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Sample records for carmen general hospital

  1. Specialized consultant in radiological safety to the Ciudad del Carmen general hospital, PEMEX; Asesoria especializada en seguridad radiologica al hospital general Ciudad del Carmen, PEMEX

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Hernandez C, J. E.; Rodriguez A, F.; Garcia A, J

    2003-02-15

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

  2. Specialized consultant in radiological safety to the Ciudad del Carmen general hospital, PEMEX

    International Nuclear Information System (INIS)

    Angeles C, A.; Hernandez C, J. E.; Rodriguez A, F.; Garcia A, J.

    2003-02-01

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

  3. Specialized consultant in radiological safety to the Ciudad del Carmen general hospital, PEMEX. III.- September and October of 2002; Asesoria especializada en seguridad radiologica al hospital general Ciudad del Carmen, PEMEX. III.- Septiembre y Octubre de 2002

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Rodriguez A, F.; Garcia A, J

    2003-02-15

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

  4. Specialized consultant in radiological safety to the Ciudad del Carmen general hospital, PEMEX. III.- September and October of 2002

    International Nuclear Information System (INIS)

    Angeles C, A.; Rodriguez A, F.; Garcia A, J.

    2003-02-01

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

  5. Programa de hipertensión arterial. hospital el carmen de santafé de bogotá

    OpenAIRE

    Chiappe, Félix M.; Bottia, Luis E.

    2010-01-01

    El presente trabajo es el producto de la participación de docentes y estudiantes de pre y post-grado de la Facultad de Enfermería de la Universidad Nacional de Bogotá, en el desarrollo del programa de hipertensión arterial en el hasta hace algunos días llamado Hospital El Carmen, hoy Cami II El Carmen Sur, de Santafé de Bogotá, durante más de 14 años.

  6. [Knowledge and practices regarding cystic echinococcosis and trichinellosis in users and companions of users of the Hospital Comunitario de Salud Familiar El Carmen, Biobio Region, Chile].

    Science.gov (United States)

    Lisboa-Navarro, Raúl; González, Jorge; Junod, Tania; Melín-Coloma, Millaray; Landaeta-Aqueveque, Carlos

    2016-08-01

    We surveyed users of the Hospital Comunitario de Salud Familiar El Carmen and their companions to analyze knowledge and practices regarding cystic echinococcosis and trichinellosis. Most people recognized risky practices. Previous attendance at talks and working in agricultural-livestock enhanced the knowledge. Age, sex and formal education were not associated with the knowledge. Knowledge was not associated with practices.

  7. Carmen Bernand

    Directory of Open Access Journals (Sweden)

    2008-01-01

    Full Text Available Entrevista (en francés/Entretien Presentación Carmen Muñoz Bernand se graduó en antropología en la Universidad de Buenos Aires, en 1964, siendo con otros compañeros estudiantes quienes contribuyeron a crear esta carrera universitaria. Ese mismo año viajó a Francia con el fin de comenzar un doctorado con Claude Lévi-Strauss, tesis defendida en 1970. En 1972 empredió una tesis de Estado – en Francia hasta los años ochenta se requerían dos tesis de doctorado para poder aspirar al Profesorado de...

  8. [Incurable disease in Spain during the 19th century. The Hospital para Hombres Incurables Nuestra Señora del Carmen].

    Science.gov (United States)

    Zaragoza, Juan Manuel

    2012-01-01

    This paper examines the State's assumption of medical care for patients with "permanent needs" in 19th century Spain. These patients were the incurably ill, the chronically ill and the elderly. This process is contextualized within the liberal reforms of the Spanish healthcare system in the reign of Isabel 11 (1833-1868). The goal of these reforms was the creation and consolidation of a national health system that would gradually replace the religious health charities. Healthcare reform became necessary due to the increase in migration that started in the 1830's and intensified in the 1850's. Traditional care networks formed by the family, local community and religious charities were no longer available to those who had left their village or town. In addition, many religious charities were bankrupted by the seizure of their properties in a programme of confiscation. Similar healthcare reform processes were taking place in the United Kingdom, France and Germany, among other European countries, and involved significant changes in the lives of patients, who became strictly controlled and medicalised. My aim was to identify changes in the patients' experience of illness through a case study of the living conditions of inmates at the Nuestra Señora del Carmen Hospital for Incurable Men, based in Madrid from 1852 to 1949. This was one of the institutions devoted to caring for patients with "permanent needs" and was under the direct control of the General State Administration.

  9. The general NFP hospital model.

    Science.gov (United States)

    Al-Amin, Mona

    2012-01-01

    Throughout the past 30 years, there has been a lot of controversy surrounding the proliferation of new forms of health care delivery organizations that challenge and compete with general NFP community hospitals. Traditionally, the health care system in the United States has been dominated by general NFP (NFP) voluntary hospitals. With the number of for-profit general hospitals, physician-owned specialty hospitals, and ambulatory surgical centers increasing, a question arises: “Why is the general NFP community hospital the dominant model?” In order to address this question, this paper reexamines the history of the hospital industry. By understanding how the “general NFP hospital” model emerged and dominated, we attempt to explain the current dominance of general NFP hospitals in the ever changing hospital industry in the United States.

  10. Carmen: the disorder of Eros

    Directory of Open Access Journals (Sweden)

    Simona Argentieri

    2013-02-01

    Full Text Available Starting from the original story by Mérimée, Carmen, in all its forms, has the right of permanent citizenship as a form of entertainment and in everyone’s fantasies: opera, rock opera, hip opera and musicals, dance and ballet, literature, theater, but especially in films (about 80 versions with varied musical accompaniment, from jazz to rap. However, the representation of the character changes significantly in time and space. Carmen is a metaphor of the feminine par excellence, in all its glaring cultural variations: psychological, political, racial.

  11. Bacteriological Evaluation of Kwale General Hospital Environment ...

    African Journals Online (AJOL)

    ... Pharmacy (40.7%) and Theatre (18.5%). This study showed that Kwale General Hospital environment is heavily contaminated and therefore underlies the necessity for regular evaluation of the hospital environment. Keywords: Bacteriological evaluation, hospital, environment. Journal of Medical Laboratory Sciences Vol.

  12. The CARMEN software as a service infrastructure.

    Science.gov (United States)

    Weeks, Michael; Jessop, Mark; Fletcher, Martyn; Hodge, Victoria; Jackson, Tom; Austin, Jim

    2013-01-28

    The CARMEN platform allows neuroscientists to share data, metadata, services and workflows, and to execute these services and workflows remotely via a Web portal. This paper describes how we implemented a service-based infrastructure into the CARMEN Virtual Laboratory. A Software as a Service framework was developed to allow generic new and legacy code to be deployed as services on a heterogeneous execution framework. Users can submit analysis code typically written in Matlab, Python, C/C++ and R as non-interactive standalone command-line applications and wrap them as services in a form suitable for deployment on the platform. The CARMEN Service Builder tool enables neuroscientists to quickly wrap their analysis software for deployment to the CARMEN platform, as a service without knowledge of the service framework or the CARMEN system. A metadata schema describes each service in terms of both system and user requirements. The search functionality allows services to be quickly discovered from the many services available. Within the platform, services may be combined into more complicated analyses using the workflow tool. CARMEN and the service infrastructure are targeted towards the neuroscience community; however, it is a generic platform, and can be targeted towards any discipline.

  13. Psychiatric referrals in two general hospitals.

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    Doongaji D

    1989-07-01

    Full Text Available A prospective study was undertaken to compare the patterns of psychiatric referrals in two general hospitals in Bombay viz. the King Edward Memorial Hospital (64 cases and the Jaslok Hospital and Research Centre (62 cases. It was observed that depressive symptoms were the most common presenting symptoms in these patients attending either of the hospitals. Similarly, the commonest diagnoses were depression and organic mental disorder. Attempted suicide with organophosphorous compounds was the commonest reason for hospitalization at K.E.M. Hospital (p less than 0.001. A significant number of these patients were females (p less than 0.05. The psychiatric referrals at Jaslok had been hospitalized mainly for suspected medical or neurological illness (p less than 0.001. These patients belonged to higher economic strata and hence had a better paying capacity compared to patients at KEM hospital, a significant number of whom were unemployed (p less than 0.001. The duration of pre-referred illness of patients and their stay at Jaslok hospital were longer as compared to those at KEM Hospital (p less than 0.01. The number of non-relevant special investigations carried out on patients in Jaslok was more (p less than 0.01. Further analysis of diagnoses revealed that a significant number of patients at KEM Hospital were admitted as primary psychiatric illness (p less than 0.05.

  14. The 4π neutron detector CARMEN

    Energy Technology Data Exchange (ETDEWEB)

    Ledoux, X., E-mail: Xavier.ledoux@ganil.fr [CEA/DAM/DIF, F-91297 Arpajon (France); GANIL, CEA/DRF-CNRS/IN2P3, Caen, F-14076 France (France); Laborie, J.-M.; Pras, P.; Lantuéjoul-Thfoin, I.; Varignon, C. [CEA/DAM/DIF, F-91297 Arpajon (France)

    2017-02-01

    CARMEN is a 4π neutron detector filled with a gadolinium-loaded liquid scintillator built to measure neutron multiplicity distributions. It is used to study fission and (n,xn) reactions. In addition to neutron multiplicity measurements, CARMEN can be used to measure neutron energy spectra with the time-of-flight technique, thanks to the time properties of the prompt signal. The detector, detection technique and efficiency determination are presented in detail. Two examples are also presented: the measurement of {sup 252}Cf spontaneous fission neutron multiplicity probability distribution and the measurement of the neutron energy spectrum emitted by an Am-Be radioactive source.

  15. Appropriateness of pediatric hospitalization in a general hospital in Kuwait.

    Science.gov (United States)

    Shafik, Magdy H; Seoudi, Tarek M M; Raway, Tarek S; Al Harbash, Nowair Z; Ahmad, Meshal M A; Al Mutairi, Hanan F

    2012-01-01

    To determine the rate of inappropriate pediatric admissions using the Pediatric Appropriateness Evaluation Protocol (PAEP) and to examine variables associated with inappropriateness of admissions. A prospective study was conducted in the Department of Pediatrics, Farwania General Hospital, Kuwait, to examine successive admissions for appropriateness of admission as well as several sociodemographic characteristics over a 5-month period (August 2010 to December 2010). A total of 1,022 admissions were included. Of the 1,022 admissions, 416 (40.7%) were considered inappropriate. Factors associated with a higher rate of inappropriate admission included older age of patients and self-referral. The rate of inappropriate hospitalization of children was high in Farwania Hospital, Kuwait, probably due to the relatively free health care services, parental preference for hospital care, easy access to hospital services, and insufficient education about the child's condition. Copyright © 2012 S. Karger AG, Basel.

  16. Perspectiva sobre una Personalidad Senera: Carmen Fischer Ramirez (Perspective on a Singular Personality: Carmen Fischer Ramirez).

    Science.gov (United States)

    Quezeda, Dina Alarcon

    1992-01-01

    Traces the career of Carmen Fischer Ramirez, focusing on her work in improving early childhood education in Chile. Reviews her university career, work with the World Organization for Early Childhood Education, and major publications. (AC)

  17. Carmen, me jumaldame sind! / Tarmo Vahter

    Index Scriptorium Estoniae

    Vahter, Tarmo, 1970-

    2000-01-01

    1999. a. märtsis tegevust alustanud, arvutispetsialist Alwyn Greeri loodud Carmen Kassi koduleheküljest internetis (www.versailles.net/ck/index.htm). C. Kassi interneti külalisteraamatust leitud meiliaadressidel tehtud järelepärimisest.

  18. carmen covito, writing, literature and technology

    African Journals Online (AJOL)

    User

    Sommario. L'Internet cambia l'idea del libro e pone allo scrittore nuovi orizzonti di lettori prima impensabili. Carmen Covito è fra i primi scrittori italiani ad avere un proprio sito web. Le sue varie iniziative in internet hanno destato l'attenzione sia di critici culturali e letterari sia del grande pubblico. Tramite l'analisi di.

  19. Offensive language in the general hospital.

    Science.gov (United States)

    Zimmerman, Daniel J; Stern, Theodore A

    2010-01-01

    Offensive language (spoken by medical staff and by patients and their families) is often heard in the general hospital, but its manifestations and clinical implications have not been previously examined. The authors sought to facilitate an understanding of the effects and treatment of offensive utterances and their downstream consequences. The authors present a sampling of clinical vignettes that illustrate a variety of examples of hospital-based events in which offensive language was used and discuss differential diagnoses and management strategies. Swearing can also be used as a psychological tool in the service of helping. Swearing may provide a channel of catharsis for aggressive drives and affects that have been building in either the doctor or the patient. Placing offensive behaviors, for example, use of profane language, in a biopsychosocial context can facilitate an understanding of the causes, effects, and treatment of these events.

  20. CARMENES instrument control system and operational scheduler

    Science.gov (United States)

    Garcia-Piquer, Alvaro; Guàrdia, Josep; Colomé, Josep; Ribas, Ignasi; Gesa, Lluis; Morales, Juan Carlos; Pérez-Calpena, Ana; Seifert, Walter; Quirrenbach, Andreas; Amado, Pedro J.; Caballero, José A.; Reiners, Ansgar

    2014-07-01

    The main goal of the CARMENES instrument is to perform high-accuracy measurements of stellar radial velocities (1m/s) with long-term stability. CARMENES will be installed in 2015 at the 3.5 m telescope in the Calar Alto Observatory (Spain) and it will be equipped with two spectrographs covering from the visible to the near-infrared. It will make use of its near-IR capabilities to observe late-type stars, whose peak of the spectral energy distribution falls in the relevant wavelength interval. The technology needed to develop this instrument represents a challenge at all levels. We present two software packages that play a key role in the control layer for an efficient operation of the instrument: the Instrument Control System (ICS) and the Operational Scheduler. The coordination and management of CARMENES is handled by the ICS, which is responsible for carrying out the operations of the different subsystems providing a tool to operate the instrument in an integrated manner from low to high user interaction level. The ICS interacts with the following subsystems: the near-IR and visible channels, composed by the detectors and exposure meters; the calibration units; the environment sensors; the front-end electronics; the acquisition and guiding module; the interfaces with telescope and dome; and, finally, the software subsystems for operational scheduling of tasks, data processing, and data archiving. We describe the ICS software design, which implements the CARMENES operational design and is planned to be integrated in the instrument by the end of 2014. The CARMENES operational scheduler is the second key element in the control layer described in this contribution. It is the main actor in the translation of the survey strategy into a detailed schedule for the achievement of the optimization goals. The scheduler is based on Artificial Intelligence techniques and computes the survey planning by combining the static constraints that are known a priori (i.e., target

  1. Hernia Surgery in Nyeri Provincial General Hospital, Kenya: Our 6 ...

    African Journals Online (AJOL)

    The average length of hospital stay was 3 days. Of the inguinal ... on hernia disease with reference to prevalence, pattern and management at a provincial general hospital in Kenya. Methods. After obtaining permission from the hospital administration, we .... financial constraint on hospitals, length of hospital stay and enable ...

  2. Book Review: Review Manual for Massachusetts General Hospital ...

    African Journals Online (AJOL)

    Abstract. Book Title: Review Manual for Massachusetts General Hospital Handbook of. General Hospital Psychiatry. 5th ed. Book Author: Theodore A. Stern. Pp 121. Philadelphia: Elsevier Mosby. 2004. ISBN 0-323-02768-7.

  3. Confidencias de artistas, de Carmen de Burgos

    Directory of Open Access Journals (Sweden)

    García Templado, José

    2010-06-01

    Full Text Available Confidencias de Artistas (Artists’ Confidences is a compendium of interviews made to successful stars of the stage. These interviews support or cause the ideological purposes that inspired Colombine’s particular feminism. The crisis at the end of the century, the enlightenment, the Constitutions, the Regenerationism and the new philosophic and literary trends enlighten her path and gave her a working method. The results highlighted the infringement or the ratification of the modern women rights that Carmen de Burgos collected in her essay on the same subject.Confidencias de Artistas reúne las entrevistas a estrellas de la escena que lograron el éxito. Esas entrevistas apoyan o motivan los objetivos ideológicos que inspiraron a Colombine su peculiar feminismo. La crisis de fin de siglo, la Ilustración, las Constituciones, el Regeneracionismo, las nuevas corrientes filosóficas y literarias, iluminaron su camino y le proporcionaron un método de trabajo. Los resultados ponen de relieve la conculcación o ratificación de los derechos de la mujer moderna que Carmen de Burgos recoge en su ensayo sobre el tema.

  4. DIABETES MANAGEMENT IN CELJE GENERAL HOSPITAL

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    Gregor Veninšek

    2001-12-01

    Full Text Available Background. The prevalence of diabetes is growing. Development of chronic complications of diabetes can be prevented by intensive treatment. It is of utmost importance to know characteristics of treated population to follow it up and adjust measures. We conducted an evaluation of population of diabetic patients treated in Celje General Hospital.Methods. We studied 156 outpatients treated in Celje General Hospital in January 2000. We collected data on basic anthropologic characteristics, data on type, duration and treatment modality of diabetes, metabolic parameters, risk factors for developement and presence of chronic complications. We specially presented a subgroup of diabetics treated in our outpatient service less than two years.Results. The mean age of patients was 58 years. They have been treated for diabetes in average for 10 years. 94% of patients were type 2. 3% of patients had secondary diabetes and 3% had type 1 diabetes. 74% were overweight. 37% of patients had HbA1c equal or below 7.5%, 45% of patients had LDL equal or below 3.0 mmol/l, and 52% of patients had blood pressure equal or below 140/90 mmHg. Retinopathy was present in 34%, renal failure in 10% and neuropathy in 35%. Amputation on a lower limb had had 1% of patients. 56% of patients were treated only with oral hypoglycaemic drugs, 6% diet only and 38% of patients were treated with insulin either alone or in combination with oral hypoglycaemic drugs. In diabetics that we treat less than two years at least one late complication was present in 73%.Conclusions. Diabetics are referred to our service when complications of treatment of diabetes or chronic complications of diabetes are present. In the beginning of year 2000 we achieved acceptable value of HbA1c in 37% of patients, that of LDL and blood pressure in 45% and 52%, respectively. Prevalence of chronic complications of diabetes was comparable with the data from the literature.

  5. Carmen Kass õnnelik ja Aasta modell / Mari Klein

    Index Scriptorium Estoniae

    Klein, Mari

    2000-01-01

    Eesti Aasta modelliks valiti Carmen Kass. Aasta Disainer - Tiina Talumees ; Aasta Noor Disainer - Aldo Järvsoo; Eesti Stiilseim Naine - Elle Kull; Eesti Stiilseim Mees - Mart Sander; Trenditeadlikum Mees - Hannes Võrno; Trenditeadlikum Naine - Eda-Ines Etti

  6. EPIDURAL LABOUR ANALGESIA IN IZOLA GENERAL HOSPITAL

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    Sabina Verem

    2018-02-01

    Full Text Available Background. The study presents the experience with epidural analgesia (EPA for pain relief in Izola General Hospital from 2003 to 2006, the differences of labour between epidural analgesia and without it and the parturients’ satisfaction. Methods. A retrospective observational study was performed. Data were compared between 214 parturients with EPA matched by 214 parturients without. The control parturient was the equiipara with a term birth and the cephalic presentation of fetus that delivered just before the parturient of the EPA group. Maternal age, labor length, rate of oxitocin use, instrumental deliveries and cesarean sections, Apgar scores and birthweights were compared. The questionnaire was used to estimate the pain in 62 parturients. Results. In GH Izola in 214 parturients (10 % EPA was applied for labour pain relief in the period from July 2003 till December 2006. In the EPA group there was a statistically significance compared with the control group: higher parturients’ mean age (30.5 vs 28.7 y.o.; p < 0.0005, longer labour length (278 vs 222 min; p < 0.0005, higher oxitocin use rate (93.4 % vs 72.9 %; p < 0.0001 and higher instrumental delivery rate (vacuum extraction 14 % vs 1.9 %; p < 0.0001. The cesarean section rates were equal in both groups. Despite the higher instrumental delivery rate and the longer labour length in the EPA group there were no worse perinatal outcomes, neither was statisticaly significant difference in Apgar scores compared with the control group. The mean intensity of pain was highest before the EPA application (VAS 7, lowest during the transition stage (VAS 1.5 and some higher during the second phase (VAS 2.7. Most of parturients in the EPA group were satisfied; 92 % of them evaluated the EPA as good or very good. Conclusions. EPA is a very effective method for pain control during labor. The parturients’ satisfaction with this pain control method is appropriate. Despite the higher instrumental

  7. Pediatric Burns at The Rift Valley Provincial General Hospital ...

    African Journals Online (AJOL)

    Aim To determine the etiology and outcome of pediatric burns (0-12 years). Design A retrospective study of burn victims hospitalized at the Rift Valley Provincial General Hospital, Nakuru, Kenya from April 2004 to March 2007. Method Charts of all children hospitalized for burn injury were reviewed for patient demographics, ...

  8. Diva Carmen Luisa Letelier Valdés, contralto

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    Valene Georges

    2012-06-01

    Full Text Available Carmen Luisa Letelier Valdés y Valene Georges son fundadoras del célebre Ensemble Bartok Chile. En este trabajo Valene Georges presenta un recuerdo tanto de los titánicos logros que ambas han alcanzado con el Ensemble Bartok Chile en el país como en el extranjero, como de la estrecha amistad que las ha unido durante más de treinta años.Both Carmen Luisa Letelier-Valdés and Valene Georgesfounded the renowned Ensemble Bartok Chile. In this article Valene Georges presents a retrospective view ofthe titanic achievements that both have shared with this ensemble in Chile and abroad. Besides, the author presents a personal view ofher close friendship with Carmen Luisa during more than thirty years.

  9. Trabeculectomy outcomes in a Malaysian general hospital.

    Science.gov (United States)

    Hooi, S T; Hooi, S H

    2003-10-01

    A retrospective study was conducted at the Hospital Sultanah Aminah Johor Bahru to determine the outcome of trabeculectomy surgeries over a period of 4 years. One hundred and two eyes were followed up to a maximum of 63 months (mean 34.2 months). The 2-year survival rates for plain trabeculectomies, 5-Fluorouracil augmented trabeculectomies and Mitomycin-C augmented trabeculectomies were 52.9%, 27.3% and 60.5% respectively. The commonest complications noted were cataract formation (25%) and hyphaema (11%). Mitomycin-C induced complications were rarely seen. At last follow-up, 54% of eyes had intraocular pressures below 21 mmHg without medication, while 34% of eyes had intraocular pressures below 21 mmHg with medication. Vitreous at the trabeculectomy site was a statistically significant predictor of operative failure.

  10. The Best of Intentions. Interior Architecture: Massachusetts General Hospital

    Science.gov (United States)

    Ryder, Sharon Lee

    1974-01-01

    The Massachusetts General Hospital/Surgical and Special Services study, an information processing system for redesigning an outmoded existing hospital, structured information into small-scale elements that could be analyzed, reassembled into different solutions, and the solution selected that best accommodates all of the complex requirements. (MF)

  11. Hip osteoarthritis in Douala General Hospital: Clinical, radiological ...

    African Journals Online (AJOL)

    Objectives: To describe the epidemiological, clinical and radiological profile of hip OA, and also treatment options offered to patients presenting with this condition at the Douala General Hospital, Cameroon. Methods: After prior ethical clearance, a hospital-based cross sectional descriptive study was carried out, including ...

  12. LIGASURE (PRECISION HAEMORROIDECTOMY AT GOVT. GENERAL HOSPITAL

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    Anand

    2015-09-01

    Full Text Available BACKGROUND : Haemorrhoids is a common problem throughout the world. Many procedures are available for management of grade II and grade III hemorrhoids. The main postoperative complications associated with any of these procedures are pain and bleeding per rectum and pro longed healing time. Liga Surel TM haemorroidectomy was evaluated in this study for post - operative complications and symptomatic relief. METHODS: We analyzed 50 patients of hemorrhoids of grade II, III and IV who underwent Ligasure Precise haemorroidectomy by a classical Milligan - Morgan technique. The outcome factors analyzed were total operative time, blood loss, post - operative pain on visual analogue scale, any other complication and days of hospital stay. RESULTS: Of all the 50 patients, the operative ti me was less than 10 minutes in 27 patients (54% and the blood loss, as was measured by number of soaked gauze pieces only one gauze piece was soaked in 31 patients (62%. The Average Post - operative pain score measured on Visual Analogue Scale (VAS at 12, 24 & 48 hours were 6.54, 4.52 and 3.12 respectively. In all patients postoperative period and follow up was uneventful except for one patient who developed transient flatus incontinence. With physiotherapy and dietary management this problem resolved ther eafter. CONCLUSIONS: Liga Sure Hemarrhoidectomy is a safe, Technically easy and fast modality of treatment for 2 nd , 3 rd & 4 th degree of hemorrhoids whether single or multiple, requiring very less operating ti me, with no major post - operative complications an d early return to day to day activities

  13. Analysis of incidents notified in a general hospital

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    Mirela Lopes de Figueiredo

    Full Text Available ABSTRACT Objective: To evaluate the incidents spontaneously notified in a general hospital in Minas Gerais. Method: Retrospective, descriptive, quantitative study performed at a general hospital in Montes Claros - Minas Gerais State. The sample comprised 1,316 incidents reported from 2011 to 2014. The data were submitted to descriptive statistical analysis using Statistical Package for the Social Sciences version 18.0. Results: The prevalence of incidents was 33.8 per 1,000 hospitalizations, with an increase during the investigation period and higher frequency in hospitalization units, emergency room and surgical center. These occurred mostly with adult clients and relative to the medication supply chain. The main causes were noncompliance with routines/protocols, necessitating changes in routines and training. Conclusion: There was a considerable prevalence of incidents and increase in notifications during the period investigated, which requires the attention of managers and hospital staff. Nevertheless, we observed development of the patient safety culture.

  14. Supermodell Carmen Kass osaleb Eestis filmivõtetel / Risto Berendson

    Index Scriptorium Estoniae

    Berendson, Risto, 1975-

    2003-01-01

    Produtsent Kristian Taska uue mängufilmi "Täna öösel me ei maga" võtted algasid 28. juunil Tallinna vanalinnas. Lavastab Ilmar Taska, operaatoriks on Istvan Borbas, peaosades Carmen Kass, Peter Franzen, Maria Avdjushko, Priit Võigemast

  15. Provision of general paediatric surgical services in a regional hospital.

    LENUS (Irish Health Repository)

    Zgraj, O

    2012-01-31

    BACKGROUND: In Ireland, specialist paediatric surgery is carried out in paediatric hospitals in Dublin. General surgeons\\/consultants in other surgical specialities provide paediatric surgical care in regional centres. There has been a failure to train general surgeons with paediatric skills to replace these surgeons upon retirement. AIM: To assess paediatric surgical workload in one regional centre to focus the debate regarding the future provision of general paediatric surgery in Ireland. METHODS: Hospital in-patient enquiry (HIPE) system was used to identify total number of paediatric surgical admissions and procedures. Cases assessed requiring hospital transfer. RESULTS: Of 17,478 surgical patients treated, 2,584 (14.8%) were under 14 years. A total of 2,154 procedures were performed. CONCLUSION: Regional centres without dedicated paediatric surgeons deliver care to large numbers of paediatric patients. The demand for care highlights the need for formal paediatric services\\/appropriate surgical training for general surgical trainees.

  16. Primary prevention in psychiatry in general hospitals in South Asia

    Science.gov (United States)

    Sood, Mamta; Chadda, Rakesh Kumar; Kallivayalil, Roy Abraham

    2017-01-01

    The focus of primary prevention is on reducing the disease incidence. Primary prevention in mental health has been given minimal priority in low-resource settings with no significant investments. General hospitals are one of the main providers of mental health services in South Asia. This paper focuses on primary prevention activities, which can be undertaken in a general hospital in South Asia with abysmally low-mental health resources. For implementing primary prevention in psychiatry, a general hospital may be conceptualized as a population unit, located in a well-populated area with easy accessibility where different kinds of communities, for example, students and resident doctors, consultants, patients and their caregivers, and paramedical, nursing, administrative and other supportive staff, coexist and have varied functions. All the functional components of the general hospital psychiatric units (GHPUs) offer scope for introducing primary preventive psychiatry services. Psychiatrists in GHPUs can lead efforts for primary prevention in mental health in the hospital by employing strategies in the framework of universal, selective, and indicated prevention. The preventive strategies could be targeted at the patients visiting the hospital for various health services and their caregivers, employees, and the trainees. Similar principles can be employed in teaching and training. PMID:29497199

  17. General Surgery Programs in Small Rural New York State Hospitals: A Pilot Survey of Hospital Administrators

    Science.gov (United States)

    Zuckerman, Randall; Doty, Brit; Gold, Michael; Bordley, James; Dietz, Patrick; Jenkins, Paul; Heneghan, Steven

    2006-01-01

    Context: Hospitals play a central role in small rural communities and are frequently one of the major contributors to the local economy. Surgical services often account for a substantial proportion of hospital revenues. The current shortage of general surgeons practicing in rural communities may further threaten the financial viability of rural…

  18. Hospital costs associated with smoking in veterans undergoing general surgery.

    Science.gov (United States)

    Kamath, Aparna S; Vaughan Sarrazin, Mary; Vander Weg, Mark W; Cai, Xueya; Cullen, Joseph; Katz, David A

    2012-06-01

    Approximately 30% of patients undergoing elective general surgery smoke cigarettes. The association between smoking status and hospital costs in general surgery patients is unknown. The objectives of this study were to compare total inpatient costs in current smokers, former smokers, and never smokers undergoing general surgical procedures in Veterans Affairs (VA) hospitals; and to determine whether the relationship between smoking and cost is mediated by postoperative complications. Patients undergoing general surgery during the period of October 1, 2005 to September 30, 2006 were identified in the VA Surgical Quality Improvement Program (VASQIP) data set. Inpatient costs were extracted from the VA Decision Support System (DSS). Relative surgical costs (incurred during index hospitalization and within 30 days of operation) for current and former smokers relative to never smokers, and possible mediators of the association between smoking status and cost were estimated using generalized linear regression models. Models were adjusted for preoperative and operative variables, accounting for clustering of costs at the hospital level. Of the 14,853 general surgical patients, 34% were current smokers, 39% were former smokers, and 27% were never smokers. After controlling for patient covariates, current smokers had significantly higher costs compared with never smokers: relative cost was 1.04 (95% Cl 1.00 to 1.07; p = 0.04); relative costs for former smokers did not differ significantly from those of never smokers: 1.02 (95% Cl 0.99 to 1.06; p = 0.14). The relationship between smoking and hospital costs for current smokers was partially mediated by postoperative respiratory complications. These findings complement emerging evidence recommending effective smoking cessation programs in general surgical patients and provide an estimate of the potential savings that could be accrued during the preoperative period. Published by Elsevier Inc.

  19. History of Cardiovascular Surgery at Toronto General Hospital.

    Science.gov (United States)

    Lee, Myunghyun M; Alvarez, Juglans; Rao, Vivek

    2016-01-01

    The Division of Cardiovascular Surgery at Toronto General Hospital has enjoyed an enviable history of academic achievement and clinical success. The foundations of this success are innovation, creativity and excellence in patient care, which continue to influence the current members of the division. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Nurses' experiences of inpatients suicide in a general hospital

    African Journals Online (AJOL)

    Mirriam Matandela

    Nurses' experiences of inpatients suicide in a general hospital. *. Mirriam Matandela, Mokgadi C. Matlakala. *. Department of Health Studies, University of South Africa, PO BOX 392, UNISA, 0003, South Africa article info. Article history: Received 9 February 2015. Accepted 5 October 2015. Available online xxx. Keywords:.

  1. Pattern of Maternal Mortality in A General Hospital, South Western ...

    African Journals Online (AJOL)

    Type III delay, low literacy level and low utilization of antenatal services were associated with maternal death. There is need to put in place a sustainable, timely and sfae blood ... 5 that is reduction of maternal mortality in a general hospital set up. Keywords: Maternal Mortality, Audit, Haemorrhage, Induce abortion, illiteracy.

  2. Hospital Factors Associated With Care Discontinuity Following Emergency General Surgery.

    Science.gov (United States)

    Havens, Joaquim M; Olufajo, Olubode A; Tsai, Thomas C; Jiang, Wei; Columbus, Alexandra B; Nitzschke, Stephanie L; Cooper, Zara; Salim, Ali

    2017-03-01

    Although there is evidence that changes in clinicians during the continuum of care (care discontinuity) are associated with higher mortality and complications among surgical patients, little is known regarding the drivers of care discontinuity among emergency general surgery (EGS) patients. To identify hospital factors associated with care discontinuity among EGS patients. We performed a retrospective analysis of the 100% Medicare inpatient claims file, from January 1, 2008, to November 30, 2011, and matched patient details to hospital information in the 2011 American Hospital Association Annual Survey database. We selected patients aged 65 years and older who had the most common procedures associated with the previously defined American Association for the Surgery of Trauma EGS diagnosis categories and survived to hospital discharge across the United States. The current analysis was conducted from February 1, 2016, to March 24, 2016. Care discontinuity defined as readmission within 30 days to nonindex hospitals. There were 109 443 EGS patients readmitted within 30 days of discharge and 20 396 (18.6%) were readmitted to nonindex hospitals. Of the readmitted patients, 61 340 (56%) were female. Care discontinuity was higher among patients who were male (19.5% vs 18.0%), those younger than 85 years old (19.0% vs 16.6%), and those who lived 12.8 km (8 miles) or more away from the index hospitals (23.7% vs 14.8%) (all P < .001). Care discontinuity was independently associated with mortality (adjusted odds ratio [aOR], 1.16; 95% CI, 1.08-1.25). Hospital factors associated with care discontinuity included bed size of 200 or more (aOR, 1.45; 95% CI, 1.36-1.54), safety-net status (aOR, 1.35; 95% CI, 1.27-1.43), and teaching status (aOR, 1.18; 95% CI, 1.09-1.28). Care discontinuity was significantly lower among designated trauma centers (aOR, 0.89; 95% CI, 0.83-0.94) and highest among hospitals in the Midwest (aOR, 1.15; 95% CI, 1.05-1.26). Nearly 1 in 5 older EGS

  3. [Audit of general hospitals and private surgical clinics in Israel].

