriptions ordered by outpatient clinics and the emergency room over one year in Beit Jala Hospital in Bethlehem, West Bank. The orders were analysed for the rate and types of NSAIDs and ATBs utilised, and the appropriateness of these drugs to the diagnosis. Of the total prescriptions, 410 contained NSAIDs (18.6%), including diclofenac (40.2%), low dose aspirin (23.9%), ibuprofen (17.8%) and indomethacin (15.1%). A minority of these prescriptions contained a combination of these agents (2.5%). Only one prescription contained cyclooxyeganse-2 inhibitors (0.2%). The appropriateness of NSAID use to the diagnosis was as follows: appropriate (58.3%), inappropriate (14.4%) and difficult to tell (27.3%). The rate of ATB use was 30.3% (669 prescriptions). The ATBs prescribed were amoxicillin (23.3%), augmentin (14.3%), quinolones (12.7%), first and second generation cephalosporins (9.4% and 12.7%, respectively) and macrolides (7.2%). ATB combinations were identified in 9.4%, with the most common being second-generation cephalopsorins and metronidazole (4.3%). Regarding the appropriateness of prescribing ATBs according to the diagnosis, it was appropriate in 44.8%, inappropriate in 20.6% and difficult to tell in 34.6% of the prescriptions. These findings revealed a relatively large number and inappropriate utilisation of ATBs and NSAIDs. An interventional programme needs to be adopted to reinforce physicians' knowledge of the rational prescription of these agents.

  11. Relationship between patient safety and accountability of nurses in Al-Zahra Gilangharb Hospital in 2015.

    Science.gov (United States)

    Esfandnia, F; Mohammadi, E; Mohammadi, M; Cheraghi, R; Esfandnia, N; Esfandnia, A

    2015-01-01

    Introduction. The purpose of this research was to investigate the connection between the patient safety and the accountability of nurses in Gilangharb Hospital in 2015. Methods. This research was a cross-sectional study conducted in Al-Gilangharb, in 2015. The data needed for research was taken from the library and an internet search and was gathered by using standard questionnaireThe professional and caring nurses' questionnaire was based on the extension evaluation office Nursing Care, Ministry of Health and Medical Education and demographic information and questions about 4 different roles of nurses were prepared and included. Moreover, patient safety was highlighted in a validation questionnaire, validated by experts judging group of teachers and academics, which was established. Cronbach's alpha test was used to assess the reliability. Finally, the reliability and professional standards of nursing care, patient safety questionnaire 093. 86/ 0 percent calculated the population of Gilangharb Hospital nurses (n = 70) and, in the strata selected, a statistical analysis using data from the questionnaires included in the SPSS statistical software, version 21, took place. Results. The patients' safety and accountability was observed at the level of 95 percent by using the Spearman correlation (SIG = .000). The correlation coefficient was (R=.768). Also, the dimensions of responsibility between the patient's safety (regarding the role of the nurse teacher, manager, researcher, and clinician) at 95 percent and the positive use of Spearman correlation was found (SIG = .000). Conclusions. Given the correlation among the patient protection and accountability, it can be said that the nurses in all roles (educator, researcher, administrator, and clinical specialist) have been successful, so, we suggested that given the experience, expertise and abilities, they have made an efficient use of their lifting power.

  12. Implementation of the WHO multimodal Hand Hygiene Improvement Strategy in a University Hospital in Central Ethiopia.

    Science.gov (United States)

    Pfäfflin, Frieder; Tufa, Tafese Beyene; Getachew, Million; Nigussie, Tsehaynesh; Schönfeld, Andreas; Häussinger, Dieter; Feldt, Torsten; Schmidt, Nicole

    2017-01-01

    The burden of health-care associated infections in low-income countries is high. Adequate hand hygiene is considered the most effective measure to reduce the transmission of nosocomial pathogens. We aimed to assess compliance with hand hygiene and perception and knowledge about hand hygiene before and after the implementation of a multimodal hand hygiene campaign designed by the World Health Organization. The study was carried out at Asella Teaching Hospital, a university hospital and referral centre for a population of about 3.5 million in Arsi Zone, Central Ethiopia. Compliance with hand hygiene during routine patient care was measured by direct observation before and starting from six weeks after the intervention, which consisted of a four day workshop accompanied by training sessions and the provision of locally produced alcohol-based handrub and posters emphasizing the importance of hand hygiene. A second follow up was conducted three months after handing over project responsibility to the Ethiopian partners. Health-care workers' perception and knowledge about hand hygiene were assessed before and after the intervention. At baseline, first, and second follow up we observed a total of 2888, 2865, and 2244 hand hygiene opportunities, respectively. Compliance with hand hygiene was 1.4% at baseline and increased to 11.7% and 13.1% in the first and second follow up, respectively (p hand hygiene was consistent across professional categories and all participating wards and was independently associated with the intervention (adjusted odds ratio, 9.18; 95% confidence interval 6.61-12.76; p hand hygiene actions. The median hand hygiene knowledge score overall was 13 (interquartile range 11-15) at baseline and increased to 17 (15-18) after training (p hand hygiene is feasible and sustainable in a resource-constrained setting using a multimodal improvement strategy. However, absolute compliance remained low. Strong and long-term commitment by hospital management and

  13. Calidad del servicio de atención en la Unidad de Laboratorio de Emergencia y Laboratorio Central, Hospital Público de Lima, 2016

    OpenAIRE

    Castillo Acuña, Marissa Gladys

    2016-01-01

    La Calidad en el Servicio de Atención de acuerdo a Camarasa (2004) “La Calidad de los servicios de atención constituyen el conjunto de prestaciones y atenciones que el cliente espera recibir de la organización que los presta”. (p.13) Objetivo: Comparar el nivel de calidad del servicio de atención en la unidad de Laboratorio de Emergencia con respecto a la unidad de Laboratorio Central en un Hospital Público de Lima 2016. Metodología: Estudio de Nivel descriptivo comparativo, tr...

  14. Specialized consulting in radiological safety to the North Central Hospital of high specialty, PEMEX. V. November of 2001

    International Nuclear Information System (INIS)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F.

    2002-01-01

    It is a report of a specialized consulting in radiological safety that to be carried the ININ to PEMEX for the North Central Hospital of High Specialty, to maintain the sanitary license for the use of X ray equipment of medical diagnostic, and guarantee these services with a program of quality assurance. To give fulfilment to that requests it is programmed a technical assistance monthly, with reports of results during the development of the service. In this document it is carried a report of the advances and results in the month of November of the 2001, where the following documents are analyzed: Manual of radiological safety, program of quality assurance, operation procedures, procedure of maintenance team, procedure of medical radiological control of the specialized personnel; also are annotate the obtained results and their observations. (Author)

  15. Specialized consulting in radiological safety to the south central hospital of high specialty, PEMEX. VI. December of 2001

    International Nuclear Information System (INIS)

    Angeles C, A.; Vizuet G, J.; Benitez S, J.A.; Garcia A, J.; Rodriguez A, F.

    2002-01-01

    It is a report of a specialized consulting in radiological safety that to be carried the ININ to PEMEX for the South Central Hospital of High Specialty, to maintain the sanitary license for the use of X-ray equipment of medical diagnostic, and guarantee these services with a program of quality assurance. To give fulfilment to that requests it is programmed a technical assistance monthly, with reports of results during the development of the service. In this document it is carried a report of the advances and results in the month of december of the 2001, where the following documents are analyzed: Manual of radiological safety, program of quality assurance, operation procedures, procedure of maintenance team, procedure of medical radiological control of the specialized personnel; also are annotate the obtained results and their observations. (Author)

  16. Gastric cancers at Kibogora Hospital | Ntakiyiruta | East and Central ...

    African Journals Online (AJOL)

    East and Central African Journal of Surgery. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 14, No 1 (2009) >. Log in or Register to get access to full text downloads.

  17. Variabilidad del ADN cloroplástico y su contribución al conocimiento del estado de conservación de Ulmus glabra en el Sistema Central

    OpenAIRE

    Martin del Puerto, Maria; Martinez Garcia, Felipe; Martin Clemente, Juan Pedro

    2011-01-01

    En el presente trabajo se ha analizado la diversidad existente en el ADN cloroplástico (ADNcp) de 16 poblaciones distribuidas a lo largo del Sistema Central. Para ello, se ha empleado la técnica de PCR-RFLP (amplificación de fragmentos específicos y posterior digestión con enzimas de restricción) sobre 38 regiones del ADNcp (Grivet et al., 2001).

  18. Hospital costs of central line-associated bloodstream infections and cost-effectiveness of closed vs. open infusion containers. The case of Intensive Care Units in Italy.

    Science.gov (United States)

    Tarricone, Rosanna; Torbica, Aleksandra; Franzetti, Fabio; Rosenthal, Victor D

    2010-05-10

    The aim was to evaluate direct health care costs of central line-associated bloodstream infections (CLABSI) and to calculate the cost-effectiveness ratio of closed fully collapsible plastic intravenous infusion containers vs. open (glass) infusion containers. A two-year, prospective case-control study was undertaken in four intensive care units in an Italian teaching hospital. Patients with CLABSI (cases) and patients without CLABSI (controls) were matched for admission departments, gender, age, and average severity of illness score. Costs were estimated according to micro-costing approach. In the cost effectiveness analysis, the cost component was assessed as the difference between production costs while effectiveness was measured by CLABSI rate (number of CLABSI per 1000 central line days) associated with the two infusion containers. A total of 43 cases of CLABSI were compared with 97 matched controls. The mean age of cases and controls was 62.1 and 66.6 years, respectively (p = 0.143); 56% of the cases and 57% of the controls were females (p = 0.922). The mean length of stay of cases and controls was 17.41 and 8.55 days, respectively (p Use of innovative technologies such as closed infusion containers can significantly reduce the incidence of healthcare acquired infection without posing additional burden on hospital budgets.

  19. Evaluation of disaster preparedness for mass casualty incidents in private hospitals in Central Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Abdullah A. Bin Shalhoub

    2017-03-01

    Full Text Available Objectives: To identify and describe the hospital disaster preparedness (HDP in major private hospitals in Riyadh, Saudi Arabia. Methods: This is an observational cross-sectional survey study performed in Riyadh city, Saudi Arabia between December 2015 and April 2016. Thirteen major private hospitals in Riyadh with more than 100 beds capacity were included in this investigation. Results: The 13 hospitals had HDP plan and reported to have an HDP committee. In 12 (92.3% hospitals, the HDP covered both internal and external disasters and HDP was available in every department of the hospital. There were agreements with other hospitals to accept patients during disasters in 9 facilities (69.2% while 4 (30.8% did not have such agreement. None of the hospitals conducted any unannounced exercises in previous year. Conclusion: Most of the weaknesses were apparent particularly in the education, training and monitoring of the hospital staff to the preparedness for disaster emergency occasion. Few hospitals had conducted an exercise with casualties, few had drilled evacuation of staff and patients in the last 12 months, and none had any unannounced exercise in the last year.

  20. Le volcanisme cambrien du Maroc central : implications géodynamiquesThe Central Morocco Cambrian volcanism: geodynamic implications

    Science.gov (United States)

    Ouali, Houssa; Briand, Bernard; Bouchardon, Jean-Luc; Capiez, Paul

    2003-05-01

    In southeastern Central Morocco, the Bou-Acila volcanic complex is considered of Cambrian age. In spite of low-grade metamorphic effect, initial volcanic texture and mineralogy can be recognized and volcanic rocks are dominated by dolerites and porphyric dolerites. The initial mineralogy is composed of plagioclases, pyroxenes and dark minerals. A secondary mineral assemblage is composed of albite, epidote, chlorite and calcite. According to their immobile elements compositions, the southeastern central Morocco metavolcanites are of within-plate continental tholeiites. This volcanism and those recognized in many other areas in Morocco confirm a Cambrian extensive episode within the Gondwana supercontinent. To cite this article: H. Ouali et al., C. R. Geoscience 335 (2003).To cite this article: H. Ouali et al., C. R. Geoscience 335 (2003).

  1. Competition or coordination in hospital markets with unionised labour.

    Science.gov (United States)

    Brekke, Kurt R

    2004-03-01

    This paper study labour market responses to hospital mergers. The market consists of two hospitals providing horizontally and vertically differentiated services. Hospitals compete either in price and quality or just in quality (non-price competition). To provide medical care, hospitals employ health care workers (e.g., physicians, nurses). The workers collectively bargain wages either at a central level, firm level or plant level. Anticipating wage responses, hospitals decide whether or not to merge. The main finding is that the bargaining structure, the nature of competition and the patient copayment rate have a crucial impact on the profitability of hospital mergers.

  2. Patient satisfaction regarding eye care services at tertiary hospital of central India

    Directory of Open Access Journals (Sweden)

    Anand Sudhan

    2011-01-01

    Study Design : Descriptive study. Materials and Methods : This study was conducted between September 2005 and June 2006. Patients attending the eye clinic of Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India, and admitted as in-patients in this hospital were our study population. Randomly selected patients were interviewed by trained staff. Close-ended questionnaire was used to conduct these structured interviews. Their responses were grouped into one of five categories and evaluated to determine satisfaction for different components of eye care services. Results : Three hundred and twenty persons were interviewed. The satisfaction was of excellent grade among 77 (48.1% patients attending clinic and 156 (97.5% patients who were admitted in the hospital. The participants expressed dissatisfaction for the long waiting period in clinics, poor cleanliness, and insufficient toilet facilities. Those admitted in the hospital felt that food facilities were less than the expected quality. Child-friendly facilities received high satisfaction scores. Conclusion : Although eye care services both in clinics and in the wards were satisfactory according to the end-users, there are scopes for improvement. Patient satisfaction surveys should be encouraged in hospitals for better accountability and also for strengthening the quality of eye care services.

  3. Comentarios al Salto Social

    Directory of Open Access Journals (Sweden)

    Facultad de Ciencias Económicas

    1995-06-01

    Full Text Available 1. El Plan considera que la política social es un componente central de la estrategia macroeconómica. A diferencia de la administración Gaviria, lo social ha dejado de ser un asunto marginal, es consustancial al desarrollo y, por tanto, se le confiere una dimensión cualitativamente diferente.

  4. Awareness and Knowledge of Glaucoma in Central India: A Hospital-Based Study.

    Science.gov (United States)

    Maharana, Prafulla K; Rai, Vaishali G; Pattebahadur, Rajesh; Singhi, Shipra; Chauhan, Ashish K

    2017-01-01

    To assess the awareness and knowledge of glaucoma among people attending the ophthalmology outpatient department at a tertiary care hospital in central India. A prospective observational study. A questionnaire-based study was conducted, involving persons aged 18 and above attending the ophthalmology outpatient department from October 2014 to September 2015. Data on awareness and knowledge of glaucoma was collected through a face-to-face interview. Fourteen hundred people participated in the study. The mean age of participants was 43 ± 15 years (range, 18-85). The study participants included 53% men and 47% women. Only 27% (n = 380/1400) of the participants were aware of glaucoma. Age, sex, and presence or type of refractive error had no impact on glaucoma awareness. Awareness level was greater in individuals with higher education levels and those belonging to an upper socioeconomic class (SEC). Multiple logistic regression analysis revealed significantly higher levels of glaucoma awareness among participants belonging to the upper 2 SECs (P = 0.05) and those educated above the high school level (P = 0.001). The most common source of awareness was close acquaintance with relatives, famly members, and friends of glaucoma patients. Awareness of glaucoma in India is low. Lack of education and lower socioeconomic status are the major risk factors for late preentation of glaucoma. Continuous presence of a low level of awareness and the same factors accounting for it warrants the need for an aggressive and refined approach to increase awareness of glaucoma to prevent glaucoma-related blindness. Copyright 2017 Asia-Pacific Academy of Ophthalmology.

  5. Effective bending strain estimated from I c test results of a D-shaped Nb3Al CICC coil fabricated with a react-and-wind process for the National Centralized Tokamak

    International Nuclear Information System (INIS)

    Ando, T.; Kizu, K.; Miura, Y.M.; Tsuchiya, K.; Matsukawa, M.; Tamai, H.; Ishida, S.; Koizumi, N.; Okuno, K.

    2005-01-01

    Japan National Centralized Tokamak (NCT) is a superconducting tokamak proposed as a modification to JT-60U. As part of the R and D for the National Centralized Tokamak, a two-turn, approximately 2 m tall, D-shaped Nb 3 Al coil was wound and tested using a full-size cable-in-conduit conductor (CICC). The Nb 3 Al cable-in-conductor was bent following the heat treatment reaction with a maximum bending strain of 0.4% to simulate the react-and-wind fabrication. The comparison of the coil performance to the measured strand data shows that the effective axial strain of the conductor strands is essentially zero despite the 0.4% bending strain of the conductor. This suggests that the strands in the cable slipped relatively to each other during bending of the conduit, thus reducing the effective strain transmitted to the strands. This result is very encouraging for the low-cost fabrication of high-current-density fusion coils using the react-and-wind method

  6. Pasado y esperanza de un hospital Instituto Materno Infantil hospital universitario monumento nacional

    Directory of Open Access Journals (Sweden)

    Manuel Mercado Pedroza

    2002-07-01

    Full Text Available El Instituto Materno Infantil (IMI ha sido fundamentalmente una casa de educación en la cultura del respeto por la mujer, el recién nacido y la familia, en un país asolado por la muerte es un centro de vida y esperanza de un futuro mejor para todos. Ha sido un hospital comprometido con la misión de atender a la mujer y al binomio madre - recién nacido, especialmente aquellos de escasos recursos. El IMI es un hospital por el Género femenino, para el género humano.

  7. Molecular epidemiology of Acinetobacter baumannii in central intensive care unit in Kosova teaching hospital

    Directory of Open Access Journals (Sweden)

    Lul Raka

    Full Text Available Infections caused by bacteria of genus Acinetobacter pose a significant health care challenge worldwide. Information on molecular epidemiological investigation of outbreaks caused by Acinetobacter species in Kosova is lacking. The present investigation was carried out to enlight molecular epidemiology of Acinetobacterbaumannii in the Central Intensive Care Unit (CICU of a University hospital in Kosova using pulse field gel electrophoresis (PFGE. During March - July 2006, A. baumannii was isolated from 30 patients, of whom 22 were infected and 8 were colonised. Twenty patients had ventilator-associated pneumonia, one patient had meningitis, and two had coinfection with bloodstream infection and surgical site infection. The most common diagnoses upon admission to the ICU were politrauma and cerebral hemorrhage. Bacterial isolates were most frequently recovered from endotracheal aspirate (86.7%. First isolation occurred, on average, on day 8 following admission (range 1-26 days. Genotype analysis of A. baumannii isolates identified nine distinct PFGE patterns, with predominance of PFGE clone E represented by isolates from 9 patients. Eight strains were resistant to carbapenems. The genetic relatedness of Acinetobacter baumannii was high, indicating cross-transmission within the ICU setting. These results emphasize the need for measures to prevent nosocomial transmission of A. baumannii in ICU.

  8. Estimated radiation exposure from medical imaging for patients of radiology service of Al Faraby Hospital, Oujda Morocco

    Directory of Open Access Journals (Sweden)

    Slimane Semghouli

    2015-09-01

    Full Text Available Purpose: To evaluate the effective dose received per radiological examination per patient and the additional cancer risk factor in the Radiological Service of Al Faraby Hospital in 2012. Methods: From the number of radiological procedures (NX made in 2012 in the radiology service of Al Faraby Hospital and the average effective dose DEX associated with each type of act exam X, it is possible to calculate the effective dose collective [S =∑ DEX * NX]. The additional cancer risk factor is calculated by the X-ray risk software promoting responsible imaging through patient and provider education. It is function of the effective dose received, the age at the time of exam, and gender of patient. Results: The radiological average effective dose received per act exam is 1 millisievert (mSv, whereas it is 4.45 mSv and 0.21 mSv for the computed tomography (CT scan and conventional radiological examinations, respectively. As for the average number of acts per patient 2.66, the effective dose is 1.16 mSv and 3.8 mSv for CT scan and conventional radiological examinations, respectively. As for the average effective dose per patient 2.69 mSv, it is 5.16 mSv and 0.81 mSv for CT scan and conventional radiological examinations, respectively. As for the additional cancer risk in 40 years at the time of exam, the average additional cancer risk is equal to 2.17 × 10-4, wheras the risk is 4.17 × 10-4 and 6.54 × 10-5 for CT scan and conventional radiological examinations, respectively. Conclusion: Medical exposure related to the diagnosis of patients in the radiology service in 2012 can be characterized by: (a 2.66 Act exams on average per patient diagnosis corresponding to a mean effective dose equal to 2.69 mSv per patient, (bfrequency of conventional radiology and CT scan was 81% and 19%, respectively. These act exams contribute to the collective effective dose by 17% and 83%, respectively, and (c radiological acts can be divided into three levels of exposures

  9. Positive effects of tertiary centres for amyotrophic lateral sclerosis on outcome and use of hospital facilities.

    Science.gov (United States)

    Chiò, A; Bottacchi, E; Buffa, C; Mutani, R; Mora, G

    2006-08-01

    To evaluate the effects of tertiary centres for amyotrophic lateral sclerosis (ALS) on ALS outcome and the use of hospital facilities. The study was based on the data of an epidemiological, prospective, population-based register on ALS (Piemonte and Valle d'Aosta Register for amyotrophic lateral sclerosis, PARALS). The 221 patients recruited between 1995 and 1996 were prospectively followed up for outcome and use of hospital-based services. In all, 97 patients were followed up by tertiary ALS centres and 124 by general neurological clinics. Patients followed up by tertiary ALS centres were found to be 4 years younger and underwent percutaneous endoscopic gastronomy and non-invasive positive-pressure ventilation more often. Patients followed up by tertiary ALS centres were found to have a considerably longer median survival time (1080 v 775 days), even when stratifying by age, site of onset and respiratory function at diagnosis. In Cox multivariate analysis, attending a tertiary ALS centre was observed to be an independent positive prognostic factor. Moreover, patients attending a tertiary ALS centre were admitted to hospital less often (1.2 v 3.3) and were more frequently admitted for planned interventions. Conversely, patients followed up by general neurological clinics were more frequently admitted for acute events. Also, the hospital stay was considerably shorter for patients attending tertiary ALS centres (5.8 v 12.4 days). Improved survival was seen in patients with ALS attending tertiary ALS centres, independently from all other known prognostic factors, possibly through a better implementation of supportive treatments. Moreover, because of these centres, the hospitalisation rate was markedly reduced, thus offering a cost-effective service to patients with ALS and to the community as a whole.

  10. Capacitación sobre lactancia materna al personal de enfermería del Hospital General de México

    Directory of Open Access Journals (Sweden)

    Hernández-Garduño Adolfo Gabriel

    2000-01-01

    Full Text Available OBJETIVO: Evaluar el cambio de conocimientos acerca de la lactancia entre el personal de enfermería del Hospital General de México que asistió a un curso teórico-práctico sobre lactancia materna de 18 horas de duración. MATERIAL Y MÉTODOS: Se realizó una intervención educativa sobre lactancia materna, con evaluación inicial y final, en el Hospital General de México, de mayo de 1996 a mayo de 1997. Se capacitó a 152 enfermeras. Se aplicó la prueba t de Student para muestras dependientes y análisis de varianza. RESULTADOS: De 152 participantes, 140 (92% respondieron ambas evaluaciones. Los resultados globales de la evaluación inicial y final fueron 5.39±1.37 y 7.74±0.79, respectivamente, y resultaron estadísticamente significativos (p<0.001. La significancia se mantuvo aun después de ajustar por el nivel de instrucción de los participantes. En la evaluación final se observó que a mayor nivel de escolaridad, mayores conocimientos sobre lactancia (p=0.004. CONCLUSIONES: Un curso de capacitación en lactancia de tipo teórico-práctico y de 18 horas de duración, dirigido al personal de enfermería, permite un cambio significativo en los conocimientos alcanzados.

  11. Risk of central nervous system defects in offspring of women with and without mental illness.

    Science.gov (United States)

    Ayoub, Aimina; Fraser, William D; Low, Nancy; Arbour, Laura; Healy-Profitós, Jessica; Auger, Nathalie

    2018-02-22

    We sought to determine the relationship between maternal mental illness and the risk of having an infant with a central nervous system defect. We analyzed a cohort of 654,882 women aged less than 20 years between 1989 and 2013 who later delivered a live born infant in any hospital in Quebec, Canada. The primary exposure was mental illness during pregnancy or hospitalization for mental illness before pregnancy. The outcomes were neural and non-neural tube defects of the central nervous system in any offspring. We computed risk ratios (RR) and 95% confidence intervals (CI) for the association between mental disorders and risk of central nervous system defects in log-binomial regression models adjusted for age at delivery, total parity, comorbidity, socioeconomic deprivation, place of residence, and time period. Maternal mental illness was associated with an increased risk of nervous system defects in offspring (RR 1.76, 95% CI 1.64-1.89). Hospitalization for any mental disorder was more strongly associated with non-neural tube (RR 1.84, 95% CI 1.71-1.99) than neural tube defects (RR 1.31, 95% CI 1.08-1.59). Women at greater risk of nervous system defects in offspring tended to be diagnosed with multiple mental disorders, have more than one hospitalization for mental disease, or be 17 or older at first hospitalization. A history of mental illness is associated with central nervous system defects in offspring. Women hospitalized for mental illness may merit counseling at first symptoms to prevent central nervous system defects at pregnancy.

  12. Comparing colon cancer outcomes: The impact of low hospital case volume and case-mix adjustment.

    Science.gov (United States)

    Fischer, C; Lingsma, H F; van Leersum, N; Tollenaar, R A E M; Wouters, M W; Steyerberg, E W

    2015-08-01

    When comparing performance across hospitals it is essential to consider the noise caused by low hospital case volume and to perform adequate case-mix adjustment. We aimed to quantify the role of noise and case-mix adjustment on standardized postoperative mortality and anastomotic leakage (AL) rates. We studied 13,120 patients who underwent colon cancer resection in 85 Dutch hospitals. We addressed differences between hospitals in postoperative mortality and AL, using fixed (ignoring noise) and random effects (incorporating noise) logistic regression models with general and additional, disease specific, case-mix adjustment. Adding disease specific variables improved the performance of the case-mix adjustment models for postoperative mortality (c-statistic increased from 0.77 to 0.81). The overall variation in standardized mortality ratios was similar, but some individual hospitals changed considerably. For the standardized AL rates the performance of the adjustment models was poor (c-statistic 0.59 and 0.60) and overall variation was small. Most of the observed variation between hospitals was actually noise. Noise had a larger effect on hospital performance than extended case-mix adjustment, although some individual hospital outcome rates were affected by more detailed case-mix adjustment. To compare outcomes between hospitals it is crucial to consider noise due to low hospital case volume with a random effects model. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Central Line Associated Blood Stream Infection Rate after ...

    African Journals Online (AJOL)

    find out the CLABSI rate before and after central line (CL) bundle intervention and compare the outcome with international surveillance ... was reduced from 10.1 to 6.5 per 1000 CL days after interventions and had significant correlation with overall bundle ..... Sales AE, Almenoff PL, et al. Reduction of central line infections ...

  14. Central Dogma Goes Digital.

    Science.gov (United States)

    Lin, Yihan; Elowitz, Michael B

    2016-03-17

    In this issue of Molecular Cell, Tay and colleagues (Albayrak et al., 2016) describe a new technique to digitally quantify the numbers of protein and mRNA in the same mammalian cell, providing a new way to look at the central dogma of molecular biology. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Implementation of the WHO multimodal Hand Hygiene Improvement Strategy in a University Hospital in Central Ethiopia

    Directory of Open Access Journals (Sweden)

    Frieder Pfäfflin

    2017-01-01

    Full Text Available Abstract Background The burden of health-care associated infections in low-income countries is high. Adequate hand hygiene is considered the most effective measure to reduce the transmission of nosocomial pathogens. We aimed to assess compliance with hand hygiene and perception and knowledge about hand hygiene before and after the implementation of a multimodal hand hygiene campaign designed by the World Health Organization. Methods The study was carried out at Asella Teaching Hospital, a university hospital and referral centre for a population of about 3.5 million in Arsi Zone, Central Ethiopia. Compliance with hand hygiene during routine patient care was measured by direct observation before and starting from six weeks after the intervention, which consisted of a four day workshop accompanied by training sessions and the provision of locally produced alcohol-based handrub and posters emphasizing the importance of hand hygiene. A second follow up was conducted three months after handing over project responsibility to the Ethiopian partners. Health-care workers’ perception and knowledge about hand hygiene were assessed before and after the intervention. Results At baseline, first, and second follow up we observed a total of 2888, 2865, and 2244 hand hygiene opportunities, respectively. Compliance with hand hygiene was 1.4% at baseline and increased to 11.7% and 13.1% in the first and second follow up, respectively (p < 0.001. The increase in compliance with hand hygiene was consistent across professional categories and all participating wards and was independently associated with the intervention (adjusted odds ratio, 9.18; 95% confidence interval 6.61-12.76; p < 0.001. After the training, locally produced alcohol-based handrub was used in 98.4% of all hand hygiene actions. The median hand hygiene knowledge score overall was 13 (interquartile range 11–15 at baseline and increased to 17 (15–18 after training (p < 0.001. Health

  16. 77 FR 27869 - Medicare Program; Hospital Inpatient Prospective Payment Systems for Acute Care Hospitals and the...

    Science.gov (United States)

    2012-05-11

    ... Considered HAC Candidate: Iatrogenic Pneumothorax With Venous Catheterization 3. Present on Admission (POA.... History of Measures Adopted for the Hospital IQR Program b. Maintenance of Technical Specifications for...-Associated Infection (HAI) Measures (A) Proposed Central Line Associated Blood Stream Infections ((CLABSI...

  17. Efficiency and productivity of hospitals in Vietnam.

    Science.gov (United States)

    Pham, Thuy Linh

    2011-01-01

    The purpose of this paper is to examine the relative efficiency and productivity of hospitals during the health reform process. Data envelopment analyses method (DEA) with the input-oriented variable-returns-to-scale model was used to calculate efficiency scores. Malmquist total factor productivity index approach was then employed to calculate productivity of hospitals. Data of 101 hospitals was extracted from databases of the Ministry of Health, Vietnam from the years 1998 to 2006. There was evidence of improvement in overall technical efficiency from 65 per cent in 1998 to 76 per cent in 2006. Hospitals' productivity progressed around 1.4 per cent per year, which was mainly due to the technical efficiency improvement. Furthermore, provincial hospitals were more technically efficient than their central counterparts and hospitals located in different regions performed differently. The paper provides an insight in the performance of Vietnamese public hospitals that has been rarely examined before and contributes to the existing literature of hospital performance in developing countries

  18. Central corneal thickness among glaucoma patients attending ...

    African Journals Online (AJOL)

    AAU_CHS

    ocular pressure measurement and is different among different ethnic population and subtypes of glaucoma. The central corneal thickness of different subtypes of glaucoma at Menelik II Hospital ... Intraocular pressure is a key element in the.

  19. Factores de riesgo del bajo peso al nacer, Hospital Gineco-Obstétrico Provincial de Sancti Spíritus, Cuba

    Directory of Open Access Journals (Sweden)

    Marcos Aurelio Grau Espinosa

    1999-08-01

    Full Text Available El objetivo de este trabajo fue identificar algunos factores de riesgo que pudiera presentar la madre durante el embarazo, asociados con la incidencia de bajo peso al nacer (menos de 2500 g. Se diseñó un estudio con 378 casos y 649 controles del Hospital Gineco-Obstétrico Provincial de Sancti Spíritus, Cuba, durante el año 1994. Los datos se obtuvieron de la historia clínica, el registro de partos y una entrevista personal con la madre. Se realizó un análisis bivariado y se controlaron los posibles factores de confusión utilizando la regresión logística dicotómica, mediante los programas Epi Info 5 y SPSS. Por medio del modelo multivariado final se identificaron como factores de riesgo significativos de bajo peso al nacer la hipertensión arterial durante el embarazo, la consulta extemporánea de evaluación del embarazo, los abortos anteriores, último intervalo intergenésico menor de 2 años y el aumento de peso materno menor de 8 kg. Se debe dar prioridad a estas tres últimas variables para mantener buenos indicadores en el programa maternoinfantil de la Provincia de Sancti Spíritus, Cuba.

  20. Estigma relacionado a VIH/SIDA asociado con adherencia al tratamiento antirretroviral en pacientes de un hospital de Lima, Perú 2014

    Directory of Open Access Journals (Sweden)

    Jessica Hanae Zafra-Tanaka

    Full Text Available Objetivos.Determinar el nivel de estigma relacionado a VIH/SIDA y su asociación con la adherencia al tratamientoantirretroviral (TARV en pacientes de un hospital nacional de Lima, Perú. Materiales y métodos. Estudio transversal que incluyó a pacientes adultos que seguían el programa de TARV con un mínimo de seis meses. Se consideró el estigma como la desvalorización de la persona por tener la infección de VIH y se midió con la escala de Berger para estigma relacionado a VIH, la adherencia a la toma adecuada de los medicamentos fue medida con la encuesta Simplified medication adherence questionaire (SMAQ. Para evaluar los factores asociados a estigma se calcularon razones de prevalencia (RP usando la regresión de Poisson. Resultados. Se analizaron 339 encuestas, la mediana de edad fue 39 años (RIC: 16 donde 74,0% eran hombres. Se halló un estigma alto en 25,4% y moderado en 47,5% de los encuestados. Una reducción de 10 puntos en la escala de estigma relacionado a VIH/SIDA se asoció a un aumento de 5% de adherencia al TARV en hombres (RPa 0,95, IC95%: 0,91-0,99 y un aumento del 7% en mujeres (RPa 0,93, IC95%: 0,87-0,98. Conclusiones. Existe un alto nivel de estigma relacionado a VIH/SIDA y se asocia a la falta de adherencia al tratamiento con diferencias de acuerdo al sexo. Se recomiendan intervenciones dirigidas a reducir el estigma relacionado a divulgación de estatus en las mujeres y el relacionado a actitudes públicas en hombres.

  1. Modular organization and hospital performance.

    Science.gov (United States)

    Kuntz, Ludwig; Vera, Antonio

    2007-02-01

    The concept of modularization represents a modern form of organization, which contains the vertical disaggregation of the firm and the use of market mechanisms within hierarchies. The objective of this paper is to examine whether the use of modular structures has a positive effect on hospital performance. The empirical section makes use of multiple regression analyses and leads to the main result that modularization does not have a positive effect on hospital performance. However, the analysis also finds out positive efficiency effects of two central ideas of modularization, namely process orientation and internal market mechanisms.

  2. International overview of hospital procurement.

    Science.gov (United States)

    Ferrier, Maud; Lariviere, David; Laurent, Claire; Roque, Eric

    2011-01-01

    This article was written by four French hospital director students at the Ecole des Hautes Etudes en Santé Publique (EHESP-School of Public Health) from a study conducted jointly with students at the Grenoble School of Management to present an international overview of hospital procurement methods in ten countries. An analysis of these methods showed that there was a general trend towards group purchasing, with some common aims in terms of costs and performance and some differences in legislation (competition), size of the public sector and centralization or decentralization.

  3. Enterprise resource planning for hospitals

    NARCIS (Netherlands)

    van Merode, Godefridus G.; Groothuis, Siebren; Hasman, Arie

    2004-01-01

    Integrated hospitals need a central planning and control system to plan patients' processes and the required capacity. Given the changes in healthcare one can ask the question what type of information systems can best support these healthcare delivery organizations. We focus in this review on the

  4. Enterprise resource planning for hospitals

    NARCIS (Netherlands)

    Merode, van G.G.; Groothuis, S.; Hasman, A.

    2004-01-01

    Integrated hospitals need a central planning and control system to plan patients’ processes and the required capacity. Given the changes in healthcare one can ask the question what type of information systems can best support these healthcare delivery organizations. We focus in this review on the

  5. Channeling the Central Dogma.

    Science.gov (United States)

    Calabrese, Ronald L

    2014-05-21

    How do neurons and networks achieve their characteristic electrical activity, regulate this activity homeostatically, and yet show population variability in expression? In this issue of Neuron, O'Leary et al. (2014) address some of these thorny questions in this theoretical analysis that starts with the Central Dogma. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. The architecture of enterprise hospital information system.

    Science.gov (United States)

    Lu, Xudong; Duan, Huilong; Li, Haomin; Zhao, Chenhui; An, Jiye

    2005-01-01

    Because of the complexity of the hospital environment, there exist a lot of medical information systems from different vendors with incompatible structures. In order to establish an enterprise hospital information system, the integration among these heterogeneous systems must be considered. Complete integration should cover three aspects: data integration, function integration and workflow integration. However most of the previous design of architecture did not accomplish such a complete integration. This article offers an architecture design of the enterprise hospital information system based on the concept of digital neural network system in hospital. It covers all three aspects of integration, and eventually achieves the target of one virtual data center with Enterprise Viewer for users of different roles. The initial implementation of the architecture in the 5-year Digital Hospital Project in Huzhou Central hospital of Zhejiang Province is also described.

  7. Central line associated sepsis in children receiving parenteral nutrition in Oman.

    Science.gov (United States)

    Al Lawati, Tawfiq T; Al Jamie, Adawaiya; Al Mufarraji, Nasra

    Parenteral Nutrition (PN) is used when gut fails to provide complete nutrition. Central line Associate Blood Stream Infection (CLABSI) a major complication of this therapy. The objective of the study was to report the incidence of CLABSI and associated mortality in children receiving PN in the Royal Hospital and study the indication and duration of PN use. All children from the age of 0-48 months who received TPN outside NICU from the period between 1/1/2011 till 31/12/2014 were included. Data were retrieved from the hospital electronic data base. There were 42 children 27 males and 15 females who used PN through a central line for a total duration of 569 days. The incidence of CLABSI was 14 days per 1000 days catheter and mortality of 556 per 10000. The average duration of TPN was 14.5 days. Most of the patient had CLABSI in the PICU and cardiac related illness or surgery was the most common indication of PN use. The average duration of use was 14 days. Inspite of that short duration use of PN, there is a very high incidence of CLABSI and its related mortality. Bundle policy for central line care is not used in the Royal Hospital and this study calls for urgent implementation of central line care bundle policy in the Royal Hospital. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. Influenza and other respiratory viruses in three Central American countries

    Science.gov (United States)

    Laguna‐Torres, Victor A.; Sánchez‐Largaespada, José F.; Lorenzana, Ivette; Forshey, Brett; Aguilar, Patricia; Jimenez, Mirna; Parrales, Eduardo; Rodriguez, Francisco; García, Josefina; Jimenez, Ileana; Rivera, Maribel; Perez, Juan; Sovero, Merly; Rios, Jane; Gamero, María E.; Halsey, Eric S.; Kochel, Tadeusz J.

    2010-01-01

    Please cite this paper as: Laguna‐Torres et al. (2011) Influenza and other respiratory viruses in three Central American countries. Influenza and Other Respiratory Viruses 5(2), 123–134. Background  Despite the disease burden imposed by respiratory diseases on children in Central America, there is a paucity of data describing the etiologic agents of the disease. Aims  To analyze viral etiologic agents associated with influenza‐like illness (ILI) in participants reporting to one outpatient health center, one pediatric hospital, and three general hospitals in El Salvador, Honduras, and Nicaragua Material & Methods  Between August 2006 and April 2009, pharyngeal swabs were collected from outpatients and inpatients. Patient specimens were inoculated onto cultured cell monolayers, and viral antigens were detected by indirect and direct immunofluorescence staining. Results  A total of 1,756 patients were enrolled, of whom 1,195 (68.3%) were under the age of 5; and 183 (10.4%) required hospitalization. One or more viral agents were identified in 434 (24.7%) cases, of which 17 (3.9%) were dual infections. The most common viruses isolated were influenza A virus (130; 7.4% of cases), respiratory syncytial virus (122; 6.9%), adenoviruses (63; 3.6%), parainfluenza viruses (57; 3.2%), influenza B virus (47; 2.7% of cases), and herpes simplex virus 1 (22; 1.3%). In addition, human metapneumovirus and enteroviruses (coxsackie and echovirus) were isolated from patient specimens. Discussion  When compared to the rest of the population, viruses were isolated from a significantly higher percentage of patients age 5 or younger. The prevalence of influenza A virus or influenza B virus infections was similar between the younger and older age groups. RSV was the most commonly detected pathogen in infants age 5 and younger and was significantly associated with pneumonia (p < 0.0001) and hospitalization (p < 0.0001). Conclusion  Genetic analysis of influenza

  9. Relationship between nurse's general health and their personal occupational traits in Al-Zahra Hospital of Isfahan, 2015

    Directory of Open Access Journals (Sweden)

    Mahnaz Adibi

    2016-11-01

    Full Text Available Health state is one of the most important factors in their life. Individuals may be subject to threatening factors in different ways. Nurses are one main group of community whose health may be threatened due to their occupational environment. Therefore, this study aimed at investigating general health of nurses and their personal occupational traits. Method: This study is correlation-descriptive research. Statistical population consists of 220 nurses working in Al-Zahra hospital selected by random sampling. Instrument of this study includes a demographic questionnaire and a standard Goldberg 28-question questionnaire. The data were analyzed by SPSS software. Findings: in this study, nurses are subject to occupational events, physical and chemical harmful materials, biologic harmful materials, mental/ ergonomic harmful occupational factors. And there exists relation between their general health and their age, number of children and marital status. But no relation has been seen with their surgery records, rate of sport they do, vaccination, the unit in which they work, their occupational environment, their occupational record and posts.

  10. Infestation of Tunga penetrans in villages near Zomba Central Hospital

    African Journals Online (AJOL)

    perform such basic tasks as collecting water or farming. Although the recommended .... Cook, G. Manson's Tropical Diseases 20th Edition,London: Saunders; 1996. 2. Feldmeier et al: ... cases in French Guyana. Bull Soc,Pathol Exot 2003 ...

  11. [Munchausen syndrome: need for centralized administrative health-care management].

    Science.gov (United States)

    Altmark, D; Sigal, M; Gelkopf, M

    1991-03-01

    The clinical picture of Munchausen syndrome is that of feigned or self-induced illness with the aim of being hospitalized and/or receiving unnecessary medical interventions, peregrination from 1 hospital to another, and disruptive behavior when hospitalized. These patients are a danger to themselves and heavily burden inpatient facilities that care for them. We present a case that illustrates the problems of diagnosing and managing such patients. We stress the need for adequate centralization and distribution of the relevant information concerning these patients.

  12. The Market for Hospital Medicine in Denmark

    DEFF Research Database (Denmark)

    Hostenkamp, Gisela

    2012-01-01

    Pharmaceutical expenditure growth has outpaced GDP and healthcare expenditure growth rates in Denmark as in most OECD countries for the last decade. A major part of this increase was due to high growth rates in specialist areas that are typically located in hospital settings. Yet the market...... for hospital medicines and their procurement are still poorly understood. The present paper characterises the market for hospital medicines in Denmark in terms of its organisation and developments between 2005 and 2009. In Denmark hospital medicines are publicly financed and procurement is centrally organised....... 98% of all medicines administered at Danish public hospitals are purchased through a public procurement agency by means of public tenders. Using data on actual contract prices we decompose pharmaceutical expenditure growth into the contributions from newly introduced medicines, price and volume...

  13. Work-Related Accidents and Sharp Injuries in Paramedics-Illustrated with an Example of a Multi-Specialist Hospital, Located in Central Poland.

    Science.gov (United States)

    Garus-Pakowska, Anna; Szatko, Franciszek; Ulrichs, Magdalena

    2017-08-10

    (1) Background: An analysis of work-related accidents in paramedics in Poland by presenting the model and trend of accidents, accident rates and by identifying causes and results of accidents; (2) Methods: A retrospective analysis of medical documentation regarding work-related accidents in a multi-specialist hospital, located in central Poland, in the period 2005-2015. The study group included paramedics who had an accident while being on duty; (3) Results: According to hospital records, 88 paramedics were involved in 390 accidents and 265 injuries caused by sharp instruments. The annual accident rate was 5.34/100 employed paramedics. Most of the accidents occurred at night. The most common reason for the accident was careless behaviour of the paramedic, which resulted in joint sprains and dislocations. Injuries accounted for a huge portion of the total number of events. As many as 45% of injuries were not officially recorded; (4) Conclusion: High rates of work-related accidents and injuries caused by sharp instruments in paramedics are a serious public health problem. Further studies should be conducted in order to identify risk factors of accidents, particularly injuries, and to implement preventative programmes, aiming to minimise rates of occupational hazards for paramedics.

  14. Als2 mRNA splicing variants detected in KO mice rescue severe motor dysfunction phenotype in Als2 knock-down zebrafish.

    Science.gov (United States)

    Gros-Louis, Francois; Kriz, Jasna; Kabashi, Edor; McDearmid, Jonathan; Millecamps, Stéphanie; Urushitani, Makoto; Lin, Li; Dion, Patrick; Zhu, Qinzhang; Drapeau, Pierre; Julien, Jean-Pierre; Rouleau, Guy A

    2008-09-01

    Recessive ALS2 mutations are linked to three related but slightly different neurodegenerative disorders: amyotrophic lateral sclerosis, hereditary spastic paraplegia and primary lateral sclerosis. To investigate the function of the ALS2 encoded protein, we generated Als2 knock-out (KO) mice and zAls2 knock-down zebrafish. The Als2(-/-) mice lacking exon 2 and part of exon 3 developed mild signs of neurodegeneration compatible with axonal transport deficiency. In contrast, zAls2 knock-down zebrafish had severe developmental abnormalities, swimming deficits and motor neuron perturbation. We identified, by RT-PCR, northern and western blotting novel Als2 transcripts in mouse central nervous system. These Als2 transcripts were present in Als2 null mice as well as in wild-type littermates and some rescued the zebrafish phenotype. Thus, we speculate that the newly identified Als2 mRNA species prevent the Als2 KO mice from developing severe neurodegenerative disease and might also regulate the severity of the motor neurons phenotype observed in ALS2 patients.

  15. Del santuario al caserío: acerca de la neolitización en la Cordillera de los Andes Centrales

    Directory of Open Access Journals (Sweden)

    1988-01-01

    . Piruru presenta, en el Precerámico Final (3000/2500 - 1800/1500 a.C., un largo período de construcción con fines religiosos antes de que existan, en el Formativo Inicial y Medio (1800/1500 - 800/600 a.C., estructuras de uso doméstico. Esta anterioridad de la arquitectura pública y ceremonial, observable en la escala regional, permite proponer la hipótesis que durante el Precerámico Final, los santuarios de la sierra tienen un rol catalizador, no sólo en lo que concierne al surgimiento y al desarrollo de la arquitectura, sino también en lo referente a la organización espacial de las comunidades en proceso de sedentarización. Durante la larga ocupación del Precerámico Final, más de 1000 años, las primeras fases de la secuencia de Piruru muestran la existencia de templetes que son los más antiguos que se conocen hasta hoy en los Andes Centrales. Luego, la fase más reciente del Templo P1 permite vincular Piruru a los demás santuarios conocidos y definir la tradición Mito, corriente religiosa que se manifiesta durante la segunda parte del Precerámico Final en las sierras de Ancash y Huánuco. En el Formativo Inicial, al mismo tiempo que se introduce la cerámica en el sitio arqueológico, Piruru se transforma en un pequeño hábitat agrupado, primer ejemplo conocido hoy en día en la sierra. En el transcurso de un largo proceso de más de 700 años, las transformaciones en la organización global del asentamiento indican un grado creciente de sedentarismo y muestran la transición desde un caserío utilizado de manera temporal hasta una aldea poblada de modo permanente, pues el sedentarismo parece haber sido adquirido al principio del Formativo Medio. 'From Shrine to Hamlet: About the Neolithic Process in the Central Andes Highlands'. The archaeological evidence found in Piruru opens new perspectives about sedentism and the rise of the village in the Central Andes. Piruru presents, during the Late Preceramic (3000/2500 -1800/1500 BC, a long period of

  16. La Vega Central: Del lugar al no lugar

    Directory of Open Access Journals (Sweden)

    María Teresa Herrera Urrutia

    2014-01-01

    Full Text Available La Vega Central de Santiago de Chile. Un mercado reconocido por los santiaguinos como mercado popular compuesto por personas de distintos orígenes tanto sociales como étnicos. Para comprender la importancia de este sector comercial, es necesario hacer un recorrido histórico que muestre cuál es el origen de la Vega y cómo el lugar que ocupa le otorga un significado en el mundo popular para así entender los nuevos procesos emergentes relativos a la multiculturalidad. Desde la teoría de los No Lugares, se intenta entender cómo La Vega logra constituirse como un Lugar en la medida en que es habitado y construido por las personas, y como, a su vez, la temporalidad a la que es sometida logra generar un pliegue que transforma a este mercado en un No Lugar. Por lo tanto, la hipótesis que dirige este artículo tiene relación con que el horario de funcionamiento de La Vega permite el pliegue o la transformación entre este mercado como un Lugar y como un No Lugar. Abstract This paper focuses in a particular place, La Vega Central in Santiago de Chile. This is a marketplace known for santiaguinos as a people’s market, composed of people from different backgrounds, both social and ethnic. In order to understand the importance of this comercial sector, it is necesarry to do an historical overview showing La Vega’s origin and how the place gives it a meaning in the popular world. From the Non Place theory, we try to understand how La Vega does constitute a Place to the extent that it is inhabited and built by people, and how, in turn, the temporality to wich is subjected to achieves to generate a fold that transforms this market in a Non Place. Therefore, the hypothesis that runs this article is related to La Vega’s operating hours that allows the market’s transformation as a Place and a Non Place.

  17. L’ambientalista nucleare Alternative al cambiamento climatico

    CERN Document Server

    Gómez Cadenas, Juan José

    2012-01-01

    Che cosa emette più radioattività nell'atmosfera: una centrale nucleare o una centrale termica? Una centrale termica. Che cosa comporta maggior rischio: vivere nei pressi di una centrale nucleare o fumare una sigaretta? Fumare una sola sigaretta equivale al rischio di vivere due anni vicino a una centrale nucleare. Che cosa si fa in un'ora di punta di richiesta energetica se non soffia il vento? Si ricorre a impianti di pompaggio o centrali a gas di riserva. L'energia elettrica non può essere immagazzinata. Quanti aerogeneratori servono per sostituire una centrale nucleare? Circa duemila, dell'ultima generazione. Separati tra di loro dei cinquecento metri necessari perché siano efficienti, la fila dei mulini si estenderebbe da Barcellona a Ginevra, attraversando l'intera Francia. È un errore contrapporre tra loro le energie alternative, sarebbe molto più sensato considerarle alleate nella grande battaglia contro un Signore Oscuro ogni giorno più potente: il cambiamento climatico, che potrebbe benissimo...

