Sample records for behaviour comparing hospitals

  1. Non-fatal suicidal behaviour at the Johannesburg General Hospital ...

    African Journals Online (AJOL)

    Non-fatal suicidal behaviour at the Johannesburg General Hospital. ... African Journal of Psychiatry ... Patients who threaten deliberate self-harm and who have a history of previous NFSB, past psychiatric illness and physical or sexual abuse, are at a higher risk of this behaviour as compared to the general population.

  2. Lifestyle behaviours and weight among hospital-based nurses. (United States)

    Zapka, Jane M; Lemon, Stephenie C; Magner, Robert P; Hale, Janet


    The purpose of this study was to (i) describe the weight, weight-related perceptions and lifestyle behaviours of hospital-based nurses, and (ii) explore the relationship of demographic, health, weight and job characteristics with lifestyle behaviours. The obesity epidemic is widely documented. Worksite initiatives have been advocated. Nurses represent an important part of the hospital workforce and serve as role models when caring for patients. A sample of 194 nurses from six hospitals participated in anthropometric measurements and self-administered surveys. The majority of nurses were overweight and obese, and some were not actively involved in weight management behaviours. Self-reported health, diet and physical activity behaviours were low, although variable by gender, age and shift. Reports of co-worker norms supported low levels of healthy behaviours. Findings reinforce the need to address the hospital environment and culture as well as individual behaviours for obesity control. Nurse managers have an opportunity to consider interventions that promote a climate favourable to improved health habits by facilitating and supporting healthy lifestyle choices (nutrition and physical activity) and environmental changes. Such efforts have the potential to increase productivity and morale and decrease work-related disabilities and improve quality of life.

  3. Risk profile of young people admitted to hospital for suicidal behaviour in Melbourne, Australia. (United States)

    Borschmann, Rohan; Stark, Patrick; Prakash, Chidambaram; Sawyer, Susan M


    Self-harm and suicidal behaviour is most prevalent during adolescence, but little is known about the risk profile of adolescents admitted to hospital for suicidal behaviour. Young people who self-harm are at an increased risk of mortality compared to those who do not self-harm; adolescents admitted to hospital for suicidal behaviour are particularly at risk. The aim of this study was to generate a risk profile of adolescents admitted to hospital with suicidal behaviour. We conducted a 12-month retrospective audit of adolescent admissions to the mental health inpatient unit at a tertiary children's hospital in Melbourne, Australia. Routinely collected data were used to generate a risk profile. We found that 212 of 271 (78.2%) admissions were due to suicidal behaviour. Of these, 107 (51%) adolescents were diagnosed with one or more mental disorders at discharge, most commonly major depressive disorder. Beyond known distal determinants of health risk, the proximal risk profile of these adolescents included factors relating to gender, substance use, prior mental health diagnoses and prior admission to hospital. Poor sleep was also a risk factor, with 159 (75%) reporting a recent history of sleeping problems. The very high proportion of admissions to the mental health inpatient unit due to suicidal behaviour reinforces the importance of finding effective methods of identification of the risk processes underpinning suicidal behaviours to reduce the unnecessary waste of young lives by suicide. © 2018 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).

  4. Hospital Compare (United States)

    U.S. Department of Health & Human Services — Hospital Compare has information about the quality of care at over 4,000 Medicare-certified hospitals across the country. You can use Hospital Compare to find...

  5. Suicide death and hospital-treated suicidal behaviour in asylum seekers in the Netherlands: a national registry-based study

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    van Oostrum Irene EA


    Full Text Available Abstract Background Several suicide and suicidal behaviour risk factors are highly prevalent in asylum seekers, but there is little insight into the suicide death rate and the suicidal behaviour incidence in this population. The main objective of this study is to assess the burden of suicide and hospital-treated non-fatal suicidal behaviour in asylum seekers in the Netherlands and to identify factors that could guide prevention. Methods We obtained data on cases of suicide and suicidal behaviour from all asylum seeker reception centres in the Netherlands (period 2002-2007, age 15+. The suicide death rates in this population and in subgroups by sex, age and region of origin were compared with the rate in the Dutch population; the rates of hospital-treated suicidal behaviour were compared with that in the population of The Hague using indirect age group standardization. Results The study included 35 suicide deaths and 290 cases of hospital-treated suicidal behaviour. The suicide death rate and the incidence of hospital-treated suicidal behaviour differed between subgroups by sex and region of origin. For male asylum seekers, the suicide death rate was higher than that of the Dutch population (N = 32; RR = 2.0, 95%CI 1.37-2.83. No difference was found between suicide mortality in female asylum seekers and in the female general population of the Netherlands (N = 3; RR = 0.73; 95%CI 0.15-2.07. The incidence of hospital-treated suicidal behaviour was high in comparison with the population of The Hague for males and females from Europe and the Middle East/South West Asia, and low for males and females from Africa. Health professionals knew about mental health problems prior to the suicidal behaviour for 80% of the hospital-treated suicidal behaviour cases in asylum seekers. Conclusions In this study the suicide death rate was higher in male asylum seekers than in males in the reference population. The incidence of hospital-treated suicidal behaviour

  6. [Aggressive behaviour and substance abuse among schizophrenic adolescents compared to antisocial adolescents--a follow-up study]. (United States)

    Sevecke, Kathrin; Dreher, Jan; Walger, Petra; Junglas, Jürgen; Lehmkuhl, Gerd


    The objective of this study was to analyze aggressive behaviour towards others by schizophrenic as opposed to antisocial adolescents, and the influence of substance abuse before, during and after their hospitalization. We analyzed 21 schizophrenic adolescents and compared their aggressive behaviour and their substance abuse to that of 21 antisocial juveniles before and during their hospitalization and again at the time of a follow-up interview. The two samples were matched for age, sex and intelligence. In a first step, data were gathered from the hospital records, in a second step, for follow-up data we conducted standardized telephone interview with the patient and his or her parent or caregiver. Within the analysis we focused on aggressive behaviour towards other people and objects, as well as on criminal acts and regular substance abuse. We found less aggressive behaviour among psychotic patients during and post-hospitalization than among their antisocial counterparts. As inpatients, the acutely psychotic juveniles were at higher risk for aggressive acts, but adequate treatment subdued their offensive behaviour. In the long term, there were fewer criminal arrests among psychotic patients. Only in connection with their substance abuse, their aggressive misconduct towards others increased. Our results suggest that drug treatment during adolescence might help to lessen the risk of aggressive behaviour towards others.

  7. Processes of In-Hospital Psychiatric Care and Subsequent Criminal Behaviour Among Patients With Schizophrenia: A National Population-Based, Follow-Up Study

    DEFF Research Database (Denmark)

    Pedersen, C. G.; Jensen, S. O. W.; Johnsen, S. P.


    Objectives: It is unknown whether evidence-based, in-hospital processes of care may influence the risk of criminal behaviour among patients with schizophrenia. Our study aimed to examine the association between guideline recommended in-hospital psychiatric care and criminal behaviour among patients...... patients receiving the most processes of in hospital care (top quartile of received recommended care, compared with bottom quartiles, adjusted hazard ratio = 0.86, 95% CI 0.75 to 0.99). The individual processes of care associated with the lowest risk of criminal behaviour were antipsychotic treatment...

  8. Hygiene behaviour and hospitalized severe childhood diarrhoea: a case-control study.


    Baltazar, J. C.; Tiglao, T. V.; Tempongko, S. B.


    The relationship between personal and domestic hygiene behaviour and hospitalized childhood diarrhoea was examined in a case-control study of 356 cases and 357 controls from low-income families in metropolitan Manila. Indices of hygiene behaviour were defined for overall cleanliness, kitchen hygiene, and living conditions. Only the indices for overall cleanliness and kitchen hygiene were significantly associated with diarrhoea. An increasing excess risk of hospitalization with severe diarrhoe...

  9. Health professional perspectives on lifestyle behaviour change in the paediatric hospital setting: a qualitative study. (United States)

    Elwell, Laura; Powell, Jane; Wordsworth, Sharon; Cummins, Carole


    Research exists examining the challenges of delivering lifestyle behaviour change initiatives in practice. However, at present much of this research has been conducted with primary care health professionals, or in acute adult hospital settings. The purpose of this study was to identify barriers and facilitators associated with implementing routine lifestyle behaviour change brief advice into practice in an acute children's hospital. Thirty-three health professionals (nurses, junior doctors, allied health professionals and clinical support staff) from inpatient and outpatient departments at a UK children's hospital were interviewed about their attitudes and beliefs towards supporting lifestyle behaviour change in hospital patients and their families. Responses were analysed using thematic framework analysis. Health professionals identified a range of barriers and facilitators to supporting lifestyle behaviour change in a children's hospital. These included (1) personal experience of effectiveness, (2) constraints associated with the hospital environment, (3) appropriateness of advice delivery given the patient's condition and care pathway and (4) job role priorities, and (5) perceived benefits of the advice given. Delivery of lifestyle behaviour change advice was often seen as an educational activity, rather than a behaviour change activity. Factors underpinning the successful delivery of routine lifestyle behaviour change support must be understood if this is to be implemented effectively in paediatric acute settings. This study reveals key areas where paediatric health professionals may need further support and training to achieve successful implementation.

  10. Repeat non-fatal suicidal behaviour at Johannesburg Hospital

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    M YH Moosa


    Full Text Available Objective. To describe the characteristics of non-fatal suicide behaviour (NFSB in a group of patients and to determine factors, if any, that may be associated with repetition of this behaviour. Method. The study included all patients treated for NFSB at Johannesburg Hospital during the period August 2002 - October 2002. The information was gathered by means of a structured questionnaire designed to evaluate characteristics of the behaviour. Results. The study sample comprised 43 patients with NFSB (mean age 29.7 years, range of 16 - 75 years, of whom 26 (60% were female. Sixty-three per cent of the patients overdosed with medication and 33% ingested household poisons. Events that precipitated the event included relationship problems (70%, illness (12%, financial difficulties (9%, and depressed mood (9%. In 65% of patients the behaviour was impulsive. Factors associated with non-fatal repetition included being in the 18 - 30-year age group (76% (χ2 = 6.74, p < 0.05; being female (90% (χ2 = 4.75, p < 0.05; having children (90% (χ2 = 4.72, p < 0.05; a past psychiatric history (50% (χ2 = 4.08, p < 0.05; and the current attempt deemed medically serious (50% (χ2 = 6.67, p < 0.05. Conclusions. NFSB is a major problem in South Africa and the incidence is still increasing. Hospital-based interventions following admission are recommended to reduce repeat attempts in such patients. Significant factors associated with non-fatal repetition include among others, a history of a previous medically serious attempt and/or a known psychiatric illness.

  11. Processes of in-hospital psychiatric care and subsequent criminal behaviour among patients with schizophrenia: a national population-based, follow-up study. (United States)

    Pedersen, Charlotte Gjørup; Olrik Wallenstein Jensen, Signe; Johnsen, Søren Paaske; Nordentoft, Merete; Mainz, Jan


    It is unknown whether evidence-based, in-hospital processes of care may influence the risk of criminal behaviour among patients with schizophrenia. Our study aimed to examine the association between guideline recommended in-hospital psychiatric care and criminal behaviour among patients with schizophrenia. Danish patients with schizophrenia (18 years or older) discharged from a psychiatric ward between January 2004 and March 2009 were identified using a national population-based schizophrenia registry (n = 10 757). Data for in-hospital care and patient characteristics were linked with data on criminal charges obtained from the Danish Crime Registry until November 2010. Twenty per cent (n = 2175) of patients were charged with a crime during follow-up (median = 428 days). Violent crimes accounted for 59% (n = 1282) of the criminal offences. The lowest risk of crime was found among patients receiving the most processes of in-hospital care (top quartile of received recommended care, compared with bottom quartiles, adjusted hazard ratio = 0.86, 95% CI 0.75 to 0.99). The individual processes of care associated with the lowest risk of criminal behaviour were antipsychotic treatment and staff contact with relatives. High-quality, in-hospital psychiatric care was associated with a lower risk of criminal behaviour after discharge among patients with schizophrenia.

  12. Male anorexia and bulimia nervosa: Disorder symptoms and impulsive behaviour during hospital treatment and one year follow-up period. (United States)

    Sernec, Karin; Mrevlje, Gorazd V; Čarapič, Jadranka; Weber, Urška; Zalar, Bojan


    The study aimed to evaluate treatment efficacy in male patients with anorexia (AN) and bulimia nervosa (BN) treated at the Eating Disorder Unit, University Psychiatric Clinic Ljubljana, Slovenia (EDU UPCL), using longitudinal assessments of eating disorder (ED) symptoms and selected impulsive behaviours highly correlated with these entities from hospital admission till twelve months after. 35 male AN and 35 male BN patients were included. Participants were aged 17 or more and somatically stable with the BMI>12 kg/m(2). Patients with psychiatric comorbidity, mental disorder due to a general medical condition, or serious somatic or neurological disease were excluded. Intensity of ED symptoms and presence of selected impulsive behaviours were evaluated at hospital admission and discharge, and three, six and twelve months after, using an internal Eating Disorder Unit Questionnaire. For statistical analysis multivariate analysis of variance was used. Throughout the research period the appropriate changes in BMI were observed in both patient groups. In both, AN and BN patient groups, the evaluation of longitudinal differences regarding the intensity of all ED symptoms and the presence of studied impulsive behaviours showed a significant decline at discharge and all subsequent assessments compared to the results obtained upon admission to the hospital. The re-hospitalization rates of patients with AN and BN in the first year after discharge from the hospital were 3.84% vs. 3.7% respectively. In male patients with AN and BN treated at the EDU UPCL, ED symptoms, BMI, and studied impulsive behaviours show a substantial improvement during hospital treatment. These changes seem to be long lasting, still being effective through one-year post-hospitalization follow-up.

  13. Hygiene behaviour and hospitalized severe childhood diarrhoea: a case-control study. (United States)

    Baltazar, J C; Tiglao, T V; Tempongko, S B


    The relationship between personal and domestic hygiene behaviour and hospitalized childhood diarrhoea was examined in a case-control study of 356 cases and 357 controls from low-income families in metropolitan Manila. Indices of hygiene behaviour were defined for overall cleanliness, kitchen hygiene, and living conditions. Only the indices for overall cleanliness and kitchen hygiene were significantly associated with diarrhoea. An increasing excess risk of hospitalization with severe diarrhoea was noted as the ratings for standards of hygiene became lower, and this excess risk persisted even after controlling for confounding variables. The implications of our findings for the control of diarrhoeal disease are discussed.

  14. Hospitals need to customise care according to patients' differing information-seeking behaviour

    DEFF Research Database (Denmark)

    Riiskjær, Erik; Ammentorp, Jette; Nielsen, Jørn Flohr


    INTRODUCTION: The aim of the study was to describe how often patients seek information about their disease in connection with contact to a hospital and to elucidate how information-seeking behaviour is related to the patients' perception of this contact. MATERIAL AND METHODS: The study was based...... on patient surveys from the Danish county of Aarhus from 1999 to 2006 including eight public hospitals. The patients' information-seeking behaviour was related to patient characteristics, organisational context and patient perceptions. RESULTS: Among the 75,769 patients who responded, 33.4% had actively...

  15. Nursing magnet hospitals have better CMS hospital compare ratings

    Directory of Open Access Journals (Sweden)

    Robbins RA


    Full Text Available Background: There has been conflicting data on whether Nursing Magnet Hospitals (NMH provide better care. Methods: NMH in the Southwest USA (Arizona, California, Colorado, Hawaii, Nevada, and New Mexico were compared to hospitals not designated as NMH using the Centers for Medicare and Medicaid (CMS hospital compare star designation. Results: NMH had higher star ratings than non-NMH hospitals (3.34 + 0.78 vs. 2.86 + 0.83, p<0.001. The hospitals were mostly large, urban non-critical access hospitals. Academic medical centers made up a disproportionately large portion of the NMH. Conclusions: Although NMH had higher hospital ratings, the data may favor non-critical access academic medical centers which are known to have better outcomes.

  16. Hospital Compare - Archived Data (United States)

    U.S. Department of Health & Human Services — Hospital Compare is a consumer-oriented website that provides information on how well hospitals provide recommended care to their patients. This information can help...

  17. Investigating and profiling the leadership behaviours of Jordanian nursing leaders. (United States)

    Mrayyan, Majd; Khasawneh, Israa

    Leadership' is a social process in which a member or members of a group influence the interpretation of events, choice of goals/outcomes, organization of work activities, motivation, abilities, power relations, and shared orientations. This study identifies leadership behaviours of Jordanian nursing leaders. A descriptive comparative design was used to collect data from four governmental and three private hospitals. Data were collected during April 2005. The total number of recruited nursing leaders was 140 with a 70% response rate. T-tests and chi-squares were performed to compare the phenomenon of interest. The mean reported leadership behaviours were slightly higher in private hospitals than those in governmental hospitals. However, more than half of the time, leaders in both types of hospitals used supportive leadership behaviours. There were significant differences between governmental and private hospitals in most demographics of the sample. Based on types of hospitals and gender, differences in leadership behaviours were advantageous for nursing leaders in private hospitals, while differences based on units and wards were advantageous for nursing leaders in governmental hospitals. In general, Jordanian nursing leaders used supportive leadership behaviours. Differences in leadership behaviours have implications for nursing practice, research, and education.

  18. Processes of In-Hospital Psychiatric Care and Subsequent Criminal Behaviour Among Patients With Schizophrenia: A National Population-Based, Follow-Up Study

    DEFF Research Database (Denmark)

    Pedersen, Charlotte Gjørup; Olrik Wallenstein Jensen, Signe; Johnsen, Søren Paaske


    Objectives: It is unknown whether evidence-based, in-hospital processes of care may influence the risk of criminal behaviour among patients with schizophrenia. Our study aimed to examine the association between guideline recommended in-hospital psychiatric care and criminal behaviour among patients...... on criminal charges obtained from the Danish Crime Registry until November 2010. Results: Twenty per cent (n = 2175) of patients were charged with a crime during follow-up (median = 428 days). Violent crimes accounted for 59% (n = 1282) of the criminal offences. The lowest risk of crime was found among...... patients receiving the most processes of inhospital care (top quartile of received recommended care, compared with bottom quartiles, adjusted hazard ratio = 0.86, 95% CI 0.75 to 0.99). The individual processes of care associated with the lowest risk of criminal behaviour were antipsychotic treatment...

  19. An empirical analysis of executive behaviour with hospital executive information systems in Taiwan. (United States)

    Huang, Wei-Min


    Existing health information systems largely only support the daily operations of a medical centre, and are unable to generate the information required by executives for decision-making. Building on past research concerning information retrieval behaviour and learning through mental models, this study examines the use of information systems by hospital executives in medical centres. It uses a structural equation model to help find ways hospital executives might use information systems more effectively. The results show that computer self-efficacy directly affects the maintenance of mental models, and that system characteristics directly impact learning styles and information retrieval behaviour. Other results include the significant impact of perceived environmental uncertainty on scan searches; information retrieval behaviour and focused searches on mental models and perceived efficiency; scan searches on mental model building; learning styles and model building on perceived efficiency; and finally the impact of mental model maintenance on perceived efficiency and effectiveness.

  20. Suicidal behaviour characteristics and factors associated with mortality in the hospital setting. (United States)

    Sendra-Gutiérrez, Juan Manuel; Esteban-Vasallo, María; Domínguez-Berjón, M Felicitas


    Suicide is a major public health problem worldwide, and an approach is necessary due to its high potential for prevention. This paper examines the main characteristics of people admitted to hospitals in the Community of Madrid (Spain) with suicidal behaviour, and the factors associated with their hospital mortality. A study was conducted on patients with E950-E959 codes of suicide and self-inflicted injuries of the International Classification of Diseases, Ninth Revision, Clinical Modification, contained in any diagnostic field of the minimum basic data set at hospital discharge between 2003 and 2013. Sociodemographic, clinical and health care variables were assessed by uni- and multivariate logistic regression analysis in the evaluation of factors associated with hospital mortality. Hospital suicidal behaviour predominates in women (58.7%) and in middle-age. Hospital mortality is 2.2% (1.6% in women and 3.2% in men), increasing with age. Mental disorders are detected 3-4 times more in secondary diagnoses. The main primary diagnosis (>74%) is poisoning with substances, with lower mortality (∼1%) than injury by hanging and jumping from high places (≥12%), which have the highest numbers. Other factors associated with increased mortality include different medical comorbidities and severity of the injury, while length of stay and mental disorders are protective factors. Type of hospital, poisoning, and Charlson index are associated differently with mortality in men and women. Hospitalised suicidal acts show a low mortality, mainly related to comorbidities and the severity of injuries. Copyright © 2016 SEP y SEPB. Published by Elsevier España. All rights reserved.

  1. House of healing, house of disrespect: a Kantian perspective on disrespectful behaviour among hospital workers. (United States)

    Bernstein, Mark; Fundner, Rita


    Respect toward patients is one of the most fundamental and central tenets guiding both modern bioethical practice and the everyday behaviour of all healthcare professionals. However, similar courtesy and respect is often breached in day-to-day interactions between hospital workers. Many examples are relatively minor, while egregious examples such as gender discrimination and physical abuse do occur. The more egregious transgressions may be handled by formal processes, even legal proceedings. However, the innumerable smaller examples of disrespectful behaviour are ubiquitous and insidious in their erosion of a productive collaborative approach to patient care and other aspects of functioning within the institution. The authors briefly summarize some of the pertinent literature on this subject and analyze the problem of disrespect in the hospital with special focus on the issue as seen from the perspective of the moral philosophy of Immanuel Kant. Some simple recommendations for improving disrespectful behaviour amongst hospital workers are offered.

  2. Hospital Compare Data (United States)

    U.S. Department of Health & Human Services — These are the official datasets used on the Hospital Compare Website provided by the Centers for Medicare and Medicaid Services. These data allow you to...

  3. A study of the information seeking behaviour of hospital pharmacists: empirical evidence from Greece. (United States)

    Kostagiolas, Petros A; Aggelopoulou, Vasiliki A; Niakas, Dimitris


    Hospital pharmacists need access to high-quality information in order to constantly update their knowledge and improve their skills. In their modern role, they are expected to address three types of challenges: scientific, organizational and administrative, thus having an increased need for adequate information and library services. This study investigates the information-seeking behaviour of public hospital pharmacists providing evidence from Greece that could be used to encourage the development of effective information hospital services and study the links between the information seeking behaviour of hospital pharmacists and their modern scientific and professional role. An empirical research was conducted between January and February 2010 with the development and distribution of a structured questionnaire. The questionnaire was filled in and returned by 88 public hospital pharmacists from a total of 286 working in all Greek public hospitals, providing a response rate of 31%. The hospital pharmacists in Greece are in search of scientific information and, more particularly, pharmaceutical information (e.g., drug indications, storage, dosage and prices). The Internet and the National Organization of Medicines are their main information sources, while the lack of time and organized information are the main obstacles they have to face when seeking information. The modern professional role of hospital pharmacists as invaluable contributors to efficient and safer healthcare services may be further supported through the development of specialized libraries and information services within Greek public hospitals. © 2011 The authors. Health Information and Libraries Journal © 2011 Health Libraries Group.

  4. Comparing the driving behaviours of individuals with frontotemporal lobar degeneration and those with Alzheimer's disease. (United States)

    Fujito, Ryoko; Kamimura, Naoto; Ikeda, Manabu; Koyama, Asuka; Shimodera, Shinji; Morinobu, Shigeru; Inoue, Shimpei


    Assessing driving aptitude in dementia patients is critically important for both patient and public safety. However, there have been only a few reports on the driving behaviours and accident risk of patients with dementia, especially frontotemporal lobar degeneration (FTLD). Therefore, we compared the characteristics of driving behaviours in patients with FTLD and those with Alzheimer's disease (AD). The subjects were 28 FTLD and 67 AD patients who visited the Department of Psychiatry, Kochi Medical School Hospital. We conducted semi-structured interviews with their families and caregivers about traffic accident history and changes in patient driving behaviours after dementia onset and then compared the findings between the two groups. Overall changes in driving behaviours were reported in 89% (25/28) and 76% (51/67) of the FTLD and AD patients, respectively (P = 0.17). In the FTLD group, difficulty in judging inter-vehicle distances, ignoring road signs and traffic signals, and distraction were reported in 50% (14/28), 61% (17/28), and 50% (14/28) of patients, respectively, and 75% (21/28) patients had caused a traffic accident after dementia onset. The risk of causing an accident was higher in the FTLD group than in the AD group (odds ratio = 10.4, 95% confidence interval = 3.7-29.1). In addition, the mean duration between dementia onset and a traffic accident was 1.35 years in the FTLD group compared with 3.0 years in the AD group (P driving behaviours than those with AD, and the risk of causing a traffic accident may be higher in patients with FTLD from an early disease stage. © 2015 The Authors. Psychogeriatrics © 2015 Japanese Psychogeriatric Society.

  5. Behavioural and psychological symptoms in general hospital patients with dementia, distress for nursing staff and complications in care: results of the General Hospital Study. (United States)

    Hessler, J B; Schäufele, M; Hendlmeier, I; Junge, M N; Leonhardt, S; Weber, J; Bickel, H


    Little is known about how behavioural and psychological symptoms of dementia (BPSD) manifest in the general hospital. The aim was to examine the frequency of BPSD in general hospitals and their associations with nursing staff distress and complications in care. Cross-sectional representative study with 1469 patients aged ≥65, including 270 patients with dementia, of 33 randomly selected general hospitals in Germany. BPSD and complications were reported by nurses. Overall frequency of BPSD was higher in patients with dementia (76%) than without (38%). The most frequent symptoms in patients with dementia were nighttime disturbances (38%), depression (29%) and aberrant motor behaviour (28%) and the most distressing symptoms for nursing staff were delusions, aggression and nighttime disturbances. The overall frequency of BPSD increased from 67% in mild dementia, to 76% in moderate dementia and to 88% in severe dementia. The most frequent symptoms in patients without dementia were depression (19%), nighttime disturbances (13%) and irritability (13%). The most distressing symptoms were aggression and delusions, while the same symptoms were consistently rated as less distressing than in patients with dementia. Factor analysis revealed three independent groups of BPSD that explained 45% of the total variance. First, expansive symptoms (aggression, irritability, nighttime disturbances, aberrant motor behaviour and disinhibition) were frequent, distressing for nursing staff and associated with many complications. Second, psychotic symptoms (delusions and hallucinations) were infrequent, distressing and associated with some complications. Third, affective symptoms (apathy, anxiety and depression) were frequent, non-distressing and associated with few complications. The results did not change when cases with delirium were excluded from both groups. BPSD are common in older hospital patients with dementia and associated with considerable distress in nursing staff, as well as

  6. Comparing Candidate Hospital Report Cards

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    Burr, T.L.; Rivenburgh, R.D.; Scovel, J.C.; White, J.M.


    We present graphical and analytical methods that focus on multivariate outlier detection applied to the hospital report cards data. No two methods agree which hospitals are unusually good or bad, so we also present ways to compare the agreement between two methods. We identify factors that have a significant impact on the scoring.

  7. Benign Prostatic Hyperplasia: Health Seeking Behaviour of patients at a tertiary care hospital.

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    Aman Deep


    Full Text Available BackgroundBenign Prostatic Hyperplasia is a widely prevalent conditionaffecting elderly men throughout the world. With increasinglife expectancy, there has been a rise in the percentage ofelderly men and so for this disease across the globe. There islack of information about health seeking behaviour of patientswith Benign Prostatic Hyperplasia. Therefore the study wasdesigned with the objectives of assessing health-seekingbehaviour and the effect of literacy on it among adult andolder subjects suffering from Benign Prostatic Hyperplasiaattending a tertiary care hospital.MethodA series of 81 patients suffering from Benign ProstaticHyperplasia above the age of 50 years, attending surgical OutPatient Department of a tertiary care hospital in Delhi, wereassessed for their health seeking behaviour using a pre-testedand a modified questionnaire designed for assessing healthseeking behaviour.ResultsPositive health seeking behaviour of patients was observed in44%, who reported to a doctor within a month of noticingtheir problem. A greater proportion of the literates was awareabout the symptoms suggestive of enlarged prostate andconsulted a qualified health care practitioner as their firstaction. More literates approached the higher level of healthcare facility on being referred and had maximum faith inallopathic system of medicine. Also, lesser number of literateshad performed pooja (Hindi word for worship or othertraditional rituals for relief of their problems.ConclusionWe concluded that majority of subjects suffering fromBenign Prostatic Hypertrophy were not aware of theirdisease and their health-seeking behaviour was poor andcould be related to literacy. Our data highlights the needfor public awareness program targeting the younger malepopulation so that early detection and treatment can beoffered.

  8. Health-related behaviour among managers of Slovenian hospitals and institutes of public health

    Directory of Open Access Journals (Sweden)

    Jerneja Farkas


    Full Text Available Aim: Behavioural risk factors have a significant impact on health. We aimed to assess health-related behaviour, health status, and use of healthcare services among managers of Slovenian hospitals and institutes of public health. Methods: This was a cross-sectional study which included management (directors, scientific directors, directors’ deputies of Slovenian hospitals and institutes of public health (63 respondents; 57% women; overall mean age: 51±7 years; response rate: 74%. Data were obtained using an anonymous self-administered questionnaire. Results: About 35% of respondents were directors. More than half of the respondents were overweight or obese (52%, the majority were not sufficiently physically active (59% and overloaded with stress (87%. Hypercholesterolemia (36%, spinal disease (17%, and arterial hypertension (16% were most common chronic diseases. Whilst only few participants visited their general practitioner due their health complaints, blood pressure (76%, cholesterol (51%, and glucose (54% were measured within last year in most of the respondents. Conclusion: Our findings point to a high prevalence of overweight and obesity as well as workplace-related stress among Slovenian public health managers. Therefore, effective preventive strategies should be focused on stress management along with promotion of healthy behavioural patterns.

  9. HSMR : Comparing Death Rates Across UK Hospitals

    NARCIS (Netherlands)

    Ben Teeuwen; Thuy Ngo; Frans Nauta


    The Hospital Standardized Mortality Ratio (HSMR) is a measurement tool that shows hospitals’ death rates. The HSMR compares deaths that occur in hospitals with death ratios that one would normally expect based on patients’ diseases. It is used as a benchmark for adjusted hospital death rates. These

  10. Comparing solutions to the expectancy-value muddle in the theory of planned behaviour. (United States)

    O' Sullivan, B; McGee, H; Keegan, O


    The authors of the Theories of Reasoned Action (TRA) and Planned Behaviour (TPB) recommended a method for statistically analysing the relationship between the indirect belief-based measures and the direct measures of attitude, subjective norm, and perceived behavioural control (PBC). However, there is a growing awareness that this yields statistically uninterpretable results. This study's objective was to compare two solutions to what has been called the 'expectancy-value muddle'. These solutions were (i) optimal scoring of modal beliefs and (ii) individual beliefs without multiplicative composites. Cross-sectional data were collected by telephone interview. Participants were 110 first-degree relatives (FDRs) of patients diagnosed with colorectal cancer (CRC), who were offered CRC screening in the study hospital (83% response rate). Participants were asked to rate the TPB constructs in relation to attending for CRC screening. There was no significant difference in the correlation between behavioural beliefs and attitude for rescaled modal and individual beliefs. This was also the case for control beliefs and PBC. By contrast, there was a large correlation between rescaled modal normative beliefs and subjective norm, whereas individual normative beliefs did not correlate with subjective norm. Using individual beliefs without multiplicative composites allows for a fairly unproblematic interpretation of the relationship between the indirect and direct TPB constructs (French & Hankins, 2003). Therefore, it is recommended that future studies consider using individual measures of behavioural and control beliefs without multiplicative composites and examine a different way of measuring individual normative beliefs without multiplicative composites to that used in this study.

  11. Information Sharing, Cooperative Behaviour and Hotel Performance: A Survey of the Kenyan Hospitality Industry

    Directory of Open Access Journals (Sweden)

    Sammy Odari Namusonge


    Full Text Available Information sharing is the life blood of supply chain collaboration. Its role in achieving operational performance of supply chains has been widely acclaimed. However whether information sharing would result in improved performance in the context of the hospitality industry has not been empirically determined. This study sought to find out the role of information sharing on hotel performance when the relationship was mediated by cooperative behaviour. A survey design was employed where proportionate stratified sampling was used to select 50 out of 57 town hotels. Data was collected through the use of questionnaires as well interview guides to the procurement\\supply chain departments of these hotels. Logarithmic transformations were used in conjunction with multiple regression analysis to determine the relationship between information sharing, cooperative behaviour and hotel performance. The study concludes that information sharing in the Kenyan hospitality industry does not directly relate to hotel performance. Its relationship is mediated by cooperative behaviour (trust and attitude with supply chain partners. This suggests that information sharing is essential but insufficient by itself to bring significant performance improvements in hotels in the Kenyan hospitality industry. A possible reason for this is that this collaborative practice is highly dependent on information sharing capability, structure of the information as well as culture. Through quadrant analysis the study identifies and recommends the sharing of information about long term strategic plans and events such as entering new markets and acquiring a new customer base as an area of primary priority for improvement.

  12. Hospital responses to pay-for-performance incentives. (United States)

    Reiter, Kristin L; Nahra, Tammie A; Alexander, Jeffrey A; Wheeler, John R C


    Not-for-profit hospitals are complex organizations and, therefore, may face unique challenges in responding to financial incentives for quality. In this research, we explore the types of behavioural changes made by not-for-profit Michigan hospitals in response to a pay-for-performance system for quality. We also identify factors that motivate or facilitate changes in effort. We apply a conceptual framework based on agency theory to motivate our research questions. Using data derived from structured interviews and surveys administered to 86 hospitals participating in a pay-for-performance system, we compare hospitals reporting and not reporting behavioural changes. Separate analyses are performed for hospitals reporting structure-related changes and hospitals reporting process-related changes. Our findings confirm that hospitals respond to incentive payments; however, our findings also reveal that hospital responses are not universal. Rather, involvement by boards of trustees, willingness to exert leverage with physicians, and financial and competitive motivations are all associated with hospitals' behavioural responses to incentives. Results of this research will help inform payers and hospital managers considering the use of incentives about the nature of hospitals' responses.

  13. From neurons to nests: nest-building behaviour as a model in behavioural and comparative neuroscience. (United States)

    Hall, Zachary J; Meddle, Simone L; Healy, Susan D

    Despite centuries of observing the nest building of most extant bird species, we know surprisingly little about how birds build nests and, specifically, how the avian brain controls nest building. Here, we argue that nest building in birds may be a useful model behaviour in which to study how the brain controls behaviour. Specifically, we argue that nest building as a behavioural model provides a unique opportunity to study not only the mechanisms through which the brain controls behaviour within individuals of a single species but also how evolution may have shaped the brain to produce interspecific variation in nest-building behaviour. In this review, we outline the questions in both behavioural and comparative neuroscience that nest building could be used to address, summarize recent findings regarding the neurobiology of nest building in lab-reared zebra finches and across species building different nest structures, and suggest some future directions for the neurobiology of nest building.

  14. Analysis of Nurses’ Organizational Deviant Behaviour: An Example of a University Hospital

    Directory of Open Access Journals (Sweden)

    Gamze Bayın


    Full Text Available Organizational deviant behavior is defined as intentionally behavior which is damaging both employees and organization and unsuitable to organization rules, norms, values, expectations and legal regulations.The aim of this study is to determine the level of organizational deviance of nurses, to expose differentiates of this level. according to the descriptive characteristics, to detect the dimensions of organizational deviance and to evaluate the relationship between these dimensions. Population of the study is nurses working at a University Hospital in Ankara. The sample is not selected and tried to reach all the nurses working at this hospital. However, 244 nurses were reached (%48,12. To measure organizational deviance, “Measure of Workplace Deviance Items”which was developed by Bennett and Robinson (2000was used. This scale consists from 15 expressions and 2 dimensions and its’ Cronbach's alpha coefficient was 0,94. As a result of the study, the mean score of nurses’ organizational deviance was found 1.85 ± 0.718. In addition, statistically significant, positive and moderately strong correlation was found between the two dimensions of organizational deviance (R= 0.701 . It can be suggested that health care managers should identify reasons and the ways of preventing of individual deviant behaviour. Thus, managers may prevent behaviour of deviation to the organization.

  15. Quality competition and hospital mergers-An experiment. (United States)

    Han, Johann; Kairies-Schwarz, Nadja; Vomhof, Markus


    On the basis of a Salop model with regulated prices, we investigate quality provision behaviour of competing hospitals before and after a merger. For this, we use a controlled laboratory experiment where subjects decided on the level of treatment quality as head of a hospital. We find that the post-merger average quality is significantly lower than the average pre-merger quality. However, for merger insiders and outsiders, average quality choices are significantly higher than predicted for pure profit-maximising hospitals. This upward deviation is potentially driven by altruistic behaviour towards patients. Furthermore, we find that in the case where sufficient cost synergies are realised by the merged hospitals, there is a significant increase in average quality choices compared to the scenario without synergies. Finally, we find that our results do not change when comparing individual decisions to team decisions. Copyright © 2017 John Wiley & Sons, Ltd.

  16. Specialty and full-service hospitals: a comparative cost analysis. (United States)

    Carey, Kathleen; Burgess, James F; Young, Gary J


    To compare the costs of physician-owned cardiac, orthopedic, and surgical single specialty hospitals with those of full-service hospital competitors. The primary data sources are the Medicare Cost Reports for 1998-2004 and hospital inpatient discharge data for three of the states where single specialty hospitals are most prevalent, Texas, California, and Arizona. The latter were obtained from the Texas Department of State Health Services, the California Office of Statewide Health Planning and Development, and the Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project. Additional data comes from the American Hospital Association Annual Survey Database. We identified all physician-owned cardiac, orthopedic, and surgical specialty hospitals in these three states as well as all full-service acute care hospitals serving the same market areas, defined using Dartmouth Hospital Referral Regions. We estimated a hospital cost function using stochastic frontier regression analysis, and generated hospital specific inefficiency measures. Application of t-tests of significance compared the inefficiency measures of specialty hospitals with those of full-service hospitals to make general comparisons between these classes of hospitals. Results do not provide evidence that specialty hospitals are more efficient than the full-service hospitals with whom they compete. In particular, orthopedic and surgical specialty hospitals appear to have significantly higher levels of cost inefficiency. Cardiac hospitals, however, do not appear to be different from competitors in this respect. Policymakers should not embrace the assumption that physician-owned specialty hospitals produce patient care more efficiently than their full-service hospital competitors.

  17. Glycaemic Control and Associated Self-Management Behaviours in Diabetic Outpatients: A Hospital Based Observation Study in Lusaka, Zambia

    Directory of Open Access Journals (Sweden)

    Emmanuel Mwila Musenge


    Full Text Available Background. The control of diabetes mellitus depends on several factors that also include individual lifestyles. We assessed glycaemic control status and self-management behaviours that may influence glycaemic control among diabetic outpatients. Methods. This cross-sectional study among 198 consenting randomly selected patients was conducted at the University Teaching Hospital diabetic clinic between September and December 2013 in Lusaka, Zambia. A structured interview schedule was used to collect data on demographic characteristics, self-management behaviours, and laboratory measurements. Binary logistic regression analysis using IBM SPSS for Windows version 20.0 was carried out to predict behaviours that were associated with glycaemic control status. Results. The proportion of patients that had good glycaemic control status (HbA1c≤ 48 mmol/mol was 38.7% compared to 61.3% that had poor glycaemic control status (HbA1c≥ 49 mmol/mol. Adherence to antidiabetic treatment and fasting plasma glucose predicted glycaemic control status of the patients. However, self-blood glucose monitoring, self-blood glucose monitoring means and exercise did not predict glycaemic control status of the patients.  Conclusion. We find evidence of poor glycaemic control status among most diabetic patients suggesting that health promotion messages need to take into account both individual and community factors to promote behaviours likely to reduce nonadherence.

  18. Working hours and health behaviour among nurses at public hospitals. (United States)

    Fernandes, Juliana da Costa; Portela, Luciana Fernandes; Rotenberg, Lúcia; Griep, Rosane Harter


    To analyse the differences between genders in the description in the professional, domestic and total work hours and assess its association with health-related behaviour among nurses. This is a transversal study carried out in 18 different public hospitals in the municipality of Rio de Janeiro. The data collection procedure was based on questionnaires. All nurses working with assistance were considered eligible (n=2,279). Men and women showed significant differences in relation to working hours. The female group showed longer domestic and total work hours when compared to the group of men. In contrast, the number of hours spent on professional work was higher among men. For the women, both the professional hours and total work hours were often associated with excessive consumption of fried food and also coffee, lack of physical exercise and also the greater occurrence of overweight and obesity. Both the professional hours and the domestic work hours need to be taken into account in studies about health, self-care and also the care provided within the context of nursing workers, particularly among women. The results add weight to the need for actions for health promotion in this occupational group and the importance of assessing the impact of long working hours on the health of workers.

  19. The effect of performance-related pay of hospital doctors on hospital behaviour: a case study from Shandong, China

    Directory of Open Access Journals (Sweden)

    Mills Anne


    Full Text Available Abstract Background With the recognition that public hospitals are often productively inefficient, reforms have taken place worldwide to increase their administrative autonomy and financial responsibility. Reforms in China have been some of the most radical: the government budget for public hospitals was fixed, and hospitals had to rely on charges to fill their financing gap. Accompanying these changes was the widespread introduction of performance-related pay for hospital doctors – termed the "bonus" system. While the policy objective was to improve productivity and cost recovery, it is likely that the incentive to increase the quantity of care provided would operate regardless of whether the care was medically necessary. Methods The primary concerns of this study were to assess the effects of the bonus system on hospital revenue, cost recovery and productivity, and to explore whether various forms of bonus pay were associated with the provision of unnecessary care. The study drew on longitudinal data on revenue and productivity from six panel hospitals, and a detailed record review of 2303 tracer disease patients (1161 appendicitis patients and 1142 pneumonia patients was used to identify unnecessary care. Results The study found that bonus system change over time contributed significantly to the increase in hospital service revenue and hospital cost recovery. There was an increase in unnecessary care and in the probability of admission when the bonus system switched from one with a weaker incentive to increase services to one with a stronger incentive, suggesting that improvement in the financial health of public hospitals was achieved at least in part through the provision of more unnecessary care and drugs and through admitting more patients. Conclusion There was little evidence that the performance-related pay system as designed by the sample of Chinese public hospitals was socially desirable. Hospitals should be monitored more closely

  20. The relationships among social capital, organisational commitment and customer-oriented prosocial behaviour of hospital nurses. (United States)

    Hsu, Chiu-Ping; Chang, Chia-Wen; Huang, Heng-Chiang; Chiang, Chi-Yun


    This study examines the perceptions of registered nurses of social capital, organisational commitment and customer-oriented prosocial behaviour. Additionally, this study also addresses a conceptual model for testing how registered nurses' perceptions of three types of social capital influence their organisational commitment, in turn intensifying customer-oriented prosocial behaviour, including role-prescribed customer service and extra-role customer service. Customer-oriented prosocial behaviour explains differences in job satisfaction and job performance. However, the critical role of customer orientation in the hospital setting has yet to be explored. Survey. The survey was conducted to obtain data from registered nurses working for a large Taiwanese medical centre, yielding 797 usable responses and a satisfactory response rate of 86.7%. The partial least squares method was adopted to obtain parameter estimates and test proposed hypotheses. The study measurements display satisfactory reliability, as well as both convergent and discriminant validities. All hypotheses were supported. Empirical results indicate that registered nurses' perceptions of social capital were significantly impacted the extent of organisational commitment, which in turn significantly influenced customer-oriented prosocial behaviour. By stimulating nursing staff commitment, health care providers can urge them to pursue organisational goals and provide high quality customer service. To enhance organisational commitment, health care managers should endeavour to create interpersonal interaction platforms in addition to simply offering material rewards. Nurses act as contact employees for their patient customers in the hospital, and they are required to provide patient safety and service quality. This study shows that nurses with high organisational commitment are willing to provide customer-oriented prosocial activities, which in turn enhances patient satisfaction. © 2011 Blackwell Publishing

  1. Comparing public and private hospitals in China: evidence from Guangdong. (United States)

    Eggleston, Karen; Lu, Mingshan; Li, Congdong; Wang, Jian; Yang, Zhe; Zhang, Jing; Quan, Hude


    The literature comparing private not-for-profit, for-profit, and government providers mostly relies on empirical evidence from high-income and established market economies. Studies from developing and transitional economies remain scarce, especially regarding patient case-mix and quality of care in public and private hospitals, even though countries such as China have expanded a mixed-ownership approach to service delivery. The purpose of this study is to compare the operations and performance of public and private hospitals in Guangdong Province, China, focusing on differences in patient case-mix and quality of care. We analyze survey data collected from 362 government-owned and private hospitals in Guangdong Province in 2005, combining mandatorily reported administrative data with a survey instrument designed for this study. We use univariate and multi-variate regression analyses to compare hospital characteristics and to identify factors associated with simple measures of structural quality and patient outcomes. Compared to private hospitals, government hospitals have a higher average value of total assets, more pieces of expensive medical equipment, more employees, and more physicians (controlling for hospital beds, urban location, insurance network, and university affiliation). Government and for-profit private hospitals do not statistically differ in total staffing, although for-profits have proportionally more support staff and fewer medical professionals. Mortality rates for non-government non-profit and for-profit hospitals do not statistically differ from those of government hospitals of similar size, accreditation level, and patient mix. In combination with other evidence on health service delivery in China, our results suggest that changes in ownership type alone are unlikely to dramatically improve or harm overall quality. System incentives need to be designed to reward desired hospital performance and protect vulnerable patients, regardless of

  2. Comparing public and private hospitals in China: Evidence from Guangdong

    Directory of Open Access Journals (Sweden)

    Yang Zhe


    Full Text Available Abstract Background The literature comparing private not-for-profit, for-profit, and government providers mostly relies on empirical evidence from high-income and established market economies. Studies from developing and transitional economies remain scarce, especially regarding patient case-mix and quality of care in public and private hospitals, even though countries such as China have expanded a mixed-ownership approach to service delivery. The purpose of this study is to compare the operations and performance of public and private hospitals in Guangdong Province, China, focusing on differences in patient case-mix and quality of care. Methods We analyze survey data collected from 362 government-owned and private hospitals in Guangdong Province in 2005, combining mandatorily reported administrative data with a survey instrument designed for this study. We use univariate and multi-variate regression analyses to compare hospital characteristics and to identify factors associated with simple measures of structural quality and patient outcomes. Results Compared to private hospitals, government hospitals have a higher average value of total assets, more pieces of expensive medical equipment, more employees, and more physicians (controlling for hospital beds, urban location, insurance network, and university affiliation. Government and for-profit private hospitals do not statistically differ in total staffing, although for-profits have proportionally more support staff and fewer medical professionals. Mortality rates for non-government non-profit and for-profit hospitals do not statistically differ from those of government hospitals of similar size, accreditation level, and patient mix. Conclusions In combination with other evidence on health service delivery in China, our results suggest that changes in ownership type alone are unlikely to dramatically improve or harm overall quality. System incentives need to be designed to reward desired hospital

  3. Smoking behaviour predicts tobacco control attitudes in a high smoking prevalence hospital: A cross-sectional study in a Portuguese teaching hospital prior to the national smoking ban

    Directory of Open Access Journals (Sweden)

    Aguiar Pedro


    Full Text Available Abstract Background Several studies have investigated attitudes to and compliance with smoking bans, but few have been conducted in healthcare settings and none in such a setting in Portugal. Portugal is of particular interest because the current ban is not in line with World Health Organization recommendations for a "100% smoke-free" policy. In November 2007, a Portuguese teaching-hospital surveyed smoking behaviour and tobacco control (TC attitudes before the national ban came into force in January 2008. Methods Questionnaire-based cross-sectional study, including all eligible staff. Sample: 52.9% of the 1, 112 staff; mean age 38.3 ± 9.9 years; 65.9% females. Smoking behaviour and TC attitudes and beliefs were the main outcomes. Bivariable analyses were conducted using chi-squared and MacNemar tests to compare categorical variables and Mann-Whitney tests to compare medians. Multilogistic regression (MLR was performed to identify factors associated with smoking status and TC attitudes. Results Smoking prevalence was 40.5% (95% CI: 33.6-47.4 in males, 23.5% (95% CI: 19.2-27.8 in females (p Conclusions Smoking prevalence was high, especially among the lower socio-economic groups. The findings showed a very high level of support for smoking bans, despite the pro-smoking environment. Most staff reported passive behaviour, despite high SHS exposure. This and the high smoking prevalence may contribute to low compliance with the ban and low participation on smoking cessation activities. Smoking behaviour had greater influence in TC attitudes than health professionals' education. Our study is the first in Portugal to identify potential predictors of non-compliance with the partial smoking ban, further emphasising the need for a 100% smoke-free policy, effective enforcement and public health education to ensure compliance and promote social norm change.

  4. Nurse managers: Determinants and behaviours in relation to patient and visitor aggression in general hospitals. A qualitative study. (United States)

    Heckemann, Birgit; Peter, Karin A; Halfens, Ruud Jg; Schols, Jos Mga; Kok, Gerjo; Hahn, Sabine


    To explore nurse managers' behaviours, attitudes, perceived social norms, and behavioural control in the prevention and management of patient and visitor aggression in general hospitals. Patient and visitor aggression in general hospitals is a global problem that incurs substantial human suffering and organizational cost. Managers are key persons for creating low-aggression environments, yet their role and behaviours in reducing patient and visitor aggression remains unexplored. A qualitative descriptive study underpinned by the Reasoned Action Approach. Between October 2015-January 2016, we conducted five focus groups and 13 individual interviews with nurse leaders in Switzerland. The semi-structured interviews and focus groups were recorded, transcribed, and analysed in a qualitative content analysis. We identified three main themes: (i) Background factors: "Patient and visitor aggression is perceived through different lenses"; (ii) Determinants and intention: "Good intentions competing with harsh organizational reality"; (iii) Behaviours: "Preventing and managing aggressive behaviour and relentlessly striving to create low-aggression work environments". Addressing patient and visitor aggression is difficult for nurse managers due to a lack of effective communication, organizational feedback loops, protocols, and procedures that connect the situational and organizational management of aggressive incidents. Furthermore, tackling aggression at an organizational level is a major challenge for nurse managers due to scant financial resources and lack of interest. Treating patient and visitor aggression as a business case may increase organizational awareness and interest. Furthermore, clear communication of expectations, needs and resources could optimize support provision for staff. © 2017 John Wiley & Sons Ltd.

  5. Hospital profitability and capital structure: a comparative analysis. (United States)

    Valvona, J; Sloan, F A


    This article compares the financial performance of hospitals by ownership type and of five publicly traded hospital companies with other industries, using such indicators as profit margins, return on equity (ROE) and total capitalization, and debt-to-equity ratios. We also examine stock returns to investors for the five hospital companies versus other industries, as well as the relative roles of debt and equity in new financing. Investor-owned hospitals had substantially greater margins and ROE than did other hospital types. In 1982, investor-owned chain hospitals had a ROE of 26 percent, 18 points above the average for all hospitals. Stock returns on the five selected hospital companies were more than twice as large as returns on other industries between 1972 and 1983. However, after 1983, returns for these companies fell dramatically in absolute terms and relative to other industries. We also found investor-owned hospitals to be much more highly levered than their government and voluntary counterparts, and more highly levered than other industries as well.

  6. Effects of perceived workplace politics in hospitals on nurses' behavioural intentions in Ghana. (United States)

    Atinga, Roger A; Domfeh, Kwame A; Kayi, Esinam; Abuosi, Aaron; Dzansi, Gladys


    To examine the effects of perceived workplace politics in hospitals on nurses' job satisfaction, commitment, exit intention, job neglect, absenteeism and performance. One of the factors contributing to nurses' poor advancement in clinical practice is the existence of petty politics, which has given rise to competing self-interest. However, little evidence exists to inform policy direction on the implication of politics on nurses' behaviour. A total of 610 nurses comprising associate and nursing professionals completed a structured questionnaire modelled on workplace politics and its outcome variables. Descriptive statistics and mean comparisons were used to analyse data. A multivariate regression model was computed to examine association between perceived politics and nurses' behavioural intentions. Perceived politics potentially leads to decline in job satisfaction, commitment and work performance. However, perceived workplace politics is associated with high intention to leave, negligent behaviour and absenteeism. Measures aimed at improving nursing management and health-care delivery should be directed at minimising the use of politics to promote self-interest. Evidence-based best practices in nursing management centred on the creation of an enabling environment for nurses to participate in decision-making should be given critical attention. © 2013 John Wiley & Sons Ltd.

  7. Working hours and health behaviour among nurses at public hospitals

    Directory of Open Access Journals (Sweden)

    Juliana da Costa Fernandes


    Full Text Available OBJECTIVE: to analyse the differences between genders in the description in the professional, domestic and total work hours and assess its association with health-related behaviour among nurses. METHODS: this is a transversal study carried out in 18 different public hospitals in the municipality of Rio de Janeiro. The data collection procedure was based on questionnaires. All nurses working with assistance were considered eligible (n=2,279. RESULTS: men and women showed significant differences in relation to working hours. The female group showed longer domestic and total work hours when compared to the group of men. In contrast, the number of hours spent on professional work was higher among men. For the women, both the professional hours and total work hours were often associated with excessive consumption of fried food and also coffee, lack of physical exercise and also the greater occurrence of overweight and obesity. CONCLUSION: both the professional hours and the domestic work hours need to be taken into account in studies about health, self-care and also the care provided within the context of nursing workers, particularly among women. The results add weight to the need for actions for health promotion in this occupational group and the importance of assessing the impact of long working hours on the health of workers.

  8. Hospital nurses' information retrieval behaviours in relation to evidence based nursing: a literature review. (United States)

    Alving, Berit Elisabeth; Christensen, Janne Buck; Thrysøe, Lars


    The purpose of this literature review is to provide an overview of the information retrieval behaviour of clinical nurses, in terms of the use of databases and other information resources and their frequency of use. Systematic searches carried out in five databases and handsearching were used to identify the studies from 2010 to 2016, with a populations, exposures and outcomes (PEO) search strategy, focusing on the question: In which databases or other information resources do hospital nurses search for evidence based information, and how often? Of 5272 titles retrieved based on the search strategy, only nine studies fulfilled the criteria for inclusion. The studies are from the United States, Canada, Taiwan and Nigeria. The results show that hospital nurses' primary choice of source for evidence based information is Google and peers, while bibliographic databases such as PubMed are secondary choices. Data on frequency are only included in four of the studies, and data are heterogenous. The reasons for choosing Google and peers are primarily lack of time; lack of information; lack of retrieval skills; or lack of training in database searching. Only a few studies are published on clinical nurses' retrieval behaviours, and more studies are needed from Europe and Australia. © 2018 Health Libraries Group.

  9. Hospital clinicians' information behaviour and attitudes towards the 'Clinical Informationist': an Irish survey.

    LENUS (Irish Health Repository)

    Flynn, Maura G


    BACKGROUND: Hospital clinicians are increasingly expected to practice evidence-based medicine (EBM) in order to minimize medical errors and ensure quality patient care, but experience obstacles to information-seeking. The introduction of a Clinical Informationist (CI) is explored as a possible solution. AIMS: This paper investigates the self-perceived information needs, behaviour and skill levels of clinicians in two Irish public hospitals. It also explores clinicians\\' perceptions and attitudes to the introduction of a CI into their clinical teams. METHODS: A questionnaire survey approach was utilised for this study, with 22 clinicians in two hospitals. Data analysis was conducted using descriptive statistics. RESULTS: Analysis showed that clinicians experience diverse information needs for patient care, and that barriers such as time constraints and insufficient access to resources hinder their information-seeking. Findings also showed that clinicians struggle to fit information-seeking into their working day, regularly seeking to answer patient-related queries outside of working hours. Attitudes towards the concept of a CI were predominantly positive. CONCLUSION: This paper highlights the factors that characterise and limit hospital clinicians\\' information-seeking, and suggests the CI as a potentially useful addition to the clinical team, to help them to resolve their information needs for patient care.

  10. A comparative study of the costliness of Manitoba hospitals. (United States)

    Shanahan, M; Loyd, M; Roos, N P; Brownell, M


    In light of ongoing discussions about health care policy, this study offered a method of calculating costs at Manitoba hospitals that compared relative costliness of inpatient care provided in each hospital. This methodology also allowed comparisons across types of hospitals-teaching, community, major rural, intermediate and small rural, as well as northern isolated facilities. Data used in this project include basic hospital information, both financial and statistical, for each of the Manitoba hospitals, hospital charge information by case from the State of Maryland, and hospital discharge abstract information for Manitoba. The data from Maryland were used to create relative cost weights (RCWs) for refined diagnostic related groups (RDRGs) and were subsequently adjusted for Manitoba length of stay. These case weights were then applied to cases in Manitoba hospitals, and several other adjustments were made for nontypical cases. This case mix system allows cost comparisons across hospitals. In general, hospital case mix costing demonstrated variability in hospital costliness, not only across types of hospitals but also within hospitals of the same type and size. Costs at the teaching hospitals were found to be considerably higher than the average, even after accounting for acuity and case mix.

  11. Examination of psychosocial predictors of Chinese hospital pharmacists' intention to provide clinical pharmacy services using the theory of planned behaviour: a cross-sectional questionnaire study. (United States)

    He, Yuan; Yang, Fan; Mu, Dongqin; Xing, Yuan; Li, Xin


    Main study aim was as follows: (1) to explore the usefulness of the theory of planned behaviour (TPB) model in predicting Chinese hospital pharmacists' intention to provide clinical pharmacy services (CPSs), including auxiliary CPSs and core CPSs; (2) to identify the main factors affecting the Chinese hospital pharmacists' intention to provide core CPSs based on TPB quantitatively. Cross-sectional questionnaire study. The study was conducted in 22 general hospitals in seven cities located in the eastern and western part of China. 416 hospital pharmacists (292 (70.2%) female) entered and completed the study. Quantitative responses with hospital pharmacists' intention, attitude, subjective norms (SNs) and perceived behavioural control (PBC) over provision of CPSs and their past behaviour (PB)-related CPSs. The structural equation model analysis found that attitude (p=0.0079, β=0.12), SN (p=0.038, β=0.10) and the pharmacists' intention to provide auxiliary CPSs (p=0.0001, β=0.63) significantly predicted of their intention to provide core CPSs, accounting for 54.0% of its variance. Attitude (p=0.0001, β=0.35), PBC (p=0.0182, β=0.12) and PB (p=0.0009, β=0.15) are significant predictors of pharmacists' intention, accounting for 21% of the variance in pharmacists' intention to provide auxiliary CPSs. The TPB with the addition of PB is a useful framework for predicting pharmacists' intention to provide CPSs in Chinese hospital care context. Strategies to improve hospital pharmacists' intention to provide CPSs should focus on helping the individuals related medical care see the value of CPSs, altering their perception of social pressure towards core CPSs and the removal of obstacles that impede the translation of intentions into behaviour. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  12. Examination of psychosocial predictors of Chinese hospital pharmacists' intention to provide clinical pharmacy services using the theory of planned behaviour: a cross-sectional questionnaire study (United States)

    He, Yuan; Yang, Fan; Mu, Dongqin; Xing, Yuan; Li, Xin


    Objectives Main study aim was as follows: (1) to explore the usefulness of the theory of planned behaviour (TPB) model in predicting Chinese hospital pharmacists' intention to provide clinical pharmacy services (CPSs), including auxiliary CPSs and core CPSs; (2) to identify the main factors affecting the Chinese hospital pharmacists' intention to provide core CPSs based on TPB quantitatively. Design Cross-sectional questionnaire study. Setting The study was conducted in 22 general hospitals in seven cities located in the eastern and western part of China. Participants 416 hospital pharmacists (292 (70.2%) female) entered and completed the study. Primary and secondary outcome measures Quantitative responses with hospital pharmacists' intention, attitude, subjective norms (SNs) and perceived behavioural control (PBC) over provision of CPSs and their past behaviour (PB)-related CPSs. Results The structural equation model analysis found that attitude (p=0.0079, β=0.12), SN (p=0.038, β=0.10) and the pharmacists' intention to provide auxiliary CPSs (p=0.0001, β=0.63) significantly predicted of their intention to provide core CPSs, accounting for 54.0% of its variance. Attitude (p=0.0001, β=0.35), PBC (p=0.0182, β=0.12) and PB (p=0.0009, β=0.15) are significant predictors of pharmacists' intention, accounting for 21% of the variance in pharmacists' intention to provide auxiliary CPSs. Conclusions The TPB with the addition of PB is a useful framework for predicting pharmacists' intention to provide CPSs in Chinese hospital care context. Strategies to improve hospital pharmacists' intention to provide CPSs should focus on helping the individuals related medical care see the value of CPSs, altering their perception of social pressure towards core CPSs and the removal of obstacles that impede the translation of intentions into behaviour. PMID:27707835

  13. Smoking behaviour predicts tobacco control attitudes in a high smoking prevalence hospital: a cross-sectional study in a Portuguese teaching hospital prior to the national smoking ban. (United States)

    Ravara, Sofia B; Calheiros, Jose M; Aguiar, Pedro; Barata, Luis Taborda


    Several studies have investigated attitudes to and compliance with smoking bans, but few have been conducted in healthcare settings and none in such a setting in Portugal. Portugal is of particular interest because the current ban is not in line with World Health Organization recommendations for a "100% smoke-free" policy. In November 2007, a Portuguese teaching-hospital surveyed smoking behaviour and tobacco control (TC) attitudes before the national ban came into force in January 2008. Questionnaire-based cross-sectional study, including all eligible staff. 52.9% of the 1, 112 staff; mean age 38.3 ± 9.9 years; 65.9% females. Smoking behaviour and TC attitudes and beliefs were the main outcomes. Bivariable analyses were conducted using chi-squared and MacNemar tests to compare categorical variables and Mann-Whitney tests to compare medians. Multilogistic regression (MLR) was performed to identify factors associated with smoking status and TC attitudes. Smoking prevalence was 40.5% (95% CI: 33.6-47.4) in males, 23.5% (95% CI: 19.2-27.8) in females (p smoking bans, even among smokers, despite the fact that 70.3% of the smokers smoked on the premises and 76% of staff reported being frequently exposed to second-hand smoke (SHS). In addition 42.8% reported that SHS was unpleasant and 28.3% admitted complaining. MLR showed that smoking behaviour was the most important predictor of TC attitudes. Smoking prevalence was high, especially among the lower socio-economic groups. The findings showed a very high level of support for smoking bans, despite the pro-smoking environment. Most staff reported passive behaviour, despite high SHS exposure. This and the high smoking prevalence may contribute to low compliance with the ban and low participation on smoking cessation activities. Smoking behaviour had greater influence in TC attitudes than health professionals' education. Our study is the first in Portugal to identify potential predictors of non-compliance with the partial

  14. Parental leave: comparing children's hospitals with Fortune 500 companies. (United States)

    Weiss, A H; Gordon, E J; O'Connor, M E


    To identify parental leave policies and availability of support systems for new parents employed by children's hospitals and compare these benefits with those offered by Fortune 500 companies. Telephone or facsimile survey of all (n=118) children's hospitals and pediatric medical centers in the National Association of Children's Hospitals and Related Institutions 1995 Directory of Members, and 118 geographically matched Fortune 500 companies. Policies for maternity and paternity leave, adoption benefits, and support services for new parents were compared. Ninety-four children's hospitals (80%) and 82 Fortune 500 companies (69%) responded to the survey. No difference in duration of maternity (P>.30) or paternity (P=.12) leave was found. Sixty-two companies (77%) classified maternity leave as short-term disability while 47 hospitals (50%) classified it as sick time (Pleave as short-term disability generally gives better benefits to employees with short duration of service, whereas classifying maternity leave as sick time usually favors employees with longer employment. Companies provided more financial support for adoption expenses (Ppaid or unpaid leave for adoption (P=.14). Hospitals provided more on-site day care (69% vs 42%; Pparental leave benefits than Fortune 500 companies; however, they offer better support systems for parents returning to work after the birth of a child.

  15. Comparing EU hospital efficiency using diagnosis-related groups

    NARCIS (Netherlands)

    Rhodes, G.; Wiley, M.; Tomas, R.; Casas, M.; Leidl, R.


    This article considers the feasibility of comparing the differences in efficiency and price in the provision of hospital products defined on the basis of diagnosis-related groups (DRGs). Two measures of resource use are compared, the length of stay and the administrative price, both independently

  16. Does the professional attitude of physicians always affect their professional behaviour? A survey in tertiary hospitals in Nanchang City, China. (United States)

    Wang, Xuan; Wang, Xuan; Du, Xin; Du, Xin; Liu, Chenxi; Liu, Chenxi; Zhang, Xinping; Zhang, Xinping


    Objective Understanding the effect of professional attitude on professional behaviour is conducive to the development of targeted measures to promote professionalism. The aim of the present study was to explore the effect of professional attitude on professional behaviour. Methods Using a self-reported questionnaire, 212 physicians were surveyed using quota sampling in six tertiary hospitals in Nanchang City. The effect of professional attitude on professional behaviour was analysed through logistic regression analysis. Results Providing necessary care regardless of a patient's ability to pay, working on quality improvement initiatives, informing patients of medical errors and reporting incompetent colleagues had significant positive effects on corresponding professional behaviour (odds ratios (95% confidence intervals) 11.06 (3.78, 32.40), 9.42 (1.93, 46.01), 4.04 (1.29, 12.63) and 5.51 (1.26, 24.08) respectively). However, attitudes towards minimising disparities in care, undergoing periodic recertification examinations and reporting medical errors did not significantly affect corresponding professional behaviour. Conclusions Professional attitude affects professional behaviour, but such an effect varies with different professional norms. These findings imply that improving the professional attitude is useful but insufficient to promote medical professionalism. A management system conducive to the conversion of professional attitude to professional behaviour should be established. What is known about the topic? Several studies have affirmed that Chinese physicians accept most areas of medical professionalism embodied in the Charter on Medical Professionalism. However, only a few published studies have examined the effect of professional attitude on professional behaviour. Understanding the effect of professional attitude on professional behaviour is conducive to the development of targeted measures to promote professionalism. The present study attempted to fill

  17. Comparing safety climate in naval aviation and hospitals: implications for improving patient safety. (United States)

    Singer, Sara J; Rosen, Amy; Zhao, Shibei; Ciavarelli, Anthony P; Gaba, David M


    Evidence of variation in safety climate suggests the need for improvement among at least some hospitals. However, comparisons only among hospitals may underestimate the improvement required. Comparison of hospitals with analogous industries may provide a broader perspective on the safety status of our nation's hospitals. The purpose of this study was to compare safety climate among hospital workers with personnel from naval aviation, an organization that operates with high reliability despite intrinsically hazardous conditions. We surveyed a random sample of health care workers in 67 U.S. hospitals and, for generalizability, 30 veterans affairs hospitals using questions comparable with those posed at approximately the same time (2007) to a census of personnel from 35 squadrons of U.S. naval aviators. We received 13,841 (41%) completed surveys in U.S. hospitals, 5,511 (50%) in veterans affairs hospitals, and 14,854 (82%) among naval aviators. We examined differences in respondents' perceptions of safety climate at their institution overall and for 16 individual items. Safety climate was three times better on average among naval aviators than among hospital personnel. Naval aviators perceived a safer climate (up to seven times safer) than hospital personnel with respect to each of the 16 survey items. Compared with hospital managers, naval commanders perceived climate more like frontline personnel did. When contrasting naval aviators with hospital personnel working in comparably hazardous areas, safety climate discrepancies increased rather than decreased. One individual hospital performed as well as naval aviation on average, and at least one hospital outperformed the Navy benchmark for all but three individual survey items. Results suggest that hospitals have not sufficiently created a uniform priority of safety. However, if each hospital performed as well as the top-performing hospital in each area measured, hospitals could achieve safety climate levels comparable

  18. Comparative analysis of hospital energy use: pacific northwest and scandinavia. (United States)

    Burpee, Heather; McDade, Erin


    This study aimed to establish the potential for significant energy reduction in hospitals in the United States by providing evidence of Scandinavian operational precedents with high Interior Environmental Quality (IEQ) and substantially lower energy profiles than comparable U.S. facilities. These facilities set important precedents for design teams seeking operational examples for achieving aggressive energy and interior environmental quality goals. This examination of operational hospitals is intended to offer hospital owners, designers, and building managers a strong case and concrete framework for strategies to achieve exceptionally high performing buildings. Energy efficient hospitals have the potential to significantly impact the U.S.'s overall energy profile, and key stakeholders in the hospital industry need specific, operationally grounded precedents in order to successfully implement informed energy reduction strategies. This study is an outgrowth of previous research evaluating high quality, low energy hospitals that serve as examples for new high performance hospital design, construction, and operation. Through extensive interviews, numerous site visits, the development of case studies, and data collection, this team has established thorough qualitative and quantitative analyses of several contemporary hospitals in Scandinavia and the Pacific Northwest. Many Scandinavian hospitals demonstrate a low energy profile, and when analyzed in comparison with U.S. hospitals, such Scandinavian precedents help define the framework required to make significant changes in the U.S. hospital building industry. Eight hospitals, four Scandinavian and four Pacific Northwest, were quantitatively compared using the Environmental Protection Agency's Portfolio Manager, allowing researchers to answer specific questions about the impact of energy source and architectural and mechanical strategies on energy efficiency in operational hospitals. Specific architectural, mechanical

  19. Taking a comparative approach: analysing personality as a multivariate behavioural response across species.

    Directory of Open Access Journals (Sweden)

    Alecia J Carter

    Full Text Available Animal personality, repeatable behaviour through time and across contexts, is ecologically and evolutionarily important as it can account for the exhibition of sub-optimal behaviours. Interspecific comparisons have been suggested as important for understanding the evolution of animal personality; however, these are seldom accomplished due, in part, to the lack of statistical tools for quantifying differences and similarities in behaviour between groups of individuals. We used nine species of closely-related coral reef fishes to investigate the usefulness of ecological community analyses for the analysis of between-species behavioural differences and behavioural heterogeneity. We first documented behavioural carryover across species by observing the fishes' behaviour and measuring their response to a threatening stimulus to quantify boldness. Bold fish spent more time away from the reef and fed more than shy fish. We then used ecological community analysis tools (canonical variate analysis, multi-response permutation procedure, and permutational analysis of multivariate dispersion and identified four 'clusters' of behaviourally similar fishes, and found that the species differ in the behavioural variation expressed; some species are more behaviourally heterogeneous than others. We found that ecological community analysis tools are easily and fruitfully applied to comparative studies of personality and encourage their use by future studies.