    Science.gov (United States)

    Freund, Ruth; Dor, Michael; Lotan, Yoram; Haver, Eitan

    2007-12-01

    Supervision and inspection of medical facilities are among the responsibilities of the Ministry of Health (MOH) anchored in the "Public Health Act 1940". In order to implement the law, the General Medical Division of the MOH began the process of auditing hospitals and private surgical clinics prior to considering the reissue of their license. The audit aimed to implement the law, activate supervision on general hospitals and private surgical clinics, provide feed-back to the audited institution and upgrade quality assurance, regulate medical activities according to the activities elaborated in the license and recommend the license renewal. Prior to the audits, 20 areas of activity were chosen for inspection. For each activity a check list was developed as a tool for inspection. Each area was inspected during a 4-5 hour visit by a MOH expert, accompanied by the local service manager in the institution under inspection. A comprehensive report, summarizing the findings was sent to the medical institute, requesting correction in those areas where improvements were needed. Recommendation for license renewal was sent to the Director of Licensing Division Ministry of Health. Between June 2003 and July 2006, 91 structured audits took place. A total of 47 general hospitals and 24 private surgical clinics were visited at least once. Most general hospitals were found abiding, functioning according to the required standards and eligible for license renewal. Licenses of institutions that complied with the standards determined by the audit teams, were renewed. Two private hospitals in central Israel, that were given an overall poor evaluation, were issued with a temporary license and subsequently re-audited 4 times over the next two years. Generally, the standards in private surgical clinics were lower than those found in general public hospitals. In one clinic the license was not renewed, and in another an order was issued to cease surgical procedures requiring general

  4. Martin Luther King, Jr., General Hospital and community involvement.

    Science.gov (United States)

    Humphrey, M M

    1973-07-01

    Community involvement is not just one facet of the new Martin Luther King, Jr., General Hospital's existence. It is the mainstream from which all other activities flow. In addition to meeting the conventional needs of a conventional hospital staff with the core collection of texts and journals, this library goes one step further. It acts as a resource for its community health workers, dietitians, and nurses in their various outreach programs. It serves as a stimulus for the high school or community college student who may be curious about a health career. It also finds time to provide reading material for its patients.

  5. GENERAL HOSPITAL MARIBOR FROM ITS FOUNDATION TILL WORLD WAR II

    Directory of Open Access Journals (Sweden)

    Gregor Pivec

    2004-04-01

    Full Text Available Author describes the history of General Hospital Maribor from its foundation (1799 to the beginning of World War II. In 1799 the magistrate of the town Maribor issued a memorandum regarding establishment of a town hospital in the renovated building of the town hospice, providing space for 24 patients. The work of the hospital was carried out in the former hospice building until 1855. 26 beds were added in the period between its establishment and eventual relocation. The last two decades of the hospital’s operation at the original location were marked by the assiduous work of the town’s physicist, Dr. Anton Kuker. In the first half of the 19th century, the population of Maribor rapidly grew as a consequence of the construction of the Southern Railway. The city authorities therefore purchased the Prosenjak family villa in the Magdalena suburbs and relocated the hospital to it in 1855, providing 28 rooms for 110 patients. For a whole century, the care of patients was taken over by the Daughters of Charity of Saint Vincent de Paul. The hospital was soon admitting over 1000 patients a year; the most common complaints being pulmonary catarrh, gastritis and fever. In 1872, when the Master of Surgery, Feliks Ferk, joined the hospital, the internal, medical, and the »external« surgical departments were formed. Although medical studies were not easily accessible, there was a number of Slovene physicians working in the hospital and the town in that period. In the last decades of the 19th century, the hospital was often renovated and enlarged. The infrastructure (telephone, water supply system, heating, lighting had also been modernized by World War I. In 1914, the first X-ray apparatus was purchased. Between the wars, the hospital’s development was stepped up by the recruitment of the Slovene physicians Ivan Matko, Mirko Černič, Janko Dernovšek and Hugon Robič. The initial external and medical departments split into several departments

  6. First 101 Robotic General Surgery Cases in a Community Hospital.

    Science.gov (United States)

    Oviedo, Rodolfo J; Robertson, Jarrod C; Alrajhi, Sharifah

    2016-01-01

    The general surgeon's robotic learning curve may improve if the experience is classified into categories based on the complexity of the procedures in a small community hospital. The intraoperative time should decrease and the incidence of complications should be comparable to conventional laparoscopy. The learning curve of a single robotic general surgeon in a small community hospital using the da Vinci S platform was analyzed. Measured parameters were operative time, console time, conversion rates, complications, surgical site infections (SSIs), surgical site occurrences (SSOs), length of stay, and patient demographics. Between March 2014 and August 2015, 101 robotic general surgery cases were performed by a single surgeon in a 266-bed community hospital, including laparoscopic cholecystectomies, inguinal hernia repairs; ventral, incisional, and umbilical hernia repairs; and colorectal, foregut, bariatric, and miscellaneous procedures. Ninety-nine of the cases were completed robotically. Seven patients were readmitted within 30 days. There were 8 complications (7.92%). There were no mortalities and all complications were resolved with good outcomes. The mean operative time was 233.0 minutes. The mean console operative time was 117.6 minutes. A robotic general surgery program can be safely implemented in a small community hospital with extensive training of the surgical team through basic robotic skills courses as well as supplemental educational experiences. Although the use of the robotic platform in general surgery could be limited to complex procedures such as foregut and colorectal surgery, it can also be safely used in a large variety of operations with results similar to those of conventional laparoscopy.

  7. Evaluation of a radioisotope service in a general hospital

    International Nuclear Information System (INIS)

    Mateil, P.-Y.

    1978-12-01

    The value of radioisotopes in medicine has become increasingly apparent over the last few years. Nuclear medicine however recent, has nevertheless reached adult hood and doctors appreciate its substantial contribution in the field of diagnosis especially. So far nuclear medicine has been confined to University Hospital Centres, mainly for legal reasons. However the considerable help offered by this discipline is now taken for granted in the medical world and the wholly experimental stage is long past. While this aspect of nuclar medicine still exists, and is still dealt with by the services of University Hospital Centres, radioisotopes are now used to a large extend and on a day-to-day basis in pathology. Owing to pressure of work it is difficult for UH Centres to meet all request for examinations, so would the presence of nuclear medicine Service be justified in general Hospitals. The existence of one such service at the Bayonne HC might help to answer this question. For this reason the activity of the Bayonne HC Nuclear Medicine Service during its first year of practice is examined here. For a better understanding of the position this report first presents the Bayonne Hospital and the place occupied by a nuclear Medicine service in such an establishment. The activity of this service during its first year is then studied and the situation weighed up generally [fr

  8. [The practice of the mental health in the general hospital].

    Science.gov (United States)

    Kuroki, Nobuo

    2012-01-01

    On December 2, 2011 a new reform bill concerning the Labor Safety and Hygiene law was presented to parliament. The bill states that all companies and businesses regardless of size are obliged to have all employees take a stress test once a year in addition to the regular health check. In September 2010 the employees fo Toho University Sakura Hospital were given this new stress. The test included categories for occupation and the various departments in the hospital. There were 40 employees found to test high for stress and to have depressive tendencies. We interviewed about 16 of these employees. One employee started to receive medicine to help reduce the stress and 4 employees received counseling only. The other 11 employees did not need to receive counseling or medicine. From April 2005 to September 2011, we conducted another study. The subjects this time were 92 employees of the hospital who have received treatment at other facilities for mental problems from occupational physicians. We categorized the subjects by sex, age occupation, length of time employed at the hospital, department and period of time from the onset of symptoms to the time they sought treatment. In this paper I will present my findings and suggestions for improving mental health care for employees of general hospital throughout Japan.

  9. Terapia ocupacional en un hospital general de pacientes agudos = Occupational therapy in a general hospital for acute pacients

    Directory of Open Access Journals (Sweden)

    Ocello, M. G

    2006-09-01

    Full Text Available RESUMEN Desde su creación, el Hospital Provincial “Dr. José María Cullen” posee la característica de ser un hospital de emergencias, sostenido por la Sociedad de Beneficencia y la Hermanas de la Caridad.Su funcionamiento responde a un Modelo Clínico-Asistencial, lo cual influye en la inserción de Terapia Ocupacional debiendo adaptar sus funciones a las características de la Institución.Los marcos de referencia teóricos y programas que se implementandeber ser acordes con las necesidades surgidas de un Hospital General de Agudos y de emergencias.En el Sector de Terapia Ocupacional se desarrolla la actividad docente cumpliendo con los requisitos reglamentados por el Ministerio de Salud de la Provincia de Santa Fe.ABSTRACT Ever since its start the Provincial Hospital “Dr. José María Cullen” is characterised for being an emergency hospital under the guidance of the Benfit Society of Hermanas de la Caridad.Its function responds to a Clinical Assistential Model, which influences the insertion of Occupational Therapy, adapting its functiones to the characteristics of the Institution as and when called for.The theoretical points of reference and programmes that are used must be in accordance with tehe necessities that appear in an Acute and Emergency General Hospital.In the Occupational Therapy Sector the teaching activity is developed as required by rules and regulations of the Ministry of Health for the Province of Santa Fe.

  10. General practice: the DREEM attachment? Comparing the educational environment of hospital and general practice placements.

    Science.gov (United States)

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

    2012-01-01

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

  11. A “novel site”: Carmen Covito, writing, literature and technology ...

    African Journals Online (AJOL)

    A “novel site”: Carmen Covito, writing, literature and technology. R Wilson. Abstract. L'Internet cambia l'idea del libro e pone allo scrittore nuovi orizzonti di lettori prima impensabili. Carmen Covito è fra i primi scrittori italiani ad avere un proprio sito web. Le sue varie iniziative in internet hanno destato l'attenzione sia di critici ...

  12. La técnica narrativa del espejo en Carmen de Icaza (1899-1979 y en Carmen Martín Gaite (1925-2000 / The mirror’s narrative technique in Carmen de Icaza (1899-1979 and in Carmen Martín Gaite (1925-2000

    Directory of Open Access Journals (Sweden)

    Carmen Fragero Guerra

    2013-01-01

    Full Text Available Resumen: El texto muestra algunas coincidencias entre las técnicas narrativas de la olvidada novelista Carmen de Icaza (1899-1979 y Carmen Martín Gaite (1925-2000. Analizamos en La fuente enterrada (1947 y en Yo, la reina (1950 de Carmen de Icaza el uso del espejo como una técnica narrativa para describir la apariencia física de los personajes y sus sentimientos interiores. Luego, estudiamos cómo estos dos aspectos han sido tomados por Carmen Martín Gaite y desarrollados en un modo más amplio e imaginativo. Abstract: The text shows some coincidences in narrative techniques between the forgotten novelist Carmen de Icaza (1899-1979 and Carmen Martín Gaite (1925-2000. We analyze in La Fuente Enterrada (1947 and in Yo, la Reina (1950 by Carmen de Icaza the use of mirror as a narrative technique intended to describe the characters’ appearance and their inner feelings. Then we study how this aspect has been taken by Carmen Martin Gaite and developed in a broader and more imaginative way.

  13. St Joseph's Unit, Bantry General Hospital, Bantry General Hospital, Bantry, Cork.

    LENUS (Irish Health Repository)

    Trompet, Stella

    2011-10-06

    Abstract Background The PHArmacogenetic study of Statins in the Elderly at risk (PHASE) is a genome wide association study in the PROspective Study of Pravastatin in the Elderly at risk for vascular disease (PROSPER) that investigates the genetic variation responsible for the individual variation in drug response to pravastatin. Statins lower LDL-cholesterol in general by 30%, however not in all subjects. Moreover, clinical response is highly variable and adverse effects occur in a minority of patients. In this report we first describe the rationale of the PROSPER\\/PHASE project and second show that the PROSPER\\/PHASE study can be used to study pharmacogenetics in the elderly. Methods The genome wide association study (GWAS) was conducted using the Illumina 660K-Quad beadchips following manufacturer\\'s instructions. After a stringent quality control 557,192 SNPs in 5,244 subjects were available for analysis. To maximize the availability of genetic data and coverage of the genome, imputation up to 2.5 million autosomal CEPH HapMap SNPs was performed with MACH imputation software. The GWAS for LDL-cholesterol is assessed with an additive linear regression model in PROBABEL software, adjusted for age, sex, and country of origin to account for population stratification. Results Forty-two SNPs reached the GWAS significant threshold of p = 5.0e-08 in 5 genomic loci (APOE\\/APOC1; LDLR; FADS2\\/FEN1; HMGCR; PSRC1\\/CELSR5). The top SNP (rs445925, chromosome 19) with a p-value of p = 2.8e-30 is located within the APOC1 gene and near the APOE gene. The second top SNP (rs6511720, chromosome 19) with a p-value of p = 5.22e-15 is located within the LDLR gene. All 5 genomic loci were previously associated with LDL-cholesterol levels, no novel loci were identified. Replication in WOSCOPS and CARE confirmed our results. Conclusion With the GWAS in the PROSPER\\/PHASE study we confirm the previously found genetic associations with LDL-cholesterol levels. With this proof

  14. Hospital Anxiety and Depression Scale (HADS: validation in a Greek general hospital sample

    Directory of Open Access Journals (Sweden)

    Patapis Paulos

    2008-03-01

    Full Text Available Abstract Background The Hospital Anxiety and Depression Scale (HADS has been used in several languages to assess anxiety and depression in general hospital patients with good results. Methods The HADS was administered to 521 participants (275 controls and 246 inpatients and outpatients of the Internal Medicine and Surgical Departments in 'Attikon' General Hospital in Athens. The Beck Depression Inventory (BDI and the State-Trait Anxiety Inventory (STAI were used as 'gold standards' for depression and anxiety respectively. Results The HADS presented high internal consistency; Cronbach's α cofficient was 0.884 (0.829 for anxiety and 0.840 for depression and stability (test-retest intraclass correlation coefficient 0.944. Factor analysis showed a two-factor structure. The HADS showed high concurrent validity; the correlations of the scale and its subscales with the BDI and the STAI were high (0.722 – 0.749. Conclusion The Greek version of HADS showed good psychometric properties and could serve as a useful tool for clinicians to assess anxiety and depression in general hospital patients.

  15. Optimising neuroimaging effectiveness in a district general hospital.

    Science.gov (United States)

    McCarron, M O; Wade, C; McCarron, P

    2014-01-01

    Diagnostic accuracy in neurology frequently depends on clinical assessment and neuroimaging interpretation. We assessed neuroimaging discrepancy rates in reported findings between general radiologists and neuroradiologists among patients from a district general hospital (DGH). A neuroradiologist's report was sought on selected DGH patients over 28 months. Pre-planned outcomes included comparisons of primary findings (main diagnosis or abnormality), secondary findings (differential diagnoses and incidental findings) and advice from neuroradiologists for further investigations. A total of 233 patients (119 men and 114 women), mean age 47.2 (SD 17.8) years were studied: 43 had a computed tomography (CT) brain scan only, 37 had CT and magnetic resonance imaging (MRI) scans and 153 had only MRI scans. Discrepancies in the primary diagnosis/abnormality were identified in 33 patients (14.2%). This included 7 of 43 patients (16.3%) who had a CT brain scan as their only neuroimaging. Secondary outcomes differed in 50 patients (21.5%). Neuroradiologists recommended further neuroimaging for 29 patients (12.4%). The most common discrepancies in the primary diagnosis/abnormality were misinterpreting normal for hippocampal sclerosis and missed posterior fossa lesions. There was no evidence of temporal changes in discrepancy rates. Selecting CT and MR neuroimaging studies from general hospitals for reviewing by neuroradiologists is an important and effective way of optimising management of neurological patients.

  16. [Treatment with tuberculostatic drugs: compliance at a general hospital].

    Science.gov (United States)

    Polo Friz, H; Kremer, L; Acosta, H; Abdala, O; Canova, S; Rojo, S; Roca, G; Daín, A

    1997-01-01

    The purpose of this study was to assess the compliance with tuberculostatic drugs treatment in a public hospital from Córdoba City and to establish the causes of noncompliance. All the patients to which treatment with tuberculostatic drugs was indicated from January 1991 up to December 1994 were included. 45 patients were included: 18 females (40%) and 29 males. Sixteen (35.6%) did not complete the time of treatment indicated. Nine (56.3%) abandoned the treatment 2 months after having initiated it. In the group that did not complete the treatment there was a higher percentage of female patients (62.5%) than in the group that did complete it (27.6%), p = 0.02. There were not statistically significant differences in age, percentages of pulmonar and extrapulmonar tuberculosis and months of treatment indicated between both groups. Thirty-six percent of the patients who abandoned the treatment referred having interrupted it due to their own negligency, knowing the risk of such behavior; 36% suffered side effects and did not come back to hospital; 21% referred having consulted another physician who indicated to interrupt the treatment without performing other tests; and 7% misunderstood the indications. It is concluded that in a general hospital from Córdoba City, the percentage of patients who abandoned tuberculostatic treatment is high. In most cases the cause was related to failures in the conduct of patients, physicians or both.

  17. Characterizing and predicting rates of delirium across general hospital settings.

    Science.gov (United States)

    McCoy, Thomas H; Hart, Kamber L; Perlis, Roy H

    2017-05-01

    To better understand variation in reported rates of delirium, this study characterized delirium occurrence rate by department of service and primary admitting diagnosis. Nine consecutive years (2005-2013) of general hospital admissions (N=831,348) were identified across two academic medical centers using electronic health records. The primary admitting diagnosis and the treating clinical department were used to calculate occurrence rates of a previously published delirium definition composed of billing codes and natural language processing of discharge summaries. Delirium rates varied significantly across both admitting diagnosis group (X 2 10 =12786, pdelirium (86/109764; 0.08%) and neurological admissions the greatest (2851/25450; 11.2%). Although the rate of delirium varied across the two hospitals the relative rates within departments (r=0.96, pdelirium varies significantly across admitting diagnosis and hospital department. Both admitting diagnosis and department of care are even stronger predictors of risk than age; as such, simple risk stratification may offer avenues for targeted prevention and treatment efforts. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Cambios morfológicos costeros en lsla del Carmen. Campeche, por el paso del huracán "Roxanne"

    Directory of Open Access Journals (Sweden)

    José Luis Palacio-Prieto

    1999-08-01

    Full Text Available Based on the interpretation of vertical video images taken from an helicopter, a geornorphological survey of the coast of Isla del Carmen, Campeche, was made in connection with hurricane "Roxanne" Geomorphological processes and derived coastal fandforms are identified, which indicate a general receding trend of the coastline during the event, although some local accumulative features are recognized. The most affected areas correspond to ancient channels, today closed, reactivated during extraordinary storm events. Some conclusions area also drawn in relation to the use of video images as a tool for a rapid assessment and detection of damages to infrastructure.

  19. The complete integration of MissionLab and CARMEN

    Directory of Open Access Journals (Sweden)

    FJ Serrano Rodriguez

    2017-05-01

    Full Text Available Nowadays, a major challenge in the development of advanced robotic systems is the creation of complex missions for groups of robots, with two main restrictions: complex programming activities not needed and the mission configuration time should be short (e.g. Urban Search And Rescue. With these ideas in mind, we analysed several robotic development environments, such as Robot Operating System (ROS, Open Robot Control Software (OROCOS, MissionLab, Carnegie Mellon Robot Navigation Toolkit (CARMEN and Player/Stage, which are helpful when creating autonomous robots. MissionLab provides high-level features (automatic mission creation, code generation and a graphical mission editor that are unavailable in other significant robotic development environments. It has however some weaknesses regarding its map-based capabilities. Creating, managing and taking advantage of maps for localization and navigation tasks are among CARMEN’s most significant features. This fact makes the integration of MissionLab with CARMEN both possible and interesting. This article describes the resulting robotic development environment, which makes it possible to work with several robots, and makes use of their map-based navigation capabilities. It will be shown that the proposed platform solves the proposed goal, that is, it simplifies the programmer’s job when developing control software for robot teams, and it further facilitates multi-robot deployment task in mission-critical situations.

  20. Alcohol misuse in the general hospital: some hard facts.

    LENUS (Irish Health Repository)

    Bradshaw, P

    2012-02-03

    AIMS: To examine (1) the prevalence of alcohol use disorders in adult general hospital inpatients; (2) the accuracy of documentation in relation to alcohol use. METHODS: A total of 210 random patients were interviewed out of 1,448 consecutive new admissions to CUH over 7 days. Case notes were reviewed for 206 (98%). Alcohol consumption was assessed using the Fast Alcohol Screening Test (FAST) and weekly drinking diary. FAST-positive (and a random sample of FAST-negative) patients then had a standardized interview. RESULTS: A total of 82% admitted for drinking alcohol. Among them 22% were drinking in excess of guidelines, 9% had DSM-IV Alcohol Abuse and 7% dependence. The sensitivity and specificity of the FAST for detecting those drinking above guidelines were 89 and 94% and for detecting a DSM-IV diagnosis was 100 and 73%. The majority of case notes contained inadequate information about alcohol intake. CONCLUSION: Alcohol use disorders are common and often undetected in the general hospital setting.

  1. Financial management challenges for general hospital psychiatry 2001.

    Science.gov (United States)

    Goldberg, R J

    2001-01-01

    Psychiatry programs are facing significant business and financial challenges. This paper provides an overview of these management challenges in five areas: departmental, hospital, payment system, general finance, and policy. Psychiatric leaders will require skills in a variety of business management areas to ensure their program success. Many programs will need to develop new compensation models with more of an emphasis on revenue collection and overhead management. Programs which cannot master these areas are likely to go out of business. For academic programs, incentive systems must address not only clinical productivity, but academic and teaching output as well. General hospital programs will need to develop increased sophistication in differential cost accounting in order to be able to advocate for their patients and program in the current management climate. Clinical leaders will need the skills (ranging from actuarial to negotiations) to be at the table with contract development, since those decisions are inseparable from clinical care issues. Strategic planning needs to consider the value of improving integration with primary care, along with the ability to understand the advantages and disadvantages of risk-sharing models. Psychiatry leaders need to define and develop useful reports shared with clinical division leadership to track progress and identify problems and opportunities. Leaders should be responsible for a strategy for developing appropriate information system architecture and infrastructure. Finally, it is hoped that some leaders will emerge who can further our needs to address inequities in mental health fee schedules and parity issues which affect our program viability.

  2. Interoperability prototype between hospitals and general practitioners in Switzerland.

    Science.gov (United States)

    Alves, Bruno; Müller, Henning; Schumacher, Michael; Godel, David; Abu Khaled, Omar

    2010-01-01

    Interoperability in data exchange has the potential to improve the care processes and decrease costs of the health care system. Many countries have related eHealth initiatives in preparation or already implemented. In this area, Switzerland has yet to catch up. Its health system is fragmented, because of the federated nature of cantons. It is thus more difficult to coordinate efforts between the existing healthcare actors. In the Medicoordination project a pragmatic approach was selected: integrating several partners in healthcare on a regional scale in French speaking Switzerland. In parallel with the Swiss eHealth strategy, currently being elaborated by the Swiss confederation, particularly medium-sized hospitals and general practitioners were targeted in Medicoordination to implement concrete scenarios of information exchange between hospitals and general practitioners with a high added value. In this paper we focus our attention on a prototype implementation of one chosen scenario: the discharge summary. Although simple in concept, exchanging release letters shows small, hidden difficulties due to the multi-partner nature of the project. The added value of such a prototype is potentially high and it is now important to show that interoperability can work in practice.

  3. General surgical services at an urban teaching hospital in Mozambique.

    Science.gov (United States)

    Snyder, Elizabeth; Amado, Vanda; Jacobe, Mário; Sacks, Greg D; Bruzoni, Matias; Mapasse, Domingos; DeUgarte, Daniel A

    2015-10-01

    As surgery becomes incorporated into global health programs, it will be critical for clinicians to take into account already existing surgical care systems within low-income countries. To inform future efforts to expand the local system and systems in comparable regions of the developing world, we aimed to describe current patterns of surgical care at a major urban teaching hospital in Mozambique. We performed a retrospective review of all general surgery patients treated between August 2012 and August 2013 at the Hospital Central Maputo in Maputo, Mozambique. We reviewed emergency and elective surgical logbooks, inpatient discharge records, and death records to report case volume, disease etiology, and mortality. There were 1598 operations (910 emergency and 688 elective) and 2606 patient discharges during our study period. The most common emergent surgeries were for nontrauma laparotomy (22%) followed by all trauma procedures (18%), whereas the most common elective surgery was hernia repair (31%). The majority of lower extremity amputations were above knee (69%). The most common diagnostic categories for inpatients were infectious (31%), trauma (18%), hernia (12%), neoplasm (10%), and appendicitis (5%). The mortality rate was 5.6% (146 deaths), approximately half of which were related to sepsis. Our data demonstrate the general surgery caseload of a large, academic, urban training and referral center in Mozambique. We describe resource limitations that impact operative capacity, trauma care, and management of amputations and cancer. These findings highlight challenges that are applicable to a broad range of global surgery efforts. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Transcatheter arterial revascularization outcomes at vascular and general surgery teaching hospitals and nonteaching hospitals are comparable.

    Science.gov (United States)

    Bhamidipati, Castigliano M; LaPar, Damien J; Stukenborg, George J; Lutz, Charles J; Tracci, Margaret C; Cherry, Kenneth J; Upchurch, Gilbert R; Kern, John A

    2012-07-01

    Outcomes following transcatheter interventions at vascular and general surgery teaching hospitals (STH) are unknown. We examine whether surgery training programs influence clinically relevant outcomes after commonly performed endovascular procedures. Using an all-payer inpatient care database from 2008, we selected adults who underwent either endovascular carotid stenting, endografting of descending thoracic aortic aneurysm, endovascular abdominal aortic aneurysm repair, or peripheral arterial revascularization. Patients were stratified by procedures completed at Surgery Teaching (Participate in Accreditation Council for Graduate Medical Education [ACGME]-accredited vascular and general surgery programs), STH, or nonteaching hospitals (NTH). Hierarchical regression models assessed adverse outcomes and in-hospital mortality among groups. Of the 175,698 records, 44% of the patients were treated at STH, while 56% underwent procedures at NTH. The adjusted odds ratio of any complication or mortality at STH and NTH were similar. Transfers, weekend admissions, and nonelective cases were higher at STH (P STH treated fewer patients with more than three comorbidities compared with NTH (STH: 47% vs NTH: 53%; P STH. Following commonly performed transcatheter vascular procedures, and despite more transfers, weekend admissions, and nonelective procedures completed at STH, complications, and mortality were comparable across centers. Copyright © 2012 Society for Vascular Surgery. Published by Mosby, Inc. All rights reserved.

  5. \\'Nada\\', de Carmen Laforet: uma tradução

    OpenAIRE

    Estrella da Fonseca

    2006-01-01

    Nada é considerada a primeira referência de romance do realismo existencialista do pósguerra civil espanhol. Em 1944, mesmo ano de seu lançamento, obteve o reconhecimento por parte da crítica especializada, com a primeira edição do Prêmio Nadal de Literatura. Hoje, é objeto de estudo dos que se ocupam com sua crítica e parte obrigatória de qualquer antologia ou história da literatura espanhola do século XX. O objetivo desta dissertação é fazer uma tradução da obra Nada, de Carmen Laforet. Rel...

  6. Modelliagentuurid toodavad Carmen Kassile tasemel järglasi / Kerli Nõu

    Index Scriptorium Estoniae

    Nõu, Kerli

    2006-01-01

    Eestis tegutsevatest modelliagentuuridest Beatrice Mass Modelnet, Baltic Models OÜ ja Eesti Modelliagentuuri OÜ. Kommentaarid: Tasane algus kulisside taga, Edukad Eesti modellid (Annika Vohta), Eesti uus Carmen Kass (Claudia Meriküla)

  7. 42 CFR 412.370 - General provisions for hospitals located in Puerto Rico.

    Science.gov (United States)

    2010-10-01

    ... Prospective Payment System for Inpatient Hospital Capital Costs Special Rules for Puerto Rico Hospitals § 412.370 General provisions for hospitals located in Puerto Rico. Except as provided in § 412.374, hospitals located in Puerto Rico are subject to the rules in this subpart governing the prospective payment...

  8. CARMEN, a human super enhancer-associated long noncoding RNA controlling cardiac specification, differentiation and homeostasis.

    Science.gov (United States)

    Ounzain, Samir; Micheletti, Rudi; Arnan, Carme; Plaisance, Isabelle; Cecchi, Dario; Schroen, Blanche; Reverter, Ferran; Alexanian, Michael; Gonzales, Christine; Ng, Shi Yan; Bussotti, Giovanni; Pezzuto, Iole; Notredame, Cedric; Heymans, Stephane; Guigó, Roderic; Johnson, Rory; Pedrazzini, Thierry

    2015-12-01

    Long noncoding RNAs (lncRNAs) are emerging as important regulators of developmental pathways. However, their roles in human cardiac precursor cell (CPC) remain unexplored. To characterize the long noncoding transcriptome during human CPC cardiac differentiation, we profiled the lncRNA transcriptome in CPCs isolated from the human fetal heart and identified 570 lncRNAs that were modulated during cardiac differentiation. Many of these were associated with active cardiac enhancer and super enhancers (SE) with their expression being correlated with proximal cardiac genes. One of the most upregulated lncRNAs was a SE-associated lncRNA that was named CARMEN, (CAR)diac (M)esoderm (E)nhancer-associated (N)oncoding RNA. CARMEN exhibits RNA-dependent enhancing activity and is upstream of the cardiac mesoderm-specifying gene regulatory network. Interestingly, CARMEN interacts with SUZ12 and EZH2, two components of the polycomb repressive complex 2 (PRC2). We demonstrate that CARMEN knockdown inhibits cardiac specification and differentiation in cardiac precursor cells independently of MIR-143 and -145 expression, two microRNAs located proximal to the enhancer sequences. Importantly, CARMEN expression was activated during pathological remodeling in the mouse and human hearts, and was necessary for maintaining cardiac identity in differentiated cardiomyocytes. This study demonstrates therefore that CARMEN is a crucial regulator of cardiac cell differentiation and homeostasis. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. Risk factor for preterm labor in Haji Adam Malik General Hospital, Pirngadi General hospital and satellite hospitals in Medan from January 2014 to December 2016

    Science.gov (United States)

    Sukatendel, K.; Hasibuan, C. L.; Pasaribu, H. P.; Sihite, H.; Ardyansah, E.; Situmorang, M. F.

    2018-03-01

    In 2010, Indonesia was ranked fifth in the world for the number of premature birth. Prematurity is a multifactorial problem. Preterm Labor (PTL) can occur spontaneously without a clear cause. Preventing PTL, its associated risk factors must be recognized first. To analyze risk factors associated with the incidence of PTL. It is a cross sectional study using secondary data obtained from medical records in Haji Adam Malik general hospital, Pirngadi general hospital and satellite hospitals in Medan from January 2014 to December 2016. Data were analyzed using chi-square method and logistic regression test. 148 cases for each group of preterm labor and obtained term laborin this study. Using the logistic regression test, three factors with astrong association to the incidence of identifiedpreterm labor. Antenatal Care frequency (OR 2,326; CI 95%), leucorrhea (OR 6,291; 95%), and premature rupture of membrane (OR 9,755; CI 95%). In conclusion, antenatal care frequency, leucorrhea, and history of premature rupture of themembrane may increase the incidence of Preterm Labor (PTL).

  10. Prevalence of depression in a general hospital in Izhevsk, Russia.

    Science.gov (United States)

    Pakriev, Sergei; Kovalev, Juri; Mozhaev, Mikhail

    2009-11-01

    There are a lot of studies on depressive disorders in a general hospital done across the world, but no data from Russia on this subject was found in international psychiatric journals or MEDLINE. to determine the prevalence of depressive disorders in medical inpatients in Izhevsk, the capital of the Udmurt Republic, a region in Russia, and to identify associated factors. A sample of 323 adult medical inpatients was composed. The Russian version of the MINI 5.0.0 was used. The prevalence of lifetime and current depressive disorders was 30% and 20.7%, respectively. Depression was more common in women, widowed or divorced, retired or disabled, with low income and bad family relationships, and among respondents with a chronic somatic illness. Depression had a high comorbidity with organic mental and anxiety disorders. Only 40.3% of the individuals with depression had referred for psychiatric consultations, most of them being treated with fluvoxamine. Prevalence of depression was substantial but consistent with other studies. Taking into consideration associated factors, physicians can improve recognition and treatment of depression in medical inpatients.

  11. Profilaxia para tromboembolia venosa em um hospital geral Venous thromboembolism prophylaxis in a general hospital

    Directory of Open Access Journals (Sweden)

    Fernanda Fuzinatto

    2011-04-01

    Full Text Available OBJETIVO: Avaliar a prática de profilaxia para tromboembolia venosa (TEV em pacientes em um hospital geral. MÉTODOS: Estudo de coorte transversal conduzido no Hospital Nossa Senhora da Conceição, localizado na cidade de Porto Alegre (RS, com uma amostra constituída de pacientes internados selecionados randomicamente entre outubro de 2008 e fevereiro de 2009. Foram incluídos pacientes maiores de 18 anos e internados por mais de 48 h. Os critérios de exclusão foram pacientes em uso de anticoagulantes, história de doença tromboembólica, gestação e puerpério. A adequação da profilaxia foi avaliada seguindo as recomendações de um protocolo criado pela instituição e tendo como base principal a diretriz da American College of Chest Physician, oitava edição. RESULTADOS: Foram incluídos 262 pacientes com média de idade de 59,1 ± 16,6 anos. Os fatores de risco mais comuns foram imobilização (70,6%, infecção (44,3%, câncer (27,5%, obesidade (23,3% e cirurgia maior (14,1%. Na avaliação do nível de risco para TEV, 143 (54,6% e 117 pacientes (44,7%, respectivamente, foram classificados como de risco alto e moderado. No geral, 46,2% dos pacientes tiveram profilaxia adequada, assim como 25% dos pacientes com três ou mais fatores de risco e 18% dos pacientes com câncer, e houve diferenças estatisticamente significativas entre esses grupos quando comparados àqueles com menos de três fatores de risco e sem câncer (p OBJECTIVE: To evaluate the use of venous thromboembolism (VTE prophylaxis in a general hospital. METHODS: A cross-sectional cohort study at the Hospital Nossa Senhora da Conceição, located in the city of Porto Alegre, Brazil, involving a random sample of patients admitted between October of 2008 and February of 2009. We included patients over 18 years of age and hospitalized for more than 48 h. The exclusion criteria were anticoagulant use, pregnancy, puerperium, and a history of thromboembolic disease. The

  12. 42 CFR 412.22 - Excluded hospitals and hospital units: General rules.

    Science.gov (United States)

    2010-10-01

    ... from the governing body of the hospital occupying space in the same building or on the same campus. The hospital's governing body is not under the control of the hospital occupying space in the same building or... body is under the control of the State hospital with which it shares a building or a campus, or is...