  18. Hemoglobin H disease in the Al-Qatif region of Saudi Arabia

    International Nuclear Information System (INIS)

    Ankra-Badu, George A.; Al-Jama, A.; Al-Kadim, Y.

    2001-01-01

    The Al-Qatif region in the Eastern Province of Saudi Arabia has thehighest prevalence of alpha-thalassemia genes in the Kingdom. Hemoglobin H(Hb H) disease, however, has been rarely reported. We decided therefore toverify the rarity of disease and characterize the presenting features incases identified. All patients seen in Qatif Central Hospital betweenSeptember 1988 and November 1990 with low red cell indices were screened forHb H disease and those found positive had clinical data compiled from theirhospital records and analyzed. Thirty-nine cases of Hb H were diagnosed. Themean age of patients was 18 years. The mean hemoglobin was 13.5 g/dL forneonates and 7.6 g/dL for others. The mean Hb Bart's level was 27.5% inneonates and the mean Hb H level in others was 11.1%. In addition to low redcell indices, all patients had a high red cell distribution width (RDW) meanof 25.6%. The main clinical signs were jaundice and hepatosplenomegaly.Concurrent glucose-6-phosphate Dehydrogenase (G6PD) deficiency was seen in28.2% of patients. Hemoglobin H disease is not uncommon in the Al-Qatifregion of Saudi Arabia. The red cell indices may mimic iron deficiency, whichshould be excluded by the presence of jaundice and organomegaly. Thecondition often co-exists with G6PD deficiency. (author)

  19. Peripherally Inserted Central Catheter-Related Infections in a Cohort of Hospitalized Adult Patients

    Energy Technology Data Exchange (ETDEWEB)

    Bouzad, Caroline, E-mail: caroline.bouzad@gmail.com [Percy Military Teaching Hospital, Radiology Department (France); Duron, Sandrine, E-mail: duronsandrine@yahoo.fr [GSBdD, Military Centre for Epidemiology and Public Health (CESPA) (France); Bousquet, Aurore, E-mail: aurorebousquet@yahoo.fr [Begin Military Teaching Hospital, Bacteriology Department (France); Arnaud, François-Xavier, E-mail: fxa0160@hotmail.com [Percy Military Teaching Hospital, Radiology Department (France); Valbousquet, Laura, E-mail: laura.valbousquet@gmail.com [Begin Military Teaching Hospital, Radiology Department (France); Weber-Donat, Gabrielle, E-mail: weberdonatgabrielle@yahoo.fr; Teriitehau, Christophe, E-mail: cteriitehau@me.com; Baccialone, Jacques, E-mail: jacques.baccialone@wanadoo.fr; Potet, Julien, E-mail: potet-julien@yahoo.fr [Percy Military Teaching Hospital, Radiology Department (France)

    2016-03-15

    PurposeTo determine the incidence and the risks factors of peripherally inserted central catheter (PICC)-related infectious complications.Materials and MethodsMedical charts of every in-patient that underwent a PICC insertion in our hospital between January 2010 and October 2013 were reviewed. All PICC-related infections were recorded and categorized as catheter-related bloodstream infections (CR-BSI), exit-site infections, and septic thrombophlebitis.ResultsNine hundred and twenty-three PICCs were placed in 644 unique patients, mostly male (68.3 %) with a median age of 58 years. 31 (3.4 %) PICC-related infections occurred during the study period corresponding to an infection rate of 1.64 per 1000 catheter-days. We observed 27 (87.1 %) CR-BSI, corresponding to a rate of 1.43 per 1000 catheter-days, 3 (9.7 %) septic thrombophlebitis, and 1 (3.2 %) exit-site infection. Multivariate logistic regression analysis showed a higher PICC-related infection rate with chemotherapy (odds ratio (OR) 7.2–confidence interval (CI) 95 % [1.77–29.5]), auto/allograft (OR 5.9–CI 95 % [1.2–29.2]), and anti-coagulant therapy (OR 2.2–95 % [1.4–12]).ConclusionChemotherapy, auto/allograft, and anti-coagulant therapy are associated with an increased risk of developing PICC-related infections.Clinical AdvanceChemotherapy, auto/allograft, and anti-coagulant therapy are important predictors of PICC-associated infections. A careful assessment of these risk factors may be important for future success in preventing PICC-related infections.

  20. Peripherally Inserted Central Catheter-Related Infections in a Cohort of Hospitalized Adult Patients

    International Nuclear Information System (INIS)

    Bouzad, Caroline; Duron, Sandrine; Bousquet, Aurore; Arnaud, François-Xavier; Valbousquet, Laura; Weber-Donat, Gabrielle; Teriitehau, Christophe; Baccialone, Jacques; Potet, Julien

    2016-01-01

    PurposeTo determine the incidence and the risks factors of peripherally inserted central catheter (PICC)-related infectious complications.Materials and MethodsMedical charts of every in-patient that underwent a PICC insertion in our hospital between January 2010 and October 2013 were reviewed. All PICC-related infections were recorded and categorized as catheter-related bloodstream infections (CR-BSI), exit-site infections, and septic thrombophlebitis.ResultsNine hundred and twenty-three PICCs were placed in 644 unique patients, mostly male (68.3 %) with a median age of 58 years. 31 (3.4 %) PICC-related infections occurred during the study period corresponding to an infection rate of 1.64 per 1000 catheter-days. We observed 27 (87.1 %) CR-BSI, corresponding to a rate of 1.43 per 1000 catheter-days, 3 (9.7 %) septic thrombophlebitis, and 1 (3.2 %) exit-site infection. Multivariate logistic regression analysis showed a higher PICC-related infection rate with chemotherapy (odds ratio (OR) 7.2–confidence interval (CI) 95 % [1.77–29.5]), auto/allograft (OR 5.9–CI 95 % [1.2–29.2]), and anti-coagulant therapy (OR 2.2–95 % [1.4–12]).ConclusionChemotherapy, auto/allograft, and anti-coagulant therapy are associated with an increased risk of developing PICC-related infections.Clinical AdvanceChemotherapy, auto/allograft, and anti-coagulant therapy are important predictors of PICC-associated infections. A careful assessment of these risk factors may be important for future success in preventing PICC-related infections

  1. Comparability of Point-of-Care versus Central Laboratory Hemoglobin Determination in Emergency Patients at a Supra-Maximal Care Hospital.

    Directory of Open Access Journals (Sweden)

    Ramona C Dolscheid-Pommerich

    Full Text Available Fulfilling the requirements of point-of-care testing (POCT training regarding proper execution of measurements and compliance with internal and external quality control specifications is a great challenge. Our aim was to compare the values of the highly critical parameter hemoglobin (Hb determined with POCT devices and central laboratory analyzer in the highly vulnerable setting of an emergency department in a supra maximal care hospital to assess the quality of POCT performance. In 2548 patients, Hb measurements using POCT devices (POCT-Hb were compared with Hb measurements performed at the central laboratory (Hb-ZL. Additionally, sub collectives (WHO anemia classification, patients with Hb 85y. were analyzed. Overall, the correlation between POCT-Hb and Hb-ZL was highly significant (r = 0.96, p2.5g/dl occurred. McNemar´s test revealed significant differences regarding anemia diagnosis according to WHO definition for male, female and total patients (♂ p<0.001; ♀ p<0.001, total p<0.001. Hb-ZL resulted significantly more often in anemia diagnosis. In samples with Hb<8g/dl, McNemar´s test yielded no significant difference (p = 0.169. In suprageriatric patients, McNemar´s test revealed significant differences regarding anemia diagnosis according to WHO definition in male, female and total patients (♂ p<0.01; ♀ p = 0.002, total p<0.001. The difference between Hb-ZL and POCT-Hb with Hb<8g/dl was not statistically significant (<8g/dl, p = 1.000. Overall, we found a highly significant correlation between the analyzed hemoglobin concentration measurement methods, i.e. POCT devices and at the central laboratory. The results confirm the successful implementation of the presented POCT concept. Nevertheless some limitations could be identified in anemic patients stressing the importance of carefully examining clinically implausible results.

  2. Clinical Perspective of Oxidative Stress in Sporadic ALS

    Science.gov (United States)

    D’Amico, Emanuele; Factor-Litvak, Pam; Santella, Regina M.; Mitsumoto, Hiroshi

    2013-01-01

    Sporadic amyotrophic lateral sclerosis (sALS) is one of the most devastating neurological diseases; most patients die within 3 to 4 years after symptom onset. Oxidative stress is a disturbance in the pro-oxidative/anti-oxidative balance favoring the pro-oxidative state. Autopsy and laboratory studies in ALS indicate that oxidative stress plays a major role in motor neuron degeneration and astrocyte dysfunction. Oxidative stress biomarkers in cerebrospinal fluid, plasma, and urine, are elevated, suggesting that abnormal oxidative stress is generated outside of the central nervous system. Our review indicates that agricultural chemicals, heavy metals, military service, professional sports, excessive physical exertion, chronic head trauma, and certain foods might be modestly associated with ALS risk, with a stronger association between risk and smoking. At the cellular level, these factors are all involved in generating oxidative stress. Experimental studies indicate that a combination of insults that induce modest oxidative stress can exert additive deleterious effects on motor neurons, suggesting multiple exposures in real-world environments are important. As the disease progresses, nutritional deficiency, cachexia, psychological stress, and impending respiratory failure may further increase oxidative stress. Moreover, accumulating evidence suggests that ALS is possibly a systemic disease. Laboratory, pathologic, and epidemiologic evidence clearly support the hypothesis that oxidative stress is central in the pathogenic process, particularly in genetically susceptive individuals. If we are to improve ALS treatment, well-designed biochemical and genetic epidemiological studies, combined with a multidisciplinary research approach, are needed and will provide knowledge crucial to our understanding of ALS etiology, pathophysiology, and prognosis. PMID:23797033

  3. The Role of Necropsy in Diagnostic Dilemmas as Seen in a Tertiary Hospital in North Central Nigeria

    Directory of Open Access Journals (Sweden)

    Olugbenga A. Silas

    2009-01-01

    Full Text Available Background. Necropsy (autopsy has helped medical science and law. It has given rise to numerous diagnostic surprises as it explains cause of death, pathogenesis of diseases, and circumstances of death. It also explains reasons for most therapeutic failures. In spite of its usefulness, the rate has dropped worldwide and Africa is worse hit. This work aims to highlight the role autopsy (Necropsy plays in demystifying diagnostic dilemmas and to encourage its patronage by medical practitioners, law enforcement agents and society. Methods. This is a retrospective review of autopsy and clinical reports of cases seen by pathologists and physicians in the Jos University Teaching Hospital (JUTH, Jos, North central Nigeria. Results. A total 166 cases were studied out of which 52 had same diagnosis for both attending physician and pathologist, 106 had different diagnoses and in eight cases diagnoses remained unknown even after autopsy was performed. Conclusions. Autopsy remains an important tool for obtaining definitive diagnosis, determining cause of death to explain pathogenesis of diseases, medical auditing and a vital source of data for health statistics and planning.

  4. Frequency of anti-Chlamydia trachomatis antibodies in infertile women referred to Tabriz Al-Zahra hospital

    Directory of Open Access Journals (Sweden)

    Mahtab Sattari

    2017-08-01

    Full Text Available Background: Infertility is one of the major issues in society and its incidence is estimated to be almost 10-15%. Chlamydia trachomatis (C. trachomatis is an important cause of sexually transmitted diseases leading to infertility. Objective: This study was designed to determine the frequency of anti-C. trachomatis antibodies in infertile women at Al-zahra hospital, Tabriz, Iran. Materials and Methods: In this cross-sectional study, the blood samples were collected randomly from 184 infertile women (case group and 100 pregnant women (control group. The frequency of specific IgG and IgM anti-C. trachomatis antibodies were evaluated using ELISA method. Results: The frequency of IgG anti-C. trachomatis antibody in the control and case groups was 18% and 35.88%, respectively. IgM anti-C. trachomatis antibody was found in 2% of controls and 5.44% of infertile women. Our results showed the significant differences between the case and control groups in anti-C. trachomatis antibodies (IgG, p=0.035 and IgM, p=0.004. Also, no significant relation was seen between the frequency of anti-C. trachomatis antibodies and age, location, and tubal factor infertility in our two study groups. Conclusion: According to high frequency of antibody anti-C. trachomatis among infertile women in competition to the control group, evaluation and treatment of Chlamydia infections is necessary in these patients

  5. Epidemiological trends of cutaneous leishmaniasis in Al-Madinah Al-Munawarah Province, Western Region of Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Miskelyemen Abdelatti Elmekki

    2017-01-01

    Full Text Available Objective: To investigate the epidemiological trends of cutaneous leishmaniasis (CL in Al-Madinah Al-Munawarah, western region of KSA. Materials and Methods: Four hundred and sixty-seven parasitologically confirmed CL cases attending Al-Meeqat Hospital, Al-Madinah, during 2012–2015, were included in this study. Results: Both Saudi and non-Saudi nationals were infected, with the highest infection rate being among Saudis (68.7%. Males were more affected than females as 86.9% of the total CL cases were males. Moreover, CL was prevalent in all age groups with higher frequency among young adults and adolescents (23.1% and 22.7%, respectively. Interestingly, almost all the patients in the adolescent and child age groups were Saudis (96.2% and 93.5%, respectively. Considering geographical distribution, the highest percentage of the cases (40.5% were from the northern parts of Al-Madinah province while the eastern parts reported the least infection rate (7.3%. Few cases (2.5% were supposed to encounter the infection abroad. Additionally, the frequency of infection was found to follow a seasonal distribution. Regarding treatment, pentostam, ketoconazole, or cryotherapy were the treatment options usually used. Conclusion: CL is prevalent in Al-Madinah Al-Munawarah area and new foci are being introduced. Thus, detailed studies with large surveillances regarding vector and reservoir hosts in and around the area are needed.

  6. Administrative behavior of directors in hospitals: the Israeli case.

    Science.gov (United States)

    Stern, Z; Schmid, H; Nirel, N

    1994-01-01

    This article presents research findings on the behavior of directors in hospitals in Israel. According to the findings, hospital directors devote most of their time to internal organization processes and less time to the management of the external organizational environment. The findings also reveal that the orientation of these directors is toward centralization of authority and concentration of the decision-making process.

  7. Prevalence of lens opacity at Queen Elizabeth Central Hospital in ...

    African Journals Online (AJOL)

    Laterality is reported probably for the first time in Central Africa - bilateral cataracts being more common than unilateral ones, and the leading cause of cataracts in adults was senility whereas congenital cataracts were commoner in children. The prevalence increased with age, males being affected more than females.

  8. Prevalence of multiple sclerosis in Al Quseir city, Red Sea Governorate, Egypt

    Directory of Open Access Journals (Sweden)

    El-Tallawy HN

    2016-01-01

    Full Text Available Hamdy N El-Tallawy,1 Wafaa M A Farghaly,1 Reda Badry,1 Nabil A Metwally,2 Ghaydaa A Shehata,1 Tarek A Rageh,1 Mohamed Abd El Hamed,1 Mahmoud R Kandil1 1Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt; 2Department of Neurology and Psychiatry, Al Azhar University Hospital, Assiut Branch, Assiut, Egypt Background: Multiple sclerosis (MS is a chronic and disabling disorder with considerable social effects and economic sequelae. It is one of the major causes of disability in young adults.Objectives: This study aimed at detecting the prevalence of MS among the population of Al Quseir city.Methods: This study is a part of door-to-door survey of major neurological disorders that was conducted in Al Quseir city, Red Sea Governorate, Egypt. The sample size was 33,285 persons. The youngest patient was 17 years old. The number of people at and above 17 years of age was 21,827. They were screened by three neurologists. Then, the positive cases were subjected to meticulous clinical evaluation by three staff members of Department of Neurology, Assiut University Hospital, Egypt. Essential investigations were done.Results: A total of three cases of MS were diagnosed with an age-specific prevalence ≥17 years of 13.7/100,000. Keywords: prevalence, multiple sclerosis, Al Quseir, door-to-door survey 

  9. [Drug supply chain safety in hospitals: current data and experience of the Grenoble university hospital].

    Science.gov (United States)

    Bedouch, P; Baudrant, M; Detavernier, M; Rey, C; Brudieu, E; Foroni, L; Allenet, B; Calop, J

    2009-01-01

    Drug supply chain safety has become a priority for public health which implies a collective process. This process associates all health professionals including the pharmacist who plays a major role. The objective of this present paper is to describe the several approaches proven effective in the reduction of drug-related problem in hospital, illustrated by the Grenoble University Hospital experience. The pharmacist gets involved first in the general strategy of hospital drug supply chain, second by his direct implication in clinical activities. The general strategy of drug supply chain combines risk management, coordination of the Pharmacy and Therapeutics Committee, selection and purchase of drugs and organisation of drug supply chain. Computer management of drug supply chain is a major evolution. Nominative drug delivering has to be a prior objective and its implementation modalities have to be defined: centralized or decentralized in wards, manual or automated. Also, new technologies allow the automation of overall drug distribution from central pharmacy and the implementation of automated drug dispensing systems into wards. The development of centralised drug preparation allows a safe compounding of high risk drugs, like cytotoxic drugs. The pharmacist should develop his clinical activities with patients and other health care professionals in order to optimise clinical decisions (medication review, drug order analysis) and patients follow-up (therapeutic monitoring, patient education, discharge consultation).

  10. Is the system really the solution? Operating costs in hospital systems.

    Science.gov (United States)

    Burns, Lawton Robert; McCullough, Jeffrey S; Wholey, Douglas R; Kruse, Gregory; Kralovec, Peter; Muller, Ralph

    2015-06-01

    Hospital system formation has recently accelerated. Executives emphasize scale economies that lower operating costs, a claim unsupported in academic research. Do systems achieve lower costs than freestanding facilities, and, if so, which system types? We test hypotheses about the relationship of cost with membership in systems, larger systems, and centralized and local hub-and-spoke systems. We also test whether these relationships have changed over time. Examining 4,000 U.S. hospitals during 1998 to 2010, we find no evidence that system members exhibit lower costs. However, members of smaller systems are lower cost than larger systems, and hospitals in centralized systems are lower cost than everyone else. There is no evidence that the system's spatial configuration is associated with cost, although national system hospitals exhibit higher costs. Finally, these results hold over time. We conclude that while systems in general may not be the solution to lower costs, some types of systems are. © The Author(s) 2015.

  11. Motivation and Factors Affecting It among Health Professionals in the Public Hospitals, Central Ethiopia.

    Science.gov (United States)

    Dagne, Tesfaye; Beyene, Waju; Berhanu, Negalign

    2015-07-01

    Motivation is an individual's degree of willingness to exert and maintain an effort towards organizational goals. This study assessed motivational status and factors affecting it among health professionals in public hospitals of West Shoa Zone, Oromia Region. Facility based cross-sectional survey was employed. All health professionals who served at least for 6 months in Ambo, Gedo and Gindeberet hospitals were included. Self-administered Likert scale type questionnaire was used. Data were analyzed using SPSS version 20. Mean motivation calculated as percentage of maximum scale score was used. Bivariate and multiple linear regression analyses were done to see the independent effects of explanatory variables. The overall motivation level of health professionals was 63.63%. Motivation level of health professionals varied among the hospitals. Gindeberet Hospital had lower motivation score as compared to Ambo Hospital (B = -0.54 and 95% CI; -0.08,-0.27). The mean motivation score of health professionals who got monthly financial benefit was significantly higher than those who did not (B = 0.71 and 95% CI; 0.32, 1.10). Environmental factors had higher impact on doctors' motivation compared to nurses' (B = 0.51 and 95% CI; 0.10, 0.92). Supervisor-related factors highly varied in motivation relative to other variables. Motivation of health professionals was affected by factors related to supervisor, financial benefits, job content and hospital location. Efforts should be made to provide financial benefits to health professionals as appropriate especially, to those who did not get any such benefits. Officially recognizing best performance is also suggested.

  12. Numerical investigation of airborne infection in naturally ventilated hospital wards with central-corridor type

    DEFF Research Database (Denmark)

    Zhou, Qi; Qian, Hua; Liu, Li

    2018-01-01

    Natural ventilation is believed to control airborne infection due to high ventilation rates while an undesired flow pattern may cause infection transmission in hospital wards. A computational fluid dynamics simulation was carried out in this study to investigate the impact of airflow pattern....... The results not only give direct evidence to strongly support World Health Organization’s recommendation but also suggest required amendment of the Chinese standard GB 51039-2014 to improve ventilation arrangement in general hospital wards in China. Our findings are useful for improving the future design...... of general hospital wards for airborne infection control....

  13. Impacto económico del tratamiento y gestión de los residuos sólidos producidos por el Hospital Militar Central – Lima

    OpenAIRE

    Nava Torres, César Augusto; Nava Torres, César Augusto; Loayza Berrocal, Luis Alberto; Nava Torres, César Augusto

    2012-01-01

    El manejo de los residuos sólidos hospitalarios en nuestro país es uno de los aspectos de la gestión hospitalaria que ha ido tomando importancia e interés en los últimos años. Mediante la presente investigación se pretende evaluar el actual Tratamiento y Gestión de los residuos sólidos en el Hospital Militar Central (HMC) de la ciudad de Lima, analizando los servicios de salud donde los pacientes se hospitalizan y se genere la mayor cantidad de desechos, a fin de determinar las ganancias...

  14. Work-Related Accidents and Sharp Injuries in Paramedics—Illustrated with an Example of a Multi-Specialist Hospital, Located in Central Poland

    Science.gov (United States)

    Szatko, Franciszek; Ulrichs, Magdalena

    2017-01-01

    (1) Background: An analysis of work-related accidents in paramedics in Poland by presenting the model and trend of accidents, accident rates and by identifying causes and results of accidents; (2) Methods: A retrospective analysis of medical documentation regarding work-related accidents in a multi-specialist hospital, located in central Poland, in the period 2005–2015. The study group included paramedics who had an accident while being on duty; (3) Results: According to hospital records, 88 paramedics were involved in 390 accidents and 265 injuries caused by sharp instruments. The annual accident rate was 5.34/100 employed paramedics. Most of the accidents occurred at night. The most common reason for the accident was careless behaviour of the paramedic, which resulted in joint sprains and dislocations. Injuries accounted for a huge portion of the total number of events. As many as 45% of injuries were not officially recorded; (4) Conclusion: High rates of work-related accidents and injuries caused by sharp instruments in paramedics are a serious public health problem. Further studies should be conducted in order to identify risk factors of accidents, particularly injuries, and to implement preventative programmes, aiming to minimise rates of occupational hazards for paramedics. PMID:28796193

  15. Definition of the large-scale extinction - A new solution of the central void phenomenon

    Science.gov (United States)

    Grabinska, T.

    1989-11-01

    The Estonian School results (Joeveer et al., 1977) concerning the galaxy cell structure were partly interpreted in the spirit of Zwicky's idea on intergalactic dust, although it remained a speculation. The same view was proposed also by Rudnicki to explain the evident deficit of galaxies in the central region (central void) of the Jagellonian field. Zieba (1974) tried to explain the effect of the central void in terms of an interstellar obscuration. This explanation of the central void (CV) in terms of a possible intergalactic dust was opened up again in 1984 and 1985; and its merits considered by Rudnicki et al. (1989). Now a new solution of the problem of the CV mystery is presented.

  16. Risk Factors for Multidrug-resistant Pseudomonas aeruginosa Among Hospitalized Patients at a Malaysian Hospital

    International Nuclear Information System (INIS)

    Mohd, N.M.D.; Nurnajwa, M.H.; Lay, J.; Teoh, J.C.; Syafinaz, A.N.; Niazlin, M.T.

    2015-01-01

    A case-control study was conducted based on medical cases of 100 hospitalized patients with Pseudomonas aeruginosa-isolation at a Malaysian hospital. Cases with 50 multidrug-resistant P. aeruginosa MDRPA and 50 non-multidrug-resistant P. aeruginosa (NMDRPA) were randomly included and compared with socio-demographic and clinical data of the patients, using Chi-square and Fisher's exact tests as the statistical tool. Analysis found no significant association between MDRPA with ages, gender and ethnicity of patients (p>0.050). Other risk factors being investigated were invasive procedure, immunosuppression, bedridden and clinical diagnosis such as central nervous- and respiratory-system disorder, as well as antibiotic exposure during hospitalization and duration of hospital stay with only the last two were found to have significant association (p=0.035 and 0.019, respectively). Some other studies also reported a similar association indicating that the two factors could serve as an important predictive tool for isolation of MDRPA. More studies involving a larger sampling size are warranted to establish the association. (author)

  17. Deterioro funcional en ancianos ingresados en un hospital sin unidades geriátricas Functional impairment in elderly inpatients in a hospital without geriatric units

    Directory of Open Access Journals (Sweden)

    Alfonso Jesús Cruz Lendínez

    2010-03-01

    Full Text Available Introducción: El aumento de la población de personas mayores de 65 años hace cada vez más frecuente su ingreso en los hospitales. La estancia hospitalaria en unidades de hospitalización convencionales puede llevar aparejado el deterioro de la capacidad funcional en los ancianos. Objetivos: Establecer el perfil del paciente anciano atendido en las Unidades de Medicina Interna del Complejo Hospitalario de Jaén. Analizar los resultados de la hospitalización en personas mayores en términos de variación de la capacidad funcional al alta respecto del ingreso. Identificar qué variables influyen en la variación de esa capacidad funcional de los ancianos hospitalizados en un centro sin unidades geriátricas. Métodos: Estudio prospectivo observacional en tres unidades de hospitalización de medicina interna de un hospital universitario de la red pública de Andalucía. Se ha incluido una muestra de 190 pacientes ancianos hospitalizados. Las variables recogidas fueron: demográficas, relacionadas con la hospitalización y con la capacidad funcional. Los datos se han obtenido mediante el uso del Índice de valoración de dependencia de Barthel. Resultados: La hospitalización en las unidades de medicina interna no contribuye a la mejora de la capacidad funcional de las personas mayores, más bien tiene un efecto negativo, favoreciendo el deterioro en un importante grupo de estos pacientes. En función de la edad, de entre los pacientes analizados (65-85 años y más, los pacientes de menor edad son los que obtienen mejores resultados de recuperación funcional al alta, mientras que los mayores de 85 años son los que peor resultado presentan. Observamos cómo pierden capacidad funcional el 16% de los menores de 85 años y el 67,5% de los mayores de 85. Conclusiones: La edad, la capacidad funcional al ingreso, la capacidad funcional al alta, la presencia de acompañantes durante la hospitalización y el destino al alta son los factores que m

  18. Enterprise resource planning for hospitals.

    Science.gov (United States)

    van Merode, Godefridus G; Groothuis, Siebren; Hasman, Arie

    2004-06-30

    Integrated hospitals need a central planning and control system to plan patients' processes and the required capacity. Given the changes in healthcare one can ask the question what type of information systems can best support these healthcare delivery organizations. We focus in this review on the potential of enterprise resource planning (ERP) systems for healthcare delivery organizations. First ERP systems are explained. An overview is then presented of the characteristics of the planning process in hospital environments. Problems with ERP that are due to the special characteristics of healthcare are presented. The situations in which ERP can or cannot be used are discussed. It is suggested to divide hospitals in a part that is concerned only with deterministic processes and a part that is concerned with non-deterministic processes. ERP can be very useful for planning and controlling the deterministic processes.

  19. The comparison of printed resources bacterial contamination in libraries of Al-Zahra Hospital and Sciences Faculty of Isfahan University and the determination of their antibiotic sensitivity pattern.

    Science.gov (United States)

    Rafiei, Hosein; Chadeganipour, Mostafa; Ojaghi, Rezvan; Maracy, Mohammad Reza; Nouri, Rasool

    2017-01-01

    During the library loan process, the printed resources can be a carrier of pathogenic bacteria. In this study, it was tried to compare the Bacterial Contamination Rates and their antibiotic sensitivity pattern in printed resources of a hospital and a non-hospital library. This is a cross-sectional study. Returning books from the Al-Zahra hospital library and library of Sciences faculty of Isfahan University provides the research community. The sample size, 96 cases, was calculated using quota sampling. For sampling sterile swab dipped in trypticase soy broth medium and transfer trypticase soy broth medium were used. To identify different type of isolated bacteria from Gram-staining test and biochemical tests such as; TSI, IMViC and etc., were used. 76 (79.2%) and 20 (20.8%) of cultured samples were negative and positive, the respectively. Of 20 positive samples, 11 samples (55%) belong to the family Enterobacteriaceae that after detecting by Differential teste identified all 11 samples of Enterobacter that all of them were sensitive to Gentamicin and Ofloxacin. Also the most resistance to Nitrofurantoin and Amikacin was observed. 9 cases remained (45%) were coagulase-negative Staphylococcus that all of them were sensitive to the Trimethoprim-sulfamethoxazole and Cephalexin antibiotics also the most resistance to Cefixime was observed. Considering that the Enterobacter sp and coagulase-negative Staphylococcus were separated from the books, the books as well as other hospital and medical equipment can transmit the infection to librarians, library users, patients and hospital staff, and also it can produce serious infections in patients with immune deficiency.

  20. Polisomnografía neonatal en recién nacidos con peso al nacer inferior a 1 500 gramos

    Directory of Open Access Journals (Sweden)

    Yolma Ruiz Tellechea

    2000-06-01

    Full Text Available Se evaluó la utilidad de la polisomnografía neonatal en 64 recién nacidos con peso al nacer inferior a 1 500 g, nacidos en el Hospital Ginecoobstétrico "Ramón González Coro", en el período comprendido entre octubre de 1988 y agosto de 1994. Se estudió la utilidad de la polisomnografía en la evaluación neurológica del recién nacido de muy bajo peso, también la utilidad de los estudios electroencefalográficos de seguimiento, así como se determinó la relación del polisomnograma con las causas de defunción neonatal. En este grupo de riesgo el polisomnograma al término resultó ser un buen indicador del estado anatomofuncional del sistema nervioso central en el período de recién nacido; quedó demostrada la utilidad del estudio electroencefalográfico de seguimiento y la existencia de una significativa relación entre la polisomnografía y las lesiones anatomopatológicas halladas en recién nacidos de muy bajo peso fallecidos.The usefulness of neonatal polysomnography was assessed in 64 infants weighing under 1 5000 at birth and born at "Ramón González Coro" Gynecologic and Obstetric Hospital from October 1988 to August 1994. The usefulness of this technique for neurologically evaluating very low birth weight neonates and the benefits of followup electroencephalographic studies were studied as well as the association of polysomnography with neonatal mortality was determined. In this risk group, polysomnogram on term pregnancy was a good indicator of the anatomofunctional status of the central nervous system in the neonatal period. The benefits of follow-up electroencephalographic study and the existence of a significant relationship between polysomnography and anatomopathological lesions found in dead very low birth weight infants were proved.

  1. Ocular trauma: A tertiary hospital experience from Oman

    Directory of Open Access Journals (Sweden)

    Haitham H Al-Mahrouqi

    2017-01-01

    CONCLUSION: Ocular trauma is a common presentation at Al-Nahdha Hospital. Although the majority of trauma cases were minor without any resultant visual disability, OGI could have been prevented with better ocular protection in the workplace.

  2. 123 East and Central African Journal of Surgery Volume 12 Number ...

    African Journals Online (AJOL)

    Josephine Nakato

    limb associated with avascular necrosis of the head of femur. [Table 2]. Discussion. Our study involved 165 patients hospitalized in surgical ward of BUTH. Male were slightly more than female. The male predominance was previously reported by Boukinda et al2 in. Brazzaville and Cacala et al3 in South. Africa. In this study ...

  3. LANGUAGE USE AT AL-AMIN CHILDREN ISLAMIC BOARDING SCHOOL IN SUKOHARJO, CENTRAL JAVA (A CASE STUDY

    Directory of Open Access Journals (Sweden)

    Qanitah Masykuroh

    2017-07-01

    Full Text Available This paper is abstracted from the findings of a case study aimed at describing the codes used by children at Al-Amin Children Islamic Boarding School in Sukoharjo, Central Java. The majority of children at this Children Islamic Boarding School are bilinguals. They use javanese as their first language and Indonesian as their second language. However; they live in a specific language condition in which they should only use Indonesian in their daily activities. The analysis shows that the codes used by children are in the form of language (Indonesian and Javanese, speech level (ngoko, madya and krama, and style (formal, informal and brief. The differentiation of function between Indonesian and Javanese is not quite clear. Frequently, children use both Indonesian and Javanese in many occassions. As a result, there amny code switching and code mixing in their speech. Code swicthing occured in their speech to function: (1 count (2 think aloud (3 show annoyance (4 give emphasis (5 give reinforcement (6 give respect, and (7 make quotation. The result also shows that code mixing indicates that children's mastery of Indonesian and Javanese is still lacking. Besides, it also indicates that they get confused with language function. Key words: code forms, code function, code switching, and code mixing

  4. Multivariate optimization of process parameters in the synthesis of calcined Ca‒Al (NO3) LDH for defluoridation using 3(3) factorial, central composite and Box-Behnken design.

    Science.gov (United States)

    Ghosal, Partha S; Gupta, Ashok K; Sulaiman, Ayoob

    2016-01-01

    Response surface methodology was applied for the first time in the optimization of the preparation of layered double hydroxide (LDH) for defluoridation. The influence of three vital process parameters (viz. pH, molar ratio and calcination temperature) in the synthesis of the adsorbent 'Calcined Ca‒Al (NO3) LDH' was thoroughly examined to maximize its fluoride scavenging potential. The process parameters were optimized using the 3(3) factorial, face centered central composite and Box-Behnken designs and a comparative assessment of the methods was conducted. The maximum fluoride removal efficiency was achieved at a calcination temperature of approximately 500ºC; however, the efficiency decreased with increasing pH and molar ratio. The outcome of the comparative assessment clearly delineates the case specific nature of the models. A better predictability over the entire experimental domain was obtained with the 3(3) factorial method, whereas the Box-Behnken design was found to be the most efficient model with lesser number of experimental runs. The desirability function technique was performed for optimizing the response, wherein face centered central composite design exhibited a maximum desirability. The calcined Ca‒Al (NO3) LDH, synthesized under the optimum conditions, demonstrated the removal efficiencies of 95% and 99% for the doses of 3 g L(-1) and 5 g L(-1), respectively.

  5. Performance Measurement in Belgian Hospitals : a state-of-the-art

    OpenAIRE

    Van Caillie, Didier; Rouhana, Rima; Santin, Sarah

    2007-01-01

    This communication proposes a global state-of-the-art around the central question : "How is performance measured and controlled in Belgian hospitals. As a first step in a global research project dedicated to the use of Balanced ScoreCard in publics hospitals around the world, it is essentially focused on global economic aspects and on major macroeconomic statistics.

  6. Medical research at the Albert Schweitzer Hospital.

    Science.gov (United States)

    Issifou, Saadou; Adegnika, Ayola A; Lell, Bertrand

    2010-03-01

    Built in 1981, the Medical Research Unit is located at the campus of the Albert Schweitzer Hospital. The main scientific activities of this research unit lie on clinical research focusing on antimalarial drugs and vaccines, and basic studies on pathogenesis of infectious diseases. Since 2002 the Medical Research Unit has experience in organising and hosting high quality training in clinical research in collaboration with the Vienna School of Clinical Research and other partners. For the future, this unit is involved as a key partner in the Central African Network on Tuberculosis, HIV/AIDS and Malaria (CANTAM) consortium playing a central role for the excellence in clinical research in Central Africa.

  7. CALCULUL CINETOSTATIC AL MECANISMELOR PLANETARE CILINDRICE

    Directory of Open Access Journals (Sweden)

    Păun ANTONESCU

    2012-05-01

    Full Text Available În lucrare se prezintă o metodă analitică pentru calculul cinetostatic al mecanismului planetarmonomobil cu două roţi dinţate centrale. Se consideră mai întâi cazul general al schemelor cinematice cu douăroţi dinţate solidare tip satelit, în două variante practice (multiplicator şi reductor de turaţie. Este menţionatcazul particular al mecanismelor planetare cu o singură roată satelit cu angrenare dublă (exterioară şiinterioară. Pe baza modelului de analiză cinetostatică a mecanismului planetar monomobil cu două roţi dinţatecentrale, în finalul lucrării se abordează o problemă practică de calcul cinetostatic al unui mecanism planetarcilindric simplu folosit la capul de frezat pentru prelucrarea roţilor dinţate cilindrice cu dinţi curbi înhipocicloidă.

  8. Centralized vs. decentralized child mental health services.

    Science.gov (United States)

    Adams, M S

    1977-09-01

    One of the basic tenets of the Community Mental Health Center movement is that services should be provided in the consumers' community. Various centers across the country have attempted to do this in either a centralized or decentralized fashion. Historically, most health services have been provided centrally, a good example being the traditional general hospital with its centralized medical services. Over the years, some of these services have become decentralized to take the form of local health centers, health maintenance organizations, community clinics, etc, and now various large mental health centers are also being broken down into smaller community units. An example of each type of mental health facility is delineated here.

  9. Biological control and surveillance measures for hospital radiopharmacy

    International Nuclear Information System (INIS)

    Joshi, S.H.; Mehra, K.S.; Ramamoorthy, N.

    1997-01-01

    The principles and procedures for the surveillance measures and the care required to be observed in hospital radiopharmacy, though much of the aspects are quite valid for centralized and industrial radiopharmacies, are described. 1 tab

  10. HHARP: The Historical Hospital Admission Records Project – a review

    Directory of Open Access Journals (Sweden)

    Cara Hirst

    2018-04-01

    Full Text Available Hospital records have frequently been used in epidemiological research (Kilgore et al. 2017; Rushton 2016, and in some cases palaeopathological research. However, the availability of data is problematic, with written records requiring considerable time to interpret, digitise and analyse. In 2001, the Historical Hospital Records Project (HHARP began digitising over 140,000 hospital admission records from four hospitals in London and Glasgow, providing researchers with an online data base of hospital records (Figure 1. I review the data available in the HHARP database, as well as make a preliminary analysis of the hospital records from London and Glasgow between c.1852-1921 which illustrates the value of the HHARP database in understanding disease and medical care during this period.

  11. Vitamin D deficiency in medical patients at a central hospital in Malawi: a comparison with TB patients from a previous study.

    Directory of Open Access Journals (Sweden)

    Yamikani Mastala

    Full Text Available OBJECTIVES: To determine the prevalence of vitamin D deficiency (VDD in adult medical, non-tuberculous (non-TB patients. To investigate associations with VDD. To compare the results with a similar study in TB patients at the same hospital. DESIGN: Cross-sectional sample. SETTING: Central hospital in Malawi. PARTICIPANTS: Adult non-TB patients (n = 157, inpatients and outpatients. OUTCOME MEASURES: The primary outcome was the prevalence of VDD. Potentially causal associations sought included nutritional status, in/outpatient status, HIV status, anti-retroviral therapy (ART and, by comparison with a previous study, a diagnosis of tuberculosis (TB. RESULTS: Hypovitaminosis D (≤75 nmol/L occurred in 47.8% (75/157 of patients, 16.6% (26/157 of whom had VDD (≤50 nmol/L. None had severe VDD (≤25 nmol/L. VDD was found in 22.8% (23/101 of in-patients and 5.4% (3/56 of out-patients. In univariable analysis in-patient status, ART use and low dietary vitamin D were significant predictors of VDD. VDD was less prevalent than in previously studied TB patients in the same hospital (68/161 = 42%. In multivariate analysis of the combined data set from both studies, having TB (OR 3.61, 95%CI 2.02-6.43 and being an in-patient (OR 2.70, 95%CI 1.46-5.01 were significant independent predictors of VDD. CONCLUSIONS: About half of adult medical patients without TB have suboptimal vitamin D status, which is more common in in-patients. VDD is much more common in TB patients than non-TB patients, even when other variables are controlled for, suggesting that vitamin D deficiency is associated with TB.

  12. Sultana et al., Afr J Tradit Complement Altern Med. (2016) 13(2):185 ...

    African Journals Online (AJOL)

    Shahid Mahboob

    broken anaphase bridges formed due to chromosome rearrangements such as dicentric chromatids, intermingled ring chromosomes or union of sister chromatids‖ (Albertini et al., 2000; Bouraoui et al., 2014). The objective of this study was to assess the indirect effect of radiation in the hospital workers of radiotherapy from ...

  13. Job satisfaction and attitudes towards nursing care among nurses working at Mzuzu Central Hospital in Mzuzu, Malawi.

    Science.gov (United States)

    Nyirenda, Maloni; Mukwato, Patricia

    2016-12-01

    Job satisfaction is a major determinant of performance at the workplace. Studies have shown that job dissatisfaction can intensify emotional exhaustion, and this can influence nurses to perceive their work as tiresome and repetitive, leading to frustration and discouragement. The purpose of this study was to investigate the relationship between job satisfaction and attitude towards nursing care at Mzuzu Central Hospital in Mzuzu, Malawi. This was a descriptive correlational study. Eighty-nine nurses were selected using simple random sampling. A self-administered questionnaire was used to collect data. Data were analysed using Stata (version 12). Frequencies, means, and standard deviations were used to summarise sociodemographic data and also to determine job satisfaction and attitudes towards nursing care among the participants. Independent t-tests were used to determine if differences in professional qualifications, job title, work experience, or the clinical setting in which the nurses worked were associated with differences in job satisfaction and attitude. Pearson's product-moment correlation was used to determine the relationship between job satisfaction and attitude in the study sample. The nurses who participated in this study generally had positive attitudes towards nursing care and were moderately satisfied with their jobs. There was a significant variation in attitude depending on the amount of time a nurse worked at a particular post (P = 0.0308), as well as the amount of time a nurse had worked at the hospital (P = 0.0012). There was a significant positive relationship between job satisfaction and attitude (r = 0.226, P = 0.033). The nurses in the study sample were moderately satisified with their work and generally had positive attitudes towards nursing care. There was a positive correlation between attitude towards nursing care and job satisfaction. Addressing factors which dissatisfy nurses can promote nurses' attitudes and likely improve performance

  14. SERVICE MARKETING MIX OF INDIAN HOSPITALS: A CRITICAL REVIEW

    Directory of Open Access Journals (Sweden)

    Dharmesh, MOTWANI

    2014-07-01

    Full Text Available Sreenivas, Srinivasarao and Srinivasa (2013 said that “The health care market has become consumer centered and expecting high quality care at a reasonable price. The mushroomed development of corporate hospitals in India, competition is also bringing massive changes in industry structure. In this context, hospital services’ marketing is slowly and surely coming of age and is being woven into the fabric of hospitals planning and public relations programmes.” The essence of any marketing activity is marketing mix, and the central theme of the present paper revolves around the contemporary service marketing mix offered by Indian hospitals. In this paper author has critically reviewed 51 papers to describe elements of hospital service marketing mix; product, price, place, promotion, people, process and physical evidence.

  15. Aucas en la ciudad de Santiago. La rebelión mapuche de 1723 y el miedo al «otro» en Chile central

    Directory of Open Access Journals (Sweden)

    Contreras Cruces, Hugo

    2013-06-01

    Full Text Available Within the context of the so-called indigenous rebellion in 1723, this article reconstructs the actions carried out to suppress an alleged rebel attack on the city of Santiago in October of that year, an attack which never occurred, but nevertheless brought to jail over one hundred Indians, inhabitants of the nearby city areas, and most of whom were immigrants who had come from the border of the river Biobio or from within the Araucania. This process is studied from the perspective of fear of the «other» who was in this case an indigenous migrant carrying language, customs and religion all of which were mostly incomprehensible to the hispanocriollos of central Chile, thereby making them immediately to appear suspicious and be referred to as «Auca», or rebel.En el contexto de la llamada rebelión general indígena de 1723, este artículo reconstituye las acciones llevadas a cabo para reprimir un supuesto ataque rebelde a la ciudad de Santiago en octubre de dicho año, el cual nunca llegó a realizarse, pero que llevó a la cárcel a más de una centena de indios que habitaban en las cercanías de la ciudad, la mayoría de los cuales eran inmigrantes venidos de la frontera del río Biobío o desde el interior de la Araucanía. Dicho proceso se estudia desde la perspectiva del miedo al «otro», en este caso al indígena migrante, portador de un idioma, costumbres y una religiosidad mayormente incomprensibles para los hispanocriollos de Chile central, lo que los convertía inmediatamente en sospechosos y se les calificaba como «aucas» o rebeldes.

  16. Survival of Extremely Premature Infants at the Largest MOH Referral Hospital in UAE: Comparable Results to Developed Countries

    OpenAIRE

    YASEEN, Hakam; YASEEN, Hoda

    2010-01-01

    Objective: to investigate the survival rate of extreme premature infants born between 2000 and 2008 at AL Qassimi hospital that is the largest Ministry of Health (MOH) referral hospital in the United Arab Emirates (UAE).Methods: This was an institutional review board approved retrospective study of the outcomes of pregnancies in women who were in labor and delivered between 23 and 25 weeks' completed gestation at Al Qassimi Hospital in the Emirate of Sharjah between January 1,2000 and De...

  17. Central nervous system tuberculomata presenting as internuclear ...

    African Journals Online (AJOL)

    Central nervous system (CNS) tuberculoma can have variable presentation depending upon the site and number of tuberculomata. We are reporting a rare case of a 15 years old girl who presented to our hospital with binocular diplopia on right gaze. Clinical examination revealed left sided internuclear ophthalmoplegia ...

  18. Epidemiology and Outcomes of Bloodstream Infections in Patients With Solid Tumors in a Central American Population at Mexico Hospital, San Jose, Costa Rica

    Directory of Open Access Journals (Sweden)

    Jorge Calvo-Lon

    2017-12-01

    Full Text Available Purpose: Bloodstream infections (BSIs are an important cause of mortality in patients with solid tumors. We conducted a retrospective study to evaluate the epidemiologic profile and mortality of patients with solid tumors who have BSIs and were admitted to Mexico Hospital. This is the first study in Costa Rica and Central America describing the current epidemiologic situation. Methods: We analyzed the infectious disease database for BSIs in patients with solid tumors admitted to Mexico Hospital from January 2012 to December 2014. Epidemiology and mortality were obtained according to microorganism, antibiotic sensitivity, tumor type, and presence of central venous catheter (CVC. Descriptive statistics were used. Results: A total of 164 BSIs were recorded, the median age was 58 years, 103 patients (63% were males, and 128 cases of infection (78% were the result of gram-negative bacilli (GNB. Klebsiella pneumoniae (21%, Escherichia coli (21%, and Pseudomonas aeruginosa (15% were the most common microorganisms isolated. Gram-positive cocci (GPC were found in 36 patients, with the most frequent microorganisms being Staphylococcus aureus (10% and Staphyloccocus epidermidis (6%. With respect to tumor type, BSIs were more frequent in the GI tract (57% followed by head and neck (9% and genitourinary tract (8%. Regarding antibiotic susceptibility, only 17% (GNB expressed extended-spectrum beta-lactamase and 12% (GPC had methicillin resistance. Patients with CVCs (n = 59 were colonized mainly by GNB (78%. Overall the mortality rate at 30 days was about 30%. Conclusion: GNB are the most frequent cause of BSIs in solid tumors and in patients with CVCs. GI cancers had more BSIs than other sites. Mortality and antibiotic sensitivity remained stable and acceptable during this observational period in this Latin American population.

  19. Bloodstream infection in patients with end-stage renal disease in a teaching hospital in central-western Brazil

    Directory of Open Access Journals (Sweden)

    Tamara Trelha Gauna

    2013-08-01

    Full Text Available Introduction Vascular access in patients undergoing hemodialysis is considered a critical determinant of bloodstream infection (BSI and is associated with high morbidity and mortality. The purpose of this study was to investigate the occurrence of BSI in patients with end-stage renal disease using central venous catheters for hemodialysis. Methods A cohort study was conducted in a public teaching hospital in central-western Brazil from April 2010 to December 2011. For every patient, we noted the presence of hyperemia/exudation upon catheter insertion, as well as fever, shivering, and chills during hemodialysis. Results Fifty-nine patients were evaluated. Thirty-five (59.3% patients started dialysis due to urgency, 37 (62.7% had BSI, and 12 (20% died. Hyperemia at the catheter insertion site (64.9% was a significant clinical manifestation in patients with BSI. Statistical analysis revealed 1.7 times more cases of BSI in patients with hypoalbuminemia compared with patients with normal albumin levels. The principal infective agents identified in blood cultures and catheter-tip cultures were Staphylococcus species (24 cases, non-fermentative Gram-negative bacilli (7 cases of Stenotrophomonas maltophilia and 5 cases of Chryseobacterium indologenes, and Candida species (6. Among the Staphylococci identified, 77.7% were methicillin-resistant, coagulase-negative Staphylococci. Of the bacteria isolated, the most resistant were Chryseobacterium indologenes and Acinetobacter baumannii. Conclusions Blood culture was demonstrated to be an important diagnostic test and identified over 50% of positive BSI cases. The high frequency of BSI and the isolation of multiresistant bacteria were disturbing findings. Staphylococcus aureus was the most frequently isolated microorganism, although Gram-negative bacteria predominated overall. These results highlight the importance of infection prevention and control measures in dialysis units.

