Carolina Franco Ricart
Full Text Available Objetivo: Describir la frecuencia de infecciones oportunistas y determinar cual es la más frecuente en pacientes VIH+ del Hospital Vargas de Caracas durante el período 2005 - 2006. Diseño: Estudio descriptivo, transversal, retrospectivo y observacional. Lugar: Hospital "José María Vargas" de Caracas, Venezuela. Participantes: Pacientes ingresados con historia de VIH+ e infección oportunista. Intervención: Revisión de Historias Clínicas de archivo entre los años 2005-2006. Principales medidas de Resultados : Porcentajes y Medidas de Tendencia Central, tabuladas en una base de datos con ayuda del programa Microsoft Excel 2003 para Windows ®. Resultados : Se revisaron 120 historias; 83 cumplían con los criterios de inclusión. El promedio de edad fue 36,87 años; 59,04% correspondían al sexo masculino y 40,96% al sexo femenino. El 44,4% fueron infecciones respiratorias, 31,88% infecciones del SNC. Las infecciones más frecuentes: 24,64% Mycobacterium tuberculosis, 19,87% Toxoplasma gondii, 15,94% Candida albicans y 10,14% Pneumocystis jiroveci. En el 63,86% de los casos se encontraron dos o más infecciones simultáneas. El 64% de estos pacientes recibía tratamiento y el 46% era heterosexual no promiscuo. Conclusiones : Las alteraciones respiratorias constituyen la infección oportunista más frecuente en pacientes VIH+.
Carolina Lissete Franco Ricart
Full Text Available Objetivo: Describir la frecuencia de infecciones oportunistas y determinar cual es la más frecuente en pacientes VIH+ del Hospital Vargas de Caracas durante el período 2005 – 2006. Diseño: Estudio descriptivo, transversal, retrospectivo y observacional. Lugar: Hospital “José María Vargas” de Caracas, Venezuela. Participantes: Pacientes ingresados con historia de VIH+ e infección oportunista. Intervención: Revisión de Historias Clínicas de archivo entre los años 2005-2006. Principales medidas de Resultados: Porcentajes y Medidas de Tendencia Central, tabuladas en una base de datos con ayuda del programa Microsoft Excel 2003 para Windows ®. Resultados: Se revisaron 120 historias; 83 cumplían con los criterios de inclusión. El promedio de edad fue 36,87 años; 59,04% correspondían al sexo masculino y 40,96% al sexo femenino. El 44,4% fueron infecciones respiratorias, 31,88% infecciones del SNC. Las infecciones más frecuentes: 24,64% Mycobacterium tuberculosis, 19,87% Toxoplasma gondii, 15,94% Candida albicans y 10,14% Pneumocystis jiroveci. En el 63,86% de los casos se encontraron dos o más infecciones simultáneas. El 64% de estos pacientes recibía tratamiento y el 46% era heterosexual no promiscuo. Conclusiones: Las alteraciones respiratorias constituyen la infección oportunista más frecuente en pacientes VIH+.
Débora de Araújo Milfont
Full Text Available Objective: Verify the prevalence of dental caries and its relationship with the type of feeding, oral hygiene habits, and gender of children at the Cândida Vargas Maternity hospital in João Pessoa, Paraíba, Brazil. Methods: The study population included 50 mentally and physically healthy children ranging from 12 the 48 months of age. This was descriptive study using direct documentation (forms and the clinical examinations performed by one calibrated examiner (Kappa = 1. Dental caries diagnosis was according to World Health Organization criteria. Interviews were conducted with the parents for information about the children’s oral hygiene and dietary habits. Data was analysed by means of descriptive statistics (frequencies and percentages and statistical analyses, using the Pearson Chi – Square and Fisher tests. Results: the prevalence of dental caries was 28%; the majority of the parents cared for the children’s daytime oral hygiene (60%, and the prevalent type of feeding was with powdered milk. The average dmf-t was 0.28 and 16% of children had early childhood caries. There was no statistically significant association with any of the variables studied.Conclusion: the prevalence of caries–free children was high. However, the poor oral hygiene after nocturnal breast-feeding and the early introduction of artificial milk, especially with bottle feeding suggests the need to reinforce educational strategies for the parents.
Avaliação epidemiológica das fraturas da coluna torácica e lombar dos pacientes atendidos no Serviço de Ortopedia e Traumatologia do Hospital Getúlio Vargas em Recife/PE Evaluación epidemiológica de las fracturas de la columna torácica y lumbar de los pacientes atendidos en el Servicio de Ortopedia y Traumatología del Hospital Getúlio Vargas en Recife/PE Epidemiological evaluation of the thoracic and lumbar spine fractures of patients treated in the Orthopedics and Traumatology Service at Hospital Getúlio Vargas in Recife/PE
André Flávio Freire Pereira
Full Text Available INTRODUÇÃO: as fraturas da coluna torácica e lombar estão se tornando mais frequentes, devido ao aumento dos acidentes de alta energia. Elas apresentam um elevado índice de morbidade e mortalidade, acarretando grandes prejuízos socioeconômicos. OBJETIVO: analisar a epidemiologia das fraturas torácicas e lombares de pacientes atendidas no Serviço de Ortopedia e Traumatologia do Hospital Getúlio Vargas em Recife (PE. MÉTODOS: este estudo é uma análise epidemiológica dos pacientes com fraturas da coluna torácica e lombar, admitidos na emergência do Hospital Getúlio Vargas no período de 1º de novembro de 2007 a 30 de abril de 2008. Foram admitidos 42 pacientes com fraturas da coluna torácica e lombar, perfazendo um total de 54 vértebras fraturadas. RESULTADOS: observou-se que as fraturas da coluna torácica e lombar foram mais frequentes no gênero masculino, com uma média de idade de 39 anos. As quedas de altura foram responsáveis por 61,9% dos casos, seguida dos acidentes com motos (19,05%. Lesões neurológicas estiveram presentes em 14,28% dos casos e o tratamento cirúrgico foi realizado em 50% deles. CONCLUSÃO: as fraturas da coluna torácica e lombar, no presente estudo, foram frequentes nos adultos jovens, do gênero masculino, trabalhadores e causadas por queda de altura.INTRODUCCIÓN: las fracturas de la columna torácica y lumbar están más frecuentes debido al aumento de los accidentes de alta energía. Estas presentaron un índice elevado de morbilidad y mortalidad, acarreando grandes daños socioeconómicos. Objetivo: analizar la epidemiología de las fracturas torácicas y lumbares de pacientes atendidas en el Servicio de Ortopedia y Traumatología del Hospital Getúlio Vargas, en Recife (PE. MÉTODOS: este estudio es un análisis epidemiológico de los pacientes con fracturas de la columna torácica y lumbar, admitidos en la emergencia del Hospital Getúlio Vargas durante el periodo de 1 de noviembre de 2007
Reis, M M; Tessaro, M M; Cruz e Silva, J; Giordano, S A; d'Azevedo, P A
Rubella serum assays performed in the laboratory of the Materno-Infantil Presidente Vargas Hospital (HMIPV) from 1998 to 2002 were reviewed to determine if IgG avidity assays should be implemented. IgG was determined using the Enzyme Linked Fluorescent Assay, ELFA, VIDAS system, bioMerieux or the Microparticle Enzyme Immunoassay, MEIA, Axsym system, Abbott, and IgM was determined using the ELFA, VIDAS system, bioMerieux, a capture format assay. Specific IgG was assayed in 2,863 samples, with positive results for 84% of the patients, for the most part with high levels of antibodies. IgM was assayed in 2,851 samples, being positive in 14 (0.49%) and inconclusive in 25 (0.88%). Serology for toxoplasmosis was also positive or inconclusive in 5 patients. After a cost-effectiveness analysis, it was decided not to implement avidity assays, considering that the HMIPV is a public institution, with limited funding. Difficulties concerning the integration of the Clinical Pathology Service with the Clinical Staff of the institution were also considered.
Pesquisa de Micobactérias Ambientais em água de torneira, luvas e soluções utilizadas em procedimentos cirúrgicos no Hospital Universitário Getúlio Vargas - Manaus/AM Investigation of Environmental Mycobacteria in tap water, surgical gloves and antiseptic solutions used in surgical procedures at the Getúlio Vargas University Hospital, Manaus-AM/Brazil
Adriana Vallejo Restrepo
Full Text Available Investigou-se por métodos bacteriológicos (cultivo e moleculares (PCR - Restriction Enzyme Analysis, PRA, a presença de micobactérias ambientais em águas de torneira, soluções e luvas cirúrgicas, utilizadas nas etapas dos procedimentos cirúrgicos executados no centro cirúrgico do Hospital Universitário Getulio Vargas (HUGV, na cidade de Manaus-Amazonas/Brasil. Foram colhidas e analisadas 105 amostras sendo: 24 de águas (colhidas das 2 torneiras existentes no centro cirúrgico, 8 de solução de Povidine e 7 de solução de Clorhexidina, que servem para a higienização das mãos dos cirurgiões; 39 de luvas cirúrgicas (superfícies internas e externas; e 27 de soluções que foram efetivamente utilizadas durante o ato cirúrgico. Por método bacteriológico obteve-se 41 isolados micobacterianos apenas de águas das torneiras. Pelo PRA obteve-se a detecção de DNA micobacteriano somente na amostra de água que forneceu acima de 100 colônias de micobactérias por tubo semeado. Os isolados foram identificados como sendo Mycobacterium celatum perfil 2, M. gordonae perfil 3, M. gordonae perfil 6, M. intracellulare perfil 1, M. lentiflavum perfil 3 e M. mucogenicum perfil 1. O encontro de M. mucogenicum, espécie já incriminada em surtos pós-cirúrgicos, indica que devem ser efetuados procedimentos de limpeza e monitoramento em todos os pontos de distribuição de águas, visando à prevenção de surtos de micobacterioses nosocomiais induzidos pelo uso das águas nas diferentes atividades de manuseio ou higienização dos pacientes submetidos a procedimentos invasivos.Using bacteriological (culture and molecular (PCR - Restriction Enzyme Analysis, PRA methods, we investigated the presence of environmental mycobacteria in tap water, antiseptic solutions and surgical gloves, used in carrying out surgical procedures at the Getúlio Vargas University Hospital Surgical Center, in Manaus -Amazonas/Brazil. Samples (105 were collected and
Perfil epidemiológico e avaliação da resposta ao tratamento cirúrgico nos pacientes com espondilodiscite atendidos no serviço de cirurgia da coluna do Hospital Getúlio Vargas em Recife/PE Perfil epidemiológico y evaluación de la respuesta al tratamiento quirúrgico en pacientes con espondilodiscitis tratados en el servicio de cirugía de la columna del Hospital Vargas en Recife/PE Epidemiologic profile and assessment of response to surgery in patients with spondylodiscitis in the department of spine surgery at Hospital Getulio Vargas in Recife/PE
Jocemir Paulino da Silva Junior
Full Text Available OBJETIVO: Analisar a epidemiologia da população acometida por espondilodiscite e avaliar a resposta ao tratamento cirúrgico . MÉTODO: Foram avaliados 13 pacientes, sendo três do sexo feminino e 10 do sexo masculino, com diagnóstico de espondilodiscite e tratados cirurgicamente no período de outubro de 2007 a janeiro de 2010. A média da idade no momento da cirurgia foi de 54 anos. Foram analisados os prontuários e entrevistados os pacientes, considerando-se os seguintes parâmetros: gênero, faixa etária, etiologia, nível comprometido, sintomatologia, tempo de evolução até a cirurgia, alterações neurológicas, tratamento realizado, complicações pós-operatórias e evolução clínica. RESULTADOS: O sexo masculino foi mais acometido, assim como indivíduos mais idosos; a dor na região comprometida foi o sintoma inicial em 80% dos pacientes. O tempo médio entre o inicio dos sintomas e o tratamento cirúrgico foi de 20,25 meses. O segmento lombar foi o mais acometido, seguido pelo torácico e toracolombar, e a forma piogênica foi a mais frequente. O procedimento em dois tempos cirúrgicos pela via posterior (VP e via anterior (VA, foi utilizado em 53% dos pacientes. CONCLUSÃO: Os pacientes do sexo masculino e os idosos foram os mais acometidos. O tratamento cirúrgico em dois tempos foi seguro e apresentou menor morbidade para os pacientes com espondilodiscite.OBJETIVO: Analizar la epidemiología de la población afectada por espondilodiscitis y evaluar la respuesta al tratamiento quirúrgico en estos pacientes. MÉTODO: Trece pacientes, tres mujeres y diez hombres con diagnóstico de espondilodiscitis tratados quirúrgicamente en el Departamento de Cirugía de Columna del Hospital Getulio Vargas de octubre de 2007 a enero de 2010. La edad promedio de pacientes sometidos a la cirugía fue de 54 años. El historial clínico fue analizado y se entrevistó a los pacientes, comprobándose: sexo, edad, etiología, nivel de peligro
Alfredo Jácome Roca
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El doctor Jorge Segura Vargas nació en Duitama, Boyacá, el 14 de agosto de 1924. Ingresó como estudiante fundador en 1942 a la naciente escuela de medicina de la Javeriana, la segunda facultad en Bogotá, que contó con no pocos enemigos que casi acaban con ella. El apoyo de algunos distinguidos profesores de la época –que además firmaron el acta de fundación- el tesón del Padre Félix Restrepo, a la sazón Rector Magnífico, y la perseverancia de alumnos como Segura, permitió que este finalizara sus estudios en 1947 en la primera promoción y se graduara en 1950 con la tesis “Vesícula no visible, intubación duodenal”. Con el título no terminaron los avatares, por la resistencia que generaban los egresados de la nueva escuela médica. Sin embargo, Jorge y algunos compañeros lograron ingresar al Hospital San José de Bogotá, donde llegaron a ser muy apreciados. El entrenamiento lo logró realizar en este tradicional centro hospitalario de la capital, con el profesor Hernando Anzola Cubides. Era Anzola un distinguido académico, miembro de la Sociedad de Cirugía de Bogotá, quien creó una importante escuela quirúrgica en la capital.
Fue Alumno Fundador y Profesor Distinguido de la Facultad de Medicina de la Universidad Javeriana, Jefe del Departamento Quirúrgico del Hospital San Ignacio, donde dejó un legado de habilidades y conocimientos quirúrgicos, bonhomía y lealtad con la Facultad, que acompañó de principio a fin, en las buenas y en las malas.
Full Text Available El artículo revisa las vinculaciones estético-políticas que la obra de Mario Vargas Llosa mantiene con el cine y enfatiza la permanente conexión entre palabra e imagen que hay en sus novelas más conocidas. Una correspondencia entre cine y literatura, pues son el modo que tiene el autor peruano de imaginar la identidad y sus figuras.The article points out the relation between film and literature in the work of Mario Vargas Llosa, especially between word and image in some of his most well-known novels. This relation suggests that to configure his characters and their identity, Vargas Llosa requires both: text and images, literature and film.
Carlos Abarca Barrantes
Full Text Available La Universidad Latina rinde homenaje al Dr. Eduardo Vargas Alvarado, Decano de la Facultad de Medicina de esta Universidad. El Dr. Eduardo VaIgas Alvarado desarrollo la Morgue Judicial, desde su inicio en de enero de 1965, y desde 1975 hasta su jubilación del Poder Judicial en 1992 fue el Jefe del Departamento de Medicina Legal. La Dra. Leslie Solano Calderón es la Jefa actual de dicho Departamento y junto con el Dr. Abarca, fueron discípulos de Don Eduardo. El Dr. Vargas ha escrito varios libros de Medicina Legal, ha recibido múltiples reconocimientos por su labor en la Medicina Legal Latinoamericana y es el Presidente Honorario de la Asociación Costarricense de Medicina Forense. El Departamento de Medicina Legal y la Asociación Costarricense de Medicina Forense se han sumado a este justo y oportuno reconocimiento.The Latina University give honor to Dr. Eduardo Vargas Alvarado, Dean of the Medicine Faculty of this University. Dr. Vargas developed the Judicial Morgue, from its very beginning, January 1, of 1965; and from 1975 until his jubilation from the Judicial Power in 1992 was the Boss of the Legal Medicine Department. Dr. Leslie Solano Calderon, the actual Boss of this Department, and Dr. Abarca were disciples of Mr. Vargas. Dr. Vargas has written many books of Legal Medicine and has received many acknowledgements because of his legal medicine work in Latin America and is the Honorary President of the Costa Rican Forensic Medicine Association. The Legal Medicine Department and the Costa Rican Forensic Medicine Association are added to this just and opportune acknowledge.
Full Text Available Para explicarnos el "caso"· de Vargas Vila, tendríamos que remitirnos a la frase con la cual Rufino Blanco Fombona nos presenta a Juan Montalvo en Los siete tratados: "esta tierra de volcanes produce temperamentos volcánicos".
En numerosos artículos y ensayos Vargas Llosa ha tomado posición a favor de los derechos de homosexuales (lo que ha provocado fuertes reacciones de ciertas personas u organizaciones homófobas). En su obra de ficción, la homosexualidad no tiene un papel muy importante, pero con la figura de Mayta, encontramos, ya en los años 1980, a un homosexual en el proceso de su emancipación. En contra de estas tendencias en su obra, el protagonista de El sueño del Celta sufre permanentemente de su 'dispos...
Clemens A Franken Kurzen
Full Text Available Luego de exponer los antecedentes blo-blbllográficos más relevantes, la visión de la sociedad y el concepto de la literatura y del lector del escritor peruano Mario Vargas Llosa se analiza en forma detallada su novela con formato policial ¿Quién mató a Palomino Motero? (1986, señalando rasgos característicos de los detectives, su forma de pensar, su perfil psicológico y su modo de investigar, los motivos sociales y culturales del crimen y la crítica a la sociedad peruana. Especial énfasis se pone en destacar la hibridez Ínter e intragenérica presente en esta obra literaria, es decir, la mezcla de diferentes géneros literarios y subgéneros policiales.IAfter presenting his most relevant bio-bibliographic antecedents, his view of society and his concept of literature, Mario Vargas Llosa's novel Who killed PalominoMolero?(] 986, written with a detective fiction format, isanalysed in detail pointing at characteristic features that detectives have, at their way of thinking, at their psychological profile and at their method of investigation; the social and cultural motives for crime and a criticism towards Peruvian society are also analysed. Special attention is paid to highlighting the Ínter and ¡ntrageneríc hybridation -the mixture of different literary genres and detective subgenres- that appear in this novel.
Full Text Available En numerosos artículos y ensayos Vargas Llosa ha tomado posición a favor de los derechos de homosexuales (lo que ha provocado fuertes reacciones de ciertas personas u organizaciones homófobas. En su obra de ficción, la homosexualidad no tiene un papel muy importante, pero con la figura de Mayta, encontramos, ya en los años 1980, a un homosexual en el proceso de su emancipación. En contra de estas tendencias en su obra, el protagonista de El sueño del Celta sufre permanentemente de su 'disposición sexual' supuestamente problemática.Vargas Llosa has defended the rights of homosexuals in numerous articles and essays, a fact that has provoked strong reactions by homophobic individuals and organizations. In his fiction, homosexuality does not play an important role, but in the figure of Mayta we find, as early as in the 1980s, a homosexual in the process of emancipation. Against these trends in his work, the protagonist of El sueño del Celta suffers permanently from his supposedly problematic "sexual disposition".
José Luis Mata-Mata
Full Text Available Se sintetizaron y se evaluaron como agentes curtientes de pieles vacunas dos tipos de agentes de reticulación base poliuretano bloqueado. Se presentan los resultados de la síntesis de dispersiones acuosas de poliuretano bloqueado (DPU’s, basadas en prepolímeros a partir de la reacción de los diisocianatos alifáticos H12MDI (4,4’ metilenbis-ciclohexilisocianato y HDI (hexametilendiisocianato con polioles base poliéter óxido de etileno de peso molecular 1 y 2 KDa, en una relación molar isocianato/oxhidrilo (NCO/OH de 4:1 y 6:1 a 100 °C por 2 y 4 horas. En una segunda reacción, los grupos isocianato (NCO libres del prepolímero se bloquearon con una solución acuosa de NaHSO3 ó Na2S2O5 al 40%p/p. Los prepolímeros se caracterizaron mediante espectroscopia IR y RMN de ¹H. El tanto por ciento de isocianato libre en el prepolímero, así como el bloqueo de dichos grupos, se determinaron por espectroscopía IR. La evaluación de la capacidad curtiente de las DPU’s se determinó de acuerdo a la estabilidad térmica de la piel (temperatura de desnaturalización, mediante Calorimetría Diferencial de Barrido (DSC y a la determinación del índice de reticulación de las DPU’s con la colágena de la piel mediante un ensayo con ninhidrina.Two types of crosslinking agents blocked polyurethanes were synthesized and evaluated as tanning agents of bovine skins. The results of the synthesis of aqueous dispersions of blocked polyurethane (DPU’s are presented. They were based on prepolymers from the reaction of the aliphatic diisocyanates H12MDI 4,4’-methylenebis(cyclohexyl isocyanate and HDI (hexamethylene diisocyanate with HO-polyols such as polyethylene oxide of molecular weight 1 and 2 kDa. The molar NCO/OH ratio was fixed in 4:1 or 6:1, at 100 °C and 2 or 4 hours for the reaction time. In a second reaction, the prepolymer containing terminal NCO groups were blocked by reaction with an aqueous NaHSO3 or Na2S2O5 solution to 40% w/w. The
Pedro Cezar Dutra Fonseca
Full Text Available The myth of Vargas' economic populism. The Second Vargas Administration in Brazil (1951-1954 is commonly associated with the phenomenon of populism. However, based on the models of economic populism, it is clear that the economic policy of the period is not the one shown by those models. Besides, based on this historic experience, it is advocated that there is no incompatibility between developmentalism and the adoption of macroeconomic stability-oriented measures.
Martha L. Canfield
Full Text Available In this article the polycentric and polymorphous writing of Mario Vargas Llosa is presented from his first novels until his most recent critic production. Just one literary genre seemed to miss in his long and prolific career: poetry. Nevertheless, this article demonstrates how poetry too is an unknown but fundamental part of Vargas Llosa’s lifework. As a tribute to this incredible trajectory, the University of Florence will be honoured to confer him the Honorary Doctorate in spring 2014.
Salomon, Herman P.
Full Text Available The team of Ferrara editors was headed by two former New Christians: an entrepreneur, a native of Spain, and a Latin scholar from Portugal who in the introductions to variant editions of their scriptural production alternately call themselves by their Christian names Jeronimo de Vargas and Duarte Pinel, and by their Jewish names Yom Tob Atias and Abraham Usque. This “editorial schizophrenia” is reflected in the Italian archives. Whereas the historian Renata Segre’s researches have documented that Duarte Pinel and Abraham Usque were one and the same person, she was unable to find archival proof uniting Jeronimo de Vargas and Yom Tob Atias. The researcher Aron Leoni came up with a Latin notarial deed in the Ferrara archives wherein “Joantu Athias” is called “ptrem ac legitimum administratorum Hieronimi Vargas” and also the latter’s “patre et legitimo administrator.” He supposed “ptrem” to be an abbreviation of “procuratorem” and “patre” to mean father. Thus he concluded that Yom Tob Atias was the father of Jeronimo de Vargas. Close examination of the document and comparison with two others which have recently come to light reveal, however, the incontrovertible identity of Yom Tob Atias and Jeronimo de Vargas. We are dealing with a typical case of ex-Marrano heteronomy: a former New Christian maintaining a separate onomastic Christian identity alongside his Jewish one.
El equipo de editores de Ferrara fue dirigido por dos antiguos cristianos nuevos, uno financiero, originario de España, y el otro, un latinista portugués. En las distintas introducciones a edición bíblica los dos se autodenominan alternativamente por sus nombres cristianos –Jerónimo de Vargas y Duarte Pinel– y por sus nombres judíos, Yom Tob Atías y Abraham Usque. Esta «esquizofrenia editorial» ha dejado huella en los archivos italianos. Mientras que las investigaciones de Renata Segre han documentado que Pinel y Usque eran la misma
Este articulo se trata de un comentario del escritor Mario Vargas Llosa, quien tue el ganador del Premio Nobel de literatura en el afio 2010, y las relaciones entre el ＂Realismo Estructural＂ y el escritor. E1 articulo contiene un anālisis de algunas obras representativas y las técnicas utilizadas en ellas. En este trabajo, trato de analizar las tbr- mas narrativas utilizadas en sus obras, tanto la estructura como otras técnicas narrativas, mús la combinacin de lo real y lo ficticio, con el fin de disfrutar de las artes del lengueje de Mario Vargas Llosa para describir una historia real, en forma fictional.
Arturo Escobar Uribe
Full Text Available Los hombres como Vargas Vila no pueden pasarse íntegramente por el tamiz de la crítica sin conocer el riesgo de irrespetarlos. Ellos valen ante la historia, no por lo que tienen de común ante la especie, sino por la inteligencia que los individualiza, haciéndoles sobresalir con perfiles propios, del resto del rebaño humano.
Fabiola Escárzaga Nicté
Full Text Available The article analyzes the principles and postulates of the neoliberal ideology as conceived and made public by world-renowned writer and journalist Mario Vargas Llosa, as well as the process followed in its formulation. It also discusses the inconsistencies of the neoliberal program he advanced as Peruvian right-wing presidential candidate in 1990, and his erratic campaign strategies, both of which factors contributed to his defeat before Alberto Fujimori.
Pablo S. Rotella
Full Text Available Introducción El enclavado endomedular bloqueado en fracturas diafisarias de tibia probó ser un valioso método de tratamiento, y sus resultados superan a los de la osteosíntesis con placas y el enclavado endomedular elástico con clavos múltiples. El objetivo de este trabajo fue evaluar los resultados funcionales con la utilización de este método en todas las lesiones en las que está indicada la estabilización con este tipo de implante, y con un seguimiento de 2 años. Material y Métodos Se estudiaron 112 pacientes tratados en el Servicio de Ortopedia y traumatología, desde marzo de 2000 hasta diciembre de 2009, sometidos a enclavado endomedular bloqueado como osteosíntesis primaria, con un seguimiento de 2 años. Las variables recabadas fueron: edad (años, sexo, infección, lesión vascular, deformidad, movilidad, dolor, marcha, actividad, tipo de fractura. Se realizó un análisis descriptivo de las variables involucradas en este estudio y de asociación mediante el puntaje de Jones y Wruhs. El nivel de confiabilidad utilizado fue del 5%. Resultados Ciento siete (96% de las 112 fracturas evaluadas tuvieron consolidación sin otros procedimientos, dentro de las 17 semanas. En la serie, hubo 5 casos de seudoartrosis, pero una fractura en tres niveles de la tibia consolidó en 32 semanas y una fractura de tercio distal consolidó en 24 semanas. Las complicaciones posoperatorias fueron escasas y, al finalizar el tratamiento, la mayoría de los pacientes regresó a sus actividades previas, tanto laborales como de la vida diaria. El índice de infección fue del 8,03%, con un seguimiento promedio de 27,48 meses. Conclusión En nuestra experiencia, es un método seguro, relativamente sencillo, con gran versatilidad y ofrece al paciente un confortable posoperatorio con muy buen resultado funcional. Por ello, lo consideramos de primera elección para tratar fracturas diafisarias de tibia.
Full Text Available Siddhamantra, the Nighantu of early 13th century AD, written by Vaidyacharya Kesava is now a forgotten work among the lexicons of Indian Materia Medica. Kesava has adopted a reverse method of describing the drugs in this Nighantu. In Siddhamantra the drugs have been arranged according to effect on Dosas. Rasa, Veerya, Vipaka have to be inferred on this basis. Literary research on Siddhamantra was carried out using all available literatures in Dravyagunashastra and clarified with Vopadeva’s Prakasha commentary. Objectives of the study were to establish known botanical source of the medicinal plants mentioned in Siddhamantra through profound literary research, analysing the mode of classification of the drugs in Siddhamantra and a literary review of Rasapanchaka of each drug in Pittaghna Varga of Siddhamantra.
Jorge Valenzuela Garcés
Full Text Available La historia del otorgamiento del Premio Nobel de Literatura es bien conocida yen ella podemos advertir, con los estupores del caso, injusticias notables, omisionesimperdonables, olvidos que podrían poner en duda la relevancia de este premio decarácter ecuménico. Felizmente tenemos, y son las más, premiaciones muy justas,reconocimientos que concitaron el acuerdo y el aplauso de todos en su momentoy que no solo confirmaron la notable trayectoria del autor laureado, sino su lanzamientoa nivel universal. Nombres como los de Steinbeck, Camus o García Márqueznos devolvieron la fe en este premio y en lo que no debería dejar de ser nunca: laverdadera consagración de una obra, de notable calidad e importancia, y la de unescritor, ejemplo de conducta moral. Afortunadamente esto es lo que ha sucedido el2010, al recaer el Premio Nobel en un escritor de nuestra casa, comprometido con sutiempo y con su obra como Mario Vargas Llosa, quien es, antes que nada, un hombreconsecuente con sus ideas y creencias.
Miguel Ángel Huamán
Full Text Available Uno de los efectos más recurrentes de la escritura literaria es el asombro que se produce en el lector frente a la revelación de la dimensión estética.A partir de esa experiencia, el usuario intenta descifrar o comprender la peculiar naturaleza de la creación verbal. Entonces, en el afán por entender el secreto de la palabra poética, la primera alternativa consiste en indagar en el autor o escritor al respecto, porque se supone que quién ha concretado una obra que genera tal reacción, debe de saber en qué consiste su arte, su destreza, su particular habilidad creativa. En este sentido, la intención de este artículo es realizar una rápida revisión del “arte poética”del autor de La casa verde, con el objeto de clarificar la continuidad de sus convicciones básicas y observar cómo la aparente adscripción de su postura a una opción esteticista, que algunos han considerado homóloga a su postura ideológica a favor del liberalismo, ha sido modificada, de conformidad con sus últimas reflexiones. Ello acerca su obra a la del otrogran narrador peruano del siglo XX: José María Arguedas.Palabras claves: Mario Vargas Llosa, arte poética, escritura utópica, narrativa peruana.
Adriane Vidal Costa
Full Text Available O propósito desse artigo é refletir sobre o compromisso político do escritor peruano Mario Vargas Llosa a partir de textos “circunstanciais” escritos pelo autor entre 1962 e 1982, e, posteriormente, compilados no livro Contra viento y marea (1983. Enfim, buscamos compreender como Vargas Llosa, à luz dos argumentos contrapostos por Sartre e Camus, procurou desvendar seu próprio engajamento em uma época de grande efervescência política. E, ao mesmo tempo, compreender os motivos que levaram Vargas Llosa a dar razão a Camus duas décadas após tê-la dado a Sartre.
Full Text Available This paper aims to investigate the way in which native cultures are represented in Mario Vargas Llosa’s literary works. Trough a survey of the most important texts of the author we will try to show how the idea of the incompatibility between modernity and indigenous cultures grows increasingly stronger and important within Vargas Llosa writings.
Full Text Available La intención de estas páginas es analizar de qué modo se despliega el imaginario perruno en La ciudad y los perros de Mario Vargas Llosa. Se estudiará cómo se vinculan y relacionan los significantes: animal - humano.This work intends to study the ways in which the conceptual image of the dog is represented in Mario Vargas Llosa's novel La ciudady los perros, particularly the significant connections and relationships between animals and humans.
Adriane Vidal Costa
O propósito desse artigo é refletir sobre o compromisso político do escritor peruano Mario Vargas Llosa a partir de textos “circunstanciais” escritos pelo autor entre 1962 e 1982, e, posteriormente, compilados no livro Contra viento y marea (1983). Enfim, buscamos compreender como Vargas Llosa, à luz dos argumentos contrapostos por Sartre e Camus, procurou desvendar seu próprio engajamento em uma época de grande efervescência política. E, ao mesmo tempo, compreender os motivos que levaram Var...
Antonio Panesso Robledo
Full Text Available No es fácil leer ni releer a don José María Vargas Vila. Es una literatura de museo, una mariposa clavada en un muro, con el brillo falso de las cosas que ya murieron. La razón de ello es probablemente que Vargas Vila es en su totalidad un producto del siglo XIX aunque él mismo se haya creído heraldo del XX y profeta del futuro. Detestaba a los críticos, quizás porque le dijeron, en su tiempo, verdades que aún hoy tienen vigencia.
Department of Homeland Security — This database contains locations of Hospitals for 50 states and Washington D.C. , Puerto Rico and US territories. The dataset only includes hospital facilities and...
Cellini, Alva V.
As Latin American literature progressively enters into the English curriculum, two writers deserve special commentary for their representative contribution to the literary world. Through their works, the Columbian author, Gabriel Garcia Marquez, and the Peruvian author, Mario Vargas Llosa clearly convey the Latin American writer's desire to be…
Héctor A. Vargas
Full Text Available First host plant records for Iridopsis hausmanni Vargas (Lepidoptera, Geometridae in the coastal valleys of northern Chile. The trees Haplorhus peruviana Engl. and Schinus molle L. (Anacardiaceae are mentioned as the first host plant records for the little known native moth Iridopsis hausmanni Vargas, 2007 (Lepidoptera, Geometridae, Ennominae in the coastal valleys of the northern Chilean Atacama Desert. This is also the first record of Anacardiaceae as host plant for a Neotropical species of Iridopsis Warren, 1894.
In order to have a better understanding of the impressive success of Fred Vargas' detective novels, this thesis endeavours to place the writer in editorial landscape, analyses her positioning among the sub-categories of crime fiction, and aims to clarify the cathartic function in her literary creation. As a result, the study is about novelistic mutations, about transmedia and transnational spreading of Fred Vargas' works, with a corpus basically relating to the serie of the Three Evangelists ...
Juana Martínez Gómez
Full Text Available El periodismo y la literatura son prácticas escriturales que interesan a Vargas Llosa desde muy temprana edad y que cultiva de forma simultánea durante toda su vida. Desde su concepción realista de la literatura, el autor no puede soslayar la presencia del ámbito periodístico en algunasde sus novelas como una faceta relevante del conglomerado social ficcionalizado. Este trabajo aborda las diferentes formas que el periodismo adopta en sus novelas empezando brevemente por Conversación en la Catedral, para repasar después otras novelas y detenerse con mayorprofundidad en la última, El sueño del celta, en la que el periodismo aparece como soporte narrativo de gran envergadura.Palabras claves: Mario Vargas Llosa, literatura, periodismo, narrativa peruana.
Francisco Gil Tovar
Full Text Available Miguel Díaz Vargas fue uno de esos pintores honrados que rellenaron -si bien no nutrieron- la pequeña historia del Arte nacional en este siglo. Bogotano, nacido en 1886 y muerto en 1956, discípulo en sus principios de aquel maestro del impresionismo que fue Andrés de Santamaría y formado más tarde en Madrid, de donde regresó para ocupar puesto eminentes en la vida artística colombiana. Díaz Vargas pintó paisajes, bodegones y escenas del "folklore" del país, como era lo obligado para la temática de los naturalistas académicos de su generación.
Lectura jurídico-civil de la novela "La tía Julia y el escribidor", de Mario Vargas Llosa. Esta novela se presta a una lectura desde la óptica del Derecho civil que puede ser muy sugerente, prestándose a un repaso de diversas instituciones jurídico-privadas y de su reflejo en la novela. Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech.
Claudia Saraí Fernández-López
Full Text Available This paper is a chronotopic interpretation of the novel The bad girl, by Mario Vargas Llosa. It emphasizes the functioning of different cities, where the plot takes place, as essential parts of the argumentative structure. The emotional load of these cities, ideologies and implied ethics, as well as the characters’ evolution, within the author’s context and represented events, were needed to know the text’s sense and intention.
in the navigation experience and wasted time of medical staff in providing directions. Space in hospitals: space can be divided into personal, social and outdoor space. Personal space: single rooms have been well documented in: admission length, mortality rates, comfort levels, sense of privacy, all users...
Zalamea León, Sergio
A partir de las 4 hojas Dín A1 generadas para el concurso del nuevo campus de la Fundación Getulio Vargas en Sao Paulo Brasil , se recrea el edificio virtualmente en su totalidad. La investigación se basa en todos los dibujos que generó Paulo Mandes da Rocha y sus colaboradores el estudio MMBB, también en un recorrido por las obras de la Arquitectura Moderna Paulista poniendo especial atención en algunas de las obras mas importantes del autor... Magíster en Proyectos Arquitectónicos Cu...
Alvarado Teodorika, Tatiana
Mario Vargas Llosa inicia su ensayo precisando que lo que busca es dejar constancia de la metamorfosis de contenido que ha sufrido (y aquí la palabra la empleo a propósito) el término cultura. Hace una revisión de ensayos de las últimas décadas en lo que se debate precisamente sobre la crisis que atraviesa la cultura de nuestra época, y empieza con el Notes Towards the Definition of Culture de T. S. Eliot (de 1948), en el que advierte el anuncio de los tiempos que vivimos nosotros hoy... Expo...
Full Text Available The purpose of this study is to explore the relationship, from an intertextual perspective, between Las travesuras de la niña mala by Mario Vargas Llosa (2006, and the picaresque genre developed in Spain during the 16th and 17th century. In order to achieve this aim, I will take into account the filiation discourse and the appearance of the picaresque canon, as well as the female picaresque works ignored by the critics. Vargas Llosa draws the character of the «niña mala» gathering charateristics which belong both to male and female picaro.
Full Text Available Mario Vargas Llosa’s recent novel The Bad Girl centers around a sexually liberated woman whois in search of individual emancipation through transgressions of all social norms. The issue offemale sexuality and its relation with woman liberation occupies an important and debatableposition in Feminist discourse. Llosa’s own attitude to liberated female sexuality had been anambivalent one. In this paper I would like analyse and explore the question of woman’s liberationin the novel of Mario Vargas Llosa, taking into account the major conflicting Feminist discoursesas well as the presence and erasure of female sexuality in the history of Latin American novels.
Pedro Antonio Agudelo
Full Text Available Este artículo propone una relectura de la novela Los cuadernos de don Rigoberto de Mario Vargas Llosa, concentrando la atención en la figura retórica de la ecfrasis. Examina la arquitectura novelesca y la representación verbal y visual como pilares de lo que constituiría una genuina novela iconoverbal. El estudio está soportado en las estrategias de análisis provenientes de la semiótica literaria, la narratología y la retórica, que permiten una comprensión amplia del objeto de estudio. This paper proposes a different interpretation of the novel Los cuadernos de don Rigoberto by Mario Vargas Llosa, focusing on the rhetorical figure of ekphrasis. It examines the novelistic architecture and verbal and visual representation as pillars of what would constitute a genuine iconoverbal novel. The study is supported by the analysis strategies from literary semiotics, narratology and rhetoric, which allow a comprehensive understanding of subject matter.
German Arce Ross
Full Text Available Se trata de poner en perspectiva la mayor parte de novelas de Mario Vargas Llosa en función del tema de la huída, partiendo del hecho que é1 solicitó la nacionalidad Española inmediatamente después de haber perdido las elecciones para la Presidencia del Perú y de haber escrito El pez en el agua. Nuestro análisis intenta demostrar la importancia de la figura paterna – principalmente en el sentido de su ausencia y de sus bruscas reapariciones – en la cristalización sintomática del tema de la fuga. Es por eso que una analogía con la posición fóbica, en relación al padre o a sus substitutos, nos ha parecido pertinente. Teniendo como pivot el análisis de la forma, del contexto y del contenido de su libro de memorias, este trabajo definiría así las bases de una contribución literaria de la obra de Vargas Llosa a la clinica de la fobia.
Guillermo Hernández de Alba
Full Text Available Dos siglos corridos desde su nacimiento, más de uno y medio de la proclamación de la Independencia Nacional, han sido necesarios para que la memoria de Pedro Fermín de Vargas sea públicamente restituida a su patria, que al conocer y estudiar su vida extraordinaria lo celebrará entre los precursores de su libertad, lo admirará por la excelencia de su clara inteligencia y de su formación intelectual y le dará sitio de honor en los anales de su historia económica porque es capaz de proyectar, con arte de visionario, el estudio perfecto de la producción nacional y la distribución de su riqueza latente.
Fernández Ariza, Guadalupe
El estudio «Mario Vargas Llosa, la creación y la crítica» se centra en una parcela de la obra del escritor peruano, que abarca las diversas realizaciones genéricas (la novela, el teatro, el ensayo) e integra un amplio periodo temporal: desde La orgía perpetua (1975) hasta El viaje a la ficción (2008), además de otras obras, tales como la novela histórica La guerra del fin del mundo, la pieza teatral La Señorita de Tacna y las novelas de arte, Elogio de la madrastra y Los cuadernos de don Rigo...
Maia, Andréa Casa Nova
This article analyzes the control strategies in place at Morro Velho mine in the Brazilian state of Minas Gerais, and the changes after the implementation of labor legislation during the Vargas administration. The diseases common amongst mine workers, silicosis and arsenicosis, are investigated through statements given by former miners and a book by an anonymous author that discusses the diseases and the power relations between employers and employees, identifying the limitations of the legislation and the workers' struggles. The book presents a striking story of how for many years the British company side-stepped laws such as the insalubrity premium, a right which other mining companies, not only of British ownership, flouted and still flout in different parts of the world.
Full Text Available Uno de los medidores más concretos para dimensionar el impacto cultural y artístico de un autor en estos días es la cantidad de relecturas que generan sus obras (reescrituras, obras de teatro, películas, etc.. Cada una de estas reinterpretaciones genera nuevas perspectivas y lecturas sobre los textos originales, en un diálogo permanente. Al ser Mario Vargas Llosa uno de los autores latinoamericanos más adaptados en cine, se hace importante revisar críticamente las propuestas cinematográficas a partir de su obra. De este modo, este artículo revisa las tres principales adaptaciones de sus novelas, a saber, La ciudad y los perros, Pantaleón y las Visitadoras y La Fiesta del Chivo, analizando algunos aspectos centrales de cada una de éstas, ya sean estructurales o temáticos, para así iluminar algunas dimensiones no solo de cada adaptación en particular, sino de este intercambio discursivo en general.Nowadays, one of the most concrete ways to measure an author's cultural and artistic impact is the amount of reinterpretations over his works (in literature, theatre, cinema, etc.. Each one of these versions produces new interpretations and perspectives over the original texts, in a constant dialogue. One of the most adapted Latin-American authors to cinema is Mario Vargas Llosa, which reveals the importance of a critical study of the film versions of his works. Thus, this article reviews the three main adaptations of his novels (The Time of the Hero, Captain Pantoja and the Special Service, and The Feast of the Goat by analyzing central aspects pertaining either to structures or themes in order to elucidate certain dimensions relevant not only to each particular adaptation, but also to this discursive interchange in general.
Lucero de Vivanco
Full Text Available Este artículo aborda cuatro textos narrativos del escritor peruano Mario Vargas Llosa relacionados con la violencia que se vivió en Perú en el contexto de la guerra entre Sendero Luminoso y el Estado: las novelas Historia de Mayta y Lituma en los Andes y los documentos Informe de Uchuraccay e Historia de una matanza. La lectura que hago parte problematizando los supuestos teóricos planteados por el escritor en La verdad de las mentiras en relación con la "verdad" de la literatura y su independencia con respecto a la realidad. Desde este lugar crítico, propongo que sus teorías no solo son problemáticas en sí mismas cuando se trata de narrar la violencia, sino que no son coincidentes con las prácticas culturales de sus lectores, razón por la cual los debates se encienden en la escena ideológica y la cuestión de la referencialidad se vuelve lucha política.The present article focuses on four narrative texts by Peruvian writer Mario Vargas Llosa that deal with the war between Shining Path and the Peruvian state: the novels Historia de Mayta and Lituma en los Andes, and the documents Informe de Uchuraccay and Historia de una matanza. My reading begins by discussing the writer's theories about "truth" in literature and its independence from reality as shown in La verdad de las mentiras. From this critical position, I propose that these theories are not only problematic in themselves when narrating violence, but also that they do not match with his readers' cultural practices. This point has led to incensed discussions in ideological debates, turning the question of referentiality into a problem of political struggle.
Larsen, Matthew C.; Wieczorek, Gerald F.; Eaton, L.S.; Torres-Sierra, Heriberto; Sylva, Walter F.