  13. Vida de Carmen Caamaño Díaz : una voz del exilio interior

    Directory of Open Access Journals (Sweden)

    Mercedes Montero Caldera

    1999-01-01

    Full Text Available Este artículo recoge el testimonio oral de Carmen Caamaño Díaz (Madrid, 1911, quien a través de su memoria hace un recorrido autobiográfico en el que manifiesta la evolución de un compromiso ideológico que la convertiría en sujeto activo del exilio interior durante el régimen franquista. En su etapa universitaria, Carmen fue miembro de la junta Directiva de la FUE (Federación Española de Enseñantes y Secretaria General de la UFEH (Unión Federal de estudiantes Hispanoamericanos desde 1930 a 1931. Licenciada en Filosofía y Letras, trabajó en él Centro de estudios tiistohcos formando parte del equipo de investigación que dirigía Claudio Sáncfiez Albornoz. En 1937 ingresó en el P.C.E, desempeñando, entre otros cargos, el de Gobernadora Civil de Cuenca desde enero a marzo de 1939. Al finalizar la guerra, fue detenida y condenada a prisión. En 1941 trató de reorganizar en la clandestinidad el partido comunista en la provincia de Alicante, siendo nuevamente detenida y condenada a muerte, pena que le sería conmutada por la de cárcel. Depurada profesionalmente y bajo control policial durante varios años, su actividad de oposición al régimen de Franco la llevaría a cabo desde la Asociación de Mujeres Universitarias.This article includes the oral statement of Carmen Caamaño Díaz (Madrid, 1911, who covers her autobiography through her memory, expressing an ideogical compromise evolution through which she would become an active subjet of the inner exile throughout Franco's regime. While being a student at university, she was a member of the Board of Directors of the UFEH (Spanish Teachers Union and General Secretary of the UFEH (Latin American Student Union from 1930 to 1931. With a degree in Arts, she worked at the Centre of Historie Studies taking part within the investigation team conducted by Claudio Sánchez Albornoz. In 1937 she joined the Spanish Communist Party, performing the charge, amongst others, of Civil Governor

  14. Anaplastic Thyroid Cancer: Experience of the Philippine General Hospital.

    Science.gov (United States)

    Lo, Tom Edward; Jimeno, Cecilia Alegado; Paz-Pacheco, Elizabeth

    2015-06-01

    Anaplastic thyroid cancer (ATC) is a rare type of thyroid malignancy and one of the most aggressive solid tumors, responsible for between 14% and 50% of the total annual mortality associated with thyroid cancer. A retrospective study was made of all ATC cases diagnosed by biopsy in the Philippine General Hospital between 2008 and 2013. A total of 15 patients were identified, with a median age at diagnosis of 63 years. All tumors were at least 6 cm in size upon diagnosis. All patients had a previous history of thyroid pathology, presenting with an average duration of 11 years. Eleven patients presented with cervical lymphadenopathies, whereas seven exhibited signs of distant metastases, for which the lungs appeared to be the most common site. More than 70% of the patients presented with a rapidly growing neck mass, leading to airway obstruction. Only three patients were treated using curative surgery; the majority received palliative and supportive forms of treatment. In addition, only three patients were offered radiotherapy. Chemotherapy was not offered to any patient. Only two patients were confirmed to still be alive during the study period. The median survival time for the other patients was 3 months; in the majority of cases the patient died within the first year following diagnosis. Our experience with ATC demonstrated concordance with other institutions with respect to current clinical profile, presentation, and prognosis. An absence of distant metastases and lymph node involvement was associated with improved survival outcomes, whereas age at diagnosis and tumor size did not affect survival. Curative surgery offers the most effective means of prolonging survival. Radiotherapy and chemotherapy in combination with surgery represents a promising treatment strategy.

  15. General surgical adverse events in a UK district general hospital-lessons to learn.

    Science.gov (United States)

    Gurjar, S V; Roshanzamir, S; Patel, Sandeep; Harinath, G

    2011-01-01

    An adverse event (AE) is defined as an unintended injury or complication caused by healthcare management rather than the disease process that may prolong admission and lead to disability or death. This study retrospectively assessed all reported general surgery-related AEs in a district general hospital in the south-east of England. All general surgical AEs arising from adult inpatient admissions between 2002 and 2007, that had been reported to the risk management team, following completion of the standard 'Adverse Incident Report Form', were retrospectively reviewed. There were 24,185 general surgical admissions over the period of the study; 461 AEs were reported (1.9% mean annual incident rate; 95% CI, 1.3%-2.5%). The majority (85%) were near miss or no injury events (category I and II) while serious/serious near-miss incidents accounted for just 2% of events. Communicative or administrative problems were implicated in 54% of cases while 12% arose from theatre/surgery-related failure. Of 58 medico-legal claims (0.24% of admissions) that were made, 16 (27.5%) progressed to the law courts for formal settlement. The reported annual AE incident rate of approximately 2% is well below the national average: this may be due to pre-selection of general surgery-related AEs or represent under-reporting of incidents. The vast majority of AEs were related to administrative and communicative error. These areas must be addressed if patient safety and outcome is to be significantly improved. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

  16. Behavior Assessment in Children Following Hospital-Based General Anesthesia versus Office-Based General Anesthesia

    Directory of Open Access Journals (Sweden)

    LaQuia A. Vinson

    2016-08-01

    Full Text Available The purpose of this study was to determine if differences in behavior exist following dental treatment under hospital-based general anesthesia (HBGA or office-based general anesthesia (OBGA in the percentage of patients exhibiting positive behavior and in the mean Frankl scores at recall visits. This retrospective study examined records of a pediatric dental office over a 4 year period. Patients presenting before 48 months of age for an initial exam who were diagnosed with early childhood caries were included in the study. Following an initial exam, patients were treated under HBGA or OBGA. Patients were followed to determine their behavior at 6-, 12- and 18-month recall appointments. Fifty-four patients received treatment under HBGA and 26 were treated under OBGA. OBGA patients were significantly more likely to exhibit positive behavior at the 6- and 12-month recall visits p = 0.038 & p = 0.029. Clinicians should consider future behavior when determining general anesthesia treatment modalities in children with early childhood caries presenting to their office.

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

    OpenAIRE

    Minas, H; Zamzam, R; Midin, M; Cohen, A

    2011-01-01

    Abstract Background The context of the study is the increased assessment and treatment of persons with mental illness in general hospital settings by general health staff, as the move away from mental hospitals gathers pace in low and middle income countries. The purpose of the study was to examine whether general attitudes of hospital staff towards persons with mental illness, and extent of mental health training and clinical experience, are associated with different attitudes and behaviours...

  18. Readmissions due to traffic accidents at a general hospital

    Directory of Open Access Journals (Sweden)

    Luciana Paiva

    2015-08-01

    Full Text Available AbstractObjective: to verify the occurrence and the causes of hospital readmissions within a year after discharge from hospitalizations due to traffic accidents.Methods: victims of multiple traumas due to traffic accidents were included, who were admitted to an Intensive Care Unit. Sociodemographic data, accident circumstances, body regions affected and cause of readmission were collected from the patient histories.Results: among the 109 victims of traffic accidents, the majority were young and adult men. Most hospitalizations due to accidents involved motorcycle drivers (56.9%. The causes of the return to the hospital were: need to continue the surgical treatment (63.2%, surgical site infection (26.3% and fall related to the physical sequelae of the trauma (10.5%. The rehospitalization rate corresponded to 174/1,000 people/year.Conclusion: the hospital readmission rate in the study population is similar to the rates found in other studies. Victims of severe limb traumas need multiple surgical procedures, lengthier hospitalizations and extended rehabilitation.

  19. End-of-life hospital transfers in out-of-hours general practice.

    NARCIS (Netherlands)

    Korte-Verhoef, M.C. de; Pasman, H.R.W.; Schweitzer, B.P.M.; Francke, A.L.; Onwuteaka-Philipsen, B.D.; Deliens, L.

    2012-01-01

    Background: During the end of life, many patients experience transfers from home to hospital, and the majority of them die in a hospital. Aim: To explore the reasons for hospital transfers of palliative care patients in out-of-hours general practices. Methods: A retrospective descriptive chart study

  20. A comparison of antibiotic point prevalence survey data from four Irish regional/general hospitals.

    LENUS (Irish Health Repository)

    Naughton, C

    2011-06-01

    Point prevalence surveys (PPS) are increasingly used to examining and compare hospital antibiotic consumption. The aim of this study was to identify the (1) point prevalence of antibiotic use in one regional hospital and (2) compare PPS data from similar regional\\/general hospitals.

  1. Evaluation of Outpatient Antibiotic Use in Beijing General Hospitals in 2015

    Directory of Open Access Journals (Sweden)

    Chuan Yang

    2017-01-01

    Conclusions: Antibiotic use in Beijing general hospitals is generally low; however, inappropriate antibiotic use still exists. Inappropriately used antibiotics should be subject to rigorous control and management, and public policy initiatives are required to promote the judicious use of antibiotics.

  2. Transferable and non-transferable drug resistance in enteric bacteria from hospital and from general practice

    DEFF Research Database (Denmark)

    Møller, JK; Bak, AL; Bülow, P

    1976-01-01

    Drug resistance to 8 different antibiotics in Enterobacteriaceae isolated from different hospitals and two groups of general practitioners was studied. Escherichia coli dominated among the 632 strains investigated. Drug resistance was found in 62% of the 512 hospital strains and in 38% of the 120...... strains from general practice. Multiple resistance was common especially in strains from hospital. R factors was found in 23% of the 317 drug-resistant strains from hospital and in 11% of the 46 drug-resistant strains from general practice. Resistance to streptomycin, sulphonamide and tetracycline either...

  3. Economic impact of surgery cancellation in a general hospital, Iran

    African Journals Online (AJOL)

    unhcc

    hospital, Iran. Namaitijiang Maimaiti14, Azam Rahimi15, Leila Afzal Aghaie2. Abstract. Background: Cancellation of surgical procedures creates a financial burden to health providers and patients. It also ... 14 Department of Health Management, Faculty of Health Sciences, Necmettin Erbakan University, Konya, Turkey,.

  4. Economic impact of surgery cancellation in a general hospital, Iran

    African Journals Online (AJOL)

    unhcc

    Rev Lat Am Enfermagem .2007;15:1018-1024. 7. Ezike HA, Ajuzieogu VO, Amucheazi AO. Reasons for elective surgery cancellation in a referral hospital. Annals of Medical & Health. Sciences Research. 2011;1(2):197-202. 8. Trentman TL, Mueller JT, Fassett SL, Dormer CL,. Weinmeister KP. Day of Surgery Cancellations ...

  5. Microbiological etiology of bacterial prostatitis in general hospital and primary care clinic in Korea

    Directory of Open Access Journals (Sweden)

    Yong Sun Choi

    2013-09-01

    Conclusions: The total portion of chronic bacterial prostatitis was 59.3% (174/293. Culture-positive patients in the PCC were significantly higher than in the general hospital, but the number of PCR positive patients in the PCC was the same as in the general hospital.

  6. Maailma aasta ärinaiseks valiti Carmen Kass : 2010 Eestist on saanud Põhjamaade Singapur / Aavo Kokk, Paavo Kangur

    Index Scriptorium Estoniae

    Kokk, Aavo, 1964-

    2000-01-01

    Tulevikunägemus Eesti edust ärimaailmas, näiteks 2006. a. mai - Singapuri-Bombay-Tallinna lennukist astub välja maailma edukaim äritandem Rein Kilk ja Carmen Kass, kes juhivad moefirmat Carmen Kass Fashion

  7. Evaluation of utilization and efficacy of general hospitals in Serbia: is there a shift forward?

    Science.gov (United States)

    Crncević-Radović, Ljiljana; Djokić, Dragoljub; Zizić-Borjanović, Slavica

    2012-01-01

    In the Republic of Serbia the activity of general hospitals has not been sufficiently evaluated. The aim of this study was to evaluate, by analyzing the basic indicators of general hospitals condition and functioning, the network, utilization and efficacy of general hospitals for further improvement of their organization and work. The paper is a part of a retrospective-prospective analysis of hospital healthcare services which we performed in 2011. The research involved all 40 general hospitals in Serbia evaluated as a general hospitals system. We selected seven basic indicators of hospitals condition and functioning that we followed-up in the period 2000-2009. As the data source we used the Reports of the Office for Hospital Stationary Treatment of general hospitals and the Report of the Republican Institution for Statistics entitled Vital Events in the Republic of Serbia. Numerical data were analyzed using the methods of descriptive statistics and the program Microsoft Office Excel 2007 and SPSS for Windows. Statistical significance indicators of differences were determined by Student's t-test. In general hospitals during the studied years, the number of beds decreased by 16.5% (p(t)=0.057). The number of discharged patients was increased by 11.8% (p(t)=0.035). The number of hospitalization days was reduced by 11.2% (p(t)=0.038).The average length of treatment was reduced by 1.9 days (p(t)=0.074). The average daily bed occupancy was increased by 4% (p(t)=0.020). The utilization of beds was increased by 4.5% (p(t)=0.019). Throughput capacity of beds increased by 8.5 patients per bed or by 27.8% (p(t)=0.091). The most significant indicators of the utilization and efficacy of general hospitals were improved. Nevertheless, European and domestic guidelines were achieved only in the average length of treatment.

  8. Evaluation of utilization and efficacy of general hospitals in Serbia: Is there a shift forward?

    Directory of Open Access Journals (Sweden)

    Crnčević-Radović Ljiljana

    2012-01-01

    Full Text Available Introduction. In the Republic of Serbia the activity of general hospitals has not been sufficiently evaluated. Objective. The aim of this study was to evaluate, by analyzing the basic indicators of general hospitals condition and functioning, the network, utilization and efficacy of general hospitals for further improvement of their organization and work. Methods. The paper is a part of a retrospective-prospective analysis of hospital healthcare services which we performed in 2011. The research involved all 40 general hospitals in Serbia evaluated as a general hospitals system. We selected seven basic indicators of hospitals condition and functioning that we followed-up in the period 2000-2009. As the data source we used the Reports of the Office for Hospital Stationary Treatment of general hospitals and the Report of the Republican Institution for Statistics entitled Vital Events in the Republic of Serbia. Numerical data were analyzed using the methods of descriptive statistics and the program Microsoft Office Excel 2007 and SPSS for Windows. Statistical significance indicators of differences were determined by Student’s t-test. Results. In general hospitals during the studied years, the number of beds decreased by 16.5% (pt=0.057. The number of discharged patients was increased by 11.8% (pt=0.035. The number of hospitalization days was reduced by 11.2% (pt=0.038. The average length of treatment was reduced by 1.9 days (pt=0.074. The average daily bed occupancy was increased by 4% (pt=0.020. The utilization of beds was increased by 4.5% (pt=0.019. Throughput capacity of beds increased by 8.5 patients per bed or by 27.8% (pt=0.091. Conclusion. The most significant indicators of the utilization and efficacy of general hospitals were improved. Nevertheless, European and domestic guidelines were achieved only in the average length of treatment.

  9. A Dance Class, a Drag King, & the Pedagogical Possibilities of Performative Hip-Hop: An Interview with Carmen Morrison & Alex U. Inn

    Science.gov (United States)

    Schönfeldt-Aultman, Scott M.; Morrison, Carmen

    2015-01-01

    Alex U. Inn is the co-founder and one of the two MCs of the hip-hop drag king group, Momma's Boyz. Momma's Boyz celebrated their tenth anniversary in 2014. Carmen Morrison is the offstage name of Alex U. Inn, though "Carmen" now goes by Alex offstage, as well. Within this interview, the names "Carmen" and "Alex" are…

  10. Une femme écrivain sous le franquisme : Carmen Laforet de Nada au silence…

    OpenAIRE

    Pallas, Claire

    2017-01-01

    A partir de 1939, el régimen franquista instaura un «nuevo orden», basado en el rechazo sistemático de los valores de la República. El papel de la mujer se limita al de esposa y madre. Lejos de los cánones de novela rosa destinada a las mujeres, Nada, de Carmen Laforet, ganadora en 1945 del primer premio Nadal, abre el camino por su sorprendente modernidad a una generación de escritoras. Mujer libre y exigente consigo misma, Carmen Laforet tardará en publicar una segunda novela y acabará vari...

  11. In a niche of time: do specialty hospitals outperform general services hospitals?

    Science.gov (United States)

    Poole, LeJon; Davis, Jullet A; Gunby, Norris W

    2013-01-01

    Niche hospitals represent a growing segment in the health care industry. Niche facilities are primarily engaged in the treatment of cardiac or orthopedic conditions. The effectiveness of this strategy is of interest because niche hospitals focus on only the most profitable services. The purpose of this research was to assess the financial effectiveness of the niche strategy. We theorize that firm and market-level factors concomitantly with the strategy of the hospital-niche versus traditional-are associated with financial performance. This research used 2 data sources, the 2003 Medicare Cost Report and the 2003 Area Resource File. The sample was limited to only for-profit, urban, nongovernmental hospitals (n = 995). The data were analyzed using hierarchical least squares regression. Financial performance was operationalized using the hospital's return on assets. The principal finding of this project is that niche hospitals had significantly higher performance than traditional facilities. From the organizational perspective, the niche strategy leads to better financial performance. From a societal perspective, the niche strategy provides increased focus and efficiencies through repetition. Despite the limited focus of this strategy, patients who can access these providers may experience better outcomes than patients in more traditional hospitals.

  12. Parasuicide among youth in a general hospital in South Africa

    Directory of Open Access Journals (Sweden)

    T Mhlongo

    1999-09-01

    Full Text Available Parasuicide cases among youth (15-24 years referred to the clinical psychology section of a regional hospital from 1995 to 1998 were reviewed. In all 100 cases (37 males and 63 females were identified being about 10% of the caseload. As part of the clinical psychological assessment sociodemographic, clinical characteristics, trigger factors, employed methods and suicide intentions were analysed. Most patients were students (79% or unemployed (16%. The major method employed to attempt suicide was ingestion of harmful substances (like paraffin, pesticides or battery acid(73%. Acute social conflicts (38%, socio-economic deprivation (17%, AIDS phobia (17%, academic failure (14%, teenage pregnancy (10% and mental illness (5% triggered suicide attempts. Fifty-eight percent of the attempts were categorised as demonstrative and 27% as genuine. The psychodynamics of parasuicides are discussed in case studies and with reference to other studies.

  13. General principles of radiation protection in hospital media

    International Nuclear Information System (INIS)

    Chanteur, J.

    1993-01-01

    Principles of radiation protection given by ICRP in term of justification, optimization, limitation are applicable in hospital media. The medical act has to be justified and, in France, it is not possible to use ionizing radiations without a prescription from a doctor. The acceleration of technologies development make non radiological techniques more employed than radiologic ones, in an aim of efficiency more than an aim radiation protection. The second principle of optimization means to give medical care with the minimum of ionizing radiations for the patients as well the operators. For the principle of limitation which applied only for operators, we have the new recommends of ICRP, but it would be reasonable to give the most part of decision to the works doctor to decide if somebody has the aptitude to work at an exposed place. The last points concern the quality of equipment, the safety of installations, the organization of works which are under laws and regulations. 3 tabs

  14. Epidemiology of carbapenemase producing Enterobacteriaceae in a general hospital

    Directory of Open Access Journals (Sweden)

    Amina Kandeel

    2015-06-01

    Full Text Available Objective: Detect the presence of carbapenemases producing Enterobacteriaceae (CPE and associated epidemiologi­cal, microbiological, and clinical characteristics of patients in our hospital Methods: During 15 months period, all non duplicate Enterobacteriaceae isolates with reduced susceptibility to car­bapenem detected by MicroScan WalkAway system and confirmed by E test were collected. These suspected isolates were further screened by modified Hodge test and carbapenemase inhibition discs to identify CPE. Results: Out of 54 suspected Enterobacteriaceae isolates, 44 (88.5% isolates were either extended spectrum beta-lac­tamases (ESBLs or AmpC producers with porin loss whereas 10 isolates (18.5% were confirmed to produce carbapen­emase representing (0.74% of the total Enterobacteriaceae. Among these 10 isolates, 6 were OXA 48 producers and 2 isolates were class B and class A each. Six out of the 10 CPE were detected in ICU and specimen source was tracheal aspirate in 5 CPE isolates. All CPE isolates were sensitive to colistin and all but one to tigecycline. All patients had history of previous antibiotic exposure and hospital stays for more than 5 days. Conclusion: Although CPE is not the main cause of carbapenem resistance in Enterobacteriaceae in our setting, its emergence there represents a serious infection control and therapeutic challenge. This mandates its early detection using MHT and carbapenemase inhibition tests together with strict infection control measures to limit its spread. J Mi­crobiol Infect Dis 2015;5(2: 57-62

  15. Collaboration between physicians and a hospital-based palliative care team in a general acute-care hospital in Japan

    Directory of Open Access Journals (Sweden)

    Nishikitani Mariko

    2010-06-01

    Full Text Available Abstract Background Continual collaboration between physicians and hospital-based palliative care teams represents a very important contributor to focusing on patients' symptoms and maintaining their quality of life during all stages of their illness. However, the traditionally late introduction of palliative care has caused misconceptions about hospital-based palliative care teams (PCTs among patients and general physicians in Japan. The objective of this study is to identify the factors related to physicians' attitudes toward continual collaboration with hospital-based PCTs. Methods This cross-sectional anonymous questionnaire-based survey was conducted to clarify physicians' attitudes toward continual collaboration with PCTs and to describe the factors that contribute to such attitudes. We surveyed 339 full-time physicians, including interns, employed in a general acute-care hospital in an urban area in Japan; the response rate was 53% (N = 155. We assessed the basic characteristics, experience, knowledge, and education of respondents. Multiple logistic regression analysis was used to determine the main factors affecting the physicians' attitudes toward PCTs. Results We found that the physicians who were aware of the World Health Organization (WHO analgesic ladder were 6.7 times (OR = 6.7, 95% CI = 1.98-25.79 more likely to want to treat and care for their patients in collaboration with the hospital-based PCTs than were those physicians without such awareness. Conclusion Basic knowledge of palliative care is important in promoting physicians' positive attitudes toward collaboration with hospital-based PCTs.

  16. Julián navarro y luis carlos rodríguez, música de guitarra de mi sª dª carmen cayzedo [cd] (medellín:instituto departamental de cultura y secretaría de educación y cultura de antioquia, 2011).

    OpenAIRE

    Barrera Orrego, Humberto

    2012-01-01

    Como parte de la Colección Bicentenario de Antioquia, a fi nes de 2011 la Dirección de Fomento a la Cultura (hoy Instituto Departamental de Cultura) y la Secretaría de Educación y Cultura de Antioquia publicaron un disco titulado Música de guitarra de mi Sª Dª Carmen Cayzedo, en el cual se recogen las piezas que integran un álbum manuscrito que fue propiedad de María del Carmen Cayzedo y Jurado, hija del general Domingo Cayzedo, personaje de campanillas de la historia nacional....

  17. Planning Development for a Family Planning Centre in Nursing Unit of the General Hospital of Argolida

    OpenAIRE

    Koukoufilippou J; Koinis A.

    2015-01-01

    Introduction: The family planning centres must be upgraded to a cornerstone of primary health care, and prevent, advise and protect the citizen's health while reducing hospitalization costs for hospitals. Aim: The purpose of this literature review is the family planning centre development in general hospital of Argolida that has a similar clinic. Material and Methods: Literature review was conducted of published English and Greek Articles from bibliographic databases Medline, Goog...

  18. Ambulatory surgery center and general hospital competition: entry decisions and strategic choices.

    Science.gov (United States)

    Al-Amin, Mona; Housman, Michael

    2012-01-01

    General hospitals are consistently under pressure to control cost and improve quality. In addition to mounting payers' demands, hospitals operate under evolving market conditions that might threaten their survival. While hospitals traditionally were concerned mainly with competition from other hospitals, today's reimbursement schemes and entrepreneurial activities encouraged the proliferation of outpatient facilities such as ambulatory surgery centers (ASCs) that can jeopardize hospitals' survival. The purpose of this article was to examine the relationship between ASCs and general hospitals. More specifically, we apply the niche overlap theory to study the impact that competition between ASCs and general hospitals has on the survival chances of both of these organizational populations. Our analysis examined interpopulation competition in models of organizational mortality and market demand. We utilized Cox proportional hazard models to evaluate the impact of competition from each on ASC and hospital exit while controlling for market factors. We relied on two data sets collected and developed by Florida's Agency for Health Care Administration: outpatient facility licensure data and inpatient and outpatient surgical procedure data. Although ASCs do tend to exit markets in which there are high levels of ASC competition, we found no evidence to suggest that ASC exit rates are affected by hospital density. On the other hand, hospitals not only tend to exit markets with high levels of hospital competition but also experience high exit rates in markets with high ASC density. The implications from our study differ for ASCs and hospitals. When making decisions about market entry, ASCs should choose their markets according to the following: demand for outpatient surgery, number of physicians who would practice in the surgery center, and the number of surgery centers that already exist in the market. Hospitals, on the other hand, should account for competition from ASCs

  19. Culture-proven bacterial keratitis in a Malaysian general hospital.

    Science.gov (United States)

    Hooi, S H; Hooi, S T

    2005-12-01

    One hundred patients (101 eyes) with culture-proven bacterial keratitis were treated in the Department of Ophthalmology, Hospital Sultanah Aminah, Johor Bahru, over a 4-year period. The majority of patients was male (63%), Malay (60%), from the Johor Bahru district (62%) and aged between 41 to 50 years (20%). The ocular predisposing factors were ocular trauma (41 eyes), ocular surface disease (28 eyes) and contact lens wear (26 eyes). The corneal ulcers were mainly large (50.5%), central (59.4%) and colonized by Gram-negative bacteria (78.1%). The most frequently isolated microorganisms were Pseudomonas aeruginosa (67 eyes), Staphylococcus aureus (12 eyes), Acinetobacter baumanii (6 eyes), Klebsiella pneumoniae (5 eyes), Corynebacterium sp. (3 eyes:) and Streptococcus pneumonliae (3 eyes). Twelve eyes (11.8%) had polymicrobial infection. A good visual outcome occurred in 52.5% of eyes analysed. Prognostic factors for visual outcome include presenting Snellen visual acuity, time to presentation after onset of ocular symptoms, ocular predisposing factor, corneal ulcer location and corneal ulcer size.

  20. A methodology model for quality management in a general hospital.

    Science.gov (United States)

    Stern, Z; Naveh, E

    1997-01-01

    A reappraisal is made of the relevance of industrial modes of quality management to the issues of medical care. Analysis of the nature of medical care, which differentiates it from the supplier-client relationships of industry, presents the main intrinsic characteristics, which create problems in application of the industrial quality management approaches to medical care. Several examples are the complexity of the relationship between the medical action and the result obtained, the client's nonacceptance of economic profitability as a value in his medical care, and customer satisfaction biased by variable standards of knowledge. The real problems unique to hospitals are addressed, and a methodology model for their quality management is offered. Included is a sample of indicator vectors, measurements of quality care, cost of medical care, quality of service, and human resources. These are based on the trilogy of planning quality, quality control, and improving quality. The conclusions confirm the inadequacy of industrial quality management approaches for medical institutions and recommend investment in formulation of appropriate concepts.

  1. Carmen Covito’s ‘Tempo parziale’ : Mothering and Work in Italy in a Nutshell

    NARCIS (Netherlands)

    Jansen, M.M.

    2016-01-01

    Carmen Covito’s short story ‘Tempo parziale’ (2009) [‘Part Time’] can be read as a comment on the peculiarities of female employment and defective social policies in contemporary Italy. Originally written in 2007 for the INAIL campaign Diritti senza rovesci [Rights without flip side] against

  2. Carmen Miranda’s white dress: ethnicity, syncretism and subaltern sexualities in springtime in the rockies

    Directory of Open Access Journals (Sweden)

    José Gatti

    2006-04-01

    Full Text Available This essay calls for a reassessment of Carmen Miranda's work in Hollywood. Her singing and dancing can reveal unexpected ethnic and cultural alignments. The focus here is on the costumes she designed for Springtime in the Rockies, a Fox musical in which Brazilian as well as Native American cultural references are made explicit in Miranda's performance.

  3. "Kõige mugavam oli filmis öötööd teha Carmen Kassil" / Verni Leivak

    Index Scriptorium Estoniae

    Leivak, Verni, 1966-

    2003-01-01

    Lõppesid produtsent Kristian Taska uue mängufilmi "Täna öösel me ei maga" võtted. Lavastab Ilmar Taska, operaatoriks on Istvan Borbas, peaosades Carmen Kass, Peter Franzen; Maria Avdjushko, Priit Võigemast. Esilinastus tuleb 13. veebruaril 2004

  4. Carmen Martín Gaite and the Writing of History

    Science.gov (United States)

    Herzberger, David K.

    2015-01-01

    In this brief article, David Herzberger begins by describing how, with the help of Juan Benet as her interlocutor in 1966, renowned Spanish author Carmen Martín Gaite found her historiographic voice. Herzberger goes on to examine how this relates to Martín Gaite's legacy in historiography and her understanding of the Franco regime and the Spanish…

  5. Reflections of Oneself: Reconciling Identity in Carmen Laforet's "Al Volver la Esquina"

    Science.gov (United States)

    Del Mastro, Mark P.

    2014-01-01

    The Spanish author Carmen Laforet is recognized almost exclusively for her first and seminal novel "Nada" published in 1945. However, her posthumous "Al volver la esquina" (2004), the last of her five novels, is an indispensable example of the author's achievement as a psychological novelist. Yet ten years following its…

  6. A cost study of a general practitioner hospital in the Netherlands.

    NARCIS (Netherlands)

    Hakkart-van Roijen, L.; Moll van Charante, E.P.; Bindels, P.J.E.; Yzermans, C.J.; Rutten, F.F.H.

    2004-01-01

    To perform a cost study of the first general practitioner (GP) hospital in the Netherlands. We conducted a cost study in a GP hospital in the Netherlands. Data on healthcare utilisation from 218 patients were collected for a period of one year. The costs of admission to the GP hosptial were compared

  7. A cost study of a general practitioner hospital in the Netherlands

    NARCIS (Netherlands)

    Hakkaart-van Roijen, Leona; Moll van Charante, E. P.; Bindels, P. J. E.; Yzermans, C. J.; Rutten, F. F. H.

    2004-01-01

    OBJECTIVE: To perform a cost study of the first general practitioner (GP) hospital in the Netherlands. METHODS: We conducted a cost study in a GP hospital in the Netherlands. Data on healthcare utilisation from 218 patients were collected for a period of one year. The costs of admission to the GP

  8. What is the future for General Surgery in Model 3 Hospitals?

    Science.gov (United States)

    Mealy, K; Keane, F; Kelly, P; Kelliher, G

    2017-02-01

    General Surgery consultant recruitment poses considerable challenges in Model 3 Hospitals in Ireland. The aim of this paper is to examine General Surgery activity and consultant staffing in order to inform future manpower and service planning. General surgical activity in Model 3 Hospitals was examined using the validated 2014 Hospital Inpatient Enquiry (HIPE) dataset. Current consultant staffing was ascertained from hospital personnel departments and all trainees on the National Surgical Training Programme were asked to complete a questionnaire on their career intentions. Model 3 Hospitals accounted for 50% of all General Surgery discharges. In the elective setting, 51.5% of all procedures were endoscopic investigations and in the acute setting only 22% of patients underwent an operation. Most surgical procedures were of low acuity and included excision of minor lesions, appendicectomy, cholecystectomy and hernia repair. Of 76 General Surgeons who work in Model 3 Hospitals 25% were locums and 54% had not undergone formal training in Ireland. A further 22% of these surgeons will retire in the next five years. General Surgical trainees surveyed indicated an unwillingness to take up posts in Model 3 Hospitals, while 83% indicated that a post in a Model 4 Hospital is 'most desirable'. Lack of attractiveness related to issues regarding rotas, lack of ongoing skill enhancement, poor experience in the management of complex surgical conditions, limited research and academic opportunity, isolation from colleagues and poor trainee support. These data indicated that an impending General Surgery consultant manpower crisis can only be averted in Model 3 Hospitals by either major change in the emphasis of surgical training or a significant reorganisation of surgical services.

  9. A model of facilitative communication for support of general hospital nurses nursing mentally ill people

    Directory of Open Access Journals (Sweden)

    TR Mavundla

    2001-09-01

    Full Text Available Part 1 of this article dealt with a full description of the research design and methods. This article aims at describing a model of facilitative communication to support general hospital nurses nursing the mentally-ill. In this article a model of facilitative communication applicable to any general hospital setting is proposed. Fundamental assumptions and relationship statements are highlighted and the structure and process of facilitative communication is described according to the three steps employed: 1 assisting the general hospital nurse learn the skill; 2 assisting the general hospital nurse practise the skill in order to develop confidence; and 3 using the skill in a work setting. The guidelines for operationalising this model are dealt with in the next article. The evaluation of the model is also briefly described.

  10. Management of chronic orofacial pain: a survey of general dentists in german university hospitals

    NARCIS (Netherlands)

    Wirz, Stefan; Ellerkmann, Richard K.; Buecheler, Marcus; Putensen, Christian; Nadstawek, Joachim; Wartenberg, Hans-Christian

    2010-01-01

    AIM: This survey assessed procedures performed by general dentists in German university hospitals treating patients with chronic orofacial pain (COP). METHODS: A standardized questionnaire was sent to dentists at all 42 German universities. Doctors were asked to describe demographics, diagnoses,

  11. Well-Differentiated Thyroid Cancer: The Philippine General Hospital Experience.

    Science.gov (United States)

    Lo, Tom Edward N; Uy, Abigail T; Maningat, Patricia Deanna D

    2016-03-01

    Well-differentiated thyroid cancer (WDTC) is the most common form of thyroid malignancy. While it is typically associated with good prognosis, it may exhibit higher recurrence and mortality rates in selected groups, particularly Filipinos. This paper aims to describe the experience of a Philippine Hospital in managing patients with differentiated thyroid cancer. We performed a retrospective cohort study of 723 patients with WDTC (649 papillary and 79 follicular), evaluating the clinicopathologic profiles, ultrasound features, management received, tumor recurrence, and eventual outcome over a mean follow-up period of 5 years. The mean age at diagnosis was 44±13 years (range, 18 to 82), with a majority of cases occurring in the younger age group (<45 years). Most tumors were between 2 and 4 cm in size. The majority of papillary thyroid cancers (PTCs, 63.2%) and follicular thyroid cancers (FTCs, 54.4%) initially presented as stage 1, with a greater proportion of FTC cases (12.7% vs. 3.7%) presenting with distant metastases. Nodal metastases at presentation were more frequent among patients with PTC (29.9% vs. 7.6%). A majority of cases were treated by complete thyroidectomy, followed by radioactive iodine therapy and thyroid stimulating hormone suppression, resulting in a disease-free state. Excluding patients with distant metastases at presentation, the recurrence rates for papillary and FTC were 30.1% and 18.8%, respectively. Overall, PTC among Filipinos was associated with a more aggressive and recurrent behavior. FTC among Filipinos appeared to behave similarly with other racial groups.