  20. Pre-hospital care after a seizure: Evidence base and United Kingdom management guidelines.

    Science.gov (United States)

    Osborne, Andrew; Taylor, Louise; Reuber, Markus; Grünewald, Richard A; Parkinson, Martin; Dickson, Jon M

    2015-01-01

    Seizures are a common presentation to pre-hospital emergency services and they generate significant healthcare costs. This article summarises the United Kingdom (UK) Ambulance Service guidelines for the management of seizures and explores the extent to which these guidelines are evidence-based. Summary of the Clinical Practice Guidelines of the UK Joint Royal Colleges Ambulance Liaison Committee relating to the management of seizures. Review of the literature relating to pre-hospital management of seizure emergencies. Much standard practice relating to the emergency out of hospital management of patients with seizures is drawn from generic Advanced Life Support (ALS) guidelines although many patients do not need ALS during or after a seizure and the benefit of many ALS interventions in seizure patients remains to be established. The majority of studies identified pertain to medical treatment of status epilepticus. These papers show that benzodiazepines are safe and effective but it is not possible to draw definitive conclusions about the best medication or the optimal route of administration. The evidence base for current pre-hospital guidelines for seizure emergencies is incomplete. A large proportion of patients are transported to hospital after a seizure but many of these may be suitable for home management. However, there is very little research into alternative care pathways or criteria that could be used to help paramedics avoid transport to hospital. More research is needed to improve care for people after a seizure and to improve the cost-effectiveness of the healthcare systems within which they are treated. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  1. Logistica de coleta e transporte de material biologico e organizacao do laboratorio central no ELSA-Brasil

    Directory of Open Access Journals (Sweden)

    Ligia G Fedeli

    2013-06-01

    Full Text Available O Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil é um estudo de coorte multicêntrico com o objetivo de identificar os fatores de risco associados ao diabetes tipo 2 e à doença cardiovascular na população brasileira. O artigo descreve as estratégias de coleta, processamento, transporte e de controle de qualidade dos exames de sangue e urina no ELSA. O estudo optou pela centralização dos exames em um único laboratório. O processamento das amostras foi realizado nos laboratórios locais, reduzindo o peso do material a ser transportado e diminuindo os custos do transporte para o laboratório central no Hospital da Universidade de São Paulo. O estudo incluiu exames para avaliação de diabetes, resistência à insulina, dislipidemias, alterações eletrolíticas, hormônios tireoidianos, ácido úrico, alterações de enzimas hepáticas, inflamação e hemograma completo. Além desses exames, foram estocados DNA de leucócitos, amostras de urina, plasma e soro. O laboratório central realizou aproximadamente 375.000 exames.

  2. Cuidando desde la central de estirilización al cliente interno y externo

    OpenAIRE

    González Consuegra, Renata Virginia

    2012-01-01

    A partir del concepto de cuidado, pretendo mostrar la importancia que representa la labor de enfermería en la central de esterilización, lugar desde el cual, en forma muy silenciosa, se realizan acciones que sin discusión alguna garantizan el éxito de los diferentes procedimientos que se realizan por parte del equipo de salud relacionados con la técnica aséptica.La complejidad de la Central de Esterilización es tal, que puede ser comparada con una gran industria, en la cual se encuentran una ...

  3. Advanced vs. Basic Life Support in the Treatment of Out-of-Hospital Cardiopulmonary Arrest in the Resuscitation Outcomes Consortium.

    Science.gov (United States)

    Kurz, Michael Christopher; Schmicker, Robert H; Leroux, Brian; Nichol, Graham; Aufderheide, Tom P; Cheskes, Sheldon; Grunau, Brian; Jasti, Jamie; Kudenchuk, Peter; Vilke, Gary M; Buick, Jason; Wittwer, Lynn; Sahni, Ritu; Straight, Ronald; Wang, Henry E

    2018-04-30

    Prior observational studies suggest no additional benefit from advanced life support (ALS) when compared with providing basic life support (BLS) for patients with out-of-hospital cardiac arrest (OHCA). We compared the association of ALS care with OHCA outcomes using prospective clinical data from the Resuscitation Outcomes Consortium (ROC). Included were consecutive adults OHCA treated by participating emergency medical services (EMS) agencies between June 1, 2011, and June 30, 2015. We defined BLS as receipt of cardiopulmonary resuscitation (CPR) and/or automated defibrillation and ALS as receipt of an advanced airway, manual defibrillation, or intravenous drug therapy. We compared outcomes among patients receiving: 1) BLS-only; 2) BLS + late ALS; 3) BLS + early ALS; and 4) ALS-first care. Using multivariable logistic regression, we evaluated the associations between level of care and return of spontaneous circulation (ROSC), survival to hospital discharge, and survival with good functional status, adjusting for age, sex, witnessed arrest, bystander CPR, shockable initial rhythm, public location, EMS response time, CPR quality, and ROC site. Among 35,065 patients with OHCA, characteristics were median age 68 years (IQR 56-80), male 63.9%, witnessed arrest 43.8%, bystander CPR 50.6%, and shockable initial rhythm 24.2%. Care delivered was: 4.0% BLS-only, 31.5% BLS + late ALS, 17.2% BLS + early ALS, and 47.3% ALS-first. ALS care with or without initial BLS care was independently associated with increased adjusted ROSC and survival to hospital discharge unless delivered greater than 6 min after BLS arrival (BLS + late ALS). Regardless of when it was delivered, ALS care was not associated with significantly greater functional outcome. ALS care was associated with survival to hospital discharge when provided initially or within six minutes of BLS arrival. ALS care, with or without initial BLS care, was associated with increased ROSC, however it was

  4. Taiwan's Experience in Hospital Preparedness and Response for Emerging Infectious Diseases.

    Science.gov (United States)

    Kao, Hui-Yun; Ko, Hai-Yun; Guo, Peng; Chen, Chang-Hsun; Chou, Su-Mei

    The Communicable Disease Control Medical Network (CDCMN), established in 2003 after the SARS outbreak in Taiwan, has undergone several phases of modification in structure and activation. The main organizing principles of the CDCMN are centralized isolation of patients with severe highly infectious diseases and centralization of medical resources, as well as a network of designated regional hospitals like those in other countries. The CDCMN is made up of a command system, responding hospitals, and supporting hospitals. It was tested and activated in response to the H1N1 influenza pandemic in 2009-10 and the Ebola outbreak in West Africa in 2014-2016, and it demonstrated high-level functioning and robust capacity. In this article, the history, structure, and operation of the CDCMN is introduced globally for the first time, and the advantages and challenges of this system are discussed. The Taiwanese experience shows an example of a collaboration between the public health system and the medical system that may help other public health authorities plan management and hospital preparedness for highly infectious diseases.

  5. Clinical trials for neuroprotection in ALS.

    Science.gov (United States)

    Siciliano, G; Carlesi, C; Pasquali, L; Piazza, S; Pietracupa, S; Fornai, F; Ruggieri, S; Murri, L

    2010-07-01

    Owing to uncertainty on the pathogenic mechanisms underlying motor neuron degeneration in amyotrophic lateral sclerosis (ALS) riluzole remains the only available therapy, with only marginal effects on disease survival. Here we review some of the recent advances in the search for disease-modifying drugs for ALS based on their putative neuroprotective effetcs. A number of more or less established agents have recently been investigated also in ALS for their potential role in neuroprotection and relying on antiglutamatergic, antioxidant or antiapoptotic strategies. Among them Talampanel, beta-lactam antibiotics, Coenzyme Q10, and minocycline have been investigated. Progress has also been made in exploiting growth factors for the treatment of ALS, partly due to advances in developing effective delivery systems to the central nervous system. A number of new therapies have also been identified, including a novel class of compounds, such as heat-shock protein co-inducers, which upregulate cell stress responses, and agents promoting autophagy and mitochondriogenesis, such as lithium and rapamycin. More recently, alterations of mRNA processing were described as a pathogenic mechanism in genetically defined forms of ALS, as those related to TDP-43 and FUS-TLS gene mutations. This knowledge is expected to improve our understanding of the pathogenetic mechanism in ALS and developing more effective therapies.

  6. The fecal microbiome of ALS patients.

    Science.gov (United States)

    Brenner, David; Hiergeist, Andreas; Adis, Carolin; Mayer, Benjamin; Gessner, André; Ludolph, Albert C; Weishaupt, Jochen H

    2018-01-01

    Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative motor neuron disease accompanied by both systemic and central nervous system-specific inflammation as well as deregulated energy metabolism. These potential pathogenetic factors have recently been found to mutually interact with the gut microbiota, raising the hypothesis of a link between microbiome alterations and ALS pathogenesis. The aim of our study was to assess whether ALS is associated with an altered composition of the fecal microbiota. We compared the fecal microbiota of 25 ALS patients with 32 age- and gender-matched healthy persons using 16S rRNA gene sequencing analysis. Confounding factors and secondary disease effects on the microbiome were minimized by selection of patients without dysphagia, gastrostomy, noninvasive ventilation, or reduced body mass index. Comparing the 2 carefully matched groups, the diversity and the abundance of the bacterial taxa on the different taxonomic levels as well as PICRUSt-predicted metagenomes were almost indistinguishable. Significant differences between ALS patients and healthy controls were only observed with regard to the overall number of microbial species (operational taxonomic units) and in the abundance of uncultured Ruminococcaceae. Conclusively, ALS patients do not exhibit a substantial alteration of the gut microbiota composition. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. O Priorado do Crato da Ordem do Hospital

    Directory of Open Access Journals (Sweden)

    Dirceu Marchini Neto

    2017-12-01

    Full Text Available Este artigo analisa o surgimento e a expansão da Ordem do Hospital de São João de Jerusalém no Reino de Portugal durante a Idade Média. Além disso, apresenta um estudo sobre a relação entre a relíquia do Santo Lenho, a Batalha do Salado e a transferência da sede hospitalária portuguesa de Leça do Balio para a comenda do Crato.

  8. Epidemiology and clinical characteristics of patients hospitalized for ocular trauma in South-Central China.

    Science.gov (United States)

    Wang, Wanpeng; Zhou, Yalan; Zeng, Jun; Shi, Meng; Chen, Baihua

    2017-09-01

    Ocular trauma is a major cause of visual loss, but little is known about its epidemiology and clinical characteristics in China. The aim of this study was to determine the prevalence and clinical characteristics of ocular trauma and assess prognostic factors in Changsha, Hunan, located in South-Central China. A retrospective case series (ICD codes: S05) study of ocular trauma in patients was performed at the Second Xiangya Hospital, Central South University, from 1 January 2010 to 31 December 2014. Demographic information, injury causes, ocular trauma types and initial and final visual acuity (VA) were recorded and analysed. The ocular trauma score (OTS) was calculated to assess the extent of the eye injury, prognosis and factors associated with visual impairment. All patient data were collected from the medical records system. Of the 2009 patients presenting during this 5-year period, 1695 (84.4%) were males and 314 (15.6%) were females. The average age of all patients was 37.0 ± 19.3 years (range from 1 to 87 years). The age distribution showed a peak in the ocular trauma population in the 41- to 50-year age group (24%, n = 482), followed by the 51- to 60-year age group (16.9%, n = 339). Overall, open-globe injuries had a higher frequency (70.7%, n = 1420) than closed-globe injuries (28.6%, n = 575) and thermal/chemical injuries (0.7%, n = 14). Of the open-globe injuries, corneal penetration was the most common injury (32.2%, n = 646) followed by rupture (21.5%, n = 432) and an intraocular foreign body (16.2%, n = 325). Overall, the most frequent ocular trauma setting was the workplace (39.6%, n = 795), followed by the home (28.4%, n = 570), and the most frequent activity was ironwork. Firecracker- and firework-associated ocular trauma was significantly higher during the months of January and February than during other months (50.0%, n = 112, p firework-related ocular trauma occurred during the months adjacent to the Chinese New Year

  9. Influence of hospitalization on potentially inappropriate prescribing ...

    African Journals Online (AJOL)

    Methods: This was a prospective observational study conducted in the multidisciplinary medical and surgical units ... Having a PIM at discharge was associated with the number of discharge medications and the history of .... assess the impact of hospitalization on PIPs in .... Central Nervous System and Psychotropic Drugs.

  10. Grain refinement efficiency and mechanism of aluminium carbide in Mg-Al alloys

    International Nuclear Information System (INIS)

    Lu, L.; Dahle, A.K.; StJohn, D.H.

    2005-01-01

    Detailed microscopic examination using optical and electron microscopes suggests that Al 4 C 3 , often observed in the central regions of magnesium grains on polished sections, is a potent substrate for primary Mg. Calculations of the crystallographic relationships between magnesium and Al 4 C 3 further support the experimental observations

  11. Improving financial performance by modeling and analysis of radiology procedure scheduling at a large community hospital.

    Science.gov (United States)

    Lu, Lingbo; Li, Jingshan; Gisler, Paula

    2011-06-01

    Radiology tests, such as MRI, CT-scan, X-ray and ultrasound, are cost intensive and insurance pre-approvals are necessary to get reimbursement. In some cases, tests may be denied for payments by insurance companies due to lack of pre-approvals, inaccurate or missing necessary information. This can lead to substantial revenue losses for the hospital. In this paper, we present a simulation study of a centralized scheduling process for outpatient radiology tests at a large community hospital (Central Baptist Hospital in Lexington, Kentucky). Based on analysis of the central scheduling process, a simulation model of information flow in the process has been developed. Using such a model, the root causes of financial losses associated with errors and omissions in this process were identified and analyzed, and their impacts were quantified. In addition, "what-if" analysis was conducted to identify potential process improvement strategies in the form of recommendations to the hospital leadership. Such a model provides a quantitative tool for continuous improvement and process control in radiology outpatient test scheduling process to reduce financial losses associated with process error. This method of analysis is also applicable to other departments in the hospital.

  12. Evidence-based measures to prevent central line-associated bloodstream infections: a systematic review.

    Science.gov (United States)

    Perin, Daniele Cristina; Erdmann, Alacoque Lorenzini; Higashi, Giovana Dorneles Callegaro; Sasso, Grace Teresinha Marcon Dal

    2016-09-01

    to identify evidence-based care to prevent CLABSI among adult patients hospitalized in ICUs. systematic review conducted in the following databases: PubMed, Scopus, Cinahl, Web of Science, Lilacs, Bdenf and Cochrane Studies addressing care and maintenance of central venous catheters, published from January 2011 to July 2014 were searched. The 34 studies identified were organized in an instrument and assessed by using the classification provided by the Joanna Briggs Institute. the studies presented care bundles including elements such as hand hygiene and maximal barrier precautions; multidimensional programs and strategies such as impregnated catheters and bandages and the involvement of facilities in and commitment of staff to preventing infections. care bundles coupled with education and the commitment of both staff and institutions is a strategy that can contribute to decreased rates of central line-associated bloodstream infections among adult patients hospitalized in intensive care units. identificar evidências de cuidados para prevenção de infecção de corrente sanguínea relacionada a cateter venoso central em pacientes adultos em Unidades de Terapia Intensiva. revisão Sistemática realizada por meio de busca nas bases de dados Pubmed, Scopus, Cinahl, Web of Science, Lilacs, Bdenf e Cochrane. Foram buscadas pesquisas com cuidados com a cateterização e manutenção do cateter venoso central, publicados de janeiro de 2011 a julho de 2014. Os 34 estudos incluídos foram organizados em um instrumento e avaliados por meio da classificação do The Joanna Briggs Institute. os estudos apresentaram bundles de cuidados com elementos como a higiene das mãos e precauções máximas de barreira; programas multidimensionais e estratégias como cateteres e curativos impregnados e o envolvimento da instituição e engajamento da equipe nos esforços para prevenção de infecção. os cuidados no formato de bundles aliados com a educação e engajamento da equipe e

  13. Adesão ao tratamento e hospitalizações entre pacientes que realizam aplicações de Flufenazina Depot Adhesión al tratamiento y hospitalización entre pacientes que realizan aplicaciones de Flufenazina Depot Compliance with treatment and hospitalization among patients using Flufenazine Depot

    Directory of Open Access Journals (Sweden)

    José Menna Oliveira

    2003-08-01

    Full Text Available OBJETIVOS: Os autores revisam a bibliografia sobre medicação depot e apresentam dados referentes à adesão ao tratamento e hospitalizações entre os pacientes que realizam aplicações de enantato de flufenazina em regime ambulatorial no Hospital Espírita de Pelotas. MÉTODO: Analisaram-se os prontuários de pacientes que foram incluídos no regime depot anteriormente a maio de 2001 e que realizaram pelo menos uma aplicação entre maio de 2001 e junho de 2002, quanto à adesão ao tratamento e eventuais hospitalizações. RESULTADOS: De um total de 100 pacientes, 66 permaneciam em regime depot ao término do período estudado. Destes, 40 (61% apresentavam boa adesão ao tratamento, enquanto 26 (39% apresentavam má adesão. Houve um total de 25 pacientes que sofreram hospitalizações, entre os quais a maioria não estava em tratamento no término do estudo ou apresentava má adesão. Entre os pacientes procedentes do mesmo bairro em que se situa o hospital, 10 (67% apresentavam boa adesão em comparação com 30 pacientes (59% procedentes de bairros distintos. DISCUSSÃO: O número de hospitalizações variou visivelmente, conforme a permanência ou não em tratamento e a adesão ao mesmo. Pacientes provenientes de bairros distantes do hospital tenderam a apresentar pior adesão ao tratamento. CONCLUSÕES: É possível que pacientes em regime de aplicação depot residentes próximos ao local de aplicação beneficiem-se mais do tratamento que aqueles residentes em locais distantes. São necessários mais estudos comparando administrações depot com VO em termos de adesão e investigando fatores preditores de boa adesão ao tratamento.OBJETIVOS: Los autores revisan la bibliografía sobre medicación depot y presentan datos referentes a la adhesión al tratamiento y hospitalizaciones entre los pacientes que realizan aplicaciones de enantato de flufenazina en régimen ambulatorio en el Hospital Espiritista de Pelotas. MÉTODO: Fueron

  14. Right abdominal mass: keep an open mind

    African Journals Online (AJOL)

    2010-01-07

    Jan 7, 2010 ... 1Department of Radiology, National Organ Transplant Centre, Tripoli, Libya; 2Department of General. Surgery, Tripoli Central Hospital, University of Al-Fateh, Tripoli, Libya; 3Department of Microbiology,. AlMargeb University, AlKhooms, Libya ... His medical history was unremarkable. Physical examination ...

  15. [Central diabetes insipidus: diagnostic difficulties].

    Science.gov (United States)

    Matoussi, N; Aissa, K; Fitouri, Z; Hajji, M; Makni, S; Bellagha, I; Ben Becher, S

    2008-06-01

    Central diabetes insipidus is rare in children. Characteristic features include polyuria and polydipsia due to arginine vasopressin deficiency. The differential diagnosis of polyuric states may be difficult. Etiologic diagnosis of central diabetes insipidus may be an equally difficult task. To specify the difficulties encountered in the diagnosis of central diabetes insipidus and to point out features of the etiologic work-up and of long-term follow-up of children with idiopathic central diabetes insipidus. A retrospective study of 12 children admitted with a polyuria/polydipsia syndrome to the pediatric - consultation and emergency unit of the children's hospital of Tunis between 1988 and 2005. Children with acquired nephrogenic central diabetes insipidus were excluded. Fourteen-hour fluid restriction test and/or desmopressin test were used without plasma vasopressin measurement. Eight patients were classified as having central diabetes insipidus, which was severe in seven children and partial in one girl. One patient was classified as having primary polydipsia. The diagnosis remains unclear in three patients. The etiological work-up in eight patients with central diabetes insipidus enabled the identification of Langerhan's-cell histiocytosis in two patients and neurosurgical trauma in one. The cause was considered idiopathic in five patients. The median follow-up of the five patients with idiopathic central diabetes insipidus was five years two months plus or minus six years seven months (range five months, 14.5 years). During this follow-up, neither brain magnetic resonance imaging scans findings nor anterior pituitary function have changed. Fluid restriction and desmopressin tests did not enable an accurate distinction between partial diabetes insipidus and primary polydipsia. Regular surveillance is warranted in patients with idiopathic central diabetes insipidus to identify potential etiologies.

  16. Regional cost differences of hospital supply in Germany

    Directory of Open Access Journals (Sweden)

    Lauterbach, Karl W.

    2005-04-01

    Full Text Available The intended adoption of a global reimbursement system for inpatient care in Germany envisions identical payments for identical treatments at different hospitals. This may lead to losses in some hospitals and may cause problems for the supply with health care facilities in the long run if there a important regional cost differences. Cost and performance data of 1112 hospitals in Germany have been analysed for regional differences in 2001: As regional categorizations we used official classification schemes based on centrality. The investigation does not support the postulation of additional payments for selected regions in Germany accounting for level cost-differences between hospitals. Confounding influence factors like ownership and hospital size seem to be more important. We recommend further investigations to evaluate regional cost-differences on the level of medical wards and using more risk-adjusted data. The examination of the individual case is necessary.

  17. Antibiotic Prescribing Patterns in Outpatient Emergency Clinics at Queen Rania Al Abdullah II Children's Hospital, Jordan, 2013.

    Science.gov (United States)

    Al-Niemat, Sahar I; Aljbouri, Tareq M; Goussous, Lana S; Efaishat, Rania A; Salah, Rehab K

    2014-07-01

    To investigate antibiotics prescribing patterns in the outpatient pediatric emergency clinic at Queen Rania Al Abdullah II Children's Hospital at Royal Medical Services in Amman, Jordan. The data was collected from the emergency pharmacy over the period of a -five consecutive months. The methodology recommended by the World Health Organization for investigating drug use in a health facility was followed. The study measures the percentage of encounter with a prescribed antibiotic and the percentage share of each antibiotic category. The distribution of diagnostic categories that accounted for all antibiotics being prescribed and the distribution of each antibiotic being prescribed for upper respiratory tract infections (URTIs) were also measured. Antibiotic prescribing was frequent during pediatric visits to the outpatient pediatric emergency clinic resulting in a high percentage of encounters (85%) when compared to appropriate. Emergency physicians continue to frequently prescribe broad spectrum antibiotics which accounted for approximately (60%) of the total prescribed antibiotics and (83%) of prescribed antibiotics for upper respiratory tract infections and macrolides (primarily azithromycin) were the leading class among them. Our results showed high consumption of antibiotics by emergency department pediatricians which highlight the importance for interventions to promote rational and judicious prescribing. An insight into factors influencing antibiotics prescribing patterns by military prescribers is required.

  18. Disseny d'una central domòtica

    OpenAIRE

    Penelo Arias, Òscar

    2012-01-01

    Avui en dia estem envoltats de dispositius mòbils avançats, ja sigui tablets o smartphones. En aquest projecte s'ha construït un prototip d'una central domòtica amb el control basat en aquests dispositius, sense renunciar al control tradicional (interruptors).

  19. Incidence and hospital mortality of vascular surgery patients with ...

    African Journals Online (AJOL)

    Central Hospital (IALCH) intensive care unit (ICU) following vascular surgery between 1 January ... patients have a perioperative myocardial infarction (PMI) and 4.6 .... Emergency surgery was performed in 17.8% of the ..... area is needed.

  20. Infection after open heart surgery in Golestan teaching hospital of Ahvaz, Iran.

    Science.gov (United States)

    Nashibi, Roohangiz; Mohammadi, Mohammad Javad; Alavi, Seyed Mohammad; Yousefi, Farid; Salmanzadeh, Shokrolah; Ahmadi, Fatemeh; Varnaseri, Mehran; Ramazani, Asghar; Moogahi, Sasan

    2018-02-01

    The present study surveyed demographic and infection data which were obtained after open heart surgery (OHS) through patient's admission in Golestan teaching hospital, Ahvaz metropolitan city of Iran, taking into account the confirmed location of the infection, microorganism and antibiotic susceptibility. The occurrence of infection among patients during 48 to 72 h after surgery and hospital admission is the definition of Nosocomial infections (NIs) (Salmanzadeh et al., 2015) [1]. All of them after OHS were chosen for this study. In this paper, type of catheter, fever, type of microorganism, antibiotic susceptibility, location of the infection and outcome (live or death) were studied (Juhl et al., 2017; Salsano et al., 2017) [2], [3]. After the completion of the observations and recording patients' medical records, the coded data were fed into EXCELL. Data analysis was performed using SPSS 16.

  1. Effect of hospital nutrition support on growth velocity and nutritional status of low birth weight infants.

    Science.gov (United States)

    Azzeh, Firas S; Alazzeh, Awfa Y; Dabbour, Ibrahim R; Jazar, Abdelelah S; Obeidat, Ahmed A

    2014-10-01

    Infants with low birth weights are provided with hospital nutrition support to enhance their survivability and body weights. However, different hospitals have different nutrition support formulas. Therefore, the effectiveness of these nutrition support formulas should be investigated. To assess the effect of hospital nutrition support on growth velocity and nutritional status of low birth weight infants at Al-Noor hospital, Saudi Arabia. A cross-sectional study was conducted between October, 2010 and December, 2012. Three hundred newborns were recruited from Al-Noor Hospital in Makkah city, Saudi Arabia. Infants were selected according to their birth weights and were divided equally into three groups; (i) Low Birth Weight (LBW) infants (1501- 2500 g birth weight), (ii) Very Low Birth Weight (VLBW) infants (1001-1500 g birth weight) and (iii) Extremely Low Birth Weight (ELBW) infants ( 0.05) were observed among groups. Serum calcium, phosphorus and potassium levels at discharge were higher (p < 0.05) than that at birth for ELBW and VLBW groups; while sodium level decreased in ELBW group to be within normal ranges. Albumin level was improved (p < 0.05) in ELBW group. Health care management for low birth weight infants in Al-Noor Hospital was not sufficient to achieve normal growth rate for low birth weight infants, while biochemical indicators were remarkably improved in all groups. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  2. Trends in diarrhea hospitalizations among infants at three hospitals in Tanzania before and after rotavirus vaccine introduction.

    Science.gov (United States)

    Lyamuya, Faraja; Michael, Fausta; Jani, Bhavin; Fungo, Yohana; Chambo, Alfred; Chami, Inviolatha; Bulali, Regina; Mpamba, Amina; Cholobi, Happy; Kallovya, Dotto; Kamugisha, Christopher; Mwenda, Jason M; Cortese, Margaret M

    2018-04-11

    The Tanzania Ministry of Health introduced monovalent human rotavirus vaccine in January 2013, to be administered at ages 6 and 10 weeks. Data suggest there was high vaccine uptake. We used hospital ward registers from 3 hospitals to examine trends in diarrhea hospitalizations among infants before and after vaccine introduction. Ward registers from Dodoma Regional Referral Hospital (Central Tanzania), and two hospitals in Mbeya (Southwest area), Mbeya Zonal Referral Hospital and Mbalizi Hospital, were used to tally admissions for diarrhea among children by age group, month and year. Rotavirus surveillance had started at these hospitals in early 2013; the proportion of infants enrolled and rotavirus-EIA positive were examined by month to determine peak periods of rotavirus disease post-vaccine introduction. Registers were available for 2-4 prevaccine years and 2-3 post introduction years. At Dodoma Regional Referral Hospital, compared with the mean of 2011 and 2012, diarrhea hospitalizations among infants were 26% lower in 2015 and 58% lower in 2016. The diarrhea peak shifted later in the year first by 1 and then by 2-3 months from prevaccine. At the Mbeya hospitals, the number of diarrhea admissions in prevaccine period varied substantially by year. At Mbeya Referral Hospital, diarrhea hospitalizations among infants were lower by 25-37% in 2014 and 11-26% in 2015, while at Mbalizi Hospital, these hospitalizations were 4% lower in 2014 and 14% higher in 2015. Rotavirus testing data demonstrated a lowering of the prevaccine peak, a shift in timing of the peak months and indicated that other diarrheal peaks in post-introduction years were not due to rotavirus. In this ecological evaluation, total diarrhea hospitalizations among infants were lower (≥25% lower in ≥1 year) following introduction in 2 of 3 hospitals. There are challenges in using ward registers to ascertain possible impact of rotavirus vaccine introduction on trends in hospitalizations for

  3. Factores predisponentes a la Eritrocitosis de altura en pacientes atendidos en el Hospital III Essalud-Puno 2000-2005

    OpenAIRE

    Mercado Portal, Edy

    2010-01-01

    La presente investigación se realizó con el objetivo de explicar los factores predisponentes que se asocian con la eritrocitosis de altura en pacientes atendidos en el Hospital III de ESSALUD PUNO; la muestra estuvo constituida por 550 historias clínicas de pacientes que acudieron al Hospital entre los años 2000 al 2005, seleccionadas de forma aleatoria entre aquellas que cumplieron con los criterios de selección de la muestra. Los resultados muestran que el 23.8% de pacientes que asisten al ...

  4. Tradução e adaptação para a língua portuguesa do In-hospital Utstein Style Traducción y adaptación al idioma portugués del instrumento In-hospital Utstein Style Translation and adaptation of the In-Hospital Utstein Style into the portuguese language

    Directory of Open Access Journals (Sweden)

    Patrícia do Amaral Avansi

    2008-09-01

    Full Text Available A parada cardiorrespiratória (PCR é um evento potencialmente letal e a qualidade do atendimento prestado depende da agilidade, conhecimento e habilidade de toda a equipe envolvida. Desenvolvido em 1997, o In-hospital Utstein Style é um relatório padrão para coleta de dados significativos em PCR. O estudo objetivou realizar a tradução e adaptação à língua portuguesa do instrumento. O instrumento foi submetido ao processo de tradução e adaptação cultural. O resultado deste processo gerou um instrumento aplicado em fase de pré-teste a 20 pacientes vítimas de PCR. As variáveis de resultado não foram coletadas, pois pressupõe o acompanhamento destes pacientes ao longo do tempo. O ritmo de PCR mais comum foi atividade elétrica sem pulso (65%; o tempo médio para desfibrilar foi de 1,25 minutos. Houve itens sem resposta. Podemos concluir que o instrumento é aplicável à realidade brasileira, buscando melhor atendimento ao evento da PCR.El paro cardiopulmonar (PCP es un estado potencialmente letal, donde la calidad del servicio depende de la agilidad, conocimiento y habilidad del equipo involucrado. El In-hospital Utstein Style fue elaborado en 1997. Este instrumento que recolecta datos de importancia durante un PCP fue traducido y adaptado al portugués. De esta forma fue sometido al proceso de traducción y adaptación cultural. Se obtuvo como resultado un instrumento, el cual fue aplicado a 20 victimas de PCP a través de un pre-test. Las variables de resultado no fueron consideradas en la recolección de datos, pues suponía el seguimiento de los pacientes por un periodo prolongado. El ritmo del PCP más común fue la actividad eléctrica sin pulso (65% y el tiempo promedio de desfibrilación fue de 1,25 minutos. Algunos ítems no fueron respondidos. Se concluye que el instrumento puede ser aplicado al contexto brasileño, en busca de una mejor atención en casos de PCP.Cardiopulmonary arrest (CPA is a potentially lethal event

  5. A STUDY ON ADVERSE DRUG REACTIONS INVOLVING CENTRAL NERVOUS SYSTEM, ITS SEVERITY AND CAUSALITY ASSESSMENT IN PEDIATRIC PATIENTS ADMITTED TO A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Arati

    2015-09-01

    Full Text Available A retrospective study was conducted in Department of pediatrics SCB Medical College and SVPPGIP for a period of 2 years i.e. September 2012 to August 2014 . All the patients from birth to 14 years admitted to the pediatric ward in this study were under ADR surveillance. Patients admitted to our hospital with adverse drug reaction o r patients developing adverse drug reaction in our hospital were studied; only those cases where the central nervous system was involved were taken in our study. The cases were compiled and the causality of offending drugs was found using WHO - UMC causality assessment score. The severity of drug reaction in every case was determined by using HARTWIG’s severity scoring scale. Total 350 Adverse reactions were reported in this period with prevalence rate of 2.04% i.e. 20 out of 1000 children faced ADR due to dr ugs, with annual incidence rate of 0.9% and 1.14% over two years. Out of total 350 cases dermatological system was most commonly involved i.e. 207 cases (59.14%. This is followed by involvement of central nervous system 46 number of cases (13.14%. The GI system was involved in 34 cases i.e. (9.71%. Life threatening reactions like anaphylaxis, angioedema and shock like immediate life threatening ADRs were reported in 16 cases. Our study group was the patient in whom the ADR involved the CNS. Out of 46 suc h cases, there were 25 female and 21 male. Various reaction due to drug were encephalopathy , eps, febrile seizure, tremor, head reeling, ototoxicity, persistant cry, pseudotumor cerebri, psychosis, seizure, status epilepticus, toxic amblyopia, tremor, atax ia etc. The most common CNS manifestation was Extra pyramidal side effects (EPS involving 21% of cases. The most common Drug causing CNS manifestation was ATT (HRZE causing blindness, Eps, psychosis , toxic amblyopia blindness etc.

  6. Biopsy case mix and diagnostic yield at a Malawian central hospital ...

    African Journals Online (AJOL)

    Pathological examination of tissue biopsies with histological confirmation of a correct cancer diagnosis is central to cancer care. Without an accurate and specific ... The oesophagus was the most common biopsied site followed by breast, bladder, bone, prostate, bowel, and cervical lymph node. Malignancies were found in ...

  7. Ocular biometry and central corneal thickness in children: a hospital-based study

    Directory of Open Access Journals (Sweden)

    Adem Gul

    2014-06-01

    Full Text Available Objetivo: Investigar a distribuição do comprimento axial, profundidade da câmara anterior, espessura do cristalino, profundidade da câmara vítrea e espessura corneal central em crianças em diferentes faixas etárias. Métodos: Foram estudados 364 olhos de 182 crianças entre 1 e 12 anos de idade. O comprimento axial, a profundidade da câmara anterior , a espessura do cristalino e a profundidade da câmara vítrea foram medidos por biometria ultrassônica. A espessura corneal central foi medida por paquimetria ultrassônica em todas as crianças. Resultados: A idade média foi de 6,54 ± 3,42 anos. O comprimento axial foi 20,95 mm no grupo de 1-2 anos de idade e 22,95 mm no grupo de 11-12 anos de idade. A espessura corneal central foi 556 µm no grupo de 1-2 anos de idade e 555 µm no grupo de 11-12 anos de idade. A profundidade da câmara anterior média e profundidade da câmara vítrea aumentou com a idade (3,06 mm a 3,44 mm de profundidade da câmara anterior, 13,75 mm a 15,99 mm de profundidade da câmara vítrea e da espessura do cristalino diminuiu com o aumento da idade (3,67 mm a 3,51 mm. Conclusões: Em nosso estudo, os valores do comprimento axial aumentou com a idade e atingiu os níveis adultos aos 9-10 anos de idade. A espessura do cristalino diminuiu gradualmente até os 12 anos de idade. As medições de espessura corneal central não seguiu um algoritmo linear.

  8. Process-based organization design and hospital efficiency.

    Science.gov (United States)

    Vera, Antonio; Kuntz, Ludwig

    2007-01-01

    The central idea of process-based organization design is that organizing a firm around core business processes leads to cost reductions and quality improvements. We investigated theoretically and empirically whether the implementation of a process-based organization design is advisable in hospitals. The data came from a database compiled by the Statistical Office of the German federal state of Rheinland-Pfalz and from a written questionnaire, which was sent to the chief executive officers (CEOs) of all 92 hospitals in this federal state. We used data envelopment analysis (DEA) to measure hospital efficiency, and factor analysis and regression analysis to test our hypothesis. Our principal finding is that a high degree of process-based organization has a moderate but significant positive effect on the efficiency of hospitals. The main implication is that hospitals should implement a process-based organization to improve their efficiency. However, to actually achieve positive effects on efficiency, it is of paramount importance to observe some implementation rules, in particular to mobilize physician participation and to create an adequate organizational culture.

  9. A quality control exercise of radionuclide calibrators among Belgian hospitals

    International Nuclear Information System (INIS)

    Reher, D.F.G.; Merlo, P.

    1990-01-01

    On the initiative of the Belgian Association of Hospital Physicists, eleven Belgian hospitals participated in a quality control of radionuclide calibrators conducted in collaboration with the Central Bureau for Nuclear Measurements of the Commission of the European Communities. For practical reasons the nuclide 57 Co was chosen. The results from 20 different radionuclide calibrators show a fair agreement with a similar comparison carried out in 1980 in the UK. (orig.)

  10. Identifying competitive strategies to improve the performance of hospitals in a competitive environment.

    Science.gov (United States)

    Chang, Chuan-Hui; Chiao, Yu-Ching; Tsai, Yafang

    2017-11-21

    This study is based on competitive dynamics theory, and discusses competitive actions (including their implementation requirements, strategic orientation, and action complexity) that influence hospitals' performance, while also meeting the requirements of Taiwan's "global budget" insurance payment policy. In order to investigate the possible actions of hospitals, the study was conducted in two stages. The first stage investigated the actions of hospitals from March 1 to May 31, 2009. Semi-structured questionnaires were used, which included in-depth interviews with senior supervisors of 10 medium- and large-scale hospitals in central Taiwan. This stage collected data related to the types of actions adopted by the hospitals in previous years. The second stage was based on the data collected from the first stage and on developed questionnaires, which were distributed from June 29 to November 1, 2009. The questionnaires were given to 20 superintendents, deputy superintendents, and supervisors responsible for the management of a hospital, and focused on medical centers and regional hospitals in central Taiwan in order to determine the types and number of competitive actions. First, the strategic orientation of an action has a significantly positive influence on subjective performance. Second, action complexity has a significantly positive influence on the subjective and the objective performance of a hospital. Third, the implementation requirements of actions do not have a significantly positive impact on the subjective or the objective performance of a hospital. Managers facing a competitive healthcare environment should adopt competitive strategies to improve the performance of the hospital.

  11. Towards the centralization of digestive oncologic surgery: changes in activity, techniques and outcome

    Directory of Open Access Journals (Sweden)

    Cristian Tebé

    Full Text Available Aim: The objective of the present study was to examine changes in the activity, surgical techniques and results from the process of centralization of complex digestive oncologic surgery in 2005-2012 as compared to 1996-2000. Material and methods: A retrospective cohort study employing the minimum basic data set of hospital discharge (MBDSHD 1996-2012 from public centers in Catalonia (Spain was performed. The population consisted of individuals aged > 18 who underwent digestive oncologic surgery (esophagus, pancreas, liver, stomach or rectum. Medical centers were divided into low, medium, and high-volume centers (≤ 5, 6-10, and > 10 interventions/year, respectively. The tendency Chi-squared test was used to assess the centralization of patients in high-volume centers and hospital mortality evolution during the study period. Logistic regression was performed to assess the relationship between volume and outcome. Results: A centralization of complex oncologic digestive surgery between 10% (liver and 46% (esophagus was obtained by means of a reduction in the number of hospitals that perform these interventions and a significant rise in the number of patients operated in high-volume centers (all types p ≤ 0.0001, except for esophagus. A significant decrease in mortality was observed, especially in esophagus (from 15% in 1996/2000 to 7% in 2009/12, p = 0.003 and pancreas (from 12% in 1996/2000 to 6% in 2009/12, p trend < 0.0001. Conclusions: A centralization of oncologic digestive surgery in high-volume centers and a reduction of hospital mortality in Catalonia were reported among esophageal and pancreatic cancers. However, no significant changes were found for others cancer types.

  12. Prevalence and determinants of erectile dysfunction among diabetic patients attending in hospitals of central and northwestern zone of Tigray, northern Ethiopia: a cross-sectional study.

    Science.gov (United States)

    Seid, Awole; Gerensea, Hadgu; Tarko, Shambel; Zenebe, Yosef; Mezemir, Rahel

    2017-03-15

    The prevalence of erectile dysfunction among diabetic men varies between 35-90%. Although erectile dysfunction is widespread among men with diabetes, the condition often remains undiagnosed and demands appropriate assessment and prompt treatment. Erectile dysfunction can affect all aspects of a patient's life including physical, emotional, social, sexual, and relationships. The main aim of this study is to determine the prevalence and determinants of erectile dysfunction among diabetic patients attending hospitals in the Central and Northwest zone of Tigray, Ethiopia. A hospital based cross-sectional study was conducted on 249 male diabetic patients attending five hospitals in the Central and Northwestern Zone of Tigray, Ethiopia using systematic random sampling. The data was collected from January 1 - February 30, 2016 and was entered and analyzed using SPSS version 20. Correlation and multivariate logistic regression was employed to test associations between independent and outcome variables. The mean age of study participants was 43.39 years and the mean duration of diabetes diagnosis was 6.22 years. The overall prevalence of erectile dysfunction was 69.9%, with 32.9% suffering from mild, 31.7% moderate, and 5.2% severe erectile dysfunction. Multivariate logistic regression revealed that erective dysfunction was significantly predicted by old age (Adjusted Odds Ratio [AOR] =15.013, CI:3.212-70.166), longer duration of diabetes (AOR = 3.77, CI:1.291-11.051), and lower monthly income (AOR = 0.285, CI:0.132-0.615). No association was found with body mass index, co-morbidity, glycemic control, and alcohol consumption. The prevalence of erective dysfunction in this study population was very high. Age, income, and duration of diabetes were the independent predictors of erectile dysfunction. Nearly all of the patients in the sample (97%) had not been screened or treated for erectile dysfunction. Assessment and management of erectile dysfunction in the

  13. Radioactive waste management in a hospital.

    Science.gov (United States)

    Khan, Shoukat; Syed, At; Ahmad, Reyaz; Rather, Tanveer A; Ajaz, M; Jan, Fa

    2010-01-01

    Most of the tertiary care hospitals use radioisotopes for diagnostic and therapeutic applications. Safe disposal of the radioactive waste is a vital component of the overall management of the hospital waste. An important objective in radioactive waste management is to ensure that the radiation exposure to an individual (Public, Radiation worker, Patient) and the environment does not exceed the prescribed safe limits. Disposal of Radioactive waste in public domain is undertaken in accordance with the Atomic Energy (Safe disposal of radioactive waste) rules of 1987 promulgated by the Indian Central Government Atomic Energy Act 1962. Any prospective plan of a hospital that intends using radioisotopes for diagnostic and therapeutic procedures needs to have sufficient infrastructural and manpower resources to keep its ambient radiation levels within specified safe limits. Regular monitoring of hospital area and radiation workers is mandatory to assess the quality of radiation safety. Records should be maintained to identify the quality and quantity of radioactive waste generated and the mode of its disposal. Radiation Safety officer plays a key role in the waste disposal operations.

  14. Radioactive Waste Management in A Hospital

    Science.gov (United States)

    Khan, Shoukat; Syed, AT; Ahmad, Reyaz; Rather, Tanveer A.; Ajaz, M; Jan, FA

    2010-01-01

    Most of the tertiary care hospitals use radioisotopes for diagnostic and therapeutic applications. Safe disposal of the radioactive waste is a vital component of the overall management of the hospital waste. An important objective in radioactive waste management is to ensure that the radiation exposure to an individual (Public, Radiation worker, Patient) and the environment does not exceed the prescribed safe limits. Disposal of Radioactive waste in public domain is undertaken in accordance with the Atomic Energy (Safe disposal of radioactive waste) rules of 1987 promulgated by the Indian Central Government Atomic Energy Act 1962. Any prospective plan of a hospital that intends using radioisotopes for diagnostic and therapeutic procedures needs to have sufficient infrastructural and manpower resources to keep its ambient radiation levels within specified safe limits. Regular monitoring of hospital area and radiation workers is mandatory to assess the quality of radiation safety. Records should be maintained to identify the quality and quantity of radioactive waste generated and the mode of its disposal. Radiation Safety officer plays a key role in the waste disposal operations. PMID:21475524

  15. Pulling Drugs Along the Supply Chain: Centralization of Hospitals’ Inventory

    OpenAIRE

    Iannone, Raffaele; Lambiase, Alfredo; Miranda, Salvatore; Riemma, Stefano; Sarno, Debora

    2014-01-01

    Due to the economic crisis and the predominance of drug expenditure in healthcare costs, the cooperation of groups of hospitals to negotiate with suppliers and centralize warehouses has been a recent trend in the pharmaceutical supply chain. This paper shows the economic convenience of centralizing the hospitals’ inventory decisions (how much/when to order) based on the sharing of medical prescriptions of patients along the supply chain. The logistic network under investigation (TO BE model) ...

  16. Sífilis congénita en el Hospital Universitario de Santander, Bucaramanga (Colombia, 2006 - 2007

    Directory of Open Access Journals (Sweden)

    Cecilia del Carmen Matos Mareño

    2013-12-01

    Full Text Available Antecedentes. La sífilis congénita (SC aumenta en nuestro país a pesar de existir un programa diseñado para su control. Se requiere conocer las características de los afectados y sus padres, para implementar medidas de control. Objetivo. Caracterizar los casos de SC atendidos en el Hospital Universitario de Santander, Bucaramanga (Colombia, entre Junio/2006 y Septiembre/2007. Materiales y métodos. Estudio de corte transversal prospectivo. Se analizaron variables sociodemográficas y clínicas de los recién nacidos y sus padres. Resultados. Se presentaron 36 recién nacidos (RN con SC. Nueve sintomáticos (25%, 6 con compromiso del sistema nervioso central (16.7%; 2 murieron (5.6%. En 12 casos (33.3% las madres no hicieron control prenatal; 16 (44.4% no aparecen inscritas al sistema de seguridad social en salud. Tres madres (8.3% infectadas por VIH; 6 (16.7% con más de 9 compañeros sexuales y 10 (27.8% con un compañero sexual; 8 (22.2% usó drogas ilícitas. El diagnóstico de sífilis fue hecho en el tercer trimestre del embarazo en 15 casos (41.7% y 14 (38.9% en postparto. El 47.2% de las madres no recibió tratamiento durante el embarazo (17 casos; 25 padres (69.5% no lo recibieron. Conclusiones. Pese a que la SC es una enfermedad prevenible, en el Hospital Universitario de Santander se encontraron 36 casos entre junio de 2006 a septiembre 2007. Sobresalen factores inherentes a la madre, a su entorno y al acceso al servicio de salud que hacen que la SC aumente en nuestro medio. Para modificar la incidencia de la SC es mandatorio mejorar la calidad del control prenatal, garantizar el acceso y captación de las gestantes de manera oportuna, lograr adherencia a los protocolos de manejo por parte de las IPS para poder mejorar la calidad de vida de la infancia en Santander

  17. Impact on continuity of care of decentralized versus partly centralized mental health care in Northern Norway

    Directory of Open Access Journals (Sweden)

    Lars Henrik Myklebust

    2011-12-01

    Full Text Available Background: The issue of continuity of care is central in contemporary psychiatric services research. In Norway, inpatient admissions are mainly to take place locally, in a system of small bed-units that represent an alternative to traditional central psychiatric hospitals. This type of organization may be advantageous for accessibility and cooperation, but has been given little scientific attention.Aims: To study whether inpatients' utilization of outpatient services differ between an area with a decentralized care model in comparison to an adjacent area with a partly centralized model.  Method: The study was based on data from a one-year registered prevalence sample, drawing on routinely sampled data supplemented with data from medical records. Service-utilization for 247 inpatients was analyzed. The results were controlled for diagnosis, demographic variables, type of service system, localization of inpatient admissions, and length of hospitalization. Results: Most inpatients in the area with the decentralized care model also utilized outpatient consultations, whereas a considerable number of inpatients in the area with a partly centralized model did not enter outpatient care at all. Type of service system, localization of inpatient admission, and length of hospitalization predicted inpatients' utilization of outpatient consultations. The results are discussed in the light of systems integration, particularly management-arrangements and clinical bridging over the transitional phase from inpatient to outpatient care. Conclusion: Inpatients' utilization of outpatient services differed between an area with a decentralized care model in comparison to an adjacent area with a partly centralized care model. In the areas studied, extensive decentralization of the psychiatric services positively affected coordination of inpatient and outpatient services for people with severe psychiatric disorders. Small, local-bed units may therefore represent a

  18. Impact on continuity of care of decentralized versus partly centralized mental health care in Northern Norway

    Directory of Open Access Journals (Sweden)

    Lars Henrik Myklebust

    2011-12-01

    Full Text Available Background: The issue of continuity of care is central in contemporary psychiatric services research. In Norway, inpatient admissions are mainly to take place locally, in a system of small bed-units that represent an alternative to traditional central psychiatric hospitals. This type of organization may be advantageous for accessibility and cooperation, but has been given little scientific attention. Aims: To study whether inpatients' utilization of outpatient services differ between an area with a decentralized care model in comparison to an adjacent area with a partly centralized model.   Method: The study was based on data from a one-year registered prevalence sample, drawing on routinely sampled data supplemented with data from medical records. Service-utilization for 247 inpatients was analyzed. The results were controlled for diagnosis, demographic variables, type of service system, localization of inpatient admissions, and length of hospitalization.  Results: Most inpatients in the area with the decentralized care model also utilized outpatient consultations, whereas a considerable number of inpatients in the area with a partly centralized model did not enter outpatient care at all. Type of service system, localization of inpatient admission, and length of hospitalization predicted inpatients' utilization of outpatient consultations. The results are discussed in the light of systems integration, particularly management-arrangements and clinical bridging over the transitional phase from inpatient to outpatient care.  Conclusion: Inpatients' utilization of outpatient services differed between an area with a decentralized care model in comparison to an adjacent area with a partly centralized care model. In the areas studied, extensive decentralization of the psychiatric services positively affected coordination of inpatient and outpatient services for people with severe psychiatric disorders. Small, local-bed units may therefore

  19. Impact on continuity of care of decentralized versus partly centralized mental health care in Northern Norway

    Science.gov (United States)

    Myklebust, Lars Henrik; Olstad, Reidun; Bjorbekkmo, Svein; Eisemann, Martin; Wynn, Rolf; Sørgaard, Knut

    2011-01-01

    Background The issue of continuity of care is central in contemporary psychiatric services research. In Norway, inpatient admissions are mainly to take place locally, in a system of small bed-units that represent an alternative to traditional central psychiatric hospitals. This type of organization may be advantageous for accessibility and cooperation, but has been given little scientific attention. Aims To study whether inpatients’ utilization of outpatient services differ between an area with a decentralized care model in comparison to an adjacent area with a partly centralized model. Method The study was based on data from a one-year registered prevalence sample, drawing on routinely sampled data supplemented with data from medical records. Service-utilization for 247 inpatients was analyzed. The results were controlled for diagnosis, demographic variables, type of service system, localization of inpatient admissions, and length of hospitalization. Results Most inpatients in the area with the decentralized care model also utilized outpatient consultations, whereas a considerable number of inpatients in the area with a partly centralized model did not enter outpatient care at all. Type of service system, localization of inpatient admission, and length of hospitalization predicted inpatients’ utilization of outpatient consultations. The results are discussed in the light of systems integration, particularly management-arrangements and clinical bridging over the transitional phase from inpatient to outpatient care. Conclusion Inpatients’ utilization of outpatient services differed between an area with a decentralized care model in comparison to an adjacent area with a partly centralized care model. In the areas studied, extensive decentralization of the psychiatric services positively affected coordination of inpatient and outpatient services for people with severe psychiatric disorders. Small, local-bed units may therefore represent a favourable alternative

  20. Efficiency and hospital effectiveness in improving Hospital Consumer Assessment of Healthcare Providers and Systems ratings.