Large populations live on or near alluvial fans in locations such as Los Angeles, California, Salt Lake City, Utah, Denver, Colorado, and lesser known areas such as Sarno, Italy, and Vargas, Venezuela. Debris flows and flash floods occur episodically in these alluvial fan environments, and place many communities at high risk during intense and prolonged rainfall. In December 1999, rainstorms induced thousands of landslides along the Cordillera de la Costa, Vargas, Venezuela. Rainfall accumulation of 293 mm during the first 2 weeks of December was followed by an additional 911 mm of rainfall on December 14 through 16. Debris flows and floods inundated coastal communities resulting in a catastrophic death toll of as many as 30,000 people. Flash floods and debris flows caused severe property destruction on alluvial fans at the mouths of the coastal mountain drainage network. In time scales spanning thousands of years, the alluvial fans along this Caribbean coastline are dynamic zones of high geomorphic activity. Because most of the coastal zone in Vargas consists of steep mountain fronts that rise abruptly from the Caribbean Sea, the alluvial fans provide practically the only flat areas upon which to build. Rebuilding and reoccupation of these areas requires careful determination of hazard zones to avoid future loss of life and property. KEY TERMS: Debris flows, flash floods, alluvial fans, natural hazards, landslides, Venezuela
Adriane Vidal Costa
Full Text Available No final dos anos 1970 e início dos 80, Julio Cortázar e Mario Vargas Llosa compararam a Nicarágua sandinista com a Cuba de Fidel Castro, colocando em dia o debate sobre a revolução e o socialismo na América Latina. O presente trabalho analisa os artigos de Cortázar e Vargas Llosa para mostrar como eles compreenderam e traduziram a experiência sandinista. Em fins dos anos 1970, muitos intelectuais passaram a defender a Revolução Sandinista, como a possível revolução ideal ou uma nova chance para a experiência socialista na América Latina, como foi o caso de Cortázar. Vargas Llosa, desencantado com as esquerdas, apontava os "erros" do regime que poderiam levar a experiência sandinista a transformar o país centro-americano em uma "nova Cuba".
Full Text Available Cuando conocí a Mario Vargas Llosa, corría el año 1970; el escritor por aquel entoncesya había empezado su progresivo alejamiento de la izquierda canónica. Era elmomento del caso Padilla, el poeta cubano disidente de quien el futuro premio Nobel,primer peruano en ser galardonado, se erguía en valiente defensor. Mario, en esasfechas, vivía afincado en el barrio de Sarrià de Barcelona y, a pesar de su éxito literariotras las grandes novelas del exordio, desde La ciudad y los perros (1963 y La casaverde (1966 hasta Conversación en la catedral (1969, mantenía un apego sincero ycordial, desenfadado, en nada ostentoso. Se le consideraba, sin embargo, un autormuy afamado y brillante, algo más que una promesa. Sonriente y feliz, compartía eltrabajo meticuloso de escribir a diario con lecturas de amplio abanico, compromisossociales (pocos y vida familiar. Como revelaría pronto con su novela La tía Julia y elescribidor (1977, esa etapa existencial venía marcada por sentar familia con labellísima prima Patricia, y sus niños. Mario era además un guapo (belleza que no hamenguado con la madurez, ni siquiera con la entrada en una tercera edad biendisimulada; en aquel entonces era un joven capaz de fascinar a hombres y mujeres detodo tipo, incluidos los estudiantes. Con todo, estos últimos no dudaron en rebatirlede forma incisiva tras una conferencia dictada en la Universidad, al grito de«colonizado». Tardaría Mario muchos y muchos años en elegir la ciudadanía españolay tomar posesión de la silla en la Real Academia. Ello, cabe hacer memoria, ocurrió entodo caso ya muerto el Dictador y realizada la transición democrática, y tras el fracasodel proceso político en el Perú, que en lugar de elegir a Vargas Llosa para laPresidencia optó por otorgarle la mayoría al siniestro Fujimori.
Andressa Tanise Vooss
Full Text Available To evaluate the conditions of the services offered to the community regarding medications, the World Health Organization (WHO has developed the Medication Use Indicators, among them Prescription indicators. The objective of this study was to evaluate drug prescriptions in a Basic Health Care Center in Getúlio Vargas - RS, according to the Prescription Indicators recommended by the WHO. The data collection was performed with the use of a form and the prescriptions for June / July and November / December 2008 were evaluated. The average number of drugs prescribed was 2.03, and 72.8% of the drugs were prescribed by generic name, 80.3% were on the list of essential drugs, 21.7% were antibiotics and 2.4% were injectable drugs. The results were in accordance with WHO recommendations and were similar to those reported by other studies.Para avaliar as condições dos serviços prestados à população no que se refere aos medicamentos, a Organização Mundial da Saúde (OMS desenvolveu Indicadores do uso de Medicamentos, entre eles os de Prescrição. O objetivo da pesquisa foi avaliar prescrições medicamentosas de usuários de uma Unidade Básica de Saúde do município de Getúlio Vargas - RS conforme os Indicadores de Prescrição preconizados pela OMS. A coleta de dados foi realizada com uma ficha. Para isso houve acesso as prescrições atendidas no período de junho/julho e de novembro/dezembro de 2008. A média de medicamentos prescritos foi de 2,03, 72,8% dos medicamentos foram prescritos pelo nome genérico, 80,3% constavam na lista dos medicamentos essenciais, 21,7% eram antibióticos e 2,4% injetáveis. Observou-se que os resultados obtidos estão de acordo com os recomendados pela OMS e que foram similares a outros estudos.
Celso Pereira de Sá
Full Text Available O artigo trata da memória histórica de Getulio Vargas (1883-1954 - que governou o país de 1930 a 1945 e de 1951 a 1954 -, em sua estreita associação com o Palácio do Catete, no Rio de Janeiro, sede da Presidência da República naquele período. Tal memória foi investigada em termos das representações sociais de Getúlio manifestadas por 410 visitantes de uma exposição realizada no Palácio - hoje, Museu da República - em homenagem ao cinqüentenário da sua morte. Os resultados, obtidos a partir das respostas a uma tarefa de associação livre e a um questionário expedito, evidenciam que a memória construída a propósito da trajetória histórica de Vargas é complexa e controvertida, mas tende nitidamente para o pólo positivo, visto que predominam as avaliações de que Getúlio fez mais coisas boas do que ruins e de que merece ser lembrado como "pai dos pobres" e como "maior estadista do Brasil".The article deals with the historical memory of Getúlio Vargas (1883-1954 - who governed Brazil from 1930 to 1945 and from 1951 to 1954 -, in its close association to the Catete Palace, in Rio de Janeiro, which was the Republic Presidency's seat during that period. Such a memory was investigated in terms of the social representations about Getúlio which were manifested by 410 visitors to an exhibition held in the Palace - Republic Museum, nowadays - in honor to the fiftieth anniversary of his death. Results, which were obtained from responses to a free association task and to a concise questionnaire, evidence that the memory which was built about the historical trajectory of Vargas is a complex and controversial one, but it tends sharply for the positive pole, since the evaluations that Getúlio did more good than bad things and that he deserves to be remembered as "father of the poor people" and as "Brazil's greatest statesman" prevail.
Sergio Elías Ortíz
Full Text Available Entre los papeles relacionados con la vida de Don Pedro Fermín de Vargas, que pueden consultarse en el Archivo General de Indias de Sevilla, hay una carta de él y una lista de libros que envía al Administrador de Correos de la Habana, Don José Fuertes, antiguo amigo suyo, luego su corresponsal y a la vez espía de sus pasos para aprisionarlo, con el objeto de que se los guardase “en algún rincón de sus casa”.
Full Text Available O texto reflete sobre o esforço de organização e tutela do trabalho industrial do governo Vargas, dentro de seu projeto de desenvolver uma massa urbana capaz de servir de mercado de consumo para bens não-duráveis e alimentos, base para a constituição de um mercado auto-sustentável. O norte teórico é o conceito de ilhas de fordismo periférico, apoiado na percepção gramsciana das transformações sociais, no sentido de que o fordismo procura reorganizar o meio ambiente e o cotidiano do trabalhador, muito além do espaço da fábrica.This paper is a reflection on the Vargas Administration’s effort to organize and protect the industrial workforce within his project which aimed to prepare and develop an urban mass of consumers for food and non-durable commodities as a basis to build a self-sustainable market. Concept of peripheral Fordism islands, based on Gramscian perception of social transformations, in the sense that Fordism attempts to reorganize the environment and the worker’s everyday life far beyond the factory itself as the theoretical support of this study.
José Morales Saravia
Full Text Available Lo nuevo de la "nueva novela hispanoamericana", que La ciudad y los perros (1962 de Mario Vargas Llosa representa, se halla en el re-trabajo de las categorías suministradas por la tradición realista bajo premisas que buscan despertar en el lector vivencias directas de lo feo. Este artículo analiza ambas estéticas implicadas en ello: aquella que construye lo feo en toda su amplitud y aquella del efecto que hace vivenciar lo feo directamente por el lector.The new aspect of the "nueva novela hispanoamericana", represented by Vargas Llosa's 1962 The Time of Hero, lies in the rework of categories from the realistic tradition under premises that seek to awaken in readers direct experiences of ugliness. This article analyses the two aesthetics involved in this process: one that constructs a vast fiction world of ugliness (KarlRosenkranz's Asthetik des Hasslichen, and another that enables readers to experience ugliness directly (Wirkungsasthetik.
Considerações clínicas e etiológicas das síndromes epilépticas sintomáticas com paroxismos occipitais bloqueados à abertura dos olhos Clinical and ethiological considerations about the symptomatic epileptic syndromes with occipital paroxism bloqued when the eyes open
Gilson Edmar Gonçalves e Silva
Full Text Available A síndrome da epilepsia parcial com paroxismos occipitais no eletrencefalograma (EEG mostra características clínicas heterogêneas. Visando descrever esta rara forma de epilepsia, investigamos a significância dos achados eletrofisiológicos e clínicos em oito pacientes com paroxismos occipitais bloqueados pela abertura dos olhos. Os pacientes foram submetidos a exames radiológicos de RNM do encéfalo e/ou TC de crânio. Houve concordância entre as alterações do EEG e do tipo de crise em 5 pacientes, e entre as anormalidades anatômicas na TC ou RNM com anormalidades focais no EEG em 7 casos. Nossos resultados confirmam que este padrão inusitado origina-se de uma expressão eletrográfica multifatorial.The syndrome of idiophatic partial epilepsy with occipital paroxysms in the EEG shows a considerable clinical heterogeneity. The present paper investigated the signficance of electrophysiologic and clinical characteristics in eigth patients with occipital paroxysms blocked by the eye opening. All patients were submitted to radiological exams including brain MRI and/or CT. There was agreement between EEG findings and type of seizures in 5 patients and between anatomical abnormalities in the MRI or CT and EEG focal abnormalities in 7 patients. Our results confirm that the unusual pattern comes from eletrographic multifactors origins.
Camilo Rubén Fernández-Cozman
Full Text Available This article holds that there is a radical ethnocentrism in two essays of Mario Vargas Llosa, Archaic Utopia and Civilization of the Show. In this regard, the Peruvian writer does not recognize a mythical rationality and conceived that legal culture is superior to oral culture.
Fernández Cozman, Camilo
Este artículo sustenta que hay un etnocentrismo radical en dos libros de ensayo de Mario Vargas Llosa: La utopía arcaica y La civilización del espectáculo. En tal sentido, el escritor peruano no reconoce una racionalidad mítica y concibe que la cultura letrada es superior a la cultura oral.
Full Text Available El estudio de Efraín Kiistal sobre las novelas de Mario VargasLlosa se centra en el análisis del proceso creativo del autor, en losdiálogos que entabla con otros trabajos literarios y en la transformaciónde la experiencia vital en sus textos ficcionales.
María de las Mercedes Ortiz Rodríguez
Full Text Available In his novels The Green House (1966, The Storyteller (1989 and Death in the Andes (1996, Mario Vargas Llosa reinforces the dominant visions in which the Peruvian Andes and jungle are portrayed as the realms of barbarism and savagery respectively—as opposed to the Coast, which is considered the civilized center of the nation. I discuss how he resuscitates topics like cannibalism and the extirpation of idolatries in colonial times, clearly employing the linear evolutionism of the nineteenth century. He uses these familiar tropes and images to characterize, as did his predecessors, indigenous people as savages, cannibals and pagans who constitute an obstacle for the development of Peru in a neoliberal and global world.
Full Text Available En la novela La Guerra del fin del mundo Mario Vargas Llosa presenta una reescritura y ficcionalización del texto fundacional Os Sertdes de Euclides da Cunha. El presente artículo sitúa esta novela en el momento de un cambio radical de las convicciones ideológicas y políticas de Mario Vargas Llosa en la década de los 70 y se propone analizar de qué manera las nuevas posiciones neoliberales asumidas por el autor se reflejan en la poética de la novela. Como argumento central se sostiene que en el proceso de ficcionalización del texto referencial de Euclides da Cunha se dejan descubrir dos estrategias: la primera es la individualización de la Historia, es decir, la narración privilegia las experiencias subjetivas de los protagonistas para explicar sus disposiciones a la violencia; en la segunda, la ficcionalización asume una paradoja: finge representar lo irrepresentable advirtiendo al mismo tiempo al lector que se trata solamente de ficción, es decir, ella responsabiliza al propio lector en qué medida él está dispuesto a identificar la narración con la 'verdad' histórica. En los dos casos nos encontramos frente a una poética que valoriza la responsabilidad individual y lo subjetivo en vez de la dependencia individual de lo colectivo y del compromiso de la narración con la historia objetiva.In the novel The War of the End of the World (La guerra del fin del mundo Mario Vargas Llosa presents a rewriting and fictionalization of Euclides da Cunha's foundational text Os Sertdes. The article relates this novel to the radical change in Mario Vargas Llosa's ideological and political convictions in the 1970s and intends to analyze how the author's neo-liberal positions are reflected in the poetics of this novel. The central argument is that in this process of fictionalization of Euclides da Cunha's text, two strategies can be discovered: the first being the individualization of History, that is, the narrative privileges the subjective
Claudia Saraí Fernández-López
Full Text Available Se realizó una lectura cronotópica de la novela Travesuras de la niña mala, de Mario Vargas Llosa. Se hizo énfasis en el funcionamiento de las distintas ciudades en las que se desarrolla la trama como partes esenciales de la estructura argumentativa, la carga emotiva de estas urbes, las ideologías y las éticas implicadas, así como la evolución de los personajes según la metró- poli en la que van residiendo. También se analizó la relación entre la acción de los personajes, el contexto del autor y los acontecimientos representados, necesarios para conocer el sentido y la intención del texto.
El etnocentrismo radical y las técnicas argumentativas en La utopía arcaica y La civilización del espectáculo, de Mario Vargas Llosa / The Radical Ethnocentrism and Argumentative Techniques in Vargas Llosa's The Archaic Utopia And Notes On The Death Of Culture: Essays On Spectacle And Society
Camilo Rubén Fernández-Cozman
Full Text Available Este artículo sustenta que hay un etnocentrismo radical en dos libros de ensayo de Mario Vargas Llosa: La utopía arcaica y La civilización del espectáculo. En tal sentido, el escritor peruano no reconoce una racionalidad mítica y concibe que la cultura letrada es superior a la cultura oral. This article holds that there is a radical ethnocentrism in two essays of Mario Vargas Llosa, Archaic Utopia and Civilization of the Show. In this regard, the Peruvian writer does not recognize a mythical rationality and conceived that legal culture is superior to oral culture.
El etnocentrismo radical y las técnicas argumentativas en La utopía arcaica y La civilización del espectáculo, de Mario Vargas Llosa / The Radical Ethnocentrism and Argumentative Techniques in Vargas Llosa's The Archaic Utopia And Notes On The Death Of Culture: Essays On Spectacle And Society
Camilo Rubén Fernández-Cozman
Este artículo sustenta que hay un etnocentrismo radical en dos libros de ensayo de Mario Vargas Llosa: La utopía arcaica y La civilización del espectáculo. En tal sentido, el escritor peruano no reconoce una racionalidad mítica y concibe que la cultura letrada es superior a la cultura oral. This article holds that there is a radical ethnocentrism in two essays of Mario Vargas Llosa, Archaic Utopia and Civilization of the Show. In this regard, the Peruvian writer does not recognize a mythi...
Full Text Available Homme d'affaires, aviateur, journaliste et écrivain, Jean-Gérard Fleury (1905-2002 a vécu presque toute sa vie au Brésil. En 1940, il publie en France une biographie, la seule à ce jour, du président Getúlio Vargas. De nature ouvertement hagiographique, ce texte propose une lecture de la trajectoire politique de Vargas qui oscille entre démocratie et autoritarisme. De fait, cette biographie nous parle autant du Brésil que de la France : elle construit une image du président brésilien, et en même temps témoigne des aspirations idéologiques d'une certaine droite française dans l'entre-deux guerres. Elle a par conséquent sa place dans une étude des représentations du populisme au XXe siècle.Hombre de negocios, aviador, periodista y escritor, Jean-Gérard Fleury (1905-2002 vivió durante casi toda su vida en Brasil. En 1940, publica una corta biografía, la única hasta hoy en francés, del presidente Getúlio Vargas. De carácter francamente hagiográfico, este texto propone una lectura de la trayectoria de Vargas que oscila entre democracia y autoritarismo. De hecho, esta biografía nos habla tanto de Brasil como de Francia: construye una imagen del presidente brasileño y, al mismo tiempo, declara las aspiraciones populistas de cierta derecha francesa entre los dos guerras mundiales.Business man, aviator, journalist and writer, Jean-Gérard Fleury (1905-2002 lived almost all his life in Brazil. In 1940, he published a short biography, the only one to this day in French, of the president Getulio Vargas; openly pictorially outlined in nature, this text offers a reading of the political trajectory of Vargas, which oscillates between democracy and authoritarianism. In fact, this biography tells us as much about Brazil as about France: it constructs an image of the Brazilian president, and at the same time witnesses the popular aspirations of a certain French political right trend between the two wars.
Muertes bajo sospecha: Investigación sobre el número de fallecidos en el desastre del estado Vargas, Venezuela, en 1999 Deaths under suspicion: Investigation on the number of deaths in the Vargas state disaster, Venezuela, in 1999
Full Text Available El desastre ocurrido en diciembre de 1999 en el estado Vargas, Venezuela, dio la vuelta al mundo como noticia espectacular, en donde el número de fallecidos siempre osciló entre decenas de miles. Muchas de estas cifras fueron el resultado de declaraciones inexpertas o irresponsables, desde las cuales se nubló toda posibilidad de precisión al respecto, contribuyendo con ello a que la noción sobre aquel evento alimentara la imaginería y no la interpretación. Este trabajo se concentró en la sistematización de la información existente en los servicios forenses que intervinieron en el levantamiento de los cadáveres, así como en otras instancias vinculadas al caso, acompañando los razonamientos con aproximaciones cualitativas a la zona del desastre. Los resultados ofrecidos a la vuelta de esta investigación, no sólo discuten las cifras ofrecidas desde aquel momento, sino que también evidencian la problemática resultante de la no aplicación de metodologías eficaces para el trato de cadáveres en desastres con muertes masivas, demostrando, del mismo modo, la necesidad de desarrollar investigaciones formales sobre casos similares.The disaster happened in December of 1999 in the Vargas state, Venezuela, run around the world like spectacular news, in which the number of deceases always oscillated between tens of thousands. Many of these numbers were the result of inexpert or irresponsible declarations, from which all possibility of precision became cloudy on the matter, contributing with it to that the notion on that event fed suppositions and not interpretations. This work are focused in the systematization of the existing information in the forensic offices that took part in the rise of corpses, as well as other instances to the case, accompanying the reasoning with qualitative approaches to the disaster zone. The results offered around this investigation, not only discuss the numbers offered from that moment, but that also demonstrate
Full Text Available Pour tout auteur, choisir d’écrire dans une langue ou dans la variante d’une langue qui n’est pas la sienne représente un défi de taille. Nous nous intéresserons au roman Sous les vents de Neptune, de l’écrivaine française Fred Vargas, qui a situé une partie de son intrigue au Québec, sans maîtriser la notion de variation linguistique. En analysant les réactions des lecteurs européens et québécois, de même que les caractéristiques de la langue québécoise de Vargas, nous aborderons la question de l’impérialisme linguistique et de son anachronisme au xxie siècle.
Auluck, S. K. H.
The Gratton-Vargas snowplow model, recently revisited and expanded [S. K. H. Auluck, Phys. Plasmas 20, 112501 (2013)], has given rise to significant new insights into some aspects of the Dense Plasma Focus (DPF), in spite of being a purely kinematic description having no reference to plasma phenomena. It is able to provide a good fit to the experimental current waveforms in at least 4 large facilities. It has been used for construction of a local curvilinear frame of reference, in which conservation laws for mass, momentum, and energy can be reduced to effectively-one-dimensional hyperbolic conservation law equations. Its utility in global parameter optimization of device parameters has been demonstrated. These features suggest that the Gratton-Vargas model deserves a closer look at its supposed limitations near the singular phase of the DPF. This paper presents a discussion of its development near the device axis, based on the original work of Gratton and Vargas, with some differences. It is shown that the Gratton-Vargas partial differential equation has solutions for times after the current singularity, which exhibit an expanding bounded volume (which can serve as model of an expanding plasma column) and decreasing dynamic inductance of the discharge, in spite of having no built-in hydrodynamics. This enables the model to qualitatively reproduce the characteristic shape of the current derivative in DPF experiments without reference to any plasma phenomena, such as instabilities, anomalous resistance, or reflection of hydrodynamic shock wave from the axis. The axial propagation of the solution exhibits a power-law dependence on the dimensionless time starting from the time of singularity, which is similar to the power-law relations predicted by theory of point explosions in ideal gases and which has also been observed experimentally.
@@ 巴尔加斯·略萨,这位1936年3月28日出生于秘鲁阿雷基帕市的文学天才,全名是豪尔赫·马里奥·佩德罗·巴尔加斯·略萨(Jorge Mario Pedro Vargas Llosa),其中"巴尔加斯"是父姓,而"略萨"是母姓.
Auluck, S. K. H., E-mail: email@example.com [HiQ TechKnowWorks Private Limited, Nerul, Navi Mumbai 400706 (India)
The Gratton-Vargas snowplow model, recently revisited and expanded [S. K. H. Auluck, Phys. Plasmas 20, 112501 (2013)], has given rise to significant new insights into some aspects of the Dense Plasma Focus (DPF), in spite of being a purely kinematic description having no reference to plasma phenomena. It is able to provide a good fit to the experimental current waveforms in at least 4 large facilities. It has been used for construction of a local curvilinear frame of reference, in which conservation laws for mass, momentum, and energy can be reduced to effectively-one-dimensional hyperbolic conservation law equations. Its utility in global parameter optimization of device parameters has been demonstrated. These features suggest that the Gratton-Vargas model deserves a closer look at its supposed limitations near the singular phase of the DPF. This paper presents a discussion of its development near the device axis, based on the original work of Gratton and Vargas, with some differences. It is shown that the Gratton-Vargas partial differential equation has solutions for times after the current singularity, which exhibit an expanding bounded volume (which can serve as model of an expanding plasma column) and decreasing dynamic inductance of the discharge, in spite of having no built-in hydrodynamics. This enables the model to qualitatively reproduce the characteristic shape of the current derivative in DPF experiments without reference to any plasma phenomena, such as instabilities, anomalous resistance, or reflection of hydrodynamic shock wave from the axis. The axial propagation of the solution exhibits a power-law dependence on the dimensionless time starting from the time of singularity, which is similar to the power-law relations predicted by theory of point explosions in ideal gases and which has also been observed experimentally.
Auluck, S K H
The Gratton-Vargas snowplow model, recently revisited and expanded (S K H Auluck, Physics of Plasmas, 20, 112501 (2013)), has given rise to significant new insights into some aspects of the Dense Plasma Focus (DPF), in spite of being a purely kinematic description having no reference to plasma phenomena. It is able to provide a good fit to the experimental current waveforms in at least 4 large facilities. It has been used for construction of a local curvilinear frame of reference, in which conservation laws for mass, momentum and energy can be reduced to effectively-one-dimensional hyperbolic conservation law equations. Its utility in global parameter optimization of device parameters has been demonstrated. These features suggest that the Gratton-Vargas model deserves a closer look at its supposed limitations near the singular phase of the DPF. This paper presents a discussion of its development near the device axis, based on the original work of Gratton and Vargas, with some differences. It is shown that the...
Pedro Cezar Dutra Fonseca
Full Text Available O segundo governo de Vargas (1951-54 e o governo de João Goulart (1961-64 são usualmente considerados como exemplos típicos do populismo no Brasil. A maior parte da literatura considera as políticas econômicas neles implementadas como "hesitantes", "irracionais" ou "ambíguas". Entretanto, a análise das políticas econômicas dos dois governos permite que sejam detectadas certas regularidades, que podem ser compreendidas como o resultado de equilíbrio em um modelo de credibilidade. Observa-se que a condução das políticas econômicas parte de uma mesma estratégia de convencer os agentes privados quanto à prioridade no combate à inflação. À medida que o tempo avança, essa prioridade vai gradualmente sendo afrouxada, iniciando-se uma segunda fase, de randomização. Essa política oscilatória contribui para abalar a credibilidade dos governos e inaugura uma terceira fase em que, vendo a crise aprofundar-se, estes acabam por abandonar a opção pela estabilidade.The Vargas' second administration (1951-54 and Goulart's administration (1961-64 are considered typical examples of populism in Brazil. Because of the political problems both presidents had to face, the literature usually defines their economic policies as "hesitating", "irrational" or "ambiguous". However, the analysis of the two periods indicates that there is a pattern in the way economic policies were conducted, which can be understood as a result of an equilibrium strategy in a model of credibility. The governments started with measures to fight against inflation that improved the credibility of the economic policies. As time goes on, though, the policies were random, alternating measures pro and against stabilization. Later, as a result of the costs associated with the policies, they abandoned the austerity and, in consequence, the credibility decreased and the attempts of stabilization failed.
Full Text Available Desde los tiempos de su candidatura a la presidencia de Perú, el Premio Nobel de Literatura Mario Vargas Llosa nunca renunció a su faceta política así como tampoco a la de observador de la sociedad. Algo que le ha procura- do numerosos detractores pero que no ha mermado sus dotes narrativas. Esta controversia provocó interpretaciones frontalmente encontradas a su discurso en la ceremonia de entrega de los galardones, celebrada en diciembre de 2010. Cuando observamos la interpretación que de aquel acontecimiento realizaron dos medios de comunicación escritos, queda reflejada, al aplicar en el más amplio sentido del término, el uso de las técnicas de comunicación periodística persuasiva. Se realiza así en este trabajo un análisis de diversos aspectos que influyen en esta forma de comunicación, desde la elección de la persona que ha de redactar la información o el comentario de fondo, hasta la selección de los textos originales, completos o fragmentados, que apoyan las opiniones vertidas en la información, pasando por el análisis formal, incluso, del tipo de imágenes elegidas para ilustrar la información y su apoyo en forma de texto de pie de foto.
Osteossíntese das fraturas da extremidade proximal do úmero com sistema de placa de ângulo fixo com parafusos bloqueados: técnica e resultados Osteosynthesis of proximal humeral end fractures with fixed angle plate and locking screws: technique and results
Full Text Available OBJETIVO: Descrever os resultados do tratamento cirúrgico das fraturas da extremidade proximal do úmero com a placa de sistema bloqueado Philos. MÉTODOS: Entre março de 2003 e outubro de 2004 foram avaliados, de forma prospectiva, 24 de 26 pacientes com fratura da extremidade proximal do úmero tratados com a placa Philos. A média de seguimento foi de 12 meses e da idade dos pacientes, de 57 anos. Seis pacientes tinham fraturas em quatro partes, 11 em três partes e nove em duas partes. A avaliação clínica foi feita por meio dos critérios da University of California at Los Angeles (UCLA. RESULTADOS: A média do escore da UCLA foi de 30 pontos (17-35. Todas as fraturas consolidaram. Em três pacientes a fratura consolidou em varo. Nesses, o índice da UCLA médio foi de 27 pontos. CONCLUSÃO: A osteossíntese com a placa Philos permite fixação estável com bom resultado funcional.OBJECTIVE: Describe the results of proximal humeral fractures surgically treated with the Philos locking plate system. METHOD: Between March 2003 and October 2004 we prospectively reviewed 24 of 26 patients with proximal humerus fractures treated with a Philos plate. The mean follow-up time was 12 months and the mean age of patients was 57 years. Six patients had four-part proximal humerus fractures, 11 patients had three-part proximal humerus fractures, and nine patients had two-part proximal humerus fractures. Clinical evaluation was performed using the University of California at Los Angeles (UCLA criteria. RESULTS: The mean UCLA score was 30 points (17-34. All fractures showed union. Three patients showed fracture union at varus position. The mean UCLA score for these patients was 27 points. CONCLUSION: Osteosynthesis with Philos plate provides a stable fixation method with good functional outcome.
Alessandro Carvalho Bica
Full Text Available As primeiras décadas da chamada era Vargas podem ser caracterizadas por suas mudanças políticas, culturais, sociais ou pedagógicas. No que tange às transformações ou alterações no campo da escolarização, muitos pesquisadores tem se dedicado a pesquisas acerca dessa temática. Ademais, afirma-se que a preocupação com os rumos educacionais e os altos índices de analfabetismo da população brasileira, inflamou os discursos políticos no limiar da década de 1930. Nesta ótica, o Manifesto dos Pioneiros da Educação Nova consolidou a visão de um segmento da intelectualidade que, embora com diferentes posições, vislumbrava a possibilidade de interferir na organização da sociedade brasileira do ponto de vista da educação. Neste sentido, pelo decreto n. 21.731, de 15 de agosto de 1932, a Cruzada Nacional de Educação foi declarada de utilidade pública. Considerava-se que a alfabetização se constituía no elemento básico para a solução de todos os problemas políticos e sociais do Brasil. Em seus principais artigos, o decreto instituía anualmente a Semana da Alfabetização no Brasil, durante o mês de outubro. Esta campanha mobilizou vários setores da sociedade na possibilidade de abrir mais de 10.000 escolas primárias em todo o Brasil. No documento que segue, pode-se observar um discurso permeado de intenções cívicas e patrióticas.
Esport e propaganda política: um estudo comparado dos governos de Vargas (1930-1945 e Perón (1946-1955 Deporte y propaganda política: un estudio comparado de los gobiernos de Vargas (1930-1945 Y Perón (1946-1955 = Sports and political propagand:a comparative study of the Vargas Government (1930-1945 and Peron (1946-1955
Victor Andrade de Melo
Full Text Available Este artigo tem por objetivo analisar a utilização do esporte como instrumento político durante e primeira Era Vargas, no Brasil, e durante os dois primeiros mandatos de Juan Domingo Perón, na Argentina. Tanto Vargas como Perón buscavam identificar o regime político com as vitórias obtidas no campo esportivo. Desta forma, o controle estatal sobre o esporte e sua utilização pelos meios de propaganda política visavam criar um elo de identificação nacional entre o esporte e os governos, ressaltando os novos modelos de nação e cidadãos engendrados pelo varguismo e pelo peronismo. Pretendeuse também analisar as diferenças na abordagem de cada governo sobre o esporte e seus modelos de intervenção na estrutura política interna do esporte. Esperase que este trabalho possa trazer contribuições significativas para o debate sobre a produção de um ideário político através do esporte, assim como sobre o processo de formação de identidades nacionais na América Latina, mais especificamente no Brasil e na Argentina.Este artículo tiene por objetivo analizarla utilización del deporte como instrumento político durante la primera etapa Vargas, en Brasil, y durante los dos primeros mandatos de Juan Domingo Perón, en Argentina. Tanto Vargas como Perón buscaban identificar su régimen político con las victorias obtenidas en los campos de deporte. De esta forma, el control estatal sobre el deporte y su utilización por los medios de propaganda política reafirmaban la identificación nacional entre el deporte y los gobiernos, resaltando los nuevos modelos de nación y ciudadanos creados por el varguismo y el peronismo. Se pretende también analizar las diferencias en la forma en que cada gobierno abordó el deporte y sus modelos de intervención en la estructura política interna del mismo. Se espera que este trabajo aporte contribuciones significativas para el debate sobre la producción de un ideario político a través del deporte
O título, evidentemente, é provocativo. O que se quer dizer dois dois governantes ditatoriais é que souberam - intuitivamente ou não - utilizar-se do veículo para seus fins políticos, deixando que o mesmo se dirigisse ao imaginário popular, sem instrumentalizá-lo totalmente. Tanto Vargas quanto Perón permitiram que o rádio operasse comercialmente, com a sua programação normal de radio-novelas, programas de humor, de auditórios, musicais, esportivos, informativos, sempre, sob a ação vigilante ...
Full Text Available The modernization process is analyzed here in two peripheral realities of the world system - nineteenth-century Brazil and Sicily - as depicted in La guerra del fin del mundo and in Il gattopardo. In particular, we show how in the world that Vargas Llosa creates there is no social class capable of becoming the leader of the transition towards a modern society that responds to the needs and nature of an independent Brazil. This absence leads to resistances and catastrophic conflicts. Resistance and conflicts help explaining the phenomenon of opposition to the advance of modernity that we are witnessing today.
Full Text Available This paper argues that Mario Vargas Llosa’s novel The Feast of the Goat (2000 uses the images of the bodies of three of its characters (Urania Cabral, Trujillo and Agustín Cabral to represent the mechanisms of state terrorism at the time of Trujillo’s dictatorship in the Dominican Republic. It is a traumatizing system, which leaves somatic marks in all the actors involved. We analyze the manners in which the Peruvian author uses the images of protagonists’ organic processes to sketch the psychical, emotional and ideological processes and states, linked to or generated by the policies of intimidation.
Jorge Valenzuela Garcés
Full Text Available En este artículo nos ocupamos de analizar el modo en que Mario Vargas Llosa construye, en el texto “La literatura es fuego”, la imagen del héroe intelectual a partir de la vida del poeta Carlos Oquendo de Amat. El texto “La literatura es fuego”, leído el 11 de agosto de 1967, en Caracas, a propósito de la concesión a Vargas Llosa del Premio Rómulo Gallegos, es uno de los más extraordinarios discursos dados por un escritor al momento de recibir un premio literario. El énfasis con el que se construye la imagen del escritor inconforme a partir del recuerdo de un poeta como Carlos Oquendo de Amat y la forma en que la literatura es presentada como una actividad crítica, corrosiva e indomeñable, convierte este discurso en una muestra del desarrollo que, entonces, el campo intelectual había alcanzado en relación a los niveles de conciencia que los escritores de la época tuvieron respecto a su propia condición, a su oficio y a sus relaciones con el poder. Para el análisis empleamos el marco de la crítica cultural y nos centramos en las relaciones que los intelectuales, a través del ejercicio de la literatura, establecen con el poder.
Jorge Valenzuela Garcés
Full Text Available El proyecto de “novela total” que concibieron y llevaron a la práctica connotados integrantes del “boom” de la novela hispanoamericana tuvo extraordinarias muestras en textos como Cien años de soledad o La casa verde. En este estudio nos ocupamos de describir el campo literario delos años sesenta y el modo en que este influye, a través de la figura del compromiso, en las demandas al escritor-intelectual de izquierda sobre la necesidad de proyectar, en los textos literarios, una imagen integral del proceso histórico y social del continente. El análisis se centra en la forma en que Vargas Llosa construye, a partir del análisis de una novela como Cien años de soledad, el proyecto de la novela total y el modo en que la novela del escritor colombiano representó esta totalidad respondiendoa las demandas del campo literario en un contexto marcado porun discurso que entonces explicaba la situación de retraso de nuestro continente debido a la dependencia del imperialismo.Palabras claves: Mario Vargas Llosa, novela total, campo intelectual, campo literario.
This booklet resulted from a 1980 visit by the author, a Hungarian mathematics educator, to the Teachers' Center Project at Southern Illinois University at Edwardsville. Included are activities and problems that make probablility concepts accessible to young children. The topics considered are: two probability games; choosing two beads; matching…
Auluck, S K H
Dense Plasma Focus (DPF) is known to produce highly energetic ions, electrons and plasma environment which can be used for breeding of short-lived isotopes, plasma nanotechnology and other material processing applications. Commercial utilization of DPF in such areas would need a design tool which can be deployed in an automatic search for the best possible device configuration for a given application. The recently revisited [S K H Auluck, Physics of Plasmas 20, 112501 (2013)] Gratton-Vargas (GV) two-dimensional analytical snowplow model of plasma focus provides a numerical formula for dynamic inductance of a Mather type plasma focus fitted to thousands of automated computations, which enables construction of such design tool. This inductance formula is utilized in the present work to explore global optimization, based on first-principles optimality criteria, in a 4-dimensional parameter-subspace of the zero-resistance GV model. The optimization process is shown to reproduce the empirically observed constancy ...
Santos, Tânia Cristina Franco; Gomes, Maria da Luz Barbosa; Oliveira, Alexandre Barbosa de; Almeida Filho, Antonio José de
This is a historical and social study, which aimed to describe the main characteristics of the Vargas and Franco dictatorships, and to analyze the implications of these to the institutionalization of nursing in Brazil and Spain. As fonts, it was used written documents located in the historical Brazilian and Spanish archives, in addition to the literature on the subject. Data analysis, supported by concepts of Pierre Bourdieu's World Social Theory, showed that, in Brazil and Spain, in referring to the social division of labor, the meeting point between Church and the State was the seclusion of women in private space. It is concluded that the feminine qualities were capitalized by the nurses to legitimize their actions in public space, even to reproduce in that space, consented to by the State and Church, occupations appropriate to femininity.
Full Text Available La novela de Mario Vargas Llosa Lituma en los Andes1 poco tiene que ver, aparentemente, con el mundo narrativo de José María Arguedas: las nuevas aventuras de un personaje ficticio bien conocido de los lectores, presente en varias obras anteriores de aquel autor, en nada se asemejan a las del niño Ernesto ni a las de otro protagonista arguediano. Los Andes sirven de decorado para los dos relatos, pero entre la naturaleza y los pueblos que se suceden en Los ríos profundos2en toda su diversidad, y los paisajes hoscos y siempre peligrosos por los que cruza Lituma, apenas reconoce el lector aquella parte del sur peruano. Algunos detalles, sin embargo, al examinar bien el texto y el contexto de Lituma en los Andes, llaman la atención.
Eduardo Marks de Marques
Full Text Available The following article will present reflections about the character Urania in the novel The Feast of the Goat, originally published in 2000 by Peruvian writer Mario Vargas Llosa. To this analysis, the concept of historiographical metafiction, coined by Linda Hutcheon ( 1991 was used to discuss the relations between literature and history in the novel. In what concerns the analysis of the character Urania (core of this article, the lathing of memory and trauma is central, since the character suffered a traumatic experience in a difficult era of the Dominican Republic: the Trujillo Era (1930-1961. On the pathway between theory and practice, that is, the historical living experience and the historical knowledge, stands Urania and the power to recreate, using fiction, the consequences that dictatorships can have upon individuals. Besides, it is exactly in the movement between theory and practice that the reconstruction of Urania’s Dominican identity becomes possible.
Héctor A. Vargas
Full Text Available The native tree Schinus molle (Anacardiacae is reported for the first time as a host plant for larvae of the little known geometrid moth Eupithecia yubitzae Vargas & Parra (Lepidoptera, Geometridae in the Atacama Desert of northern Chile, based on morphology and DNA barcodes. This discovery importantly expands the host range of E. yubitzae, as previous records were restricted to Fabaceae trees. Larvae were previously known as florivorous, while these were found to be folivorous on S. molle. Furthermore, host-associated cryptic larval polychromatism was detected, as larvae collected on S. molle were found to be mostly pale green, contrasting with the dark yellow ground color of the larvae typically collected on fabaceous host plants.
Auluck, S K H
Recent resurgence of interest in applications of dense plasma focus and doubts about the conventional view of dense plasma focus as a purely irrotational compressive flow have re-opened questions concerning device optimization. In this context, this paper re-appraises and extends the analytical snowplow model of plasma focus sheath evolution developed by F. Gratton and J.M. Vargas (GV) (Energy Storage, Compression and Switching, Ed. V. Nardi, H. Sahlin, and W. H. Bostick, Eds., vol. 2. New York: Plenum, 1983, p. 353) and shows its relevance to contemporary research. The GV model enables construction of a special orthogonal coordinate system in which the plasma flow problem can be simplified and a model of sheath structure can be formulated. The LPP plasma focus facility, which reports neutron yield better than global scaling law, is shown to be operating closer to an optimum operating point of the GV model as compared with PF-1000.
Colchero Cervantes, Esther María
Falta palabras clave El propósito de este trabajo es sacar a la luz la vida y obra de María Luisa Muñoz de Vargas (1898-1975), una de las figuras más destacadas dentro del panorama literario y cultural onubense de comienzos del siglo XX y del conjunto de la escritura femenina andaluza en esos años. Esta autora escribió literatura en revistas y periódicos, de carácter nacional y local, en unos años de profundos cambios a nivel político, económico y tecnológico en España. María Luisa Muño...
Full Text Available El 2002 puede ser considerado un año crítico en la vida política venezolana. La promulgación inconsulta de más de 40 leyes por parte del Poder Ejecutivo a finales del año 2001 inició una sucesión de hechos que concluyeron en una huelga general que se inició en diciembre de 2002 y se suspendió al año siguiente. Estos hechos produjeron opiniones en todo el mundo. Entre tales opiniones encontramos la de tres renombrados escritores latinoamericanos: Tomás Eloy Martínez, Mario Vargas Llosa y Carlos Fuentes. El presente trabajo intenta reconstruir a partir del análisis semántico - pragmático la imagen que estos escritores poseían de Hugo Chávez y de su gobierno para ese momento. El corpus analizado lo constituyen el artículo de opinión La soga al cuello, del primer escritor mencionado; la charla titulada ¿Por qué fracasa América Latina? dictada por Vargas Llosa y una declaración de prensa ofrecida por Carlos Fuentes en Barcelona España y que el periodista tituló Carlos Fuentes no aboga por una salida militar. Estos textos fueron producidos en tres momentos diferentes de ese año y por lo tanto responden de una u otra forma a los momentos específicos en los que se produjeron.
University of Rhode Island Geospatial Extension Program — Hospital Facilities information was compiled from several various sources. Main source was the RI Department of Health Facilities Regulation database, License 2000....
Vermont Center for Geographic Information — This data layer contains point locations of all major community, regional, comprehensive health, and healthcare provider hospitals in the state of Vermont. The...
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...
U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...
Auluck, S. K. H.
Dense plasma focus (DPF) is known to produce highly energetic ions, electrons and plasma environment which can be used for breeding short-lived isotopes, plasma nanotechnology and other material processing applications. Commercial utilization of DPF in such areas would need a design tool that can be deployed in an automatic search for the best possible device configuration for a given application. The recently revisited (Auluck 2013 Phys. Plasmas 20 112501) Gratton-Vargas (GV) two-dimensional analytical snowplow model of plasma focus provides a numerical formula for dynamic inductance of a Mather-type plasma focus fitted to thousands of automated computations, which enables the construction of such a design tool. This inductance formula is utilized in the present work to explore global optimization, based on first-principles optimality criteria, in a four-dimensional parameter-subspace of the zero-resistance GV model. The optimization process is shown to reproduce the empirically observed constancy of the drive parameter over eight decades in capacitor bank energy. The optimized geometry of plasma focus normalized to the anode radius is shown to be independent of voltage, while the optimized anode radius is shown to be related to capacitor bank inductance.
Full Text Available The Irish revolutionary Roger Casement, executed in 1916, has spawned an army of books, articles, and news stories, more about his diaries and the authenticity controversy that still surrounds them than about his seminal work encouraging and arming Irish separatism or his humanitarian investigations in the Congo and the Peruvian Amazon. His aura and image in life, and more so in death, was Christ-like. A cult developed that required him to be sexless. The more he was said to be an active homosexual, as graphically revealed in his journals, ironically, the more he was revered as an icon by his Catholic nationalist supporters. The entry of Nobel prizewinning novelist Mario Vargas Llosa to the field and his adoption of a mixed, even contradictory, view of Casement’s sexuality in his Dream of the Celt (2010 has sparked a new round of disputation particularly from Angus Mitchell, the foremost proponent of the diary forgery theory. This emerges in his extensive Field Day Review articles, one of which provides a full history of the controversy.