  12. Well-Differentiated Thyroid Cancer: The Philippine General Hospital Experience

    Directory of Open Access Journals (Sweden)

    Tom Edward N. Lo

    2016-03-01

    Full Text Available BackgroundWell-differentiated thyroid cancer (WDTC is the most common form of thyroid malignancy. While it is typically associated with good prognosis, it may exhibit higher recurrence and mortality rates in selected groups, particularly Filipinos. This paper aims to describe the experience of a Philippine Hospital in managing patients with differentiated thyroid cancer.MethodsWe performed a retrospective cohort study of 723 patients with WDTC (649 papillary and 79 follicular, evaluating the clinicopathologic profiles, ultrasound features, management received, tumor recurrence, and eventual outcome over a mean follow-up period of 5 years.ResultsThe mean age at diagnosis was 44±13 years (range, 18 to 82, with a majority of cases occurring in the younger age group (<45 years. Most tumors were between 2 and 4 cm in size. The majority of papillary thyroid cancers (PTCs, 63.2% and follicular thyroid cancers (FTCs, 54.4% initially presented as stage 1, with a greater proportion of FTC cases (12.7% vs. 3.7% presenting with distant metastases. Nodal metastases at presentation were more frequent among patients with PTC (29.9% vs. 7.6%. A majority of cases were treated by complete thyroidectomy, followed by radioactive iodine therapy and thyroid stimulating hormone suppression, resulting in a disease-free state. Excluding patients with distant metastases at presentation, the recurrence rates for papillary and FTC were 30.1% and 18.8%, respectively.ConclusionOverall, PTC among Filipinos was associated with a more aggressive and recurrent behavior. FTC among Filipinos appeared to behave similarly with other racial groups.

  13. Self medication amongst general outpatients in a nigerian community hospital.

    Science.gov (United States)

    Omolase, C O; Adeleke, O E; Afolabi, A O; Afolabi, O T

    2007-12-01

    This study was designed to determine the proportion of general out patients who practice self medication, the drugs employed and the reasons for resorting to self medication. This study was conducted between June and December, 2007 at the General Outpatient Clinic of the Federal Medical Centre, Owo, Ondo State, Nigeria. Two hundred consenting respondents were selected by simple random sampling and interviewed with the aid of semi structured questionnaire by the authors with three assistants. Information regarding their bio-data, history of self medication, drugs used and the reasons for resorting to self medication were obtained. Majority of the respondents (85%) admitted to self medication while the remaining proportion (15%) did not practice it. Drugs utilized could be single, usually analgesics (26.5%) and anti-malaria (15.9%) or in combinations, usually antimalaria-analgesics (22.4%), antimalariaanalgesic- antibiotic (15.3%) and antibiotic-analgesic (10.0%). The reasons cited by respondents for self medication were their perception of their complaints been minor enough to be amenable to self medication (54.7%) and financial constraint (22.4%). Majority of the respondents practiced self medication using an array of drugs like analgesics, anti-malaria and antibiotics used either singly or in combination. The main reasons identified for self medication were that the ailments were minor and financial constraint.

  14. An assessment of the quality of sleep among health professionals of the general hospital of Karpenissi

    OpenAIRE

    Ifanti Ε.; Zagkotsi Μ.; Gketsios Ι.; Armagos P.; Ifantis Α.; Charalampopoulou Ν.

    2011-01-01

    Introduction: Employees in cyclic or night shifts often complain of sleep disturbances. The latter are extremely frequent among health care workers. Aim: To evaluate sleep quality in health care workers of a Greek provincial general hospital Material and Methods: Seventy seven health professionals of General Hospital of Karpenisi took part in the study( doctors, nurses and paramedicals). 49 were women and 28 were men. Athens Insomnia Scale was used to evaluate sleep quality. The scale include...

  15. Satisfaction degree evaluation of the users of "Attikon" University General Hospital's library.

    Science.gov (United States)

    Stamouli, Maria-Aggeliki; Balis, Charalampos; Georgakopoulou, Konstantina-Maria

    2013-01-01

    The ability of hospital medical libraries to meet users' needs is a complicated issue and has been examined by many surveys. The aim of this study is to evaluate the satisfaction degree of the users of "Attikon" University General Hospital's medical library. A questionnaire was used to collect the necessary information Although, in general, the users seems to be satisfied, some adjustments, such as up-to-date books, journals and computers, have to be made.

  16. Carmen de Burgos y Ramón Gómez de la Serna

    Directory of Open Access Journals (Sweden)

    Ubach Medina, Antonio

    2010-06-01

    Full Text Available Carmen de Burgos, born in the southern province of Almería, arrives to Madrid at the beginning of the 20th century. She has decided to maintain her independence after an unhappy marriage and to earn her bread with her writings. She also uses them to promote different social issues, her idea of literature and the young writers who are starting their careers. Ramón Gómez de la Serna, twenty years her younger, meets her in 1908, when he is starting his career. Carmen represents the ideal woman he describes in his conference titled “The New Literature”. Along the next twenty years they share their lives, travels and writing in a rich partnership that ends suddenly in 1929 after the short flirt of Carmen’s daughter with the writer.

    Carmen de Burgos, proveniente de la sureña provincia de Almería, llega a Madrid a principios del s. XX, decidida a mantener su independencia tras un desdichado matrimonio y a ganarse la vida escribiendo, apoyando una serie de causas sociales, su idea de la literatura y los jóvenes valores. Ramón Gómez de la Serna, veinte años más joven que ella, la conoce en 1908, cuando comienza su carrera literaria. Carmen encarna el ideal de mujer que describe en su conferencia sobre “La nueva literatura”. Durante veinte años comparten vida, viajes y escritura en una fructífera compañía que termina bruscamente en 1929 tras la relación fugaz de la hija de Carmen con el escritor.

  17. [Mental Health in the General Hospital: Results of the Patient Health Questionnaire (PHQ) in Four Hospital Services].

    Science.gov (United States)

    Castro-Camacho, Leonidas; Escobar, Juan Manuel; Sáenz-Moncaleano, Camilo; Delgado-Barrera, Lucía; Aparicio-Turbay, Soraya; Molano, Juan Carlos; Noguera, Efraín

    2012-03-01

    Few individuals have access to mental health services due in part to underdetection. As it is more likely to consult for medical conditions, primary care may be a useful gateway for early detection of mental health problems. Detection of the frequency of mental health problems in four hospital services at the Fundación Santa Fe de Bogotá: Outpatient unit, hospitalization, emergency department, and primary care through a brief detection questionnaire, the Patient Health Questionnaire (PHQ). Cross-sectional study of patients seen at the four services who answered a Demographic Data Questionnaire and the PHQ together with information gathered about current medical diagnosis, history of visits, and hospitalizations during the last year. 1094 patients seen at the four hospital services between September 2010 and May 2011 were selected at random. A mental health problem was detected in 36.7% of the total sample. Major depressive disorder (7.3%), alcohol abuse (14.4%), and any anxiety disorder (7.7%) showed the highest prevalence with the emergency department showing the highest frequency of detection. The usefulness of a brief detection questionnaire such as the PHQ in hospital settings is demonstrated and implications in the design of mental health programs in the general hospital are discussed. The need to replicate this study in other settings and to undertake further research is outlined. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  18. A review of governance of maternity services at South Tipperary general hospital

    LENUS (Irish Health Repository)

    Flory, David

    2015-09-01

    This review of the governance of maternity services at South Tipperary General Hospital has focussed on the systems and processes for assurance of service quality, risk management and patient safety primarily inside the hospital but also in the Hospital Group structure within which it operates. The effectiveness of the governance arrangements is largely determined by the quality of the leadership and management – both clinical and general – which designs, implements, and oversees those systems and processes and is ultimately responsible and accountable.\\r\

  19. Ketamine Use for Suicidal Ideation in the General Hospital: Case Report and Short Review.

    Science.gov (United States)

    Vulser, Hélène; Vulser, Claire; Rieutord, Marion; Passeron, Amélie; Lefebvre, Didier; Baup, Emilie; Seigneurie, Anne-Sophie; Thauvin, Isabelle; Limosin, Frédéric; Lemogne, Cédric

    2018-01-01

    Low-dose infusion of ketamine may have rapid antisuicide properties. Such a treatment may therefore be useful in the general hospital to prevent suicide in an environment that cannot be made safe enough. We report on the use of ketamine as an efficient, well-tolerated treatment for persistent suicidal ideation in a patient hospitalized in a general hospital after a severe suicide attempt. Based on data in the literature, we suggest that the benefit-risk ratio for ketamine use in such a context is highly favorable.

  20. Ten thousand steps: a pedometer study of junior dentists in a major British teaching hospital and a district general hospital.

    Science.gov (United States)

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

    2017-05-01

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

  1. DRUG MANAGEMENT REVIEWS IN DISTRICT DRUG MANAGEMENT UNIT AND GENERAL HOSPITAL

    Directory of Open Access Journals (Sweden)

    Max Joseph Herman

    2009-12-01

    Full Text Available Drug is one of the essential elements in healthcare that should be effectively and efficiently managed. Following thedecentralization in 2001 in Indonesia, drug management has changed in district drug management units and also in District General Hospitals. Certainly this condition influences the sustainability of drug access in primary health care such as in Community Health Center and District General Hospital, especially in drug financing policy. A cross sectional descriptive study to obtain information on drug management in public healthcare in district had been carried out between July and December 2006 in 10 District Public Drug Management Units from 10 district health offices and 9 district general hospitals as samples. Data were collected by interviewing heads of Drug Section in District Health Offices and heads of Hospital Pharmacies using structured questionnaires and observing drug storage in District Drug Management Units, Community Health Centers, and Hospital Pharmacies. Results of the study show that drug planning in District Health Offices and General Hospitals did not meet the basic real need in some districts nor District Hospitals. The minimum health service standards had no been achieved yet. Furthermore, drug procurement, storage and recording as well as reporting was not good enough either, such as shown by the existence of expired drugs. Lead time for drug delivery to community health centers in some districts was longer than the average of lead time in the past 3 years.

  2. José del Carmen Acosta. Un hombre sin enemigos

    Directory of Open Access Journals (Sweden)

    Fernando Guzmán Mora

    1990-08-01

    hasta entonces cálida relación médico paciente, que si bien no curaba, siempre consolada, para citar el conocido refrán popular.

    El hombre que marca en nuestro medio bogotano el período de transición entre la formación médica de influencia francesa y la nueva formacion norteamericana es el profesor José del Carmen Acosta Villaveces, gineco-obstetra de oficio, cirujano de corazón, internista de pensamiento y gran maestro de generaciones médicas colombianas entre los años de 1920 y 1960, época de cruciales cambios políticos, crisis de valores filosóficos y profundas transformaciones científicas, que formaron el criterio de la generación que tuvo que sufrir el mayor paso evolutivo de la educación médica en nuestro país...

  3. Evaluation of Outpatient Antibiotic Use in Beijing General Hospitals in 2015.

    Science.gov (United States)

    Yang, Chuan; Cai, Wen-Qiang; Zhou, Zi-Jun

    2017-02-05

    Medical misuse of antibiotics is associated with the acquisition and spread of antibiotic resistance, resulting in a lack of effective drugs and increased health-care cost. Nevertheless, inappropriate antibiotic use in China remains common and the situation requires urgent improvement. Here, we analyzed the prescriptions of antibiotics and evaluated the rationality of antibiotic use among outpatients in Beijing general hospitals during 2015. We collected basic medical insurance claim data from January 1, 2015 to December 31, 2015 in 507 general hospitals of Beijing. A descriptive analysis of outpatient antibiotic prescribing was performed. The Anatomical Therapeutic Chemical Classification/defined daily doses system was used to evaluate the rationality of antibiotic use. Over the study, an estimated 721,930, 613,520, and 822,480 antibiotics were dispensed in primary, secondary, and tertiary general hospitals corresponding to 5.09%, 5.06%, and 2.53% of all prescriptions, respectively. Antibiotic combinations represented 2.95%, 7.74%, and 10.18% of the total antibiotic prescriptions, respectively. Expenditure for the top twenty antibiotics in primary, secondary, and tertiary general hospitals was RMB 42.92, 65.89, and 83.26 million Yuan, respectively. Cephalosporins were the most frequently prescribed class of antibiotic in clinical practice. The antibiotics used inappropriately included azithromycin enteric-coated capsules, compound cefaclor tablets and nifuratel nysfungin vaginal soft capsules in primary hospitals, amoxicillin and clavulanate potassium dispersible tablets (7:1) and cefonicid sodium for injection in secondary hospitals, cefminox sodium for injection and amoxicillin sodium and sulbactam sodium for injection in tertiary hospitals. Antibiotic use in Beijing general hospitals is generally low; however, inappropriate antibiotic use still exists. Inappropriately used antibiotics should be subject to rigorous control and management, and public policy

  4. Prioritizing of performance indicators of quality - effectiveness areas of general hospitals using Analytic Hierarchy Process (AHP

    Directory of Open Access Journals (Sweden)

    hosein Jabbari Beyrami

    2014-06-01

    Full Text Available Background: Quality of health care includes some degree of services provided to individuals and communities to increase the likelihood of desired results and are updated in accordance with professional knowledge. To assess the quality of services provided in hospitals, indicators and performance standards are needed to be identified, because these indicators are the structure of the hospital evaluation. This study aimed to determine the performance indicators in general- public hospitals in area of quality and effectiveness and prioritization of these indicators. Materials and Methods: This descriptive-qualitative and practical research was done through a systematic review of literature and data were obtained from the hospital authorities. In order to prioritize public hospital performance indicators, Analytic Hierarchy Process (AHP was used and the results were analyzed by the Expert Choice software. Results: In the field of quality and effectiveness, 73 performance indicators were considering at various texts. Indicators such as the rate of hospital infections (100%, the incidence of hospital events (72%, Net hospital mortality(63%, Percentage of patients' satisfaction(53% selected as key performance indicators. Conclusion: Performance indicators in the field of quality and effectiveness has important place in health system and hospital organization. By evaluating the quality of services in health centers, the problems and shortcomings can be seen, and consequently analyzing information can lead to a try to reduce them.

  5. Components of Hospital Perioperative Infrastructure Can Overcome the Weekend Effect in Urgent General Surgery Procedures.

    Science.gov (United States)

    Kothari, Anai N; Zapf, Matthew A C; Blackwell, Robert H; Markossian, Talar; Chang, Victor; Mi, Zhiyong; Gupta, Gopal N; Kuo, Paul C

    2015-10-01

    We hypothesized that perioperative hospital resources could overcome the "weekend effect" (WE) in patients undergoing emergent/urgent surgeries. The WE is the observation that surgeon-independent patient outcomes are worse on the weekend compared with weekdays. The WE is often explained by differences in staffing and resources resulting in variation in care between the week and weekend. Emergent/urgent surgeries were identified using the Healthcare Cost and Utilization Project State Inpatient Database (Florida) from 2007 to 2011 and linked to the American Hospital Association (AHA) Annual Survey Database to determine hospital level characteristics. Extended median length of stay (LOS) on the weekend compared with the weekdays (after controlling for hospital, year, and procedure type) was selected as a surrogate for WE. Included were 126,666 patients at 166 hospitals. A total of 17 hospitals overcame the WE during the study period. Logistic regression, controlling for patient characteristics, identified full adoption of electronic medical records (OR 4.74), home health program (OR 2.37), pain management program [odds ratio (OR) 1.48)], increased registered nurse-to-bed ratio (OR 1.44), and inpatient physical rehabilitation (OR 1.03) as resources that were predictors for overcoming the WE. The prevalence of these factors in hospitals exhibiting the WE for all 5 years of the study period were compared with those hospitals that overcame the WE (P general surgery procedures. Improved hospital perioperative infrastructure represents an important target for overcoming disparities in surgical care.

  6. CARMEN: a system Monte Carlo based on linear programming from direct openings; CARMEN: Un sistema de planficiacion Monte Carlo basado en programacion lineal a partir de aberturas directas

    Energy Technology Data Exchange (ETDEWEB)

    Ureba, A.; Pereira-Barbeiro, A. R.; Jimenez-Ortega, E.; Baeza, J. A.; Salguero, F. J.; Leal, A.

    2013-07-01

    The use of Monte Carlo (MC) has shown an improvement in the accuracy of the calculation of the dose compared to other analytics algorithms installed on the systems of business planning, especially in the case of non-standard situations typical of complex techniques such as IMRT and VMAT. Our treatment planning system called CARMEN, is based on the complete simulation, both the beam transport in the head of the accelerator and the patient, and simulation designed for efficient operation in terms of the accuracy of the estimate and the required computation times. (Author)

  7. Can the use of Electronic Health Records in General Practice reduce hospitalizations for diabetes patients?

    DEFF Research Database (Denmark)

    Kongstad, Line Planck; Mellace, Giovanni; Rose Olsen, Kim

    on Electronic Health Records (EHR) on diabetes patients total hospitalizations, diabetes related hospitalizations and hospitalizations with diabetes and cardiovascular related Ambulatory Care Sentive Conditions (ACSC). We use a rich nationwide panel dataset (2004-2013) with information of stepwise enrolment......Disease management programmes (DMP) in the general practice sector are increasingly used to improve health of chronically ill patients, reduce hospitalizations and thereby costs. The aim of this paper is to estimate the causal effects of the enrolment of general practices (GP) in a DMP based...... of GPs in the EHR program. As a control group we use GPs who never enrolled. Following the recent literature on causal inference with panel data, we use a standard propensity score matching estimator where we also match on pre-treatment outcomes. This allows controlling for all the unobservable...

  8. Annual Progress Summary Report for Grant N00014-89-J-3073 (Massachusetts General Hospital)

    Science.gov (United States)

    1992-11-15

    Infectious Disease Units, Departments of ’Me.icine and + Childrens Service, Mass- acIsetts General Hospital; S~hrlners Burns Institute, Boston, MA and...Department of the Navy, Office of the Chief of Naval Research, and grants 15875 and 15855 from the Shriners Hospital for Crippled Children . "-3- The use of...antibodies function by binding and neutralizing the toxic effects of LPS. Liaooolvsaccharides Unlabeled LPS from tybimuru K. A neumoniae , S. marcesvens

  9. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. VI. - December of 2001

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  10. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. II.- August of 2001

    International Nuclear Information System (INIS)

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

    2001-10-01

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

  11. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. III.- September of 2001

    International Nuclear Information System (INIS)

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

    2001-12-01

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

  12. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. IV. - October of 2001

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  13. MANAGEMENT OF DIABETES IN ACUTE MYOCARDIAL INFARCTION IN CELJE GENERAL HOSPITAL IN 1999

    Directory of Open Access Journals (Sweden)

    Gregor Veninšek

    2001-12-01

    Full Text Available Background. DIGAMI study showed that intrahospital mortality and mortality at one year after myocardial infarction can be significantly reduced in diabetics treated in acute phase of myocardial infarction by GI infusion and afterwards for at least three months with intensive insulin treatment. Mortality can be reduced for more than 50% in a subgroup of patients younger than 70 years, without congestive heart failure, with first myocardial infarction, not treated with insulin or digitalis. In this perspective we reviewed treatment of diabetics with acute myocardial infarction in 1999 in Celje General Hospital.Methods. We reviewed documentation of treatment of all diabetics with acute myocardial infarction treated in Celje General Hospital in 1999. We collected data on number of newly discovered diabetes, on previous treatment of diabetes, on treatment of diabetes during hospitalization and at discharge, on drugs used for treatment of diabetes and on mortality during hospitalization.Results. Diabetics presented 20% of all patients with acute myocardial infarction treated in Celje General Hospital in 1999. None of patients received GI infusion, none had intensively managed blood sugar. 24% of patients were treated with sulfonylureas in acute phase of myocardial infarction. 33% of patients were discharged from hospital with insulin therapy. Intrahospital mortality was 9%, comparable with patients without diabetes.Conclusions. In 1999 was intrahospital treatment of diabetics with acute myocardial infarction in Celje General Hospital successful as their intrahospital mortality equaled non-diabetics. Treatment of diabetes itself, during hospitalization and after discharge, on the other hand, in 1999 had not been up to date according to results of recent studies. In our opinion, it is mandatory for diabetologist to make part of the team that treats diabetic with acute myocardial infarction

  14. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. V. - November of 2001

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  15. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. I.- July of 2001

    International Nuclear Information System (INIS)

    Angeles C, A.; Vizuet G, J.

    2001-09-01

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

  16. New onset of insomnia in hospitalized patients in general medical wards: incidence, causes, and resolution rate

    OpenAIRE

    Ho, An; Raja, Bronson; Waldhorn, Richard; Baez, Valentina; Mohammed, Idiris

    2017-01-01

    ABSTRACT Background: Insomnia is common in hospitalized patients. However, no study has examined new onset of insomnia in patients without a prior history of insomnia. Objectives: Incidence of new onset of insomnia in inpatients, associated factors and resolution rate after 2 weeks. Method: This is a prospective observational study conducted at a community hospital. We used the Insomnia Severity Index questionnaire to screen for insomnia in all patients located in the general medical floors f...

  17. Lewd, crude, and rude behavior: the impact of manners and etiquette in the general hospital.

    Science.gov (United States)

    Silverman, Benjamin C; Stern, Thomas W; Gross, Anne F; Rosenstein, Donald L; Stern, Theodore A

    2012-01-01

    Lewd, crude, and rude behaviors of patients and staff members have the potential to complicate care; unfortunately, the medical literature on manners and etiquette is sparse. We sought to understand the impact of lewd, crude, and rude behaviors in the general hospital and to provide a context in which to educate clinicians about the management of troublesome behaviors of patients and staff members. We reviewed the history of etiquette in the general hospital, and discuss the ethical ramifications and clinical management of inappropriate behaviors. Lewd, crude, and rude language and behaviors are often heard and seen in the general hospital; such behaviors can be understood in a biopsychosocial context. Teaching trainees about manners and etiquette can help them identify and manage offensive behaviors and can facilitate the provision of effective and ethical care. Copyright © 2012 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

    Minas, Harry; Zamzam, Ruzanna; Midin, Marhani; Cohen, Alex

    2011-05-14

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

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

    Directory of Open Access Journals (Sweden)

    Midin Marhani

    2011-05-01

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

  20. Control costs, enhance quality, and increase revenue in three top general public hospitals in Beijing, China.

    Directory of Open Access Journals (Sweden)

    Lue-Ping Zhao

    Full Text Available BACKGROUND: With market-oriented economic and health-care reform, public hospitals in China have received unprecedented pressures from governmental regulations, public opinions, and financial demands. To adapt the changing environment and keep pace of modernizing healthcare delivery system, public hospitals in China are expanding clinical services and improving delivery efficiency, while controlling costs. Recent experiences are valuable lessons for guiding future healthcare reform. Here we carefully study three teaching hospitals, to exemplify their experiences during this period. METHODS: We performed a systematic analysis on hospitalization costs, health-care quality and delivery efficiencies from 2006 to 2010 in three teaching hospitals in Beijing, China. The analysis measured temporal changes of inpatient cost per stay (CPS, cost per day (CPD, inpatient mortality rate (IMR, and length of stay (LOS, using a generalized additive model. FINDINGS: There were 651,559 hospitalizations during the period analyzed. Averaged CPS was stable over time, while averaged CPD steadily increased by 41.7% (P<0.001, from CNY 1,531 in 2006 to CNY 2,169 in 2010. The increasing CPD seemed synchronous with the steady rising of the national annual income per capita. Surgical cost was the main contributor to the temporal change of CPD, while medicine and examination costs tended to be stable over time. From 2006 and 2010, IMR decreased by 36%, while LOS reduced by 25%. Increasing hospitalizations with higher costs, along with an overall stable CPS, reduced IMR, and shorter LOS, appear to be the major characteristics of these three hospitals at present. INTERPRETATIONS: These three teaching hospitals have gained some success in controlling costs, improving cares, adopting modern medical technologies, and increasing hospital revenues. Effective hospital governance and physicians' professional capacity plus government regulations and supervisions may have played a role

  1. Lower emergency general surgery (EGS) mortality among hospitals with higher-quality trauma care.

    Science.gov (United States)

    Scott, John W; Tsai, Thomas C; Neiman, Pooja U; Jurkovich, Gregory J; Utter, Garth H; Haider, Adil H; Salim, Ali; Havens, Joaquim M

    2018-03-01

    Patients undergoing emergency general surgery (EGS) procedures are up to eight times more likely to die than patients undergoing the same procedures electively. This excess mortality is often attributed to nonmodifiable patient factors including comorbidities and physiologic derangements at presentation, leaving few targets for quality improvement. Although the hospital-level traits that contribute to EGS outcomes are not well understood, we hypothesized that facilities with lower trauma mortality would have lower EGS mortality. Using the Nationwide Inpatient Sample (2008-2011), we calculated hospital-level risk-adjusted trauma mortality rates for hospitals with more than 400 trauma admissions. We then calculated hospital-level risk-adjusted EGS mortality rates for hospitals with more than 200 urgent/emergent admissions for seven core EGS procedures (laparotomy, large bowel resection, small bowel resection, lysis of adhesions, operative intervention for ulcer disease, cholecystectomy, and appendectomy). We used univariable and multivariable techniques to assess for associations between hospital-level risk-adjusted EGS mortality and hospital characteristics, patient-mix traits, EGS volume, and trauma mortality quartile. Data from 303 hospitals, representing 153,544 admissions, revealed a median hospital-level EGS mortality rate of 1.21% (interquartile range, 0.86%-1.71%). After adjusting for hospital traits, hospital-level EGS mortality was significantly associated with trauma mortality quartile as well as patients' community income-level and race/ethnicity (p surgery-specific systems measures and process measures are needed to better understand drivers of variation in quality of EGS outcomes. Epidemiological, level III; Care management, level IV.

  2. La novelística feminista de Carmen Laforet y el género negro

    OpenAIRE

    Johnson, Roberta

    2006-01-01

    In her five long novels, Carmen Laforet consistently attempted to find new narrative means of framing a feminist message. There exist studies of her use of the Bildungsroman, the Gothic, and Expressionism in Nada. This essay focuses on elements of detective fiction, especially the noir subgenre, in Laforet’s novelistic production, concentrating on Al volver la esquina published posthumously in 2004. The masculine protagonistnarrator moves in a world that is akin to those of North American noi...

  3. Caring for homeless persons with serious mental illness in general hospitals.

    Science.gov (United States)

    Bauer, Leah K; Baggett, Travis P; Stern, Theodore A; O'Connell, Jim J; Shtasel, Derri

    2013-01-01

    The care of homeless persons with serious mental illness remains a common and challenging problem in general hospital settings. This article aims to review data on homelessness and its psychiatric comorbidities, and to expand the skills of providers who encounter homeless individuals in general hospital settings. Literature review reveals patient, provider, and systems factors that contribute to suboptimal health outcomes in homeless individuals. Diagnostic rigor, integrated medical and psychiatric care, trauma-informed interventions, special considerations in capacity evaluations, and health care reform initiatives can improve the treatment of homeless persons with serious mental illness. Copyright © 2013 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

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

    International Nuclear Information System (INIS)

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

    2015-01-01

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

  5. Review of paediatric cardiology services in district general hospitals in the United Kingdom.

    Science.gov (United States)

    Andrews, Hannah; Singh, Yogen

    2016-03-01

    Following the Safe and Sustainable review of Paediatric Services in 2012/2013, National Health Service England recommended that local paediatric cardiology services should be provided by specially trained paediatricians with expertise in cardiology in all non-specialist hospitals. To understand the variation in local paediatric cardiology services provided across district general hospitals in the United Kingdom. An internet-based questionnaire was sent out via the Paediatrician with Expertise in Cardiology Special Interest Group and the Neonatologists with Interest in Cardiology and Haemodynamics contact databases and the National Health Service directory. Non-responders were followed-up via telephone. The response rate was 80% (141 of 177 hospitals), and paediatricians with expertise in cardiology were available in 68% of those. Local cardiology clinics led by paediatricians with expertise in cardiology were provided in 96 hospitals (68%), whereas specialist outreach clinics were held in 123 centres (87%). A total of 11 hospitals provided neither specialist outreach clinics nor any local cardiology clinics led by paediatricians with expertise in cardiology. Paediatric echocardiography services were provided in 83% of the hospitals, 12-lead electrocardiogram in 96%, Holter electrocardiogram in 91%, and exercise testing in only 47% of the responding hospitals. Telemedicine facilities were established in only 52% of the centres, where sharing echocardiogram images via picture archiving and communication system was used most commonly. There has been a substantial increase in the availability of paediatricians with expertise in cardiology since 2008. Most of the hospitals are well-supported by specialist cardiology centres via outreach clinics; however, there remains significant variation in the local paediatric cardiology services provided across district general hospitals in the United Kingdom.

  6. The association between job satisfaction and general health among employees of Golestan Hospital in Ahvaz, Iran.

    Science.gov (United States)

    Khiavi, Farzad Faraji; Dashti, Rezvan; Zergani, Nadia

    2016-04-01

    Job satisfaction is one of the most challenging organizational concepts, and it is the basis of management policies to increase productivity and efficiency of the organization. The general health rate may affect job satisfaction in several ways. This study aimed to determine the association between job satisfaction and general health among employees of Golestan Hospital in Ahvaz, Iran. The study population of this cross-sectional research included 100 employees of Golestan Hospital in Ahvaz, Iran. The data collection instruments were the General Health Questionnaire (28-GHQ) and the Job Descriptive Index (JDI) questionnaire. The data were analyzed using Pearson's product-moment correlation coefficient, independent samples t-test, and ANOVA statistical tests in SPSS software. The mean general health was calculated as 26.19 ± 11.04, which indicated a positive psychiatric condition. Job satisfaction with a mean score of 89.67 ± 23.3 was deemed to be relatively dissatisfied. A medium negative and significant association was observed between job satisfaction and general health and its subscales (physical health, anxiety, social, and depression). General health subscales and job satisfaction are associated. Some actions must be planned to cope with the negative factors in general health in order to increase employees' satisfaction in university educational hospitals.

  7. Liaison psychiatry professionals' views of general hospital care for patients with mental illness: The care of patients with mental illness in the general hospital setting.

    Science.gov (United States)

    Noblett, J; Caffrey, A; Deb, T; Khan, A; Lagunes-Cordoba, E; Gale-Grant, O; Henderson, C

    2017-04-01

    Explore the experiences of liaison psychiatry professionals, to gain a greater understanding of the quality of care patients with mental illness receive in the general hospital setting; the factors that affect the quality of care; and their insights on interventions that could improve care. A survey questionnaire and qualitative in depth interviews were used to collect data. Data collection took place at the Royal College of Psychiatrists Faculty of Liaison Psychiatry Annual conference. Qualitative analysis was done using thematic analysis. Areas of concern in the quality of care of patients with co-morbid mental illness included 'diagnostic overshadowing', 'poor communication with patient', 'patient dignity not respected' and 'delay in investigation or treatment'. Eleven contributing factors were identified, the two most frequently mentioned were 'stigmatising attitudes of staff towards patients with co-morbid mental illness' and 'complex diagnosis'. The general overview of care was positive with areas for improvement highlighted. Interventions suggested included 'formal education' and 'changing the liaison psychiatry team'. The cases discussed highlighted several areas where the quality of care received by patients with co-morbid mental illness is lacking, the consequences of which could be contributing to physical health disparities. It was acknowledged that it is the dual responsibility of both the general hospital staff and liaison staff in improving care. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Measuring unexplained variation in acute hospital use by patients enrolled with northern New Zealand general practices

    Directory of Open Access Journals (Sweden)

    Sandiford P

    2014-06-01

    Full Text Available INTRODUCTION: There is increasing concern worldwide at the steady growth in acute inpatient admissions and emergency department (ED attendances. AIM: To develop measures of variation in acute hospital use between populations enrolled at different general practices that are independent of the sociodemographic characteristics of those populations. METHODS: Two consecutive years of hospital discharge and ED attendance data were combined with primary health organisation (PHO registers from 385 practices of over 1.5 million people to develop and test two measures of unplanned hospital use: the standardised acute hospital admission ratio (SAAR and the standardised ED attendance ratio (SEAR. Disease-specific measures were also produced for inpatient events. RESULTS: The enrolled populations of a high proportion of practices had significantly higher or lower than expected acute use of hospitals and this was consistent over both years studied. Practices whose population made unexpectedly high use of acute hospital care for one condition tended to do so for others. Differences in health needs between practice populations as measured by clinical complexity, comorbidities and length of stay did not explain a significant portion of the overall variation in hospital admissions. The enrolled population’s average travelling time to a 24-hour ED accounted for some of the practice variation in unplanned utilisation of hospital services. DISCUSSION: This study confirms that there is considerable unexplained practice variation in acute hospital use. Further development of the SAAR and SEAR measures may be possible to use these to identify modifiable practice-level factors associated with high unplanned hospital use.

  9. Mobility and the Modern Intellectual: Translated Images from Early 20th-Century Literary Works in Spanish by Carmen Lyra and Luisa Luisi

    Directory of Open Access Journals (Sweden)

    Laura Kanost

    2018-02-01

    Full Text Available This essay juxtaposes original translations of contrasting images from the novel En una silla de ruedas [In a Wheelchair] by Costa Rican writer Carmen Lyra and Poemas de la inmovilidad [Poems of Immobility] by Uruguayan writer Luisa Luisi to reveal how representations of intellectuals who are paralyzed might complicate discourses of the artist, social hygiene, and eugenics in early 20th-century Spanish America. Lyra portrays her protagonist's paralysis as a tragedy, but his disability is also the source of social mobility that allows the novel to depict marginalized members of Costa Rican society. Luisi contests modernista aesthetics of perfect forms, countering with a multifaceted exploration of inner space enabled by physical stillness. Through their depictions of hospitals, asylums, and sanitariums, both writers bear witness to bodies the modernizing project would prefer to hide, and imagine alternative forms of progress.