    Science.gov (United States)

    Al-Amin, Mona; Makarem, Suzanne C; Rosko, Michael

    2016-01-01

    Efficiency has emerged as a central goal to the operations of health care organizations. There are two competing perspectives on the relationship between efficiency and organizational performance. Some argue that organizational slack is a waste and that efficiency contributes to organizational performance, whereas others maintain that slack acts as a buffer, allowing organizations to adapt to environmental demands and contributing to organizational performance. As value-based purchasing becomes more prevalent, health care organizations are incented to become more efficient and, at the same time, improve their patients' experiences and outcomes. Unused slack resources might facilitate the timely implementation of these improvements. Building on previous research on organizational slack and inertia, we test whether efficiency and other organizational factors predict organizational effectiveness in improving Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) ratings. We rely on data from the American Hospital Association and HCAHPS. We estimate hospital cost-efficiency by Stochastic Frontier Analysis and use regression analysis to determine whether efficiency, competition, hospital size, and other organizational factors are significant predictors of hospital effectiveness. Our findings indicate that efficiency and hospital size have a significant negative association with organizational ability to improve HCAHPS ratings. Although achieving organizational efficiency is necessary for health care organizations, given the changes that are currently occurring in the U.S. health care system, it is important for health care managers to maintain a certain level of slack to respond to environmental demands and have the resources needed to improve their performance.

  1. 26Al in the interstellar medium

    International Nuclear Information System (INIS)

    Clayton, D.D.; Leising, M.D.

    1987-01-01

    Several different lines of physical reasoning have converged on the importance of the radioactive nucleus 26 Al. The sciences of meteoritics, nucleosynthesis, gamma-ray astronomy, galactic chemical evolution, solar system formation, and interstellar chemistry all place this nucleus in a central position with possible profound implications. Perhaps more importantly the study of this radioactivity can unite these diverse fields in a complicated framework which will benefit all of them. This review traces the evolution of ideas concerning 26 Al in the context of these disciplines. 26 Al was first discussed for the possibility that its decay energy could melt meteorite parent bodies, and its daughter, 26 Mg, was later found in meteorites with enhanced abundance. It was also among the first radioactivities expected to be synthesized in interestingly large quantities in nulceosynthetic events. The first definitive detection of gamma-rays from an interstellar radioactivity is that of 1.809 MeV gamma-rays from 26 Al. This discovery has many implications, some of which are outlined here. The whole problem of isotopic anomalies in meteorites is greatly influenced by the specific issues surrounding excess 26 Mg, whether it represents in situ decay of 26 Al or memory of conditions of the ISM. The relationships among these ideas and their implications are examined. (orig.)

  2. Hospital femenino e instituto psiquiátrico - Chicago – (EE. UU.

    Directory of Open Access Journals (Sweden)

    Goldberg, Bertrand

    1976-11-01

    , con forjados planos de hormigón, y un cerramiento exterior de muros-cortina. La torre es, en su totalidad, de hormigón armado ligero, con arcos en voladizo que concentran las cargas sobre el núcleo central. El Hospital se completa con un variado, moderno y completo programa de instalaciones. El diseño de la torre de habitaciones, cual escultura sobre un edificio convencional, presta singularidad al conjunto.

  3. Potential gains from hospital mergers in Denmark.

    Science.gov (United States)

    Kristensen, Troels; Bogetoft, Peter; Pedersen, Kjeld Moeller

    2010-12-01

    The Danish hospital sector faces a major rebuilding program to centralize activity in fewer and larger hospitals. We aim to conduct an efficiency analysis of hospitals and to estimate the potential cost savings from the planned hospital mergers. We use Data Envelopment Analysis (DEA) to estimate a cost frontier. Based on this analysis, we calculate an efficiency score for each hospital and estimate the potential gains from the proposed mergers by comparing individual efficiencies with the efficiency of the combined hospitals. Furthermore, we apply a decomposition algorithm to split merger gains into technical efficiency, size (scale) and harmony (mix) gains. The motivation for this decomposition is that some of the apparent merger gains may actually be available with less than a full-scale merger, e.g., by sharing best practices and reallocating certain resources and tasks. Our results suggest that many hospitals are technically inefficient, and the expected "best practice" hospitals are quite efficient. Also, some mergers do not seem to lower costs. This finding indicates that some merged hospitals become too large and therefore experience diseconomies of scale. Other mergers lead to considerable cost reductions; we find potential gains resulting from learning better practices and the exploitation of economies of scope. To ensure robustness, we conduct a sensitivity analysis using two alternative returns-to-scale assumptions and two alternative estimation approaches. We consistently find potential gains from improving the technical efficiency and the exploitation of economies of scope from mergers.

  4. Economic opportunities and challenges posed by China for Mexico and Central America

    OpenAIRE

    Dussel Peters, Enrique

    2005-01-01

    "This study offers a basis for understanding China's performance from a Latin American perspective, and stressing the massive economic opportunities and challenges, and particularly for Central America and Mexico. Moreover, the document assesses in detail the macroeconomic, trade and employment policy and institutional changes in China and its potential effects in Central America and Mexico. These effects are analyzed in the Chinese, Central American, Mexican and US market in general, but als...

  5. Hospital, en Uazán

    Directory of Open Access Journals (Sweden)

    J. Chemineau

    2017-05-01

    Full Text Available Uazán, villa situada al norte de Marruecos, en el Rif, en una región bastante poblada, tiene 25.000 habitantes y reúne otros tantos de sus vecindades. La construcción de este hospital en esta pequeña villa, vino a sustituir a una serie de antiguos pabellones dispersos, de acuerdo con el plan general francés, del año 1945, de defensa sanitaria civil.

  6. Blood lactate as a predictor for in-hospital mortality in patients admitted acutely to hospital: A systematic review

    DEFF Research Database (Denmark)

    Kruse, Ole; Grunnet, Niels; Barfod, Charlotte

    2011-01-01

    to the hospital, or serial lactate measurements. Furthermore there is no consensus whether the sample should be drawn from arterial, peripheral venous, or capillary blood. The aim of this review was: 1) To examine whether blood lactate levels are predictive for in-hospital mortality in patients in the acute...... setting, i.e. patients assessed pre-hospitally, in the trauma centre, emergency department, or intensive care unit. 2) To examine the agreement between arterial, peripheral venous, and capillary blood lactate levels in patients in the acute setting. METHODS: We performed a systematic search using Pub......Med, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and CINAHL up to April 2011. 66 articles were considered potentially relevant and evaluated in full text, of these ultimately 33 articles were selected. RESULTS AND CONCLUSION: The literature reviewed supported blood...

  7. Importancia, evolución y organización de un Servicio de Esterilización Central

    OpenAIRE

    Rothamel, Alicia

    1986-01-01

    La Central de Esterilización Hospitalaria es el lugar donde se decontaminan, lavan, preparan, acondicionan y esterilizan los materiales de uso en el Hospital. La gran responsabilidad profesional y técnica que caracterizan su rol en el Hospital exigen que el Servicio esté estrictamente organizado, contando con una estructura física, equipamiento, plantel de personal y estructura técnico-administrativa conforme a las Normas de Esterilización en vigencia. La Central de Esterilización en un Hospi...

  8. Nivel de Conocimientos sobre Infecciones de Transmisión Sexual en usuarios que Acuden al Consultorio de Control de Infecciones de Transmisión Sexual. Hospital Goyeneche. Arequipa, 2008

    OpenAIRE

    Chancolla Mamani Mery Concepción

    2010-01-01

    Las infecciones de transmisión sexual (ITS) o clásicamente como enfermedades venéreas, en la actualidad presentan un elevado número de pacientes y más aún en los países tercer mundista, es por eso que se ha elaborado la presente investigación titulada: NIVEL DE CONOCIMIENTOS SOBRE INFECCIONES DE TRANSMISIÓN SEXUAL EN USUARIOS QUE ACUDEN AL CONSULTORIO DE CONTROL DE INFECCIONES DE TRANSMISIÓN SEXUAL. HOSPITAL GOYENECHE. AREQUIPA, 2008, se realizó un estudio de tipo descriptiv...

  9. easuring the quality of health services provided at a Greek Public Hospital through patient satisfaction. Case Study: The General Hospital of Kavala

    Directory of Open Access Journals (Sweden)

    Vasiliki A. Georgiadou

    2017-06-01

    Full Text Available Purpose: The aim of this study is to examine the quality of hospital services as perceived by patients in terms of patient satisfaction with services. Design/Methodology/Approach: A conceptual framework of quality of hospital services, developed by Padma et al. (2009, composed by eight quality dimensions, applied the performance measurement model (SERVPERF, was used for the approach. The Quality Score Tool was a two-part questionnaire that quantified patient satisfaction with benchmarks of the quality dimensions. In order to investigate the above model, the case study method was utilized. The survey was conducted in a public regional hospital. Findings: Five (5 quality dimensions (5Qs have found having a significant impact on overall quality of service, measure of patient satisfaction in the hospital. These dimensions are on a hierarchical scale: "clinical care", "social responsibility", "staff quality", "infrastructure" and "Hospital reliability". Originality/Value: The results of this study can be used as a source of feedback to hospital management, meaning that they can essentially lead to improved adjustments or serve as a basis of process reengineering.

  10. Central nervous system tuberculosis in children: review of 35 cases at the Hospital Universitario San Vicente de Paúl in Medellín, Colombia.1997-2004. Meningoencefalitis tuberculosa en niños: Revisión de 35 casos en el Hospital Universitario San Vicente de Paúl en Medellín, Colombia. 1997-2004

    Directory of Open Access Journals (Sweden)

    José William Cornejo Ochoa

    2005-04-01

    Full Text Available Objetive. To document the clinical and diagnostic features and to explore factors associated with central nervous system tuberculosis at the “Hospital San Vicente de Paúl (HUSVP” in Medellín-Colombia. Patients and methods. Review of the patient’s records to obtain information on demographic data, medical history, clinical manifestations, laboratory results, treatment and complications of 35 children with central nervous system tuberculosis admitted to the hospital between July 1997 and July 2004. Results. Of the 35 patients, 20 were males and 15 females. Mean age was 3.7 years. Thirty (85.7% patients were in stage III of the disease and 5 (14.3% in stage II. A symptomatic respiratory close contact was documented in 19 cases (54.3%. Malnutrition was present in 18 patients (51.4%. Fever was present in 88.6%, vomiting in 62.9%, consciousness alteration in 80%, and seizures in 51.4%. Mean duration of symptoms was 10 days. Physical examination revealed meningeal signs in 77%, movement disorders in 31.4%, stupor or coma in 82.9%, hemiparesis in 60% and fundoscopic abnormalities in 31.4%. Objetivo: documentar los rasgos clínicos y diagnósticos y explorar los factores asociados con la muerte de niños con meningoencefalitis tuberculosa (MT en el Hospital Universitario San Vicente de Paúl, Medellín, Colombia. Método: revisión de las historias clínicas para obtener los datos demográficos, clínicos, de laboratorio, de tratamiento y de las complicaciones de 35 niños con tuberculosis del sistema nervioso central, entre julio de 1997 y julio de 2004. Resultados: veinte de los 35 pacientes eran niños y 15 niñas. La edad promedio era 3.7 años; 30 (85.7% estaban en el estadio III de la enfermedad y 5 (14.3%, en el estadio II. Se documentó un contacto sintomático respiratorio en 19 casos (54.3%. Diez y ocho pacientes (51.4% estaban desnutridos. Hubo fiebre en 88.6%, vómito en 62.9%, alteración de la conciencia en 80% y convulsiones en 51

  11. Integrating centralized and decentralized organization structures: an education and development model.

    Science.gov (United States)

    Sheriff, R; Banks, A

    2001-01-01

    Organization change efforts have led to critically examining the structure of education and development departments within hospitals. This qualitative study evaluated an education and development model in an academic health sciences center. The model combines centralization and decentralization. The study results can be used by staff development educators and administrators when organization structure is questioned. This particular model maximizes the benefits and minimizes the limitations of centralized and decentralized structures.

  12. Review of thromboembolic prophylaxis in patients attending Cork University Hospital.

    Science.gov (United States)

    Byrne, Stephen; Weaver, Daniel Timothy

    2013-06-01

    Although preventable, venous thromboembolism remains a common cause of hospital acquired morbidity and mortality. Guidelines, such as the one produced by the American College of Chest Physicians (ACCP), are aimed at reducing hospital associated venous thromboemboli. Unfortunately the majority of studies have revealed inadequate adherence to these guidelines. The objective of this study was to evaluate the use of venous thromboembolism prophylaxis at Cork University Hospital. Cork University Hospital, Wilton, Cork, Ireland. Data from the patient's chart, drug kardex and laboratory results were recorded during April 2010. A Caprini score, a venous thromboembolism risk factor assessment tool, was subsequently calculated for each patient based on data collected. Appropriate prophylaxis was determined after examining data collected, Caprini score and prophylactic regime according to the ACCP 8th edition guidelines. Primary outcome was to analyse adherence to VTE prophylaxis guidelines. A total of 394 patients met the inclusion criteria and were reviewed, of which, 60% (n = 236) were medical and 37% (n = 146) were surgical patients. In total 63% of patients received some form of venous thromboembolism prophylaxis. Furthermore, 54% of medical and 76% of surgical patients received prophylaxis. However only 37% of the patients studied received appropriate thromboprophylaxis according to the ACCP 8th edition guidelines (Geerts et al. in chest 133(6 Suppl):381S-453S, 2008). Additionally 51% of surgical and 27% of medical patients received appropriate prophylaxis. Data collected from Cork University Hospital revealed poor adherence to international venous thromboembolism prophylaxis guidelines. As stated in the ACCP 8th edition guidelines, every hospital should develop a formal strategy for venous thromboembolism prevention (Geerts et al. in chest 133(6 Suppl):381S-453S, 2008). In order to improve adherence to guidelines, Cork University Hospital should develop, implement and

  13. Antibiotic Prescribing Patterns in Outpatient Emergency Clinics at Queen Rania Al Abdullah II Children's Hospital, Jordan, 2013

    Directory of Open Access Journals (Sweden)

    Sahar I. Al-Niemat

    2014-07-01

    Full Text Available Objective: To investigate antibiotics prescribing patterns in the outpatient pediatric emergency clinic at Queen Rania Al Abdullah II Children’s Hospital at Royal Medical Services in Amman, Jordan. Methods: The data was collected from the emergency pharmacy over the period of a -five consecutive months. The methodology recommended by the World Health Organization for investigating drug use in a health facility was followed. The study measures the percentage of encounter with a prescribed antibiotic and the percentage share of each antibiotic category. The distribution of diagnostic categories that accounted for all antibiotics being prescribed and the distribution of each antibiotic being prescribed for upper respiratory tract infections (URTIs were also measured. Results: Antibiotic prescribing was frequent during pediatric visits to the outpatient pediatric emergency clinic resulting in a high percentage of encounters (85% when compared to appropriate. Emergency physicians continue to frequently prescribe broad spectrum antibiotics which accounted for approximately (60% of the total prescribed antibiotics and (83% of prescribed antibiotics for upper respiratory tract infections and macrolides (primarily azithromycin were the leading class among them. Conclusion: Our results showed high consumption of antibiotics by emergency department pediatricians which highlight the importance for interventions to promote rational and judicious prescribing. An insight into factors influencing antibiotics prescribing patterns by military prescribers is required.

  14. Low-grade central osteosarcoma in proximal humerus: a rare entity

    Directory of Open Access Journals (Sweden)

    Tang F

    2017-10-01

    Full Text Available Fan Tang,1,2 Li Min,1,2 Yong Zhou,1 Yi Luo,1 Chongqi Tu1 1Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, People’s Republic of China; 2Sarcoma Biology Laboratory, Center for Sarcoma and Connective Tissue Oncology, Massachusetts General Hospital, Boston, MA, USA Abstract: Low-grade central osteosarcoma is a rare subtype of tumor with low-grade malignancy. Currently, wide resection with negative resection margin is the standard treatment for this disease. The role of neoadjuvant chemotherapy in low-grade central osteosarcoma was controversial and was mostly considered for tumors containing high-grade focal areas. Local tumor recurrences often exhibited a tumor with higher histologic grade or differentiation with the potential for metastases. In low-grade central osteosarcoma, timely wide resection after definite diagnosis can result in 5-year survival for almost 90%. However, the relatively nonspecific radiological and pathological findings make diagnosis very difficult. MDM2 and CDK4 are specific and provide sensitive markers for the diagnosis of low-grade central osteosarcoma, helping to differentiate low-grade central osteosarcoma from some benign lesions, including fibrous dysplasia, bone giant cell tumor, and chondrosarcoma. Here, we report the case of a 19-year-old woman with low-grade central osteosarcoma located at the proximal humerus. The affected site was rare, but the sensitive biomarkers CDK4 and MDM2 were positive. The patient recovered well after wide tumor resection following a proximal humerus endoprosthesis replacement. Our case highlighted the management strategies in low-grade central osteosarcoma. Being familiar with radiographic features, understanding the biological characteristics, and mastering diagnostic biomarkers can help oncologists avoid embarrassing situations in treatment when this rare tumor is highly suspected, even when located at an uncommon site. The discussion in this report

  15. Clinical protein science developments for patient monitoring in hospital central laboratories.

    Science.gov (United States)

    Malm, Johan; Marko-Varga, György

    2016-12-01

    Patient care relies heavily on standardized tests performed in hospital laboratories, typically including clinical chemistry, pathology and microbiology. With the introduction of personalized medicine tremendous efforts have been made to identify new biomarkers of disease with various omics technologies, often including mass spectrometry. In order to validate new biomarkers and perform clinical studies high quality biobank samples are of key importance. In this editorial different aspects of mass spectrometry in future personalized medicine are discussed.

  16. Challenges for the surgical capacity building of township hospitals among the Central China: a retrospective study.

    Science.gov (United States)

    Li, Zhong; Yang, Jian; Wu, Yue; Pan, Zijin; He, Xiaoqun; Li, Boyang; Zhang, Liang

    2018-05-02

    China's rapid transition in healthcare service system has posed considerable challenges for the primary care system. Little is known regarding the capacity of township hospitals (THs) to deliver surgical care in rural China with over 600 million lives. We aimed to ascertain its current performance, barriers, and summary lessons for its re-building in central China. This study was conducted in four counties from two provinces in central China. The New Rural Cooperative Medical System (NRCMS) claim data from two counties in Hubei province was analyzed to describe the current situation of surgical care provision. Based on previous studies, self-administered questionnaire was established to collect key indicators from 60 THs from 2011 to 2015, and social and economic statuses of the sampling townships were collected from the local statistical yearbook. Semi-structured interviews were conducted among seven key administrators in the THs that did not provide appendectomy care in 2015. Determinants of appendectomy care provision were examined using a negative binominal regression model. First, with the rapid increase in inpatient services provided by the THs, their proportion of surgical service provision has been nibbled by out-of-county facilities. Second, although DY achieved a stable performance, the total amount of appendectomy provided by the 60 THs decreased to 589 in 2015 from 1389 in 2011. Moreover, their proportion reduced to 26.77% in 2015 from 41.84% in 2012. Third, an increasing number of THs did not provide appendectomy in 2015, with the shortage of anesthesiologists and equipment as the most mentioned reasons (46.43%). Estimation results from the negative binomial model indicated that the annual average per capita disposable income and tightly integrated delivery networks (IDNs) negatively affected the amount of appendectomy provided by THs. By contrast, the probability of appendectomy provision by THs was increased by performance-related payment (PRP). Out

  17. Fact-finding survey of nosocomial infection control in hospitals in Vietnam and application to training programs.

    Science.gov (United States)

    Ohara, Hiroshi; Hung, Nguyen Viet; Thu, Truong Anh

    2009-12-01

    Nosocomial infection control is crucial for improving the quality of medical care. It is also indispensable for implementing effective control measures for severe acute respiratory syndrome (SARS) and the possible occurrence of a human influenza pandemic. The present authors, in collaboration with Vietnamese hospital staff, performed a fact-finding survey of nosocomial infection control in hospitals in northern Vietnam and compared the results with those of a survey conducted 4 years previously. Remarkable improvement was recognized in this period, although there were considerable differences between the central hospitals in Hanoi and local hospitals. In the local hospitals, basic techniques and the systems for infection control were regarded as insufficient, and it is necessary to improve these techniques and systems under the guidance of hospitals in the central area. Based on the results of the survey, programs were prepared and training courses were organized in local hospitals. Evaluation conducted after the training courses showed a high degree of satisfaction among the trainees. The results of the survey and the training courses conducted during the study period are expected to contribute to the improvement of nosocomial infection control in remote areas of Vietnam.

  18. VIIP: Central Nervous System (CNS) Modeling

    Science.gov (United States)

    Vera, Jerry; Mulugeta, Lealem; Nelson, Emily; Raykin, Julia; Feola, Andrew; Gleason, Rudy; Samuels, Brian; Ethier, C. Ross; Myers, Jerry

    2015-01-01

    Current long-duration missions to the International Space Station and future exploration-class missions beyond low-Earth orbit expose astronauts to increased risk of Visual Impairment and Intracranial Pressure (VIIP) syndrome. It has been hypothesized that the headward shift of cerebrospinal fluid (CSF) and blood in microgravity may cause significant elevation of intracranial pressure (ICP), which in turn may then induce VIIP syndrome through interaction with various biomechanical pathways. However, there is insufficient evidence to confirm this hypothesis. In this light, we are developing lumped-parameter models of fluid transport in the central nervous system (CNS) as a means to simulate the influence of microgravity on ICP. The CNS models will also be used in concert with the lumped parameter and finite element models of the eye described in the related IWS works submitted by Nelson et al., Feola et al. and Ethier et al.

  19. Central African Journal of Medicine - Vol 46, No 11 (2000)

    African Journals Online (AJOL)

    The incidence of cleft lip, cleft palate, hydrocephalus and spina bifida at Queen Elizabeth Central Hospital, Blantyre, Malawi. B C Msamati, P S Igbigbi, J E Chisi. http://dx.doi.org/10.4314/cajm.v46i11.8572 ...

  20. Triple Gestations in Two University Teaching Hospitals in Yaounde ...

    African Journals Online (AJOL)

    3Department of Obstetrics & Gynecology, Central Hospital Yaounde/Faculty of Medicine and Biomedical Sciences,. University of Yaounde I, BP 337, Yaounde, Cameroon. Address correspondence to E. Nkwabong, enkwabong@yahoo.fr. Received 27 November 2010; Accepted 19 January 2011. Abstract The frequency of ...

  1. Participatory simulation in hospital work system design

    DEFF Research Database (Denmark)

    Andersen, Simone Nyholm

    When ergonomic considerations are integrated into the design of work systems, both overall system performance and employee well-being improve. A central part of integrating ergonomics in work system design is to benefit from emplo y-ees’ knowledge of existing work systems. Participatory simulation...... (PS) is a method to access employee knowledge; namely employees are involved in the simulation and design of their own future work systems through the exploration of models representing work system designs. However, only a few studies have investigated PS and the elements of the method. Yet...... understanding the elements is essential when analyzing and planning PS in research and practice. This PhD study investigates PS and the method elements in the context of the Danish hospital sector, where PS is applied in the renewal and design of public hospitals and the work systems within the hospitals...

  2. The effect of eradicating Helicobacter pylori on idiopathic central serous chorioretinopathy patients

    Directory of Open Access Journals (Sweden)

    Dang Y

    2013-09-01

    Full Text Available Yalong Dang,1,2,* Yalin Mu,2,* Manli Zhao,2 Lin Li,3 Yaning Guo,4 Yu Zhu1,2 1Department of Ophthalmology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, People's Republic of China; 2Department of Ophthalmology and Visual Science, Yellow River Hospital of Henan University of Science and Technology, Sanmenxia City, Henan, People's Republic of China; 3Department of Ophthalmology, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang City, Henan, People's Republic of China; 4Gu-Cheng Eye Hospital, Xi'an City, Shanxi, People's Republic of China *These authors contributed equally to this work Purpose: To evaluate the effect of Helicobacter pylori (H. pylori eradication on the remission of acute idiopathic central serous chorioretinopathy (ICSCR. Study design: A prospective, randomized, placebo-controlled study of 53 participants. Main outcome measure: Twenty-seven acute ICSCR patients tested positive for H. pylori were given an eradication H. pylori therapy, and another 26 patients with the same diagnosis received matching placebo medication. All participants were tested for the following items: (1 disappearance rate of subretinal fluid (SRF; (2 best-corrected visual acuity (BCVA; and (3 central retinal sensitivity at baseline, 2 weeks, 4 weeks, 8 weeks, and 12 weeks after treatment. The difference between the two groups was analyzed by PASW statistics version 18.0. Results: At each follow-up, the disappearance rate of SRF in the active treatment group seemed slightly better than in the control group, but no statistically significant differences were observed (P > 0.05 at each follow-up. The BCVA between the two groups also did not demonstrate statistically significant differences (P > 0.05 at each follow-up. Unlike the BCVA and the disappearance rate of SRF, we compared the change in central retinal sensitivity at 12 weeks after treatment; a statistical difference was observed (P = 0

  3. Misdiagnosis of acute peripheral vestibulopathy in central nervous ischemic infarction.

    Science.gov (United States)

    Braun, Eva Maria; Tomazic, Peter Valentin; Ropposch, Thorsten; Nemetz, Ulrike; Lackner, Andreas; Walch, Christian

    2011-12-01

    Vertigo is a very common symptom at otorhinolaryngology (ENT), neurological, and emergency units, but often, it is difficult to distinguish between vertigo of peripheral and central origin. We conducted a retrospective analysis of a hospital database, including all patients admitted to the ENT University Hospital Graz after neurological examination, with a diagnosis of peripheral vestibular vertigo and subsequent diagnosis of central nervous infarction as the actual cause for the vertigo. Twelve patients were included in this study. All patients with acute spinning vertigo after a thorough neurological examination and with uneventful computed tomographic scans were referred to our ENT department. Nine of them presented with horizontal nystagmus. Only 1 woman experienced additional hearing loss. The mean diagnostic delay to the definite diagnosis of a central infarction through magnetic resonance imaging was 4 days (SD, 2.3 d). A careful otologic and neurological examination, including the head impulse test and caloric testing, is mandatory. Because ischemic events cannot be diagnosed in computed tomographic scans at an early stage, we strongly recommend to perform cranial magnetic resonance imaging within 48 hours from admission if vertigo has not improved under conservative treatment.

  4. Ocular neovascularization in eyes with a central retinal artery occlusion or a branch retinal artery occlusion

    Directory of Open Access Journals (Sweden)

    Mason lll JO

    2015-06-01

    Full Text Available John O Mason III,1,2 Shyam A Patel,1 Richard M Feist,1,2 Michael A Albert Jr,1,2 Carrie Huisingh,1 Gerald McGwin Jr,1,3 Martin L Thomley1,2 1Department of Ophthalmology, University of Alabama School of Medicine, Birmingham, AL, USA; 2Retina Consultants of Alabama, Callahan Eye Foundation Hospital, Birmingham, AL, USA; 3Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA Purpose: To investigate the ocular neovascularization (ONV rate in eyes with a branch retinal artery occlusion (BRAO or a central retinal artery occlusion (CRAO, and to study factors that may influence the ONV rate secondary to CRAO.Methods: This was a retrospective case series of consecutive patients (286 total eyes: 83 CRAOs and 203 BRAOs who were diagnosed with a retinal artery occlusion from 1998 to 2013 at the Retina Consultants of Alabama and University of Alabama at Birmingham, Birmingham, AL, USA. Generalized estimating equations were used to evaluate the association between hypothesized risk factors and ONV development.Results: Twelve (14.5% of the 83 eyes with a CRAO developed ONV. Eleven of 12 eyes (91.7% had iris neovascularization, ten of 12 eyes (83.3% had neovascular glaucoma, and two of 12 eyes (16.7% had neovascularization of the optic disc. The average time for ONV development secondary to CRAO was 30.7 days, ranging from the date of presentation to 137 days. Only two (<1.0% of the 203 eyes with a BRAO developed iris neovascularization. Diabetes mellitus type 2 was a risk factor for ONV development following a CRAO with an adjusted odds ratio of 5.2 (95% confidence interval: 1.4–19.8 (P=0.02.Conclusion: ONV is an important complication of CRAO and is a less-frequent complication of BRAO. Patients with a CRAO, especially those with diabetes mellitus type 2, should be closely monitored for the first 6 months for ONV. Keywords: neovascularization, neovascular glaucoma, retinal artery occlusion, central

  5. Unlocking India’s Strategic Potential in Central Asia

    Science.gov (United States)

    2015-10-01

    war. Nearly 4 decades since, Islamabad has struggled to ensure do- mestic security amid militant attacks, some of which bear the hallmarks of...see Huasheng, pp. 131-138. 79. Jagannath P. Panda , “India’s New Look at Central Asia Policy: A Strategic Review,” in Laruelle, Huchet, et al., pp...Central Asia,” in Dash, p. 8. 99. Peyrouse, Monsoon, p. 197. 100. Stobdan, pp. 48-54. 101. Panda , p. 116. 102. Kavalski, pp. 102-103. 98 103. Peyrouse

  6. Infection and natural history of emergency department-placed central venous catheters.

    Science.gov (United States)

    LeMaster, Christopher H; Schuur, Jeremiah D; Pandya, Darshan; Pallin, Daniel J; Silvia, Jennifer; Yokoe, Deborah; Agrawal, Ashish; Hou, Peter C

    2010-11-01

    Central line-associated bloodstream infection (CLABSI, hereafter referred to in this paper as "bloodstream infection") is a leading cause of hospital-acquired infection. To our knowledge, there are no previously published studies designed to determine the rate of bloodstream infection among central venous catheters placed in the emergency department (ED). We design a retrospective chart review methodology to determine bloodstream infection and duration of catheterization for central venous catheters placed in the ED. Using hospital infection control, administrative, and ED billing databases, we identified patients with central venous catheters placed in the ED between January 1, 2007, and December 31, 2008, at one academic, urban ED with an annual census of 57,000. We performed a structured, explicit chart review to determine duration of catheterization and confirm bloodstream infection. We screened 4,251 charts and identified 656 patients with central venous catheters inserted in the ED, 3,622 catheter-days, and 7 bloodstream infections. The rate of bloodstream infection associated with central venous catheters placed in the ED was 1.93 per 1,000 catheter-days (95% confidence interval 0.50 to 3.36). The mean duration of catheterization was 5.5 days (median 4; range 1 to 29 days). Among infected central venous catheters, the mean duration of catheterization was 8.6 days (median 7; range 2 to 19 days). A total of 667 central venous catheters were placed in the internal jugular (392; 59%), subclavian (145; 22%), and femoral (130; 19%) veins. The sensitivity of using ED procedural billing code for identifying ED-placed central venous catheters among patients subsequently admitted to any ICU was 74.9% (95% confidence interval 71.4% to 78.3%). The rate of ED bloodstream infection at our institution is similar to current rates in ICUs. Central venous catheters placed in the ED remain in admitted patients for a substantial period. Copyright © 2010 American College of

  7. Micro satellite instability in colorectal cancer stage II. Hospital Central de las fuerzas armadas

    International Nuclear Information System (INIS)

    Della Valle, A; Santander G; Camejo, N; Spera, G.

    2010-01-01

    Introduction: micro satellite instability (MSI) is a good prognostic factor in colorectal cancer (CRC) located. Its value as a predictive marker against adjuvant treatment of chemotherapy (CT) has been shown fluoropyrimidine in various publications. The MSI occurs in 15% of colorectal tumors and sporadic in 90% of tumors in the context of colorectal cancer syndrome hereditary nonpolyposis. In Uruguay there are no studies about this phenomenon. Objective: To determine the incidence of micro satellite instability in a sample of patients using the Hospital Central de las fuerzas armadas oncology service, association with a compatible family history and the histological features of the tumors associated therewith. Methods: The medical records of patients were analyzed with CRC diagnosed stage II between 01/2001 and 12/2009. Data of the patients were analyzed which had complete histology and evolution. Results: 30/52 patients (57.6%) were analyzed. 40% had a detected MSI by kits for Pcr (polymerase chain reaction) to D2S123, D5S250, D17S346, BAT25 and BAT26 according to the Bethesda criteria. In those patients they filed a MSI: the median age was 70 years; 58.3% male. No patient had a family history consistent with HNPCC. 5.6% (3) they received Adjuvant chemotherapy treatment. Regarding tumor characteristics: 75% (9) were T3, and T4 were 25% (3); 8.3% histologic grade I (1) II 58.3% (7) 8.3% III (1) without Data 33% (6). This tumor lymphocyte infiltration was reported in 25% (3), absent 33.3% (4), not reported in 41.6% (5). Conclusions: This is the first analysis of these characteristics carried out in Uruguay. The same has been detected MSI percentage higher than reported in the literature International. In either case a compatible family history met HNPCC

  8. Use of tritium for estimation of groundwater mean residence time, a case study of the Ain Al-Samak Karst springs (Central Syria)

    International Nuclear Information System (INIS)

    Kattan, Z.

    2003-01-01

    This work is an attempt to estimate the mean residence time of groundwater in the Ain Al-Tanour and Ain-Samak, which are the major karst springs in the Upper Orontes Basin (Central Syria). This estimate, which consists on the application of a mathematical modeling approach, was based on the use of tritium, as a natural radioisotope tracer and a tool for ground water age dating. By adopting a completely mixed reservoir model, linked with exponential time distribution function, the mean residence time (turnover time) of these two springs was evaluated to be about 50 years. This result is in good agreement with previous estimation obtained for the Figeh main spring, which belongs to the same aquifer (Cenomanian-Turonian complex) in the Damascus Basin. On the basis of this evaluation, a value of about 800 million m 3 was obtained for the maximum groundwater reservoir size

  9. Impact of morphologic characteristics of central pulmonary thromboemboli in massive pulmonary embolism.

    Science.gov (United States)

    Podbregar, Matej; Krivec, Bojan; Voga, Gorazd

    2002-09-01

    To assess the impact of morphologically different central pulmonary artery thromboemboli in patients with massive pulmonary emboli (MPEs) on short-term outcome. A prospective registry of consecutive patients. An 11-bed closed medical ICU at a 860-bed community general hospital Forty-seven patients with shock or hypotension due to MPE and central pulmonary thromboemboli detected by transesophageal echocardiography who were treated with thrombolysis between January 1994 and April 2000. Patients were divided into two groups according to the following characteristics of the detected thromboemboli: group 1, thrombi with one or more long, mobile parts; and group 2, immobile thrombi. Right heart catheterization was performed. The incidence of both types of thromboemboli was comparable. Groups 1 and 2 showed no differences in demographic data, risk factors for pulmonary embolism, length of preceding clinical symptoms, percentage of patients in shock, hemodynamic variables, serum lactate levels on hospital admission, and treatment. Seven fatal cases due to obstructive shock and right heart failure were present in group 2, but none were present in group 1 (7 of 23 patients vs 0 of 24 patients, respectively; p < 0.05). At 12 h, the cardiac index was lower in group 2 than in group 1 (2.6 +/- 1.0 vs 3.1 +/- 0.9 L/min/m(2), respectively; p < 0.05), and the central venous pressure (15.0 +/- 6.2 vs 12.5 +/- 3.7 mm Hg, respectively; p < 0.05) and total pulmonary resistance (12.9 +/- 5.9 vs 8.6 +/- 2.7 mm Hg/L/min/m(2), respectively; p < 0.001) were higher in group 2 compared to group 1. On hospital admission, inclusion in group 2 (p < 0.03; hazard ratio, 9.53; 95% confidence interval [CI], 1.19 to 76.47) and preexisting chronic medical or neurologic disease (p < 0.01; hazard ratio, 16.4; 95% CI, 1.97 to 136.3) were independent predictors of 30-day mortality. On hospital admission, morphology of the thromboemboli and the presence of pre-existing chronic medical or neurologic disease

  10. Primary cerebral angitis of the central nervous | Das | East African ...

    African Journals Online (AJOL)

    Various medications like intravenous immunoglobulin, antibiotics, acyclovir, methyl prednisolone and management for raised intracranial pressure were instituted. She rapidly deteroriated and died on tenth hospital day. Only at autopsy was the diagnosis of primary angitis of central nervous system established. East African ...

  11. Protocolo POG 9061 en la recaída aislada a sistema nervioso central en pacientes con diagnóstico de leucemia linfoide aguda. Resultados de una serie de casos en el Hospital Universitario de Santander POG 9061 protocol to treat isolated central nervous system recurrence in patients with acute lymphoid leukemia at Hospital Universitario de Santander

    Directory of Open Access Journals (Sweden)

    Ernesto Rueda

    2010-04-01

    Full Text Available Introducción: La leucemia linfoide aguda (LLA es la neoplasia más común en niños; el 5-10 % presentan recaídas a sistema nervioso central (SNC, un factor de mal pronóstico. Objetivo: Describir los resultados obtenidos en una unidad de oncología pediátrica con el protocolo POG 9061 modificado, en pacientes con LLA y recaída aislada a SNC. Metodología: Cohorte de los pacientes atendidos en el Hospital Universitario de Santander (HUS. Se estimó la sobrevida libre de evento (SLE y la sobrevida total (ST, así como las alteraciones resultantes del protocolo. Se incluyeron 15 pacientes atendidos entre enero/93 y marzo/07; el último diagnóstico de recaída al SNC se hizo en noviembre/04. Resultados: El 66,6 % de las recaídas se dieron antes de 18 meses luego de remitir la LLA. Dos pacientes abandonaron el protocolo, uno de los cuales falleció; dos o más fallecieron luego de terminar el protocolo. La ST a cinco años fue de 85,6 % (IC95 % 53,3-96,2, mientras que la SLE de 84,9 % (IC95 % 51,2-96,0 %. La complicación más frecuente fue mielosupresión; no hubo alteraciones de la función renal y solo una ligera elevación de las pruebas de función hepática. Las causas de hospitalización fueron principalmente infecciones. El coeficiente intelectual de los pacientes posterior a la aplicación del protocolo indicaba deficiencia leve en el 45,4 % de ellos. Conclusiones: La sobrevida, el tipo y la frecuencia de complicaciones, son similares a las encontradas a nivel mundial, lo que es relevante dada la alta proporción de pacientes con recaída precoz luego de remisión de la LLA. Salud UIS 2010; 42: 7-17Introduction: Acute lymphoblastic leukemia (ALL is the most frequent neoplasm in children. Relapses to central nervous system (CNS Appears in 5-10 % of the ALL patients and is a bad prognostic factor. Objective: To describe the results obtained with modified POG 9061 protocol in a pediatric oncology unit. Methodology: Survival analysis was

  12. Factores contribuyentes al desarrollo de infecciones adquiridas en la comunidad en diabéticos tipo 2 admitidos en salas de medicina del Hospital Nacional Cayetano Heredia Factors contributing to the development of community-acquired infections in type-2 diabetics admitted to the Cayetano Heredia National Hospital

    Directory of Open Access Journals (Sweden)

    Gino Guillermo Tapia-Zegarra

    2001-12-01

    Full Text Available El propósito del estudio es identificar factores contribuyentes al desarrollo de infecciones adquiridas en la comunidad en diabéticos tipo 2 hospitalizados. De tal forma, se siguió el diseño de un estudio de casos y controles no apareado. Consecuentemente, se eligieron en forma aleatoria 105 diabéticos con infección adquirida en la comunidad y 105 diabéticos con patología no infecciosa, obtenidos de los Servicios de Medicina de un hospital universitario, entre 1991 y 1998. Mediante el análisis bivariado y multivariado, se obtuvo la estimación ajustada del valor de odds ratio. Los resultados permitieron, según análisis estratificado por edad y sexo, obtener a neuropatía autonómica como factor contribuyente de infecciones urinarias (OR = 4,07. En el modelo multivariado se aisló a vasculopatía periférica (R²: 0,24 como contribuyente de infección de piel y partes blandas (OR = 6,79. Los intervalos de confianza fueron significativos y de 95% de confiabilidad. En conclusión, vasculopatía periférica y vejiga neurogénica contribuyen al desarrollo de infecciones adquiridas en la comunidad en diabéticos tipo 2 hospitalizados.This study aims to identify factors contributing to the development of community-acquired infections in hospitalized type-2 diabetics, using an unmatched case-control design. A total of 105 pairs of diabetic patients with community-acquired infections as compared to non-infectious diseases, respectively, were chosen randomly from the discharge registry of the clinical wards of a teaching hospital from 1991 to 1998. Bivariate and multivariate analysis was conducted with estimation of the adjusted odds ratio. According to stratified analysis controlling for age and sex, autonomic neuropathy proved to be a contributing factor to development of urinary tract infections (OR = 4.07. In the multivariate model, peripheral vasculopathy was isolated (R²: 0.24 as a contributing factor in the development of soft

  13. Violence in Al-Zahra Hospital from the Viewpoint of Administrative Support Staff: A Qualitative Study

    Directory of Open Access Journals (Sweden)

    Mahmoud Keyvanara

    2015-10-01

    Conclusion: Considering the high prevalence of violence in hospitals and its adverse effects on the societies, organizations and individuals, necessary measures must be taken to diminish the occurrence of this problem, some of which include: increasing insurance coverage, changing physical structure of hospitals to increase security, limiting the entrance of individuals, making administrative processes more transparent, culture-making about terms of visiting and patient companionship, holding workshops on violence and proper relationship with patients and families and using experienced staff to interact with clients.

  14. Epidemiology and Outcomes of Hospitalized Burn Patients in Gaza ...

    African Journals Online (AJOL)

    BACKGROUNG: Burns are serious health problems and leading causes of mortality and morbidity in the Eastern Mediterranean Region. This study aimed to overview the epidemiological profile and to present outcomes among hospitalized burn patients in AL Alamy burn center in Gaza. METHODS: This was a ...

  15. Early discharge hospital at home.

    Science.gov (United States)

    Gonçalves-Bradley, Daniela C; Iliffe, Steve; Doll, Helen A; Broad, Joanna; Gladman, John; Langhorne, Peter; Richards, Suzanne H; Shepperd, Sasha

    2017-06-26

    Early discharge hospital at home is a service that provides active treatment by healthcare professionals in the patient's home for a condition that otherwise would require acute hospital inpatient care. This is an update of a Cochrane review. To determine the effectiveness and cost of managing patients with early discharge hospital at home compared with inpatient hospital care. We searched the following databases to 9 January 2017: the Cochrane Effective Practice and Organisation of Care Group (EPOC) register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, and EconLit. We searched clinical trials registries. Randomised trials comparing early discharge hospital at home with acute hospital inpatient care for adults. We excluded obstetric, paediatric and mental health hospital at home schemes.   DATA COLLECTION AND ANALYSIS: We followed the standard methodological procedures expected by Cochrane and EPOC. We used the GRADE approach to assess the certainty of the body of evidence for the most important outcomes. We included 32 trials (N = 4746), six of them new for this update, mainly conducted in high-income countries. We judged most of the studies to have a low or unclear risk of bias. The intervention was delivered by hospital outreach services (17 trials), community-based services (11 trials), and was co-ordinated by a hospital-based stroke team or physician in conjunction with community-based services in four trials.Studies recruiting people recovering from strokeEarly discharge hospital at home probably makes little or no difference to mortality at three to six months (risk ratio (RR) 0.92, 95% confidence interval (CI) 0.57 to 1.48, N = 1114, 11 trials, moderate-certainty evidence) and may make little or no difference to the risk of hospital readmission (RR 1.09, 95% CI 0.71 to 1.66, N = 345, 5 trials, low-certainty evidence). Hospital at home may lower the risk of living in institutional setting at six months (RR 0.63, 96% CI

  16. Embarazo adolescente en un Hospital de Paraguay durante el 2011

    OpenAIRE

    Cabañas Acosta, Beatriz Mercedes; Escobar Salinas, Jorge Sebastián

    2016-01-01

    Objetivo: Describir las características epidemiológicas del embarazo adolescente en el Hospital Regional de Coronel Oviedo, Paraguay.Material y Métodos: Estudio observacional descriptivo de corte transversal, con muestreo no probabilístico de casos consecutivos, con revisión de historias clínicas de las embarazadas adolescentes que acudieron al Hospital Regional de Coronel Oviedo, Paraguay entre los meses enero y diciembre del año 2011.Resultados: Se incluyeron 167 historias clínicas de mujer...

  17. Hospital decentralisation in Romania: stakeholders' perspectives in the newsprint media.

    Science.gov (United States)

    Popa, Adela Elena

    2014-01-01

    In the summer of 2010, Romania undertook a process of hospital decentralisation as part of the reform in the healthcare sector. The national newsprint media covered the process thoroughly. This paper is a study of how key stakeholders' views, attitudes, beliefs and attitudes towards decentralisation are represented in print media. 106 articles, published between June and September 2010, retrieved from the online databases of six leading national dailies were analysed. A mixed methodology was used in the data analysis stage. The qualitative data exploration identified five voices belonging to stakeholders involved directly or indirectly in the process: the representatives of central government, the local authorities (district and local councils, municipal mayors), health professionals (managers and physicians in hospitals), the media (journalists, analysts) and finally voices from civil society, professional associations and advocacy groups. These were the main actors negotiating the subjective meanings of the decentralisation process. An imbalance between these key actors were observed in the frequency, content and tone of the messages delivered in media during the four months. Central government and the local authorities were the most active voices, but the respective discourses differed significantly. An analysis of the accounts identified three main themes: the financial problem (hospitals liabilities and future spending), human resource in hospitals (the impact of decentralisation upon it) and the political character of the decentralisation. Copyright © 2013 John Wiley & Sons, Ltd.

  18. National trends in heart failure hospitalization rates in Slovenia 2004-2012.

    Science.gov (United States)

    Omersa, Daniel; Farkas, Jerneja; Erzen, Ivan; Lainscak, Mitja

    2016-11-01

    Heart failure (HF) hospitalization rates are decreasing in western Europe, but little is known about trends in central and east European countries. We analysed the Slovenian national hospitalization database to determine the burden of HF hospitalization. The Slovenian National Hospital Discharge Registry was searched for HF hospitalizations between 2004 and 2012 in patients aged ≥20 years. A total of 55 531 main HF hospitalizations (43 636 first HF hospitalizations) in 34 406 patients (median age 78 years, 55% female) were recorded. The most common co-morbidities were arterial hypertension (54.3%), atrial fibrillation (40.6%), diabetes mellitus (24.5%), and ischaemic heart disease (21.9%). The number of age-standardized main and first HF hospitalizations per 100 000 population decreased from 249 to 232 (7.1%, P = 0.002) and from 467 to 435 (6.8%, P = 0.074), respectively. Crude main and first HF hospitalization rates increased from 249 to 298 (19.8%, P Slovenia, standardized HF hospitalization rates have decreased but the crude HF hospitalization burden has increased. Readmissions were associated with established cardiovascular risk factors. © 2016 The Authors. European Journal of Heart Failure © 2016 European Society of Cardiology.

  19. Outbreak by ventilator-associated ST11 K. pneumoniae with co-production of CTX-M-24 and KPC-2 in SICU of a tertiary teaching hospital in central China

    Directory of Open Access Journals (Sweden)

    Longhua Hu

    2016-08-01

    Full Text Available The emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP often responsible for numerous hospital-associated outbreaks has become an important public health problem. From January 2013 to February 2014, a total of 41 non-duplicate K. pneumoniae isolates with carbapenem resistance, were collected at a tertiary teaching hospital in Nanchang, central China. Among 41 K. pneumoniae isolates, 28 were isolated from hospitalized patients including 19 from the patients in surgery intensive care unit (SICU and 13 were isolated from ventilators. Twenty-four of 28 patients infected by CRKP have been submitted to mechanical ventilation using ventilator. More than 95% of the CRKP isolates were resistant to 13 antimicrobials tested.All CRKP isolates were confirmed as carbapenemase producer and were positive for blaKPC-2, with one positive for both blaKPC-2 and blaNDM-1. All carbapenemase-producing isolates harbored at least one of extended spectrum βlactamase genes tested, among which95.1% (39/41 of the tested isolates were found to harbor both blaCTX-M-24 and blaKPC-2, Of note, one isolate harbored simultaneously two carbapenemase genes (blaKPC-2 and blaNDM-1 and two ESBL genes (blaCTX-M-3 and blaTEM-104 . To the best of our knowledge, coexistence of blaKPC-2 and blaCTX-M-24 in one isolate is first reported. MLST results showed that 41 CRKP isolates belonged to 4 sequence types (STs including ST11, novel ST1854, novel ST1855 and ST1224. PFGE results displayed 3 PFGE clusters. Thirty-eight ST11 CRKP isolates (92.7%, 38/41 including all 13 isolates from ventilators and 25 isolates from patients from 7 wards (18 from是ICU belonged to same PFGE cluster, indicating these isolates were clonally related. Fifteen isolates have an identical undistinguished pattern (100% similarity forming a single clonal population. Moreover, this clone was exclusively linked to the cases attended in SICU and linked to the Ventilators. Additionally, the other SICU cases were

  20. The pattern and presentation of myathenia gravis in Al-Shaab and ...

    African Journals Online (AJOL)

    Introduction: Myasthenia gravis (MG) is the most common acquired autoimmune disorder of neuromuscular transmission. It has different patterns of presentation. Objective: to study the pattern and mode of presentation of Myasthenia Gravis in Al-Shaab and Omdurman Teaching Hospitals, Khartoum Sudan. Methods: The ...

  1. A RETROSPECTIVE ANALYSIS OF ACUTE APPENDICITIS, RUPTURED APPENDICITIS AND THE LEVEL OF LEUKOCYTOSIS IN PAEDIATRIC SURGICAL PATIENTS OF NELSON MANDELA CENTRAL HOSPITAL.

    Science.gov (United States)

    Mtimba, L; Dhaffala, A; Molaoa, S Z

    2017-06-01

    Appendicectomy is the most commonly performed operation worldwide. The diagnosis is predominantly based on clinical findings. Some patients will clinically be unclear if ruptured or acute inflamed appendicitis; the level of white cell count has been used as the predictor for ruptured appendicitis. This was a retrospective chart review of paediatric surgical patients admitted at Nelson Mandela Central Hospital, Mthatha South Africa. A total of 214 patients with a diagnosis of acute appendicitis. Overall, the ruptured appendicitis was 62% and 38% were inflamed appendicitis. Nature of the acute appendicitis: White cell count, Inflamed, Ruptured, Total p-value 30 0 4 4. This study has demonstrated that in patients who are diagnosed with acute appendicitis clinically, the normal white cell count does not necessarily rule out ruptured acute appendicitis. But the risks of ruptured acute appendicitis increase with the increase level of white cell count.