MARIANA XAVIER NICOLLETTI
Full Text Available The aim of this paper is to discuss improvements for the Master in Sustainability Management of Fundação Getulio Vargas (FGV, in order to incorporate the topic of disaster risk management (DRM. Considering the risks and opportunities that climate change - and more specifically extreme weather events that can lead to disasters - represent to business, it is essential that business schools help prepare managers to deal with this critical sustainability issue. Therefore, it is extremely important to include this topic in management education. Aiming to support companies to assess and address business risks and opportunities derived from climate change, the Business for Climate Platform (EPC of the Center for Sustainability Studies (GVces of FGV has developed a framework and a tool for business adaptation strategies for climate change and implemented them with seven large companies in Brazil. Thus, based on EPC's experience, the paper brings a proposal for the inclusion of DRM in the MSM's syllabi, through the lens of climate change adaptation.
Full Text Available La relación entre teoría política y literatura quizás no pueda contarse entre las más fecundas si se la compara con el vínculo que han establecido disciplinas como la filosofía, la historia y la psicología. Si bien la política ha ocupado un lugar central en la literatura es difícil sostener que la teoría política haya obtenido un sitio destacado. Una notable excepción encontramos en la novela La guerra del fin del mundo de Mario Vargas Llosa, no porque el autor se dedique a la teoría política, sino por la complicidad de la trama de la novela con ciertas perspectivas teóricas contemporáneas. En este horizonte, el artículo tiene como objetivo realizar una lectura de La guerra del fin del mundo y sugerir su relación con categorías centrales de la teoría política de inspiración posfundacional como Heterogeneidad, Antagonismo, exterior constitutivo, significante vacío, discurso y hegemonía. El trabajo que presentamos, de este modo, pretende aportar a la discusión de ciertas categorías teórico políticas que muchas veces por su grado de abstracción han suscitado dificultades pero también ofrecer claves de lectura de esta novela desde la teoría política actual
Full Text Available En una zona de alto crecimiento poblacional como el estado Vargas, levantar información con el propósito de elaborar escenarios de riesgo ambiental, se hace aplicar al geotecnologías que garanticen la validez y ubicación de los datos recuperados en campo. En este contexto, se desarrolló un estudio en las cuencas La Zorra, Tacagua y Mamo, las más densamente pobladas en el litoral central. Se construyó un sistema de información geográfica para gestionar datos del área de estudio a objeto de producir análisis espaciales que lleven a la generación de un mapa de vulnerabilidad urbana. Para ello se realizó una detección de cambios con imágenes Landsat de distintos años a fin de identificar áreas con cambios significativos. Posteriormente, la cartografía digital de coberturas urbanas se superpuso a los datos del satélite IKONOS y se combinaron con el mapa de amenaza hidrometeorológica para seleccionar áreas críticas. La información colectada de las estructuras dentro de las áreas críticas fue localizada utilizando sistemas de posicionamiento global (GPS. Finalmente, este procedimiento permitió identificar los niveles de daños que podrían sufrir las edificaciones a la hora de un evento extraordinario (aludes torrenciales así como establecer áreas con distintos grados de vulnerabilidad.
Alessandro Carvalho Bica
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As primeiras décadas da chamada era Vargas podem ser caracterizadas por suas mudanças políticas, culturais, sociais ou pedagógicas. No que tange às transformações ou alterações no campo da escolarização, muitos pesquisadores tem se dedicado a pesquisas acerca dessa temática. Ademais, afirma-se que a preocupação com os rumos educacionais e os altos índices de analfabetismo da população brasileira, inflamou os discursos políticos no limiar da década de 1930. Nesta ótica, o Manifesto dos Pioneiros da Educação Nova consolidou a visão de um segmento da intelectualidade que, embora com diferentes posições, vislumbrava a possibilidade de interferir na organização da sociedade brasileira do ponto de vista da educação. Neste sentido, pelo decreto n. 21.731, de 15 de agosto de 1932, a Cruzada Nacional de Educação foi declarada de utilidade pública. Considerava-se que a alfabetização se constituía no elemento básico para a solução de todos os problemas políticos e sociais do Brasil. Em seus principais artigos, o decreto instituía anualmente a Semana da Alfabetização no Brasil, durante o mês de outubro. Esta campanha mobilizou vários setores da sociedade na possibilidade de abrir mais de 10.000 escolas primárias em todo o Brasil. No documento que segue, pode-se observar um discurso permeado de intenções cívicas e patrióticas.
Full Text Available Tratando del estudio de la lectura de obras literarias para niños en el período de Vargas, este artículo examina el trabajo de la Comisión Nacional de Literatura Infantil (CNLI y su comprensión de este tipo de lectura. El análisis muestra cómo la perspectiva de aquelllos intelectuales fue determinada por la tensión entre lo lúdico y lo pedagógico. A continuación, el artículo discute la renovación pedagógica propuesta por la Escuela Nueva y sus conexiones con el concepto de la lectura de obras literarias propuestas por la CNLI. Por fin, el texto analiza la obra didáctica de Cecilia Meireles Rute e Alberto resolveram ser turistas (1938. Se há verificado que em esa obra de carácter eminentemente didáctico, la autora dejó clara su relación con los valores consagrados por la Escuela Nueva. Cecilia, en essa obra, intento utilizar recursos literarios, tales como la creación de personajes, espacios de ficción, el uso de diálogos y narraciones, sin obtener el equilibrio en la compleja dinámica entre la enseñanza y lo lúdico. El resultado es una obra que, en comparación con otras de la misma autora, no está a la altura de sus logros literarios.
Justesen, Lise; Gyimóthy, Szilvia; Mikkelsen, Bent Egberg
Hospital meals and their role in nutritional care have been studied primarily from a life and natural science perspective. This article takes a different approach and explores the idea of hospitality inspired by Jacques Derrida’s work on the ontology of hospitality. By drawing on ethnographic...... fieldwork in a Danish hospital, hospitality practices were studied using a socio-material assemblage approach. The study showed that rethinking the meal event could change the wards into temporary “pop-up-restaurants,” transcending the hospital context and providing a scene for shifting host...... and management involved in hospital food service and in nutritional care to work more systematically with the environment for improved hospital meal experiences in the future...
A tese investiga o papel dos presidentes no processo de construção do Estado e de desenvolvimento do Brasil. Para tanto, compara as presidências de Campos Salles e de Getúlio Vargas. O objetivo específico é entender como os presidentes, no exercício de suas funções de Estado (administração pública e regulação), empregam recursos institucionais (incentivos ou restrições e punições) para impulsionar ou tolher as possibilidades de desenvolvimento nacional. A partir do referenci...
After discussing some of Claude Duchet's theoretical propositions and after defining socio-criticism as it is understood by the Centre d'Etudes et de Recherche Sociocritiques de l'Université de Montpellier, the author of this article goes on to stress the judiciousness of Duchet's approach in his analysis of the incipit of Madame Bovary, and proposes to apply the same method to Vargas Llosa's novel La tía Julia y el escribidor. He first examines the social discourses express...
Ayçaguer, Ana María Rodríguez
Full Text Available Quando aconteceram os levantes da ANL, em novembro de 1935, o regime de Vargas afirmou que os revolucionários contavam com o apoio da legação soviética em Montevidéu. Embora o Itamaraty não pôde provar essa intromissão, o governo de Terra rompeu relações com a URSS, demonstrando a efetividade das pressões exercidas pela "diplomacia do anticomunismo", bem como o caráter prioritário que tinha para o pequeno Uruguai a amizade com seu poderoso visión, o Brasil
Full Text Available Development of accommodation, as basic services offered to tourists, led to the creation of a genuine hospitality industry. Currently, the hospitality industry is no longer just the accommodation service itself but also requires an atmosphere that ensures leisure tourists in the hotel. Thus, hospitable unit manager offers its service in addition to accommodation and catering services, leisure services, treatment services, business services required.. The existence of factors such as revenue growth, increasing leisure time, the development of transport services, the emergence of new tourist attractions have caused increasing international flows of tourists, with consequent development of units hospitable, and therefore a strong hospitality industry. In Romania, after 1990, the tourism sector experienced a true expansion, both through the development of the hotel sector, but also by developing rural hospitality units.
Gastroenteritis - norovirus; Colitis - norovirus; Hospital acquired infection - norovirus ... are not treated with antibiotics because antibiotics kill bacteria, not viruses. Receiving plenty of extra fluids through ...
Efraim Otero Ruiz
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La Segunda Edición de un Libro Admirable (Comentario a la 2ª Edición del libro “Antonio Vargas Reyes-La Medicina del Siglo XIX en Colombia” por el Académico Roberto de Zubiría C.-Febrero 2003
Circunstancias ajenas a la voluntad de los protagonistas hicieron que la presentación de este libro ante la Academia Nacional de Medicina tuviera que ser postergada hasta la fecha actual. De todas maneras, persiste mi vivo agradecimiento ante las directivas de la Academia y ante el mismo autor por haberme distinguido con el honor de ser yo quien presente ante ustedes esta obra, en el momento ya con varios meses de haber sido publicada por Editorial Kimpres, en un elegante volumen de 212 páginas y que marca un hito entre los libros de historia médica publicados en el país en el año 2002.
Efectivamente, en sus 20 capítulos, seguidos de un apéndice y del testamento del personaje aquí biografiado, además de una extensa bibliografía curiosamente referida con números romanos, Roberto de Zubiría nos entrega una visión panorámica de lo que fue, como reza el subtítulo, la medicina del siglo XIX en Colombia. Medicina que estuvo rubricada y marcada por los sucesos de la independencia, en su segunda década, a la que se siguió el cambio intelectual necesario y obligatorio que nos trocaba de un pensamiento de colonos y súbditos al de seres independientes, que debían crear o transformar las nuevas instituciones de la patria. Como lo ha dicho el historiador médico español García-Valdés a propósito de Europa, podría decirse que el siglo XIX sólo llega a la medicina colombiana a partir de 1820. Por eso el primer capítulo hace un inventario de lo que era el ambiente y las escuelas iniciales de la primera mitad de ese siglo, con los primeros intentos de establecer una cátedra por José Celestino Mutis y Miguel de Isla, a quienes el autor señala justamente como los verdaderos precursores
Full Text Available The study examines three novels of apocalyptic character, Cien años de soledad by Gabriel García Márquez, La guerra del fin del mundo by Mario Vargas Llosa and Estrella distante by Roberto Bolaño. Both in Cien años de soledad and in La guerra del fin del mundo apocalypse is related to the sudden and forced graft of modernity in a backward society and to the inability of the ruling class to understand the disturbing and devastating aspects of such a graft and, more generally, to understand themselves, their own development, their own history. Through the metaliterary component that characterizes them, Garcia Marquez’s and Vargas Llosa’ novels represent literature as an instrument that as memory, as a form of processing and understanding of history, can help to prevent the repetition of the apocalypse they narrate. In Bolaño’s novel, on the contrary, writers seem not to have any cognitive power anymore and their literature not only doesn’t play any salvific role, but rather becomes one of the elements that contributes to the historical catastrophe.
U.S. Department of Health & Human Services — Welcome to hospitalinspections.org, a website run by the Association of Health Care Journalists (AHCJ) that aims to make federal hospital inspection reports easier...
Maria Angélica Pedra Minhoto
Full Text Available O objetivo do texto é o de caracterizar o peso seletivo do exame de admissão ao ginásio, entre os anos de 1931 e 1945, tendo em vista a política educacional do governo de Getúlio Vargas voltada ao Ensino Secundário. Para tanto, verificou-se o padrão de recrutamento estabelecido pelo exame e as relações existentes entre a regulamentação jurídica e o comportamento dos estabelecimentos de ensino frente às normas. O levantamento de informações foi feito em arquivos de cinco instituições de ensino, localizadas na cidade de São Paulo, em funcionamento à época, e que permanecem abertas até hoje. Para a análise do percurso escolar dos alunos entre os Ensinos Primário e Secundário, foi utilizado o conceito de segmentação elaborado por Fritz Ringer em obra que descreve e compara as diferentes configurações de sistemas educacionais da Europa e dos Estados Unidos. Para o autor, o sistema educacional segmentado é aquele que oferece caminhos paralelos de estudos, separados por barreiras institucionais, pelo currículo e por diferenças de origem social dos estudantes. Os resultados obtidos indicam que o exame legitimou um padrão específico de recrutamento de alunos e camuflou a existência de barreiras institucionais no ensino elementar. Ademais, as estratégias desenvolvidas pelas instituições privadas para contornar sistematicamente a regulamentação jurídica do exame permitiram entrever limites ao papel repressivo e interventor do Estado da época.The objective of this text is to characterize the relative weight of the admission exam to the gymnasium (the four series following primary education in the years between 1931 and 1945, in view of the educational policy for Secondary Education during the govern of Getúlio Vargas. To this end, we have examined the pattern of recruiting established by the exam, and the relations existing between the juridical regulations and the ensuing behavior of institutes of education
This article looks at a prescribed academic framework for various criteria that serve as a checklist for marketing performance that can be applied to hospital marketing organizations. These guidelines are drawn from some of Dr. Noel Capon of Columbia University's book Marketing Management in the 21st Century and applied to actual practices of hospital marketing organizations. In many ways this checklist can act as a "marketing" balanced scorecard to verify performance effectiveness and develop opportunities for innovation.
Auluck, S K H
Recent work on the revised Gratton-Vargas model has demonstrated that there are some aspects of Dense Plasma Focus (DPF) which are not sensitive to details of plasma dynamics and are well captured in an oversimplified model assumption which contains very little plasma physics. A hyperbolic conservation law formulation of DPF physics reveals the existence of a velocity threshold related to specific energy of dissociation and ionization, above which, the work done during shock propagation is adequate to ensure dissociation and ionization of the gas being ingested. These developments are utilized to formulate an algorithmic definition of DPF optimization that is valid in a wide range of applications, not limited to neutron emission. A universal scaling theory of DPF design optimization is proposed and illustrated for designing devices working at one or two orders higher pressure of deuterium than the current practice of designs optimized at pressures less than 10 mbar of deuterium. These examples show that the u...
Full Text Available This article offers a panoramic as well as comparative overview of the consequences of the colonial policy on the indigenous societies of the Charca region, through the study of the general visit undertaken by the Charcas Oidor Martínez Luján de Vargas to the encomiendas of Tucuman, between 1693 and 1694. The analysis is focused on such variables as land property, work and tax systems, and the native response to the particularities adopted by the encomienda system in each jurisdiction. Finally, it examines the miscegenation and cultural change contexts that had become visible towards the end of 17th Century
A través de la visita general que el oidor de Charcas Martínez Luján de Vargas realizará a las encomiendas de la gobernación del Tucumán entre 1693 y 1694, este artículo intenta ofrecer una mirada a la vez panorámica y comparativa de los efectos de la política colonial sobre las sociedades indígenas de la región. Las variables de análisis elegidas para apreciar los diferentes procesos de transformación son la tenencia de la tierra, el sistema de trabajo y tributación y las respuestas nativas frente a las particularidades que el sistema de encomienda adoptó en cada jurisdicción. Finalmente, se exploran los contextos de mestizaje y cambio cultural visibles hacia finales del siglo XVII.
在西班牙语世界乃至全球文学界，马里奥·巴尔加斯·略萨被公认为“结构现实主义大师”，也是起源于二十世纪50年代左右的拉丁美洲文学“爆炸”时期最具代表性和较年轻的一位作家。自从2010年获诺贝尔文学奖，成为这一奖项的第107位得主之后，巴尔加斯·略萨及其作品也被更多中国读者所熟知。其作品中如实展现了拉丁美洲、尤其是秘鲁的社会现实。本文通过对其作品的解析，分析其中所体现出的结构现实主义特征，进而对巴尔加斯·略萨与结构现实主义小说进行更深一步的了解。%In the world of Spanish literature,and even in the whole world,Mario Vargas Llosa has been greatly considered as a "master of structural realism"by the public.He is a one of the most significant novelists and essayists,and one of the younger writers in the Latin American boom,which is started in the 1960s.Since Vargas Llosa became the No.107 winner of the Nobel Prize in Literature in 2010,he and his masterpiece has been known by more Chinese readers.In his works,Vargas Llosa shows the social reality of Latin America,especially in Peru.In the following article,it will embody the characteristics of structural realism by analyzing on Vargas Llosa's works,and then readers are able to have a further understanding of Vargas Llosa and his structural realism novels.
Eimeria atlapetesi nom. nov., a replacement name for Eimeria pileata Soriano-Vargas et al., 2015 (Apicomplexa: Eimeriidae), preoccupied by Eimeria pileata Straneva and Kelley, 1979 (Apicomplexa: Eimeriidae), with observations on histopathology and phylogenetic analysis.
Soriano-Vargas, Edgardo; Salgado-Miranda, Celene; Zepeda-Velázquez, Andrea Paloma; Medina, Juan Pablo; Janczur, Mariusz Krzysztof; González-Gómez, Maricruz; Flores-Valle, Izanami Tereira; Berto, Bruno Pereira; Lopes, Carlos Wilson Gomes
Eimeria pileata Soriano-Vargas, Medina, Salgado-Miranda, García-Conejo, Galindo-Sánchez, Janczur, Berto and Lopes, 2015 is a junior homonym of Eimeria pileata Straneva and Kelley, 1979 and needs to be replaced. This coccidium was described from a rufous-capped brush finch Atlapetes pileatus Wagler in the Nevado de Toluca Natural Protected Area, Mexico. Thus, to maintain the original intent of the specific epithet derived from the scientific name of the type-host, the name Eimeria atlapetesi nom. nov. is proposed as a replacement name. Additionally, the current work reports another rufous-capped brush finch A. pileatus parasitized by E. atlapetesi in co-infection with an Isospora sp., providing observations of histopathology and phylogenetic analysis of 18S ribosomal RNA (rRNA) gene from E. atlapetesi. Endogenous forms of E. atlapetesi and Isospora sp. were observed in intestinal sections. Few oocysts of Isospora sp. were observed; therefore they were not morphologically or molecularly identified. In return, E. atlapetesi was identified and it was phylogenetically close to Eimeria dispersa Tyzzer, 1929 from the domestic turkey Meleagris gallopavo Linnaeus.
Yasmira González Tovar
Full Text Available En el presente artículo se examina la situación del abastecimiento de agua potable en la parroquia Carlos Soublette (Maiquetía, estado Vargas y, se analiza la distribución espacial del servicio de acueducto por sectores de la referida parroquia. Se destaca la influencia del medio físico local y subregional y el patrón de ocupación del territorio sobre el funcionamiento precario del servicio de acueducto. El estudio se basó en un diseño mixto (de campo y documental, con la aplicación de una encuesta a una muestra de 67 jefes de familia distribuidos, en los nueve sectores en que fue dividida el área de estudio a los fines de la investigación. Se evidencia un déficit crónico en la oferta de agua potable para la parroquia, que se agrava hacia las zonas de mayores altitud y pendiente, y de patrón de ocupación espontáneo, no consolidado y dentro de la poligonal correspondiente al Parque Nacional Waraira-Repano o El Ávila
Full Text Available El debate en torno al papel de los intelectuales tiene un lugar central en el Boom de la Literatura Latinoamericana. Por un lado, porque es un momento en que los escritores saltan a la esfera pública e intervienen en ámbitos que exceden o literario. Por otro, porque ha sido uno de los temas que ha ocupado a la crítica en su afán de adscribir el fenómeno al mercado o a las circunstancias políticas de América Latina. Bajo el supuesto de esa centralidad, el presente artículo busca desentrañar las representaciones del intelectual que aparecen en dos novelas del período: Conversación en la Catedral (1969 de Mario Vargas Llosa y Cien años de soledad (1967 de Gabriel García Márquez. En ellas aparecen elementos y problemáticas presentes en los debates que les son contemporáneos con una mirada más amplia que la que opone al escritor y el político (o al intelectual y el revolucionario. Las tareas propias del letrado y la relación con la esfera pública y con las masas definen a los dos personajes principales a partir de los que se puede reconstruir una definición del intelectual.
Rômulo de Paula Andrade
Full Text Available O artigo analisa a Amazônia no pensamento social do Estado Novo (1937-1945, quando acontecimentos e projetos governamentais, como a "Marcha para o Oeste" e o "Discurso do rio Amazonas", representaram uma maior atenção do poder central à região. A partir de 1941, artigos sobre a Amazônia foram publicados no periódico "Cultura Política", produzido pelo Departamento de Imprensa e Propaganda, sendo um dos principais meios de divulgação do pensamento social do Estado Novo. Conceitos de Euclides da Cunha, Alberto Rangel e Alfredo Ladislau sobre clima, raça e civilização foram apropriados para a produção destes textos com o objetivo de construir um ideário capitaneado pelo Estado. Desta forma, nossa análise aponta continuidades e descontinuidades entre a produção literária da Primeira República e o ideário oficial formulado pela ditadura de Getúlio Vargas.
U.S. Department of Health & Human Services — Hospital Outpatient Prospective Payment System (OPPS) Partial Hospitalization Program LDS This file contains select claim level data and is derived from 2010 claims...
U.S. Department of Health & Human Services — A list of hospitals and the availability of structural measures at that hospital. A structural measure reflects the environment in which hospitals care for patients....
... tends to be more serious than other lung infections because: People in the hospital are often very sick and cannot fight off ... prevent pneumonia. Most hospitals have programs to prevent hospital-acquired infections.
U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...
巴尔加斯·略萨获得2010年度诺贝尔文学奖对人们重新聚焦拉美文学具有重要的意义。略萨以文学介入生活、介入政治，具有小说家与政治家的双重文化身份。他如一只啄食社会腐肉的兀鹫，用文学对抗社会黑暗、腐朽的独裁政治。在对拉美社会权力结构精细的描绘中，他以虚构小说的方式将理想与现实两个世界对举连通；从而在立体的艺术世界中，扫荡着现实社会生活的荒谬，呼唤人类的尊严。%The Nobel Prize for Literature in 2010 is awarded to Vargas Llosa, which is greatly significant for people to refocus on Latin American literature. As Llosa＇ s literature involves life and politics, he has the dual cultural identity of both a novelist and a statesman. He is like a vulture pecking at the carrion of society, fighting against social darkness and corrupt dictatorship by means of his literature. In his vivid description of the social power structure in Latin America, Llosa manages to connect the worlds of idealism and reality in a fictional manner, thus having swept the social absurdity and called for human dignity in the stereoscopic world of art.
Auluck, S. K. H.
Recent work on the revised Gratton-Vargas model (Auluck, Phys. Plasmas 20, 112501 (2013); 22, 112509 (2015) and references therein) has demonstrated that there are some aspects of Dense Plasma Focus (DPF), which are not sensitive to details of plasma dynamics and are well captured in an oversimplified model assumption, which contains very little plasma physics. A hyperbolic conservation law formulation of DPF physics reveals the existence of a velocity threshold related to specific energy of dissociation and ionization, above which, the work done during shock propagation is adequate to ensure dissociation and ionization of the gas being ingested. These developments are utilized to formulate an algorithmic definition of DPF optimization that is valid in a wide range of applications, not limited to neutron emission. This involves determination of a set of DPF parameters, without performing iterative model calculations, that lead to transfer of all the energy from the capacitor bank to the plasma at the time of current derivative singularity and conversion of a preset fraction of this energy into magnetic energy, while ensuring that electromagnetic work done during propagation of the plasma remains adequate for dissociation and ionization of neutral gas being ingested. Such a universal optimization criterion is expected to facilitate progress in new areas of DPF research that include production of short lived radioisotopes of possible use in medical diagnostics, generation of fusion energy from aneutronic fuels, and applications in nanotechnology, radiation biology, and materials science. These phenomena are expected to be optimized for fill gases of different kinds and in different ranges of mass density compared to the devices constructed for neutron production using empirical thumb rules. A universal scaling theory of DPF design optimization is proposed and illustrated for designing devices working at one or two orders higher pressure of deuterium than the current
Costello, M M
With more hospitals embracing the marketing function in their organizational management over the past decade, hospital marketing can no longer be considered a fad. However, a review of hospital marketing efforts as reported in the professional literature indicates that hospitals must pay greater attention to the marketing mix elements of service, price and distribution channels as their programs mature.
Pedagogies of dress and fashion during World War II: the looks of first lady Darcy Vargas as president of the brazilian legion of assistance (1942-1945 - doi: 10.4025/dialogos.v14i2.470 Pedagogías del vestir y de la moda durante la Segunda Guerra Mundial: las apariencias de la primera dama Darcy Vargas en la presidencia de la legión brasileña de asistencia (1942-1945 Pedagogias do vestir e da moda na Segunda Guerra Mundial: as aparências da primeira-dama Darcy Vargas na presidência da Legião Brasileira de Assistência (1942-1945 - 10.4025/dialogos.v14i2.470
Full Text Available This article proposes an analysis of the participation of First Lady Darcy Vargas as president of the Brazilian Legion of Assistance, in the scope of fashion. We examined the photographs that narrate her performances, looking to detect the dress codes in the appearances of the character, in order to obtain a description of Brazilian fashion during World War II. As such, we conceived and showed that the construction of the character was marked by a wardrobe that contains teachings on clothing trends and manners of composing a look (hair, hairstyle, makeup, which set the trends for fashion among women during that period.Este artículo propone el análisis sobre la actuación de la primera dama Darcy Vargas en la presidencia de la Legión Brasileña de Asistencia, enfocando la moda. Examinamos las fotografías que narran su desempeño, tratando de detectar los códigos de la indumentaria en las apariencias de la protagonista, con el objetivo de obtener una caracterización de la moda brasileña durante la Segunda Guerra Mundial. De este modo, concebimos y mostramos que la construcción de esta personalidad fue marcada por la producción de un guardarropa que contiene enseñanzas sobre las tendencias de ropas y las formas de crear un visual (cabellos, peinados, maquillaje que dictaron la moda femenina del período.Este artigo propõe uma análise sobre a atuação da primeira-dama Darcy Vargas na presidência da Legião Brasileira de Assistência, sob o foco da moda. Examinamos as fotografias que narram suas performances, procurando detectar, nas aparências da personagem, os códigos da indumentária, de modo a obter uma caracterização para a moda brasileira durante a Segunda Guerra Mundial. Deste modo, concebemos e mostramos que a construção da personagem foi marcada pela produção de um guarda-roupa que contém ensinamentos acerca de tendências de roupas e formas de compor o visual (cabelos, penteados, maquiagem que ditaram moda no per
Slenka Leandra Botello Gil
Full Text Available En el libro se hace una invitación a pensar la historia en la contemporaneidad, como una herramienta de transformación social, de emancipación para las luchas sociales y culturales. Al sumergirse en la argumentación que presenta el autor, el lector devela un escenario muy amplio, que desborda los límites del estudio de la historia en la academia y que le permite observar un proyecto de varios años, en los que Vargas desarrolló su propuesta política desde la “microfísica del poder”.
Wu, Ziqi; Robson, Stephani; Hollis, Brooke
In the last decade, many hospital designs have taken inspiration from hotels, spurred by factors such as increased patient and family expectations and regulatory or financial incentives. Increasingly, research evidence suggests the value of enhancing the physical environment to foster healing and drive consumer decisions and perceptions of service quality. Although interest is increasing in the broader applicability of numerous hospitality concepts to the healthcare field, the focus of this article is design innovations, and the services that such innovations support, from the hospitality industry. To identify physical hotel design elements and associated operational features that have been used in the healthcare arena, a series of interviews with hospital and hotel design experts were conducted. Current examples and suggestions for future hospitality elements were also sought from the experts, academic journals, and news articles. Hospitality elements applied in existing hospitals that are addressed in this article include hotel-like rooms and decor; actual hotels incorporated into medical centers; hotel-quality food, room service, and dining facilities for families; welcoming lobbies and common spaces; hospitality-oriented customer service training; enhanced service offerings, including concierges; spas or therapy centers; hotel-style signage and way-finding tools; and entertainment features. Selected elements that have potential for future incorporation include executive lounges and/or communal lobbies with complimentary wireless Internet and refreshments, centralized controls for patients, and flexible furniture. Although the findings from this study underscore the need for more hospitality-like environments in hospitals, the investment decisions made by healthcare executives must be balanced with cost-effectiveness and the assurance that clinical excellence remains the top priority.
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...
U.S. Department of Health & Human Services — Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Hospital Survey The intent of the HCAHPS initiative is to provide a standardized survey...
... look no further than your local hospital. From health videos to yoga classes, many hospitals offer information families need to stay healthy. You also may be able to find ways to save money on health supplies and services.
U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...
Mark W. Westmoreland
Full Text Available Come in. Welcome. Be my guest and I will be yours. Shall we ask, in accordance with the Derridean question, "Is not hospitality an interruption of the self?" What is the relationship between the interruption and the moment one enters the host's home? Derrida calls us toward a new understanding of hospitality - as an interruption. This paper will illuminate the history of hospitality in the West as well as trace Derrida's discussions of hospitality throughout many of works. The overall goal of this project is to provide readers of Derrida with a sort of reference guide for his discussions on and deconstructive approach to hospitality.
Prætorius, Thim; Hasle, Peter; Edwards, Kasper;
of the collaborative hospital concern the creation of an appropriate balance between standardization and local autonomy, shared purpose centred around providing the best possible care, and use of enabling structures that sustain the new ways of collaborative work. The chapter builds on the theoretical framework...... for the collaborative hospital as new organizational form which is better equipped to respond to the challenges facing modern hospitals. The collaborative hospital is an ambidextrous organization that opens for pursuing both exploration and exploitation within the same organizational structure. The basic principles...... of the collaborative organization which is used for a discussion of theoretical and empirical aspects of the collaborative hospital....
The 465-bed Santa Barbara Cottage Hospital is the largest medical facility on the California coast between Los Angeles and the San Francisco bay area. The hospital dates back to 1888, when a group of local citizens began raising funds to build a "cottage-style" hospital for the growing community. Their original plans called for a complex in which each medical specialty would be housed in a separate bungalow. Even then, however, such a decentralized plan was too costly, so work began instead on a single cottage for all hospital departments. The first Cottage Hospital opened in 1891, with 25 beds housed in a two story Victorian building. Now a hugh medical complex employing some 1,500 people, the hospital continues to be called "Cottage" after the original home-like building. Rodney J. Lamb has been Hospital Administrator for the last 30 years.
Humberto Jaramillo Ángel
Full Text Available En Roma. Cuando aún no había fenecido, del todo, el año 1900. El Maestro vivía solo. Muy solo, en la ciudad Imperial. Leía. Escribía. Odiaba. Y era odiado. Su lucha, lucha de cóndor con águila caudal, no cesaba a ninguna hora del día o de la noche.
Full Text Available Hacia el año de 1924, siendo yo estudiante de la Facultad de Derecho de la Universidad Nacional, fui a pasar unas vacaciones a la ciudad de Barranquilla. Quería conocer el mar, y me atraía la idea de relacionarme con algunos escritores importantes de esa ciudad, que formaban parte del grupo literario llamado Voces, nombre de la revista que les servía de órgano de publicidad.
... infection; Central venous catheter - infection; CVC - infection; Central venous device - infection; Infection control - central line infection; Nosocomial infection - central line infection; Hospital acquired ...
Kerwat, Klaus; Wulf, Hinnerk
As a general rule drinking water in hospitals does not represent a risk for the normal patient. However, for high-risk patients with compromised immune defense systems drinking water in hospitals may become a source of nosocomial infections. It may be contaminated with microorganisms that may have the potential to be infectious agents in the hospital environment. Of particular significance in such circumstances are the Gram-negative rods such as Pseudomonas aeruginosa, Acinetobacter spp. and Legionella bacteria. Accordingly, specific behavior patterns and measures in the handling of drinking water in hospitals are meaningful in order to reduce the risks of water-associated nosocomial infections.
La novela La guerra del fin del mundo fue engendrada por Vargas Llosa a partir del impacto que le causó la lectura de Os sertões, de Euclides da Cunha. El escritor peruano realizó extenso trabajo de investigación por los sertones del nordeste de Brasil e investigó en archivos históricos, recurriendo también a informaciones divulgadas en revistas y periódicos. En el período en el cual se desencadenó la guerra de Canudos (1896-1897), los periódicos de las grandes ciudades brasileñas han dado am...
... Digital Storytelling System for Teaching Common Pediatric Problems Virtual Pediatric Hospital is the Apprentice's Assistant Last revised ... pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com Virtual Pediatric Hospital is curated by Donna M. D' ...
Finn, D W; Lamb, C W
Market segmentation is an important topic to both health care practitioners and researchers. The authors explore the relative importance that health care consumers attach to various benefits available in a major metropolitan area hospital. The purposes of the study are to test, and provide data to illustrate, the efficacy of one approach to hospital benefit segmentation analysis.
The idea of hospitality is evident in several types of human behavior including obligatory duties, commercial activity, and prosocial action. These are intertwined and revolve around the commitment to caring for others whether they are relatives, guests, or strangers. This article explores the ethic of hospitality in its various forms.
Full Text Available The idea of hospitality is evident in several types of human behavior including obligatory duties, commercial activity, and prosocial action. These are intertwined and revolve around the commitment to caring for others whether they are relatives, guests, or strangers. This article explores the ethic of hospitality in its various forms.
Frandsen, F; Nielsen, J R; Gram, L;
During the period 1.10.1986-30.9.1987, all patients with cardiac arrest outside hospital brought to the casualty department in Odense Hospital were registered. Out of 160 patients, 133 (83%) could be primarily resuscitated, 19 (12%) were resuscitated but died later in hospital and eight patients (5......%) were resuscitated and could be discharged alive from hospital. Out of the eight patients who were discharged alive, only two (1%) had retained reasonable cerebral function as assessed by dementia testing. Treatment of the cardiac arrest prior to the arrival of the ambulance, duration of the cardiac...... arrest for less than six minutes and staffing of the ambulance with three first-aid men were factors of decisive importance for survival of the patients. The results of this investigation demonstrate that treatment of cardiac arrest outside hospital is unsatisfactory. Proposals for improvement...
The appropriateness of diversification as a growth strategy for hospitals is discussed, and planning for diversification is described. Because new forms of health-care delivery are now in direct competition with hospitals, many hospitals are confronting environmental pressures and preparing for future survival through diversification. To explore the potential risks and benefits of diversification, the hospital must identify opportunities for new business ventures. Diversification can be "related," through an expansion of the primary product line (health care), or "unrelated," into areas not directly associated with health care. The hospital must establish specific criteria for evaluating each diversification alternative, and the two or three most attractive options should be analyzed further through a financial feasibility study. The hospital should also seek legal advice to determine the implications of diversification for maintenance of tax status, antitrust limitations, and applicability of certificate of need. Although diversification may not be appropriate for every institution, hospitals should consider it as a strategy for increasing their revenue base, confronting environmental pressures, and securing future survival.
Although specialists in hospitality have worked extensively on hospitality with respect to relations between different nations or between nations and individuals of a different nationality, for instance when they seek asylum, Jacques Derrida preferred to focus instead upon the relationship between...... the market place, the religious sanctuary and places for the performing arts and cultural heritage. For the modern city they are the tightly woven fabric of social reality, and their configuration can make certain cities more hospitable than others, is the leading idea....
Holst, Malene Kirstine
foundation. The basis of the present study lies in solving the architectural design problem in order to respond to functionalities and performances. The emphasis is the practical applicability for architects, engineers and hospital planners for assuring usability and a holistic approach of functionalities......This PhD project presents a design model that generates and evaluates hospital designs with respect to long-term performances and functionalities. By visualizing and quantifying costs and performances in the early design phases, it is possible to make design choices based on a qualified, profound...... and performances. By formal descriptions, a design model can weigh and compare the impact of different perspectives and, even in the early design phase, it can visualize and quantify consequences for design choices. By qualitative study of hospital design and hospital functionality, formal descriptions develop...
... healthcare facilities finance new construction, refinance debt, or purchase new equipment such as hospital beds and office ... our site? Suggest a resource SHARE THIS PAGE Facebook Twitter LinkedIn Google+ Email © 2002–2017 Rural Health ...
U.S. Department of Health & Human Services — In October 2012, CMS began reducing Medicare payments for Inpatient Prospective Payment System hospitals with excess readmissions. Excess readmissions are measured...
U.S. Department of Health & Human Services — In October 2012, CMS began reducing Medicare payments for Inpatient Prospective Payment System hospitals with excess readmissions. Excess readmissions are measured...
Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This data includes the number of people hospitalized with diabetes between 2013-2015, by age group, for Allegheny County Zip Codes.
Ryherd, Erica E; Moeller, Michael; Hsu, Timothy
Effective communication between staff members is key to patient safety in hospitals. A variety of patient care activities including admittance, evaluation, and treatment rely on oral communication. Surprisingly, published information on speech intelligibility in hospitals is extremely limited. In this study, speech intelligibility measurements and occupant evaluations were conducted in 20 units of five different U.S. hospitals. A variety of unit types and locations were studied. Results show that overall, no unit had "good" intelligibility based on the speech intelligibility index (SII > 0.75) and several locations found to have "poor" intelligibility (SII speech intelligibility across a variety of hospitals and unit types, offers some evidence of the positive impact of absorption on intelligibility, and identifies areas for future research.
Vermont Center for Geographic Information — (Link to Metadata) This data layer contains point locations of all major community, regional, comprehensive health, and healthcare provider hospitals in the state of...
U.S. Department of Health & Human Services — Section 4523 of the Balanced Budget Act of 1997 (BBA) provides authority for CMS to implement a prospective payment system (PPS) under Medicare for hospital...
U.S. Department of Health & Human Services — Use of medical imaging - provider data. These measures give you information about hospitals' use of medical imaging tests for outpatients. Examples of medical...
U.S. Department of Health & Human Services — Section 6001 of the Affordable Care Act of 2010 amended section 1877 of the Social Security Act to impose additional requirements for physician-owned hospitals to...
U.S. Department of Health & Human Services — These are the official datasets used on the Medicare.gov Hospital Compare Website provided by the Centers for Medicare and Medicaid Services. These data allow you to...
Özkil, Ali Gürcan
services to maintain the quality of healthcare provided. This thesis and the Industrial PhD project aim to address logistics, which is the most resource demanding service in a hospital. The scale of the transportation tasks is huge and the material flow in a hospital is comparable to that of a factory. We...... believe that these transportation tasks, to a great extent, can be and will be automated using mobile robots. This thesis consequently addresses the key technical issues of implementing service robots in hospitals. In simple terms, a robotic system for automating hospital logistics has to be reliable...... manual work and offer many advantages beyond robotics. Finally, this thesis outlines our contributions in representation of multi-floor buildings, which is a vital requirement to achieve robust and practical, real-world service robot applications....
An overseas biometric and RFID solutions provider eyes up China’s emerging healthcare IT solutions market New mothers in China can look forward to more peaceful hos-pital stays without worries that their precious newborns might be
Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Hypertension Hospitalization data for 2013-2015, by age group, for Allegheny County. The information provided shows the number of individuals who were diagnosed...
... replay of the AHA’s breakdown of the 2016 election results and what they mean for hospitals. Click ... Forum Trustee and Community Leadership Volunteers and Auxiliary Leaders Workforce Center News Center Press Releases AHA Awards ...
Bittar, O J
The basic point for an Institution to work is the existence of a definite organizational structure that puts together similar areas allowing decisions and the operationalization of different tasks. Knowledge and analysis of structures of private and public hospitals and a bibliography review about the issue is the purpose of this paper. Suggestions are given about the elaboration of small structures and the utilization of matrix management in order to accomplish the hospitals objectives.
Nutrition support in hospitals is becoming an area of focus because of the evidence showing improved clinical outcome with nutrition support, its status as a human rights issue and its integration into quality assurance.......Nutrition support in hospitals is becoming an area of focus because of the evidence showing improved clinical outcome with nutrition support, its status as a human rights issue and its integration into quality assurance....
Stephen W. Litvin
Government policy has a significant impact on the hospitality and tourism industry, but it is unclear if political leaders fully understand this economic sector when crafting policies. This article offers new research about the direct involvement of industry practitioners in the political process, by analyzing the backgrounds of legislators in the six New England states. The data indicate that only 3% of these legislators have current or former careers related to hospitality and tourism. The ...
van den Bergh-Braam, A H
This study focuses on hospital sisters in 30 Dutch hospitals. The so-called role-set approach has been adopted. In this approach the sisters are the focal persons. Direct superiors, specialists, registered nurses and student nurses acted as role-senders. The possible number of respondents is 600 (120 of each group). The response of hospital sisters is 100%, that of role-senders 88%. The study started out as an attempt to collect background information on the causes of wastage of sisters. High wastage rates are generally regarded as an indication of an unfavourable working environment. Since hospital sisters occupy a key position in hospitals, the ward problems will be studied from their angle. Although wastage rates have dropped recently, it does not necessarily follow that the working environment has improved. Wastage is known to act as a safety valve, thus allowing tensions to resolve. The threat of unemployment clogs this outlet, which increases the tensions on the hospital ward. Data from the study show that work overload is one of the major stress factors for sisters. Analyses demonstrated that there exists a relationship between work overload and tensions with the management and direct superiors, tensions in job execution, irritableness on the ward, low self-esteem, health complaints and psychological condition. Sisters with an excessive job involvement refer to work overload more often than their moderate colleagues. There is a relationship between an unfavourable working environment and irritableness of sisters.
Full Text Available Byrne’s paper consists of two parallel texts. The first explores the limits of cosmopolitanism in practice, taking as its subject the Life in the UK Citizenship Test, inaugurated under the Labour Government in 2005. It argues that the test exemplifies the predicament of all attempts at cosmopolitan hospitality as unconditional welcoming, through a discussion of the relation between questioning and welcoming the stranger. Establishing the relationship between cosmopolitanism and hospitality as envisaged in Derrida’s reading of Kant it asks what kind of cosmopolitan hospitality is either possible or desirable by exploring what Derrida calls the ‘perversions’ inherent in the structures of hospitality. It focuses on the concept of the ‘trick questions’ that the state asks the foreigner observed by Derrida in his reading of The Apology of Socrates; questions that seem to invite answers but foreclose the possibilities of a free response. The second text asks how this logic that Derrida identifies can be pushed or coaxed into new ways of addressing the perceived threats of ‘unconditional’ hospitality through a reading of ‘unconditional hospitality’ as queer in the work of Tove Jansson.
Edwards, Don; Kusel, Jim; Oxner, Tom
The authors analyzed two national surveys to determine answers for two basic questions: How do the roles of internal auditors compare with those of their counterparts in other industries and to what extent over the past 6 years have the activities of internal auditors changed? Internal auditors in hospitals allocate their time primarily to financial/compliance and operational types of audits, as do their counterparts. The current trend is toward more operational types of audits. In the early years of employment, staff turnover in hospitals is significantly higher than in all combined industries, often leading to internal auditors' filling other positions in the organization. Hospital staff salaries are higher than are salaries in other industries combined. Staff composition continues to reflect the growing presence of women in the field. The majority of internal auditing directors believe that their salaries are fair, would recommend internal auditing as a career position, and are treated as valued consultants in the organization.
Terças, Ana L. G.; Marques, Sirlei G.; Moffa, Eduardo B.; Alves, Márcia B.; de Azevedo, Conceição M. P. S.; Siqueira, Walter L.; Monteiro, Cristina A.
Oropharyngeal candidiasis is the most common fungal infection in hospitalized patients with acquired immune deficiency syndrome (AIDS). Its progression results in invasive infections, which are a significant cause of morbidity and mortality. This study aimed to quickly and accurately identify Candida spp. from oral mucosa of AIDS patients recruited at Presidente Vargas Hospital, in São Luís city, Brazil and to evaluate the sensitivity profile of these fungi to antifungals by using an automated system. Isolates were collected from oropharyngeal mucosa of 52 hospitalized AIDS patients, under anti-viral and antifungal therapies. Patients were included in research if they were HIV-positive, above 18 years of age and after obtaining their written consent. CHROMagar®Candida and the automated ViteK-2®system were used to isolate and identify Candida spp., respectively. Antifungal susceptibility testing was performed using the ViteK-2®system, complemented with the Etest®, using the drugs amphotericin B, fluconazole, flucytosine, and voriconazole. Oropharyngeal candidiasis had a high prevalence in these hospitalized AIDS patients (83%), and the most prevalent species was Candida albicans (56%). Antifungal susceptibility test showed that 64.7% of the Candida spp. were susceptible, 11.8% were dose-dependent sensitive, and 23.5% were resistant. All the Candida krusei and Candida famata isolates and two of Candida glabrata were resistant to fluconazole. Most of AIDS patients presented oropharyngeal candidiasis and C. albicans was the most frequently isolated species. The results showed high variability in resistance among isolated species and indicates the need to identify the Candida spp. involved in the infection and the need to test antifungal susceptibility as a guide in drug therapy in patients hospitalized with AIDS. This is the first relate about AIDS patients monitoring in a public hospital in São Luís concerning the precise identification and establishing of
Many librarians do not see themselves as marketers, but marketing is an essential role for hospital librarians. Library work involves education, and there are parallels between marketing and education as described in this article. It is incumbent upon hospital librarians actively to pursue ways of reminding their customers about library services. This article reinforces the idea that marketing is an element in many of the things that librarians already do, and includes a list of suggested marketing strategies intended to remind administrators, physicians, and other customers that they have libraries in their organizations.