  10. The use of the truth and deception in dementia care amongst general hospital staff.

    Science.gov (United States)

    Turner, Alex; Eccles, Fiona; Keady, John; Simpson, Jane; Elvish, Ruth

    2017-08-01

    Deceptive practice has been shown to be endemic in long-term care settings. However, little is known about the use of deception in dementia care within general hospitals and staff attitudes towards this practice. This study aimed to develop understanding of the experiences of general hospital staff and explore their decision-making processes when choosing whether to tell the truth or deceive a patient with dementia. This qualitative study drew upon a constructivist grounded theory approach to analyse data gathered from semi-structured interviews with a range of hospital staff. A model, grounded in participant experiences, was developed to describe their decision-making processes. Participants identified particular triggers that set in motion the need for a response. Various mediating factors influenced how staff chose to respond to these triggers. Overall, hospital staff were reluctant to either tell the truth or to lie to patients. Instead, 'distracting' or 'passing the buck' to another member of staff were preferred strategies. The issue of how truth and deception are defined was identified. The study adds to the growing research regarding the use of lies in dementia care by considering the decision-making processes for staff in general hospitals. Various factors influence how staff choose to respond to patients with dementia and whether deception is used. Similarities and differences with long-term dementia care settings are discussed. Clinical and research implications include: opening up the topic for further debate, implementing staff training about communication and evaluating the impact of these processes.

  11. Ben Taub General Hospital & LifeGift: Strengthening a Partnership to Save Lives and Improve Healthcare Delivery

    National Research Council Canada - National Science Library

    Philpot, Douglas G

    2007-01-01

    Ben Taub General Hospital, working closely with LifeGift, consistently ranks at or near the top of the list of hospitals in the United States that receive informed consent for organ donation from patients' families...

  12. Audit and account billing process in a private general hospital: a case study

    Directory of Open Access Journals (Sweden)

    Raquel Silva Bicalho Zunta

    2017-12-01

    Full Text Available Our study aimed to map, describe and, validate the audit, account billing and billing reports processes in a large, private general hospital.  An exploratory, descriptive, case report study. We conducted non-participatory observation moments in Internal Audit Sectors and  Billing Reports from the hospital, aiming to map the processes which were the study objects. The data obtained was validated by internal and external audit specialists in hospital bills. The described and illustrated processes in three flow-charts favor professionals to rationalize their activities and the time spent in hospital billing, avoiding or minimizing the occurrence of flaws and, generating more effective financial results. The mapping, the description and the audit validation process and billing and, the billing reports propitiated more visibility and legitimacy to actions developed by auditor nurses.

  13. Assessing knowledge and attitudes towards addictions in medical residents of a general hospital

    OpenAIRE

    Barral, Carmen; Eiroa-Orosa, Francisco Jose; Navarro-Marfisis, Maria Cecilia; Roncero, Carlos; Casas, Miguel

    2014-01-01

    Addiction treatment training has been recognized to be an essential part of the curriculum in psychiatry and general medicine. Our objective in this study was to measure the knowledge and attitudes towards addictions among medical residents of a general hospital in Catalonia, Spain.\\ud \\ud Method\\ud Within a sample of medical residents, we administered a questionnaire based on previous literature including attitudes towards patients with drug use problems, evaluation of knowledge and beliefs ...

  14. Trends in exodontia under general anaesthesia at a dental teaching hospital.

    Science.gov (United States)

    Grant, S M; Davidson, L E; Livesey, S

    1998-10-10

    To survey the use of simple exodontia for children under general anaesthesia on an out-patient basis at a Northern Dental Hospital. To monitor any effects resulting from the introduction of the Poswillo guidelines on the referral for and treatment of patients under general anaesthesia. A retrospective longitudinal analysis. A Northern Dental Hospital in England. Information was recorded from original case records of children undergoing exodontia under general anaesthesia on an out-patient basis during October between 1989 and 1997. The mean and modal age of the children decreased from 7.7 years to 6.0 years respectively in 1989 to 5.7 years and 4.0 years in 1997. The proportion receiving a general anaesthetic for orthodontic extractions substantially decreased from 18.0% in 1989 to 0.7% in 1997 and the need for repeat dental general anaesthetics within 18 months was eliminated with the introduction of a pre-general anaesthetic screening service. Dental treatment under general anaesthesia should continue to be available where it is justified. A separate assessment appointment reduces the prescription of general anaesthesia and minimises its usage for orthodontic extractions and the necessity for repeat general anaesthesia.

  15. Neural network based pattern matching and spike detection tools and services--in the CARMEN neuroinformatics project.

    Science.gov (United States)

    Fletcher, Martyn; Liang, Bojian; Smith, Leslie; Knowles, Alastair; Jackson, Tom; Jessop, Mark; Austin, Jim

    2008-10-01

    In the study of information flow in the nervous system, component processes can be investigated using a range of electrophysiological and imaging techniques. Although data is difficult and expensive to produce, it is rarely shared and collaboratively exploited. The Code Analysis, Repository and Modelling for e-Neuroscience (CARMEN) project addresses this challenge through the provision of a virtual neuroscience laboratory: an infrastructure for sharing data, tools and services. Central to the CARMEN concept are federated CARMEN nodes, which provide: data and metadata storage, new, thirdparty and legacy services, and tools. In this paper, we describe the CARMEN project as well as the node infrastructure and an associated thick client tool for pattern visualisation and searching, the Signal Data Explorer (SDE). We also discuss new spike detection methods, which are central to the services provided by CARMEN. The SDE is a client application which can be used to explore data in the CARMEN repository, providing data visualization, signal processing and a pattern matching capability. It performs extremely fast pattern matching and can be used to search for complex conditions composed of many different patterns across the large datasets that are typical in neuroinformatics. Searches can also be constrained by specifying text based metadata filters. Spike detection services which use wavelet and morphology techniques are discussed, and have been shown to outperform traditional thresholding and template based systems. A number of different spike detection and sorting techniques will be deployed as services within the CARMEN infrastructure, to allow users to benchmark their performance against a wide range of reference datasets.

  16. Two decades of external peer review of cancer care in general hospitals; the Dutch experience

    NARCIS (Netherlands)

    Kilsdonk, Melvin; Siesling, Sabine; Otter, R.; van Harten, Willem H.

    2015-01-01

    External peer review was introduced in general hospitals in the Netherlands in 1994 to assess and improve the multidisciplinary team approach in cancer care. This paper aims to explore the value, perceived impact, and (future) role of external peer review in cancer care. Semistructured interviews

  17. Assessment of the Penta-XT radiography table at Mansfield General Hospital

    International Nuclear Information System (INIS)

    1984-07-01

    A DHSS assessment report, prepared by Mansfield General Hospital, is presented for a Penta-XT radiographic table. The table has a fully floating table top with longitudinal and lateral movement and a variable height which has proved to be very acceptable to both staff and patients utilising the equipment. Details of operational experience and reliability are given. (U.K.)

  18. Minor surgery in general practice and effects on referrals to hospital care: observational study.

    NARCIS (Netherlands)

    Dijk, C.E. van; Verheij, R.A.; Spreeuwenberg, P.; Groenewegen, P.P.; Bakker, D.H. de

    2011-01-01

    Background: Strengthening primary care is the focus of many countries, as national healthcare systems with a strong primary care sector tend to have lower healthcare costs. However, it is unknown to what extent general practitioners (GPs) that perform more services generate fewer hospital

  19. An analysis of acute admissions to a general hospital psychiatric unit

    African Journals Online (AJOL)

    Rapid turnover of patients in a general hospital psychiatric unit demands stabilization and discharge as soon as possible. It is likely that patients are being prematurely discharged because of this pressure. Aim: The study sought to analyse admissions to an acute psychiatric unit with a view to determining the demographic ...

  20. [Acute care of critically ill children in general hospitals: organisation and training].

    Science.gov (United States)

    van Sambeeck, S J L; Janssen, E J M; Hundscheid, T; Martens, S J L; Vos, G D

    2013-01-01

    To gain insight into how the acute care of critically ill children at general hospitals is organised, whether staff is sufficiently trained and whether the necessary materials and medications are present. Questionnaire combined with a site visit. Questionnaires were sent to all primarily involved specialists (emergency room specialists and paediatricians), and to the auxiliary anaesthetists and intensivists involved, at the nine general hospitals in Southeast Netherlands. Two researchers performed standardised interviews with the lead paediatricians on site and checked for materials and medication present in the emergency and paediatric departments. Of the 195 questionnaires sent, 97 (49.7%) were deemed suitable for analysis. The response from the primary specialists involved (77.6%) was more than twice that of the auxiliary specialists (31.9%). At 7 hospitals, verbal agreements on the organisation of acute care were maintained, 1 hospital had a written protocol, and 2 hospitals had a task force addressing this topic. One out of 5 respondents was unaware of the verbal agreements and 1 out of 3 mistakenly assumed that a protocol existed. Two out of 3 primary specialists involved were certified for Advanced Paediatric Life Support (APLS); 1 out of 13 of the auxiliary specialists had such a certificate. Scenario training was being conducted at 8 hospitals. A paediatric resuscitation cart was available at both the emergency and paediatric departments of 8 hospitals, 3 of which were fully stocked at both departments. Laryngeal mask airways and PEEP-valves (Positive End Expiratory Pressure) were lacking at 6 of the 9 hospitals. The medication stock was complete at all the hospitals. The organisation of and training for the acute care of critically ill children and presence of materials - the aspects we investigated - need attention at all general hospitals evaluated. It appeared that many specialists are not APLS certified and written protocols concerning organisation

  1. Study of Patients Absconding Behavior in a General Hospital at Southern Region of Iran

    Directory of Open Access Journals (Sweden)

    Mohammad Khammarnia

    2015-03-01

    Full Text Available Background Patients’ escape from hospital imposes a significant cost to patients as well as the health system. Besides, for these patients, exposure to adverse events (such as suicide, self-harm, violence and harm to hospital reputation are more likely to occur compared to others. The present study aimed to determine the characteristics of the absconding patients in a general hospital through a case-control design in Shiraz, Iran. Methods This case-control study was conducted on 413 absconded patients as case and 413 patients as control in a large general hospital in Shiraz, southern Iran. In this study, data on the case and control patients was collected from the medical records using a standard checklist in the period of 2011–3. Then, the data were analyzed using descriptive and analytical statistics, through SPSS 16. Results The finding showed that 413 patients absconded (0.50% and mean of age in case group was 40.98 ± 16.31 years. In univariate analysis, variables of gender [Odds Ratio (OR= 2], ward (OR= 1.22, insurance status (OR= 0.41, job status (OR= 0.34 and residence expenditure were significant. However, in multivariate analysis significant variables were age (ORadj= 0.13, gender (ORadj= 2.15, self-employment/unemployed (ORadj= 0.47, emergency/admission (ORadj= 2.14, internal/admission (ORadj= 3.16, insurance status (ORadj= 4.49 and residence expenditure (ORadj= 1.15. Conclusion Characteristics such as middle age, male gender, no insurance coverage, inability to afford hospital expenditures and admission in emergency department make patients more likely abscond from the hospital. Therefore, it may be necessary to focus efforts on high-risk groups and increase insurance coverage in the country to prevent absconding from hospital.

  2. Sleep disorder status of nurses in general hospitals and its influencing factors.

    Science.gov (United States)

    Han, Yanjie; Yuan, Yingzi; Zhang, Li; Fu, Yanru

    2016-06-01

    This study aimed to evaluate the current sleep disorder status of nurses in general hospitals and analyze its influencing factors. A total of 2,033 nurses who have worked for 6 months in 3 general hospitals, namely, The First Affiliated Hospital of Harbin Medical University, The Second Affiliated Hospital of Harbin Medical University, and The Third Affiliated Hospital of Harbin Medical University, were selected by random sampling from April 2015 to November 2015 and investigated. The Effort-Reward Imbalance Questionnaire (ERI) and Job Content Questionnaire (JCQ) were applied to evaluate occupational stress. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate the sleep disorder status of the research subjects. Logistic regression analysis was adopted to determine the influencing factors of nurses' sleep disorders. The average PSQI score of 2,003 research subjects is 7.26±3.56, including 860 subjects with PSQI ≥8, accounting for 42.9%. The female research subjects in the department of gynecology and obstetrics, emergency department, and ICU show high risks of sleep disorders (i.e., many years of working; job title: registered nurse; many times of night shift per month; no frequent exercise; many efforts and few rewards; high decision-making autonomy). Educational background and marital status did not exhibit statistical relevance with sleep disorders. The sleep disorder status of nurses in general hospitals is closely related to occupational stress. As such, nurse managers should focus more attention to the influencing factors of nurses' sleep disorders and relieve their occupational stress to reduce the occurrence rate of sleep disorders.

  3. Simulating policy options for psychiatric care in general hospitals under Medicare's PPS.

    Science.gov (United States)

    Freiman, M P; Mitchell, J B; Rosenbach, M L

    1988-11-01

    Psychiatric hospitals and certain distinct part psychiatric units of general hospitals are currently exempt from diagnosis related group (DRG)-based payment under Medicare's prospective payment system (PPS), in large part due to concern about the degree to which such payment would match historical costs for these facilities. This communication simulates DRG-based payments for psychiatric admissions to general hospitals under the PPS and also under a modified version of the PPS. Two major types of modifications are made: (1) an increase in the role of outlier payments and (2) a restructuring of the DRG classification to allow for a difference in the basic payment rate, depending on whether or not care is provided in a facility that is currently exempt. When compared with cost data from just before the start of the PPS, the simulation results show the degree to which these hypothetical modifications will decrease the systematic risk of general hospitals with exempt units from receiving payments that fall short of costs.

  4. Psychopathology of adolescents with an intellectual disability who present to general hospital services.

    Science.gov (United States)

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

    2017-10-01

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

  5. No. 3 Canadian General Hospital (McGill) in the Great War: service and sacrifice.

    Science.gov (United States)

    Beckett, Andrew; Harvey, Edward J

    2018-02-01

    During the Great War, McGill University fielded a full general hospital to care for the wounded and sick among the Allied forces fighting in France and Belgium. The unit was designated No. 3 Canadian General Hospital (McGill) and included some of the best medical minds in Canada. Because the unit had a relationship with Sir William Osler, who was a professor at McGill from 1874 to 1885, the unit received special attention throughout the war, and legendary Canadian medical figures, such as John McCrae, Edward Archibald and Francis Scrimger, VC, served on its staff. The unit cared for thousands of victims of the war, and its trauma care advanced through the clinical innovation and research demanded by the nature of its work. Although No. 3 Canadian General Hospital suffered tragedies as well, such as the deaths of John McCrae and Osler's only son Revere, by the war's end the McGill hospital was known as one of the best medical units within the armies in France.

  6. Comparing salivary cotinine concentration in non-smokers from the general population and hospitality workers in Spain.

    Science.gov (United States)

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

    2009-12-01

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

  7. Perfil clínico del adulto mayor atendido ambulatoriamente en un hospital general.

    OpenAIRE

    Casas, Paola; Varela, Luis; Tello, Tania; Ortiz, Pedro; Chávez, Helver

    2012-01-01

    Objetivo: Describir el perfil clínico del adulto mayor atendido ambulatoriamente en un hospital general. Material y métodos: Estudio descriptivo, transversal, realizado a través de encuestas aplicadas a pacientes en la consulta ambulatoria de geriatría del Hospital Nacional Cayetano Heredia (HNCH), entre agosto de 2011 y enero 2012. Resultados: Se evaluaron 290 pacientes, el 69,3% fueron mujeres; el 65,5% tenía entre 60 y 79 años. La hipertensión arterial fue el diagnóstico más frecuente (55,...

  8. An analysis of OSHA inspections assessing contaminant exposures in general medical and surgical hospitals.

    Science.gov (United States)

    Knight, Jordan L; Sleeth, Darrah K; Larson, Rodney R; Pahler, Leon F

    2013-04-01

    This study analyzed data from the Occupational Safety and Health Administration's (OSHA) Chemical Exposure Health Database to assess contaminant exposures in general medical and surgical hospitals. Seventy-five inspections conducted in these hospitals from 2005 through 2009 were identified. Five categories of inspections were conducted, the three most common being complaint-based, planned, and referral-based inspections. Complaint-based inspections comprised the majority of inspections-55 (73%) of the 75 conducted. The overall violation rate for all inspection types was 68%. This finding was compared to the violation rates of planned inspections (100%), referral-based inspections (83%), and complaint-based inspections (62%). Asbestos was the hazardous substance most commonly sampled and cited by OSHA in hospitals, with 127 samples collected during 24 inspections; 31% of the total 75 inspections resulting in one or more violations were due to asbestos. Copyright 2013, SLACK Incorporated.

  9. Five-Year Data of Clinical Characteristics and Laboratory Findings of Hospitalized Hemophilic Patients in Dr. Hasan Sadikin General Hospital

    Directory of Open Access Journals (Sweden)

    Dina Marlina

    2016-12-01

    Full Text Available Background: Hemophilia A has the highest incidence, more than 80% of 172.323 cases worldwide in 2012. It is stated that clinical characteristics of hemophilia A is worse than others, so it is required to prove and to know further about the clinical characteristics and severity likelihood in all hemophilic patients in order to prevent re-bleeding and re-injury and also for a better medical response. Methods: A retrospective cross-sectional study was carried out to 43 medical records of hospitalized hemophilic patients from 2009 to 2013 in Dr Hasan Sadikin General Hospital. The inclusion criteria were a complete patient identity (name, age, sex, written chief complaint, complete physical examination (bleeding, edema, hematoma, hemarthrosis, anemic symptoms and laboratory test results (factor level, hemoglobin, hematocrit, platelet and Activated Partial Thromboplastin Time. The data was collected from August‒October 2014, analyzed and presented using frequency distribution. Results: Most of the patients were 5-10 years old, male and had hemophilia A. The most common complaint was external bleeding, followed by edema. From 43 patients, 38 (88% cases were classified as severe factor deficiency, had mild to severe anemia, however the platelet count in most of the cases was in normal value. About 91% cases had prolonged Activated Partial Thromboplastin Time in moderate to severe level. Conclusions: Similar with other studies worldwide, most of the hospitalized hemophilic patients have hemophilia A. Most of the patents has moderate to severe bleeding with laboratory test result between moderate to severe level as well.

  10. Factors Affecting The Adoption Of Mhealth In Maternal Health Care In Nakuru Provincial General Hospital

    Directory of Open Access Journals (Sweden)

    Simon Munyua

    2015-08-01

    Full Text Available Abstract Access to timely and quality maternal health care remains to be a major development challenge in many developing economies particularly in Kenya. The countrys system of providing maternal health care also continue to be anchored on conventional methods of physical presence of the patient and the doctor in a hospital setup. The countrys ICT and health policies also place very little emphasis on the use of these platforms. This study therefore sought to establish the factors affecting the adoption of mHealth by focusing on maternal health in Nakuru Provincial General Hospital. Objectives of the study were to determine the extent to knowledge and awareness affects the adoption of mHealth in maternal health care at Nakuru PGH to identify the government policies affecting the adoption of mHealth in maternal health care at Nakuru PGH to assess how access to technology affects the adoption of mHealth in maternal healthcare to establish the effects of ICT infrastructure on the adoption of mHealth in maternal health care and to identify the cost aspects affecting the adoption of mHealth in maternal health care at Nakuru Provincial General Hospital. It is envisaged that the study could provide useful information on the adoption of mHealth in managing maternal health care in Nakuru Provincial General Hospital. Descriptive survey research design will be used where all the medical staff and patients of Nakuru Provincial General Hospital was surveyed. The study population therefore was made up of 24 medical staff and 3460 mothers visiting the antenatal clinic selected using clustered random sampling technique. The main instrument for primary data collection was the questionnaire. Data analysis was then done using both descriptive and inferential statistics. Descriptive statistics to be used include frequency counts percentages and measures of central tendency. Inferential statistics on the other hand include t-test analysis and spearman correlation

  11. Apuntes del Colegio “Estudio” Una santanderina, Carmen García del Diestro, cofundadora. // Notes of School "Estudio" A Santanderina, Carmen Garcia del Diestro, cofounder.

    Directory of Open Access Journals (Sweden)

    José Luis Rodríguez Villa

    2013-06-01

    Full Text Available (ES El Colegio “Estudio” de Madrid, gracias a una serie de profesoras que habían trabajado en el Instituto-Escuela de la capital, salvaguardó y transmitió de alguna manera los valores educativos de la Institución Libre de Enseñanza. Jimena Menéndez-Pidal, Ángeles Gasset y la santanderina Carmen García del Diestro ocuparían un lugar fundamental en la creación, y en funcionamiento en las primeras décadas, del Colegio “Estudio”. Su modelo pedagógico estaba basado en el fomento de la curiosidad hacia el entorno natural por parte del niño y en el desarrollo de un sentido de la tolerancia y el respeto hacia los demás, así como en la creación de hábitos de trabajo apoyados en un sistema riguroso de estudio. // (EN The School “Estudio” in Madrid, thanks to a number of teachers who had worked at the Instituto-Escuela of the capital, safeguarded and transmitted in some way the educational values of the Institución Libre de Enseñanza. Jimena Menéndez-Pidal, Ángeles Gasset and Carmen García del Diestro, born in Santander, occupy a central place in creation, and operation during the first decades, the School “Estudio”. His pedagogical model was based on the promotion of curiosity about the natural environment by the child and to develop a sense of tolerance and respect for others as well as creating work habits supported by a rigorous study.

  12. Hospital costs associated with surgical site infections in general and vascular surgery patients.

    Science.gov (United States)

    Boltz, Melissa M; Hollenbeak, Christopher S; Julian, Kathleen G; Ortenzi, Gail; Dillon, Peter W

    2011-11-01

    Although much has been written about excess cost and duration of stay (DOS) associated with surgical site infections (SSIs) after cardiothoracic surgery, less has been reported after vascular and general surgery. We used data from the National Surgical Quality Improvement Program (NSQIP) to estimate the total cost and DOS associated with SSIs in patients undergoing general and vascular surgery. Using standard NSQIP practices, data were collected on patients undergoing general and vascular surgery at a single academic center between 2007 and 2009 and were merged with fully loaded operating costs obtained from the hospital accounting database. Logistic regression was used to determine which patient and preoperative variables influenced the occurrence of SSIs. After adjusting for patient characteristics, costs and DOS were fit to linear regression models to determine the effect of SSIs. Of the 2,250 general and vascular surgery patients sampled, SSIs were observed in 186 inpatients. Predisposing factors of SSIs were male sex, insulin-dependent diabetes, steroid use, wound classification, and operative time (P general and vascular surgical procedures share many risk factors with SSIs after cardiothoracic surgery. Although the excess costs and DOS associated with SSIs after general and vascular surgery are somewhat less, they still represent substantial financial and opportunity costs to hospitals and suggest, along with the implications for patient care, a continuing need for cost-effective quality improvement and programs of infection prevention. Copyright © 2011 Mosby, Inc. All rights reserved.

  13. Emergency department boarding and adverse hospitalization outcomes among patients admitted to a general medical service.

    Science.gov (United States)

    Lord, Kito; Parwani, Vivek; Ulrich, Andrew; Finn, Emily B; Rothenberg, Craig; Emerson, Beth; Rosenberg, Alana; Venkatesh, Arjun K

    2018-03-20

    Overcrowding in the emergency department (ED) has been associated with patient harm, yet little is known about the association between ED boarding and adverse hospitalization outcomes. We sought to examine the association between ED boarding and three common adverse hospitalization outcomes: rapid response team activation (RRT), escalation in care, and mortality. We conducted an observational analysis of consecutive patient encounters admitted from the ED to the general medical service between February 2013 and June 2015. This study was conducted in an urban, academic hospital with an annual adult ED census over 90,000. We defined boarding as patients with greater than 4h from ED bed order to ED departure to hospital ward. The primary outcome was a composite of adverse outcomes in the first 24h of admission, including RRT activation, care escalation to intensive care, or in-hospital mortality. A total of 31,426 patient encounters were included of which 3978 (12.7%) boarded in the ED for 4h or more. Adverse outcomes occurred in 1.92% of all encounters. Comparing boarded vs. non-boarded patients, 41 (1.03%) vs. 244 (0.90%) patients experienced a RRT activation, 53 (1.33%) vs. 387 (1.42%) experienced a care escalation, and 1 (0.03%) vs.12 (0.04%) experienced unanticipated in-hospital death, within 24h of ED admission. In unadjusted analysis, there was no difference in the composite outcome between boarding and non-boarding patients (1.91% vs. 1.91%, p=0.994). Regression analysis adjusted for patient demographics, acuity, and comorbidities also showed no association between boarding and the primary outcome. A sensitivity analysis showed an association between ED boarding and the composite outcome inclusive of the entire inpatient hospital stay (5.8% vs. 4.7%, p=0.003). Within the first 24h of hospital admission to a general medicine service, adverse hospitalization outcomes are rare and not associated with ED boarding. Copyright © 2018 Elsevier Inc. All rights

  14. Leukocytosis as an Alarming Sign for Mortality in Patients Hospitalized in General Wards

    Directory of Open Access Journals (Sweden)

    Khairollah Asadollahi

    2011-03-01

    Full Text Available There is some evidence that leukocytosis without infection is associated with increased hospital mortality, but data in this regard are very incomplete. This study was designed to investigate the relationship between leukocytosis at the time of admission and mortality among patients hospitalized in general wards. During July to Nov 2004, all deceased patients who had a white blood cell (WBC count record for the first 24 hours of admission were selected as cases. Among survivors, twice the number of cases was selected as controls. Different levels of WBC counts were compared between cases and controls. Totally 1650 patients, including 550 deceased (cases and 1100 survivors (controls were analyzed. Of these, 876 (53% were males and 774 (47% females, and 42 (3% were admitted to ICU, 1426 (86% to medical and 182 (11% to surgical wards. There was a significant difference between the mean age of deceased patients (78.0 years and survivors (53.0 years (P10×109/l accounted for 804, among which 335 (42% were deceased. Leukocytosis and leukopoenia were more frequent among the deceased patients compared to the survivors. The likelihood ratio for leukocytosis and leukopenia among the cases and controls was 1.4 and 2.3, respectively. Leukocytosis was identified as an alarming sign for mortality among patients admitted to general hospital wards at early stages of admission. A quick medical intervention for amendment of the causes related to leukocytosis should consequently reduce hospital mortality

  15. Physician staffing for the practice of psychosomatic medicine in general hospitals: a pilot study.

    Science.gov (United States)

    Kunkel, Elisabeth J S; Del Busto, Elena; Kathol, Roger; Stern, Theodore A; Wise, Thomas N; Stoddard, Frederick R; Straus, Joshua; Saravay, Stephen M; Muskin, Philip R; Dresner, Nehama; Harrington, Colin J; Weiner, Joseph; Barnhill, John; Becker, Madeleine; Joseph, Robert C; Oyesanmi, Olugbenga; Fann, Jesse R; Colon, Eduardo; Epstein, Steven; Weinrieb, Robert

    2010-01-01

    The treatment of psychiatric illnesses, prevalent in the general hospital, requires broadly trained providers with expertise at the interface of psychiatry and medicine. Since each hospital operates under different economic constraints, it is difficult to establish an appropriate ratio of such providers to patients. The authors sought to determine the current staffing patterns and ratios of Psychosomatic Medicine practitioners in general hospitals, to better align manpower with clinical service and educational requirements on consultation-liaison psychiatry services. Program directors of seven academic Psychosomatic Medicine (PM) programs in the Northeast were surveyed to establish current staffing patterns and patient volumes. Survey data were reviewed and analyzed along with data from the literature and The Academy of Psychosomatic Medicine (APM) fellowship directory. Staffing patterns varied widely, both in terms of the number and disciplines of staff providing care for medical and surgical inpatients. The ratio of initial consultations performed per hospital bed varied from 1.6 to 4.6. Although staffing patterns vary, below a minimum staffing level, there is likely to be significant human and financial cost. Efficient sizing of a PM staff must be accomplished in the context of a given institution's patient population, the experience of providers, the presence/absence and needs of trainees, and the financial constraints of the department and institution. National survey data are needed to provide benchmarks for both academic and nonacademic PM services.

  16. Workplace sexual harassment in two general hospitals in Taiwan: the incidence, perception, and gender differences.

    Science.gov (United States)

    Wang, Liang-Jen; Chen, Chih-Ken; Sheng, Yi-Chen; Lu, Pei-Wen; Chen, Yi-Ting; Chen, Huei-Jun; Lin, Jyh-Sheng

    2012-01-01

    The aims of this study were to examine sexual harassment (SH) among hospital staffs in Taiwan, in terms of three-month incidence rate, the frequency of each type and the perception of SH, perpetrated by coworkers, patients and patients' families and to investigate the gender differences for these issues. The subjects were employees at two general hospitals in Taiwan. The self-administered "Hospital Sexual Harassment Questionnaire" was sent to eligible staff, and the voluntary respondents answered the questionnaire anonymously. There were 536 respondents available for analysis, with an overall response rate of 43.4%. The three-month incidence rates of SH by coworkers, patients, and patients' families in our study population were 2.4, 4.3, and 1.7%, respectively. Telling sexual jokes was the most common type of SH. The males had greater opportunities to be exposed to porn videos by their coworkers. The females were more frequently exposed to sex jokes and remarks made by patients and their family members and unwanted physical touching by patients in the workplace. There were significant differences with regard to the perception of sex jokes and sexually explicit verbal descriptions as SH or not between genders. The information in this study can be a helpful reference for administrators in hospitals when they are establishing education plans and policies. It might be possible to prevent sexual harassment and misunderstandings between genders and to further avoid the negative impact on the emotional well-being of workers in hospitals.

  17. Evaluation of low-dose CT implementation for lung cancer screening in a general practice hospital

    Science.gov (United States)

    Karostik, D. V.; Kamyshanskaya, I. G.; Cheremisin, V. M.; Drozdov, A. A.; Vodovatov, A. V.

    2018-02-01

    The aim of the current study was to evaluate the possibility of the implementation of LDCT for the screening for lung cancer and tuberculosis in a typical general hospital practice. Diagnostic and economic effectiveness, patient doses and the corresponding radiation risks for LDCT were compared with the existing digital chest screening radiography. The results of the study indicate that the implementation of LDCT allowed verifying false-positive cases or providing additional excessive diagnostic information, but did not significantly improve the sensitivity of screening. Per capita costs for LDCT were higher compared to digital radiography up to a factor of 12; corresponding radiation risk - by a factor of 4. Hence, it was considered unjustified to implement LDCT in a general practice hospital.

  18. Relations between ethnic Croats and ethnic Serbs at Vukovar General Hospital in wartime and peacetime.

    Science.gov (United States)

    Bloom, Joshua D; Sondorp, Egbert

    2006-01-01

    This article examines war and peacetime ethnic relations at Vukovar General Hospital in Croatia's Eastern Slavonia region. A negotiated peace agreement paved the way for a multi-sectored approach to the reintegration of Eastern Slavonia back into the state and rapprochement between ethnic groups under the supervision of a United Nations transitional administration. This case study provides a glimpse into the realities of those peace-building processes on an institutional level in Eastern Slavonia's healthcare system. The reintegration of Vukovar hospital, the transition of Eastern Slavonia's health sector and peace-building in the region in general received much deserved accolades despite some flaws and minor setbacks. These experiences can still serve as a model for the rest of Croatia and for other countries emerging from civil conflicts.

  19. [Investigation into drinking problem of patients who visited a general hospital in central and northern Okinawa].

    Science.gov (United States)

    Nakai, Minori; Hotta, Hiroshi; Ootsuru, Taku; Hiejima, Shigeto; Murakami, Masaru; Yuzuriha, Takefumi; Kondo, Tsuyoshi

    2013-04-01

    In Japan, many problems related to alcohol are pointed out from before. We believe that there is a unique drinking culture in Okinawa, such as a large amount of alcohol. Therefore, we estimate many people in Okinawa have a drinking problem. We conducted a survey of patients who visited general hospital (medical or surgical or orthopedic) in 2007. The purpose of this study is to collect basic data for introducing alcoholics to specialized treatment as early as possible, detecting the person who drink large amounts of alcohol, performing early intervention for people who drink large amount of alcohol, and advancing cooperation with specialized medical agencies of alcohol. As a result, Among the patients who visited general hospital in Okinawa, many problem drinkers are concentrated in the young age. and they have strong fears of health. The possibility of early intervention with intervention techniques, such as brief intervention, has been suggested.

  20. [Design of an atrial fibrillation and embolic risk registry in Mexico: CARMEN-AF].

    Science.gov (United States)

    González-Hermosillo, Jesús A; Márquez, Manlio F; Ocampo-Peña, Salvador

    Atrial fibrillation (AF) is one of the most common arrhythmias, and its prevalence increase with age. It is associated with high risk of stroke. The prevention of such thromboembolism is done with oral anticoagulants, which in our country seem to be underused. CARMEN-AF registry aims primarily to determine the current status of thromboprophylaxis of non-valvular AF in Mexico. A secondary objective is to know the morbidity and mortality associated with non-valvular AF in at least one year of follow-up. CARMEN-AF registry is an observational, longitudinal, multicenter, and national survey about the use of oral anticoagulants in patients with non-valvular AF. Patients 18years old or older, diagnosed with AF during the last 6months, and with at least one risk factor of thromboembolism based in the CHA 2 DS 2 -Vasc score are being selected. Demographic and clinical data will be collected during the visits to their usual clinic with a follow-up of 2years. The recruitment began on September 19, 2014, and the inclusion of the last patient is expected on September 18, 2016. According to the reported incidence of AF globally and taking into account the total Mexican population, the inclusion of 1,200 patients is estimated. The Atrial Fibrillation and Embolic Risk Registry (CARMEN-AF) will reveal the current status of thromboprophylaxis in patients with non-valvular AF, and will allow to get an overview of the national and international clinical practice guidelines accomplishment in this area. Copyright © 2016 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

  1. Consumption of psychiatric drugs by patients of medical and surgical clinics in a general hospital

    OpenAIRE

    Shirama,Flavio Hiroshi; Miasso,Adriana Inocenti

    2013-01-01

    PURPOSES: to identify the prevalence of the use of psychiatric drugs among patients admitted to medical and surgical clinics of a general hospital, and also the factors related to the consumption of this type of medication. METHOD: this is a transversal, descriptive, correlational study with quantitative analysis. For the collection of data, there was use of structured interviews and also reference to medical files. RESULTS: there was confirmation of a high prevalence of users of psy...

  2. Survey of "do not resuscitate" orders in a district general hospital.

    OpenAIRE

    Aarons, E J; Beeching, N J

    1991-01-01

    OBJECTIVE--To evaluate the local use of written "Do not resuscitate" orders to designate inpatients unsuitable for cardiopulmonary resuscitation in the event of cardiac arrest. DESIGN--Point prevalence questionnaire survey of inpatients' medical and nursing records. SETTING--10 acute medical and six acute surgical wards of a district general hospital. PARTICIPANTS--Questionnaires were filled in anonymously by nurses and doctors working on the wards surveyed. MAIN OUTCOME MEASURES--Responses t...