  20. The effects of a non-smoking policy on nursing staff smoking behaviour and attitudes in a psychiatric hospital. (United States)

    Bloor, R N; Meeson, L; Crome, I B


    The UK Department of Health required that by April 2001, all NHS bodies would have implemented a smoking policy. It has been suggested that the best demonstration a hospital can make of its commitment to health is to ban smoking on its premises. This paper reports on an evaluation of the effectiveness of a non-smoking policy in a newly opened NHS psychiatric hospital. Questionnaires were sent to all 156 nursing staff in a psychiatric hospital to assess the effectiveness of the policy in terms of staff smoking behaviour, attitudes to the restriction and compliance with the policy. Of the 156 questionnaires distributed, 92 (58%) were returned; smokers, former smokers and those who have never smoked were quite evenly represented at 34.78%, 34.78% and 30.43%, respectively. Of eight critical success factors for the policy, only one, staff not smoking in Trust public areas, had been achieved. A non-smoking policy was generally accepted as necessary by nursing staff working in a mental health setting. Staff felt that the policy was not effective in motivating smoking nurses to stop and that insufficient support was given to these nurses. The study highlights the importance of introducing staff support systems as an integral part of smoking policies and the role of counterintuitive behaviour in the effectiveness of smoking policy introduction in healthcare settings.

  1. Using participant or non-participant observation to explain information behaviour. Participant observation, Non-participant observation, Information behaviour, Hospital pharmacists, Older people

    Directory of Open Access Journals (Sweden)

    Janet Cooper


    Full Text Available The aim of the paper is to provide guidance on conducting participant and non-participant observation studies of information behaviour. Examines lessons learned during non-participant observation of hospital pharmacists, and participant observation with dependent older people living in their own homes. Describes the methods used in both studies, and discusses the ethical issues involved in gaining access to the subjects. In the hospital setting, professional affiliation between the researcher and the subjects (six pharmacists made access easier to obtain. In the home care setting, access to subjects (seven clients for participant observation (as a care worker was more difficult, as was withdrawal from the field study. In both studies, the observation element was triangulated with survey data. Both studies indicated the fundamental need for trust between the observer and the research subjects. In some situations, professional relations offer instant access and trust, whereas in closed and sensitive situations such as social care, time is required to build up trust. With participant observation, that trust should not be damaged by withdrawal of the researcher from the research setting.

  2. Vision Screening of Ophthalmic Nursing Staff in a Tertiary Eye Care Hospital; Outcomes and ocular healthcare-seeking behaviours

    Directory of Open Access Journals (Sweden)

    Ruhi A. Khan


    Full Text Available Objectives: This study aimed to evaluate ocular healthcare-seeking behaviours and vision screening outcomes of nursing staff at a tertiary eye care hospital. Methods: This study was conducted between April and September 2016 among all 500 nurses employed at the King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia. Data were collected on age, gender, use of visual aids, the presence of diabetes, a history of refractive surgery and date of last ocular health check-up. Participants were tested using a handheld Spot™ Vision Screener (Welch Allyn Inc., Skaneateles Falls, New York, USA. Results: A total of 150 nurses participated in the study (response rate: 30.0%. The mean age was 41.2 ± 8.9 years old. Distance spectacles, reading spectacles and both types of spectacles were used by 37 (24.7%, 32 (21.3% and 10 (6.7% nurses, respectively. A total of 58 nurses (38.7% failed the vision screening test. Visual defects were detected for the first time in 13 nurses (8.7%. With regards to regular eye checkups, 77 participants (51.3% reported acceptable ocular healthcare-seeking behaviours; this factor was significantly associated with age and the use of visual aids (P <0.01 each. Conclusion: A high proportion of participants failed the vision screening tests and only half displayed good ocular healthcare-seeking behaviours. This is concerning as ophthalmic nurses are likely to face fewer barriers to eye care services than the general population.

  3. Admission of people with dementia to psychiatric hospitals in Japan: factors that can shorten their hospitalizations. (United States)

    Morikawa, Takako; Maeda, Kiyoshi; Osaki, Tohmi; Kajita, Hiroyuki; Yotsumoto, Kayano; Kawamata, Toshio


    People exhibiting serious behavioural and psychological symptoms of dementia are usually voluntarily or involuntarily committed to psychiatric hospitals for treatment. In Japan, the average hospital stay for individuals with dementia is about 2 years. Ideally, individuals should be discharged once their symptoms have subsided. However, we see cases in Japan where individuals remain institutionalized long after behavioural and psychological symptoms of dementia are no longer apparent. This study will attempt to identify factors contributing to shorter stays in psychiatric hospitals for dementia patients. Questionnaires consisting of 17 items were mailed to 121 psychiatric hospitals with dementia treatment wards in western Japan. Out of 121 hospitals that received the questionnaires, 45 hospitals returned them. The total number of new patient admissions at all 45 hospitals during the month of August 2014 was 1428, including 384 dementia patients (26.9%). The average length of stay in the dementia wards in August 2014 was 482.7 days. Our findings revealed that the rate of discharge after 2 months was 35.4% for the dementia wards. In addition, we found that the average stay in hospitals charging or planning to charge the rehabilitation fee to dementia patients was significantly shorter than in hospitals not charging the rehabilitation fee. In Japan, dementia patients account for over 25% of new admissions to psychiatric hospitals with dementia wards. The average length of stay in a psychiatric hospital dementia ward is more than 1 year. A discharge after fewer than 2 months is exceedingly rare for those in a dementia ward compared with dementia patients in other wards. If institutions focus on rehabilitation, it may be possible to shorten the stay of dementia patients in psychiatric hospitals. © 2017 Japanese Psychogeriatric Society.

  4. [Operation directions by comparing financial ratio of 22 provincial hospitals]. (United States)

    Wang, J Y; Ko, Y C; Wang, J W; Jan, L C; Chang, F M; Lin, K C


    Even more restrictive regulations and reimbursement limits seem to be a very heavy burden and stress for most provincial hospitals, especially after the National Health Insurance System has been introduced. The purpose of this project to find a better, universal direction for these hospitals through three steps: 1) Using different financial and accounting ratio indexes to evaluate the general business performance of each hospital. 2) Taking a comprehensive questionnaire with senior managers of each hospital to know their concepts and attitudes concerning external environment and internal operation. 3) Comparing data's correlation and differentiation to ascertain better trends for future operation for all hospitals. The database for this project comes from two resources: 1) Government finance and budget reports of 22 provincial hospitals for the 1994 accounting calendar year. 2) The results of questionnaires returned by 274 senior managers of hospitals, and analysis of these by chi-square test. Through statistical comparison, a number of conclusions can be made: 1) Most hospitals have better operation efficiency if any professional hospital administrator is working for them. 2) The hospital with more comprehensive personnel system shows better business performance. 3) The hospital with routine and formal financial analysis reports always has better business performance. 4) The hospital with poor operational efficiency tends to get rid of restriction or limitation from government's system. 5) The hospital with good operational efficiency has more confidence and desire to improve and change. 6) The hospital with poor operational efficiency is more dependent on outside support from government. 7) The hospital with better business performance has more concern about the impact of malpractice around the hospital. In short, a hospital with poor business efficiency always has more pessimistic attitude and tends to rely on outside resource support. On the other hand, a

  5. Impact of leadership styles adopted by head nurses on job satisfaction: a comparative study between governmental and private hospitals in Jordan. (United States)

    Abdelhafiz, Ibrahim Mbarak; Alloubani, Aladeen Mah'D; Almatari, Mohammad


    Previous studies demonstrated that leadership styles are the basis of daily interactions between leaders and employees and facilitate and enhance work processes. This study aimed to explore how the leadership styles of nurse leaders affect job satisfaction among working nurses. Quantitative, descriptive and comparative methods were used. Three main Ministry of Health hospitals in different areas of Jordan and three private hospitals in Amman were selected. Among the leadership styles measured by the Multi-factor Leadership Questionnaire 5X, transformational leadership had been used by head nurse managers in both settings more than transactional leadership and passive-avoidant leadership. The level of job satisfaction among nursing staff was higher in public hospitals than in private hospitals in this study. A positive relationship was found between the overall score for transformational leadership and job satisfaction (r = 0.374**). The overall transactional leadership score correlated positively with job satisfaction (r = 0.391**). Conversely, the overall correlation between passive-avoidant leadership and job satisfaction was negative (r = -0.240). The increased development of transformational leadership behaviours increases nurses' job satisfaction and thus contributes to an increased retention of nurses. The ability of hospitals to address the leadership styles of head nurses and their impacts on job satisfaction will be strengthened. © 2015 John Wiley & Sons Ltd.

  6. Domestication effects on behavioural traits and learning performance: comparing wild cavies to guinea pigs. (United States)

    Brust, Vera; Guenther, Anja


    The domestication process leads to a change in behavioural traits, usually towards individuals that are less attentive to changes in their environment and less aggressive. Empirical evidence for a difference in cognitive performance, however, is scarce. Recently, a functional linkage between an individual's behaviour and cognitive performance has been proposed in the framework of animal personalities via a shared risk-reward trade-off. Following this assumption, bolder and more aggressive animals (usually the wild form) should learn faster. Differences in behaviour may arise during ontogeny due to individual experiences or represent adaptations that occurred over the course of evolution. Both might singly or taken together account for differences in cognitive performance between wild and domestic lineages. To test for such possible linkages, we compared wild cavies and domestic guinea pigs, both kept in a university stock for more than 30 years under highly comparable conditions. Animals were tested in three behavioural tests as well as for initial and reversal learning performance. Guinea pigs were less bold and aggressive than their wild congeners, but learnt an association faster. Additionally, the personality structure was altered during the domestication process. The most likely explanation for these findings is that a shift in behavioural traits and their connectivity led to an altered cognitive performance. A functional linkage between behavioural and cognitive traits seems to exist in the proposed way only under natural selection, but not in animals that have been selected artificially over centuries.

  7. Organizational climate: Comparing private and public hospitals within professional roles

    Directory of Open Access Journals (Sweden)

    Diana Rojas


    Full Text Available This study compares the organizational climate differences within professional roles in private and public hospitals. We focused on how physicians, administrative, healthcare and non-healthcare staff either in the public or in the private perceived their work environment and each organizational climate dimension. Data came from organizational-climate questionnaires administered in 2010 and 2012 to 19616 and 1276 health employees in public and private hospitals in the Tuscany Region respectively. We applied exploratory factoranalysis to verify the validity and internal consistency between items in the questionnaire and t-test, one-way analysis of variance to compare mean perceptions regarding to the dimensions across different groups of respondents. We measured four dimensions: “training opportunities”, “managerial tools”, “organization” and “management & leadership style” and overall job satisfaction. Hospital status in the professional roles was found significant in the staff's perceptions (p≤0.05.

  8. Comparative analysis of graphite oxidation behaviour based on microstructure

    Energy Technology Data Exchange (ETDEWEB)

    Badenhorst, Heinrich, E-mail:; Focke, Walter


    Two unidentified powdered graphite samples, from a natural and a synthetic origin respectively, were examined. These materials are intended for use in nuclear applications, but have an unknown treatment history since they are considered proprietary. In order to establish a baseline for comparison, the samples were compared to two commercial flake natural graphite samples with varying impurity levels. The samples were characterized by conventional techniques such as powder X-ray diffraction, Raman spectroscopy and X-ray fluorescence. The results indicated that all four samples were very similar, with low impurity levels and good crystallinity, yet they exhibit remarkably different oxidation behaviours. The oxidized microstructures of the materials were examined using high-resolution scanning electron microscopy at low acceleration voltages. The relative influence of each factor affecting the oxidation was established, enabling a structured comparison of the different oxidative behaviours. Based on this analysis, it was possible to account for the measured differences in oxidative reactivity. The material with the lowest reactivity was a flake natural graphite which was characterized as having highly visible crystalline perfection, large particles with a high aspect ratio and no traces of catalytic activity. The second sample, which had an identical inherent microstructure, was found to have an increased reactivity due to the presence of small catalytic impurities. This material also exhibited a more gradual reduction in the oxidation rate at higher conversion, caused by the accumulation of particles which impede the oxidation. The sample with the highest reactivity was found to be a milled, natural graphite material, despite its evident crystallinity. The increased reactivity was attributable to a smaller particle size, the presence of catalytic impurities and extensive damage to the particle structure caused by jet milling. Despite displaying the lowest levels of

  9. Geometric morphometrics as a tool for improving the comparative study of behavioural postures. (United States)

    Fureix, Carole; Hausberger, Martine; Seneque, Emilie; Morisset, Stéphane; Baylac, Michel; Cornette, Raphaël; Biquand, Véronique; Deleporte, Pierre


    Describing postures has always been a central concern when studying behaviour. However, attempts to compare postures objectively at phylogenetical, populational, inter- or intra-individual levels generally either rely upon a few key elements or remain highly subjective. Here, we propose a novel approach, based on well-established geometric morphometrics, to describe and to analyse postures globally (i.e. considering the animal's body posture in its entirety rather than focusing only on a few salient elements, such as head or tail position). Geometric morphometrics is concerned with describing and comparing variation and changes in the form (size and shape) of organisms using the coordinates of a series of homologous landmarks (i.e. positioned in relation to skeletal or muscular cues that are the same for different species for every variety of form and function and that have derived from a common ancestor, i.e. they have a common evolutionary ancestry, e.g. neck, wings, flipper/hand). We applied this approach to horses, using global postures (1) to characterise behaviours that correspond to different arousal levels, (2) to test potential impact of environmental changes on postures. Our application of geometric morphometrics to horse postures showed that this method can be used to characterise behavioural categories, to evaluate the impact of environmental factors (here human actions) and to compare individuals and groups. Beyond its application to horses, this promising approach could be applied to all questions involving the analysis of postures (evolution of displays, expression of emotions, stress and welfare, behavioural repertoires…) and could lead to a whole new line of research.

  10. The impact of professional and organizational identification on the relationship between hospital-physician exchange and customer-oriented behaviour of physicians. (United States)

    Trybou, Jeroen; De Caluwé, Gaelle; Verleye, Katrien; Gemmel, Paul; Annemans, Lieven


    Hospitals face increasingly competitive market conditions. In this challenging environment, hospitals have been struggling to build high-quality hospital-physician relationships. In the literature, two types of managerial strategies for optimizing relationships have been identified. The first focuses on optimizing the economic relationship; the second focuses on the noneconomic dimension and emphasizes the cooperative structure and collaborative nature of the hospital-physician relationship. We investigate potential spillover effects between the perceptions of physicians of organizational exchange and their customer-oriented behaviors. A cross-sectional study was conducted on 130 self-employed physicians practicing at six Belgian hospitals. Economic exchange was measured using the concept of distributive justice (DJ); noneconomic exchange was measured by the concept of perceived organizational support (POS). Our outcomes consist of three types of customer-oriented behaviours: internal influence (II), external representation (ER), and service delivery (SD). Our results show a positive relationship between DJ and II (adjusted R(2) = 0.038, t = 2.35; p = 0.028) and ER (adjusted R(2) = 0.15, t = 4.59; p relationship between POS and II (adjusted R(2) = 0.032, t = 2.26; p = 0.026) and ER (adjusted R(2) = 0.22, t = 5.81; p relationship was present between DJ (p = 0.54) or POS (p = 0.57) and SD. Organizational identification positively moderates the relationship between POS and ER (p = 0.045) and between DJ and ER (p = 0.056). The relationships between POS and II (p = 0.54) and between DJ and II (p = 0.99) were not moderated by OI. Professional identification did not moderate the studied relationships. Our results demonstrate that both perceptions of economic and noneconomic exchange are important to self-employed physicians' customer-oriented behaviours. Fostering organizational identification could enhance this reciprocity dynamic.

  11. Comparing Hospital Processes and Outcomes in California Medicare Beneficiaries: Simulation Prompts Reconsideration. (United States)

    Escobar, Gabriel J; Baker, Jennifer M; Turk, Benjamin J; Draper, David; Liu, Vincent; Kipnis, Patricia


    This article is not a traditional research report. It describes how conducting a specific set of benchmarking analyses led us to broader reflections on hospital benchmarking. We reexamined an issue that has received far less attention from researchers than in the past: How variations in the hospital admission threshold might affect hospital rankings. Considering this threshold made us reconsider what benchmarking is and what future benchmarking studies might be like. Although we recognize that some of our assertions are speculative, they are based on our reading of the literature and previous and ongoing data analyses being conducted in our research unit. We describe the benchmarking analyses that led to these reflections. The Centers for Medicare and Medicaid Services' Hospital Compare Web site includes data on fee-for-service Medicare beneficiaries but does not control for severity of illness, which requires physiologic data now available in most electronic medical records.To address this limitation, we compared hospital processes and outcomes among Kaiser Permanente Northern California's (KPNC) Medicare Advantage beneficiaries and non-KPNC California Medicare beneficiaries between 2009 and 2010. We assigned a simulated severity of illness measure to each record and explored the effect of having the additional information on outcomes. We found that if the admission severity of illness in non-KPNC hospitals increased, KPNC hospitals' mortality performance would appear worse; conversely, if admission severity at non-KPNC hospitals' decreased, KPNC hospitals' performance would appear better. Future hospital benchmarking should consider the impact of variation in admission thresholds.

  12. Comparing Indications for Cardiovascular Admissions into a Nigerian and an Israeli Hospital (United States)

    Ukpabi, Ogba Joseph; Uwanurochi, Kelechukwu


    Background: Changing epidemiologic profile with increase in cardiovascular risk factors is well documented in literature. Our study sought to see how this is reflected in cardiovascular admissions into medical wards of a Nigerian and an Israeli hospital. Objective: To compare the range and pattern of cardiovascular admissions encountered in a Nigerian hospital and an Israel hospital. Methods: This was a retrospective study of admission records of patients admitted into both Federal Medical Centre (FMC), Umuahia, Abia State, Nigeria, and Sheba Medical Centre, Israel. Results: Ischemic heart disease (IHD) was the most prevalent among the Israeli hospital's admissions but ranks very low as an indication for admission in Nigeria. The most common causes of admission in Nigeria were hypertension and heart failure (HF). The spectrum of cardiovascular diseases (CVDs) was very limited in the Nigerian hospital, indicating disparity in diagnostic capacity. Conclusion: There were more patients with CVD as a cause of medical admission in the Israel hospital as compared to the Nigerian hospital. Hypertension and HF were prevalent indications for CVD in FMC, Umuahia, Nigeria, while hypertension and IHD were the prevalent indications for admission in Sheba Medical Centre, Israel. Future studies are needed to monitor spectrum and frequency of cardiovascular admissions in view of evolving epidemiological transition in developing countries. PMID:28469120

  13. Comparative costs and cost-effectiveness of behavioural interventions as part of HIV prevention strategies. (United States)

    Hsu, Justine; Zinsou, Cyprien; Parkhurst, Justin; N'Dour, Marguerite; Foyet, Léger; Mueller, Dirk H


    Behavioural interventions have been widely integrated in HIV/AIDS social marketing prevention strategies and are considered valuable in settings with high levels of risk behaviours and low levels of HIV/AIDS awareness. Despite their widespread application, there is a lack of economic evaluations comparing different behaviour change communication methods. This paper analyses the costs to increase awareness and the cost-effectiveness to influence behaviour change for five interventions in Benin. Cost and cost-effectiveness analyses used economic costs and primary effectiveness data drawn from surveys. Costs were collected for provider inputs required to implement the interventions in 2009 and analysed by 'person reached'. Cost-effectiveness was analysed by 'person reporting systematic condom use'. Sensitivity analyses were performed on all uncertain variables and major assumptions. Cost-per-person reached varies by method, with public outreach events the least costly (US$2.29) and billboards the most costly (US$25.07). Influence on reported behaviour was limited: only three of the five interventions were found to have a significant statistical correlation with reported condom use (i.e. magazines, radio broadcasts, public outreach events). Cost-effectiveness ratios per person reporting systematic condom use resulted in the following ranking: magazines, radio and public outreach events. Sensitivity analyses indicate rankings are insensitive to variation of key parameters although ratios must be interpreted with caution. This analysis suggests that while individual interventions are an attractive use of resources to raise awareness, this may not translate into a cost-effective impact on behaviour change. The study found that the extensive reach of public outreach events did not seem to influence behaviour change as cost-effectively when compared with magazines or radio broadcasts. Behavioural interventions are context-specific and their effectiveness influenced by a

  14. Adverse events in surgical inpatients: A comparative analysis of public hospitals in Victoria


    Katharina Hauck; Xueyan Zhao; Terri Jackson


    We compare adverse event rates for surgical inpatients across 36 public hospitals in the state of Victoria, Australia, conditioning on differences in patient complexity across hospitals. We estimate separate models for elective and emergency patients which stay at least one night in hospitals, using fixed effects complementary log-log models to estimate AEs as a function of patient and episode characteristics, and hospital effects. We use 4 years of patient level administrative hospital data ...

  15. Comparing systems for costing hospital treatments. The case of stable angina pectoris. (United States)

    Larsen, Jytte; Skjoldborg, Ulla Slothuus


    This paper demonstrates the basic properties in the systems most commonly considered for costing treatments in the Danish hospitals. The differences between the traditional charge system, the DRG system and the ABC system are analysed, and difficulties encountered in comparing these systems are discussed. A sample of patients diagnosed with stable angina pectoris (SAP) at Odense University Hospital was used to compare the three systems when costing an entire treatment path, costing single hospitalisations and studying the effects of length of stay. Furthermore, it is illustrated that the main idea behind each system is reflected in how the systems over- or underestimate costs. Implications when managing the hospitals, particularly reimbursement, are discussed.

  16. A Study of the Impact of an Educational Intervention on Nurse Attitudes and Behaviours toward Mobile Device Use in Hospital Settings

    Directory of Open Access Journals (Sweden)

    Lori Giles-Smith


    Full Text Available Introduction: Mobile applications (apps provide nurses with evidence-based information at the bedside. Librarians encourage app use by purchasing licenses and promoting their features. While many high-quality nursing apps exist, there is inconsistency in published reports on whether nurses use them in patient care. The aim of this research is to describe the use of mobile apps by nurses at two urban hospitals and to examine the impact of educational sessions led by hospital librarians and educators on nurse usage, attitudes and behaviour as they relate to mobile apps. Methods: Phase I consisted of a descriptive, cross-sectional survey of in-patient nurses to determine mobile app use and attitudes. Phase II involved a one-group pre/post-test design to examine the impact of education sessions led by librarians and hospital educators on nurse attitudes, usage and behaviours. A post-intervention focus group captured thoughts on using mobile apps at the bedside. Results: Results indicate that most nurses who have a personal mobile device are interested in using them at the bedside though few are currently doing so. While nurses cite many conveniences and uses, they also highlight a number of barriers associated with using mobile devices that must be addressed in order to realize the benefits in patient-centred care. Discussion: Hospital librarians and educators should work together to provide the education and support nurses require to realize the benefits of using apps at the bedside. Larger studies are needed to determine the impact of educational sessions on patient and health provider satisfaction with mobile device use.

  17. Comparing public and private sector employees' innovative behaviour

    DEFF Research Database (Denmark)

    Bysted, Rune; Hansen, Jesper Rosenberg


    Innovation is argued to be of key importance in the public sector. Little is known about possible sector differences in innovative behaviour. The stereotype in literature is that public employees are less innovative. We analyse whether sector is associated with innovative behaviour...... and the influence of job/organizational characteristics. We test this by using a three-country representative survey in Scandinavia with 8,310 respondents. We control for subsectors/industries and job functions. We do not find that public employees are less innovative. Furthermore, the study emphasizes...... the importance of understanding the major differences in innovative behaviour between different subsectors/industries and job types....

  18. A comparative study of East and West Europe's food retailers' buying behaviour

    DEFF Research Database (Denmark)

    Blunch, Niels Johan; Skytte, Hans; Esbjerg, Lars


    This paper reports findings from a project comparing retail buy-ing behaviour in Poland and Germany. The study demon-strates several differences in the way listing decisions are made in the two countries - differences which at the same time raise prob-lems and offer opportunities for small...

  19. Psychopathology of adolescents with an intellectual disability who present to general hospital services. (United States)

    Theodoratos, Oreste; McPherson, Lyn; Franklin, Catherine; Tonge, Bruce; Einfeld, Stewart; Lennox, Nicholas; Ware, Robert S


    Adolescents with intellectual disability have increased rates of psychopathology compared with their typically developing peers and present to hospital more frequently for ambulant conditions. The aim of this study is to describe the psychopathology and related characteristics of a sample of adolescents with intellectual disability who presented to general hospital services. We investigated a cohort of adolescents with intellectual disability in South East Queensland, Australia between January 2006 and June 2010. Demographic and clinical data were obtained via mailed questionnaires and from general practice notes. Psychopathology was measured with the Short Form of the Developmental Behaviour Checklist. Of 98 individuals presenting to hospital, 71 (72.5%) had significant levels of psychopathology. Unknown aetiology for the intellectual disability was associated with presence of problem behaviours. Adolescents with more severe intellectual disability were more likely to have major problem behaviours. Co-morbid physical health issues were not associated with psychopathology. Only 12 (12.1%) adolescents had undergone specialized mental health intervention. The general hospital environment may offer opportunities for liaison psychiatry services to screen and provide management expertise for adolescent individuals with intellectual disability presenting for physical health issues.

  20. Comparing the risk associated with psychosocial work conditions and health behaviours on incident hypertension over a nine-year period in Ontario, Canada. (United States)

    Smith, Peter M; Mustard, Cameron A; Lu, Hong; Glazier, Richard H


    Hypertension is an increasingly important health concern in Canada. This paper examines the risks associated with psychosocial working conditions compared to health behaviours on the risk of hypertension over a 9-year period in Ontario, Canada. We used data from Ontario respondents to the 2000-01 Canadian Community Health Survey linked to the Ontario Health Information Plan database covering physician services and the Canadian Institute for Health Information database for hospital admissions. We focused on labour market participants aged 35 to 60, who had not been previously diagnosed with hypertension, were not self-employed, and were working more than 10 hours per week, more than 20 weeks in the previous 12 months (N = 6,611). Subjects were followed for a nine-year period to ascertain incidence of hypertension. Low job control was associated with an increased risk of hypertension among men, but not among women. The population attributable fraction associated with low job control among males was 11.8% in our fully adjusted model. There was no consistent pattern of increased risk of hypertension across different levels of health behaviours. Primary prevention efforts to reduce the incidence of hypertension predominantly target modifiable health behaviours. Evidence from this longitudinal cohort suggests that modifiable characteristics of the work environment should also be considered in the design of cardiovascular disease prevention programs, in particular for male labour market participants.

  1. [Chemical and behavioural addiction of medical students. Comparative study in Lebanese students]. (United States)

    Moaouad, J; Kazour, F; Haddad, R; Rouhayem, J; Chammai, R; Richa, S


    Evaluate chemical and behavioural dependence of medical students, and compare it to a control group (students in non-medical faculties), in order to underline the harmful effect of university on medical students' dependence. A three-part questionnaire was distributed to a sample of 140 medical students at the Saint-Joseph university of Beirut (USJ), and to 140 students in many other USJ faculties, and filled in anonymously. The first part is about demographic criteria and the second and third parts are respectively about chemical and behavioural dependence, based on DSM IV criteria. There is no statistically significant difference between the two studied populations concerning the dependence on alcohol, cannabis, sedatives, opiates, amphetamines, workaholism, gambling and Internet. However, the prevalence of addiction to caffeine, cocaine, nicotine; sexual addiction, and compulsive buying are significantly lower in medical students when compared to the control group. Men, compared to women, did not show significantly higher levels of dependence on chemical substances. Workaholism is not significantly more prevalent in women. Sexual addiction and compulsive buying are not significantly higher in men. However, pathological gambling and Internet addiction are significantly more prevalent in men. Finally, this study does not show a variation in dependence through the years of medical studies. Most studies show that medical students have high levels of dependence on alcohol, opiates and sedatives. The results of our study show greater dependence on caffeine followed by nicotine, alcohol and sedatives. Medical students in our population did not reveal higher dependence rates compared to other university students. Overall, substance addiction in medical students may be related to the stress of medical studies, and easy access to drugs and prescriptions. These factors may be balanced by perfectionist traits, ethical standards and knowledge of adverse effects seen in

  2. Comparing public and private providers: a scoping review of hospital services in Europe. (United States)

    Tynkkynen, Liina-Kaisa; Vrangbæk, Karsten


    What is common to many healthcare systems is a discussion about the optimal balance between public and private provision. This paper provides a scoping review of research comparing the performance of public and private hospitals in Europe. The purpose is to summarize and compare research findings and to generate questions for further studies. The review was based on a methodological approach inspired by the British EPPI-Centre's methodology. This review was broader than review methodologies used by Cochrane and Campbell and included a wider range of methodological designs. The literature search was performed using PubMed, EconLit and Web of Science databases. The search was limited to papers published from 2006 to 2016. The initial searches resulted in 480 studies. The final sample was 24 papers. Of those, 17 discussed economic effects, and seven studies addressed quality. Our review of the 17 studies representing more than 5500 hospitals across Europe showed that public hospitals are most frequently reported as having the best economic performance compared to private not-for-profit (PNFP) and private for-profit (PFP) hospitals. PNFP hospitals are second, while PFP hospitals are least frequently reported as superior. However, a sizeable number of studies did not find significant differences. In terms of quality, the results are mixed, and it is not possible to draw clear conclusions about the superiority of an ownership type. A few studies analyzed patient selection. They indicated that public hospitals tend to treat patients who are slightly older and have lower socioeconomic status, riskier lifestyles and higher levels of co-morbidity and complications than patients treated in private hospitals. The paper points to shortcomings in the available studies and argues that future studies are needed to investigate the relationship between contextual circumstances and performance. A big weakness in many studies addressing economic effects is the failure to control for

  3. Comparative analysis of inflammatory complications after firearm injuries of the cerebrum in two clinics with different surgical behaviours

    International Nuclear Information System (INIS)

    Panov, Y.; Guergueltchev, N.


    Injuries in the cerebrum caused by firearm shots are found to be more and more in our everyday life. The mortality rate is high (40 - 90 %) regardless of the differences in the therapy applied according to the viewpoints of the surgeons. The valuation of the results is contradictory due to the difficulties to set up systematized groups for these appraisals. Some of the severe complications, which aggravate the process of recovery on the days after the trauma, are the suppurations of the wounds and the purulent meningoencephalitis. The aim of this study is to compare the inflammatory complications after injuries caused by firearm shots in the head according to their type and severity in two clinics with different surgical behaviour. The study involved 30 patients in the Clinic of Emergency Neurosurgery at the Military Medical Academy in Sofia, Bulgaria, during a 7-year period, and 11 patients hospitalized at the Clinic of Neurosurgery in the city of Tours, France, during a 3-year period. At the group of the Military Medical Academy suppuration of the wounds was found in 2 patients without development of cerebral infection. At the Neurosurgical Clinic in Tours, France, 4 patients developed meningoencephalitis and three died (p<0.001). The comparative analysis gives grounds to draw a conclusion that the inflammatory complications of the cerebrum after gunshot injuries have a direct relation to the operative procedure. In order to avert these complications, it is necessary to have aggressive surgical behaviour: elimination of devitalized soft tissues, craniectomy around the inlet and outlet openings, revision of the brain wound in depth of 3-4 cm and hermetic closure of the dura. (authors)

  4. Dysfunctional illness perception and illness behaviour associated with high somatic symptom severity and low quality of life in general hospital outpatients in China. (United States)

    Zhang, Yaoyin; Fritzsche, Kurt; Leonhart, Rainer; Zhao, Xudong; Zhang, Lan; Wei, Jing; Yang, Jianzhong; Wirsching, Michael; Nater-Mewes, Ricarda; Larisch, Astrid; Schaefert, Rainer


    In primary care populations in Western countries, high somatic symptom severity (SSS) and low quality of life (QoL) are associated with adverse psychobehavioural characteristics. This study assessed the relationship between SSS, QoL and psychobehavioural characteristics in Chinese general hospital outpatients. This multicentre cross-sectional study enrolled 404 patients from 10 outpatient departments, including Neurology, Gastroenterology, Traditional Chinese Medicine [TCM] and Psychosomatic Medicine departments, in Beijing, Shanghai, Chengdu and Kunming. A structured interview was used to assess the cognitive, affective and behavioural features associated with somatic complaints, independent of their origin. Several standard instruments were used to assess SSS, emotional distress and health-related QoL. Patients who reported low SSS (PHQ-15Western countries, high SSS was associated with negative illness and self-perception, low physical QoL with avoidance behaviour, and low mental QoL with reassurance seeking in Chinese general hospital outpatients. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Hospital Evaluations by Social Media: A Comparative Analysis of Facebook Ratings among Performance Outliers. (United States)

    Glover, McKinley; Khalilzadeh, Omid; Choy, Garry; Prabhakar, Anand M; Pandharipande, Pari V; Gazelle, G Scott


    An increasing number of hospitals and health systems utilize social media to allow users to provide feedback and ratings. The correlation between ratings on social media and more conventional hospital quality metrics remains largely unclear, raising concern that healthcare consumers may make decisions on inaccurate or inappropriate information regarding quality. The purpose of this study was to examine the extent to which hospitals utilize social media and whether user-generated metrics on Facebook(®) correlate with a Hospital Compare(®) metric, specifically 30-day all cause unplanned hospital readmission rates. This was a retrospective cross-sectional study conducted among all U.S. hospitals performing outside the confidence interval for the national average on 30-day hospital readmission rates as reported on Hospital Compare. Participants were 315 hospitals performing better than U.S. national rate on 30-day readmissions and 364 hospitals performing worse than the U.S. national rate. The study analyzed ratings of hospitals on Facebook's five-star rating scale, 30-day readmission rates, and hospital characteristics including beds, teaching status, urban vs. rural location, and ownership type. Hospitals performing better than the national average on 30-day readmissions were more likely to use Facebook than lower-performing hospitals (93.3 % vs. 83.5 %; p Facebook rating was associated with increased odds of the hospital belonging to the low readmission rate group by a factor of 5.0 (CI: 2.6-10.3, p Facebook-related variables. Hospitals with lower rates of 30-day hospital-wide unplanned readmissions have higher ratings on Facebook than hospitals with higher readmission rates. These findings add strength to the concept that aggregate measures of patient satisfaction on social media correlate with more traditionally accepted measures of hospital quality.

  6. Mapping barriers and intervention activities to behaviour change theory for Mobilization of Vulnerable Elders in Ontario (MOVE ON), a multi-site implementation intervention in acute care hospitals. (United States)

    Moore, Julia E; Mascarenhas, Alekhya; Marquez, Christine; Almaawiy, Ummukulthum; Chan, Wai-Hin; D'Souza, Jennifer; Liu, Barbara; Straus, Sharon E


    As evidence-informed implementation interventions spread, they need to be tailored to address the unique needs of each setting, and this process should be well documented to facilitate replication. To facilitate the spread of the Mobilization of Vulnerable Elders in Ontario (MOVE ON) intervention, the aim of the current study is to develop a mapping guide that links identified barriers and intervention activities to behaviour change theory. Focus groups were conducted with front line health-care professionals to identify perceived barriers to implementation of an early mobilization intervention targeted to hospitalized older adults. Participating units then used or adapted intervention activities from an existing menu or developed new activities to facilitate early mobilization. A thematic analysis was performed on the focus group data, emphasizing concepts related to barriers to behaviour change. A behaviour change theory, the 'capability, opportunity, motivation-behaviour (COM-B) system', was used as a taxonomy to map the identified barriers to their root causes. We also mapped the behaviour constructs and intervention activities to overcome these. A total of 46 focus groups were conducted across 26 hospital inpatient units in Ontario, Canada, with 261 participants. The barriers were conceptualized at three levels: health-care provider (HCP), patient, and unit. Commonly mentioned barriers were time constraints and workload (HCP), patient clinical acuity and their perceived 'sick role' (patient), and lack of proper equipment and human resources (unit level). Thirty intervention activities to facilitate early mobilization of older adults were implemented across hospitals; examples of unit-developed intervention activities include the 'mobility clock' communication tool and the use of staff champions. A mapping guide was created with barriers and intervention activities matched though the lens of the COM-B system. We used a systematic approach to develop a guide

  7. Practise what you preach: health behaviours and stress among non-consultant hospital doctors.

    LENUS (Irish Health Repository)

    Feeney, Sinéad


    High rates of psychological distress, depression and suicide have been reported among doctors. Furthermore, many doctors do not access healthcare by conventional means. This study aimed to increase understanding regarding non-consultant hospital doctors\\' (NCHDs\\') response to stress and barriers to accessing supports, and identify possible solutions. Medical manpower departments in 58 hospitals distributed a 25-item questionnaire to 4,074 NCHDs; we received 707 responses (response rate, 17.4%). 60% of NCHDs were unable to take time off work when unwell; \\'letting teammates down\\' (90.8%) and \\'difficulty covering call\\' (85.9%) were the leading reasons. \\'Being too busy\\' (85%), \\'self-prescription\\' (66.6%) and \\'self-management\\' (53.1%) were ranked highest in deterring NCHDs from visiting a general practitioner (GP). 22.9% of NCHDs would not attend a GP with anxiety or depression until they began to feel hopeless, helpless or suicidal. 12.2% would not seek help at all. 55% of respondents (n = 330) had to move away from partners or dependants due to work, negatively affecting the social supports of 82.9%. Possible practical solutions were explored. NCHDS are a vulnerable population and have a particularly challenging lifestyle. Key recommendations include improved GP and counselling access for NCHDs, and addressing the culture of self-treatment and poor health behaviours through undergraduate and postgraduate education.

  8. Evidence-informed obstetric practice during normal birth in China: trends and influences in four hospitals

    Directory of Open Access Journals (Sweden)

    Liang Ji


    Full Text Available Abstract Background A variety of international organizations, professional groups and individuals are promoting evidence-informed obstetric care in China. We measured change in obstetric practice during vaginal delivery that could be attributed to the diffusion of evidence-based messages, and explored influences on practice change. Methods Sample surveys of women at postnatal discharge in three government hospitals in Shanghai and one in neighbouring Jiangsu province carried out in 1999, repeated in 2003, and compared. Main outcome measures were changes in obstetric practice and influences on provider behaviour. "Routine practice" was defined as more than 65% of vaginal births. Semi-structured interviews with doctors explored influences on practice. Results In 1999, episiotomy was routine at all four hospitals; pubic shaving, rectal examination (to monitor labour and electronic fetal heart monitoring were routine at three hospitals; and enema on admission was common at one hospital. In 2003, episiotomy rates remained high at all hospitals, and actually significantly increased at one; pubic shaving was less common at one hospital; one hospital stopped rectal examination for monitoring labour, and the one hospital where enemas were common stopped this practice. Mobility during labour increased in three hospitals. Continuous support was variable between hospitals at baseline and showed no change with the 2003 survey. Provider behaviour was mainly influenced by international best practice standards promoted by hospital directors, and national legislation about clinical practice. Conclusion Obstetric practice became more evidence-informed in this selected group of hospitals in China. Change was not directly related to the promotion of evidence-based practice in the region. Hospital directors and national legislation seem to be particularly important influences on provider behaviour at the hospital level.

  9. The population impact of smoke-free workplace and hospitality industry legislation on smoking behaviour. Findings from a national population survey. (United States)

    Nagelhout, Gera E; Willemsen, Marc C; de Vries, Hein


    To study the impact of implementing smoke-free workplace and hospitality industry legislation on smoking behaviour. A cross-sectional population survey from 2001 to 2008 (n ≈ 18,000 per year) was used to assess trends and seasonal patterns in smoking and quitting, and to examine whether changes could be observed after the workplace smoking ban in the Netherlands in 2004 and the hospitality industry ban in 2008. Outcome measures were smoking prevalence, quit attempts and successful quit attempts. Interactions with educational level (socio-economic status) and bar visiting (exposure to the hospitality industry ban) were tested. The workplace ban was followed by a decrease in smoking prevalence (OR = 0.91, P hospitality industry ban was not (OR = 0.96, P = 0.127). Both bans, especially the workplace ban, were followed by an increase in quit attempts and successful quit attempts: workplace ban, OR = 1.31, P hospitality industry ban, OR = 1.13, P = 0.013; OR = 1.44, P hospitality industry ban had a larger effect on quit attempts among frequent bar visitors (OR = 1.48, P = 0.003) than on non-bar visitors (OR = 0.71, P = 0.014). A workplace smoking ban in the Netherlands was followed by more changes in smoking and quitting than a hospitality industry ban. The hospitality industry ban only appeared to have an impact on quit attempts, and not on smoking prevalence. © 2010 The Authors, Addiction © 2010 Society for the Study of Addiction.

  10. [Suicidal behaviour and attempted suicide occurring during assessment by the outreach psychiatric emergency service]. (United States)

    de Winter, R F P; de Groot, M H; van Dassen, M; Deen, M L; de Beurs, D P

    The outreach emergency psychiatric service plays an important role in recognising, arranging interventions and preventing suicide and suicidal behaviour. However, little is known about the assessments that members of the emergency team make when faced with patients showing suicidal behaviour. AIM: To describe the relationships that are revealed between patient characteristics, suicidal thoughts and attempted suicide during assessments made by the emergency psychiatric service in The Hague. METHOD: The emergency service kept a detailed record of 14,705 consultations. We compared the characteristics of patients who had suicidal thoughts with those of patients who had no such thoughts and we also compared the characteristics of patients who had attempted to commit suicide with those of patients who had not. We drew these comparisons by using logistic regression models, adjusting for clustering. RESULTS: 32.2% of the patients showed signs of suicidal behaviour and 9.2 % appeared likely to attempt suicide. Suicidal behaviour occurred most often in patients with depression. Suicidal patients were more often admitted to hospital than were non-suicidal patients and they were more likely to have been referred by a general practitioner or a general hospital. Medication was the most frequent means employed in attempts to commit suicide. CONCLUSION: In about one third of the consultations of the outreach emergency psychiatric service, the patient showed suicidal behaviour. The actions and the policy of the emergency psychiatric service with regard to suicidal behaviour were diverse and dependent on factors that could change over the course of time.

  11. Quality Management Systems Implementation Compared With Organizational Maturity in Hospital. (United States)

    Moradi, Tayebeh; Jafari, Mehdi; Maleki, Mohammad Reza; Naghdi, Seyran; Ghiasvand, Hesam


    A quality management system can provide a framework for continuous improvement in order to increase the probability of customers and other stakeholders' satisfaction. The test maturity model helps organizations to assess the degree of maturity in implementing effective and sustained quality management systems; plan based on the current realities of the organization and prioritize their improvement programs. We aim to investigate and compare the level of organizational maturity in hospitals with the status of quality management systems implementation. This analytical cross sectional study was conducted among hospital administrators and quality experts working in hospitals with over 200 beds located in Tehran. In the first step, 32 hospitals were selected and then 96 employees working in the selected hospitals were studied. The data were gathered using the implementation checklist of quality management systems and the organization maturity questionnaire derived from ISO 10014. The content validity was calculated using Lawshe method and the reliability was estimated using test - retest method and calculation of Cronbach's alpha coefficient. The descriptive and inferential statistics were used to analyze the data using SPSS 18 software. According to the table, the mean score of organizational maturity among hospitals in the first stage of quality management systems implementation was equal to those in the third stage and hypothesis was rejected (p-value = 0.093). In general, there is no significant difference in the organizational maturity between the first and third level hospitals (in terms of implementation of quality management systems). Overall, the findings of the study show that there is no significant difference in the organizational maturity between the hospitals in different levels of the quality management systems implementation and in fact, the maturity of the organizations cannot be attributed to the implementation of such systems. As a result, hospitals

  12. An empirical analysis of the public's attitudes toward advertising hospital services: a comparative cross-sectional study. (United States)

    Moser, H Ronald; Freeman, Gordon L


    This study investigates current opinions about hospital advertising and compares them to the attitudes expressed 25 years ago. It replicates a survey done in 1985, using the same questionnaire and population to compare responses longitudinally. The study indicates some changes in the public's opinions of hospital advertising. Although the image of hospitals remains positive, most of the 2010 respondents' opinions were rather mixed regarding whether it is proper for hospitals to advertise. The study also confirmed that the quality of service and reputation of hospitals remain more important to the public than price.

  13. Direct hospital costs of total laparoscopic hysterectomy compared with fast-track open hysterectomy at a tertiary hospital: a retrospective case-controlled study. (United States)

    Rhou, Yoon J J; Pather, Selvan; Loadsman, John A; Campbell, Neil; Philp, Shannon; Carter, Jonathan


    To assess the direct intraoperative and postoperative costs in women undergoing total laparoscopic hysterectomy and fast-track open hysterectomy. A retrospective review of the direct hospital-related costs in a matched cohort of women undergoing total laparoscopic hysterectomy (TLH) and fast-track open hysterectomy (FTOH) at a tertiary hospital. All costs were calculated, including the cost of advanced high-energy laparoscopic devices. The effect of the learning curve on cost in laparoscopic hysterectomy was also assessed, as was the hospital case-weighted cost, which was compared with the actual cost. Fifty women were included in each arm of the study. TLH had a higher intraoperative cost, but a lower postoperative cost than FTOH (AUD$3877 vs AUD$2776 P funding model in our hospital is inaccurate when compared to directly calculated hospital costs. © 2013 The Authors ANZJOG © 2013 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  14. Conditions associated with REM sleep behaviour disorder: Description of a hospital series. (United States)

    Abenza Abildúa, M J; Miralles Martinez, A; Arpa Gutiérrez, F J; Lores Gutiérrez, V; Algarra Lucas, C; Jimeno Montero, C; Sánchez García, B; Mata Álvarez-Santullano, M; Borrue Fernández, C; Cordero Martín, G; Gutiérrez Cueto, G; Torrecillas Narváez, M D; Thuissard Vasallo, I; Gómez Aceña, A


    REM sleep behaviour disorder (RBD) is characterised by violent behaviours (screaming, kicking, vivid dreams) during REM sleep. It has a prevalence of 1% to 2% of the general population and is especially frequent in men and the population older than 60. In the last decade, RBD has been suggested to be a prodrome of neurodegenerative disease. We analysed associated neurological diseases and responses to drug treatment in 33 patients with RBD treated in the multidisciplinary sleep disorders unit at Hospital Infanta Sofía. We conducted an observational descriptive retrospective analysis of patients diagnosed with RBD and treated in our multidisciplinary sleep disorders unit between October 2012 and December 2015. We recorded age, sex, associated diseases, and treatments administered to these patients. A total of 365 patients were attended at our unit, including 33 with RBD: 13 women (40%) and 20 men (60%). Mean age was 62.72 years. An associated disorder was identified in 48%, with the most common being mild cognitive impairment (69%). The percentage of patients with RBD and an associated disorder among patients older than 60 was 68%. Eighty-two percent of the patients required treatment. The most commonly used drug was clonazepam (76%), followed by melatonin (9%), gabapentin (6%), and trazodone (3%). In our series, 48% of the patients had an associated disorder. The likelihood of detecting an associated disorder increases with patients' age. The vast majority of patients required drug treatment due to symptom severity; the most frequently administered drug was clonazepam (76%). Copyright © 2017 The Author(s). Publicado por Elsevier España, S.L.U. All rights reserved.

  15. The relationships between organisational citizenship behaviour, job satisfaction and turnover intention. (United States)

    Tsai, Yafang; Wu, Shih-Wang


    This study aims to explore the relationships between organisational citizenship behaviour, job satisfaction and turnover intention. Because of the changing health policies landscape, Taiwan's hospital administrators are facing major cost reduction challenges. Specifically, the high turnover rate of nurses represents a hindrance and a human resource cost. This study focuses on ways of reducing the employee turnover rate through enhanced organisational citizenship behaviour and job satisfaction. A cross-sectional study. This study focuses on hospital nurses in Taiwan. Our research samples were obtained from one medical centre, three regional hospitals and seven district hospitals. Out of 300 questionnaires distributed among samples, 237 were completed and returned. Pearson's correlation was used to test for relationships among the main variables. One-way analysis of variance and Scheffé's post hoc analysis were employed to test the influence of demographic data on the main variables. The results reveal that the nurses' job satisfaction has a significantly positive correlation with organisational citizenship behaviour and a negative correlation with turnover intention. This study has proven that the turnover intention of clinical nurses is related to their organisational citizenship behaviour and job satisfaction. Hospital administrators can reduce the turnover intention by meeting nurses' needs and by promoting their organisational citizenship behaviour. Organisational citizenship behaviour involves behaviour that encourages staff to endeavour to voluntarily improve organisational performance without lobbying for compensation. Employees' job satisfaction includes satisfaction with the working environment or welfare programme in the context of human resource initiatives. Similarly, human resource protocols may serve as the starting point for promoting staff organisational citizenship behaviour. Administrators in clinical healthcare are encouraged to meet their

  16. Comparing the organisational structure of the preoperative assessment clinic at eight university hospitals

    NARCIS (Netherlands)

    Edward, G. M.; Biervliet, J. D.; Hollmann, M. W.; Schlack, W. S.; Preckel, B.


    The preoperative assessment clinic (PAC) has been implemented in most major hospitals. However, there is no uniformity in the way PACs are organised. We compared the organisational structure of the PACs from all eight university hospitals in The Netherlands, looking at the following variables:

  17. A comparative study of ICU patient diaries vs. hospital charts

    DEFF Research Database (Denmark)

    Egerod, Ingrid; Christensen, Doris


    Intensive care survivors often suffer from memory disorders, and some go on to develop anxiety, depression, and posttraumatic stress. Since the 1980s nurses have written diaries for intensive care patients to help them understand their illness and come to terms with their experiences after...... discharge. The central question we posed in this study was: Why do nurses write diaries in addition to conventional charting in the medical record? To answer this question, we compared intensive care diaries and hospital charts using textual analysis and narrative theory. The aims of our study were...... to compare patient diaries and hospital charts to explore (a) what each documentation instrument has to offer patients in their quest to make sense of their illness, and (b) why it is worthwhile for nurses to sustain the practice of writing diaries. The study findings show that the diary is coherent...

  18. Health-risk behaviour in deprived neighbourhoods compared with non-deprived neighbourhoods

    DEFF Research Database (Denmark)

    Algren, Maria Holst; Bak, Carsten Kronborg; Berg-Beckhoff, Gabriele


    in deprived neighbourhoods compared with those who live in non-deprived neighbourhoods and to summarise what kind of operationalisations of neighbourhood deprivation that were used in the studies. METHODS: PRISMA guidelines for systematic reviews were followed. Systematic searches were performed in Pub......Med, Embase, Web of Science and Sociological Abstracts using relevant search terms, Boolean operators, and truncation, and reference lists were scanned. Quantitative observational studies that examined health-risk behaviour in deprived neighbourhoods compared with non-deprived neighbourhoods were eligible...... for inclusion. RESULTS: The inclusion criteria were met by 22 studies. The available literature showed a positive association between smoking and physical inactivity and living in deprived neighbourhoods compared with non-deprived neighbourhoods. In regard to low fruit and vegetable consumption and alcohol...

  19. Physiotherapists use a small number of behaviour change techniques when promoting physical activity: A systematic review comparing experimental and observational studies. (United States)

    Kunstler, Breanne E; Cook, Jill L; Freene, Nicole; Finch, Caroline F; Kemp, Joanne L; O'Halloran, Paul D; Gaida, James E


    Physiotherapists promote physical activity as part of their practice. This study reviewed the behaviour change techniques physiotherapists use when promoting physical activity in experimental and observational studies. Systematic review of experimental and observational studies. Twelve databases were searched using terms related to physiotherapy and physical activity. We included experimental studies evaluating the efficacy of physiotherapist-led physical activity interventions delivered to adults in clinic-based private practice and outpatient settings to individuals with, or at risk of, non-communicable diseases. Observational studies reporting the techniques physiotherapists use when promoting physical activity were also included. The behaviour change techniques used in all studies were identified using the Behaviour Change Technique Taxonomy. The behaviour change techniques appearing in efficacious and inefficacious experimental interventions were compared using a narrative approach. Twelve studies (nine experimental and three observational) were retained from the initial search yield of 4141. Risk of bias ranged from low to high. Physiotherapists used seven behaviour change techniques in the observational studies, compared to 30 behaviour change techniques in the experimental studies. Social support (unspecified) was the most frequently identified behaviour change technique across both settings. Efficacious experimental interventions used more behaviour change techniques (n=29) and functioned in more ways (n=6) than did inefficacious experimental interventions (behaviour change techniques=10 and functions=1). Physiotherapists use a small number of behaviour change techniques. Less behaviour change techniques were identified in observational studies compared to experimental studies, suggesting physiotherapists use less BCTs clinically than experimentally. Copyright © 2017 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  20. Innovative medical devices and hospital decision making: a study comparing the views of hospital pharmacists and physicians. (United States)

    Billaux, Mathilde; Borget, Isabelle; Prognon, Patrice; Pineau, Judith; Martelli, Nicolas


    -based health technology assessment has been developed to support decisions. However, little is known about the different perceptions of innovative medical devices among practitioners and how different perceptions may affect decision making. What does this paper add? This paper compares and understands the perceptions of two groups of health professionals concerning innovative devices in the university hospital environment. What are the implications for practitioners? Such a comparison of viewpoints could facilitate improvements in current practices and decision-making processes in local health technology assessment for these medical products.

  1. Problem behaviours and parenting in preschool children with cystic fibrosis. (United States)

    Ward, C; Massie, J; Glazner, J; Sheehan, J; Canterford, L; Armstrong, D; Jaffe, A; Hiscock, H


    Problems with sleep, eating and adherence to therapy may adversely affect health outcomes in children with cystic fibrosis (CF). Data on the prevalence of such problems, associated parenting styles and caregiver mental health are limited. To determine: (a) the prevalence of sleep, mealtime, therapy adherence and externalising and internalising behavioural problems in preschool children with CF; (b) the prevalence of caregiver mental health problems and poor sleep quality; and (c) associations between child behavioural problems and parenting styles. This was a cross sectional survey of caregivers of children aged 6 months to 5 years attending CF outpatient clinics at Royal Children's Hospital (Melbourne), Monash Medical Centre (Melbourne) and Sydney Children's Hospital. Main outcome measures were child externalising and internalising behaviours, sleep, eating and adherence with therapy; the predictor was parenting styles (harsh, inconsistent, overprotective). 117 of 139 families participated. Problems were common with child sleep (small 31.6%; moderate/large problem: 21.9%), eating (32.4%) and adherence with physiotherapy (50.4%). Compared to normative data, sleep and mealtime problems were more prevalent. Caregivers reported high rates of symptoms indicating depression (33.3%), anxiety (16.4%) and stress (34.2%). Harsh parenting was associated with internalising behaviours (adjusted OR 3.9, 95% CI 1.16 to 13.17, p = 0.03). Problems with sleeping, eating and physiotherapy adherence were common in preschool children with CF. Caregivers reported high rates of symptoms indicative of mental health problems. Harsh parenting was associated with internalising problems. An intervention targeting child problem behaviours and parental mental health would be appropriate for CF families.

  2. Comparing colon cancer outcomes: The impact of low hospital case volume and case-mix adjustment. (United States)

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


    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.

  3. Predicting People's Environmental Behaviour: Theory of Planned Behaviour and Model of Responsible Environmental Behaviour (United States)

    Chao, Yu-Long


    Using different measures of self-reported and other-reported environmental behaviour (EB), two important theoretical models explaining EB--Hines, Hungerford and Tomera's model of responsible environmental behaviour (REB) and Ajzen's theory of planned behaviour (TPB)--were compared regarding the fit between model and data, predictive ability,…

  4. Criminal offenses in gamblers anonymous and hospital treated pathological gamblers. (United States)

    Blaszczynski, A P; McConaghy, N


    The purpose of this study was to compare the nature and prevalence of gambling and non-gambling related offenses in samples of pathological gamblers seeking behavioural treatment from a hospital-based program and those attending Gamblers Anonymous. A semi-structured interview schedule obtaining demographic data and details of the nature, frequency, and consequent legal action of criminal offenses committed was administered to 152 consecutive hospital treated pathological gamblers, and 154 Gamblers Anonymous attendees who volunteered to participate in the study. Of the total sample, 59% admitted a gambling-related offense, and 23% to a conviction. There was no difference in the proportion of hospital treated and Gamblers Anonymous subjects who offended. The most common gambling-related offenses were larceny, embezzlement and misappropriation. Gamblers committed a median of ten offenses over an average ten year period of pathological gambling with a median value of $ A 300(1) per offense. The median value for each non-gambling-related offense was $ A 130. Except for the significantly older mean age of Gamblers Anonymous subjects, hospital treated gamblers did not differ from Gamblers Anonymous attenders on relevant demographic features or parameters of gambling behaviour. Findings were interpreted to suggest a possible causal link between pathological gambling and the commission of non-violent property offenses.

  5. Outcomes of antiretroviral treatment programmes in rural Lesotho: health centres and hospitals compared. (United States)

    Labhardt, Niklaus Daniel; Keiser, Olivia; Sello, Motlalepula; Lejone, Thabo Ishmael; Pfeiffer, Karolin; Davies, Mary-Ann; Egger, Matthias; Ehmer, Jochen; Wandeler, Gilles


    Lesotho was among the first countries to adopt decentralization of care from hospitals to nurse-led health centres (HCs) to scale up the provision of antiretroviral therapy (ART). We compared outcomes between patients who started ART at HCs and hospitals in two rural catchment areas in Lesotho. The two catchment areas comprise two hospitals and 12 HCs. Patients ≥16 years starting ART at a hospital or HC between 2008 and 2011 were included. Loss to follow-up (LTFU) was defined as not returning to the facility for ≥180 days after the last visit, no follow-up (no FUP) as not returning after starting ART, and retention in care as alive and on ART at the facility. The data were analysed using logistic regression, competing risk regression and Kaplan-Meier methods. Multivariable analyses were adjusted for sex, age, CD4 cell count, World Health Organization stage, catchment area and type of ART. All analyses were stratified by gender. Of 3747 patients, 2042 (54.5%) started ART at HCs. Both women and men at hospitals had more advanced clinical and immunological stages of disease than those at HCs. Over 5445 patient-years, 420 died and 475 were LTFU. Kaplan-Meier estimates for three-year retention were 68.7 and 69.7% at HCs and hospitals, respectively, among women (p=0.81) and 68.8% at HCs versus 54.7% at hospitals among men (phospitals among women (odds ratio (OR): 0.89, 95% confidence interval (CI): 0.73-1.09) and higher retention at HCs among men (OR: 1.53, 95% CI: 1.20-1.96). The latter result was mainly driven by a lower proportion of patients LTFU at HCs (OR: 0.68, 95% CI: 0.51-0.93). In rural Lesotho, overall retention in care did not differ significantly between nurse-led HCs and hospitals. However, men seemed to benefit most from starting ART at HCs, as they were more likely to remain in care in these facilities compared to hospitals.

  6. Comparing methodologies for the allocation of overhead and capital costs to hospital services. (United States)

    Tan, Siok Swan; van Ineveld, Bastianus Martinus; Redekop, William Ken; Hakkaart-van Roijen, Leona


    Typically, little consideration is given to the allocation of indirect costs (overheads and capital) to hospital services, compared to the allocation of direct costs. Weighted service allocation is believed to provide the most accurate indirect cost estimation, but the method is time consuming. To determine whether hourly rate, inpatient day, and marginal mark-up allocation are reliable alternatives for weighted service allocation. The cost approaches were compared independently for appendectomy, hip replacement, cataract, and stroke in representative general hospitals in The Netherlands for 2005. Hourly rate allocation and inpatient day allocation produce estimates that are not significantly different from weighted service allocation. Hourly rate allocation may be a strong alternative to weighted service allocation for hospital services with a relatively short inpatient stay. The use of inpatient day allocation would likely most closely reflect the indirect cost estimates obtained by the weighted service method.

  7. Benchmarking healthcare logistics processes: a comparative case study of Danish and US hospitals

    DEFF Research Database (Denmark)

    Feibert, Diana Cordes; Andersen, Bjørn; Jacobsen, Peter


    Logistics processes in hospitals are vital in the provision of patient care. Improving healthcare logistics processes provides an opportunity for reduced healthcare costs and better support of clinical processes. Hospitals are faced with increasing healthcare costs around the world and improvement...... initiatives prevalent in manufacturing industries such as lean, business process reengineering and benchmarking have seen an increase in use in healthcare. This study investigates how logistics processes in a hospital can be benchmarked to improve process performance. A comparative case study of the bed...... logistics process and the pharmaceutical distribution process was conducted at a Danish and a US hospital. The case study results identified decision criteria for designing efficient and effective healthcare logistics processes. The most important decision criteria were related to quality, security...

  8. Recycling behaviour in healthcare: waste handling at work. (United States)

    Vogt, Joachim; Nunes, Katia R A


    This article reviews the motivational factors for environmental behaviour in general, presenting a case study on recycling disposable plastics in hospitals. Results show that 90% of over 600 employees from six analysed hospitals in Germany reported that the recycling of disposable plastics on the wards makes sense from an environmental and economic point of view. The case study reports an assessment of recycling attitudes and problems of hospital staff, mainly nurses. Employees in eco-certified hospitals were much more satisfied and reported fewer problems with the recycling system. The gender effect was significant only for saving energy, while age correlated with nearly all reported pro-environmental behaviour at home. At work, the mere introduction of a recycling system was insufficient to achieve good recycling results. Based on the study findings, recommendations are given aimed at improving the safety and sustainability of the recycling system.

  9. Hospital Costs of Foreign Non-Resident Patients: A Comparative Analysis in Catalonia, Spain. (United States)

    Arroyo-Borrell, Elena; Renart-Vicens, Gemma; Saez, Marc; Carreras, Marc


    Although patient mobility has increased over the world, in Europe there is a lack of empirical studies. The aim of the study was to compare foreign non-resident patients versus domestic patients for the particular Catalan case, focusing on patient characteristics, hospitalisation costs and differences in costs depending on the typology of the hospital they are treated. We used data from the 2012 Minimum Basic Data Set-Acute Care hospitals (CMBD-HA) in Catalonia. We matched two case-control groups: first, foreign non-resident patients versus domestic patients and, second, foreign non-resident patients treated by Regional Public Hospitals versus other type of hospitals. Hospitalisation costs were modelled using a GLM Gamma with a log-link. Our results show that foreign non-resident patients were significantly less costly than domestic patients (12% cheaper). Our findings also suggested differences in the characteristics of foreign non-resident patients using Regional Public Hospitals or other kinds of hospitals although we did not observe significant differences in the healthcare costs. Nevertheless, women, 15-24 and 35-44 years old patients and the days of stay were less costly in Regional Public Hospitals. In general, acute hospitalizations of foreign non-resident patients while they are on holiday cost substantially less than domestic patients. The typology of hospital is not found to be a relevant factor influencing costs.

  10. Measuring experience of hospitality : scale development and validation

    NARCIS (Netherlands)

    Pijls-Hoekstra, Ruth; Groen, Brenda H.; Galetzka, Mirjam; Pruyn, Adriaan T.H.

    This paper describes the development of the Experience of Hospitality Scale (EH-Scale) for assessing hospitality in service environments from a guest point of view. In contrast to other scales, which focus specifically on staff behaviour, the present scale focuses on the experience of hospitality

  11. Assessing and comparing information security in swiss hospitals. (United States)

    Landolt, Sarah; Hirschel, Jürg; Schlienger, Thomas; Businger, Walter; Zbinden, Alex M


    Availability of information in hospitals is an important prerequisite for good service. Significant resources have been invested to improve the availability of information, but it is also vital that the security of this information can be guaranteed. The goal of this study was to assess information security in hospitals through a questionnaire based on the International Organization for Standardization (ISO) and the International Electrotechnical Commission (IEC) standard ISO/IEC 27002, evaluating Information technology - Security techniques - Code of practice for information-security management, with a special focus on the effect of the hospitals' size and type. The survey, set up as a cross-sectional study, was conducted in January 2011. The chief information officers (CIOs) of 112 hospitals in German-speaking Switzerland were invited to participate. The online questionnaire was designed to be fast and easy to complete to maximize participation. To group the analyzed controls of the ISO/IEC standard 27002 in a meaningful way, a factor analysis was performed. A linear score from 0 (not implemented) to 3 (fully implemented) was introduced. The scores of the hospitals were then analyzed for significant differences in any of the factors with respect to size and type of hospital. The participating hospitals were offered a benchmark report about their status. The 51 participating hospitals had an average score of 51.1% (range 30.6% - 81.9%) out of a possible 100% where all items in the questionnaire were fully implemented. Room for improvement could be identified, especially for the factors covering "process and quality management" (average score 1.3 ± 0.8 out of a maximum of 3) and "organization and risk management" (average score 1.3 ± 0.7 out of a maximum of 3). Private hospitals scored significantly higher than university hospitals in the implementation of "security zones" and "backup" (P = .008). Half (50.00%, 8588/17,177) of all assessed hospital beds

  12. Impact of Self Efficacy on Innovative Behaviour Pharmacist in Hospital

    Directory of Open Access Journals (Sweden)

    Sri M. Wahyuningrum


    Full Text Available Hospitals are always required in order to improve the quality of service in accordance with professional standards in accordance with their code of ethics. Therefore, health workers in hospitals, especially pharmacists, are required to continuously improve its service to the community. To improve health services to the community, then the pharmacist must interact and be accepted by other professional health personnel in hospitals. The purpose of this study was to determine the effect of self-efficacy pharmacist in a hospital organization that became an impact on innovative behavior. This study used an obsevational quantitative measurement using questionnaire instrument. The results measured by number consist of value, rank, and frequencies were analyzed using statistics software smartPLS to answer the research question or hypothesis to predict a particular variable affects another variable. The results showed that effect between self-efficacy of behavioral innovations in the hospital pharmacist significantly different. A pharmacist who has high self-efficacy will obviously have the higher innovation behavior in hospitals.