  2. Reinventing the Hospital – A Study of Lost Synergies in Danish Healthcare

    DEFF Research Database (Denmark)

    Bekdik, Baris; Thuesen, Christian

    2016-01-01

    The purpose of this study is to identify the effects of inter organizational relationships in construction projects by investigating how complexities are manifested in variance and repetitions across projects. The case is a set of 27 hospital projects in Denmark including new buildings as well...... project. This lead us to the conclusion that the hospital is reinvented in each project leaving behind unrealized potential for leveraging similarity across the projects. This could have been achieved by a stronger central coordination, thinking of super hospitals as programs and portfolios rather than...

  3. Clinical and radiological characteristics of central pulmonary adenocarcinoma: a comparison with central squamous cell carcinoma and small cell lung cancer and the impact on treatment response

    Directory of Open Access Journals (Sweden)

    Wang Z

    2018-05-01

    Full Text Available Zhe Wang,1,2 Minghuan Li,2 Yong Huang,3 Li Ma,3 Hui Zhu,2 Li Kong,2 Jinming Yu2 1School of Medicine, Shandong University, Jinan, Shandong, China; 2Department of Radiation Oncology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong, China; 3Department of Radiology, Shandong Cancer Hospital Affiliated to Shandong University, Jinan, Shandong, China Purpose: The proportion of central pulmonary adenocarcinoma (ADC in central-type lung cancer has been gradually increasing due to the overall increasing incidence of pulmonary ADC. But the clinical and radiological characteristics of central ADCs remain unclear. In this study, we compared the clinical and radiological characteristics of central ADCs with those of small cell lung cancers (SCLCs and squamous cell carcinomas (SQCCs and investigated the impact of these characteristics on patients’ treatment response. Patients and methods: The medical records of 302 consecutive patients with central lung cancer from July 2014 to September 2016 were retrospectively reviewed. There were 99 patients with ADC, 95 with SQCC and 108 with SCLC. Computed tomography images were interpreted by two radiologists. Treatment response was determined by Response Evaluation Criteria In Solid Tumors 1.1. Results: Univariate analyses found that younger age, female sex, no history of smoking, higher levels of carcinoembryonic antigen (CEA, contralateral hilum lymphadenopathy, contralateral lung metastasis, pleural nodules and pleural metastasis to the interlobular fissure were significantly correlated with central ADC. Multivariate logistic regression analyses revealed that compared with central SQCC, female sex, younger age, no history of smoking, higher levels of CEA and contralateral hilum lymphadenopathy were the significantly independent indicators of central pulmonary ADC. Furthermore, compared with central SCLC, younger age, higher levels of CEA and cytokeratin 19 fragment (Cyfra21-1, lower

  4. Comment on: "Morphotectonic records of neotectonic activity in the vicinity of North Almora Thrust Zone, Central Kumaun Himalaya", by Kothyari et al. 2017, Geomorphology (285), 272-286

    Science.gov (United States)

    Rana, Naresh; Sharma, Shubhra

    2018-01-01

    The recent paper by Kothyari et al. (2017) suggests that the North Almora Thrust (NAT) and a few subsidiary faults in the central Lesser Himalaya were active during the late Quaternary and Holocene. Considering that in the Indian Summer Monsoon (ISM) dominated and tectonically active central Himalaya, the landscape owes their genesis to a coupling between the tectonics and climate. The present study would have been a good contribution toward improving our understanding on this important topic. Unfortunately, the inferences drawn by the authors are based on inadequate/vague field observations, supported by misquoted references, which reflects their poor understanding of the geomorphic processes. For example, authors implicate tectonics in the landform evolution without providing an argument to negate the role of climate (ISM). In view of this, the above contribution does not add anything substantial in improving our existing knowledge of climate-tectonic interaction in landform evolution. On the contrary, if the above publication is not questioned for its scientific merit, it may create enormous confusion and proliferation of wrong scientific data and inferences.

  5. Use of biomarkers in ALS drug development and clinical trials.

    Science.gov (United States)

    Bakkar, Nadine; Boehringer, Ashley; Bowser, Robert

    2015-05-14

    The past decade has seen a dramatic increase in the discovery of candidate biomarkers for ALS. These biomarkers typically can either differentiate ALS from control subjects or predict disease course (slow versus fast progression). At the same time, late-stage clinical trials for ALS have failed to generate improved drug treatments for ALS patients. Incorporation of biomarkers into the ALS drug development pipeline and the use of biologic and/or imaging biomarkers in early- and late-stage ALS clinical trials have been absent and only recently pursued in early-phase clinical trials. Further clinical research studies are needed to validate biomarkers for disease progression and develop biomarkers that can help determine that a drug has reached its target within the central nervous system. In this review we summarize recent progress in biomarkers across ALS model systems and patient population, and highlight continued research directions for biomarkers that stratify the patient population to enrich for patients that may best respond to a drug candidate, monitor disease progression and track drug responses in clinical trials. It is crucial that we further develop and validate ALS biomarkers and incorporate these biomarkers into the ALS drug development process. This article is part of a Special Issue entitled ALS complex pathogenesis. Copyright © 2014 Elsevier B.V. All rights reserved.

  6. Encuadrando corazones: el encuadre arteterapeutico en el hospital infantil

    OpenAIRE

    Cock Moncada, Adriana

    2013-01-01

    El presente trabajo de investigación, pretende reflexionar acerca de las dificultades que existen al interior de un hospital infantil para establecer un encuadre arteterapéutico adecuado. Así mismo, trata de dar cuenta de los ajustes que se pueden realizar en la intervención arteterapéutica con relación al encuadre, para conseguir crear un espacio de creatividad saludable que ayude a mejorar la calidad de vida de los niños y niñas hospitalizados. Finalmente, intenta arrojar una luz para futur...

  7. Portable Sleep Monitoring for Diagnosing Sleep Apnea in Hospitalized Patients With Heart Failure.

    Science.gov (United States)

    Aurora, R Nisha; Patil, Susheel P; Punjabi, Naresh M

    2018-04-21

    Sleep apnea is an underdiagnosed condition in patients with heart failure. Efficient identification of sleep apnea is needed, as treatment may improve heart failure-related outcomes. Currently, use of portable sleep monitoring in hospitalized patients and those at risk for central sleep apnea is discouraged. This study examined whether portable sleep monitoring with respiratory polygraphy can accurately diagnose sleep apnea in patients hospitalized with decompensated heart failure. Hospitalized patients with decompensated heart failure underwent concurrent respiratory polygraphy and polysomnography. Both recordings were scored for obstructive and central disordered breathing events in a blinded fashion, using standard criteria, and the apnea-hypopnea index (AHI) was determined. Pearson's correlation coefficients and Bland-Altman plots were used to examine the concordance among the overall, obstructive, and central AHI values derived by respiratory polygraphy and polysomnography. The sample consisted of 53 patients (47% women) with a mean age of 59.0 years. The correlation coefficient for the overall AHI from the two diagnostic methods was 0.94 (95% CI, 0.89-0.96). The average difference in AHI between the two methods was 3.6 events/h. Analyses of the central and obstructive AHI values showed strong concordance between the two methods, with correlation coefficients of 0.98 (95% CI, 0.96-0.99) and 0.91 (95% CI, 0.84-0.95), respectively. Complete agreement in the classification of sleep apnea severity between the two methods was seen in 89% of the sample. Portable sleep monitoring can accurately diagnose sleep apnea in hospitalized patients with heart failure and may promote early initiation of treatment. Copyright © 2018 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  8. Centralized vs. Decentralized Nursing Stations: An Evaluation of the Implications of Communication Technologies in Healthcare.

    Science.gov (United States)

    Bayramzadeh, Sara; Alkazemi, Mariam F

    2014-01-01

    This study aims to explore the relationship between the nursing station design and use of communication technologies by comparing centralized and decentralized nursing stations. The rapid changes in communication technologies in healthcare are inevitable. Communication methods can change the way occupants use a space. In the meantime, decentralized nursing stations are emerging as a replacement for the traditional centralized nursing stations; however, not much research has been done on how the design of nursing stations can impact the use of communication technologies. A cross sectional study was conducted using an Internet-based survey among registered nurses in a Southeastern hospital in the United States. Two units with centralized nursing stations and two units with decentralized nursing stations were compared in terms of the application of communication technologies. A total of 70 registered nurses completed the survey in a 2-week period. The results revealed no significant differences between centralized and decentralized nursing stations in terms of frequency of communication technologies used. However, a difference was found between perception of nurses toward communication technologies and perceptions of the use of communication technologies in decentralized nursing stations. Although the study was limited to one hospital, the results indicate that nurses hold positive attitudes toward communication technologies. The results also reveal the strengths and weaknesses of each nursing station design with regard to communication technologies. Hospital, interdisciplinary, nursing, technology, work environment.

  9. The association of debt financing with not-for-profit hospitals' provision of uncompensated care.

    Science.gov (United States)

    Magnus, Stephen A; Smith, Dean G; Wheeler, John R C

    2004-01-01

    Not-for-profit hospitals undertook unprecedented amounts of debt in the mid to late 1990s. Corporate finance theory and the literature on hospital financing suggest that debt may constrain hospitals' capacity to deliver uncompensated care. Using data from audited financial statements for a sample of hospitals, this article explores whether debt financing is associated with hospitals' provision of uncompensated care, an output central to many hospitals' service missions. Contrary to expectations, our analysis finds that higher debt is associated with higher levels of uncompensated care. However, the results may reflect the unusual economic and stock-market conditions prevailing in the mid 1990s, and they are consistent with the views of hospital financial managers and other practitioners whom we interviewed.

  10. Pattern and Management of Priapism in a Tertiary Hospital of North ...

    African Journals Online (AJOL)

    ADMIN

    COSECSA/ASEA Publication --East & Central African Journal of Surgery 2017; Vol. 22 (1) ... Hospital of North- Western Nigeria ... In Western world, ischaemic priapism is .... This difference can be accounted for by the late presentation in.

  11. Factors driving physician-hospital alignment in orthopaedic surgery.

    Science.gov (United States)

    Page, Alexandra E; Butler, Craig A; Bozic, Kevin J

    2013-06-01

    The relationships between physicians and hospitals are viewed as central to the proposition of delivering high-quality health care at a sustainable cost. Over the last two decades, major changes in the scope, breadth, and complexities of these relationships have emerged. Despite understanding the need for physician-hospital alignment, identification and understanding the incentives and drivers of alignment prove challenging. Our review identifies the primary drivers of physician alignment with hospitals from both the physician and hospital perspectives. Further, we assess the drivers more specific to motivating orthopaedic surgeons to align with hospitals. We performed a comprehensive literature review from 1992 to March 2012 to evaluate published studies and opinions on the issues surrounding physician-hospital alignment. Literature searches were performed in both MEDLINE(®) and Health Business™ Elite. Available literature identifies economic and regulatory shifts in health care and cultural factors as primary drivers of physician-hospital alignment. Specific to orthopaedics, factors driving alignment include the profitability of orthopaedic service lines, the expense of implants, and issues surrounding ambulatory surgery centers and other ancillary services. Evolving healthcare delivery and payment reforms promote increased collaboration between physicians and hospitals. While economic incentives and increasing regulatory demands provide the strongest drivers, cultural changes including physician leadership and changing expectations of work-life balance must be considered when pursuing successful alignment models. Physicians and hospitals view each other as critical to achieving lower-cost, higher-quality health care.

  12. Central African Journal of Medicine - Vol 61, No 1-4 (2015)

    African Journals Online (AJOL)

    Etiology and risk factors of meningitis in patients admitted at a Central Hospital ... rupture of the Achilles tendon in a rat model · EMAIL FULL TEXT EMAIL FULL TEXT ... An echocardiography audit to determine and characterise rheumatic heart ...

  13. Tuberculosis patients hospitalized in the Albert Schweitzer Hospital, Lambaréné, Gabon-a retrospective observational study.

    Science.gov (United States)

    Stolp, S M; Huson, M A M; Janssen, S; Beyeme, J O; Grobusch, M P

    2013-11-01

    Epidemiological data on tuberculosis in Central Africa are limited. We performed a retrospective observational study on clinical characteristics of 719 hospitalized tuberculosis patients in Lambaréné, Gabon. Human immunodeficiency virus (HIV) co-infection rate was high (34%) and in-hospital mortality was significantly higher in HIV-positive patients (10% versus 2%). Long-term information on patient outcome was limited; however, from 2008 to 2011, loss to follow up was noted in 28% of cases. Our data illustrate the high burden of TB in Gabon, where loss to follow up and emerging drug resistance are important problems for which comprehensive data are still lacking. © 2013 The Authors Clinical Microbiology and Infection © 2013 European Society of Clinical Microbiology and Infectious Diseases.

  14. Evaluation of Etiology and Treatment Methods for Epistaxis: A Review at a Tertiary Care Hospital in Central Nepal

    Science.gov (United States)

    2015-01-01

    Introduction. Epistaxis is one of the most common emergencies in Otorhinolaryngology. It is usually managed with simple conservative measures but occasionally it is a life threatening condition. Identification of the cause is important, as it reflects the management plan being followed. Aims and Objectives. To analyze the etiology and treatment methods for patients with epistaxis. Methods. A retrospective study was done in a tertiary care hospital in central Nepal. The study period was from May 2014 to April 2015. Results. A total of 84 patients had epistaxis; 52 were males and 32 were females. The most common cause of epistaxis was idiopathic (38.09%) followed by hypertension (27.38%), trauma (15.47%), and coagulopathy (8.33%). Regarding treatment methods, most (52.38%) of our patients required anterior nasal packing. Chemical cautery was sufficient to stop bleeding in 14.28% of patients while electrocautery and posterior nasal packing were performed in 2.38% and 16.66% patients, respectively. Two (2.38%) patients required endoscopic sphenopalatine arterial ligation. Conclusion. Hypertension, trauma and coagulopathy were the most common etiological factors among the patients in whom etiology was found although in most of the patients etiology could not be found. Anterior nasal packing was the most common treatment method applied to these patients. PMID:26346242

  15. Evaluation of Etiology and Treatment Methods for Epistaxis: A Review at a Tertiary Care Hospital in Central Nepal.

    Science.gov (United States)

    Parajuli, Ramesh

    2015-01-01

    Introduction. Epistaxis is one of the most common emergencies in Otorhinolaryngology. It is usually managed with simple conservative measures but occasionally it is a life threatening condition. Identification of the cause is important, as it reflects the management plan being followed. Aims and Objectives. To analyze the etiology and treatment methods for patients with epistaxis. Methods. A retrospective study was done in a tertiary care hospital in central Nepal. The study period was from May 2014 to April 2015. Results. A total of 84 patients had epistaxis; 52 were males and 32 were females. The most common cause of epistaxis was idiopathic (38.09%) followed by hypertension (27.38%), trauma (15.47%), and coagulopathy (8.33%). Regarding treatment methods, most (52.38%) of our patients required anterior nasal packing. Chemical cautery was sufficient to stop bleeding in 14.28% of patients while electrocautery and posterior nasal packing were performed in 2.38% and 16.66% patients, respectively. Two (2.38%) patients required endoscopic sphenopalatine arterial ligation. Conclusion. Hypertension, trauma and coagulopathy were the most common etiological factors among the patients in whom etiology was found although in most of the patients etiology could not be found. Anterior nasal packing was the most common treatment method applied to these patients.

  16. Evaluation of Etiology and Treatment Methods for Epistaxis: A Review at a Tertiary Care Hospital in Central Nepal

    Directory of Open Access Journals (Sweden)

    Ramesh Parajuli

    2015-01-01

    Full Text Available Introduction. Epistaxis is one of the most common emergencies in Otorhinolaryngology. It is usually managed with simple conservative measures but occasionally it is a life threatening condition. Identification of the cause is important, as it reflects the management plan being followed. Aims and Objectives. To analyze the etiology and treatment methods for patients with epistaxis. Methods. A retrospective study was done in a tertiary care hospital in central Nepal. The study period was from May 2014 to April 2015. Results. A total of 84 patients had epistaxis; 52 were males and 32 were females. The most common cause of epistaxis was idiopathic (38.09% followed by hypertension (27.38%, trauma (15.47%, and coagulopathy (8.33%. Regarding treatment methods, most (52.38% of our patients required anterior nasal packing. Chemical cautery was sufficient to stop bleeding in 14.28% of patients while electrocautery and posterior nasal packing were performed in 2.38% and 16.66% patients, respectively. Two (2.38% patients required endoscopic sphenopalatine arterial ligation. Conclusion. Hypertension, trauma and coagulopathy were the most common etiological factors among the patients in whom etiology was found although in most of the patients etiology could not be found. Anterior nasal packing was the most common treatment method applied to these patients.

  17. Análise da satisfação dos usuários de um hospital privado Análisis de satisfacción de los usuarios de un hospital privado Assessment levels of the user's satisfaction in a private hospital

    Directory of Open Access Journals (Sweden)

    Wilma Batista Souza da Cruz

    2010-03-01

    Full Text Available Trata-se de um estudo exploratório-descritivo de abordagem quantitativa, cujo objetivo foi analisar a satisfação dos usuários referente aos serviços prestados em unidades de internação. O local da investigação foi um hospital privado do Município de São Paulo, e a amostra constituiu-se de 71 usuários. A coleta de dados ocorreu de março a agosto de 2007, por meio de um instrumento derivado da escala Service Quality do modelo avaliativo de Parasuraman et al. O nível de satisfação geral oscilou em torno de 95%, sendo garantia (96% e confiabilidade (96% as dimensões de maior relevância, seguidas da empatia (95%, responsividade (93% e tangibilidade (88%. As equipes médica e de enfermagem apresentaram maiores níveis de satisfação, e 91% dos usuários demonstraram intenção de indicar o hospital. Esta pesquisa permitiu conhecer os atributos intervenientes na satisfação dos usuários da referida instituição, contribuindo para confirmar ou reformular os processos assistenciais e gerenciais.Se trata de un estudio exploratorio descriptivo, de abordaje cuantitativo, cuyo objetivo fue analizar la satisfacción de los usuarios respecto de los servicios prestados en unidades de internación. El trabajo se localizó en un hospital privado del Municipio de São Paulo, Brasil, y la muestra consistió en 71 usuarios. La recopilación de datos se realizó entre marzo y agosto de 2007, a través de un instrumento derivado de la escala Service Quality del modelo evaluativo de Parasuraman et al. El nivel de satisfacción general osciló en torno al 95%, resultando garantía (96% y confiabilidad (96% las dimensiones de mayor relevancia, seguidas de empatía (95%, responsividad (93% y tangibilidad (88%. Los equipos médicos y de enfermería presentaron mayores niveles de satisfacción, y el 91% de los usuarios manifestaron intenciones de recomendar al hospital. Esta investigación permitió conocer los atributos que hacen a la satisfacción de

  18. Place and role of multifield hospital in teaching program on surgery for students

    Directory of Open Access Journals (Sweden)

    A. V. Kapshytar

    2013-08-01

    Full Text Available Present time is characterized by increase of dynamics of world and social development, introduction of ECTS (European Credit Transfer System [Andrushchenko V. P. at al. 2007; Pertseva T. O. at al. 2008]. Features of new information technologies and forms of educational process dictate need of active introduction of the principles of evidential medicine [Pidayev A. Century at al. 2004; Pishak at al. 2005; Bereznitsky Y. S. at al. 2006]. Thus the main postulate of the Bologna declaration is providing adequate material level of educational base where the training program is implemented in the hospital [Desyaterik V.I. 2008]. Research objective: to determine place and role of multifield clinical base in student’s teaching “General surgery”. Material and research methods. The chair of the general surgery with care of the patients, located in the Community organization “City clinical hospital urgent and an emergency medical service” based in 3 abdominal surgical departments. The hospital has totally 10 surgical departments of a various profile which are the specialized centers and bases of chairs of urology and medicine of accidents, military medicine, anesthesiology and resuscitation. Results of research. Students under the supervision of the teacher visit departments in the hospital and achieve practical skills according to subject goals, make the acquaintance of structure of surgical departments, desmurgy, an asepsis and antiseptics, anesthesia, participate in primary surgical processing of wounds, a bleeding stop, reposition of changes and dislocations, imposing of plaster bandages, imposing or removal of spoke and rod devices, performance of drainage. Big importance has studying of nosological forms is purulent - septic diseases of skin and hypoderma, chronic specific and nonspecific surgical infection, an necrosis, sepsis, tumors and anomalies of development, etc. Wreath of an educational program, the General surgery is writing of the

  19. HOW COULD HOSPITALS ACT IN AN AGEING SOCIETY?

    Directory of Open Access Journals (Sweden)

    Leuca Mirela

    2011-12-01

    Full Text Available The demographic changes are of great importance for all European societies. Their impact and effects have multiple, deep facets. Each European healthcare and welfare system will be facing considerable changes in the new demographic context. The hospital sector plays an important role in each health system. This paper focuses on the impact of the demographic changes on hospitals, presents and analyzes statistical data for the German hospitals sector in order to underline the importance of the older age groups for the number of the hospital inpatient cases, the provided range of medical services and disciplines and for the hospital disease costs. The paper also reveals main findings from 30 interviews conducted in 2010 with German health experts (from hospitals, health insurance companies, universities, institutes and regional healthcare policy makers that accepted to answer questions referring to the demographic impact on the German healthcare system and hospital sector. The results of the interviews show that hospitals will have to act and react to the demographic changes. German hospitals might play different roles in the healthcare service provision for older people when engaging in new models of integrated care that will have to be developed. Processes, structures, human resources expertise, hospital service provision and medical departments will undergo major changes in response to the demographic challenges. Networks, centres of excellence for older persons and integrated care will probably be indispensable structures of the German healthcare system in the future. Strategic partnerships with pre- and post-hospital healthcare service providers are considered to be top priorities for German hospitals when facing the demographic challenge. Central case management and process optimization can be essential factors of success in the hospital care of the older, multimorbid patients. Acute geriatric medicine will be a main quality feature for the

  20. Tipologías de cuarzo como indicadores de la procedencia en areniscas: excepciones al método de Basu et al. (1975

    Directory of Open Access Journals (Sweden)

    Arribas, J.

    1988-12-01

    Full Text Available In this study we have analized the content of the different detrital quartz types (Basu et al., 1975 in recent sands derived from single source areas (granitic, gneissic and slate-schists lithologies in the Sistema Central. Following the methodology of Basu et al (1975, for sand provenance interpretation, we have observed Ibat, in these deposits, the content of monocrystaline quartz types is not useful to discriminate plutonic and high rank metamorphic sources. However, we can confirm the validity of the policrystaline types content to distinguish sands of low rank metamorphic parentage.En el presente trabajo se analiza el contenido de las distintas tipologías de cuarzo, definidas por Basu et al. (1975 para análisis de procedencia, en depósitos arenosos actuales, generados a partir de macizos del Sistema Central con distintas litologías (granitos, gneises, pizarras-esquistos. Aplicando la metodología de dichos autores se observa que, para los depósitos estudiados, pierde validez para discriminar áreas de procedencia plutónica y metamórfica de alto grado en función del contenido en las tipologías monocristalinas. No obstante, se corrobora la utilidad del contenido en las tipologías policristalinas para diferenciar áreas metamórficas de bajo grado.

  1. The market for hospital medicine in Denmark

    Directory of Open Access Journals (Sweden)

    Gisela Hostenkamp

    2011-11-01

    Full Text Available Pharmaceutical expenditure growth has outpaced GDP and healthcare expenditure growth rates in Denmark as in most OECD countries for the last decade. A major part of this increase was due to high growth rates in specialist areas that are typically located in hospital settings. Yet the market for hospital medicines and their procurement are still poorly understood. The present paper characterises the market for hospital medicines in Denmark in terms of its organisation and developments between 2005 and 2009. In Denmark hospital medicines are publicly financed and procurement is centrally organised. 98% of all medicines administered at Danish public hospitals are purchased through a public procurement agency by means of public tenders. Using data on actual contract prices we decompose pharmaceutical expenditure growth into the contributions from newly introduced medicines, price and volume increases and use summary statistics to compare market performance in both sectors. The market for hospital medicine is more concentrated than the pharmaceutical retail sector and the share of generics and parallel imported products is significantly lower. Between 2005 and 2009 expenditures for hospital medicines more than doubled -accounting for almost 40% of the total Danish pharmaceutical market in 2009. Price increases however - although positive and higher than in the pharmaceutical retail sector - were only moderate. The majority of the expenditure growth was due to an increase in utilisation and the introduction of new medicines in the hospital sector. Centralised tendering may therefore have important implications for competition and industry structure in the long run.

  2. Using central venous catheter for suprapubic catheterization in cardiac surgery

    Directory of Open Access Journals (Sweden)

    Bilehjani E

    2017-01-01

    Full Text Available Eissa Bilehjani,1 Solmaz Fakhari2 1Department of Cardiovascular Anesthesia, Tabriz University of Medical Sciences, Madani Heart Hospital, 2Department of Anesthesiology, Tabriz University of Medical Sciences, Madani Heart Hospital, Tabriz, Iran Abstract: Suprapubic catheterization is an alternative method for urinary drainage that is used when transurethral catheterization fails. Traditionally, inserted large-bore suprapubic catheters may cause fatal complications. During the past decade, we used a small central venous catheter (CVC suprapubicly in 16 male patients for the purpose of urinary drainage, when transurethral catheterization failed. The procedure is performed in no more than 10 minutes. Success rate was 100% and this approach did not lead to any complications. In conclusion, placing a CVC for suprapubic drainage is a safe method with a high success rate and we recommend it in patients with failed transurethral catheterization after a few attempts (2–3 attempts. Keywords: suprapubic catheterization complication, urethral catheterization, central venous catheter, Seldinger’s technique, cardiac surgery

  3. Landscape and Early Farming Settlement Dynamics in Central Greece

    DEFF Research Database (Denmark)

    Sarri, Kalliopi; Bintliff, John; Farinetti, Emeri

    2006-01-01

    also small, short-lived farms; both were associated withwetland hand cultivation. In later Neolithic and Early Bronze Age times, these locationsremained, but vestigial traces discovered by hyperintensive survey methods have identified anexplosion of small, short-lived, and horizontally migrating farms......Current hyperintensive surface survey in the Tanagra district of Boeotia, central Greece (J. L.Bintliff et al., 2002), together with a recent reanalysis of survey results from the Thespiae dis-trict (J. L. Bintliff et al., 1999), have led to a radical rethinking of how and where early farm...

  4. The Use of the Peripherally Inserted Central Catheter (Picc in the Hospital Environment La utilización del catéter central de inserción periférica (CCIP en el ambiente hospitalario A utilização do cateter central de inserção periférica (CCIP no ambiente hospitalar

    Directory of Open Access Journals (Sweden)

    Graziella Gasparotto Baiocco

    2010-12-01

    Full Text Available The study aimed to analyze the history of the use of the peripherally inserted central catheters in adult patients admitted to hospital from 2000 to 2007. The historical cohort approach was used with retrospective data collection from medical records of the Catheter Group of the Moinhos de Vento Hospital Association in Porto Alegre, RS, totaling 229 catheters inserted. The growth curve in the use of the PICC was from 1 catheter inserted in 2000 to 57 in 2007. The most prevalent pathology was oncology (17.9%, n=41. In relation to the indications of use, antibiotic use prevailed (54.1%, n=124. In the radiological confirmation the vena cava was prevalent (68.1%, n=156. The use of the PICC in the hospital environment is expanding and nursing has a fundamental role in its insertion, maintenance and removal.El estudio objetivó analizar el histórico de la utilización del catéter central de inserción periférica en pacientes adultos e internados en ambiente hospitalario de 2000 a 2007. Tuvo abordaje de cohorte histórico con recolección de datos retrospectivo en fichas del Grupo de Catéteres de la Asociación Hospitalaria Molinos de Viento en Porto Alegre, RS, totalizando 229 catéteres inseridos. La curva de crecimiento en la utilización del CCIP fue de 1 catéter inserido en 2000 a 57 inseridos en 2007. La prevalencia inherente a la patología fue oncológica (17,9%, n=41. En relación a las indicaciones de uso prevaleció la terapia con antibióticos (54,1%, n=124. En la confirmación radiológica la vena cava fue prevalente (68,1%, n=156. La utilización del CCIP en el ambiente hospitalario está en expansión y la enfermería tiene un papel fundamental en la inserción, manutención y remoción.O estudo objetivou analisar o histórico da utilização do cateter central de inserção periférica em pacientes adultos e internados, em ambiente hospitalar, de 2000 a 2007. Teve abordagem de coorte histórica, com coleta de dados retrospectiva em

  5. Varicella-related Primary Health-care Visits, Hospitalizations and Mortality in Norway, 2008-2014.

    Science.gov (United States)

    Mirinaviciute, Grazina; Kristensen, Erle; Nakstad, Britt; Flem, Elmira

    2017-11-01

    Norway does not currently implement universal varicella vaccination in childhood. We aimed to characterize health care burden of varicella in Norway in the prevaccine era. We linked individual patient data from different national registries to examine varicella vaccinations and varicella-coded primary care consultations, hospitalizations, outpatient hospital visits, deaths and viral infections of central nervous system in the whole population of Norway during 2008-2014. We estimated health care contact rates and described the epidemiology of medically attended varicella infection. Each year approximately 14,600 varicella-related contacts occurred within primary health care and hospital sector in Norway. The annual contact rate was 221 cases per 100,000 population in primary health care and 7.3 cases per 100,000 in hospital care. Both in primary and hospital care, the highest incidences were observed among children 1 year of age: 2,654 and 78.1 cases per 100,000, respectively. The annual varicella mortality was estimated at 0.06 deaths per 100,000 and in-hospital case-fatality rate at 0.3%. Very few (0.2-0.5%) patients were vaccinated against varicella. Among hospitalized varicella patients, 22% had predisposing conditions, 9% had severe-to-very severe comorbidities and 5.5% were immunocompromised. Varicella-related complications were reported in 29.3% of hospitalized patients. Varicella zoster virus was the third most frequent virus found among 16% of patients with confirmed viral infections of central nervous system. Varicella causes a considerable health care burden in Norway, especially among children. To inform the policy decision on the use of varicella vaccination, a health economic assessment of vaccination and mathematical modeling of vaccination impact are needed.

  6. The Hospital de Santiago in Cuenca: an institution with 800 years history

    Directory of Open Access Journals (Sweden)

    Julián Solís García del Pozo

    2018-04-01

    Full Text Available The Hospital de Santiago in the city of Cuenca is one of the Spanish healthcare institutions that has maintained its activity for a longer time. Initially, this hospital was an institution for the redemption of captives in a border area of the kingdom of Castile with Al-Andalus, later it functioned as a hospital for the sick poor, maintaining its assistance activity despite the different destructions that the building has gone throughout its history. Currently, the hospital is a geriatric residence. Historical studies on hospitals have extended their scope of action, leaving the particular scope of institutional functioning and entering into areas as the hospital's relationship with the political, religious, social and economic environment. From this point of view, the hospital in Cuenca is still a little-explored ground to study these relationships in a city in interior Spain during a large part of the historical stages it has gone through, and especially from the Modern Age.

  7. Centrality Robustness and Link Prediction in Complex Social Networks

    DEFF Research Database (Denmark)

    Davidsen, Søren Atmakuri; Ortiz-Arroyo, Daniel

    2012-01-01

    . Secondly, we present a method to predict edges in dynamic social networks. Our experimental results indicate that the robustness of the centrality measures applied to more realistic social networks follows a predictable pattern and that the use of temporal statistics could improve the accuracy achieved......This chapter addresses two important issues in social network analysis that involve uncertainty. Firstly, we present am analysis on the robustness of centrality measures that extend the work presented in Borgati et al. using three types of complex network structures and one real social network...

  8. The effect of centralization of health care services on travel time and its equality.

    Science.gov (United States)

    Kobayashi, Daisuke; Otsubo, Tetsuya; Imanaka, Yuichi

    2015-03-01

    To analyze the regional variations in travel time between patient residences and medical facilities for the treatment of ischemic heart disease and breast cancer, and to simulate the effects of health care services centralization on travel time and equality of access. We used medical insurance claims data for inpatients and outpatients for the two target diseases that had been filed between September 2008 and May 2009 in Kyoto Prefecture, Japan. Using a geographical information system, patient travel times were calculated based on the driving distance between patient residences and hospitals via highways and toll roads. Locations of residences and hospital locations were identified using postal codes. We then conducted a simulation analysis of centralization of health care services to designated regional core hospitals. The simulated changes in potential spatial access to care were examined. Inequalities in access to care were examined using Gini coefficients, which ranged from 0.4109 to 0.4574. Simulations of health care services centralization showed reduced travel time for most patients and overall improvements in equality of access, except in breast cancer outpatients. Our findings may contribute to the decision-making process in policies aimed at improving the potential spatial access to health care services. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. The mission of the well-managed community hospital.

    Science.gov (United States)

    Griffith, J R

    1988-07-01

    The well-managed community hospital as an organization is in dynamic equilibrium with its geographic community and with other communities providing finance, physicians, nurses, other professionals and resources necessary to meet local health care needs. The hospital is "well-managed" when it develops an equilibrium that permits all of its various constituencies to be satisfied. Growth in market share results from good management. The hospital's ability to attract and satisfy the needs of health care professionals while simultaneously meeting the needs of patients and their families at competitive prices allows it to flourish. Its financial success allows it to reward its medical staff and employees in ways that attract the best of each work group. A central problem in achieving good management is communication. Hospitals must communicate their goals convincingly to a large number of doctors and employees. "The Well-Managed Community Hospital," winner of the James A. Hamilton Hospital Administration Book Award, argues that a well-structured mission statement is the essential first step in the communications process. According to the book, final responsibility for the mission statement lies with the governing board and is one of five non-delegable functions of the board. The nature of the mission setting function as described in the book follows.

  10. Learning to deal with psychosocial strains at hospitals

    DEFF Research Database (Denmark)

    Hvid, Helge Søndergaard; Hagedorn-Rasmussen, Peter; Lund, Henrik Lambrecht

    This paper examines the psychosocial work environment in the hospital sector from a learning perspective. The paper is based on case studies in the Danish hospital system, characterized by professionalism, centralized management and constant organizational change. In all cases, the psychosocial...... and employees in the individual departments must learn to cope with the stress imposed. Learning-related concepts are found to be suitable for analysing how they actually do cope locally. However, these concepts not only pave the way for an analysis. They also open for reflection, interpretations and learning...... at the work site as a result of the incremental practice intervention. This might have a positive effect in reducing psychosocial stress. The paper focuses on one of the cases – a specialized hospital section with approx. 400 employees. It is investigated how learning-related activities, studied through three...

  11. East and Central African Journal of Surgery http://www.bioline.org.br ...

    African Journals Online (AJOL)

    Patrick

    populations in Asia, far-east, and North America. By far reported cases ... Zomba Central hospital with long standing history of a giant scalp cutenous horn for about 28 years .Excision ... educative pathologies goes under reported. Case Report.

  12. Risk factors for common cancers among patients at Kamuzu Central ...

    African Journals Online (AJOL)

    Background: Little is known about risk factors for different cancers in Malawi. This study aimed to assess risk factors for and epidemiologic patterns of common cancers among patients treated at Kamuzu Central Hospital (KCH) in Lilongwe, and to determine the prevalence of Human Immunodeficiency Virus (HIV) infection in ...

  13. Relationship between organizational structure and creativity in teaching hospitals.

    Science.gov (United States)

    Rezaee, Rita; Marhamati, Saadat; Nabeiei, Parisa; Marhamati, Raheleh

    2014-07-01

    Organization structure and manpower constitute two basic components of anorganization and both are necessary for stablishing an organization. The aim of this survey was to investigate the type of the organization structure (mechanic and organic) from viewpoint of senior and junior managers in Shiraz teaching hospitals and creativity in each of these two structures. In this cross-sectional and descriptive-analytic study, organization structure and organizational creation questionnaires were filled out by hospital managers. According to the statistical consultation and due to limited target population, the entire study population was considered as sample. Thus, the sample size in this study was 84 (12 hospitals and every hospital, n = 7). For data analysis, SPSS 14 was used and Spearman correlation coefficient and t-test were used. RESULTS showed that there is a negative association between centralization and complexity with organizational creation and its dimensions. Also there was a negative association between formalization and 4 organizational creation dimensions: reception change, accepting ambiguity, abet new view and less control outside (p=0.001). The results of this study showed that the creation in hospitals with organic structure is more than that in hospitals with mechanic structure.

  14. Construction and Application of a Refined Hospital Management Chain.

    Science.gov (United States)

    Yi, Lihua; Hao, Aimin; Hu, Minmin; Huang, Pei; Yuan, Huikang; Xing, Ming

    2015-05-01

    Gaining large scale success was quite common in the later period of industrialization for hospitals in China. Today, Chinese hospital management face such problems as service inefficiency, high human resources cost, and low rate of capital use. This study analyzes the refined management chain of the Wuxi No. 2 People's Hospital. This consists of six gears namely "organizational structure, clinical practice, outpatient service, medical technology, and nursing care and logistics" used to achieve maximum scale and benefits. The gears are based on "flat management system targets, chief of medical staff, centralized outpatient service, intensified medical examinations, vertical nursing management and socialized logistics". The hospital took innovative measures. The "one doctor-one patient-one clinic" was well accepted; "one dispensary" shorten the waiting time by 20 min. The 168 rear service hot line "made patients' lives easier; and a red wrist ribbon" for seriously ill patient was implemented to prioritize medical treatment. The core concepts of refined hospital management are optimizing flow process, reducing waste, improving efficiency, saving costs, and taking good care of patients as most important.

  15. Etiologic agents of central nervous system infections among febrile hospitalized patients in the country of Georgia.

    Directory of Open Access Journals (Sweden)

    Tamar Akhvlediani

    Full Text Available OBJECTIVES: There is a large spectrum of viral, bacterial, fungal, and prion pathogens that cause central nervous system (CNS infections. As such, identification of the etiological agent requires multiple laboratory tests and accurate diagnosis requires clinical and epidemiological information. This hospital-based study aimed to determine the main causes of acute meningitis and encephalitis and enhance laboratory capacity for CNS infection diagnosis. METHODS: Children and adults patients clinically diagnosed with meningitis or encephalitis were enrolled at four reference health centers. Cerebrospinal fluid (CSF was collected for bacterial culture, and in-house and multiplex RT-PCR testing was conducted for herpes simplex virus (HSV types 1 and 2, mumps virus, enterovirus, varicella zoster virus (VZV, Streptococcus pneumoniae, HiB and Neisseria meningitidis. RESULTS: Out of 140 enrolled patients, the mean age was 23.9 years, and 58% were children. Bacterial or viral etiologies were determined in 51% of patients. Five Streptococcus pneumoniae cultures were isolated from CSF. Based on in-house PCR analysis, 25 patients were positive for S. pneumoniae, 6 for N. meningitidis, and 1 for H. influenzae. Viral multiplex PCR identified infections with enterovirus (n = 26, VZV (n = 4, and HSV-1 (n = 2. No patient was positive for mumps or HSV-2. CONCLUSIONS: Study findings indicate that S. pneumoniae and enteroviruses are the main etiologies in this patient cohort. The utility of molecular diagnostics for pathogen identification combined with the knowledge provided by the investigation may improve health outcomes of CNS infection cases in Georgia.

  16. Etiologic Agents of Central Nervous System Infections among Febrile Hospitalized Patients in the Country of Georgia

    Science.gov (United States)

    Akhvlediani, Tamar; Bautista, Christian T.; Shakarishvili, Roman; Tsertsvadze, Tengiz; Imnadze, Paata; Tatishvili, Nana; Davitashvili, Tamar; Samkharadze, Tamar; Chlikadze, Rusudan; Dvali, Natia; Dzigua, Lela; Karchava, Mariam; Gatserelia, Lana; Macharashvili, Nino; Kvirkvelia, Nana; Habashy, Engy Emil; Farrell, Margaret; Rowlinson, Emily; Sejvar, James; Hepburn, Matthew; Pimentel, Guillermo; Dueger, Erica; House, Brent; Rivard, Robert

    2014-01-01

    Objectives There is a large spectrum of viral, bacterial, fungal, and prion pathogens that cause central nervous system (CNS) infections. As such, identification of the etiological agent requires multiple laboratory tests and accurate diagnosis requires clinical and epidemiological information. This hospital-based study aimed to determine the main causes of acute meningitis and encephalitis and enhance laboratory capacity for CNS infection diagnosis. Methods Children and adults patients clinically diagnosed with meningitis or encephalitis were enrolled at four reference health centers. Cerebrospinal fluid (CSF) was collected for bacterial culture, and in-house and multiplex RT-PCR testing was conducted for herpes simplex virus (HSV) types 1 and 2, mumps virus, enterovirus, varicella zoster virus (VZV), Streptococcus pneumoniae, HiB and Neisseria meningitidis. Results Out of 140 enrolled patients, the mean age was 23.9 years, and 58% were children. Bacterial or viral etiologies were determined in 51% of patients. Five Streptococcus pneumoniae cultures were isolated from CSF. Based on in-house PCR analysis, 25 patients were positive for S. pneumoniae, 6 for N. meningitidis, and 1 for H. influenzae. Viral multiplex PCR identified infections with enterovirus (n = 26), VZV (n = 4), and HSV-1 (n = 2). No patient was positive for mumps or HSV-2. Conclusions Study findings indicate that S. pneumoniae and enteroviruses are the main etiologies in this patient cohort. The utility of molecular diagnostics for pathogen identification combined with the knowledge provided by the investigation may improve health outcomes of CNS infection cases in Georgia. PMID:25369023

  17. Comparison of blood loss between using non central part cutting knee prosthesis and distal central part cutting.

    Science.gov (United States)

    Malairungsakul, Anan

    2014-12-01

    Patients who undergo knee replacement surgery may need to receive a blood transfusion due to blood loss during the operation. Therefore it was important to improve the design of knee implant operative procedures in an attempt to reduce the rate of blood loss. The present study aimed to compare the blood loss between two types of knee replacement surgery. This is a retrospective study in which 78 patients received cemented knee replacements in Phayao Hospital between October 2010 and March 2012. There were two types of surgical procedure: 1) using an implant position covering the end of the femoral bone without cutting into the central part of the distal femoral, 2) using an implant position covering the end of the femoral bone cutting the central part of the distal femoral. Blood loss, blood transfusion, hemoglobin and hematocrit were recorded preoperatively, immediately postsurgery and 48 hours after surgery. Findings revealed that the knee replacement surgery using the implant position covering the end of the femoral bone without cutting the central part of the distal femoral significantly lowered the rate of blood loss when compared to using the implant position covering the end of the femoral bone with central cutting of the distal femor. The average blood loss during the operation without cutting at the central part of distal femoral was 49.50 ± 11.11 mL; whereas the operation cutting the central part of the distal femoral was 58.50 ± 11.69 mL. As regards blood loss, the knee replacement surgery using the implant position covering the end ofthefemoral bone without cutting the central part of distal femor was better than using the implant position covering the end of the femoral bone cutting at the central part of the distal femor.

  18. Retinopathy and risk factors in diabetic patients from Al-Madinah Al-Munawarah in the Kingdom of Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Al-Sisi A

    2012-02-01

    Full Text Available Mohamed F El-Bab1, Nashaat Shawky2, Ali Al-Sisi3, Mohamed Akhtar31Department of Physiology, Faculty of Medicine, Suez Canal University, Ismailia; 2Department of Ophthalmology, College of Medicine, Taibah University, Faculty of Medicine, El-Mansoura University, El-Mansoura, Egypt; 3Department of Ophthalmology, Ohud Hospital, Al-Madinah Al-Munawarah, Kingdom of Saudi ArabiaBackground: Diabetes mellitus is accompanied by chronic and dangerous microvascular changes affecting most body systems, especially the eye, leading to diabetic retinopathy. Diabetic retinopathy without appropriate management is emerging as one of the leading causes of blindness. Therefore, it is necessary to improve the early diagnosis of diabetic retinopathy, reduce the risk of blindness, and identify relevant risk factors.Methods: This descriptive study was designed to estimate the prevalence of retinopathy and its staging in diabetic patients attending the diabetes clinic at King Fahd Hospital in Al-Madinah Al-Munawarah, Kingdom of Saudi Arabia, from 2008 to 2010. Patients completed a questionnaire, underwent a full medical assessment carried out by the treating clinicians, and were examined for evidence of diabetic retinopathy using standard ophthalmic outpatient instruments.Results: In total, 690 randomly selected diabetic patients of mean age 46.10 ± 11.85 (range 16–88 years were included, comprising 395 men (57.2% of mean age 46.50 ± 11.31 years and 295 women (42.8% of mean age 45.55 ± 12.53 years. The mean duration of diabetes mellitus was 11.91 ± 7.92 years in the women and 14.42 ± 8.20 years in the men, and the mean total duration of known diabetes mellitus was 13.35 ± 8.17 years. Glycated hemoglobin was higher in men (8.53% ± 1.81% than in women (7.73% ± 1.84%, and this difference was statistically significant (P ≤ 0.0001. Of the 690 diabetic patients, 249 (36.1% had retinopathy. Mild nonproliferative diabetic retinopathy was present in 13.6% of patients

  19. Aspergilosis cervical con diseminación al sistema nervioso central. Presentación de un caso y revisión de bibliografía

    Science.gov (United States)

    Vergara, Guillermo Enrique; Roura, Natalia; del Castillo, Marcelo; Mora, Andrea; Alcorta, Santiago Condomi; Mormandi, Rubén; Cervio, Andrés; Salvat, Jorge

    2015-01-01

    Introducción: la Aspergilosis Invasiva (AI) del Sistema Nervioso Central (SNC) es infrecuente y ocurre generalmente en pacientes inmunocomprometidos. Puede presentarse con cuadros de meningitis, aneurismas micóticos, infartos o abscesos. Es una infección con pronóstico reservado y puede afectar el SNC de forma primaria o secundaria a partir de un foco que se disemina por vía hematógena. Presentamos el caso de un paciente con AI con invasión primaria a nivel óseo y diseminación posterior al cerebro. Caso clínico: Paciente masculino de 25 años con diagnóstico de leucemia linfática aguda en tratamiento quimioterápico que presentó neumonitis por metotrexate por lo que inicia tratamiento con corticoides. Posteriormente agregó cervicalgia y con el diagnóstico de osteomielitis cervical se realiza punción bajo tomografía computada (TC) sin aislarse gérmenes. Se colocó Halo Vest e inició tratamiento antibiótico empírico. Posteriormente presentó afasia de expresión secundaria a lesión frontal izquierda. Se realizó evacuación de absceso cerebral aislando A. fumigatus. El tratamiento antibiótico específico posterior permitió una buena respuesta clínica y radiológica. Conclusión: La presencia de lesiones en el SNC de pacientes inmunocomprometidos debe incluir a las micosis como diagnóstico diferencial. La evacuación quirúrgica permite llegar rápidamente al diagnóstico mejorando la respuesta posterior al tratamiento antibiótico. Para evaluar la respuesta terapéutica y posibles recaídas se debe realizar un seguimiento periódico clínico radiológico. Palabras clave: Aspergilosis cerebral; Aspergilosis cervical; Aspergilosis invasiva; Voriconazol. PMID:26600985

  20. Homenaje al Dr. Fernando Merino Niño

    Directory of Open Access Journals (Sweden)

    Lisbeth Berrueta

    2013-12-01

    Full Text Available encuentra tu pasión y hazla posible, dale un propósito a tu vida por encima de todo; que la motivación por alcanzar tus metas sea siempre mayor que el temor al fracaso” Anónimo FERNANDO MERINO NINO (1946-2011 DEDICO SU VIDA A SU PASION MÁS GRANDE: LA INVESTIGACION. Nació en España y a los 7 años de edad se mudó con su familia a Caracas, Venezuela, en donde creció y se obtuvo su título de Médico Cirujano a los 22 años de edad, en las aulas de la ilustre Universidad Central de Venezuela (UCV. Posteriormente, continuo su formación académica en Búfalo en el estado de Nueva York, USA, donde obtuvo el grado de Doctor en Ciencias y luego regresa a Venezuela e inicia su carrera como investigador en el Centro de Medicina Experimental del Instituto Venezolano de Investigaciones Científicas (IVIC y paralelamente como profesor de la UCV adscrito al Instituto Anatomopatológico de la Universidad Central de Venezuela. Fernando

  1. Cells in the Body Politic: Social identity and hospital construction in Peronist Argentina

    Directory of Open Access Journals (Sweden)

    J Hagood

    2012-09-01

    Full Text Available This article examines the critical role played by social identity in the construction of hospitals in the Argentine health care sector during the 1940s and 1950s by uncovering the way in which the “jungle” of hospitals withstood attempts by the state to apply some sense of order, purpose, and centralized organization. The first section examines how physicians envisioned the “modern” hospital they hoped to construct. The second section reveals the important antecedents of nationalized hospitalization schemes found in the collaboration between physicians’ unions and the state. In the third section, an analysis of political speeches illuminates how Juan and Evita Perón packaged new hospitals as gifts to the people from their leader. The fourth section outlines specific plans to increase the number of hospital beds. The final section surveys examples of hospital construction to demonstrate how sub-national identities were instrumental to fragmenting both Argentine society and its hospital infrastructure.

  2. Fecundity as a biomarker of health? - Semen quality and subsequent hospitalization

    DEFF Research Database (Denmark)

    Lindahl-Jacobsen, Rune; Latif, Tabassam; Skakkebæk, Niels Erik

    . Men with a low total sperm count had a 50% higher risk of first hospitalization from all causes of disease (95%CI: 1.4-1.6). The higher risk of hospitalization was robust across disease categories and not confined to specific diseases. A man with low sperm concentration (0-10 mill/ml) had an average...... Hospital Discharge Registry for hospitalizations and the Central Person Registry to obtain information on vital status and childhood status. A clear dose - response relationship between semen quality (total sperm count, sperm concentration or sperm motility) and survival was observed in both cohorts...... data from two unique Danish cohorts; The Copenhagen Sperm Analysis Laboratory and the Fertility Clinic - Frederiksberg Hospital. In total, semen samples from 51,543 and 4,712 men from the two cohorts respectively for the period 1963-2010 was used for the analysis. The data was linked to the Danish...