  3. Psiquiatría de Enlace. Experiencia en el Hospital General de México

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    I.C. González-Salas

    2014-07-01

    El objetivo de este trabajo es revisar algunos antecedentes históricos de la Salud Mental en México y en el Hospital General de México «Dr. Eduardo Liceaga» (HGM-DEL considerando la evolución institucional y las características de los pacientes que recibe el Servicio de Salud Mental, como parte del equipo multidisciplinario de salud.

  4. Retrospective chart review of elderly patients receiving electroconvulsive therapy in a tertiary general hospital

    OpenAIRE

    Mosam Phirke; Harshal Sathe; Nilesh Shah; Sushma Sonavane; Anup Bharati; Avinash DeSousa

    2015-01-01

    Background: Electroconvulsive therapy (ECT) is the one of the oldest and effective treatments in psychiatry today. It has been used in a wide variety of psychiatric disorders in both young and old patients. Aims of the study: The present study is a retrospective chart review of geriatric patients receiving ECT as a treatment option in a tertiary care general hospital psychiatry setting. Methodology: The study evaluated ECT records over a 5-year period between the years 2010 and 2014...

  5. Perception of transformational leadership behaviour among general hospital nurses in Ogun State, Nigeria

    OpenAIRE

    Oluwatosin Olu-Abiodun; Olumide Abiodun

    2017-01-01

    Introduction: Effective nursing leadership engenders staff retention, job satisfaction, commitment, work unit climate and client satisfaction with nursing services. This study assessed the perception of transformational leadership among nurses working in general hospitals in Nigeria. Materials and methods: A cross-sectional study was conducted among 176 nurses in Ogun State, Nigeria. The independent student t-test was used to test the relationship between respondents’ characteristics and l...

  6. [Decentralized psychiatry. Evaluation of the first 5 years of psychiatric service based on a general hospital].

    Science.gov (United States)

    Saameli, W; Kopp, W

    1990-11-01

    In 1977 the state parliament of Berne took the decision to reform the existing psychiatric health care. decentralized, community oriented institutions were to be established with the aim of preventing secondary disabilities due to psychiatric illness, and of enhancing or instigating rehabilitative measures. 4 different psychiatric services based in general hospitals were installed. The present report presents an analysis of statistical data collected during the first 5 years on one of these services. We found a linear increase of admission which appears to be due to several factors: demand, image, manpower, cooperation with other institutions, breadth of the offered service. Furthermore, the distance between the institution and the place of living proved to be an important factor influencing the incidence of psychiatric treatment and the degree of cooperation with other care services--this aspect being consistent with the arguments for a decentralization of care. The degree of consistency in the distribution of diagnoses and the changes of treatment was surprising: an average of 50% of our patients were referred on an out-patient basis, approx. 40% by general hospital wards, 16% remain under the care of the general hospital. Our statistical analysis shows that in an average of 61% of the cases in which a referral to a psychiatric hospital was discussed, this measure could be avoided (although there is a certain degree of subjectivity in this judgement). The psychiatric service does not appear to compete with private practice care: 44% of the patients are referred to general practitioners and practing psychiatrists for after care, while only half as many are referred from private practices.

  7. Analysis on the Implementation of Nutrition Services in Tugurejo General Hospital Semarang

    OpenAIRE

    Dewi, Emy Shinta; Kartasurya, Martha Irene; Sriatmi, Ayun

    2015-01-01

    Nutrition was an important factor for patient care and cure. Results of an evaluation by nutritionalresearch and development unit of Tugurejo district general hospital (RSUD) in 2011 indicated thatfood remains of patient were still below the minimal standard of service. Objective of this study wasto analyze the implementation of nutritional service in the RSUD Tugurejo Semarang.This was a qualitative study with 4 nutritionists, 8 cook assistants, and 8 waitresses as maininformants. Triangulat...

  8. Motivation and job satisfaction among medical and nursing staff in a Cyprus public general hospital

    OpenAIRE

    Lambrou, Persefoni; Kontodimopoulos, Nick; Niakas, Dimitris

    2010-01-01

    Abstract Background The objective of this study was to investigate how medical and nursing staff of the Nicosia General Hospital is affected by specific motivation factors, and the association between job satisfaction and motivation. Furthermore, to determine the motivational drive of socio-demographic and job related factors in terms of improving work performance. Methods A previously developed and validated instrument addressing four work-related motivators (job attributes, remuneration, co...

  9. Two decades of external peer review of cancer care in general hospitals; the Dutch experience.

    Science.gov (United States)

    Kilsdonk, Melvin J; Siesling, Sabine; Otter, Rene; van Harten, Wim H

    2016-03-01

    External peer review was introduced in general hospitals in the Netherlands in 1994 to assess and improve the multidisciplinary team approach in cancer care. This paper aims to explore the value, perceived impact, and (future) role of external peer review in cancer care. Semistructured interviews were held with clinicians, oncology nurses, and managers from fifteen general hospitals that participated in three rounds of peer review over a period of 16 years. Interviewees reflected on the goals and expectations, experiences, perceived impact, and future role of external peer review. Transcriptions of the interviews were coded to discover recurrent themes. Improving clinical care and organization were the main motives for participation. Positive impact was perceived on multiple aspects of care such as shared responsibilities, internal prioritization of cancer care, improved communication, and a clear structure and position of cancer care within general hospitals. Establishing a direct relationship between the external peer review and organizational or clinical impact proved to be difficult. Criticism was raised on the content of the program being too theoretical and organization-focussed after three rounds. According to most stakeholders, external peer review can improve multidisciplinary team work in cancer care; however, the acceptance is threatened by a perceived disbalance between effort and visible clinical impact. Leaner and more clinically focused programs are needed to keep repeated peer reviews challenging and worthwhile. © 2015 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  10. Trends in fatalities due to poisoning at Umtata General Hospital, Mthatha (1993–2005

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    Banwari L. Meel

    2009-04-01

    Full Text Available Poisoning is a common method of committing suicide in this region of South Africa. Females generally ingest poisons but it is increasingly becoming common in males too. This is a record review of autopsies carried out at the Umtata (Mthatha General Hospital mortuary, which forms part of the teaching hospital of the Walter Sisulu University Medical School. There were 10 230 unnatural deaths between 1993 and 2005. Of these deaths, 161 (1.6% were deaths due to poisoning. There was a marked increase in death by poisoning from 2.5% in 1993 to 13.7% in 2004. The highest percentage (17.4% of poison-related deaths was in 2001, and the lowest (2.5% was in 1993 and 1994. About two-thirds of victims (66% were males, and more than half of the victims (51.5% were in the 11 to 30 age group. There is an increasing trend in fatalities due to poisoning at Umtata General Hospital, Mthatha.

  11. Indications of Tonsillectomy and Adenoidectomy in Dr. Hasan Sadikin General Hospital Bandung

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    Dini Atiyah

    2015-03-01

    Full Text Available Background: Tonsillectomy is the intervention to take out the palatine tonsils either whole or sub capsular, while adenoidectomy is the intervention of extraction of the adenoid gland which is commonly done with curettage method. Both interventions are done to eliminate repeated infections and also obstructions due to inflammation and hypertrophy of the tonsils and adenoids. This study was conducted to examine the indications of tonsillectomy and adenoidectomy in the Departement of Otorhinolaryngology and Head Neck Surgery Dr. Hasan Sadikin General Hospital Bandung in the period of January 2009–December 2011. Methods: A cross-sectional descriptive study was conducted in October–November of 2012 using 207 medical records of patients who had tonsillectomy and adenoidectomy executed in the Department of Otorhinolaryngology and Head Neck Surgery Dr. Hasan Sadikin General Hospital, Bandung in the period of January 2009–December 2011. Data collected were age, gender, main complaint, tonsil size, history of repeated infections, history of snoring as well as of Obstructive Sleep Apnea Syndrome (OSAS. The indication for tonsillectomy and adenoidectomy such as infection, obstruction and neoplasia was selected. Results: The indications of tonsillectomy and adenoidectomy were infection at 106 (51.2% patients, obstruction at 100 (48.3% patients, and neoplasia at 1 (0.05% patient. Conclusions: The most numerous indications for tonsillectomy and tonsilloadenoidectomy in the Department of Otorhinolaryngology and Head Neck Surgery Dr. Hasan Sadikin General Hospital were infection.

  12. El "Carmen de prouidentia Dei". Estudio histórico y doctrinal.

    OpenAIRE

    Villegas Marín, Raúl

    2008-01-01

    El objetivo del presente estudio es la contextualización histórica del Carmen de prouidentia Dei, composición poética cristiana escrita en época de las primeras grandes oleadas de pueblos germánicos sobre territorio galorromano y comúnmente atribuida al cálamo del historiador y teólogo Próspero de Aquitania. Hemos reexaminado el valor de esta obra como testimonio del impacto de las invasiones bárbaras sobre lo que hemos dado en llamar la "conciencia colectiva" de la época y, en esta misma lín...

  13. METAFICTION AND INTERTEXTUALITY IN 'PRÉNOM: CARMEN0 BY JEAN-LUC GODARD

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    Carmen Pujante Segura

    2014-10-01

    Full Text Available J. L. Godard appears as a character in Prénom: Carmen (1983, not only as a homage to himself and/or to the cinema, to genres, to texts, to actors, etc., but also to leave his mark on his version, that is, the adaptation of the well-known myth of the modern and godardian femme fatale. Godard uses the recurrence to intertextuality and to metafiction as the only possible instruments to make and to think about the language of cinema and about art in all their splendour. In this way, prejudices of adaptation are overcome by cinema.

  14. Realidad y ficción en la obra de Carmen Martín Gaite

    OpenAIRE

    Carrillo Romero, María Coronada

    2013-01-01

    La tesis estudia uno de los aspectos fundamentales de la obra de Carmen Martín Gaite, así como su tratamiento a lo largo de toda su trayectoria literaria: la fusión de la realidad y la ficción, del mundo real y de la imaginación, el sueño, el recuerdo y la literatura. Está estructurada en dos partes: teniendo en cuenta la afinidad que la autora sentía hacia determinados escritores cuya influencia en su obra declaró abiertamente en numerosas ocasiones, la primera parte está dedicada a est...

  15. Carmen Miranda em Hollywood : filmes para uma boa vizinhança

    OpenAIRE

    Macedo, Káritha Bernardo de

    2014-01-01

    Esta dissertação tem como objetivo analisar como os filmes de Carmen Miranda, produzidos entre 1940 e 1945 nos Estados Unidos, contribuíram com a construção simbólica de uma identidade cultural latino-americana sob o olhar estadunidense, questionando em que medida as narrativas cinematográficas de América Latina correspondiam a uma estratégia de poder dos Estados Unidos sobre a América Latina, articulada pela Política da Boa Vizinhança. A produção destes filmes se liga a ...

  16. La narrativa de Carmen de Burgos, Colombine. El universo humano y los lenguajes

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    Núñez Rey, Concepción

    2006-06-01

    Full Text Available Carmen de Burgos (Almería, 1867-Madrid, 1932 with her literary and erudite work was part of the main currents of the Spanish literature throughout the first third of the XXth. Century. The dimension and variety of the work seem endless: more than a hundred short and long novels, literary studies, travel books, biographies, translations, social studies. She was the first female newspaper editor. She published thousands of articles in the main Spanish and foreign publications. The yearning of modernity and social justice always guided her. As far as her literary trajectory is concerned, Carmen de Burgos always held two complementary paths that she followed throughout different tendencies and influences and ordered her wide production: her commitment to society and a constant desire of plenitude that pushed her to explore the world looking for an unreachable paradise. Travelling therefore occupied most part of her life and work. Vitalism and rationalism define her life and her literature.Carmen de Burgos (Almería, 1867-Madrid, 1932 participó con su obra literaria y erudita en las corrientes fundamentales de la literatura española a lo largo del primer tercio del siglo XX. La dimensión y variedad de su obra parece inabarcable: más de un centenar de novelas cortas y largas, estudios literarios, libros de viajes, biografías, traducciones, estudios sociales. Primera mujer redactora de un periódico, publicó miles de artículos en las principales publicaciones españolas y también extranjeras. Siempre la guió un anhelo de modernidad y de justicia social. En cuanto a su trayectoria literaria, Carmen de Burgos sostuvo siempre dos caminos complementarios, que mantuvo a través de distintas tendencias e influencias, y que ordenan su extensa producción: su compromiso con la sociedad y un permanente anhelo de plenitud que la empuja a explorar el mundo, en busca de un paraíso inalcanzable. Los viajes ocuparon por ello gran parte de su vida y de sus

  17. [Epidemiology of gunshot wounds at Ciudad Juárez, Chihuahua General Hospital].

    Science.gov (United States)

    Moye-Elizalde, G A; Ruiz-Martínez, F; Suarez-Santamaría, J J; Ruiz-Ramírez, M; Reyes-Gallardo, A; Díaz-Apodaca, B A

    2013-01-01

    Since 2007, Ciudad Juárez, Chihuahua has been considered as one of the most violent cities in the world. The General Hospital in this city is the main facility where patients with gunshot wounds are taken. The increased number of admissions of patients with these injuries to many hospitals in the country deserves special attention, as it has an impact on hospital resources and management protocols. To disseminate the epidemiology of fractures caused by gunshot wounds and the hospital care of these patients. A retrospective, observational cohort study was conducted of patients admitted to the Traumatology and Orthopedics Service, Cd. Juárez General Hospital, in Chihuahua, Mexico, from January 2008 to December 2010. All of them sustained fractures resulting from gunshot wounds. A total of 1281 patients with a diagnosis of gunshot wounds were admitted to the hospital; 402 of them were included in this study with 559 fractures; 329 were males and 73 females. Of the 559 fractures, 257 involved the upper limb, 294 the lower limb, and 8 the pelvis. Gunshot wounds-related fractures were classified according to the Gustilo classification. Seventy-nine patients had grade I fractures, 302 grade III, and 21 patients had both grades. Conservative treatment was used in 44.3% of fractures and osteosynthesis in 55%. One patient underwent amputation upon admission. The most widely used osteosynthesis methods were external fixator (37%), straight plates (21%) and intramedullary nail (17%). Five patients (1.3%) underwent amputation: two with femur fracture and 3 with humeral fracture. There were 27 deep infections (6%); one of them resulted in late amputation of the pelvic limb. The most common associated injuries included: chest injuries in 20 patients and abdominal injuries in 17. The range of hospital stay was 1-18 days, with a mean stay of 11 days. The overall mortality rate considering the total number of patients admitted (1,281) was 99 patients (7.72%). From 2006 to 2010 the

  18. The Difference in the Online Medical Information Searching Behaviors of Hospital Patients and Their Relatives versus the General Public

    Science.gov (United States)

    Wang, Hung-Yuan; Liang, Jyh-Chong; Tsai, Chin-Chung

    2014-01-01

    The purpose of this study is two-fold: to explore the differences in online medical information searching behaviors, including evaluative standards and search strategies, of the general public (general group) and those of hospital patients and their relatives (hospital group); and to compare the predictive relationship between the evaluative…

  19. Diagnostic and therapeutic endoscopic retrograde cholangiopancreaticography after Billroth II gastrectomy--safe provision in a district general hospital.

    OpenAIRE

    Swarnkar, K.; Stamatakis, J. D.; Young, W. T.

    2005-01-01

    INTRODUCTION: Endoscopic retrograde cholangiopancreaticography (ERCP) is available in many district general hospitals in the UK. Most of the published literature on ERCP in cases with Billroth II gastrectomy reflects teaching hospital experience. The aim of this study was to evaluate this procedure in the district general hospital setting, over a 10-year period. PATIENTS AND METHODS: Details of 41 consecutive patients, whom had previously undergone Billroth II gastrectomy and were referred fo...

  20. Mortality of emergency general surgical patients and associations with hospital structures and processes.

    Science.gov (United States)

    Ozdemir, B A; Sinha, S; Karthikesalingam, A; Poloniecki, J D; Pearse, R M; Grocott, M P W; Thompson, M M; Holt, P J E

    2016-01-01

    Variations in patient outcomes between providers have been described for emergency admissions, including general surgery. The aim of this study was to investigate whether differences in modifiable hospital structures and processes were associated with variance in mortality, amongst patients admitted for emergency colorectal laparotomy, peptic ulcer surgery, appendicectomy, hernia repair and pancreatitis. Adult emergency admissions in the English NHS were extracted from the Hospital Episode Statistics between April 2005 and March 2010. The association between mortality and structure and process measures including medical and nursing staffing levels, critical care and operating theatre availability, radiology utilization, teaching hospital status and weekend admissions were investigated. There were 294 602 emergency admissions to 156 NHS Trusts (hospital systems) with a 30-day mortality of 4.2%. Trust-level mortality rates for this cohort ranged from 1.6 to 8.0%. The lowest mortality rates were observed in Trusts with higher levels of medical and nursing staffing, and a greater number of operating theatres and critical care beds relative to provider size. Higher mortality rates were seen in patients admitted to hospital at weekends [OR 1.11 (95% CI 1.06-1.17) Psurgical doctors [1.07 (1.01-1.13) P=0.019] and with lower nursing staff ratios [1.07 (1.01-1.13) P=0.024]. Significant differences between Trusts were identified in staffing and other infrastructure resources for patients admitted with an emergency general surgical diagnosis. Associations between these factors and mortality rates suggest that potentially modifiable factors exist that relate to patient outcomes, and warrant further investigation. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  1. Outcomes of hospitalized patients undergoing emergency general surgery remote from admission.

    Science.gov (United States)

    Sharoky, Catherine E; Bailey, Elizabeth A; Sellers, Morgan M; Kaufman, Elinore J; Sinnamon, Andrew J; Wirtalla, Christopher J; Holena, Daniel N; Kelz, Rachel R

    2017-09-01

    Emergency general surgery during hospitalization has not been well characterized. We examined emergency operations remote from admission to identify predictors of postoperative 30-day mortality, postoperative duration of stay >30 days, and complications. Patients >18 years in The American College of Surgeons National Surgical Quality Improvement Program (2011-2014) who had 1 of 7 emergency operations between hospital day 3-18 were included. Patients with operations >95th percentile after admission (>18 days; n = 581) were excluded. Exploratory laparotomy only (with no secondary procedure) represented either nontherapeutic or decompressive laparotomy. Multivariable logistic regression was used to identify predictors of study outcomes. Of 10,093 patients with emergency operations, most were elderly (median 66 years old [interquartile ratio: 53-77 years]), white, and female. Postoperative 30-day mortality was 12.6% (n = 1,275). Almost half the cohort (40.1%) had a complication. A small subset (6.8%) had postoperative duration of stay >30 days. Postoperative mortality after exploratory laparotomy only was particularly high (>40%). In multivariable analysis, an operation on hospital day 11-18 compared with day 3-6 was associated with death (odds ratio 1.6 [1.3-2.0]), postoperative duration of stay >30 days (odds ratio 2.0 [1.6-2.6]), and complications (odds ratio 1.5 [1.3-1.8]). Exploratory laparotomy only also was associated with death (odds ratio 5.4 [2.8-10.4]). Emergency general surgery performed during a hospitalization is associated with high morbidity and mortality. A longer hospital course before an emergency operation is a predictor of poor outcomes, as is undergoing exploratory laparotomy only. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Dying at home or in the hospital? An observational study in German general practice.

    Science.gov (United States)

    Gágyor, Ildikó; Himmel, Wolfgang; Pierau, Andrea; Chenot, Jean-François

    2016-01-01

    Although determinants of place of death have been investigated in several studies, there is a lack of knowledge on factors associated with dying at home from the general practice perspective. To identify factors associated with dying at home for patients in German general practice. In a retrospective study, general practitioners of 30 general practices were asked to provide data for all patients aged 18 years or older who died within the last 12 months, using a self-developed questionnaire. 'Dying in hospital' was defined as dying in hospital or hospice and 'dying at home' as dying at one's usual residence including the nursing home. Multiple logistic regression analyses were used to determine factors associated with 'dying at home'; odds ratios (ORs) and their 95% confidence intervals (CI) were calculated as measures of effect size. Of 439 deceased patients, 52.2% died at home, and 47.8% died in hospital or hospice. Determinants for dying at home were patients' care in the last 48 hours of life by family members (OR: 7.8, 95% CI: 3.4-18.0), by general practitioners (GPs) (OR: 7.3, 4.2-12.9) and living in a nursing home (OR: 3.8, 1.7-8.3). In the adjusted model, low comorbidity was positively associated (OR: 3.2, 1.4-7.0), and low functional health status (Karnofsky performance status) was negatively associated with dying at home (OR: 0.3, 0.1-0.7). Apart from patient-related factors such as comorbidity and health status, care by family members and GPs respectively, were determinants of dying at home.

  3. Physical Violence against General Practitioners and Nurses in Chinese Township Hospitals: A Cross-Sectional Survey.

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    Kai Xing

    Full Text Available The purpose of this study is to identify risk factors of physical violence in Chinese township hospitals.A cross-sectional survey was used in a sample of 442 general practitioners and 398 general nurses from 90 township hospitals located in Heilongjiang province, China (response rate = 84.8%.A total of 106 of the 840 (12.6% respondents reported being physically attacked in their workplace in the previous 12 months. Most perpetrators were the patients' relatives (62.3%, followed by the patient (22.6%; 73.6% of perpetrators were aged between 20 and 40 years. Of the physical violence incidents, about 56.6% (n = 60 resulted in a physical injury, and 45.4% of respondents took two or three days of sick leave. Reporting workplace violence in hospitals to superiors or authorities was low (9.4%. Most respondents (62.8% did not receive training on how to avoid workplace violence. Logistic regression analyses indicated that general nurses, aged 35 years or younger, and with a higher-level professional title were more likely to experience physical violence. Healthcare workers with direct physical contact (washing, turning, lifting with patients had a higher risk of physical violence compared to other health care workers. Procedures for reporting workplace violence were a protective factor for physical violence; when in place, reporting after psychological violence (verbal abuse, bullying/mobbing, harassment, and threats was more protective than waiting until an instance of physical violence (beating, kicking, slapping, stabbing, etc..Physical violence in Chinese township hospitals is an occupational hazard of rural public health concern. Policies, procedures, and intervention strategies should be undertaken to manage this issue.

  4. Idosos asilados em hospitais gerais Long-term care elderly residents in general hospitals

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    Milton Luiz Gorzoni

    2006-12-01

    Full Text Available Instituições de longa permanência para idosos interagem periodicamente com hospitais gerais para internações de casos agudos ou dos que necessitam de métodos diagnósticos complexos e da atenção de várias especialidades simultaneamente. A decisão de indicar hospitalização é multifatorial, sendo influenciada por circunstâncias como a gravidade do quadro clínico e a infra-estrutura das instituições de longa permanência para idosos. Internações hospitalares apresentam benefícios e riscos, como o desenvolvimento de iatrogenias, delirium e declínios funcionais, podendo resultar em piora do estado geral e da qualidade de vida do idoso asilado durante e/ou após a hospitalização. O objetivo do estudo foi abordar aspectos peculiares na avaliação, tratamento e manejo de idosos asilados em internações hospitalares, particularmente quanto a cuidados que os auxiliem efetivamente nessas circunstâncias. Discutiram-se situações freqüentes como delirium, iatrogenias, desnutrição, declínio funcional e cuidados paliativos e características próprias de residentes em instituições para idosos durante internações em hospitais gerais.Long-term care facilities for the elderly have regularly to work together with general hospitals to provide care to acutely ill residents or when they require all together more complex diagnostic procedures and multi-specialty care. The decision to hospitalize a nursing home elderly resident is multifactorial and it is based on factors such as illness severity and care facility infrastructure. Hospitalizations have benefits and risks such developing iatrogenic diseases, delirium, and functional decline, which may deteriorate patients' general condition and their quality of life during and/or after hospitalization. This study aimed at addressing specific aspects of assessment, treatment and management of nursing home elderly who require to be hospitalized, especially focusing on their effective care

  5. Use of antibacterial drugs in Jesenice General hospital in years 1998 to 2004

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    Brigita Mavsar-Najdenov

    2007-11-01

    Full Text Available Background: Continuous monitoring of drug consumption is an important strategy for prudent and cost-effective use of drugs. Antimicrobials are among the most prescribed drugs in outpatient practice and in hospital care. In most cases antimicrobials are improperly prescribed or are even misused. Irrational use of antimicrobials is clinically ineffective and leads to higher treatment costs. Clinical ineffectiveness due to irrational use additionally leads to loss of confidence in antimicrobial drugs, unnecessary exposure of patients and development of antimicrobial resistance. Antimicrobial resistance has become a major global health problem as it presents an imperative for development of new potent antimicrobials which are necessarily associated with markedly higher treatment costs.Material and methods: This survey was focused on rational prescribing of antimicrobial drugs. The data on consumption of antimicrobials for various clinical departments of the Jesenice General Hospital were collected by the hospital pharmacy. WHO ATC 2005 classification system, which ranks antimicrobials in a large group J01: drugs for systemic treatment of bacterial infections and Defined Daily Dose as a measuring unit according to the WHO ATC/DDD methodology was used. Antimicrobial use at the Jesenice General Hospital in the period between 1998 and 2004 was estimated by the Department of Infectious Diseases, Medical Centre Ljubljana as a part of European Surveillance on Antibiotic Consumption project (ESAC. Statistical part of survey was performed by the Chair of Biopharmaceutics and Pharmacokinetics, Faculty of Pharmacy, University of Ljubljana.Results: After year 2000 a trend of decrease in antimicrobial consumption was observed. Compared to European Surveillance on Antibiotic Consumption results in the year 2003 higher usage of penicillins with extended spectrum, fluoroquinolones and 3rd generation cephalosporins in Slovenian hospitals was estimated. These three

  6. Qualitative Performance Evaluation of Hospitals Using DEA, Balanced Scorecard and Servqual; A Case Study of General Hospitals of Yazd

    Directory of Open Access Journals (Sweden)

    M Asadi

    2011-02-01

    Full Text Available Introduction: Evaluation is an important factor in productivity context, and acts as a control system for other areas of productivity. Hospitals are large organizations incurring heavy expenses in every country. The level of efficiency in a hospital is a good criterion to understand how hospitals consume their resources. The goal of this research was to determine relative efficiency of 13 public hospitals in Yazd province by using integrated DEA, BSC and SERVQUAL model. Methods: In this study, relative efficiency of 13 public hospitals of Yazd province was calculated using data envelopment analysis technique(DEA and balanced score card and servqual. BSC was used as a tool for designing of performance evaluation indexes, while DEA was used as a tool of evaluating performance and ranking. Results: The mean relative efficiency of hospitals under study was about 0.945 in the Persian calendar year 2008-9. The efficiency levels of nine hospitals were borderline and the efficiency of four hospitals was less than 1. Hospital no.3 had the highest efficiency levels and hospital no.10 had the lowest efficiency level. Conclusion: In this stage, on the basis of references presented by the DEA model, solutions for increasing the quality performance levels of inefficient hospitals in fourth dimensions were determined and some suggestions were proposed. Although all performance indices of the inefficient hospitals need to be addressed, priorities have to be determined by the respective managers.

  7. Pilot Quality Control Program for Brachytherapy of Low Dose Rate at the General Hospital of Mexico

    Science.gov (United States)

    Álvarez R., J. T.; Tovar M., V.; Salinas, B.; Hernández O., O.; Santillán B., L.; Molero M., C.; Montoya M., J.

    2004-09-01

    We describe the pilot quality control program for brachytherapy of low dose rate proposed to be used in the Radiotherapy Department at the General Hospital of Mexico. The program consists of three parts: a) development of calibration procedures, performed in terms of air-kerma strength for calibration of 137Cs and 192Ir brachytherapy sources, and for the calibration of well-type ionization chambers for 137Cs, b) performance of localisation and reconstruction techniques for radioactive sources with a Baltas' phantom. The results obtained for the media deviation , are in the optimum level, ± 0.5 mm hospital. It consists on the characterisation of a TLD-100 powder dosimetry system at SSDL: The calibration curves for powder response (nC or nC/ mg) vs Dw and the control charts for the Harshaw 3500 reader were obtained. The statistical validation of the calibration curve by normality of the residuals and the lack of fit tests were realised. In the other hand, TLD's were irradiated in the hospital to a nominal Dw = 2 Gy with sources of 137Cs. The percent deviations Δ%, between the Dw imparted by the Hospital and the determined by SSDL, are 1.2% Δ⩽ 6.5 % which are consistent with the expanded uncertainty U% for DW, 5.6 U% 10%.

  8. Pilot Quality Control Program for Brachytherapy of Low Dose Rate at the General Hospital of Mexico

    International Nuclear Information System (INIS)

    Alvarez R, J.T.; Tovar M, V.; Salinas, B.; Hernandez O, O.; Santillan B, L.; Molero M, C.; Montoya M, J.

    2004-01-01

    We describe the pilot quality control program for brachytherapy of low dose rate proposed to be used in the Radiotherapy Department at the General Hospital of Mexico. The program consists of three parts: a) development of calibration procedures, performed in terms of air-kerma strength for calibration of 137Cs and 192Ir brachytherapy sources, and for the calibration of well-type ionization chambers for 137Cs, b) performance of localisation and reconstruction techniques for radioactive sources with a Baltas' phantom. The results obtained for the media deviation , are in the optimum level, ± 0.5 mm < ± 1.0 mm; the confidence limit Δ, is in the emergency level, Δ=3.2 mm. c) verification of absorbed dose to water DW, given by the hospital. It consists on the characterisation of a TLD-100 powder dosimetry system at SSDL: The calibration curves for powder response (nC or nC/ mg) vs Dw and the control charts for the Harshaw 3500 reader were obtained. The statistical validation of the calibration curve by normality of the residuals and the lack of fit tests were realised. In the other hand, TLD's were irradiated in the hospital to a nominal Dw = 2 Gy with sources of 137Cs. The percent deviations Δ%, between the Dw imparted by the Hospital and the determined by SSDL, are 1.2% Δ≤ 6.5 % which are consistent with the expanded uncertainty U% for DW, 5.6 U% 10%

  9. The role of rotavirus associated with pediatric gastroenteritis in a general hospital in Lagos, Nigeria.

    Science.gov (United States)

    Anochie, Philip Ifesinachi; Onyeneke, Edwina Chinwe; Asowata, Emmanuel Osaretin; Afocha, Ebelechukwu; Onyeozirila, Anthony Chidiebere; Ogu, Angelina Chinyere; Onyeneke, Bestman Chukwuemeka

    2013-09-01

    Bacterial, viral and parasitic agents have been implicated and confirmed as causative agents of gastroenteritis in children with ages below 5 years old. The major role of rotavirus as causative agent is not widely recognized within the public health community, particularly in developing countries. This study examined the role of rotavirus as a causative agent of childhood gastroenteritis in infants and young children below 5 years of age in a General Hospital in Lagos, Nigeria. Parents and caregivers of children admitted to the hospital were interviewed using a structured questionnaire. Viral RNA was extracted from the stool samples collected and analyzed using RT-PCR for genotyping and agarose gel electrophoresis for identification of rotavirus electrophoretypes. Out of the 71 samples analyzed, 16 (22.5%) were positive for rotavirus. A total of 12 (75%) males and 4 (25%) females were positive for rotavirus gastroenteritis with most cases (7, 43.8%) distributed to the 13-24 months age group, followed closely by the 1-6 months age group, with 6 cases, 37.5%. Rotavirus G2 genotype was the most prevalent strain in the hospital (10 patients, 62.5%) followed by G1 (6 patients, 37.5%). These were the only rotavirus genotypes detected in the hospital.

  10. Changing Smoking Behavior of Staff at Dr. Zainoel Abidin Provincial General Hospital, Banda Aceh

    Directory of Open Access Journals (Sweden)

    Said Usman

    2014-01-01

    Full Text Available Smoking tobacco is a habit of individuals. Determinants of smoking behavior are multiple factors both within the individual and in the social environment around the individual. Staff smoking has been an undesirable phenomenon at Dr. Zainoel Abidin Provincial General Hospital in Banda Aceh. Health promotion efforts are a strategy that has resulted in behavioral changes with reductions in smoking by staff. This action research was designed to analyze changes in smoking behavior of hospital staff. The sample for this research was all 152 male staff who were smokers. The results of this research showed that Health Promotion Interventions (HPI consisting of personal empowerment plus social support and advocacy to improve employee knowledge and attitudes influenced staff to stop or to significantly. HPI employed included counseling programs, distribution of antismoking leaflets, putting up antismoking posters, and installation of no smoking signs. These HPI proved effective to increase knowledge and create a positive attitude to nonsmoking that resulted in major reductions in smoking by staff when offsite and complete cessation of smoking whilst in the hospital. Continuous evaluation, monitoring, and strengthening of policies banning smoking should be maintained in all hospitals.

  11. Twenty years of electroconvulsive therapy in a psychiatric unit at a university general hospital

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    Amilton dos Santos Jr.

    2013-01-01

    Full Text Available Objective: To describe the sociodemographic and clinical profile of patients who underwent electroconvulsive therapy (ECT at a university general hospital. Method: In this retrospective study, records from all patients undergoing ECT between January 1988 and January 2008 at the psychiatric unit of the general hospital of Universidade Estadual de Campinas (UNICAMP were reviewed. Telephone contact was made with patients/relatives to collect follow-up data. Results: A total of 200 charts were reviewed. The majority of patients were women, with a mean age of 39 years, and history of psychiatric hospitalization. The main indications for ECT were depression and catatonia. Complications were observed in less than half of the cases, and most were temporary and not severe. There was a good psychiatric outcome for 89.7% of the patients, especially for catatonic patients (100%, p = 0.02. Thirty-four percent of the cases were later contacted by telephone calls, at a mean of 8.5 years between the procedure and the contact. Among these, three (1.5% reported persistent memory disorders and 73% considered ECT a good treatment. Conclusion: ECT has been performed according to international guidelines. In the vast majority of cases, undesirable effects were temporary and not severe. Response to ECT was positive in most cases, particularly in catatonic patients.

  12. The proton therapy system for Massachusetts General Hospital's Northeast Proton Therapy Center

    International Nuclear Information System (INIS)

    Jongen, Y.