  13. Behavioural typologies of experienced benefit of psychomotor therapy in patients with chronic shoulder pain: A grounded theory approach. (United States)

    Stamp, Anne Schinkel; Pedersen, Lise Lang; Ingwersen, Kim Gordon; Sørensen, Dorthe


    In this study we aimed to develop a theoretical account of the experienced benefit of psychomotor therapy in addition to treatment as usual in patients with chronic shoulder pain. The qualitative study design was based on a grounded theory approach. Open-ended face-to-face interviews were conducted after treatment was completed. We generated data and performed analyses by constant comparative analysis and theoretical sampling that focused on the patients' behavioural characteristics related to the experienced benefit of psychomotor therapy. We conducted 12 interviews, eight of which were with men. "Regaining capability" emerged as representative of the pattern of behaviour. Through this pattern, the patients resolved concern about losing capability. Regaining capability involved three behavioural typologies: taking advice, minding the body, and encompassing life changes. The patients' behavioural typologies revealed different levels of life changes. Psychomotor therapy offered the patients in our study new and better ways of coping with their shoulder pain. Copyright © 2018 Department of Physio- and Occupational Therapy, Hospital Lillebaelt - Vejle Hospital. Published by Elsevier Ltd.. All rights reserved.

  14. Autogenic Training as a behavioural approach to insomnia: a prospective cohort study. (United States)

    Bowden, Ann; Lorenc, Ava; Robinson, Nicola


    Insomnia is commonly associated with chronic health problems. Behavioural and cognitive factors often perpetuate a vicious cycle of anxiety and sleep disturbance, leading to long-term insomnia. National Institute for Health and Clinical Excellence currently recommends behavioural approaches before prescribing hypnotics. Behavioural approaches aim to treat underlying causes, but are not widely available. Research usually includes patients diagnosed with insomnia rather than secondary, co-morbid sleep- related problems. To examine the effectiveness of autogenic training (AT) as a non-drug approach to sleep-related problems associated with chronic ill health. Prospective pre- and post-treatment cohort study. AT centre, Royal London Hospital for Integrated Medicine, University College London Hospitals NHS Foundation Trust. All patients referred for AT from April 2007 to April 2008 were invited to participate. Participants received standard 8-week training, with no specific focus on sleep. Sleep questionnaires were administered at four time points, 'Measure Your Medical Outcome Profile' (MYMOP) and Hospital Anxiety and Depression Scale, before and after treatment. Results before and after treatment were compared. Camden and Islington Community Local Research and Ethics Committee approved the study. The AT course was completed by 153 participants, of whom 73% were identified as having a sleep-related problem. Improvements in sleep patterns included: sleep onset latency (P = 0.049), falling asleep quicker after night waking (P training. AT may provide an approach to insomnia that could be incorporated into primary care.

  15. Comparative analysis of informal borrowing behaviour between ...

    African Journals Online (AJOL)

    Tools of analyses were descriptive statistics of mean and percentages and probit model, The result of the Probit model on the variables influencing borrowing behaviour of male-headed households indicated that the coefficients of household size, farm size, purpose of borrowing, loan duration, interest rate and collateral ...

  16. Nurses' behaviour regarding CPR and the theories of reasoned action and planned behaviour. (United States)

    Dwyer, Trudy; Mosel Williams, Leonie


    Cardiopulmonary resuscitation (CPR) has been used in hospitals for approximately 40 years. Nurses are generally the first responders to a cardiac arrest and initiate basic life support while waiting for the advanced cardiac life support team to arrive. Speed and competence of the first responder are factors contributing to the initial survival of a person following a cardiac arrest. Attitudes of individual nurses may influence the speed and level of involvement in true emergency situations. This paper uses the theories of reasoned action and planned behaviour to examine some behavioural issues with CPR involvement.

  17. Comparing performance of 30-day readmission risk classifiers among hospitalized primary care patients. (United States)

    Garrison, Gregory M; Robelia, Paul M; Pecina, Jennifer L; Dawson, Nancy L


    Hospital readmission within 30 days of discharge occurs in almost 20% of US Medicare patients and may be a marker of poor quality inpatient care, ineffective hospital to home transitions, or disease severity. Within a patient centered medical home, care transition interventions may only be practical from cost and staffing perspectives if targeted at patients with the greatest risk of readmission. Various scoring algorithms attempt to predict patients at risk for 30-day readmission, but head-to-head comparison of performance is lacking. Compare published scoring algorithms which use generally available electronic medical record data on the same set of hospitalized primary care patients. The LACE index, the LACE+ index, the HOSPITAL score, and the readmission risk score were computed on a consecutive cohort of 26,278 hospital admissions. Classifier performance was assessed by plotting receiver operating characteristic curves comparing the computed score with the actual outcome of death or readmission within 30 days. Statistical significance of differences in performance was assessed using bootstrapping techniques. Correct readmission classification on this cohort was moderate with the following c-statistics: Readmission risk score 0.666; LACE 0.680; LACE+ 0.662; and HOSPITAL 0.675. There was no statistically significant difference in performance between classifiers. Logistic regression based classifiers yield only moderate performance when utilized to predict 30-day readmissions. The task is difficult due to the variety of underlying causes for readmission, nonlinearity, and the arbitrary time period of concern. More sophisticated classification techniques may be necessary to increase performance and allow patient centered medical homes to effectively focus efforts to reduce readmissions. © 2016 John Wiley & Sons, Ltd.

  18. Hospital safety climate surveys: measurement issues. (United States)

    Jackson, Jeanette; Sarac, Cakil; Flin, Rhona


    Organizational safety culture relates to behavioural norms in the workplace and is usually assessed by safety climate surveys. These can be a diagnostic indicator on the state of safety in a hospital. This review examines recent studies using staff surveys of hospital safety climate, focussing on measurement issues. Four questionnaires (hospital survey on patient safety culture, safety attitudes questionnaire, patient safety climate in healthcare organizations, hospital safety climate scale), with acceptable psychometric properties, are now applied across countries and clinical settings. Comparisons for benchmarking must be made with caution in case of questionnaire modifications. Increasing attention is being paid to the unit and hospital level wherein distinct cultures may be located, as well as to associated measurement and study design issues. Predictive validity of safety climate is tested against safety behaviours/outcomes, with some relationships reported, although effects may be specific to professional groups/units. Few studies test the role of intervening variables that could influence the effect of climate on outcomes. Hospital climate studies are becoming a key component of healthcare safety management systems. Large datasets have established more reliable instruments that allow a more focussed investigation of the role of culture in the improvement and maintenance of staff's safety perceptions within units, as well as within hospitals.

  19. Oral health related knowledge and behaviour among nursing ...

    African Journals Online (AJOL)

    Aim: To investigate oral health knowledge and behaviour amongst nursing students in a Nigerian tertiary hospital. Materials and methods: The study was conducted at University of Nigeria Teaching Hospital on respondents aged 17 to 40 years, using self administered structured questionnaire. Result: From oral health ...

  20. General practice: the DREEM attachment? Comparing the educational environment of hospital and general practice placements. (United States)

    Kelly, Martina; Bennett, Deirdre; O'Flynn, Siun


    The clinical learning environment is changing. General practice placements are now a fundamental part of undergraduate medical education. There is growing recognition that changes in hospital work practices are altering the breadth of exposure available to students. Surprisingly little work has been done comparing the quality of clinical placements between the hospital and community using validated tools. Such comparisons inform curriculum planning and resource allocation. The aim of this study was to compare the quality of the educational environment experienced by junior medical students during hospital and general practice placements using a widely used tool. Following the introduction of a new integrated curriculum, all Year 3 students (n=108) completed a standardised evaluation instrument, the Dundee Ready Education Environment Measure (DREEM) at the end of each of their clinical attachments (two different hospital sites and one in general practice), giving a total of 324 questionnaires. All forms were analysed and input into Graphpad INSTAT version 3. Total DREEM scores as well as subscale scores were calculated for each site. These were compared across sites using a Mann-Whitney U non-parametric test. By comparison with international standards, clinical attachments in our new integrated curriculum were rated highly. In particular, attachments in general practice scored highly with a mean score of 156.6 and perform significantly better (P students' perceptions of atmosphere and students' social self-perceptions. Finally, significant differences also emerged in students' perceptions of teachers in general practice when compared to those in the hospital setting. These findings provide evidence of the high-quality educational environment afforded students in primary care. They challenge the traditional emphasis on hospital-based teaching and preempt the question - Is the community a better place for junior students to learn?

  1. How hospitalized children and parents perceive nurses and hospital amenities: A qualitative descriptive study in Poland. (United States)

    Marcinowicz, Ludmiła; Abramowicz, Paweł; Zarzycka, Danuta; Abramowicz, Magdalena; Konstantynowicz, Jerzy


    A qualitative descriptive design using an interview guide approach was adopted to investigate the patient-nurse relationship and paediatric ward amenities from the perspective of parents and hospitalised children in Poland. The study included 26 parents or caregivers of hospitalised children (between 13 months and 15 years old) and 22 children (from 10 to 16 years old). Qualitative content analysis was used to analyse the recorded verbal data. Data from patients' transcripts were coded and classified in terms of topics on the patient-nurse relationship and hospital care. We identified five main topics. 1. Nurse qualities; 2. Nurse verbal behaviour; 3. Nurse tone of voice and non-verbal behaviour; 4. Hospital amenities; 5. Parents' expectations towards nurses. Our study contributes to increased understanding of parents' and children's experiences of paediatric hospital care. © The Author(s) 2014.

  2. Rumination-focused cognitive behaviour therapy vs. cognitive behaviour therapy for depression: study protocol for a randomised controlled superiority trial. (United States)

    Hvenegaard, Morten; Watkins, Ed R; Poulsen, Stig; Rosenberg, Nicole K; Gondan, Matthias; Grafton, Ben; Austin, Stephen F; Howard, Henriette; Moeller, Stine B


    Cognitive behavioural therapy is an effective treatment for depression. However, one third of the patients do not respond satisfactorily, and relapse rates of around 30 % within the first post-treatment year were reported in a recent meta-analysis. In total, 30-50 % of remitted patients present with residual symptoms by the end of treatment. A common residual symptom is rumination, a process of recurrent negative thinking and dwelling on negative affect. Rumination has been demonstrated as a major factor in vulnerability to depression, predicting the onset, severity, and duration of future depression. Rumination-focused cognitive behavioural therapy is a psychotherapeutic treatment targeting rumination. Because rumination plays a major role in the initiation and maintenance of depression, targeting rumination with rumination-focused cognitive behavioural therapy may be more effective in treating depression and reducing relapse than standard cognitive behavioural therapy. This study is a two-arm pragmatic randomised controlled superiority trial comparing the effectiveness of group-based rumination-focused cognitive behaviour therapy with the effectiveness of group-based cognitive behavioural therapy for treatment of depression. One hundred twenty-eight patients with depression will be recruited from and given treatment in an outpatient service at a psychiatric hospital in Denmark. Our primary outcome will be severity of depressive symptoms (Hamilton Rating Scale for Depression) at completion of treatment. Secondary outcomes will be level of rumination, worry, anxiety, quality of life, behavioural activation, experimental measures of cognitive flexibility, and emotional attentional bias. A 6-month follow-up is planned and will include the primary outcome measure and assessment of relapse. The clinical outcome of this trial may guide clinicians to decide on the merits of including rumination-focused cognitive behavioural therapy in the treatment of depression in

  3. Measuring and Comparing Hospital Accessibility for Palm Beach County's Elderly and Nonelderly Populations During a Hurricane. (United States)

    Prasad, Shivangi


    To determine whether, during a hurricane, geographic accessibility to hospitals with emergency care is compromised disproportionately for the elderly than for the nonelderly. The locations of hospitals with emergency health care and a subset of those hospitals functional during a hurricane were compared with the distribution of the elderly population at the block group level in Palm Beach County, Florida. Geographic Information Systems (GIS) proximity analysis (minimum distance to closest hospital) and cumulative distribution functions were used to measure and compare hospital accessibility during normal and hurricane conditions for the elderly and nonelderly populations. Accessibility to closest functional hospital during a hurricane was compromised disproportionately for the elderly. Geographic accessibility to emergency health care is compromised disproportionately for the elderly in Palm Beach County. Compounding the risk is the likelihood of the elderly experiencing a greater health care need during a hurricane. This poses a community public health crisis and calls for effective and collaborative planning between health professionals and disaster planners to address the health care needs of the elderly. (Disaster Med Public Health Preparedness. 2017;page 1 of 5).

  4. Oral health knowledge, perceptions and behaviour among nursing ...

    African Journals Online (AJOL)

    Aim: The purpose of the study was to investigate oral health knowledge, perceptions and behaviour amongst nursing students in a Nigerian tertiary hospital. Materials and methods: The study was conducted at University of Nigeria Teaching Hospital on 244 respondents aged 17 to 40 years, using self administered ...

  5. Hospital food service: a comparative analysis of two foodservice systems at a Danish Hospital

    DEFF Research Database (Denmark)

    Justesen, Lise; René, Michael; Kristensen, Marianne Boll


    meals from BTS and the dietary intake was measured. After implementation of CCP on the wards, dietary intake was measured on 56 patients. Intake at mealtimes was assessed through a visual portion size assessment method and intake in-between meals was measured using a self-reported dietary record......% of the protein requirements on CCP compared to 33 % on BTS (p=0,216). Conclusions A new foodservice system (CCP) which increases availability and choice of food 24/7 does not show a significant improvement of energy and protein intake in hospitalized patients and patients at nutritional risk. However, further...

  6. Accelerometer-measured sedentary behaviour and physical activity of inpatients with severe mental illness. (United States)

    Kruisdijk, Frank; Deenik, Jeroen; Tenback, Diederik; Tak, Erwin; Beekman, Aart-Jan; van Harten, Peter; Hopman-Rock, Marijke; Hendriksen, Ingrid


    Sedentary behaviour and lack of physical activity threatens health. Research concerning these behaviours of inpatients with severe mental illness is limited but urgently needed to reveal prevalence and magnitude. In total, 184 inpatients (men n =108, women n =76, mean age 57,4, 20% first generation antipsychotics, 40% second generation antipsychotics, 43% antidepressants, mean years hospitalisation 13 years), with severe mental illness of a Dutch psychiatric hospital wore an accelerometer for five days to objectively measure total activity counts per hour and percentages in sedentary behaviour, light intensity physical activity and moderate to vigorous physical activity. Accelerometer data were compared with data of 54 healthy ward employees. Patients showed significantly less activity counts per hour compared to employees (p=0.02), although the differences were small (d=0.32). Patients were sedentary during 84% of the wear time (50min/h), spend 10% in light intensity physical activity and 6% in moderate to vigorous physical activity. Age was the only significant predictor, predicting less total activity counts/h in higher ages. Decreasing sedentary behaviour and improving physical activity in this population should be a high priority in clinical practice. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  7. Comparative epidemiology of human metapneumovirus- and respiratory syncytial virus-associated hospitalizations in Guatemala (United States)

    McCracken, John P; Arvelo, Wences; Ortíz, José; Reyes, Lissette; Gray, Jennifer; Estevez, Alejandra; Castañeda, Oscar; Langley, Gayle; Lindblade, Kim A


    Background Human metapneumovirus (HMPV) is an important cause of acute respiratory infections (ARI), but little is known about how it compares with respiratory syncytial virus (RSV) in Central America. Objectives In this study, we describe hospitalized cases of HMPV- and RSV-ARI in Guatemala. Methods We conducted surveillance at three hospitals (November 2007–December 2012) and tested nasopharyngeal and oropharyngeal swab specimens for HMPV and RSV using real-time reverse transcription-polymerase chain reaction. We calculated incidence rates, and compared the epidemiology and outcomes of HMPV-positive versus RSV-positive and RSV-HMPV-negative cases. Results We enrolled and tested specimens from 6288 ARI cases; 596 (9%) were HMPV-positive and 1485 (24%) were RSV-positive. We observed a seasonal pattern of RSV but not HMPV. The proportion HMPV-positive was low (3%) and RSV-positive high (41%) for age Guatemala, but HMPV hospitalizations are less frequent than RSV and, in young children, less severe than other etiologies. Preventive interventions should take into account the wide variation in incidence by age and unpredictable timing of incidence peaks. PMID:24761765

  8. Reason for hospital admission: a pilot study comparing patient statements with chart reports. (United States)

    Berger, Zackary; Dembitzer, Anne; Beach, Mary Catherine


    Providers and patients bring different understandings of health and disease to their encounters in the hospital setting. The literature to date only infrequently addresses patient and provider concordance on the reported reason for hospitalization, that is, whether they express this reason in similar ways. An agreement or common ground between such understandings can serve as a basis for future communication regarding an illness and its treatment. We interviewed a convenience sample of patients on the medical wards of an urban academic medical center. We asked subjects to state the reason why their doctors admitted them to the hospital, and then compared their statement with the reason in the medical record. We defined concordance on reported reason for hospitalization as agreement between the patient's report and the reason abstracted from the chart. We interviewed and abstracted chart data from a total of 46 subjects. Concordance on reported reason for hospitalization was present in 24 (52%) and discordance in 17 (37%); 5 patients (11%) could not give any reason for their hospitalization. Among the 17 patients whose report was discordant with their chart, 12 (71%) reported a different organ system than was recorded in the chart. A significant proportion of medical inpatients could not state their physicians' reason for admission. In addition, patients who identify a different reason for hospitalization than the chart often give a different organ system altogether. Providers should explore patient understanding of the reason for their hospitalization to facilitate communication and shared decision making.

  9. Brief Cognitive Behavioural Therapy compared to optimised general practitioners’ care for depression : A randomised trial

    NARCIS (Netherlands)

    Schene, A.H.; Baas, K.D.; Koeter, M.W.J.; Lucassen, P.; Bockting, C.L.H.; Wittkampf, K.A.; Huyser, J.; van Weert, H.C.


    Background: How to treat Major Depressive Disorder (MDD) in primary care? Studies that compared (brief) Cognitive Behavioural Therapy (CBT) with care as usual by the General Practitioner (GP) found the first to be more effective. However, to make a fair comparison GP care should be optimised and

  10. Brief Cognitive Behavioural Therapy Compared to Optimised General Practitioners? Care for Depression: A Randomised Trial

    NARCIS (Netherlands)

    Schene, A. H.; Baas, K. D.; Koeter, M.; Lucassen, P.; Bockting, C. L. H.|info:eu-repo/dai/nl/258267992; Wittkampf, K. F.; van Weert, H. C.; Huyser, J.


    Background: How to treat Major Depressive Disorder (MDD) in primary care? Studies that compared (brief) Cognitive Behavioural Therapy (CBT) with care as usual by the General Practitioner (GP) found the first to be more effective. However, to make a fair comparison GP care should be optimised and

  11. Re-Conceptualising Hospitality Management: Analysing Changing Views On Leadership Approaches


    YILMAZER, Assis.Prof.Dr.Aydın


    Transformational and transactional leadership are distinct but not mutually exclusive processes. In an effort to clarify some of the consequences of these leadership styles, and their impact on the hospitality industry, the aim of the proposed study can best be summarised in three key objectives: To compare the relationships between transformational and transactional leadership behaviour in the hotel industry; To develop a better understanding of the unique factors in other organ...

  12. Evaluating the Social Media Performance of Hospitals in Spain: A Longitudinal and Comparative Study. (United States)

    Martinez-Millana, Antonio; Fernandez-Llatas, Carlos; Basagoiti Bilbao, Ignacio; Traver Salcedo, Manuel; Traver Salcedo, Vicente


    Social media is changing the way in which citizens and health professionals communicate. Previous studies have assessed the use of Health 2.0 by hospitals, showing clear evidence of growth in recent years. In order to understand if this happens in Spain, it is necessary to assess the performance of health care institutions on the Internet social media using quantitative indicators. The study aimed to analyze how hospitals in Spain perform on the Internet and social media networks by determining quantitative indicators in 3 different dimensions: presence, use, and impact and assess these indicators on the 3 most commonly used social media - Facebook, Twitter, YouTube. Further, we aimed to find out if there was a difference between private and public hospitals in their use of the aforementioned social networks. The evolution of presence, use, and impact metrics is studied over the period 2011- 2015. The population studied accounts for all the hospitals listed in the National Hospitals Catalog (NHC). The percentage of hospitals having Facebook, Twitter, and YouTube profiles has been used to show the presence and evolution of hospitals on social media during this time. Usage was assessed by analyzing the content published on each social network. Impact evaluation was measured by analyzing the trend of subscribers for each social network. Statistical analysis was performed using a lognormal transformation and also using a nonparametric distribution, with the aim of comparing t student and Wilcoxon independence tests for the observed variables. From the 787 hospitals identified, 69.9% (550/787) had an institutional webpage and 34.2% (269/787) had at least one profile in one of the social networks (Facebook, Twitter, and YouTube) in December 2015. Hospitals' Internet presence has increased by more than 450.0% (787/172) and social media presence has increased ten times since 2011. Twitter is the preferred social network for public hospitals, whereas private hospitals

  13. Comparative study of heat transfer and wetting behaviour of conventional and bioquenchants for industrial heat treatment

    Energy Technology Data Exchange (ETDEWEB)

    Fernandes, Peter; Prabhu, K. Narayan [Department of Metallurgical and Materials Engineering, National Institute of Technology Karnataka, Surathkal, P.O. Srinivasnagar 575 025 Mangalore, Karnataka State (India)


    An investigation was conducted to study the suitability of vegetable oils as bioquenchants for industrial heat treatment. The study involved the assessment of the severity of quenching and wetting behaviour of conventional and vegetable oil quench media. Quench severities of sunflower, coconut and palm oils were found to be greater than mineral oil. The quench severity of aqueous media is greater than oil media although their wettability is poor as indicated by their higher contact angles. A dimensionless contact angle parameter defined in this work is found to be a better parameter to compare the wetting behaviour with heat transfer. (author)

  14. Comparative effects of building envelope improvements and occupant behavioural changes on the exergy consumption for heating and cooling

    International Nuclear Information System (INIS)

    Schweiker, Marcel; Shukuya, Masanori


    Much focus is put on measures to improve the building envelope system performance to reduce the impact of the building sector on the global environmental degradation. This paper compares the potential of building envelope improvements to those of a change in the occupant's behavioural pattern. Three cases of improvements together with a base case were analysed using exergy analysis, because the exergy concept is useful to understand the underlying processes and the necessary adjustments to the calculation of the heat-pump system. The assumptions for the occupant behaviour were set up based on our field measurements conducted in a dormitory building and the calculation was for steady-state conditions. It was found that the potential of occupant behavioural changes for the reduction in exergy consumption is more affected by the outdoor temperature compared to building envelope improvements. The influence of occupant behaviour was highly significant (more than 90% decrease of exergy consumption) when the temperature difference between indoors and outdoors is small, which is the case for long periods in regions with moderate temperatures during summer and/or winter. Nevertheless, both measures combined lead to a reduction from 76% up to 95% depending on the outside conditions and should be the final goal.

  15. Comparing image search behaviour in the ARRS GoldMiner search engine and a clinical PACS/RIS. (United States)

    De-Arteaga, Maria; Eggel, Ivan; Do, Bao; Rubin, Daniel; Kahn, Charles E; Müller, Henning


    Information search has changed the way we manage knowledge and the ubiquity of information access has made search a frequent activity, whether via Internet search engines or increasingly via mobile devices. Medical information search is in this respect no different and much research has been devoted to analyzing the way in which physicians aim to access information. Medical image search is a much smaller domain but has gained much attention as it has different characteristics than search for text documents. While web search log files have been analysed many times to better understand user behaviour, the log files of hospital internal systems for search in a PACS/RIS (Picture Archival and Communication System, Radiology Information System) have rarely been analysed. Such a comparison between a hospital PACS/RIS search and a web system for searching images of the biomedical literature is the goal of this paper. Objectives are to identify similarities and differences in search behaviour of the two systems, which could then be used to optimize existing systems and build new search engines. Log files of the ARRS GoldMiner medical image search engine (freely accessible on the Internet) containing 222,005 queries, and log files of Stanford's internal PACS/RIS search called radTF containing 18,068 queries were analysed. Each query was preprocessed and all query terms were mapped to the RadLex (Radiology Lexicon) terminology, a comprehensive lexicon of radiology terms created and maintained by the Radiological Society of North America, so the semantic content in the queries and the links between terms could be analysed, and synonyms for the same concept could be detected. RadLex was mainly created for the use in radiology reports, to aid structured reporting and the preparation of educational material (Lanlotz, 2006) [1]. In standard medical vocabularies such as MeSH (Medical Subject Headings) and UMLS (Unified Medical Language System) specific terms of radiology are often

  16. A person-oriented approach to hand hygiene behaviour: Emotional empathy fosters hand hygiene practice. (United States)

    Sassenrath, Claudia; Diefenbacher, Svenja; Siegel, André; Keller, Johannes


    Adopting a social-psychological approach, this research examines whether emotional empathy, an affective reaction regarding another's well-being, fosters hand hygiene as this affects other's health-related well-being extensively. Three studies tested this notion: (a) a cross-sectional study involving a sample of health care workers at a German hospital, (b) an experiment testing the causal effect of empathy on hand hygiene behaviour and (c) an 11-week prospective study testing whether an empathy induction affected disinfectant usage frequency in two different wards of a hospital. Self-reported hand hygiene behaviour based on day reconstruction method was measured in Study 1, actual hand sanitation behaviour was observed in Study 2 and disinfectant usage frequency in two different hospital wards was assessed in Study 3. Study 1 reveals an association of empathy with hand hygiene cross-sectionally, Study 2 documents the causal effect of empathy on increased hand sanitation. Study 3 shows an empathy induction increases hand sanitiser usage in the hospital. Increasing emotional empathy promotes hand hygiene behaviour, also in hospitals. Besides providing new impulses for the design of effective interventions, these findings bear theoretical significance as they document the explanatory power of empathy regarding a distal explanandum (hand hygiene).


    Macedo Gonçalves, Juliana; Lameiro Rodrigues, Kelly; Santiago Almeida, Ângela Teresinha; Pereira, Giselda Maria; Duarte Buchweitz, Márcia Rúbia


    since food service in hospitals complements medical treatment, it should be produced in proper hygienic and sanitary conditions. It is a well-known fact that food-transmitted illnesses affect with greater severity hospitalized and immunosuppressed patients. good practices in hospital food service are evaluated by comparing assessment instruments. good practices were evaluated by a verification list following Resolution of Collegiate Directory n. 216 of the Brazilian Agency for Sanitary Vigilance. Interpretation of listed items followed parameters of RCD 216 and the Brazilian Association of Collective Meals Enterprises (BACME). Fisher's exact test was applied to detect whether there were statistically significant differences. Analysis of data grouping was undertaken with Unweighted Pair-group using Arithmetic Averages, coupled to a correlation study between dissimilarity matrixes to verify disagreement between the two methods. Good Practice was classified with mean total rates above 75% by the two methods. There were statistically significant differences between services and food evaluated by BACME instrument. Hospital Food Services have proved to show conditions of acceptable good practices. the comparison of interpretation tools based on RCD n. 216 and BACME provided similar results for the two classifications. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  18. Inpatient satisfaction at different public sector hospitals of a metropolitan city in Pakistan: a comparative cross-sectional study. (United States)

    Hussain, Mehwish; Rehman, Rehana; Ikramuddin, Zia; Asad, Nava; Farooq, Ayesha


    To observe inpatient satisfaction at different public sector hospitals of Karachi, Pakistan. A cross sectional study was carried out during 2010-2012 in four major public sector hospitals of Karachi. A total of 710 patients completed the study. Responses were gathered in a self-structured questionnaire that comprised of four dimensions of satisfaction with doctor, staff, administration and treatment. Average Score of each dimension was taken and compared using one way analysis of variance. Satisfaction with doctors, staff and administration of provincial and federal hospitals were comparatively similar (P > 0.05). However, satisfaction with treatment significantly differed in all four hospitals (P public sector hospitals showed satisfaction with healthcare personnel and related administration. However, treatment dimension needs to be improved to get more satisfaction.

  19. Patient safety climate and worker safety behaviours in acute hospitals in Scotland. (United States)

    Agnew, Cakil; Flin, Rhona; Mearns, Kathryn


    To obtain a measure of hospital safety climate from a sample of National Health Service (NHS) acute hospitals in Scotland and to test whether these scores were associated with worker safety behaviors, and patient and worker injuries. Data were from 1,866 NHS clinical staff in six Scottish acute hospitals. A Scottish Hospital Safety Questionnaire measured hospital safety climate (Hospital Survey on Patient Safety Culture), worker safety behaviors, and worker and patient injuries. The associations between the hospital safety climate scores and the outcome measures (safety behaviors, worker and patient injury rates) were examined. Hospital safety climate scores were significantly correlated with clinical workers' safety behavior and patient and worker injury measures, although the effect sizes were smaller for the latter. Regression analyses revealed that perceptions of staffing levels and managerial commitment were significant predictors for all the safety outcome measures. Both patient-specific and more generic safety climate items were found to have significant impacts on safety outcome measures. This study demonstrated the influences of different aspects of hospital safety climate on both patient and worker safety outcomes. Moreover, it has been shown that in a hospital setting, a safety climate supporting safer patient care would also help to ensure worker safety. The Scottish Hospital Safety Questionnaire has proved to be a usable method of measuring both hospital safety climate as well as patient and worker safety outcomes. Copyright © 2013 National Safety Council and Elsevier Ltd. Published by Elsevier Ltd. All rights reserved.

  20. Silymarin improves the behavioural, biochemical and histoarchitecture alterations in focal ischemic rats: a comparative evaluation with piracetam and protocatachuic acid. (United States)

    Muley, Milind M; Thakare, Vishnu N; Patil, Rajesh R; Kshirsagar, Ajay D; Naik, Suresh R


    Comparative neuroprotective potential of silymarin, piracetam and protocatechuic acid ethyl ester (PCA) was evaluated in focal ischemic rats. Various pharmacological, biochemical (lipid peroxidation, reduced glutathione, catalase, nitrite content, brain water content) and behavioural (memory impairment, motor control, neurological score) including infarct size and histopathological alterations were evaluated. Silymarin (200mg/kg) and PCA treatment significantly improved behavioural, biochemical and histopathological changes, and reduced water content and infarct size. However, piracetam only improved behavioural and histopathological changes, reduced water content and infarct size. The findings indicate that silymarin exhibits neuroprotective activity better than PCA and piracetam in focal ischemia/reperfusion reflected by its better restoration of behavioural and antioxidant profile. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. Attitudes of Malaysian general hospital staff towards patients with mental illness and diabetes

    Directory of Open Access Journals (Sweden)

    Midin Marhani


    Full Text Available Abstract Background The context of the study is the increased assessment and treatment of persons with mental illness in general hospital settings by general health staff, as the move away from mental hospitals gathers pace in low and middle income countries. The purpose of the study was to examine whether general attitudes of hospital staff towards persons with mental illness, and extent of mental health training and clinical experience, are associated with different attitudes and behaviours towards a patient with mental illness than towards a patients with a general health problem - diabetes. Methods General hospital health professionals in Malaysia were randomly allocated one of two vignettes, one describing a patient with mental illness and the other a patient with diabetes, and invited to complete a questionnaire examining attitudes and health care practices in relation to the case. The questionnaires completed by respondents included questions on demographics, training in mental health, exposure in clinical practice to people with mental illness, attitudes and expected health care behaviour towards the patient in the vignette, and a general questionnaire exploring negative attitudes towards people with mental illness. Questionnaires with complete responses were received from 654 study participants. Results Stigmatising attitudes towards persons with mental illness were common. Those responding to the mental illness vignette (N = 356 gave significantly lower ratings on care and support and higher ratings on avoidance and negative stereotype expectations compared with those responding the diabetes vignette (N = 298. Conclusions Results support the view that, in the Malaysian setting, patients with mental illness may receive differential care from general hospital staff and that general stigmatising attitudes among professionals may influence their care practices. More direct measurement of clinician behaviours than able to be implemented

  2. Improving patient safety and physician accountability using the hospital credentialing process


    Forster, Alan J; Turnbull, Jeff; McGuire, Shaun; Ho, Michael L; Worthington, JR


    Abstract The lack of systematic oversight of physician performance has led to some serious cases related to physician competence and behaviour. We are currently implementing a hospital-wide approach to improve physician oversight by incorporating it into the hospital credentialing process. Our proposed credentialing method involves four systems: (1) a system for monitoring and reporting clinical performance; (2) a system for evaluating physician behaviour; (3) a complaints management system; ...

  3. Focus on aggressive behaviour in mental illness. (United States)

    Pompili, Enrico; Carlone, Cristiano; Silvestrini, Cristiana; Nicolò, Giuseppe


    Aggression is a behaviour with evolutionary origins, but in today’s society it is often both destructive and maladaptive. Increase of aggressive behaviour has been observed in a number of serious mental illnesses, and it represents a clinical challenge for mental healthcare provider. These phenomena can lead to harmful behaviours, including violence, thus representing a serious public health concern. Aggression is often a reason for psychiatric hospitalization, and it often leads to prolonged hospital stays, suffering by patients and their victims, and increased stigmatization. Moreover, it has an effect on healthcare use and costs in terms of longer length of stay, more readmissions and higher drug use. In this review, based on a selective search of 2010-2016 pertinent literature on PubMed, we analyze and summarize information from original articles, reviews, and book chapters about aggression and psychiatric disorders, discussing neurobiological basis and therapy of aggressive behaviour. A great challenge has been revealed regarding the neurobiology of aggression, and an integration of this body of knowledge will ultimately improve clinical diagnostics and therapeutic interventions. The great heterogeneity of aggressive behaviour still hampers our understanding of its causal mechanisms. Still, over the past years, the identification of specific subtypes of aggression has released possibilities for new and individualized treatment approaches. Neuroimaging studies may help to further elucidate the interrelationship between neurocognitive functioning, personality traits, and antisocial and violent behaviour. Recent studies point toward manipulable neurobehavioral targets and suggest that cognitive, pharmacological, neuromodulatory, and neurofeedback treatment approaches can be developed to ameliorate urgency and aggression in schizophrenia. These combined approaches could improve treatment efficacy. As current pharmacological and therapeutic interventions are

  4. Hospital staffing and hospital costs. (United States)

    Andrew, R R


    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%.

  5. Oral health and oral health risk behaviour in children with and without externalising behaviour problems. (United States)

    Staberg, M; Norén, J G; Gahnberg, L; Ghaderi, A; Kadesjö, C; Robertson, A


    This was to study children with early detected externalising behaviour problems compared to matched controls regarding oral health, oral health risk behaviour and the parental evaluation of the child's oral health and dental care. Children aged 10-13 years and with externalising behaviour problems, were compared to matched controls. Behavioural characteristics were based on the Strength and Difficulties Questionnaire. The children and their parents completed questionnaires regarding dental fear, tooth brushing, dietary habits and evaluation of oral health and dental care. Data on dental caries risk assessments, caries, behaviour management problems and dental trauma were obtained from dental files. There were no differences in caries prevalence in children with early detected externalising behaviour problems, compared to controls. However, the former group consumed more sweet drinks when thirsty and brushed their teeth fewer than twice daily; they also had more dental trauma in both dentitions and a higher risk range for dental fear, compared to controls. This study points out potential oral health risk factors in children with early-detected externalising behaviour problems. Although no difference in caries prevalence was observed, externalising behaviour may affect oral health. Therefore, dental professionals should support the families and the children to preserve dental health by offering increased prophylactic measures. There were no differences between children with externalising behaviour problems, compared with controls, regarding the parent evaluation of their child's dental health. However, more parents in the study group evaluated the dental care as poor or not functioning.

  6. Struggle against privatization: a case history in the use of comparative performance evaluation of public hospitals. (United States)

    Oh, Juhwan; Lee, Jin-Seok; Choi, Yong-Jun; Park, Hyeung-Keun; Do, Young Kyung; Eun, Sang-Jun


    After the 1997 economic crisis, the South Korean government implemented neoliberal policies in many sectors. In health care, the government attempted to privatize nine public hospitals, framing the initiative as "better management." In this discourse, public hospital workers were stereotyped as lazy and incompetent, while public hospitals were portrayed as poorly managed and of low quality. However, the government did not present any relevant evidence of improvement in already privatized hospitals, even though three hospitals had been semi-privatized at that time. In this study, the authors evaluated the effects of the semi-privatization, comparing the performance of the semi-privatized hospitals with that of the nine other hospitals targeted for privatization. The study found adverse effects on performance, unlike the claims made by the government. Semi-privatization intensified the workloads of hospital workers and the instability of employment, froze or decreased real wages, and drastically increased hospital revenue per patient stay. The changes may have resulted from redefining profit as the goal of the hospitals, as opposed to the previous focus on decision-making on public health. These research findings played a decisive role in the struggle to keep the targeted public hospitals free of privatization, especially in two of the nine hospitals targeted for privatization in 2001.

  7. Social responsibility: a new paradigm of hospital governance? (United States)

    Brandão, Cristina; Rego, Guilhermina; Duarte, Ivone; Nunes, Rui


    Changes in modern societies originate the perception that ethical behaviour is essential in organization's practices especially in the way they deal with aspects such as human rights. These issues are usually under the umbrella of the concept of social responsibility. Recently the Report of the International Bioethics Committee of UNESCO on Social Responsibility and Health has addressed this concept of social responsibility in the context of health care delivery suggesting a new paradigm in hospital governance. The objective of this paper is to address the issue of corporate social responsibility in health care, namely in the hospital setting, emphasising the special governance arrangements of such complex organisations and to evaluate if new models of hospital management (entrepreneurism) will need robust mechanisms of corporate governance to fulfil its social responsiveness. The scope of this responsible behaviour requires hospitals to fulfil its social and market objectives, in accordance to the law and general ethical standards. Social responsibility includes aspects like abstention of harm to the environment or the protection of the interests of all the stakeholders enrolled in the deliverance of health care. In conclusion, adequate corporate governance and corporate strategy are the gold standard of social responsibility. In a competitive market hospital governance will be optimised if the organization culture is reframed to meet stakeholders' demands for unequivocal assurances on ethical behaviour. Health care organizations should abide to this new governance approach that is to create organisation value through performance, conformance and responsibility.

  8. Comparing Millennials With Their Predecessors Regarding Online Travel Behaviours: A Logistical Regression Modelling Approach


    Amaro, Suzanne; Henriques, Carla; Duarte, Paulo


    Millennials, also known as Generation Y, are characterized by their use of technology, which is an integral part of their lives. Research has shown that they are different from earlier generations regarding their behaviours and attitudes. This article investigates and compares the behavior of Millennials with those of previous generations using data collected among 1,732 Worldwide Internet users. In order to understand what differentiates Millennials, this study considers several characterist...

  9. Catalysts of worker-to-worker violence and incivility in hospitals. (United States)

    Hamblin, Lydia E; Essenmacher, Lynnette; Upfal, Mark J; Russell, Jim; Luborsky, Mark; Ager, Joel; Arnetz, Judith E


    To identify common catalysts of worker-to-worker violence and incivility in hospital settings. Worker-to-worker violence and incivility are prevalent forms of mistreatment in healthcare workplaces. These are forms of counterproductive work behaviour that can lead to negative outcomes for employees, patients and the organisation overall. Identifying the factors that lead to co-worker mistreatment is a critical first step in the development of interventions targeting these behaviours. Retrospective descriptive study. Qualitative content analysis was conducted on the total sample (n = 141) of employee incident reports of worker-to-worker violence and incivility that were documented in 2011 at a large American hospital system. More than 50% of the incidents involved nurses, and the majority of incidents did not involve physical violence. Two primary themes emerged from the analysis: Work Behaviour and Work Organisation. Incidents in the Work Behaviour category were often sparked by unprofessional behaviour, disagreement over responsibilities for work tasks or methods of patient care, and dissatisfaction with a co-worker's performance. Incidents in the Work Organisation category involved conflicts or aggression arising from failure to following protocol, patient assignments, limited resources and high workload. Incidents of worker-to-worker violence and incivility stemmed from dissatisfaction with employee behaviour or from organisational practices or work constraints. These incident descriptions reflect worker dissatisfaction and frustration, resulting from poor communication and collaboration between employees, all of which threaten work productivity. Violence and incivility between hospital employees can contribute to turnover of top performers, hinder effective teamwork and jeopardise the quality of patient care. Identification of common catalysts for worker-to-worker violence and incivility informs the development of mistreatment prevention programmes that can be

  10. A Comparative Study of the Behaviour of Five Dense Glass Materials Under Shock Loading Conditions (United States)

    Radford, Darren D.; Proud, William G.; Field, John E.


    Previous work at the Cavendish Laboratory on the properties of glasses under shock loading has demonstrated that the material response is highly dependent upon the composition of the glass. The shock response of glass materials with an open structure, such as borosilicate, exhibits a ramping behaviour in the longitudinal stress histories due to structural collapse. Glass materials with a “filled” microstructure, as in the case of Type-D, Extra Dense Flint (DEDF) do not exhibit a ramping behaviour and behave in a manner similar to polycrystalline ceramics [1]. The current investigation compares the behaviour of five such glasses (SF15, DEDF, LACA, SF57 and DEDF-927210) under shock loading conditions. It is observed that slight changes in material composition can have a large affect on the inelastic behaviour. Principal Hugoniot and shear strength data are presented for all of the materials for pressures ranging from 2 to 14 GPa. Evidence of the so-called failure-front [2] is presented via lateral stress histories measured using manganin stress gauges and confirmed with high-speed photography. 1. Bourne, N.K., Millett, J.C.F., and Field, J.E., “On the strength of shocked glasses” Proc. R. Soc. Lond. A 455 (1999) 1275-1282 2. Brar, N.S., “Failure Waves in Glass and Ceramics Under Shock Compression”, in "Shock Compression of Condensed Matter 1999", ed. M.D. Furnish, L.C. Chhabildas, and R.S. Hixson, American Institute of Physics, Woodbury, New York, (1999) 601-606

  11. Wage Inequity: Within-Market Comparative Analysis of Salary for Public Health Nurses and Hospital Nurses. (United States)

    Issel, L Michele; Lurie, Christine Fitzpatrick; Bekemeier, Betty


    The labor market perspective focuses on supply and demand for registered nurses (RNs) as employees. This perspective contrasts with beliefs in the public health sector that RNs working in local health departments (LHD) as public health nurses (PHNs) accept lower wages because of factors other than market demand. This study sought to describe the extent to which hourly wages of RNs working in LHDs are competitive with hospital RN wages within the same county market. A repeated measures survey design was used in collecting 2010 and 2014 data. The unit of analysis was the county, as an RN labor market for LHDs and hospitals. Survey questions captured factors common in human resources benefits and wage packages, such as differential pay, hourly rate pay based on years of experience, components of benefit packages (eg, sick and vacation leave), and reimbursement for education. Within each county, the LHD and all hospitals constituted a "market," yielding a potential 12 markets in our study sample. Human resources representatives from each of the 12 LHDs and from all hospitals within those 12 counties were invited to participate. We conducted comparisons with survey data using t test of mean differences on mean RN wages across years of experience. On average, LHDs paid significantly less than hospitals in their markets, at all levels of RN experience, and this gap increased with RN experience in the sample markets. Salary compression was evident in 2010 and worsened for PHNs in 2014, when compared with hospital RNs. In 2014, 100% of the sample LHDs offered reimbursements for continuing education for PHNs compared with 89% of hospitals providing this benefit. This study contributes to our understanding of the human resources challenges faced by LHDs and provides evidence elucidating resources issues that need to be addressed in order to improve recruitment and retention of PHNs.

  12. Ten-year mortality is increased after hospitalization for atopic dermatitis compared with the general population, but reduced compared with psoriasis

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Skov, Lone; Andersen, Yuki M F


    Background Psoriasis and atopic dermatitis (AD) are chronic inflammatory skin disorders. Mortality is increased in psoriasis, yet no studies on mortality in AD are currently available.  Objective We investigated 10-year mortality after hospitalization for AD compared with psoriasis and the genera...

  13. Linking Environmental Sustainability and Healthcare: The Effects of an Energy Saving Intervention in Two Hospitals


    Danae Manika; Diana Gregory-Smith; Victoria K. Wells; Lee Comerford; Lucy Aldrich-Smith


    Set in a real organisational setting, this study examines the challenges of implementing environmentally sustainable behaviour in healthcare. It evaluates the success of a real energy saving behaviour change intervention, based on social marketing principles, which targeted the employees of two National Health Service (NHS) hospitals. It also explores the intervention benefits for three key stakeholders: the organisation/hospitals, hospital employees and patients. A rich secondary dataset con...

  14. Comparing salivary cotinine concentration in non-smokers from the general population and hospitality workers in Spain. (United States)

    Martínez-Sánchez, Jose M; Fu, Marcela; Pérez-Ríos, Mónica; López, María J; Moncada, Albert; Fernández, Esteve


    The objective was to compare the pattern of exposure to second-hand smoke (SHS) among non-smokers in the general population and in hospitality workers. We used the adult (16-64 years) non-smokers of two independent studies (general population and hospitality workers) in Spain. We assessed the exposure to SHS by means of questionnaire and salivary cotinine concentration. The salivary cotinine concentration by sex, age, educational level, day of week of saliva collection, and exposure to SHS were always higher in hospitality workers than in the general population. Our results indicated that non-smoker hospitality workers have higher levels of exposure to SHS than general population.

  15. Hospitalized Patients' Awareness Of Their Rights-A Cross Sectional Survey In A Public And Private Tertiary Care Hospitals Of Punjab, Pakistan. (United States)

    Tabassum, Tahirah; Ashraf, Mariam; Thaver, Inayat


    The awareness of patient's rights is negligible in developing countries where no legal framework is present to protect these rights and Pakistan is no exception. Not only is there an absence of legal structure for protection of patients' rights, but the enforcement and implementation for existing law is also questionable. Pakistan has an Islamic Charter of Medical and Health Ethics which includes the medical behaviour and physician's rights and duties towards the patients. Despite all these charters on patients' rights, there is little to no awareness regarding these rights and their practice remains low in healthcare system of Pakistan. This assessment of awareness among patients about their rights will guide in formulating recommendations to improve the existing system of healthcare delivery in the country. This descriptive cross-sectional comparative study was conducted in two hospitals in Lahore, each belonging to public and private sector. A structured questionnaire was used to collect data from patients. A total of 220 patients were selected to participate in the study, 110 belonging to each private and public hospital. The findings indicate that most of the patients (64%) were not aware of their rights. The awareness level was better in patients seeking care from private hospital than those from public hospital. Education, monthly income and type of hospital utilized were found to be positively associated with the level of awareness. Most of the patients were not satisfied with the practices of their rights, especially in public hospitals. The lack of awareness regarding the rights of a patient was more common in patients of public/government hospitals compared to private hospitals. A nation-wide healthcare education program is needed to increase awareness and practice of patients' rights in the country.

  16. Comparing the Value of Nonprofit Hospitals' Tax Exemption to Their Community Benefits. (United States)

    Herring, Bradley; Gaskin, Darrell; Zare, Hossein; Anderson, Gerard


    The tax-exempt status of nonprofit hospitals has received increased attention from policymakers interested in examining the value they provide instead of paying taxes. We use 2012 data from the Internal Revenue Service (IRS) Form 990, Centers for Medicare and Medicaid Services (CMS) Hospital Cost Reports, and American Hospital Association's (AHA) Annual Survey to compare the value of community benefits with the tax exemption. We contrast nonprofit's total community benefits to what for-profits provide and distinguish between charity and other community benefits. We find that the value of the tax exemption averages 5.9% of total expenses, while total community benefits average 7.6% of expenses, incremental nonprofit community benefits beyond those provided by for-profits average 5.7% of expenses, and incremental charity alone average 1.7% of expenses. The incremental community benefit exceeds the tax exemption for only 62% of nonprofits. Policymakers should be aware that the tax exemption is a rather blunt instrument, with many nonprofits benefiting greatly from it while providing relatively few community benefits.

  17. Hospital staff views of prescribing and discharge communication before and after electronic prescribing system implementation. (United States)

    Mills, Pamela Ruth; Weidmann, Anita Elaine; Stewart, Derek


    Background Electronic prescribing system implementation is recommended to improve patient safety and general practitioner's discharge information communication. There is a paucity of information about hospital staff perspectives before and after system implementation. Objective To explore hospital staff views regarding prescribing and discharge communication systems before and after hospital electronic prescribing and medicines administration (HEPMA) system implementation. Setting A 560 bed United Kingdom district general hospital. Methods Semi-structured face-to-face qualitative interviews with a purposive sample of hospital staff involved in the prescribing and discharge communication process. Interviews transcribed verbatim and coded using the Framework Approach. Behavioural aspects mapped to Theoretical Domains Framework (TDF) to highlight associated behavioural change determinants. Main outcome measure Staff perceptions before and after implementation. Results Nineteen hospital staff (consultant doctors, junior doctors, pharmacists and advanced nurse practitioners) participated before and after implementation. Pre-implementation main themes were inpatient chart and discharge letter design and discharge communication process with issues of illegible and inaccurate information. Improved safety was anticipated after implementation. Post-implementation themes were improved inpatient chart clarity and discharge letter quality. TDF domains relevant to staff behavioural determinants preimplementation were knowledge (task or environment); skills (competence); social/professional roles and identity; beliefs about capabilities; environmental context and resources (including incidents). An additional two were relevant post-implementation: social influences and behavioural regulation (including self-monitoring). Participants described challenges and patient safety concerns pre-implementation which were mostly resolved post-implementation. Conclusion HEPMA implementation

  18. Feather damaging behaviour in parrots: A review with consideration of comparative aspects

    DEFF Research Database (Denmark)

    Van Zeeland, Yvonne R A; Spruit, Berry M; Rodenburg, T Bas


    similarities with behavioural disorders present in other bird species. Feather pecking (FP) in poultry is of particular interest in this case. Because of the major impacts on welfare and economy, the disorder has been thoroughly investigated. It has been shown that genetic, socio-environmental...... and neurobiological factors all play a role in FP. Several theories have been postulated about the different motivational systems that affect the behaviour, of which (redirected) foraging appears to be the most generally accepted. FDB may result from similar motivations and underlying mechanisms, but has also been......Feather damaging behaviour (also referred to as feather picking or feather plucking) is a behavioural disorder that is frequently encountered in captive parrots. This disorder has many characteristics that are similar to trichotillomania, an impulse control disorder in humans. Unfortunately...

  19. Sign and Symptom and Ability to Control Violent Behaviour with Music Therapy and Rational Emotive Cognitive Behaviour Therapy

    Directory of Open Access Journals (Sweden)

    Heri Setiawan


    Full Text Available Introduction: Prevalence of violence is highly occur in mental disorders clients at psychiatric hospitals. The impact is injure to others. This research aims to examine the effectiveness of music therapy and RECBT to sign and symptom and ability to control violent behaviour. Methods: Quasi-experimental research design with a sample of 64 respondents. Result: The study found a decrease symptoms of violent behaviour, ability to control violent behavior include relaxation, change negative thingking, irational belief, and negative behavior have increased significantly than the clients that did not receiving therapy. Discussion: Music therapy and RECBT is recommended as a therapeutic nursing at the client’s violent behaviour. Key Word: violent, sign and simptom, ability, music therapy, RECBT

  20. Net Income of Pharmacy Faculty Compared to Community and Hospital Pharmacists. (United States)

    Chisholm-Burns, Marie A; Gatwood, Justin; Spivey, Christina A; Dickey, Susan E


    Objective. To compare the net cumulative income of community pharmacists, hospital pharmacists, and full-time pharmacy faculty members (residency-trained or with a PhD after obtaining a PharmD) in pharmacy practice, medicinal chemistry, pharmaceutics, pharmacology, and social and administrative sciences. Methods. Markov modeling was conducted to calculate net projected cumulative earnings of career paths by estimating the costs of education, including the costs of obtaining degrees and student loans. Results. The economic model spanned 49 years, from ages 18 to 67 years. Earning a PharmD and pursuing an academic career resulted in projected net cumulative lifetime earnings ranging from approximately $4.7 million to $6.3 million. A pharmacy practice faculty position following public pharmacy school and one year of residency resulted in higher net cumulative income than community pharmacy. Faculty members with postgraduate year 1 (PGY1) training also had higher net income than other faculty and hospital pharmacy career paths, given similar years of prepharmacy education and type of pharmacy school attended. Faculty members with either a PharmD or PhD in the pharmacology discipline may net as much as $5.9 million and outpace all other PhD graduates by at least $75 000 in lifetime earnings. Projected career earnings of postgraduate year 2 (PGY2) trained faculty and PharmD/PhD faculty members were lower than those of community pharmacists. Findings were more variable when comparing pharmacy faculty members and hospital pharmacists. Conclusion. With the exception of PGY1 trained academic pharmacists, faculty projected net cumulative incomes generally lagged behind community pharmacists, likely because of delayed entry into the job market as a result of advanced training/education. However, nonsalary benefits such as greater flexibility and autonomy may enhance the desirability of academic pharmacy as a career path.

  1. Healthcare seeking behaviour among Chinese elderly. (United States)

    Lu, Hui; Wang, Wei; Xu, Ling; Li, Zhenhong; Ding, Yan; Zhang, Jian; Yan, Fei


    Purpose The Chinese population is rapidly ageing before they are rich. The purpose of this paper is to describe healthcare seeking behaviour and the critical factors associated with healthcare seeking behaviour. Design/methodology/approach Using a purposive sampling method, the authors recruited 44 adults aged 60 years or older from three provinces, representing the developed (Shanghai), undeveloped (Ningxia) regions and the regions in between (Hubei). From July to September 2008, using a semi-structured guide, the authors interviewed participants in focus group discussions. Findings The healthcare needs for chronic and catastrophic diseases were high; however, the healthcare demands were low and healthcare utilizations were even lower owing to the limited accessibility to healthcare services, particularly, in underdeveloped rural areas. "Too expensive to see a doctor" was a prime complaint, explaining substantial discrepancies between healthcare needs, demands and use. Care seeking behaviour varied depending on insurance availability, perceived performance, particularly hospital services, and prescription medications. Participants consistently rated increasing healthcare accessibility as a high priority, including offering financial aid, and improving service convenience. Improving social security fairness was the first on the elderly's wish list. Originality/value Healthcare demand and use were lower than needs, and were influenced by multiple factors, primarily, service affordability and efficiency, perceived performance and hospital service quality.

  2. Time perspective and attitude-behaviour consistency in future-oriented behaviours

    NARCIS (Netherlands)

    Rabinovich, A.; Morton, T.; Postmes, T.

    The authors propose that the salience of a distant-future time perspective, compared to a near-future time perspective, should increase attitude-behaviour and attitude-intention consistency for future-oriented behaviours. To test this prediction, time perspective was experimentally manipulated in

  3. Vulnerability to burnout within the nursing workforce-The role of personality and interpersonal behaviour. (United States)

    Geuens, Nina; Van Bogaert, Peter; Franck, Erik


    To study the combination of personality and interpersonal behaviour of staff nurses in general hospitals in relation to burnout and its separate dimensions. More research on the individual factors contributing to the development of burnout is needed to improve the risk profile of nursing staff. Therefore, a combination of Leary's interpersonal circumplex model, which depicts the interpersonal behaviour trait domain, and the five-factor model was considered in the study at hand. A cross-sectional research method was applied using self-report questionnaires. A total of 880 Belgian general hospital nurses were invited to participate in the study. Data were collected from November 2012-July 2013. The questionnaire consisted of three validated self-report instruments: the NEO five-factor inventory, the Dutch Interpersonal Behaviour Scale and the Maslach Burnout Inventory. Of the 880 nurses invited to participate, 587 (67%) returned the questionnaire. Sex, neuroticism, submissive-friendly behaviour, dominant-friendly behaviour and vector length were found to be predictive factors for emotional exhaustion. For depersonalisation, sex, neuroticism, conscientiousness, friendly behaviour, submissive-friendly behaviour, dominant-hostile behaviour and vector length were predictive factors. Finally, personal accomplishment was determined by neuroticism, openness, conscientiousness, and hostile behaviour. This study confirmed the influence of the Big Five personality factors on the separate dimensions of burnout. Interpersonal behaviour made a significant contribution to the predictive capacity of the regression models of all three dimensions of burnout. Additional longitudinal research is required to confirm the causal relationship between these individual factors and burnout. The results of this study can help to achieve a better understanding of which vulnerabilities an individual prevention programme for burnout should target. In addition, hospitals could use assessment

  4. Immoral behaviour in medicine. (United States)

    Carmon, P; Tabak, N


    The purpose of this paper is to emphasize a social phenomenon that exists in Israel: immoral medicine. In recent years, nurses have been exposed to many instances of immoral medicine in hospitals. We want to protest about the demands for money from patients who are waiting for surgical intervention, arouse the medical community's conscience concerning these immoral activities, and improve professional and moral behaviour.

  5. [Emotional climate and internal communication in a clinical management unit compared with two traditional hospital services]. (United States)

    Alonso, E; Rubio, A; March, J C; Danet, A


    The aim of this study is to compare the emotional climate, quality of communication and performance indicators in a clinical management unit and two traditional hospital services. Quantitative study. questionnaire of 94 questions. 83 health professionals (63 responders) from the clinical management unit of breast pathology and the hospital services of medical oncology and radiation oncology. descriptive statistics, comparison of means, correlation and linear regression models. The clinical management unit reaches higher values compared with the hospital services about: performance indicators, emotional climate, internal communication and evaluation of the leadership. An important gap between existing and desired sources, channels, media and subjects of communication appear, in both clinical management unit and traditional services. The clinical management organization promotes better internal communication and interpersonal relations, leading to improved performance indicators. Copyright © 2011 SECA. Published by Elsevier Espana. All rights reserved.

  6. Fulfilment of administrative and professional organisational obligations and nurses' customer-oriented behaviours. (United States)

    Trybou, Jeroen; Gemmel, Paul


    The aim of the study was to examine the relationship between the perceived quality of organisational exchange and nurses' customer-oriented behaviours. Hospitals face increasing competitive market conditions. Registered nurses interact closely with patients and therefore play an important front-office role towards patients. A cross-sectional study was conducted. Registered nurses (n = 151) of a Belgian hospital received a questionnaire to assess the fulfilment of administrative and professional organisational obligations and their customer-oriented behaviours. We found a positive relationship between psychological contract fulfilment and nurses' customer-oriented behaviours. More precisely administrative and professional psychological contract fulfilment relates significantly to nurses' service delivery and external representation. In case of internal influence only administrative psychological contract fulfilment was significantly related. Nurses' perceptions of the fulfilment of administrative and professional obligations are important to their customer-oriented behaviours. Nurse managers must be aware of the impact of fulfilling both administrative and professional obligations of registered nurses in order to optimise their customer-oriented behaviours. © 2016 John Wiley & Sons Ltd.

  7. Linking Environmental Sustainability and Healthcare: The Effects of an Energy Saving Intervention in Two Hospitals

    Directory of Open Access Journals (Sweden)

    Danae Manika


    Full Text Available Set in a real organisational setting, this study examines the challenges of implementing environmentally sustainable behaviour in healthcare. It evaluates the success of a real energy saving behaviour change intervention, based on social marketing principles, which targeted the employees of two National Health Service (NHS hospitals. It also explores the intervention benefits for three key stakeholders: the organisation/hospitals, hospital employees and patients. A rich secondary dataset containing actual workplace behaviour measures (collected via observations and self-reported data from employee interviews and patient questionnaires is used for this purpose. The intervention encouraged three employee energy saving actions (called TLC actions: (1 Turn off machines, (2 Lights out when not needed, and (3 Close doors when possible; which led to energy savings and carbon reduction for the two hospitals. Hospital employees reported a greater level of work efficiency as a result of engaging in TLC actions, which increased the 'quiet time' periods in both hospitals. Indirectly, employees' TLC actions also improved patients' quality of sleep (which in turn is positively associated with greater patient hospital experience satisfaction. These findings shed light on the benefits of social marketing interventions targeting energy saving behaviour change for multiple stakeholders in healthcare organisations. They also illustrate connections between environmental sustainability and social and political pillars of corporate social responsibility. Additionally, organisational culture was highlighted as a key challenge in changing practices. To encourage long-term sustainable behaviour, this study recommends a pre-intervention assessment of infrastructure and equipment, the communication of expected benefits to motivate higher involvement of employees, the need for internal green champions and the dissemination of post-intervention feedback on various energy

  8. Health Behaviour among Nurses Working in Public Hospitals in Kakamega County, Kenya

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    Mchidi Kiguhe Nebert


    Full Text Available Health behaviour refers to actions undertaken by a person who perceives self to be ill for the purpose of finding an appropriate remedy. Nurses as gate keepers of health are expected to seek formal treatment when they are taken ill because this is what they teach their patients. Nurses’ working conditions all over the world are described as squalid with long working hours and workload. This scenario predisposes them to occupational health hazards and at the same time denies them time for self-care. Although nurses are knowledgeable about disease and its treatment and have access to health care, they engage in self-treatment in contrast to what they teach patients. Health behaviour among nurses in Kakamega County was investigated using a cross-sectional design. Data was collected using self-administered questionnaires and subjected to bivariate and logistic regression analyses. The study found that health behaviour of nurses in Kakamega County is below expectation, as 33% (n=61 engaged in voluntary screening services. Further, 34.8% (n=65 said that their health would improve if they engaged in health promotion activities. The study recommends empowering nurses to engage in positive health behaviour through education. The county should also provide affordable screening services to its nurses.

  9. Comparing Service Delivery Models for Children with Developmental Delays in Canada: Adaptive and Maladaptive Behaviours, Parental Perceptions of Stress and of Care (United States)

    Sladeczek, Ingrid E.; Fontil, Laura; Miodrag, Nancy; Karagiannakis, Anastasia; Amar, Daniel; Amos, Janet


    This study compares two service delivery models (community-based and centre-based), examining them in light of children's adaptive and maladaptive behaviours, and parental perceptions of stress and of care. More specifically, parents of 96 children with developmental delays assessed their children's adaptive and maladaptive behaviours and rated…

  10. Linking Environmental Sustainability and Healthcare: The Effects of an Energy Saving Intervention in Two Hospitals\\ud


    Manika, D.; Gregory-Smith, D.; Wells, V.K.; Comerford, L.; Aldrich-Smith, L.


    Set in a real organisational setting, this study examines the challenges of implementing environmentally sustainable behaviour in healthcare. It evaluates the success of a real energy saving behaviour change intervention, based on social marketing principles, which targeted the employees of two National Health Service (NHS) hospitals. It also explores the intervention benefits for three key stakeholders: the organisation/hospitals, hospital employees and patients. A rich secondary dataset con...

  11. Time perspective and attitude-behaviour consistency in future-oriented behaviours. (United States)

    Rabinovich, Anna; Morton, Thomas; Postmes, Tom


    The authors propose that the salience of a distant-future time perspective, compared to a near-future time perspective, should increase attitude-behaviour and attitude-intention consistency for future-oriented behaviours. To test this prediction, time perspective was experimentally manipulated in three studies. Across studies, participants in the distant-future time perspective condition demonstrated a strong positive relationship between attitudes towards future-oriented behaviours (saving and environmental protection) and corresponding intentions, as well as between attitudes and behaviour. In the near-future time perspective condition, the relationship between attitudes and intentions and attitudes and behaviour was significantly weaker than in the distant-future time perspective condition. The theoretical implications of these results and suggestions for future research are discussed.

  12. Comparing the organisational structure of the preoperative assessment clinic at eight university hospitals. (United States)

    Edward, G M; Biervliet, J D; Hollmann, M W; Schlack, W S; Preckel, B


    The preoperative assessment clinic (PAC) has been implemented in most major hospitals. However, there is no uniformity in the way PACs are organised. We compared the organisational structure of the PACs from all eight university hospitals in The Netherlands, looking at the following variables: number of patients visiting the PAC, staffing of the PAC, opening hours, scheduling, and additional preoperative diagnostic testing. The number of patients seen yearly varies from 7.000 to 13.500. In all clinics, the preoperative assessment was performed by anaesthetists and residents. In five PACs, preoperative assessment was also performed by physician assistants or nurse practitioners. Opening hours varied. Consultations are by appointment, 'walk-in', or a combination of these two. In four clinics additional testing is performed at the PAC itself. This study shows that the organisational structure of the PAC at similar university hospitals varies greatly; this can have important implications when designing a benchmarking process.

  13. Consumer psychology of tourism, hospitality and leisure, volume 3

    NARCIS (Netherlands)

    Crouch, G.I.; Perdue, R.R.; Timmermans, H.J.P.; Uysal, M.


    Knowledge of consumer psychology and consumer behaviour in relation to tourism is valuable in determining the success of tourism and hospitality ventures. The book is an edited collection of papers from the 3rd Symposium on Consumer Psychology of Tourism, Hospitality and Leisure, held in Melbourne,

  14. Human Resources and Innovative Behaviour : Improving Nursing Performance


    Xerri, Matthew; Reid, Stuart


    This study examines, using the social exchange theory, the mediating effect of employees’ perception of wellbeing on the relationship between two human resource (HR) management factors (satisfaction with teamwork and satisfaction with training opportunities) and innovative behaviour of nurses working in Australian public and private hospitals. Current nurse shortages and limited budgets have increased the need for hospitals to improve their efficiency and cost-effectiveness. It is proposed th...

  15. Predictors of hospitalized patients' intentions to prevent healthcare harm: a cross sectional survey. (United States)

    Davis, R; Anderson, O; Vincent, C; Miles, K; Sevdalis, N


    Patients can play an important role in reducing healthcare harm but little is known about the factors that may affect patients' willingness to participate. In order to encourage the 'active' patient it is critical that we gain a deeper understanding of the antecedents of safety-relevant behaviours. Doing this will enable the implementation of effective interventions aimed at supporting patients to work with healthcare professionals in ensuring safe care. To examine predictors of patients' intentions to engage in two safety behaviours: (1) reminding healthcare staff to wash their hands and; (2) notifying healthcare staff if they are not wearing a hospital identification bracelet. Cross-sectional survey study. A purposive sampling method was employed to recruit 80 medical and surgical hospital inpatients aged 18-80 (mean 48) from one inner city London teaching hospital. A 42 item survey that measured the extent that patients' control beliefs, behavioural beliefs, normative beliefs and perceived susceptibility and severity towards a hospital-acquired infection or a misidentification error could predict their intentions to ask doctors/nurses about their hand washing compliance or notify doctors/nurses if they are not wearing a hospital identification bracelet. Data was analysed using multiple regression analysis. Control beliefs, normative beliefs and perceived severity were the strongest predictors of patients' intentions to participate in both behaviours. The regression models accounted for a smaller percentage of the variance in patients' intentions to ask doctors/nurses if they have washed their hands (42%/37%) than notifying staff if they were not wearing an identification bracelet (54%/56%). If patients understand why a behaviour is beneficial, they perceive it as acceptable to participate in and that they have control over the decision to engage in the behaviour, we hypothesise that more patients will intend to participate in that behaviour. When designing

  16. Comparing Tactical Behaviour of Soccer Players in 3 vs. 3 and 6 vs. 6 Small-Sided Games

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    Silva Bernardo


    Full Text Available The present study aimed to compare players’ tactical behaviour in 3 vs. 3 and 6 vs. 6 soccer small-sided games (SSGs. The sample comprised 3,482 tactical actions performed by 18 U-11 youth soccer players from a Portuguese club, in 3 vs. 3 and 6 vs. 6 SSGs. All participants played eight minutes in both situations and field size was adapted according to the number of players involved (30 m x 19.5 m for 3 vs. 3 and 60 m x 39 m for 6 vs. 6. The System of Tactical Assessment in Soccer (FUT-SAT was used for data collection and analyses. Descriptive analysis was conducted to verify frequencies and percentages of the variables assessed. The chi-squared (χ2 test was performed to compare the frequencies of the variables between 3 vs. 3 and 6 vs. 6 SSGs and Standardized Residuals (e were used to examine the influence of the frequency of one or more variables within 3 vs. 3 and 6 vs. 6 SSGs. Data treatment was performed through SPSS for Windows®, version 18.0. Results indicated that players displayed safer behaviours in 6 vs. 6 SSG and more aggressive behaviours in 3 vs. 3 SSG. Findings can aid coaches and teachers to develop different players’ tactical skills according to the chosen SSG (3 vs. 3 or 6 vs. 6 form.