  3. Using database reports to reduce workplace violence: Perceptions of hospital stakeholders.

    Science.gov (United States)

    Arnetz, Judith E; Hamblin, Lydia; Ager, Joel; Aranyos, Deanna; Essenmacher, Lynnette; Upfal, Mark J; Luborsky, Mark

    2015-01-01

    Documented incidents of violence provide the foundation for any workplace violence prevention program. However, no published research to date has examined stakeholders' preferences for workplace violence data reports in healthcare settings. If relevant data are not readily available and effectively summarized and presented, the likelihood is low that they will be utilized by stakeholders in targeted efforts to reduce violence. To discover and describe hospital system stakeholders' perceptions of database-generated workplace violence data reports. Eight hospital system stakeholders representing Human Resources, Security, Occupational Health Services, Quality and Safety, and Labor in a large, metropolitan hospital system. The hospital system utilizes a central database for reporting adverse workplace events, including incidents of violence. A focus group was conducted to identify stakeholders' preferences and specifications for standardized, computerized reports of workplace violence data to be generated by the central database. The discussion was audio-taped, transcribed verbatim, processed as text, and analyzed using stepwise content analysis. Five distinct themes emerged from participant responses: Concerns, Etiology, Customization, Use, and Outcomes. In general, stakeholders wanted data reports to provide ``the big picture,'' i.e., rates of occurrence; reasons for and details regarding incident occurrence; consequences for the individual employee and/or the workplace; and organizational efforts that were employed to deal with the incident. Exploring stakeholder views regarding workplace violence summary reports provided concrete information on the preferred content, format, and use of workplace violence data. Participants desired both epidemiological and incident-specific data in order to better understand and work to prevent the workplace violence occurring in their hospital system.

  4. The central Iowa project.

    Science.gov (United States)

    Allen, H M

    1994-10-01

    This project developed and tested a population-based survey, the HS Form, to examine health and health care in the Central Iowa community. Data from this new collection of proven sets of items were used to compare competing health plans, doctor offices, hospitals, and to develop preliminary norms of the community's insured, in two areas: system performance and health burden. The results showed that the survey: (1) was both feasible and efficient in delivering a comprehensive and generic assessment of consumers and patients; (2) revealed consistent, noteworthy differences between plans and between providers across both sets of criteria; and (3) indicated that there is substantial room for improvement in Central Iowa's health care delivery system from the public's perspective. Recommendations for next steps include: (1) following through on the June 1993 community forum (held to discuss the project's methods and results with local decision makers); (2) broadening the evaluation design to increase sample representativeness; and (3) implementing a pre/post approach to measure changes in plan and provider performance.

  5. Exploración conceptual de la responsabilidad patrimonial del Estado frente al desplazamiento forzado.

    OpenAIRE

    López-Martínez, Miguel-Andrés

    2013-01-01

    El propósito central de la propuesta de investigación es responder a la siguiente pregunta: ¿la proliferación de respuestas teóricas al desplazamiento forzado, impulsada con la declaratoria del estado de cosas inconstitucional (ECI) en 2004, generó algún cambio en el paradigma de la responsabilidad patrimonial del Estado (REPE), que orientó al Consejo de Estado al definir la responsabilidad de las autoridades por desplazamiento forzado (DEFO), entre 2004 y 2010? Para lograrlo, comenzamos por ...

  6. Factores contribuyentes al desarrollo de infecciones adquiridas en la comunidad en diabéticos tipo 2 admitidos en salas de medicina del Hospital Nacional Cayetano Heredia

    Directory of Open Access Journals (Sweden)

    Tapia-Zegarra Gino Guillermo

    2001-01-01

    Full Text Available El propósito del estudio es identificar factores contribuyentes al desarrollo de infecciones adquiridas en la comunidad en diabéticos tipo 2 hospitalizados. De tal forma, se siguió el diseño de un estudio de casos y controles no apareado. Consecuentemente, se eligieron en forma aleatoria 105 diabéticos con infección adquirida en la comunidad y 105 diabéticos con patología no infecciosa, obtenidos de los Servicios de Medicina de un hospital universitario, entre 1991 y 1998. Mediante el análisis bivariado y multivariado, se obtuvo la estimación ajustada del valor de odds ratio. Los resultados permitieron, según análisis estratificado por edad y sexo, obtener a neuropatía autonómica como factor contribuyente de infecciones urinarias (OR = 4,07. En el modelo multivariado se aisló a vasculopatía periférica (R²: 0,24 como contribuyente de infección de piel y partes blandas (OR = 6,79. Los intervalos de confianza fueron significativos y de 95% de confiabilidad. En conclusión, vasculopatía periférica y vejiga neurogénica contribuyen al desarrollo de infecciones adquiridas en la comunidad en diabéticos tipo 2 hospitalizados.

  7. Specialized consultant in radiological safety to the Ciudad del Carmen general hospital, PEMEX; Asesoria especializada en seguridad radiologica al hospital general Ciudad del Carmen, PEMEX

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Hernandez C, J. E.; Rodriguez A, F.; Garcia A, J

    2003-02-15

    The Ciudad del Carmen general hospital, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)

  8. Regarding optical coherence tomography grading of ischemia in central retinal venous occlusion

    Directory of Open Access Journals (Sweden)

    Tripathy K

    2017-02-01

    Full Text Available Koushik TripathyDepartment of Vitreoretina and Uvea, ICARE Eye Hospital & Postgraduate Institute, Noida, Uttar Pradesh, IndiaThe author read with interest the article by Browning et al.1 The author humbly wants to discuss a few facts.1. The article1 discusses grading of retinal ischemia based on optical coherence tomography features in central retinal venous occlusion. As coexisting central retinal arterial occlusion or cilioretinal arterial occlusion may also cause inner retinal hyper-reflectivity, exclusion of such cases is an important consideration before implicating central retinal venous occlusion for the ischemia. Extensive intraretinal hemorrhages are other important hindrances to the evaluation of the perfusion status of the retina using both fluorescein angiogram and optical coherence tomography.2. It would be interesting to know the gonioscopic findings, especially neovascularization of the anterior chamber angle if it was performed at presentation and during the follow-ups.3. The manuscript documented that the incidence of anterior segment neovascularization at 1 year was 8.9% in severe ischemia group.1 The incidence of anterior segment neovascularization in perfused groups was higher (15.4% and 17.6% for mild and moderate ischemia, respectively. Although the sample size was low, such findings are contrary to the literature2 and require further discussion. Authors' replyDavid J Browning, Omar S Punjabi, Chong LeeDepartment of Ophthalmology, Charlotte Eye, Ear, Nose and Throat Associates, P.A., Charlotte, NC, USA We thank Dr Tripathy for his interest in our article and would respond to his above-mentioned points.1. We agree that excluding eyes with cilioretinal artery and central retinal artery occlusions is necessary to be able to attribute inner retinal reflectivity changes to central retinal vein occlusion. Cilioretinal artery occlusion is associated with a band of ischemic retinal whitening and central retinal artery occlusion

  9. Amyotrophic lateral sclerosis with extension of the central canal of the spinal cord according to magnetic resonance imaging data

    Directory of Open Access Journals (Sweden)

    E. G. Mendelevich

    2016-01-01

    Full Text Available The paper describes an atypical case of amyotrophic lateral sclerosis (ALS concurrent with extension of the central canal – hydromyelia.Diagnostic difficulty is due to the presence of symptoms which are atypical for ALS, such as early age of onset, slow progression with long-term involvement of one leg, as well as extension of the central canal of the spinal cord at the level of TIII-IX bodies, as evidenced by magnetic resonance imaging (MRI. The paper presents a clinical case, a review of current literature on the clinical and MRI signs of ALS and on the differential diagnosis of motor neuron disease.

  10. Central de producción de calor - Madrid – España

    Directory of Open Access Journals (Sweden)

    Laorden Jiménez, J.

    1973-10-01

    Full Text Available The Heat Production Station of the University City Hospital in Madrid is described, after several years operation. The Station is equipped for an output of 13,000,000 kcal/hr, for heating; 1,000,000 kcal/hr, for hospital hot water, and 3,200,000 kcal/hr, for steam at 5 kp/cm2. The different alternatives are presented and the general outline of the solution chosen, as well as a comprehensive list of the materials used.Se describe la Central de Producción de Calor del Hospital Clínico de la Ciudad Universitaria de Madrid, después de algunos años de funcionamiento. La Central está preparada para una producción de 13.000.000 de kcal/h, para calefacción; 1.000.000 de kilocalorías/h, para agua caliente sanitaria, y 3.200.000 kcal/h, para vapor a 5 kp/cm2. Se presentan las diversas alternativas y el esquema general de la solución elegida, así como una extensa relación de ios materiales empleados.

  11. [Evaluation of the efficiency and quality of hospitals publicly owned with private management and hospitals of the public sector].

    Science.gov (United States)

    Giraldes, Maria Do Rosário

    2007-01-01

    , and by the Garcia de Orta Hospital, which are the less efficient hospitals. In Group V, with central hospitals and hospitals with functions of central hospital, it is the Hospital of Vila Real/Régua, EPE, to present the best situation of the Composite Efficiency Indicator, followed by the Santo António Hospital, EPE, the Santa Maria Hospital, EPE, and the HUC, while the hospitals with a worst situation of the Composite Efficiency Indicator are the Hospitals of Faro, Evora and S. José. In Group VI hospitals with a better Composite Efficiency Indicator are the hospitals of Santa Marta, Gama Pinto Institute and Orthopedic Hospital of Outão, while the Estefânia Hospital is the most inefficient. Tondela, Valongo and Peniche Hospitals (Group I), have a good value of the Composite Efficiency and Quality Indicator, while Barcelos, Oliveira de Azeméis and Póvoa de Varzim/Vila do Conde Hospitals (Group II) present also good values of this indicator. The Hospitals of Vila Franca de Xira, Bragança and Setúbal (Group III), the Hospitals of Santarém, Garcia de Orta, and Curry Cabral (Group IV), the Hospital of Vila Real/Régua, the Egas Moniz Hospital and the Santa Maria Hospital (Group V), and the Gama Pinto Institute, the Orthopedic Hospital of Outão, and the Santa Cruz Hospital (Group VI) are the best classified in their groups. EPE Hospitals (Hospitals publicly owned with private management) are the best classified in their groups in what efficiency is concerned, what is a better result tan the one shown in 2003. The lower inequality in relation to management indicators, in all hospital groups, exists in the areas of expenditure with inpatient care by user, what shows the existence of a norm of proceeding, in this traditional hospital area. The higher inequalities are those of day hospital, drugs in day hospital, drugs in outpatient care and rehabilitation by user. In what management indicators are concerned incentives must be created. The most efficient hospitals

  12. Resistance patterns of bacterial isolates to antimicrobials from 3 hospitals in the United Arab Emirates

    International Nuclear Information System (INIS)

    AlDhaheri, Ahmed S; AlNiyadi, Mohammed S; AlDhaheri Ahmed D; Bastaki, Salim M

    2009-01-01

    To compare the resistance pattern of common bacterial pathogens to commonly used drugs. Information and statistics of antimicrobial resistance for 1994 and 2005 were collected from the 3 hospital microbiology laboratories in the United Arab Emirates. The resistance patterns of Staphylococcus aureus, Escherichia coli, Klebsiella spp, and Pseudomonas aeruginosa to several front-line drugs were estimated. All laboratories used automatic machines (Vitek 2), which identifies and determines minimum inhibitory concentrations simultaneously. Increased resistance was observed for Staphylococcus aureus, (n=315, 2005) to erythromycin (approximately 6 fold, Al-Ain Hospital only), cloxacillin (Al-Ain Hospital), and gentamicin (more than 3-10 folds in all hospitals). Increased penicillin resistance was not observed. For the common Gram-negative organisms, there was a high resistance to ampicillin, gentamicin, ceftriaxone, ciprofloxacin, and imipenem, which seemed to increase for Escherichia coli, (by 4.2-200%, n=305, 2005); however, there was very little resistance to imipenem (0.4%) in Tawam Hospital. Variable resistance patterns were obtained for Pseudomonas aeruginosa (n=316, 2005) and Klebsiella spp,(n=316, 2005) against aminoglycosides, cephalosporins, ciprofloxacin, and norfloxacin. Overall, there was an obvious increase in resistance of bacteria and the prevalence rate to a number of drugs from 1-120 folds during the 11-year period. (author)

  13. Audit of appendicectomies at Frere Hospital | Rogers | South African ...

    African Journals Online (AJOL)

    Objective. We sought to evaluate the surgical service in the central part of the Eastern Cape Province by reviewing the practice of appendicectomy at Frere Hospital. Specifically, it was our aim to compare the service to those patients who reside in and outside the East London metropolitan area and the outcomes of patients ...

  14. Repurposing Waste Streams: Lessons on Integrating Hospital Food Waste into a Community Garden.

    Science.gov (United States)

    Galvan, Adri M; Hanson, Ryan; George, Daniel R

    2018-04-06

    There have been increasing efforts in recent decades to divert institutional food waste into composting programs. As major producers of food waste who must increasingly demonstrate community benefit, hospitals have an incentive to develop such programs. In this article, we explain the emerging opportunity to link hospitals' food services to local community gardens in order to implement robust composting programs. We describe a partnership model at our hospital in central Pennsylvania, share preliminary outcomes establishing feasibility, and offer guidance for future efforts. We also demonstrate that the integration of medical students in such efforts can foster systems thinking in the development of programs to manage hospital waste streams in more ecologically-friendly ways.

  15. Outsourced central archiving: an information bridge in a multi-IMAC environment

    Science.gov (United States)

    Gustavsson, Staffan; Tylen, Ulf; Carlsson, Goeran; Angelhed, Jan-Erik; Wintell, Mikael; Helmersson, Roger; Norrby, Clas

    2001-08-01

    In 1998 three hospitals merged to form the Sahlgrenska University Hospital. The total radiology production became 325 000 examinations per year. Two different PACS and RIS with different and incompatible archiving solutions were used since 1996. One PACS had commercial origin and the other was developed inhouse. Together they managed 1/3 of the total production. Due to differences in standard compliance and system architecture the communication was unsatisfactory. In order to improve efficiency, communication and the service level to our customers the situation was evaluated. It was decided to build a transparent virtual radiology department based on a modular approach. A common RIS and a central DICOM image archive as the central nodes in a star configured system were chosen. Web technique was chosen as the solution for distribution of images and reports. The reasons for the decisions as well as the present status of the installation are described and discussed is this paper.

  16. Estrés Laboral en Médicos Residentes del Hospital Nacional Carlos Alberto Seguín Escobedo y del Hospital Regional Honorio Delgado Espinosa. Arequipa, 2015

    OpenAIRE

    Mazeyra Guillén, Alvaro Augusto

    2017-01-01

    El presente estudio tuvo como objetivos determinar el estrés laboral en los médicos residentes del Hospital “Carlos Alberto Seguín Escobedo” de EsSalud (HNCASE). y del Hospital Regional “Honorio Delgado Espinosa” (HRHDE) y establecer las semejanzas y diferencias del estrés laboral de los médicos residentes de ambos hospitales. La población estuvo conformada por 220 médicos residentes de primero, segundo y tercer año de residencia. Se aplicó el muestreo al azar estratifica...

  17. Loiasis in a Japanese Traveler Returning from Central Africa

    Science.gov (United States)

    Kobayashi, Tetsuro; Hayakawa, Kayoko; Mawatari, Momoko; Itoh, Makoto; Akao, Nobuaki; Yotsu, Rie R.; Sugihara, Jun; Takeshita, Nozomi; Kutsuna, Satoshi; Fujiya, Yoshihiro; Kanagawa, Shuzo; Ohmagari, Norio; Kato, Yasuyuki

    2015-01-01

    We encountered a probable case of loiasis in a returned traveler from Central Africa. A 52-year-old Japanese woman presented to our hospital complaining of discomfort in her eyes and skin. She reported having frequently visited Central Africa over many years and having been extensively exposed to the rainforest climate and ecosystem. Although no microfilariae were found in her blood, there was an elevated level of IgG antibodies against the crude antigens of Brugia pahangi, which have cross-reactivity with Loa loa. She was treated with albendazole for 21 days, after which the antigen-specific IgG level decreased and no relapse occurred. PMID:26161033

  18. On compensation in Si-doped AlN

    Science.gov (United States)

    Harris, Joshua S.; Baker, Jonathon N.; Gaddy, Benjamin E.; Bryan, Isaac; Bryan, Zachary; Mirrielees, Kelsey J.; Reddy, Pramod; Collazo, Ramón; Sitar, Zlatko; Irving, Douglas L.

    2018-04-01

    Controllable n-type doping over wide ranges of carrier concentrations in AlN, or Al-rich AlGaN, is critical to realizing next-generation applications in high-power electronics and deep UV light sources. Silicon is not a hydrogenic donor in AlN as it is in GaN; despite this, the carrier concentration should be controllable, albeit less efficiently, by increasing the donor concentration during growth. At low doping levels, an increase in the Si content leads to a commensurate increase in free electrons. Problematically, this trend does not persist to higher doping levels. In fact, a further increase in the Si concentration leads to a decrease in free electron concentration; this is commonly referred to as the compensation knee. While the nature of this decrease has been attributed to a variety of compensating defects, the mechanism and identity of the predominant defects associated with the knee have not been conclusively determined. Density functional theory calculations using hybrid exchange-correlation functionals have identified VAl+n SiAl complexes as central to mechanistically understanding compensation in the high Si limit in AlN, while secondary impurities and vacancies tend to dominate compensation in the low Si limit. The formation energies and optical signatures of these defects in AlN are calculated and utilized in a grand canonical charge balance solver to identify carrier concentrations as a function of Si content. The results were found to qualitatively reproduce the experimentally observed compensation knee. Furthermore, these calculations predict a shift in the optical emissions present in the high and low doping limits, which is confirmed with detailed photoluminescence measurements.

  19. Access to facility delivery and caesarean section in north-central Liberia: a cross-sectional community-based study

    Science.gov (United States)

    Gartland, Matthew G; Taryor, Victor D; Norman, Andy M; Vermund, Sten H

    2012-01-01

    Objective Rural north-central Liberia has one of the world's highest maternal mortality ratios. We studied health facility birthing service utilisation and the motives of women seeking or not seeking facility-based care in north-central Liberia. Design Cross-sectional community-based structured interviews and health facility medical record review. Setting A regional hospital and the surrounding communities in rural north-central Liberia. Participants A convenience sample of 307 women between 15 and 49 years participated in structured interviews. 1031 deliveries performed in the regional hospital were included in the record review. Primary outcomes Delivery within a health facility and caesarean delivery rates were used as indicators of direct utilisation of care and as markers of availability of maternal health services. Results Of 280 interview respondents with a prior childbirth, only 47 (16.8%) delivered their last child in a health facility. Women who did not use formal services cited cost, sudden labour and family tradition or religion as their principal reasons for home delivery. At the regional hospital, the caesarean delivery rate was 35.5%. Conclusions There is an enormous unmet need for maternal health services in north-central Liberia. Greater outreach and referral services as well as community-based education among women, family members and traditional midwives are vital to improve the timely utilisation of care. PMID:23117566

  20. Knowledge, Attitude, and Perception of Barriers for Eye Care among Diabetic Persons Registered at Employee Health Department of a Tertiary Eye Hospital of Central Saudi Arabia

    Science.gov (United States)

    Al-Alawi, Abeer; Al-Hassan, Arif; Chauhan, Deepti; Al-Futais, Muneera; Khandekar, Rajiv

    2016-01-01

    Purpose: To evaluate the level of knowledge, attitudes, and barriers to diabetic retinopathy (DR) screening among diabetic healthcare staff at a tertiary eye hospital in central Saudi Arabia. Methods: This was a descriptive survey using a closed-ended questionnaire. A. 5-grade. Likert scale was used for responses to each question. Data were collected on patient demographics and the status of diabetes. Survey responses related to knowledge, attitude, and barriers were grouped. Results: The study sample was comprised of 45 diabetics employed at the hospital. The mean age was 49 ± 11 years and 33 diabetics were males. One-third of the study population was referred to the eye clinic for DR screening. DR screening was performed in 25% of diabetics over the previous year. Twenty-nine (64%; 95% confidence intervals: 50–78) participants had excellent knowledge of eyecare for diabetic complications. Thirteen percent of participants had a positive attitude toward periodic eye checkups. Travel distance to an eyecare unit, no referral from family physicians for annual eye checkups and the lack of availability of gender-specific eyecare professionals were the main perceived barriers. Conclusion: Annual DR screening needs to be promoted to primary healthcare providers and diabetic patients. Barriers should be addressed to improve the uptake of DR screening. PMID:26957842

  1. Knowledge, Attitude, and Perception of Barriers for Eye Care among Diabetic Persons Registered at Employee Health Department of a Tertiary Eye Hospital of Central Saudi Arabia.

    Science.gov (United States)

    Al-Alawi, Abeer; Al-Hassan, Arif; Chauhan, Deepti; Al-Futais, Muneera; Khandekar, Rajiv

    2016-01-01

    To evaluate the level of knowledge, attitudes, and barriers to diabetic retinopathy (DR) screening among diabetic healthcare staff at a tertiary eye hospital in central Saudi Arabia. This was a descriptive survey using a closed-ended questionnaire. A. 5-grade. Likert scale was used for responses to each question. Data were collected on patient demographics and the status of diabetes. Survey responses related to knowledge, attitude, and barriers were grouped. The study sample was comprised of 45 diabetics employed at the hospital. The mean age was 49 ± 11 years and 33 diabetics were males. One-third of the study population was referred to the eye clinic for DR screening. DR screening was performed in 25% of diabetics over the previous year. Twenty-nine (64%; 95% confidence intervals: 50-78) participants had excellent knowledge of eyecare for diabetic complications. Thirteen percent of participants had a positive attitude toward periodic eye checkups. Travel distance to an eyecare unit, no referral from family physicians for annual eye checkups and the lack of availability of gender-specific eyecare professionals were the main perceived barriers. Annual DR screening needs to be promoted to primary healthcare providers and diabetic patients. Barriers should be addressed to improve the uptake of DR screening.

  2. Co-circulation of Dengue and Chikungunya Viruses, Al Hudaydah, Yemen, 2012.

    Science.gov (United States)

    Rezza, Giovanni; El-Sawaf, Gamal; Faggioni, Giovanni; Vescio, Fenicia; Al Ameri, Ranya; De Santis, Riccardo; Helaly, Ghada; Pomponi, Alice; Metwally, Dalia; Fantini, Massimo; Qadi, Hussein; Ciccozzi, Massimo; Lista, Florigio

    2014-08-01

    We investigated 400 cases of dengue-like illness in persons hospitalized during an outbreak in Al Hudaydah, Yemen, in 2012. Overall, 116 dengue and 49 chikungunya cases were diagnosed. Dengue virus type 2 was the predominant serotype. The co-circulation of these viruses indicates that mosquitoborne infections represent a public health threat in Yemen.

  3. Using data from a multi-hospital clinical network to explore prevalence of pediatric rickets in Kenya

    Science.gov (United States)

    Karuri, Stella W.; Murithi, Maureen K.; Irimu, Grace; English, Mike

    2017-01-01

    Background: Nutritional rickets is a public health concern in developing countries despite tropical climates and a re-emerging issue in developed countries. In this study, we reviewed pediatric admission data from the Clinical Information Network (CIN) to help determine hospital and region based prevalence of rickets in three regions of Kenya (Central Kenya, Western Kenya and Nairobi County). We also examine the association of rickets with other diagnosis, such as malnutrition and pneumonia, and study the effect of rickets on regional hospital stays. Methods: We analyzed discharge records for children aged 1 month to 5 years from county (formerly district) hospitals in the CIN, with admissions from February 1 st 2014 to February 28 th 2015. The strength of the association between rickets and key demographic factors, as well as with malnutrition and pneumonia, was assessed using odds ratios. The Fisher exact test was used to test the significance of the estimated odd ratios. Kaplan-Meier curves were used to analyze length of hospital stays. Results: There was a marked difference in prevalence across the three regions, with Nairobi having the highest number of cases of rickets at a proportion of 4.01%, followed by Central Region at 0.92%. Out of 9756 admissions in the Western Region, there was only one diagnosis of rickets. Malnutrition was associated with rickets; this association varied regionally. Pneumonia was found to be associated with rickets in Central Kenya. Children diagnosed with rickets had longer hospital stays, even when cases of malnutrition and pneumonia were excluded in the analysis. Conclusion: There was marked regional variation in hospital based prevalence of rickets, but in some regions it is a common clinical diagnosis suggesting the need for targeted public health interventions. Factors such as maternal and child nutrition, urbanization and cultural practices might explain these differences. PMID:29062911

  4. Designing for Economies of Scale vs. Economies of Focus in Hospital Departments

    NARCIS (Netherlands)

    Vanberkel, Peter T.; Boucherie, Richardus J.; Hans, Elias W.; Hurink, Johann L.; Litvak, Nelli

    2010-01-01

    Subject/Research problem: Hospitals traditionally segregate resources into centralized functional departments such as diagnostic departments, ambulatory care centres, and nursing wards. In recent years this organizational model has been challenged by the idea that higher quality of care and

  5. Curriculum-Making in School and College: The Case of Hospitality

    Science.gov (United States)

    Edwards, Richard; Miller, Kate; Priestley, Mark

    2009-01-01

    Drawing upon research in the curriculum of hospitality, this article explores the contrasting ways in which the prescribed curriculum is translated into the enacted curriculum in school and college contexts. It identifies organisational culture and teacher and student backgrounds and dispositions as central to the emerging contrasts. It uses this…

  6. Paediatric utilisation of a teaching hospital and a community health ...

    African Journals Online (AJOL)

    to Red Cross Children's Hospital (RXH) that could be more ... better access and perceived quality. S Atr Med ... tertiary resources, low levels of efficiency and staff ... However, central to improved patterns of utilisation is the .... the modei were: (/) age of the child; (it) duration of residence ... There was no significant association.

  7. Corporate and philanthropic models of hospital governance: a taxonomic evaluation.

    Science.gov (United States)

    Weiner, B J; Alexander, J A

    1993-08-01

    We assess the theoretical integrity and practical utility of the corporate-philanthropic governance typology frequently invoked in debates about the appropriate form of governance for nonprofit hospitals operating in increasingly competitive health care environments. Data were obtained from a 1985 national mailed survey of nonprofit hospitals conducted by the American Hospital Association (AHA) and the Hospital Research and Educational Trust (HRET). A sample 1,577 nonprofit community hospitals were selected for study. Representativeness was assessed by comparing the sample with the population of non-profit community hospitals on the dimensions of bed size, ownership type, urban-rural location, multihospital system membership, and census region. Measurement of governance types was based on hospital governance attributes conforming to those cited in the literature as distinguishing corporate from philanthropic models and classified into six central dimensions of governance: (1) size, (2) committee structure and activity, (3) board member selection, (4) board composition, (5) CEO power and influence, and (6) bylaws and activities. Cluster analysis and ANCOVA indicated that hospital board forms adhered only partially to corporate and philanthropic governance models. Further, board forms varied systematically by specific organizational and environmental conditions. Boards exhibiting more corporate governance forms were more likely to be large, privately owned, urban, and operating in competitive markets than were hospitals showing more philanthropic governance forms. Findings suggest that the corporate-philanthropic governance distinction must be seen as an ideal rather than an actual depiction of hospital governance forms. Implications for health care governance are discussed.

  8. Management of hospitals solid waste in Khartoum State.

    Science.gov (United States)

    Saad, Suhair A Gayoum

    2013-10-01

    This research had been conducted during year 2012 to review existing data on hospital waste management for some of Khartoum town hospitals and to try to produce appropriate proposals acceptable for waste management and final treatment methods. The overall status of hospital waste management in Khartoum has been assessed through direct visits and designated questionnaires. Eight main hospitals were covered in the study with an overall bed capacity of 2,978. The current waste management practice observed at all studied hospitals was that most of waste, office, general, food, construction debris, and hazardous chemical materials were all mixed together as they are generated, collected, and finally disposed of. Only a small portion of waste in some hospitals (part of potentially infectious, body parts, and sharps) are collected separately and treated in a central incinerator. The estimated value of per bed generation rate in the studied hospitals was found to be 0.87 kg/day, which lies within the range for the low-income countries. In all studied hospitals, it was found that workers were working under very poor unsafe conditions with very low salaries ($35 to $45 per month on average). About 90 % were completely illiterate or had very low education levels. At the national level, no laws considering hospital waste, or even hazardous waste, were found; only some federal general environmental regulations and some procedures from town and city localities for controlling general municipal waste exist. At the hospital level, no policies or rules were found, except in the radiotherapy center, where they manage radioactive wastes under the laws of the Sudanese Atomic Agency. Urgent actions are needed for the remediation and prevention of hazards associated with this type of waste.

  9. Mental Hospitals in India: Reforms for the future.

    Science.gov (United States)

    Daund, Muktesh; Sonavane, Sushma; Shrivastava, Amresh; Desousa, Avinash; Kumawat, Sanjay

    2018-02-01

    Mental hospitals are an integral part of mental health services in India. It is an interesting story how mental hospitals have responded to the challenges of contemporary period they were built in. It is beyond doubt that it is a progressive journey along with advances in mental health both in India and internationally. As in other countries, mental hospitals in India have responded to the social challenges, disparities, and poor resources of workforce and fiscal investment. Historically, there have been changes and three major reforms are needed, namely attempt to facilitate discharge and placing patients back into the family, introducing teaching and research in mental hospitals, and accountability to civil rights as per the requirements of the National Human Rights Commission. In this review, we explore the brief history of mental hospitals in India and examine the reforms in the clinical, administrative, and psychosocial areas of these hospitals and progress in teaching and research. We finally summarize and conclude the necessity and the relevance of mental hospitals in India akin to modern psychiatric practice. We believe that mental hospitals have an important and perhaps a central role in mental health services in India. Its modernization to address issues of long-term stay, burden on caregivers, stigma, research and teaching including undergraduate and postgraduate training, new curriculum, and training for nonpsychiatric professionals and primary care physicians are necessary components of the role of mental hospitals and responsibilities of both government and nongovernmental sectors. Last but not the least, it is obligatory for mental hospitals to ensure that evidence-based treatments are implemented and that the standard of care and respect of civil and human rights of the patients and families are provided while involving the people's participation in its functioning.

  10. Errors in the administration of intravenous medication in Brazilian hospitals.

    Science.gov (United States)

    Anselmi, Maria Luiza; Peduzzi, Marina; Dos Santos, Claudia Benedita

    2007-10-01

    To verify the frequency of errors in the preparation and administration of intravenous medication in three Brazilian hospitals in the State of Bahia. The administration of intravenous medications constitutes a central activity in Brazilian nursing. Errors in performing this activity may result in irreparable damage to patients and may compromise the quality of care. Cross-sectional study, conducted in three hospitals in the State of Bahia, Brazil. Direct observation of the nursing staff (nurse technicians, auxiliary nurses and nurse attendants), preparing and administering intravenous medication. When preparing medication, wrong patient error did not occur in any of the three hospitals, whereas omission dose was the most frequent error in all study sites. When administering medication, the most frequent errors in the three hospitals were wrong dose and omission dose. The rates of error found are considered low compared with similar studies. The most frequent types of errors were wrong dose and omission dose. The hospitals studied showed different results with the smallest rates of errors occurring in hospital 1 that presented the best working conditions. Relevance to clinical practice. Studies such as this one have the potential to improve the quality of care.

  11. Radial macrosegregation and dendrite clustering in directionally solidified Al-7Si and Al-19Cu alloys

    Science.gov (United States)

    Ghods, M.; Johnson, L.; Lauer, M.; Grugel, R. N.; Tewari, S. N.; Poirier, D. R.

    2016-05-01

    Hypoeutectic Al-7 wt% Si and Al-19 wt% Cu alloys were directionally solidified upward in a Bridgman furnace through a range of constant growth speeds and thermal gradients. Though processing is thermo-solutally stable, flow initiated by gravity-independent advection at, slightly leading, central dendrites moves rejected solute out ahead and across the advancing interface. Here any lagging dendrites are further suppressed which promotes a curved solid-liquid interface and the eventual dendrite "clustering" seen in transverse sections (dendrite "steepling" in longitudinal orientations) as well as extensive radial macrosegregation. Both aluminum alloys showed considerable macrosegregation at the low growth speeds (10 and 30 μm s-1) but not at higher speed (72 μm s-1). Distribution of the fraction eutectic-constituent on transverse sections was determined in order to quantitatively describe radial macrosegregation. The convective mechanisms leading to dendrite-steepling were elucidated with numerical simulations, and their results compared with the experimental observations.

  12. Draft Genome Sequences of Four Hospital-Associated Pseudomonas putida Isolates.

    Science.gov (United States)

    Mustapha, Mustapha M; Marsh, Jane W; Ezeonwuka, Chinelo D; Pasculle, Anthony W; Pacey, Marissa P; Querry, Ashley M; Muto, Carlene A; Harrison, Lee H

    2016-09-29

    We present here the draft genome sequences of four Pseudomonas putida isolates belonging to a single clone suspected for nosocomial transmission between patients and a bronchoscope in a tertiary hospital. The four genome sequences belong to a single lineage but contain differences in their mobile genetic elements. Copyright © 2016 Mustapha et al.

  13. BODY HEIGHT AND ITS ESTIMATION UTILIZING ARM SPAN MEASUREMENTS IN MALE ADOLESCENTS FROM CENTRAL REGION IN MONTENEGRO

    Directory of Open Access Journals (Sweden)

    Dobrislav Vujović

    2015-05-01

    Full Text Available Anthropologists recognized the tallness of nations in the Dinaric Alps long time ago (Popovic et al, 2013. As the modern Montenegrins fall partly into the Dinaric racial classification (Bjelica et al., 2012, the purpose of this study was to examine the body height in Montenegrin male adolescents from central region as well as the relationship between arm span as an alternative to estimating the body height, which would vary from region to region in Montenegro. Method: Our investigation analyses 548 male adolescents from the central region in Montenegro. The anthropometric measurements were taken according to the protocol of the International Society for the Advancement of Kinanthropometry (ISAK. Means and standard deviations regarding the anthropometric measurements were obtained. A comparison of means of body heights and arm spans within this gender group were carried out using a t-test. The relationships between body height and arm span were determined using simple correlation coefficients and their 95% confidence interval. Then a linear regression analysis was performed to examine the extent to which the arm span can reliably predict body height. Results: The results displayed that male Central-Montenegrins are 183.66±6.93 cm tall and have an arm span of 184.99±8.30cm. Discussion: Compared to other studies, the results of this study have shown that this gender made Central-Macedonians the tall population, taller than general male population in Montenegro (Bjelica et al., 2012. On the other hand, expectably, the arm span reliably predicts body height in this gender. However, the estimation equations which have been obtained in Central-Montenegrins are, different alike in general population, since arm span was closer to body heights (1.33±1.37 centimetres, more than in general population (Bjelica et al., 2012. This confirms the necessity for developing separate height models for each region in Montenegro.

  14. Al-Qurû’ fi Al-Qur’an ‘Inda Al-Anbary fi Al-Adhdâd

    Directory of Open Access Journals (Sweden)

    Raushani Azza

    2018-03-01

    Full Text Available This study examines about the term al-Qurû in the Qur’an. Al-Qurû is one of the most popular discussions among muslim scholars and mufasir, both in terms of language and fiqh. However, there is a bate among muslim scholar and mufasir about the meaning of al-Qurû. It’s because al-Qurû is one of the sentence of al-Adhdâd wich has two meaning, especially in the Qur’an, namely haid (menstruation and thahr. One of the most popular muslim scholar who concern in Qur’an and Arabic is al-Anbari with his book al-Adhdâd. Al-Anbari explains that Qurû has two meanings, First, al-Qurû in etymology is the form of Jama’ from aqra and qurû. Second, al-Qurû has a meaning of menstruation, thahr, or the period of iddah as a sign of being allowed to remarry after certain period of time.

  15. Hospital ownership: a risk factor for nosocomial infection rates?

    Science.gov (United States)

    Schröder, C; Behnke, M; Geffers, C; Gastmeier, P

    2018-03-26

    In some countries, a relationship between hospital ownership and the occurrence of healthcare-associated infection (HCAI) rates has been described. To investigate the association between hospital ownership and occurrence of HCAI in Germany. Five different components of the German national nosocomial infection surveillance system were analysed with regard to the influence of hospital ownership in the period 2014-2016. Endpoints included ventilator-associated pneumonia, central-venous-catheter-associated bloodstream infections, urinary-catheter-associated urinary tract infections, surgical site infections (SSI) following hip prosthesis and colon surgery, meticillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile infections (CDI) and hand rub consumption per 1000 patient-days. Three hospital ownership types (public, non-profit and private) were analysed using univariate and multi-variate methods. The distribution of hospitals according to the three ownership types was similar in all components. In total, 661 intensive care units (ICUs), 149 departments performing colon procedures, and 349 departments performing hip prosthesis were included. In addition, 568 hospitals provided their MRSA rates and 236 provided their CDI rates, and 1833 ICUs and 12,934 non-ICUs provided their hand rub consumption data. In general, the differences between the hospital types were rather small and not significant for the ICUs. In the multi-variate analysis, public hospitals had a lower SSI rate following hip prosthesis (odds ratio 0.80, 95% confidence interval 0.65-0.99). Hospital ownership was not found to have a major influence on the incidence of HCAI in Germany. Copyright © 2018 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  16. Study of intraventricular hemorrhage in VLBW neonates admitted in Al-Zahra Hospital, Tabriz, Iran.

    Science.gov (United States)

    Jodeiry, B; Heidarzadeh, M; Sahmani-Asl, S; Hoseini, M; Javaherizadeh, H; Eliasi, S; Abedini, K

    2012-01-01

    Intra-ventricular hemorrhage (IVH) is an important predictor of adverse neurodevelopmental outcome. IVH risk factor identification may conduct improvement of quality of care in neonatal intensive care units. The aim of the current study was to determine possible risk factors associated with IVH in VLBW neonates admitted in our hospital. All neonates with birth weight below 1500 gr admitted to NICU. Cranial ultrasonography was done for premature neonates weighed 1000 g, sonography was done in 7 days and 30 days of life respectively. If there is any conditions such as apnea, seizure, significant decrease in level of hemoglobin, increased head circumference, increased oxygen consumption, and other significant changes another sonography was done again. Exclusion criteria were cerebral malformations, metabolic disturbances, chromosomal anomalies, central nervous system infection, and genetic syndromes. Data was analyzed by SPSS ver 16.0 (SPSS Inc, Chicago, IL, USA). In this study 64 cases with IVH and without IVH were included. Mean of gestational age was 28.78 +/- 12.08. From neonates, 54.6% were boys and 45.4% were girls. Vaginal delivery and cesarean section was done in 56 (32.2%) and 118 (67.8%) cases respectively. Mean +/- SD of pH in cases with IVH and without IVH was 7.19 +/- 0.22 and 7.30 +/- 0.12 respectively (p = 0.001). Mean ISD of pco2 in cases with IVH and without IVH was 65.15 +/- 29.89 and 49.88 +/- 40.89 respectively(p = 0.001). Mean of 5th min APGAR score in patients required CPR was 7.36 +/- 1.57 and in patients without CPR was 8.68 +/- 1.25 (P = 0.001). From cases with IVH, hydrocephaly was detected in 20 cases. From cases without IVH, hydrocephaly was detected in 6 cases. Result of chi-square show significant correlation between IVH and prematurity (chi2 = 21.94, df=1, P preclampsia in mother was significantly higher in cases without IVH (chi-square, p < 0.05). PDA, pressure support, surfactant therapy, inotrop drug administration, vaginal delivery

  17. Demand-driven care and hospital choice. Dutch health policy toward demand-driven care: results from a survey into hospital choice.

    Science.gov (United States)

    Lako, Christiaan J; Rosenau, Pauline

    2009-03-01

    In the Netherlands, current policy opinion emphasizes demand-driven health care. Central to this model is the view, advocated by some Dutch health policy makers, that patients should be encouraged to be aware of and make use of health quality and health outcomes information in making personal health care provider choices. The success of the new health care system in the Netherlands is premised on this being the case. After a literature review and description of the new Dutch health care system, the adequacy of this demand-driven health policy is tested. The data from a July 2005, self-administered questionnaire survey of 409 patients (response rate of 94%) as to how they choose a hospital are presented. Results indicate that most patients did not choose by actively employing available quality and outcome information. They were, rather, referred by their general practitioner. Hospital choice is highly related to the importance a patient attaches to his or her physician's opinion about a hospital. Some patients indicated that their hospital choice was affected by the reputation of the hospital, by the distance they lived from the hospital, etc. but physician's advice was, by far, the most important factor. Policy consequences are important; the assumptions underlying the demand-driven model of patient health provider choice are inadequate to explain the pattern of observed responses. An alternative, more adequate model is required, one that takes into account the patient's confidence in physician referral and advice.

  18. Mujeres musulmanas situadas en torno al poder

    Directory of Open Access Journals (Sweden)

    Paulina López Pita

    2002-01-01

    Full Text Available Aunque sabemos que en el Islam la mujer, en términos generales, estaba excluida del poder, encontramos haciendo un breve repaso en el Islam medieval que muchas mujeres desempeñaron un papel político de cierta importancia, de manera especial, entre las dinastías nacidas en Asia Central. Asimismo, fueron también numerosas las mujeres que ejercieron una notable influencia en el gobierno tanto a través de sus maridos como actuando como regentes de sus hijos en al-Andalus y en el norte de África. Es por tanto a estas mujeres que ejercieron el poder entre los musulmanes a las que dedicamos estas líneas.Although it is known that in the Islamic worid, women in general, couldn't access to power, we find that looking back at the middie age period, women didn't only particípate in military campaigns, but as well they played their role of certain importance in politics, specially among dynasties coming from Central Asia. At the same time, there were a number of women who had influence in the political power, both acting through their husbands, and as regents of their children in Al - Andalus, and in North África. Therefore, we dedícate the following text to these women with political power among the Muslims.

  19. First step to reducing infection risk as a system: evaluation of infection prevention processes for 71 hospitals.

    Science.gov (United States)

    Fakih, Mohamad G; Heavens, Michelle; Ratcliffe, Carol J; Hendrich, Ann

    2013-11-01

    Hospitals can better focus their efforts to prevent health care-associated infections (HAIs) if they identify specific areas for improvement. We administered a 96-question survey to infection preventionists at 71 Ascension Health hospitals to evaluate opportunities for the prevention of catheter-associated urinary tract infection, central line-associated bloodstream infection, ventilator-associated pneumonia, and surgical site infection. Seventy-one (100%) infection preventionists completed the survey. The majority of hospitals had established policies for urinary catheter placement and maintenance (55/70, 78.6%), central venous catheter maintenance (68/71, 95.8%), and care for the mechanically ventilated patient (62/66, 93.9%). However, there was variation in health care worker practice and evaluation of competencies and outcomes. When addressing device need, 55 of 71 (77.5%) hospitals used a nurse-driven evaluation of urinary catheter need, 26 of 71 (36.6%) had a team evaluation for central venous catheters on transfer out of intensive care, and 53 of 57 (93%) assessed daily ventilator support for continued need. Only 19 of 71 (26.8%) hospitals had annual nursing competencies for urinary catheter placement and maintenance, 29 of 71 (40.8%) for nursing venous catheter maintenance, and 38 of 66 (57.6%) for appropriate health care worker surgical scrubbing. We suggest evaluating infection prevention policies and practices as a first step to improvement efforts. The next steps include implementing spread of evidence-based practices, with focus on competencies and feedback on performance. Copyright © 2013 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

  20. Comments to Middle Miocene closure of the Central American Seaway

    Science.gov (United States)

    Coates, A.G.; Stallard, Robert F.

    2016-01-01

    In a recent paper proposing an early (mid-Miocene) closure of the Central American Seaway (CAS), Montes et al. 2015 (1) disregard existing paleogeographic data that invalidate Panama as a source for zircons, and inappropriately ignore the evidence for trans-isthmian marine connections until 4-3 Ma. They also fail to cite previous work (2, 3), that had reconstructed the Central American arc already docked with South America by 12 Ma. Montes et al. 2015 (1) (Fig. 1) disregard the Atrato-San Juan sedimentary basin (3), a shallowing Oligocene to Pliocene, Pacific to Caribbean seaway (3, 4, 5). This deep graben (6) is filled with thousands of meters of Pre-Pliocene marine sediments (3, 5, 6) that now occupy a lowland between the Baudo uplift to the west and the Western Cordillera to the east. The Mande Batholith and numerous Eocene and younger volcanic rocks (4), the most proximal source of the zircons, are situated to the east of this seaway and would have shed zircons eastward towards the Cordillera Central. There is no evidence for any rivers crossing the seaway (3, 5), and thus no Panamanian source of zircons. Instead this seaway is evidence of a significant marine connection between the Pacific and Atlantic oceans into the Pliocene. The authors assume that the middle Miocene closure of the CAS effectively creates a continuous land bridge connecting North and South America and separating the Atlantic from the Pacific. They acknowledge, but then discount, marine connections across the Isthmus until 4-3 Ma even though these satisfactorily explain (Coates and Stallard, 2014 (6)) the oceanographic, molecular and Great American Biological Interchange events ignore unexplained by Montes et al. 2015. Only by conspicuously ignoring these events can they imply that the Isthmus was formed at 15-13 Ma. References 1. C. Montes et al., Middle Miocene closure of the Central American Seaway. Science 348, 226-229 (2015). 2. A. G. Coates, R. F. Stallard, How old is the Isthmus of

  1. Antibiotic sensitivity pattern of bacteria from diabetic foot infections Haji Adam Malik central general hospital

    Science.gov (United States)

    Bulolo, B. A.; Pase, M. A.; Ginting, F.

    2018-03-01

    Increasing rate of Diabetic Foot Infections (DFIs) caused by multi-drug-resistance pathogens plays a huge role in the duration of hospitalization, morbidity, and mortality of diabetic patients. The aim of the study is to assess the antibiotic sensitivity pattern of bacteria in DFIs and causative microorganisms. Using cross-sectional retrospective study, data were collected from medical records of DFIs patients previously hospitalized atHaji Adam Malik Hospital, Medan from January to July 2017. 33 patients met the criteria and got enrolled in the study. The classification of DFIs was evaluated according to Wagner’s Classification. Evaluation of antibiotic sensitivity and identification of causative microorganisms were performed in standard microbiologic methods. The most common grade of DFIs was Grade-4 (48.5%), followed by Grade-3 (39.4%) and Grade-5 (9.1%). A total of 12 pathogens were identified. The most common infecting microorganism isolated on pus cultures was Klebsiella pneumonia (33.3%), followed by Escherichia coli (24.2%), Acinetobacter baumanni (12.1%), and Staphylococcus aureus (9.1%). Frequent susceptible antibiotics were Amikacin (88.8%), Imipenem (87%), Meropenem (84.6%), Erythromycin (75%), and Cefoperazone/Sulbactam (68.9%). DFIs are polymicrobial infections in this study K. pneumonia was the most common cause microorganism.

  2. Prevalencia del tabaquismo en los trabajadores de un hospital

    Directory of Open Access Journals (Sweden)

    Arévalo Alonso José Miguel

    1997-01-01

    Full Text Available FUNDAMENTO: Sobre tabaquismo se han realizado muchos estudios tanto en España como en otros países. El objetivo de esta encuesta es valorar la prevalencia de tabaquismo en una muestra representativa de trabajadores del hospital y su asociación con la edad, sexo, estamento profesional y actitudes. MÉTODOS: Después de un estudio piloto, se realizó una encuesta en una muestra representativa y aleatoria (n=360 de trabajadores del hospital, a los que se les preguntó por sus actitudes al hábito tabáquico, clasificados por edad, sexo y estamentos. RESULTADOS: El porcentaje total de fumadores es de 36.4%, pero no se han encontrado diferencias estadísticamente significativas ni por sexo ni grupo de edad. Los estamentos con mayor porcentaje de fumadores son ATS/DUE y Administrativos. El 42.8% de los no fumadores declaran haberlo hecho antes, siendo los estamentos de ATS/DUE, Administrativos y Facultativos los que mostraron el mayor porcentaje. Un 40.5% de fumadores declaran estar dispuestos a dejar el hábito, mientras el grupo de personas mayores de 50 años se muestran más resistentes. La mayoría de fumadores de cigarrillos señalan que fuman en el hospital. La mayor parte de ellos son fumadores intermedios (10-20 cigarrillos/día y lo llevan haciendo muchos años. La mayor parte de los exfumadores declaran haber dejado el hábito en los últimos años. CONCLUSIONES: Estos resultados demuestran que un gran porcentaje de trabajadores del hospital son fumadores. Sin embargo, existe un importante número que está dispuestos a dejarlo. Por ello, animamos a estas personas a que dejen de fumar y ayudarles por medio de diversas acciones tales como: consulta de tratamiento del tabaquismo, consejo médico y educación para la salud. Proponemos declarar al hospital como "HOSPITAL SIN TABACO" para el año 2000, lo cual incluye a trabajadores, pacientes y visitas, de acuerdo con la estrategia de la OMS "Salud para todos".

  3. Risk factors of Acute Respiratory Infection (ARI in under-fives in a rural hospital of Central India

    Directory of Open Access Journals (Sweden)

    Amar M. Taksande

    2015-11-01

    Full Text Available Introduction: Acute Respiratory Infection (ARI is a major cause of morbidity and mortality in developing countries in children especially in under-fives. Every year in the world, about 13 million under-5 children dies, 95% from developing countries; one third of total deaths are due to ARI. The aim of this study was to identify the significant risk factors for ARI in children less than five years of age living in rural areas of Central India.Methods: A hospital based case control study was undertaken to determine risk factors associated with respiratory tract infections in children. Children less than 5 years admitted in a pediatric ward with diagnosis of ARI were enrolled in the study as cases (n = 300 while the same number of controls (n = 300 were selected from neighborhood and were matched for age, sex and religion. Details of risk factors in cases and controls were recorded in pre-designed proforma. Results: A significant association was found between ARI and lack of breastfeeding, nutritional status, immunization status, delayed weaning, prelactal feeding, living in overcrowded conditions, mothers’ literacy status, low birth weight and prematurity. Among the environmental variables, inadequate ventilation, improper housing condition, exposure to indoor air pollution in form of combustion from fuel used for cooking were found as significant risk factors for ARI in under-fives.Conclusions: ARIs are affected by socio-demographic and socio-cultural risk factors, which can be modified with simple interventions. The various risk factors identified in this study were lack of breastfeeding, undernutrition, delayed weaning, overcrowding and prelactal feeding.