    1996-01-01

    In 1989, two companies, Ion Beam Applications in Belgium (IBA) and Sumitomo Heavy Industries in Japan (SHI) started to design proton therapy equipments based on cyclotrons. In 1991, SHI and IBA decided to join their development efforts in this field. In 1993, the Massachusetts General Hospital (MGH), pioneer in the field of proton therapy, launched an international request for proposals for the procurement of an in-hospital proton therapy facility. The 18 may 1994, the contract was signed with a team of industries led by IBA, including also SHI and General Atomics (GA) of California. The proposed system is based on a fixed energy, isochronous cyclotron, followed by an energy degrader and an energy selection system. The variable energy beam can be rapidly switched in any one of three treatment rooms. Two rooms are equipped with large isocentric gantries and robotic patient positioners allowing to direct the proton beam within the patient from any direction. The third room is equipped with fixed horizontal beam. The complete system is computer controlled by a distributed network of computers, programmable logic controllers and workstations. This computer control allows to change the energy in one treatment room is less than two second, a performance matching or exceeding the flexibility offered by synchrotrons. The system is now built and undergoing factory tests. The beam has been accelerated to full energy in the cyclotron, and beam extraction tests are underway. Installation in the hospital building will take place in 1997. (author)

  13. General aspects of radiological protection to consider for the licensing a hospital cyclotron

    International Nuclear Information System (INIS)

    Andrada Contardi, F.A.; Fruttero, N.H.; Bozzo, R.H.; Moschella, E.G.

    2010-01-01

    The use of PET/PET-CT studies for a variety of diagnoses has increased significantly on a global scale. Modern medical cyclotrons must be placed in or near hospitals on account of the short radioactive half-life of the pharmaceuticals used in such studies. Many countries in Latin America are now licensing cyclotrons and laboratories for the production of radio-pharmaceuticals for the first time, and most are expected to have installations within the near future. This report outlines the general aspects of radiological protection important to consideration during the licensing of these facilities, and includes the following: general operation of the cyclotron and laboratory for the production of radiopharmaceuticals, safety systems (shielding, interlocks, ventilation, manual safety systems, alarms and monitors), and general aspects for licensing an installation (monitoring, accidental and incidental events, activation of components, etc.) and personnel. (authors) [es

  14. Carmen Martín Gaite: la escritura terapéutica

    Directory of Open Access Journals (Sweden)

    Escartín Gual, Montserrat

    2014-12-01

    Full Text Available This article discusses the therapeutic power of the written and oral communication, as well as the benefit of reading literary texts proposed by the narrative of Carmen Martín Gaite. If the author prioritized spoken communication in her first novels, with the passing of time, defended her narrative writing versus orality, making it the vehicle of choice for characters to communicate and ultimately for herself, to find the healing through the word.En este artículo se analiza el poder terapéutico de la comunicación oral y escrita, así como el beneficio de la lectura de textos literarios que propone la narrativa de Carmen Martín Gaite. Si la autora priorizó la comunicación hablada en su primeras novelas, con el paso del tiempo, su discurso narrativo defendió la escritura frente a la oralidad, convirtiéndola en el vehículo elegido por sus personajes para comunicarse y, en definitiva por ella misma, para buscar la curación a través de la palabra.

  15. Hablando con los descendientes, de Carmen de Burgos

    Directory of Open Access Journals (Sweden)

    Torres González, Begoña

    2010-06-01

    Full Text Available Hablando con los descendientes (Talking to descendants is a compendium of interviews made to the descendants of the most outstanding artists –especially– the ones in the Romantic period. It is related to the customs articles and the journalistic report. In this compilation, Colombine is usually capable to see the general facts although she felt overwhelmed by the particular details that’s why so many times she lost her way and quibble and focussed on the mere anecdotes of the stars’ life. She carried out the categorization of the characters and like in Mesonero’s, the ways of living are much more important than the ways of being. Touched by the positivism and the rationalism the author defended the importance of each man’s own vital experience. She had felt fascinated by the material progress in the modern society anyway she seemed to glimpse the need to give this project an alternative lead by the virtue. We find a humanistic idealism of moral codes “hobnobbing” the past tradition as this one is considered a valid option in order to form the new standards in the present time.Hablando con los descendientes es un compendio de entrevistas llevadas a cabo a los descendientes de los más importantes artistas –sobre todo– del período romántico. Se relaciona con el artículo de costumbres y con la crónica periodística. En esta recopilación Colombine sabe ver lo general, pero le abruma lo particular por lo que, en muchas ocasiones, se pierde en la maleza de las nimiedades y anécdotas de las vidas de sus protagonistas. Lleva a cabo una tipificación de sus personajes en la que, como ocurría con Mesonero, cuentan más los modos de vivir, que los modos de ser. Tocada de lleno por el positivismo y el racionalismo, la autora defendió la importancia de la experiencia vital propia de cada hombre. Fascinada por el progreso material de la sociedad moderna, parece vislumbrar, sin embargo, la necesidad de proveer a este proyecto una

  16. [Standardized management of acupuncture-moxibustion clinic in Singapore General Hospital].

    Science.gov (United States)

    Cui, Shu-Li; Tan, Kian Hian; Ong, Biauw Chi; Lim, Shih hui; Yong, Yang; Seah, Cheng Ngee; Huang, Youyi; Han, Seong Ng

    2014-02-01

    The standardized management of acupuncture-moxibustion in Singapore General Hospital is introduced. With gradual improvement of outpatient infrastructure, re-training of medical staff, strict disinfection of manipulation, periodical inspection of medical instruments, unified management of writing, saving and processing in medical records and public education of TCM knowledge, a standardized management system in accordance with modernized hospital is gradually established. As a result, efficiency and quality of clinical treatment is continuously increasing. From April of 1998 to December of 2012, a total of 74 654 times of treatment were performed, and treatment amount per day is gradually increased. The unusual condition of acupuncture is avoided. Periodical strict inspection of joint committee authenticated by domestic and overseas medical health organization is repeatedly passed and accepted. Additionally, three clinical researches funded by Singapore Health-care Company are still in progress in acupuncture-moxibustion department.

  17. Changes in diagnostic case mix in psychiatric care in general hospitals, 1980-85.

    Science.gov (United States)

    Kiesler, C A; Simpkins, C

    1992-05-01

    The Hospital Discharge Survey of 1980 and 1985 was used to assess changes in diagnostic case mix of psychiatric inpatient care in short-term, nonfederal general hospitals. Information regarding presence of psychiatric and chemical dependency units was added to both surveys, and information regarding exemption from Medicare's PPS system was noted for 1985. The largest increase was in ICD-9 code 296 (affective disorder), which more than doubled in frequency, along with a similar decrease in Diagnosis-Related Group 426, depressive neurosis. One explanation for this sizable shift was "gaming the system." One cannot conclusively, however, distinguish between gaming the system and the effects of changing professional views of depression during this time period. Other variables potentially contributing to the effect are described as well.

  18. [Atypical Mycobacterias in Mexico. Incidence and epidemiology in a general hospital].

    Science.gov (United States)

    Frati Munari, A C; Vargas Cuba, R; Vergara Sedeño, L; Gonzaĺez Sanchez, S

    1975-01-01

    All the cultures for mycobacteriae taken from 1967 to 1973 at the Hospital General del Centro Médico Nacional del Instituto Mexicano del Seguro Social were reviewed. From 802 positive cultures, 361 (44.2 per cent) were atypical mycobacteriae. 89 per cent of them were scotochromogen, 10.3 per cent of rapid growth, one non-chromogen, and none were photochromogen. These data are in contrast with those observed in other countries. Isolation sources varied also from other reports, in this series the most common isolation were from urine specimens, sputum, feces and bone marrow. A possible explanation for that in this hospital there are very few pulmonary patients. The percentage of atypical mycobacteriae was greatest in the last two years. In bacterioscopic examination atypical micobacteriae were detected less frequently than M. tuberculosis.

  19. Variable lengths of stay among ischemic stroke subtypes in Chinese general teaching hospitals.

    Directory of Open Access Journals (Sweden)

    Yi Li

    Full Text Available BACKGROUND: Length of stay (LOS is one of the most important quantitative indexes that measures health service utilization within a hospital. Many studies have examined the association of three major stroke categories with LOS. Our aim is to investigate the differences of LOS among ischemic stroke subtypes, results from which are helpful to healthcare providers and government agencies to improve health care delivery efficiency. METHODOLOGY/PRINCIPAL FINDINGS: Using the Beijing Municipal Health Bureau's hospitalization summary reports, we performed a retrospective study among first-ever in-hospital patients with ischemic stroke (ICD-10 I63 in three general teaching hospitals in Beijing, China, from 2006 to 2010 with generalized linear model. In our study, 5,559 patients (female, 36.0%; age, 64.4 ± 12.9 years were included. The estimated mean LOS of ischemic stroke was 17.4 ± 1.8 days. After adjusting for confounders, LOS of lacunar infarction (14.7 days; p<0.001 and LOS of small cerebral infarction (17.0 days; p=0.393 were shorter than that of single cerebral infarction (17.9 days, p<0.001. LOS of multi-infarct (19.0 days; p=0.028, brainstem infarction (19.3 days; p=0.045, basal ganglia infarction (18.5 days; p=0.452 and other subtypes of ischemic stroke (18.9 days; p=0.327 were longer than that of single cerebral infarction. CONCLUSIONS: LOS of ischemic stroke patient differes across single cerebral infarction, lacunar infarction, multi-infarct and brainstem infarction patients. The ascending order of LOS was lacunar infarction, small cerebral infarction, single cerebral infarction, basal ganglia infarction, other subtypes of ischemic stroke, multi-infarct and brainstem infarction.

  20. Standardized-care pathway vs. usual management of syncope patients presenting as emergencies at general hospitals.

    Science.gov (United States)

    Brignole, Michele; Ungar, Andrea; Bartoletti, Angelo; Ponassi, Irene; Lagi, Alfonso; Mussi, Chiara; Ribani, Maria Angela; Tava, Gianni; Disertori, Marcello; Quartieri, Fabio; Alboni, Paolo; Raviele, Antonio; Ammirati, Fabrizio; Scivales, Alessandro; De Santo, Tiziana

    2006-08-01

    The study hypothesis was that a decision-making approach improves diagnostic yield and reduces resource consumption for patients with syncope who present as emergencies at general hospitals. This was a prospective, controlled, multi-centre study. Patients referred from 5 November to 7 December 2001 were managed according to usual practice, whereas those referred from 4 October to 5 November 2004 were managed according to a standardized-care pathway in strict adherence to the recommendations of the guidelines of the European Society of Cardiology. In order to maximize its application, a decision-making guideline-based software was used and trained core medical personnel were designated-both locally in each hospital and centrally-to verify adherence to the diagnostic pathway and give advice on its correct application. The 'usual-care' group comprised 929 patients and the 'standardized-care' group 745 patients. The baseline characteristics of the two study populations were similar. At the end of the evaluation, the standardized-care group was seen to have a lower hospitalization rate (39 vs. 47%, P=0.001), shorter in-hospital stay (7.2+/-5.7 vs. 8.1+/-5.9 days, P=0.04), and fewer tests performed per patient (median 2.6 vs. 3.4, P=0.001) than the usual-care group. More standardized-care patients had a diagnosis of neurally mediated (65 vs. 46%, P=0.001) and orthostatic syncope (10 vs. 6%, P=0.002), whereas fewer had a diagnosis of pseudo-syncope (6 vs. 13%, P=0.001) or unexplained syncope (5 vs. 20%, P=0.001). The mean cost per patient and the mean cost per diagnosis were 19 and 29% lower in the standardized-care group (P=0.001). A standardized-care pathway significantly improved diagnostic yield and reduced hospital admissions, resource consumption, and overall costs.

  1. Principal components and generalized linear modeling in the correlation between hospital admissions and air pollution

    Science.gov (United States)

    de Souza, Juliana Bottoni; Reisen, Valdério Anselmo; Santos, Jane Méri; Franco, Glaura Conceição

    2014-01-01

    OBJECTIVE To analyze the association between concentrations of air pollutants and admissions for respiratory causes in children. METHODS Ecological time series study. Daily figures for hospital admissions of children aged < 6, and daily concentrations of air pollutants (PM10, SO2, NO2, O3 and CO) were analyzed in the Região da Grande Vitória, ES, Southeastern Brazil, from January 2005 to December 2010. For statistical analysis, two techniques were combined: Poisson regression with generalized additive models and principal model component analysis. Those analysis techniques complemented each other and provided more significant estimates in the estimation of relative risk. The models were adjusted for temporal trend, seasonality, day of the week, meteorological factors and autocorrelation. In the final adjustment of the model, it was necessary to include models of the Autoregressive Moving Average Models (p, q) type in the residuals in order to eliminate the autocorrelation structures present in the components. RESULTS For every 10:49 μg/m3 increase (interquartile range) in levels of the pollutant PM10 there was a 3.0% increase in the relative risk estimated using the generalized additive model analysis of main components-seasonal autoregressive – while in the usual generalized additive model, the estimate was 2.0%. CONCLUSIONS Compared to the usual generalized additive model, in general, the proposed aspect of generalized additive model − principal component analysis, showed better results in estimating relative risk and quality of fit. PMID:25119940

  2. Principal components and generalized linear modeling in the correlation between hospital admissions and air pollution.

    Science.gov (United States)

    Souza, Juliana Bottoni de; Reisen, Valdério Anselmo; Santos, Jane Méri; Franco, Glaura Conceição

    2014-06-01

    OBJECTIVE To analyze the association between concentrations of air pollutants and admissions for respiratory causes in children. METHODS Ecological time series study. Daily figures for hospital admissions of children aged generalized additive models and principal model component analysis. Those analysis techniques complemented each other and provided more significant estimates in the estimation of relative risk. The models were adjusted for temporal trend, seasonality, day of the week, meteorological factors and autocorrelation. In the final adjustment of the model, it was necessary to include models of the Autoregressive Moving Average Models (p, q) type in the residuals in order to eliminate the autocorrelation structures present in the components. RESULTS For every 10:49 μg/m3 increase (interquartile range) in levels of the pollutant PM10 there was a 3.0% increase in the relative risk estimated using the generalized additive model analysis of main components-seasonal autoregressive - while in the usual generalized additive model, the estimate was 2.0%. CONCLUSIONS Compared to the usual generalized additive model, in general, the proposed aspect of generalized additive model - principal component analysis, showed better results in estimating relative risk and quality of fit.

  3. Avaliação de classificadora de cilindros divergentes para tomate "Carmen" Performance evaluation of divergent sizing cylinders equipment for "Carmen" tomato

    Directory of Open Access Journals (Sweden)

    Márcia E Atarassi

    2010-04-01

    Full Text Available As normas de classificação garantem o mesmo padrão para produtores, atacadistas e consumidores finais, facilitando a comercialização, agregando valor ao produto e diminuindo as perdas. O objetivo deste trabalho foi avaliar uma classificadora de tomates in natura por diâmetro, por meio de cilindros rotativos divergentes com diferentes velocidades de rotação. Foram realizados ensaios para avaliar a eficiência da classificação, conformidade da classificação por diâmetro com a norma do PROGRAMA BRASILEIRO PARA A MODERNIZAÇÃO DA HORTICULTURA (2003 e incidência de danos mecânicos em tomates "Carmen". Os cilindros divergentes apresentaram conformidade de mistura na classificação por diâmetro, nas classes 60 e 80. Entretanto, para a classe 70, nenhum tratamento esteve em conformidade com a mistura permitida de 10% de frutos de outras classes. O conjunto de um cilindro liso e outro com helicoide de borracha a 150 rpm obteve a maior eficiência de classificação, com menor perda de massa dos tomates armazenados e atividade respiratória similar aos frutos-controle.Grading standards guarantee consistent quality for growers, wholesalers and consumers, helping the trading, adding value to products and reducing postharvest losses. The main purpose of this study was to evaluate a grading diameter system for fresh market tomatoes in a rotative cylinder equipment in different rotation velocities. Sorting efficiency, based on the standard diameter of THE BRAZILIAN PROGRAM FOR THE HORTICULTURE MODERNIZATION (2003 and mechanical damage incidence for "Carmen" tomatoes were evaluated. The divergent cylinders were in accordance with grade mixing in classes 60 and 80 grading. However, for grade 70 no treatment was in accordance with the mixture percentage allowed, which is 10% of fruit from other classes. The combination of a flat and a helical rubber cylinder, both at 150 rpm, had the highest sorting efficiency, showing low weight loss and

  4. Patient and proxy measurement of quality of life among general hospital in-patients with dementia.

    Science.gov (United States)

    Sheehan, Bart D; Lall, Ranjit; Stinton, Christopher; Mitchell, Kate; Gage, Heather; Holland, Caroline; Katz, Jeanne

    2012-01-01

    We aimed to investigate quality of life ratings among people with varying severity of dementia and their carers, recruited in general hospital. We recruited 109 people with dementia, and their proxies (carers), from psychiatric referrals of inpatients in two general hospitals in England. From patients, we gathered data on quality of life (QoL-AD and EQ5-D) and depressive symptoms, and from proxies we gathered data on patient quality of life (Proxy QoL-AD and EQ5-D), severity of dementia, activities of daily living, physical illness and depressive symptoms, and on carer stress. Completion rates for both measures were progressively lower with increasing dementia severity. Patients rated their quality of life more highly than proxies on Qol-AD (patients=32.2, CI=30.7-33.7, proxies=24.7, CI=23.8-26.0, pproxies=0.30, CI=0.22-0.38, pproxy EQ5D, impaired instrumental ADLs (p=0.003) and more severe dementia (p=0.019) were associated with ratings, while for proxy QoL-AD, only more severe dementia (p=0.039) was associated with ratings. Lower patient EQ-5D scores were independently associated only with carer stress (p=0.01). Lower patient QoL-AD scores were associated with patient depression (p=0.001), impaired activities of daily living (p=0.02) and proxy psychiatric symptoms (p=0.002). Among patients with moderate to severe dementia in general hospital, proxy measures of quality of life are the only practical option. Patients and proxies appear to have very different concepts of quality of life in dementia.

  5. Antipsychotics for delirium in the general hospital setting in consecutive 2453 inpatients: a prospective observational study.

    Science.gov (United States)

    Hatta, Kotaro; Kishi, Yasuhiro; Wada, Ken; Odawara, Toshinari; Takeuchi, Takashi; Shiganami, Takafumi; Tsuchida, Kazuo; Oshima, Yoshio; Uchimura, Naohisa; Akaho, Rie; Watanabe, Akira; Taira, Toshihiro; Nishimura, Katsuji; Hashimoto, Naoko; Usui, Chie; Nakamura, Hiroyuki

    2014-03-01

    Attention to risk of antipsychotics for older patients with delirium has been paid. A clinical question was whether risk of antipsychotics for older patients with delirium would exceed efficacy of those even in the general hospital setting. A prospective observational study proceeded over a 1-year period at 33 general hospitals, where at least one psychiatrist worked full time. Subjects were patients who developed delirium during their admission due to acute somatic diseases or surgery, and who received antipsychotics for delirium. The primary outcome was rates and kinds of serious adverse events. Among 2834 patients who developed delirium, 2453 patients received antipsychotics, such as risperidone (34%), quetiapine (32%), and parenteral haloperidol (20%), for delirium. Out of 2453 patients, 22 serious adverse events (0.9%) were reported. Aspiration pneumonia was the most frequent (17 patients, 0.7%), followed by cardiovascular events (4 patients, 0.2%) and venous thromboembolism (1 patient, 0.0%). There was no patient with a fracture or intracranial injury due to a fall. No one died because of antipsychotic side effects. The mean Clinical Global Impressions-Improvement Scale score was 2.02 (SD 1.09). Delirium was resolved within 1 week in more than half of the patients (54%). In the general hospital setting under management including fine dosage adjustment and early detection of side effects, risk of antipsychotics for older patients with delirium might be low, in contrast to antipsychotics for dementia in the nursing home or outpatient settings. A point may be not how to avoid using antipsychotics but how to monitor their risk. © 2013 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons, Ltd.

  6. Screening for sepsis in general hospitalized patients: a systematic review.

    Science.gov (United States)

    Alberto, L; Marshall, A P; Walker, R; Aitken, L M

    2017-08-01

    Sepsis is a condition widely observed outside critical care areas. To examine the application of sepsis screening tools for early recognition of sepsis in general hospitalized patients to: (i) identify the accuracy of these tools; (ii) determine the outcomes associated with their implementation; and (iii) describe the implementation process. A systematic review method was used. PubMed, CINAHL, Cochrane, Scopus, Web of Science, and Embase databases were systematically searched for primary articles, published from January 1990 to June 2016, that investigated screening tools or alert mechanisms for early identification of sepsis in adult general hospitalized patients. The review protocol was registered with PROSPERO (CRD42016042261). More than 8000 citations were screened for eligibility after duplicates had been removed. Six articles met the inclusion criteria testing two types of sepsis screening tools. Electronic tools can capture, recognize abnormal variables, and activate an alert in real time. However, accuracy of these tools was inconsistent across studies with only one demonstrating high specificity and sensitivity. Paper-based, nurse-led screening tools appear to be more sensitive in the identification of septic patients but were only studied in small samples and particular populations. The process of care measures appears to be enhanced; however, demonstrating improved outcomes is more challenging. Implementation details are rarely reported. Heterogeneity of studies prevented meta-analysis. Clinicians, researchers and health decision-makers should consider these findings and limitations when implementing screening tools, research or policy on sepsis recognition in general hospitalized patients. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  7. Introducing an annualised contract for a consultant team in a district general hospital.

    Science.gov (United States)

    Ayres, Lachlan; Hughes, Rebecca; Brooklyn, Trevor; Shaw, Ian; Valori, Roland

    2013-06-01

    The majority of physicians work a weekly timetable consisting of programmed activities (PAs) defined by the consultant contract. This paper describes the implementation of an annualised contract within a gastroenterology department, which is located across two district general hospital sites within the same trust. The perceived benefits of the system include the introduction of a new out-of-hours emergency endoscopy service, more efficient backfilling of vacant endoscopy lists and greater transparency of work patterns and workload between colleagues and within the trust.

  8. Biological dosimetry laboratory of the Hospital General Gregorio Maranon. A review of cases investigated

    International Nuclear Information System (INIS)

    Gomez-Espi, M.; Herranz, R.; Olivares, P.; Orera, M.

    1992-01-01

    Since 1989, in part because of our initiatory, and due in part to the support of the 'Consejo de Seguridad Nuclear', the biological dosimetry laboratory of the 'Hospital General Gregorio Maranon' is attending the individuals that are sent to the level I and II Radiopathology and Radioprotection Center with a suspicion of ionizing radiation overexposure. We have performed chromosomal aberration analysis in peripheral lymphocytes in 31 cases (June 1991). We present here the first biological dosimetry analysis performed in our Country, to demonstrate the usefulness of a technique that is commonly used outside our Country. (author)

  9. When Suicide Is Not Suicide: Self-induced Morbidity and Mortality in the General Hospital

    Directory of Open Access Journals (Sweden)

    J. Michael Bostwick

    2015-04-01

    Full Text Available Suicidal phenomena in the general hospital can take a variety of forms that can be parsed by taking into account whether or not the patient 1 intended to hasten death, and 2 included collaborators, including family and health care providers, in the decision to act. These two criteria can be used to distinguish entities as diverse as true suicide, non-compliance, euthanasia/physician-assisted suicide, and hospice/palliative care. Characterizing the nature of “suicide” events facilitates appropriate decision-making around management and disposition.

  10. Dementia training programmes for staff working in general hospital settings - a systematic review of the literature.

    Science.gov (United States)

    Scerri, Anthony; Innes, Anthea; Scerri, Charles

    2017-08-01

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

  11. Cruris Fracture among Child Patients in Dr. Hasan Sadikin General Hospital Bandung

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    Wenny Dwi Chandra

    2015-06-01

    Full Text Available Background: Cruris are lower extremity fractures commonly found in children. These dangerous fractures may alter the quality of life of the patients. This study was conducted to explore the characteristics of cruris fractures in children. Methods: A descriptive cross-sectional study was performed by reviewing the medical records of children who were hospitalized at the Department of Orthopaedi and raumatology, Dr. Hasan Sadikin General Hospital Bandung during 2010–2011. Results: On two years study, 62 cases have been reported. Most cases occurred among senior high school group (37.1%. Boys (71.0% have a higher rate of fractures than girls. Fractures most frequently occurred by traffic accidents (87.1%. The fractures are mostly open (58.1%. The common fracture site was tibia (50.0% rather than fibula (3.2% and the most frequent location was on the right side (79.0% and on the middle third of the leg (41.9%. Majority of the patients went home in good condition (79.0%. Conclusion: Fractures are most frequently occurred in April because of high humidity. The causes and distribution of the fractures based on diagnosis were related to another study. Furthermore, additional studies are needed to explore the characteristics of cruris fracture among children, not only in certain hospital but also in Indonesia especially in West Java.

  12. Pregnancy outcomes of women with HIV in a district general hospital in the UK.

    Science.gov (United States)

    Carey, L; Desouza, C; Moorcroft, A; Elgalib, A

    2018-03-12

    The aim of this study was to describe the obstetrical and virological outcomes in HIV-infected pregnant women who delivered at a district general hospital in south London in the period from 2008 to 2014. Our review identified 137 pregnancies; most (60%, 63/105) of them were unplanned. The commonest mode of delivery was spontaneous vaginal delivery (SVD) (42%, 48/114) followed by emergency Caesarean section (32%, 36/114). Gestational age at delivery was ≥37 weeks in most (84%, 91/106) of the cases. Maternal HIV VL at or closest to delivery was undetectable (1000 copies/mL in 73% (94/129), 90% (116/129) and 6% (8/129) of the pregnancies, respectively. None of the infants were infected with HIV making the rate of MTCT of HIV 0% (zero). Our study shows that favourable virological and obstetrical outcomes of HIV-infected pregnant women are achievable in non-tertiary HIV treatment centres. Impact Statement What is already known on this subject: Prevention of mother-to-child transmission (MTCT) of HIV has been one of the major public health successes in the last decades. This success was evident by the reduction of MTCT of HIV in the UK from 25.6% in the 1993 to only 0.46% in 2011. Furthermore, many reports from individual providers, mainly from tertiary centres, of HIV care in the UK also showed very low rates MTCT of HIV. What the results of this study add: Our study shows that favourable virological and obstetrical outcomes of HIV-infected pregnant women are achievable in non-tertiary HIV treatment centres. The MTCT of HIV rate in our hospital was zero in the period from 2008 to 2014. What the implications are of these findings for clinical practice and/or further research: Staff caring for pregnant HIV positive women in general hospitals and small-to-medium HIV clinics should liaise closely with each other and utilise the skill-mix within their hospital in order to provide a quality care that is similar to what is achieved in large teaching centres; however, a

  13. Evolución del estado nutritivo de pacientes pediátricos ingresados en hospital general terciario de Brasil

    OpenAIRE

    Silveira, Carla Rosane de Moraes; Mello, Elza Daniel de; Carvalho, Paulo Roberto Antonacci

    2008-01-01

    Justification and objective: Identify changes in the nutritional status of hospitalized children is fundamental for the early establishment of interventions. This study aims at describing the prevalence of undernutrition at admission and over the weeks of in-hospital stay in pediatric patients and evaluate the association between nutritional status and length of in-hospital stay. Materials and methods: A cohort study was carried out. It followed all the in-patients admitted to the general ped...

  14. La dimensión del descalabro: Carmen Vincenti ante la fundación de la República Bolivariana de Venezuela Carmen Vicenti facing the foundation of the Bolivarian Republic of Venezuela

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    Mariana Libertad Suárez

    2008-06-01

    Full Text Available La década de los años noventa, en Venezuela, fue sinónimo de una crisis generalizada de los sistemas políticos y económicos, que se tradujo en la proliferación de representaciones mediáticas y literarias con tintes abiertamente apocalípticos. A partir del año 1998, con el triunfo en las elecciones presidenciales del líder militar de las intentonas golpistas del año 1992, surgió a la par de esta visión desoladora de la República una corriente discursiva mucho más utópica, que también alcanzaba tanto a los medios de comunicación social, como a la literatura. Más que de un diálogo, podría hablarse de una lucha simbólica que se llevó a cabo tanto en los espacios académicos como en la producción de objetos culturales, y que buscaba construir y/o deconstruir el discurso político estructurado desde los espacios de poder. Como ocurre con frecuencia ante estos gestos sobreinclusivos, en los márgenes de las dos grandes líneas de pensamiento confrontadas emergió una serie de expresiones alternativas que reivindicaban el derecho a ser en sociedad de una amplia gama de subjetividades excluidas de los dos proyectos de nación enfrentados. Precisamente, en este marco se inscribe la novela La noche oscura del alma (2002, de Carmen Vincenti, texto que además de funcionar como una suerte de glosa a las escrituras canónicas en torno a la fundación de la República Bolivariana de Venezuela, sirve también como dispositivo de inscripción de la mujer intelectual en el campo cultural venezolano del siglo XXI.The Nineties, in Venezuela , were synonymous of a generalized crisis of the political and economic systems that was translated in the proliferation of media and literary representations with openly apocalyptic dyes. Parallel, from year 1998, with the victory in the presidential elections of the military leader of rebel attempts of year 1992, Hugo Chávez, it appeared on a par from this devastating vision of the Republic, a

  15. The barriers and facilitators for recognising distress in people with severe dementia on general hospital wards.

    Science.gov (United States)

    Crowther, G J E; Brennan, C A; Bennett, M I

    2018-01-17

    psychological symptoms and delirium are common, but underreported in people with dementia on hospital wards. Unrecognised and untreated symptoms can manifest as distress. Identifying distress accurately therefore could act as a trigger for better investigation and treatment of the underlying causes. The challenges faced by healthcare professionals to recognise and report distress are poorly understood. semi-structured interviews with a purposive sample of 25 healthcare professionals working with older people in general hospitals were conducted. Interviews were analysed generating themes that describe the facilitators and barriers of recognising and caring for distress in dementia. regardless of training or experience all participants had a similar understanding of distress, and identified it as a term that is easily understood and communicated. All participants believed they recognised distress innately. However, the majority also believed it was facilitated by experience, being familiar with their patients and listening to the concerns of the person's usual carers. Barriers to distress recognition included busy ward environments, and that some people may lack the skill to identify distress in hypoactive patients. distress may be a simple and easily identified marker of unmet need in people with dementia in hospital. However, modifiable and unmodifiable barriers are suggested that reduce the chance of distress being identified or acted on. Improving our understanding of how distress is identified in this environment, and in turn developing systems that overcome these barriers, may improve the accuracy with which distress is identified on hospital wards. © The Author(s) 2018. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For permissions, please email: journals.permissions@oup.com

  16. Morbilidad y mortalidad en pacientes con infarto agudo de miocardio ST elevado en un hospital general

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    Eduardo Carcausto

    2010-10-01

    Full Text Available Objetivo: Determinar la morbilidad y mortalidad de los pacientes con infarto agudo de miocardio ST elevado (IMA STE atendidos en un hospital general y describir sus características demográficas, clínicas y epidemiológicas. Material y métodos: Estudio descriptivo, serie de casos, retrospectivo, en pacientes con IMA STE en el Hospital Nacional Cayetano Heredia, del 1 de enero a 31 de diciembre del 2007. Se registraron variables clínicas y de laboratorio. Resultados: Se incluyeron 30 casos. El 86,7% fueron varones. La edad media fue de 62,8±12,6 años. El antecedente de hipertensión arterial se encontró en 57%, obesidad en 40%, tabaquismo en 40%, y de diabetes mellitus en 30%. El dolor torácico típico ocurrió en 75% de pacientes. El 50% de pacientes tuvieron hipertensión no controlada a la admisión, 33% leucocitosis, y 46% glicemia >110 mg/dl. Sólo 25% recibió terapia de reperfusión, 33,3% de casos de forma exitosa, siendo el tiempo puerta-aguja de 250 ± 114 minutos. Las complicaciones ocurrieron en 26,6% de pacientes, siendo la mortalidad de 13,3%. El 76% ingresó al hospital con un tiempo de dolor menor de 3 horas, Conclusiones: Los pacientes con IMA ST elevado fueron predominantemente varones, mayores de 60 años, ingresaron al hospital con un tiempo de dolor torácico menor de tres horas y un mínimo porcentaje recibió terapia de repercusión. Las arritmias fueron las complicaciones más frecuentes y la mortalidad post IMA alcanzó 13,3 % de los casos.(Rev Med Hered 2010;21:202-207.

  17. [Pediatric intermediate care unit in general hospital: recent survey in French Polynesia].

    Science.gov (United States)

    Gatti, H; Dauger, S; Sommet, J; Chenel, C; Naudin, J

    2014-03-01

    In 2006, decrees relating to pediatric critical care defined the main rules of pediatric intermediate care units (PIMU). These units ensure continuous monitoring of children at risk of critical deterioration without requiring invasive support. In French Polynesia, a PIMU has been integrated into the general pediatric ward since the new hospital opened in November 2010. We conducted a prospective observational study of patients admitted to the PIMU depending on whether they were surgical patients or were secondarily transferred to the ICU or were transferred via long-distance medical air transport for specialized care. For the very first operational year, 199 children (median age, 3 years old) were admitted to the PIMU: for the most part respiratory (31.7%) and neurologic (23.6%) failures were involved. Surgical patients more often required a prosthesis or treatments associated with serious adverse effects than nonsurgical patients (respectively, 46% vs. 16%, P<0.01; 29% vs. 7%, P<0.01) and the length of the hospital stay was longer (5 days vs. 2, P<0.01). Patients who were secondarily transferred to the ICU had a higher admission Pediatric RISk of Mortality (PRISM) score (6 vs. 4, P<0.01) and required more treatments associated with serious adverse effects (50% vs. 20%, P<0.01) than nontransferred patients. The length of the hospital stay was longer (6days) for patients who underwent long-distance medical transport. In addition to PIMU defining criteria, the use of treatments associated with serious adverse effects should be considered risk factors of impaired prognosis in local practical procedures. Assessment of PIMU activity should take into account that intensive surgical care and geographical isolation are closely related to increased length of hospital stay. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  18. [Study of Staphylococcus aureus infections in a general acute care hospital (2002-2013)].

    Science.gov (United States)

    Togneri, Ana M; Podestá, Laura B; Pérez, Marcela P; Santiso, Gabriela M

    A twelve-year retrospective review of Staphylococcus aureus infections in adult and pediatric patients (AP and PP respectively) assisted in the Hospital Interzonal General de Agudos Evita in Lanús was performed to determine the incidence, foci of infection, the source of infection and to analyze the profile of antimicrobial resistance. An amount of 2125 cases of infection in AP and 361 in PP were documented. The incidence in AP decreased significantly in the last three years (χ i 2 ; p<0.05); in PP it increased significantly during the last five years (χ 2 ; p<0.0001). In both populations was detected a notable increase in skin infections and associated structures (PEA) in bacteremia to the starting point of a focus on PEA, and in total S. aureus infections of hospital-onset (χ 2 ; p < 0.005). Methicillin-resistance (MRSA) increased from 28 to 78% in PP; in AP it remained around 50%, with significant reduction in accompanying antimicrobial resistance to non-β-lactams in both groups of MRSA. In S. aureus documented from community onset infections (CO-MRSA) in the last three years, the percentage of methicillin-resistance was 57% in PP and 37% in AP; in hospital-onset infections it was 43% and 63% respectively. Although data showed that S. aureus remains a pathogen associated with the hospital-onset, there was an increase of CO-MRSA infections with predominance in PEA in both populations. Copyright © 2016 Asociación Argentina de Microbiología. Publicado por Elsevier España, S.L.U. All rights reserved.