Tvedebrink, Tenna Doktor Olsen; Fisker, Anna Marie; Kirkegaard, Poul Henning
This poster presents a series of drawings depicting the initial considerations made with the Ph.D. project for an improved ‘Interior Design for Food’ in a Danish hospital ward. The project concerns a study on the ontological and symbolic interrelationship possibly existing between food and archit......This poster presents a series of drawings depicting the initial considerations made with the Ph.D. project for an improved ‘Interior Design for Food’ in a Danish hospital ward. The project concerns a study on the ontological and symbolic interrelationship possibly existing between food...
This article builds around a framework of cure, care, control, and community, with collaboration at the center, to consider 12 issues common to many hospitals. These include, among others, the fragmentation of efforts, confusion in mission (and in mission statements), the problems of bundling research with clinical work, selectivity in informing board members, the dangers of professional management, and the difficulties of combining external advocacy with internal reconciliation in the senior manager's job. The article concludes that hospitals could better learn how to solve systemic problems systemically, and that to do so will require not the wish lists of strategic planning and structural reorganizing, but tangible changes in their collective behavior.
Stephen W. Litvin
Full Text Available Government policy has a significant impact on the hospitality and tourism industry, but it is unclear if political leaders fully understand this economic sector when crafting policies. This article offers new research about the direct involvement of industry practitioners in the political process, by analyzing the backgrounds of legislators in the six New England states. The data indicate that only 3% of these legislators have current or former careers related to hospitality and tourism. The author suggests that practitioners should seek election to political office, to better influence government policy.
Glenn A. Melnick PhD
Full Text Available A surge in hospital consolidation is fueling formation of ever larger multi-hospital systems throughout the United States. This article examines hospital prices in California over time with a focus on hospitals in the largest multi-hospital systems. Our data show that hospital prices in California grew substantially (+76% per hospital admission across all hospitals and all services between 2004 and 2013 and that prices at hospitals that are members of the largest, multi-hospital systems grew substantially more (113% than prices paid to all other California hospitals (70%. Prices were similar in both groups at the start of the period (approximately $9200 per admission. By the end of the period, prices at hospitals in the largest systems exceeded prices at other California hospitals by almost $4000 per patient admission. Our study findings are potentially useful to policy makers across the country for several reasons. Our data measure actual prices for a large sample of hospitals over a long period of time in California. California experienced its wave of consolidation much earlier than the rest of the country and as such our findings may provide some insights into what may happen across the United States from hospital consolidation including growth of large, multi-hospital systems now forming in the rest of the rest of the country.
Schneider, Rita; Reiners, Christoph
Effective response to radiological emergencies requires information about available qualified hospitals and defined methods to timely allocate patients to appropriate hospitals. In Germany, updated information about hospitals concerning their qualification and willingness to treat radiological emergency patients is not summarized. The objectives were to identify qualified hospitals, assess hospital capacities and treatment capabilities, to examine willingness to respond to various radiological emergencies and to develop a concept for matching patients to hospitals. A Germany-wide combined postal/Web survey of 99 selected hospitals conducted in 2007 covered relevant organizational characteristics, hospital resources, treatment expertise, and the willingness to accept radiological emergency patients by a self-reported written questionnaire with 57 items. Survey results were documented in a Microsoft Access database. A database-driven Web application was developed to allocate patients to hospitals. Of 99 hospitals, 69 responded and 54 indicated their willingness to accept radiological emergency patients. 17,512 total hospital beds, 2,084 intensive care, and 170 reverse isolation beds were reported. Availability of laboratory and in-patient departments ranged from 14 radiobiology to 47 laboratory medicine departments and from 13 burn care to 52 trauma surgery departments. 48 and 40 hospitals stated treatment competence for local and whole body external exposure, respectively. 34 and 29 hospitals reported treatment expertise for contamination and incorporation, respectively. In this publication baseline data of qualified hospitals concerning capacities and competence to manage radiological emergency patients are presented, and an allocation concept for radiological emergency patients is provided.
Principais indicadores e ferramentas utilizados pelos gestores: uma análise estatística da percepção dos alunos de MBA da Fundação Getúlio Vargas Management indicators and tools: perceptions of MBA students
Marcelo Cauduro de Castro
Full Text Available O objetivo deste estudo foi identificar a relevância de indicadores e ferramentas de gestão na percepção dos alunos de MBA da Fundação Getúlio Vargas (FGV. Para isso, utilizou-se um questionário com 26 quesitos definidos a partir de pesquisas anteriores e uma escala de variação de importância do tipo Likert. A amostra foi composta de um total de 425 alunos. Desses, 97 entrevistados não selecionaram nenhum indicador ou ferramenta de gestão. Assim, 328 respostas foram analisadas e interpretadas. Os resultados demonstraram que o Fluxo de Caixa Projetado é o indicador de gestão mais relevante, seguido da Margem Líquida de Vendas. Os dados também apontaram, entre as cinco primeiras posições, indicadores considerados mais sofisticados, como, por exemplo, o Balanced Scorcard (BSC, o Earnings before Interest Taxes Depreciation and Amortization (EBITDA e o Economic Value Added (EVA®. Verificou-se também que as exigências relativas à informação contábil variavam de acordo com o perfil dos respondentes. Os resultados demonstram também que não existe um indicador ou ferramenta de gestão que seja considerado ótimo. Finalmente, há indícios apontados pela pesquisa de que, apesar de a contabilidade gerencial ser considerada uma disciplina global, suas especificidades e características podem ser locais ou regionais.The relevance of management indicators and tools, according to perception of 425 MBA students of the Fundação Getulio Vargas, was identified using a questionnaire with 26 queries based on previous surveys. Results from only 328 respondents were analyzed because 97 did not select any management indicator or tool. Project Cash Flow was the most relevant indicator followed by Net Revenues. In addition the three more sophisticated indicators of Balanced Scorecard (BSC, Earnings before Interest Taxes Depreciation and Amortization (EBITDA and Economic Value Added (EVA® were among the first five ranked. Since it was noted
Wallington, J W
The design of a modern hospital owes more to engineering than the layman may realize. In this context, many engineers are in the position of laymen, being unfamiliar with the multitude of services that lies behind the impressive facade of a modern hospital. In recent years medicine and surgery themselves have taken on many of the characteristics of a technology. This has required a matching development of the services both mechanical and electrical that are required in modern health care buildings. In medical terms, if the architectural features provide the 'skin' of the hospital, the mechanical and electrical engineering services provide the nerves and sinews. If we take as an example the recently completed Freeman Hospital, Newcastle upon Tyne, (Fig. 1), which cost 10 million pounds at current cost, the service network was responsible for about half the total cost. About 400 miles (643 km) of electrical wiring and more than 40 mile (64.5 km) of copper and steel piping were used to service 3000 separate rooms. This compares with percentages of between 18 and 25 per cent for other large buildings such as office blocks, hotels and sports complexes.
Poulsen, Signe; Jørgensen, Michael Søgaard
also identified. Research limitations: The assessment of the dietary changes based on the canteen take-away food was only based on indirect assessments based on interviews with users and non-users and furthermore based on a questionnaire at one of the hospitals. Value/originality: Canteen take...
Dzhandzhugazova, Elena A.; Blinova, Ekaterina A.; Orlova, Liubov N.; Romanova, Marianna M.
The article focuses on the study of the role and importance of innovation, its classification, the problems of its application in the hotel industry with emphasis on the application of sensory marketing tools in the development of the innovative marketing mix within the hospitality industry. The article provides an analysis of the "seven…
Responsible Hospitality (RH)--also called Responsible Beverage Service (RBS)--encompasses a variety of strategies for reducing risks associated with the sale and service of alcoholic beverages. RH programs have three goals: (1) to prevent illegal alcohol service to minors; (2) to reduce the likelihood of drinkers becoming intoxicated; and (3) to…
Greenglass, Esther R; Burke, Ronald J
Increasingly, organizations are experiencing changes as a result of extensive downsizing, restructuring, and merging. In Canada, government-sponsored medicine has been affected as hospitals have merged or closed, reducing essential medical services and resulting in extensive job loss for hospital workers, particularly nurses. Hospital restructuring has also resulted in greater stress and job insecurity in nurses. The escalation of stressors has created burnout in nurses. This study examines predictors of burnout in nurses experiencing hospital restructuring using the MBI-General Survey which yields scores on three scales: Emotional exhaustion, Cynicism, and Professional efficacy. Multiple regressions were conducted where each burnout scale was the criterion and stressors (e.g., amount of work, use of generic workers to do nurses' work), restructuring effects, social support, and individual resources (e.g., control coping, self-efficacy, prior organizational commitment) were predictors. There were differences in the amount of variance accounted for in the burnout components by stressors and resources. Stressors contributed most to emotional exhaustion and least to professional efficacy. Individual resources were more likely to contribute to professional efficacy and least to emotional exhaustion. Stressors and resources accounted for approximately equal amounts of variance in cynicism. Three conclusions were drawn. First, present findings parallel others by showing that individual coping patterns contribute to professional efficacy. Second, emotional exhaustion was found to be the prototype of stress. Third, prior organizational commitment, self-efficacy, and control coping resulted in lower burnout.
Current concepts in leadership and governance on the level of supervisory board, management and departments are often considered as insufficient to cope with the profound structural change which actually takes place in the German health care system. While vertical and horizontal disconnecting is typical of the professional bureaucracy of hospitals, transition from functional to divisional structure further increases this risk. Accordingly, medical experts are oriented towards their professional peers and patient care on the one side; on the other side the management gets isolated and looses operative and strategic control. Several studies provide evidence for the relevance of role models to serve as agents of change, which are now developed into the concept of "Clinical Governance": evidence-based medicine, guidelines, continuous quality improvement, safety culture, resource accountability and organisational learning. The present situation makes it necessary to extend this conception, which focuses on the departmental level in an organisation with divisional features, to one of "Clinical Corporate Governance". This term, which also includes supervisory structures and the management board and is relevant for the total hospital and company, respectively, is based on the corporate governance concept. Inside the hospital, the management and the heads of the departments have to agree that (1) experts really need to be integrated into the decision process, and that (2) the outcomes of the entire hospital have to be regarded as equal or superior to the aims of a single department. The public image of the hospital should be one of a strong and reliable partner in health care and health care business on a local, regional and national level. Members of the supervisory board should clearly put corporate aspects above political and other implications and pay attention to personal independence from the leaders of the medical departments.
Feder, J; Spitz, B
This paper analyzes the politics of hospital payment over the last decade. The authors explain how provider interests and judgments became a standard for appropriate hospital payment: the impact of that standard on hospital costs; and the political obstacles to imposing an alternative standard and controlling hospital costs. The authors draw lessons from this experience, here and in other countries, to propose an alternative approach to hospital payment that would allow policymakers, accountable to the public, to make explicit choices about the level and nature of hospital expenditures.
Hospital-acquired infections (nosocomial infections) are acquired in healthcare settings by patients admitted for reasons unrelated to the infection or not previously infected when admitted to the facility. Liability for hospital-acquired infections depends on whether the hospital: (i) has introduced best practice infection control measures; (ii) has implemented best practice infection control measures; or (iii) will be vicariously liable for negligent or intentional failures by staff to comply with the infection control measures implemented. A hospital and hospital administrators may be held directly liable for not introducing or implementing best practice infection control measures, resulting in harm to patients. The hospital may also be held vicariously liable where patients have been harmed because hospital staff negligently or intentionally failed to comply with the infection control measures that have been implemented by the hospital, during the course and scope of their employment.
Kamath, S K; Lawler, M; Smith, A E; Kalat, T; Olson, R
A collaborative study involving nutrition screening of 3,047 patients (excluding 125 pregnant women) at admission to 33 hospitals in and around the greater Chicago area was carried out to identify patients at nutritional risk. Information on sex, age, admitting diagnosis, serum albumin, hemoglobin, total lymphocyte count, and height and weight was collected from the medical chart within 48 hours of admission. Nutrition screening could not be completed for a larger number of patients (60%) because data at admission were not available. Of the remaining 40% of patients, more than 50% had below normal values for one or more of the variables studied: serum albumin, hemoglobin, and total lymphocyte count. A large number of the patients (40%) also were considered at nutritional risk as judged by the criteria of weight/height (measured only). Early nutrition intervention for high-risk patients cannot be implemented, nor can the efficacy of nutrition services be evaluated, unless nutrition screening is carried out on patients at admission.
Gómez Velásquez, Luis; Gómez Espinosa, Luis Néstor
The scientific and technological advances have been surprising, more in the two last decades, but they don't go united with to the ethical values of the medical professional practice, it has been totally escaped, specially when the biological subsistence, the maintenance of the life through apparatuses and the mechanisms that prolong the existence are who undergoes an alteration that until recently time was mortal shortly lapse. It is common listening that exist a crisis in the medical profession, but what really is it of human values, which as soon and taken into nowadays, actually professional account, which gives rise to a dehumanization towards the life, the health, the disease, the suffering and the death. The ideal of the doctor to give to service to the man in its life and health, as well to be conscious that the last biological process that must fulfill is the death, and when it appears, does not have considered as a actually professional failure. It has protect to the patient as the extreme cruelty therapeutic, that it has right a worthy death. It's taking to the birth of the hospital ethics committees, they have like function to analyze, to advise and to think about the ethical dilemmas that appear actually clinical or in the biomedical investigation. In 1982 in the UEA only 1% of its hospitals had a ethics committees; by 1988, it was 67% and the 100% in 2000. In Mexico the process of the formation by these committees begins, only in the Military Central Hospital, to count the ethics committee on 1983, also the Hospital no. 14 of the IMSS in Guadalajara, it works with regularity from 1995, with internal teaching of bioethic. The Secretariat of Health has asked the formation of the bioethical committees in each hospital, and order the it was be coordinated by the National Committee of Bioética. The integration of these committees is indispensable that their members have the knowledge necessary of bioética. The Mexican Society of Ortopedia, conscious of
Holst, Malene Kirstine; Kirkegaard, Poul Henning; Christoffersen, Lars D.
The present paper surveys the input parameters in hospital design and describes them formally as building attributes in preparation for facilitating planning and designing of hospitals with the aim of a more optimal design process. The overview of the hospital functionalities, bonds, logistics...
Boisen, Kirsten A; Boisen, Anne Bank; Thomsen, Stine Legarth
BACKGROUND: There is a need for youth-friendly hospital environments as the ward environment may affect both patient satisfaction and health outcomes. OBJECTIVE: To involve young people in designing youth-friendly ward environment. METHODS: We arranged a design competition lasting 42 h (Hackathon...... participation. The design concepts and ideas were in line with current evidence regarding pleasing hospital environment and youth-friendly inpatient facilities and may be applicable to other young patients....... presented their products to a jury and relevant stakeholders. RESULTS: The groups created eight unique design concepts. The young designers were extremely flexible listening to ideas and experiences from the young patients, which led to common features including individual and flexible design, privacy...
Woman's Hospital, Baton Rouge, La., is first-place winner among cancer centers. Holy Cross Hospital's Michael and Dianne Bienes Comprehensive Cancer Center, Ft. Lauderdale, Fla., is named second; and, Cardinal Health System's Ball Cancer Center, Muncie, Ind., third.
... gloves; PPE - wearing gloves; Nosocomial infection - wearing gloves; Hospital acquired infection - wearing gloves ... Wearing gloves in the hospital helps prevent the spread of germs. This helps protect both patients and health care workers from infection.
... page: https://medlineplus.gov/news/fullstory_162801.html Hospital ICUs May Be Overused Single medical center study ... While this is a study of just one hospital and results may differ at other medical centers, ...
Earth Data Analysis Center, University of New Mexico — Hospitals in New Mexico The term "hospital" ... means an institution which- (1) is primarily engaged in providing, by or under the supervision of physicians, to...
... Share | With attention increasing on the incidence of infection in hospitals, patients everywhere need sensible principles to manage their ... will reduce the chance of developing a lung infection while in the hospital and may also improve your healing abilities following ...
... These types of infections are called healthcare-associated infections (HAIs). Hospital staff and healthcare providers do everything they can ... IV tube) can increase your risk for fungal infection. During your hospital stay you may need a central venous catheter, ...
Hidalgo, Julio Villalobos; Orrit, Joan; Villalobos, Juan Pablo
This article describes the history, current status, advantages of and opposition to the implementation of e-procurement in hospitals and examines the results of its implementation in a psychiatric hospital.
Many hospitals have been looking at diversification of services with increased interest in recent years, and a small hospital in rural Wisconsin has shown that the concept need not be limited to large, urban institutions.
Full Text Available This hospital is built on the circular system. This arrangement has economic and functional advantages. The nurses walk 40 % less distance than in a hospital of similar size, of conventional layout. The rooms are situated along the external perimeter and the beds are orientated towards the corridor, rather than towards the window. However, the patients can see out of doors by turning on their side. The hospital is most carefully fitted out, and is very comfortable. There is air conditioning, and patients can control their own TV sets. There are also curtains separating each bed form the rest, thus providing maximum independence. Warm colours have been adopted in the decoration of rooms facing north, whilst those facing south are painted in cooler tones. The circular design arrangement makes the distribution far more flexible, and it will be easier to include further units later on; by adding small adjustments to the central building. To reduce external noise, and to improve the surrounding landscape, small sand hills have been provided in the garden, and the parking site also serves to partially absorb the noise.Presenta esta solución de unidades circulares numerosas ventajas de tipo económico, ahorra espacio y da eficiencia a la circulación— las enfermeras recorren un 40 por 100 menos de camino que en otro hospital de dimensiones similares—. Las habitaciones están distribuidas a lo largo del perímetro exterior y tienen las camas orientadas hacia los corredores, en lugar de hacia las ventanas, pero de tal modo que los pacientes puedan contemplar el exterior al volverse sobre uno de sus costados. Están cuidadosamente diseñadas y dotadas de las máximas comodidades: aire acondicionado y aparatos de televisión controlados por el paciente; así como cortinas divisorias que le proporcionan el grado de aislamiento deseado.
Powell y Moya, Aquitectos
Full Text Available El amplio programa desarrollado en este grande e importante Centro sanitario, abarcó tres fases de construcción, al final de las cuales se consiguió el Hospital General, capaz para 600 camas. En la primera parte se construyeron los siguientes departamentos: Enfermos del exterior, Accidentes, Medicina Física, Patología, Rayos X, y el primero de los cuatro núcleos quirúrgicos.
More people die in hospital than in any other setting which is why it is important to study the outcomes of hospital care at end of life. This study analyses what influenced outcomes in a sample of patients who died in hospital in Ireland in 2008\\/9. The study was undertaken as part of the Irish Hospice Foundation\\'s Hospice Friendly Hospitals Programme (2007-2012).
Full Text Available Hospital acquired infection is an additional affliction to the patient admitted to the hospital for some serious illness and is caused by pathogens which are prevalent in hospital environment. In the hospital, microbes are ubiquitous; and can reach the sick patient through various sources, such as air, water, food, contaminated equipments, linen, catheters, scopes, ventilators, contaminated disinfectants and other preparations used for treatment, visitors, infected patients, etc.
Holst, Malene Kirstine; Kirkegaard, Poul Henning; Christoffersen, L.D.
Present paper presents a parametric performancebased design model for optimizing hospital design. The design model operates with geometric input parameters defining the functional requirements of the hospital and input parameters in terms of performance objectives defining the design requirements...... and preferences of the hospital with respect to performances. The design model takes point of departure in the hospital functionalities as a set of defined parameters and rules describing the design requirements and preferences....
ABSTRACT This paper reflects the application of visual methodologies adapted in an explorative study on hospitality and hospital meals. It takes point of departure in a multi-sited ethnographic fieldwork placed at a general hospital in 2012. Visual methodologies were applied in multiple ways....... This includes visual methodologies as part of observation and interview strategies. The paper presents and discusses how the application of different visual methodologies can contribute to the construction of ethnographical knowledge on hospitality and hospital meals. Finally ethical considerations as well...
Zallocco, R L; Joseph, W B; Doremus, H
The application of strategic market planning to hospital management is discussed, along with features of the strategic marketing management process. A portfolio analysis tool, the McKinsey/G.E. Business Screen, is presented and, using a large urban hospital as an example, discussed in detail relative to hospital administration. Finally, strategic implications of the portfolio analysis are examined.
A description is provided of a 15-month, in-service nursing education program at Childrens Hospital (Los Angeles, California). The first sections of the paper describe Childrens Hospital and provide a rationale for the hospital-based program. A listing of program goals and objectives is also provided, indicating that the curriculum is designed to…
Purpose: The purpose of this paper is to explore current strands in hospitality management education and research, and suggest that future programs should reflect a more social science informed content. Design/methodology/approach: The paper reviews current research in hospitality management education and in the study of hospitality and…
Knoll, K H
For the classification of hospital-wastes in the categories infectious-contaminate or special waste are only significant views of the prevention by nosocomial infection in the hospital. Solely infectious waste become removed hospital-intern and -extern on conditions of hygienic prevention, namely through secure packing during the transport, combustion or desinfection. Special wastes to be defeated by special-conditions. The hygienist of the hospital is only competent for the classification of the wastes in the hospital as well as for their refuse.
Westert, Gert P.; Nieboer, Anna P.; Groenewegen, Peter P.
Whether one examines the average length of hospital stay at the level of geographic areas, at the level of hospitals, or at the level of doctors, length-of-stay figures are known to vary widely. Even for hospital admissions for comparable surgical procedures among comparable groups of patients, sign
Westert, G.P.; Nieboer, A.P.; Groenewegen, P.P.
Whether one examines the average length of hospital stay at the level of geographic areas, at the level of hospitals, or at the level of doctors, length-of-stay figures are known to vary widely. Even for hospital admissions for comparable surgical procedures among comparable groups of patients, sign
WESTERT, GP; NIEBOER, AP; GROENEWEGEN, PP
Whether one examines the average length of hospital stay at the level of geographic areas, at the level of hospitals, or at the level of doctors, length-of-stay figures are known to vary widely. Even for hospital admissions for comparable surgical procedures among comparable groups of patients, sign
van Venrooij, Lennard T; Barnhoorn, Pieter C
This study investigates the current position of hospital clowns from the perspective of paediatricians and paediatric residents. A total of 14 attending paediatricians and paediatric residents participated in two focus group sessions. Data were analysed using Atlas.ti 5.0. In general, physicians reported positive experiences regarding the interaction between hospital clowns and paediatric patients on the ward. Physicians were more interested in research on children's perception of hospital clowns than in research on the clinical efficacy of hospital clowning. No direct collaboration between physicians and hospital clowns was reported. However, physicians proposed conditions which may streamline their encounters with hospital clowns such as clear communication prior to hospital clown visits, and the condition that visits do not impede medical interventions.
Baceviciute, Sarune; Bruni, Luis Emilio; Burelli, Paolo
in hospitals. Most of these guidelines favor figurative over abstract art, based on ideas leaning to the emotional congruence theory, which would claim that abstract art leads to ambiguity and therefore it could augment the current emotional base-line of an already stressed patient. The early ethnographic...... studies of the “Art in Hospitals” project challenged this perspective by investigating the positive or negative effects of “lower-level” specific features (e.g.: bright colors vs. darker, contrast, predominant shapes) independent of whether they were present in abstract or figurative art, which...
Cuddy, Theresa M.; Marchok, Catherine
At Capital Health System/Fuld Campus (formerly Helene Fuld Medical Center), the Health Sciences Library lost many books and videocassettes. These materials were listed in the catalog but were missing when staff went to the shelves. The hospital had experienced a downsizing of staff, a reorganization, and a merger. When the library staff did an inventory, $10,000 worth of materials were found to be missing. We corrected the situation through a series of steps that we believe will help other li...
Full Text Available The hospital antibiogram is a periodic summary of antimicrobial susceptibilities of local bacterial isolates submitted to the hospital′s clinical microbiology laboratory. Antibiograms are often used by clinicians to assess local susceptibility rates, as an aid in selecting empiric antibiotic therapy, and in monitoring resistance trends over time within an institution. Antibiograms can also used to compare susceptibility rates across institutions and track resistance trends. Some hospitals have adequate support from the computer department to be able to extract data from their reporting module. The WHONET software can be freely downloaded and used for analysis. Consensus guidelines have been developed by the Clinical and Laboratory Standards Institute (CLSI to standardise methods used in constructing antibiograms. These guidelines can be incorporated into the WHONET software for analysis. Only the first isolate from the patient is to be included in the analysis. The analysis should be done on the basis of patient location and specimen type. The percentage susceptibility of the most frequently isolated bacteria should be presented in the antibiogram, preferably in a tabular form. The antibiogram must be printed or put up in the intranet for easy access to all clinicians. Antibiotic policy is one of the mandatory requirements for accreditation, and making an antibiogram is the first step before framing the antibiotic policy. The future of antibiograms would be the incorporation of patient related data to make information more reliable and for predicting outbreaks.
The impact of healthcare environments on children and young people's (CYP) health and psychosocial wellbeing has attracted much attention in recent years. This sits within the realm of the political drive for enhanced awareness of the need to take account of the rights and voice of the child. Perhaps as a direct result of the United Nations Convention on the Rights of the Child, and recognition from evidence in adult population studies of the impact of healthcare environments on psychosocial healing, contemporary times have witnessed a discernible movement towards enhancing quality care by promoting child and adolescent-friendly hospital environments. The Council of Europe guidelines on child-friendly health care moved to place the rights and needs of children at the heart of health care. The Council acknowledges that the delivery of child-oriented services, which includes the notion of family-centred care, should be delivered in child and family friendly environments. However, knowledge about what constitutes a child-friendly healthcare environment from CYP's perspective is often lacking with hospital architectural blueprints predominantly designed around adult proxy-reported assumptions about the needs and desires of children.
Sihuin-Tapia, Elsa Yudy; Gómez-Quispe, Oscar Elisban; Ibáñez-Quispe, Vladimiro
In order to determine the satisfaction of hospitalized patients in the Sub-regional Hospital of Andahuaylas, 175 patients were surveyed using the Servqual multidimensional model. The estimate of variables associated with the satisfaction of the hospitalized patients was performed by using bivariate and multivariate logistic regression analysis. We found 25.0% satisfaction. Lower levels of satisfaction were associated with having a secondary level education (aOR: 0.05; 95% CI: 0.01 to 0.64) and with having been hospitalized in the surgery department (aOR 0.14, CI: 95%: 0.04 to 0.53). It was concluded that there was a low level of satisfaction with the quality of care received by hospitalized patients and this was associated with the level of education and type of hospital department.
de Mello, Rita Mello; Schneider, Jacó Fernando
This study aims to identify the reasons that lead relatives to hospitalize patients in a psychiatric unit of a general hospital. It is a qualitative study based on Alfred Schutz' phenomenological sociology. Fourteen relatives, each with one family member hospitalized, were interviewed from August to October 2009. The guiding question of the phenomenological interview was "What do you expect from psychiatric hospitalization in a general hospital?". Phenomenological sociology was used to understand and interpret the interviews. Statements showed three concrete categories, that lead to the reasons for: treatment guidelines and continuity; prospects for improvement; ideas about normality. This research shows the experiences of relatives, contributing with mental health professionals' reflection about their actions and about the involvement of families in a general hospital's psychiatric unit.
Full Text Available Smoke and tobacco-free policies on hospital campuses have become more prevalent across the U.S. and Europe, de-normalizing smoking and reducing secondhand smoke exposure on hospital grounds. Concerns about the increasing use of electronic cigarettes (e-cigarettes and the impact of such use on smoke and tobacco-free policies have arisen, but to date, no systematic data describes e-cigarette policies on hospital campuses. The study surveyed all hospitals in North Carolina (n = 121 to assess what proportion of hospitals have developed e-cigarette policies, how policies have been implemented and communicated, and what motivators and barriers have influenced the development of e-cigarette regulations. Seventy-five hospitals (62% completed the survey. Over 80% of hospitals reported the existence of a policy regulating the use of e-cigarettes on campus and roughly half of the hospitals without a current e-cigarette policy are likely to develop one within the next year. Most e-cigarette policies have been incorporated into existing tobacco-free policies with few reported barriers, though effective communication of e-cigarette policies is lacking. The majority of hospitals strongly agree that e-cigarette use on campus should be prohibited for staff, patients, and visitors. Widespread incorporation of e-cigarette policies into existing hospital smoke and tobacco-free campus policies is feasible but needs communication to staff, patients, and visitors.
Meernik, Clare; Baker, Hannah M; Paci, Karina; Fischer-Brown, Isaiah; Dunlap, Daniel; Goldstein, Adam O
Smoke and tobacco-free policies on hospital campuses have become more prevalent across the U.S. and Europe, de-normalizing smoking and reducing secondhand smoke exposure on hospital grounds. Concerns about the increasing use of electronic cigarettes (e-cigarettes) and the impact of such use on smoke and tobacco-free policies have arisen, but to date, no systematic data describes e-cigarette policies on hospital campuses. The study surveyed all hospitals in North Carolina (n = 121) to assess what proportion of hospitals have developed e-cigarette policies, how policies have been implemented and communicated, and what motivators and barriers have influenced the development of e-cigarette regulations. Seventy-five hospitals (62%) completed the survey. Over 80% of hospitals reported the existence of a policy regulating the use of e-cigarettes on campus and roughly half of the hospitals without a current e-cigarette policy are likely to develop one within the next year. Most e-cigarette policies have been incorporated into existing tobacco-free policies with few reported barriers, though effective communication of e-cigarette policies is lacking. The majority of hospitals strongly agree that e-cigarette use on campus should be prohibited for staff, patients, and visitors. Widespread incorporation of e-cigarette policies into existing hospital smoke and tobacco-free campus policies is feasible but needs communication to staff, patients, and visitors.
Longo, D R; Chase, G A
In a retrospective case-control study, structural characteristics of hospitals that closed during the years 1976-1980 were contrasted with three comparison groups: hospitals that were acquired in a merger; hospitals that joined a multihospital system; and hospitals that remained autonomously opened, to investigate these characteristics as predictors of closure. Characteristics investigated included environmental, structural, and process variables. The independent variables were measured 5 years prior to outcome. Findings indicate that closed hospitals resemble hospitals acquired in a merger ("failure"), and likewise autonomous hospitals resemble hospitals that join a multihospital system ("success"). The most important predictors of hospital failure were the physician-to-population ratio, the East North Central and West North Central census regions, the level of diversification, low occupancy rate, location in a standard metropolitan statistical area, the chief executive officer's lack of affiliation in the American College of Hospital Administrators, profit status, bed size of less than 50, and presence in a state with a rate-setting agency. Surprisingly, this study shows the bed-to-population ratio to be unrelated to closure. In addition, the findings strongly support the open-system perspective, which, unlike the closed-system perspective, is concerned with the vulnerability of the organization to the uncontrollable and often unpredictable influences of the environment.
Quality improvement can not focus exclusively on peer review and the scientific evaluation of medical care processes. These essential elements have to be complemented with a focus on individual patient needs and preferences. Only then will hospitals create the competitive advantage needed to survive in an increasingly market-driven hospital industry. Hospital managers can identify these patients' needs by 'living the patient experience' and should then set the hospital's quality objectives according to its target patients and their needs. Excellent quality program design, however, is not sufficient. Successful implementation of a quality improvement program further requires fundamental changes in pivotal jobholders' behavior and mindset and in the supporting organizational design elements.
Koys, Daniel J; Martin, Wm Marty; LaVan, Helen; Katz, Marsha
The authors address the hospital outcomes of patient satisfaction, healthcare quality, and net income per bed. They define union density as the percentage of a hospital's employees who are in unions, healthcare quality as its 30-day acute myocardial infraction (AMI; heart attack) mortality rate, and patient satisfaction as its overall Hospital Consumer Assessment of Healthcare Providers and Systems score. Using a random sample of 84 union and 84 nonunion hospitals from across the United States, multiple regression analyses show that union density is negatively related to patient satisfaction. Union density is not related to healthcare quality as measured by the AMI mortality rate or to net income per bed. This implies that unions per se are not good or bad for hospitals. The authors suggest that it is better for hospital administrators to take a Balanced Scorecard approach and be concerned about employee satisfaction, patient satisfaction, healthcare quality, and net income.
Danvers, Kreag; Nikolov, Pavel
Organizations outsource non-core service functions to achieve cost reductions and strategic benefits, both of which can impact profitability performance. This article examines relations between managerial outsourcing decisions and profitability for a multi-state sample of non-profit hospitals, across 16 states and four regions of the United States. Overall regression results indicate that outsourcing does not necessarily improve hospital profitability. In addition, we identify no profitability impact from outsourcing for urban hospitals, but somewhat positive effects for teaching hospitals. Our regional analysis suggests that hospitals located in the Midwest maintain positive profitability effects with outsourcing, but those located in the South realize negative effects. These findings have implications for cost reduction efforts and the financial viability of non-profit hospitals.
Keeping track of thousands of pieces of equipment in a busy hospital environment is a considerable challenge, but, according to RFID tagging and asset tracking specialist, Harland Simon, RFID technology can make the task considerably simpler. Here Andrew James, the company's RFID sales manager, describes the positive benefits the technology has brought the Medical Equipment Library (MEL) at Addenbrooke's Hospital, one of the world's most famous teaching hospitals.
Cuddy, Theresa M; Marchok, Catherine
At Capital Health System/Fuld Campus (formerly Helene Fuld Medical Center), the Health Sciences Library lost many books and videocassettes. These materials were listed in the catalog but were missing when staff went to the shelves. The hospital had experienced a downsizing of staff, a reorganization, and a merger. When the library staff did an inventory, $10,000 worth of materials were found to be missing. We corrected the situation through a series of steps that we believe will help other libraries control their theft. Through regularly scheduling inventories, monitoring items, advertising, and using specific security measures, we have successfully controlled the library theft. The January 2002 inventory resulted in meeting our goal of zero missing books and videocassettes. We work to maintain that goal.
TSUMOTO Yuko; TSUMOTO Shusaku
Rapid progress in information technology has come to enable us to store all the information in a hospital in- formation system, including management data, patient records, discharge summary and laboratory data. Although the reuse of those data has not started, it has been expected that the stored data will contribute to analysis of hospi-tal management. In this paper, the diseharge summary of Chiba University Hospital, which has been stored since 980's were analyzed to characterize the university hospital. The results show several interesting results, which uggests that the reuse of stored data will give a powerful tool to support a long-period management of a university ospital.
de Quevedo, Francisco Vázquez
The history of the hospitals and general surgeons that best represent the centres in Madrid are here in reviewed, comprising the period between 1940 and the closure of the Hospital Clinico (1957) as well as the Hospital General (General Hospital) (1967), both in Atocha. Other hospitals which are reviewed and highlighted are: the H. de la Princesa (the Princess Hospital), the H. del Nifio Jesus (Hospital of the Child Jesus), the H. Militar (Military Hospital) and the Cruz Roja (Red Cross). Data is provided on the permanent surgeons in the following centres: H. General: J. Goyanes, J. Die, J. de la Villa, T. Rodriguez, E. Diaz, G. Bueno e H. Huerta; H. Clinico: L. de la Peña, L. Cardenal, L. Olivares, R. Argüelles, J. Estella y M. F. Zumel; H. Militar: M. G. Ulla, M. Bastos, M. G. Durán, J. S. Galindo, y A. G. Durán; Hospital de la Cruz Roja: V. M. Noguera, L. Serrada, F. Luque y L. L. Durán; H. de la Princesa: P. Cifuentes, P. G. Duarte, L. Estella y R. Aiguabella; H. del Niño Jesús: J. Garrido Lestache; H. Clinico, last time, Atocha: F. M. Lagos, R. Vara y A. de la Fuente.
Wilson, Mark H; Habig, Karel; Wright, Christopher; Hughes, Amy; Davies, Gareth; Imray, Chirstopher H E
Pre-hospital care is emergency medical care given to patients before arrival in hospital after activation of emergency medical services. It traditionally incorporated a breadth of care from bystander resuscitation to statutory emergency medical services treatment and transfer. New concepts of care including community paramedicine, novel roles such as emergency care practitioners, and physician delivered pre-hospital emergency medicine are re-defining the scope of pre-hospital care. For severely ill or injured patients, acting quickly in the pre-hospital period is crucial with decisions and interventions greatly affecting outcomes. The transfer of skills and procedures from hospital care to pre-hospital medicine enables early advanced care across a range of disciplines. The variety of possible pathologies, challenges of environmental factors, and hazardous situations requires management that is tailored to the patient's clinical need and setting. Pre-hospital clinicians should be generalists with a broad understanding of medical, surgical, and trauma pathologies, who will often work from locally developed standard operating procedures, but who are able to revert to core principles. Pre-hospital emergency medicine consists of not only clinical care, but also logistics, rescue competencies, and scene management skills (especially in major incidents, which have their own set of management principles). Traditionally, research into the hyper-acute phase (the first hour) of disease has been difficult, largely because physicians are rarely present and issues of consent, transport expediency, and resourcing of research. However, the pre-hospital phase is acknowledged as a crucial period, when irreversible pathology and secondary injury to neuronal and cardiac tissue can be prevented. The development of pre-hospital emergency medicine into a sub-specialty in its own right should bring focus to this period of care.
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.
Haverkort, J. J Mark; Biesheuvel, Tessa H.; Bloemers, Frank W.; de Jong, MB; Hietbrink, Falco; van Spengler, Lukas L.; Leenen, Luke P H
Introduction: The Dutch Major Incident Hospital (MIH) is a standby, highly prepared, 200-bed hospital strictly reserved to provide immediate, large-scale, and emergency care for victims of disasters and major incidents. It has long-standing experience training for various major incident scenarios, i
Søbjerg, Lene Mosegaard; Noesgaard, Susanne; Henriksen, Jan Erik;
This article presents a study of an RCT comparing video interpretation with in-person interpretation at the Endocrinology Ward at Odense University Hospital.......This article presents a study of an RCT comparing video interpretation with in-person interpretation at the Endocrinology Ward at Odense University Hospital....
LATEX in the Hospital Environment Updated Fall 2015 This list provides a guide to some of the most common objects containing latex and offers some ... remover–Sepha Pharm) 1 LATEX in the Hospital Environment (continued) Frequently contains LATEX OR/Infection Control masks, ...
Strømgaard, Sofie; Rasmussen, Søren Wistisen; Schmidt, Thomas Andersen
BACKGROUND: Crowded departments are a common problem in Danish hospitals, especially in departments of internal medicine, where a large proportion of the patients are elderly. We therefore chose to investigate the number and character of hospitalizations of elderly patients with a duration of less...
Bradford Hudson, Ph.D.
An astonishing array of firsts and near firsts in the history of the modern hospitality sector have occurred in and around Boston, and some of the oldest surviving hospitality businesses in the United States may be found in the area today. This article explores the evolution of hotels and restaurants in Boston from 1633 to the present.
Bradford Hudson, Ph.D.
Full Text Available An astonishing array of firsts and near firsts in the history of the modern hospitality sector have occurred in and around Boston, and some of the oldest surviving hospitality businesses in the United States may be found in the area today. This article explores the evolution of hotels and restaurants in Boston from 1633 to the present.
Dranove, D; White, W D; Wu, L
This study examines evidence of market segmentation on the basis of patients' insurance status, demographic characteristics, and medical condition in selected local markets in California in the years 1983 and 1989. Substantial differences exist in the probability patients may be admitted to particular hospitals based on insurance coverage, particularly Medicaid, and race. Segmentation based on insurance and race is related to hospital characteristics, but not the characteristics of the hospital's community. Medicaid patients are more likely to go to hospitals with lower costs and fewer service offerings. Privately insured patients go to hospitals offering more services, although cost concerns are increasing. Hispanic patients also go to low-cost hospitals, ceteris paribus. Results indicate little evidence of segmentation based on medical condition in either 1983 or 1989, suggesting that "centers of excellence" have yet to play an important role in patient choice of hospital. The authors found that distance matters, and that patients prefer nearby hospitals, moreso for some medical conditions than others, in ways consistent with economic theories of consumer choice.
Kay, B G; Boyar, R L; Raspante, P S
Cooperation between the pharmacy director and the hospital's architects in planning a modern hospital pharmacy is described. The pharmacy director at an 870-bed voluntary nonprofit institution and the hospital's architects planned the design for a new 3250-square foot pharmacy department. They developed a preliminary floor plan based on the following functions that the pharmacy would perform: centralized unit dose drug distribution; compounding; bulk and unit dose prepackaging; preparation of sterile products; controlled substance storage; outpatient and employee prescription dispensing; reserve stock storage; purchasing, receiving, and inventory control; drug information services; and administrative services. A final floor plan was designed that incorporated these functions with structural and utility requirements, such as placement of the computer system and dispensing and lighting fixtures. By integrating modern material management concepts with contemporary hospital pharmacy practice, the pharmacy director and the hospital's architects were able to plan and construct a pharmacy that receives, processes, and dispenses medication efficiently.
This PhD thesis explores the possibilities and design qualities of using functional textiles in the interior of hospital environments, and is the result of a three years collaboration between Aalborg University, Department of Civil Engineering, and VIA University College, VIA Design. The project...... that the physical environments affect the patients’ level of stress and influence their process of recovery and healing. However, although research in this field of hospital design has increased substantially in recent years, knowledge on the use of new materials and textiles in hospital interiors is still rather...... limited. Concerned with the design potentials of using textiles in hospital interiors, the purpose of the PhD project has been to explore the possibilities and design qualities of using these materials in hospital design. Relating to both technical and aesthetic aspects of using functional textiles...
Shortell, S M
This article suggests new directions for hospital governance to meet the demands of a rapidly changing health care environment. Board members must increasingly play roles as risk takers, strategic directors, experts, mentors, and evaluators. Lessons from other industries regarding risk taking, use of expertise, and streamlining decision making must be adapted to meet hospital needs. Recent data suggest that these needs may still differ by hospital ownership despite a convergence in investor-owned and not-for-profit corporate structures. The effectiveness of hospital boards in the future will depend on their ability to: (1) manage a diverse group of stakeholders; (2) involve physicians in the management and governance process; (3) meet the governance needs of multi-institutional systems and hospital restructuring; (4) meet the challenges of diversification and vertical integration; and (5) understand strategy formulation and implementation as interdependent and interrelated processes.
Full Text Available Background. Bevacizumab (BEV, a humanized immunoglobulin G1 monoclonal antibody that inhibits VEGF has demonstrated activity against recurrent high-grade gliomas (HGG in phase II clinical trials. Patients and Methods. Data were collected from patients with recurrent HGG who initiated treatment with BEV outside a clinical trial protocol at two Belgian university hospitals. Results. 19 patients (11 M/8 F were administered a total of 138 cycles of BEV (median 4, range 1–31. Tumor response assessment by MRI was available for 15 patients; 2 complete responses and 3 partial responses for an objective response rate of 26% for the intent to treat population were observed on gadolinium-enhanced T1-weighted images; significant regressions on T2/FLAIR were documented in 10 out of 15 patients (67%. A reduced uptake on PET was documented in 3 out of 4 evaluable patients. The six-month progression-free survival was 21% (95% CI 2.7–39.5. Two patients had an ongoing tumor response and remained free from progression after 12 months of BEV treatment. Conclusions. The activity and tolerability of BEV were comparable to results from previous prospective phase II trials. Reduced uptake on PET suggests a metabolic response in addition to an antiangiogenic effect in some cases with favorable clinical outcome.