  17. Population-based versus hospital-based controls: are they comparable? Controles poblaciones frente a controles hospitalarios: ¿son comparables?

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    Alberto Ruano-Ravina


    Full Text Available Objective: To compare whether there are differences among hospital and population controls. Methods: Two case-control studies were conducted on lung cancer risk factors in the Santiago de Compostela Public Health District. Whereas one used randomly chosen census-based population controls, the other used consecutive hospital controls that went to the reference hospital for non-smoking-related trivial interventions. The differences were analyzed using logistic regression. The dependent variable was type of control (hospital or population. Results: Hospital controls had a similar tobacco habit than population controls, but consumed more alcohol. For those consuming more than 50 ml daily, the risk of being a hospital control was 4.83 (95%CI: 2.55-9.14. Conclusions: There may be some differences between hospital and population-based controls, which must be taken into account in the design of case-control studies. It is necessary to ascertain whether such differences are reproduced at other geographic locations and whether they can affect estimation of exposure-disease.Objetivo: Comparar si hay diferencias entre los controles poblacionales y los hospitalarios. Métodos: Se llevaron a cabo dos estudios de casos y controles sobre factores de riesgo de cáncer de pulmón en el Área Sanitaria de Santiago de Compostela. En uno de los estudios los controles fueron seleccionados aleatoriamente entre la población general, y en el otro los controles hospitalarios fueron incluidos de manera consecutiva entre los individuos que acudían al hospital por intervenciones quirúrgicas banales no relacionadas con el consumo de tabaco. Las diferencias fueron analizadas mediante regresión logística. La variable dependiente fue el tipo de control (hospitalario o poblacional. Resultados: Los controles hospitalarios y los poblacionales tenían un hábito tabáquico similar, pero los controles hospitalarios consumían más alcohol. Para los que consumían más de 50 ml

  18. Manager traits and quality-of-care performance in hospitals. (United States)

    Aij, Kjeld Harald; Aernoudts, René L M C; Joosten, Gepke


    This paper aims to assess the impact of the leadership traits of chief executive officers (CEOs) on hospital performance in the USA. The effectiveness and efficiency of the CEO is of critical importance to the performance of any organization, including hospitals. Management systems and manager behaviours (traits) are of crucial importance to any organization because of their connection with organizational performance. To identify key factors associated with the quality of care delivered by hospitals, the authors gathered perceptions of manager traits from chief executive officers (CEOs) and followers in three groups of US hospitals delivering different levels of quality of care performance. Three high- and three low-performing hospitals were selected from the top and bottom 20th percentiles, respectively, using a national hospital ranking system based on standard quality of care performance measures. Three lean hospitals delivering intermediate performance were also selected. A survey was used to gather perceptions of manager traits (providing a modern or lean management system inclination) from CEOs and their followers in the three groups, which were compared. Four traits were found to be significantly different (alpha management inclination. No differences were found between lean (intermediate-) and high-performing hospitals, or between high- and low-performing hospitals. These findings support a need for hospital managers to acquire appropriate traits to achieve lean transformation, support a benefit of measuring manager traits to assess progress towards lean transformation and lend weight to improved quality of care that can be delivered by hospitals adopting a lean system of management.

  19. Ten thousand steps: a pedometer study of junior dentists in a major British teaching hospital and a district general hospital. (United States)

    Keat, R M; Thomas, M; McKechnie, A


    Sedentary behaviour is widely associated with deleterious health outcomes that in modern medicine have similar connotations to smoking tobacco and alcohol misuse. The integration of e-portfolio, e-logbook, British National Formulary (BNF) and encrypted emails has made smartphones a necessity for trainees. Smartphones also have the ability to record the amount of exercise taken, which allows activity at work to be monitored. The aim of this study to compare the activity of the same group of dental core trainees when they worked within a large multisite teaching hospital and a smaller district general hospital, to find out if supplementary activity was needed outside work. Data were collected from smartphones. To ensure continuity, data were collected only from those who had calibrated iPhones (n=10). At the teaching hospital six of the trainees walked over 10 000 steps a day while working (mean (SD) 10 004 (639)). At the district hospital none of the trainees walked 10 000 steps. The mean (SD) number of steps completed by all trainees was 6265 (119). Walking at work provides the full quota of recommended daily exercise most of the time for those working in the teaching hospital, but additional exercise is occasionally required. While working at the district hospital they walk less, meaning that they should try to increase their activity outside work. Trainees working in the teaching hospital walk significantly more steps than in the district hospital. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  20. Challenges of using Hospital Information Systems by nurses: comparing academic and non-academic hospitals. (United States)

    Ahmadian, Leila; Dorosti, Nafise; Khajouei, Reza; Gohari, Sadrieh Hajesmaeel


    Hospital Information Systems (HIS) are used for easy access to information, improvement of documentation and reducing errors. Nonetheless, using these systems is faced with some barriers and obstacles. This study identifies the challenges and the obstacles of using these systems in the academic and non-academic hospitals in Kerman. This is a cross-sectional study which was carried out in 2015. The statistical population in this study consisted of the nurses who had been working in the academic and non-academic hospitals in Kerman. A questionnaire consisting of two sections was used. The first section consisted of the demographic information of the participants and the second section comprised 34 questions about the challenges of HIS use. Data were analyzed by the descriptive and statistical analysis (t-test, and ANOVA) using SPSS 19 software. The most common and important challenges in the academic hospitals were about human environment factors, particularly "negative attitude of society toward using HIS". In the non-academic hospitals, the most common and important challenges were related to human factors, and among them, "no incentive to use system" was the main factor. The results of the t-test method revealed that there was a significant relationship between gender and the mean score of challenges related to the organizational environment category in the academic hospitals and between familiarity with HIS and mean score of human environment factors (pinformation systems are the factors related to the human environment and the human factors. The results of this study can bring a good perspective to the policy makers and the managers regarding obstacles of using HISs from the nurses' perspective, so that they can solve their problems and can successfully implement these systems.

  1. Hospital-acquired acute kidney injury in medical, surgical, and intensive care unit: A comparative study

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    T B Singh


    Full Text Available Acute kidney injury (AKI is a common complication in hospitalized patients. There are few comparative studies on hospital-acquired AKI (HAAKI in medical, surgical, and ICU patients. This study was conducted to compare the epidemiological characteristics, clinical profiles, and outcomes of HAAKI among these three units. All adult patients (>18 years of either gender who developed AKI based on RIFLE criteria (using serum creatinine, 48 h after hospitalization were included in the study. Patients of acute on chronic renal failure and AKI in pregnancy were excluded. Incidence of HAAKI in medical, surgical, and ICU wards were 0.54%, 0.72%, and 2.2% respectively ( P < 0.0001. There was no difference in age distribution among the groups, but onset of HAAKI was earliest in the medical ward ( P = 0.001. RIFLE-R was the most common AKI in medical (39.2% and ICU (50% wards but in the surgical ward, it was RIFLE-F that was most common (52.6%. Acute tubular necrosis was more common in ICU ( P = 0.043. Most common etiology of HAAKI in medical unit was drug induced (39.2%, whereas in surgical and ICU, it was sepsis (34% and 35.2% respectively. Mortality in ICU, surgical and medical units were 73.5%, 43.42%, and 37.2%, respectively ( P = 0.003. Length of hospital stay in surgical, ICU and medical units were different ( P = 0.007. This study highlights that the characters of HAAKI are different in some aspects among different hospital settings.

  2. Shorter Hospital Stays and Lower Costs for Rivaroxaban Compared With Warfarin for Venous Thrombosis Admissions. (United States)

    Margolis, Jay M; Deitelzweig, Steven; Kline, Jeffrey; Tran, Oth; Smith, David M; Bookhart, Brahim; Crivera, Concetta; Schein, Jeff


    Venous thromboembolism, including deep vein thrombosis and pulmonary embolism, results in a substantial healthcare system burden. This retrospective observational study compared hospital length of stay (LOS) and hospitalization costs for patients with venous thromboembolism treated with rivaroxaban versus those treated with warfarin. Hospitalizations for adult patients with a primary diagnosis of deep vein thrombosis or pulmonary embolism who were initiated on rivaroxaban or warfarin were selected from MarketScan's Hospital Drug Database between November 1, 2012, and December 31, 2013. Patients treated with warfarin were matched 1:1 to patients treated with rivaroxaban using exact and propensity score matching. Hospital LOS, time from first dose to discharge, and hospitalization costs were reported descriptively and with generalized linear models (GLMs). The final study cohorts each included 1223 patients (751 with pulmonary embolism and 472 with deep vein thrombosis). Cohorts were well matched for demographic and clinical characteristics. Mean (±SD) LOS was 3.7±3.1 days for patients taking rivaroxaban and 5.2±3.7 days for patients taking warfarin, confirmed by GLM-adjusted results (rivaroxaban 3.7 days, warfarin 5.3 days, P<0.001). Patients with provoked venous thromboembolism admissions showed longer LOSs (rivaroxaban 5.1±4.5 days, warfarin 6.5±5.6 days, P<0.001) than those with unprovoked venous thromboembolism (rivaroxaban 3.3±2.4 days, warfarin 4.8±2.8 days, P<0.001). Days from first dose to discharge were 2.4±1.7 for patients treated with rivaroxaban and 3.9±3.7 for patients treated with warfarin when initiated with parenteral anticoagulants (P<0.001), and 2.7±1.7 and 3.7±2.1, respectively, when initiated without parenteral anticoagulants (P<0.001). Patients initiated on rivaroxaban incurred significantly lower mean total hospitalization costs ($8688±$9927 versus $9823±$9319, P=0.004), confirmed by modeling (rivaroxaban $8387 [95

  3. Pulmonary Embolism Inpatients Treated With Rivaroxaban Had Shorter Hospital Stays and Lower Costs Compared With Warfarin. (United States)

    Margolis, Jay M; Deitelzweig, Steven; Kline, Jeffrey; Tran, Oth; Smith, David M; Crivera, Concetta; Bookhart, Brahim; Schein, Jeff


    Using real-world data, this study compares inpatient length of stay (LOS) and costs for patients with a primary diagnosis of pulmonary embolism (PE) initiating treatment with oral anticoagulation with rivaroxaban versus warfarin. Hospitalizations from MarketScan's Hospital Drug Database were selected from November 1, 2012, through December 31, 2013, for adults with a primary diagnosis of PE initiating treatment with rivaroxaban or warfarin. Warfarin patients were matched 1:1 to rivaroxaban patients using exact and propensity score matching. Hospital LOS, treatment patterns, and hospitalization costs were evaluated. Matched cohorts included 751 rivaroxaban-treated patients and 751 warfarin-treated patients. Adjusted mean LOS was 3.77 days for rivaroxaban patients (95% CI, 3.66-3.87 days) and 5.48 days for warfarin patients (95% CI, 5.33-5.63 days; P < .001). Mean (SD) LOS was shorter for patients taking rivaroxaban whether admission was for provoked PE (rivaroxaban: 5.2 [5.1] days; warfarin: 7.0 [6.5] days; P < .001) or unprovoked PE (rivaroxaban: 3.4 [2.3] days; warfarin: 5.1 [2.7] days; P < .001). Mean (SD) days from first dose to discharge were 2.5 (1.7) (rivaroxaban) and 4.0 (2.9) (warfarin) when initiated with parenteral anticoagulants (P < .001) and 2.7 (1.7) (rivaroxaban) and 4.0 (2.2) (warfarin) without parenteral anticoagulants (P < .001). The rivaroxaban cohort incurred significantly lower unadjusted mean (SD) hospitalization costs (rivaroxaban: $8473 [$9105]; warfarin: $10,291 [$9185]; P < .001), confirmed by covariate adjustment with generalized linear modeling estimating predicted mean hospitalization costs of $8266 for rivaroxaban patients (95% CI, $7851-$8681) and $10,511 for warfarin patients (95% CI, $10,031-$10,992; P < .001). patients with PE treated with rivaroxaban incurred significantly lower hospitalization costs by $2245 per admission compared with patients treated with warfarin, which was attributable to cost offsets from 1.71 fewer days of

  4. Post diagnosis reaction, perceived stigma and sexual behaviour of HIV/AIDS patients attending Aminu Kano Teaching Hospital, Northern Nigeria. (United States)

    Iliyasu, Zubairu; Abubakar, Isa S; Musa, Babashani; Aliyu, Muktar H


    The process of becoming aware of one's serostatus, immediate and delayed responses of the individual, family and community have profound implications on health seeking behaviour of PLWHAs especially in developing countries. We investigated post-diagnosis reactions, disclosure, perceived stigmatization and sexual behaviour of PLWHAs in northern Nigeria. A triangulation of methods consisting of structured interviewer questionnaire administered on 205 respondents and two Focus Group Discussions with PLWHAs receiving care at Aminu Kano Teaching Hospital was used. HIV serodiagnosis, immediate and delayed reaction to serostatus and responses of family, friends and community members were elicited in addition to perceived stigma and sexual behaviour. Overall, 111 (54.1%) of the 205 patients were counseled before being tested for HIV infection. Majority of women 59 (51.8%) were tested and informed during antenatal care or 46 (40.4%) following diagnostic workup for symptoms related to AIDS. Most men 69 (75.8%) came to know during diagnostic workup or as part of screening for blood transfusion 5 (5.5%). Up to 37.2% of the respondents had kept their serostatus secret. Disclosures were more likely to mothers (51.9%), sisters (31.0%), brothers (11.0%) and spouses (6.1%). Of all respondents, 149 (72.6%) said they were shocked, afraid, angry and sad while 29 (14.1%) reported being indifferent. A higher proportion of females 68 (59.7%) were shocked, sad and angry than males 36 (39.6%) (Pworkplace and the remaining 17 (37.8%) among friends. Of 85 (41.5%) that were sexually active, 78 (91.8%) reported protecting their partners through use of condoms. The sub-optimal counseling resulted in strong emotional reactions that threatened the strong social support system of PLWHAs. Supportive counseling could improve VCT uptake and well being of PLWHAs in northern Nigeria.

  5. Behavioural and psychological responses of lower educated smokers to the smoke-free legislation in Dutch hospitality venues: a qualitative study. (United States)

    Van der Heiden, Sander; Gebhardt, Winifred A; Willemsen, Marc C; Nagelhout, Gera E; Dijkstra, Arie


    In 2008, smoke-free legislation was implemented in hospitality venues (HV) in the Netherlands. We investigated how continuing smokers with a lower educational background respond behaviourally and psychologically to the legislation and the norm it communicates. In 2010, 18 lower-educated daily smokers were interviewed. Transcripts were analysed with MAXQDA software. Theories of self-awareness and social in- and exclusion were applied to interpret findings. Smokers had become more self-aware and the experience of a more negative norm surrounding smoking had made them reevaluate their smoking. Smokers had also become more self-aware of their own smoking, both in HV and in general. Feelings of increased social exclusion were reported. Participants dealt with the increased awareness and feelings of social exclusion in different ways depending on their evaluation of the smoking ban, changes in attitude towards own smoking, changes in HV patronage and changes in smoking behaviour. Theories of self-awareness and social in- and exclusion were useful in understanding consequences of a HV smoking ban on continuing smokers. Four different types of responses were identified, i.e. (1) actively trying to quit, (2) socially conscious smoking, (3) feeling victimised and (4) rejecting the norm. Implications for future smoke-free legislation are discussed.

  6. A multifaceted hospital-wide intervention increases hand hygiene compliance. (United States)

    Patel, B; Engelbrecht, H; McDonald, H; Morris, V; Smythe, W


    Hand hygiene is an important and basic practice that should be used by all healthcare staff to protect both themselves and their patients against infection. Unfortunately hand hygiene compliance remains poor. To show an improvement in hand hygiene compliance using a multifaceted approach. This was a quasiexperimental pre-post intervention study design with a number of standardised interventions to promote hand hygiene. The World Health Organization hand hygiene multimodal (five-step) intervention approach was used. The study ran from June 2015 to August 2015 in 11 selected wards of a 975-bed tertiary and quaternary care public hospital (Groote Schuur Hospital, Cape Town, South Africa). The outcome was to assess improvement in hand hygiene compliance monthly over the 3 months, compared with non-intervention wards and compared with the wards' own performance measured in 2014. The study included both descriptive and analytical components. Post intervention, hand hygiene compliance showed a statistically significant improvement for before patient contact from 34% in 2014 to 76% in 2015 (p<0.05) and for after patient contact from 47% in 2014 to 82% in 2015 (p<0.05). The intervention improved hand hygiene compliance and can easily be replicated in other wards, resulting in sustaining a culture of hand hygiene improvement and behavioural change throughout the hospital.

  7. Smoking-Cessation Interventions for Urban Hospital Patients: A Randomized Comparative Effectiveness Trial. (United States)

    Sherman, Scott E; Link, Alissa R; Rogers, Erin S; Krebs, Paul; Ladapo, Joseph A; Shelley, Donna R; Fang, Yixin; Wang, Binhuan; Grossman, Ellie


    Hospitalization is a unique opportunity for smoking cessation, but prior interventions have measured efficacy with narrowly defined populations. The objective of this study was to enroll smokers admitted to two "safety net" hospitals and compare the effectiveness of two post-discharge cessation interventions. A randomized comparative effectiveness trial was conducted. At two New York City public hospitals, every hospitalized patient identified as a smoker (based on admission records) was approached. Inclusion criteria were: smoked cigarettes in the past 30 days; spoke English, Spanish, or Mandarin; had a U.S. phone number; not discharged to an institution where follow-up or smoking was limited; and not pregnant/breastfeeding. Of 18,797 patients identified as current smokers between July 2011 and April 2014, a total of 3,047 (16%) were discharged before being approached, 3,273 (17%) were not current smokers, 4,026 (21%) had no U.S. phone number, 2,831 (15%) were ineligible for other reasons, and 3,983 (21%) refused participation. In total, 1,618 (9%) participants enrolled in the study. During follow-up, 69% of participants were reached at 2 months and 68% at 6 months. At discharge, participants were randomized to multisession telephone counseling from study staff (n=804) or referral to the state quitline for proactive outreach and counseling (n=814). Self-reported abstinence at 6 months was measured. Analyses were conducted in late 2015. One quarter of participants were homeless or in unstable housing, 60% had a history of substance abuse, 43% reported current hazardous drinking, and half had a psychiatric diagnosis other than substance abuse. At follow-up, the rate of abstinence (30-day point prevalence) was higher in the intensive counseling arm than the quitline arm at 2 months (29.0% vs 20.7%; relative risk=1.40; 95% CI=1.13, 1.73) and 6 months (37.4% vs 31.5%; relative risk=1.19; 95% CI=1.01, 1.40). Intensive counseling was more effective than referral to the

  8. A comparative study of behaviour problems between adopted and ...

    African Journals Online (AJOL)

    We found that adopted children had more behaviour problems on the PSQ. On SAICA, adopted children showed less social competence. The parenting practices as revealed by the Alabama Parenting Questionnaire did not differ between the two groups. The IQ of the children in both groups was within the normal range.

  9. Inpatient Hospitalization Costs: A Comparative Study of Micronesians, Native Hawaiians, Japanese, and Whites in Hawai‘i

    Directory of Open Access Journals (Sweden)

    Megan Hagiwara


    Full Text Available Considerable interest exists in health care costs for the growing Micronesian population in the United States (US due to their significant health care needs, poor average socioeconomic status, and unique immigration status, which impacts their access to public health care coverage. Using Hawai‘i statewide impatient data from 2010 to 2012 for Micronesians, whites, Japanese, and Native Hawaiians (N = 162,152 hospitalizations, we compared inpatient hospital costs across racial/ethnic groups using multivariable models including age, gender, payer, residence location, and severity of illness (SOI. We also examined total inpatient hospital costs of Micronesians generally and for Medicaid specifically. Costs were estimated using standard cost-to-charge metrics overall and within nine major disease categories determined by All Patient Refined Diagnosis Related Groups. Micronesians had higher unadjusted hospitalization costs overall and specifically within several disease categories (including infectious and heart diseases. Higher SOI in Micronesians explained some, but not all, of these higher costs. The total cost of the 3486 Micronesian hospitalizations in the three-year study period was $58.1 million and 75% was covered by Medicaid; 23% of Native Hawaiian, 3% of Japanese, and 15% of white hospitalizations costs were covered by Medicaid. These findings may be of particular interests to hospitals, Medicaid programs, and policy makers.

  10. Driving behaviours, traffic risk and road safety: comparative study between Malaysia and Singapore. (United States)

    Khan, Saif ur Rehman; Khalifah, Zainab Binti; Munir, Yasin; Islam, Talat; Nazir, Tahira; Khan, Hashim


    The present study aims to investigate differences in road safety attitude, driver behaviour and traffic risk perception between Malaysia and Singapore. A questionnaire-based survey was conducted among a sample of Singaporean (n = 187) and Malaysian (n = 313) road users. The data was analysed using confirmatory factor analysis and structural equation modelling applied to measure comparative fit indices of Malaysian and Singaporean respondents. The results show that the perceived traffic risk of Malaysian respondents is higher than Singaporean counterparts. Moreover, the structural equation modelling has confirmed perceived traffic risk performing the role of full mediation between perceived driving skills and perceived road safety for both the countries, while perceived traffic skills was found to perform the role of partial mediation between aggression and anxiety, on one hand, and road safety, on the other hand, in Malaysia and Singapore. In addition, in both countries, a weak correlation between perceived driving skills, aggression and anxiety with perceived road safety was found, while a strong correlation exists with traffic risk perception. The findings of this study have been discussed in terms of theoretical, practical and conceptual implications for both scholars and policy-makers to better understand the young drivers' attitude and behaviour relationship towards road safety measures with a view to future research.

  11. Comparative behaviour of the Dynamically Penalized Likelihood algorithm in inverse radiation therapy planning

    Energy Technology Data Exchange (ETDEWEB)

    Llacer, Jorge [EC Engineering Consultants, LLC, Los Gatos, CA (United States)]. E-mail:; Solberg, Timothy D. [Department of Radiation Oncology, University of California, Los Angeles, CA (United States)]. E-mail:; Promberger, Claus [BrainLAB AG, Heimstetten (Germany)]. E-mail:


    This paper presents a description of tests carried out to compare the behaviour of five algorithms in inverse radiation therapy planning: (1) The Dynamically Penalized Likelihood (DPL), an algorithm based on statistical estimation theory; (2) an accelerated version of the same algorithm; (3) a new fast adaptive simulated annealing (ASA) algorithm; (4) a conjugate gradient method; and (5) a Newton gradient method. A three-dimensional mathematical phantom and two clinical cases have been studied in detail. The phantom consisted of a U-shaped tumour with a partially enclosed 'spinal cord'. The clinical examples were a cavernous sinus meningioma and a prostate case. The algorithms have been tested in carefully selected and controlled conditions so as to ensure fairness in the assessment of results. It has been found that all five methods can yield relatively similar optimizations, except when a very demanding optimization is carried out. For the easier cases, the differences are principally in robustness, ease of use and optimization speed. In the more demanding case, there are significant differences in the resulting dose distributions. The accelerated DPL emerges as possibly the algorithm of choice for clinical practice. An appendix describes the differences in behaviour between the new ASA method and the one based on a patent by the Nomos Corporation. (author)

  12. Periodic activations of behaviours and emotional adaptation in behaviour-based robotics (United States)

    Burattini, Ernesto; Rossi, Silvia


    The possible modulatory influence of motivations and emotions is of great interest in designing robotic adaptive systems. In this paper, an attempt is made to connect the concept of periodic behaviour activations to emotional modulation, in order to link the variability of behaviours to the circumstances in which they are activated. The impact of emotion is studied, described as timed controlled structures, on simple but conflicting reactive behaviours. Through this approach it is shown that the introduction of such asynchronies in the robot control system may lead to an adaptation in the emergent behaviour without having an explicit action selection mechanism. The emergent behaviours of a simple robot designed with both a parallel and a hierarchical architecture are evaluated and compared.

  13. Rumination-focused cognitive behaviour therapy vs. cognitive behaviour therapy for depression

    DEFF Research Database (Denmark)

    Hvenegaard, Morten; Watkins, Ed R; Poulsen, Stig


    BACKGROUND: Cognitive behavioural therapy is an effective treatment for depression. However, one third of the patients do not respond satisfactorily, and relapse rates of around 30 % within the first post-treatment year were reported in a recent meta-analysis. In total, 30-50 % of remitted patients...... of future depression. Rumination-focused cognitive behavioural therapy is a psychotherapeutic treatment targeting rumination. Because rumination plays a major role in the initiation and maintenance of depression, targeting rumination with rumination-focused cognitive behavioural therapy may be more...... effective in treating depression and reducing relapse than standard cognitive behavioural therapy. METHOD/DESIGN: This study is a two-arm pragmatic randomised controlled superiority trial comparing the effectiveness of group-based rumination-focused cognitive behaviour therapy with the effectiveness...

  14. [Subjective Workload, Job Satisfaction, and Work-Life-Balance of Physicians and Nurses in a Municipal Hospital in a Rural Area Compared to an Urban University Hospital]. (United States)

    Körber, Michael; Schmid, Klaus; Drexler, Hans; Kiesel, Johannes


    Medical and nursing shortages in rural areas represent a current serious public health problem. The healthcare of the rural population is at risk. This study compares perceived workload, job satisfaction and work-life balance of physicians and nurses at a clinic in a rural area with two clinics of a University hospital. Physicians and nurses were interviewed anonymously with a standardized questionnaire (paper and pencil), including questions on job satisfaction, subjective workload and work-life balance. The response rate was almost 50% in the University hospital as well as in the municipal hospital. 32 physicians and 54 nurses from the University hospital and 18 physicians and 137 nurses from the municipal hospital participated in the survey. Nurses at the University hospital assessed the organization of the daily routine with 94.1% as better than those at the municipal hospital (82.4%, p=0.03). Physicians at the University hospital were able to better implement acquired knowledge at a University clinic with 87.5% than their counterparts at the municipal hospital (55.5%, p=0.02). In contrast to their colleagues at the municipal hospital, only 50% of the physicians at the University hospital subjectively considered their workload as just right (83.3% municipal, p=0.02). 96.9% of the physicians at the University hospital were "daily" or "several times a week" under time pressure (municipal 50%, pwork and family life (62.9% University hospital, 72.8% Municipal hospital). In contrast, only 20% of the physicians at the University Hospital but 42.9% of the physicians of the municipal hospital had sufficient opportunities to balance workload and family (p=0.13). The return rate of almost 50% can be described as good. Due to the small number of physicians, especially from the municipal hospital, it can be assumed that some interesting differences could not be detected. There were only slight differences between the nurses from the two hospitals. In contrast, subjective

  15. Variation in Surgical Quality Measure Adherence within Hospital Referral Regions: Do Publicly Reported Surgical Quality Measures Distinguish among Hospitals That Patients Are Likely to Compare? (United States)

    Safavi, Kyan C; Dai, Feng; Gilbertsen, Todd A; Schonberger, Robert B


    Objective To determine whether surgical quality measures that Medicare publicly reports provide a basis for patients to choose a hospital from within their geographic region. Data Source The Department of Health and Human Services' public reporting website, Medicare Claims Processing Manual Baltimore, MD CMS Study Design We identified hospitals (n = 2,953) reporting adherence rates to the quality measures intended to reduce surgical site infections (Surgical Care Improvement Project, 1–3) in 2012. We defined regions within which patients were likely to compare hospitals using the hospital referral regions (HRRs) from the Dartmouth Atlas of Health Care Project. We described distributions of reported SCIP adherence within each HRR, including medians, interquartile ranges (IQRs), skewness, and outliers. Principal Findings Ninety-seven percent of HRRs had median SCIP-1 scores ≥95 percent. In 93 percent of HRRs, half of the hospitals in the HRR were within 5 percent of the median hospital's score. In 62 percent of HRRs, hospitals were skewed toward the higher rates (negative skewness). Seven percent of HRRs demonstrated positive skewness. Only 1 percent had a positive outlier. SCIP-2 and SCIP-3 demonstrated similar distributions. Conclusions Publicly reported quality measures for surgical site infection prevention do not distinguish the majority of hospitals that patients are likely to choose from when selecting a surgical provider. More studies are needed to improve public reporting's ability to positively impact patient decision making. PMID:24611578

  16. Better together? A Hospitality Case for Umbrella Branding


    Kooli, Kaouther; Cai, Huifen; Beer, Cornelia; Wright, Len Tiu


    Purpose: While the topic of ‘umbrella branding’ (UB) strategies for manufacturers' products in the business-to business literature has received attention, much less has been written about UB strategies in the hospitality industry. With the aid of a theoretical framework this paper explores three types of behavioural characteristics: alliance attribute; communication behaviour; and alliance management to examine cost and service benefits for alliance success within one umbrella organisation in...

  17. Event rates, hospital utilization, and costs associated with major complications of diabetes: a multicountry comparative analysis.

    Directory of Open Access Journals (Sweden)

    Philip M Clarke


    Full Text Available Diabetes imposes a substantial burden globally in terms of premature mortality, morbidity, and health care costs. Estimates of economic outcomes associated with diabetes are essential inputs to policy analyses aimed at prevention and treatment of diabetes. Our objective was to estimate and compare event rates, hospital utilization, and costs associated with major diabetes-related complications in high-, middle-, and low-income countries.Incidence and history of diabetes-related complications, hospital admissions, and length of stay were recorded in 11,140 patients with type 2 diabetes participating in the Action in Diabetes and Vascular Disease (ADVANCE study (mean age at entry 66 y. The probability of hospital utilization and number of days in hospital for major events associated with coronary disease, cerebrovascular disease, congestive heart failure, peripheral vascular disease, and nephropathy were estimated for three regions (Asia, Eastern Europe, and Established Market Economies using multiple regression analysis. The resulting estimates of days spent in hospital were multiplied by regional estimates of the costs per hospital bed-day from the World Health Organization to compute annual acute and long-term costs associated with the different types of complications. To assist, comparability, costs are reported in international dollars (Int$, which represent a hypothetical currency that allows for the same quantities of goods or services to be purchased regardless of country, standardized on purchasing power in the United States. A cost calculator accompanying this paper enables the estimation of costs for individual countries and translation of these costs into local currency units. The probability of attending a hospital following an event was highest for heart failure (93%-96% across regions and lowest for nephropathy (15%-26%. The average numbers of days in hospital given at least one admission were greatest for stroke (17-32 d across

  18. Hospital costs during the first 5 years of life for multiples compared with singletons born after IVF or ICSI. (United States)

    van Heesch, M M J; Evers, J L H; van der Hoeven, M A H B M; Dumoulin, J C M; van Beijsterveldt, C E M; Bonsel, G J; Dykgraaf, R H M; van Goudoever, J B; Koopman-Esseboom, C; Nelen, W L D M; Steiner, K; Tamminga, P; Tonch, N; Torrance, H L; Dirksen, C D


    Do in vitro fertilization (IVF) multiples generate higher hospital costs than IVF singletons, from birth up to age 5? Hospital costs from birth up to age 5 were significantly higher among IVF/ICSI multiple children compared with IVF/ICSI singletons; however, when excluding the costs incurred during the birth admission period, hospital costs of multiples and singletons were comparable. Concern has risen over the long-term outcome of children born after IVF. The increased incidence of multiple births in IVF as a result of double-embryo transfer predisposes children to a poorer neonatal outcome such as preterm birth and low birthweight. As a consequence, IVF multiples require more medical care. Costs and consequences of poorer neonatal outcomes in multiples may also exist later in life. All 5497 children born from IVF in 2003-2005, whose parents received IVF or ICSI treatment in one of five participating Dutch IVF centers, served as a basis for a retrospective cohort study. Based on gestational age, birthweight, Apgar and congenital malformation, children were assigned to one of three risk strata (low-, moderate- or high-risk). To enhance the efficiency of the data collection, 816 multiples and 584 singletons were selected for 5-year follow-up based on stratified (risk) sampling. Parental informed consent was received of 322 multiples and 293 singletons. Individual-level hospital resource use data (hospitalization, outpatient visits and medical procedures) were retrieved from hospital information systems and patient charts for 302 multiples and 278 singletons. The risk of hospitalization (OR 4.9, 95% CI 3.3-7.0), outpatient visits (OR 2.6, 95% CI 1.8-3.6) and medical procedures (OR 1.7, 95% CI 1.2-2.2) was higher for multiples compared with singletons. The average hospital costs amounted to €10 018 and €2093 during the birth admission period (P IVF/ICSI multiples compared with IVF/ICSI singletons. Single-embryo transfer may result in substantial savings

  19. Traumatic Hemothorax and Pneumothorax Detected by EFAST Compared with Chest Radio- graphy at Siriraj Hospital

    Directory of Open Access Journals (Sweden)

    Lertpong Somcharit


    Full Text Available Objective: EFAST is the evaluation of thoracoabdominal injury in trauma patients. This study aimed to evaluate the diagnostic utility of EFAST for detection of traumatic pneumothorax and hemothorax compared to standard routine chest radiography at Siriraj Hospital. Methods: From January 2013 to April 2015, 119 patients who visited the Division of Trauma, Siriraj Hospital were included in the study. EFAST was performed during the initial resuscitation of the injured patients and plain chest radiographs were obtained as routine hospital protocols. Patients’ charts were retrospectively reviewed and real-time EFAST examinations were compared to the results of chest radiographs. EFAST diagnosis was con- sidered positive when there was absence of normal sliding lung signs (pneumothorax and presence of free fluid above the diaphragm (hemothorax. Results: The sensitivity, specificity, PPV, and NPV of EFAST for the diagnosis of pneumothorax and hemothorax were 76%, 100%, 100%, and 93%, respectively, whereas the sensitivity, specificity, PPV and NPV of plain chest radiographs were 80%, 100%, 100% and 94.9%, respectively. Conclusion: EFAST shows similar diagnostic accuracy compared to plain supine AP chest radiograph. The results are operator-dependent and higher accuracy can be achieved by well-trained emergency health care personnel. EFAST can be performed during resuscitation, and still provides promising results which can lead to early treat- ment procedure. Under experienced hands, EFAST is considered effective. This study suggests that it should be used as a complimentary procedure in all thoracic injured patients’ evaluations.

  20. Risky sexual behaviours among HIV Sero-discordant individuals ...

    African Journals Online (AJOL)

    Backgound: HIV/AIDS pandemic is a great public health concern hence the need to identify interventions to prevent new infections among risk groups. Objective: To determine risky sexual behaviours among HIV sero-discordant individuals attending Defence Forces Memorial Hospital (DFMH). Design: A descriptive ...

  1. Using the Analytic Network Process (ANP) to assess the distribution of pharmaceuticals in hospitals – a comparative case study of a Danish and American hospital

    DEFF Research Database (Denmark)

    Feibert, Diana Cordes; Sørup, Christian Michel; Jacobsen, Peter


    Pharmaceuticals are a vital part of patient treatment and the timely delivery of pharmaceuticals to patients is therefore important. Hospitals are complex systems that provide a challenging environment for decision making. Implementing process changes and technologies to improve the pharmaceutical...... distribution process can therefore be a complex and challenging undertaking. A comparative case study was conducted benchmarking the pharmaceutical distribution process at a Danish and US hospital to identify best practices. Using the ANP method, taking tangible and intangible aspects into consideration...

  2. A comparative analysis of exposure doses between the radiation workers in dental and general hospital

    International Nuclear Information System (INIS)

    Yang, Nam Hee; Chung, Woon Kwan; Dong, Kyung Rae; Ju, Yong Jin; Song, Ha Jin; Choi, Eun Jin


    Research and investigation is required for the exposure dose of radiation workers to work in the dental hospital as increasing interest in exposure dose of the dental hospital recently accordingly, study aim to minimize radiation exposure by making a follow-up study of individual exposure doses of radiation workers, analyzing the status on individual radiation exposure management, prediction the radiation disability risk levels by radiation, and alerting the workers to the danger of radiation exposure. Especially given the changes in the dental hospital radiation safety awareness conducted the study in order to minimize radiation exposure. This study performed analyses by a comparison between general and dental hospital, comparing each occupation, with the 116,220 exposure dose data by quarter and year of 5,811 subjects at general and dental hospital across South Korea from January 1, 2008 through December 31, 2012. The following are the results obtained by analyzing average values year and quarter. In term of hospital, average doses were significantly higher in general hospitals than detal ones. In terms of job, average doses were higher in radiological technologists the other workers. Especially, they showed statistically significant differences between radiological technologists than dentists. The above-mentioned results indicate that radiation workers were exposed to radiation for the past 5 years to the extent not exceeding the dose limit (maximum 50 mSv y -1 ). The limitation of this study is that radiation workers before 2008 were excluded from the study. Objective evaluation standards did not apply to the work circumstance or condition of each hospital. Therefore, it is deemed necessary to work out analysis criteria that will be used as objective evaluation standard. It will be necessary to study radiation exposure in more precise ways on the basis of objective analysis standard in the future. Should try to minimize the radiation individual dose of

  3. A comparative analysis of exposure doses between the radiation workers in dental and general hospital

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Nam Hee; Chung, Woon Kwan; Dong, Kyung Rae; Ju, Yong Jin; Song, Ha Jin [Dept. of Nuclear Engineering, Chosun University, Gwangju (Korea, Republic of); Choi, Eun Jin [Dept. of Public Health and Medicine, Dongshin University, Naju (Korea, Republic of)


    Research and investigation is required for the exposure dose of radiation workers to work in the dental hospital as increasing interest in exposure dose of the dental hospital recently accordingly, study aim to minimize radiation exposure by making a follow-up study of individual exposure doses of radiation workers, analyzing the status on individual radiation exposure management, prediction the radiation disability risk levels by radiation, and alerting the workers to the danger of radiation exposure. Especially given the changes in the dental hospital radiation safety awareness conducted the study in order to minimize radiation exposure. This study performed analyses by a comparison between general and dental hospital, comparing each occupation, with the 116,220 exposure dose data by quarter and year of 5,811 subjects at general and dental hospital across South Korea from January 1, 2008 through December 31, 2012. The following are the results obtained by analyzing average values year and quarter. In term of hospital, average doses were significantly higher in general hospitals than detal ones. In terms of job, average doses were higher in radiological technologists the other workers. Especially, they showed statistically significant differences between radiological technologists than dentists. The above-mentioned results indicate that radiation workers were exposed to radiation for the past 5 years to the extent not exceeding the dose limit (maximum 50 mSv y{sup -1}). The limitation of this study is that radiation workers before 2008 were excluded from the study. Objective evaluation standards did not apply to the work circumstance or condition of each hospital. Therefore, it is deemed necessary to work out analysis criteria that will be used as objective evaluation standard. It will be necessary to study radiation exposure in more precise ways on the basis of objective analysis standard in the future. Should try to minimize the radiation individual dose of

  4. Implications of design on infection prevention and control practice in a novel hospital unit: the Medical Ward of the 21st Century. (United States)

    VanSteelandt, Amanda; Conly, John; Ghali, William; Mather, Charles


    The physical design of hospital wards is associated with transmission of pathogenic organisms and hospital-acquired infections. A novel hospital unit, the Medical Ward of the 21st Century (W21C), optimizes features for infection prevention and control practices. Ethnographic research on the W21C versus conventional hospital wards examined the experiential and behavioural elements of the different designs. Three recurring themes emerged regarding the design features on the W21C and included visual cues, 'having a place for things', and less sharing of spaces and materials. Observational data of healthcare worker practices demonstrated significantly higher compliance with hand hygiene opportunities on the W21C compared with older hospital units. These findings suggest how the physical design of a hospital ward may enhance infection prevention and control practices.

  5. Comparing the Affordable Care Act's Financial Impact on Safety-Net Hospitals in States That Expanded Medicaid and Those That Did Not. (United States)

    Dobson, Allen; DaVanzo, Joan E; Haught, Randy; Phap-Hoa, Luu


    Safety-net hospitals play a vital role in delivering health care to Medicaid enrollees, the uninsured, and other vulnerable patients. By reducing the number of uninsured Americans, the Affordable Care Act (ACA) was also expected to lower these hospitals’ significant uncompensated care costs and shore up their financial stability. To examine how the ACA’s Medicaid expansion affected the financial status of safety-net hospitals in states that expanded Medicaid and in states that did not. Using Medicare hospital cost reports for federal fiscal years 2012 and 2015, the authors compared changes in Medicaid inpatient days as a percentage of total inpatient days, Medicaid revenues as a percentage of total net patient revenues, uncompensated care costs as a percentage of total operating costs, and hospital operating margins. Medicaid expansion had a significant, favorable financial impact on safety-net hospitals. From 2012 to 2015, safety-net hospitals in expansion states, compared to those in nonexpansion states, experienced larger increases in Medicaid inpatient days and Medicaid revenues as well as reduced uncompensated care costs. These changes improved operating margins for safety-net hospitals in expansion states. Margins for safety-net hospitals in nonexpansion states, meanwhile, declined.

  6. Comparative heart failure profile over a 3-year period in a Romanian general hospital

    Directory of Open Access Journals (Sweden)

    Pop D


    Full Text Available Dana Pop,1 Oana Maria Penciu,1 Adela Viviana Sitar-Taut,2 Dumitru Tudor Zdrenghea11Department of Cardiology, Clinical Rehabilitation Hospital, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania; 2"Babes-Bolyai" University, Cluj-Napoca, RomaniaBackground: Heart failure (HF has become an increasingly significant public health problem, associated with repeated hospitalizations, high costs, low quality of life, and decreased survival rate. The progress of the disease may be slowed if treatment is administered in accordance with current guidelines.Objectives: To compare the clinical profile of HF patients in a Romanian general hospital over a 3-year period.Methods and results: We studied two cohorts of patients admitted in the cardiology department of a rehabilitation hospital with a diagnosis of chronic HF New York Heart Association class II–IV. The first, in 2006, included 415 patients, 67.08 ± 10.59 years; the second, in 2009, included 500 patients, 67.31 ± 11.27 years. Considering all patients, the left ventricle ejection fraction (LVEF was not statistically different in the two cohorts. Compared to the 2006 cohort, the 2009 female cohort had higher LVEF (60.49% ± 13.41% vs 64.42% ± 13.79%, P < 0.05, while males over 65 years of age had lower LVEF (52.75% ± 15.02% vs 54.37% ± 15.23%, P = NS. For females, the probability of having LVEF ,45% was higher in 2006 (odds ratio = 1.573. HF with preserved LVEF was more common in females, both in 2006 (78.2% vs 54.2% and 2009 (87.2% vs 57.3%. In the 2009 cohort, LVEF was higher both in young patients (59.08% ± 14.22% vs 55.35% ± 14.92% and patients ≥ than 75 years of age (62.28% ± 13.81% vs 56.79% ± 14.81% compared to the 2006 cohort. Ischemic heart disease was the main underlying cause for HF in both cohorts.Conclusion: HF appeared to have the same clinical profile over a 3-year period. Females diagnosed with HF showed higher rates of preserved LVEF.Keywords: heart

  7. The influence of leadership behaviour on organisational citizenship behaviour in self-managed work teams in Malaysia

    Directory of Open Access Journals (Sweden)

    Zoharah Omar


    Full Text Available This study examined the influence of transformational-transactional leadership behaviour on organisational citizenship behaviour in self-managed work teams and the augmenting effect of transformational-transactional leadership behaviour. This cross-sectional correlation study was conducted on 93 self-managed work teams in a multinational manufacturing company. Data were collected through group face-to-face administration by the researcher and statistically analysed through Pearson correlation, partial correlation and multiple regressions. Results showed that both transactional and transformational leadership behaviour have a positive influence on organisational citizenship behaviour among team members. Transformational leadership behaviour, however, has a greater influence on organisational citizenship behaviour compared to transactional leadership behaviour. The results also conf rmed the augmenting effect of transformational leadership behaviour on the relationship between transactional leadership behaviour and organisational citizenship behaviour.

  8. Comparative evaluations of individual radiation doses at hospital environment in two decades 73-82 and 86-95

    International Nuclear Information System (INIS)

    Carreira, Mauricio Costa; Almeida, Adelaide de; Santos, Maria Concepta P.S.


    Individual radiation doses in two decades of Hospital das Clinicas, Ribeirao Preto, Sao Paulo State, Brazil, are analysed. The annual values are studied according to the hospital service and specific worker categories. The workers are classified in categories A or B as recommended by ICRP 35. Three types of individual monitors (film badges, Ca So 4 and Li F + Ca So 4 ) supplied by three distinct laboratories are compared

  9. Economic burden of primary compared with recurrent Clostridium difficile infection in hospitalized patients: a prospective cohort study. (United States)

    Shah, D N; Aitken, S L; Barragan, L F; Bozorgui, S; Goddu, S; Navarro, M E; Xie, Y; DuPont, H L; Garey, K W


    Few studies have investigated the additional healthcare costs of recurrent C. difficile infection (CDI). To quantify inpatient treatment costs for CDI and length of stay among hospitalized patients with primary CDI only, compared with CDI patients who experienced recurrent CDI. This was a prospective, observational cohort study of hospitalized adult patients with primary CDI followed for three months to assess for recurrent CDI episodes. Total and CDI-attributable hospital length of stay (LOS) and hospitalization costs were compared among patients who did or did not experience at least one recurrent CDI episode. In all, 540 hospitalized patients aged 62±17 years (42% males) with primary CDI were enrolled, of whom 95 patients (18%) experienced 101 recurrent CDI episodes. CDI-attributable median (interquartile range) LOS and costs (in US$) increased from 7 (4-13) days and $13,168 (7,525-24,456) for patients with primary CDI only versus 15 (8-25) days and $28,218 (15,050-47,030) for patients with recurrent CDI (Pcosts increased from 11 (6-22) days and $20,693 (11,287-41,386) for patients with primary CDI only versus 24 (11-48) days and $45,148 (20,693-82,772) for patients with recurrent CDI (Pcost of pharmacological treatment while hospitalized was $60 (23-200) for patients with primary CDI only (N=445) and $140 (30-260) for patients with recurrent CDI (P=0.0013). This study demonstrated that patients with CDI experience a significant healthcare economic burden attributed to CDI. Economic costs and healthcare burden increased significantly for patients with recurrent CDI. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  10. Cognitive behaviour therapy for common mental disorders in people with Multiple Sclerosis: A bench marking study. (United States)

    Askey-Jones, S; David, A S; Silber, E; Shaw, P; Chalder, T


    Mental health problems such as depression and anxiety are common in Multiple Sclerosis (MS) and are often under treated. This paper reports on the clinical effectiveness of a cognitive behaviour therapy service for common mental disorders in people with MS and compares it to previous randomised controlled trials (RCTs) of cognitive behaviour therapy (CBT) in this population. 49 patients were deemed appropriate for CBT and 29 accepted treatment. Assessments were completed at baseline and end of treatment and included the Hospital Anxiety & Depression Scale. Results in the form of a standardized effect of treatment were compared with five previous RCTs. The results from this clinical service indicated statistically significant outcomes with reductions in depression and anxiety. The uncontrolled effect size was large but inferior to those found in published RCTs. Cognitive behaviour therapy is effective for people with MS in routine clinical practice. Possible limits on effectiveness include more liberal patient selection, lack of specificity in rating scales and heterogeneity of target problems. Given the high rates of distress in this population, routine psychological interventions within neurology services are justifiable. Future research should aim to maximise CBT in such settings. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Traumatic brain injury in a rural and an urban Tanzanian hospital--a comparative, retrospective analysis based on computed tomography. (United States)

    Maier, Daniel; Njoku, Innocent; Schmutzhard, Erich; Dharsee, Jaffer; Doppler, Magdalena; Härtl, Roger; Winkler, Andrea Sylvia


    In a resource-poor environment such as rural East Africa, expensive medical devices such as computed tomographic (CT) scanners are rare. The CT scanner at the rural Haydom Lutheran Hospital (HLH) in Tanzania therefore offers a unique chance to observe possible differences with urban medical centers in the disease pattern of trauma-related cranial pathologies. The purpose of this study was to compare traumatic brain injuries (TBIs) between a rural and an urban area of Tanzania. HLH has 350 beds and one CT scanner. The urban Aga Khan Hospital is a private hospital with 80 beds and one CT scanner. This was a retrospective study. Data of 248 patients at HLH and of 432 patients at Aga Khan Hospital with TBI could be collected. The prevalence of TBI was significantly higher in the rural area compared to the urban area (34.2% vs. 21.9%, P workplace is primarily urban or rural. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Disruption, control and coping: responses of and to the person with dementia in hospital. (United States)

    Porock, Davina; Clissett, Philip; Harwood, Rowan H; Gladman, John R F


    This qualitative study aimed to gain insight into the experience of hospitalisation from the perspectives of the older person with dementia, their family care-giver and other patients sharing the ward (co-patients). Non-participant observation of care on 11 acute hospital wards was supplemented by 39 semi-structured interviews with 35 family care-givers and four co-patients following discharge. Constant comparative analysis produced the core problem facing all those involved: disruption from normal routine meaning that the experience of hospitalisation was disrupted by the presence and behaviour of the person with dementia. Disruption adversely affected the person with dementia, triggering constructive, disengaged, distressed and neutral behaviours. Using Kitwood's model of person-centred care, these behaviours were interpreted as attempts by the person with dementia at gaining a sense of control over the unfamiliar environment and experience. Family care-givers' lives and experiences both inside and outside the hospital were disrupted by the hospitalisation. They too attempted to gain a sense of control over the experience and to give a sense of control to the patient, co-patients and staff. Co-patients experienced disruption from sharing space with the person with dementia and were left feeling vulnerable and sometimes afraid. They too attempted to gain a sense of control over their situation and give some control by helping the person with dementia, the family care-giver and the staff.

  13. Travel behaviour of tourists to a South African holiday resort | van ...

    African Journals Online (AJOL)

    C van Vuuren, E Slabbert ... Knowledge regarding travel behaviour can assist in marketing, product planning and development which ... be management and hospitality aspects, destination attributes, site attractiveness and economic benefits.

  14. Distinguishing dimensions of pro-environmental behaviour


    Lynn, Peter


    This study empirically identifies dimensions of behaviour that are distinct in terms of the extent to which people act pro-environmentally. Three dimensions are identified, relating to at-home, transport-related and purchasing behaviour. The correlation between behaviour in each dimension is explored and the characteristics and attitudes associated with the extent to which behaviour is pro-environmental in each dimension are compared. The correlates of pro-environmental behaviour are found to...

  15. Work-related behaviour and experience patterns of physicians compared to other professions. (United States)

    Voltmer, Edgar; Kieschke, Ulf; Spahn, Claudia


    To identify health risk factors and resources of physicians in comparison with other professions. Data of cross-sectional mail surveys conducted among German physicians (n = 344), teachers (n = 5169), policemen (n = 851), prison officers (n = 3653), and starting entrepreneurs (n = 632) were analysed regarding eleven health-relevant dimensions and four behaviour patterns examined by the questionnaire "Work-Related Behaviour and Experience Pattern (AVEM)". Only 17% of the physicians showed healthy behaviour and experience patterns. With 43%, they scored highest in terms of reduced working motivation. Together with the teachers, they also had the highest scores for resignation and burnout (27%). Satisfaction with life and work as well as social support showed medium scores. Starting entrepreneurs showed the healthiest patterns (45%), but also the highest risk pattern for overexertion (38%). It was possible to identify clear risk patterns for profession-related psychosocial symptoms and impairments. The high scores for reduced working motivation demonstrate the need for interventions to improve organisation of health care and individual coping strategies.

  16. Improved physical fitness of cancer survivors : A randomised controlled trial comparing physical training with physical and cognitive-behavioural training

    NARCIS (Netherlands)

    May, Anne M.; Van Weert, Ellen; Korstjens, Irene; Hoekstra-Weebers, Josette E. H. M.; Van Der Schans, Cees P.; Zonderland, Maria L.; Mesters, Ilse; Van Den Borne, Bart; Ros, Wynand J. G.


    We compared the effect of a group-based 12-week supervised exercise programme, i.e. aerobic and resistance exercise, and group sports, with that of the same programme combined with cognitive-behavioural training on physical fitness and activity of cancer survivors. One hundred and forty seven cancer

  17. Quantitative assessment of organizational culture within hospitals and its relevance to infection prevention and control strategies. (United States)

    Borg, M A; Waisfisz, B; Frank, U


    It has been suggested that organizational culture (OC) is an important driver of infection prevention and control (IPC) behaviour among healthcare workers. This study examined OC in seven European hospitals using a validated assessment tool based on Hofstede's model, and identified significant variations in OC scores. Hospitals with low prevalence of meticillin-resistant Staphylococcus aureus (MRSA) exhibited high scores for change facilitation and change readiness, whereas hospitals with high prevalence of MRSA exhibited low scores for these determinants. It is possible to use tools, available outside health care, to study OC within hospitals and gain better insight into IPC behaviour change strategies. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  18. Exploring the impact of transformational leadership on nurse innovation behaviour: a cross-sectional study. (United States)

    Weng, Rhay-Hung; Huang, Ching-Yuan; Chen, Li-Mei; Chang, Li-Yu


    This study explored the influences of transformational leadership on nurse innovation behaviour and the mediating role of organisational climate. Recently, global nursing experts have been aggressively encouraging nurses to pursue innovation in nursing in order to improve nursing outcomes. Nursing innovation, in turn, is affected by nursing leadership. We employed a questionnaire survey to collect data, and selected a sample of nurses from hospitals in Taiwan. A total of 439 valid surveys were obtained. Hierarchical multiple regression model analysis was conducted to test the study hypothesis. The mean values of agreement of nurse innovation behaviour and transformational leadership were 3.40 and 3.78, respectively. Patient safety climate and innovation climate were found to have full mediating effects on the relationship between transformational leadership and innovation behaviour. Organisational climate has a significant impact on innovation behaviour. Transformational leadership has indirect effects on innovation behaviour via the mediation of patient safety climate and innovation climate. Hospitals should enhance transformational leadership by designing leadership training programmes and establishing transformational culture. In addition, nursing managers should foster nursing innovation through improvements in organisational climate. © 2013 John Wiley & Sons Ltd.

  19. Psychosocial behaviour management programme for home-dwelling people with dementia: A cluster-randomized controlled trial. (United States)

    Nakanishi, Miharu; Endo, Kaori; Hirooka, Kayo; Granvik, Eva; Minthon, Lennart; Nägga, Katarina; Nishida, Atsushi


    Little is known about the effectiveness of a psychosocial behaviour management programme on home-dwelling people with dementia. We developed a Behaviour Analytics & Support Enhancement (BASE) programme for care managers and professional caregivers of home care services in Japan. We investigated the effects of BASE on challenging behaviour of home-dwelling people with dementia. A cluster-randomized controlled trial was conducted with home care providers from 3 different districts in Tokyo. Each provider recruited persons with dementia aged 65 years or older to receive home care in the BASE programme in August 2016. An online monitoring and assessment system was introduced to the intervention group for repeated measures of challenging behaviour with a total score of the Neuropsychiatric Inventory. Care professionals in both the intervention and control groups evaluated challenging behaviour of persons with dementia at baseline (September 2016) and follow-up (February 2017). A majority of persons with dementia had Alzheimer disease (59.3%). One-hundred and forty-one persons with dementia were included in the intervention group and 142 in the control group. Multilevel modelling revealed a significant reduction in challenging behaviour in the intervention group after 6 months (mean score, 18.3 to 11.2) compared with that of the control group (11.6 to 10.8; P dwelling people with dementia. Future research should examine the long-term effects of behaviour management programmes on behaviour, nursing home placement, and hospital admission of home-dwelling people with dementia. Copyright © 2017 John Wiley & Sons, Ltd.

  20. Birth weight distribution of Hospital Geral do Grajaú population compared to São Paulo city population

    Directory of Open Access Journals (Sweden)

    José Ricardo Dias Bertagnon


    Full Text Available Objective: To compare the growth curves from a population from a large city suburban hospital with those of the city of São Paulo, São Paulo State, Brazil. Methods: At Hospital Geral do Grajaú, that serves the high pregnancy risk population lacking health facilities, of low education level and smaller number of prenatal visits and great morbidity, a growth curve was built for the newborns, as the Hospital is provided with updated equipment and personnel. The curve was built from the database available containing information on live births during the 2003 to 2007 period and totaling 9,952 newborns, as their weight at birth and gestational age were taken as parameters. The distribution curves of 3%, 10%, 50% and 90% of the Grajaú were compared to those of the city of São Paulo curve. Results: The curves did not significantly differ from those of the São Paulo curve percentiles, as shown by the mean deviation (Z score calculation, notwithstanding the higher rates for prematurity, low weight, teenager mothers and lack of prenatal visits among the Grajaú population as compared to those of São Paulo. Conclusions: The São Paulo city curve showed to be appropriate for the suburban population despite the existing differences.

  1. Comparative analysis of the current payment system for hospital services in Serbia and projected payments under diagnostic related groups system in urology. (United States)

    Babić, Uroš; Soldatović, Ivan; Vuković, Dejana; Milićević, Milena Šantrić; Stjepanović, Mihailo; Kojić, Dejan; Argirović, Aleksandar; Vukotić, Vinka


    Global budget per calendar year is a traditional method of funding hospitals in Serbia. Diagnose related groups (DGR) is a method of hospital payment based on classification of patients into groups with clinically similar problems and similar utilization of hospital resources. The aim of this study was to compare current methods of hospital services payment with the projected costs by DRG payment method in urology. The data were obtained from the information system used in the Clinical Hospital Center "Dr. Dragiša Mišović"--Dedinje in Belgrade, Serbia. The implemented hospital information system was the main criterion for selection of healthcare institutions. The study included 994 randomly selected patients treated surgically and conservatively in 2012. Average costs under the current payment method were slightly higher than those projected by DRG, however, the variability was twice as high (54,111 ± 69,789 compared to 53,434 ± 32,509, p payment method as well as with the projected one by DRG was observed in relation to the number of days of hospitalization (ρ = 0.842, p payment system (β = 0.843, p payment system (β = 0.737, p payment method and the pro- jected DRG payment methods (β = 0.501, p Payment under the DRG system is administratively more complex because it requires detailed and standardized coding of diagnoses and procedures, as well as the information on the average consumption of resources (costs) per DRG. Given that aggregate costs of treatment under two hospital payment methods compared in the study are not significantly different, the focus on minor surgeries both under the current hospital payment method and under the introduced DRG system would be far more cost-effective for a hospital as great variations in treatment performance (reductions of days of hospitalization and complications), and consequently invoiced amounts would be reduced.

  2. Dementia training programmes for staff working in general hospital settings - a systematic review of the literature. (United States)

    Scerri, Anthony; Innes, Anthea; Scerri, Charles


    Although literature describing and evaluating training programmes in hospital settings increased in recent years, there are no reviews that summarise these programmes. This review sought to address this, by collecting the current evidence on dementia training programmes directed to staff working in general hospitals. Literature from five databases were searched, based on a number of inclusion criteria. The selected studies were summarised and data was extracted and compared using narrative synthesis based on a set of pre-defined categories. Methodological quality was assessed. Fourteen peer-reviewed studies were identified with the majority being pre-test post-test investigations. No randomised controlled trials were found. Methodological quality was variable with selection bias being the major limitation. There was a great variability in the development and mode of delivery although, interdisciplinary ward based, tailor-made, short sessions using experiential and active learning were the most utilised. The majority of the studies mainly evaluated learning, with few studies evaluating changes in staff behaviour/practices and patients' outcomes. This review indicates that high quality studies are needed that especially evaluate staff behaviours and patient outcomes and their sustainability over time. It also highlights measures that could be used to develop and deliver training programmes in hospital settings.

  3. A subacute model of geriatric care for frail older persons: the Tan Tock Seng Hospital experience. (United States)

    Chong, Mei Sian; Empensando, Esmiller F; Ding, Yew Yoong; Tan, Thai Lian


    The subacute care unit in Tan Tock Seng Hospital (TTSH) was set up in May 2009. We examined its impact on the transitions at the nexus between hospital and community sectors, patients' discharge destination and functional performance. We studied patients admitted during the initial 6-month period (May to October 2009). Differences in demographics, length of stay (LOS), comorbidity and severity of illness measures, functional outcomes (modified Barthel Index (MBI)) according to discharge destinations were obtained. We also studied the impact of LOS on the geriatric department and the bill size over the pre- and post-subacute implementation periods. Majority of the subacute patients' hospital stay was in subacute care. Of these patients, 44.9% were discharged home, 24.2% to a slow stream rehabilitation (SSR) setting and 29.2% to nursing homes. 16.9% consisted of a subgroup of dementia patients requiring further behavioural and functional interventions, of which 50% managed to be discharged home. Functional gains were seen during subacute stay; with greatest gains observed in the SSR group. There were no differences in overall LOS nor total bill size (DRG-adjusted) for the geriatric medicine department during the first 6 months of operating this new subacute model compared with the prior 4-month period. We propose this subacute model of geriatric care, which allows right-siting of care and improved functional outcomes. It fulfills the role easing transitions between acute hospital and community sectors. In particular, it provides specialised care to a subgroup of dementia patients with challenging behaviours and is fiscally sound from the wider hospital perspective.

  4. Effect of preceding home-visit nursing on time to discharge in hospitalization for the treatment of behavioural and psychological symptoms of dementia among patients with limited familial care. (United States)

    Kitamura, Tatsuru; Shiota, Shigehito; Jinkawa, Shigetoshi; Kitamura, Maki; Hino, Shoryoku


    During hospitalization for behavioural and psychological symptoms of dementia (BPSD), it is imperative to build a support system for each patient in the community for after they obtain symptom remission. To this end, patients lacking adequate family support are less likely to be discharged to their own homes and need stronger support systems to be established. This study therefore investigated the effects of home-visit nursing before admission on time to home discharge among patients with limited familial care who were hospitalized for treatment of BPSD. A single-centre chart review study was conducted on consecutive patients admitted from home between April 2013 and September 2015 for treatment of BPSD and who had lived alone or with a working family member. Time to home discharge was compared between patients who had home-visit nursing before their admission and those who did not. In total, 58 patients were enrolled in the study, of whom 12 had preceding home-visit nursing (PHN group) and 46 did not (non-PHN group). Patients in the PHN group were younger (77.7 ± 4.9 vs. 84.1 ± 6.1 years, P = 0.0011) and had higher Mini-Mental State Examination scores (16.8 ± 7.2 vs 11.8 ± 7.3, P = 0.0287). A multivariate Cox proportional hazard regression analysis adjusted for age and Mini-Mental State Examination scores showed a higher likelihood of discharge to home in the PHN group (hazard ratio: 3.85; 95% confidence interval: 1.27-11.6;, P = 0.017) than in the non-PHN group. Home-visit nursing before admission of BPSD patients for treatment could improve the rate of discharge to home among patients with limited familial care after subsequent hospitalization. Home-visit nursing could also enhance collaborative relationships between social and hospital-based care systems, and early implementation could improve the likelihood of vulnerable patient types remaining in their own homes for as long as possible. © 2018 Japanese Psychogeriatric

  5. Sexual Behaviour and Contraceptive Use Among Student Nurses ...

    African Journals Online (AJOL)

    This was a survey study designed to determine the sexual behaviour and contraceptive use among student Nurses, School of Nursing, University of Maiduguri Teaching Hospital (U.M.T.H.), Maiduguri, Borno State. The population of this study was the entire 136 student Nurses, School of Nursing, U.M.T.H.), Maiduguri.

  6. Stage-related behavioural problems in the 1-4 year old child: parental expectations in a child development unit referral group compared with a control group. (United States)

    Ticehurst, R L; Henry, R L


    Behavioural problems in preschool (1-4 years) children are a common cause of referral to health services. Parents of children presenting to the child development unit with behavioural problems (n = 18) were compared with a control group (n = 45). A questionnaire was utilized to examine the parents' expectations of the children's behaviours. As might be expected, the parents of children presenting to the Unit rated their children as having more difficult behaviours. These parents had unrealistic expectations, particularly for the 'negative' behaviours (disobedience, temper tantrums, defiance and whinging). However, they were able to anticipate normal age-related difficulties in some problem areas (dawdling during mealtimes, masturbating, not sharing toys and being jealous of one's siblings). Counselling should address the issue of matching the expectations of parents with the individual rates of development of their children.

  7. Examining Teacher Job Satisfaction and Principals' Instructional Supervision Behaviours: A Comparative Study of Turkish Private and Public School Teachers (United States)

    Sungu, Hilmi; Ilgan, Abdurrahman; Parylo, Oksana; Erdem, Mustafa


    In spite of a strong body of research examining teacher job satisfaction and teachers' assessment of their principals' behaviours, most studies focus on the educational systems in the first world countries. This quantitative study focuses on a lesser-examined educational context by comparing school teachers' job satisfaction levels and principals'…


    Directory of Open Access Journals (Sweden)

    Agnieszka Kozera


    Full Text Available Savings generated by the sector of households constitute an important growth factor in every economy. They are the basic source of capital accumulation, determining investment opportunities of the economy. Financial behaviour of households in terms of the accumulation of savings is infl uenced  by numerous factors, both internal, i.e. connected directly with a given household, and external, independent of it. The aim of this paper was to analyse savings behaviour of households of farmers as compared to the other socio-economicgroups in Poland in the years 2003 and 2013. Analyses were conducted on saving propensity, savings rates, and objectives and forms of savings accumulation by households of various socio-economic groups. Analyses showed that in 2013, saving propensity and savings rates in households of farmers were relatively low in comparison to other household groups. In households of farmers the objective of savings was, more frequently than in the other socio-economic groups of households, to ensure provisions for running consumption expenditure, purchase durable goods and expand their economic activity. In contrast, in comparison to the other households, farmers less frequently saved money for recreation and physical therapy.

  9. A comparative study of the mechanical behaviour of thermally oxidised commercially pure titanium and zirconium. (United States)

    Alansari, A; Sun, Y


    The objective of this study is to compare the mechanical behaviour of thermally oxidised commercially pure titanium (CP-Ti) and commercially pure zirconium (CP-Zr). For this purpose, these two bio-metals were thermally oxidised under the same condition (650°C for 6h) and the oxidised specimens were characterised using various analytical and experimental techniques, including oxygen uptake analysis, layer thickness and hardness measurements, scratch tests, dry sliding friction and wear tests and tribocorrosion tests in Ringer's solution. The results show that under the present thermal oxidation condition, 4 times more oxygen is introduced into CP-Zr than into CP-Ti and the oxide layer produced on CP-Zr is nearly 6 times thicker than that on CP-Ti. Thermally oxidised CP-Zr possesses a higher hardness, a deeper hardening depth and better scratch resistance than thermally oxidised CP-Ti. Under dry sliding and tribocorrosion conditions, thermally oxidised CP-Zr also possesses much better resistance to material removal and a higher load bearing capacity than thermally oxidised CP-Ti. Thus, thermally oxidised Zr possesses much better mechanical behaviour than thermally oxidised Ti. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. The Status of Information Technology in Iranian Hospital Libraries: A Comparative Study of Managers' Attitude (United States)

    Isfandyari-Moghaddam, Alireza; Sedehi, Maryam; Dehghani, Mozhdeh; Nemati-Anaraki, Leila; Hasanzadeh-Dizaji, Elaheh


    Purpose: The purpose of this paper is to compare the attitude of the managers of libraries located at Iran, Tehran and Shahid Beheshti Medical Sciences Universities' training hospitals, on the status of information technology (IT) in the mentioned libraries. Design/methodology/approach: This study employed a researcher-made questionnaire. The…

  11. Induction behaviour and race and its association with postoperative ...

    African Journals Online (AJOL)

    Previous studies have suggested that adult African patients have a lower incidence of postoperative nausea and ... patients in a South African hospital and their association with preoperative agitation and patient race. Methods: A ... Watcha behavioural scale was used to assess pre- and postoperative agitation. A Watcha ...