  4. Relationships between central and peripheral corneal thickness in different degrees of myopia.

    Science.gov (United States)

    Ortiz, Sara; Mena, Laura; Rio-San Cristobal, Ana; Martin, Raul

    2014-01-01

    To analyze the relationship between the central corneal thickness (CCT) and mid-peripheral corneal thickness (PCT) with the degree of myopia [axial length (AL) and spherical equivalent refractive error (SE)]. 175 right myopic eyes from 175 patients were divided according to the degree of SE: group #1 (n=76, 12.00 D). The CCT and PCT (3mm from the apex to the superior, inferior, nasal and temporal locations) were measured with the Orbscan-II. Relative peripheral index (RPI) was calculated by dividing the PCT by the CCT. The AL was measured with the IOL Master, and the SE was obtained with subjective refraction. AL was 25.18±1.16 mm, 26.59±1.26 mm and 29.45±2.58 mm and SE was -3.31±1.40 D, -8.32±1.64 D and -16.44±4.48 D for groups #1, #2 and #3, respectively. Non-statistically significant differences in central and peripheral corneal thickness were found between groups (P>0.05 ANOVA). Non-significant relationship was found between central and peripheral corneal thickness with the AL and SE in the three study groups and in the total sample (r0.05). The RPI values were similar between groups without significant difference between groups (P>0.05 ANOVA). Linear relationship was found between RPI superior location in group #2 (r=-0.23; P=0.04) and RPI nasal location in group #3 with the EE (r=0.41; P=0.03). There are no significant differences among low, moderate and extremely myopic eyes related to the CCT and PCT. Corneal thickness is very similar in myopic eyes with small differences that are not clinically relevant to myopic patient management. Copyright © 2012 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  5. [Impact of HIV infection in hospital environment].

    Science.gov (United States)

    Martínez Avilés, P; López Benito, I; Berbegal Serra, J

    1998-12-01

    Retrospective study to review the admissions at the Hospital Marina Alta due to infection for HIV or its complications and look for risk factors. Clinical charts of patients admitted at the hospital from 1989 to 1996 were analyzed. From 11,932 admissions, 199 (1.7%) were due to patients with infection from HIV, resulting in the 2.4% of the total stay. The medium stays were higher (8.6 +/- 7.4 vs 6 +/- 4.5) more re-admissions (42.7% vs 25.5%) and higher mortality (11% vs 7.8%). The parasitic infestations of the nervous central system and cardiovascular were the most numerous number of admissions and also the longer stays. Throughout the years we saw a increase in the patients at the outpatient clinic with HIV infection and a paradogic decrease in the inpatient admissions, and also a decrease in the media stay and total stays. There is a decrease in the admissions at the inpatient level in contrast with a increment of the prevalence in the outpatients with HIV infection. The improved treatments, the experience of the physicians, the use of the Day Hospital and the use of the service of Home Care Hospitalization allows to keep more patients with less admissions and more outpatient visits.

  6. Amyotrophic lateral sclerosis with extension of the central canal of the spinal cord according to magnetic resonance imaging data

    OpenAIRE

    E. G. Mendelevich; G. R. Mukhamedzhanova; E. I. Bogdanov

    2016-01-01

    The paper describes an atypical case of amyotrophic lateral sclerosis (ALS) concurrent with extension of the central canal – hydromyelia.Diagnostic difficulty is due to the presence of symptoms which are atypical for ALS, such as early age of onset, slow progression with long-term involvement of one leg, as well as extension of the central canal of the spinal cord at the level of TIII-IX bodies, as evidenced by magnetic resonance imaging (MRI). The paper presents a clinical case, a review of ...

  7. Ozonation for degradation of pharmaceutical in hospital wastewater

    DEFF Research Database (Denmark)

    Bester, Kai; Hansen, Kamilla S; Spiliotopoulou, Aikaterini

    -pollutants (Antoniou et al., 2013). In the present work, ozonation of biological treated hospital wastewater spiked with pharmaceuticals were performed to determine the required ozone dose for 90 % removal of the investigated pharmaceuticals. Effluents with different DOC level were used to investigate the effect...... of DOC on the removal of the pharmaceuticals. Furthermore, the effect of pH on ozone decomposition was investigated in relevant pH range....

  8. PHARMACOEPIDEMIOLOGIC ANALYSIS OF ST-ELEVATION MYOCARDIAL INFARCTION REPERFUSION THERAPY AT SARATOV REGION HOSPITALS OF DIFFERENT TYPES

    Directory of Open Access Journals (Sweden)

    O. V. Reshetko

    2016-01-01

    Full Text Available Aim. To evaluate the real practice of thrombolytic therapy of patients with ST-elevation myocardial infarction (STEMI at cardiological departments of Saratov and Saratov region hospitals.Material and methods. Retrospective pharmacoepidemiologic study was carried out. Case histories of STEMI patients discharged from cardiologic departments of several central district hospitals (CDH of Saratov region, cardiologic department of one of Saratov general municipal hospitals (MH and urgent cardiology department of Saratov clinical hospital (CH in 2006 were analyzed.Results. In CH all patients received thrombolytic therapy given they did not have contraindications and were admitted to the hospital timely. Few patients received thrombolytic therapy in MH and CDH in 2006.Conclusion. Correlation between hospital type and quality of STEMI management has been revealed.

  9. Le poesie della rivoluzione egiziana e la loro riproduzione come testi multimodali in YouTube: al-Midàn (La Piazza di Abd al-Rahmàn al-Abnudi

    Directory of Open Access Journals (Sweden)

    Lorenzo Casini

    2013-03-01

    Full Text Available The article investigates Abd al-Rahmàn al-Abnudi’s al-Midàn (The Square, the celebrated poem in colloquial Egyptian Arabic dedicated to the Egyptian young people who occupied the central Midàn al-Tahrìr (Tahrìr Square or Liberation Square in Cairo on 25th January 2011 paving the way for the revolution. The poem, written during the very first days of the uprising, is analyzed in the context of the major transformations in the Egyptian literary field during the decade 2001-2011. In this period the state’s cultural institutions lost much of their traditional power to exert authority over the contents of literary production and its circulation among the reading public. One of the most outstanding features of these transformations, is represented by the role of internet as a means of circulation and reception of literary texts, especially by means of blogs and YouTube. The article considers several versions of al-Midàn uploaded on YouTube and highlights the process by which the poem was transformed by each user into a (re newed multimodal text, where different semiotic resources interact: the reading of the poem, the video images, and (if present the soundtrack. These videos were viewed and commented on by hundreds of thousands of YouTube users in the weeks following the writing of the poem and have made a decisive contribution to the shaping of the revolution’s collective imaginary.

  10. Discovery of a [WO] central star in the planetary nebula Th 2-A

    Science.gov (United States)

    Weidmann, W. A.; Gamen, R.; Díaz, R. J.; Niemela, V. S.

    2008-09-01

    Context: About 2500 planetary nebulae are known in our Galaxy but only 224 have central stars with reported spectral types in the Strasbourg-ESO Catalogue of Galactic Planetary Nebulae (Acker et al. 1992; Acker et al. 1996). Aims: We have started an observational program aiming to increase the number of PN central stars with spectral classification. Methods: By means of spectroscopy and high resolution imaging, we identify the position and true nature of the central star. We carried out low resolution spectroscopic observations at CASLEO telescope, complemented with medium resolution spectroscopy performed at Gemini South and Magellan telescopes. Results: As a first outcome of this survey, we present for the first time the spectra of the central star of the PN Th 2-A. These spectra show emission lines of ionized C and O, typical in Wolf-Rayet stars. Conclusions: We identify the position of that central star, which is not the brightest one of the visual central pair. We classify it as of type [WO 3]pec, which is consistent with the high excitation and dynamical age of the nebula. Based on data collected at (i) the Complejo Astronómico El Leoncito (CASLEO), which is operated under agreement between the Consejo Nacional de Investigaciones Científicas y Técnicas de la República Argentina y Universidades Nacionales de La Plata, Córdoba y San Juan, Argentina; (ii) the 6.5 m Magellan Telescopes at Las Campanas Observatory, Chile; (iii) the 8 m Gemini South Telescope, Chile.

  11. Al-Âyah al-Mutasyâbihât al-Lafzhiyyah fi Sûrah al-An’âm ‘Inda al-Kirmâny

    Directory of Open Access Journals (Sweden)

    Hikmatiar Pasya

    2017-07-01

    Full Text Available This paper discusses about the verses of mutasyâbihât in the Quran. The debate of this verses caused various opinions. The meaning of the mutasyâbihât in this paper is the similarity and difference of the words in the Qur'an. Mufasir have different opinion about the meaning of the verse of mutasyâbihât al-lafdzi. In addition, many Hufadz of the Quran who are confused from one verse to another, or one chapter to another. It’s because similarity of verses in the Qur'an with other verses. So the writer wants to explain the verses mutasyâbihât al-lafdzi in the perspective of Hamzh al-Karmani in Surah al-An'âm. In this discussion the author discovers some passages in mutasyâbihât al-lafdzi, namely Asrâru al-balaghah fi mutasyabih al-lafdzi, Asrar al-balaghah fi mutasyabih al-hurf, and murâ'ah al-ikhtilâfmurâd bi al-lafdzi al-mukarrar.

  12. Outcome among patients suffering from in-hospital cardiac arrest

    Directory of Open Access Journals (Sweden)

    Trpković Sladjana

    2014-01-01

    Full Text Available Introduction. In relation to pre-hospital treatment of patients with cardiac arrest (CA in the field where resuscitation is often started by nonprofessionals, resuscitation in hospital is most commonly performed by well-trained personnel. Objective. The aim was to define the factors associated with an improved outcome among patients suffering from the inhospital CA (IHCA. Methods. The prospective study included a total of 100 patients in the Emergency Center over two-year period. The patterns by the Utstein-Style guidelines recorded the following: age, sex, reason for hospital admission, comorbidity, cause and origin of CA, continuous monitoring, time of arrival of the medical emergency team and time of delivery of the first defibrillation shock (DC. Results. Most patients (61% had cardiac etiology. Return of spontaneous circulation (ROSC was achieved in 58% of patients. ROSC was more frequently achieved in younger patients (57.69±11.37, (p<0.05, non-surgical patients (76.1%, (p<0.01 and in patients who were in continuous monitoring (66.7% (p<0.05. The outcome of CPR was significantly better in patients who received advanced life support (ALS (76.6% (p<0.01. Time until the delivery of the first DC shock was significantly shorter in patients who achieved ROSC (1.67±1.13 min, (p<0.01. A total of 5% of IHCA patients survived to hospital discharge. Conclusion. In our study, the outcome of CPR was better in patients who were younger and with non-surgical diseases, which are prognostic factors that we cannot control. Factors associated with better outcome of IHCA patients were: continuous monitoring, shorter time until the delivery of the first DC and ALS. This means that better education of medical staff, better organization and up-to-dated technical equipment are needed.

  13. Carta al Editor

    Directory of Open Access Journals (Sweden)

    Darío Maldonado Romero

    1991-03-01

    establecidos estalló la Primera Guerra Mundial y en su calidad de Alsacianos fueron internados en un campo de concentración y el Doctor empezó a escribir su Filosofía de la Civilización. El Respeto a la Vida infundióle ánimo para soportar las dificultades que los abrumaron al ser remitidos a Europa al Campo de Concentración de Sr. Remy. Cuando se firmó el Armisticio habían almacenado fortaleza física y espiritual.

    Estaba más decidido que nunca a ir a donde mas lo necesitaran yen 1924 volvió al África a su hospital haciéndose a fondos con recitales de órgano y dando conferencias para proseguir su obra en Lambarené. Tendría que pasar largos períodos reclutando dineros, dando conferencias y recibiendo distinciones en diversos países.

    La ciudad de Francfort le confirió un premio en dinero, en memoria de Goethe, por “servicios a la comunidad” y la Reina Isabel lo honró con la Insignia de Miembro Honorario de la Orden del Mérito, que solamente había sido concedida a otro, no británico, el Presidente Eisenhower.

    En 1939 se declaró la Segunda Guerra Mundial y las dos fuerzas, la de Vichy y la de Francia Libre, sobrevolaron con sus aviones sobre el pueblito de Lambarené, quedando los alsacianos como franceses; el trabajo en el hospital había disminuido mucho pero después de algún tiempo llegó como visitante distinguida la esposa del Doctor a quien éste le había agradecido mucho que le hubiera dejado volver solo. En mayo de 1945 terminó la guerra.

    El hospital nuevamente iba creciendo. El Doctor trataba de escribir un poco cada noche, pero, si había enfermos graves, prefería atenderlos; en una sala se celebraban oficios religiosos y el doctor predicaba con dos intérpretes, que repetían sus palabras en las dos lenguas nativa” principales, sobre temas sencillos como las parábolas del hijo pródigo y el buen samaritano.

    La nauseabunda medicación chalmúgrica oral y la dolorosa ineficacia de los esteres inyectados

  14. Derivaciones al Servicio de Urgencias del hospital en una población de ancianos residentes: Estudio retrospectivo sobre sus causas y adecuación Hospital transfers from a population of elderly residents: A retrospective study about the causes and suitability

    Directory of Open Access Journals (Sweden)

    José Carlos Bermejo Higuera

    2010-09-01

    Full Text Available Objetivo: analizar las causas y la adecuación de las derivaciones de ancianos institucionalizados al Servicio de Urgencias del hospital. Método: estudio descriptivo retrospectivo transversal sobre la población de una residencia de la Comunidad de Madrid. Se recogieron datos de 45 pacientes derivados durante el año 2008, con un total de 62 derivaciones. Derivación adecuada o pertinente fue aquella que cumpliera uno de los siguientes criterios: 1 el paciente ingresó o estuvo en observación más de 24 horas; 2 precisó ser valorado por un especialista y/o requirió pruebas diagnósticas no disponibles en el centro; y 3 necesitó tratamiento no disponible en el centro. Análisis estadístico descriptivo. Resultados: el 98,4% de las derivaciones cumplió los criterios de adecuación; 67% Criterio 1,21% Criterio 2 y no otros, y 77,4% Criterio 3. La causa más frecuente de derivación fue la sospecha de fractura poscaída (32,3%. El porcentaje anual de fallecidos (22,38% fue menor que el observado en otras residencias madrileñas, de ellos, el 15,55% falleció en el hospital.Aim: to analyse the causes and suitability of elderly resident transfers to hospital emergencies service. Methods: a retrospective and descriptive study about the resident population in a Residence of Comunidad de Madrid. We recorded data from 45 patients transferred in 2008, out of a total of 62 transfers. A suitable or appropriate derivation was one fulfilling at least one of the following criteria: 1-the patient was admitted to hospital or stayed in observation for more than 24 hours, 2- the patient had to be seen by a specialist or required a diagnosis test that was not available in the centre, 3- the patient needed treatment that was not available in the centre. The statistical analysis was descriptive. Results: 98.4% of the transfers complied with the suitability criteria: 67% criterion 1,21% criterion 2 but not other and 77% criterion 3. The most frequent cause for

  15. Caracterización de gneises glandulares del alto valle del Lozoya (Sistema Central Español) en base al quimismo de las biotitas y estado estructural del feldespato potásico

    OpenAIRE

    Tornos Arroyo, Fernando; Casquet, César

    1982-01-01

    En el presente trabajo se estudian las litologías gneísicas glandulares que afloran en la ladera este del Macizo de Peñalara (Sistema Central Español), en base a la interpretación del quimismo de las biotitas de glándulas y mesostasia y del estado estructural del feldespato potásico que forma la mayoría de estas glándulas. Se deduce a partir del estudio de las biotitas, que las glándulas se comportan como sistema cerrado para el Ti y abierto para el Al durante el metamorf...

  16. Factores Asociados a la Dismenorrea Primaria en Mujeres Atendidas en el Hospital de la Solidaridad de San Juan de Lurigancho 2014.

    OpenAIRE

    Ticlla Vargas, Mery

    2015-01-01

    Objetivo: Determinar los factores asociados a la dismenorrea primaria en mujeres atendidas en el Hospital de la Solidaridad de San Juan de Lurigancho, 2014. Metodología: Se realizó un estudio de tipo observacional, corte transversal, colección de los datos tipo retrospectivo, al nivel explicativo, tipo de diseño caso-control, en el cual participaron 40 mujeres atendidas en el Hospital de la Solidaridad de San Juan de Lurigancho, 2014 basado en una encuesta anónima aplicada a la una muestra al...

  17. [The Jewish Hospital in Budapest under the Nazi occupation (1944-1945)].

    Science.gov (United States)

    Weisskopf, Varda

    2008-01-01

    On March 19, 1944 the German army invaded and occupied Hungary. The Waffen-SS soldiers captured the buildings of the Jewish community in Budapest, including the famous and important Jewish hospital on Szabolcs Street, founded in 1802. The Jewish hospital moved into a school belonging to the Jewish community on 44 Wesselényi Street. The hospital personnel managed to smuggle out medical equipment, and operating rooms were transferred into this central, temporary medical location. Other hospitals were founded, some inside the ghetto, others outside. The Judenrat supplied these hospitals with medical equipment obtained through contributions from Jews. The temporary hospitals admitted sick patients and a great number of those injured as a result of the war in Budapest. These hospitals operated with poor equipment. Surgeries were sometimes performed on kitchen tables, and medical equipment was sterilized by burning the synagogue's benches and library books. As of December 1944, there was no electricity in the hospitals. Thus doctors were forced to operate by the light of candles and flashlights. Nevertheless, they managed to save numerous lives. In spite of the terrible conditions under which the medical staff worked, they were committed to their mission, and their courage deserves appreciation. Ghetto Budapest was liberated by the Red army on 18th January, 1945. Thousands of Jews were released from the temporary hospitals.

  18. En el sellado del catéter venoso central en hemodiálisis, ¿presenta el uso de citrato respecto al uso de heparina menos complicaciones de infección? Una revisión de la literatura

    Directory of Open Access Journals (Sweden)

    Mateu Nadal Servera

    Full Text Available Resumen Introducción: La heparina es el fármaco anticoagulante de elección y de uso habitual en los servicios de hemodiálisis, en el procedimiento de permeabilización de los catéteres venosos centrales, aunque su uso no está exento de riesgos como la hemorragia. La infección asociada al catéter, bien por colonización del catéter o por bacteriemia, es el evento más importante y la segunda causa de mortalidad tras la enfermedad cardiovascular en el paciente en hemodiálisis. En este sentido, el uso del citrato se está presentando como una alternativa para el sellado de los catéteres venosos centrales, dado que tiene propiedades tanto anticoagulantes locales como antimicrobianas y podría ser más eficiente en la prevención o la reducción de la infección asociada al catéter. Objetivos: Identificar qué anticoagulante de uso en el sellado del catéter venoso central, la heparina o el citrato, presenta menos complicaciones de bacteriemia asociada al catéter y de colonización del catéter; Material y Método: se realizó una búsqueda bibliográfica a través del metabuscador EBSCOhost (Academic Search Premier, CINAHL y las bases de datos PubMed, IME, Ibecs, LILACS, CUIDEN, Scopus y Cochrane Library, con la selección final de 15 documentos tras la aplicación de los límites de búsqueda, la eliminación de duplicados y la aplicación de los criterios de inclusión/exclusión. Los resultados más relevantes y actuales disponibles en la literatura científica presentaron cierta variabilidad, tanto en las concentraciones de anticoagulante como en la incidencia de infección. Resultados y Discusión: La numerosa evidencia sobre la bacteriemia asociada al catéter, tanto en relación con la concentración como en la combinación del anticoagulante de sellado, indica que el citrato 4% podría reducir la incidencia de bacteriemia, aunque el citrato asociado a antimicrobianos es más efectivo en la prevención de ésta respecto a la

  19. Factors associated with intention to exclusive breastfeed in central women's hospital, Yangon, Myanmar.

    Science.gov (United States)

    Hmone, Myat Pan; Li, Mu; Agho, Kingsley; Alam, Ashraful; Dibley, Michael J

    2017-01-01

    Under-nutrition is a public health problem in Myanmar. Despite current efforts, the exclusive breastfeeding rate (EBF) for children under six months is only 24%. Intention to breastfeed is a strong predictor for long-term breastfeeding, however, little is known about pregnant women's breastfeeding intentions in Myanmar. We, therefore, aimed to identify the factors associated with women's intention to EBF. Data in this article was collected in a baseline survey for a randomized controlled trial, which aimed to assess the impact of mobile text messages on the breastfeeding practices of women in Yangon, Myanmar. A total of 353 pregnant women at 28-34 weeks of gestation, recruited into the trial from the antenatal clinics of the Central Women's Hospital, Yangon, Myanmar, responded to the baseline survey questions, which included background information and breastfeeding related characteristics. To determine factors associated with women's intention to EBF logistic regression was used to analyse individual demographic, household economic and breastfeeding characteristics. In-depth interviews were performed with a sub-sample of 24 women who participated in the survey, to gain a further understanding of these associated factors. After adjusting for potential confounders, working women were less likely to intend to EBF (adjusted odds ratio (AOR) = 0.30, CI 0.17-0.53). Women from rich households (AOR = 2.43, CI 1.08-5.47) and middle income households (AOR = 1.79, CI 1.01-3.16); those who had high (AOR = 10.19, CI 3.43-30.23) and medium (AOR = 5.46, CI 1.79-16.72) breastfeeding knowledge levels, and received information from health professionals (AOR = 2.29, CI 1.29-4.03) and mobile internet (AOR 3.62, CI 2.04-6.41) had a higher intention to EBF. These findings were supported by qualitative analysis, which revealed that returning to work was the main barrier; health staff and printed media are reliable sources and; women with higher knowledge had high intentions

  20. Central nervous system complications after liver transplantation.

    Science.gov (United States)

    Kim, Jeong-Min; Jung, Keun-Hwa; Lee, Soon-Tae; Chu, Kon; Roh, Jae-Kyu

    2015-08-01

    We investigated the diversity of central nervous system complications after liver transplantation in terms of clinical manifestations and temporal course. Liver transplantation is a lifesaving option for end stage liver disease patients but post-transplantation neurologic complications can hamper recovery. Between 1 January 2001 and 31 December 2010, patients who had undergone liver transplantation at a single tertiary university hospital were included. We reviewed their medical records and brain imaging data and classified central nervous system complications into four categories including vascular, metabolic, infectious and neoplastic. The onset of central nervous system complications was grouped into five post-transplantation intervals including acute (within 1 month), early subacute (1-3 months), late subacute (3-12 months), chronic (1-3 years), and long-term (after 3 years). During follow-up, 65 of 791 patients (8.2%) experienced central nervous system complications, with 30 occurring within 1 month after transplantation. Vascular etiology was the most common (27 patients; 41.5%), followed by metabolic (23; 35.4%), infectious (nine patients; 13.8%), and neoplastic (six patients). Metabolic encephalopathy with altered consciousness was the most common etiology during the acute period, followed by vascular disorders. An initial focal neurologic deficit was detected in vascular and neoplastic complications, whereas metabolic and infectious etiologies presented with non-focal symptoms. Our study shows that the etiology of central nervous system complications after liver transplantation changes over time, and initial symptoms can help to predict etiology. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. THE IMPACT OF CENTRALIZATION, CORRUPTION AND INSTITUTIONAL QUALITY ON PROCUREMENT PRICES: AN APPLICATION TO PHARMACEUTICAL PURCHASING IN ITALY

    OpenAIRE

    Simona, Baldi; Davide, Vannoni

    2014-01-01

    This paper deals with the open issue about the choice between a centralized versus a decentralized public procurement strategy. Using a unique dataset on tender prices of selected drugs for hospital usage awarded by a sample of 52 Italian local health service providers (ASLs) between 2009 and 2012, we test which procurement system (centralized, decentralized or hybrid) performs better. Controlling for several covariates, we always find that centralized and hybrid procurers pay lower prices as...

  2. New trace element determinations in the fingernails of ALS patients

    Energy Technology Data Exchange (ETDEWEB)

    Van Dalsem, D.J.; Ehmann, W.D. [Univ. of Kentucky, Lexington, KY (United States); Robinson, L. [Oak Ridge National Laboratory, TN (United States)

    1996-12-31

    Amyotrophic lateral sclerosis (ALS) afflicts 2 of every 100,000 people in the United States each year. A well-known example of ALS today is Stephen Hawking. He is a theoretical physicist, the author of A Brief History of Time, and is virtually immobilized by ALS. Diseases that cause progressive paralysis because of motor neuron degeneration in the central nervous system are termed motor neuron disorders (MND). Amyotrophic lateral sclerosis is a common form of MND. Pain-free, progressive muscular weakness is the most common clinical symptom. There is chronic weakness with atrophy of the affected muscles by the time the disease is diagnosed. Atrophy eventually results in wheelchair confinement and then only bed without the ability to speak or swallow. Death often occurs as a result of respiratory problems. Unlike other neurodegenerative diseases, in ALS the patient`s bladder and bowel control, eye movement, and mental faculties are preserved. The question today is whether or not certain trace elements are involved in the etiology or pathogenesis of ALS. A collaborative study was undertaken by the University of Kentucky and Oak Ridge National Laboratory (ORNL) using neutron activation analysis (NAA) to study trace element concentrations in ALS patients fingernails to determine if there existed statistically significant imbalances.

  3. Dental trauma that require fixation in a children's hospital.

    Science.gov (United States)

    Bruns, Timothy; Perinpanayagam, Hiran

    2008-02-01

    Children and adolescents who suffer traumatic injuries often seek emergency treatment at a Children's Hospital. Complex injuries to permanent teeth and their periodontium require immediate repositioning and stabilization. Many of these emergencies are treated by pediatric dental residents at the Women and Children's Hospital of Buffalo, Buffalo, New York. The purpose of this study was to characterize these complex injuries of permanent teeth that require emergency treatment in a Children's Hospital. All of the cases of dental trauma which had involved permanent teeth and which had been treated with a splint in 2001 and 2002 were reviewed. There were 79 patients that were between 5 and 19 years of age with twice as many males (54) as females (25). The number of males increased from childhood (5-10 years) to early adolescence (11-15 years) and then decreased rapidly in late adolescence (16-19 years), whereas the number of females decreased steadily with age. Most of the incidents occurred during the summer months (72%), particularly in June and July (42%), and Fridays and Saturdays were the busiest days of the week. Most of the injuries were caused by organized and recreational sporting activities (39%) and accidental falls (33%), followed by interpersonal violence (15%) and a few motor vehicle accidents (7%). The 173 permanent tooth injuries were mostly luxations (62%) or avulsions (20%), with only a few fractures of the alveolar bone (5%) or tooth root (1%). Most of the displacements were lateral luxations (40%) or extrusions (18%) with only a few intrusions (3%). These injuries most commonly afflicted the maxillary central incisors (54%), followed by the maxillary laterals (18%) and mandibular centrals (17%). The emergency treatment that was provided at the Children's Hospital included replantation and repositioning, and the placement of a semi-rigid or flexible splint.

  4. [Burnout syndrome in pre-hospital and hospital emergency. Cognitive study in two cohorts of nurses].

    Science.gov (United States)

    Cicchitti, Chiara; Cannizzaro, Giorgia; Rosi, Fabrizio; Maccaroni, Roberto; Menditto, Vincenzo G

    2014-01-01

    Burnout syndrome (BOS) associated with stress has been documented in health care professionals in many specialties. The emergency department and the pre-hospital healthcare services are highly stressful environments. Little is known about the BOS in critical care nursing staff. The objective of the study is to compare the incidence of BOS and its three domains, namely, emotional exhaustion, depersonalization and reduced professional accomplishment, in two cohorts of critical care nurses: a pre-hospital and a hospital emergency service. A survey using a questionnaire (the Maslach Burnout Inventory-General Survey, MBI-GS), among nurses of two Italian emergency services has been performed: a hospital emergency service (HES, Emergency Department or "Pronto Soccorso") and a pre-hospital emergency service (PHES, territorial healthcare service or "Centrale Operativa 118"). All 60 nurses surveyed (82% female) filled the questionnaires. BOS-related symptoms have been identified in at least 50% of the nurses in the HES: 50% suffered a medium-high emotional exhaustion, 75% had a medium-high depersonalization and 92.5% had a medium-high reduced professional accomplishment. Among the PEHS nurses, BOS-related symptoms have been identified in at least 60% of the respondents: 60% had a medium-high emotional exhaustion, 70% had a medium-high depersonalization and 95% had a medium-high reduced professional accomplishment. Moreover, the likelihood that a nurse has a severe BOS, that is at least one degree of high burnout or ≥2 degrees of medium burnout, is significantly higher in the group of the PHES than in the HES (90% vs 60%, p nursing staff had a severe BOS. The incidence of BOS appeared to be similar among PHES and HES nurses with a higher trend for the former. Further interventional studies are needed to investigate the determinants of BOS among critical care nurses and the potentially preventive strategies.

  5. The relative effectiveness of managed care penetration and the healthcare safety net in reducing avoidable hospitalizations.

    Science.gov (United States)

    Pracht, Etienne E; Orban, Barbara L; Comins, Meg M; Large, John T; Asin-Oostburg, Virginia

    2011-01-01

    Avoidable hospitalizations represent a key indicator for access to, and the quality of, primary care. Therefore, understanding their behavior is essential in terms of management of healthcare resources and costs. This analysis examines the affect of 2 healthcare strategies on the rate of avoidable hospitalization, managed care and the healthcare safety net. The avoidable hospitalizations definition developed by Weissman et al. (1992) was used to identify relevant inpatient episodes. A 2-stage simultaneous equations multivariate regression model with instrumental variables was used to estimate the relative influence of HMO penetration and the composition of local hospital markets on the rate of avoidable hospitalizations. Control variables in the model include healthcare supply and demand, demographic, socioeconomic, and health status characteristics. Increased market presence of public hospitals significantly reduced avoidable hospitalizations. HMO penetration did not influence the rate of avoidable hospitalizations. The results suggest that public investments in healthcare facilities and infrastructure are more effective in reducing avoidable hospitalizations. © 2011 National Association for Healthcare Quality.

  6. Modos de conhecer e intervir: a constituição do corpo no cuidado de enfermagem no hospital

    Directory of Open Access Journals (Sweden)

    Rosemeiry Capriata de Souza Azevedo

    2006-01-01

    Full Text Available El presente trabajo analiza los modos en que el cuerpo se constituye en un objeto de conocimiento e intervención de la enfermera en el cuidado en el hospital. Los datos fueron recolectados en el período de 2000 a 2003, por medio de observaciones de campo, análisis de manuales y el libro de registro del turno de las enfermeras. El análisis reveló que el ritual de internación es hecho desde la lógica de la institución, de los profesionales médicos y del saber construido en relación al sujeto. El examen da visibilidad al poder médico, examina el cuerpo y objetiva el paciente sujetándolo a las verdades de un campo de conocimiento. El cuidado de enfermería se expresa en los ejercicios de poder, rituales, dispositivos, simbolizaciones y juegos de intereses que circulan, traman y lo sostienen en el hospital. Por lo tanto, el cuerpo producido es fragmentado, con dominios múltiples, disciplinado, vigilado; tomado por la enfermedad. El hospital se reveló como un cuerpo "construido", al mismo tiempo que "construye" los cuerpos.

  7. Zolpidem prescribing and adverse drug reactions in hospitalized general medicine patients at a Veterans Affairs hospital.

    Science.gov (United States)

    Mahoney, Jane E; Webb, Melissa J; Gray, Shelly L

    2004-03-01

    Zolpidem is prescribed for sleep disruption in hospitalized patients, but data on the incidence of adverse drug reactions (ADRs) are based largely on outpatient studies. Thus, the incidence of ADRs in hospitalized patients may be much higher. The goal of this study was to describe prescribing patterns of zolpidem for hospitalized medical patients aged 50 years, the incidence of ADRs possibly and probably associated with its use, and the factors associated with central nervous system (CNS) ADRs. This case series was conducted in 4 general medicine wards at a Veterans Affairs hospital and was a consecutive sample of patients aged 50 years who were hospitalized between 1993 and 1997 and received zolpidem as a hypnotic during hospitalization, but had not received it in the previous 3 months. Chart review was conducted by 2 evaluators. Data extracted from the medical records included admission demographic characteristics, medications, comorbidities, and levels of function in performing basic and instrumental activities of daily living. The main outcome measure was ADRs possibly or probably related to zolpidem use. The association between zolpidem and the occurrence of CNS ADRs (eg, confusion, dizziness, daytime somnolence) was analyzed separately. The review included 119 medical patients aged > or =50 years who had newly received zolpidem for sleep disruption during hospitalization. The median age of the population was 70 years; 86 (72.3%) patients were aged 65 years. The initial zolpidem dose was 5 mg in 42 patients (35.3%) and 10 mg in 77 patients (64.7%). Twenty-three patients had a respective 16 and 10 ADRs possibly and probably related to zolpidem use (19.3% incidence). Of a total of 26 ADRs, 21 (80.8%) were CNS ADRs, occurring with both zolpidem 5 mg (10.8% of users) and 10 mg (18.3% of users). On univariate analyses, the only factor significantly associated with a CNS ADR was functional impairment at baseline (P = 0.003). Zolpidem was discontinued in 38.8% of

  8. Lucha tras las rejas franquistas. La prisión central de mujeres de Segovia

    Directory of Open Access Journals (Sweden)

    Santiago VEGA SOMBRÍA

    2012-02-01

    Full Text Available Edificio de tipo panóptico inaugurado en 1924 como Reformatorio de Mujeres, posteriormente sería Hospital Asilo Penitenciario para ancianos y enfermos de tuberculosis. Con la guerra civil se vio abarrotado de presos políticos, que ya no abandonarían el edificio durante toda la dictadura. En 1946 se transformó en Prisión Central de Mujeres y, durante sus diez años de existencia, albergó al mayor contingente de luchadoras antifranquistas españolas, que convirtieron esta prisión en un centro de formación política y cultural clandestino. El papel que representó la cárcel de Burgos para los presos políticos lo constituyó Segovia para las políticas. Su impulso organizativo desarrolló y mantuvo redes de solidaridad que llevaron a declarar una huelga de hambre en enero de 1949. Aunque fueron castigadas severamente, con este pulso ante las autoridades represivas, las presas defendieron su dignidad y su identidad como reclusas políticas. Desde finales de los sesenta, el edificio encerró de nuevo a militantes antifranquistas de organizaciones políticas y sindicales.

  9. Building patient-centeredness: hospital design as an interpretive act.

    Science.gov (United States)

    Bromley, Elizabeth

    2012-09-01

    Hospital designs reflect the sociocultural, economic, professional, and aesthetic priorities prevalent at a given time. As such, hospital buildings concretize assumptions about illness, care and healing, patienthood, and medical providers' roles. Trends in hospital design have been attributed to the increasing influence of consumerism on healthcare, the influx of business-oriented managers, and technological changes. This paper describes the impact of the concept of patient-centeredness on the design of a new hospital in the USA. Data come from 35 interviews with planners, administrators, and designers of the new hospital, as well as from public documents about the hospital design. Thematic content analysis was used to identify salient design principles and intents. For these designers, administrators, and planners, an interpretation of patient-centeredness served as a heuristic, guiding the most basic decisions about space, people, and processes in the hospital. I detail the particular interpretation of patient-centeredness used to build and manage the new hospital space and the roles and responsibilities of providers working within it. Three strategies were central to the implementation of patient-centeredness: an onstage/offstage layout; a concierge approach to patients; and the scripting of communication. I discuss that this interpretation of patient-centeredness may challenge medical professionals' roles, may construct medical care as a product that should sate the patient's desire, and may distance patients from the realities of medical care. By describing the ways in which hospital designs reflect and reinforce contemporary concepts of patienthood and caring, this paper raises questions about the implementation of patient-centeredness that deserve further empirical study by medical social scientists. Copyright © 2012 Elsevier Ltd. All rights reserved.

  10. Hospital de La Misericordia, 6 de mayo de 1906 - 6 de mayo de 1981

    Directory of Open Access Journals (Sweden)

    Liborio Sánchez Avella

    1981-07-01

    Full Text Available El 6 de mayo de 1981 cumplió el Hospital de La Misericordia 75 años de haber iniciado sus labores. La idea de crear el Hospital se venía gestando desde comienzos de 1890. Obtuvo la Personería Jurídica el 23 de julio de 1897y el 25 de julio del mismo año colocó la primera piedra el Presidente de la República Miguel Antonio Caro. José Ignacio Barberi, su fundador, dejó un escrito en el cual relataba la historia de este Hospital. El mejor homenaje que se le puede hacer al Hospital y a José Ignacio Barberi, es transcribir las palabras que él dejó inéditas en 1940.

  11. [in-hospital mortality in patient with acute ischemic and hemorrhagic stroke].

    Science.gov (United States)

    Sadamasa, Nobutake; Yoshida, Kazumichi; Narumi, Osamu; Chin, Masaki; Yamagata, Sen

    2011-09-01

    There is a lack of evidence to compare in-hospital mortality with different types of stroke. The purpose of this study was to elucidate the in-hospital mortality after acute ischemic/hemorrhagic stroke and compare the factors associated with the mortality among stroke subtypes. All patients admitted to Kurashiki Central Hospital in Japan between January 2009 and December 2009, and diagnosed with acute ischemic/hemorrhagic stroke were included in this study. Demographics and clinical data pertaining to the patients were obtained from their medical records. Out of 738 patients who had an acute stroke, 53 (7.2%) died in the hospital. The in-hospital mortality was significantly lower in the cerebral infarction group than in the intracerebral hemorrhage and subarachnoid hemorrhage group (3.5%, 15.1%, and 17.9%, respectively; Phemorrhage group than in the other 2 groups. With regard to past history, diabetes mellitus was significantly found to be a complication in mortality cases of intracranial hemorrhage. Further investigation is needed to clarify the effect of diabetes on mortality after intracranial hemorrhage.

  12. Cambios fisiológicos asociados al envejecimiento

    OpenAIRE

    Dr. M. Felipe Salech; Dr. L. Rafael Jara; A. Luis Michea, DR, PHD

    2012-01-01

    La población envejece en forma acelerada, y la comprensión de los cambios fisiológicos asociados al envejecimiento es una herramienta importante para enfrentar las demandas biomédicas y sociales de ese grupo etario. El objetivo de la presente revisión es definir los principales cambios morfológicos y funcionales en los sistemas cardiovascular, renal, nervioso central, muscular y metabolismo de la glucosa asociados a la edad. La evidencia de estudios clínicos y experimentales muestra que...

  13. Reply to the commentary by Hillman et al. on: "Vascular distensibilities have minor effects on intracardiac shunt patterns in reptiles" by Filogonio et al. (2017).

    Science.gov (United States)

    Filogonio, Renato; Costa Leite, Cléo Alcantara; Wang, Tobias

    2017-06-01

    Our meta-analysis (Filogonio et al., 2017) on central vascular blood flows in a snake (Crotalus durissus) and a turtle (Trachemys scripta) was motivated by Hillman et al.'s (2014) analysis on amphibians to investigate whether cardiac shunt patterns depend on cardiac output and vascular distensibilities. In contrast to Hillman et al. (2014), we did not uncover a general trend that supports the notion that cardiac shunts in reptiles are dictated by vascular distensibilities. In addition to our response to the criticism raised by Hillman et al. (2017), we suggest that future experiments should consider (i) both compliance and distensibility of the major arteries; (ii) differences in volume of the systemic and pulmonary circuits to account for the accommodation of stroke volume; and (iii) an evaluation of the pulsatile pressures in both the ventricle and the major arteries to consider the timing of the ventricular ejection provided by opening of the ventricular valves. We hope these suggestions may help future clarification of the relative importance of passive arterial mechanical properties compared to autonomic regulation in determining intracardiac shunts in both amphibians and reptiles. Copyright © 2017 Elsevier GmbH. All rights reserved.

  14. Efficacy and safety of ERCP in a low-volume hospital Eficacia y seguridad de la CPRE en un hospital con bajo volumen

    Directory of Open Access Journals (Sweden)

    José María Riesco-López

    2013-02-01

    primeros procedimientos. Pacientes y métodos: estudio retrospectivo de las primeras 200 CPRE practicadas en nuestro hospital, analizando la progresión entre los 100 primeros procedimientos y los 100 segundos, comparándolos con los estándares de calidad propuestos en la literatura. Resultados: desde febrero de 2009 hasta abril de 2011 se realizaron 200 procedimientos a 169 pacientes con las siguientes indicaciones: coledocolitiasis (77 %, neoplasias (14,5 % y otras patologías (8,5 %. La tasa de canulación ascendió del 85 % en las 100 primeras CPRE al 89 % en las siguientes, el éxito clínico del 81 % al 87 %, disminuyendo la tasa de pancreatitis aguda post-CPRE del 11 al 4 %, la de hemorragia digestiva alta del 3 al 2 % y la de colangitis aguda del 4 al 1 %. Hubo un éxitus secundario a una hemorragia digestiva alta en una paciente cirrótica en el primer grupo y un caso de perforación biliar resuelto mediante cirugía en el segundo. Conclusiones: los resultados obtenidos tras la realización de 200 procedimientos apoyan la posibilidad de practicar CPRE en hospitales con bajo volumen consiguiendo niveles de eficacia y seguridad acorde con los estándares de calidad publicados.

  15. Gondwana subduction-modified mantle domain prevents magmatic seafloor generation in the Central Indian Ridge

    Science.gov (United States)

    Morishita, T.; Nakamura, K.; Senda, R.; Suzuki, K.; Kumagai, H.; Sato, H.; Sato, T.; Shibuya, T.; Minoguchi, K.; Okino, K.

    2013-12-01

    The creation of oceanic crust at mid-ocean ridges is essential to understanding the genesis of oceanic plate and the evolution of the Earth. Detailed bathymetric measurements coupled with dense sample recovery at mid-ocean ridge revealed a wide range of variations in the ridge and seafloor morphologies, which cannot be simply explained by a spreading rate, but also by ridge geometry, mantle compositions and thermal structure (Dick et al., 2003 Nature; Cannat et al. 2006 Geology). It is now widely accepted that very limited magmatic activity with tectonic stretching generates oceanic core complex and/or smooth seafloor surface in the slow to ultraslow-spreading ridges, where serpentinized peridotite and gabbros are expected to be exposed associated with detachment faults (Cann et al., 1997 Nature; Cannat et al., 2006), although magmatism might be an essential role for the formation of oceanic core complexes (Buck et al., 2005 Nature; Tucholke et al 2008 JGR). A rising question is why magmatic activity is sometimes prevented during the oceanic plate formation. Ancient melting domain, that are too refractory to melt even in adiabatically upwelling to the shallow upper mantle, might cause the amagmatic spreading ridges (Harvey et al., 2006 EPSL, Liu et al.,2008 Nature). Its origin and effect on seafloor generations are, however, not well understood yet. We report an oceanic hill as an example of an ancient subduction-modified mantle domain, probably formed at continental margin of the Gondwanaland~Pangea supercontinent, existing beneath the Central Indian Ridge. This domain is the most likely to have prevented magmatic seafloor generation, resulting in creation of very deep oceanic valley and serpentine diaper (now the studied oceanic hill) at the present Central Indian ridge.

  16. Racial/Ethnic Pay Disparities among Registered Nurses (RNs) in U.S. Hospitals: An Econometric Regression Decomposition.

    Science.gov (United States)

    Moore, Jean; Continelli, Tracey

    2016-04-01

    To detect the presence of racial and ethnic pay disparities between minority and white hospital RNs using a national sample. The National Sample Survey of Registered Nurses, 2008, which is representative at both the state and national level. Cross-sectional data were analyzed using multivariate regression and regression decomposition. Differences between groups were decomposed into differences in the possession of characteristics and differences in the value of the same characteristic between different groups, the latter being a commonly used measure of wage discrimination. As the majority of minority hospital RNs are employed within the most densely populated (central) counties of metropolitan statistical areas (MSAs), only hospital RNs employed in the central counties of MSAs were selected. Regression decomposition found that black and Hispanic RNs earned less than whites and Asians, while Asian RNs earned more than white RNs. The majority of pay variation between white RNs, versus Asian, black, or Hispanic RNs was due to unexplained differences in the value of the same characteristic between groups. Differences in earnings between underrepresented and overrepresented hospital RNs is suggestive of discrimination. © Health Research and Educational Trust.

  17. Tratamiento antimicrobiano en la meningoencefalitis, Hospital Militar Central "Dr. Luis Díaz Soto", 2004-2011

    Directory of Open Access Journals (Sweden)

    María del Carmen Jiménez Martínez

    Full Text Available Introducción: las meningoencefalitis constituyen un grupo de gran importancia dentro de las enfermedades infecciosas, en las cuales la introducción de los antibióticos hizo posible que fuese curable, pero la morbilidad y la mortalidad de esta enfermedad continúan siendo inaceptablemente altas. Objetivo: identificar la terapia antimicrobiana usada en las meningoencefalitis. Métodos: estudio descriptivo, observacional y retrospectivo. Se estudiaron 150 pacientes con diagnóstico de meningoencefalitis viral o meningoencefalitis bacteriana confirmada por cuadro clínico, estudio citoquímico del líquido cefalorraquídeo o identificación del agente etiológico. Todos se atendieron en el período comprendido entre los años 2004 y primer semestre del 2011, en los servicios de Medicina y Pediatría del Hospital Militar Central "Dr. Luis Díaz Soto". Se empleó el diseño de un estudio de utilización de medicamentos que hace uso de la indicación-prescripción y el esquema terapéutico para este tipo de paciente. Resultados: se utilizó terapia antimicrobiana en el 18,67 % de pacientes con meningoencefalitis viral (23,93 % de 117 y el 22 % con bacteriana (100 % de 33 casos. Las antibioticoterapias más usadas fueron la ceftriaxona (como único antibiótico en la meningoencefalitis viral, y asociada (ceftriaxona más vancomicina en la meningoencefalitis bacteriana. El patógeno más aislado (Streptococcus pneumoniae fue tratado en la mayoría de los casos con ceftriaxona más vancomicina. La generalidad de los tratamientos para la meningoencefalitis bacteriana duró menos de 21 días. Conclusiones: se evidenció el uso de terapia antimicrobiana en pacientes con meningoencefalitis viral y la coincidencia entre la terapia empírica y la específica en la meningoencefalitis bacteriana.

  18. [The establishment of the hospital-system in the Byzantine Empire].

    Science.gov (United States)

    Józsa, László

    2011-01-01

    Byzantine hospitals developed out of Christian institutions for the poor and homeless. Philanthropy provided the initial impulse to create hospices (xenons) and to expand these institutions into specialized medical centers (iatreons or nosokomeions). However the Byzantine nosocomeions resemble more closely modern hospitals than they do any of the institutions of Greek-Roman antiquity or any of the houses of charity in the Latin West during the Middle Ages. Since the 4th century the Byzantine hospitals have stressed the central position of the nosocomeion in Byzantine society at the intersection of state, ecclesiastical and professional interest. In the great cities and in the capital, more than hundred hospitals worked in the East-Roman Empire. The Byzantine hospital rules guaranted patients private beds, required physicians to wash their hands after each examination and arranged the physical plant to keep all the sick warm. The Byzantine hospitals had separate sections (in modern terms: surgery-trauma surgery, internal medicine, ophthalmology, etc.) and at the beginning of the sixth century a separate institution for women. From the sixth century at least, bathing facilities normally adjoined Byzantine nosocomeia. By the twelfth century Byzantine hospitals also set aside a room or perhaps a separate building to treat outpatients. In addition to the main dormitories the surgery, baths and outpatient clinic, the large parts of hospitals also had separate rooms (or adjoining buildings) for library, for lecture hall, for administrative functions and record keeping for storage and for other services.

  19. Diffusion-induced quadrupole relaxation of 27Al nuclei in dilute Al-Ti, Al-Cr, Al-Mn, and Al-Cu alloys at high temperatures

    International Nuclear Information System (INIS)

    Bottyan, L.; Beke, D.L.; Tompa, K.

    1983-01-01

    The temperature dependence of the laboratory frame spin-lattice relaxation time of 27 Al nuclei is measured in 5N Al and in dilute Al-Ti, Al-Cr, Al-Mn, and Al-Cu alloys at 5.7 and 9.7 MHz resonance frequencies. The relaxation in pure aluminium is found to be purely due to the conduction electrons. An excess T 1 -relaxation contribution is detected in all Al-3d alloys investigated above 670 K. The excess relaxation rate is proportional to the impurity content and the temperature dependence of the excess contribution is of Arrhenius-type with an activation energy of (1.3 +- 0.3) eV for all of the investigated alloys. The relaxation contribution is found to be quadrupolar in origin and is caused by the relative diffusional jumps of solute atoms and Al atoms relatively far from the impurity. (author)

  20. Abnormal intrinsic functional hubs in alcohol dependence: evidence from a voxelwise degree centrality analysis

    Directory of Open Access Journals (Sweden)

    Luo X

    2017-07-01

    Full Text Available Xiaoping Luo,1,2 Linghong Guo,1 Xi-Jian Dai,3 Qinglai Wang,2 Wenzhong Zhu,2 Xinjun Miao,2 Honghan Gong1 1Department of Radiology, The First Affiliated Hospital of Nanchang University, Nangchang, Jiangxi, People’s Republic of China; 2Department of Radiology, Wenzhou Chinese Medicine Hospital, Wenzhou, Zhejiang, People’s Republic of China; 3Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, People’s Republic of China Objective: To explore the abnormal intrinsic functional hubs in alcohol dependence using voxelwise degree centrality analysis approach, and their relationships with clinical features.Materials and methods: Twenty-four male alcohol dependence subjects free of medicine (mean age, 50.21±9.62 years and 24 age- and education-matched male healthy controls (mean age, 50.29±8.92 years were recruited. The alcohol use disorders identification test and the severity of alcohol dependence questionnaire (SADQ were administered to assess the severity of alcohol craving. Voxelwise degree centrality approach was used to assess the abnormal intrinsic functional hubs features in alcohol dependence. Simple linear regression analysis was performed to investigate the relationships between the clinical features and abnormal intrinsic functional hubs.Results: Compared with healthy controls, alcohol dependence subjects exhibited significantly different degree centrality values in widespread left lateralization brain areas, including higher degree centrality values in the left precentral gyrus (BA 6, right hippocampus (BA 35, 36, and left orbitofrontal cortex (BA 11 and lower degree centrality values in the left cerebellum posterior lobe, bilateral secondary visual network (BA 18, and left precuneus (BA 7, 19. SADQ revealed a negative linear correlation with the degree centrality value in the left precentral gyrus (R2=0.296, P=0.006.Conclusion: The specific abnormal intrinsic functional hubs appear

  1. Radiology integration in a multi-hospital system.

    Science.gov (United States)

    Welch, D

    1999-01-01

    In 1989, Salt Lake City's Intermountain Health Care (IHC) began a process to reduce costs and streamline processes. Divided into four geographic regions, IHC consists of 24 hospitals and 100 clinics, a 400-member practitioner-physician group, and a staff of 23,000. IHC determined that three Salt Lake Valley hospitals, part of its Urban Central Region, must become one entity with shared management and a reduced staff to cover operations at all three hospitals. Management of the three radiology departments were charged with creating an integration process for the three hospitals. Two directors were selected to manage radiology and meet the outlined goals. Difficulty arose when one director needed to make changes in a facility managed by the other. The directors found that structuring by modality allowed them to plan for all three facilities, standardize equipment purchases and create integrated rather than departmental programs. As consolidation was taking place in top management, employees worried what the resulting changes meant for their jobs. Many were unfamiliar with the concepts of team structure and continuous quality improvement. Various courses and meetings were held to educate staff members and bring them up to new standards. Most successful were the meetings that allowed staff from different facilities to come together and share ideas. Although travel was an issue, these meetings quickly helped move the integration processes forward as peer relationships were developed. Employees were recruited for cross-training and new staff worked wherever needed. As they began to share data, the three hospitals identified best-practice and internal benchmarks. IHC is now ready to hire a single director to manage the radiology departments at the three Salt Lake Valley hospitals.