Henrik H Rasmussen
Full Text Available Henrik H Rasmussen1,2, Mette Holst3, Jens Kondrup41Centre for Nutrition and Bowel Disease, Department of Medical Gastroenterology, Aarhus University Hospital, Aalborg, Denmark; 2Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 3Centre for Nutrition and Bowel Disease, Aarhus University Hospital, Aalborg, Denmark; 4Department of Human Nutrition, Faculty of Life Sciences, University of Copenhagen, Clinical Nutrition Unit, Rigshospitalet University Hospital, Copenhagen, DenmarkAbstract: About 20%–50% of patients in hospitals are undernourished. The number varies depending on the screening tool amended and clinical setting. A large number of these patients are undernourished when admitted to the hospital, and in most of these patients, undernutrition develops further during hospital stay. The nutrition course of the patient starts by nutritional screening and is linked to the prescription of a nutrition plan and monitoring. The purpose of nutritional screening is to predict the probability of a better or worse outcome due to nutritional factors and whether nutritional treatment is likely to influence this. Most screening tools address four basic questions: recent weight loss, recent food intake, current body mass index, and disease severity. Some screening tools, moreover, include other measurements for predicting the risk of malnutrition. The usefulness of screening methods recommended is based on the aspects of predictive validity, content validity, reliability, and practicability. Various tools are recommended depending on the setting, ie, in the community, in the hospital, and among elderly in institutions. The Nutrition Risk Screening (NRS 2002 seems to be the best validated screening tool, in terms of predictive validity ie, the clinical outcome improves when patients identified to be at risk are treated. For adult patients in hospital, thus, the NRS 2002 is recommended.Keywords: nutritional risk screening
David, Guy; Lindrooth, Richard C; Helmchen, Lorens A; Burns, Lawton R
Despite its salience as a regulatory tool to ensure the delivery of unprofitable medical services, cross-subsidization of services within hospital systems has been notoriously difficult to detect and quantify. We use repeated shocks to a profitable service in the market for hospital-based medical care to test for cross-subsidization of unprofitable services. Using patient-level data from general short-term hospitals in Arizona and Colorado before and after entry by cardiac specialty hospitals, we study how incumbent hospitals adjusted their provision of three uncontested services that are widely considered to be unprofitable. We estimate that the hospitals most exposed to entry reduced their provision of psychiatric, substance-abuse, and trauma care services at a rate of about one uncontested-service admission for every four cardiac admissions they stood to lose. Although entry by single-specialty hospitals may adversely affect the provision of unprofitable uncontested services, these findings warrant further evaluation of service-line cross-subsidization as a means to finance them.
Foster, K R; Soltys, M; Arnofsky, S; Doshi, P; Hanover, D; Mercado, R; Schleck, D
The authors surveyed levels of radiofrequency (RF) fields in the frequency range 0.1-1,000 MHz in four hospitals in the Philadelphia area, to obtain background information related to the possible interference of radiofrequency fields with medical equipment. Two large center-city hospitals, a regional county hospital, and two suburban hospitals were surveyed. Measurements were made at six to 12 sites in each hospital, in each of the three frequency bands. More limited additional measurements were conducted in a fifth hospital as well. Sites were selected to include areas where strong RF signals from transmitting antennas might be expected to be present (e.g., locations close to windows in upper stories of buildings near paging antennas) as well as other representative sites in the hospital. The median RF field strengths were quite low (0.1-0.5 V/m), but at specific locations the RF signals from broadcast sources exceeded 1 V/m. Much stronger fields were recorded close to electrosurgical units and hand-held transmitters (cellular telephones and UHF transceivers).
de Micheli, Alfredo
The predecessor institutions of modern hospitals--Byzantine nosocómeion, European hospitale and Islamic maristan--were dissimilar both in their patients and their aims. The first charitable organizations in West Europe (Rome) and in the East (Cesarea in Cappadocia) were rather hospices. After the collapse of the Western Roman Empire (476 A.D.), some monastic centers were prepared to provide medical assistance to religious and secular patients. Since the XI and XII Centuries in all of Christian Europe the charitable institutions, designated as hospitale, multiplied. Among the Italian ones, the Roman Santo Spirito (Holy Ghost) Hospital, built in the 1201-1204 period, reached a preeminet position. This one soon became the most important of the entire Christendom (archihospital), with a lot of affiliated hospitals in Europe and later in America. The first American hospital, Saint Nicholas Hospital, opened on December 29, 1503 in Santo Domingo, obtained in 1541 its affiliation to the Santo Spirito archihospital. Regarding continental America, the first health centers were established in Mexico: the Immaculate Conception Hospital and the Saint Lazarus Hospital, both established by Hernán Cortés. For its part, clinical teaching was systematized at the Saint Francis Hospital in Padua and by there moved to Leyden. In Mexico, the chair of medical clinics or practical medicine was established in 1806 at the Saint Andrew Hospital. During the XX century, Dr. Ignacio Chávez was the driving force behind the creation of the modern Mexican Health Institutes. These ones are dedicated to the treatment of poor patients, as well as to medical teaching and research.
Fuller, S S
Access to Internet resources and communications has rapidly become a necessity in many hospitals nationally. The results of a Pacific Northwest pilot Intenet connections project provides important evidence of the value of librarians in establishing such connections in their institutions The pilot project has resulted in a wealth of information regarding approaches to promoting the utility of the Internet to health professionals in hospitals. Roles that librarians are playing in support of such connections include facilitator, negotiator, provider, publisher, integrator, and educator.
Fuller, S S
Access to Internet resources and communications has rapidly become a necessity in many hospitals nationally. The results of a Pacific Northwest pilot Intenet connections project provides important evidence of the value of librarians in establishing such connections in their institutions The pilot project has resulted in a wealth of information regarding approaches to promoting the utility of the Internet to health professionals in hospitals. Roles that librarians are playing in support of suc...
Neudeck, M M
Hospital workers at every level--from administrators to housekeepers--will be affected by the interaction of changes already underway in the healthcare industry. Societal forces that will affect the hospital workforce include demographic change, the rise of the participatory ethic and decentralization, a growing philosophy of job entitlement, and new pressures for unionization. At the same time, the industry is faced with changing manpower requirements, cost containment, and the oversupply of physicians. This article identifies some of the likely effects of these changes on hospital human resources and suggests ways that administrators can prepare for them.
Full Text Available This article is based on the history of an Italian psychiatric hospital (Arezzo that closed in 1989 and was turned into a university. The illegal and inhumane treatment in asylum-type institutions is condemned. In particular the treatment of those patients who, according to the analysis, hospital directors referred to as “social cases.” These individuals did not stay in hospital because of health problems but only due to the lack of social care by the state. AS a consequence they are condemned to be “prisoners” without committing any crimes.
Full Text Available Objectives: This paper evaluates the drivers of profitability for a large sample of U.S. hospitals. Following a methodology frequently used by financial analysts, we use a DuPont analysis as a framework to evaluate the quality of earnings. By decomposing returns on equity (ROE into profit margin, total asset turnover, and capital structure, the DuPont analysis reveals what drives overall profitability. Methods: Profit margin, the efficiency with which services are rendered (total asset turnover, and capital structure is calculated for 3,255 U.S. hospitals between 2007 and 2012 using data from the Centers for Medicare & Medicaid Services’ Healthcare Cost Report Information System (CMS Form 2552. The sample is then stratified by ownership, size, system affiliation, teaching status, critical access designation, and urban or non-urban location. Those hospital characteristics and interaction terms are then regressed (OLS against the ROE and the respective DuPont components. Sensitivity to regression methodology is also investigated using a seemingly unrelated regression. Results: When the sample is stratified by hospital characteristics, the results indicate investor-owned hospitals have higher profit margins, higher efficiency, and are substantially more leveraged. Hospitals in systems are found to have higher ROE, margins, and efficiency but are associated with less leverage. In addition, a number of important and significant interactions between teaching status, ownership, location, critical access designation, and inclusion in a system are documented. Many of the significant relationships, most notably not-for-profit ownership, lose significance or are predominately associated with one interaction effect when interaction terms are introduced as explanatory variables. Results are not sensitive to the alternative methodology. Conclusion: The results of the DuPont analysis suggest that although there appears to be convergence in the behavior of
Staff at the Oak Ridge Associated Universities (ORAU) conducted energy audits at 48 hospitals in four states (New York, Pennsylvania, Virginia, Tennessee) between 1978 and 1980. Staff at the Oak Ridge National Laboratory (ORNL) and ORAU developed and organized a computerized data base containing information from these audits. This paper describes the ORAU audit process; summarizes the data collected from these audits on hospital characteristics annual energy use, and the audit recommendations; and analyzes the audit data in terms of cost effectiveness, type of recommendations, and the relationship between potential energy saving and characteristics of the individual hospital.
O'Sullivan, E; Deasy, C
We describe the incidence and outcomes of in-hospital cardiac arrest (IHCA) at Cork University Hospital over a one year time period (2011), prior to the implementation of national early warning scoring (NEWS) systems. There were 43 217 coded CUH admissions, in 2011, to 518 in-patient beds. The Hospital In-Patient Enquiry Database was used to identify adults (>/= 18 years) who sustained IHCA. Available Utstein variables were collected. Fifty-two patients were found to be incorrectly coded IHCA. 17 of 63 (27.0%) IHCA survived to discharge. IHCA with shockable rhythm had significantly higher survival. IHCA survival was significantly lower on wards versus any other hospital location. Median days of stay prior to arrest were significantly different between survivors and non-survivors. All survivors (n = 17) had intact neurological outcome post-event. Our outcomes from IHCA are poorest on hospital wards when compared to other areas of the hospital. Those that survive have excellent function and one-year survival.
Plet, H. T.; Hallas, J.; Kjeldsen, L. J.
PURPOSE: To investigate adherence rates to hospital drug formularies (HDFs) and cost of drugs in hospitals. METHODS: Data on drugs used during 2010 were analyzed for ten hospitals (two hospitals from each of the five regions), constituting 30 % of hospitals and 45 % of hospital beds in Denmark. D...
U.S. Department of Health & Human Services — In the interest of promoting high-quality, patient-centered care and accountability, the Centers for Medicare and Medicaid Services (CMS) and Hospital Quality...
Fogel, L A
Auxiliaries can serve a more important financial role in today's environment than ever before. Hospitals are searching for positive avenues to promote themselves to the community and to generate more financial support to help offset the losses created by decreasing inpatient utilization and payments from third-party payers. Auxiliaries should recognize that their financial role has never been more important to the financial viability of their hospitals. Auxiliaries should communicate closely with hospital administration so that both organizations work to achieve compatible goals. Auxiliaries should be operated more like businesses, which means establishing goals and objectives, preparing effective budgets and interim financial statements, thinking and planning innovatively, and establishing adequate inventory controls, investment policies, and pricing structures. If auxiliaries follow these steps, they will not only succeed in providing more financial support to hospitals than ever before but will also receive the recognition and support they deserve for their effort.
U.S. Department of Health & Human Services — Hospital Value-Based Purchasing (VBP) is part of the Centers for Medicare and Medicaid Services (CMS) long-standing effort to link Medicares payment system to a...
A new legislation concerning financial matters of hospitals in Germany requires fundamental changes and adjustment. Formerly grown structures of a high-grade centralization erode into a process of change. Despite hospitals will maintain their non-profit character in public health services, modifications of medical care processes will promote elements of cost-centres. All medical care units as well as hospital management are confronted with rising requirements concerning performance and transparency. Increasingly patients and social health insurances behave like self-confident customers not willing to accept rising costs. Public health services loose their character of a planned economy. Hospitals with features of health-entrepreneurship are on the incline. A process of quality-planning and efficient management has been evoqued.
U.S. Department of Health & Human Services — Medicaid Disproportionate Share Hospital (DSH) Payments This link provides you with information about Medicaid DSH Payments. You can find information on DSH Audit...
Vermont Center for Geographic Information — Hospital service areas (HSAs) are organized by towns and are based on inpatient discharges where the diagnosis indicated the need for immediate care. Plurality...
Ana Cláudia Afonso Valladares
Full Text Available ABSTRACT: Hospitalization may have negative effects on child development. It takes the child off her routine and prevents her from contacts with stimulating environments. The aim of this work was to evaluate the development and quality on drew productions, before and after art therapy intervention, during the hospitalization of 7 to 10 years old children, with infectious diseases. It was proposed a quasi experimental design with a control group (n=9 and a group that was submitted to art therapy intervention (n=10. Results show that these interventions were effective in improving the development and the quality of the drawings. Hospitals can also be stimulating environments for children offering them caring practices that go beyond the disease. KEY WORDS: Art therapy; Pediatric Nursing; Hospitalization.
Maldin, Beth; Lam, Clarence; Franco, Crystal; Press, David; Waldhorn, Richard; Toner, Eric; O'Toole, Tara; Inglesby, Thomas V
This article describes issues related to the engagement of hospitals and other community partners in a coordinated regional healthcare preparedness and response effort. The report is based on interviews with public health and hospital representatives from 13 regions or states across the country. It aims to identify key ingredients for building successful regional partnerships for healthcare preparedness as well as critical challenges and policy and practical recommendations for their development and sustainability.
Facility management and optimum building management offer for hospitals a chance to reduce costs and to increase quality, process sequences, employee motivation and customer satisfaction. Some years ago simple services such as cleaning, catering or laundry were outsourced. Now, German hospitals progress to more complex fields such as building and medical technology, clinical support processes such as pharmacy, central laboratory and sterilization, goods and logistics services.
Eastaugh, S R
Hospital diversification and its impact on the operating ratio are studied for 62 New York hospitals during the period 1974-1979. Diversification and operating ratio are modeled in a two-stage least squares (TSLS) framework as being jointly dependent. Institutional diversification is found to yield better financial position, and the better operating ratio allows the institution the wherewithal to diversify. The impact of external government planning and hospital competition are also measured. An institution life cycle hypothesis is advanced to explain hospital behavior: boom and bust, diversification and divestiture, occasionally leading to closure or merger. These results should not be generalized beyond the New York State context. Restructuring of the organization, unrelated business ventures, and transactions with related organizations were not a problem in this sample. However, in 1983, many a new corporation is set up whose revenues do not become part of the hospital's and whose complex transactions conceal unallowable costs and maximize reimbursement. A number of hypotheses are advanced concerning hospital administrator's attitude toward risk.
Silk, Benjamin J; McCoy, Morgan H; Iwamoto, Martha; Griffin, Patricia M
Listeriosis is characterized by bacteremia or meningitis. We searched for listeriosis case series and outbreak investigations published in English by 2013, and assessed the strength of evidence for foodborne acquisition among patients who ate hospital food. We identified 30 reports from 13 countries. Among the case series, the median proportion of cases considered to be hospital-acquired was 25% (range, 9%-67%). The median number of outbreak-related illnesses considered to be hospital-acquired was 4.0 (range, 2-16). All patients were immunosuppressed in 18 of 24 (75%) reports with available data. Eight outbreak reports with strong evidence for foodborne acquisition in a hospital implicated sandwiches (3 reports), butter, precut celery, Camembert cheese, sausage, and tuna salad (1 report each). Foodborne acquisition of listeriosis among hospitalized patients is well documented internationally. The number of listeriosis cases could be reduced substantially by establishing hospital policies for safe food preparation for immunocompromised patients and by not serving them higher-risk foods.
Ali Zarei Mahmoudabadi
Full Text Available Background and Objectives: Nosocomial infections are usually acquired during hospitalization. Fungal infection of the urinary tract is increasing due to predisposing factors such as; antibacterial agents, indwelling urinary catheters, diabetes mellitus, long hospitalization, immunosuppressive agents, use of IV catheters, radiation therapy, malignancy. The aim of our study was to determine the prevalence of candiduria and urinary tract infection in patients admitted in Golestan and Emam Khomeini hospitals of Ahvaz, Iran.Materials and Methods: During 14 months, a total of 744 urine samples were collected and transferred to medical mycology laboratory immediately. Ten μl of uncentrifuged sample was cultured on CHROM agar Candida plates and incubated at 37°C for 24-48h aerobically. Candida species were identified based on colony morphology on CHROM agar Candida, germ tube production and micro-morphology on corn meal agar including 1% Tween 80.Results: In the present study, 744 hospitalized patients were sampled (49.5%, female; 50.5%, male. The prevalence of candiduria in subjects was 16.5% that included 65.1% female and 34.9% male. The most common isolates were C. albicans (53.3%, followed by C. glabrata (24.4%, C. tropicalis (3.7%, C. krusei (2.2%, and Geotrichum spp. (0.7% Urine cultures yielded more than 10,000 yeast colonies in 34.1% of cases, and the major predisposing factor associated with candiduria was antibiotic therapy (69.1%.Conclusion: Candiduria is relatively common in hospitalized patients in educational hospitals of Ahvaz. In addition, there is a strong correlation between the incidence of candiduria in hospitalized patients and broad-spectrum antibiotics therapy.
There are so many obvious delays and inefficiencies in our traditional system of acute hospital care; it is clear that if outcomes are to be improved prompt accurate assessment immediately followed by competent and efficient treatment is essential. Early warning scores (EWS) help detect acutely ill patients who are seriously ill and likely to deteriorate. However, it is not known if any EWS has universal applicability to all patient populations. The benefit of Rapid Response Systems (RRS) such as Medical Emergency Teams has yet to be proven, possibly because doctors and nurses are reluctant to call the RRS for help. Reconfiguration of care delivery in an Acute Medical Assessment Unit has been suggested as a "proactive" alternative to the "reactive" approach of RRS. This method ensures every patient is in an appropriate and safe environment from the moment of first contact with the hospital. Further research is needed into what interventions are most effective in preventing the deterioration and\\/or resuscitating seriously ill patients. Although physicians expert in hospital care decrease the cost and length of hospitalization without compromising outcomes hospital care will continue to be both expensive and potentially dangerous.
... 46 Shipping 4 2010-10-01 2010-10-01 false Hospital spaces. 108.209 Section 108.209 Shipping COAST... Construction and Arrangement Accommodation Spaces § 108.209 Hospital spaces. (a) Each unit carrying twelve or more persons on a voyage of more than three days must have a hospital space. (b) Each hospital...
Anderson, H J
Sophisticated planning efforts are increasing among hospitals. However, hospital planners and marketers still have far to go before they can match their counterparts in industry. This is according to a report on hospital planning recently released by the Society for Healthcare Planning and Marketing of the American Hospital Association, Chicago.
Hospitality is often understood as an ethical openness towards the other. Hospitality, in this way, is a gift. But is this really the situation of hospitality in the world today? Europeans have created another, bespoke hospitality and they insist on being given a generous welcome all over the world
Traverso, G; Lu, C -C; Maa, R; Langer, R; Bourouiba, L
Hospital-acquired infections represent significant health and financial burdens to society. Clostridium difficile (C. difficile) is a particularly challenging bacteria with the potential to cause severe diarrhea and death. One mode of transmission for C. difficile, as well as other pathogens, which has received little attention is the potential air contamination by pathogen-bearing droplets emanating from toilets. In the fluid dynamics video submitted to the APS DFD Gallery of Fluid Motion 2013, we present flow visualizations via high-speed recordings showing the capture of the product of the fluid fragmentation generated by hospital toilet high-pressure flushes. Important quantities of both large and small droplets are observed. We illustrate how high-pressure flushes and cleaning products currently used in hospital toilets result in aggravating, rather than alleviating, the suspension and recirculation of tenacious airborne pathogen-bearing droplets.
Cormac, H D
The position of actinotherapy in Mental Hospitals in this country is reviewed. An investigation of the results of ultra-violet irradiation in mental disorders at Parkside Mental Hospital is described and it is shown that certain types of the psychoses appear to benefit. The physiological action of actinic rays in relation to mental disorders is discussed and their mode of action on the nervous system suggested. Reference is made to substances which sensitize the body tissues to sunlight and ultra-violet radiation. An allusion is made to glass, penetrable by a portion of the actinic rays, and its uses. The need for ultra-violet ray apparatus in every mental hospital is urged both for treatment of mental and physical conditions and for the study of its action.
Özkil, Ali Gürcan
be and will be automated using mobile robots. This talk consequently addresses the key technical issues of implementing service robots in hospitals. In simple terms, a robotic system for automating hospital logistics has to be reliable, adaptable and scalable. Robots have to be semi-autonomous, and should reliably...... for localization. The system features automatic annotation, which significantly reduces manual work and offer many advantages beyond robotics. A case study on logistics solutions is finally presented. A robotic solution is tested in a hospital to handle the transportation of blood samples between the clinic...... and the lab. Without any environmental modification; it is shown that lab turnover time can be reduced from hours to minutes; by simply replacing the human porter with a mobile robot....
Ratib, Osman M.; Ligier, Yves; Hochstrasser, Denis; Scherrer, Jean-Raoul
The PACS under development at the University Hospital of Geneva is a hospital-wide image management system for radiological as well as non-radiological medical images which is part of one of the widest hospital information systems (HIS) in Switzerland (Diogene system). It is based on a multi-vendor open architecture and a set of widely available industry standards, namely: Unix as the operating system, TCP-IP as network protocol and an SQL-based distributed database (INGRES) that handles both the PACS and the HIS. The PACS is based on a distributed architecture of servers of two types: the archive servers connected to the sources of images and equipped with large optical disk libraries (jukeboxes) and display servers distributed over the hospital. A standard image storage format was developed based on the ACR-NEMA standard. This file format (the PAPYRUS format) allows storage of sets of images as a sequence of ACR-NEMA messages in an 'encapsulated' file structure. In order to provide a more uniform user interface on a variety of different workstations, a common platform for image display and manipulation called OSIRIS is developed based on X-11 windowing system and OSF/Motif extension. Such a platform is designed to be portable to any computer running Unix and equipped with a graphic display system running X-11. Because this software is written in the object-oriented language C++, it is easily expandable and easily adaptable to different needs and requirements.
Smith, R P
We have all faced the problem of whether or not to venture into that gastronomic wasteland known as the hospital cafeteria. Hospital cafeterias have developed a reputation, deserved or otherwise, as less than ideal places to eat. Many people overlook the fact that this is a direct result of trying to provide patient meals that are salt-free, sugar-free, fiber-free, and taste-free. (Some faint traces of color may, occasionally, be found.) How then does one go about choosing whether to venture in, and how does one survive the encounter once there? The following guide has been assembled to help the reader through this difficult process.
Curtis & Davis, Arquitectos
Full Text Available Un hospital debe estar proyectado, especialmente, para la comodidad y el cuidado de los enfermos. Atendiendo a este postulado, en el hospital St. James se ha buscado que los dormitorios se orienten al sur, y que desde ellos puedan apreciarse a través de amplias superficies acristaladas, la belleza del paisaje circundante. El gran ventanal corrido que compone la fachada meridional está protegido con parteluces giratorios verticales, que cada paciente puede abrir o cerrar a voluntad desde la misma cama.
Buelow, Janet R; Zuckweiler, Kathryn M; Rosacker, Kirsten M
The authors report the findings of a survey of hospital managers on the utilization of various project selection and evaluation methodologies. The focus of the analysis was the empirical relationship between a portfolio of project evaluation(1) methods actually utilized for a given project and several measures of perceived project success. The analysis revealed that cost-benefit analysis and top management support were the two project evaluation methods used most often by the hospital managers. The authors' empirical assessment provides evidence that top management support is associated with overall project success.
Figueiredo, Ana Teresa
Dissertação de Mestrado Integrado em Arquitectura, apresentada ao Departamento de Arquitectura da F. C. T. da Univ. de Coimbra. A partir do século XX, uma nova linguagem, proveniente da revolução industrial, torna-se transversal a todo o discurso arquitectónico. O hospital pavilhonar é substituído por uma nova tipologia – o hospital vertical. Com o acelerado crescimento urbano proveniente do processo de industrialização das cidades, as novas construções hospitalares tendem a oc...
... and Medicaid Programs: Changes Affecting Hospital and Critical Access Hospital Conditions of...) for both hospitals and critical access hospitals (CAHs). The final rule will implement a new.... Currently, a hospital or CAH receiving telemedicine services must go through a burdensome credentialing...
QIAO Chun-yan; WANG Liang-hai; TANG Xin; WANG Tao; YANG Di-ya; WANG Ning-li
Background No population-based assessment of the prevalence and incidence of pediatric glaucoma in China are available. Here we describe the spectrum of hospitalized pediatric glaucoma patients in Beijing Tongren Hospital in China.Methods We reviewed the charts of pediatric patients, from birth to 18 years old, with a discharge diagnosis of glaucoma in Beijing Tongren Hospital, from 2002 to 2008. All children were admitted for anti-glaucoma surgery, treating the sequelae of the glaucoma, or managing postoperative complications. We evaluated the demographic characteristics and the proportion of different glaucoma subtypes.Results Pediatric patients (n=1452) accounted for 12.91% of the total glaucoma in-patients from 2002 to 2008, and at last data of pediatric glaucoma were presented for 1055 children who came from 28 provinces, municipalities and autonomous regions in China. Boys were more common in all subtypes and et all ages, with a total ratio of boys to girls of 2.32:1. Congenital glaucoma was the most common subtype, accounting for 46.07% in all patients and accounting for 69.95% in children under 3 years of age. The median presenting age of congenital glaucoma patients was 2 years.Patients with traumatic glaucoma were the second most common group (n=128, 12.13%), and presented at older age (the median presenting age was 11 years). The majority of traumatic glaucoma occurred in children between 10 and 15 years of age (n=72, 56.25%). Aphakic glaucoma was the third most common (9.19%) subtype.Conclusions Congenital glaucoma is the most prevalent glaucoma subtype in hospitalized pediatric patients in Beijing Tongren Hospital. The prevention and treatment of traumatic glaucoma can reduce the incidence of visual damage in developing countries. Close follow-up for glaucoma is important after pediatric cataract surgery.
Full Text Available Podría decirse que la nueva narrativa latinoamericana, comienza en la década de los cuarenta, casi al finalizar el medio siglo. Aparecen entonces, o mejor, empiezan a ser conocidos y divulgados escritores como Jorge Luis Borges, Alejo Carpentier, Miguel Ángel Asturias, Ernesto Sábato, Felisberto Hernández, Juan Carlos Onetti. Un nuevo concepto de la novela y del cuento está surgiendo en América Latina.
Full Text Available This hospital basically serves the districts of Aubonne and Morges and partly those of Cossonay and Rolle. It comprises a block of six storeys, with the actual hospital, and another one of five storeys with a college for nurses and male nurses; both of them equipped with the latest inventions with regard to technique and comfort. Both centres mutually use the service installations and the rooms that the other building disposes of, for a more rational utilization of the investment made. The complex has a magnificent location in a natural environment. The construction is traditional, the structure being of reinforced concrete and the finishing of high quality.Este hospital atiende fundamentalmente a los distritos Aubonne y Morges y, parcialmente, a los de Cossonay y Rolle. Consta de un bloque de seis plantas, como hospital propiamente dicho, y otro de cinco plantas, para escuela de enfermeras y enfermeros asistentes; ambos dotados con los últimos adelantos de la técnica y el confort. Uno y otro centro utilizan, recíprocamente, los servicios y locales de que disponen, para un más racional aprovechamiento de la inversión realizada. El conjunto está magníficamente ambientado en el entorno natural que lo rodea. La construcción es tradicional, con estructura de hormigón armado y acabados de gran calidad.
This PhD thesis is a contribution to an ongoing debate in Denmark about improving the building design processes of complex buildings, especially in relation to the current hospital developments. It provides knowledge about capturing user needs and defines the process model for usability briefing ...... of complex buildings, such as hospitals. The research results have relevance to researchers, architects, facility managers and client organizations planning new complex facilities, and especially for professionals working with briefing and design of hospitals.......This PhD thesis is a contribution to an ongoing debate in Denmark about improving the building design processes of complex buildings, especially in relation to the current hospital developments. It provides knowledge about capturing user needs and defines the process model for usability briefing...... and evaluations, can be fed into briefing and design processes. This PhD thesis proposes methods for usability briefing.Usability is a concept similar to functionality, but usability depends on: subjective view of users, context, culture, situation and experience. Understanding usability is achieved by involving...
Neale R. Chumbler
Full Text Available This article examines the extent to which older adult patients’ perceptions of inpatient dimensions of care experiences are associated with their overall satisfaction. A secondary objective is to determine if these specific care experiences differed between elderly female and male patients. Patient satisfaction data from 6,021 older patients (65 years of age and older were collected by using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS Survey through telephone interviews of older patients who were recently discharged. Multiple linear regression analyses with older patients’ HCAHPS dimensions (Communication With Nurses, Communication With Doctors, Responsiveness of Hospital Staff, Communication About Medicines, Cleanliness of the Hospital Environment, and Quietness of Hospital Environment and gender were conducted while controlling for self-rated health status, age, race, and education. Multiple linear regression analysis showed that all of the HCAHPS dimensions were significantly associated with overall satisfaction. Older female patients reported substantially more positive global evaluations than their male counterparts. However, for older male patients, Communication With Doctors was more influential in their ratings of overall satisfaction than for older female patients. For older female patients, Communication With Nurses was more influential in their ratings of overall satisfaction than for older male patients.
Rognås, Leif Kåre; Christensen, Erika Frischknecht; Sloth, Erik;
Danish anaesthesiologists use ultrasound (US) to examine and treat acutely ill or traumatized patients in the emergency room, operating theatre and intensive care unit. They are also involved in pre-hospital care where US may theoretically be beneficial for both diagnostic and therapeutic purpose...
Prætorius, Thim; Hasle, Peter; Nielsen, Anders Paarup
To meet demands for high quality and efficient care, hospitals increasingly organize horizontally around standardized processes (like lean and care pathways) and/or set-up formal structural arrangements such as using performance boards, having daily huddles or assigning specific roles. This trend...
Li, Yuguo; Nielsen, Peter V.; Sandberg, Mats
Hospital differ from conventional buildings in terms of ventilation needs. Exhaled infectious droplets or droplet nuclei of an infected patient need to be removed in general wards, waiting areas and isolation rooms to minimize transmission to health-care workers, other patients and visitors...
Zarb, P; Amadeo, B; Muller, A;
respiratory (19.2%) and gastrointestinal (18.8%). The most used antifungal was fluconazole (60.5%) followed by caspofungin (10.5%). Antifungal-antibacterial combinations were frequently used (77.5%). The predominance of fluconazole use in participating hospitals could result in an increase in prevalence...
Health care facilities need to be prepared for disasters such as floods, tornadoes and earthquakes. Rochester, NY, and its surrounding communities devised a hospital mutual aid evacuation plan in the event a disaster occurs and also to comply with the Joint Commission. This document discusses the plan's development process and also provides the end result.
... 2000. 1 According to the Bureau of Labor Statistics, the healthcare industry as a whole is projected to add 5. ... hospitals (see Section 2). 1 Bureau of Labor Statistics. Current Population Survey. Employed Persons by Detailed Industry, Sex, and Age. www. bls. gov/ cps/ demographics. ...
Full Text Available In this paper, we propose an architecture and a scheme of smart hospital based on Internet of Things (IOT in order to overcome the disadvantages of the present hospital information system, such as the fixed information point, inflexible networking mode and so on. The key technologies and construction of smart hospital is presented based on understanding of the connotation and architecture of smart hospital. Furthermore, taking a third grade-A hospital as an example, a scheme of smart hospital is given, and its logic structure, application framework, the construction of basic network environment etc. are described in detail. Experiment proves that deployment of smart hospital can effectively solve the prominent problems existing the diagnosis and treatment of hospital and it brings a positive and profound effect for the present diagnosis and treatment mode in hospital.
Harrison, Jeffrey P; Meyer, Sean
This study evaluates the efficiency of federal hospitals, specifically those hospitals administered by the US Department of Veterans Affairs and the US Department of Defense. Hospital executives, health care policymakers, taxpayers, and federal hospital beneficiaries benefit from studies that improve hospital efficiency. This study uses data envelopment analysis to evaluate a panel of 165 federal hospitals in 2007 and 157 of the same hospitals again in 2011. Results indicate that overall efficiency in federal hospitals improved from 81% in 2007 to 86% in 2011. The number of federal hospitals operating on the efficiency frontier decreased slightly from 25 in 2007 to 21 in 2011. The higher efficiency score clearly documents that federal hospitals are becoming more efficient in the management of resources. From a policy perspective, this study highlights the economic importance of encouraging increased efficiency throughout the health care industry. This research examines benchmarking strategies to improve the efficiency of hospital services to federal beneficiaries. Through the use of strategies such as integrated information systems, consolidation of services, transaction-cost economics, and focusing on preventative health care, these organizations have been able to provide quality service while maintaining fiscal responsibility. In addition, the research documented the characteristics of those federal hospitals that were found to be on the Efficiency Frontier. These hospitals serve as benchmarks for less efficient federal hospitals as they develop strategies for improvement.
This study analyzes data on peptic ulcer disease based on deaths for 1951-1988 and hospital separations for 1969-1988. The source of the data are mortality and morbidity statistics provided to Statistics Canada by the provinces. The age-standardized mortality rates (ASMR) for peptic ulcer disease decreased from 1951 to 1988 by 69.4% for men (8.5 to 2.6 per 100,000 population), and 31.8% for women (2.2 to 1.5). Separation rates from hospitals during 1969-1988 for peptic ulcer disease also decreased by 59.8% for men (242.7 to 97.6 per 100,000 population) and 35.6% for women (103.2 to 66.5). Age-specific rates for both mortality and hospital separations increased with age. Epidemiological studies indicate that the incidence of peptic ulcer disease is declining in the general population. The downward trends in mortality and hospitalization rates for peptic ulcer disease reflect this change in incidence, but additional factors probably contribute as well to this decline. Male rates for both mortality and hospital separations were much higher than female rates at the beginning of the study period; but toward the end, the gap between the sexes narrowed considerably, mainly because the male rates declined substantially while the female rates decline moderately. The slower decline in the rates for women may be related to such factors as the increasing labour force participation among women and the slower decline in the population of female smokers.
Shaffer, F A; Preziosi, P
The health care marketplace is becoming increasingly competitive. The hospital has a built-in marketing force with the nursing department, because nurses are in constant, direct contact with the customer. Nursing must identify the case mix profile of the community and focus the hospital product lines to meet community needs. The nursing department should decentralize, change, measure, and innovate the staff mix needed to operationalize these product lines. The development of nursing practice standards for the case mix will help to identify the staff mix needed and create systems to efficiently manage the product lines. Nursing management must become aware of cross-subsidization and downward skill substitution of nursing personnel. Nursing information systems must generate quality reports that invoke cost consciousness on the part of nursing staff. Quality assurance programs must become unit based and complete with frequent audits to correlate length of stay with nursing quality. Correlations must be determined between nursing productivity and case mix to determine the hospital's niche in the marketplace. The transformation of health care into a competitive business industry has created many opportunities for nursing. The health care industry's incentives for efficiency along with the decreasing demand for inpatient hospital services will be the forces driving health care toward a competitive marketplace. The hospital's nursing department should be strategically positioned to become accountable for increasing market share and enhancing quality patient outcomes. The focus has shifted from the theoretical to the tactical, which is a step in the right direction, particularly for nursing. Nursing, if strategically positioned, will not only thrive but will also excel in this chaotic environment by capturing the opportunities and being innovative.
In 1993 the Victorian Government introduced casemix funding as part of its restructure of the public hospital system. Casemix funding provides a new basis for government funding according to outcomes. At the same time, restructure of hospitals allows for a reconsideration of who is eligible to use them. Historical research into the growth of the public hospital system in Melbourne shows that attempts to reform the hospital system are as old as the system itself. This paper argues that the views of hospitals in funding crises and the solutions that are recommended have more to do with the politics of the day than the economics of running hospitals.
Coddington, D C; Palmquist, L E; Trollinger, W V
Hospitals, besieged by new competitors and pressured to cut costs, are entering a new and unfamiliar environment. As usage declines and the government's new prospective payment system makes itself felt, hospitals are feeling the pinch. Nonprofit hospitals face competition from newer, for-profit providers of health care. These authors discuss the factors that have led some hospitals to close and forced most others to consider how they can lower costs while maintaining high-quality care. Several strategies exist to help hospitals cope with their new problems. The authors point out the advantages and disadvantages of downsizing, diversification, and joint ventures, among other practical measures that hospitals can take.
Bani, I A; Al-Kanhal, M A
The present study was undertaken to determine the incidence of malnutrition among hospitalized patients. A cross-sectional study of patients were evaluated for findings suggestive of protein calorie malnutrition (PCM). Hundred and sixty patients admitted to the medical and surgical wards over a period of five months were studied. Anthropometrics and biochemical measurements were used. Nutrition status was calculated based on some nutrition parameters weight for height, midarm, circumference, serum albumin and total lymphocyte count. Anthropometric measurements, weight for height and midarm circumference reflected malnutrition (PCM) of 33.8% and 30% respectively. The overall prevalence of obesity was 21%. A higher proportion (23.9%) of medical cases were found to be obese compared to surgical cases (19.7%). If malnutrition can be documented on hospital admission, attempts can be made to reverse malnutrition in the high risk patients.
Full Text Available The present study was undertaken to determine the incidence of malnutrition among hospitalized patients. A cross-sectional study of patients were evaluated for findings suggestive of protein calorie malnutrition (PCM. Hundred and sixty patients admitted to the medical and surgical wards over a period of five months were studied. Anthropometrics and biochemical measurements were used. Nutrition status was calculated based on some nutrition parameters weight for height, midarm, circumference, serum albumin and total lymphocyte count. Anthropometric measurements, weight for height and midarm circumference reflected malnutrition (PCM of 33.8% and 30% respectively. The overall prevalence of obesity was 21%. A higher proportion (23.9% of medical cases were found to be obese compared to surgical cases (19.7%. If malnutrition can be documented on hospital admission, attempts can be made to reverse malnutrition in the high risk patients.
Bani Ibrahim; Al-Kanhal Mohammad
The present study was undertaken to determine the incidence of malnutrition among hospitalized patients. A cross-sectional study of patients were evaluated for findings suggestive of protein calorie malnutrition (PCM). Hundred and sixty patients admitted to the medical and surgical wards over a period of five months were studied. Anthropometrics and biochemical measurements were used. Nutrition status was calculated based on some nutrition parameters weight for height, midarm, circumference, ...
Fajardo-Ortiz, Guillermo; Salcedo-Alvarez, Rey Arturo
This study attempts to recount the history of the main hospitals of the port of Acapulco from colonial times until the end of the 20th century. The Augustine friars began hospital care at the end of the first part of the 16th century. Later, Bernardino Alvarez (1514?-1584), with the support of the Spanish crown, founded the first formal hospital in Acapulco called Hospital de Nuestra Señora de la Consolación (Our Lady of Consolation Hospital). During the 16th and 17th centuries, the sick were attended by friars, and by the end of the 19th century there were physicians and surgeons. From the end of the Independence War until the end of the 19th century, the port did not have any true hospital. The first degreed physicians and surgeons arrived and resided in Acapulco in 1920. In 1938, the Hospital Civil Morelos (Morelos Civil Hospital) began providing services. It was replaced by the Hospital General de Acapulco (General Hospital of Acapulco). At the fourth decade of the past century the Cruz Roja (Red Cross) was created. In 1957 the hospital services of the Instituto Mexicano del Seguro Social (IMSS, Mexican Institute of Social Security), which was founded in 1963, was inaugurated with the Unidad Medico/Social (Medical and Social Unit) of the IMSS in Acapulco. This began the journey of modernity in Acapulco. In 1992, Hospital Regional Vicente Guerrero (Regional Hospital Vicente Guerrero) of the IMSS, initiated its services. In 1960, medical services for civil workers and their families were housed in the Hospital Civil Morelos (Morelos Civil Hospital). Shortly afterwards, the Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado (ISSSTE, Security and Social Services Institute for State Employees) had their own hospital. During the 20th century, Acapulco has added other hospital services to care for members of the navy and armed forces, as well as for those persons with financial resources for private care.
Bergenholtz, Heidi; Jarlbæk, Lene; Hølge-Hazelton, Bibi
Background: It can be challenging to provide generalist palliative care in hospitals, owing to difficulties in integrating disease-orientedtreatment with palliative care and the influences of cultural and organisational conditions. However, knowledge on the interactionsthat occur is sparse. Aim......: a quantitative study, in whichthree independent datasets were triangulated to study the organisation and evaluation of generalist palliative care, and a qualitative,ethnographic study exploring the culture of generalist palliative nursing care in medical departments. Setting/participants: A Danish regional......: To investigate the interactions between organisation and culture as conditions for integrated palliative care in hospital and, ifpossible, to suggest workable solutions for the provision of generalist palliative care. Design: A convergent parallel mixed-methods design was chosen using two independent studies...
Initial position & background: There are various methods and tools for evaluating facilities. The focus is usually on the technical building performance, function/usability or form/beauty. Examples are: Post-Occupancy Evaluation (POE) and Usability Appraisal. Nevertheless, evaluations of buildings...... according to focus areas and proposes which evaluation methods to use in different building phases of healthcare facilities. Hospital evaluations with experts and users are also considered; their subjective view on space, function, technology, usability and aesthetics. Results & solutions: This paper...... of creating buildings with enhanced usability. Additionally various evaluation methods used in hospital cases in Denmark and Norway are presented. Involvement of users is proposed, not just in defining requirements but also in co-creation/design and evaluation of solutions. The theories and preliminary...
van de Klundert, Joris; Muls, Philippe; Schadd, Maarten
This paper deals with the optimization of the flow of sterile instruments in hospitals which takes place between the sterilization department and the operating theatre. This topic is especially of interest in view of the current attempts of hospitals to cut cost by outsourcing sterilization tasks. Oftentimes, outsourcing implies placing the sterilization unit at a larger distance, hence introducing a longer logistic loop, which may result in lower instrument availability, and higher cost. This paper discusses the optimization problems that have to be solved when redesigning processes so as to improve material availability and reduce cost. We consider changing the logistic management principles, use of visibility information, and optimizing the composition of the nets of sterile materials.
Full Text Available Hospitality industry is a complex product-service economic activity which besides accommodation, food and beverages offers a variety of complementary and ancillary services in order to meet modern needs, demands and desires of tourists consumers. Contemporary needs, demands and desires of tourists consumers (increased need for security and preservation of health; emphasis on ecology and healthy food; pure nature stay; growing demand for adventure activities and excitement; convention facilities and incentive offerings; visits to towns, big sports, cultural, religious, business events; new travel motivation have led to the emergence of new trends in hospitality offering design. Wellness and spa hotels, boutique hotels, all inclusive hotels, slow-food restaurants, and wine and lounge bars are just some of the main trends, and successful hoteliers and caterers will examine each of the trends and devise development politics in accordance with the new requirements and global market needs.
... patientinstructions/000867.htm Leaving the hospital - your discharge plan To use the sharing features on this page, ... once you leave. This is called a discharge plan. Your health care providers at the hospital will ...
U.S. Department of Health & Human Services — The National Hospital Ambulatory Medical Care Survey (NHAMCS) is designed to collect data on the utilization and provision of ambulatory care services in hospital...
U.S. Department of Health & Human Services — In October 2014, CMS began reducing Medicare payments for subsection (d) hospitals that rank in the worst performing quartile with respect to hospital-acquired...
U.S. Department of Health & Human Services — There are two methods for a hospital to qualify for the Medicare DSH adjustment. The primary method is for a hospital to qualify based on a statutory formula that...
... What are the hospital's statistics for cesarean sections, episiotomies, and mortality? (Keep in mind, though, that these ... What are the center's statistics for hospital transfers, episiotomies, and mortality? What procedures are followed after your ...
Department of Veterans Affairs — The Veterans Health Administration (VHA) pays for care provided to VA beneficiaries in non-VA hospitals through its contract hospitalization program as mandated by...
U.S. Department of Health & Human Services — Hospital Outpatient Prospective Payment System (OPPS) Limited Data Set This file contains select claim level data and is derived from 2010 hospital outpatient PPS...
U.S. Department of Health & Human Services — The current Medicare policy of non-payment to hospitals for Hospital Acquired Conditions (HAC) seeks to avoid payment for preventable complications identified within...
Escher, Achim; Hainc, Nicolin; Boll, Daniel
Business intelligence (BI) is a worthwhile investment, and will play a significant role in hospital management in the near future. Implementation of BI is challenging and requires resources, skills, and a strategy, but enables management to have easy access to relevant analysis of data and visualization of important key performance indicators (KPI). Modern BI applications will help to overcome shortages of common "hand-made" analysis, save time and money, and will enable even managers to do "self-service" analysis and reporting.