  12. Does Objective Quality of Physicians Correlate with Patient Satisfaction Measured by Hospital Compare Metrics in New York State? (United States)

    Bekelis, Kimon; Missios, Symeon; MacKenzie, Todd A; O'Shaughnessy, Patrick M


    It is unclear whether publicly reported benchmarks correlate with quality of physicians and institutions. We investigated the association of patient satisfaction measures from a public reporting platform with performance of neurosurgeons in New York State. This cohort study comprised patients undergoing neurosurgical operations from 2009 to 2013 who were registered in the Statewide Planning and Research Cooperative System database. The cohort was merged with publicly available data from the Centers for Medicare and Medicaid Services Hospital Compare website. Propensity-adjusted regression analysis was used to investigate the association of patient satisfaction metrics with neurosurgeon quality, as measured by the neurosurgeon's individual rate of mortality and average length of stay. During the study period, 166,365 patients underwent neurosurgical procedures. Using propensity-adjusted multivariable regression analysis, we demonstrated that undergoing neurosurgical operations in hospitals with a greater percentage of patient-assigned "high" scores was associated with higher chance of being treated by a physician with superior performance in terms of mortality (odds ratio 1.90, 95% confidence interval 1.86-1.95), and a higher chance of being treated by a physician with superior performance in terms of length of stay (odds ratio 1.24, 95% confidence interval 1.21-1.27). Similar associations were identified for hospitals with a higher percentage of patients who claimed they would recommend these institutions to others. Merging a comprehensive all-payer cohort of neurosurgery patients in New York State with data from the Hospital Compare website, we observed an association of superior hospital-level patient satisfaction measures with objective performance of individual neurosurgeons in the corresponding hospitals. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Analysis of the effects of hospitalization on fine hand functions compared to gross grip in patients with rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Zeynep Tuna


    Full Text Available Objective: Hospitalization process causes a variety of physical problems. The decrease of hand use in daily life during hospitalization brings hand dysfunction to mind in inpatients. The aim of this study is to compare the hand functions of hospitalized patients with Rheumatoid Arthritis (RA to outpatients in detail. Methods: Grip and pinch strengths of both hospitalized patients in rheumatology service and outpatients on the routine control day were measured. In addition, 9-Hole Peg Test was performed and the disability level was determined by the Turkish version of Michigan Hand Outcomes Questionnaire (MHOQ. Results: While grip strength and MHOQ scores were similar (p>0.05 in both groups, all three pinch strengths (lateral, bipod, tripod and 9HPT scores were lower (p<0.05 in hospitalized patients. Conclusion: Consequently, besides disease activity, hospitalization process also impairs fine hand functions in rheumatological patients. Evaluation of fine hand functions and appropriate rehabilitative interventions may prevent further disability in hospitalized patients. J Clin Exp Invest 2015; 6 (3: 228-232

  14. Experimental analysis of the dynamic structural behaviour of the Hospital of Pievepelago (Modena); Analisi sperimentale del comportamento dinamico del poliambulatorio di Pievepelago a seguito dell`intervento di miglioramento antisismico

    Energy Technology Data Exchange (ETDEWEB)

    Buffarini, Giacomo; Clemente, Paolo; Rinaldis, Dario [ENEA, Centro Ricerche Casaccia, Rome (Italy). Dipt. Ambiente


    The research work leading to this report is the result of a joint effort between the National Agency for New Technologies and the Environments and the Emilia Romagna regional council, that involved the Environmental Department of the National Agency for New Technologies and the Environments in the experimental analysis of the dynamic structural behaviour of the Hospital of Pievepelago (Modena). A strengthening design has been performed on behalf of the Pievepelago town council, and the Emilia Romagna regional council asked the National Agency for New Technologies and the Environments to study the effectiveness of the intervention by carrying out the analysis of the dynamic behaviour of the structure both before and after the works. The results of the first phase are shown in a previous report. This report is relative to the experimental study on the strengthened building.

  15. [Comparative evaluation of maternity hospitals in Auvergne: from planning to contracting]. (United States)

    Gerbaud, L; Biolay, S; Venet, M; Pomey, M P; Belgacem, B; Jacquetin, B; Glanddier, P Y


    Two reforms of public hospitals have been launched by the French government in 1991 and 1996 aimed at lowering costs and increasing the quality of services and ultimately the safety of patients. As concerns maternity hospitals, several new rules have been imposed upon. For example, those who performed less than 300 births a year should be closed. The basic idea was to concentrate technical resources and human skills in middle-size and important hospitals for saving money, and simultaneously, raising the safety level for mothers and babies. However, negative adverse effects fastly appeared: to avoid closure, some small maternity homes tried to convince future mothers not to go to well-equipped hospitals, even if their cases appeared complex and their health at risk. An experience of partnership between maternity hospitals (care providers), the Sickness Insurance Fund (the financing body) and the Administration was carried out in the Auvergne region. It was based on the observation of a large number of indicators concerning the activity of hospitals, the size and quality of their equipment, the satisfaction of their patients ... etc ... for designing the rights and duties of each partner. Instead of planning from the summit, a process of mutually-agreed contract was established.

  16. New hospital payment systems: comparing medical strategies in The Netherlands, Germany and England. (United States)

    van Essen, Anne Marije


    This paper seeks to identify different medical strategies adopted in relation to the new hospital payment systems in Germany, The Netherlands and England and analyse how the medical strategies have impacted on the emergence of these New Public Management policy tools between 2002 and 2007. A comparative approach is applied. In addition to secondary sources, the study uses publications in professional journals, official publications of the (national) physician organisations and a (non-random) expert questionnaire to obtain the views of the medical corporate bodies in the three countries. The results reveal differences in the medical strategies in the three countries that point towards the significance of institutional and interest configurations. The Dutch corporate medical body was most willing to solve the conflict, while the German and English corporate medical bodies seem to be keen to use a strategy of confrontation. The differences in medical strategies also impact on the ways in which hospital payment systems have emerged in the three countries. Further research is necessary to study the medical strategies in healthcare reforms from a broader perspective, for instance by including other countries. The paper gives insights into the interplay between the medical profession and the government in the context of new managerial governance practices in the hospital sector. It adds to the scholarly debates about the role of the medical profession in health policy-making.

  17. Effectiveness of external inspection of compliance with standards in improving healthcare organisation behaviour, healthcare professional behaviour or patient outcomes (United States)

    Flodgren, Gerd; Pomey, Marie-Pascale; Taber, Sarah A; Eccles, Martin P


    Background Inspection systems are used in health care to promote quality improvements, i.e. to achieve changes in organisational structures or processes, healthcare provider behaviour and patient outcomes. These systems are based on the assumption that externally promoted adherence to evidence-based standards (through inspection/assessment) will result in higher quality of health care. However, the benefits of external inspection in terms of organisational, provider and patient level outcomes are not clear. Objectives To evaluate the effectiveness of external inspection of compliance with standards in improving healthcare organisation behaviour, healthcare professional behaviour and patient outcomes. Search methods We searched the following electronic databases for studies: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effectiveness, Scopus, HMIC, Index to Theses and Intute from their inception dates up to May 2011. There was no language restriction and studies were included regardless of publication status. We searched the reference lists of included studies and contacted authors of relevant papers, accreditation bodies and the International Organization for Standardisation (ISO), regarding any further published or unpublished work. Selection criteria We included randomised controlled trials (RCTs), controlled clinical trials (CCTs), interrupted time-series (ITSs) and controlled before and after studies (CBAs) evaluating the effect of external inspection against external standards on healthcare organisation change, healthcare professional behaviour or patient outcomes in hospitals, primary healthcare organisations and other community-based healthcare organisations. Data collection and analysis Two review authors independently applied eligibility criteria, extracted data and assessed the risk of bias of each included study. Since meta-analysis was

  18. Comparative studies of photoelectrochemical behaviours of rutile and anatase electrodes prepared by OMCVD technique

    Energy Technology Data Exchange (ETDEWEB)

    Minoura, H; Nasu, M; Takahashi, Y


    Photoelectrochemical behaviours of two kinds of polymorphic form of TiO2, rutile and anatase, prepared by the organometallic chemical vapour deposition from isopropyl titanate have been comparatively studied. Photoelectrochemical characteristics of these TiO2 electrodes depend strongly upon the crystal structure and the deposition temperature. Their bandgap energies have been determined to be 3.0 eV and 3.2 eV, respectively, by the analysis of the photocurrent action spectra. The conduction band-edge and the valence band-edge of the anatase electrode, which have been estimated from photocurrent-potential curves, locate at the energy level about 0.1 eV higher and lower, respectively, than those of the rutile electrode. (orig.).

  19. Comparative analysis of current payment system for hospital services in Serbia and projected payments under diagnostic related groups system in urology

    Directory of Open Access Journals (Sweden)

    Babić Uroš


    Full Text Available Background/Aim. Global budget per calendar year is a traditional method of funding hospitals in Serbia. Diagnose related groups (DGR is a method of hospital payment based on classification of patients into groups with clinically similar problems and similar utilization of hospital resources. The aim of this study was to compare current methods of hospital services payment with the projected costs by DRG payment method in urology. Methods. The data were obtained from the information system used in the Clinical Hospital Center “Dr. Dragiša Mišović” - Dedinje in Belgrade, Serbia. The implemented hospital information system was the main criterion for selection of healthcare institutions. The study included 994 randomly selected patients treated surgically and conservatively in 2012. Results. Average costs under the current payment method were slightly higher than those projected by DRG, however, the variability was twice as high (54,111 ± 69,789 compared to 53,434 ± 32,509, p < 0,001 respectively. The univariate analysis showed that the highest correlation with the current payment method as well as with the projected one by DRG was observed in relation to the number of days of hospitalization (ρ = 0.842, p < 0.001, and ρ = 0.637, p < 0.001, respectively. Multivariate regression models confirmed the influence of the number of hospitalization days to costs under the current payment system (β = 0.843, p < 0.001 as well as under the projected DRG payment system (β = 0.737, p < 0.001. The same predictor was crucial for the difference in the current payment method and the projected DRG payment methods (β = 0.501, p <0.001. Conclusion. Payment under the DRG system is administratively more complex because it requires detailed and standardized coding of diagnoses and procedures, as well as the information on the average consumption of resources (costs per DRG. Given that aggregate costs of treatment under two hospital payment methods compared

  20. Leadership behaviours, organizational culture and intention to stay amongst Jordanian nurses. (United States)

    AbuAlRub, R F; Nasrallah, M A


    To investigate the impact of leadership behaviours of nurse managers and organizational culture on Jordanian nurses' intention to stay at work in public, private and university hospitals. Leadership behaviours of nurses and organizational culture are considered important factors in enhancing retention of nurses. A correlational design was used in the study. A sample of 285 Jordanian nurses was conveniently selected to complete a self-administered questionnaire that consisted of three measures; Kouzes and Posner's Leadership Practise Inventory, Professional Organizational Culture questionnaire and McCain's Intent to Stay Scale. Nurse managers' leadership behaviours and organizational culture were positively associated with the level of intention to stay at work. The study variables explained almost 43% of the variance in nurses' intention to stay at work. The limitation of the study was the use of convenience sampling method. The results asserted that transformational leadership styles of nurse managers enhance positive hospitals' culture as well as the intention of nurses to stay at work. Nurse executives should promote leadership behaviours of nurse managers through training. The regulatory bodies of nursing profession in collaboration with nurse educators and administrators should help in developing competencies for nurse managers that are based on transformational leadership and incorporate such competencies in nursing education programs as well as continuous education programs. © 2017 International Council of Nurses.

  1. Serum magnesium and calcium in preeclampsia: a comparative study at the Korle-Bu Teaching Hospital, Ghana

    Directory of Open Access Journals (Sweden)

    Owusu Darkwa E


    Full Text Available Ebenezer Owusu Darkwa,1 Charles Antwi-Boasiako,2 Robert Djagbletey,1 Christian Owoo,1 Samuel Obed,3,† Daniel Sottie4 1Department of Anaesthesia, University of Ghana School of Medicine and Dentistry, 2Department of Physiology, University of Ghana School of Biomedical and Allied Health Sciences, 3Department of Obstetrics and Gynaecology, University of Ghana School of Medicine and Dentistry, College of Health Sciences, 4Department of Anaesthesia, Korle-Bu Teaching Hospital, Accra, Ghana †Samuel Obed passed away on May 12, 2017 Background: A large percentage (16% of maternal mortality in developed countries, compared to 9% in developing countries, is due to hypertensive disorders in pregnancy. The etiology of preeclampsia remains unknown, with poorly understood pathophysiology. Magnesium and calcium play an important role in vascular smooth muscle function and therefore a possible role in the development of preeclampsia.Aim: We aimed to compare serum magnesium and total calcium levels of preeclamptic and normal pregnant women at the Korle-Bu Teaching Hospital in Ghana.Patients and methods: A comparative cross-sectional study involving 30 normal pregnant and 30 preeclamptic women with >30 weeks gestation and aged 18–35 years, was conducted at the Korle-Bu Teaching Hospital. Magnesium and calcium were determined using a flame atomic absorption spectrometer.Results: Mean serum magnesium and total calcium levels in preeclamptic women were 0.70±0.15 and 2.13±0.30 mmol/L, respectively. Mean serum magnesium and total calcium levels in normal pregnant women were 0.76±0.14 and 2.13±0.35 mmol/L, respectively. There was a statistically nonsignificant difference in serum magnesium and total calcium in preeclamptic women compared to normal pregnant women, with p-values of 0.092 and 0.972, respectively.Conclusion: Serum magnesium and total calcium, therefore, seem not to differ in preeclamptic women compared to normal pregnant women in Ghana

  2. Support for smoke-free policies in the Cyprus hospitality industry. (United States)

    Lazuras, Lambros; Savva, Christos S; Talias, Michael A; Soteriades, Elpidoforos S


    The present study used attitudinal and behavioural indicators to measure support for smoke-free policies among employers and employees in the hospitality industry in Cyprus. A representative sample of 600 participants (95 % response rate) completed anonymous structured questionnaires on demographic variables, smoking status, exposure to second-hand smoke at work and related health beliefs, social norms, and smoke-free policy support. Participants were predominantly males (68.3 %), with a mean age of 40 years (SD = 12.69), and 39.7 % were employers/owners of the hospitality venue. Analysis of variance showed that employers and smokers were less supportive of smoke-free policies, as compared to employees and non-smokers. Linear regression models showed that attitudes towards smoke-free policy were predicted by smoking status, SHS exposure and related health beliefs, and social norm variables. Logistic regression analysis showed that willingness to confront a policy violator was predicted by SHS exposure, perceived prevalence of smoker clients, and smoke-free policy attitudes. SHS exposure and related health beliefs, and normative factors should be targeted by interventions aiming to promote policy support in the hospitality industry in Cyprus.

  3. Out of Pocket Expenditure for Hospitalization among Below Poverty Line Households in District Solan, Himachal Pradesh, India, 2013. (United States)

    Gupt, Anadi; Kaur, Prabhdeep; Kamraj, P; Murthy, B N


    Health insurance schemes, like Rashtriya Swasthya Bima Yojana (RSBY), should provide financial protection against catastrophic health costs by reducing out of pocket expenditure (OOPE) for hospitalizations. We estimated and compared the proportion and extent of OOPE among below poverty line (BPL) families beneficiaries and not beneficiaries by RSBY during hospitalizations in district Solan, H.P., India, 2013. We conducted a cross sectional survey among hospitalized BPL families in the beneficiaries and non-beneficiaries groups. We compared proportion incurring OOPE and its extent during hospitalization, pre/post-hospitalization periods in different domains. Overall, proportion of non-beneficiaries who incurred OOPE was higher than the beneficiaries but it was not statistically significant (87.2% vs. 80.9%). The median overall OOPE was $39 (Rs 2567) in the non-beneficiaries group as compared to $11 (Rs 713) in the beneficiaries group (p<0.01). Median expenditure on in house and out house drugs and consumables was $23 (Rs 1500) in the non beneficiaries group as compared to nil in the beneficiaries group (p<0.01). Non-beneficiary status was significantly associated [OR: 2.4 (1.3-4.3)] with OOPE above median independently and also after adjusting for various covariates. RSBY has decreased the extent of OOPE among the beneficiaries; however OOPE was incurred mainly due to purchase of drugs from outside the health facility. The treatment seeking behaviour in beneficiaries group has improved among comparatively older group with chronic conditions. RSBY has enabled beneficiaries to get more facilities such as drugs, consumables and diagnostics from the health facility.

  4. Out of Pocket Expenditure for Hospitalization among Below Poverty Line Households in District Solan, Himachal Pradesh, India, 2013.

    Directory of Open Access Journals (Sweden)

    Anadi Gupt

    Full Text Available Health insurance schemes, like Rashtriya Swasthya Bima Yojana (RSBY, should provide financial protection against catastrophic health costs by reducing out of pocket expenditure (OOPE for hospitalizations. We estimated and compared the proportion and extent of OOPE among below poverty line (BPL families beneficiaries and not beneficiaries by RSBY during hospitalizations in district Solan, H.P., India, 2013.We conducted a cross sectional survey among hospitalized BPL families in the beneficiaries and non-beneficiaries groups. We compared proportion incurring OOPE and its extent during hospitalization, pre/post-hospitalization periods in different domains.Overall, proportion of non-beneficiaries who incurred OOPE was higher than the beneficiaries but it was not statistically significant (87.2% vs. 80.9%. The median overall OOPE was $39 (Rs 2567 in the non-beneficiaries group as compared to $11 (Rs 713 in the beneficiaries group (p<0.01. Median expenditure on in house and out house drugs and consumables was $23 (Rs 1500 in the non beneficiaries group as compared to nil in the beneficiaries group (p<0.01. Non-beneficiary status was significantly associated [OR: 2.4 (1.3-4.3] with OOPE above median independently and also after adjusting for various covariates.RSBY has decreased the extent of OOPE among the beneficiaries; however OOPE was incurred mainly due to purchase of drugs from outside the health facility. The treatment seeking behaviour in beneficiaries group has improved among comparatively older group with chronic conditions. RSBY has enabled beneficiaries to get more facilities such as drugs, consumables and diagnostics from the health facility.

  5. A new modelling approach for zooplankton behaviour (United States)

    Keiyu, A. Y.; Yamazaki, H.; Strickler, J. R.

    We have developed a new simulation technique to model zooplankton behaviour. The approach utilizes neither the conventional artificial intelligence nor neural network methods. We have designed an adaptive behaviour network, which is similar to BEER [(1990) Intelligence as an adaptive behaviour: an experiment in computational neuroethology, Academic Press], based on observational studies of zooplankton behaviour. The proposed method is compared with non- "intelligent" models—random walk and correlated walk models—as well as observed behaviour in a laboratory tank. Although the network is simple, the model exhibits rich behavioural patterns similar to live copepods.

  6. The influence of team members on nurses' perceptions of transgressive behaviour in care relationships: A qualitative study. (United States)

    Vandecasteele, Tina; Van Hecke, Ann; Duprez, Veerle; Beeckman, Dimitri; Debyser, Bart; Grypdonck, Maria; Verhaeghe, Sofie


    The aim of this study was to gain insight into the influence of team members in how nurses perceive and address patients' transgressive behaviour. Aggression and transgressive behaviour in health care have been a focus of research over the past few decades. Most studies have focused on individual nurses' experiences with aggression and transgressive behaviour. Literature examining group dynamics in nursing teams and team members' interactions in handling patients' transgressive behaviour is scarce. Qualitative interview study. Seven focus-group interviews and two individual interviews were carried out in 2014-2016. Twenty-four nurses were drawn from eight wards in three general hospitals. Interviews were analysed using the constant comparative method influenced by the grounded theory approach. While elaborating how they perceived and addressed transgressive behaviour, nurses disclosed how interactions with team members occurred. Several patterns arose. Nurses talk to one another, excuse one another, fill in for one another, warn one another and protect and safeguard one another. In these patterns in reaction to patients' transgressive behaviour, implicit group norms transpire, causing nursing teams to acquire their specific identity "as a group". Consequently, these informal group norms in nursing teams impinge how nurses feel threatened by patients' potential transgressive behaviour; gain protection from the group of nurses and conform to informal ward rules. The findings of this study can support intervention strategies aimed at supporting nurses and nursing teams in managing patient aggression and transgressive behaviour by identifying and explicating these group dynamics and team members' interactions. © 2017 John Wiley & Sons Ltd.

  7. Effects of cancer rehabilitation on problem-solving, anxiety and depression : a RCT comparing physical and cognitive-behavioural training versus physical training

    NARCIS (Netherlands)

    Korstjens, Irene; Mesters, Ilse; May, Anne M; van Weert, Ellen; van den Hout, Johanna H C; Ros, Wynand; Hoekstra-Weebers, Josette E H M; van der Schans, Cees; van den Borne, Bart


    We tested the effects on problem-solving, anxiety and depression of 12-week group-based self-management cancer rehabilitation, combining comprehensive physical training (PT) and cognitive-behavioural problem-solving training (CBT), compared with PT. We expected that PT + CBT would outperform PT in

  8. Effects of cancer rehabilitation on problem-solving, anxiety and depression : A RCT comparing physical and cognitive-behavioural training versus physical training

    NARCIS (Netherlands)

    Korstjens, Irene; Mesters, Ilse; May, Anne M.; van Weert, Ellen; van den Hout, Johanna H. C.; Ros, Wynand; Hoekstra-Weebers, Josette E. H. M.; van der Schans, Cees P.; van den Borne, Bart


    We tested the effects on problem-solving, anxiety and depression of 12-week group-based self-management cancer rehabilitation, combining comprehensive physical training (PT) and cognitive-behavioural problem-solving training (CBT), compared with PT. We expected that PT + CBT would outperform PT in

  9. Health-seeking behaviour of human brucellosis cases in rural Tanzania

    Directory of Open Access Journals (Sweden)

    MacMillan Alastair


    Full Text Available Abstract Background Brucellosis is known to cause debilitating conditions if not promptly treated. In some rural areas of Tanzania however, practitioners give evidence of seeing brucellosis cases with symptoms of long duration. The purpose of this study was to establish health-seeking behaviour of human brucellosis cases in rural Tanzania and explore the most feasible ways to improve it. Methods This was designed as a longitudinal study. Socio-demographic, clinical and laboratory data were collected from patients who reported to selected hospitals in rural northern Tanzania between June 2002 and April 2003. All patients with conditions suspicious of brucellosis on the basis of preliminary clinical examination and history were enrolled into the study as brucellosis suspects. Blood samples were taken and tested for brucellosis using the Rose-Bengal Plate Test (RBPT and other agglutination tests available at the health facilities and the competitive ELISA (c-ELISA test at the Veterinary Laboratory Agencies (VLA in the UK. All suspects who tested positive with the c-ELISA test were regarded as brucellosis cases. A follow-up of 49 cases was made to collect data on health-seeking behaviour of human brucellosis cases. Results The majority of cases 87.7% gave a history of going to hospital as the first point of care, 10.2% purchased drugs from a nearby drug shop before going to hospital and 2% went to a local traditional healer first. Brucellosis cases delayed going to hospital with a median delay time of 90 days, and with 20% of the cases presenting to hospitals more than a year after the onset of symptoms. Distance to the hospital, keeping animals and knowledge of brucellosis were significantly associated with patient delay to present to hospital. Conclusion More efforts need to be put on improving the accessibility of health facilities to the rural poor people who succumb to most of the diseases including zoonoses. Health education on brucellosis in

  10. Tracks FAQs: How Do Heart Attack Hospitalization Rates In My Community Compare With Other Counties Or States?

    Centers for Disease Control (CDC) Podcasts

    In this podcast, CDC Tracking experts discuss how to compare heart attack hospitalization rates in your community with other counties or states. Do you have a question for our Tracking experts? Please e-mail questions to

  11. It takes three to tango: Soft budget constraint and cream skimming in the hospital care market


    Levaggi, Rosella; Montefiori, Marcello


    Cream skimming is an illegal behaviour that consists in choosing to treat patients according to their ability to recover. It arises from the use of prospective payment schemes in an asymmetry of information framework. In this context in fact the provider can observe some relevant information (freely or at a cost) before making its effort which will then be used to its own advantage. The paper studies the scope for these types of behaviour in a mixed market for hospital care where the hospital...

  12. Effects of a behaviour change intervention for Girl Scouts on child and parent energy-saving behaviours (United States)

    Boudet, Hilary; Ardoin, Nicole M.; Flora, June; Armel, K. Carrie; Desai, Manisha; Robinson, Thomas N.


    Energy education programmes for children are hypothesized to have great potential to save energy. Such interventions are often assumed to impact child and family behaviours. Here, using a cluster-randomized controlled trial with 30 Girl Scout troops in Northern California, we assess the efficacy of two social cognitive theory-based interventions focused on residential and food-and-transportation energy-related behaviours of Girl Scouts and their families. We show that Girl Scouts and parents in troops randomly assigned to the residential energy intervention significantly increased their self-reported residential energy-saving behaviours immediately following the intervention and after more than seven months of follow-up, compared with controls. Girl Scouts in troops randomly assigned to the food-and-transportation energy intervention significantly increased their self-reported food-and-transportation energy-saving behaviours immediately following the intervention, compared with controls, but not at follow-up. The results demonstrate that theory-based, child-focused energy interventions have the potential to increase energy-saving behaviours among both children and their parents.

  13. [On comparison of hospital performance]. (United States)

    Kjekshus, L E


    The motivation to identify the causes of rising health care cost and variations across providers has intensified in all industrialized countries. These countries have an ongoing debate on efficiency and effectiveness in hospital production. In this debate, national and international comparative studies are important. There are very few international comparative studies that include Norwegian hospitals. Actually we know very little about how Norwegian hospitals are performing compared to others. This paper gives an introduction to comparative studies and to the DEA model which is often used in such studies and also a multilevel model which is not so common. A short review is given of a comparative study of Norwegian and North American hospitals. I also discuss the feasibility of comparative studies of hospitals from the Nordic countries, with references to several comparative studies performed in these countries. Comparative studies are often closely linked to national health politics, policy making and reforms; thus the outcome of such studies is important for the hospitals included. This makes such studies a sensitive field of research. It is important to be aware of the strength and weaknesses of comparative studies and acknowledge their importance beyond the development of new knowledge.

  14. A comparative study of collimation in bedside chest radiography for preterm infants in two teaching hospitals

    International Nuclear Information System (INIS)

    Stollfuss, J.; Schneider, K.; Krüger-Stollfuss, I.


    •Potential factors influencing non-optimal image collimation in the setting of bedside chest X-ray in preterm infants were investigated.•A comparable rate of optimal images was observed in two hospitals.•Size, weight or disease severity had no influence on collimation quality.•Unrelated to the years of experience a large variation of the technician in correct collimation was noted (18–86%).•Individualized quality control and education is necessary. Potential factors influencing non-optimal image collimation in the setting of bedside chest X-ray in preterm infants were investigated. A comparable rate of optimal images was observed in two hospitals. Size, weight or disease severity had no influence on collimation quality. Unrelated to the years of experience a large variation of the technician in correct collimation was noted (18–86%). Individualized quality control and education is necessary. Unnecessary exposure of the abdomen, arms or head may lead to a substantial increase of the radiation dose in portable chest X-rays on the neonatal intensive care unit. The objective was to identify potential factors influencing inappropriate exposure of non-thoracic structures in two teaching hospitals. The study analysed 200 consecutive digital chest radiographs in 20 preterm neonates (mean gestation 25 ± 1 weeks). Demographical data, tube settings and exposure parameters were recorded. To grade the collimation, we used a scoring system with a maximum of 12 exposed non-thoracic structures. Length of gestation, age, the radiographer, years of experience in performing X-rays and the number of in situ catheters or lines, were correlated with collimation quality. There was no significant difference between the rates of optimal images obtained in the two hospitals (0.32 vs 0.39, n.s.). Scores showed that most suboptimal images had only mildly reduced image quality (1.40 ± 1.38 vs 1.20 ± 1.43, n.s.). Length of gestation or presence of surgical drains, catheters and

  15. 'The singing hospital'--integrated group therapy in the Black mentally ill. (United States)

    Benjamin, B


    Integrated group therapy was originally introduced at Sterkfontein Hospital in 1957, and reintroduced 6 years ago in an effort to overcome difficulties in communication with approximately 100 Black male and female mental hospital patients. This therapy consisted mainly of song and dance activation, sociodrama, psychodrama and behavioural modification methods. These techniques are flexible, and can be carried out by proxy therapists working with doctors and psychologists.

  16. Quantum circuit behaviour

    International Nuclear Information System (INIS)

    Poulton, D.


    Single electron tunnelling in multiply connected weak link systems is considered. Using a second quantised approach the tunnel current, in both normal and superconducting systems, using perturbation theory, is derived. The tunnel currents are determined as a function of an Aharanov-Bohm phase (acquired by the electrons). Using these results, the multiply connected system is then discussed when coupled to a resonant LC circuit. The resulting dynamics of this composite system are then determined. In the superconducting case the results are compared and contrasted with flux mode behaviour seen in large superconducting weak link rings. Systems in which the predicted dynamics may be seen are also discussed. In analogy to the electron tunnelling analysis, the tunnelling of magnetic flux quanta through the weak link is also considered. Here, the voltage across the weak link, due to flux tunnelling, is determined as a function of an externally applied current. This is done for both singly and multiply connected flux systems. The results are compared and contrasted with charge mode behaviour seen in superconducting weak link systems. Finally, the behaviour of simple quantum fluids is considered when subject to an external rotation. Using a microscopic analysis it is found that the microscopic quantum behaviour of the particles is manifest on a macroscopic level. Results are derived for bosonic, fermionic and BCS pair-type systems. The connection between flux quantisation in electromagnetic systems is also made. Using these results, the dynamics of such a quantum fluid is considered when coupled to a rotating torsional oscillator. The results are compared with those found in SQUID devices. A model is also presented which discusses the possible excited state dynamics of such a fluid. (author)

  17. Compare Clinical Competence and Job Satisfaction Among Nurses Working in Both University and Non-University Hospital in Bushehr 2015

    Directory of Open Access Journals (Sweden)

    Abdolrasoul Abbasi


    Full Text Available Background: Nurses are the biggest component of the health care system in the world and their job satisfaction and clinical competence affect performance and success of the organization. This study aimed to determine and compare the clinical competence and job satisfaction of nurses in both academic and non-academic hospitals in Bushehr in 2015. Materials & Methods: In this cross-sectional study, 257 nurses were studied in two hospitals of Bushehr city selected by census method. Data was collected by using valid and reliable Nurse Clinical Competence and Job Satisfaction Inventory questionnaires. Data analyzed by using SPSS- 21, and descriptive statistics, t-test, and ANOVA and Pearson correlation coefficient. Statistical significance was set at P< 0.05. Results: Findings showed that there were no significant diffrences between academic hospital nurses' job satisfaction with 126.96±29.34 and non-academic hospital with 128.31±23.26. Also, there were a significant diffrences between total score of nurses' clinical competence in academic hospital 62.18±18.09 and in non-academic hospital 67.78±17.64. There were a significant and direct association between the clinical competence and job satisfaction of nurses in both hospitals (p≤0.05. Conclusion: Although nurses clinical competence and job satisfaction in both hospitals were assessed at desirable level but both criteria were higher in non-university hospital nurses. It is nessessary that Nurse Manager’s of academic hospitals should pay attention to assessment and improvement of nurse clinical competence and job satisfaction

  18. Developmental and behavioural problems in children with severe acute malnutrition in Malawi: A cross–sectional study (United States)

    van den Heuvel, Meta; Voskuijl, Wieger; Chidzalo, Kate; Kerac, Marko; Reijneveld, Sijmen A; Bandsma, Robert; Gladstone, Melissa


    Background Early childhood development provides an important foundation for the development of human capital. Although there is a clear relation between stunting and child development outcomes, less information is available about the developmental and behavioural outcomes of children with severe acute malnutrition (SAM). Particularly an important research gap exists in Sub–Saharan Africa where there is a high prevalence of SAM and a high rate of co–occurring HIV (human immune deficiency virus) infection. Our first objective was to assess the prevalence and severity of developmental and behavioural disorders on a cohort of children admitted to an inpatient nutritional rehabilitation centre in Malawi. Our second objective was to compare the developmental and behavioural profiles of children with the two main phenotypes of SAM: kwashiorkor and marasmus. Methods This was a cross–sectional observational study including all children hospitalized with complicated SAM in Blantyre, Malawi over an 8–month period from February to October 2015. At discharge, children were assessed with the well-validated Malawi Developmental Assessment Tool (MDAT) for gross motor, fine motor, language and social development. In children ≥24 months, emotional and behavioural problems were measured using the Strengths and Difficulties Questionnaire (SDQ). Results 150 children (55% boys) with SAM were recruited; mean age of 27.2 months (standard deviation 17.9), 27 children (18%) had pre–existing neurodisabilities (ND) and 34 (23%) had a co–occurring human immune deficiency virus (HIV) infection. All children with SAM experienced profound delays in the gross and fine motor, language and social domains. Linear regression analysis demonstrated that children with kwashiorkor scored 0.75 standard deviations lower (95% confidence interval –1.43 to –0.07) on language MDAT domain than children with marasmus when adjusted for covariates. The prosocial behaviour score of the SDQ was low

  19. Comparative Analysis of Direct Hospital Care Costs between Aseptic and Two-Stage Septic Knee Revision (United States)

    Kasch, Richard; Merk, Sebastian; Assmann, Grit; Lahm, Andreas; Napp, Matthias; Merk, Harry; Flessa, Steffen


    Background The most common intermediate and long-term complications of total knee arthroplasty (TKA) include aseptic and septic failure of prosthetic joints. These complications cause suffering, and their management is expensive. In the future the number of revision TKA will increase, which involves a greater financial burden. Little concrete data about direct costs for aseptic and two-stage septic knee revisions with an in depth-analysis of septic explantation and implantation is available. Questions/Purposes A retrospective consecutive analysis of the major partial costs involved in revision TKA for aseptic and septic failure was undertaken to compare 1) demographic and clinical characteristics, and 2) variable direct costs (from a hospital department’s perspective) between patients who underwent single-stage aseptic and two-stage septic revision of TKA in a hospital providing maximum care. We separately analyze the explantation and implantation procedures in septic revision cases and identify the major cost drivers of knee revision operations. Methods A total of 106 consecutive patients (71 aseptic and 35 septic) was included. All direct costs of diagnosis, surgery, and treatment from the hospital department’s perspective were calculated as real purchase prices. Personnel involvement was calculated in units of minutes. Results Aseptic versus septic revisions differed significantly in terms of length of hospital stay (15.2 vs. 39.9 days), number of reported secondary diagnoses (6.3 vs. 9.8) and incision-suture time (108.3 min vs. 193.2 min). The management of septic revision TKA was significantly more expensive than that of aseptic failure ($12,223.79 vs. $6,749.43) (p costs of explantation stage ($4,540.46) were lower than aseptic revision TKA ($6,749.43) which were again lower than those of the septic implantation stage ($7,683.33). All mean costs of stays were not comparable as they differ significantly (p cost drivers were the cost of the implant and

  20. Nonverbal expressive behaviour in schizophrenia and social phobia. (United States)

    Del-Monte, Jonathan; Raffard, Stéphane; Salesse, Robin N; Marin, Ludovic; Schmidt, Richard C; Varlet, Manuel; Bardy, Benoît G; Philippe Boulenger, Jean; Christine Gély-Nargeot, Marie; Capdevielle, Delphine


    Expressive behaviour plays a crucial role in the success of social interactions. Abnormality of expressive behaviour has been reported in interpersonal interactions of patients suffering from schizophrenia and social phobia, two debilitating mental disorders with important social deficits. However, no study has compared the expressive behaviour in these two disorders. Thirty schizophrenia patients, 21 social phobia patients and 30 healthy controls were evaluated and compared on expressive, cognitive and clinical dimensions. Expressive behaviour was assessed using the Motor Affective subscale of the Motor-Affective-Social-Scale (MASS). Covariables include the Positive and Negative Syndrome Scale (PANSS), the anxiety level Liebowitz-Social-Anxiety-Scale (LSAS) and cognitive tasks. After controlling for depression, schizophrenia and social phobia patients both exhibited significantly fewer expressive behaviours compared to healthy controls. Moreover, our results showed specific signatures: schizophrenia patients performed fewer spontaneous gestures (hand gestures and smiles) whereas social phobia patients had an impaired ability to produce voluntary smiles in comparison to healthy controls. Interestingly, poor social functioning was significantly correlated with a decrease of expressive behaviour for schizophrenia patients. Expressive behaviour is impaired in different ways in social phobia and schizophrenia and is associated in schizophrenia with poorer social functioning. The Motor Affective subscale of the MASS is an interesting tool for assessing the dysfunction of interpersonal expressive behaviour in mental disorders. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  1. A budget impact analysis comparing use of a modern fecal management system to traditional fecal management methods in two canadian hospitals. (United States)

    Langill, Mike; Yan, Songkai; Kommala, Dheerendra; Michenko, Michael


    Research suggests that fecal management systems (FMS) offer advantages, including potential cost savings, over traditional methods of caring for patients with little or no bowel control and liquid or semi-liquid stool. A budget impact model accounting for material costs of managing fecal incontinence was developed, and 1 year of experiential data from two hospitals' ICUs were applied to it. Material costs were estimated for traditional methods (ie, use of absorbent briefs/pads, skin cleansers, moisturizers) and compared with material costs of using a modern FMS for both average (normal-range weight) and complex (bariatric with wounds) ICU patients at hospital 1 and any ICU patient at hospital 2. Reductions in daily material costs per ICU patient using FMS versus traditional methods were reported by hospital 1 ($93.74 versus $143.89, average patient; $150.55 versus $476.41, complex patient) and by hospital 2 ($61.15 versus $104.85 per patient). When extrapolated to the total number of patients expected to use FMS at each institution, substantial annual cost savings were projected (hospital 1: $57,216; hospital 2: $627,095). In addition, total nursing time per day for managing fecal incontinence (ie, changing, cleaning, repositioning patients, changing pads, linens, and the like) was estimated at hospital 1, showing substantial reductions with FMS (120 minutes versus 348 minutes for average patients; 240 minutes versus 760 minutes for complex). Nursing time was not included in cost calculations to keep the analysis conservative. Results of this study suggest the materials cost of using the FMS in ICU patients was substantially lower than the cost of traditional fecal incontinence management protocols of care in both hospitals. Comparative studies using patient level data, materials, and nursing time costs, as well as complication rates, are warranted.

  2. Planned home compared with planned hospital births: Mode of delivery and Perinatal mortality rates, an observational study

    NARCIS (Netherlands)

    Kooy, J. (Jacoba); E. Birnie (Erwin); S. Denktaş (Semiha); E.A.P. Steegers (Eric); G.J. Bonsel (Gouke)


    textabstractBackground: To compare the mode of delivery between planned home versus planned hospital births and to determine if differences in intervention rates could be interpreted as over- or undertreatment. Methods: Intervention and perinatal mortality rates were obtained for 679,952 low-risk

  3. Communication and Low Mood (CALM): a randomized controlled trial of behavioural therapy for stroke patients with aphasia. (United States)

    Thomas, Shirley A; Walker, Marion F; Macniven, Jamie A; Haworth, Helen; Lincoln, Nadina B


    The aim was to evaluate behavioural therapy as a treatment for low mood in people with aphasia. A randomized controlled trial comparing behavioural therapy plus usual care with a usual care control. Potential participants with aphasia after stroke were screened for the presence of low mood. Those who met the criteria and gave consent were randomly allocated. Participants were recruited from hospital wards, community rehabilitation, speech and language therapy services and stroke groups. Of 511 people with aphasia identified, 105 had low mood and were recruited. Behavioural therapy was offered for up to three months. Outcomes were assessed three and six months after random allocation. Stroke Aphasic Depression Questionnaire, Visual Analog Mood Scales 'sad' item, and Visual Analogue Self-Esteem Scale. Participants were aged 29 to 94 years (mean 67.0, SD 13.5) and 66 (63%) were men. Regression analysis showed that at three months, when baseline values and communication impairment were controlled for, group allocation was a significant predictor of the Stroke Aphasic Depression Questionnaire (P aphasia.

  4. Impact of knowledge oriented leadership on knowledge management behaviour through employee work attitudes.


    Shamim, S.; Cang, Shuang; Yu, Hongnian


    Despite the acknowledged importance of knowledge management (KM), many employees avoid practicing KM at the individual level. This avoidance often leads to loss of the intellectual capital due to employee turnover. Many potential behavioural remedies are still untapped in the existing literature. This study extends the construct of knowledge oriented leadership (KOL) and examines its role in predicting KM behaviour among employees of the hospitality sector, at the individual level. It also in...

  5. Emission of biocides from hospitals: comparing current survey results with European Union default values. (United States)

    Tluczkiewicz, Inga; Bitsch, Annette; Hahn, Stefan; Hahn, Torsten


    Under the European Union (EU) Biocidal Products Directive 98/8/EC, comprehensive evaluations on substances of the Third Priority List were conducted until 31 July 2007. This list includes, among other categories, disinfectants for human hygiene (e.g., skin and surface disinfection). For environmental exposure assessment of biocides, the EU emission scenarios apply. Currently available default values for disinfectants are based on consumption data from not more than 8 hospitals and were originally assembled for other purposes. To revalidate these default values, a survey on annual consumption data was performed in 27 German hospitals. These data were analyzed to provide consumption data per bed and day and per nurse and day for particular categories of active ingredients and were compared with default values from the EU emission scenario documents. Although several deviations were detected, an overall acceptable correspondence between Emission Scenario Documents default values and the current survey data was found. (c) 2009 SETAC

  6. The importance of early anti-social behaviour among men with a schizophrenia spectrum disorder in a specialist forensic psychiatry hospital unit in Denmark

    DEFF Research Database (Denmark)

    Pedersen, Liselotte; Rasmussen, Kirsten; Elsass, Peter


    People with a major mental disorder are at increased risk of committing crimes, especially violent crimes, compared with the general population. Sub-groups have been identified based on age of onset of anti-social or violent behaviour. Mentally disordered offenders with early onset anti-social...

  7. Behavioural social choice: a status report. (United States)

    Regenwetter, Michel; Grofman, Bernard; Popova, Anna; Messner, William; Davis-Stober, Clintin P; Cavagnaro, Daniel R


    Behavioural social choice has been proposed as a social choice parallel to seminal developments in other decision sciences, such as behavioural decision theory, behavioural economics, behavioural finance and behavioural game theory. Behavioural paradigms compare how rational actors should make certain types of decisions with how real decision makers behave empirically. We highlight that important theoretical predictions in social choice theory change dramatically under even minute violations of standard assumptions. Empirical data violate those critical assumptions. We argue that the nature of preference distributions in electorates is ultimately an empirical question, which social choice theory has often neglected. We also emphasize important insights for research on decision making by individuals. When researchers aggregate individual choice behaviour in laboratory experiments to report summary statistics, they are implicitly applying social choice rules. Thus, they should be aware of the potential for aggregation paradoxes. We hypothesize that such problems may substantially mar the conclusions of a number of (sometimes seminal) papers in behavioural decision research.

  8. Job satisfaction among hospital doctors in Norway and Germany. A comparative study on national samples. (United States)

    Rosta, Judith; Nylenna, Magne; Aasland, Olaf G


    To compare German and Norwegian hospital doctors on 10 different aspects of job satisfaction and general life satisfaction. The study population consisted of a representative sample of 1,448 German and 484 Norwegian hospital doctors aged 33-65 years (n = 1,932), selected from nationwide postal surveys in 2006. The questionnaires contained items on subjective life satisfaction and the validated 10-item Job Satisfaction Scale. Each item was scored on a seven-point Likert scale from 1 (very dissatisfied) to 7 (very satisfied). A mean sum score was calculated, ranging from 1 to 7. Regression analyses and generalized-linear-model-estimated means controlled for age and gender with 95% confidence intervals were used for comparison. Norwegian hospital doctors had significantly higher life satisfaction (mean 5.31 vs. 5.15) and job satisfaction (mean 5.09 vs. 4.55) than their German colleagues. Item by item, doctors in Norway were significantly more content with seven aspects of their work: "Freedom to choose your own methods of working'' (mean 5.00 vs. 4.72), "opportunities to use your skills'' (mean 5.49 vs. 5.01), "physical working conditions'' (mean 4.62 vs. 4.08), "recognition you get for good achievements'' (mean 4.83 vs. 4.26), "overall job situation'' (mean 5.57 vs. 4.64), "work hours'' (mean 4.39 vs. 3.39), "ate of pay'' (mean 4.70 vs. 3.70). General life satisfaction and age, but not gender, were positively associated with job satisfaction in both countries. Norwegian hospital doctors enjoy a higher level of life and job satisfaction than German hospital doctors. The most likely reasons for this are more acceptable work hours, salary and control over clinical work in Norway.

  9. Impact of a hospital improvement initiative in Bangladesh on patient experiences and satisfaction with services: two cross-sectional studies

    Directory of Open Access Journals (Sweden)

    Omer Khalid


    Full Text Available Abstract Background The Bangladesh government implemented a pilot Hospital Improvement Initiative (HII in five hospitals in Sylhet division between 1998 and 2003. This included management and behaviour change training for staff, waste disposal and procurement, and referral arrangements. Two linked cross-sectional surveys in 2000 and 2003 assessed the impact of the HII, assessing both patients' experience and satisfaction and public views and use of the hospitals. Methods In each survey we asked 300 consecutive outpatients and a stratified random sample of 300 inpatients in the five hospitals about waiting and consultation time, use of an agent for admission, and satisfaction with privacy, cleanliness, and staff behaviour. The field teams observed cleanliness and privacy arrangements, and visited a sample of households in communities near the hospitals to ask about their opinions and use of the hospital services. Analysis examined changes over time in patients' experience and views. Multivariate analysis took account of other variables potentially associated with the outcomes. Survey managers discussed the survey findings with gender stratified focus groups in each sample community. Results Compared with 2000, an outpatient in three of the hospitals in 2003 was more likely to be seen within 10 minutes and for at least five minutes by the doctor, but outpatients were less likely to report receiving all the prescribed medicines from the hospital. In 2003, inpatients were more likely to have secured admission without using an agent. Although patients’ satisfaction with several aspects of care improved, most changes were not statistically significant. Households in 2003 were significantly more likely to rate the hospitals as good than in 2000. Use of the hospitals did not change, except that more households used the medical college hospital for inpatient care in 2003. Focus groups confirmed criticisms of services and suggested improvements

  10. Monte Carlo Simulations Comparing Fisher Exact Test and Unequal Variances t Test for Analysis of Differences Between Groups in Brief Hospital Lengths of Stay. (United States)

    Dexter, Franklin; Bayman, Emine O; Dexter, Elisabeth U


    We examined type I and II error rates for analysis of (1) mean hospital length of stay (LOS) versus (2) percentage of hospital LOS that are overnight. These 2 end points are suitable for when LOS is treated as a secondary economic end point. We repeatedly resampled LOS for 5052 discharges of thoracoscopic wedge resections and lung lobectomy at 26 hospitals. Unequal variances t test (Welch method) and Fisher exact test both were conservative (ie, type I error rate less than nominal level). The Wilcoxon rank sum test was included as a comparator; the type I error rates did not differ from the nominal level of 0.05 or 0.01. Fisher exact test was more powerful than the unequal variances t test at detecting differences among hospitals; estimated odds ratio for obtaining P < .05 with Fisher exact test versus unequal variances t test = 1.94, with 95% confidence interval, 1.31-3.01. Fisher exact test and Wilcoxon-Mann-Whitney had comparable statistical power in terms of differentiating LOS between hospitals. For studies with LOS to be used as a secondary end point of economic interest, there is currently considerable interest in the planned analysis being for the percentage of patients suitable for ambulatory surgery (ie, hospital LOS equals 0 or 1 midnight). Our results show that there need not be a loss of statistical power when groups are compared using this binary end point, as compared with either Welch method or Wilcoxon rank sum test.

  11. How Does Patient Safety Culture in the Surgical Departments Compare to the Rest of the County Hospitals in Xiaogan City of China? (United States)

    Wang, Manli; Tao, Hongbing


    Objectives : Patient safety culture affects patient safety and the performance of hospitals. The Hospital Survey on Patient Safety Culture (HSOPSC) is generally used to assess the safety culture in hospitals and unit levels. However, only a few studies in China have measured surgical settings compared with other units in county hospitals using the HSOPSC. This study aims to assess the strengths and weaknesses of surgical departments compared with all other departments in county hospitals in China with HSOPSC. Design : This research is a cross-sectional study. Methods : In 2015, a Chinese translation of HSOPSC was administered to 1379 staff from sampled departments from 19 county hospitals in Xiaogan City (Hubei Province, China) using a simple random and cluster sampling method. Outcome Measures : The HSOPSC was completed by 1379 participants. The percent positive ratings (PPRs) of 12 dimensions (i.e., teamwork within units, organizational learning and continuous improvement, staffing, non-punitive response to errors, supervisor/ manager expectations and actions promoting patient safety, feedback and communication about errors, communication openness, hospital handoffs and transitions, teamwork across hospital units, hospital management support for patient safety, overall perception of safety, as well as frequency of events reported) and the positive proportion of outcome variables (patient safety grade and number of events reported) between surgical departments and other departments were compared with t -tests and X² tests, respectively. A multiple regression analysis was conducted, with the outcome dimensions serving as dependent variables and basic characteristics and other dimensions serving as independent variables. Similarly, ordinal logistic regression was used to explore the influencing factors of two categorical outcomes. Results : A total of 56.49% of respondents were from surgical departments. The PPRs for "teamwork within units" and "organizational

  12. Comparing variation in hospital rates of cesarean delivery among low-risk women using 3 different measures. (United States)

    Armstrong, Joanne C; Kozhimannil, Katy B; McDermott, Patricia; Saade, George R; Srinivas, Sindhu K


    This report describes the development of a measure of low-risk cesarean delivery by the Society for Maternal-Fetal Medicine (SMFM). Safely lowering the cesarean delivery rate is a priority for maternity care clinicians and health care delivery systems. Therefore, hospital quality assurance programs are increasingly tracking cesarean delivery rates among low-risk pregnancies. Two commonly used definitions of "low risk" are available, the Joint Commission (JC) and the Agency for Healthcare Research and Quality (AHRQ) measures, but these measures are not clinically comprehensive. We sought to refine the definition of the low-risk cesarean delivery rate to enhance the validity of the metric for quality measurement. We created this refined definition-called the SMFM definition-and compared it to the JC and AHRQ measures using claims-based data from the 2011 Nationwide Inpatient Sample of >863,000 births in 612 hospitals. Using these definitions, we calculated means and interquartile ranges (25th-75th percentile range) for hospital low-risk cesarean delivery rates, stratified by hospital size, teaching status, urban/rural location, and payer mix. Across all hospitals, the mean low-risk cesarean delivery rate was lowest for the SMFM definition (12.65%), but not substantially different from the JC and AHRQ measures (13.12% and 13.29%, respectively). We empirically examined the SMFM definition to ensure its validity and utility. This refined definition performs similarly to existing measures and has the added advantage of clinical perspective, enhanced face validity, and ease of use. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Science Teachers' Information Processing Behaviours in Nepal: A Reflective Comparative Study (United States)

    Acharya, Kamal Prasad


    This study examines the investigation of the information processing behaviours of secondary level science teachers. It is based on the data collected from 50 secondary level school science teachers working in Kathmandy valley. The simple random sampling and the Cognitive Style Inventory have been used respectively as the technique and tool to…

  14. Education in geriatric medicine for community hospital staff.

    LENUS (Irish Health Repository)

    O'Hanlon, Shane


    Community hospitals provide many services for older people. They are mainly managed by nursing staff, with some specialist input. Little is known about education provided in these facilities. Most education in geriatric medicine is provided in hospitals, despite most elderly care being provided in the community. The authors surveyed senior nursing staff in Irish community hospitals to examine this area in more detail. Staff in all 18hospitals in the Health Service Executive (South) area were invited to participate. The response rate was 100%. Sixteen of the 18 respondents (89%) felt staff did not have enough education in geriatric medicine. Just over half of hospitals had regular staff education sessions in the area, with a minority of sessions led by a geriatrician, and none by GPs. Geriatrician visits were valued, but were requested only every 1-3 months. Staff identified challenging behaviour and dementia care as the areas that posed most difficulty.

  15. The importance of early anti-social behaviour among men with a schizophrenia spectrum disorder in a specialist forensic psychiatry hospital unit in Denmark

    DEFF Research Database (Denmark)

    Pedersen, Liselotte; Rasmussen, Kirsten; Elsass, Peter


    People with a major mental disorder are at increased risk of committing crimes, especially violent crimes, compared with the general population. Sub-groups have been identified based on age of onset of anti-social or violent behaviour. Mentally disordered offenders with early onset anti-social be...

  16. Estudo comparativo das indicações de cesariana entre um hospital público-universitário e um hospital privado Comparative study of cesarean section indications between a public university hospital and a private hospital

    Directory of Open Access Journals (Sweden)

    Renato Humberto Fabri


    Full Text Available OBJETIVOS: analisar a incidência e as indicações de cesariana realizadas no Hospital Escola da Falculdade de Medicina do Triângulo Mineiro e um hospital privado, ambos localizados em Uberaba, Minas Gerais, Brasil. MÉTODOS: trata-se de estudo transversal desenvolvido a partir da coleta nos prontuários dos hospitais, consistindo da idade, procedência, situação conjugal, escolaridade, paridade e indicações de cesariana. RESULTADOS: a incidência de cesariana foi de 24,3% no Hospital Escola contra 89,2% no hospital privado. As indicações mais freqüentes de cesariana no Hospital Escola foram a cesárea iterativa (26,7%, distócia (22,4% e o sofrimento fetal agudo (18,2%, e no hospital privado foram cesárea iterativa (36% e distócia (36%. As pacientes do hospital privado tinham maior escolaridade. CONCLUSÕES: os dados sugerem que o aumento de cesarianas no hospital privado foi decorrente de iteratividade, distócia e a escolaridade mais elevada das pacientes.OBJECTIVES: to analyse the incidence and the indications of cesarean section performed in the University Hospital of the "Triângulo Mineiro Faculty of Medicine " and a private hospital in Uberaba, Minas Gerais, Brazil. METHODS: a cross sectional study was carried out by using the data source of the medical files from both hospitals consisting of patient age, place of origin, marital status, education level, parity and cesarean sections indications. RESULTS: the cesarean sections rate was 24,3 % (325 of 1.441 births at the university hospital against 89,2% (100 of 112 births of the private hospital. The most frequent indications in the University Hospital were previous cesarean sections (26,7%, dystocia (22,4% and acute fetal distress (18,2%. In the private hospital, indications were previous cesarean section (36% and dystocia (36%. The private hospital's patients had higher education levels. CONCLUSIONS: the higher rate of cesarean sections observed in the private hospital

  17. Inhibited attachment behaviour and disinhibited social engagement behaviour as relevant concepts in referred home reared children. (United States)

    Scheper, F Y; Abrahamse, M E; Jonkman, C S; Schuengel, C; Lindauer, R J L; de Vries, A L C; Doreleijers, T A H; Jansen, L M C


    Disorders of attachment and social engagement have mainly been studied in children, reared in institutions and foster care. There are few studies amongst home reared children living with biological parents. The aim of this study was to test the clinical significance of inhibited attachment behaviour and disinhibited social engagement behaviour in young home reared children, referred for treatment of emotional and behavioural problems, compared with young children in treatment foster care. The Disturbances of Attachment Interview, Maltreatment Classification System, the Child Behaviour Checklist and Parenting Stress Index were used in 141 referred home reared children and 59 referred foster children, aged 2.0-7.9 years (M = 4.7, SE = 1.3), 71% boys. Inhibited attachment behaviour was less prevalent in the referred home reared group (9%) than in the foster care group (27%). Disinhibited social engagement behaviour was found in 42% of the home reared group, similar to the foster care group. Inhibited attachment behaviour and disinhibited social engagement behaviour were not associated with child maltreatment. More inhibited attachment behaviour was associated with clinical levels of child internalizing and externalizing behaviour in the home reared group, not in the foster care group. In both groups, more disinhibited social engagement behaviour was associated with clinical levels of externalizing behaviour and with more parenting stress. Even without evident links to maltreatment, results of this study suggest clinical significance of inhibited attachment behaviour and disinhibited social engagement behaviour in young home reared children referred for treatment of emotional and behavioural problems. © 2016 John Wiley & Sons Ltd.

  18. Comparing hospital outcomes between open and closed tibia fractures treated with intramedullary fixation. (United States)

    Smith, Evan J; Kuang, Xiangyu; Pandarinath, Rajeev


    Tibial shaft fractures comprise a large portion of operatively treated long bone fractures, and present with the highest rate of open injuries. Intramedullary fixation has become the standard of care for both open and closed injuries. The rates of short term complications and hospital length of stay for open and closed fractures treated with intramedullary fixation is not fully known. Previous series on tibia fractures were performed at high volume centers, and data were not generalizable, further they did not report on length of stay and the impact of preoperative variables on infections, complications and reoperation. We used a large surgical database to compare these outcomes while adjusting for preoperative risk factors. Data were extracted from the ACS-NSQIP database from 2005 to 2014. Cases were identified based on CPT codes for intramedullary fixation and categorized as closed vs open based on ICD9 code. In addition to demographic and case data, primary analysis examined correlation between open and closed fracture status with infection, complications, reoperation and hospital length of stay. Secondary analysis examined preoperative variables including gender, race, age, BMI, and diabetes effect on outcomes. There were 272 cases identified. There were no significant demographic differences between open and closed tibia fracture cases. Open fracture status did not increase the rate of infection, 30day complications, reoperation, or length of stay. The only preoperative factor that correlated with length of stay was age. There was no correlation between BMI, presence of insulin dependent and nondependent diabetes, and any outcome measure. When considering the complication rates for open and closed tibial shaft fractures treated with intramedullary fixation, there is no difference between 30-day complication rate, length of stay, or return to the operating room. Our reported postoperative infection rates were comparable to previous series, adding validity to

  19. Aggressive Behaviour and Mental Illness: A Study of in-patients at ...

    African Journals Online (AJOL)

    To determine the magnitude and pattern of aggressive behaviour among psychiatric in-patients and identity associated socio-demographic and clinical factors. The studywas cross-sectional in design. Among patients admitted to theNeuro-psychiatricHospital, Aro (and its Lantoro annex), Abeokuta between January 1 to ...

  20. Behaviour Problems in Children with Congenital Heart Disease

    Directory of Open Access Journals (Sweden)

    Beena Johnson


    Full Text Available As more children survive with congenital heart diseases, management of their behavioural problems are becoming increasingly important. In this article we aim to review the current status of knowledge on this aspect. Children with congenital heart diseases have more behavioural problems compared to children without chronic illnesses. Behavioural problems in children can be classified into externalizing behaviours and internalizing behaviours. Externalizing behaviours are marked by defiance, impulsivity, hyperactivity, disruptiveness, aggression and antisocial features. Internalizing behaviours are evidenced by withdrawal, dysphoria and anxiety. Boys with congenital heart diseases have more externalizing problems compared to girls. Preoperative hypoxia as well as peri and postoperative cardiocirculatory insufficiency can lead to internalizing and externalizing behavioral problems in future. High treatment intensity and palliative interventions are associated with poor behavioral outcomes. Children who underwent open heart surgery at very young age are prone to develop attention-deficit hyperactivity disorder on reaching school age. A comprehensive approach in this field is essential, so that effective early interventions and guidance can be planned.

  1. Behavioural development in children of divorce and remarriage. (United States)

    Pagani, L; Boulerice, B; Tremblay, R E; Vitaro, F


    We employed an autoregressive modelling technique with data from the Québec Longitudinal Study to prospectively examine the developmental impact of family transition on behaviour while controlling for predivorce and preremarriage effects. Teachers rated children's anxious, hyperactive, physically aggressive, oppositional, and prosocial behaviour every 2 years from kindergarten through to the end of elementary school. Once individual and parental characteristics and antecedent family events were controlled, children who experienced parental divorce before age 6 exhibited comparatively more behavioural disturbance than their peers whose parents divorced later. With the exception of a protective effect on hyperactive behaviour, remarriage did not have a significant impact on children's behaviour when the legacy of divorce was controlled. Although the results suggest that children of divorced parents show difficulty in many areas of functioning, the effects of family transition on behavioural development were dependent on the child's age and the specific behavioural dimension assessed. Compared to other points in development, early childhood divorce was associated with long-term increases in anxious, hyperactive, and oppositional behaviour during later childhood. The effects of divorce on children's fighting were short-lived. Unlike previous prospective studies that suggest predivorce effects, we did not observe behavioural disturbance prior to divorce or remarriage.

  2. The comparative economic performance of investor-owned chain and not-for-profit hospitals. (United States)

    Watt, J M; Derzon, R A; Renn, S C; Schramm, C J; Hahn, J S; Pillari, G D


    We examined the differences in the economic performance of 80 matched pairs of investor-owned chain and not-for-profit hospitals in eight states during 1978 and 1980, and considered how their operating strategies might affect their relative success in a more price-conscious market. We found that total charges (adjusted for case mix) and net revenues per case were both significantly higher in the investor-owned chain hospitals, mainly because of higher charges for ancillary services; there were no significant differences between the two groups of hospitals in regard to patient-care costs per case (adjusted for case mix), but the investor-owned hospitals had significantly higher administrative overhead costs; investor-owned hospitals were more profitable; investor-owned hospitals had fewer employees per occupied bed but paid more per employee; investor-owned hospitals had funded more of their capital through debt and had significantly higher capital costs in proportion to their operating costs; and the two groups did not differ in patient mix, as measured by their Medicare case-mix indexes or the proportions of their patients covered by Medicare or Medicaid. We conclude that investor-owned chain hospitals generated higher profits through more aggressive pricing practices rather than operating efficiencies - a result not unexpected in view of past cost-based reimbursement policies. Recent changes in these policies are creating new pressures for cost control and moderation in charges, to which both types of hospitals must adapt. Neither type has a clear-cut advantage in the ability to make the necessary changes.

  3. Brief report: Aggressive challenging behaviour in adults with intellectual disability following community resettlement. (United States)

    Bhaumik, S; Watson, J M; Devapriam, J; Raju, L B; Tin, N N; Kiani, R; Talbott, L; Parker, R; Moore, L; Majumdar, S K; Ganghadaran, S K; Dixon, K; Das Gupta, A; Barrett, M; Tyrer, F


    Aggressive challenging behaviour is common in adults with intellectual disability (ID) in long-term care facilities. The government's commitment to the closure of all facilities in England has led to concerns over how to manage this behaviour in the community. The aim of this study was to assess changes in aggressive challenging behaviour and psychotropic drug use in adults with ID following resettlement using a person-centred approach. The Modified Overt Aggression Scale was administered to carers of 49 adults with ID prior to discharge from a long-stay hospital and 6 months and 1 year after community resettlement. All areas of aggressive challenging behaviour reduced significantly between baseline and 6 months following resettlement (P < 0.001). This reduction remained (but did not decrease further) at 1-year follow-up. Further work is needed to evaluate the role of environmental setting on aggressive challenging behaviour in adults with ID.

  4. Coping styles relate to health and work environment of Norwegian and Dutch hospital nurses : A comparative study

    NARCIS (Netherlands)

    Schreuder, Jolanda A. H.; Roelen, Corne A. M.; Groothoff, Johan W.; van der Klink, Jac J. L.; Mageroy, Nils; Pallesen, Stale; Bjorvatn, Bjorn; Moen, Bente E.


    Nurses exposed to high nursing stress report no health complaints as long as they have high coping abilities. The purpose of this study was to investigate coping styles in relation to the health status and work environment of Norwegian and Dutch hospital nurses. This comparative study included a

  5. Environmentally friendly health care food services: a survey of beliefs, behaviours, and attitudes. (United States)

    Wilson, Elisa D; Garcia, Alicia C


    There is increasing global interest in sustainability and the environment. A hospital/health care food service facility consumes large amounts of resources; therefore, efficiencies in operation can address sustainability. Beliefs, attitudes, and behaviours about environmentally friendly practices in hospital/health care food services were explored in this study. Questionnaires addressed environmentally friendly initiatives in building and equipment, waste management, food, and non-food procurement issues. The 68 participants included hospital food service managers, clinical dietitians, dietary aides, food technicians, and senior management. Data analysis included correlation analysis and descriptive statistics. Average scores for beliefs were high in building and equipment (90%), waste management (94%), and non-food procurement (87%), and lower in food-related initiatives (61%) such as buying locally, buying organic foods, buying sustainable fish products, and reducing animal proteins. Average positive scores for behaviours were positively correlated with beliefs (waste management, p=0.001; food, p=0.000; non-food procurement, p=0.002). Average positive scores for attitude in terms of implementing the initiatives in health care were 74% for building and equipment, 81% for waste management, 70% for non-food procurement, and 36% for food. The difference in food-related beliefs, behaviours, and attitudes suggests the need for education on environmental impacts of food choices. Research is recommended to determine facilitators and barriers to the implementation of green strategies in health care. As food experts, dietitians can lead changes in education, practice, and policy development.

  6. Stressful life events in childhood and risk of infectious disease hospitalization. (United States)

    Nielsen, Nete Munk; Hansen, Anne Vinkel; Simonsen, Jacob; Hviid, Anders


    Individuals exposed to high levels of stress might have an increased risk of infectious diseases. However, most of the previous studies have been conducted among adults. To examine the effect of childhood stress, we conducted a nationwide cohort study including all Danish children born from 1977 to 2004. Stressful life events (SFLE) included parental death, death of sibling or parental divorce. Outcome was defined as hospitalizations due to less severe (LSID) or severe infectious diseases (SID). Children were followed until the age of 15 years. The association between SFLE and risk of infections was evaluated through rate ratios (RR) comparing infectious disease incidence ratios in children with and without a history of SFLE. Overall, children exposed to SFLE were at 13% increased risk of LSID (RR = 1.13 (1.10-1.15)), but at no increased risk of SID hospitalization (RR = 1.05 (0.97-1.14)). Looking at the specific type of SFLE, parental divorce increased the risk of LSID (RR = 1.11 (1.09-1.14)) and SID hospitalization (1.11 (1.02-1.21)) by 11%, whereas no increased risk of LSID and SID hospitalization was observed following parental death. Finally, a 34% increased risk of LSID hospitalization (RR = 1.34 (1.23-1.45)) was observed following death of sibling, in contrast to no increased risk of SID hospitalization. Childhood exposure to SFLE, especially parental divorce seems to increase the risk of infectious disease hospitalization. Although we cannot determine whether our observations are the result of a biological effect of stress, adoption of unhealthy behaviours or increased likelihood of hospitalization, our findings do have public health relevance as a considerable proportion of the children today will be exposed to SFLE, the majority to parental divorce.