  2. Interfacial phenomena in the reactions of Al-B, Al-Ti-B, and Al-Zr-B alloys with KF-AlF3 and NaF-AlF3 melts

    International Nuclear Information System (INIS)

    Lee, M.S.; Terry, B.S.; Grieveson, P.

    1993-01-01

    The interfacial phenomena occurring during the contacting of liquid Al-B, Al-Ti-B, and Al-Zr-B melts with KF-AlF 3 liquid fluxes have been investigated by optical examination of quenched metal drops previously immersed in the liquid fluxes. Reactions in the Al-B/KF-AlF 3 system involve the formation of metastable AlB 12 at the metal/flux interface. At high KBF 4 levels in the flux, the AlB 12 is dispersed in the flux and also at low KBF 4 levels in the metal. Reactions in the Al-Ti-B/KF-AlF 3 system involve the formation of TiB 2 , which may be dispersed in either the metal or the flux depending upon the composition of the flux. The results obtained for the Al-Ti-B/NaF-AlF 3 and Al-Zr-B/KF-AlF 3 systems were similar to those observed for the Al-Ti-B/KF-AlF 3 system

  3. Leptospirosis following a major flood in Central Queensland, Australia.

    Science.gov (United States)

    Smith, J K G; Young, M M; Wilson, K L; Craig, S B

    2013-03-01

    Throughout December 2010 and January 2011, Queensland experienced widespread flooding due to unusually protracted and heavy rainfalls. In mid-January 2011, four individuals from a small community in Central Queensland were hospitalized with leptospirosis. A further five cases were subsequently identified from around Central Queensland, bringing the total to nine. Microscopic agglutination testing found that serovar Arborea (Leptospira borgpetersenii serovar Arborea) was presumptively responsible for leptospirosis in seven of nine confirmed cases. Serovars Hardjo and Australis were identified in samples from two remaining cases. All cases had exposure to flood water. No single exposure source was identified. This is the first reported outbreak of leptospirosis in Central Queensland and the first report of leptospirosis cases associated with flood water inundation in Queensland. Public health authorities should continue to promote awareness of leptospirosis in flood-affected populations. Healthcare providers must maintain a high level of suspicion for leptospirosis during and after flood events.

  4. Vivências de mulheres à dor no infarto do miocárdio Vivencias de mujeres frente al dolor en el infarto del miocardio Experiences of women in face of pain from acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Fernanda Carneiro Mussi

    2006-06-01

    Full Text Available O estudo objetivou compreender os significados da experiência da dor em mulheres que sofreram infarto do miocárdio e identificar as suas ações imediatas diante da mesma. A pesquisa qualitativa utilizou a teoria do Interacionismo Simbólico e a metodologia da Teoria Fundamentada nos Dados. Quarenta e três mulheres foram entrevistadas em Hospital Universitário. A categoria central que expressou o sentido da experiência foi "Tendo uma ruptura com a vida cotidiana". As categorias que revelaram essa ruptura mostraram que diante da dor crescente as mulheres se sentiram dominadas e com medo de morrer, pois perderam o controle pessoal sobre o corpo e a vida. Não reconheceram o infarto e resistiram, a princípio, à procura de atendimento, fazendo tentativas para minorar a dor. Interagindo com a dor insuportável e com a impotência no seu controle, pediram a salvação Divina, ajuda às pessoas e recorreram a tratamento médico.En el presente estudio se tuvo como objetivo comprender los significados de la experiencia del dolor en mujeres que sufrieron infarto del miocardio e identificar sus acciones inmediatas frente a la misma. En esta investigación cualitativa se utilizó la teoría del Interaccionismo Simbólico y la metodología de la Teoría Fundamentada en los Datos. Fueron entrevistadas cuarenta y tres mujeres del Hospital Universitario. La categoría central que expresó el sentido de la experiencia fue "Teniendo una ruptura con la vida cotidiana". Las categorías que revelaron esa ruptura mostraron que frente al creciente dolor las mujeres se sintieron dominadas y con miedo de morir, pues perdieron el control personal sobre el cuerpo y la vida. No reconocieron el infarto y se resistieron, al principio, a procurar atención, haciendo intentos para aminorar el dolor. Ante el dolor insoportable y la impotencia en su control, pidieron la salvación Divina, ayuda a las personas y recurrieron al tratamiento médico.The aim of this study was

  5. [Hospital governance: between crisis management and implementation of public health policy].

    Science.gov (United States)

    Bréchat, Pierre-Henri; Antoine, Leenhardt; Mathieu-Grenouilleau, Marie-Christine; Rymer, Roland; Matisse, François; Baraille, Denis; Beaufils, Philippe

    2010-01-01

    The implementation of the recent act to amend the law on hospitals, patient health and territories (HPST Law) completes the reform of the organization and governance of health facilities, which was announced in 2002 by the "Hospital 2007" plan. What kind of assessments and perspectives can be considered and envisaged for these Hospital Activity Poles? We compared our experience with a review of the professional and scientific literature in order to stimulate answers to these questions for advocacy purposes prior to the Act's implementation. The hospital's cluster of activities should reinforce--not call into question the core activities and the financial stability of the facility, while respecting the contract on agreed objectives and the necessary means and resources to meet the health needs of the catchment population as well as national priorities. Although significant, but limited, successes exist, five obstacles to hospital reorganization can be identified. These include, for example: lack of delegation of management and centralization of decisions, the heterogeneity of numerous Hospital Activity Poles or problems related to timing. These obstacles may cause strain, or put the Hospital Activity Poles and the health facilities in a difficult situation with respect to their dynamics. This may show that the State and social health insurance should steer and direct public health policy and that the delegation of management roles and responsibilities to the Hospital Activity Poles should be addressed.

  6. In-hospital mortality, 30-day readmission, and length of hospital stay after surgery for primary colorectal cancer: A national population-based study.

    Science.gov (United States)

    Pucciarelli, S; Zorzi, M; Gennaro, N; Gagliardi, G; Restivo, A; Saugo, M; Barina, A; Rugge, M; Zuin, M; Maretto, I; Nitti, D

    2017-07-01

    The simultaneous assessment of multiple indicators for quality of care is essential for comparisons of performance between hospitals and health care systems. The aim of this study was to assess the rates of in-hospital mortality and 30-day readmission and length of hospital stay (LOS) in patients who underwent surgical procedures for colorectal cancer between 2005 and 2014 in Italy. All patients in the National Italian Hospital Discharge Dataset who underwent a surgical procedure for colorectal cancer during the study period were included. The adjusted odd ratios for risk factors for in-hospital mortality, 30-day readmission, and LOS were calculated using multilevel multivariable logistic regression. Among the 353 941 patients, rates of in-hospital mortality and 30-day readmission were 2.5% and 6%, respectively, and the median LOS was 13 days. High comorbidity, emergent/urgent admission, male gender, creation of a stoma, and an open approach increased the risks of all the outcomes at multivariable analysis. Age, hospital volume, hospital geographic location, and discharge to home/non-home produced different effects depending on the outcome considered. The most frequent causes of readmission were infection (19%) and bowel obstruction (14.6%). We assessed national averages for mortality, LOS and readmission and related trends over a 10-year time. Laparoscopic surgery was the only one that could be modified by improving surgical education. Higher hospital volume was associated with a LOS reduction, but our findings only partially support a policy of centralization for colorectal cancer procedures. Surgical site infection was identified as the most preventable cause of readmission. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  7. Incidencia, pronóstico y evolución clínica, inmunológica y virológica de las infecciones oportunistas del sistema nervioso central en pacientes con infección por VIH en la era del tratamiento antirretroviral de alta eficacia. Relación con el síndrome inflamatorio de reconstitución inmunológica

    OpenAIRE

    Riveiro Barciela, María del Mar

    2012-01-01

    Després de la introducció de la teràpia antirretroviral d'alta eficàcia, s'ha objectivat a l'hospital vall d'hebron, una disminució progressiva de la incidencia de les principals infeccions oportunistes del sistema nerviós central (toxoplasmosis, meningitis tuberculosa, meningitis criptococócica i de la leucoencefalopatia multifocal progresiva-LMP). La supervivencia global d'aquestes infeccions va ser de 2 mesos, sent la de pitjor pronòstic la LMP, l'estimació de supervivencia de la qual als ...

  8. Early weaning and hospitalization with alcohol-related diagnoses in adult life

    DEFF Research Database (Denmark)

    Sørensen, Holger J; Mortensen, Erik L; Reinisch, June M

    2006-01-01

    hospitalizations with alcohol-related diagnoses according to ICD-8 or ICD-10 were identified in the Danish Psychiatric Central Register in 1999. Nine potential confounders were included as covariates: gender of the cohort member, maternal age, parental social status, maternal prenatal smoking, unwanted pregnancy...... of early weaning was 1.47. Elevated relative risks were also associated with maternal smoking during pregnancy (1.52) and unwanted pregnancy status (1.59). Other independent predictors were male gender, maternal psychiatric hospitalization with alcohol-related diagnosis, and low parental social status......OBJECTIVE: This study attempted to determine whether lack of breast-feeding or a short duration of breast-feeding during infancy is associated with an elevated risk of hospitalization with alcohol-related diagnoses in adult life. METHOD: The study was a prospective longitudinal birth cohort design...

  9. The Rural Inpatient Mortality Study: Does Urban-Rural County Classification Predict Hospital Mortality in California?

    Science.gov (United States)

    Linnen, Daniel T; Kornak, John; Stephens, Caroline

    2018-03-28

    Evidence suggests an association between rurality and decreased life expectancy. To determine whether rural hospitals have higher hospital mortality, given that very sick patients may be transferred to regional hospitals. In this ecologic study, we combined Medicare hospital mortality ratings (N = 1267) with US census data, critical access hospital classification, and National Center for Health Statistics urban-rural county classifications. Ratings included mortality for coronary artery bypass grafting, stroke, chronic obstructive pulmonary disease, heart attack, heart failure, and pneumonia across 277 California hospitals between July 2011 and June 2014. We used generalized estimating equations to evaluate the association of urban-rural county classifications on mortality ratings. Unfavorable Medicare hospital mortality rating "worse than the national rate" compared with "better" or "same." Compared with large central "metro" (metropolitan) counties, hospitals in medium-sized metro counties had 6.4 times the odds of rating "worse than the national rate" for hospital mortality (95% confidence interval = 2.8-14.8, p centers may contribute to these results, a potential factor that future research should examine.

  10. Incidence rates of in-hospital carpal tunnel syndrome in the general population and possible associations with marital status

    OpenAIRE

    Melani Carla; Fateh-Moghadam Pirous; dell'Omo Marco; de Giacomi Giovanna; Bena Antonella; Cooke Robin MT; Curti Stefania; Baldasseroni Alberto; Mattioli Stefano; Biocca Marco; Buiatti Eva; Campo Giuseppe; Zanardi Francesca; Violante Francesco S

    2008-01-01

    Abstract Background Carpal tunnel syndrome (CTS) is a socially relevant condition associated with biomechanical risk factors. We evaluated age-sex-specific incidence rates of in-hospital cases of CTS in central/northern Italy and explored relations with marital status. Methods Seven regions were considered (overall population, 14.9 million) over 3–6-year periods between 1997 and 2002 (when out-of-hospital CTS surgery was extremely rare). Incidence rates of in-hospital cases of CTS were estima...

  11. Nutrient-enriched formula milk versus human breast milk for preterm infants following hospital discharge.

    Science.gov (United States)

    Henderson, G; Fahey, T; McGuire, W

    2007-10-17

    Preterm infants are often growth-restricted at hospital discharge. Feeding infants after hospital discharge with nutrient-enriched formula milk instead of human breast milk might facilitate "catch-up" growth and improve development. To determine the effect of feeding nutrient-enriched formula compared with human breast milk on growth and development of preterm infants following hospital discharge. The standard search strategy of the Cochrane Neonatal Review Group was used. This included searches of the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 2, 2007), MEDLINE (1966 - May 2007), EMBASE (1980 - May 2007), CINAHL (1982 - May 2007), conference proceedings, and previous reviews. Randomised or quasi-randomised controlled trials that compared feeding preterm infants following hospital discharge with nutrient-enriched formula compared with human breast milk. The standard methods of the Cochrane Neonatal Review Group were used, with separate evaluation of trial quality and data extraction by two review authors. No eligible trials were identified. There are no data from randomised controlled trials to determine whether feeding preterm infants following hospital discharge with nutrient-enriched formula milk versus human breast milk affects growth and development. Mothers who wish to breast feed, and their health care advisors, would require very clear evidence that feeding with a nutrient-enriched formula milk had major advantages for their infants before electing not to feed (or to reduce feeding) with maternal breast milk. If evidence from trials that compared feeding preterm infants following hospital discharge with nutrient-enriched versus standard formula milk demonstrated an effect on growth or development, then this might strengthen the case for undertaking trials of nutrient-enriched formula milk versus human breast milk.

  12. Splenectomy for hematological diseases: The Qatif Central HospitalExperience

    International Nuclear Information System (INIS)

    Al-Salem, Ahmed H.; Naserullah, Z.; Qaisaruddin, S.; Al-Dabbous, I.; Al-Abkari, H.; Al-Jama, A.; Al-Faraj, A.; Yassin, Yassin M.

    1999-01-01

    In the Eastern Province of Saudi Arabia, an area known for varioushemoglobinopathies, splenectomy is performed rather frequently. This study isan analysis of our experience with splenectomy performed for varioushematological disorders between 1988 and 1997, outlining the indications,complications and outcome. This is a retrospective analysis of all patientswho had splenectomy at our hospital during this period. One hundred andforty-three patients were treated for various hematological disorders at ourhospital. These disorders included sickle cell disease (SCD) (100 patients),sickle thalassemia (S-B-thalassemia) (13 ITP) (5 patients), Gaucher's disease(2 patients), hereditary spherocytosis (1 patient), autoimmune hemolyticanemia (1 patient), thalssemia intermediate (2 patients) and chronic myeloidleukemia (1 patient). The indications for splenectomy in those with SCD andthalassemia were: hypersplenism (26 patients), major splenic sequestrationcrisis (50 patients), splenic abscess (12 patients), and massive splenicinfarction (2 patients). Splenectomy in these patients was beneficial inreducing their transfusion requirements and its attendant risks, eliminatingthe discomfort from mechanical pressure of the enlarged spleen, avoiding therisks of acute splenic sequestration crisis, and managing splenic abscess.For those with Thalassemia, total splenectomy was beneficial in reducingtheir transfusion requirements, while partial splenectomy was beneficial onlyas a temporary measure, as regrowth of splenic remnant in these patientssubsequently led to increase in their transfusion requirements. Those withITP, hereditary spherocytosis, and autoimmune hemolytic anemia showedexcellent response following splenectomy. There was no mortality, and thepostoperative morbidity was 5.6%. With careful perioperative management,splenectomy is both safe and beneficial in a selected group of patients withhematological diseases. (author)

  13. Synthesizing (ZrAl3 + AlN)/Mg-Al composites by a 'matrix exchange' method

    Science.gov (United States)

    Gao, Tong; Li, Zengqiang; Hu, Kaiqi; Han, Mengxia; Liu, Xiangfa

    2018-06-01

    A method named 'matrix exchange' to synthesize ZrAl3 and AlN reinforced Mg-Al composite was developed in this paper. By inserting Al-10ZrN master alloy into Mg matrix and reheating the cooled ingot to 550 °C, Al and Mg atoms diffuse to the opposite side. As a result, liquid melt occurs once the interface areas reach to proper compositions. Then dissolved Al atoms react with ZrN, leading to the in-situ formation of ZrAl3 and AlN particles, while the Al matrix is finally replaced by Mg. This study provides a new insight for preparing Mg composites.

  14. The activities of hospital nursing unit managers and quality of patient care in South African hospitals: a paradox?

    Directory of Open Access Journals (Sweden)

    Susan J. Armstrong

    2015-05-01

    Full Text Available Background: Improving the quality of health care is central to the proposed health care reforms in South Africa. Nursing unit managers play a key role in coordinating patient care activities and in ensuring quality care in hospitals. Objective: This paper examines whether the activities of nursing unit managers facilitate the provision of quality patient care in South African hospitals. Methods: During 2011, a cross-sectional, descriptive study was conducted in nine randomly selected hospitals (six public, three private in two South African provinces. In each hospital, one of each of the medical, surgical, paediatric, and maternity units was selected (n=36. Following informed consent, each unit manager was observed for a period of 2 hours on the survey day and the activities recorded on a minute-by-minute basis. The activities were entered into Microsoft Excel, coded into categories, and analysed according to the time spent on activities in each category. The observation data were complemented by semi-structured interviews with the unit managers who were asked to recall their activities on the day preceding the interview. The interviews were analysed using thematic content analysis. Results: The study found that nursing unit managers spent 25.8% of their time on direct patient care, 16% on hospital administration, 14% on patient administration, 3.6% on education, 13.4% on support and communication, 3.9% on managing stock and equipment, 11.5% on staff management, and 11.8% on miscellaneous activities. There were also numerous interruptions and distractions. The semi-structured interviews revealed concordance between unit managers’ recall of the time spent on patient care, but a marked inflation of their perceived time spent on hospital administration. Conclusion: The creation of an enabling practice environment, supportive executive management, and continuing professional development are needed to enable nursing managers to lead the provision

  15. Beroual., et al., Afr J Tradit Complement Altern Med. (2016) 13(2 ...

    African Journals Online (AJOL)

    fouzi

    oil extraction, resultant flaxseed meal is used as a protein supplement in livestock feeds (Maddock et al., 2005). The present work aims to .... hepatocytes, with clearly visible nuclei, central vein and portal triad. Also, the kidneys' ... metabolism in kidneys in an experimental model of polycystic kidney disease. Srp. Arh. Celok.

  16. Neutron activation analysis in the central nervous system tissues and bones of rats maintained on minerally unbalanced diets

    Energy Technology Data Exchange (ETDEWEB)

    Yasui, Masayuki; Ota, Kiichiro [Wakayama Medical Coll. (Japan); Sasajima, Kazuhisa

    1994-07-01

    It is presumed that by the shortage of Mg, Zn and Ca, functional or organic diseases may occur. When Al deposits to central nervous tissues and bones, various diseases are induced. As the degeneracy of central nervous system, in which minerals are presumed to take part, amyotrophic lateral sclerosis, Parkinsonism dementia, Alzheimer disease and Parkinson`s disease are enumerated. Four groups of Winstar rats were bred for 90 days with standard diet, low Ca diet, low Ca and Mg diet and low Ca and Mg, high Al diet, and the contents of Mg, Ca and Zn in the tissues of various parts were analyzed by plasma luminescence analysis, and the content of Al was analyzed by activation analysis. The results for blood serum, bones, soft tissues and the correlation of respective minerals in thighbones and lumbars are reported. It was presumed that the adjustment of the mineralization of bones was disturbed by low Ca and Mg diet, and consequently, also the adjustment of Al, Mn, Zn and other elements caused failure in living bodies. It is considered that as the adjustment of the mineralization of bones was disturbed, the deposit of Al in living bodies was increased. The possibility of preventing Al deposit can be expected by the rational adjustment of mineral metabolism. (K.I.).

  17. Neutron activation analysis in the central nervous system tissues and bones of rats maintained on minerally unbalanced diets

    International Nuclear Information System (INIS)

    Yasui, Masayuki; Ota, Kiichiro; Sasajima, Kazuhisa.

    1994-01-01

    It is presumed that by the shortage of Mg, Zn and Ca, functional or organic diseases may occur. When Al deposits to central nervous tissues and bones, various diseases are induced. As the degeneracy of central nervous system, in which minerals are presumed to take part, amyotrophic lateral sclerosis, Parkinsonism dementia, Alzheimer disease and Parkinson's disease are enumerated. Four groups of Winstar rats were bred for 90 days with standard diet, low Ca diet, low Ca and Mg diet and low Ca and Mg, high Al diet, and the contents of Mg, Ca and Zn in the tissues of various parts were analyzed by plasma luminescence analysis, and the content of Al was analyzed by activation analysis. The results for blood serum, bones, soft tissues and the correlation of respective minerals in thighbones and lumbars are reported. It was presumed that the adjustment of the mineralization of bones was disturbed by low Ca and Mg diet, and consequently, also the adjustment of Al, Mn, Zn and other elements caused failure in living bodies. It is considered that as the adjustment of the mineralization of bones was disturbed, the deposit of Al in living bodies was increased. The possibility of preventing Al deposit can be expected by the rational adjustment of mineral metabolism. (K.I.)

  18. Coupled growth of Al-Al2Cu eutectics in Al-Cu-Ag alloys

    International Nuclear Information System (INIS)

    Hecht, U; Witusiewicz, V; Drevermann, A

    2012-01-01

    Coupled eutectic growth of Al and Al 2 Cu was investigated in univariant Al-Cu-Ag alloys during solidification with planar and cellular morphology. Experiments reveal the dynamic selection of small spacings, below the minimum undercooling spacing and show that distinct morphological features pertain to nearly isotropic or anisotropic Al-Al 2 Cu interfaces.

  19. Evaluation of hospital medication inventory policies.

    Science.gov (United States)

    Gebicki, Marek; Mooney, Ed; Chen, Shi-Jie Gary; Mazur, Lukasz M

    2014-09-01

    As supply chain costs constitute a large portion of hospitals' operating expenses and with $27.7 billion spent by the US hospitals on drugs alone in 2009, improving medication inventory management provides a great opportunity to decrease the cost of healthcare. This study investigates different management approaches for a system consisting of one central storage location, the main pharmacy, and multiple dispensing machines located in each department. Each medication has a specific unit cost, availability from suppliers, criticality level, and expiration date. Event-driven simulation is used to evaluate the performance of several inventory policies based on the total cost and patient safety (service level) under various arrangements of the system defined by the number of drugs and departments, and drugs' criticality, availability, and expiration levels. Our results show that policies that incorporate drug characteristics in ordering decisions can address the tradeoff between patient safety and cost. Indeed, this study shows that such policies can result in higher patient safety and lower overall cost when compared to traditional approaches. Additional insights from this study allow for better understanding of the medication inventory system's dynamics and suggest several directions for future research in this topic. Findings of this study can be applied to help hospital pharmacies with managing their inventory.

  20. Nonlinear electron transport in InAs/AlGaSb three-terminal ballistic junctions

    International Nuclear Information System (INIS)

    Koyama, M; Inoue, T; Amano, N; Maemoto, T; Sasa, S; Inoue, M

    2008-01-01

    We have fabricated and characterized an InAs/AlGaSb three-terminal ballistic junction device. The fabricated device exhibited nonlinear electron transport properties because of ballistic motion of electrons in this structure that is comparable to the electron mean free path. When the left branch is biased to a finite voltage Vand the right to a voltage of -V (push-pull fashion), negative voltages appeared at the floating central branch regardless of the polarity of the input voltages. In the case of the central branch grounded in push-pull fashion, the clear current rectification effect also observed in the current flow of the central branch at 4.2K to even at 300K

  1. AL ITTIJAHAT AL MUNHARIFAH FI AT TAFSIR LI BADLI ASHAB AL MADZAHIB AL NAHWIYYAH WA BADL MAN YAJHALUNA QAWAID AL LUGHAH AL ARABIYYAH FI NADHAR MUHAMMAD HUSAIN AL DZAHABIY

    Directory of Open Access Journals (Sweden)

    Misbakhudin Misbakhudin

    2017-06-01

    Full Text Available One of the most precious achievement in qur’anic studies was the book of Al-Ittijâhât al-Munharifah fî al-Tafsîr: Dawâfi’uha wa Daf’uha written by A great Islamic scholar, Muhammad Husein al-Dzahabî. He was succeeded in discussing several issues of corruptions of the exegesis of the holy Qur’an. This article is aimed to explain and to describe his analysis toward several corrupted linguist interpretations in their originations and such corrupted linguistic interpretations of the holy Qur’an which are ignoring Arabic structures and grammers

  2. Organisational adaptation in an activist network: social networks, leadership, and change in al-Muhajiroun.

    Science.gov (United States)

    Kenney, Michael; Horgan, John; Horne, Cale; Vining, Peter; Carley, Kathleen M; Bigrigg, Michael W; Bloom, Mia; Braddock, Kurt

    2013-09-01

    Social networks are said to facilitate learning and adaptation by providing the connections through which network nodes (or agents) share information and experience. Yet, our understanding of how this process unfolds in real-world networks remains underdeveloped. This paper explores this gap through a case study of al-Muhajiroun, an activist network that continues to call for the establishment of an Islamic state in Britain despite being formally outlawed by British authorities. Drawing on organisation theory and social network analysis, we formulate three hypotheses regarding the learning capacity and social network properties of al-Muhajiroun (AM) and its successor groups. We then test these hypotheses using mixed methods. Our methods combine quantitative analysis of three agent-based networks in AM measured for structural properties that facilitate learning, including connectedness, betweenness centrality and eigenvector centrality, with qualitative analysis of interviews with AM activists focusing organisational adaptation and learning. The results of these analyses confirm that al-Muhajiroun activists respond to government pressure by changing their operations, including creating new platforms under different names and adjusting leadership roles among movement veterans to accommodate their spiritual leader's unwelcome exodus to Lebanon. Simple as they are effective, these adaptations have allowed al-Muhajiroun and its successor groups to continue their activism in an increasingly hostile environment. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  3. Magnetic resonance imaging features of neuroinfections in patients with AIDS. Pablo Tobon Hospital, Medellin (2008-2009)

    International Nuclear Information System (INIS)

    Pulgarin R, Luis G; Gomez R, Susana; Sanchez Z, Jonathan A; Abreo L, Diego F; Hernandez J, Andres F; Donado G, Jorge H.

    2010-01-01

    Our purpose is to describe the clinical and magnetic resonance imaging (MRI) features of the central nervous system (CNS ) most common infectious diseases in patients with human immunodeficiency virus (HIV) and / or acquired immunodeficiency syndrome (AIDS ) that consulted to the Hospital Pablo Tobon Uribe in the period 2008-2009. We included four adult patients with HIV and / or AIDS from Hospital Pablo Tobon Uribe database, who were diagnosed having central nervous system infections by MRI and diagnostic microbiological tests. The most common MRI patterns of CNS infections in AIDS patients in our institution were irregular multifocal intra-axial space-occupying lesions with heterogeneous and variable signals on T1, T2 and FLAI R, with perilesional edema and rim postcontrast enhancement.

  4. Ultrafine and Fine Particles and Hospital Admissions in Central Europe Results from the UFIREG Study

    Czech Academy of Sciences Publication Activity Database

    Lanzinger, S.; Schneider, A.; Breitner, S.; Stafoggia, M.; Erzen, I.; Dostál, Miroslav; Pastorková, Anna; Bastian, S.; Cyrys, J.; Zscheppang, A.; Kolodnitská, T.; Peters, A.

    2016-01-01

    Roč. 194, č. 10 (2016), s. 1233-1241 ISSN 1073-449X Institutional support: RVO:68378041 Keywords : ultrafine particles * particulate matter * hospital admissions * respiratory Subject RIV: DN - Health Impact of the Environment Quality Impact factor: 13.204, year: 2016

  5. [Centralization in obstetrics: pros and cons].

    Science.gov (United States)

    Roemer, V M; Ramb, S

    1996-01-01

    Possible advantages and disadvantages of a general centralization of German obstetric facilities are analysed in the study. The need for centralization of risk cases, especially premature births (regionalization) is pointed out. Centralization appears appropriate, since every fifth maternity unit in Germany (19.78%) has 300 or fewer deliveries per year. This one fifth of perinatal clinics accounts for 6.3% of all deliveries (N = 49450). There are appreciable differences between the old and new federal states (Bundesländer): in the recently acceded federal states, 48.7% of all perinatal clinics have deliveries of 300 and less per year. This group of perinatal clinics accounts for 29% of all deliveries in the new federal states. We have carried out a survey of the mother's attitude to centralization: out of 416 patients in the Detmold women's hospital whose mean age was 29.0 +/- 4.2 years, 90.4% were not in favor of general centralization of obstetrics. 43% were also against a centralization of risk cases (regionalization). 75% of the women surveyed objected to centralized obstetrics because of the 'possible absence of the family', the 'possible absence of students and trainees' (44.9%), the 'unfamiliarity with staff and premises' (41.8%) and 'fear of anonymity' (44.5%). The majority of all women (84.1%) did not want to have a drive more than 20 km to an obstetrics center. Fear of 'delivery in a taxi'(78.6%), the 'fear that the husband will come too late to the delivery' (65.4%) and that the 'overall course of the delivery might not be adequate for reasons of time'. The presence of a pediatrics department in conjunction with the perinatal clinic was rated very positively (93%). It is concluded from the data and further juridical considerations that centralization of risk cases (regionalization) is indispensable in the near future and that somewhat more further into the future decentralization should be carried out by closing obstetrics departments with substantially

  6. BODY HEIGHT AND ITS ESTIMATION UTILIZING ARM SPAN MEASUREMENTS IN FEMALE ADOLESCENTS FROM CENTRAL REGION IN MONTENEGRO

    Directory of Open Access Journals (Sweden)

    Marija Bubanja

    2015-05-01

    Full Text Available Anthropologists recognized the tallness of nations in the Dinaric Alps long time ago (Popovic et al, 2013. As the modern Montenegrins fall partly into the Dinaric racial classification (Bjelica et al., 2012, the purpose of this study was to examine the body height in Montenegrin female adolescents from central region as well as the relationship between arm span as an alternative to estimating the body height, which would vary from region to region in Montenegro. Method: Our investigation analyses 593 female adolescents from the central region in Montenegro. The anthropometric measurements were taken according to the protocol of the International Society for the Advancement of Kinanthropometry (ISAK. Means and standard deviations regarding the anthropometric measurements were obtained. A comparison of means of body heights and arm spans within this gender group were carried out using a t-test. The relationships between body height and arm span were determined using simple correlation coefficients and their 95% confidence interval. Then a linear regression analysis was performed to examine the extent to which the arm span can reliably predict body height. Results: The results displayed that female Central-Montenegrins are 169.24±11.61cm tall and have an arm span of 168.03±10.34cm. Discussion: Compared to other studies, the results of this study have shown that this gender made Central-Macedonians the tall population, taller than general female population in Montenegro (Bjelica et al., 2012. On the other hand, expectably, the arm span reliably predicts body height in this gender. However, the estimation equations which have been obtained in Central-Montenegrins are, different alike in general population, since arm span was shorter than the body heights (1.21±1.27 centimetres, much more than in general population (Bjelica et al., 2012. This confirms the necessity for developing separate height models for each region in Montenegro.

  7. Impact of centralization of pancreatoduodenectomy on reported radical resections rates in a nationwide pathology database.

    Science.gov (United States)

    Onete, Veronica G; Besselink, Marc G; Salsbach, Chanielle M; Van Eijck, Casper H; Busch, Olivier R; Gouma, Dirk J; de Hingh, Ignace H; Sieders, Egbert; Dejong, Cornelis H; Offerhaus, Johan G; Molenaar, I Quintus

    2015-08-01

    Centralization of a pancreatoduodenectomy (PD) leads to a lower post-operative mortality, but is unclear whether it also leads to improved radical (R0) or overall resection rates. Between 2004 and 2009, pathology reports of 1736 PDs for pancreatic and peri-ampullary neoplasms from a nationwide pathology database were analysed. Pre-malignant lesions were excluded. High-volume hospitals were defined as performing ≥ 20 PDs annually. The relationship between R0 resections, PD-volume trends, quality of pathology reports and hospital volume was analysed. During the study period, the number of hospitals performing PDs decreased from 39 to 23. High-volume hospitals reported more R0 resections in the pancreatic head and distal bile duct tumours than low-volume hospitals (60% versus 54%, P = 0.035) although they operated on more advanced (T3/T4) tumours (72% versus 58%, P < 0.001). The number of PDs increased from 258 in 2004 to 394 in 2009 which was partly explained by increased overall resection rates of pancreatic head and distal bile duct tumours (11.2% in 2004 versus 17.5% in 2009, P < 0.001). The overall reported R0 resection rate of pancreatic head and distal bile duct tumours increased (6% in 2004 versus 11% in 2009, P < 0.001). Pathology reports of low-volume hospitals lacked more data including tumour stage (25% versus 15%, P < 0.001). Centralization of PD was associated with both higher resection rates and more reported R0 resections. The impact of this finding on overall survival should be further assessed. © 2015 International Hepato-Pancreato-Biliary Association.

  8. ESTUDIO COMPARATIVO DEL EFECTO DE CRANEO-ACUPUNTURA VS ACUPUNTURA CORPORAL, EN PACIENTES CON SECUELAS DE ENFERMEDAD VASCULAR CEREBRAL EN EL HOSPITAL REGIONAL DEL INSTITUTO DE SEGURIDAD SOCIAL AL SERVICIO DE LOS TRABAJADORES DEL ESTADO DE PUEBLA

    OpenAIRE

    MENDEZ MENDEZ, NAZARIO CELSO

    2011-01-01

    ESTUDIO COMPARATIVO DEL EFECTO DE LA CRANEOACUPUNTURA VS ACUPUNTURA CORPORAL, EN PACIENTES CON SECUELAS DE ENFERMEDAD VASCULAR CEREBRAL EN EL HOSPITAL REGIONAL DEL INSTITUTO DE SEGURIDAD SOCIAL AL SERVICIO DE LOS TRABAJADORES DEL ESTADO DE PUEBLA. LAS SECUELAS DE EVC SON UN PROBLEMA DE SALUD PUBLICA, CON MAYOR FRECUENCIA DE LA ISQUEMIA 81.25 POR CIENTO POR CIENTO Y EN SEGUNDO LUGAR LA HEMORRÁGICA CON EL 18.75 POR CIENTO, EL SEXO FEMENINO ES LA MAS FRECUENTE Y LA EDAD MAS AFECTADA ES DE LO...

  9. An audit of hospital based outpatient infusions and a pilot program of community-based monoclonal antibody infusions.

    LENUS (Irish Health Repository)

    Doran, J-P

    2012-02-01

    INTRODUCTION: Infliximab, a chimeric monoclonal antibody to tumour necrosis factor alpha, is administered as an intravenous infusion requiring a costly hospital day case or inpatient admission. METHODS: An audit of all current therapies given by intravenous infusions in an outpatient setting in St Vincent\\'s University Hospital (SVUH) was undertaken. Furthermore, in conjunction with TCP homecare, we established in a general practise health clinic, the first Irish community infusion centre for the administration of infliximab in August 2006. RESULTS: All outpatient departments indicated that they would favour a centralized hospital infusion unit. There were no adverse events and the mean global satisfaction improved in the community infliximab infusion pilot programme of seven patients. CONCLUSION: This study suggests efficiencies in providing centralized infusion facilities, while the community based infusion of infliximab is feasible and safe in this small cohort and identifies the community infusion unit as a viable and cost efficient alternative for administration of infliximab.

  10. Risk factors for hospital-associated venous thromboembolism in critically ill children following cardiothoracic surgery or therapeutic cardiac catheterisation.

    Science.gov (United States)

    Atchison, Christie M; Amankwah, Ernest; Wilhelm, Jean; Arlikar, Shilpa; Branchford, Brian R; Stock, Arabela; Streiff, Michael; Takemoto, Clifford; Ayala, Irmel; Everett, Allen; Stapleton, Gary; Jacobs, Marshall L; Jacobs, Jeffrey P; Goldenberg, Neil A

    2018-02-01

    Paediatric hospital-associated venous thromboembolism is a leading quality and safety concern at children's hospitals. The aim of this study was to determine risk factors for hospital-associated venous thromboembolism in critically ill children following cardiothoracic surgery or therapeutic cardiac catheterisation. We conducted a retrospective, case-control study of children admitted to the cardiovascular intensive care unit at Johns Hopkins All Children's Hospital (St. Petersburg, Florida, United States of America) from 2006 to 2013. Hospital-associated venous thromboembolism cases were identified based on ICD-9 discharge codes and validated using radiological record review. We randomly selected two contemporaneous cardiovascular intensive care unit controls without hospital-associated venous thromboembolism for each hospital-associated venous thromboembolism case, and limited the study population to patients who had undergone cardiothoracic surgery or therapeutic cardiac catheterisation. Odds ratios and 95% confidence intervals for associations between putative risk factors and hospital-associated venous thromboembolism were determined using univariate and multivariate logistic regression. Among 2718 admissions to the cardiovascular intensive care unit during the study period, 65 met the criteria for hospital-associated venous thromboembolism (occurrence rate, 2%). Restriction to cases and controls having undergone the procedures of interest yielded a final study population of 57 hospital-associated venous thromboembolism cases and 76 controls. In a multiple logistic regression model, major infection (odds ratio=5.77, 95% confidence interval=1.06-31.4), age ⩽1 year (odds ratio=6.75, 95% confidence interval=1.13-160), and central venous catheterisation (odds ratio=7.36, 95% confidence interval=1.13-47.8) were found to be statistically significant independent risk factors for hospital-associated venous thromboembolism in these children. Patients with all three

  11. PACS in Töölö hospital.

    Science.gov (United States)

    Kinnunen, J; Pohjonen, H

    2001-07-01

    A 3-year PACS project was started in 1997 and completed in 1999 with filmless radiology and surgery. An efficient network for transferring images provides the infrastructure for integration of different distributed imaging systems and enables efficient handling of all patient-related information on one display station. Because of the need for high-speed communications and the massive amount of image data transferred in radiology, ATM (25, 155 Mbit/s) was chosen to be the main technology used. Both hardware and software redundancy of the system have been carefully planned. The size of the Dicom image library utilizing MO discs is currently 1.2 TB with 300 GB RAID capacity. For the increasing amount of teleradiologic consultations, a special Dicom gateway is planned. It allows a centralized and resilient handling and routing of received images around the hospital. Hospital-wide PACS has already improved the speed and quality of patient care by providing instant access to diagnostic information at multiple locations simultaneously. The benefits of PACS are considered from the viewpoint of the entire hospital: PACS offers a method for efficiently transporting patient-related images and reports to the referring physicians.

  12. Hospital staffing and hospital costs.

    Science.gov (United States)

    Andrew, R R

    1976-08-07

    A comparative study of costs per bed per day in teaching hospitals affiliated with Monash University compared with large non-teaching metropolitan hospitals (1964 to 1974) shows they are much higher in teaching hospitals. There is no evidence that this is due to the additional costs arising from the clinical schools. Research in the teaching hospitals and the accompanying high professional standards and demands on services are major factors accounting for the difference. Over the decade studied, the resident staff have increased by 77% and other salaried staff by 24%. The index of expenditure for the three teaching hospitals in the decade has increased by 386%.

  13. Association between value-based purchasing score and hospital characteristics

    Directory of Open Access Journals (Sweden)

    Borah Bijan J

    2012-12-01

    Full Text Available Abstract Background Medicare hospital Value-based purchasing (VBP program that links Medicare payments to quality of care will become effective from 2013. It is unclear whether specific hospital characteristics are associated with a hospital’s VBP score, and consequently incentive payments. The objective of the study was to assess the association of hospital characteristics with (i the mean VBP score, and (ii specific percentiles of the VBP score distribution. The secondary objective was to quantify the associations of hospital characteristics with the VBP score components: clinical process of care (CPC score and patient satisfaction score. Methods Observational analysis that used data from three sources: Medicare Hospital Compare Database, American Hospital Association 2010 Annual Survey and Medicare Impact File. The final study sample included 2,491 U.S. acute care hospitals eligible for the VBP program. The association of hospital characteristics with the mean VBP score and specific VBP score percentiles were assessed by ordinary least square (OLS regression and quantile regression (QR, respectively. Results VBP score had substantial variations, with mean score of 30 and 60 in the first and fourth quartiles of the VBP score distribution. For-profit status (vs. non-profit, smaller bed size (vs. 100–199 beds, East South Central region (vs. New England region and the report of specific CPC measures (discharge instructions, timely provision of antibiotics and beta blockers, and serum glucose controls in cardiac surgery patients were positively associated with mean VBP scores (p Conclusions Although hospitals serving the poor and the elderly are more likely to score lower under the VBP program, the correlation appears small. Profit status, geographic regions, number and type of CPC measures reported explain the most variation among scores.

  14. Using the Theory of Planned Behavior to explore hospital-based nurses' intention to use peripherally inserted central catheter (PICC): a survey study.

    Science.gov (United States)

    Bertani, Laura; Carone, Maria; Caricati, Luca; Demaria, Serena; Fantuzzi, Silvia; Guarasci, Alessandro; Pirazzoli, Luca

    2016-11-22

    The peripherally inserted central catheters (PICC) have become an alternative to the traditional CVC. PICCs are usually inserted by trained nurses who decided to attend and complete a special training on PICC insertion and management. The present work aimed to investigate the intention of using PICC in a sample of hospital-based nurses using the theory of planned behavior as theoretical framework. A cross-sectional design was used in which a questionnaire was delivered to 199 nurses. According to the theory of planned behavior, the attitude toward the use of PICC, subjective norms and perceived self-efficacy predicted the intention to use PICC. Contrary to the expectations, the effect of subjective norms on intention to use PICC was mediated by attitude and self-efficacy. Finally, age of participants was negatively related to the intention to use the PICC. The theory of planned behavior offers a useful framework to explain nurses' intention to use PICC. Shared norms favoring the use of PICC seem to increase both nurse's positive attitudes and self-efficacy whit respect to the use of these devices. Thus, it appears that to train professionals individually does not necessarily results in an increased use of PICC.

  15. FEM modeling on the compaction of Fe and Al composite powders

    Directory of Open Access Journals (Sweden)

    Han P.

    2015-01-01

    Full Text Available The compaction process of Fe and Al composite powders subjected to single action die compaction was numerically modeled by FEM method. The relationship between the overall relative density and compaction pressure of the compacts with various Al contents was firstly identified, and the influences of Al content on the local relative density, stress, and their distributions were studied. Then the compaction pressure effects on the above properties with fixed Al content were discussed. Furthermore, detailed flow behaviors of the composite powders during compaction and the relationship between the compaction pressure and the ejection force/spring back of the compact were analyzed. The results show that: (1 With each compaction pressure, higher relative density can be realized with the increase of Al content and the relative density distribution tends to be uniform; (2 When the Al content is fixed, higher compaction pressure can lead to composite compact with higher relative density, and the equivalent Von Mises stress in the central part of the compact increases gradually; (3 Convective flow occurs at the top and bottom parts of the compact close to the die wall, each indicates a different flow behavior; (4 The larger the compaction pressure for each case, the higher the residual elasticity, and the larger the ejection force needed.

  16. Hospital: lugar para o enfermeiro cuidar do imaginário? Hospital Is the hospital a place for caring about imagination?: ¿un lugar para cuidar de lo imaginario?

    Directory of Open Access Journals (Sweden)

    Maria de Lourdes Castanha

    2005-03-01

    Full Text Available Artigo que aborda relato de experiência sobre a atuação do enfermeiro como cuidador na modalidade 'Contador de Histórias', em hospital infantil. Como instrumento de cuidado, a atividade demonstra o dinamismo do imaginário, pois, mediante a fantasia das histórias, transforma a realidade vivida em sonho e transporta a criança, por momentos, para um mundo em que não se convive com a dor e o sofrimento. Ainda, a atividade estabelece relação interpessoal entre o enfermeiro e a criança e de ambos com os personagens das histórias. Essa modalidade de cuidado auxilia na recuperação da criança doente, na aceitação da condição em que ela se encontra e na sua adaptação ao novo espaço, trazendo benefícios ao seu estado geral. É uma terapia que ajuda a liberar a fantasia e a afastar a tristeza e as sensações desagradáveis, e isso permite ao enfermeiro desenvolver o cuidado sensível.Aborda un relato de experiencias sobre la actuación del enfermero como cuidador, utilizando la modalidad "Contador de Historias" en un hospital infantil. En cuanto instrumento para cuidados, demuestra el dinamismo del imaginario de un niño, pues transforma la realidad vivida en sueño, a través de la fantasía de la historia y es transportada, por momentos, a un mundo que convive con el dolor y el sufrimiento. Establece la relación interpersonal entre enfermero-niño y los personajes de las historias. Esa modalidad de cuidados auxilia en la recuperación, aceptación de la condición en que se encuentra, adaptación al nuevo espacio y trae beneficios al estado general del niño enfermo. Funciona como terapia que ayuda a liberar la fantasía y eliminar la tristeza y las sensaciones desagradables, permitiendo al enfermero desarrollar el cuidado sensible.This paper discloses an experience report on nurse's work as caregiver, in which he makes use of 'storyteller' modality in a children's hospital. As a caring tool, such activity shows dynamism of

  17. Optimization of Nb/Al-AlO{sub x}/Nb technology for the investigation of fluxon dynamics in long Josephson junctions

    Energy Technology Data Exchange (ETDEWEB)

    Meckbach, Johannes M.; Kaiser, Christoph; Il' in, Konstantin; Siegel, Michael [Institut fuer Mikro- und Nanoelektronische Systeme, KIT (Germany); Buckenmaier, Kai; Gaber, Tobias; Kienzle, Uta; Sickinger, Hanna; Goldobin, Edward; Kleiner, Reinhold; Koelle, Dieter [Physikalisches Institut - Experimentalphysik II, Universitaet Tuebingen (Germany)

    2010-07-01

    Underdamped long Josephson junctions (LJJs) are ideal systems for the investigation of fluxon dynamics. In LJJs the Josephson phase may vary on the length scale of {lambda}{sub J}, the Josephson penetration depth, and thus is very sensitive to defects in the structure. Inhomogeneities in the barrier can lead to a locally suppressed critical current density and parasitic resonances in the microwave spectra of the JJ. We have developed and optimized the process for Nb/Al-AlO{sub x}/Nb based LJJs exhibiting an exceptionally high quality. We show spectroscopic measurements which confirm the uniformity of the AlO{sub x} barriers. In very long linear JJs, the bias current peaks at the edges while the central part of LJJs is left almost unbiased. This results in unusual I{sub c}(H) dependences with reduced I{sub c}(0) and hampers the control of (semi)fluxons situated near the center of LJJs. To optimize the bias feed circuitry, we have investigated a variety of bias line geometries (multiple lines, resistors, etc.) measuring the scaling of the maximum critical current over the JJ length. We discuss advantages and drawbacks of these designs.

  18. The definition, selection and implementation of a new Clinical Information System to prepare the hospital for the electronic future : an example of project-based education

    NARCIS (Netherlands)

    Spil, Antonius A.M.; van de Meeberg, Henk J.; Sikkel, Nicolaas

    The software supplier of a large hospital has been taken over. The hospital gets notice that the central hospital information system (HIS) will no longer be maintained, starting next year. This problem, not uncommon in business today, is used as a real-life case in a project-based course for first

  19. Physical Plant Design and Engineering Controls to Reduce Hospital-Acquired Infections

    Directory of Open Access Journals (Sweden)

    JM Conly

    2006-01-01

    Full Text Available The importance of the environment as a reservoir for microorganisms implicated in disease transmission in the hospital setting has been increasingly recognized, especially with respect to dialysis units, ventilation in specialized areas, and the proper use of disinfectants (1. Inherent within the environmental setting is the importance of physical plant design. Several studies have underscored the importance of optimizing design standards to maximize patient and health care worker (HCW safety, including the prevention of hospital-acquired infections in patients (2-6. Ulrich et al (7 recently completed an evidence-based review, entitled 'The role of the physical environment in the hospital of the 21st century: A once-in-a-lifetime opportunity', for the Center for Health Design in California (USA, which was funded by the Robert Wood Johnson Foundation. Ulrich and colleagues identified over 600 studies that examined the hospital environment and its effects on staff effectiveness, patient safety, patient and family stress, quality and costs. They suggested that one of the important elements in improving patient safety is the reduction of the risk of hospital-acquired infections through improved facility design.

  20. Hospitality within hospital meals—Socio-material assemblages

    DEFF Research Database (Denmark)

    Justesen, Lise; Gyimóthy, Szilvia; Mikkelsen, Bent E.

    2016-01-01

    Hospital meals and their role in nutritional care have been studied primarily from a life and natural science perspective. This article takes a different approach and explores the idea of hospitality inspired by Jacques Derrida’s work on the ontology of hospitality. By drawing on ethnographic fie...... and management involved in hospital food service and in nutritional care to work more systematically with the environment for improved hospital meal experiences in the future......Hospital meals and their role in nutritional care have been studied primarily from a life and natural science perspective. This article takes a different approach and explores the idea of hospitality inspired by Jacques Derrida’s work on the ontology of hospitality. By drawing on ethnographic...