Full Text Available Is there something distinct about the traditional Hospitality Management curriculum? First offered in 1893 at the Ecole Hoteliere Lausanne in Switzerland and launched in the United States at The School of Hotel Administration at Cornell University in 1922, has this course of study evolved over time to focus on both of Meyer's skills - originally based on technical skills but now transforming to emotional skills?
Katona, Katalin; Canoy, Marcel
There is a broad literature on the consequences of applying different welfare standards in merger control. Total welfare is usually defined as the sum of consumer and provider surplus, i.e., potential external effects are not considered. The general result is then that consumer welfare is a more restrictive standard than total welfare, which is advantageous in certain situations. This relationship between the two standards is not necessarily true when the merger has significant external effects. We model mergers on hospital markets and allow for not-profit-maximizing behavior of providers and mandatory health insurance. Mandatory health insurance detaches the financial and consumption side of health care markets, and the concept consumer in merger control becomes non-evident. Patients not visiting the merging hospitals still are affected by price changes through their insurance premiums. External financial effects emerge on not directly affected consumers. We show that applying a restricted interpretation of consumer (neglecting externality) in health care merger control can reverse the relation between the two standards; consumer welfare standard can be weaker than total welfare. Consequently, applying the wrong standard can lead to both clearing socially undesirable and to blocking socially desirable mergers. The possible negative consequences of applying a simple consumer welfare standard in merger control can be even stronger when hospitals maximize quality and put less weight on financial considerations. We also investigate the implications of these results for the practice of merger control.
Wheeler, J. R.; Zuckerman, H S
Previous studies have shown that external management by contract can improve the performance of managed hospitals. This article presents a conceptual framework which develops specific hypotheses concerning improved hospital operating efficiency, increased ability to meet hospital objectives, and increased ability to meet community objectives. Next, changes in the process and structure of management under contractual arrangements, based on observations from two not-for-profit hospital systems,...
Proenca, E J
Hospitals have been advised to respond to environmental pressures by changing from a product to a market orientation. Such changes are difficult to accomplish because of the entrenched behaviors and attitudes of hospitals employees. This article proposes organizational cultures as the avenue to a market orientation. It describes the role of hospital culture as an antecedent to market orientation. It also suggests ways to develop and maintain a market-oriented culture in hospitals.
Nauta, Frans; Teeuwen, Ben; Ngo, Thuy
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
Hospital CEOs say the Persian Gulf crisis could hit them hard where it counts. In fact, hospitals are already seeing some adverse impact from events in the Middle East. From fundraising to plant management to strategic planning, the confrontations in the Gulf are having an impact on the hospital's bottom line.
Full Text Available This is a retrospective study of the factors which contributed to accidental injuries sustained by those patients who fell in a White provincial hospital in die period 1 January to 30 June 1982. The research study was undertaken by Diploma in Nursing Administration students during their 3-week hospital practice at a White provincial hospital.
Sylvia Gallegos Espinosa
Full Text Available Rationale: Hospital malnutrition is a global health problem affecting 30-50% of hospitalized patients. There are no estimates of the size of this problem in Ecuadorian hospitals. Hospital malnutrition might influence the quality of medical assistance provided to hospitalized populations. Objectives: To estimate the current frequency of malnutrition among patients admitted to Ecuadorian public hospitals. Materials and methods: The Ecuadorian Hospital Malnutrition Study was conducted between November 2011 and June 2012 with 5,355 patients (Women. 37.5%; Ages ≥ 60 years. 35.1%; Length of stay ≤ 15 days. 91.2% admitted to 36 public hospitals located in the prominent cities of 22 out of the 24 provinces of the country. Malnutrition frequency was estimated by means of the Subjective Global Assessment survey. Results: Malnutrition affected 37.1% of the surveyed patients. Malnutrition was dependent upon patient's age and education level; as well as the presence of cancer, sepsis, and chronic organic failure. Hospital areas showed different frequencies of hospital malnutrition. Health condition leading to hospital admission influenced negatively upon nutritional status. Malnutrition frequency increased as length of stay prolonged. Conclusions: Malnutrition currently affects an important proportion of patients hospitalized in public health institutions of Ecuador. Policies and actions are urgently required in order to successfully deal with this health problem and thus to ameliorate its negative impact upon quality of medical care
Pijls-Hoekstra, Ruth; Groen, Brenda H.; Galetzka, M.; Pruyn, A.T.H.
Hospitality is a much-researched topic, but its definition is still debated. This paper is part of a larger research project into the perception of hospitality. Previous research using the Delphi-method (hospitality providers and experts) and the Critical Incident Technique (guests and consumers) yi
... 42 Public Health 3 2010-10-01 2010-10-01 false Hospital outpatient services excluded from payment under the hospital outpatient prospective payment system. 419.22 Section 419.22 Public Health CENTERS... PROSPECTIVE PAYMENT SYSTEM FOR HOSPITAL OUTPATIENT DEPARTMENT SERVICES Categories of Hospitals and...
... Hospital Deductible and Hospital and Extended Care Services Coinsurance Amounts for CY 2011 AGENCY: Centers... inpatient hospital deductible and the hospital and extended care services coinsurance amounts for services... (c) $141.50 for the 21st through 100th day of extended care services in a skilled nursing facility...
... hospitals, if hospitals so choose. Nursing care plan: We have allowed hospitals the options of having a stand-alone nursing care plan or a single interdisciplinary care plan that addresses nursing and other... hospitals to have a stand-alone nursing care plan or a single interdisciplinary care plan that...
Vaughan-Sarrazin Mary S
Full Text Available Abstract Background The emergence of physician owned specialty hospitals focusing on high margin procedures has generated significant controversy. Yet, it is unclear whether physician owned specialty hospitals differ significantly from non physician owned specialty hospitals and thus merit the additional scrutiny that has been proposed. Our objective was to assess whether physician owned specialty orthopedic hospitals and non physician owned specialty orthopedic hospitals differ with respect to hospital characteristics and patient populations served. Methods We conducted a descriptive study using Medicare data of beneficiaries who underwent total hip replacement (THR (N = 10,478 and total knee replacement (TKR (N = 15,312 in 29 physician owned and 8 non physician owned specialty orthopedic hospitals during 1999–2003. We compared hospital characteristics of physician owned and non physician owned specialty hospitals including procedural volumes of major joint replacements (THR and TKR, hospital teaching status, and for profit status. We then compared demographics and prevalence of common comorbid conditions for patients treated in physician owned and non physician owned specialty hospitals. Finally, we examined whether the socio-demographic characteristics of the neighborhoods where physician owned and non physician owned specialty hospitals differed, as measured by zip code level data. Results Physician owned specialty hospitals performed fewer major joint replacements on Medicare beneficiaries in 2003 than non physician owed specialty hospitals (64 vs. 678, P Conclusion Physician owned specialty orthopedic hospitals differ significantly from non physician owned specialty orthopedic hospitals and may warrant the additional scrutiny policy makers have proposed.
Özkil, Ali Gürcan; Fan, Zhun; Dawids, Steen
In this paper, the need for automated transportation systems for hospitals is investigated. Among other alternatives, mobile robots stand out as the most prominent means of automation of transportation tasks in hospitals. Existing transportation routines of a hospital are analyzed in order to ver...... for implementing mobile service robots for transportation tasks in hospitals.......In this paper, the need for automated transportation systems for hospitals is investigated. Among other alternatives, mobile robots stand out as the most prominent means of automation of transportation tasks in hospitals. Existing transportation routines of a hospital are analyzed in order...
Hao, Aimin; Yi, Tao; Li, Xia; Wei, Lei; Huang, Pei; Xu, Xinzhou; Yi, Lihua
Purpose: The quality of medical services provided by competing public hospitals is the primary consideration of the public in determining the selection of a specific hospital for treatment. The main objective of strategic planning is to improve the quality of public hospital medical services. This paper provides an introduction to the history, significance, principles and practices of public hospital medical service strategy, as well as advancing the opinion that public hospital service strategy must not merely aim to produce but actually result in the highest possible level of quality, convenience, efficiency and patient satisfaction.
Alkibay, Sanem; Ozdogan, F Bahar; Ermec, Aysegul
This paper aims to present a perspective to better understand corporate identity through examining the perceptions of Turkish patients and develop a corporate visual identity scale. While there is no study related to corporate identity research on hospitals in Turkey as a developing country, understanding consumer's perceptions about corporate identity efforts of hospitals could provide different perspectives for recruiters. When the hospitals are considered in two different groups as university and state hospitals, the priority of the characteristics of corporate visual identity may change, whereas the top five characteristics remain the same for all the hospitals.
Mann, J; Melnick, G; Bamezai, A; Zwanziger, J
This Data Watch examines the impact of hospital competition, the Medicare prospective payment system (PPS), and Medi-Cal selective contracting on the provision of uncompensated care by private hospitals in California during 1980-1989. It finds that hospitals subject to more intense competition and greater fiscal pressure from Medicare and Medi-Cal reduced their provision of uncompensated care relative to hospitals facing less pressure from these sources. We estimate that had hospitals not been subjected to increasing price competition from growth of managed care plans and financial tightening in public programs, they would have provided 36 percent more uncompensated care than was actually provided in 1989.
Wig, Eldon D.
The information processing needs of a hospital are many, with varying degrees of complexity. The prime concern in providing an integrated hospital information management system lies in the ability to process the data relating to the single entity for which every hospital functions - the patient. This paper examines the PRIMIS computer system developed to accommodate hospital needs with respect to a central patient registry, inpatients (i.e., Admission/Transfer/Discharge), and out-patients. Finally, the potential for expansion to permit the incorporation of more hospital functions within PRIMIS is examined.
Full Text Available Background: Nowadays, restriction on access and optimum use of resources is the main challenge of development in all organizations. Therefore, the aim of this study was to determine the technical efficiency and its factors, influencing hospitals of Tehran.Methods: This research was a descriptive-analytical and retrospective study conducted in 2014-2015. Fifty two hospitals with public, private, and social security ownership type were selected for this study. The required data was collected by a researcher-made check list in 3 sections of background data, inputs and outputs. The data was analyzed by DEAP 1.0.2, and STATA-13 technique.Results: Seventeen (31/48 of hospitals had the efficiency score of 1 as the highest technical efficiency. The highest average score of efficiency was related to social security hospitals as 84.32, and then the public and private hospitals with the average of 84.29 and 79.64 respectively. Tobit regression results showed that the size, type of practice, and ownership of hospitals were effective on the degree of their technical efficiency. However, there was no significant correlation between teaching / non-teaching hospitals with technical efficiency.Conclusion: Establishment of competition system among hospitals, constitution of medium size hospitals and allocation of budget to hospitals based on national accreditation system are recommended. Keywords: Technical efficiency, Data envelopment analysis, Hospital, Iran
Healing by the use of humor has become popular over the last few years and it is used not only in alternative medicine but also in conventional medicine in hospitals all over the world, particularly in the USA and Europe. This practice has been well implemented in pediatric wards. It is easier to make a child laugh than an adult. In the framework of healing by humor, use is made of a medical clown who is in fact a person who has undergone special training in acting and clowning, combined with medical knowledge and an understanding of patient behavior. Some medical clowns come from the world of entertainment, and are actors, clowns, and magicians. Some have a paramedical or medical background. Medical research demonstrates that medical clowns and humor have a positive effect on patients. The implementation of medical clowning has been increasing throughout the world from year to year and has, slowly but surely, started a movement to integrate it into formal frameworks in both pediatric and adult wards in hospitals. However, there is still a necessity to conduct larger, well controlled clinical trials regarding the influence of the different programs. Maybe the growing awareness in the world will fill the void that demands resources of both personnel and budgets, both of which are often missing from health budgets.
Skarstein, Jon; Dahl, Alv A; Laading, Jacob; Fosså, Sophie D
Predictors of 'patient satisfaction' with hospitalization at a specialized cancer hospital in Norway are examined in this study. Two weeks after their last hospitalization, 2021 consecutive cancer patients were invited to rate their satisfaction with hospitalization, quality of life, anxiety and depression. Compliance rate was 72% (n = 1453). Cut-off levels separating dissatisfied from satisfied patients were defined. It was found that 92% of the patients were satisfied with their stay in hospital, independent of cancer type and number of previous admissions. Performance of nurses and physicians, level of information perceived, outcome of health status, reception at the hospital and anxiety independently predicted 'patient satisfaction'. The model explained 35% of the variance with an area under the curve of 0.76 of the Receiver Operator Curve. Cancer patients' satisfaction with their hospital stay was high, and predicted by four independently predictive variables related to the performance of caregivers. These suggest areas for further improvement in the healthcare service.
Fajardo-Ortiz, Guillermo; Fajardo-Dolci, Germán
Until now the bed has been the basic physical resource in hospitals. This type of furniture has served to study and treat patients, through out the centuries it has undergone changes in the materials they are made of dimensions, functionality, accessories, aesthetic, and design. The hospital bed history is not well known, there are thousands of documents about the evolution of hospitals, but not enough is known about hospital beds, a link between the past and the present. The medical, anthropological, technological, social, and economic dynamics and knowledge have produced a variety of beds in general and hospital beds in particular. From instinctive, rustic, poor and irregular "sites" that have differed in shape and size they had evolved into ergonomic equipment. The history of the hospital bed reflects the culture, techniques and human thinking. Current hospital beds include several types: for adults, for children, for labor, for intensive therapy, emergency purposes, census and non census beds etc.
Bertoli, Paola; Grembi, Veronica
We assess the lifesaving effect of hospital proximity using data on fatality rates of road-traffic accidents. While most of the literature on this topic is based on changes in distance to the nearest hospital triggered by hospital closures and use OLS estimates, our identification comes from the ...... more when the road safety is low; the emergency service is not properly organized, and the nearest hospital has lower quality standards.......We assess the lifesaving effect of hospital proximity using data on fatality rates of road-traffic accidents. While most of the literature on this topic is based on changes in distance to the nearest hospital triggered by hospital closures and use OLS estimates, our identification comes from...
Amestoy, Simone Coelho; Trindade, Letícia de Lima; Waterkemper, Roberta; Heidman, Ivonete Teresinha Schülter; Boehs, Astrid Egged; Backes, Vânia Marli Schubert
The aim of this study is make a theorical-reflection about the importance of using dialogical leadership in hospital institutions through Freirean referencial. The dialogical leadership pattern differs from the coercive and autocratic methods, for being reasoned on the establishment of an efficient communicational process, able to stimulate autonomy, co-responsibility and appreciation of each member from nurse team. The dialogical leadership, unlike the directive one, is a management instrument, that pursuits to minimize the conflicts and stimulate the formation of healthy interpersonal relationships, which can contribute to the improvement of organizational atmosphere and quality care provided to health services users.
Stidsen, Lone Mandrup
. The four key aspects are: ‘Light’, ‘Space’, ‘Users’ and ‘Time’. The ‘Light’ aspect describes, as shown in (Fig 0.6), the character of the light, light information and light effect i.e. function, aesthetics or symbolism. The ‘Space’ aspect looks into the dimension of the space, geographical orientation...... in Denmark are lastly an investigation on light zones at the hospital ward defined in order to optimize the illumination. The third cycle of iteration is an experimental study testing a lighting concept developed and grounded in the knowledge gained through the first and second cycle. The fourth cycle...
Kirkland, Lisa L; Kashiwagi, Deanne T; Brantley, Susan; Scheurer, Danielle; Varkey, Prathibha
Almost 50% of patients are malnourished on admission; many others develop malnutrition during admission. Malnutrition contributes to hospital morbidity, mortality, costs, and readmissions. The Joint Commission requires malnutrition risk screening on admission. If screening identifies malnutrition risk, a nutrition assessment is required to create a nutrition care plan. The plan should be initiated early in the hospital course, as even patients with normal nutrition become malnourished quickly when acutely ill. While the Harris-Benedict equation is the most commonly used method to estimate calories, its accuracy may not be optimal in all patients. Calculating the caloric needs of acutely ill obese patients is particularly problematic. In general, a patient's caloric intake should be slightly less than calculated needs to avoid the metabolic risks of overfeeding. However, most patients do not receive their goal calories or receive parenteral nutrition due to erroneous practices of awaiting return of bowel sounds or holding feeding for gastric residual volumes. Patients with inadequate intake over time may develop potentially fatal refeeding syndrome. The hospitalist must be able to recognize the risk factors for malnutrition, patients at risk of refeeding syndrome, and the optimal route for nutrition support. Finally, education of patients and their caregivers about nutrition support must begin before discharge, and include coordination of care with outpatient facilities. As with all other aspects of discharge, it is the hospitalist's role to assure smooth transition of the nutrition care plan to an outpatient setting.
Smith, J E; Phillips, D J; Meyer, G E
Several ways used by the pharmacy department of a large university hospital to generate revenue through diversification are described. The department offers its facilities and staff as a resource in training medical service representatives for several pharmaceutical manufacturers, which is projected to provide $85,000 in net income for fiscal year (FY) 1983-84. The pharmacy department also conducts a six-month program for training pharmacy technicians, which yields a small net profit. The pharmacy department actively participates in educational programs such as college courses and clerkships earning extra income. An apothecary-style outpatient pharmacy was set up under a for-profit corporation. Services have been expanded to include the preparation of i.v. solutions that support home care. A durable medical equipment (DME) business is planned. The ambulatory and home-care programs are expected to generate approximately $165,000 in net profit next year. Contract pharmaceutical services are provided to another hospital. The net income generated through diversification in this pharmacy department will exceed $250,000 in FY 1983-84.
MacStravic, R C
Physicians' referring and admitting behavior as well as their clinical management practices are major determinants of hospitals' profitability under prospective payment. Four techniques are available to hospitals that seek to increase market share: Recruitment and retention strategies. In planning the mix of specialties represented on staff, hospitals should consider the effects of a physician's practice on the hospital's case mix. Peer pressure. Peer review programs in hospitals as well as through medical or specialty societies may help persuade physicians to alter their use of services. Education and information programs. Hospitals can assist physicians in patient management by conducting economic grand rounds, developing committees to study and communicate cost data to physicians, and providing information on alternatives to hospitalization. Incentives. Putting physicians at risk by linking planned expenditures to hospital financial performance can influence practice patterns. Other techniques include offering limited partnerships to medical staff members and merging the hospital and medical staff into one corporation. Hospitals may also need to influence physicians away from ventures that compete directly with the institution, such as ambulatory surgery centers.
Full Text Available Abstract Objective In-hospital mortality is an important performance measure for quality improvement, although it requires proper risk adjustment. We set out to develop in-hospital mortality prediction models for acute hospitalization using a nation-wide electronic administrative record system in Japan. Methods Administrative records of 224,207 patients (patients discharged from 82 hospitals in Japan between July 1, 2002 and October 31, 2002 were randomly split into preliminary (179,156 records and test (45,051 records groups. Study variables included Major Diagnostic Category, age, gender, ambulance use, admission status, length of hospital stay, comorbidity, and in-hospital mortality. ICD-10 codes were converted to calculate comorbidity scores based on Quan's methodology. Multivariate logistic regression analysis was then performed using in-hospital mortality as a dependent variable. C-indexes were calculated across risk groups in order to evaluate model performances. Results In-hospital mortality rates were 2.68% and 2.76% for the preliminary and test datasets, respectively. C-index values were 0.869 for the model that excluded length of stay and 0.841 for the model that included length of stay. Conclusion Risk models developed in this study included a set of variables easily accessible from administrative data, and still successfully exhibited a high degree of prediction accuracy. These models can be used to estimate in-hospital mortality rates of various diagnoses and procedures.
Ramirez, Adriana G; Tracci, Margaret C; Stukenborg, George J; Turrentine, Florence E; Kozower, Benjamin D; Jones, R Scott
Background The Hospital Value-Based Purchasing Program measures value of care provided by participating Medicare hospitals while creating financial incentives for quality improvement and fostering increased transparency. Limited information is available comparing hospital performance across healthcare business models. Study Design 2015 hospital Value-Based Purchasing Program results were used to examine hospital performance by business model. General linear modeling assessed differences in mean total performance score, hospital case mix index, and differences after adjustment for differences in hospital case mix index. Results Of 3089 hospitals with Total Performance Scores (TPS), categories of representative healthcare business models included 104 Physician-owned Surgical Hospitals (POSH), 111 University HealthSystem Consortium (UHC), 14 US News & World Report Honor Roll (USNWR) Hospitals, 33 Kaiser Permanente, and 124 Pioneer Accountable Care Organization affiliated hospitals. Estimated mean TPS for POSH (64.4, 95% CI 61.83, 66.38) and Kaiser (60.79, 95% CI 56.56, 65.03) were significantly higher compared to all remaining hospitals while UHC members (36.8, 95% CI 34.51, 39.17) performed below the mean (p UHC members (mean =1.99, p<0.0001) while Kaiser Permanente hospitals had lower case mix value (mean =1.54, p<0.0001). Re-estimation of TPS did not change the original results after adjustment for differences in hospital case mix index. Conclusions The Hospital Value-Based Purchasing Program revealed superior hospital performance associated with business model. Closer inspection of high-value hospitals may guide value improvement and policy-making decisions for all Medicare Value-Based Purchasing Program Hospitals. PMID:27502368
Yang, Yiju; Zeng, Na; Shen, Minxue; Sun, Zhenqiu
Green hospital construction is a new challenge for medical industry after global sustainable development strategy was put forward. The core connotation of green hospital includes green building, green healthcare, patient safety, and doctor-patient harmony. Many countries have established green building evaluation system to deal with energy crisis. Leadership in Energy and Environmental Design (LEED), Green Guide for Health Care (GGHC) in the U.S., and Evaluation System for Green Hospital Building (CSUS/GBC 2-2011) in China have guiding significance for the development of green hospitals in China. The evaluation system of green hospitals home and abroad still focuses on green building, and establishment of suitable synthesis evaluation system of green hospitals in China needs further research.
Smith, H L; Haley, D; Piland, N F
Rural hospitals confront an inauspicious environment due to changes in patient reimbursement and medical practice. Facing a situation of declining revenues, marketing presents an option for rural hospitals to adapt to the growing constraints. This paper analyzes the determinants of marketing strategy emphasis in rural hospitals. The conceptual model adopted in this study predicts that prior performance and contextual variables explain marketing strategy emphasis. The relationships are examined in a case study of rural New Mexico hospitals. Results suggest that prior performance and several contextual variables explain variations in marketing strategy emphasis. In particular, higher gross patient revenues are associated with more emphasis on television and radio advertising. Furthermore, rural New Mexico hospitals with high numbers of licensed beds and medical staff members, or that are affiliated with a chain organization, place greater emphasis on market research and market planning. The implications for marketing practice in rural hospitals are discussed.
Health care administration in many OECD countries has undergone substantial changes in recent years as a consequence of NPM reforms, rising costs, the pace of technological innovation, heightened competition for patients and resources, quality of managed care and demographic shifts. Hospitals...... especially have been reformed due to the high proportion of resources they absorb and the apparent difficulty of prioritizing and coordinating health care within hospitals. There is abundant research literature on the topic of reforming hospital management models. Lacking from the literature, however...... adapt, interpret and negotiate hospital management over time in relation to changing hospital management models in hospital organizations in the Nordic health system context, illustrated by the Danish health system....
Xuzhou Center Hospital is in a competing medical market in Xuzhou city. This hospital has been dedicating to improve the medical skills and provide professional and individualized service to the patients in order to improve the patient's experience and increase the patient's satisfaction. On the other side, this hospital has provided an all-round marketing campaign to build up the social influence and public reputation through public-praise marketing, web marketing, media marketing, and scholar marketing. Besides, this hospital has been cooperating with foreign medical institutions and inviting foreign medical specialists to academic communication. With the combined effects of improving medical service and all-round marketing, the hospital's economic performance has been enhanced significantly and laid a solid foundation for its ambition to become the first-class hospital in Huaihai Economic Zone.
increases and use summary statistics to compare market performance in both sectors. The market for hospital medicine is more concentrated than the pharmaceutical retail sector and the share of generics and parallel imported products is significantly lower. Between 2005 and 2009 expenditures for hospital...... for hospital medicines and their procurement are still poorly understood. The present paper characterises the market for hospital medicines in Denmark in terms of its organisation and developments between 2005 and 2009. In Denmark hospital medicines are publicly financed and procurement is centrally organised....... 98% of all medicines administered at Danish public hospitals are purchased through a public procurement agency by means of public tenders. Using data on actual contract prices we decompose pharmaceutical expenditure growth into the contributions from newly introduced medicines, price and volume...
Paradis, Johanne; Gauthier, Jacques-Bernard
The lack of interest of researchers in relation to question of hospital pharmacy management, and the status quo of existing managerial practices serving the reforms, justifies analysis of theoretical foundations of hospital pharmacy management. The objective is twofold. First, provide an overview of the socio-historical eras of the organizational theories in order to position the hospital pharmacy management on the axis of the changing ways of thinking about the organization and management. S...
Due to a strike among nurses in the spring of 2008, the existing waiting time guarantee of one month was suspended until June 1, 2009. Regions turned to private hospitals to assist reducing the hump of patients. It has been claimed that the private sector used to be favorably treated by the Liberal-Conservative...... government because the DRG price paid to them was higher than the actual costs at private hospitals. Now the regions will negotiate lower prices with private hospitals....
Bhuian, S N; Abdul-Gader, A
Using the more recent methodological developments in the assessment of the unidemensionality, reliability, and validity, the authors developed and examined a scale of market orientation for the hospital industry. The scale is based on a clear definition of the content of the construct of market orientation in the hospital industry. To this end, a national random sample of 237 hospital administrators was used. In addition to the support for the reliability and validity, the scale promises parsimony, pragmatism, and wide-ranging applicability.
OBJECTIVES--To determine incidence of malnutrition among patients on admission to hospital, to monitor their changes in nutritional status during stay, and to determine awareness of nutrition in different clinical units. DESIGN--Prospective study of consecutive admissions. SETTING--Acute teaching hospital. SUBJECTS--500 patients admitted to hospital: 100 each from general surgery, general medicine, respiratory medicine, orthopaedic surgery, and medicine for the elderly. MAIN OUTCOME MEASURES-...
Cleverley, W O; Harvey, R K
Comparisons are continuously being made between the financial performance, products and services, of the healthcare industry and those of non-healthcare industries. Several useful measures of financial performance--profitability, liquidity, financial risk, asset management and replacement, and debt capacity, are used by the authors to compare the financial performance of the hospital industry with that of the industrial, transportation and utility sectors. Hospitals exhibit weaknesses in several areas. Goals are suggested for each measure to bring hospitals closer to competitive levels.
Snail, T S; Robinson, J C
This paper outlines a conceptual framework of organizational diversification and assesses the state of empirical research on hospital organizational change. The literature on economic organization of hospitals, one of the most developed branches of health services research, still has only weak ties to economic theory. Evolving physician-hospital organizations do not fit into existing frameworks based on horizontal integration, vertical integration, or diversification. Empirical research has primarily focused on horizontal integration, and cause-effect relationships are often obscured by models that depart from economic theory and lack controls for self-selection bias. Recent empirical studies indicate that hospital mergers had moderate, rather than dramatic, effects on the rate of change in operating costs, staffing, and scale. Mergers rarely resulted in hospital closure, but were as likely to result in acute care consolidation and restructuring as in conversion to non-acute inpatient uses. While administrative costs were higher in for-profit than non-profit system hospitals, total costs were similar. System hospitals had lower marginal and average costs per stay than independent hospitals. Hospital vertical integration into subacute care was largely an artifact of the governmental uniform pricing system, which encouraged vertical integration. Hospitals that shared governance or financial risks with physicians outperformed those with high levels of physician governance and financial integration (e.g. stock ownership). Formal physician-hospital organizational arrangements often served to coordinate managed care contracting or to forge links with primary care group practices. Hospital diversification into related services improved short-term financial performance over unrelated diversification, although long-term performance was similar.
Stidsen, Lone Mandrup
Sociocultural aspects of light are important for the user experience of the atmosphere in a ward. According to the Danish Regulation for light in hospitals (DS703, 1983), a home-like feeling is required to support the patients, as they needa pleasant environment for their recovery. The term ‘Light...... the requirements. What does it mean to create a 'home-like' and 'pleasant or appealing' light in this context? Does the composition of CRI and degree of Kelvin tell it all? Is it enough information to provide a proper illumination in which the patient can have a homely and pleasant experience? The 'Model of Light...... from the Danish interior design magazine BO BEDRE.The findings show that the placement of light atmosphere in Denmark are determined as three horizontal light zones: 'High Lighting Zone', 'Center Lighting Zone' and 'Low Lighting Zone' An experimental study evaluates the experience of the atmosphere...
Vernon, Walter N
When health-care facilities do pursue green initiatives, it's often because there is some incentive available to them that buys down the cost. When hospitals make claims that green does not cost more, generally, these claims are based on strategies that simply cost less, and would therefore be pursued regardless of green goals, and/or strategies implemented because of a one-time opportunity to buy-down the cost through some kind of incentive programme. Engineers who design health-care facilities are often cast as being "nay-sayers"; we can't find ways to do better systems because we are too constrained. Behind the voluminous green smoke that surrounds healthcare building, there is some real green fire.
This article explores the two paradigms available in anthropology to make a fuller sense of the ritual .One is“hospitality”, and the other is “sacrifice”.The author specially ana-lyses the complexity of Chinese “hospitality” and “hosting”, and draws upon certain contrasts between his and other views .He also outlines the role in China of personal self -sacrifice , and concludes that sacrifice as self -sacrifice is a historically specific expectation and a transforma-tion of filial self-sacrifice.Hospitality to the gods, on the contrary, is the offering of a sacrifi-cial victim in a sequence of ritual sacralisation , divined danger and lack leading to benign effica-cy and completed encompassment , and then withdrawal from that danger .
Rayburn, J M; Rayburn, L G
This research traces the origins, development, and reasons for change in the power equation in the U.S. hospitals between physicians, administrators and accountants. The paper contains three major sections: a review of the literature concerning authority, power, influence, and institutional theory; a review of the development of the power of professions, especially physicians, accounting and healthcare administrators, and the power equilibrium of a hospital; and, a discussion of the social policy implications of the power struggle. The basis for physicians' power derives from their legal ability to act on which others are dependent, such as choosing which hospital to admit patients, order tests and procedures for their patients. The Federal Government's prospective payment system and the hospitals' related case-mix accounting systems appear to influence the power structure in hospitals by redistributing that power. The basis of the accountants' power base is control of financial information. Accountants have a definite potential for influencing which departments receive financial resources and for what purpose. This moves hospital accountants into the power equation. The basis of the hospital administrators' power is their formal authority in the organization. Regardless of what actions federal government agencies, hospital accountants, or hospital administrators take, physicians are expected to remain the dominant factor in the power equation. Without major environmental changes to gain control of physician services, only insignificant results in cost containment will occur.
Dychtwald, K; Zitter, M
The initial stages of developing a strategic marketing plan for hospitals are explored in this excerpt from the book, The Role of the Hospital in an Aging Society: A Blueprint for Action. The elderly have unique perceptual, cognitive, social, and psychological needs and preferences, and a marketing strategy for eldercare services must reflect these factors, as well as the financial role of third-party payers and the decision-making influence of families and physicians. Among the elements the hospital must address when developing a marketing strategy are market selection and segmentation, targeting markets with specific services, pricing, and positioning the hospital for a maximum share of the eldercare market.
Hachesu, Peyman Rezaei; Zyaei, Leila; Hassankhani, Hadi
Background: Lack of attention to the proper barcode using leads to lack of use or misuse in the hospitals. The present research aimed to investigate the requirements and barrier for using barcode technology and presenting suggestions to use it. Methods: The research is observational-descriptive. The data was collected using the designed checklist which its validity was assessed. This check list consists of two parts: “Requirements” and “barrier” of using the barcodes. Research community included 10 teaching hospitals and a class of 65 participants included people in the hospitals. The collected data was analyzed using descriptive statistics. Results: Required changes of workflow processes in the hospital and compliance them with the hospital policy are such requirements that had been infringed in the 90 % of hospitals. Prioritization of some hospital processes for barcoding, system integration with Hospital Information system (HIS), training of staff and budgeting are requirements for the successful implementation which had been infringed in the 80% of hospitals. Dissatisfaction with the quality of barcode labels and lacks of adequate scanners both whit the rate of 100 %, and the lack of understanding of the necessary requirements for implementation of barcodes as 80% were the most important barrier. Conclusion: Integrate bar code system with clinical workflow should be considered. Lack of knowledge and understanding toward the infrastructure, inadequate staff training and technologic problems are considered as the greatest barriers. PMID:27482137
Moore, Stephen M.; Beecher, David E.
Hospital enterprises are being created through mergers and acquisitions of existing hospitals. One area of interest in the PACS literature has been the integration of information systems and imaging systems. Hospital enterprises with multiple information and imaging systems provide new challenges to the integration task. This paper describes the requirements at the BJC Health System and a testbed system that is designed to acquire images from a number of different modalities and hospitals. This testbed system is integrated with Project Spectrum at BJC which is designed to provide a centralized clinical repository and a single desktop application for physician review of the patient chart (text, lab values, images).
Folmann, Nana Bro; Bossen, Kristine Skovgaard; Willaing, Ingrid;
To quantify the association between obesity and somatic hospital costs and number of overall somatic hospital contacts--number of inpatient admissions, number of outpatient visits, and number of emergency department visits--based on anthropometric measurements of waist circumference (WC) and info......To quantify the association between obesity and somatic hospital costs and number of overall somatic hospital contacts--number of inpatient admissions, number of outpatient visits, and number of emergency department visits--based on anthropometric measurements of waist circumference (WC...
Rosolio, Charles E
Relationships with hospitals and outpatient medical facilities have always been an important part of the business model for private medical practices. As healthcare delivery to patients has evolved in the United States (much of it driven by the new government mandates, regulations, and the Affordable Care Act), the delivery of such services is becoming more and more centered on the hospital or institutional setting, thus making contractual relationships with hospitals even more important for medical practices. As a natural outgrowth of this relationship, attention to hospital contracts is becoming more important.
SUN Ziyong; LI Li; ZHU Xuhui; MA Yue; LI Jingyun; SHEN Zhengyi; JIN Shaohong
The distinction of antimicrobial resistance of clinical bacteria isolated from county hospitals and a teaching hospital was investigated. Disc diffusion test was used to study the antimicrobial resistance of isolates collected from county hospitals and a teaching hospital. The data was analyzed by WHONET5 and SPSS statistic software. A total of 655 strains and 1682 strains were collected from county hospitals and a teaching hospital, respectively, in the year of 2003. The top ten pathogens were Coagulase negative staphylococci (CNS), E. coli, Klebsiella spp. , S. areus, P. aeruginosa, Enterococcus spp. , Enterobacter spp. , otherwise Salmonella spp. , Proteus spp. , Shigella spp. in county hospitals and Streptococcus spp. , Acinetobacter spp. , X. maltophilia in the teaching hospital. The prevalence of multi-drug resistant bacteria was 5% (4/86) of methicillin-resistant S. areus (MRSA), 12% (16/133) and 15.8 % (9/57) of extended-spectrum β-lactamases producing strains of E. coli and Klebsiella spp. , respectively, in county hospitals. All of the three rates were lower than that in the teaching hospital and the difference was statistically significant (P＜0.01). However, the incidence of methicillin-resistant CNS (MRCNS) reached to 70 % (109/156) in the two classes of hospitals. Generally, the antimicrobial resistant rates in the county hospitals were lower than those in the teaching hospital, except the resistant rates of ciprofloxacin, erythromycin, clindamycin, SMZco which were similar in the two classes of hospitals. There were differences between county hospitals and the teaching hospital in the distribution of clinical isolates and prevalence of antimicrobial resistance. It was the basis of rational use of antimicrobial agents to monitor antimicrobial resistance by each hospital.
Khatri, Naresh; Wells, Jack; McKune, Jeff; Brewer, Mary
The human factor is central to healthcare, yet its proper management has remained beyond the reach of healthcare organizations. This qualitative study examines strategic human resource management (HRM) issues in a university and a community hospital. The findings indicate that the two hospitals lacked a clear understanding of their strategic intent and objectives; as a result, their human resource (HR) practices lacked coherence and direction. Whereas the community hospital understood the interrelationship between culture and HRM, the university hospital did not. Moreover, the university hospital showed only a modest understanding of competencies needed in managing HR function, which hampered its ability to identify competent HR managers and employees. The community hospital made significant gains in the past few years in managing its culture and people by recruiting a competent HR manager. The relationship between HR practices and clinical outcomes was much less clear in the university hospital than it was in the community hospital.
Torun, Nazan; Celik, Yusuf; Younis, Mustafa Z
The level of competition among hospitals in Turkey was analyzed for the years 1990 through 2006 using the Herfindahl-Hirschman Index (HHI). Multiple and simple regression analyses were run to observe the development of competition among hospitals over this period of time, to examine likely determinants of competition, and to calculate the effects of competition on efficiency and quality in individual hospitals. This study found that the level of competition among hospitals in Turkey has increased throughout the years. Also, competition has had a positive effect on the efficiency of hospitals; however, it did not have a significant positive effect on their quality. Moreover, there are important differences in the level of competition among hospitals that vary according to the geographical region, the type of ownership, and the type of hospital. This study is one of the first to evaluate the effects of health policies on competition as well as the effects of increasing competition on hospital quality and efficiency in Turkey.
NSGIC GIS Inventory (aka Ramona) — HOSPITALS_CLINICS_ISDH_IN is a point shapefile showing the locations of 160 hospitals included in a "Hospital Directory" that appears on a Web page of the Indiana...
Hoa L Nguyen
Full Text Available BACKGROUND: Cardiovascular disease is one of the leading causes of morbidity and mortality in Vietnam. We conducted a pilot study of Hanoi residents hospitalized with acute myocardial infarction (AMI at the Vietnam National Heart Institute in Hanoi. The objectives of this observational study were to examine sex differences in clinical characteristics, hospital management, in-hospital clinical complications, and mortality in patients hospitalized with an initial AMI. METHODS: The study population consisted of 302 Hanoi residents hospitalized with a first AMI at the largest tertiary care medical center in Hanoi in 2010. RESULTS: The average age of study patients was 66 years and one third were women. Women were older (70 vs. 64 years and were more likely than men to have had hyperlipidemia previously diagnosed (10% vs. 2%. During hospitalization, women were less likely to have undergone percutaneous coronary intervention (PCI compared with men (57% vs. 74%, and women were more likely to have developed heart failure compared with men (19% vs. 10%. Women experienced higher in-hospital case-fatality rates (CFRs than men (13% vs. 4% and these differences were attenuated after adjustment for age and history of hyperlipidemia (OR: 2.64; 95% CI: 1.01, 6.89, and receipt of PCI during hospitalization (OR: 2.09; 95% CI: 0.77, 5.09. CONCLUSIONS: Our pilot data suggest that among patients hospitalized with a first AMI in Hanoi, women experienced higher in-hospital CFRs than men. Full-scale surveillance of all Hanoi residents hospitalized with AMI at all Hanoi medical centers is needed to confirm these findings. More targeted and timely educational and treatment approaches for women appear warranted.
Molinari, C; Morlock, L; Alexander, J; Lyles, C A
This study examined whether hospital governing boards that invest in board education and training are more informed and effective decision-making bodies. Measures of hospital financial viability (i.e., selected financial ratios and outcomes) are used as indicators of hospital board effectiveness. Board participation in educational programs was significantly associated with improved profitability, liquidity, and occupancy levels, suggesting that investment in the education of directors is likely to enhance hospital viability and thus increase board effectiveness.
HASAN TEHRANI, Tayebeh; Haghighi, Mohammad; BAZMAMOUN, Hasan
How to cite this article: Hasan Tehrani T, Haghighi M, Bazmamoun H. Effects of Stress on Mothers of Hospitalized Children in a Hospital in Iran. Iran J Child Neurol Autumn 2012;6(4):39-45.Abstract Objective Hospitalization of a child can cause severe anxiety and stress in the parents, especially for the mother. This stress consequently affects the treatment course of the child. Hereby, we investigate the impact of different stressors in mothers of hospitalized children. Materials & Metho...
Jacobs, P; Hall, E M
Comparative financial and operating ratios in Canadian hospitals are examined to reveal sources of increased efficiency. The study involved 70 Alberta hospitals, which were divided into three groups: teaching hospitals, regional hospitals and smaller rural hospitals. Data were obtained from HS-1 and HS-2 reports. Hospitals across Canada can calculate their own ratios to give them a general idea of how they compare with the hospitals in this report.
... Housing and Urban Development 24 CFR Part 242 Federal Housing Administration (FHA): Hospital Mortgage Insurance Program--Refinancing Hospital Loans; Proposed Rule #0;#0;Federal Register / Vol. 75 , No. 19... 242 RIN 2502-AI74 Federal Housing Administration (FHA): Hospital Mortgage Insurance...
Zijlker-Jansen, Pauline Y.; Janssen, M. P.; van Tilborgh-de Jong, A. J W; Schipperus, M. R.; Wiersum-Osselton, J. C.
Background: The 2011 Dutch Blood Transfusion Guideline for hospitals incorporates seven internal quality indicators for evaluation of the hospital transfusion chain. The indicators aim to measure guideline compliance as shown by the instatement of a hospital transfusion committee and transfusion saf
Pijls-Hoekstra, Ruth; Groen, Brenda H.; Galetzka, Mirjam; Pruyn, Ad T.H.
What is hospitality? Only few academic articles tap into the meaning of the concept of hospitality. Especially academic investigation of hospitality from a guest perspective is scarce; the combination of ‘hospitality’ and ‘experience’ has received hardly any attention. The present paper describes a
E.K.A. van Doorslaer (Eddy); R.C.J.A. van Vliet (René)
textabstractIn this article we want to confront some of the results of the theoretical literature on aggregation with the empirical consequences of aggregation in the context of the analysis of demand for hospital care. There has been an evolution in the estimation of hospital demand functions from
Wabo Nero C; Örtenwall P; Khorram-Manesh A
Objective: Malfunction in hospitals´ complex internal systems, or extern threats, may result in a hospital evacuation. Factors contributing to such evacuation must be identified, analyzed and action plans should be prepared. Our aims in this study were 1) to evaluate the use of risk and vulnerability analysis as a basis for hospital evacuation plan, 2) to identify risks/hazards triggering an evacuation and evaluate the respond needed and 3) to propose a template with main key points for planning, performance and evaluation of such evacuation. Methods: A risk and vulnerability analysis at two county hospitals along with a systematic online literature search based on the following keywords; “evacuation/closure”, “hospitals/medical facilities” and“disaster/hazards” alone or with “planning”, was conducted. Results: We found that although all hospitals have a disaster plan, there is a lack of knowledge and appropriate instruments to plan, perform and evaluate a hospital evacuation. Risk and vulnerability analysis can be used to reveal threats leading to an evacuation (e.g. on-going climate changes and terror actions). These key points can later be used to plan, perform and evaluate such evacuation. Conclusion: There is a need for an elaborated evacuation planning for hospitals. An evacuation plan should continuously be drilled based on a risk and vulnerability analysis. A general guide can be used as foundation to plan, perform and evaluate such plan.
Weld, Tim; Klein, Gina
Proposed rules in accounting for defined benefit plans may affect hospitals' statement of operations and affect the time, effort, and cost to comply with periodic financial reporting requirements. The new standard would require immediate recognition of the full amount of plan amendments in determining operating income. Hospitals should consider the role of pension plans in their compensation programs.
Full Text Available Pharmaceutical expenditure growth has outpaced GDP and healthcare expenditure growth rates in Denmark as in most OECD countries for the last decade. A major part of this increase was due to high growth rates in specialist areas that are typically located in hospital settings. Yet the market for hospital medicines and their procurement are still poorly understood. The present paper characterises the market for hospital medicines in Denmark in terms of its organisation and developments between 2005 and 2009. In Denmark hospital medicines are publicly financed and procurement is centrally organised. 98% of all medicines administered at Danish public hospitals are purchased through a public procurement agency by means of public tenders. Using data on actual contract prices we decompose pharmaceutical expenditure growth into the contributions from newly introduced medicines, price and volume increases and use summary statistics to compare market performance in both sectors. The market for hospital medicine is more concentrated than the pharmaceutical retail sector and the share of generics and parallel imported products is significantly lower. Between 2005 and 2009 expenditures for hospital medicines more than doubled -accounting for almost 40% of the total Danish pharmaceutical market in 2009. Price increases however - although positive and higher than in the pharmaceutical retail sector - were only moderate. The majority of the expenditure growth was due to an increase in utilisation and the introduction of new medicines in the hospital sector. Centralised tendering may therefore have important implications for competition and industry structure in the long run.