  7. Predictive value of the transtheoretical model to smoking cessation in hospitalized patients with cardiovascular disease. (United States)

    Chouinard, Maud-Christine; Robichaud-Ekstrand, Sylvie


    Several authors have questioned the transtheoretical model. Determining the predictive value of each cognitive-behavioural element within this model could explain the multiple successes reported in smoking cessation programmes. The purpose of this study was to predict point-prevalent smoking abstinence at 2 and 6 months, using the constructs of the transtheoretical model, when applied to a pooled sample of individuals who were hospitalized for a cardiovascular event. The study follows a predictive correlation design. Recently hospitalized patients (n=168) with cardiovascular disease were pooled from a randomized, controlled trial. Independent variables of the predictive transtheoretical model comprise stages and processes of change, pros and cons to quit smoking (decisional balance), self-efficacy, and social support. These were evaluated at baseline, 2 and 6 months. Compared to smokers, individuals who abstained from smoking at 2 and 6 months were more confident at baseline to remain non-smokers, perceived less pros and cons to continue smoking, utilized less consciousness raising and self-re-evaluation experiential processes of change, and received more positive reinforcement from their social network with regard to their smoke-free behaviour. Self-efficacy and stages of change at baseline were predictive of smoking abstinence after 6 months. Other variables found to be predictive of smoking abstinence at 6 months were an increase in self-efficacy; an increase in positive social support behaviour and a decrease of the pros within the decisional balance. The results partially support the predictive value of the transtheoretical model constructs in smoking cessation for cardiovascular disease patients.

  8. Developmental constraints on behavioural flexibility. (United States)

    Holekamp, Kay E; Swanson, Eli M; Van Meter, Page E


    We suggest that variation in mammalian behavioural flexibility not accounted for by current socioecological models may be explained in part by developmental constraints. From our own work, we provide examples of constraints affecting variation in behavioural flexibility, not only among individuals, but also among species and higher taxonomic units. We first implicate organizational maternal effects of androgens in shaping individual differences in aggressive behaviour emitted by female spotted hyaenas throughout the lifespan. We then compare carnivores and primates with respect to their locomotor and craniofacial adaptations. We inquire whether antagonistic selection pressures on the skull might impose differential functional constraints on evolvability of skulls and brains in these two orders, thus ultimately affecting behavioural flexibility in each group. We suggest that, even when carnivores and primates would theoretically benefit from the same adaptations with respect to behavioural flexibility, carnivores may nevertheless exhibit less behavioural flexibility than primates because of constraints imposed by past adaptations in the morphology of the limbs and skull. Phylogenetic analysis consistent with this idea suggests greater evolutionary lability in relative brain size within families of primates than carnivores. Thus, consideration of developmental constraints may help elucidate variation in mammalian behavioural flexibility.

  9. Measuring distributed leadership agency in a hospital context. (United States)

    Jønsson, Thomas; Unterrainer, Christine; Jeppesen, Hans-Jeppe; Jain, Ajay Kumar


    Purpose The purpose of this paper is to develop and validate an instrument that can measure distributed leadership (DL) as employees' active participation in DL tasks. The authors designate this as the distributed leadership agency (DLA). Design/methodology/approach Data were collected throughout all departments and occupational groups at a merged centralized hospital setting in Denmark. A total of 1,774 employees from 24 hospital departments and 16 occupational groups completed our survey. Structural equation model and confirmatory factor analyses were applied to identify appropriate items and a test for measurement invariance, predictive, discriminant and convergent validity, and ANOVAs were applied to analyse group differences in DLA. Findings The identified unidimensional questionnaire consists of seven items, as it is different from, but associated with, empowering leadership, organizational influence, attitude to participation and trust in management. As theoretically predicted, DLA is positively related to self-efficacy, job satisfaction and innovative behaviour. Chief physicians, permanent employees and employee representatives scored higher on the scale than the rest of their respective counterparts. Practical implications The survey offers a method to assess a distribution of leadership agency in hospital organizations. Such assessment may provide a basis for organizational and leadership development. Originality/value The present study provides a reliable and valid quantitative instrument that measures how much employees at all hierarchical levels are involved in concrete leadership activities in the hospital context. Taking a normative perspective the authors could show that DL - measured with the DLA-questionnaire - has positive effects on employees' behaviour.

  10. Comparative osteohistology of Hesperornis with reference to pygoscelid penguins: the effects of climate and behaviour on avian bone microstructure (United States)

    Wilson, Laura E.; Chin, Karen


    The broad biogeographic distribution of Hesperornis fossils in Late Cretaceous Western Interior Seaway deposits has prompted questions about whether they endured polar winters or migrated between mid- and high latitudes. Here, we compare microstructures of hesperornithiform long bones from Kansas and the Arctic to investigate whether migration or Late Cretaceous polar climate affected bone growth. We also examine modern penguin bones to determine how migration and climate may influence bone growth in birds with known behaviours. Histological analysis of hesperornithiform samples reveals continuous bone deposition throughout the cortex, plus an outer circumferential layer in adults. No cyclic growth marks, zonation or differences in vasculature are apparent in the Hesperornis specimens. Comparatively, migratory Adélie and chinstrap penguin bones show no zonation or changes in microstructure, suggesting that migration is not necessarily recorded in avian bone microstructure. Non-migratory gentoos show evidence of rapid bone growth possibly associated with increased chick growth rates in high-latitude populations and large body size. The absence of histological evidence for migration in extinct Hesperornis and extant pygoscelid penguins may reflect that these birds reached skeletal maturity before migration or overwintering. This underscores the challenges of using bone microstructure to infer the effects of behaviour and climate on avian growth. PMID:26064560

  11. A comparative study on low cycle fatigue behaviour of nano and micro Al2O3 reinforced AA2014 particulate hybrid composites

    Directory of Open Access Journals (Sweden)

    R. Senthilkumar


    Full Text Available Aluminium based metal matrix composites have drawn more attraction due to their improved properties in structural applications for the past two decades. The fatigue behaviour of composite materials needs to be studied for their structural applications. In this work, powder metallurgy based aluminium (AA2014 alloy reinforced with micro and nano-sized alumina particles were fabricated and consolidated with the hot extrusion process. The evaluation of mechanical properties in the extruded composite was carried out. This composite was subjected to low cycle fatigue test with a constant strain rate. Scanning Electron Microscope (SEM and Transmission Electron Microscope (TEM images were used to evaluate the fatigue behaviour of aluminium-nano composite samples. Enhanced mechanical properties were exhibited by the nano alumina reinforced aluminium composites, when compared to the micron sized alumina reinforced composites. The failure cycle is observed to be higher for the nano alumina reinforced composites when compared with micron sized alumina composites due to a lower order of induced plastic strain.

  12. Comparison of organizational learning capabilities of the personnel in public and private sector hospitals of Kermanshah

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    Homayoun Abbasi


    Full Text Available Background: Hospitals are among the most interactive organizations in which the rate of knowledge transfer and learning is considerably high. The investigation of the level of organizational learning between public and private sector hospitals can be useful for managers to select proper organizational learning strategies aiming at improving service delivery and organizational behaviour (1. This study was carried out to compare the organizational learning capabilities of the personnel in public and private sector hospitals of Kermanshah. Methods: This descriptive survey was performed on the personnel in public and private sector hospitals of Kermanshah. According to Krejcie and Morgan’s table, 175 employees were selected via stratified random sampling from 6 public and 2 private hospitals. The instrument for gathering data was Organizational Learning Capability Questionnaire (OLCQ by Gomez et al. (2005 (2. Data were analysed by inferential statistics (K-S test, Levene’s test, t-test, one-way ANOVA using SPSS software (version 20.00. Results: The level of organizational learning capabilities of personnel was higher in the private hospitals than in public hospitals, indicating a statistically significant difference between them (T (26= 11.779, P0.01، F (3, 68 = 1.859. Conclusion: With regard to the higher average of knowledge transfer and integration than the other capabilities in public and private hospitals, it seems that the managers of hospitals should make use of this component to promote the organizational knowledge of the personnel and improve other organizational learning capabilities too.

  13. Clinical, Ergonomic, and Economic Outcomes With Multichamber Bags Compared With (Hospital) Pharmacy Compounded Bags and Multibottle Systems: A Systematic Literature Review. (United States)

    Alfonso, Jorge Emilio; Berlana, David; Ukleja, Andrew; Boullata, Joseph


    Multichamber bags (MCBs) may offer potential clinical, ergonomic, and economic advantages compared with (hospital) pharmacy compounded bags (COBs) and multibottle systems (MBSs). A systematic literature review was performed to identify and assess the available evidence regarding advantages of MCBs compared with COBs and MBSs. Medline, Embase, the Cochrane Databases, and EconLit were searched for articles reporting clinical, ergonomic, and economic outcomes for MCBs compared with COBs or MBSs. The search was limited to studies conducted in hospitalized patients >2 years of age that were published in English between January 1990 and November 2014. The Population Intervention Comparison Outcomes Study Design (PICOS) framework was used for the analysis. From 1307 unique citations, 74 potentially relevant publications were identified; review of references identified 2 additional publications. Among the 76 publications, 18 published studies met the inclusion criteria. Most were retrospective in design. Ten studies reported clinical outcomes, including 1 prospective randomized trial and multiple retrospective analyses that reported a lower risk of bloodstream infection for MCBs compared with other delivery systems. Sixteen studies reported ergonomic and/or economic outcomes; most reported a potential cost benefit for MCBs, with consistent reports of reduced time and labor compared with other systems. The largest cost benefit was observed in studies evaluating total hospitalization costs. The systematic literature review identified evidence of potential clinical, ergonomic, and economic benefits for MCBs compared with COBs and MBSs; however, methodological factors limited evidence quality. More prospective studies are required to corroborate existing evidence.

  14. Outcome of planned home births compared to hospital births in Sweden between 1992 and 2004. A population-based register study. (United States)

    Lindgren, Helena E; Rådestad, Ingela J; Christensson, Kyllike; Hildingsson, Ingegerd M


    The aim of this population-based study was to measure the risk of adverse outcome for mother and child in planned home births in a Swedish population irrespective of where the birth actually occurred, at home or in hospital after transfer. A population-based study using data from the Swedish Medical Birth Register. Sweden 1992-2004. A total of 897 planned home births were compared with a randomly selected group of 11,341 planned hospital births. Prevalence of mortality and morbidity among mothers and children, emergency conditions, instrumental and operative delivery and perineal lacerations were compared. During this period in Sweden the neonatal mortality rate was 2.2 per thousand in the home birth group and 0.7 in the hospital group (RR 3.6, 95% CI 0.2-14.7). No cases of emergency complications were found in the home birth group. The risk of having a sphincter rupture was lower in the planned home birth group (RR 0.2, 95% CI 0.0-0.7). The risk of having a cesarean section (RR 0.4, 95% CI 0.2-0.7) or instrumental delivery (RR 0.3, 95% CI 0.2-0.5) was significantly lower in the planned home birth group. In Sweden, between 1992 and 2004, the intrapartum and neonatal mortality in planned home births was 2.2 per thousand. The proportion is higher compared to hospital births but no statistically significant difference was found. Women in the home birth group more often experienced a spontaneous birth without medical intervention and were less likely to sustain pelvic floor injuries.

  15. Comparative Assessment of Patients’ Rights Observance in the Hospitalization Wards of Shahid Beheshti University of Medical Sciences’ Hospitals

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    M. Sharifi


    Full Text Available Background: Patients are one of the most vulnerable social groups. Respecting patients’ rights will lead in advantages like “decrease in hospitalization time” and “increase in patients’ satisfaction”. This study is performed to assess the patients' rights observance in the hospitalization wards of educational hospitals of Shahid Beheshti University of Medical Sciences. Methods: In this descriptive-cross sectional study 137 medical student (intern were selected by convenience sampling method. We used a questionnaire with 12 questions. Reliability of questionnaire was confirmed by experts of the field and validity was confirmed by Cronbach’s Alpha coefficient (81%. The obtained data were analyzed by SPSS (v21 using descriptive statistics, analysis of variance and Tukey test. Findings: In this study the observance rate of patients’ rights was at a good level in 41.6% of cases, at an average level in 55.5% of cases and at a low level in 2.9% of cases. There was a significant difference between several hospitalization wards in the observance rate of patients’ rights. (p = 0.001. The observance rate of patients’ rights in infectious disease ward and gynecology ward was at a lower level in comparison with other wards. Conclusion: The observance rate of patients’ rights was at an average to good level in most of hospitalization ward. However this observance rate is at a low level in some wards. More studies about the causes of these differences can help us in planning about improvement of patients’ rights observance.

  16. Racemic epinephrine compared to salbutamol in hospitalized young children with bronchiolitis; a randomized controlled clinical trial [ISRCTN46561076

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    LeBlanc John C


    Full Text Available Abstract Background Bronchiolitis is the most common cause of lower respiratory tract illness in infancy, and hospital admission rates appear to be increasing in Canada and the United States. Inhaled beta agonists offer only modest short-term improvement. Trials of racemic epinephrine have shown conflicting results. We sought to determine if administration of racemic epinephrine during hospital stay for bronchiolitis improved respiratory distress, was safe, and shortened length of stay. Methods The study was a randomized, double-blind controlled trial of aerosolized racemic epinephrine compared to salbutamol every one to 4 hours in previously well children aged 6 weeks to ≤ 2 years of age hospitalized with bronchiolitis. The primary outcome was symptom improvement as measured by the Respiratory Distress Assessment Instrument (RDAI; secondary outcomes were length of stay in hospital, adverse events, and report of symptoms by structured parental telephone interview one week after discharge. Results 62 children with a mean age of 6.4 months were enrolled; 80% of children had Respiratory Syncytial Virus (RSV. Racemic epinephrine resulted in significant improvement in wheezing and the total RDAI score on day 2 and over the entire stay (p 0.05. Adverse events were not significantly different in the two arms. At one week post-discharge, over half of parents reported that their child still had a respiratory symptom and 40% had less than normal feeding. Conclusion Racemic epinephrine relieves respiratory distress in hospitalized infants with bronchiolitis and is safe but does not abbreviate hospital stay. Morbidity associated with bronchiolitis as identified by parents persists for at least one week after hospital discharge in most infants.

  17. Changing patient safety culture in China: a case study of an experimental Chinese hospital from a comparative perspective (United States)

    Gu, Yong Hong; Ng, Chui Shan; Cai, Xiao; Xu, Jun; Zhang, Xin Shi; Ke, Dong Ge; Yu, Qian Hui; Chan, Chi Kuen


    Background The World Health Organization highlights that patient safety interventions are not lacking but that the local context affects their successful implementation. Increasing attention is being paid to patient safety in Mainland China, yet few studies focus on patient safety in organizations with mixed cultures. This paper evaluates the current patient safety culture in an experimental Chinese hospital with a Hong Kong hospital management culture, and it aims to explore the application of Hong Kong’s patient safety strategies in the context of Mainland China. Methods A quantitative survey of 307 hospital staff members was conducted using the Hospital Survey on Patient Safety Culture questionnaire. The findings were compared with a similar study on general Chinese hospitals and were appraised with reference to the Manchester Patient Safety Framework. Results Lower scores were observed among participants with the following characteristics: males, doctors, those with more work experience, those with higher education, and those from the general practice and otolaryngology departments. However, the case study hospital achieved better scores in management expectations, actions and support for patient safety, incident reporting and communication, and teamwork within units. Its weaknesses were related to non-punitive responses to errors, teamwork across units, and staffing. Conclusions The case study hospital contributes to a changing patient safety culture in Mainland China, yet its patient safety culture remains mostly bureaucratic. Further efforts could be made to deepen the staff’s patient safety culture mind-set, to realize a “bottom-up” approach to cultural change, to build up a comprehensive and integrated incident management system, and to improve team building and staffing for patient safety. PMID:29750061

  18. Changing patient safety culture in China: a case study of an experimental Chinese hospital from a comparative perspective

    Directory of Open Access Journals (Sweden)

    Xu XP


    Full Text Available Xiao Ping Xu,* Dong Ning Deng,* Yong Hong Gu, Chui Shan Ng, Xiao Cai, Jun Xu, Xin Shi Zhang, Dong Ge Ke, Qian Hui Yu, Chi Kuen Chan Clinical Service Department, The University of Hong Kong - Shenzhen Hospital, Shenzhen, Guangdong, People’s Republic of China *These authors contributed equally to this work Background: The World Health Organization highlights that patient safety interventions are not lacking but that the local context affects their successful implementation. Increasing attention is being paid to patient safety in Mainland China, yet few studies focus on patient safety in organizations with mixed cultures. This paper evaluates the current patient safety culture in an experimental Chinese hospital with a Hong Kong hospital management culture, and it aims to explore the application of Hong Kong’s patient safety strategies in the context of Mainland China. Methods: A quantitative survey of 307 hospital staff members was conducted using the Hospital Survey on Patient Safety Culture questionnaire. The findings were compared with a similar study on general Chinese hospitals and were appraised with reference to the Manchester Patient Safety Framework. Results: Lower scores were observed among participants with the following characteristics: males, doctors, those with more work experience, those with higher education, and those from the general practice and otolaryngology departments. However, the case study hospital achieved better scores in management expectations, actions and support for patient safety, incident reporting and communication, and teamwork within units. Its weaknesses were related to non-punitive responses to errors, teamwork across units, and staffing. Conclusions: The case study hospital contributes to a changing patient safety culture in Mainland China, yet its patient safety culture remains mostly bureaucratic. Further efforts could be made to deepen the staff’s patient safety culture mind-set, to realize a

  19. Comparing Two Inquiry Professional Development Interventions in Science on Primary Students' Questioning and Other Inquiry Behaviours (United States)

    Nichols, Kim; Burgh, Gilbert; Kennedy, Callie


    Developing students' skills to pose and respond to questions and actively engage in inquiry behaviours enables students to problem solve and critically engage with learning and society. The aim of this study was to analyse the impact of providing teachers with an intervention in inquiry pedagogy alongside inquiry science curriculum in comparison to an intervention in non-inquiry pedagogy alongside inquiry science curriculum on student questioning and other inquiry behaviours. Teacher participants in the comparison condition received training in four inquiry-based science units and in collaborative strategic reading. The experimental group, the community of inquiry (COI) condition, received training in facilitating a COI in addition to training in the same four inquiry-based science units. This study involved 227 students and 18 teachers in 9 primary schools across Brisbane, Australia. The teachers were randomly allocated by school to one of the two conditions. The study followed the students across years 6 and 7 and students' discourse during small group activities was recorded, transcribed and coded for verbal inquiry behaviours. In the second year of the study, students in the COI condition demonstrated a significantly higher frequency of procedural and substantive higher-order thinking questions and other inquiry behaviours than those in the comparison condition. Implementing a COI within an inquiry science curriculum develops students' questioning and science inquiry behaviours and allows teachers to foster inquiry skills predicated by the Australian Science Curriculum. Provision of inquiry science curriculum resources alone is not sufficient to promote the questioning and other verbal inquiry behaviours predicated by the Australian Science Curriculum.

  20. Comparative study between single core model and detail core model of CFD modelling on reactor core cooling behaviour (United States)

    Darmawan, R.


    Nuclear power industry is facing uncertainties since the occurrence of the unfortunate accident at Fukushima Daiichi Nuclear Power Plant. The issue of nuclear power plant safety becomes the major hindrance in the planning of nuclear power program for new build countries. Thus, the understanding of the behaviour of reactor system is very important to ensure the continuous development and improvement on reactor safety. Throughout the development of nuclear reactor technology, investigation and analysis on reactor safety have gone through several phases. In the early days, analytical and experimental methods were employed. For the last four decades 1D system level codes were widely used. The continuous development of nuclear reactor technology has brought about more complex system and processes of nuclear reactor operation. More detailed dimensional simulation codes are needed to assess these new reactors. Recently, 2D and 3D system level codes such as CFD are being explored. This paper discusses a comparative study on two different approaches of CFD modelling on reactor core cooling behaviour.

  1. Indirect effect of management support on users' compliance behaviour towards information security policies. (United States)

    Humaidi, Norshima; Balakrishnan, Vimala


    Health information systems are innovative products designed to improve the delivery of effective healthcare, but they are also vulnerable to breaches of information security, including unauthorised access, use, disclosure, disruption, modification or destruction, and duplication of passwords. Greater openness and multi-connectedness between heterogeneous stakeholders within health networks increase the security risk. The focus of this research was on the indirect effects of management support (MS) on user compliance behaviour (UCB) towards information security policies (ISPs) among health professionals in selected Malaysian public hospitals. The aim was to identify significant factors and provide a clearer understanding of the nature of compliance behaviour in the health sector environment. Using a survey design and stratified random sampling method, self-administered questionnaires were distributed to 454 healthcare professionals in three hospitals. Drawing on theories of planned behaviour, perceived behavioural control (self-efficacy (SE) and MS components) and the trust factor, an information system security policies compliance model was developed to test three related constructs (MS, SE and perceived trust (PT)) and their relationship to UCB towards ISPs. Results showed a 52.8% variation in UCB through significant factors. Partial least squares structural equation modelling demonstrated that all factors were significant and that MS had an indirect effect on UCB through both PT and SE among respondents to this study. The research model based on the theory of planned behaviour in combination with other human and organisational factors has made a useful contribution towards explaining compliance behaviour in relation to organisational ISPs, with trust being the most significant factor. In adopting a multidimensional approach to management-user interactions via multidisciplinary concepts and theories to evaluate the association between the integrated management

  2. Cost analysis of the Communication and Low Mood (CALM) randomised trial of behavioural therapy for stroke patients with aphasia. (United States)

    Humphreys, Ioan; Thomas, Shirley; Phillips, Ceri; Lincoln, Nadina


    To evaluate the cost effectiveness of a behavioural therapy intervention shown to be clinically effective in comparison with usual care for stroke patients with aphasia. Randomised controlled trial with comparison of costs and calculation of incremental cost effectiveness ratio. Community. Participants identified as having low mood on either the Visual Analog Mood Scale sad item (≥50) or Stroke Aphasic Depression Questionnaire Hospital version 21 (SADQH21) (≥6) were recruited. Participants were randomly allocated to behavioural therapy or usual care using internet-based randomisation generated in advance of the study by a clinical trials unit. Outcomes were assessed at six months after randomisation, blind to group allocation. The costs were assessed from a service use questionnaire. Effectiveness was defined as the change in SADQH21 scores and a cost-effectiveness analysis was performed comparing the behavioural group with the usual care control group. The cost analysis was undertaken from the perspective of the UK NHS and Social Services. The greatest difference was in home help costs where there was a saving of £56.20 in the intervention group compared to an increase of £61.40 in the control group. At six months the SADQH21 score for the intervention group was 17.3 compared to the control group value of 20.4. This resulted in a mean increase of 0.7 in the control group, compared to a mean significant different decrease of 6 in the intervention group (P = 0.003). The Incremental Cost-Effectiveness Ratio indicated that the cost per point reduction on the SADQH21 was £263. Overall the behavioural therapy was found to improve mood and resulted in some encouraging savings in resource utilisation over the six months follow-up. © The Author(s) 2014.

  3. [Study protocol of a prevention of recurrent suicidal behaviour program based on case management (PSyMAC)]. (United States)

    Sáiz, Pilar A; Rodríguez-Revuelta, Julia; González-Blanco, Leticia; Burón, Patricia; Al-Halabí, Susana; Garrido, Marlen; García-Alvarez, Leticia; García-Portilla, Paz; Bobes, Julio


    Prevention of suicidal behaviour is a public health priority in the European Union. A previous suicide attempt is the best risk predictor for future attempts, as well as completed suicides. The primary aim of this article is to describe a controlled study protocol designed for prevention of recurrent suicidal behaviour that proposes case management, and includes a psychoeducation program, as compared with the standard intervention (PSyMAC). Patients admitted from January 2011 to June 2013 to the emergency room of the Hospital Universitario Central de Asturias were evaluated using a protocol including sociodemographic, psychiatric, and psychosocial assessment. Patients were randomly assigned to either a group receiving continuous case management including participation in a psychoeducation program (experimental group), or a control group receiving standard care. The primary objective is to examine whether or not the period of time until recurrent suicidal behaviour in the experimental group is significantly different from that of the control group. PSyMAC proposes low cost and easily adaptable interventions to the usual clinical setting that can help to compensate the shortcoming of specific action protocols and suicidal behaviour prevention programs in our country. The evaluation of PSyMAC results will determine their real effectivity as a case-magament program to reduce suicidal risk. Copyright © 2013 SEP y SEPB. Published by Elsevier España. All rights reserved.

  4. Total versus subtotal Laparoscopic Hysterectomy: A comparative study in Arash Hospital

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    Samiei H


    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 st1":*{behavior:url(#ieooui } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: Over the past 50 years, subtotal or supracervical hysterectomy has come to be viewed as a suboptimal procedure reserved for those rare instances in which when concern over blood loss or anatomic distortion dictates limiting the extent of dissection, the aim of this study was to compare total and subtotal laparoscopic hysterectomy. "n"nMethods: The patients who were candidates for hysterectomy with benign disease, with no contraindication for laparoscopic surgery entered the study in Arash Hospital, from March 2007 to April 2009. By simple randomization 45 patients (25 for TLH and 20 for SLH were selected. Demographic Details and intra and post operative complications, were recorded by the staff and were compared between two groups."n"nResults: The average time for TLH operations look significantly longer than SLH operation (148.6±29.7 minutes; 128.5±25.64 minutes, p=0.03. Although, the hemoglobin (gr/dl drop in TLH was significantly higher than SLH (1.54 Versus 0.9, p<0.05 Blood transfusion were common in SLH (1 case Versus 3 Cases. The total length of hospital stay, was significantly shorter after SLH than TLH (3.6±1.47 day and 2.85±0.59, p=0.04. The drug requirements to

  5. Readiness for hospital discharge: A concept analysis. (United States)

    Galvin, Eileen Catherine; Wills, Teresa; Coffey, Alice


    To report on an analysis on the concept of 'readiness for hospital discharge'. No uniform operational definition of 'readiness for hospital discharge' exists in the literature; therefore, a concept analysis is required to clarify the concept and identify an up-to-date understanding of readiness for hospital discharge. Clarity of the concept will identify all uses of the concept; provide conceptual clarity, an operational definition and direction for further research. Literature review and concept analysis. A review of literature was conducted in 2016. Databases searched were: Academic Search Complete, CINAHL Plus with Full Text, PsycARTICLES, Psychology and Behavioural Sciences Collection, PsycINFO, Social Sciences Full Text (H.W. Wilson) and SocINDEX with Full Text. No date limits were applied. Identification of the attributes, antecedents and consequences of readiness for hospital discharge led to an operational definition of the concept. The following attributes belonging to 'readiness for hospital discharge' were extracted from the literature: physical stability, adequate support, psychological ability, and adequate information and knowledge. This analysis contributes to the advancement of knowledge in the area of hospital discharge, by proposing an operational definition of readiness for hospital discharge, derived from the literature. A better understanding of the phenomenon will assist healthcare professionals to recognize, measure and implement interventions where necessary, to ensure patients are ready for hospital discharge and assist in the advancement of knowledge for all professionals involved in patient discharge from hospital. © 2017 John Wiley & Sons Ltd.

  6. How does individual smoking behaviour among hospital staff influence their knowledge of the health consequences of smoking?

    DEFF Research Database (Denmark)

    Willaing, Ingrid; Jørgensen, Torben; Iversen, Lars


    AIMS: This study examined associations between individual smoking habits among hospital staff and their knowledge of the health consequences of smoking and passive smoking. The a priori hypothesis was a higher level of knowledge among non-smokers compared with smokers. METHODS: A survey...... and 95% confidence intervals were calculated. Main outcome measures were knowledge of the health consequences of smoking, passive smoking and other lifestyle factors. RESULTS: A total of 445 of 487 employees (91%) from all professional groups returned the questionnaire. Compared with ex- and never...... smokers, smokers systematically underestimate the health consequences of smoking and passive smoking independent of profession, department, sex, and age. There is no consistent association between knowledge of the health consequences of smoking and profession and department. There are significant inverse...

  7. Exploring gender differences in the working lives of UK hospital consultants. (United States)

    Jefferson, Laura; Bloor, Karen; Spilsbury, Karen


    Internationally, increasing numbers of women are practising medicine. Gender differences in doctors' working hours, specialty choices and communication styles are well documented, but studies often neglect contextual factors such as the role of socialised gender expectations on behaviours in the workplace and the medical profession. These may be important as recent studies have reported gender differences in doctors' activity rates that cannot be explained by specialty or contracted hours, suggesting other sources of variation. This study sought to explore the working lives of hospital doctors and how their work is negotiated according to gender and context. Gender differences in the day-to-day work of hospital specialists (consultants) in the NHS were investigated using a qualitative approach, including observation and interview methods. Data were analysed inductively using qualitative observation and interview methods. Two NHS hospital trusts in England. Data were collected from 13 participants working in a variety of specialties and in a range of clinical and non-clinical settings. Various behaviours, attitudes and experiences were explored, such as doctor-patient communication, interactions with colleagues and workload. Influences at both individual and situational levels, appear to affect differentially the work of male and female doctors. Female consultants described awareness of the impact of behaviours on relationships with colleagues, and their interactions appeared to be more carefully performed. Nurses and other colleagues tend to demonstrate less cooperation with female consultants. Gender differences also exist in patient communication, feelings of work-family conflict and barriers to career progression. These variations in hospital consultants' work may have implications for both the quantity and quality of care provided by male and female consultants. This is timely and of importance to the medical workforce as the gender composition approaches

  8. The diagnosis, prevalence and outcome of delirium in a cohort of older people with mental health problems on general hospital wards. (United States)

    Whittamore, Kathy H; Goldberg, Sarah E; Gladman, John R F; Bradshaw, Lucy E; Jones, Rob G; Harwood, Rowan H


    This paper aimed to measure the prevalence and outcomes of delirium for patients over 70 admitted to a general hospital for acute medical care and to assess the validity of the Delirium Rating Scale-Revised-98 (DRS-R-98) in this setting. Prospective study in a British acute general hospital providing sole emergency medical services for its locality. We screened consecutive patients over 70 with an unplanned emergency hospital admission and recruited a cohort of 249 patients likely to have mental health problems. They were assessed for health status at baseline and followed over 6 months. A sub-sample of 93 participants was assessed clinically for delirium. 27% (95% confidence interval (CI) 23-31) of all older medical patients admitted to hospital had DRS-diagnosed delirium, and 41% (95% CI 37-45) had dementia (including 19% with co-morbid delirium and dementia). Compared with clinician diagnosis, DRS-R-98 sensitivity was at least 0.75, specificity 0.71. Compared with reversible cognitive impairment, sensitivity was at least 0.50, specificity 0.67. DRS-diagnosed delirium was associated with cognitive impairment, mood, behavioural and psychological symptoms, activities of daily living, and number of drugs prescribed, supporting construct validity. Of those with DRS-diagnosed delirium, 37% died within 6 months (relative risk 1.4, 95% CI 0.97-2.2), 43% had reversible cognitive impairment, but only 25% had clinically important recovery in activities of daily living. Behavioural and psychological symptoms were common and mostly resolved, but new symptoms frequently developed. Delirium is common. Some, but not all, features are reversible. DRS-R-98 has reasonable validity in populations where co-morbid dementia is prevalent. Copyright © 2013 John Wiley & Sons, Ltd.

  9. Cognitive functioning and behaviour of epileptic children in parents' assessment. (United States)

    Talarska, Dorota; Steinborn, Barbara; Michalak, Michał


    Cognitive functioning and behaviour of chronically ill children are affected by many factors, including anxiety due to hospitalization, persistent symptoms of sickness and adverse side effects of medications. The aim of this work was to seek out parents' opinion concerning cognitive functioning and behaviour of children with epilepsy. The study comprised 156 children with epilepsy aged 7-18 and treated in the Department of Developmental Neurology at Karol Marcinkowski Poznan University of Medical Sciences and in an outpatient clinic. The research tool used was the questionnaire Quality of Life in Childhood Epilepsy (QOLCE) completed by parents. Assessment of cognitive functioning and behaviour was based on the analysis of the areas V (cognitive processes) and VII (behaviour). Parents assessed children's functioning in the areas of cognitive processes and behaviour at a similar level - 55 points. In the area of cognitive processes, concentration while performing some tasks and reading was assessed as the worst. A significant difference in caregivers' assessment was found according to age, frequency of seizures and duration of disease. In the area analysing the child's behaviour, parents indicated getting angry easily and not being upset by other people's opinions. The display of aggression towards others got the lowest number of comments. The children's functioning was assessed by parents as rather poor in both analysed areas. Parents of children treated with polytherapy noticed more difficulties in cognitive functioning and behaviour than parents of children treated with one medication.

  10. Comparative brain transcriptomic analyses of scouting across distinct behavioural and ecological contexts in honeybees (United States)

    Liang, Zhengzheng S.; Mattila, Heather R.; Rodriguez-Zas, Sandra L.; Southey, Bruce R.; Seeley, Thomas D.; Robinson, Gene E.


    Individual differences in behaviour are often consistent across time and contexts, but it is not clear whether such consistency is reflected at the molecular level. We explored this issue by studying scouting in honeybees in two different behavioural and ecological contexts: finding new sources of floral food resources and finding a new nest site. Brain gene expression profiles in food-source and nest-site scouts showed a significant overlap, despite large expression differences associated with the two different contexts. Class prediction and ‘leave-one-out’ cross-validation analyses revealed that a bee's role as a scout in either context could be predicted with 92.5% success using 89 genes at minimum. We also found that genes related to four neurotransmitter systems were part of a shared brain molecular signature in both types of scouts, and the two types of scouts were more similar for genes related to glutamate and GABA than catecholamine or acetylcholine signalling. These results indicate that consistent behavioural tendencies across different ecological contexts involve a mixture of similarities and differences in brain gene expression. PMID:25355476

  11. Management of radiation hazards in hospitals: plural rationalities in a single institution

    International Nuclear Information System (INIS)

    Rayner, S.


    This paper examines the perceptions of occupational radiological hazards in a small sample of American hospitals during an anthropological pilot study conducted in 1982. The results indicate that occupants of various occupational categories exhibit diverse behaviours toward medical radiation. These behaviours are consistent with grid/group classifications of each type of occupation. Various implications for risk management and institutional design are discussed in the context of different levels of trust in individual control and institutional procedures. (author)

  12. Comparing the strength of behavioural plasticity and consistency across situations: animal personalities in the hermit crab Pagurus bernhardus. (United States)

    Briffa, Mark; Rundle, Simon D; Fryer, Adam


    Many phenotypic traits show plasticity but behaviour is often considered the 'most plastic' aspect of phenotype as it is likely to show the quickest response to temporal changes in conditions or 'situation'. However, it has also been noted that constraints on sensory acuity, cognitive structure and physiological capacities place limits on behavioural plasticity. Such limits to plasticity may generate consistent differences in behaviour between individuals from the same population. It has recently been suggested that these consistent differences in individual behaviour may be adaptive and the term 'animal personalities' has been used to describe them. In many cases, however, a degree of both behavioural plasticity and relative consistency is probable. To understand the possible functions of animal personalities, it is necessary to determine the relative strength of each tendency and this may be achieved by comparison of statistical effect sizes for tests of difference and concordance. Here, we describe a new statistical framework for making such comparisons and investigate cross-situational plasticity and consistency in the duration of startle responses in the European hermit crab Pagurus bernhardus, in the field and the laboratory. The effect sizes of tests for behavioural consistency were greater than for tests of behavioural plasticity, indicating for the first time the presence of animal personalities in a crustacean model.

  13. Incineration or autoclave? A comparative study in isfahan hospitals waste management system (2010). (United States)

    Ferdowsi, Ali; Ferdosi, Masoud; Mehrani, Mohammd Javad


    Medical wastes are among hazardous wastes and their disposal requires special methods prior to landfilling. Medical wastes are divided into infected and non-infected wastes and the infected wastes require treatment. Incineration is one of the oldest methods for treatment of medical wastes, but their usage have faced wide objections due to emission of hazardous gases such as CO2 and CO as well as Carcinogenic gases such as Dioxins and Furans which are generated as a result of incomplete combustion of compositions like PVCs. Autoclave is one the newest methods of medical wastes treatment which works based on wet disinfection. The statistical population in this descriptive, comparative study includes hospitals located in Isfahan city and the sample hospitals were selected randomly. To environmentally evaluate the Autoclave method, TST (time, steam, temperature) and Spore tests were used. Also, samples were made from incinerator's stack gases and their analyses results were compared with WHO standards. TST and spore tests results were negative in all cases indicating the success of treatment process. The comparison of incinerator's stack gases with WHO standards showed the high concentration of CO in some samples indicating the incomplete combustion. Also, the incineration efficiency in some cases was less than 99.5 percent, which is the efficiency criterion according to the administrative regulations of wastes management law of Iran. No needle stick was observed in Autoclave method during the compaction of bags containing wastes, and the handlers were facing no danger in this respect. The comparison of costs indicated that despite higher capital investment for purchasing autoclave, its current costs (e.g. maintenance, etc) are much less than the incineration method. Totally, due to inappropriate operation of incinerators and lack of air pollution control devices, the use of incinerators doesn't seem rational anymore. Yet, despite the inefficiency of autoclaves in

  14. Incineration or Autoclave? A Comparative Study in Isfahan Hospitals Waste Management System (2010) (United States)

    Ferdowsi, Ali; Ferdosi, Masoud; Mehrani, Mohammd Javad


    Introduction: Medical wastes are among hazardous wastes and their disposal requires special methods prior to landfilling. Medical wastes are divided into infected and non-infected wastes and the infected wastes require treatment. Incineration is one of the oldest methods for treatment of medical wastes, but their usage have faced wide objections due to emission of hazardous gases such as CO2 and CO as well as Carcinogenic gases such as Dioxins and Furans which are generated as a result of incomplete combustion of compositions like PVCs. Autoclave is one the newest methods of medical wastes treatment which works based on wet disinfection. Methods: The statistical population in this descriptive, comparative study includes hospitals located in Isfahan city and the sample hospitals were selected randomly. To environmentally evaluate the Autoclave method, TST (time, steam, temperature) and Spore tests were used. Also, samples were made from incinerator’s stack gases and their analyses results were compared with WHO standards. Findings: TST and spore tests results were negative in all cases indicating the success of treatment process. The comparison of incinerator’s stack gases with WHO standards showed the high concentration of CO in some samples indicating the incomplete combustion. Also, the incineration efficiency in some cases was less than 99.5 percent, which is the efficiency criterion according to the administrative regulations of wastes management law of Iran. No needle stick was observed in Autoclave method during the compaction of bags containing wastes, and the handlers were facing no danger in this respect. The comparison of costs indicated that despite higher capital investment for purchasing autoclave, its current costs (e.g. maintenance, etc) are much less than the incineration method. Discussion: Totally, due to inappropriate operation of incinerators and lack of air pollution control devices, the use of incinerators doesn’t seem rational anymore

  15. Extraversion, neuroticism, immoral judgment and criminal behaviour. (United States)

    Addad, M; Leslau, A


    The present study examines delinquent behaviour by integrating two approaches until now employed separately: Eysnck's theory linking delinquency to extraversion and neuroticism, and Kohlberg's theory of moral development and its connection to moral behaviour. The study analyzes the relations between extraversion, neuroticism and moral judgment, as well as their independent and/or interactive effect upon the development of anti-social behaviour. The relationships are tested by retrospective measurements of personality traits and moral judgment in three groups: delinquency (N = 203), control (N = 82) and comparative (N = 407) groups. Findings show that criminals are higher than control subjects in neuroticism and immoral judgment but not in extraversion. Similar relationships were found between criminals and the comparative group, with one exception: here extraversion was found to be positively related to delinquency, both independently and interactively with neuroticism. The implications of these results for differential development of anti-social behaviour are discussed.

  16. Health behaviour in children and adolescents with type 1 diabetes compared to a representative reference population.

    Directory of Open Access Journals (Sweden)

    Sebastian Kummer

    Full Text Available We provide a population-based overview of health behaviours of children and adolescents with type 1 diabetes in comparison to the general population, and analyse their relevance for glycaemic control and self-rated health status.Data from questionnaires of 11- to 17-year-old children and adolescents with diabetes (n = 629 were compared to a representative sample (n = 6,813.Children and adolescents with type 1 diabetes had a significantly increased odds of infrequent physical activity (adjusted OR 1.56, short overall duration of physical activity per week (OR 1.55, difference -1.3 hours/week, and high daily computer use (OR 2.51. They had a lower odds of active and passive smoking (OR 0.31 and OR 0.29, and high daily television time (OR 0.68. The odds of an at least good and excellent self-rated health status was increased with intense physical activity, and decreased with active smoking and prolonged daily use of computer and television. Active smoking and prolonged daily use of computer were associated with higher HbA1c.Children and adolescents with type 1 diabetes showed a different profile of health behaviour. Their overall health may improve if their education stresses specifically frequent physical activity with longer overall duration and less frequent television or computer use.

  17. Mindfulness and eating behaviour styles in morbidly obese males and females. (United States)

    Ouwens, M A; Schiffer, A A; Visser, L I; Raeijmaekers, N J C; Nyklíček, I


    Morbid obesity is a highly prevalent condition that is associated with a high risk of various diseases and high health care costs. Understanding determinants of eating behaviours that are characteristic of many morbidly obese persons is important for the development of new interventions aimed at changing eating behaviour after bariatric surgery. Dispositional mindfulness seems promising as one such potential determinant. Therefore, the association between mindfulness and eating behaviour was examined in females and males with morbid obesity. Outpatients with morbid obesity who were candidates for bariatric surgery (N = 335; 78.8% female) completed the Dutch Eating Behaviour Questionnaire (DEBQ), the Freiburg Mindfulness Inventory (FMI) and the Hospital Anxiety and Depression Scale (HADS), in addition to the collection of relevant demographic and medical data. Three separate multiple regression analyses with three eating behaviour styles (restrained, emotional, external) as dependent variables showed that mindfulness was positively associated with restrained eating behaviour (Beta = .28, p ≤ .001), and negatively associated with emotional (Beta = -.22, p ≤ .001) and external (Beta = -.32, p ≤ .001) eating behaviours, independent of sex, age, educational level, Body Mass Index and affective symptoms. Dispositional mindfulness was associated with more restrained, and less emotional and external eating behaviour in morbidly obese outpatients, above and beyond affective symptoms. Future studies, establishing the causal direction of the associations, are needed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Theory of planned behaviour variables and objective walking behaviour do not show seasonal variation in a randomised controlled trial. (United States)

    Williams, Stefanie L; French, David P


    Longitudinal studies have shown that objectively measured walking behaviour is subject to seasonal variation, with people walking more in summer compared to winter. Seasonality therefore may have the potential to bias the results of randomised controlled trials if there are not adequate statistical or design controls. Despite this there are no studies that assess the impact of seasonality on walking behaviour in a randomised controlled trial, to quantify the extent of such bias. Further there have been no studies assessing how season impacts on the psychological predictors of walking behaviour to date. The aim of the present study was to assess seasonal differences in a) objective walking behaviour and b) Theory of Planned Behaviour (TPB) variables during a randomised controlled trial of an intervention to promote walking. 315 patients were recruited to a two-arm cluster randomised controlled trial of an intervention to promote walking in primary care. A series of repeated measures ANCOVAs were conducted to examine the effect of season on pedometer measures of walking behaviour and TPB measures, assessed immediately post-intervention and six months later. Hierarchical regression analyses were conducted to assess whether season moderated the prediction of intention and behaviour by TPB measures. There were no significant differences in time spent walking in spring/summer compared to autumn/winter. There was no significant seasonal variation in most TPB variables, although the belief that there will be good weather was significantly higher in spring/summer (F = 19.46, p behaviour, or moderate the effects of TPB variables on intention or behaviour. Seasonality does not influence objectively measured walking behaviour or psychological variables during a randomised controlled trial. Consequently physical activity behaviour outcomes in trials will not be biased by the season in which they are measured. Previous studies may have overestimated the extent of

  19. Concurrently examining unrealistic absolute and comparative optimism: Temporal shifts, individual-difference and event-specific correlates, and behavioural outcomes. (United States)

    Ruthig, Joelle C; Gamblin, Bradlee W; Jones, Kelly; Vanderzanden, Karen; Kehn, Andre


    Researchers have spent considerable effort examining unrealistic absolute optimism and unrealistic comparative optimism, yet there is a lack of research exploring them concurrently. This longitudinal study repeatedly assessed unrealistic absolute and comparative optimism within a performance context over several months to identify the degree to which they shift as a function of proximity to performance and performance feedback, their associations with global individual difference and event-specific factors, and their link to subsequent behavioural outcomes. Results showed similar shifts in unrealistic absolute and comparative optimism based on proximity to performance and performance feedback. Moreover, increases in both types of unrealistic optimism were associated with better subsequent performance beyond the effect of prior performance. However, several differences were found between the two forms of unrealistic optimism in their associations with global individual difference factors and event-specific factors, highlighting the distinctiveness of the two constructs. © 2016 The British Psychological Society.

  20. Sensing behaviour in healthcare design

    DEFF Research Database (Denmark)

    Thorpe, Julia Rosemary; Hysse Forchhammer, Birgitte; Maier, Anja


    We are entering an era of distributed healthcare that should fit and respond to individual needs, behaviour and lifestyles. Designing such systems is a challenging task that requires continuous information about human behaviour on a large scale, for which pervasive sensing (e.g. using smartphones...... specifically on activity and location data that can easily be obtained from smartphones or wearables. We further demonstrate how these are applied in healthcare design using an example from dementia care. Comparing a current and proposed scenario exemplifies how integrating sensor-derived information about...... user behaviour can support the healthcare design goals of personalisation, adaptability and scalability, while emphasising patient quality of life....

  1. Behavioural syndromes differ predictably between 12 populations of three-spined stickleback

    NARCIS (Netherlands)

    Dingemanse, Niels J.; Wright, Jonathan; Kazem, Anahita J. N.; Thomas, Dawn K.; Hickling, Rachael; Dawnay, Nick


    1. Animals often differ in suites of correlated behaviours, comparable with how humans differ in personality. Constraints on the architecture of behaviour have been invoked to explain why such 'behavioural syndromes' exist. From an adaptationist viewpoint, however, behavioural syndromes should

  2. The impact of closed-loop electronic medication management on time to first dose: a comparative study between paper and digital hospital environments. (United States)

    Austin, Jodie A; Smith, Ian R; Tariq, Amina


    Closed-loop electronic medication management systems (EMMS) are recognised as an effective intervention to improve medication safety, yet evidence of their effectiveness in hospitals is limited. Few studies have compared medication turnaround time for a closed-loop electronic versus paper-based medication management environment. To compare medication turnaround times in a paper-based hospital environment with a digital hospital equipped with a closed-loop EMMS, consisting of computerised physician order entry, profiled automated dispensing cabinets packaged with unit dose medications and barcode medication administration. Data were collected during 2 weeks at three private hospital sites (one with closed-loop EMMS) within the same organisation network in Queensland, Australia. Time between scheduled and actual administration times was analysed for first dose of time-critical and non-critical medications located on the ward or sourced via pharmacy. Medication turnaround times at the EMMS site were less compared to the paper-based sites (median, IQR: 35 min, 8-57 min versus 120 min, 30-180 min, P medications, 77% were administered within 60 min of scheduled time at the EMMS site versus 38% for the paper-based sites. Similar difference was observed for non-critical medications, 80% were administered within 60 min of their scheduled time at the EMMS site versus 41% at the paper-based facilities. The study indicates medication turnaround times utilising a closed-loop EMMS are less compared to paper-based systems. This improvement may be attributable to increased accessibility of medications using automated dispensing cabinets and electronic medication administration records flagging tasks to nurses in real time. © 2018 Royal Pharmaceutical Society.

  3. Behaviour of Dairy Cows, Useful Indicator in Assessing Animal Welfare

    Directory of Open Access Journals (Sweden)

    Ioana Cristina Andronie


    Full Text Available The purpose of this research was to establish the manner in which the flooring type may influence the welfare levelsin dairy cows by assessment of laminitis incidence and animals’ behaviour. 42 dairy cows were grouped based on theshelter floor surface: concrete with straw bedding, asphalted concrete with straw bedding and concrete plus shavings.The behaviour was assessed through direct observation and laminitis incidence was established by numericalassessment of locomotion prior or following milking.The results have indicated an increase of laminitis incidence by 15-25 % in B and C lot and was absent in A lot. Thelarge number of diseases was recorded on concrete floors with shavings bedding (53%. The behavioural displays ofthe cows suffering from laminitis were different from the healthy ones, as their resting behaviour outside the stallswas more prevalent (17.6% compared to 8.8% while the feeding behaviour was less present (10.1% compared to14.7%. Likewise, the socializing behaviour was more active in these animals, compared to the healthycows.

  4. Relationships between Adaptive Behaviours, Personal Factors, and Participation of Young Children. (United States)

    Killeen, Hazel; Shiel, Agnes; Law, Mary; O'Donovan, Donough J; Segurado, Ricardo; Anaby, Dana


    To examine the extent to which personal factors (age, socioeconomic grouping, and preterm birth) and adaptive behaviour explain the participation patterns of young children. 65 Children 2-5 years old with and without a history of preterm birth and no physical or intellectual disability were selected by convenience sampling from Galway University Hospital, Ireland. Interviews with parents were conducted using the Adaptive Behaviour Assessment System, Second Edition (ABAS-II) and the Assessment of Preschool Children's Participation (APCP). Linear regression models were used to identify associations between the ABAS-II scores, personal factors, and APCP scores for intensity and diversity of participation. Adaptive behaviour explained 21% of variance in intensity of play, 18% in intensity of Skill Development, 7% in intensity of Active Physical Recreation, and 6% in intensity of Social Activities controlling for age, preterm birth, and socioeconomic grouping. Age explained between 1% and 11% of variance in intensity of participation scores. Adapted behaviour (13%), Age (17%), and socioeconomic grouping (5%) explained a significant percentage of variance in diversity of participation controlling for the other variables.  Adaptive behaviour had a unique contribution to children's intensity and diversity of participation, suggesting its importance.

  5. Hungry in hospital, well-fed in prison? A comparative analysis of food service systems. (United States)

    Johns, Nick; Edwards, John S A; Hartwell, Heather J


    Meals served in prisons and hospitals are produced in similar ways and have similar characteristics, yet hospital patients are often at risk of being undernourished, while prisoners typically are not. This article examines field notes collected during nutritional studies of prison and hospital food service, which confirmed the difference in nutrient intake claimed by other authors. A comparison of food service processes and systems showed that the production of meals and the quality leaving the kitchen was similar in both types of institution. However, the delivery and service system was found to be much less coherent in hospital than in prison. Transport and service of hospital food were subject to delays and disruptions from a number of sources, including poor communication and the demands of medical professionals. These meant that meals reached hospital patients in a poorer, less appetising condition than those received by prisoners. The findings are discussed in the light of previous work and in terms of hospital food service practice. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  6. Colour Consideration for Waiting areas in hospitals (United States)

    Zraati, Parisa


    Colour is one the most important factors in the nature that can have some affects on human behaviour. Many years ago, it was proven that using colour in public place can have some affect on the users. Depend of the darkness and lightness; it can be vary from positive to negative. The research will mainly focus on the colour and psychological influences and physical factors. The statement of problem in this research is what is impact of colour usually applied to waiting area? The overall aim of the study is to explore the visual environment of hospitals and to manage the colour psychological effect of the hospital users in the waiting area by creating a comfortable, pleasant and cozy environment for users while spend their time in waiting areas. The analysisconcentrate on satisfaction and their interesting regarding applied colour in two private hospital waiting area in Malaysia.

  7. Comparative Outcomes After Percutaneous Coronary Intervention Among Black and White Patients Treated at US Veterans Affairs Hospitals. (United States)

    Kobayashi, Taisei; Glorioso, Thomas J; Armstrong, Ehrin J; Maddox, Thomas M; Plomondon, Mary E; Grunwald, Gary K; Bradley, Steven M; Tsai, Thomas T; Waldo, Stephen W; Rao, Sunil V; Banerjee, Subhash; Nallamothu, Brahmajee K; Bhatt, Deepak L; Rene, A Garvey; Wilensky, Robert L; Groeneveld, Peter W; Giri, Jay


    Current comparative outcomes among black and white patients treated with percutaneous coronary intervention (PCI) in the Veterans Affairs (VA) health system are not known. To compare outcomes between black and white patients undergoing PCI in the VA health system. This study compared black and white patients who underwent PCI between October 1, 2007, and September 30, 2013, at 63 VA hospitals using data recorded in the VA Clinical Assessment, Reporting, and Tracking System for Cardiac Catheterization Laboratories (CART-CL) program. A generalized linear mixed model with a random intercept for site assessed the relative difference in odds of outcomes between black and white patients. The setting was integrated institutionalized hospital care. Excluded were all patients of other races or those with multiple listed races and those with missing data regarding race or the diagnostic cardiac catheterization. The dates of analysis were January 7, 2016, to April 17, 2017. Percutaneous coronary intervention at a VA hospital. The primary outcome was 1-year mortality. Secondary outcomes were 30-day all-cause readmission rates, 30-day acute kidney injury, 30-day blood transfusion, and 1-year readmission rates for myocardial infarction. In addition, variations in procedural and postprocedural care were examined, including the use of intravascular ultrasound, optical coherence tomography, fractional flow reserve measurements, bare-metal stents, postprocedural medications, and radial access. A total of 42 391 patients (13.3% black and 98.4% male; mean [SD] age, 65.2 [9.1] years) satisfied the inclusion and exclusion criteria. In unadjusted analyses, black patients had higher rates of 1-year mortality (7.1% vs 5.9%, P < .001) as well as secondary outcomes of 30-day acute kidney injury (20.8% vs 13.8%, P < .001), 30-day blood transfusion (3.4% vs 2.7%, P < .01), and 1-year readmission rates for myocardial infarction (3.3% vs 2.7%, P = .01) compared with white

  8. Incidence and costs of hip fractures vs strokes and acute myocardial infarction in Italy: comparative analysis based on national hospitalization records

    Directory of Open Access Journals (Sweden)

    Piscitelli P


    Full Text Available Prisco Piscitelli,1,2 Giovanni Iolascon,3 Alberto Argentiero,2 Giovanna Chitano,2 Cosimo Neglia,2 Gemma Marcucci,1 Manuela Pulimeno,2 Marco Benvenuto,2 Santa Mundi,2 Valentina Marzo,2 Daniela Donato,4 Angelo Baggiani,4 Alberto Migliore,5 Mauro Granata,6 Francesca Gimigliano,3 Raffaele Di Blasio,7 Alessandra Gimigliano,3 Lorenzo Renzulli,7 Maria Luisa Brandi,1 Alessandro Distante,2,4 Raffaele Gimigliano3,71University of Florence, Florence Italy; 2ISBEM Research Centre, Brindisi, Italy; 3Second University of Naples, Naples, Italy; 4University of Pisa, Pisa, Italy; 5Fatebenefratelli St Peter’s Hospital, Rome, Italy; 6St Filippo Neri Hospital, Rome, Italy; 7Casa di Cura Santa Maria del Pozzo, Somma Vesuviana, ItalyObjectives: As osteoporotic fractures are becoming a major health care problem in countries characterized by an increasing number of older adults, in this study we aimed to compare the incidence and costs of hip fragility fractures in Italian elderly people versus those of major cardiovascular diseases (strokes and acute myocardial infarctions [AMI] occurring in the whole adult population.Methods: We analyzed hospitalization records maintained at the national level by the Italian Ministry of Health for the diagnosis of hip fractures (ICD-9-CM codes 820–821, AMI (code 410, hemorrhagic (codes 430, 431, 432 and ischemic strokes (codes 433–434, and TIA (code 435 between 2001–2005. Cost analyses were based on diagnosis-related groups.Results: The incidence of hip fractures in elderly people has increased (+12.9% between 2001 and 2005, as well as that of AMI (+20.2% and strokes (hemorrhagic: +9.6%; ischemic: +14.7 occurring in the whole adult population; conversely, hospitalization due to TIA decreased by a rate of 13.6% between 2001 and 2005. In 2005, the hospital costs across the national health care system that were associated with hip fragility fractures in the elderly were comparable to those of strokes (both hemorrhagic and

  9. Cognitive function in survivors of out-of-hospital cardiac arrest after target temperature management at 33°C versus 36°C

    DEFF Research Database (Denmark)

    Lilja, Gisela; Nielsen, Niklas; Friberg, Hans


    assessed with tests for memory (Rivermead Behavioural Memory Test), executive functions (Frontal Assessment Battery), and attention/mental speed (Symbol Digit Modalities Test). A control group of 119 matched patients hospitalized for acute ST-segment-elevation myocardial infarction without cardiac arrest...... was more affected among cardiac arrest patients, but results for memory and executive functioning were similar. CONCLUSIONS: Cognitive function was comparable in survivors of out-of-hospital cardiac arrest when a temperature of 33°C and 36°C was targeted. Cognitive impairment detected in cardiac arrest...... performed the same assessments. Half of the cardiac arrest survivors had cognitive impairment, which was mostly mild. Cognitive outcome did not differ (P>0.30) between the 2 temperature groups (33°C/36°C). Compared with control subjects with ST-segment-elevation myocardial infarction, attention/mental speed...

  10. Population-based study of smoking behaviour throughout pregnancy and adverse perinatal outcomes.

    LENUS (Irish Health Repository)

    Murphy, Deirdre J


    There has been limited research addressing whether behavioural change in relation to smoking is maintained throughout pregnancy and the effect on perinatal outcomes. A cohort study addressed lifestyle behaviours of 907 women who booked for antenatal care and delivered in a large urban teaching hospital in 2010-2011. Adverse perinatal outcomes were compared for "non-smokers", "ex-smokers" and "current smokers". Of the 907 women, 270 (30%) reported smoking in the six months prior to pregnancy, and of those 160 (59%) had stopped smoking and 110 (41%) continued to smoke at the time of the first antenatal visit. There was virtually no change in smoking behaviour between the first antenatal visit and the third trimester of pregnancy. Factors associated with continuing to smoke included unplanned pregnancy (OR 1.9; 95% CI 1.3, 2.9), alcohol use (OR 3.4; 95% CI 2.1, 6.0) and previous illicit drug use (OR 3.6; 95% CI 2.1, 6.0). Ex-smokers had similar perinatal outcomes to non-smokers. Current smoking was associated with an average reduction in birth weight of 191 g (95% CI -294, -88) and an increased incidence of intrauterine growth restriction (24% versus 13%, adjusted OR 1.39 (95% CI 1.06, 1.84). Public Health campaigns emphasise the health benefits of quitting smoking in pregnancy. The greatest success appears to be pre-pregnancy and during the first trimester where women are largely self-motivated to quit.

  11. How immigrants adapt their smoking behaviour: comparative analysis among Turkish immigrants in Germany and the Netherlands. (United States)

    Reiss, Katharina; Sauzet, Odile; Breckenkamp, Jürgen; Spallek, Jacob; Razum, Oliver


    Smoking behaviour among immigrants is assumed to converge to that of the host country's majority population with increasing duration of stay. We compared smoking prevalence among Turkish immigrants residing in two different countries (Germany (DE)/the Netherlands (NL)) between and within countries by time spent in Turkey and DE/NL. The German 2009 micro-census and the Dutch POLS database (national survey, 1997-2004) were analysed. An interaction variable with dichotomised length of stay (LOS) in Turkey (age: 0-17; 18+) and categorised LOS in the host country (immigration year: 1979 and earlier, 1980-1999, 2000-2009; the latter only for Germany) was generated. Age standardised smoking prevalences and sex-specific logistic regression models were calculated. 6,517 Turkish participants were identified in Germany, 2,106 in the Netherlands. Age-standardised smoking prevalences were higher among Turkish immigrants in the Netherlands compared to those in Germany: 62.3% vs. 53.1% (men/lower education); 30.6% vs. 23.0% (women/lower education). A similar trend was observed for the majority population of both countries. The chance of being a smoker was lower among Turkish men with short LOS in Turkey and middle LOS in Germany/the Netherlands compared to those with short LOS in Turkey and long LOS in Germany/the Netherlands (NL: OR = 0.57[95% CI = 0.36-0.89]; DE: OR = 0.73[95% CI = 0.56-0.95]). Contrary to that, the chance of being a smoker was higher among Turkish men with long LOS in Turkey and middle LOS in Germany/the Netherlands compared to those with long LOS in Turkey and long LOS in Germany/the Netherlands (NL: OR = 1.35[95% CI = 0.79-2.33]; DE: OR = 1.44[95% CI = 1.03-2.02]). The effects for Turkish women were similar, but smaller and often non-significant. Turkish immigrants adapt their smoking behaviour towards that of the Dutch/German majority population with increasing duration of stay. This was particularly obvious among those who left Turkey before the age of 18

  12. Academic performance of school children with behavioural ...

    African Journals Online (AJOL)

    Introduction: Behavioural disorders can have a negative influence on the academic performance of school children. There are no similiar published is no known studies in Nigeria. Objective: To compare the academic performance of primary school children with behavioural disorders with that of their controls. Methods: A ...

  13. Consumer behaviour analysis and the behavioural perspective model.


    Foxall, G.R.; Oliveira-Castro, J.M.; James, V.K.; Schrezenmaier, T.C.


    This is the FIRST of TWO linked articles on consumer behavioural analysis. Cognitive theories have dominated the field of consumer behaviour for the last few decades, however, an observed lack of consistency between attitudes and behaviour has suggested the need to investigate more thoroughly situational and behavioural variables. Consumer behaviour analysis can be viewed as an alternative theoretical approach that emphasizes situational variables and measures of behaviour. Within consumer be...

  14. Creativity in Medical Learning: A direction-finding study of junior hospital doctors

    Directory of Open Access Journals (Sweden)

    Martin Talbot


    Full Text Available In a questionnaire study of creativity, the author has assessed the teaching and clinical practice of medical teachers, as observed by their students. The study has taken some preliminary steps to assess the place of creativity in postgraduate medical learning in the United Kingdom. Junior doctors were asked to compare their ‘best’ teacher with their ‘worst’ utilising a semantic differential scale and questions derived from Torrance’s definitions of creativity. The response rate was 81 (56.25% of 144 junior hospital doctors, in whose view, ‘best’ teachers showed greater creative behaviour as evidenced by significantly higher creativity scores on the majority of parameters (p<0.0001.

  15. Variation in cooperative behaviour within a single city.

    Directory of Open Access Journals (Sweden)

    Daniel Nettle

    Full Text Available Human cooperative behaviour, as assayed by decisions in experimental economic dilemmas such as the Dictator Game, is variable across human populations. Within-population variation has been less well studied, especially within industrial societies. Moreover, little is known about the extent to which community-level variation in Dictator Game behaviour relates to community-level variation in real-world social behaviour. We chose two neighbourhoods of the city of Newcastle upon Tyne that were similar in most regards, but at opposite ends of the spectrum in terms of level of socioeconomic deprivation. We administered Dictator Games to randomly-selected residents, and also gathered a large number of more naturalistic measures of cooperativeness. There were dramatic differences in Dictator Game behaviour between the two neighbourhoods, with the mean allocation to the other player close to half the stake in the affluent neighbourhood, and close to one tenth of the stake in the deprived neighbourhood. Moreover, the deprived neighbourhood was also characterised by lower self-reported social capital, higher frequencies of crime and antisocial behaviour, a higher frequency of littering, and less willingness to take part in a survey or return a lost letter. On the other hand, there were no differences between the neighbourhoods in terms of the probability of helping a person who dropped an object, needed directions to a hospital, or needed to make change for a coin, and people on the streets were less likely to be alone in the deprived neighbourhood than the affluent one. We conclude that there can be dramatic local differences in cooperative behaviour within the same city, and that these need further theoretical explanation.

  16. Impact of individual behaviour change on the spread of emerging infectious diseases. (United States)

    Yan, Q L; Tang, S Y; Xiao, Y N


    Human behaviour plays an important role in the spread of emerging infectious diseases, and understanding the influence of behaviour changes on epidemics can be key to improving control efforts. However, how the dynamics of individual behaviour changes affects the development of emerging infectious disease is a key public health issue. To develop different formula for individual behaviour change and introduce how to embed it into a dynamic model of infectious diseases, we choose A/H1N1 and Ebola as typical examples, combined with the epidemic reported cases and media related news reports. Thus, the logistic model with the health belief model is used to determine behaviour decisions through the health belief model constructs. Furthermore, we propose 4 candidate infectious disease models without and with individual behaviour change and use approximate Bayesian computation based on sequential Monte Carlo method for model selection. The main results indicate that the classical compartment model without behaviour change and the model with average rate of behaviour change depicted by an exponential function could fit the observed data best. The results provide a new way on how to choose an infectious disease model to predict the disease prevalence trend or to evaluate the influence of intervention measures on disease control. However, sensitivity analyses indicate that the accumulated number of hospital notifications and deaths could be largely reduced as the rate of behaviour change increases. Therefore, in terms of mitigating emerging infectious diseases, both media publicity focused on how to guide people's behaviour change and positive responses of individuals are critical. Copyright © 2017 John Wiley & Sons, Ltd.

  17. Patient-controlled hospital admission for patients with severe mental disorders: study protocol for a nationwide prospective multicentre study. (United States)

    Thomsen, Christoffer Torgaard; Benros, Michael Eriksen; Hastrup, Lene Halling; Andersen, Per Kragh; Giacco, Domenico; Nordentoft, Merete


    Patient-controlled hospital admission for individuals with severe mental disorders is a novel approach in mental healthcare. Patients can admit themselves to a hospital unit for a short stay without being assessed by a psychiatrist or contacting the emergency department. Previous studies assessing the outcomes of patient-controlled hospital admission found trends towards reduction in the use of coercive measures and length of hospital stay; however, these studies have methodological shortcomings and small sample sizes. Larger studies are needed to estimate the effect of patient-controlled hospital admission on the use of coercion and of healthcare services. We aim to recruit at least 315 patients who are offered a contract for patient-controlled hospital admissions in eight different hospitals in Denmark. Patients will be followed-up for at least 1 year to compare the use of coercive measures and of healthcare services, the use of medications and suicidal behaviour. Descriptive statistics will be used to investigate hospitalisations, global assessment of functioning (GAF) and patient satisfaction with treatment. To minimise selection bias, we will match individuals using patient-controlled hospital admission and controls with a 1:5 ratio via a propensity score based on the following factors: sex, age group, primary diagnosis, substance abuse as secondary diagnosis, coercion, number of psychiatric bed days, psychiatric history, urbanity and suicidal behaviour. Additionally, a historical control study will be undertaken in which patients serve as their own control group prior to index date. The study has been approved by The Danish Health and Medicines Authority ( 3-3013-934/1/) and by The Danish Data Protection Agency ( 2012-58-0004). The study was categorised as a register study by The Danish Health Research Ethics Committee and therefore no further approval was needed ( H-2-2014-FSP70). Findings will be disseminated through scientific

  18. Alignment of an interprofessional student learning experience with a hospital quality improvement initiative. (United States)

    Fowler, Terri O; Wise, Holly H; Mauldin, Mary P; Ragucci, Kelly R; Scheurer, Danielle B; Su, Zemin; Mauldin, Patrick D; Bailey, Jennifer R; Borckardt, Jeffrey J


    Assessment of interprofessional education (IPE) frequently focuses on students' learning outcomes including changes in knowledge, skills, and/or attitudes. While a foundational education in the values and information of their chosen profession is critical, interprofessional learning follows a continuum from formal education to practice. The continuum increases in significance and complexity as learning becomes more relationship based and dependent upon the ability to navigate complex interactions with patients, families, communities, co-workers, and others. Integrating IPE into collaborative practice is critical to enhancing students' experiential learning, developing teamwork competencies, and understanding the complexity of teams. This article describes a project that linked students with a hospital-based quality-improvement effort to focus on the acquisition and practice of teamwork skills and to determine the impact of teamwork on patient and quality outcome measures. A hospital unit was identified with an opportunity for improvement related to quality care, patient satisfaction, employee engagement, and team behaviours. One hundred and thirty-seven students from six health profession colleges at the Medical University of South Carolina underwent TeamSTEPPS® training and demonstrated proficiency of their teamwork-rating skills with the TeamSTEPPS® Team Performance Observation Tool (T-TPO). Students observed real-time team behaviours of unit staff before and after staff attended formal TeamSTEPPS® training. The students collected a total of 778 observations using the T-TPO. Teamwork performance on the unit improved significantly across all T-TPO domains (team structure, communication, leadership, situation monitoring, and mutual support). Significant improvement in each domain continued post-intervention and at 15-month follow-up, improvement remained significant compared to baseline. Student engagement in TeamSTEPPS® training and demonstration of their

  19. Costs analysis of surgical treatment of stress urinary incontinence in a brazilian public hospital, comparing burch and synthetic sling techniques. (United States)

    Limberger, Leo Francisco; Faria, Fernanda Pacheco; Campos, Luciana Silveira; Anzolch, Karin Marise Jaeger; Fornari, Alexandre


    Surgical treatment of urinary incontinence progressed significantly with the introduction of synthetic slings. However, in some public Brazilian hospitals, the costs of these materials prevent their routine use. To compare the costs of ambulatory synthetic sling surgery with an historical series of patients submitted to Burch surgery in a Brazilian public hospital. Twenty nine incontinent patients were selected to synthetic sling surgery. Demographic data were prospectively collected and also the costs of the procedure, including drugs and materials, use of surgical and recovery wards, medical staff and hospitalization. These data were compared to the costs of 29 Burch surgeries performed before the introduction of synthetic slings. Demographic data were similar, although median age was lower in the group submitted to Burch surgery (46.3±8.6 versus 56.2±11.3 (pCost was significantly lower in patients submitted to sling in all items, except for time spent in recovery ward. Total value of 29 Burch surgeries was R$ 217.766.12, and of R$ 68.049.92 of 29 patients submitted to sling surgery (pcost of the synthetic sling was considered. Copyright® by the International Brazilian Journal of Urology.