This address traces the emergence of the hospital in the 18th century as a facility for combating disease and tending to the sick. Reference is made to the reports of Tenon and Howard on hospitals in several European countries, which instead of considering the hospital as a mere architectural object make recommendations based on the numbers of beds of an institution, its usable space, the dimensions of wards, mortaility rates, etc.; the result is a new functional concept of the medical and physical organization of the hospital. The author delves into the characteristics of the hospital and medical practice in the Middle Ages, the 17th and 18th centuries, and since the middle of the 18th. He brings out the direct relationship of hospital organization to the economic regulations that emerged with mercantilism. He stresses the importance of man for social and military development on the one hand, and, on the other hand, to the application of a technology that could be described as political: the discipline. He is of the view that the introduction of disciplinary mechanisms in the confused environment of the hospital permitted its "medicalization" and the development of the medical-therapeutic hospital.
Lynn, M L; Wertheim, P
An analysis of various financial ratios sampled from open and closed hospitals shows that certain leverage, liquidity, capital efficiency, and resource availability ratios can predict hospital closure up to two years in advance of the closure with an accuracy of nearly 75 percent.
Edwards, Janine C.; Kang, JungEun; Silenas, Rasa
Context and Purpose: Rural communities face substantial risks of natural disasters but rural hospitals face multiple obstacles to preparedness. The objective was to create and implement a simple and effective training and planning exercise to assist individual rural hospitals to improve disaster preparedness, as well as to enhance regional…
Tseng, R.Y.; Li, C.K.; Spinks, J.A. (Department of Pediatrics, Chinese University, Prince of Wales Hospital, Shatin, N.T., (Hong Kong))
Age-specific quarterly asthmatic hospital discharge rates in Hong Kong during 1983 to 1989 were examined in relation to mean levels of six pollutants: sulfur dioxide (SO2), ozone (O3), total suspended particles (TSP), respiratory suspended particles (RSP), nitrogen dioxide (NO2), and nitrogen oxides (NOX). Discharges from the hospital of children under 14 years of age represented 56% of 33,952 discharges recorded in all age groups. Trends of adult hospitalization rates over time remained stable during the study period. In children, however, there was an increase in these rates, particularly marked in the age group of 1 to 4 years. Univariate analysis revealed a strong correlation between quarterly mean TSP and hospital discharge rate for the 1 to 4-year-old children (r = .62, P less than .001). In the 5 to 14-year-old age group, there was an inverse relationship between hospital discharge rate and sulfur dioxide level (r = -.38, P less than .05). Stepwise multiple regression analysis, controlling for confounding variables (seasonal and annual trends of asthma hospitalizations) confirmed these relationships. A highly significant linear regression equation was derived between hospitalization rate for ages 1 to 4 years and total suspended particles (P less than .001). The highly significant correlation between pollution and asthmatic hospitalization rate for the 1 to 4-year-old group suggests that young children are vulnerable to the adverse environmental effects of pollution. Auditing these relationships offers a logical basis for approaching control.
Rosko, M D; Broyles, R W
Hospitals may respond to the revenue constraints of prospective payment by altering their patient mix. This article provided a brief overview of marketing management and suggested that hospitals might change their patient mix by employing marketing strategies designed to attract patients to its services or to attract physicians who specialize in the appropriate medical disciplines.
Constipation is a distressing disorder that is common among older patients in hospital. It is often underdiagnosed and undertreated, and can lead to increased morbidity and prolonged hospital stays. In most cases this common problem can be treated successfully if the correct management plan is adopted. This article reviews the prevention and management strategies available to address the issue.
Klingner, Jill; Moscovice, Ira; Tupper, Judith; Coburn, Andrew; Wakefield, Mary
Implementation of patient safety initiatives can be costly in time and energy. Because of small volumes and limited resources, rural hospitals often are not included in nationally driven patient safety initiatives. This article describes the Tennessee Rural Hospital Patient Safety Demonstration project, whose goal was to strengthen capacity for…
Full Text Available Background: Instead of waiting for challenges to confront hospital management, doctors and managers should act in advance to optimize and sustain value-based health. This work highlights the importance of scenario planning in hospitals, proposes an elaborated definition of the stakeholders of a hospital and defines the influence factors to which hospitals are exposed to. Methodology: Based on literature analysis as well as on personal interviews with stakeholders we propose an elaborated definition of stakeholders and designed a questionnaire that integrated the following influence factors, which have relevant impact on hospital management: political/legal, economic, social, technological and environmental forces. These influence factors are examined to develop the so-called critical uncertainties. Thorough identification of uncertainties was based on a “Stakeholder Feedback”. Results: Two key uncertainties were identified and considered in this study: According to the developed scenarios, complementary education of the medical staff as well as of non-medical top executives and managers of hospitals was the recommended core strategy. Complementary scenario-specific strategic options should be considered whenever needed to optimize dealing with a specific future development of the health care environment. Conclusion: Strategic planning in hospitals is essential to ensure sustainable success. It considers multiple situations and integrates internal and external insights and perspectives in addition to identifying weak signals and “blind spots”. This flows into a sound planning for multiple strategic options. It is a state of the art tool that allows dealing with the increasing challenges facing hospital management.
Few industries rely on self-confidence to the extent that the hospitality industry does because guests must feel welcome and that they are in capable hands. This article examines the results of hundreds of student interviews with industry professionals at all levels to determine where the majority of the hospitality industry gets their self-confidence.
Rachel Roginsky; Matthew Arrants
In prior quarterly reports, Pinnacle Advisory Group presented timely updates about the New England lodging industry, which included focused profiles on particular cities. In this issue, the firm offers more general insight about the hospitality industry. Several Pinnacle executives recently participated in a panel discussion about investment, management, and careers in the hospitality industry.
Full Text Available Few industries rely on self-confidence to the extent that the hospitality industry does because guests must feel welcome and that they are in capable hands. This article examines the results of hundreds of student interviews with industry professionals at all levels to determine where the majority of the hospitality industry gets their self-confidence.
Burns, Nancy; Pickard, Myrna R.
Describes a rural outreach program to provide continuing education in nursing practice to all levels of nursing personnel in rural hospitals. Covers difficulties in planning and implementing the programs and the steps taken to explain the program philosophy and gain the trust of hospital adminstration and staff. (MF)
Full Text Available In prior quarterly reports, Pinnacle Advisory Group presented timely updates about the New England lodging industry, which included focused profiles on particular cities. In this issue, the firm offers more general insight about the hospitality industry. Several Pinnacle executives recently participated in a panel discussion about investment, management, and careers in the hospitality industry.
Howard Feiertag, of Blacksburg, an instructor in hospitality and tourism management at Virginia Tech's Pamplin College of Business, received the inaugural Excellence in Sales and Marketing Strategy Award at the Hospitality Sales and Marketing Association/New York University Strategy Conference in New York recently.
Full Text Available Background: Hospital waste contains a large quantity of dangerous pathogenic agents, which are hazardous to the health of man, animal, plant and the environment. In Iran, like many other developing countries, not enough attention is paid to this matter and available information regarding the generation and disposal of medical wastes are low. The existing information about production and disposal of wastes in our hospitals is little and incomplete. In this study, a survey on hospital waste management system in Bushehr province hospitals was conducted. Methods: In this cross-sectional study, 8 hospitals in Bushehr province were investigated during a period of 6 months using a questionnaire, interviews and direct observations. The questionnaire had 93 questions (open and closed about general information on the hospitals and about various systems of managing hospital waste according to the World Health Organization suggested survey questionnaire for hospital waste management in developing countries. Results: In hospitals of bushehr province, waste generation rate was 2615 kg/day, including domestic waste (51.7%, infectious waste (20.8%, sharps (15.2% and chemical and drugs wastes (12.3%. In almost all hospitals, segregation of infectious waste from domestic waste at the place of origin and putting them in special containers had been done but this segregation wasn’t complete and sometimes some hazardous waste were disposed of in domestic waste containers. All hospitals used a color coding system for waste containers, 75 % of hospitals had incinerators. In others, waste was carried out by municipal service daily. In all hospitals, all workers were trained about hospital waste management. In none of the surveyed hospitals, there was an obvious policy and plan for purchasing equipment and necessary facilities in order to dispose hospital waste correctly and also no clear budget was allocated for hospital waste management. In none of these hospitals
Søeby, Karen; Jensen, Peter Bjødstrup; Werge, Thomas
of hospital laboratory data as a source of information, we analyzed enzymatic plasma creatinine as a model analyte in two large pediatric hospital samples. Methods: Plasma creatinine measurements from 9700 children aged 0-18 years were obtained from hospital laboratory databases and partitioned into high......-resolution gender- and age-groups. Normal probability plots were used to deduce parameters of the normal distributions from healthy creatinine values in the mixed hospital datasets. Furthermore, temporal trajectories were generated from repeated measurements to examine developmental patterns in periods of changing...... in creatinine levels at different time points after birth and around the early teens, which challenges the establishment and usefulness of reference intervals in those age groups. Conclusions: The study documents that hospital laboratory data may inform on the developmental aspects of creatinine, on periods...
Williamson, S; Jauch, L R
This discussion argues that whereas ethically questionable practices have been identified in many industries, the moral consequences of many hospital management decisions make this industry particularly worthy of ethics studies. Because health care, the hospital's product, typically represents more immediate, intimate, and possibly irreversible benefit or harm to its customer, the patient, than does the typical product of general industry, hospital executives should be held to higher ethical standards in their decision making. Yet little is known about the ethical thinking of hospital managers. Kohlberg's moral reasoning development theory and Rest's Defining Issues Test offer the theoretical base and the means to compare the ethical reasoning of hospital executives to that of their nonhospital counterparts in general industry. This research agenda can offer important clues regarding the need to emphasize ethics in health care industry educational programs.
Beck, Anne Marie; Balknäs, Ulla N.; Camilo, Maria E.
Agreement member states was established. The aim was to review the current practices in Europe regarding hospital food provision, to highlight deficiencies, and to issue recommendations to improve the nutritional care and support of hospitalized patients. Five major common problems were identified: 1) lack......Disease-related undernutrition is significant in European hospitals but is seldom treated or prevented. In 1999, the Council of Europe decided to collect information regarding nutrition programs in hospitals, and for this purpose, a network consisting of national experts from 12 of the Partial...... of clearly defined responsibilities, 2) lack of sufficient education, 3) lack of influence and knowledge of the patients, 4) lack of cooperation between different staff groups, and 5) lack of involvement from the hospital management. To solve the problems highlighted, a combined timely and concerted effort...
Martínez-Jiménez, S; Lluch-Colomer, A; Desongles-Corrales, T; Bernal-González, D; Santos-Rubio, M D; Alfaro-Lara, E R; Galván-Banqueri, M
Objetivo: Analizar el procedimiento de visado y su actividad en un hospital de tercer nivel. Material y métodos: Estudio descriptivo del procedimiento de visado durante el período abril 2011-abril 2012. Se diseñó una base de datos y se definieron categorías relativas a las variables de estudio: pacientes y recetas. Para los pacientes atendidos en la Unidad de Visado se registraron las incidencias detectadas en base a una clasificación previamente establecida. Resultados: Se incluyeron 6.738 pacientes (8.465 recetas visadas). Se visaron 170 medicamentos y productos de nutrición diferentes, siendo el mayoritario Tacrolimus. Se detectaron un total de 420 incidencias, siendo las más frecuentes la «Ausencia de documento clínico» (46,67 %) y los «Errores formales de cumplimentación» (28,57%). Conclusiones: El presente trabajo ha permitido un conocimiento más pormenorizado de la actividad, los tipos de incidencias y la identificación de áreas de mejora.
Olivera, J. M.; Rocha, L. A.; Rotger, V. I.; Herrera, M. C.
There are many different services within a hospital. This means different types of noise which can be considered as acoustic pollution. Knowing that preterm infants exposed to high amounts of noise in the NICU are at a much higher risk because of their neurologic immaturity and physiologic instability, that excessive levels of noise also affect the persons and it can also impede some studies on patients, it was proposed to evaluate the Sound Pressure Level in some services of the Instituto de Maternidad, Tucumán, Argentina. There were evaluated the Level III NICU, the laundry service, a physical space destined for a service of evoked potential and a neonatal incubator under working conditions. The measurements were performed with a type II sonometer (CENTER 322) and it was also used an incubator analyzer (FLUKE INCU) for the incubator. The average values obtained were of 63.6 dBA for the NICU, 82.5dBA for the laundry room, 52.7 dBA for the evoked potential room and 62.8 dBA in the inside of the incubator under 64 dBA in the outside. The reports were documented in compliance with the appropriate standards.
Thomairy, Noora Al; Mummaneni, Mounica; Alsalamah, Sami; Moussa, Nicole; Coustasse, Alberto
Mobile technology has begun to change the landscape of the medical profession, with more than two-thirds of physicians regularly using smartphones. Smartphones have allowed health care professionals and the general public to communicate more efficiently, collect data, and facilitate clinical decision making. The methodology for this study was a qualitative literature review following a systematic approach of smartphone use among physicians in hospitals. Fifty-one articles were selected for this study based on inclusion criteria. The findings were classified and described into 7 categories: use of smartphone in obstetrics, pediatrics, surgery, internal medicine, radiology, and dermatology, which were chosen based on the documented use of smartphone application in different health care practices. A last section of patient safety and issues with confidentiality is also described. This study suggests that smartphones have been playing an increasingly important role in health care. Medical professionals have become more dependent upon medical smartphone applications. However, concerns of patient safety and confidentiality will likely lead to increased oversight of mobile device use by regulatory agencies and accrediting bodies.
Espen W. Haugom
Full Text Available Shielding is defined as the confinement of patients to a single room or a separate unit/area inside the ward, accompanied by a member of staff. It is understood as both a treatment and a control. The purpose of this study is to examine how staff in psychiatric hospitals describe and assess shielding. This qualitative study uses a descriptive and exploratory design with an inductive approach. The material was acquired through the Acute Network (in Psychiatry nationwide shielding project. Data collection was carried out by the staff, who described the shielding procedure on a semi-structured form. The analysis was inspired by Graneheim and Lundman’s qualitative content analysis. Shielding has been described as an ambiguous practice, that is, shielding can be understood in several ways. There is a clear tension between shielding as a control and shielding as a treatment, with control being described as more important. The important therapeutic elements of shielding have also been mentioned, and shielding involves isolation to different degrees.
Bahri, Meriem; Belkhadir, Rachid; Benzakour, Mohammed; Idrissi, Larbi; Khadri, Abdelhamid
Hospital waste represent, by their nature and their constitution, a big threat to health in the intra and extra hospital area. and a source of pollution for the environment. A 12-day campaign of weighing of the waste produced by the hospital Ibn Sina of Rabat-Morocco should an average of 1.75 kg/bed/day. In order to identify the hospital pathogenic germs as well as their sensitivities to antibiotics, some bacteriological analyses have been done on the percolat waste of this hospital. The results of these analyses put in evidence the presence of Pseudomonas aeruginosa and Staphylococcus aureus and their resistance to some antibiotics.
Mosallam, Rasha A; Guirguis, Wafaa W; Hassan, Mona Ha
This study aimed at estimating the percentage of hospital discharges and days of care accounted for by Ambulatory Care Sensitive Conditions (ACSCs) at Health Insurance Organization (HIO) hospitals in Alexandria, calculating hospitalization rates for ACSCs among HIO population and identifying determinants of hospitalization for those conditions. A sample of 8300 medical records of patients discharged from three hospitals affiliated to HIO at Alexandria was reviewed. The rate of monthly discharges for ACSCs was estimated on the basis of counting number of combined ACSCs detected in the three hospitals and the hospitals' average monthly discharges. ACSCs accounted for about one-fifth of hospitalizations and days of care at HIO hospitals (21.8% and 20.8%, respectively). Annual hospitalization rates for ACSCs were 152.5 per 10,000 insured population. The highest rates were attributed to cellulitis/abscess (47.3 per 10,000 population), followed by diabetes complications and asthma (42.8 and 20.8 per 10,00 population). Logistic regression indicated that age, number of previous admissions, and admission department are significant predictors for hospitalization for an ACSC.
Objectives To investigate whether the long term lease of public hospital owned land could be an additional financing mechanism for Greek public (mental) health hospitals. Methods We performed a financial analysis of the official 2008 data of a case - study hospital (Mental Health Hospital of Chania). We used a capital budgeting approach to investigate whether value is created for the public hospital by engaging its assets in a project for the development of a private renal dialysis Unit. Results The development of the private unit in hospital owned land is a good investment decision, as it generates high project Net Present Value and Internal Rate of Return. When the project commences generating operating cash flows, nearly €400.000 will be paid annually to the Mental Health Hospital of Chania as rent, thereby gradually decreasing the annual deficit of the hospital. Conclusions Revenue generated from the long term lease of public hospital land is crucial to gradually eliminate hospital deficit. The Ministry of Health should encourage similar forms of Public Private Partnerships in order to ensure the sustainability of public (mental) hospitals. PMID:21067580
Full Text Available Abstract Objectives To investigate whether the long term lease of public hospital owned land could be an additional financing mechanism for Greek public (mental health hospitals. Methods We performed a financial analysis of the official 2008 data of a case - study hospital (Mental Health Hospital of Chania. We used a capital budgeting approach to investigate whether value is created for the public hospital by engaging its assets in a project for the development of a private renal dialysis Unit. Results The development of the private unit in hospital owned land is a good investment decision, as it generates high project Net Present Value and Internal Rate of Return. When the project commences generating operating cash flows, nearly €400.000 will be paid annually to the Mental Health Hospital of Chania as rent, thereby gradually decreasing the annual deficit of the hospital. Conclusions Revenue generated from the long term lease of public hospital land is crucial to gradually eliminate hospital deficit. The Ministry of Health should encourage similar forms of Public Private Partnerships in order to ensure the sustainability of public (mental hospitals.
Lee, Bruce Y; Bartsch, Sarah M; Wong, Kim F; Yilmaz, S Levent; Avery, Taliser R; Singh, Ashima; Song, Yeohan; Kim, Diane S; Brown, Shawn T; Potter, Margaret A; Platt, Richard; Huang, Susan S
Efforts to control life-threatening infections, such as with methicillin-resistant Staphylococcus aureus (MRSA), can be complicated when patients are transferred from one hospital to another. Using a detailed computer simulation model of all hospitals in Orange County, California, we explored the effects when combinations of hospitals tested all patients at admission for MRSA and adopted procedures to limit transmission among patients who tested positive. Called "contact isolation," these procedures specify precautions for health care workers interacting with an infected patient, such as wearing gloves and gowns. Our simulation demonstrated that each hospital's decision to test for MRSA and implement contact isolation procedures could affect the MRSA prevalence in all other hospitals. Thus, our study makes the case that further cooperation among hospitals--which is already reflected in a few limited collaborative infection control efforts under way--could help individual hospitals achieve better infection control than they could achieve on their own.
... 42 Public Health 3 2010-10-01 2010-10-01 false Payment to a nonparticipating hospital. 424.52... § 424.52 Payment to a nonparticipating hospital. Medicare pays a nonparticipating hospital for the... services furnished by a U.S. hospital, if the hospital has in effect an election to claim payment...
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Pediatric hospital bed. 880.5140 Section 880.5140...) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Therapeutic Devices § 880.5140 Pediatric hospital bed. (a) Identification. A pediatric hospital bed is a...
Babyak, Jonathan M; Sharp, Claire R
OBJECTIVE To describe the epidemiology of the systemic inflammatory response syndrome (SIRS) and sepsis in cats hospitalized in a veterinary teaching hospital. DESIGN Observational study. ANIMALS 246 client-owned cats. PROCEDURES During a 3-month period, daily treatment records were evaluated for all hospitalized cats. Information extracted included signalment, temperature, heart rate, respiratory rate, diagnostic test results, diagnosis, duration of hospitalization, and outcome (survival or death). Cats were classified into 1 of 4 disease categories (sepsis [confirmed infection and SIRS], infection [confirmed infection without SIRS], noninfectious SIRS [SIRS without a confirmed infection], and no SIRS [no SIRS or infection]). RESULTS Of the 246 cats, 26 and 3 were hospitalized 2 and 3 times, respectively; thus, 275 hospitalizations were evaluated. When SIRS was defined as the presence of ≥ 2 of 4 SIRS criteria, 17 cats had sepsis, 16 had infections, 81 had noninfectious SIRS, and 161 were classified in the no SIRS category at hospital admission. The prevalence of sepsis at hospital admission was 6.2 cases/100 admissions. Four cats developed sepsis while hospitalized, resulting in a sepsis incidence rate of 1.5 cases/100 hospital admissions. Four of 17 cats with sepsis at hospital admission and 3 of 4 cats that developed sepsis while hospitalized died or were euthanized, resulting in a mortality rate of 33.3% for septic cats; 239 hospitalizations resulted in survival, 28 resulted in euthanasia, and 8 resulted in death. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that many hospitalized cats have evidence of SIRS and some have sepsis. In cats, sepsis is an important clinical entity with a high mortality rate.
Cardinale, A E; Torregrossa, M V
In this work we run over hospital history from Middle ages to the present time. Hospitals were charitable institutions in fact they rise inside monasterys, churches or castles with an architecture in modum crucis as a symbolic expression of Christ crucifix. During Renaissance, new scientific Knowledges and the need of technical assistance in a suitable place, lead to a new kind of hospital included into the functional centres of the city were medical practice takes the places of spiritual assistance. In XVIII century hospital is like a "human diseases botanical garden" divided into departments with a circular structure in conformity with a functional model of control. To exceed the isolation of single room, rectangular rooms born with a radially arrangement. At the end of 700's born the pavilions structures typical of hospitals until half 900's when the "monobloc" take place. Today hospital becomes horizontal, include in the context of the city, with hall as a big hotel and with trading centres in accordance with Renzo Piano model and with a new vision of hospital as a welcome place were the patient is a guest to treat as a person of consequence.
Full Text Available Our paper empirically examines how the decision to purchase private insurance and hospitalization are made based on household income, socio-demographic factors, and private health insurance factors in both Japan and the USA. Using these two data-sets, we found some similarities and dissimilarities between Japan and the United States. As income of households rises, households have a positive effect on purchasing health insurance as a normal good. Another similarity between the two countries is seen in the income effect on risk of hospitalization, which is negative for both Japanese and US cases. For dissimilarity, the insurance premium effect on risk of hospitalization is positive for the Japanese case, while negative for the US case. Since the Japanese insurance data had variables such as payments per day of hospitalization if household gets hospitalized, insurance payments upon death of an insured person, and annuity payments at maturity, we tested to see if these characteristics affect the risk of hospitalization for households; we do not eliminate a possibility of adverse selection. For the US pure health issuance characteristics, an increase in premium of health insurance policies cause individuals to substitute more health capital investment which causes lower risk of hospitalization.
Daurat, G; Py, J-Y
In France, most blood products are delivered by the établissement francais du sang, directly to the recipients, and hospital blood banks deliver a minor part, but are independent from it. However that may be, hospital blood banks are hazardous activities regarding to recipients, blood products, blood supply of the hospital and regional blood supply. Because of the high risk level, a computerized information system is compulsory for all hospital blood banks, except for those only devoted to vital emergency transfusion. On the field, the integration of computerization in the different processes is very heterogeneous. So, it has been decided to publish guidelines for computerizing hospital blood banks information systems and production management. They have been built according to risk assessment and are intended to minimize those risks. The principle is that all acquisition and processing of data about recipients or blood products and tracking, must be fully computerized and that the result of all manual processes must be checked by computer before proceeding to the next step. The guidelines list the different processes and, for each of them, the functions the software must play. All together, they form the basic level all hospital blood banks should reach. Optional functions are listed. Moreover, the guidelines are also aimed to be a common tool for regional health authorities who supervise hospital blood banks.
Petrosillo, Nicola; Puro, Vincenzo; Di Caro, Antonino; Ippolito, Giuseppe
The last decades have been characterized by the appearance of a substantial number of newly recognized or novel infectious agents and by the re-emergence of infectious diseases with a global impact. The objective of this article is to briefly describe the model of hospital response for early diagnosis and prompt management of patients with highly contagious infectious diseases. We reviewed the main components of hospital preparedness in response to clustering of highly contagious diseases. A model for the initial hospital response to an epidemic in our referral Institute is discussed. Prompt recognition and identification is the initial and indispensable step in facing any communicable diseases, regardless of whether it is a prevalent, a newly emerging one or deliberately released. The importance of developing and implementing nontraditional methods of public health surveillance and a system that allows a wide and immediate dissemination of information and exchange of views on risk assessment and risk management are highlighted. Case identification and laboratory capabilities and isolation procedures are the essential components for an initial hospital response. The recent bioterrorist events and the worldwide outbreaks of highly contagious infectious diseases have evidenced the need for institutional preparedness at each hospital and for identification of referral centers for patient isolation and of laboratories with adequate capabilities. Moreover, hospitals should develop a plan for coordinating all hospital components to respond to critical situations deriving from the admission of patients with highly contagious infectious diseases.
Mackay, J M; Lamb, C W
Marketing has become widely recognized as an important component of hospital management (Kotler and Clarke 1987; Ludke, Curry, and Saywell 1983). Physicians are becoming recognized as an important target market that warrants more marketing attention than it has received in the past (Super 1987; Wotruba, Haas, and Hartman 1982). Some experts predict that hospitals will begin focusing more marketing attention on physicians and less on consumers (Super 1986). Much of this attention is likely to take the form of practice management assistance, such as computer-based information system support or consulting services. The survey results reported here are illustrative only of how one hospital addressed the problem of physician need assessment. Other potential target markets include physicians who admit patients only to competitor hospitals and physicians who admit to multiple hospitals. The market might be segmented by individual versus group practice, area of specialization, or possibly even physician practice life cycle stage (Wotruba, Haas, and Hartman 1982). The questions included on the survey and the survey format are likely to be situation-specific. The key is the process, not the procedure. It is important for hospital marketers to recognize that practice management assistance needs will vary among markets (Jensen 1987). Therefore, hospitals must carefully identify their target physician market(s) and survey them about their specific needs before developing and implementing new physician marketing programs. Only then can they be reasonably confident that their marketing programs match their customers' needs.
Full Text Available Context Over the past decade the number of accidents and disasters has been growing around the world. In addition to damaging communities and infrastructures, unexpected disasters also affect service providers. This study aimed to evaluate the readiness of hospitals when confronted with unexpected disasters. Evidence Acquisition The present study was a simple review article, which was conducted via searching different sites, such as: Web of Science, Scopus, Science Direct and PubMed, using different key words such as: Disasters, Crisis, Hospital and preparedness. The relationship between the articles found in relation to our subject was investigated through the title and abstract of articles. The relationship between the articles, which were found in relation to our subject, was investigated through the title and abstract of the articles. Our search included papers published during the period between 2007 and 2015 and we only considered studies that measured the preparedness of hospitals in critical conditions. Among the 30 articles, which were found, 17 were excluded from the study due to lack of relevant data. Hence, 15 papers, which were of proper design and robust data analysis, were included in the current study. Results Hospital preparedness in disaster was evaluated in three dimensions: structural, non-structural factors and vulnerability management performance. A total of readiness of hospitals in three dimensions was mediocre. Conclusions Overall, the results derived from these studies indicated that hospital safety levels in most of the surveyed hospitals were moderate. Although the situation in hospitals is not critical, there is a need to plan and take appropriate measures to improve the safety level of the hospitals.
Mejia, Ana Maria Silva
According to architect, Ana Maria Silva Mejia, 'a new era for the design of hospitals in Guatemala has arrived', with a considerable growth in interest around good healthcare facility design. Here, in a slightly adapted version of an article, 'A new methodology for design', first published in the IFHE (International Federation of Hospital Engineering) Digest 2012, she reports on the application of a new methodology designed to optimise efficient use of space, and clinical and other adjacencies, in a district hospital in the City of Zacapa. The system has subsequently been successfully applied to a number of other Guatemalan healthcare facilities.
Kahn, Charles N
A specialty hospital joint venture between a health system and physician investors may implicate anti-kickback and tax laws when physicians self-refer patients to the hospital, raising the issue of conflict of interest. Physician self-referral can motivate behavior, such as cherry-picking patients and increased utilization, which in turn leads to windfall profits for physician owners and weakens classic community hospitals. Hopitals can best serve the interests of patients and improve performance by building enduring partnerships with physicians.
Laura Anes; Marianne Obi
A serious illness, a chronic medical condition or a hospital bed should not deny any child her/his basic right to play, a right essential for children’s development and general wellbeing. In fact, it is in these frightening and anxious moments that play and the stimulus that it provides can help the most. This article will focus on the impacts and benefits of professional hospital clowning for the wellbeing and recovery process of ill and hospitalized children. Our experience has shown that t...
van Galen, Louise S; Nanayakkara, Prabath W B
The percentage of readmissions within 30 days after discharge is an official quality indicator for Dutch hospitals in 2016. In this commentary the authors argue why readmissions cannot be regarded as a reliable way of assessing quality of healthcare in a hospital. To date, policy makers have been struggling with its precise definition and the indicator has not been properly formulated yet. It does not distinguish between planned and unplanned readmissions and does not take into account the 'preventability'. Therefore the authors believe that the indicator in its current form might falsely interpret the quality of care of a hospital and it is questionable to use readmissions as a quality indicator.
Rock, R.B. Jr.; Anderson, N.A.
Nurses and other health care professionals must be aware of the rationale and methodology for in-hospital health care product standardization, including consideration of the hospital standardization committee composition, pilot-study prerequisites, and general evaluation criteria. They must be familiar with the techniques of product sterilization, their effectiveness, and the materials required to maintain sterile product shelf-life until a product is used. Hospital standardization committees can assist in the product-use decisionmaking process. Product evaluation criteria should include considerations pertaining to cost, quality, service, and comparison to similar products.
U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...
Jensen, G V; Torp-Pedersen, C; Køber, L
In a retrospective study of 520 patients with in-hospital ventricular fibrillation 421 (81%) had acute myocardial infarction (MI), 66 (13%) had ischaemic heart disease (IHD) without MI, 33 (6%) had no signs of IHD. The in-hospital mortality of these three groups was 51%, 52%, and 27%, respectively...... (P = 0.01). Logistic regression analysis demonstrated that heart failure and cardiogenic shock were significant risk factors for in-hospital death among patients with IHD. Among discharged patients 1 and 5 years survival was 78% and 51% for patients with MI, 63% and 25% for patients with IHD, 67...... with known IHD suffering in-hospital VF without AMI have a very poor short- and long-term prognosis. These patients need extensive cardiac examination....
Serway, G D; Strum, D W; Haug, W F
This article explores the premise that the appropriateness and usefulness of typical hospital productivity measures have been affected by three changes in delivery: Organizational restructuring and other definition and data source changes that make full-time equivalent employee (FTE) measurements ambiguous. Transition to prospective payment (diagnosis-related groups). Increase in capitation (prepaid, at risk) programs. The effects of these changes on productivity management indicate the need for alternative productivity indicators. Several productivity measures that complement these changes in internal operations and the external hospital business environment are presented. These are based on an analysis of four hospitals within a multihospital system, and an illustration and interpretation of an array of measures, based on ten months of actual data, is provided. In conclusion, the recommendation is made for hospital management to collect an expanded set of productivity measures and review them in light of changing expense and revenue management schemes inherent in new payment modes.
Teare, Richard, Ed.; And Others
A theme issue devoted to management development in hospitality and tourism includes nine articles on assessing human resource needs and priorities, management development and training, preparing managers, curriculum design, supervised work experience, manager role, and the current business environment. (JOW)
U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...
Hill, R C
The rather abrupt introduction of payors to hospitals and vice versa that started a few years ago has now settled down into a learning situation. To be price competitive in the health insurance marketplace, the payor must obtain full contractual performance in price, administrative and utilization review areas. Hospitals need the patients that payors can refer, but there is only a minimal understanding of how the health insurance industry operates both internally and in the marketplace. By selecting payors and soliciting those selected, hospitals have an excellent chance to accomplish their patient and revenue goals while payors have the opportunity to determine the effectiveness of their various programs to help meet their goals. By making a little effort, hospitals can accomplish a lot by adding this new "P" to their marketing mix.
Agarwal, Divya; Garg, Poonam
In a competitive healthcare sector, hospitals have to focus on their processes in order to deliver high-quality care while at the same time reducing costs. Many hospitals have decided to adopt one or another Enterprise Resource Planning (ERP) system to improve their businesses, but implementing an ERP system can be a demanding endeavour. The systems are so difficult to implement that some are successful; many have failed, causing multimillion dollar losses. The challenge of ERP solutions lie in implementation because they are complex, time consuming and expensive too. This paper describes the various process workflows and phases of ERP implementation at Fortis Hospital Cunningham Road, Bangalore, India. This knowledge will provide valuable insights for the researchers and practitioners to understand the different process workflows and to make informed decisions when implementing ERP in any hospital.
Full Text Available Hospitalization and medical experiences can be confusing and stressful for children, teens and their families. It is very common for young people and their families to have many questions when they are scheduled for surgery or hospitalization. When children are given opportunities to cope successfully with medical experiences, they may see themselves as more capable, more in control, and more reassured. This success often leads to a more positive sense of self, as well as a healthier regard for medical procedures in general. Also, previous medical experiences can affect how the child will react to hospitalization. It is important to maintain a normal routine and activities, such as playing and schooling. Family and friend’s child should be encouraged to visit the child patient. The best way to prepare the child for hospitalization is to prepare ourselves by understanding what will occur.
Types of influence on the delivery of medical care are divided into monetary and other. These incentives effect care at the system, hospital, care team, physician and patient levels. Selected examples, primarily from the USA, are discussed.
Presentation descibes results from two studies of water quality and pathogen occurrence in water and biofilm samples from two area hospitals. Includes data on the effectiveness of copper/silver ionization as a disinfectant.
U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...
Sui Pheng, Low
This book examines the Facilities Management (FM) of hospitals and healthcare facilities, which are among the most complex, costly and challenging kind of buildings to manage. It presents and evaluates the FM service quality standards in Singapore’s hospitals from the patient’s perspective, and provides recommendations on how to successfully improve FM service quality and achieve higher patient satisfaction. The book also features valuable supplementary materials, including a checklist of 32 key factors for successful facilities management and another checklist of 24 service attributes for hospitals to achieve desirable service quality in connection with facilities management. The book adopts a unique approach of combining service quality and quality theory to provide a more holistic view of how FM service quality can be achieved in hospitals. It also integrates three instruments, namely the SERVQUAL model, the Kano model and the QFD model to yield empirical results from surveys for implementation in hosp...
Replacing a healthcare facility first opened in 1908 as a 20-bed cottage hospital, the recently opened 'new' Finchley Memorial Hospital in north-west London was designed by architects, Murphy Philipps, 'to be at the heart of a health campus', surrounded by green space for use by both the hospital itself, and the local community. The 28 million pounds hospital, which has achieved a BREAAM Excellent rating - with an annual energy target of just 35 GJ/100 m3 set by SHINE, the Department of Health-backed learning network for sustainable healthcare buildings - has also featured as one of only 20 projects in the RIBA Health Buildings Exhibition. HEJ editor, Jonathan Baillie, met with lead architect, Marc Levinson, to find out more about the key elements, and the thinking, that went into the design.
Barra, Daniela Couto Carvalho; Waterkemper, Roberta; Kempfer, Silvana Silveira; Carraro, Telma Elisa; Radünz, Vera
Qualitative research whose purpose was to reflect and argue about the relationship between hospitality, care and nursing according to experiences of PhD students. The research was developed from theoretic and practical meeting carried through by disciplines "the care in Nursing and Health" of PhD nursing Program at Santa Catarina Federal University. Its chosen theoretical frame of Hospitality perspective while nursing care. Data were collected applying a semi-structured questionnaire at ten doctoral students. The analysis of the data was carried through under the perspective of the content analysis according to Bardin. Hospitality it is imperative for the individuals adaptation in the hospital context or any area where it is looking for health care.
Full Text Available The physical design and infrastructure of a hospital or institution is an essential component of its infection control measure. Thus is must be a prerequisite to take these into consideration from the initial conception and planning stages of the building. The balance between designing a hospital to be an open, accessible and public place and the control to reduce the spread of infections diseases is a necessity. At Singapore General Hospital, many lessons were learnt during the SARS outbreak pertaining to this. During and subsequent to the SARS outbreak, many changes evolved in the hospital to enable us to handle and face any emerging infectious situation with calm, confidence and the knowledge that staff and patients will be in good stead. This paper will share some of our experiences as well as challenges
Five-rights - medication; Medication administration - hospital; Medical errors - medication; Patient safety - medication safety ... Medication safety means you get the right medicine, the right dose, at the right times. During your ...
U.S. Department of Health & Human Services — MedPAR consolidates Inpatient Hospital or Skilled Nursing Facility (SNF) claims data from the National Claims History (NCH) files into stay level records.
U.S. Department of Health & Human Services — About 25 percent of the hospitalizations for dual eligible beneficiaries in 2005 were potentially avoidable. Medicare and Medicaid spending for those potentially...
Full Text Available Abstract How to Cite This Article: Esmaeeli M, Erfani Sayar R, Saghebi A, Elmi Saghi, Rahmani Sh, Elmi S, Rabbani Javadi A. Screening for Depression in Hospitalized Pediatric Patients. Iran J Child Neurol. 2014 Winter; 8(1:47-51. Objective In chronically ill children who are hospitalized, many mood changes occur. For example, in children with cancer or renal failure, prolonged hospitalization and chemotherapy can lead to depression. With the improved survival of childhood malignancies, the effect of treatment on child’s psychosocial well-being becomes increasingly relevant. In this study, we examined the prevalence of depression in hospitalized children with chronic and acute conditions in Dr Sheikh Pediatrics Hospital in Mashhad. Materials & Methods After receiving the approval from the Ethics Committee of Mashhad University of Medical Sciences, we did this cross-sectional descriptive study, from April to June 2012 in Dr Sheikh Pediatric Hospital in Mashhad. Ninety children, aged between 8 to 16 years, were screened for depression. The sampling method was census. Children with a history of depressive or other mental disorders were excluded. Three groups of children (children with chronic renal disease, malignancy, and acute disease were evaluated for depression using standard Children Depression Inventory Questionnaire (CDI. Two specifically trained nurses with the supervision of a psychiatrist filled out the questionnaires at patients’ bedside. Depression scores were then analyzed by SPSS software. Results Of 90 children, 43(47.7% were male and 47(52.2% were female. The Children’s mean age was 11±2.3 years, and the mean length of hospitalization was 8±5.3 days. Depression was detected in various degrees in 63% of patients (N=57, and 36.6% of children (N=32 had no symptoms of depression. Severe depression was not seen in any of the patients with acute illness. More than half of patients with cancer and chronic kidney disease had
Brooks, Jo Ann
This column is designed to provide a nursing perspective on new hospital quality measurements. Future articles will cover the various quality indicators hospitals face and the role of the nurse in meeting mandated benchmarks. Reader responses to this column are welcome and will help to make it more useful to nurses in meeting the challenges posed by health care reform and changing Medicare reimbursement programs.
深谷, 香椎; Kashii, FUKAYA; 鈴鹿国際大学ビジネス英語, ビジネス・コミュニケーション; Business English ; Business Communication, Suzuka International University
To share the mutual satisfaction of both message senders and receivers proves to be a goal in effective communication with politeness strategies in hospitality business. This paper aims at studying politeness levels of communicative strategies in English usage and expression for hospitality business. The analysis reveals Japanese ESP learners seem to have some difficulties in expressing appropriate situations due to complex politeness strategies including verbal, psychological politeness as w...
Full Text Available Background: In disasters, large number of causalities rash into the hospitals in order to get health facilities. So, hospitals are the reference point for delivering the health services in all levels for helping to the most percent of injured people. Aim of study was to assess hospital disaster preparedness of Bushehr province. Maretial and Methods: This was a cross-sectional descriptive study which has been done in all Bushehr province hospitals. In order to collect data, we used 210 questions checklist with 10 different aims each aim had consisted of 6 different domains (equipment, working stuff, physical space, structure, protocols and functional chart. The checklists were completed by direct observation and evaluation of equipment, programs and documents based on their domains with different people. Results: The hospital preparedness in traffic base was very poor with mean number of 19/04±16/10 evaluation of security education and management domain with mean number 35/29±26/52, 38/65±19/46, 36/36±24/05, respectively were poor. In logistics, workforce, communications, excused transportation and addition to the hospitals with the mean number of 53/26±26/31, 49/65±27/61, 45/53±18/29, 43/33±19/72, and 40/47±20/37 were estimated as average. The most number was belonged to the emergency with the mean number of 53/80±19/18. Conclusion: The Bushehr province hospitals have not enough preparation against unexpected disasters and cannot be a good supporter for disaster happening, and in the occasions of happenings so many serious problems will occur. It will be suggested that the hospital managers should pay more attention to the unexpected disasters.
Cleverley, W O; Harvey, R K
Changes in healthcare economics now permit more meaningful financial comparisons between hospitals and other industries. A study focusing on return on equity and other financial ratios highlighted critical changes needed to improve the fiscal health of hospitals. These suggestions include increasing net prices on existing product lines, entering new markets, using short-term debt to relieve long-term debt burdens, and expanding uses of operating leases.
Dorsey, William [Jackson Park Hospital Foundation, Chicago, IL (United States); Vasquez, Nelson [Jackson Park Hospital Foundation, Chicago, IL (United States)
Jackson Park Hospital completed the construction of a new Medical Office Building on its campus this spring. The new building construction has adopted the City of Chicago's recent focus on protecting the environment, and conserving energy and resources, with the introduction of green building codes. Located in a poor, inner city neighborhood on the South side of Chicago, Jackson Park Hospital has chosen green building strategies to help make the area a better place to live and work.
In the first half of 20th century the architecture of hospitals in Germany changed considerable. Essential impulses for "The new construct" get out from the school of "Bauhaus" in Weimar, Dessau and Berlin. Clear lines and the principle of light, air and sun were characteristic of this style. Buildings of such hospitals and her creators in Chemnitz, Dresden, Freiberg and Zwenkau, all in Saxony, are described and illustrated exemplary.
Ansam F. Sawalha
Full Text Available Objective: The purpose of this study was to determine the availability and adequacy of antidote stocking at hospitals in north Palestine based on published guidelines for antidote stocking.Methodology: This study is a cross sectional survey of all hospitals at north Palestine (n=11 using a questionnaire which was completed by the director of the pharmacy department at each hospital. The questionnaire was divided into 2 parts. The first part contained a list of 25 antidotes while the second part contained a list of 12 antidotes. This classification is based on the guideline proposed by the British Association for Emergency Medicine (BAEM. The net antidote stock results were compared with the American guidelines as well.Result: The overall availability of each antidote in the first list varied widely from zero for glucagon to 100% for atropine. The number antidotes of the first list that were stocked in the 11 hospitals ranged from 5 to 12 antidotes but none of the hospitals stocked all the 25 antidotes. Additionally, availability of antidotes in the second list varied widely from zero for polyethylene glycol to 100% for dobutamine. The number of antidotes stocked ranged from 5 to 9 but none of the hospitals stocked all the 12 antidotes.Discussion and Conclusion: hospitals in north Palestine do not have adequate stock of antidotes. Raising awareness of the importance of antidotes by education, regular review of antidote storage, distribution plans, and appropriate legislation might provide solutions. Coordination between Palestinian hospitals and the PCDIC at An-Najah National University is also important.
The object of this research thesis is focused mostly on green meetings in the hospitality industry to be environment friendlier. It concerns what the hospitality industry and especially hotels can do within their meeting facilities to be environment friendlier and sustainable. The research will start with an introduction and a first impression of the reasons for the appearance of green meetings. Then the theoretical framework starts with the summary of green meetings and green technology....
Zachary H. Wood; Nicolsen, Nicole C.; Nichole Allen; Cook, Paul P.