  20. Do law students stand apart from other university students in their quest for mental health: A comparative study on wellbeing and associated behaviours in law and psychology students. (United States)

    Skead, Natalie K; Rogers, Shane L


    We are not producing a product, but a well-balanced person.(1) It is well-documented that law students experience higher levels of psychological distress than members of the general population and university students in other professional disciplines. In 2014, we published our findings on an empirical study identifying the correlations between law student wellbeing and student behaviour both at and away from law school. The results of the study informed the development of an evidence-based 'behavioural toolkit' to assist law students and law schools in making informed choices and decisions that promote and even improve the mental health of students. The study we undertook was not, however, limited to law students. It extended to collecting quantitative data on psychological distress and associated behaviours in psychology students. This article reports on the comparative findings of the study and provides a comparative basis for understanding the contextual influences on the wellbeing of law students. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Social differentiation and embodied dispositions: a qualitative study of maternal care-seeking behaviour for near-miss morbidity in Bolivia

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    Liljestrand Jerker


    Full Text Available Abstract Background Use of maternal health care in low-income countries has been associated with several socioeconomic and demographic factors, although contextual analyses of the latter have been few. A previous study showed that 75% of women with severe obstetric morbidity (near-miss identified at hospitals in La Paz, Bolivia were in critical conditions upon arrival, underscoring the significance of pre-hospital barriers also in this setting with free and accessible maternal health care. The present study explores how health care-seeking behaviour for near-miss morbidity is conditioned in La Paz, Bolivia. Methods Thematic interviews with 30 women with a near-miss event upon arrival at hospital. Near-miss was defined based on clinical and management criteria. Modified analytic induction was applied in the analysis that was further influenced by theoretical views that care-seeking behaviour is formed by predisposing characteristics, enabling factors, and perceived need, as well as by socially shaped habitual behaviours. Results The self-perception of being fundamentally separated from "others", meaning those who utilise health care, was typical for women who customarily delivered at home and who delayed seeking medical assistance for obstetric emergencies. Other explanations given by these women were distrust of authority, mistreatment by staff, such as not being kept informed about their condition or the course of their treatment, all of which reinforced their dissociation from the health-care system. Conclusion The findings illustrate health care-seeking behaviour as a practise that is substantially conditioned by social differentiation. Social marginalization and the role health institutions play in shaping care-seeking behaviour have been de-emphasised by focusing solely on endogenous cultural factors in Bolivia.

  2. Using the Hospital Nutrition Environment Scan to Evaluate Health Initiative in Hospital Cafeterias. (United States)

    Derrick, Jennifer Willahan; Bellini, Sarah Gunnell; Spelman, Julie


    Health-promoting environments advance health and prevent chronic disease. Hospitals have been charged to promote health and wellness to patients, communities, and 5.3 million adults employed in United States health care environments. In this cross-sectional observational study, the Hospital Nutrition Environment Scan (HNES) was used to measure the nutrition environment of hospital cafeterias and evaluate the influence of the LiVe Well Plate health initiative. Twenty-one hospitals in the Intermountain West region were surveyed between October 2013 and May 2014. Six hospitals participated in the LiVe Well Plate health initiative and were compared with 15 hospitals not participating. The LiVe Well Plate health initiative identified and promoted a healthy meal defined as health initiative branding were also posted at point of purchase. Hospital cafeterias were scored on four subcategories: facilitators and barriers, grab-and-go items, menu offerings, and selection options at point of purchase. Overall, hospitals scored 35.3±13.7 (range=7 to 63) points of 86 total possible points. Cafeterias in health initiative hospitals had significantly higher mean nutrition composite scores compared with non-health initiative hospitals (49.2 vs 29.7; Penvironment of hospital cafeterias. Additional research is needed to quantify and strategize ways to improve nutrition environments within hospital cafeterias and assess the influence on healthy lifestyle behaviors. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  3. Collective self and individual choice : The effects of inter-group comparative context on environmental values and behaviour

    NARCIS (Netherlands)

    Rabinovich, Anna; Morton, Thomas A.; Postmes, Tom; Verplanken, Bas


    Self-categorization theory suggests that inter-group comparisons inform individual behaviour by affecting perceived in-group stereotypes that are internalized by group members. The present paper provides evidence for this chain of effects in the domain of environmental behaviour. In two studies,

  4. A theory-driven, longitudinal evaluation of the impact of team training on safety culture in 24 hospitals. (United States)

    Jones, Katherine J; Skinner, Anne M; High, Robin; Reiter-Palmon, Roni


    Effective teamwork facilitates collective learning, which is integral to safety culture. There are no rigorous evaluations of the impact of team training on the four components of safety culture-reporting, just, flexible and learning cultures. We evaluated the impact of a year-long team training programme on safety culture in 24 hospitals using two theoretical frameworks. We used two quasi-experimental designs: a cross-sectional comparison of hospital survey on patient safety culture (HSOPS) results from an intervention group of 24 hospitals to a static group of 13 hospitals and a pre-post comparison of HSOPS results within intervention hospitals. Dependent variables were HSOPS items representing the four components of safety culture; independent variables were derived from items added to the HSOPS that measured the extent of team training, learning and transfer. We used a generalised linear mixed model approach to account for the correlated nature of the data. 59% of 2137 respondents from the intervention group reported receiving team training. Intervention group HSOPS scores were significantly higher than static group scores in three dimensions assessing the flexible and learning components of safety culture. The distribution of the adoption of team behaviours (transfer) varied in the intervention group from 2.8% to 31.0%. Adoption of team behaviours was significantly associated with odds of an individual reacting more positively at reassessment than baseline to nine items reflecting all four components of safety culture. Team training can result in transformational change in safety culture when the work environment supports the transfer of learning to new behaviour.

  5. The relation of parental alcoholism to the prevalence of suicide attempts among hospitalized psychiatric adolescents

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    Katarzyna Krajewska


    Full Text Available Suicide is the third cause of death at the age group 10–19 in the world. There are inter multiple risk factors of suicidal behaviours. In the case of children of alcoholics the increased number of suicide attempts is explained by genetic predisposition and accumulation of environmental risk factors. The aim of this study is to check whether parental alcoholism is associated with the number and repetition of suicide attempts and the age at which the first suicide attempt occurred among hospitalized psychiatric adolescents. Material and methods: A retrospective analysis – based on medical documentation – of 119 patients aged 13–18, treated during 2013–2014 at the Department of Adolescent Psychiatry in Łódź for: schizophrenia, schizotypal and delusional disorders, mood disorders, neurotic, stress-related and somatoform disorders, behavioural and emotional disorders according to ICD-10. The exclusion criteria were other psychiatric diagnoses, incomplete family history and lack of information about intended self-harm behaviours. The patients were selected at random. The number and repetition of suicide attempts, the age at which the first suicide attempt occurred, parental alcoholism and family history of suicidal behaviours were examined. Analyses were carried out using Statistica 9.1. Results: Parental alcoholism did not statistically significantly affect (p > 0.05the prevalence or repetition of suicide attempts among psychiatrically treated adolescents. The first suicide attempts were not made by adolescents – also considering the gender, diagnosis, and familial suicidal behaviours. Conclusions: In almost half of the examined psychiatrically hospitalized adolescents at least one parent met the parental alcoholism criteria. Suicide attempts occurred in over 50% of the examined patients, with somewhat higher incidence in girls whose parents met the parental alcoholism criteria, as compared to those without parental alcoholism

  6. Characterising physician listening behaviour during hospitalist handoffs using the HEAR checklist. (United States)

    Greenstein, Elizabeth A; Arora, Vineet M; Staisiunas, Paul G; Banerjee, Stacy S; Farnan, Jeanne M


    The increasing fragmentation of healthcare has resulted in more patient handoffs. Many professional groups, including the Accreditation Council on Graduate Medical Education and the Society of Hospital Medicine, have made recommendations for safe and effective handoffs. Despite the two-way nature of handoff communication, the focus of these efforts has largely been on the person giving information. To observe and characterise the listening behaviours of handoff receivers during hospitalist handoffs. Prospective observational study of shift change and service change handoffs on a non-teaching hospitalist service at a single academic tertiary care institution. The 'HEAR Checklist', a novel tool created based on review of effective listening behaviours, was used by third party observers to characterise active and passive listening behaviours and interruptions during handoffs. In 48 handoffs (25 shift change, 23 service change), active listening behaviours (eg, read-back (17%), note-taking (23%) and reading own copy of the written signout (27%)) occurred less frequently than passive listening behaviours (eg, affirmatory statements (56%) nodding (50%) and eye contact (58%)) (pRead-back occurred only eight times (17%). In 11 handoffs (23%) receivers took notes. Almost all (98%) handoffs were interrupted at least once, most often by side conversations, pagers going off, or clinicians arriving. Handoffs with more patients, such as service change, were associated with more interruptions (r=0.46, plistening behaviours. While passive listening behaviours are common, active listening behaviours that promote memory retention are rare. Handoffs are often interrupted, most commonly by side conversations. Future handoff improvement efforts should focus on augmenting listening and minimising interruptions.

  7. The External Networking Behaviour of Public Managers

    DEFF Research Database (Denmark)

    Hansen, Morten Balle; Villadsen, Anders Ryom


    There has been an increasing focus on managerial external networking behaviour within public administration. While most previous quantitative research has analysed such behaviour one-dimensionally, we suggest a two-dimensional conceptualization based on the concepts of weak and strong ties....... Utilizing measures resembling previous research, we explore the utility of the approach in an exploratory study of Danish local government. Our findings suggest that the two dimensions of external networking behaviour are distinct. We discuss our approach compared to previous approaches and argue...

  8. Smoking habits and attitudes toward tobacco bans among United Kingdom hospital staff and students. (United States)

    Lewis, K E; Shin, D; Davies, G


    A group of United Kingdom (UK) hospitals. To estimate the current smoking habits of health care professionals (HCPs) in a country with active tobacco control measures, and to record their attitudes to national and hospital tobacco bans. A cross-sectional survey of 500 HCPs. HCPs reported a lower rate of current smoking (7%) than the general population (24%). Doctors (2.6%) and medical students (3.8%) were less likely to be current smokers than both nurses (8.7%) and allied health professionals (10.9%, P smoking in health care premises. A higher proportion of UK doctors (69%) than nurses (52%) favoured a complete ban (odds ratio 2.01, 95% confidence interval 1.14-3.56). Self-reported smoking patterns in UK health professionals are lower than previously and compared to other industrialised and developing countries. Support for bans is very high, but differences remain in behaviour and especially attitudes to local bans according to professional status, although this gap is also narrowing.

  9. Travel Time to Hospital for Childbirth: Comparing Calculated Versus Reported Travel Times in France. (United States)

    Pilkington, Hugo; Prunet, Caroline; Blondel, Béatrice; Charreire, Hélène; Combier, Evelyne; Le Vaillant, Marc; Amat-Roze, Jeanne-Marie; Zeitlin, Jennifer


    Objectives Timely access to health care is critical in obstetrics. Yet obtaining reliable estimates of travel times to hospital for childbirth poses methodological challenges. We compared two measures of travel time, self-reported and calculated, to assess concordance and to identify determinants of long travel time to hospital for childbirth. Methods Data came from the 2010 French National Perinatal Survey, a national representative sample of births (N = 14 681). We compared both travel time measures by maternal, maternity unit and geographic characteristics in rural, peri-urban and urban areas. Logistic regression models were used to study factors associated with reported and calculated times ≥30 min. Cohen's kappa coefficients were also calculated to estimate the agreement between reported and calculated times according to women's characteristics. Results In urban areas, the proportion of women with travel times ≥30 min was higher when reported rather than calculated times were used (11.0 vs. 3.6%). Longer reported times were associated with non-French nationality [adjusted odds ratio (aOR) 1.3 (95% CI 1.0-1.7)] and inadequate prenatal care [aOR 1.5 (95% CI 1.2-2.0)], but not for calculated times. Concordance between the two measures was higher in peri-urban and rural areas (52.4 vs. 52.3% for rural areas). Delivery in a specialised level 2 or 3 maternity unit was a principal determinant of long reported and measured times in peri-urban and rural areas. Conclusions for Practice The level of agreement between reported and calculated times varies according to geographic context. Poor measurement of travel time in urban areas may mask problems in accessibility.

  10. Moderators of the intention-behaviour and perceived behavioural control-behaviour relationships for leisure-time physical activity

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    Godin Gaston


    Full Text Available Abstract Background Intention is a key determinant of action. However, there is a gap between intention and behavioural performance that remains to be explained. Therefore, the aim of this study was to identify moderators of the intention-behaviour and perceived behavioural control (PBC- behaviour relationships for leisure-time physical activity. Method This was tested in reference to Ajzen's Theory of Planned Behaviour. A sample of 300 volunteers, 192 women and 108 men, aged 18 to 55, participated in the study. At baseline, the participants completed a self-administrated psychosocial questionnaire assessing Ajzen's theory variables (i.e., intention and perceived behavioural control. The behavioural measure was obtained by mail three months later. Results Multiple hierarchical regression analyses indicated that age and annual income moderated the intention-behaviour and PBC-behaviour relationships. However, in the final model predicting behaviour (R2 = .46, only the interaction term of PBC by annual income (β = .24, p = 0.0003 significantly contributed to the prediction of behaviour along with intention (β = .49, p = 0.0009 and past behaviour (β = .44, p Conclusion Physical activity promotion programs would benefit not only from focusing on increasing the intention of low intenders, but also from targeting factors that moderate the perceived behavioural control-behaviour relationships.

  11. Comparing the effects of adaptive support ventilation and synchronized intermittent mandatory ventilation on intubation duration and hospital stay after coronary artery bypass graft surgery

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    Ahmadreza Yazdannik


    Full Text Available Background: Different modes of mechanical ventilation are used for respiratory support after coronary artery bypass graft (CABG. This study aimed to compare the effect(s of using adaptive support ventilation (ASV and synchronized intermittent mandatory ventilation (SIMV on the length of mechanical ventilation (intubation duration and hospital stay after coronary artery bypass graft surgery. Materials and Methods: In a randomized control trial, 64 patients were ventilated with ASV as the experiment group or with SIMV as the control group after CABG surgery in Chamran Hospital of Isfahan University of Medical Sciences. The time of tracheal intubation and the length of hospital stay were compared between the two groups. Data were analyzed and described using statistical analysis (independent t-test. Results: The mean time of intubation duration was significantly lower in ASV group compared with SIMV group. (4.83 h vs 6.71 h, P < 0.001. The lengths of hospital stay in the ASV and the SIMV groups were 140.6 h and 145.1 h, respectively. This difference was significant between the two groups (P = 0.006. Conclusions: According to the results of this study, using ASV mode for mechanical ventilation after CABG led to a decrease in intubation duration and also hospital stay in comparison with the SIMV group. It is recommended to use ASV mode on ventilators for respiratory support of patients undergoing coronary artery bypass graft surgery.

  12. The Impact of Hospital Size on CMS Hospital Profiling. (United States)

    Sosunov, Eugene A; Egorova, Natalia N; Lin, Hung-Mo; McCardle, Ken; Sharma, Vansh; Gelijns, Annetine C; Moskowitz, Alan J


    The Centers for Medicare & Medicaid Services (CMS) profile hospitals using a set of 30-day risk-standardized mortality and readmission rates as a basis for public reporting. These measures are affected by hospital patient volume, raising concerns about uniformity of standards applied to providers with different volumes. To quantitatively determine whether CMS uniformly profile hospitals that have equal performance levels but different volumes. Retrospective analysis of patient-level and hospital-level data using hierarchical logistic regression models with hospital random effects. Simulation of samples including a subset of hospitals with different volumes but equal poor performance (hospital effects=+3 SD in random-effect logistic model). A total of 1,085,568 Medicare fee-for-service patients undergoing 1,494,993 heart failure admissions in 4930 hospitals between July 1, 2005 and June 30, 2008. CMS methodology was used to determine the rank and proportion (by volume) of hospitals reported to perform "Worse than US National Rate." Percent of hospitals performing "Worse than US National Rate" was ∼40 times higher in the largest (fifth quintile by volume) compared with the smallest hospitals (first quintile). A similar gradient was seen in a cohort of 100 hospitals with simulated equal poor performance (0%, 0%, 5%, 20%, and 85% in quintiles 1 to 5) effectively leaving 78% of poor performers undetected. Our results illustrate the disparity of impact that the current CMS method of hospital profiling has on hospitals with higher volumes, translating into lower thresholds for detection and reporting of poor performance.

  13. Registration and management of smoking behaviour in patients with coronary heart disease. The EUROASPIRE survey.

    NARCIS (Netherlands)

    T.F.M. van Berkel (Dorien); D. de Baquer; J.W. Deckers (Jaap); D. Wood; H. Boersma (Eric)


    textabstractAIMS: To establish to what extent smoking status and its management is recorded in coronary patients' medical records, and to investigate their motivation to change smoking behaviour. METHODS: In EUROASPIRE, a survey on secondary prevention in 21 hospitals

  14. The Main Drivers of Environmentally Responsible Behaviour in Lithuanian Households

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    Dalia Streimikiene


    Full Text Available Preserving environmental and natural resources is one of the most important challenges for ensuring the sustainability of well-being over time. One can notice that measuring of environmental indicators related to environmentally responsible behaviour is complicated and demanding task. It is also important to define the main drivers of environmentally responsible development. The objective of this paper is to provide comparatives analysis of indicators of environmentally responsible behaviour in the Baltic States by comparing and assessing them in terms of the EU-28 average and to present the main drivers of environmentally responsible behaviour in Lithuania. Environmentally responsible behaviour is related to resource and energy savings, use of renewable energy sources, waste sorting and recycling, wastewater disposal etc. Comparative assessment of environmentally responsible behaviour indicators in the Baltic States indicated that all these indicators are bellow the EU-average, except the use of renewable energy sources. The main drivers of consumption behaviour in Lithuania were assessed by applying households surveys in order to define the major issues of concern and to develop relevant policies targeting these issues. Age, gender, education, and income of Lithuanian residents do not have impact on environmentally responsible behaviour in Lithuanian households (energy saving, buying energy efficient electric appliances, willingness to pay electricity from renewable energy sources use of biofuels. Only environmental awareness has impact on energy saving behaviour at home and use of biofuels in cars and waste recycle.

  15. Nursing leadership in an academic hospital in Gauteng. (United States)

    Maboko, D R


    This study was aimed at describing nursing leadership in an academic hospital in Gauteng, South Africa. Nurse managers' leadership styles affect nurses' attitudes, behaviour and work performance. However, little is known about how nurses experience nurse leadership and what leadership styles are found in academic hospitals in Gauteng. The study was based on Maxwell's framework of leadership (relationships, equipping, leadership and attitude). A qualitative design was used in order to describe the experiences of registered nurses and nurse managers. The population of the study was all registered nurses and nurse managers of the hospital in which the study was conducted. In phase one of the study, a discussion group with 35 registered nurses using the nominal group technique was held to respond to the following statement: 'Please explain how you have experienced leadership by nurse managers in this hospital'. In phase two of the study, five nurse managers were interviewed individually, using a semi-structured interview guide. Some nurse managers were practising autocratic leadership in this hospital. he nurse managers need to be taught about contemporary leadership styles such as transformational leadership and visionary leadership and also about supervision, role modelling and caring. © 2011 Blackwell Publishing Ltd.

  16. A retrospective study comparing the accuracy of prehistology diagnosis and surgical excision of malignant melanomas by general practitioners and hospital specialists. (United States)

    Bakhai, M; Hopster, D; Wakeel, R


    A retrospective study was carried out to compare the overall standard of surgical excision of malignant melanomas (MMs) between general practitioners (GPs) and hospital specialists before and after the introduction of the UK melanoma guidelines between 1989 and 2006. In total, 213 melanoma excision reports were examined and surgical excision margins recorded. The results showed a significant difference in the rate of adequate surgical excision margins (at all levels of Breslow thickness) between GPs and hospital specialists, with hospital specialists excising melanomas with safe surgical excision margins at a significantly higher rate compared with GPs. Since the introduction of the guidelines in 2002, GPs showed a significant improvement in the completeness of melanoma excision but remained poor at prehistology diagnosis and in particular at taking adequate excision margins. Implementation of the guidelines has not produced significant improvements in adequacy of excision margins in both primary and secondary care. The results show that hospital specialists maintained a high standard of prehistological diagnosis and completeness of excision throughout the time of the study, performing at a significantly higher standard compared with GPs. Our conclusions concur with the UK melanoma guidelines and the National Institute for Health and Clinical Excellence guidelines, which suggest that lesions suspicious for melanoma should be urgently referred to a dermatologist or plastic surgeon for surgical excision and should not be surgically excised in primary care, particularly if lesions have a Breslow thickness > 2 mm. We suggest that the new guidelines need to be more aggressively implemented in primary care and guidance introduced to improve the accuracy of diagnosis, with better training provided for GPs.

  17. Comparing Outcomes of Coronary Artery Bypass Grafting Among Large Teaching and Urban Hospitals in China and the United States. (United States)

    Zheng, Zhe; Zhang, Heng; Yuan, Xin; Rao, Chenfei; Zhao, Yan; Wang, Yun; Normand, Sharon-Lise; Krumholz, Harlan M; Hu, Shengshou


    Coronary artery disease is prevalent in China, with concomitant increases in the volume of coronary artery bypass grafting (CABG). The present study aims to compare CABG-related outcomes between China and the United States among large teaching and urban hospitals. Observational analysis of patients aged ≥18 years, discharged from acute-care, large teaching and urban hospitals in China and the United States after hospitalization for an isolated CABG surgery. Data were obtained from the Chinese Cardiac Surgery Registry in China and the National Inpatient Sample in the United States. Analysis was stratified by 2 periods: 2007, 2008, and 2010; and 2011 to 2013 periods. The primary outcome was in-hospital mortality, and the secondary outcome was length of stay. The sample included 51 408 patients: 32 040 from 77 hospitals in the China-CABG group and 19 368 from 303 hospitals in the US-CABG group. In the 2007 to 2008, 2010 period and for all-age and aged ≥65 years, the China-CABG group had higher mortality than the US-CABG group (1.91% versus 1.58%, P =0.059; and 3.12% versus 2.20%, P =0.004) and significantly higher age-, sex-, and comorbidity-adjusted odds of death (odds ratio, 1.58; 95% confidential interval, 1.22-2.04; and odds ratio, 1.73; 95% confidential interval, 1.24-2.40). There were no significant mortality differences in the 2011 to 2013 period. For preoperative, postoperative, and total hospital stay, respectively, the median (interquartile range) length of stay across the entire study period between China-CABG and US-CABG groups were 9 (8) versus 1 (3), 9 (6) versus 6 (3), and 20 (12) versus 7 (5) days (all P China and the United States. The longer length of stay in China may represent an opportunity for improvement. © 2017 The Authors.

  18. Inguinal hernia repair: are the results from a general hospital comparable to those from dedicated hernia centres? (United States)

    Cheong, Kai Xiong; Lo, Hong Yee; Neo, Jun Xiang Andy; Appasamy, Vijayan; Chiu, Ming Terk


    We aimed to report the outcomes of inguinal hernia repair performed at Tan Tock Seng Hospital and compare them with those performed at dedicated hernia centres. We retrospectively analysed the medical records and telephone interviews of 520 patients who underwent inguinal hernia repair in 2010. The majority of the patients were male (498 [95.8%] men vs. 22 [4.2%] women). The mean age was 59.9 ± 15.7 years. Most patients (n = 445, 85.6%) had unilateral hernias (25.8% direct, 64.3% indirect, 9.9% pantaloon). The overall recurrence rate was 3.8%, with a mean time to recurrence of 12.0 ± 8.6 months. Risk factors for recurrence included contaminated wounds (odds ratio [OR] 50.325; p = 0.004), female gender (OR 8.757; p = 0.003) and pantaloon hernias (OR 5.059; p = 0.013). Complication rates were as follows: chronic pain syndrome (1.2%), hypoaesthesia (5.2%), wound dehiscence (0.4%), infection (0.6%), haematoma/seroma (4.8%), urinary retention (1.3%) and intraoperative visceral injury (0.6%). Most procedures were open repairs (67.7%), and laparoscopic repair constituted 32.3% of all the inguinal hernia repairs. Open repairs resulted in longer operating times than laparoscopic repairs (86.6 mins vs. 71.6 mins; p hospital stays (2.7 days vs. 0.7 days; p = 0.020) and a higher incidence of post-repair hypoaesthesia (6.8% vs. 1.8%; p = 0.018). However, there were no significant differences in recurrence or other complications between open and laparoscopic repair. A general hospital with strict protocols and teaching methodologies can achieve inguinal hernia repair outcomes comparable to those of dedicated hernia centres.

  19. Behaviour therapy for obesity treatment considering approved drug therapy

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    Wasem, Jürgen


    Full Text Available Introduction: Obesity is a worldwide health problem whose prevalence is on the increase. Many obesity-associated diseases require intensive medical treatment and are the cause of a large proportion of health-related expenditures in Germany. Treatment of obesity includes nutritional, exercise and behaviour therapy, usually in combination. The goal of behaviour therapy for obesity is to bring about a long-term alteration in the eating and exercise habits of overweight and obese individuals. Under certain circumstances, drug treatment may be indicated. Objectives: What is the effectiveness of behaviour therapy for obesity considering approved drugs reduce weight under medical, economic, ethical-social and legal aspects? Methods: A systematic review was conducted using relevant electronic literature databases. Publications chosen according to predefined criteria are evaluated by approved methodical standards of the evidence-based medicine systematically and qualitatively. Results: In total 18 studies, included one HTA and one meta-analysis could be identified according to the predefined inclusion criteria. Three studies compare behaviour therapy to other therapy forms (advice or instruction on nutritional changes, physical activity or a combination of the two, six studies evaluate different forms of behaviour therapy, four studies and four studies compare behaviour therapies mediated by Internet or telephone. Three studies could be identified examining the effect of the combination of behaviour and drug therapy. Furthermore one HTA and one meta-analysis could be included in the evaluation. The behaviour therapy in comparison with other therapy forms reveals a higher effectiveness. In comparison of the different therapeutic approaches of the behaviour therapy intensive behaviour therapy forms and group therapy show a higher effectiveness. Studies related to behaviour therapy based on media support demonstrate a weight reduction both through the

  20. Integrating the Principles of Evidence Based Medicine and Evidence Based Public Health: Impact on the Quality of Patient Care and Hospital Readmission Rates in Jordan (United States)

    Hijazi, Heba H.; Alshraideh, Hussam A.; Alsharman, Mohammad Aser; Al Abdi, Rabah; Harvey, Heather Lea


    Introduction: Hospital readmissions impose not only an extra burden on health care systems but impact patient health outcomes. Identifying modifiable behavioural risk factors that are possible causes of potentially avoidable readmissions can lower readmission rates and healthcare costs. Methods: Using the core principles of evidence based medicine and public health, the purpose of this study was to develop a heuristic guide that could identify what behavioural risk factors influence hospital readmissions through adopting various methods of analysis including regression models, t-tests, data mining, and logistic regression. This study was a retrospective cohort review of internal medicine patients admitted between December 1, 2012 and December 31, 2013 at King Abdullah University Hospital, in Jordan. Results: 29% of all hospitalized patients were readmitted during the study period. Among all readmissions, 44% were identified as potentially avoidable. Behavioural factors including smoking, unclear follow-up and discharge planning, and being non-compliant with treatment regimen as well as discharge against medical advice were all associated with increased risk of avoidable readmissions. Conclusion: Implementing evidence based health programs that focus on modifiable behavioural risk factors for both patients and clinicians would yield a higher response in terms of reducing potentially avoidable readmissions, and could reduce direct medical costs. PMID:28413365

  1. Integrating the Principles of Evidence Based Medicine and Evidence Based Public Health: Impact on the Quality of Patient Care and Hospital Readmission Rates in Jordan

    Directory of Open Access Journals (Sweden)

    Mohammad S. Alyahya


    Full Text Available Introduction: Hospital readmissions impose not only an extra burden on health care systems but impact patient health outcomes. Identifying modifiable behavioural risk factors that are possible causes of potentially avoidable readmissions can lower readmission rates and healthcare costs. Methods: Using the core principles of evidence based medicine and public health, the purpose of this study was to develop a heuristic guide that could identify what behavioural risk factors influence hospital readmissions through adopting various methods of analysis including regression models, t-tests, data mining, and logistic regression. This study was a retrospective cohort review of internal medicine patients admitted between December 1, 2012 and December 31, 2013 at King Abdullah University Hospital, in Jordan. Results: 29% of all hospitalized patients were readmitted during the study period. Among all readmissions, 44% were identified as potentially avoidable. Behavioural factors including smoking, unclear follow-up and discharge planning, and being non-compliant with treatment regimen as well as discharge against medical advice were all associated with increased risk of avoidable readmissions. Conclusion: Implementing evidence based health programs that focus on modifiable behavioural risk factors for both patients and clinicians would yield a higher response in terms of reducing potentially avoidable readmissions, and could reduce direct medical costs.

  2. Gap analysis between provisional diagnosis and final diagnosis in government and private teaching hospitals: A record-linked comparative study. (United States)

    Chatterjee, Sudeshna; Ray, Krishnangshu; Das, Anup Kumar


    1. To identify the extent of clinical gaps at the context of knowledge, practice and systems. 2. To formulate necessary intervention measures towards bridging the gaps. Comparative, cross-sectional and non-interventional study. It is retrospective, record-based study conducted upon inpatients ( n = 200) of major disciplines of two teaching hospitals. Major outcome variables were to observe the matching and un-matching of final and provisional diagnosis by using ICD-10 criteria. Comparative analysis of specific and selective gaps were estimated in terms of percentage (%). Pilot observation showed the existence of gaps between provisional and final diagnosis in both private and government institution. Both knowledge and skill gaps were evident in caregivers and gap in documentation was existent in medical records. The pilot data is may be an eye-opener to public and private governance systems for understanding and revising the process service planning and service delivery. Necessary intervention measures may be contemplated towards enhancing diagnostic skill of doctors for quality hospital care.

  3. Post-Hospital Medical Respite Care and Hospital Readmission of Homeless Persons (United States)

    Kertesz, Stefan G.; Posner, Michael A.; O’Connell, James J.; Swain, Stacy; Mullins, Ashley N.; Michael, Shwartz; Ash, Arlene S.


    Medical respite programs offer medical, nursing, and other care as well as accommodation for homeless persons discharged from acute hospital stays. They represent a community-based adaptation of urban health systems to the specific needs of homeless persons. This paper examines whether post-hospital discharge to a homeless medical respite program was associated with a reduced chance of 90-day readmission compared to other disposition options. Adjusting for imbalances in patient characteristics using propensity scores, Respite patients were the only group that was significantly less likely to be readmitted within 90 days compared to those released to Own Care. Respite programs merit attention as a potentially efficacious service for homeless persons leaving the hospital. PMID:19363773

  4. Psychiatric referrals in two general hospitals.

    Directory of Open Access Journals (Sweden)

    Doongaji D


    Full Text Available A prospective study was undertaken to compare the patterns of psychiatric referrals in two general hospitals in Bombay viz. the King Edward Memorial Hospital (64 cases and the Jaslok Hospital and Research Centre (62 cases. It was observed that depressive symptoms were the most common presenting symptoms in these patients attending either of the hospitals. Similarly, the commonest diagnoses were depression and organic mental disorder. Attempted suicide with organophosphorous compounds was the commonest reason for hospitalization at K.E.M. Hospital (p less than 0.001. A significant number of these patients were females (p less than 0.05. The psychiatric referrals at Jaslok had been hospitalized mainly for suspected medical or neurological illness (p less than 0.001. These patients belonged to higher economic strata and hence had a better paying capacity compared to patients at KEM hospital, a significant number of whom were unemployed (p less than 0.001. The duration of pre-referred illness of patients and their stay at Jaslok hospital were longer as compared to those at KEM Hospital (p less than 0.01. The number of non-relevant special investigations carried out on patients in Jaslok was more (p less than 0.01. Further analysis of diagnoses revealed that a significant number of patients at KEM Hospital were admitted as primary psychiatric illness (p less than 0.05.

  5. Behavioural Finance and Its Postulates

    Directory of Open Access Journals (Sweden)

    Milena Vučinić


    Full Text Available The reasons for dealing with the chosen topic can be found in the fact that there is a certain number of anomalies, system errors and conduct leaving the frames of rational behaviour, not being included and presented synthetically within a concise scientific work. Instead, the analysis deals with definite, already identified postulates of behavioural economics and finance. During the research, induction, deduction, comparative and abstraction methods are used. The challenge of the research lies in the identification of those system errors, partialities and behaviours deviating from postulates of rational, typical for classical finance, not being covered by standard behavioural, economic and finance literature. However, the challenge is even bigger because of the fact that it deals with answers to demands of universality and conciseness. Its greatest importance is reflected in the extent of identified and processed anomalies decision makers face, as well as in the identification and description of factors implying absence of rationality during the decision making process.

  6. Disentangling quality and safety indicator data: a longitudinal, comparative study of hand hygiene compliance and accreditation outcomes in 96 Australian hospitals (United States)

    Mumford, Virginia; Greenfield, David; Hogden, Anne; Debono, Deborah; Gospodarevskaya, Elena; Forde, Kevin; Westbrook, Johanna; Braithwaite, Jeffrey


    Objectives The study aims are twofold. First, to investigate the suitability of hand hygiene as an indicator of accreditation outcomes and, second, to test the hypothesis that hospitals with better accreditation outcomes achieve higher hand hygiene compliance rates. Design A retrospective, longitudinal, multisite comparative survey. Setting Acute public hospitals in New South Wales, Australia. Participants 96 acute hospitals with accreditation survey results from two surveys during 2009–2012 and submitted data for more than four hand hygiene audits between 2010 and 2013. Outcomes Our primary outcome comprised observational hand hygiene compliance data from eight audits during 2010–2013. The explanatory variables in our multilevel regression model included: accreditation outcomes and scores for the infection control standard; timing of the surveys; and hospital size and activity. Results Average hand hygiene compliance rates increased from 67.7% to 80.3% during the study period (2010–2013), with 46.7% of hospitals achieving target compliance rates of 70% in audit 1, versus 92.3% in audit 8. Average hand hygiene rates at small hospitals were 7.8 percentage points (pp) higher than those at the largest hospitals (phand hygiene rates, accreditation outcomes and infection control scores is less clear. Conclusions Our results indicate that accreditation outcomes and hand hygiene audit data are measuring different parts of the quality and safety spectrum. Understanding what is being measured when selecting indicators to assess the impact of accreditation is critical as focusing on accreditation results would discount successful hand hygiene implementation by smaller hospitals. Conversely, relying on hand hygiene results would discount the infection control related research and leadership investment by larger hospitals. Our hypothesis appears to be confounded by an accreditation programme that makes it more difficult for smaller hospitals to achieve high infection

  7. Nurses caring for ENT patients in a district general hospital without a dedicated ENT ward score significantly less in a test of knowledge than nurses caring for ENT patients in a dedicated ENT ward in a comparable district general hospital. (United States)

    Foxton, C R; Black, D; Muhlschlegel, J; Jardine, A


    To assess whether there is a difference in ENT knowledge amongst nurses caring for patients on a dedicated ENT ward and nurses caring for ENT patients in a similar hospital without a dedicated ENT ward. A test of theoretical knowledge of ENT nursing care was devised and administered to nurses working on a dedicated ENT ward and then to nurses working on generic non-subspecialist wards regularly caring for ENT patients in a hospital without a dedicated ENT ward. The test scores were then compared. A single specialist ENT/Maxillo-Facial/Opthalmology ward in hospital A and 3 generic surgical wards in hospital B. Both hospitals are comparable district general hospitals in the south west of England. Nursing staff working in hospital A and hospital B on the relevant wards were approached during the working day. 11 nurses on ward 1, 10 nurses on ward 2, 11 nurses on ward 3 and 10 nurses on ward 4 (the dedicated ENT ward). Each individual test score was used to generate an average score per ward and these scores compared to see if there was a significant difference. The average score out of 10 on ward 1 was 6.8 (+/-1.6). The average score on ward two was 4.8 (+/-1.6). The average score on ward three was 5.5 (+/-2.1). The average score on ward 4, which is the dedicated ENT ward, was 9.7 (+/-0.5). The differences in average test score between the dedicated ENT ward and all of the other wards are statistically significant. Nurses working on a dedicated ENT ward have an average higher score in a test of knowledge than nurses working on generic surgical wards. This difference is statistically significant and persists despite banding or training. © 2014 John Wiley & Sons Ltd.

  8. Self-efficacy of foot care behaviour of elderly patients with diabetes

    Directory of Open Access Journals (Sweden)

    Maizatul Nadwa Mohd Razi


    Full Text Available Introduction: Elderly patients with diabetes are at a high risk of contracting diabetic foot problems. Self-efficacy is essential to help improve foot care behaviour. Aim: To identify levels of self-efficacy and foot care behaviour and their relationship with demographic characteristics in elderly patients with diabetes Methods: A cross-sectional study was conducted in two general hospitals in Malaysia from May to June 2015. Diabetes patients aged 60 years with specific inclusion criteria were invited to participate in this study. The respondents were interviewed using a set of validated questionnaires. Data were analysed with descriptive and inferential statistics (multiple linear regression using Statistical Package for the Social Sciences version 20.0. Results: Levels of foot self-efficacy (mean+31.39; standard deviation=7.76 and foot care behaviour (mean=25.37; SD=5.88 were high. There was a positive significant relationship between foot selfefficacy (β = 0.41, p < 0.001 and gender (β = 0.30, p < 0.001 with foot care behaviour. Conclusion: Self-efficacy can be incorporated in diabetes education to improve foot care behaviour. High-risk patients should be taught proper foot inspection and protection as well as the merits of skin care to prevent the occurrence of diabetic foot problems.

  9. "Will they just pack up and leave?" – attitudes and intended behaviour of hospital health care workers during an influenza pandemic

    Directory of Open Access Journals (Sweden)

    Po Kieren


    Full Text Available Abstract Background There is a general consensus that another influenza pandemic is inevitable. Although health care workers (HCWs are essential to the health system response, there are few studies exploring HCW attitudes to pandemic influenza. The aim of this study was to explore HCWs knowledge, attitudes and intended behaviour towards pandemic influenza. Methods Cross-sectional investigation of a convenience sample of clinical and non-clinical HCWs from two tertiary-referral teaching hospitals in Sydney, Australia was conducted between June 4 and October 19, 2007. The self-administered questionnaire was distributed to hospital personal from 40 different wards and departments. The main outcome measures were intentions regarding work attendance and quarantine, antiviral use and perceived preparation. Results Respondents were categorized into four main groups by occupation: Nursing (47.5%, Medical (26.0%, Allied (15.3% and Ancillary (11.2%. Our study found that most HCWs perceived pandemic influenza to be very serious (80.9%, n = 873 but less than half were able to correctly define it (43.9%, n = 473. Only 24.8% of respondents believed their department to be prepared for a pandemic, but nonetheless most were willing to work during a pandemic if a patient or colleague had influenza. The main determinants of variation in our study were occupational factors, demographics and health beliefs. Non-clinical staff were significantly most likely to be unsure of their intentions (OR 1.43, p Conclusion We identified two issues that could undermine the best of pandemic plans – the first, a low level of confidence in antivirals as an effective measure; secondly, that non-clinical workers are an overlooked group whose lack of knowledge and awareness could undermine pandemic plans. Other issues included a high level of confidence in dietary measures to protect against influenza, and a belief among ancillary workers that antibiotics would be protective. All

  10. Exploring behavioural determinants relating to health professional reporting of medication errors: a qualitative study using the Theoretical Domains Framework. (United States)

    Alqubaisi, Mai; Tonna, Antonella; Strath, Alison; Stewart, Derek


    Effective and efficient medication reporting processes are essential in promoting patient safety. Few qualitative studies have explored reporting of medication errors by health professionals, and none have made reference to behavioural theories. The objective was to describe and understand the behavioural determinants of health professional reporting of medication errors in the United Arab Emirates (UAE). This was a qualitative study comprising face-to-face, semi-structured interviews within three major medical/surgical hospitals of Abu Dhabi, the UAE. Health professionals were sampled purposively in strata of profession and years of experience. The semi-structured interview schedule focused on behavioural determinants around medication error reporting, facilitators, barriers and experiences. The Theoretical Domains Framework (TDF; a framework of theories of behaviour change) was used as a coding framework. Ethical approval was obtained from a UK university and all participating hospital ethics committees. Data saturation was achieved after interviewing ten nurses, ten pharmacists and nine physicians. Whilst it appeared that patient safety and organisational improvement goals and intentions were behavioural determinants which facilitated reporting, there were key determinants which deterred reporting. These included the beliefs of the consequences of reporting (lack of any feedback following reporting and impacting professional reputation, relationships and career progression), emotions (fear and worry) and issues related to the environmental context (time taken to report). These key behavioural determinants which negatively impact error reporting can facilitate the development of an intervention, centring on organisational safety and reporting culture, to enhance reporting effectiveness and efficiency.

  11. Psychological consequences of aggression in pre-hospital emergency care: cross sectional survey. (United States)

    Bernaldo-De-Quirós, Mónica; Piccini, Ana T; Gómez, M Mar; Cerdeira, Jose C


    Pre-hospital emergency care is a particularly vulnerable setting for workplace violence. However, there is no literature available to date on the psychological consequences of violence in pre-hospital emergency care. To evaluate the psychological consequences of exposure to workplace violence from patients and those accompanying them in pre-hospital emergency care. A retrospective cross-sectional study. 70 pre-hospital emergency care services located in Madrid region. A randomized sample of 441 health care workers (135 physicians, 127 nurses and 179 emergency care assistants). Data were collected from February to May 2012. The survey was divided into four sections: demographic/professional information, level of burnout determined by Maslach Burnout Inventory (MBI), mental health status using General Health Questionnaire (GHQ-28) and frequency and type of violent behaviour experienced by staff members. The health care professionals who had been exposed to physical and verbal violence presented a significantly higher percentage of anxiety, emotional exhaustion, depersonalization and burnout syndrome compared with those who had not been subjected to any aggression. Frequency of verbal violence (more than five times) was related to emotional exhaustion and depersonalization. Type of violence (i.e. physical aggression) is especially related to high anxiety levels and frequency of verbal aggression is associated with burnout (emotional exhaustion and depersonalization). Psychological counselling should be made available to professional staff who have been subjected to physical aggression or frequent verbal violence. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Analysis of the quality of hospital information systems Audit Trails. (United States)

    Cruz-Correia, Ricardo; Boldt, Isabel; Lapão, Luís; Santos-Pereira, Cátia; Rodrigues, Pedro Pereira; Ferreira, Ana Margarida; Freitas, Alberto


    Audit Trails (AT) are fundamental to information security in order to guarantee access traceability but can also be used to improve Health information System's (HIS) quality namely to assess how they are used or misused. This paper aims at analysing the existence and quality of AT, describing scenarios in hospitals and making some recommendations to improve the quality of information. The responsibles of HIS for eight Portuguese hospitals were contacted in order to arrange an interview about the importance of AT and to collect audit trail data from their HIS. Five institutions agreed to participate in this study; four of them accepted to be interviewed, and four sent AT data. The interviews were performed in 2011 and audit trail data sent in 2011 and 2012. Each AT was evaluated and compared in relation to data quality standards, namely for completeness, comprehensibility, traceability among others. Only one of the AT had enough information for us to apply a consistency evaluation by modelling user behaviour. The interviewees in these hospitals only knew a few AT (average of 1 AT per hospital in an estimate of 21 existing HIS), although they all recognize some advantages of analysing AT. Four hospitals sent a total of 7 AT - 2 from Radiology Information System (RIS), 2 from Picture Archiving and Communication System (PACS), 3 from Patient Records. Three of the AT were understandable and three of the AT were complete. The AT from the patient records are better structured and more complete than the RIS/PACS. Existing AT do not have enough quality to guarantee traceability or be used in HIS improvement. Its quality reflects the importance given to them by the CIO of healthcare institutions. Existing standards (e.g. ASTM:E2147, ISO/TS 18308:2004, ISO/IEC 27001:2006) are still not broadly used in Portugal.

  13. Work-related behaviour and experience pattern in nurses: impact on physical and mental health. (United States)

    Schulz, M; Damkröger, A; Voltmer, E; Löwe, B; Driessen, M; Ward, M; Wingenfeld, K


    Nursing is associated with high levels of emotional strain and heavy workloads. Changing working conditions raise the importance of investigating job satisfaction, stress and burnout and its consequences for nurses. The aim of the study was to investigate whether work-related behaviour and experience patterns are associated with mental and physical health status in nurses. A sample of 356 nurses in four German hospitals were interviewed using questionnaires regarding work-related behaviour and experience patterns, work stress, depression, anxiety and physical symptoms ('Work-related Behaviour and Experience Pattern'--AVEM and ERI). The main result of this study is that unhealthy work-related behaviour and experience patterns (i.e. the excessive ambitious type and the resigned type) are associated with reduced mental and physical health. Preventive, as well as intervention, strategies are needed that focus both on the individual as well as on working conditions. © 2011 Blackwell Publishing.

  14. What influences pre-hospital cannulation intentions in paramedics? An application of the theory of reasoned action. (United States)

    Banerjee, Smita C; Siriwardena, A Niroshan; Iqbal, Mohammad


    Intravenous cannulation is a common and important intervention undertaken by paramedics for administration of fluids and drugs in the pre-hospital setting. This study was a partial application of the theory of reasoned action to the prediction of pre-hospital cannulation intentions as part of an evaluation of an educational intervention to change cannulation behaviour in paramedics in line with national guidance. In 2008 a self-completion questionnaire was sent to paramedics from Nottinghamshire and Lincolnshire divisions of East Midlands Ambulance Service NHS Trust, UK. This included measures of prior behaviour related to cannulation, attitude towards cannulation, normative influence related to cannulation and intention to cannulate as well as demographic information. Of the 323 paramedics sent questionnaires 137 (42.2%) responded. Attitude towards cannulation (but not normative or peer influence) was a necessary factor for prediction of intention to cannulate in respondents. Past cannulation behaviour was indirectly related to intention to cannulate through the mediation of attitude towards cannulation. The theory of reasoned action provides a parsimonious way to predict intentions to cannulate. This study suggests that design and evaluation of interventions to reduce inappropriate cannulation should be targeted towards changing attitudes of paramedics, rather than towards addressing behavioural norms. Future research could utilize social-psychological theories to better understand clinical behaviour prior to implementation of complex educational or organizational interventions. © 2010 Blackwell Publishing Ltd.

  15. Predictors of seasonal influenza vaccination behaviour among nurses and implications for interventions to increase vaccination uptake: A cross-sectional survey. (United States)

    Kan, Ting; Ai, Jiaqi; Zhang, Jing; Liu, Xiaohong


    Vaccination has been proven the most effective method to prevent seasonal influenza. Nurses' vaccination can provide protection against influenza not only for themselves but also for patients they take care of. However, vaccination coverage of nurses is suboptimal worldwide, especially in China. The influencing factors need to be explored so as to develop specific, workable strategies to improve nurses' vaccination behaviour. To explore predictors of their vaccination behaviour, identify the motivators and barriers of vaccination, and provide implications for future interventions. A cross-sectional convenience sampling questionnaire survey. Nine hospitals including five tertiary hospitals, two secondary hospitals, and two primary hospitals in Shanghai, China. A total of 1000 nurses from the nine hospitals were invited to participate in this survey. Among them, 921 nurses responded and 895 returned valid questionnaires that were used in data analysis. The Chinese version of the King's Nurses' Influenza Vaccination Questionnaire was used as the survey instrument and distributed to the participants during February-November 2012. Descriptive statistics, univariate analyses, and multivariate analyses were conducted to explore the predictors of nurses' vaccination behaviour. Overall, 8.8% of the respondents received seasonal influenza vaccination in the past influenza season (2011/2012 season). Nurses had averagely received 0.38 ± 0.71 influenza vaccines during the past five influenza seasons (2007/2008 to 2011/2012 season). Predictors of nurses' vaccination status were clinical specialty, knowledge about influenza vaccination [1.331 (1.102, 1.608), p = 0.003], internal health locus of control [0.910 (0.845, 0.980), p = 0.013], chance health locus of control [1.075 (1.023, 1.130), p = 0.004]and powerful others health of locus control [1.166 (1.083, 1.255), p behaviour against seasonal influenza. Vaccination coverage in this population was suboptimal

  16. Measuring cost efficiency in the Nordic hospitals--a cross-sectional comparison of public hospitals in 2002. (United States)

    Linna, Miika; Häkkinen, Unto; Peltola, Mikko; Magnussen, Jon; Anthun, Kjartan S; Kittelsen, Sverre; Roed, Annette; Olsen, Kim; Medin, Emma; Rehnberg, Clas


    The aim of this study was to compare the performance of hospital care in four Nordic countries: Norway, Finland, Sweden and Denmark. Using national discharge registries and cost data from hospitals, cost efficiency in the production of somatic hospital care was calculated for public hospitals. Data were collected using harmonized definitions of inputs and outputs for 184 hospitals and data envelopment analysis was used to calculate Farrell efficiency estimates for the year 2002. Results suggest that there were marked differences in the average hospital efficiency between Nordic countries. In 2002, average efficiency was markedly higher in Finland compared to Norway and Sweden. This study found differences in cost efficiency that cannot be explained by input prices or differences in coding practices. More analysis is needed to reveal the causes of large efficiency disparities between Nordic hospitals.

  17. Tracks FAQs: How Do Heart Attack Hospitalization Rates In My Community Compare With Other Counties Or States?

    Centers for Disease Control (CDC) Podcasts


    In this podcast, CDC Tracking experts discuss how to compare heart attack hospitalization rates in your community with other counties or states. Do you have a question for our Tracking experts? Please e-mail questions to  Created: 9/1/2011 by National Center for Environmental Health, Division of Environmental Hazards and Health Effects, Environmental Health Tracking Branch.   Date Released: 9/1/2011.

  18. Rates of workplace aggression in the emergency department and nurses' perceptions of this challenging behaviour: A multimethod study. (United States)

    Hyland, Simone; Watts, Joanne; Fry, Margaret


    Over the last 10 years, the rate of people presenting with challenging behaviour to emergency departments (EDs) has increased and is recognised as a frequent occurrence facing clinicians today. Challenging behaviour often includes verbal aggression, physical aggression, intimidation and destruction of property. The aim of this research was to (i) identify the characteristics and patterns of ED-reported incidents of challenging behaviour and (ii) explore emergency nurses' perceptions of caring for patients displaying challenging behaviour. This was a multi-method study conducted across two metropolitan Sydney district hospitals. Phase 1 involved a 12-month review of the hospital's incident management database. Phase 2 involved a survey of emergency nurses' perceptions of caring for patients displaying challenging behaviour. Over 12 months there were 34 incidents of aggression documented and the perpetrators were often male (n=18; 53.0%). The average age was 34.5 years. The majority of reported incidents (n=33; 90.1%) involved intimidation, verbal assault and threatening behaviour. The median time between patient arrival and incident was 109.5min (IQR 192min). The median length of stay for patients was 302.5min (IQR 479min). There was no statistical difference between day of arrival and time of actual incident (t-test p=0.235), length of stay (t-test p=0.963) or ED arrival to incident time (t-test p=0.337). The survey (n=53; 66.2%) identified the average ED experience was 12.2 years (SD 9.8 years). All participants surveyed had experienced verbal abuse and/or physical abuse. Participants (n=52) ranked being spat at (n=37; 71.1%) the most difficult to manage. Qualitative survey open-ended comments were analysed and organised thematically. The survey identified three themes which were (i) increasing security, (ii) open access and (iii) rostering imbalance. The study provides insight into emergency nurses' reported perceptions of patients who display challenging

  19. Measuring cost efficiency in the Nordic hospitals--a cross-sectional comparison of public hospitals in 2002

    DEFF Research Database (Denmark)

    Linna, Miika; Häkkinen, Unto; Peltola, Mikko


    The aim of this study was to compare the performance of hospital care in four Nordic countries: Norway, Finland, Sweden and Denmark. Using national discharge registries and cost data from hospitals, cost efficiency in the production of somatic hospital care was calculated for public hospitals. Data......, average efficiency was markedly higher in Finland compared to Norway and Sweden. This study found differences in cost efficiency that cannot be explained by input prices or differences in coding practices. More analysis is needed to reveal the causes of large efficiency disparities between Nordic...

  20. Comparative effects of exposure to high-energy electrons and gamma radiation on active avoidance behaviour

    International Nuclear Information System (INIS)

    Hunt, W.A.


    The effect of two types of ionizing radiation was examined on active avoidance behaviour. Male Sprague-Dawley rats were trained to avoid footshock by jumping onto a retractable ledge. When irradiated with high-energy electrons or gamma photons, their performance was degraded in a dose-dependent manner. However, electrons were 1.6 times as effective as gamma photons with ED50s of 62 and 102 Gy, respectively. All animals recovered within 24 min for all doses used. The data suggest that different types of ionizing radiation may not be equivalent when assessing their effect on behaviour. (author)

  1. Functional analysis-based interventions for challenging behaviour in dementia. (United States)

    Moniz Cook, Esme D; Swift, Katie; James, Ian; Malouf, Reem; De Vugt, Marjolein; Verhey, Frans


    FA component was not possible.Overall, positive effects were noted at post-intervention for the frequency of reported challenging behaviour (but not for incidence or severity) and for caregiver reaction (but not burden or depression). These effects were not seen at follow-up. The delivery of FA has been incorporated within wide ranging multi-component programmes and study designs have varied according to setting - i.e. family care, care homes and hospital, with surprisingly few studies located in care homes. Our findings suggest potential beneficial effects of multi-component interventions, which utilise FA. Whilst functional analysis for challenging behaviour in dementia care shows promise, it is too early to draw conclusions about its efficacy.

  2. Male clients' behaviours with and perspectives about their last male escort encounter: comparing repeat versus first-time hires. (United States)

    Wolff, Margaret M; Grov, Christian; Smith, Michael D; Koken, Juline A; Parsons, Jeffrey T


    Research on men who have sex with men suggests that condomless anal intercourse occurs more frequently in established sexual relationships. While comparable data regarding male-for-male escorting is unavailable, research implies that many clients seek emotional as well as physical connections with the men they hire. In 2012, 495 male clients, recruited via completed an online survey about their last hiring experience. Most participants were from the USA (85.7%), the UK and Canada (3.2% each). In total, 75% of encounters involved an escort hired for the first time; 25% were with a previously hired escort ('repeat encounter'). The client's age, lifetime number of escorts hired and number hired in the past year were positively associated with the last encounter being a repeat encounter. Cuddling, sharing a meal, drinking alcohol, taking a walk, watching a show and shopping were also positively associated with repeat encounters. Conversely, none of the sexual behaviours were significantly associated with repeat encounters. Repeat encounters were significantly more likely to include non-sexual behaviours alongside sexual activities, but no more likely to involve condomless anal intercourse. Moreover, clients' knowledge of escorts' HIV status was not significantly associated with engaging in condomless anal intercourse with repeat encounters.

  3. Treating anxiety and depression in young adults: A randomised controlled trial comparing clinician-guided versus self-guided Internet-delivered cognitive behavioural therapy. (United States)

    Dear, Blake F; Fogliati, Vincent J; Fogliati, Rhiannon; Johnson, Bareena; Boyle, Olivia; Karin, Eyal; Gandy, Milena; Kayrouz, Rony; Staples, Lauren G; Titov, Nickolai


    Internet-delivered cognitive behaviour therapy may increase access by young adults to evidence-based treatments for anxiety and depression. The aim of this study was to compare the efficacy of an Internet-delivered cognitive behaviour therapy intervention designed for adults aged 18-24 years, when delivered in clinician-guided versus self-guided formats. The intervention, the Mood Mechanic Course, is a transdiagnostic treatment that simultaneously targets symptoms of anxiety and depression using cognitive and behavioural skills. The brief intervention comprised four lessons, delivered over 5 weeks. Following a brief telephone interview, young adults ( n = 191) with symptoms of anxiety and depression were randomly allocated to either (1) clinician-guided treatment ( n = 96) or (2) self-guided treatment ( n = 95). At post treatment, large reductions (average improvement; clinician guided vs self-guided) were observed in symptoms of anxiety (44% vs 35%) and depression (40% vs 31%) in both groups. Significant improvements were also observed in general psychological distress (33% vs 29%), satisfaction with life (18% vs 15%) and disability (36% vs 29%). No marked or consistent differences in clinical outcomes emerged between conditions at post-treatment, at 3-month or 12-month follow-up. Satisfaction was high with both treatment formats, but slightly higher for clinician-guided treatment. These results indicate the potential of carefully developed Internet-delivered cognitive behaviour therapy interventions for young adults with anxiety and depression provided in either self or therapist-guided format. Further large-scale research is required to determine the short- and long-term advantages and disadvantages of different models of support.

  4. Energy expenditure in frontotemporal dementia: a behavioural and imaging study (United States)

    Ahmed, Rebekah M; Landin-Romero, Ramon; Collet, Tinh-Hai; van der Klaauw, Agatha A; Devenney, Emma; Henning, Elana; Kiernan, Matthew C; Piguet, Olivier; Farooqi, I Sadaf; Hodges, John R


    Abstract See Finger (doi:10.1093/aww312) for a scientific commentary on this article. Abnormal eating behaviour and metabolic parameters including insulin resistance, dyslipidaemia and body mass index are increasingly recognized as important components of neurodegenerative disease and may contribute to survival. It has previously been established that behavioural variant frontotemporal dementia is associated with abnormal eating behaviour characterized by increased sweet preference. In this study, it was hypothesized that behavioural variant frontotemporal dementia might also be associated with altered energy expenditure. A cohort of 19 patients with behavioural variant frontotemporal dementia, 13 with Alzheimer’s disease and 16 (age- and sex-matched) healthy control subjects were studied using Actiheart devices (CamNtech) to assess resting and stressed heart rate. Actiheart devices were fitted for 7 days to measure sleeping heart rate, activity levels, and resting, active and total energy expenditure. Using high resolution structural magnetic resonance imaging the neural correlates of increased resting heart rate were investigated including cortical thickness and region of interest analyses. In behavioural variant frontotemporal dementia, resting (P = 0.001), stressed (P = 0.037) and sleeping heart rate (P = 0.038) were increased compared to control subjects, and resting heart rate (P = 0.020) compared to Alzheimer disease patients. Behavioural variant frontotemporal dementia was associated with decreased activity levels compared to controls (P = 0.002) and increased resting energy expenditure (P = 0.045) and total energy expenditure (P = 0.035). Increased resting heart rate correlated with behavioural (Cambridge Behavioural Inventory) and cognitive measures (Addenbrooke’s Cognitive Examination). Increased resting heart rate in behavioural variant frontotemporal dementia correlated with atrophy involving the mesial temporal cortex, insula, and amygdala

  5. Comparing the behavioural impact of a nudge-based handwashing intervention to high-intensity hygiene education: a cluster-randomised trial in rural Bangladesh. (United States)

    Grover, Elise; Hossain, Mohammed Kamal; Uddin, Saker; Venkatesh, Mohini; Ram, Pavani K; Dreibelbis, Robert


    To determine the impact of environmental nudges on handwashing behaviours among primary school children as compared to a high-intensity hygiene education intervention. In a cluster-randomised trial (CRT), we compared the rates of handwashing with soap (HWWS) after a toileting event among primary school students in rural Bangladesh. Eligible schools (government run, on-site sanitation and water, no hygiene interventions in last year, fewer than 450 students) were identified, and 20 schools were randomly selected and allocated without blinding to one of four interventions, five schools per group: simultaneous handwashing infrastructure and nudge construction, sequential infrastructure then nudge construction, simultaneous infrastructure and high-intensity hygiene education (HE) and sequential handwashing infrastructure and HE. The primary outcome, incidence of HWWS after a toileting event, was compared between the intervention groups at different data collection points with robust-Poisson regression analysis with generalised estimating equations, adjusting for school-level clustering of outcomes. The nudge intervention and the HE intervention were found to be equally effective at sustained impact over 5 months post-intervention (adjusted IRR 0.81, 95% CI 0.61-1.09). When comparing intervention delivery timing, the simultaneous delivery of the HE intervention significantly outperformed the sequential HE delivery (adjusted IRR 1.58 CI 1.20-2.08), whereas no significant difference was observed between sequential and simultaneous nudge intervention delivery (adjusted IRR 0.75, 95% CI 0.48-1.17). Our trial demonstrates sustained improved handwashing behaviour 5 months after the nudge intervention. The nudge intervention's comparable performance to a high-intensity hygiene education intervention is encouraging. © 2017 John Wiley & Sons Ltd.

  6. [Balance of power in hospitals]. (United States)

    Lameyer, A


    It is known that there is a large extent of working dissatisfaction within some professional groups of the health service system. Especially in the hospital sector, many "struggles for power" take place. Unfortunately, these struggles are often only examined with regard to individual points of view without considering the system-oriented background. The following text will reflect the discussion in social sciences as to the distribution of power within the health service system. The double meaning of the distribution of power will be explained and, by means of decisive phenomenons, the development of cost and efficiency structures on the one hand as well as the development of health political processes in decision-making on the other hand will be described. In the section "The Hospital in the 20th Century", the structures that still can be widely found nowadays will be specified and examined as to aspects in behavioural sciences. Finally, as a logical consequence, an urgently needed reorientation from administration towards management will be pointed out.

  7. The work engagement of nurses in multiple hospital sectors in Saudi Arabia: a comparative study. (United States)

    Aboshaiqah, Ahmad E; Hamadi, Hanadi Y; Salem, Olfat A; Zakari, Nazik M A


    To examine the differences in work engagement among nurses in Saudi Arabia and its relationship with personal characteristics across different hospital affiliations. Quality care requires an adequate supply of engaged nurses who are dedicated, energised and absorbed in their work. In the nursing profession, work engagement is of considerable importance, owing to the shortage of nurses and the continuing reduction in healthcare costs. An analytic comparative cross-sectional design was used. Eight hospitals from three provinces and different affiliation types participated in the study. The Utrecht work engagement scale (UWES) was used to measure 980 nurses' work engagement. The findings indicate that nurses' total engagement scores were closer to the higher end of the Likert scale. The findings indicate generally high levels of work engagement, particularly regarding the element of dedication. Furthermore, the study shows significant differences in nurses' engagement among the various work settings and in nurses' age and experience. A number of nurses' personal characteristics have independent influences on their work engagement. Nurse leaders should acknowledge that a statement of professional nursing scope of practice is a necessity to encourage and fulfil engagement. © 2016 John Wiley & Sons Ltd.

  8. Patient Satisfaction at America’s Lowest Performing Hospitals (United States)

    Girotra, Saket; Cram, Peter; Popescu, Ioana


    BACKGROUND Previous studies have identified hospitals with poor performance on cardiac process measures. How these hospitals fare in other domains such as patient satisfaction remains unknown. METHODS We used Hospital Compare data to identify hospitals that reported acute myocardial infarction (AMI) and heart failure (HF) process measures for 2006–2008 and calculated respective composite performance scores. Using these scores, we classified hospitals as low-performing (bottom decile for all three years), top-performing (top decile for all three years), and intermediate (all others). We used Hospital Consumer Assessment of Healthcare Providers and Systems 2008 data to compare overall satisfaction between low, intermediate, and top-performing hospitals. RESULTS Low-performing hospitals had fewer beds, fewer nurses per-patient, and were more likely rural, safety-net hospitals located in the South, compared to intermediate and top-performing hospitals (Ppatient satisfaction (kappa statisticpatient satisfaction on average suggesting that these hospitals have overall poor quality of care. However, there is discordance between the two measures in profiling hospital quality. PMID:22496113

  9. Prevalence of Cigarette Smoking in Schizophrenic Patients Compared to Other Hospital Admitted Psychiatric Patients


    Ziaaddini, Hassan; Kheradmand, Ali; Vahabi, Mostafa


    Background: This study aimed to estimate the prevalence of cigarette smoking and some of the related factors among schizophrenic and other hospitalized psychiatric patients. Methods: This was a cross-sectional study on 120 patients hospitalized in Shahid Beheshti hospital in Kerman in 2005. Patients were equally devided in two groups of schizophrenia and other psychiatric disorders. Sampling was based on statistical census and data were collected using a questionnaire including 27 questions o...

  10. Hospital Acquisitions Before Healthcare Reform. (United States)

    McCue, Michael J; Thompson, Jon M; Kim, Tae Hyun


    The hospital industry has experienced increased consolidation in the past 20 years. Since 2010, in particular, there has been a large rise in the number of hospital acquisitions, and observers have suggested this is due in part to the expected impact of federal healthcare reform legislation. This article reports on a study undertaken to identify the market, management, and financial factors affecting acute care, community hospitals acquired between 2010 and 2012. We identified 77 such hospitals and compared them to other acute care facilities. To assess how different factors were associated with acquisitions, the study used multiple logistic regressions whereby market factors were included first, followed by management and financial factors. Study findings show that acquired hospitals were located in markets with lower rates of preferred provider organization (PPO) penetration compared with nonacquired hospitals. Occupancy rate was found to be inversely related to acquisition rate; however, case-mix index was significantly and positively related to a hospital's being acquired. Financial factors negatively associated with a hospital's being acquired included age of plant and cash flow margin. In contrast to the findings from earlier studies of hospital acquisitions, our results showed that acquired hospitals possessed newer assets. However, similar to the findings of other studies, the cash flow margin of acquired hospitals was lower than that of nonacquired facilities.