Antimicrobial stewardship has become standard practice at university medical centers, but the practice is more difficult to implement in remote community hospitals that lack infectious diseases trained practitioners. Starting in 2011, six community hospitals within the Vidant Health system began an antimicrobial stewardship program utilizing pharmacists who reviewed charts remotely from Vidant Medical Center. Pharmacists made recommendations within the electronic medical record (EMR) to strea...
Enyeart, Amanda L; Weaver, Debbie
This article explores relationship marketing as adopted by staff of the Forbes Medical Library at The Children's Hospital in Denver. It provides a broad overview of relationship marketing along with its applications in libraries, and a description of how the library staff has used specific relationships with different hospital groups to enhance library service. The examples illustrate the importance of persistence, patience, and flexibility when consciously developing relationships between a library and individuals or groups.
Khan, Shoukat; Syed, AT; Ahmad, Reyaz; Rather, Tanveer A; Ajaz, M.; Jan, FA
Most of the tertiary care hospitals use radioisotopes for diagnostic and therapeutic applications. Safe disposal of the radioactive waste is a vital component of the overall management of the hospital waste. An important objective in radioactive waste management is to ensure that the radiation exposure to an individual (Public, Radiation worker, Patient) and the environment does not exceed the prescribed safe limits. Disposal of Radioactive waste in public domain is undertaken in accordance w...
Louisiana Geographic Information Center — Hospitals in the state of Louisiana. This database contains the responses provided by the hospitals to the "Emergency Response Hospital Data Verification Form" that...
Full Text Available In Italy a specific surveillance system for zoster does not exist, and thus updated and complete epidemiological data are lacking. The objective of this study was to retrospectively review the national hospital discharge forms database for the period 1999-2005 using the code ICD9-CM053. In the period 1999-2005, 35,328 hospital admissions have been registered with annual means of 4,503 hospitalizations and 543 day-hospital admissions. The great part of hospitalizations (61.9% involved subjects older than 65 years; the mean duration of stay was 8 days. These data, even if restricted to hospitalizations registered at national level, confirm the epidemiological impact of shingles and of its complications.
Putu Wuri Handayani
Full Text Available Currently, hospitals are required to improve their quality of health services to meet the higher standards. This improvement is supported by Ministry of Health which has launched electronic health (e-health program. Under this program, hospitals are required to have Hospital Information System (HIS or Enterprise Resource Planning (ERP for healthcare. However, to date only a few hospitals have implemented an integrated HIS. The purpose of this research is to asses the Information Technology (IT maturity of a teaching hospital in implementing HIS. This IT assessment observes from four layers namely business process, Information System (IS, Information Technology (IT and IS/IT management and organization. The result of this research is that teaching hospitals should prepare a plan to restructure their network with adequate infrastructure, create IT blue print and policy, IT organization restructuring, IT staff competency development and build integrated HIS.
Taylor, Janie J; Hodgson, Jennifer L; Kolobova, Irina; Lamson, Angela L; Sira, Natalia; Musick, David
Hospital chaplaincy and spiritual care services are important to patients' medical care and well-being; however, little is known about healthcare providers' experiences receiving spiritual support. A phenomenological study examined the shared experience of spiritual care between hospital chaplains and hospital-based healthcare providers (HBHPs). Six distinct themes emerged from the in-depth interviews: Awareness of chaplain availability, chaplains focus on building relationships with providers and staff, chaplains are integrated in varying degrees on certain hospital units, chaplains meet providers' personal and professional needs, providers appreciate chaplains, and barriers to expanding hospital chaplains' services. While HBHPs appreciated the care received and were able to provide better patient care as a result, participants reported that administrators may not recognize the true value of the care provided. Implications from this study are applied to hospital chaplaincy clinical, research, and training opportunities.
Bonney, R S
Survival strategies for hospitals and hospital pharmacy departments are presented, and one hospital's development into a health-services system is described. Financial and competitive pressures are forcing institutions to develop new strategies for survival. The primary institutional strategy is diversification--both horizontal and vertical. Diversification can assist in the hospital's growth, increase its asset and revenue bases, and lead to the development of a health-care delivery system. Marketing to physicians and developing information systems are also critical strategies under a prospective payment system. Institutions will need to know the cost of providing care for specific diagnosis-related groups. Strategies must be employed to develop incentives to reduce inpatient acute-care services and to increase productivity. Physicians should be involved in all of the institutional strategies. Strategies for the pharmacy department are basically the same. Pharmacy departments should develop programs to reduce drug use (especially antibiotic use) and information systems that show the actual cost of providing services by diagnosis. The major corporate restructuring and diversification efforts of one hospital are described. The future of hospitals and pharmacy departments will depend on the successful application of the strategies discussed.
Ishii, Hideko; Odauchi, Satori; Funabashi, Kaori; Ohta, Kazuko; Yamashita, Takeko
Tuberculosis control in big cities should be focused on preventing defaulting from treatment, and the prevention of the emergence of multi-drug resistant tuberculosis, and the improvement of treatment success rate. Since it is needed to organize continued case management system starting from hospitalization, discharge, management of regular drug taking at outpatient clinics and final cure, close collaboration should be made between hospital nurses and public health nurses. For this purpose, there should be no difference about the understanding on tuberculosis control between clinical and public health nurses. This research was aimed to examine "How much interest and recognition do hospital nurses have about tuberculosis control." The Aichi Nursing Association cooperated with this research. The results showed that 60% of tuberculosis ward nurses were more than forty years old, and they have served more than ten years in TB word. The levels of understanding on tuberculosis among nurses working in tuberculosis hospitals were much higher than those in general hospitals. However, it is necessary to organize a collaboration system between hospitals and public health center to improve TB case management.
M Adib Hajbaghery
Full Text Available Background: During recent years, cardiopulmonary resuscitation (CPR in hospital has received much attention. However, the survival rate of CPR in Iran’s hospitals is unknown. This study was designed to evaluate outcome of in-hospital CPR in Kashan. Methods: A longitudinal case registry study was conducted on all cases of in-hospital CPR during 6 months at 2002. Necessary data including; age, sex, underlying disease, working shift, time from cardiac arrest until initiating of CPR and until defibrillation, duration and result of CPR, frequency of tracheal intubations and time served for it were collected in a checklist. Results: In six months study, 206 cases of cardiopulmonary resuscitation attempted. The survival rate was similar for both sexes. Short-term survival observed in19.9% of cases and only 5.3% survived to discharge. Conclusions: Duration of CPR, time of the first defibrillation, response time and the location of cardiac arrest are the key predictors of survival to hospital discharge and in-hospital CPR strategies require improvement. This study promotes a national study on post CPR survival for accurate data on our performance in attention to chain of survival. KeyWords: Cardiopulmonary Resuscitation (CPR, Survival rate, Iran
Bossen, Claus; Foss, Martin
In this paper, we describe the collaborative work of hospital porters. The profession of hospital porter is understudied in sociology and in Computer Supported Cooperative Work, despite numerous studies of healthcare IT. We describe how a new IT system for hospital logistics provided porters with...... representations and accounts of porters’ work. We discuss the configurability of porters’ work arrangement and argue for the importance of comparative studies, and further argue for moving beyond the dualisms of coordination and accountability.......In this paper, we describe the collaborative work of hospital porters. The profession of hospital porter is understudied in sociology and in Computer Supported Cooperative Work, despite numerous studies of healthcare IT. We describe how a new IT system for hospital logistics provided porters...... with more influence on, and responsibility for their work; supported collaboration among porters, clinicians, and middle management; and effected a new ecology of visibility and accountability of porters’ work. We discuss how the new system simultaneously supported collaboration and generated...
Leone, Andrew J; Van Horn, R Lawrence
We hypothesize that, unlike for-profit firms, nonprofit hospitals have incentives to manage earnings to a range just above zero. We consider two ways managers can achieve this. They can adjust discretionary spending [Hoerger, T.J., 1991. 'Profit' variability in for-profit and not-for-profit hospitals. Journal of Health Economics 10, 259-289.] and/or they can adjust accounting accruals using the flexibility inherent in Generally Accepted Accounting Principles (GAAP). To test our hypothesis we use regressions as well as tests of the distribution of earnings by Burgstahler and Dichev [Burgstahler, D., Dichev, I., 1997. Earnings management to avoid earnings decreases and losses. Journal of Accounting and Economics 24, 99-126.] on a sample of 1,204 hospitals and 8,179 hospital-year observations. Our tests support the use of discretionary spending and accounting accrual management. Like Hoerger (1991), we find evidence that nonprofit hospitals adjust discretionary spending to manage earnings. However, we also find significant use of discretionary accruals (e.g., adjustments to the third-party-allowance, and allowance for doubtful accounts) to meet earnings objectives. These findings have two important implications. First, the previous evidence by Hoerger that nonprofit hospitals show less variation in income may at least partly be explained by an accounting phenomenon. Second, our findings provide guidance to users of these financial statements in predicting the direction of likely bias in reported earnings.
Osler, Merete; Iversen, Lene Hjerrild; Borglykke, Anders
This study examines variation between hospitals in 30-day mortality after surgery for colorectal cancer (CRC) in Denmark and explores whether hospital volume and patient characteristics contribute to any variation between hospitals.......This study examines variation between hospitals in 30-day mortality after surgery for colorectal cancer (CRC) in Denmark and explores whether hospital volume and patient characteristics contribute to any variation between hospitals....
Herrera Añazco, Percy; Médico Asistente, Servicio de Nefrología, Hospital Nacional 2 de Mayo, Lima, Perú; Docente de la Facultad de Medicina, Universidad Científica del Sur, Lima, Perú; Docente de la Facultad de Medicina, Universidad Nacional de Piura, Piura, Perú.; Palacios Guillén, Melissa; Médico Asistente, Servicio de Nefrología, Hospital Daniel Alcides Carrión, Lima, Perú; Docente, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú.; Chipayo Gonzales, David; Médico Residente, Servicio de Nefrología, Hospital Nacional 2 de Mayo, Lima, Perú.; Silveira Chau, Manuela; Médico Asistente, Unidad Médica Empresarial, Clínica Internacional, Lima, Perú.
The Health Ministry attends Peruvian population without social security and without a national dialysis program. Attention is limited to a few hospitals with dialysis centers. objectives: To determine mortality in the first hospitalization for dialysis in a population without social security. design: Descriptive study. Setting: Hospital Nacional Dos de Mayo, Lima, Peru. Patients: Patients with chronic renal disease. Interventions: We studied patients who started dialysis from January to Decem...
Claudia Maria Desgualdo
Full Text Available OBJECTIVES: To estimate the direct costs of hospital stays for premature newborns in the Interlagos Hospital and Maternity Center in São Paulo, Brazil and to assess the difference between the amount reimbursed to the hospital by the Unified Health System and the real cost of care for each premature newborn. METHODS: A cost-estimate study in which hospital and professional costs were estimated for premature infants born at 22 to 36 weeks gestation during the calendar year of 2004 and surviving beyond one hour of age. Direct costs included hospital services, professional care, diagnoses and therapy, orthotics, prosthetics, special materials, and blood products. Costs were estimated using tables published by the Unified Health System and the Brasindice as well as the list of medical procedures provided by the Brazilian Classification of Medical Procedures. RESULTS: The average direct cost of care for initial hospitalization of a premature newborn in 2004 was $2,386 USD. Total hospital expenses and professional services for all premature infants in this hospital were $227,000 and $69,500 USD, respectively. The costs for diagnostic testing and blood products for all premature infants totaled $22,440 and $1,833 USD. The daily average cost of a premature newborn weighing less than 1,000 g was $115 USD, and the daily average cost of a premature newborn weighing more than 2,500 g was $89 USD. Amounts reimbursed to the hospital by the Unified Health System corresponded to only 27.42% of the real cost of care. CONCLUSIONS: The cost of hospital stays for premature newborns was much greater than the amount reimbursed to the hospital by the Unified Health System. The highest costs corresponded to newborns with lower birth weight. Hospital costs progressively and discretely decreased as the newborns' weight increased.
Saeid Nazemi; Mehdi Raei; Amir Almasi-Hashiani
Currently, one of the environmental issues is waste of hospitals and healthcare facilities which due to hazardous, toxic, and disease-causing agents such as pharmaceutical, chemical and infectious disease, is of particular sensitivity. According to a 2002 survey by WHO, it was determined that 22 million people worldwide suffer from infectious diseases annually, because of contacting hospital wastes. Also based on a research conducted in 22 countries, 18 to 64 percent of hospitals wastes are n...
kamran Mirzaie; Soraya Zahmatkesh
Background: Hospital waste contains a large quantity of dangerous pathogenic agents, which are hazardous to the health of man, animal, plant and the environment. In Iran, like many other developing countries, not enough attention is paid to this matter and available information regarding the generation and disposal of medical wastes are low. The existing information about production and disposal of wastes in our hospitals is little and incomplete. In this study, a survey on hospital waste man...
Giacomino, Bria D; Cram, Peter; Vaughan-Sarrazin, Mary; Zhou, Yunshu; Girotra, Saket
Although prices for medical services are known to vary markedly between hospitals, it remains unknown whether variation in hospital prices is explained by differences in hospital quality or reimbursement from major insurers. We obtained "out-of-pocket" price estimates for coronary artery bypass grafting (CABG) from a random sample of US hospitals for a hypothetical patient without medical insurance. We compared hospital CABG price to (1) "fair price" estimate from Healthcare Bluebook data using each hospital's zip code and (2) Society of Thoracic Surgeons composite CABG quality score and risk-adjusted mortality rate. Of 101 study hospitals, 53 (52.5%) were able to provide a complete price estimate for CABG. The mean price for CABG was $151,271 and ranged from $44,824 to $448,038. Except for geographic census region, which was weakly associated with price, hospital CABG price was not associated with other structural characteristics or CABG volume (p >0.10 for all). Likewise, there was no association between a hospital's price for CABG with average reimbursement from major insurers within the same zip code (ρ = 0.07, p value = 0.6), Society of Thoracic Surgeoncomposite quality score (ρ = 0.08, p value = 0.71), or risk-adjusted CABG mortality (ρ = -0.03 p value = 0.89). In conclusion, the price of CABG varied more than 10-fold across US hospitals. There was no correlation between price information obtained from hospitals and the average reimbursement from major insurers in the same market. We also found no evidence to suggest that hospitals that charge higher prices provide better quality of care.
Paulo Cesar Sandler
Full Text Available O presente estudo cuida de pacientes "difíceis" da clínica psiquiátrica e psicoterápica: os pacientes que apresentam o fenômeno da atuação, cuja aproximação terapêutica tem se demonstrado problemática, mesmo com o advento das modernas técnicas de psicoterapia e das comunidades terapêuticas. Os diagnósticos psiquiátricos destes pacientes variam: são neuróticos, apresentam transtornos de pesonalidade, são psicóticos e quase sempre com graves doenças secundárias: alcoolismo e toxicomania (Códigos Classificação Internacional de Doenças 295 a 299, 300. 301, 303 e 304. Propõe-se, à luz da compreensão psicanalítica destas pessoas, um tratamento psicoterápico breve, focal, com o auxílio de uma hospitalização em regime fechado. Para a avaliação dos resultados do método psicoterápico diádico, criaram-se critérios de cura coerentes com a proposta terapêutica, e equiparam-se estes critérios clínicos a valores numéricos. Utilizando 36 pacientes internados, verificou-se até que ponto eles alcançavam estes critérios. Cada paciente recebeu um escore - valor numérico - que expressou o seu desempenho durante o tratamento em regime de internação, e sua conduta pós-alta hospitalar, durante um seguimento médio de 21 meses. Estes 36 pacientes puderam ser divididos em dois grupos: os de evolução favorável (obtivemos 36,1% e os de evolução desfavorável. Por meio de uma amostra sistemática composta por 41 pacientes que não foram submetidos ao método, internados no mesmo período de tempo, no mesmo hospital, e pareados com nossa casuística, fêz-se uma comparação estatística entre os percentis obtidos nas evoluções dos dois grupos. O valor do teste estatístico, o chi quadrado, não foi significante. O exame das proporções correspondentes a cada patologia em separado sugeriu fortemente que o tratamento estaria indicado nas neuroses e nas psicoses, mas que seria realmente ineficaz nos transtornos de
Noles, Marissa J; Reiter, Kristin L; Boortz-Marx, Jonathan; Pink, George
The number of stand-alone rural hospitals has been shrinking as larger health systems target these hospitals for mergers and acquisitions (M and As). However, little research has focused specifically on rural hospital M and A transactions. Using data from Irving Levin Associates' Healthcare M and A Report and Medicare Cost Reports from 2005 to 2012, we examined two research questions: (1) What were the characteristics of rural hospitals that merged or were acquired, and (2) were there changes in rural hospital financial performance, staffing, or services after an M and A transaction? We used logistic regression to identify factors predictive of merger, and we used multiple regression to examine various hospital measures after an M or A. Study results showed that hospitals with weaker financial performance but lower staffing levels and staffing costs were more likely to merge or be acquired. Statistically weak evidence suggested that operating margins declined after the merger; stronger evidence suggested reductions in salary expense. There was no statistically significant evidence of changes to the number of full-time equivalent (FTE) employees, the service lines that were included in the study, capital expenditures, or the amount of debt financing among the hospitals that merged or were acquired. M and A may not result in a rapid influx of capital, a relief of debt burden, or an improvement in bottom-line profitability. However, M and A may be a viable option for maintaining the hospital and the access to care it provides.
Pugh, Greg L
Hospital social workers are in a unique context of practice, and one where the ethical environment has a profound influence on the ethical behavior. This study determined the ratings of ethical environment by hospital social workers in large nationwide sample. Correlates suggest by and compared to studies of ethical environment with nurses are explored. Positive ratings of the ethical environment are primarily associated with job satisfaction, as well as working in a centralized social work department and for a non-profit hospital. Religiosity and MSW education were not predictive. Implications and suggestions for managing the hospital ethical environment are provided.
Full Text Available Formulary is a continually revised compilation of pharmaceuticals (plus important ancillary information that reflects the current clinical judgment of medical staff. Kasturba Hospital is a 1400 bedded tertiary care teaching hospital with different specialties, having more than 3000 brands and ancillary products in use. The hospital does not have a formulary of any kind. Present study involved development of a formulary for the hospital and comparing it with WHO Model Formulary. Monographs of the drugs were prepared as per the recommendation of Pharmacy and Therapeutic Committee of the hospital. Prepared hospital formulary consisted of 476 generic drugs of various categories and 95 fixed dose combinations. Availability of brands varied from single to many. About 75 medicines recommended by the essential medicine list were not present in the prepared hospital formulary. The drugs to be avoided or used with caution in renal failure, hepatic failure and in pregnancy were categorized and included in the formulary as additional information. The prepared hospital formulary was recommended for implementation in the hospital, which could thereby help as a tool to promote rational drug use.
Ding, Kele; Yang, Jingzhen; Cheng, Gang; Schiltz, Trisha; Summers, Karen M; Skinstad, Anne Helene
Most published studies have examined co-occurring disorders among mental health patients. Our objective was to compare the length of stay and hospital charges between hospitalized patients with alcohol- or substance-related disorders with and without co-occurring disorders. We analyzed nationally representative hospital discharge data (Nationwide Inpatient Sample, 2003-2007) and examined factors associated with length of stay and hospital charges. Forty-four percent of patients who were hospitalized with alcohol- or substance-related disorders were diagnosed with co-occurring mental disorders, representing 979,421 such disorders nationwide between 2003 and 2007. Females, those of White race, those who paid with insurance, and those who stayed in large, rural, nonteaching, and Midwest region hospitals had a high prevalence of co-occurring disorders. Co-occurring disorders were associated with longer hospital stays, but there were mixed results with hospital charges per discharge. An increase in co-occurring disorders among hospitalized patients with substance-related disorder may be due to the improvement in diagnosis and clinical attention.
Handayani, P W; Hidayanto, A N; Ayuningtyas, Dumilah; Budi, Indra
The Hospital Information System (HIS) could help hospitals as a public entity to provide optimal health services. One of the main challenges of HIS implementation is an institutional change. Using institutional theory as the analytical lens, this study aims to explain the institutionalization of HIS as an instance of e-health initiatives in Indonesia. Furthermore, this paper aims for hospital management and researchers to improve the understanding of the social forces that influence hospital personnel's HIS acceptance within an organizational context. We use case studies from four public, government-owned hospitals and four privately owned (public and specialty) hospitals to explain the HIS institutionalization process by exploring the three concepts of institutional theory: institutional isomorphism, institutional logic, and institutional entrepreneurship. This study reveals that differences exist between public, government-owned and private hospitals with regard to the institutionalization process: public, government-owned hospitals' management is more motivated to implement HIS to comply with the regulations, while private hospitals' management views HIS as an urgent requirement that must be achieved. The study findings also reveal that various institutional isomorphism mechanisms and forms of institutional logic emerge during the process. Finally, three factors-self-efficacy, social influence, and management support-have a significant influence on the individual acceptance of HIS.
Fang, Chongliang; Liu, Piyan; Jiang, Guiying
Origin and development of hospital in the West was related closely with religions and wars. Before the Medieval Ages, priests or physicians treated their patients mainly in temples, which may be regarded as the earliest type of hospital. The military hospital first appeared in the ancient Rome due to war. During the Medieval Ages, most hospitals were attached to monasteries. The Crusades prompted the development of hospitals and hospices along the route taken by the Crusaders. After the Medieval Ages, as the Protestantism rose, the monastic hospitals suffered a major setback and secular hospitals developed. From the 16th century, hospitals of Europe were spread gradually into North America. During the 18th and 19th centuries, function of hospital in medical treatment, education and research was strengthened gradually. In the 20th century, hospital facilities were matured technically and management of hospital became an important problem to which people devoted themselves to resolve it.
Full Text Available Institutional care is a growing component of health care costs in low- and middle-income countries, but local health planners in these countries have inadequate knowledge of the costs of different medical services. In India, greater utilisation of hospital services is driven both by rising incomes and by government insurance programmes that cover the cost of inpatient services; however, there is still a paucity of unit cost information from Indian hospitals. In this study, we estimated operating costs and cost per outpatient visit, cost per inpatient stay, cost per emergency room visit, and cost per surgery for five hospitals of different types across India: a 57-bed charitable hospital, a 200-bed private hospital, a 400-bed government district hospital, a 655-bed private teaching hospital, and a 778-bed government tertiary care hospital for the financial year 2010-11. The major cost component varied among human resources, capital costs, and material costs, by hospital type. The outpatient visit cost ranged from Rs. 94 (district hospital to Rs. 2,213 (private hospital (USD 1 = INR 52. The inpatient stay cost was Rs. 345 in the private teaching hospital, Rs. 394 in the district hospital, Rs. 614 in the tertiary care hospital, Rs. 1,959 in the charitable hospital, and Rs. 6,996 in the private hospital. Our study results can help hospital administrators understand their cost structures and run their facilities more efficiently, and we identify areas where improvements in efficiency might significantly lower unit costs. The study also demonstrates that detailed costing of Indian hospital operations is both feasible and essential, given the significant variation in the country's hospital types. Because of the size and diversity of the country and variations across hospitals, a large-scale study should be undertaken to refine hospital costing for different types of hospitals so that the results can be used for policy purposes, such as revising
Johnson, K F
Healthcare industry changes during the 1980s--increased competition and alterations in the Medicare payment methodology--place new and more complex demands on a hospital's information systems, which often fall short of meeting those demands. These systems were designed for financial reporting, billing, or providing clinical data, and few of them are capable of linking with other unrelated systems. Today's hospital manager needs timely and simultaneous access to data from a variety of sources within the hospital. All the elements to accomplish this are collected somewhere in the hospital, but finding them and bringing them together is difficult. The key to the efficient management and use of data bases is in understanding the fundamental concept of relational data bases, which is the capability of linking or joining separate data files through a common data element in each file. In this way, data files may be integrated into a "related" data base. Any number of separate files, or tables, may exist within a "relational" data base as long as a series of threads links them. A strategic management information data base includes the information necessary to analyze, understand, and manage the hospital's markets, products, resources, and profitability. The major components of this information system are the case mix and cost accounting, budgeting, and modeling systems. The case mix and cost accounting factors involve managing concrete pieces of data, whereas the budgeting and modeling factors manipulate data to create a scenario. The strategic management information data base is the foundation of a hospital's decision support system, which is rapidly moving into the category of a necessary tool of the hospital manager's trade.
Full Text Available Hospital readmission rates can be used as an indicator of the quality of health care services and can highlight high-priority research areas to ensure better health. A readmission is defined as when a patient is discharged from an acute care hospital and is admitted back to an acute care hospital in a set amount of days, with 30 days being the current national standard. On average, 19.6% of Medicare patients are readmitted to the hospital within 30 days of discharge and 56.1% within a year (Jencks, Williams, & Coleman, 2009. The hypothesis of this study was that the discharge location, or where a patient went immediately after discharge, would not have a significant effect on readmissions. A data set with all admission records was obtained from a major health provider. These data contain all hospital patients’ demographic and diagnosis information. General, women’s, and children’s hospitals were looked at from a system perspective to study the discharge location of patients as well as the effects of patient demographics on discharge location. By using a z-significance test in Microsoft Excel and SAS 9.2, it was discovered that patients discharged to home have a significantly lower likelihood of readmission. Generally, patients who are discharged to an extended care or intermediate care facility or patients with home health carerelated services had a significantly higher likelihood of being readmitted. The findings may indicate a possible need for an institution-to-institution intervention as well as institution-to-patient intervention. Future work will develop potential interventions in partnership with hospital staff.
Full Text Available The in-hospital mortality (MIH is used as a performance indicator and quality healthcare in hospital. However, the majority of deaths resulted from an inevitable disease process (severity of cases and / or co-morbidity, and not medical errors or changes in the quality of care. This work aims to make a distribution of deaths in the Regional Hospital of Eastern, Al Farabi hospital and to highlight that more studies on the MIH are required consistently with detailed clinical data at the admission. The MIH showed its limitation as a health care indicator. The overall rate of in-hospital deaths within the Al Farabi hospital has averaged 2.4%, with 8.4% in the emergency unit, 28% in intensive care unit, 22% Neonatology unit, 1.6% in pediatric unit. The MIH may depend, firstly, on the condition of patients before hospitalization and secondly, on the conditions of their transfer from one institution to another that supports them as a last resort. Al Farabi hospital supports patients transferred from the provinces of the eastern region. Thus, 6% of patients who died in 2014 come from Berkane, 2% from Nador, 2% from Bouarfa, 4% from Taourirt and 2% from Jerrada. One might question about the procedures and the conditions of such transfers. In conclusion, the overall MIH measured from routine data do not allow proper comparison between hospitals or the assessment of the quality of care and patient safety in the hospital. To do so, we should ideally have detailed clinical data on admission (e.g. type of admission, age of patient, sex, comorbidity, .... The MIH is however an important indicator to consider as a tool to detect potential problems related to admission procedures and to suspect an area of "non-quality" in healthcare . The MIH is interesting for the patient and for the hospital because it serves the improvement of quality healthcare.
Laura T. Eno
Full Text Available Background: Inspired by the transformation of the Regional Hospital Buea laboratory through implementation of the Strengthening Laboratory Management Toward Accreditation (SLMTA programme, hospital management adapted the SLMTA toolkit to drive hospital wide quality improvement.Objective: This paper describes changes in the hospital following the quality improvement activities in hygiene and sanitation, the outpatient waiting area and the surgical and maternity wards.Methods: In March 2011, hospital management established a quality improvement task force and created a hospital-wide quality improvement roadmap, following the SLMTA model. The roadmap comprised improvement projects, accountability plans, patient feedback forms and log books to track quality indicators including patient wait time, satisfaction level, infectionrates, birth outcomes and hospital revenue.Results: There was steady improvement in service delivery during the 11 months after the introduction of the quality improvement initiatives: patient wait time at the reception was reduced from three hours to less than 30 minutes and patient satisfaction increased from 15% to 60%. Treatment protocols were developed and documented for various units, infrastructure and workflow processes were improved and there was increased staff awareness of the importance of providing quality services. Maternal infection rates dropped from 3% to 0.5% and stillbirths from 5% to < 1%. The number of clients increased as a result of improvedservices, leading to a 25% increase in hospital revenue.Conclusion: The SLMTA approach was adapted successfully to meet the needs of the entire hospital. Such a programme has the potential to impact positively on hospital quality systems; consideration should be made for development of a formal SLMTA-like programmefor hospital quality improvement.
Cofer, Joseph B; Petros, Tommy J; Burkholder, Hans C; Clarke, P Chris
Rural communities face an impending surgical workforce crisis. The purpose of this study is to describe perceptions of rural Tennessee hospital administrators regarding the importance of surgical services to their hospitals. In collaboration with the Tennessee Hospital Association, we developed and administered a 13-item survey based on a recently published national survey to 80 rural Tennessee hospitals in August 2008. A total of 29 responses were received for an overall 36.3 per cent response rate. Over 44 per cent of rural surgeons were older than 50 years of age, and 27.6 per cent of hospitals reported they would lose at least one surgeon in the next 2 years. The responding hospitals reported losing 10.4 per cent of their surgical workforce in the preceding 2 years. Over 53 per cent were actively recruiting a general surgeon with an average time to recruit a surgeon of 11.8 months. Ninety-seven per cent stated that having a surgical program was very important to their financial viability with the mean and median reported revenue generated by a single general surgeon being $1.8 million and $1.4 million, respectively. Almost 11 per cent of the hospitals stated they would have to close if they lost surgical services. Although rural Tennessee hospitals face similar difficulties to national rural hospitals with regard to retaining and hiring surgeons, slightly more Tennessee hospitals (54 vs 36%) were actively attempting to recruit a general surgeon. The shortage of general surgeons is a threat to the accessibility of comprehensive hospital-based care for rural Tennesseans.
Sobia Munir; Syeda Adila Batool; Muhammad Nawaz Chaudhry
Background It is a common practice in developing countries that medical/infectious waste openly dumped with municipal solid waste.This paper presented a generation and characterization study of hospital waste.Determination of the waste composition is a basic step for selecting the most efficient treatment method of hospital waste.Methods Stratified random sampling was used to collect the samples of general as well as medical wastes for seven days.Medical waste was sorted into 10 categories whereas general waste was classified into 11 categories.Incineration was observed thoroughly for observing flaws in the incineration process.Data was analyzed by using SPSS software version 16.0.Results The studied hospital produced an average 297 kilograms of medical waste daily and it comprises plastics (71.0％),glass (13.9％),papers etc.(3.8％),cotton/dressings (5.7％),masks/gloves/sheets (0.3％) diapers (0.4％),wasted machines used in operation theaters (2.0％) and blades (0.1％).Laboratories,cancer ward,nursery ward,OPD and emergency ward are the largest infectious waste producing departments in the hospital.The hospital produced an average 3 511 kilograms of general waste daily in which organics constitute (44.3％),diapers etc.(42.8％),demolition materials (3.7％),plastic waste mixing medical plastic waste (2.5％),miscellaneous (2.14％),cloth/clothes (1.6％),cardboard (1.3％),papers (0.8％),cotton dressings (0.28％),glass (0.27％) and iron materials (0.18％).Other alarming facts are:medical waste is recycled in study area,after incineration of hospital waste,ash simply dumped in the premises of the hospital without any liner system.Conclusions The studied hospital produces 10％ of infectious waste and 90％ of general waste.The largest components of the infectious waste are plastic and glass.Organics and diapers are major components of the general waste coming from different sites of the hospital.Lack of training,inadequate knowledge regarding to the
Percelay, Jack M; Zipes, David G
Pediatric hospital medicine (PHM) programs are mission driven, not margin driven. Very rarely do professional fee revenues exceed physician billing collections. In general, inpatient hospital care codes reimburse less than procedures, payer mix is poor, and pediatric inpatient care is inherently time-consuming. Using traditional accounting principles, almost all PHM programs will have a negative bottom line in the narrow sense of program costs and revenues generated. However, well-run PHM programs contribute positively to the bottom line of the system as a whole through the value-added services hospitalists provide and hospitalists' ability to improve overall system efficiency and productivity. This article provides an overview of the business of hospital medicine with emphasis on the basics of designing and maintaining a program that attends carefully to physician staffing (the major cost component of a program) and physician charges (the major revenue component of the program). Outside of these traditional calculations, resource stewardship is discussed as a way to reduce hospital costs in a capitated or diagnosis-related group reimbursement model and further improve profit-or at least limit losses. Shortening length of stay creates bed capacity for a program already running at capacity. The article concludes with a discussion of how hospitalists add value to the system by making other providers and other parts of the hospital more efficient and productive.
Full Text Available El presente trabajo describe la historia del Hospital Fiorito de Avellaneda durante fines de la década del cuarenta y principios de la del cincuenta. En esta historia prima la visión de quienes fueran practicantes de la Guardia del Hospital. La trama se compone mediante una combinación de fragmentos de textos provenientes mayormente de entrevistas a ex practicantes del Hospital, periódicos y revistas. Esta apuesta, constituye un ejercicio experimental de escritura etnográfica, en donde se apunta a explorar las paradojas cautivas en el ejercicio de la transliteración.The present essay describes the Avellaneda's Fiorito Hospital history by the late forties and the begining of the fifties. The point of view of Emergency Service practicantes (advanced medicine students training in practice before graduation makes an important aspect of it. The plot is made up by the combination of narrative fragments -mainly taken from Hospital ex practicantes interviews, newspapers and magazines. The challenge has been to produce an ethnographic experimental writing and to explore the paradoxs involved in transliteration.
Bushnell, Brandon D
The concept of "alignment" between physicians and hospitals is a popular buzzword in the age of health care reform. Despite their often tumultuous histories, physicians and hospitals find themselves under increasing pressures to work together toward common goals. However, effective alignment is more than just simple cooperation between parties. The process of achieving alignment does not have simple, universal steps. Alignment will differ based on individual situational factors and the type of specialty involved. Ultimately, however, there are principles that underlie the concept of alignment and should be a part of any physician-hospital alignment efforts. In orthopedic surgery, alignment involves the clinical, administrative, financial, and even personal aspects of a surgeon's practice. It must be based on the principles of financial interest, clinical authority, administrative participation, transparency, focus on the patient, and mutual necessity. Alignment can take on various forms as well, with popular models consisting of shared governance and comanagement, gainsharing, bundled payments, accountable care organizations, and other methods. As regulatory and financial pressures continue to motivate physicians and hospitals to develop alignment relationships, new and innovative methods of alignment will also appear. Existing models will mature and evolve, with individual variability based on local factors. However, certain trends seem to be appearing as time progresses and alignment relationships deepen, including regional and national collaboration, population management, and changes in the legal system. This article explores the history, principles, and specific methods of physician-hospital alignment and its critical importance for the future of health care delivery.
Klein, Matthew B; Hollingworth, William; Rivara, Frederick P; Kramer, C Bradley; Askay, Shelley W; Heimbach, David M; Gibran, Nicole S
Modern burn care is a resource intensive endeavor requiring specialized equipment, personnel, and facilities in order to provide optimum care. The costs associated with burn injury to both patients and society as a whole can be multifaceted and large. The purpose of this study was to evaluate the association between hospital costs, patient characteristics, and injury factors in a cohort of pediatric patients admitted to a regional burn center. We performed a review of the hospital charges accrued by pediatric patients (age dollar costs using an inflation index and a cost to charge ratio. Univariate and multivariate regressions were performed to identify the factors most significantly associated with cost. In addition, we performed a subset cost analysis for patients with burns more than 20% TBSA. A total of 1443 pediatric patients (age dollars was dollars 9026 (SD = dollars 25,483; median = dollars 2138). Area of full thickness burn was the only patient or injury factor significantly associated with greater hospital costs (P < .05) on multivariate analysis. No single anatomic area was associated with increased hospital costs when adjusted for total overall burn size. Injury severity was the most significant factor impacting index hospitalization costs following pediatric burn injury. Further studies defining the long-term societal costs impact of burn injury are needed as are studies that evaluate the impact of burn injury on quality of life.
Foundation Trust Hospitals are community-controlled health care providers which have increased autonomy about how they produce outcomes for the British National Health Service. Although there is a literature on hospital economics it is unclear how these innovative providers will behave, if they have to compete for scarce resources with other hospitals. This paper reviews some of the earlier theories, such as the neoclassical theory of the firm, and discusses their relevance along with 'newer' economic theories such as the transaction costs and evolutionary theory of the firm, plus organizational and human resources theory, to the performance of Foundation Trusts. Much contemporary health care provision is shaped along modernist lines, using scientific endeavour to maximize the impact on health outcomes and technical and social efficiency. However, there is an increasingly postmodern standpoint--critical of modernity--being taken by both patients and hospital staff, to deconstruct processes in the organizations that serve them. Foundation Trusts are postmodern hospitals insomuch as they (to attract scarce resources in a competitive environment), need to marshal the diverse theories of the firm together in order to provide a mass-customized, quality experience, transparently and at least cost--whilst maintaining a stable organizational culture for staff.
Gonzalo Herranz Rodríguez
Full Text Available En la medicina hospitalaria se entrelazan las relaciones entre la ética médica y la ética de la gestión sanitaria. Son las relaciones entre el hospital en cuanto institución y las personas singulares. Algunos autores opinan que el hospital no puede existir como un organismo ético con vida propia en una sociedad pluralista. El autor defiende que el hospital no sólo es y se porta como una agente moral, sino que necesita serlo para sobrevivir. Para eso conviene que el hospital autodefina públicamente su misión y su filosofía, sus valores y sus principios, como normas que conformen un código o ideario ético pues, en buena medida, es un sujeto de responsabilidad moral, jurídica y social. Éste ideario es el proyecto humano que el hospital se debe dar a sí mismo y que ha de ser un estímulo interior para todos los que trabajan en él. Así mismo, debe hacer una apuesta decidida por la educación ética de los estudiantes y residentes que en él se forman.
Full Text Available In this paper is presented one of the important sectors of the nationaleconomy, at least from its potential for development perspective: thehospitality industry. The research interest is related to finding out the mainfactors of competitiveness in this field. This research attempts to identify theessential aspects of competitiveness in the hospitality industry. Theobjectives pursued refer to: discovering the degree to which the concept ofcompetitiveness is understood and capitalized on by the managers in theRomanian hospitality industry; identifying a set of factors considered decisivein raising the competitiveness of Romanian firms in the hospitality industry;identifying the strategic concerns of firms operating in the Romanianhospitality industry, in order to establish the connection between strategy andthe competitiveness of the firms belonging to this sector.As a result, the hypotheses are: in the hospitality industry there areparticularities which influence the firms’ competitiveness and strategicorientation; preoccupation towards raising competitiveness and strategicorientation is influenced by the type of exploitation and the number of stars(level of comfort; in the hospitality industry, managers focus on cost controland service quality as decisive factors of competitiveness.
Kaissi, Amer A; Begun, James W
Many common management practices in healthcare organizations, including the practice of strategic planning, have not been subject to widespread assessment through empirical research. If management practice is to be evidence-based, evaluations of such common practices need to be undertaken. The purpose of this research is to provide evidence on the extent of strategic planning practices and the association between hospital strategic planning processes and financial performance. In 2006, we surveyed a sample of 138 chief executive officers (CEOs) of hospitals in the state of Texas about strategic planning in their organizations and collected financial information on the hospitals for 2003. Among the sample hospitals, 87 percent reported having a strategic plan, and most reported that they followed a variety of common practices recommended for strategic planning-having a comprehensive plan, involving physicians, involving the board, and implementing the plan. About one-half of the hospitals assigned responsibility for the plan to the CEO. We tested the association between these planning characteristics in 2006 and two measures of financial performance for 2003. Three dimensions of the strategic planning process--having a strategic plan, assigning the CEO responsibility for the plan, and involving the board--are positively associated with earlier financial performance. Further longitudinal studies are needed to evaluate the cause-and-effect relationship between planning and performance.
Simmons, Florence M
Hospital overcrowding is primarily a shortage of inpatient beds, not a lack of emergency department capacity, as initially assumed. According to Asplin et al., many factors contribute to overcrowding, including inadequate or inflexible nurse-to-patient staffing ratios, isolation precautions, or delays in cleaning rooms after patient discharge; an overreliance on intensive care or telemetry beds; inefficient diagnostic and ancillary services on inpatient units; and delays in discharging hospitalized patients to postacute-care facilities. Hospital overcrowding presents a challenge for hospital employees and clients, often leading to frustration and dissatisfaction. Overcrowding also has a direct effect on patient care, including compromised patient safety, increased costs, increased length of stay, and increased mortality and morbidity rates. The emergency department is changed from a temporary holding area to an extended patient care unit, decreasing its ability to handle new admissions and to manage a mass casualty. Beds in the critical care units become filled with inappropriate patients if floor beds are not available, making placement of seriously ill patients difficult. Trauma patients may have to be diverted to other hospitals to receive the appropriate level of care. Patients who require specialty services may have to wait for extended periods to obtain a bed in a referral center.
... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Leasing of hospital. 242.72 Section... INSURANCE FOR HOSPITALS Miscellaneous Requirements § 242.72 Leasing of hospital. Leasing of a hospital in its entirety is prohibited. Notwithstanding this prohibition, any proposal in which leasing of...
... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hydraulic adjustable hospital bed. 880.5110... (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Therapeutic Devices § 880.5110 Hydraulic adjustable hospital bed. (a) Identification. A hydraulic...
... 42 Public Health 3 2010-10-01 2010-10-01 false Payment to the hospital. 424.126 Section 424.126... Foreign Country § 424.126 Payment to the hospital. (a) Conditions for payment. Medicare pays the hospital...) Reflects the hospital's intent to claim for all covered services furnished during a calendar year....
... 42 Public Health 2 2010-10-01 2010-10-01 false Payment to a foreign hospital. 413.74 Section 413....74 Payment to a foreign hospital. (a) Principle. Section 1814(f) of the Act provides for the payment of emergency and nonemergency inpatient hospitals services furnished by foreign hospitals to...
... 42 Public Health 3 2010-10-01 2010-10-01 false Payment to a hospital. 424.108 Section 424.108... by a Nonparticipating Hospital § 424.108 Payment to a hospital. (a) Conditions for payment. Medicare pays the hospital for emergency services if the hospital— (1) Has in effect a statement of election...
... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Statements filed with a hospital. 404.632... § 404.632 Statements filed with a hospital. A statement (generally a hospital admission form) filed with a hospital may serve as a written statement under § 404.630 if the requirements of this section...
... 42 Public Health 1 2010-10-01 2010-10-01 false Compliance with hospital rules. 35.2 Section 35.2... EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.2 Compliance with hospital rules. All patients and visitors in stations and hospitals of the Service are expected to comply with the rules and...
Sole Community Hospitals: Are They Different? A Statistical Analysis of the Hospitals and Their Treatment under TEFRA and PPS. Hospital Studies Program. Hospital Cost and Utilization Project. Research Note 5.
Farley, Dean E.
A study examined the treatment of sole community hospitals under the Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) and the Prospective Payment System (PPS) for Medicare as compared to the treatment of hospitals not designated as sole community hospitals under these same two policy guidelines. (A sole community hospital is defined as a…
Kamper-Jørgensen, Mads; Benn, Christine Stabell; Simonsen, Jacob;
To estimate how risk of acute respiratory infection (ARI) hospitalization in children attending childcare facilities with a recently (within 1 month) hospitalized child is affected by gender, age and other characteristics.......To estimate how risk of acute respiratory infection (ARI) hospitalization in children attending childcare facilities with a recently (within 1 month) hospitalized child is affected by gender, age and other characteristics....
... hospital care but is unable to obtain the agreement of the physician, it may request an expedited... the first full working day immediately following the day the hospital submits the request for review... hospital, and physician within 2 working days of the hospital's request and receipt of any...
... EXAMINATIONS HOSPITAL AND STATION MANAGEMENT General § 35.1 Hospital and station rules. The officer in charge of a station or hospital of the Service is authorized to adopt such rules and issue such instructions... 42 Public Health 1 2010-10-01 2010-10-01 false Hospital and station rules. 35.1 Section...
Bender, A D; Geoghegan, S S; Lundquist, S H; Cantone, J M; Krasnick, C J
With increasing competition among hospitals, primary care referral development and management programs offer an opportunity for hospitals to increase their admissions. Such programs require careful development, the commitment of the hospital staff to the strategy, an integration of hospital activities, and an understanding of medical practice management.