  11. Behaviour Centred Design: towards an applied science of behaviour change. (United States)

    Aunger, Robert; Curtis, Valerie


    Behaviour change has become a hot topic. We describe a new approach, Behaviour Centred Design (BCD), which encompasses a theory of change, a suite of behavioural determinants and a programme design process. The theory of change is generic, assuming that successful interventions must create a cascade of effects via environments, through brains, to behaviour and hence to the desired impact, such as improved health. Changes in behaviour are viewed as the consequence of a reinforcement learning process involving the targeting of evolved motives and changes to behaviour settings, and are produced by three types of behavioural control mechanism (automatic, motivated and executive). The implications are that interventions must create surprise, revalue behaviour and disrupt performance in target behaviour settings. We then describe a sequence of five steps required to design an intervention to change specific behaviours: Assess, Build, Create, Deliver and Evaluate. The BCD approach has been shown to change hygiene, nutrition and exercise-related behaviours and has the advantages of being applicable to product, service or institutional design, as well as being able to incorporate future developments in behaviour science. We therefore argue that BCD can become the foundation for an applied science of behaviour change.

  12. Medical costs, Cesarean delivery rates, and length of stay in specialty hospitals vs. non-specialty hospitals in South Korea.

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    Seung Ju Kim

    Full Text Available Since 2011, specialty hospitals in South Korea have been known for providing high- quality care in specific clinical areas. Much research related to specialty hospitals and their performance in many such areas has been performed, but investigations about their performance in obstetrics and gynecology are lacking. Thus, we aimed to compare specialty vs. non-specialty hospitals with respect to mode of obstetric delivery, especially the costs and length of stay related to Cesarean section (CS procedures, and to provide evidence to policy-makers for evaluating the success of hospitals that specialize in obstetric and gynecological (OBGYN care.We obtained National Health Insurance claim data from 2012 to 2014, which included information from 418,141 OBGYN cases at 214 hospitals. We used a generalized estimating equation model to identify a potential association between the likelihood of CS at specialty hospitals compared with other hospitals. We also evaluated medical costs and length of stay in specialty hospitals according to type of delivery.We found that 150,256 (35.9% total deliveries were performed by CS. The odds ratio of CS was significantly lower in specialty hospitals (OR: 0.95, 95% CI: 0.93-0.96compared to other hospitals Medical costs (0.74% and length of stay (1% in CS cases increased in specialty hospitals, although length of stay following vaginal delivery was lower (0.57% in specialty hospitals compared with other hospitals.We determined that specialty hospitals are significantly associated with a lower likelihood of CS delivery and shorter length of stay after vaginal delivery. Although they are also associated with higher costs for delivery, the increased cost could be due to the high level of intensive care provided, which leads to improve quality of care. Policy-makers should consider incentive programs to maintain performance of specialty hospitals and promote efficiency that could reduce medical costs accrued by patients.

  13. Hospital benchmarking: are U.S. eye hospitals ready? (United States)

    de Korne, Dirk F; van Wijngaarden, Jeroen D H; Sol, Kees J C A; Betz, Robert; Thomas, Richard C; Schein, Oliver D; Klazinga, Niek S


    Benchmarking is increasingly considered a useful management instrument to improve quality in health care, but little is known about its applicability in hospital settings. The aims of this study were to assess the applicability of a benchmarking project in U.S. eye hospitals and compare the results with an international initiative. We evaluated multiple cases by applying an evaluation frame abstracted from the literature to five U.S. eye hospitals that used a set of 10 indicators for efficiency benchmarking. Qualitative analysis entailed 46 semistructured face-to-face interviews with stakeholders, document analyses, and questionnaires. The case studies only partially met the conditions of the evaluation frame. Although learning and quality improvement were stated as overall purposes, the benchmarking initiative was at first focused on efficiency only. No ophthalmic outcomes were included, and clinicians were skeptical about their reporting relevance and disclosure. However, in contrast with earlier findings in international eye hospitals, all U.S. hospitals worked with internal indicators that were integrated in their performance management systems and supported benchmarking. Benchmarking can support performance management in individual hospitals. Having a certain number of comparable institutes provide similar services in a noncompetitive milieu seems to lay fertile ground for benchmarking. International benchmarking is useful only when these conditions are not met nationally. Although the literature focuses on static conditions for effective benchmarking, our case studies show that it is a highly iterative and learning process. The journey of benchmarking seems to be more important than the destination. Improving patient value (health outcomes per unit of cost) requires, however, an integrative perspective where clinicians and administrators closely cooperate on both quality and efficiency issues. If these worlds do not share such a relationship, the added

  14. [Language Competence and Behavioural Problems in Preschool]. (United States)

    Rißling, J K; Melzer, J; Menke, B; Petermann, F; Daseking, M


    Children with language disorders are at increased risk of developing behavioural and emotional problems. The analysis focused on the question whether behavioural problems differ depending on the type of language deficit. The present study examines the behaviour of preschool children with different language impairments. The results of N=540 children aged between 4;0 and 5;11 years were analyzed. Language impairments were classified into phonetics/phonology (n=44), vocabulary (n=44), grammar (n=58), pragmatics (n=26) and multiple language impairments (n=171). In addition, a distinction was made between deficits in language production and comprehension. The children were compared with an unimpaired control group (n=197). The extent of emotional and behavioural problems were analyzed. The results indicate that emotional and behavioural problems differ depending on the type of language deficit already in preschoolers. Especially deficits in language comprehension, pragmatic impairments and multiple language impairments increase the risk of behavioural and emotional problems and hyperactivity. The relationship between language skills and emotional and behavioural problems should be emphasized in the developmental observation and documentation in preschool. In particular, the distinction between deficits in pragmatics and behavioural problems requires a differentiated examination to ensure an optimal intervention. © Georg Thieme Verlag KG Stuttgart · New York.


    Directory of Open Access Journals (Sweden)

    Mateja Rek


    Full Text Available In many cases of unwanted behaviour that we analysed (for instance in case of cheating on school tests, beating, being bullied, conflicts with parents, gambling, intentionally damaging or destroying property we found a statistically significant effect of the extent of digital media use on incidence of such behaviour. Youth, who are large digital media users, behave in such socially unwanted ways more often compared to smaller media users. A dominant share of youth isn’t involved in violent behaviour or vandalism at all. However, the incidence of violence or vandalism in the large media users group is significantly higher compared to low and medium users group.

  16. Constructing Episodes of Inpatient Care: How to Define Hospital Transfer in Hospital Administrative Health Data? (United States)

    Peng, Mingkai; Li, Bing; Southern, Danielle A; Eastwood, Cathy A; Quan, Hude


    Hospital administrative health data create separate records for each hospital stay of patients. Treating a hospital transfer as a readmission could lead to biased results in health service research. This is a cross-sectional study. We used the hospital discharge abstract database in 2013 from Alberta, Canada. Transfer cases were defined by transfer institution code and were used as the reference standard. Four time gaps between 2 hospitalizations (6, 9, 12, and 24 h) and 2 day gaps between hospitalizations [same day (up to 24 h), ≤1 d (up to 48 h)] were used to identify transfer cases. We compared the sensitivity and positive predictive value (PPV) of 6 definitions across different categories of sex, age, and location of residence. Readmission rates within 30 days were compared after episodes of care were defined at the different time gaps. Among the 6 definitions, sensitivity ranged from 93.3% to 98.7% and PPV ranged from 86.4% to 96%. The time gap of 9 hours had the optimal balance of sensitivity and PPV. The time gaps of same day (up to 24 h) and 9 hours had comparable 30-day readmission rates as the transfer indicator after defining episode of care. We recommend the use of a time gap of 9 hours between 2 hospitalizations to define hospital transfer in inpatient databases. When admission or discharge time is not available in the database, a time gap of same day (up to 24 h) can be used to define hospital transfer.

  17. The behaviour of free-flowing granular intruders

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    Wyburn Edward


    Full Text Available Particle shape affects both the quasi-static and dynamic behaviour of granular media. There has been significant research devoted to the flowability of systems of irregularly shaped particles, as well as the flow of grains around fixed intruders, however the behaviour of free flowing intruders within granular flows remains comparatively unexplored. Here, the effect of the shape of these intruder particles is studied, looking at the kinematic behaviour of the intruders and in particular their tendency of orientation. Experiments are carried out within the Stadium Shear Device, which is a novel apparatus able to continuously apply simple shear conditions to two-dimensional grain analogues. It is found that the intruder shows different behaviour to that of the bulk flow, and that this behaviour is strongly shape dependent. These insights could lead to the development of admixtures that alter the flowability of granular materials.

  18. Accommodation Consumers and Providers’ Attitudes, Behaviours and Practices for Sustainability: A Systematic Review

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    Colin Michael Hall


    Full Text Available Accommodation and lodging are an integral component of the tourism and hospitality industry. Given the sectors’ growing contribution to resource consumption and waste, there is a growing body of literature on the attitudes, behaviours and practices of consumers, managers, staff and owners of lodging with respect to sustainability. This paper presents the results of a systematic analysis of articles on attitudes, behaviours and practices of consumers and the provision of accommodation with respect to sustainability. The results indicate that there is a dearth of longitudinal studies on the sustainability of practices and behaviours. There are limitations in geographical coverage as well as methods, with research dominated by convenience sampling approaches. It is concluded that while there appear to be improvements in the potential sustainability of lodging with respect to technological approaches, the lack of systematic long-term studies on behavioural interventions represents a significant challenge to reducing the absolute emissions of the sector as well as reductions in energy and water use and waste production. Given the lack of longitudinal studies, it is not known whether observed behavioural changes are sustained over time.

  19. Effects of an educational patient safety campaign on patients' safety behaviours and adverse events. (United States)

    Schwappach, David L B; Frank, Olga; Buschmann, Ute; Babst, Reto


    Rationale, aims and objectives  The study aims to investigate the effects of a patient safety advisory on patients' risk perceptions, perceived behavioural control, performance of safety behaviours and experience of adverse incidents. Method  Quasi-experimental intervention study with non-equivalent group comparison was used. Patients admitted to the surgical department of a Swiss large non-university hospital were included. Patients in the intervention group received a safety advisory at their first clinical encounter. Outcomes were assessed using a questionnaire at discharge. Odds ratios for control versus intervention group were calculated. Regression analysis was used to model the effects of the intervention and safety behaviours on the experience of safety incidents. Results  Two hundred eighteen patients in the control and 202 in the intervention group completed the survey (75 and 77% response rates, respectively). Patients in the intervention group were less likely to feel poorly informed about medical errors (OR = 0.55, P = 0.043). There were 73.1% in the intervention and 84.3% in the control group who underestimated the risk for infection (OR = 0.51, CI 0.31-0.84, P = 0.009). Perceived behavioural control was lower in the control group (meanCon  = 3.2, meanInt  = 3.5, P = 0.010). Performance of safety-related behaviours was unaffected by the intervention. Patients in the intervention group were less likely to experience any safety-related incident or unsafe situation (OR for intervention group = 0.57, CI 0.38-0.87, P = 0.009). There were no differences in concerns for errors during hospitalization. There were 96% of patients (intervention) who would recommend other patients to read the advisory. Conclusions  The results suggest that the safety advisory decreases experiences of adverse events and unsafe situations. It renders awareness and perceived behavioural control without increasing concerns for safety and

  20. How to reduce sitting time? A review of behaviour change strategies used in sedentary behaviour reduction interventions among adults. (United States)

    Gardner, Benjamin; Smith, Lee; Lorencatto, Fabiana; Hamer, Mark; Biddle, Stuart J H


    Sedentary behaviour - i.e., low energy-expending waking behaviour while seated or lying down - is a health risk factor, even when controlling for physical activity. This review sought to describe the behaviour change strategies used within interventions that have sought to reduce sedentary behaviour in adults. Studies were identified through existing literature reviews, a systematic database search, and hand-searches of eligible papers. Interventions were categorised as 'very promising', 'quite promising', or 'non-promising' according to observed behaviour changes. Intervention functions and behaviour change techniques were compared across promising and non-promising interventions. Twenty-six eligible studies reported thirty-eight interventions, of which twenty (53%) were worksite-based. Fifteen interventions (39%) were very promising, eight quite promising (21%), and fifteen non-promising (39%). Very or quite promising interventions tended to have targeted sedentary behaviour instead of physical activity. Interventions based on environmental restructuring, persuasion, or education were most promising. Self-monitoring, problem solving, and restructuring the social or physical environment were particularly promising behaviour change techniques. Future sedentary reduction interventions might most fruitfully incorporate environmental modification and self-regulatory skills training. The evidence base is, however, weakened by low-quality evaluation methods; more RCTs, employing no-treatment control groups, and collecting objective data are needed.

  1. How to reduce sitting time? A review of behaviour change strategies used in sedentary behaviour reduction interventions among adults (United States)

    Gardner, Benjamin; Smith, Lee; Lorencatto, Fabiana; Hamer, Mark; Biddle, Stuart JH


    Sedentary behaviour – i.e., low energy-expending waking behaviour while seated or lying down – is a health risk factor, even when controlling for physical activity. This review sought to describe the behaviour change strategies used within interventions that have sought to reduce sedentary behaviour in adults. Studies were identified through existing literature reviews, a systematic database search, and hand-searches of eligible papers. Interventions were categorised as ‘very promising’, ‘quite promising’, or ‘non-promising’ according to observed behaviour changes. Intervention functions and behaviour change techniques were compared across promising and non-promising interventions. Twenty-six eligible studies reported thirty-eight interventions, of which twenty (53%) were worksite-based. Fifteen interventions (39%) were very promising, eight quite promising (21%), and fifteen non-promising (39%). Very or quite promising interventions tended to have targeted sedentary behaviour instead of physical activity. Interventions based on environmental restructuring, persuasion, or education were most promising. Self-monitoring, problem solving, and restructuring the social or physical environment were particularly promising behaviour change techniques. Future sedentary reduction interventions might most fruitfully incorporate environmental modification and self-regulatory skills training. The evidence base is, however, weakened by low-quality evaluation methods; more RCTs, employing no-treatment control groups, and collecting objective data are needed. PMID:26315814

  2. Behaviour Centred Design: towards an applied science of behaviour change (United States)

    Aunger, Robert; Curtis, Valerie


    ABSTRACT Behaviour change has become a hot topic. We describe a new approach, Behaviour Centred Design (BCD), which encompasses a theory of change, a suite of behavioural determinants and a programme design process. The theory of change is generic, assuming that successful interventions must create a cascade of effects via environments, through brains, to behaviour and hence to the desired impact, such as improved health. Changes in behaviour are viewed as the consequence of a reinforcement learning process involving the targeting of evolved motives and changes to behaviour settings, and are produced by three types of behavioural control mechanism (automatic, motivated and executive). The implications are that interventions must create surprise, revalue behaviour and disrupt performance in target behaviour settings. We then describe a sequence of five steps required to design an intervention to change specific behaviours: Assess, Build, Create, Deliver and Evaluate. The BCD approach has been shown to change hygiene, nutrition and exercise-related behaviours and has the advantages of being applicable to product, service or institutional design, as well as being able to incorporate future developments in behaviour science. We therefore argue that BCD can become the foundation for an applied science of behaviour change. PMID:27535821

  3. Effectiveness of telephone-assisted parent-administered behavioural family intervention for preschool children with externalizing problem behaviour: a randomized controlled trial. (United States)

    Kierfeld, Frauke; Ise, Elena; Hanisch, Charlotte; Görtz-Dorten, Anja; Döpfner, Manfred


    Externalizing problem behaviour is one of the most common childhood disorders. Parent training is an effective treatment for these children and there is growing interest in the effects of parent-administered interventions with minimal therapist contact. This randomized controlled study examined the efficacy of a telephone-assisted parent-administered behavioural intervention (bibliotherapy) in families with preschool children with externalizing problem behaviour. Families were randomly assigned to a treatment group (n = 26) and an untreated waitlist control group (n = 22). The intervention comprised the reading of an 11 chapter self-help book and 11 weekly telephone consultations. Compared to the control group, the treatment group demonstrated significant decreases in parent-reported externalizing and internalizing child problem behaviour and dysfunctional parenting practices. Moreover, treated parents reported less parenting-related strains and decreases in parental depression, anxiety, and stress. The results suggest that telephone-assisted self-administered parent training is an effective alternative to more intensive forms of behavioural family intervention for preschool children with externalizing problem behaviour.

  4. Long-term follow-up of children with bacterial meningitis with emphasis on behavioural characteristics. (United States)

    Berg, Stefan; Trollfors, Birger; Hugosson, Svante; Fernell, Elisabeth; Svensson, Elisabeth


    The sequelae and behaviour in children several years after an episode of bacterial meningitis were studied. All children in Sweden aged 0-4 years with bacterial meningitis between 1987 and 1989 caused by Haemophilus influenzae, Streptococcus pneumoniae and Neisseria meningitidis were identified. After exclusion of 16 children who died, 12 with severe concomitant diseases, ten with severe neurological damage obvious already at discharge from hospital and 34 with unknown address, questionnaires were sent to the parents of the remaining 463 children The nearest-age siblings were used as a comparison group. The questionnaires included questions concerning general health, schooling, motor function, speech, hearing and behaviour (inattention, hyperactivity and impulsiveness). The children were 6-14 years old when the questionnaires were completed. Questionnaires were completed for 304 pairs of patients and siblings and for 154 patients without siblings. The majority of post-meningitic children were healthy and attended normal school but they had more hearing impairment, headaches and problems with balance than their siblings. When the distributions of answers regarding behaviour were compared, the post-meningitic children had significantly more symptoms in the fields of inattention, hyperactivity and impulsiveness than their siblings. Except for hearing impairment, severe sequelae after bacterial meningitis which are not discovered at discharge do not appear later. Children who appear well after bacterial meningitis have more non-specific symptoms like headache, and more signs and symptoms indicating inattention, hyperactivity and impulsiveness than their siblings.

  5. Is quality of colorectal cancer care good enough? Core measures development and its application for comparing hospitals in Taiwan

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    Cheng Skye H


    Full Text Available Abstract Background Although performance measurement for assessing care quality is an emerging area, a system for measuring the quality of cancer care at the hospital level has not been well developed. The purpose of this study was to develop organization-based core measures for colorectal cancer patient care and apply these measures to compare hospital performance. Methods The development of core measures for colorectal cancer has undergone three stages including a modified Delphi method. The study sample originated from 2004 data in the Taiwan Cancer Database, a national cancer data registry. Eighteen hospitals and 5585 newly diagnosed colorectal cancer patients were enrolled in this study. We used indicator-based and case-based approaches to examine adherences simultaneously. Results The final core measure set included seventeen indicators (1 pre-treatment, 11 treatment-related and 5 monitoring-related. There were data available for ten indicators. Indicator-based adherence possesses more meaningful application than case-based adherence for hospital comparisons. Mean adherence was 85.8% (79.8% to 91% for indicator-based and 82.8% (77.6% to 88.9% for case-based approaches. Hospitals performed well (>90% for five out of eleven indicators. Still, the performance across hospitals varied for many indicators. The best and poorest system performance was reflected in indicators T5-negative surgical margin (99.3%, 97.2% - 100.0% and T7-lymph nodes harvest more than twelve(62.7%, 27.6% - 92.2%, both of which related to surgical specimens. Conclusions In this nationwide study, quality of colorectal cancer care still shows room for improvement. These preliminary results indicate that core measures for cancer can be developed systematically and applied for internal quality improvement.

  6. Comparative Studies on microstructure, mechanical and corrosion behaviour of DMR 249A Steel and its welds (United States)

    Mohammed, Raffi; Dilkush; Madhusudhan Reddy, G.; Srinivasa Rao, K.


    DMR249A Medium strength (low carbon) Low-alloy steels are used as structural components in naval applications due to its low cost and high availability. An attempt has been made to weld the DMR 249A steel plates of 8mm thickness using shielded metal arc welding (SMAW) and gas tungsten arc welding (GTAW). Welds were characterized for metallography to carry out the microstructural changes, mechanical properties were evaluated using vickers hardness tester and universal testing machine. Potentio-dynamic polarization tests were carried out to determine the pitting corrosion behaviour. Constant load type Stress corrosion cracking (SCC) testing was done to observe the cracking tendency of the joints in a 3.5%NaCl solution. Results of the present study established that SMA welds resulted in formation of relatively higher amount of martensite in ferrite matrix when compared to gas tungsten arc welding (GTAW). It is attributed to faster cooling rates achieved due to high thermal efficiency. Improved mechanical properties were observed for the SMA welds and are due to higher amount of martensite. Pitting corrosion and stress corrosion cracking resistance of SMA welds were poor when compared to GTA welds.

  7. Practices regarding hospital waste management at public and private sector hospitals of Lahore

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    Mahmood, S.; Din, N.U.; Mohsin, J.


    Health care (Biomedical) waste is a term used for all waste arising from health care establishments. In most of health care centers of Pakistan, including Lahore, hospital wastes are simply mixed with the municipal waste in collecting bins at road-sides and disposed off similarly. Proper Management of biomedical waste, especially the hazardous one, being produced in hospital settings is important in terms of their ability to cause harm to the related per-sons and the environment as well. To Observe and compare the practices regarding Hospital Waste management of the public sector hospital with private sector hospital. Descriptive, Cross sectional. Methodology: Standardized checklist was used to assess the practices of nursing and sanitary staff. Practices regarding waste segregation were same at both hospitals. While practices regarding waste collection and transportation were better at The Children's Hospital. Public sector hospital has, paradoxically, better practices regarding hospital waste management in comparison to private sector hospital. (author)

  8. Predicting sun-protective intentions and behaviours using the theory of planned behaviour: a systematic review and meta-analysis. (United States)

    Starfelt Sutton, Louise C; White, Katherine M


    To synthesise theory of planned behaviour (TPB) relationships, using meta-analysis, and test the predictive utility of the model for sun protection behaviour. Thirty-eight samples were identified via database/manual searches and academic society posts based on the criteria: measuring sun-protective intentions and/or prospective behaviour; using the TPB/theory of reasoned action as a basis of measurement; and providing bivariate correlations for at least one relevant TPB association. Sun-protective intentions and behaviours. The sample-weighted average effects were moderate-to-strong with attitudes showing the strongest association with intention (r+ = 0.494), followed by perceived behavioural control (PBC; r+ = 0.451), and subjective norm (r+ = 0.419). Intentions showed a stronger association with prospective behaviour (r+ = 0.486) compared to PBC (r+ = 0.314). A total of 39% of variance in intentions and 25% of variance in behaviour were explained. Publication bias was not evident. Moderator analyses showed that TPB associations were stronger when measures specified the Target, Action, Context and Time; in non-student samples; and when follow-up exceeded two weeks. Despite recent criticism, this review shows that the TPB explains a large amount of variance in sun protection and that TPB associations are robust across different populations.

  9. Gap analysis between provisional diagnosis and final diagnosis in government and private teaching hospitals: A record-linked comparative study

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    Sudeshna Chatterjee


    Full Text Available Aims: 1. To identify the extent of clinical gaps at the context of knowledge, practice and systems. 2. To formulate necessary intervention measures towards bridging the gaps. Settings and Design: Comparative, cross-sectional and non-interventional study. Methods and Material: It is retrospective, record-based study conducted upon inpatients (n = 200 of major disciplines of two teaching hospitals. Major outcome variables were to observe the matching and un-matching of final and provisional diagnosis by using ICD-10 criteria. Statistical Analysis Used: Comparative analysis of specific and selective gaps were estimated in terms of percentage (%. Results: Pilot observation showed the existence of gaps between provisional and final diagnosis in both private and government institution. Both knowledge and skill gaps were evident in caregivers and gap in documentation was existent in medical records. Conclusions: The pilot data is may be an eye-opener to public and private governance systems for understanding and revising the process service planning and service delivery. Necessary intervention measures may be contemplated towards enhancing diagnostic skill of doctors for quality hospital care.

  10. Behavioural and Cognitive-Behavioural Treatments of Parasomnias

    Directory of Open Access Journals (Sweden)

    Andrea Galbiati


    Full Text Available Parasomnias are unpleasant or undesirable behaviours or experiences that occur predominantly during or within close proximity to sleep. Pharmacological treatments of parasomnias are available, but their efficacy is established only for few disorders. Furthermore, most of these disorders tend spontaneously to remit with development. Nonpharmacological treatments therefore represent valid therapeutic choices. This paper reviews behavioural and cognitive-behavioural managements employed for parasomnias. Referring to the ICSD-3 nosology we consider, respectively, NREM parasomnias, REM parasomnias, and other parasomnias. Although the efficacy of some of these treatments is proved, in other cases their clinical evidence cannot be provided because of the small size of the samples. Due to the rarity of some parasomnias, further multicentric researches are needed in order to offer a more complete account of behavioural and cognitive-behavioural treatments efficacy.

  11. Patterns of malaria-related hospital admissions and mortality among Malawian children: an example of spatial modelling of hospital register data

    Directory of Open Access Journals (Sweden)

    Kleinschmidt Immo


    Full Text Available Abstract Background Malaria is a leading cause of hospitalization and in-hospital mortality among children in Africa, yet, few studies have described the spatial distribution of the two outcomes. Here spatial regression models were applied, aimed at quantifying spatial variation and risk factors associated with malaria hospitalization and in-hospital mortality. Methods Paediatric ward register data from Zomba district, Malawi, between 2002 and 2003 were used, as a case study. Two spatial models were developed. The first was a Poisson model applied to analyse hospitalization and minimum mortality rates, with age and sex as covariates. The second was a logistic model applied to individual level data to analyse case-fatality rate, adjusting for individual covariates. Results and conclusion Rates of malaria hospitalization and in-hospital mortality decreased with age. Case fatality rate was associated with distance, age, wet season and increased if the patient was referred to the hospital. Furthermore, death rate was high on first day, followed by relatively low rate as length of hospital stay increased. Both outcomes showed substantial spatial heterogeneity, which may be attributed to the varying determinants of malaria risk, health services availability and accessibility, and health seeking behaviour. The increased risk of mortality of children referred from primary health facilities may imply inadequate care being available at the referring facility, or the referring facility are referring the more severe cases which are expected to have a higher case fatality rate. Improved prognosis as the length of hospital stay increased suggest that appropriate care when available can save lives. Reducing malaria burden may require integrated strategies encompassing availability of adequate care at primary facilities, introducing home or community case management as well as encouraging early referral, and reinforcing interventions to interrupt malaria

  12. Cost-benefit of hospitalization compared with outpatient care for pregnant women with pregestational and gestational diabetes or with mild hyperglycemia, in Brazil. (United States)

    Cavassini, Ana Claudia Molina; Lima, Silvana Andréa Molina; Calderon, Iracema Mattos Paranhos; Rudge, Marilza Vieira Cunha


    Pregnancies complicated by diabetes are associated with increased numbers of maternal and neonatal complications. Hospital costs increase according to the type of care provided. This study aimed to estimate the cost-benefit relationship and social profitability ratio of hospitalization, compared with outpatient care, for pregnant women with diabetes or mild hyperglycemia. This was a prospective observational quantitative study conducted at a university hospital. It included all pregnant women with pregestational or gestational diabetes, or mild hyperglycemia, who did not develop clinical intercurrences during pregnancy and who delivered at the Botucatu Medical School Hospital (Hospital das Clínicas, Faculdade de Medicina de Botucatu, HC-FMB) of Universidade Estadual de São Paulo (Unesp). Thirty pregnant women treated with diet were followed as outpatients, and twenty treated with diet plus insulin were managed through frequent short hospitalizations. Direct costs (personnel, materials and tests) and indirect costs (general expenses) were ascertained from data in the patients' records and the hospital's absorption costing system. The cost-benefit was then calculated. Successful treatment of pregnant women with diabetes avoided expenditure of US$ 1,517.97 and US$ 1,127.43 for patients treated with inpatient and outpatient care, respectively. The cost-benefit of inpatient care was US$ 143,719.16, and outpatient care, US$ 253,267.22, with social profitability of 1.87 and 5.35, respectively. Decision-tree analysis confirmed that successful treatment avoided costs at the hospital. Cost-benefit analysis showed that outpatient management was economically more advantageous than hospitalization. The social profitability of both treatments was greater than one, thus demonstrating that both types of care for diabetic pregnant women had positive benefits.

  13. Contraceptive behaviour of Christian and Muslim teenagers at the time of abortion and post-abortion in Thrace, Greece. (United States)

    Tsikouras, Panagiotis; Koukouli, Zacharoula; Psarros, Nikolaos; Manav, Bachar; Tsagias, Nikolaos; Galazios, Georgios


    The aims of the study were to compare the contraceptive behaviour of Christian and Muslim adolescents who had an abortion in Thrace, Greece, and to examine whether extensive contraceptive counselling at the time of abortion modified their subsequent contraceptive practices. Adolescents, aged 14-19 years, who had undergone an elective abortion in our department, were included in a prospective 12-year study. Extensive contraceptive counselling was offered before discharge from the hospital. Attitudes to contraception were assessed by means of a simple questionnaire at the time of abortion and at 1-year follow-up. The study population comprised of 95 Christian Orthodox adolescents (Group A) and 79 Muslim adolescents (Group B). At the time of abortion, contraceptive behaviour differed significantly between the two groups (p = .004). Contraceptive methods used in Group A in comparison with Group B were as follows: oral contraceptives (27.4% vs. 12.7%), condoms (22.1% vs. 38.0%), interrupted coitus (18.9% vs. 20.3%), periodic abstinence (16.8% vs. 25.3%) and emergency contraception (14.7% vs. 3.8%). The commonest source of information on contraception in Group A was the gynaecologist (17.9%) and family planning clinic (15.8%), whereas in Group B it was the individual's partner (25.3%) and parents (16.4%). Contraceptive behaviour was significantly modified in both groups at post-abortion follow-up (both p Cultural differences significantly affect the contraceptive behaviour. Nevertheless, interventions that promote contraception can still be successful in different populations.

  14. A longitudinal, multi-level comparative study of quality and safety in European hospitals

    DEFF Research Database (Denmark)

    Robert, Glenn B; Anderson, Janet E; Burnett, Susan J


    makers in the European Union. Throughout the study we will adopt a mixed methods approach, including qualitative (in-depth, narrative-based, ethnographic case studies using interviews, and direct non-participant observation of organisational processes) and quantitative research (secondary analysis......, patient safety and patient experience • a conceptualisation of quality as a human, social, technical and organisational accomplishment • an emphasis on translational research that is evidence-based and seeks to provide strategic and practical guidance for hospital practitioners and health care policy...... by Research' (QUASER) study will investigate how hospitals implement, spread and sustain quality improvement, including the difficulties they face and how they overcome them. The overall aim of the study is to explore relationships between the organisational and cultural characteristics of hospitals and how...

  15. Exploring consumer values of comparative performance information for hospital choice. (United States)

    Ketelaar, Nicole A B M; Faber, Marjan J; Westert, Gert P; Elwyn, Glyn; Braspenning, Jozé C


    In many countries, market orientation in healthcare has resulted in the publication of comparative performance information (CPI). Most of the research in this field is oriented towards the content and the presentation format of CPI while little is known about how consumers value CPI and the use of this information. The aim of this study was to clarify the perceived value that CPI brings for consumers of healthcare. Methods Qualitative research using six focus group interviews. Twenty-seven healthcare consumers were recruited using a mailing list and by personal invitation. Data from focus group interviews were transcribed and thematic analysis undertaken. Most participants were unaware of CPI, and valued alternative sources of information more than CPI. Through discussion with other consumers and by means of examples of CPI, respondents were able to express the values and perceived effects of CPI. Numerous underlying values hindered consumers' use of CPI, and therefore clarification of consumer values gave insights into the current non-usage of CPI. CPI is marginally valued, partly because of conflicting values expressed by consumers and, as such, it does not yet provide a useful information source on hospital choice beyond consumers' current selection routines in healthcare. Future research should be more focused on the values of consumers and their impact on the use of CPI.

  16. Nosological Inaccuracies in death certification in Northern Ireland. A comparative study between hospital doctors and general practitioners.


    Armour, A.; Bharucha, H.


    We aimed to audit nosological inaccuracies in death certification in Northern Ireland and to compare performance of hospital doctors and general practitioners. Nosology is the branch of medicine which treats of the classification of disease. 1138 deaths were registered in Northern Ireland in a 4-week period commencing 3/10/94. 195 of these were either registered by HM Coroners (HMC) or required further investigation by their staff; these cases were excluded from the study. The remaining 943 w...

  17. Sex differences in the reciprocal behaviour of children with autism. (United States)

    Backer van Ommeren, Tineke; Koot, Hans M; Scheeren, Anke M; Begeer, Sander


    Differences in the social limitations of girls compared to boys on the autism spectrum are still poorly understood. Impaired social-emotional reciprocity is a core diagnostic criterion for an autism spectrum disorder. This study compares sex differences in reciprocal behaviour in children with autism spectrum disorder (32 girls, 114 boys) and in typically developing children (24 girls, 55 boys). While children with autism spectrum disorder showed clear limitations in reciprocal behaviour compared to typically developing children, sex differences were found only in the autism spectrum disorder group: girls with autism spectrum disorder had higher reciprocity scores than boys with autism spectrum disorder. However, compared to typically developing girls, girls with autism spectrum disorder showed subtle differences in reciprocal behaviour. The sex-specific response patterns in autism spectrum disorder can inform and improve the diagnostic assessment of autism in females.

  18. Improving the smoking patterns in a general hospital psychiatric unit

    Directory of Open Access Journals (Sweden)

    Celso Iglesias García


    Full Text Available Objectives: The purpose of the present paper is to evaluate the effects of a smoking ban in a general hospital psychiatric unit. Methods: We study the effects of smoking ban in 40 consecutive psychiatric inpatients. The staff registered socio-demographic and tobacco-related variables. We also registered any kind of behavioral effects of smoking ban.Results: The patients were willing to stop smoking during their hospital stay (with or without nicotine replacement with two mild behavioural incidences registered throughout the study. Conclusions: The benefits of non-smoking policy in a psychiatric unit can be significant. The introduction of smoking bans in psychiatric inpatients settings is possible and safe.

  19. Nursing organizational climates in public and private hospitals. (United States)

    García, I García; Castillo, R F; Santa-Bárbara, E S


    Researchers study climate to gain an understanding of the psychological environment of organizations, especially in healthcare institutions. Climate is considered to be the set of recurring patterns of individual and group behaviour in an organization. There is evidence confirming a relationship between ethical climate within organizations and job satisfaction. The aim of this study is to describe organizational climate for nursing personnel in public and private hospitals and to confirm the relationships among the climate variables of such hospitals. A correlational study was carried out to measure the organizational climate of one public hospital and two private hospitals in Granada. The Work Environment Scale was used for data collection. The Work Environment Scale includes 10 scales, ranging from 0 to 9, which were used to evaluate social, demographic and organizational climate variables. In this study, 386 subjects were surveyed in three hospitals. A total of 87% of the participants were female and 16% were male. Most participants were nurses (65.6%), followed by nursing aides (20%), and technicians (14.4%). The results obtained reflected different patterns of organizational climate formation, based on hospital type (i.e. public or private) within the Spanish context. Most of the dimensions were below the midpoint of the scale. In conclusion, in public hospitals, there is a greater specialization and the organizational climate is more salient than in the private hospitals. In addition, in the public hospitals, the characteristics of the human resources and their management can have a significant impact on the perception of the climate, which gives greater importance to the organizational climate as decisive of the ethical climate. © The Author(s) 2013.

  20. Clinical and cost-effectiveness of cognitive behaviour therapy for health anxiety in medical patients: a multicentre randomised controlled trial. (United States)

    Tyrer, Peter; Cooper, Sylvia; Salkovskis, Paul; Tyrer, Helen; Crawford, Michael; Byford, Sarah; Dupont, Simon; Finnis, Sarah; Green, John; McLaren, Elenor; Murphy, David; Reid, Steven; Smith, Georgina; Wang, Duolao; Warwick, Hilary; Petkova, Hristina; Barrett, Barbara


    Health anxiety has been treated by therapists expert in cognitive behaviour therapy with some specific benefit in some patients referred to psychological services. Those in hospital care have been less often investigated. Following a pilot trial suggesting efficacy we carried out a randomised study in hospital medical clinics. We undertook a multicentre, randomised trial on health anxious patients attending cardiac, endocrine, gastroenterological, neurological, and respiratory medicine clinics in secondary care. We included those aged 16-75 years, who satisfied the criteria for excessive health anxiety, and were resident in the area covered by the hospital, were not under investigation for new pathology or too medically unwell to take part. We used a computer-generated random scheme to allocate eligible medical patients to an active treatment group of five-to-ten sessions of adapted cognitive behaviour therapy (CBT-HA group) delivered by hospital-based therapists or to standard care in the clinics. The primary outcome was change in health anxiety symptoms measured by the Health Anxiety Inventory at 1 year and the main secondary hypothesis was equivalence of total health and social care costs over 2 years, with an equivalence margin of £150. Analysis was by intention to treat. The study is registered with, ISRCTN14565822. Of 28,991 patients screened, 444 were randomly assigned to receive either adapted cognitive behaviour therapy (CBT-HA group, 219 participants) or standard care (standard care group, 225), with 205 participants in the CBT-HA group and 212 in the standard care group included in the analyses of the primary endpoints. At 1 year, improvement in health anxiety in the patients in the CBT-HA group was 2·98 points greater than in those in the standard care group (95% CI 1·64-4·33, pbehaviour therapy achieved normal levels of health anxiety compared with those in the control group (13·9% vs 7·3%; odds ratio 2·15, 95% CI 1·09-4

  1. Implementing international sexual counselling guidelines in hospital cardiac rehabilitation: development of the CHARMS intervention using the Behaviour Change Wheel. (United States)

    Mc Sharry, J; Murphy, P J; Byrne, M


    Decreased sexual activity and sexual problems are common among people with cardiovascular disease, negatively impacting relationship satisfaction and quality of life. International guidelines recommend routine delivery of sexual counselling to cardiac patients. The Cardiac Health and Relationship Management and Sexuality (CHARMS) baseline study in Ireland found, similar to international findings, limited implementation of sexual counselling guidelines in practice. The aim of the current study was to develop the CHARMS multi-level intervention to increase delivery of sexual counselling by healthcare professionals. We describe the methods used to develop the CHARMS intervention following the three phases of the Behaviour Change Wheel approach: understand the behaviour, identify intervention options, and identify content and implementation options. Survey (n = 60) and focus group (n = 14) data from two previous studies exploring why sexual counselling is not currently being delivered were coded by two members of the research team to understand staff's capability, opportunity, and motivation to engage in the behaviour. All potentially relevant intervention functions to change behaviour were identified and the APEASE (affordability, practicability, effectiveness, acceptability, side effects and equity) criteria were used to select the most appropriate. The APEASE criteria were then used to choose between all behaviour change techniques (BCTs) potentially relevant to the identified functions, and these BCTs were translated into intervention content. The Template for Intervention Description and Replication (TIDieR) checklist was used to specify details of the intervention including the who, what, how and where of proposed intervention delivery. Providing sexual counselling group sessions by cardiac rehabilitation staff to patients during phase III cardiac rehabilitation was identified as the target behaviour. Education, enablement, modelling, persuasion and

  2. A study on the information-motivation-behavioural skills model among Chinese adults with peritoneal dialysis. (United States)

    Chang, Tian-Ying; Zhang, Yi-Lin; Shan, Yan; Liu, Sai-Sai; Song, Xiao-Yue; Li, Zheng-Yan; Du, Li-Ping; Li, Yan-Yan; Gao, Douqing


    To examine whether the information-motivation-behavioural skills model could predict self-care behaviour among Chinese peritoneal dialysis patients. Peritoneal dialysis is a treatment performed by patients or their caregivers in their own home. It is important to implement theory-based projects to increase the self-care of patients with peritoneal dialysis. The information-motivation-behavioural model has been verified in diverse populations as a comprehensive, effective model to guide the design, implementation and evaluation of self-care programmes. A cross-sectional, observational study. A total of 201 adults with peritoneal dialysis were recruited at a 3A grade hospital in China. Participant data were collected on demographics, self-care information (knowledge), social support (social motivation), self-care attitude (personal motivation), self-efficacy (behaviour skills) and self-care behaviour. We also collected data on whether the recruited patients had peritoneal dialysis-associated peritonitis from electronic medical records. Measured variable path analysis was performed using mplus 7.4 to identify the information-motivation-behavioural model. Self-efficacy, information and social motivation predict peritoneal dialysis self-care behaviour directly. Information and personal support affect self-care behaviour through self-efficacy, whereas peritoneal dialysis self-care behaviour has a direct effect on the prevention of peritoneal dialysis-associated peritonitis. The information-motivation-behavioural model is an appropriate and applicable model to explain and predict the self-care behaviour of Chinese peritoneal dialysis patients. Poor self-care behaviour among peritoneal dialysis patients results in peritoneal dialysis-associated peritonitis. The findings suggest that self-care education programmes for peritoneal dialysis patients should include strategies based on the information-motivation-behavioural model to enhance knowledge, motivation and behaviour

  3. How a smiley protects health: A pilot intervention to improve hand hygiene in hospitals by activating injunctive norms through emoticons (United States)

    Tsivrikos, Dimitrios; Dollinger, Daniel; Lermer, Eva


    Hand hygiene practice in hospitals is unfortunately still widely insufficient, even though it is known that transmitting pathogens via hands is the leading cause of healthcare-associated infections. Previous research has shown that improving knowledge, providing feedback on past behaviour and targeting social norms are promising approaches to improve hand hygiene practices. The present field experiment was designed to direct people on when to perform hand hygiene and prevent forgetfulness. This intervention is the first to examine the effect of inducing injunctive social norms via an emoticon-based feedback system on hand hygiene behaviour. Electronic monitoring and feedback devices were installed in hospital patient rooms on top of hand-rub dispensers, next to the doorway, for a period of 17 weeks. In the emoticon condition, screens at the devices activated whenever a person entered or exited the room. Before using the alcohol-based hand-rub dispenser, a frowny face was displayed, indicating that hand hygiene should be performed. If the dispenser was subsequently used, this picture changed to a smiley face to positively reinforce the correct behaviour. Hand hygiene behaviour in the emoticon rooms significantly outperformed the behaviour in three other tested conditions. The strong effect in this field experiment indicates that activating injunctive norms may be a promising approach to improve hand hygiene behaviour. Theoretical and practical implications of these findings are discussed. PMID:29782516

  4. Obsessive compulsive disorder and psychopathic behaviour in Babylon. (United States)

    Reynolds, Edward H; Kinnier Wilson, James V


    The history of obsessive compulsive, phobic and psychopathic behaviour can be traced to the 17th century AD. We draw attention to these behaviours in a Babylonian cuneiform medical text known as Shurpu. These three categories were united in the Babylonian mind around the concept of the māmīt 'oath' idea, the behaviour habits being so unbreakable it appeared that the subject had sworn an oath to do or not to do the action involved. The behavioural accounts were entirely objective, including what we would call immature, antisocial and criminal behaviour, and obsessional categories of contamination, aggression, orderliness of objects, sex and religion. They do not include subjective descriptions of obsessional thoughts, ruminations or the subject's attitude to their own behaviour, which are more modern fields of enquiry. The Babylonians had no understanding of brain or psychological function but they were remarkable describers of medical disease and behaviour. Although they had both physical and supernatural theories of many medical disorders and behaviours, they had an open mind on these particular behaviours which they regarded as a 'mystery' yet to be 'resolved'. We are not aware of comparable accounts of these behaviours in ancient Egyptian or classical medicine. These Babylonian descriptions extend the history of these disorders to the first half of the second millennium BC.

  5. The quality of Dutch hospital drug formularies : Evaluation of technical features and organisational information

    NARCIS (Netherlands)

    Fijn, R; de Vries, CS; Engles, SAG; Brouwers, JRBJ; de Blaey, CJ; de Jong-van den Berg, LTW

    Introduction: Hospital drug formularies (HDFs) are widely used tools to help influence clinicians' prescribing behaviour. Besides the therapeutic quality of HDFs, the available information and the way in which this is presented are key factors in HDFs' success or failure to influence prescribing

  6. Predictors of admission to a high-security hospital of people with intellectual disability with and without schizophrenia. (United States)

    Doody, G A; Thomson, L D; Miller, P; Johnstone, E C


    Admission to secure hospital facilities is a rare outcome for people with intellectual disability with or without concomitant psychosis. The present study compares people with mild intellectual disability with and without schizophrenia resident in the Scottish and Northern Irish State Hospital, Carstairs, to matched mild intellectual disability controls, also with and without schizophrenia, in the community. It is hoped that this study may identify socio-demographic, clinical or historical predictors which may lead to admission to secure hospital facilities for people with mild intellectual disability. One hundred and eight subjects were identified from two previous studies which concerned State Hospital patients and patients with intellectual disability with and without schizophrenia. Four experimental groups were derived: (1) 14 individuals with comorbid intellectual disability and schizophrenia who had been resident in the State Hospital; (2) 34 comorbid community control subjects; (3) 33 individuals with intellectual disability and no psychosis who had been resident in the State Hospital; and (4) 27 community control subjects with mild intellectual disability. The four groups were compared on a range of socio-demographic, historical and clinical variables obtained from case records and subject interviews. Relative to community controls, people with intellectual disability and no psychosis in the State Hospital are likely to be single, to have a later age of first psychiatric hospital admission, and to have a history of previous suicide attempts, alcohol abuse or drug misuse. Subjects with comorbid intellectual disability and schizophrenia in the State Hospital are more likely to be male, to have an early age of first psychiatric admission, and to have no family history of either schizophrenia or intellectual disability. Strategies aimed at addressing suicidal behaviour, alcohol and drug misuse amongst people with intellectual disability may facilitate a

  7. A framework for mapping and comparing behavioural theories in models of social-ecological systems

    NARCIS (Netherlands)

    Schlüter, Maja; Baeza, Andres; Dressler, Gunnar; Frank, Karin; Groeneveld, Jürgen; Jager, Wander; Janssen, Marco A.; McAllister, Ryan R.J.; Müller, Birgit; Orach, Kirill; Schwarz, Nina; Wijermans, Nanda


    Formal models are commonly used in natural resource management (NRM) to study human-environment interactions and inform policy making. In the majority of applications, human behaviour is represented by the rational actor model despite growing empirical evidence of its shortcomings in NRM contexts.

  8. [Hospital deliveries in Morocco or how to reconcile different logics]. (United States)

    Richard, F; Filali, H; Lardi, M; de Brouwere, V


    In Morocco, the majority of maternal deaths and severe obstetrical complications occurs outside a health structure. If accessibility to a referral hospital is clearly a problem, this problem can be exacerbated by the perception that women and their family have of the quality of care received in these maternity services. The objective of this article is to explore how women who went through a severe obstetrical complication experienced their hospitalisation and to confront this experience with the caregivers'perception. This study was carried out in Tetouan and Sidi Kacem between July 1999 and January 2001. Semi-structured individual interviews were held with 94 women who underwent an episode of severe morbidity, 91 family members, as well as 4 focus groups and 53 interviews with health staff members. Though all show gratitude towards the hospital staff for having saved their life, half of the women and their relatives reported problems of behaviour and attitude of the staff: verbal violence, baksheesh, patronage, lack of empathy and discrimination against certain categories of the population. These result from a complex interplay of factors: the stress-load within the profession, the institutional context which by its failures leads to or allows these behaviours and the representations peculiar to each of the players, the providers and the users. In order to be professionally more effective, it would be in the caregivers'interest to set up a system of communication that would place the patient back in the centre of hospital care.

  9. Tools assessing nurse manager behaviours and RN job satisfaction: a review of the literature. (United States)

    Feather, Rebecca


    To determine the state of the science in relation to registered nurse (RN) perceptions of nurse manager behaviours that influence registered nurse job satisfaction. Nurse managers have been related by research to the job satisfaction of their staff. However, little is known about how nurses perceive the behaviours of nurse managers as influencing their job satisfaction. A literature search was conducted to identify journal articles that included studies involving instruments of nurse manager behaviours and staff nurse job satisfaction levels. The literature shows a lack of consistency in the definitions of job satisfaction, instrumentation for measurement and conclusions that identify specific management behaviours effective for high levels of job satisfaction of RNs related to staff nurse perceptions. Studies include important aspects of what shapes a healthy work environment for nurses, but no single study identified specific nurse manager behaviours based solely on the perceptions of staff nurses and their job satisfaction. The perceptions of staff nurses are important for hospital administrators and nurse managers in order to know how to improve satisfaction and reduce turnover. Instruments developed based on manager beliefs may not provide data needed to influence a change in management behaviours that results in improved job satisfaction. © 2014 John Wiley & Sons Ltd.

  10. Distinguishing in-hospital and out-of-hospital status epilepticus: clinical implications from a 10-year cohort study. (United States)

    Sutter, R; Semmlack, S; Spiegel, R; Tisljar, K; Rüegg, S; Marsch, S


    The aim was to determine differences of clinical, treatment and outcome characteristics between patients with in-hospital and out-of-hospital status epilepticus (SE). From 2005 to 2014, clinical data were assessed in adults with SE treated in an academic medical care centre. Clinical characteristics, treatment and outcomes were compared between patients with in-hospital and out-of-hospital SE. Amongst 352 patients, 213 were admitted with SE and 139 developed in-hospital SE. Patients with in-hospital SE had more acute/fatal aetiologies (60% vs. 35%, P Status Epilepticus Severity Score (STESS) was an independent predictor for death in both groups, increased Charlson Comorbidity Index and treatment refractory SE were associated with death only in patients with in-hospital SE. Continuous anaesthesia for refractory SE was associated with increased mortality only in patients with out-of-hospital SE. The area under the receiver operating curve was 0.717 for prediction of death by STESS in patients with in-hospital SE and 0.811 in patients with out-of-hospital SE. Patients with in-hospital SE had more fatal aetiologies and comorbidities, refractory SE, less return to functional baseline, and increased mortality compared to patients with out-of-hospital SE. Whilst the STESS was a robust predictor for death in both groups, the association between continuous anaesthesia and death was limited to out-of-hospital SE. © 2017 EAN.

  11. Genetic predisposition to obesity affects behavioural traits including food reward and anxiety-like behaviour in rats. (United States)

    Vogel, Heike; Kraemer, Maria; Rabasa, Cristina; Askevik, Kaisa; Adan, Roger A H; Dickson, Suzanne L


    Here we sought to define behavioural traits linked to anxiety, reward, and exploration in different strains of rats commonly used in obesity research. We hypothesized that genetic variance may contribute not only to their metabolic phenotype (that is well documented) but also to the expression of these behavioural traits. Rat strains that differ in their susceptibility to develop an obese phenotype (Sprague-Dawley, Obese Prone, Obese Resistant, and Zucker rats) were exposed to a number of behavioural tests starting at the age of 8 weeks. We found a similar phenotype in the obesity susceptible models, Obese Prone and Zucker rats, with a lower locomotor activity, exploratory activity, and higher level of anxiety-like behaviour in comparison to the leaner Obese Resistant strain. We did not find evidence that rat strains with a genetic predisposition to obesity differed in their ability to experience reward from chocolate (in a condition place preference task). However, Zucker rats show higher motivated behaviour for sucrose compared to Obese Resistant rats when the effort required to obtain palatable food is relatively low. Together our data demonstrate that rat strains that differ in their genetic predisposition to develop obesity also differ in their performance in behavioural tests linked to anxiety, exploration, and reward and that these differences are independent of body weight. We conclude that genetic variations which determine body weight and the aforementioned behaviours co-exist but that future studies are required to identify whether (and which) common genes are involved. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.


    Directory of Open Access Journals (Sweden)

    Retno Lestari


    Full Text Available Introduction: A nurse who experience burnout feelings will influence their motivation, and quality performance. This situation is probably affecting a decline in work quality towards the caring behaviour demonstrated by nurses to their patiens, particularly for a nurse who are working in the long-stay installation room facing directly to patient's problems. The purpose of this research is to identify the work stress level of nurse towards the nurse's caring behaviour in the long-stay installation room (IRNA in general hospital in Malang. Method: This research used descriptive – correlational, the sampling was Non Probability Purposive Sampling with 93 nurses as the corresponds. The data was analyzed by operating Correlation Pearson, with a significance of p < 0.05. Result: The result found that there was a substantial correlation between the work stress level and the nurse's caring behaviour with p = 0.008 and r = -0.274, and it was a negative correlation. Discussion: It means that when the stress level of nurses will declined, the nurse's caring behavior automatically will beamplified. Conversely, if the stess level of nurses intensively increased, the nurse's caring behaviour become decreased. Thus, this research is needed to be analyzed further in order to asses the quality of caring behaviour by expanding the connected indicator and variable. It is aimed to improve the professionalism and quality of nurses in giving the best service to patients this research need to be continued further in order to asses the quality of nurse's caring behavior by expanding the variable, which is related to internal factors, such as knowledge, perception, emotion, ect and also connected to external factors, such as environment, both physically and non physically like: climate, human being, social economic, culture and ect.

  13. The need for a behavioural analysis of behavioural addictions. (United States)

    James, Richard J E; Tunney, Richard J


    This review discusses research on behavioural addictions (i.e. associative learning, conditioning), with reference to contemporary models of substance addiction and ongoing controversies in the behavioural addictions literature. The role of behaviour has been well explored in substance addictions and gambling but this focus is often absent in other candidate behavioural addictions. In contrast, the standard approach to behavioural addictions has been to look at individual differences, psychopathologies and biases, often translating from pathological gambling indicators. An associative model presently captures the core elements of behavioural addiction included in the DSM (gambling) and identified for further consideration (internet gaming). Importantly, gambling has a schedule of reinforcement that shows similarities and differences from other addictions. While this is more likely than not applicable to internet gaming, it is less clear whether it is so for a number of candidate behavioural addictions. Adopting an associative perspective, this paper translates from gambling to video gaming, in light of the existing debates on this matter and the nature of the distinction between these behaviours. Finally, a framework for applying an associative model to behavioural addictions is outlined, and it's application toward treatment. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  14. Is a sedentary lifestyle an independent predictor for hospital and early mortality after elective cardiac surgery? (United States)

    Noyez, L; Biemans, I; Verkroost, M; van Swieten, H


    This study evaluates whether a sedentary lifestyle is an independent predictor for increased mortality after elective cardiac surgery. Three thousand one hundred fifty patients undergoing elective cardiac surgery between January 2007 and June 2012 completed preoperatively the Corpus Christi Heart Project questionnaire concerning physical activity (PA). Based on this questionnaire, 1815 patients were classified as active and 1335 patients were classified as sedentary. The endpoints of the study were hospital mortality and early mortality. The study population had a mean age of 69.7 ± 10.1 (19-95) years and a mean logistic EuroSCORE risk of 5.1 ± 5.6 (0.88-73.8). Sedentary patients were significantly older (p = 0.001), obese (p = 0.001), had a higher EuroSCORE risk (p = 0.001), and a higher percentage of complications. Hospital mortality (1.1 % versus 0.4 % (p = 0.014)) and early mortality (1.5 % versus 0.6 % (p = 0.006)) were significantly higher in the sedentary group compared with the active group. However, a sedentary lifestyle was not identified as an independent predictor for hospital mortality (p = 0.61) or early mortality (p = 0.70). Sedentary patients were older, obese and had a higher EuroSCORE risk. They had significantly more postoperative complications, higher hospital mortality and early mortality. Despite these results, sedentary behaviour could not be identified as an independent predictor for hospital or early mortality.

  15. Plastic pikas: Behavioural flexibility in low-elevation pikas (Ochotona princeps) (United States)

    Varner, Johanna; Horns, Joshua J.; Lambert, Mallory S.; Westberg, Elizabeth; Ruff, James; Wolfenberger, Katelyn; Beever, Erik; Dearing, M. Denise


    Behaviour is an important mechanism for accommodating rapid environmental changes. Understanding a species’ capacity for behavioural plasticity is therefore a key, but understudied, aspect of developing tractable conservation and management plans under climate-change scenarios. Here, we quantified behavioural differences between American pikas (Ochotona princeps) living in an atypical, low-elevation habitat versus those living in a more-typical, alpine habitat. With respect to foraging strategy, low-elevation pikas spent more time consuming vegetation and less time caching food for winter, compared to high-elevation pikas. Low-elevation pikas were also far more likely to be detected in forested microhabitats off the talus than their high-elevation counterparts at midday. Finally, pikas living in the atypical habitat had smaller home range sizes compared to those in typical habitat or any previously published home ranges for this species. Our findings indicate that behavioural plasticity likely allows pikas to accommodate atypical conditions in this low-elevation habitat, and that they may rely on critical habitat factors such as suitable microclimate refugia to behaviourally thermoregulate. Together, these results suggest that behavioural adjustments are one important mechanism by which pikas can persist outside of their previously appreciated dietary and thermal niches.

  16. Planned home compared with planned hospital births in the Netherlands: intrapartum and early neonatal death in low-risk pregnancies. (United States)

    van der Kooy, Jacoba; Poeran, Jashvant; de Graaf, Johanna P; Birnie, Erwin; Denktasş, Semiha; Steegers, Eric A P; Bonsel, Gouke J


    The purpose of our study was to compare the intrapartum and early neonatal mortality rate of planned home birth with planned hospital birth in community midwife-led deliveries after case mix adjustment. The perinatal outcome of 679,952 low-risk women was obtained from the Netherlands Perinatal Registry (2000-2007). This group represents all women who had a choice between home and hospital birth. Two different analyses were performed: natural prospective approach (intention-to-treat-like analysis) and perfect guideline approach (per-protocol-like analysis). Unadjusted and adjusted odds ratios (ORs) were calculated. Case mix was based on the presence of at least one of the following: congenital abnormalities, small for gestational age, preterm birth, or low Apgar score. We also investigated the potential risk role of intended place of birth. Multivariate stepwise logistic regression was used to investigate the potential risk role of intended place of birth. Intrapartum and neonatal death at 0-7 days was observed in 0.15% of planned home compared with 0.18% in planned hospital births (crude relative risk 0.80, 95% confidence interval [CI] 0.71-0.91). After case mix adjustment, the relation is reversed, showing nonsignificant increased mortality risk of home birth (OR 1.05, 95% CI 0.91-1.21). In certain subgroups, additional mortality may arise at home if risk conditions emerge at birth (up to 20% increase). Home birth, under routine conditions, is generally not associated with increased intrapartum and early neonatal death, yet in subgroups, additional risk cannot be excluded.

  17. A comparison of risky sexual behaviours between circumcised and ...

    African Journals Online (AJOL)

    though male circumcision coupled with preventive behaviour reduces this risk. Objective: To compare the factors associated with risky sexual behaviour among circumcised and uncircumcised men in Bo- tswana. Methods: Nationally representative data from the Botswana AIDS Impact Survey III were used. A sample of 313 ...

  18. Estimating inpatient hospital prices from state administrative data and hospital financial reports. (United States)

    Levit, Katharine R; Friedman, Bernard; Wong, Herbert S


    To develop a tool for estimating hospital-specific inpatient prices for major payers. AHRQ Healthcare Cost and Utilization Project State Inpatient Databases and complete hospital financial reporting of revenues mandated in 10 states for 2006. Hospital discharge records and hospital financial information were merged to estimate revenue per stay by payer. Estimated prices were validated against other data sources. Hospital prices can be reasonably estimated for 10 geographically diverse states. All-payer price-to-charge ratios, an intermediate step in estimating prices, compare favorably to cost-to-charge ratios. Estimated prices also compare well with Medicare, MarketScan private insurance, and the Medical Expenditure Panel Survey prices for major payers, given limitations of each dataset. Public reporting of prices is a consumer resource in making decisions about health care treatment; for self-pay patients, they can provide leverage in negotiating discounts off of charges. Researchers can also use prices to increase understanding of the level and causes of price differentials among geographic areas. Prices by payer expand investigational tools available to study the interaction of inpatient hospital price setting among public and private payers--an important asset as the payer mix changes with the implementation of the Affordable Care Act. © Published 2013. This article is a U.S. Government work and is in the public domain in the USA.

  19. Bullying behaviour among Norwegian adolescents: psychiatric diagnoses and school well-being in a clinical sample. (United States)

    Hansen, Hanne Hoff; Hasselgård, Cecilie Edh; Undheim, Anne Mari; Indredavik, Marit Sæbø


    Few studies have focused the association between bullying and psychiatric disorders in clinical samples. The aim of this study was to examine if bullying behaviour was associated with psychiatric disorders and school well-being. The cross-sectional study was part of a health survey at St. Olav's University Hospital. The sample consisted of 685 adolescent patients aged 13-18 years who completed an electronic questionnaire. Clinical diagnoses were collected from clinical records. In this clinical psychiatric sample, 19% reported being bullied often or very often, and 51% reported being bullied from time to time. Logistic regression analyses showed associations between being a victim and having a mood disorder, and between being involved in bullying behaviour and reporting lower scores on school well-being. No difference was found in bullying behaviour on gender, age and SES. The risk of being a victim was high among adolescents in this clinical sample, especially among patients with mood disorders. Any involvement in bullying behaviour was associated with reduced school well-being.

  20. Social networks and patterns of health risk behaviours over two decades: A multi-cohort study. (United States)

    Kauppi, Maarit; Elovainio, Marko; Stenholm, Sari; Virtanen, Marianna; Aalto, Ville; Koskenvuo, Markku; Kivimäki, Mika; Vahtera, Jussi


    To determine the associations between social network size and subsequent long-term health behaviour patterns, as indicated by alcohol use, smoking, and physical activity. Repeat data from up to six surveys over a 15- or 20-year follow-up were drawn from the Finnish Public Sector study (Raisio-Turku cohort, n=986; Hospital cohort, n=7307), and the Health and Social Support study (n=20,115). Social network size was determined at baseline, and health risk behaviours were assessed using repeated data from baseline and follow-up. We pooled cohort-specific results from repeated-measures log-binomial regression with the generalized estimating equations (GEE) method using fixed-effects meta-analysis. Participants with up to 10 members in their social network at baseline had an unhealthy risk factor profile throughout the follow-up. The pooled relative risks adjusted for age, gender, survey year, chronic conditions and education were 1.15 for heavy alcohol use (95% CI: 1.06-1.24), 1.19 for smoking (95% CI: 1.12-1.27), and 1.25 for low physical activity (95% CI: 1.21-1.29), as compared with those with >20 members in their social network. These associations appeared to be similar in subgroups stratified according to gender, age and education. Social network size predicted persistent behaviour-related health risk patterns up to at least two decades. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. A comparative analysis of the effect of gaseous fission products release on the thermal behaviour of oxide fuel rods

    International Nuclear Information System (INIS)

    Totev, T.L.; Kolev, I.G.


    Four different models of gaseous fission product release are compared in order to assess the relative effect of thermal characteristics of the fuel rods. The results show that the use of Weisman and EPRI models at a high burnup (over 50000 MW.d/tU) leads to almost the same figures of maximum fuel temperature and gas gap thermal conductivity. The use of Beyer-Hann (Betelle) and Pazdera-Valach (Rzez) models leads to under prediction of the fuel element thermal characteristics. A conclusion has been made that the Weisman model is the most suitable for the WWER-type fuel elements behaviour prediction. 10 refs., 7 figs

  2. Comparative Effectiveness of Disease Management With Information Communication Technology for Preventing Hospitalization and Readmission in Adults With Chronic Congestive Heart Failure. (United States)

    Aronow, Wilbert S; Shamliyan, Tatyana A


    Critical appraisal of all available evidence regarding the role of noninvasive communication technology for improving patient survival and reducing hospital admissions in adults with chronic heart failure (HF). Systematic literature review and grading of the quality of evidence according to the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Working Group approach. Four databases were searched in March 2018 to find 2 high-quality meta-analyses and published and unpublished data from 58 randomized controlled trials (RCTs) that compared noninvasive communication technology with usual care in community-dwelling adults with HF. Direct meta-analysis of aggregate data with random effects models. Moderate-quality evidence suggests that there are no differences in all-cause mortality between telemonitoring and usual care, whereas complex telemonitoring that includes transmission of patient parameters and analysis by health care professionals decreases all-cause mortality (relative risk [RR] 0.78, 95% confidence interval [CI] 0.62, 0.99; 2885 people in 12 RCTs). Moderate-quality evidence suggests that telemonitoring prevents HF-related hospitalizations (RR 0.74; 95% CI 0.62, 0.88; 4001 people in 11 RCTs). Moderate-quality evidence suggests that structured telephone support decreases all-cause mortality (RR 0.86; 95% CI 0.77, 0.97; 9535 people in 24 RCTs) and HF-related hospitalizations (RR 0.83; 95% CI 0.73, 0.94; 7030 people in 16 RCTs). Use of a mobile personal digital assistant prevents HF-related hospitalizations (RR 0.58; 95% CI 0.44, 0.77; 674 people in 3 RCTs). The evidence regarding the comparative effectiveness of specific telecommunication devices is insufficient. The results from many completed studies are not available. Clinicians should offer noninvasive monitoring with communication technology applications to all HF patients. Future research should examine comparative effectiveness of technology applications in patient subpopulations

  3. Nursing staffs' emotional well-being and caring behaviours. (United States)

    Chana, Navtej; Kennedy, Paul; Chessell, Zoë J


    To examine the relationships between structural factors (work stressors), individual factors (demographics and the personal resources of resilience and social support) and transactional factors (appraisals and coping), and nursing staffs' levels of burnout, psychological distress and caring behaviours. A further aim was to examine the relationships between nursing staffs' levels of burnout and psychological distress and their caring behaviours. Burnout and psychological distress levels have been found to be high in National Health Service nursing staff and furthermore this emotional distress has been found to affect patient care. In a National Health Service striving to provide high-quality patient-centred care, it is essential that factors affecting nursing staffs' well-being and their caring behaviours are examined. A cross-sectional correlation-based survey design. A sample of 102 nursing staff from an Acute National Health Service Trust were recruited in 2010. Participants completed the questionnaires: Nursing Stress Scale, Social Support Questionnaire-Short Form, Connor and Davidson Resilience Scale-2, Occupational Coping Self-Efficacy Scale for Nurses, PsychNurse Scale, Maslach Burnout Inventory, The Hospital Anxiety and Depression Scale and Caring Behaviours Inventory-revised. Due to the nonparametric nature of part of the data, Spearman's Rho correlations were used for analysis. Demographics were not found to be regularly correlated with nursing staffs' burnout, psychological distress or caring behaviours. Work stressors, coping strategies and self-efficacy were found to be significantly correlated with nursing staffs' burnout and psychological distress. Caring behaviours were also correlated with coping strategies and self-efficacy. Importantly, correlations were found between caring behaviours and nursing staffs' burnout and psychological distress. It is extremely important that the emotional well-being of nursing staff is supported, both for them, and

  4. Brain regions involved in observing and trying to interpret dog behaviour. (United States)

    Desmet, Charlotte; van der Wiel, Alko; Brass, Marcel


    Humans and dogs have interacted for millennia. As a result, humans (and especially dog owners) sometimes try to interpret dog behaviour. While there is extensive research on the brain regions that are involved in mentalizing about other peoples' behaviour, surprisingly little is known of whether we use these same brain regions to mentalize about animal behaviour. In this fMRI study we investigate whether brain regions involved in mentalizing about human behaviour are also engaged when observing dog behaviour. Here we show that these brain regions are more engaged when observing dog behaviour that is difficult to interpret compared to dog behaviour that is easy to interpret. Interestingly, these results were not only obtained when participants were instructed to infer reasons for the behaviour but also when they passively viewed the behaviour, indicating that these brain regions are activated by spontaneous mentalizing processes.

  5. Impact of environmental olfactory cues on hand hygiene behaviour in a simulated hospital environment: a randomized study. (United States)

    Birnbach, D J; King, D; Vlaev, I; Rosen, L F; Harvey, P D


    This study investigated the impact of a fresh scent on the rate of hand hygiene compliance (HHC) among novice healthcare providers. In all, 165 participants examined a standardized patient with one sample exposed to fresh scent (N = 79) and the other exposed to the standard environment (N = 86). Hand hygiene behaviours were tracked before patient contact using video surveillance. The standard environment group had an HHC rate of 51% whereas participants in the fresh scent group had a higher HHC rate of 80% (P behaviour may be subconsciously influenced by cues in the environment. © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  6. Trends in hospital librarianship and hospital library services: 1989 to 2006.