  19. [Burnout syndrome in medical residents at the General Hospital of Durango, México].

    Science.gov (United States)

    Terrones-Rodríguez, Jovany Francisco; Cisneros-Pérez, Vicente; Arreola-Rocha, José Jesús

    2016-01-01

    The burnout syndrome is commonly spread among health workers and students, due to the excessive demands they feel on their workspaces. Depersonalization, emotional exhaustion and personal accomplishment are the areas assessed. To determine the prevalence of burnout syndrome in medical residents at the General Hospital of Durango; a descriptive, prolective, cross-sectional study was designed and applied to residents of different specialties of the General Hospital of Durango who agreed to participate, the "Maslach Burnout Inventory" was applied. We surveyed 116 residents, 43.1 % (50) women and 56.89 % (66) men. The overall prevalence was 89.66 % (95 % CI: 82.63- 94.54). Affected in a single area the 48.28 % (95 % CI: 38.90-57.74), in two areas the 35.34 % (95 % CI: 26.69-44.76) and in the three areas 6.03 % (95 % CI: 2.46-12.04). Stratified by areas, high emotional exhaustion was 41.38 % (95 % CI: 32.31-50.90), high depersonalization in 54.31 % (95 % CI: 44.81-63.59), and low personal accomplishment 41.38 % (95 % CI: 32.31-50.90). The prevalence is higher than the reported. The most frequently affected is depersonalization, followed by emotional exhaustion and finally the personal accomplishment. In the areas of Gynecology and obstetrics, Internal medicine, Pediatrics and Orthopedics, the 100 % of the residents are affected.

  20. Aetiology and prognosis of encephalopathic patterns on electroencephalogram in a general hospital.

    LENUS (Irish Health Repository)

    O'Sullivan, S S

    2012-02-03

    The purpose of this study was to investigate the frequency and clinical outcome of patients with encephalopathic electroencephalograms (EEGs) in a neurophysiology department based in a general hospital. We performed a retrospective review of all EEGs obtained during an 18-month period in a large tertiary referral hospital. The referral reasons for EEG, the diagnoses reached, and patient outcomes were reviewed according to EEG severity. One hundred and twenty-three patients with encephalopathic EEGs were reviewed. The most common referral reason found was for an assessment of a possible first-onset seizure. The most common diagnosis found was one of dementia or learning disability. Of patients who were followed-up for a median of 19 months, 20.7% had died. The mortality rate generally increased according to the severity of the encephalopathy on EEG. However, 21.4% of those patients with excessive theta activity only on EEG had died. This study highlights an increased mortality even in the apparently \\'milder\\' degrees of EEG abnormalities.

  1. Balanced scorecard: application in the General Panarcadian Hospital of Tripolis, Greece.

    Science.gov (United States)

    Koumpouros, Yiannis

    2013-01-01

    The purpose of this paper is to discuss the application of the balanced scorecard (BSC) in the Greek public health sector. The basic balanced scorecard theory has been adopted in the characteristics and individualities of the Greek public health system. The theoretical model developed was applied in the General Panarcadian Hospital of Tripolis (GPHT) in Greece. GPHT is a representative paradigm of a big regional Greek public hospital. It has about 300 beds and many clinics and specialties (internal medicine, cardiology, general surgery, intensive care unit, artificial kidney unit, etc.). Strategic management was performed for almost three years. The BSC model was formulated in an appropriate software program. The problems (both technical and managerial) faced during a three-year period along with the results of this management approach are presented in the current paper. The paper highlights some important gaps in the Greek public health system, while proposing actions to be taken. The BSC theory can be very successful under certain conditions. Special attention is given to the peculiarities of the Greek public health situation. The paper presents for the first time a real life example of applying BSC in the Greek public health sector.

  2. PATTERN OF ASSAULT-RELATED MAXILLOFACIAL INJURIES TREATED AT THE GENERAL HOSPITAL, LAGOS, NIGERIA.

    Science.gov (United States)

    Olojede, Aco; Gbotolorun, O M; Ogundana, O M; Emeka, I C; Emmanuel, M M; Oluseye, Sab; Runsewe, O

    2016-01-01

    The human face often constitutes the first point of contact in various human interactions and it is frequently the preferred target for blows in assault cases. To analyze the pattern of assault-related maxillofacial injuries treated at the General Hospital, Lagos over a period of one year. This is one year prospective study of assault-related maxillofacial injuries treated at the Department of Oral-Maxillofacial Surgery, Dental Centre, General Hospital, Lagos, Nigeria. A face-to-face interviewer-administered structured proforma was used to obtain information from study subjects. Thirty-three patients with maxillofacial injuries met the inclusion criteria for this study. Their age ranged between 16 and 48 years with a mean age of 28.2 ± 7.4 years. There were 25(75.8%) males and 8(24.2%) females with a male/female ratio of 3:1. Majority of the patients, 24(72.7%) did not have any skilled employment while the remaining 9(27.3%) were road transport workers, specifically commercial bus drivers and motorcycle riders. The most frequently seen soft tissue injury was contusion which accounted for 17(51.5%) cases while 13 (39%) of the patients sustained mandibular fracture which was the most common hard tissue injury. Assault-related maxillofacial injuries are most common amongst young adult males who are not skillfully employed; this can be attributed to the increased disposition to violence in males in our environment.

  3. The Frequency and Pattern of Substance Use in Outpatients of General Hospitals

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    Behrouz Birashk

    2010-11-01

    Full Text Available Background:Patients with addictions have many acute and chronic medical illnesses, both related and unrelated to their addictions. In spite of high incidence of   substance-related disabilities, substance abuse is usually underdiagnosed in general   hospitals. The objective of the present study was to investigate the frequency and pattern of substance use in patients with different medical complaints.Methods: In this descriptive cross-sectional study , 1000 outpatients, aged 17 and   older with various medical complaints were participated. The patients were attending   neurology, ENT, nephrology, ophthalmology, cardiology, orthopedic, gastroenterology, surgical and dermatology clinics of four selected general hospitals. A 93 item clinicians-made scale, Rapid Situation Assessment of Drug Abuse in Iran, was used in this survey, and 30 items which focused on drug use were selected.   Results: 8.7% of the patients reported lifelong or recent substance use and Opium   was the most used substance, reported by 65.5% of the patients. Patients of neurology   ,ophthalmology and orthopedic clinics showed the highest consumption . Smoking   and injestion were the most frequent routes of substance used and the most reported   pattern of use were 2 or 4 times a day and once a week.   Conclusions: The current cohort of substance users were relatively young, and   many had reported detectable nervous system and orthopedic complications. Further   research must investigate -their outcomes in the long term.

  4. Leadership style and choice of strategy in conflict management among Israeli nurse managers in general hospitals.

    Science.gov (United States)

    Hendel, Tova; Fish, Miri; Galon, Vered

    2005-03-01

    To identify conflict mode choices of head nurses in general hospitals and examine the relationship between leadership style, choice of strategy in handling conflicts and demographic characteristics. Nurse managers deal with conflicts daily. The choice of conflict management mode is associated with managerial effectiveness. The ability to creatively manage conflict situations, towards constructive outcomes is becoming a standard requirement. Head nurses (N = 60) in five general hospitals in central Israel were surveyed, using a 3-part questionnaire: The Thomas-Kilmann Conflict Mode Instrument, the Multi-factor Leadership Questionnaire, Form 5X-Short (MLQ 5X) and demographic data. Head nurses perceive themselves significantly more as transformational leaders than as transactional leaders. Compromise was found to be the most commonly used conflict management strategy. Approximately half of the nurses surveyed used only one mode in conflict management. Transformational leadership significantly affected the conflict strategy chosen. Head nurses tend to choose a conflict-handling mode which is concerned a form of a Lose-Lose approach. Preparation in conflict management should start from undergraduate education.

  5. Depression and anxiety in cancer patients in a Tertiary General Hospital in Singapore.

    Science.gov (United States)

    Tan, Shian Ming; Beck, Kevin Roy; Li, Huihua; Lim, Eng Choon Leslie; Krishna, Lalit Kumar Radha

    2014-04-01

    Past research has indicated that distress, anxiety and depression may occur in cancer patients during the course of their illness and treatment. This study aims to establish the prevalence of anxiety and depression in cancer patients in a Singapore hospital. It also describes the clinical characteristics of these patients, and examines if cancer patients with a psychiatric diagnosis differ from those without. Cross-sectional anxiety and depression symptom data were collected using the MINI International Neuropsychiatric Interview generating DSM IV diagnoses from inpatients of an oncology ward in the tertiary hospital. In all, 315 patients were interviewed. Fifty three (16.8%) were diagnosed with major depression, while 30 (9.5%) were found to have generalized anxiety disorder, three to ten times higher than their corresponding prevalence rates in the general population. Patients with depression or anxiety tend to be unemployed, in stage 4 cancer, who can develop these symptoms at any time from the onset of cancer diagnosis, even when perceived social support is strong. Oncology patients with depression were more likely to be in terminal stages of cancer and to correctly identify themselves to have mental health issues, than those without (pcancer is appreciable. The lack of identifiable risk factors makes the task of diagnosing psychiatric conditions in cancer patients an onerous one. The psychiatrist involved may want to look beyond socio-demographic variables and consider biological factors in cancer to better help detect psychiatric morbidity in this group of patients. Copyright © 2013 Elsevier B.V. All rights reserved.

  6. Surveillance of nosocomial infections in Dr. Cipto Mangunkusumo National General Hospital, Jakarta, 1999-2002

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    Djoko Widodo

    2004-06-01

    Full Text Available Nosocomial infection are one of the main problem in hospital which are associated with significant morbidity, mortality and increased economic cost. Surveillance should be attempted regularly to obtain local data of incidence of nosocomial infections, types of infection, pathogen and resistance pattern. We reported the results of nosocomial surveillance in Dr. Cipto Mangunkusumo National General Hospital, Jakarta, in year 1999 to 2002. The data were obtained from surveillance, conducted by Nosocomial Infection Control Committee. Surveillance were performed to patient in risk of nosocomial infections such as underwent surgical procedure, urinary catheter, peripheral or central venous catheter, ventilator and other invasive procedure. Criteria for nosocomial infection which were used, based on technical guidelines of nosocomial infection in Dr. Cipto Mangunkusumo National General Hospital, year 1999; which referred to CDC definition of nosocomial infections. Incidence rate of nosocomial infections in year 1999, 2000, 2001 and 2002 were 1.1, 0.9, 0.6 and 0.4 % respectively. Type of nosocomial infection include catheter related, surgical wound, urinary tract and respiratory tract infections, ranged between 0 to 5.6 %. Gram negative bacteria consist of Pseudomonas sp, Enterobacter aerogenes, Escherichia coli, Proteus mirabilis were the most common nosocomial pathogen. Gram positive bacteria consist of Staphylococcus epidermidis, Staphylococcus aureus and Streptococcus anhemolyticus. Trend of increasing incidence of Gram positive nosocomial infection also showed in our surveillance. Mostly Gram negative bacteria had been resistant to penicillin, co amoxicillin-clavulanic acid and 3rd generation cephalosporin, but still sensitive to 4th generation cephalosporin and aminoglycoside. The Gram positive bacteria were still sensitive to penicillin, co amoxicillin-clavulanic acid, 4th generation cephalosporin and aminoglycoside. (Med J Indones 2004; 13: 107

  7. Our experiences with vancomycin-resistant enterococci in Jesenice General hospital

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    Helena Ribič

    2007-11-01

    Full Text Available Background: Vancomycin-resistant enterococci (VRE present a great problem in health care, especially because of their resistance to many groups of antibiotics and because of the way of their spreading in health care and long-term care institutions. Genes responsible for resistance to vancomycin can be transmitted to other species of enterococci and also to other grampositive cocci, for example Staphylococcus aureus. Experts anticipate that failure to control methicilin-resistant S. aureus and VRE may make control of vancomycin-resistant S. aureus impossible.Methods: In the medical microbiology laboratory of Institute Public Health Kranj we perform microbiology diagnosis for Jesenice General Hospital, where surveillance culturing for VRE started in May 2007. Until 15th June, 364 surveillance samples for VRE were taken from 92 patients. We also analysed the results of enterococci that were isolated in our laboratory during routine work in the period from 2004 to 2006.Results: In the three-year period we isolated 1593 strains of enterococci and among them 7 strains were VRE. In the Jesenice General Hospital, the first strain of vancomycin-resistant Enterococcus faecium was isolated in May 2007 in a patient, treated in internal intensive care unit. Nine strains of VRE with the same resistance type in nine patients followed the first case. The first four patients with VRE were moved from the same hospital. Among next six patients the common risk factor was contact with VRE positive patient.Conclusions: Control of VRE strains claims for intensive action. Active surveillance of colonised and infected patients, contact precautions with barrier isolation, intensive hand hygiene measures, aggressive environmental decontamination and prudent use of antimicrobials are needed.

  8. Evaluation of the carbon monoxide levels in staff of a general hospital

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    Tânia Cristina Malezan Fleig

    2016-10-01

    Full Text Available Backgrounds and Objective: Exposure to carbon monoxide (CO can be harmful to human health and the first effects of intoxication may go unnoticed. Our objective was to evaluate the functional capacity and respiratory muscle strength of staff of a general hospital opposite the inhalation of carbon monoxide. Methods: cross-sectional study with a convenience sample. It was used as evaluation tools: clinical research roadmap; the MicroCO for analysis of CO concentration, CO cutoff for non-smokers among 1- 6ppm, light smokers 7-10ppm, moderate smokers 11-20ppm and heavy smokers >20ppm; the manometer to determine the respiratory muscle strength (MIP and MEP; Six minute walk test (6MWT to evaluate functional capacity. Statistical analysis was performed hair Pearson correlation test to verify the association of variables. Results:The study included 14 volunteer subjects (08 men, mean age 35.14±8,76years, working in maintenance (n=5; laundry (n=6; kitchen (n=1; engineering (n=2 of the hospital. For active smokers only 03 subjects were above the cutoff (CO>6ppm then being considered active smokers. The MIP (99.50±27.37% predicted and MEP (105.64±21,39% predicted are within normal parameters. The functional capacity of smokers (6MWT=71% of predicted, with high CO (17ppm, underperformed the baseline when compared with nonsmokers (CO=0,9ppm; 6MWT=92, 6% predicted. Moderate and negative correlation was observed between 6MWT and CO (r=-0.577, p=0.031. Conclusion: adult staff of a general hospital with preserved respiratory muscle strength and higher levels of CO exhaled have worse functional performance in the 6MWT. KEYWORDS:Muscle Strength. Carbon Monoxide.Occupational Health.Public Health.

  9. Psychopathology of the General Population Referred by Primary Care Physicians for Urgent Assessment in Psychiatric Hospitals

    Directory of Open Access Journals (Sweden)

    Judith McLenan

    2016-12-01

    Full Text Available Objective: The aim of this study was to evaluate the type, severity and progression of psychiatric pathologies in a sample of 372 outpatients (age range 18–65 years referred by their primary general practitioners (GPs to an Urgent Referral Team (URT based in a psychiatric hospital in Aberdeen, Scotland. This team offers immediate appointments (1- to 7-day delays for rapid assessments and early interventions to the outpatients referred by their primary family doctors.Method: One-sample t-test and z statistic were used for data analysis. From the total population, a convenience sample of 40 people was selected and assessed to evaluate whether follow-up appointments after the first visit could reduce the severity of suicidal ideation, depression and anxiety in the outpatients seen by the URT. A two-sample t-test and a Wilcoxon signed-rank test were used to assess the variations in the scores during the follow-up visits.Results: We found a statistically significant prevalence of depressive disorders, comorbid with anxiety at first presentation in people who were females, white, never married, living with a partner, not studying and not in paid employment. The common presentation of borderline personality disorder and dysthymia in this population underscores its vulnerability to major socioeconomic challenges.Conclusion: The data confirmed the impact that primary care cooperation with psychiatric hospitals can have on the psychiatric system, and as a reflection, on the population’s mental health and well-being. In fact, active cooperation and early diagnosis and intervention will help detect cases at risk in the general population and reduce admissions into hospitals.

  10. CARMENES: Commissioning and first scientific results at the telescope. A precursor for HIRES@E-ELT

    Science.gov (United States)

    Amado, P. J.; The Carmenes Consortium

    2017-03-01

    CARMENES is the next generation instrument built for the CAHA 3.5m telescope by a large international consortium of 11 institutes in Spain and Germany. It consists of two separate highly-stabilized, high-resolution echelle spectrographs covering both the visible, from 550 to 950 nm, and the near-IR, from 950 to 1700 nm, wavelength ranges with spectral resolution of R=82,000. They are fed by fibres from the Cassegrain focus of the telescope and were designed and built to achieve high-accuracy radial velocities of nearby M-dwarf stars. This contribution overviews the main and unique design characteristics of CARMENES. The instrument MAIV phase was achieved in the last two years (2014-2015) and started commissioning in November 2015. The commissioning phases, both technical and scientific, took six full weeks in the last two months of 2015. They have shown that the instrument is well within requirements and performing to be able to achieve its objective, not proven before in the near-infrared, of providing radial velocities precisions of 5 ms^{-1}, with a goal of 1 ms^{-1}. The Guaranteed Time Observations (GTO) program has started in January 1st, 2016. CARMENES is, therefore, currently conducting a radial-velocity survey of 300 M dwarfs with a precision sufficient for detecting Earth-like planets in their habitable zones. It is also being offered in open time by the CAHA. Its modular design is the idea in which HIRES, the next very high-resolution, high-fidelity spectrograph with wide wavelength coverage at the E-ELT, is based on. This E-ELT instrument might consist of four different high-resolution spectrographs covering the blue, the visible, the near-infrared (Y, J and H bands) and the K band. A proposal to the ESO call for Phase-A studies for a HIRES at the E-ELT was submitted by the HIRES consortium last December. This proposal was accepted by ESO and the Phase-A kick-off meeting between ESO and the consortium took place in March 22, 2016.

  11. Recent and upcoming observations of the CARacterisation et Modelisation de l'ENvironnement (CARMEN) mission

    Science.gov (United States)

    Ecoffet, Robert; Maget, Vincent; Rolland, Guy; Lorfevre, Eric; Bourdarie, Sébastien; Boscher, Daniel

    2016-07-01

    We have developed a series of instruments for energetic particle measurements, associated with component test beds "MEX". The aim of this program is to check and improve space radiation engineering models and techniques. The first series of instruments, "ICARE" has flown on the MIR space station (SPICA mission), the ISS (SPICA-S mission) and the SAC-C low Earth polar orbiting satellite (ICARE mission 2001-2011) in cooperation with the Argentinian space agency CONAE. A second series of instruments "ICARE-NG" was and is flown as: - CARMEN-1 mission on CONAE's SAC-D, 650 km, 98°, 2011-2015, along with three "SODAD" space micro-debris detectors - CARMEN-2 mission on the JASON-2 satellite (CNES, JPL, EUMETSAT, NOAA), 1336 km, 66°, 2008-now, along with JAXA's LPT energetic particle detector - CARMEN-3 mission on the JASON-3 satellite in the same orbit as JASON-2, launched 17 January 2016, along with a plasma detector "AMBRE", and JAXA's LPT again. The ICARE-NG is spectrometer composed of a set of three fully depleted silicon solid state detectors used in single and coincident mode. The on-board measurements consist in accumulating energy loss spectra in the detectors over a programmable accumulation period. The spectra are generated through signal amplitude classification using 8 bit ADCs and resulting in 128/256 channels histograms. The discriminators reference levels, amplifier gain and accumulation time for the spectra are programmable to provide for possible on-board tuning optimization. Ground level calibrations have been made at ONERA-DESP using radioactive source emitting alpha particles in order to determine the exact correspondence between channel number and particle energy. To obtain the response functions to particles, a detailed sectoring analysis of the satellite associated with GEANT-4/MCNP-X calculations has been performed to characterize the geometrical factors of the each detector for p+ as well as for e- with different energies. The component test bed

  12. Implementation of a pre-hospital decision rule in general practice. Triage of patients with suspected myocardial infarction

    NARCIS (Netherlands)

    E.W.M. Grijseels (Els); J.W. Deckers (Jaap); A.W. Hoes (Arno); H. Boersma (Eric); J.A.M. Hartman; E. van der Does (Emiel); M.L. Simoons (Maarten)

    1996-01-01

    textabstractOBJECTIVE: To improve pre-hospital triage of patients with suspected acute cardiac disease. DESIGN: Prospective study. SUBJECTS. Patients with symptoms suggestive of acute cardiac pathology, who were seen by a general practitioner, for whom acute admission into hospital was requested,

  13. Interconsulta psicológica: demanda e assistência em hospital geral Interconsulta psicológica: demanda y asistencia en hospital general Consultation-liaison psychology: demand and assistance in general hospital

    Directory of Open Access Journals (Sweden)

    Nátali Castro Antunes Santos

    2011-06-01

    Full Text Available A interconsulta psicológica no hospital geral representa uma modalidade de atendimento clínico e um instrumento metodológico utilizado pelo psicólogo na assistência ao paciente internado, mediante solicitação de outros profissionais da saúde. O estudo objetivou caracterizar a demanda da interconsulta psicológica em um hospital geral, a partir da análise dos registros de solicitação de atendimento. Cento e sete pacientes foram atendidos entre janeiro e junho de 2010, dos quais 53% eram do sexo masculino e 57% eram adultos acima de 45 anos. A maioria das solicitações foi realizada por médicos (44% e enfermeiros (38%, formalmente (59%, e mediante contato prévio entre interconsultor e solicitante (85%. Os principais motivos alegados para a solicitação da interconsulta foram sintomas psicológicos relacionados ao adoecimento (43% e identificação de comprometimento na adaptação do paciente à hospitalização (41%. O modelo de interconsulta psicológica adotado no contexto estudado foi adequado, havendo engajamento da equipe multiprofissional na efetivação da prática.La interconsulta psicológica en los hospitals generales representan una modalidad de clínica y una herramienta metodológica utilizada por los psicólogos en la atención hospitalaria del paciente, a petición de los profesionales de la salud. El objetivo del estudio fue caracterizar la demanda psicológica para referirlo a un hospital general, desde el análisis del servicio de solicitud de registros. Ciento siete pacientes fueron tratados entre enero y junio de 2010, siendo 53% hombres y 57% de los adultos mayores de 45 años. La mayoría de las solicitudes fueron realizadas por los médicos (44% y enfermeras (38%, de manera formal (59% y el contacto previo entre interconsultor y su interés (85%. Las razones principales de la solicitud de remisión fueron: síntomas psicológicos relacionados con la enfermedad (43% y la identificación de la deficiencia en la

  14. The prevalence of mental health problems among older adults admitted as an emergency to a general hospital

    OpenAIRE

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

    2011-01-01

    Background: a high prevalence of co-morbid mental health problems is reported among older adults admitted to general hospitals. Setting: an 1,800 bed teaching hospital. Design: consecutive general medical and trauma orthopaedic admissions aged 70 or older were screened for mental health problems. Those screening positive were invited to undergo further assessment, and were interviewed to complete a battery of health status measurements. Results: of 1,004 patients screened, 36% had no mental h...

  15. Hospitals

    Data.gov (United States)

    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...

  16. A STUDY ON CLINICAL AND AETIOLOGICAL PROFILE OF HEART FAILURE AT KBN TEACHING AND GENERAL HOSPITAL

    Directory of Open Access Journals (Sweden)

    Chandrakala Guruprasad Yelwanti

    2016-10-01

    Full Text Available BACKGROUND The heart failure is a worldwide health problem with ever increasing proportion and is a major health problem in elderly persons. It has many aetiological factors. It is one of the most frequently encountered illnesses in day-to-day practice and most common cause of death in patients with cardiac disease. This study was done to determine the age and sex distribution and to evaluate clinical features and aetiological factors in patients admitted with heart failure at Khaja Banda Nawaz Teaching and General Hospital, Gulbarga, on the basis of clinical assessment, electrocardiography and echocardiography. MATERIALS AND METHODS A prospective study was done in Department of General Medicine at Khaja Banda Nawaz Teaching and General Hospital, Gulbarga, from January 2015 to June 2016 on patients with heart failure to determine the clinical and aetiological profile. A total of 100 cases above the age of 20 years were included in the study. The patients below the age of 20 years and known cases of congenital heart disease were excluded. RESULTS Out of 100 patients, the heart failure was seen more commonly in men than in women between the age groups of 46-65 years of age. Breathlessness was the most common presentation followed by pedal oedema, orthopnoea, etc. In our study, the primary aetiology for heart failure was found to be coronary artery disease (47% followed by dilated cardiomyopathy (20%, hypertension (14%, rheumatic heart disease (7%, anaemia (6%, cor pulmonale (4% and others (2%. Dyslipidaemia was the common risk factor followed by obesity and smoking. CONCLUSION The heart failure commonly occurs in elderly people and the incidence was higher in men than in women. The commonest presentation was breathlessness followed by pedal oedema. The commonest cause of heart failure was coronary artery disease followed by dilated cardiomyopathy and then hypertension combined with ischaemic heart disease.

  17. Effect of Surgeon and Hospital Volume on Emergency General Surgery Outcomes.

    Science.gov (United States)

    Mehta, Ambar; Efron, David T; Canner, Joseph K; Dultz, Linda; Xu, Tim; Jones, Christian; Haut, Elliott R; Higgins, Robert S D; Sakran, Joseph V

    2017-11-01

    Emergency general surgery (EGS) contributes to half of all surgical mortality nationwide, is associated with a 50% complication rate, and has a 15% readmission rate within 30 days. We assessed associations between surgeon and hospital EGS volume with these outcomes. Using Maryland's Health Services Cost Review Commission database, we identified nontrauma EGS procedures performed by general surgeons among patients 20 years or older, who were admitted urgently or emergently, from July 2012 to September 2014. We created surgeon and hospital volume categories, stratified EGS procedures into simple (mortality ≤ 0.5%) and complex (>0.5%) procedures, and assessed postoperative mortality, complications, and 30-day readmissions. Multivariable logistic regressions both adjusted for clinical factors and accounted for clustering by individual surgeons. We identified 14,753 procedures (61.5% simple EGS, 38.5% complex EGS) by 252 (73.3%) low-volume surgeons (≤25 total EGS procedures/year), 63 (18.3%) medium-volume surgeons (26 to 50/year), and 29 (8.4%) high-volume surgeons (>50/year). Low-volume surgeons operated on one-third (33.1%) of all patients. For simple procedures, the very low rate of death (0.2%) prevented a meaningful regression with mortality; however, there were no associations between low-volume surgeons and complications (adjusted odds ratio [aOR] 1.07; 95% CI 0.81 to 1.41) or 30-day readmissions (aOR 0.80; 95% CI 0.64 to 1.01) relative to high-volume surgeons. Among complex procedures, low-volume surgeons were associated with greater mortality (aOR 1.64; 95% CI 1.12 to 2.41) relative to high-volume surgeons, but not complications (aOR 1.06; 95% CI 0.85 to 1.32) or 30-day readmission (aOR 0.99; 95% CI 0.80 to 1.22). Low-volume hospitals (≤125 total EGS procedures/year) relative to high-volume hospitals (>250/year) were not associated with mortality, complications, or 30-day readmissions for simple or complex procedures. We found evidence that surgeon EGS

  18. Characteristics of High-Risk Pregnancy in Sanglah General Hospital 2011-2014

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    Ryan Saktika Mulyana

    2016-07-01

    Full Text Available Background: Pregnant women with a high-risk pregnancy are women with increased risk in pregnancy or childbirth. There is no readily available data available about the characteristics of the high-risk pregnancy in Bali. Objective: Our study aimed to provide a data, to be the base of Sanglah General Hospital resource planning to reduce maternal mortality and morbidity. Method: This was an observational study using medical records of high risk pregnancy patients at Sanglah General Hospital from 2011 to 2014. Inclusion criteria were the patients with complete medical record and exclusion criteria are patient whose medical report incomplete. There was no missing data in this study.Result Over the 4 year study period at Sanglah, there were 1027 high-risk deliveries in 2011, 1590 in 2012, 1590 in 2013, and 948 in 2014. In the 4 years, there were 748 with age ≥ 35 years. The majority were in the age group of 26-30 years. As many as 2932 were multiparous. Overall, 3082 were multigravida and only 197 were grandemultipara. There were 1406 preterm (<37 week. By onset and mode of delivery, 2027 (41.50% had a caesarean section, There were 9 (0.18% Breech deliveries and Neonatal outcomes were recorded, showing that 296 (6.29% had moderate asphyxia and 2189 (4.63% had severe asphyxia. The multiple pregnancy was 197 (3.82% twin pregnancies and 5 (0.1% cases of triplets. The largest group of obstetrics complications in Sanglah hospital was premature rupture of membrane 1652 cases (30.99%. The most common medical disorder of pregnant women at our hospital was anemia, 353 cases (45.43%. The most prevalent congenital anomalies were multiple congenital abnormalities, as many as 18 infants (20.22%.Conclusion: There were a significant number of high-risk pregnancies delivered at Sanglah, with nearly 46.85% being high risk deliveries. Characteristics of these high risk pregnancies can be used to plan appropriate care to reduce the maternal mortality rate.

  19. Epidemiology of asthma hospitalizations among American Indian and Alaska Native people and the general United States population.

    Science.gov (United States)

    Mehal, Jason M; Holman, Robert C; Steiner, Claudia A; Bartholomew, Michael L; Singleton, Rosalyn J

    2014-09-01

    Asthma, a common chronic disease among adults and children in the United States, results in nearly one-half million hospitalizations annually. There has been no evaluation of asthma hospitalizations for American Indian and Alaska Native (AI/AN) people since a previous study using data for 1988-2002. In this study, we describe the epidemiology and trends for asthma hospitalizations among AI/AN people and the general US population for 2003-2011. Hospital discharge records with a first-listed diagnosis of asthma for 2003-2011 were examined for AI/AN people, using Indian Health Service (IHS) data, and for the general US population, using the Nationwide Inpatient Sample. Average annual crude and age-adjusted hospitalization rates were calculated. The average annual asthma hospitalization rates for AI/AN people and the general US population decreased from 2003-2005 to 2009-2011 (32% and 11% [SE, 3%], respectively). The average annual age-adjusted rate for 2009-2011 was lower for AI/AN people (7.6 per 10,000 population) compared with the general US population (13.2 per 10,000; 95% CI, 12.8-13.6). Age-specific AI/AN rates were highest among infants and children 1 to 4 years of age. IHS regional rates declined in all regions except Alaska. Asthma hospitalization rates are decreasing for AI/AN people and the general US population despite increasing prevalence rates. AI/AN people experienced a substantially lower age-adjusted asthma hospitalization rate compared with the general US population. Although the rates for AI/AN infants and children 1 to 4 years of age have declined substantially, they remain higher compared with other age groups. Improved disease management and awareness should help to further decrease asthma hospitalizations, particularly among young children.

  20. A 10-year trend of dental treatments under general anesthesia of children in Taipei Veterans General Hospital.

    Science.gov (United States)

    Chen, Yung-Pan; Hsieh, Chun-Yi; Hsu, Wen-Ting; Wu, Fu-Ya; Shih, Wen-Yu

    2017-04-01

    General anesthesia (GA) as a pediatric dental procedure is a well-established method of behavior management. However, studies of pediatric dentistry under GA have mostly focused on handicapped patients, and various retrospective studies in Taiwan have mainly reviewed only a limited number of years. The purpose of the present study was to report trends in pediatric dental treatment performed under GA over the past 10 years. A retrospective review of the hospital records of patients receiving dental treatment under GA from 2006 until 2015 was performed. The patients were divided into three age groups:  6 years. A range of information including basic patient characteristics and types of dental treatment was identified and then analyzed. A total of 791 cases ( 6 years old: 235; 549 male, 242 female) were treated under GA. The case number was found to have increased from 94 during 2006-2007 to 238 during 2014-2015, with the increase being especially pronounced among those aged 3-6 years (2006-2007: 49, 2014-2015: 165). The most common treatments (extraction, restoration, and pulp therapy) were associated with multiple dental caries (684, 86.4%). The  6-years-old group had the lowest mean number of treated teeth by stainless-steel crowns (SSCs) and fewest cases treated with pulp therapy. From 2011 onwards, the number of primary tooth extractions significantly increased, while in 2013, there was a crossover whereby the SSC count surpassed the composite resin filling count. Over the past 10 years, there has been an increased use of GA for pediatric dental treatments, in particular, in cases with multiple dental caries. In addition, there has also been an increasing trend towards extraction of primary teeth and the use of SSCs. Copyright © 2017. Published by Elsevier Taiwan LLC.

  1. Espacios y viajes en la vida y en la obra de Carmen de Burgos Colombine

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    Núñez Rey, Concepción

    2010-06-01

    Full Text Available Carmen de Burgos (1867-1932 symbolized at her time the efforts to support the progress and the modern ideas; the ideas that the Regenerationism trend had encouraged in Spain. From her very arrival to Madrid in 1901 from her Almeria home town, she started a literary and journalistic career punctuated by so many successes. She signed as Colombine, and became the first female editor of a journal (Diario Universal, 1903, and then the first Spanish War correspondent (Heraldo de Madrid, 1909. She accumulated a large and rich culture made of erudition and was an indefatigable and experienced world-traveller from the European limits to the American furthest corners. Both the spaces and the travels have been given a special importance in her narrative work. Her legacy is made of nearly two hundred titles -among these short and long novels, essays, biographies, travel books, literary studies, translations, prologues, books of interviews along with thousands of articles published by the Spanish and the foreign press- it is a largest literary and scholarly work: a polygraph’s work. She was both a minded and an action woman that launched so many press campaigns in favour of social and political causes, especially in favour of women. In our literary story, Carmen de Burgos is the writer who covers the tendencies during the first third of the 20th century, from the Generation of 98 to the innovative currents, our silver age.Carmen de Burgos (1867-1932 simbolizó en su tiempo el afán de progreso y de modernidad que alentó en España la corriente del Regeneracionismo. Desde su llegada a Madrid en 1901, procedente de su Almería natal, emprendió una carrera literaria y periodística jalonada de éxitos. Firmando como Colombine, se convirtió en la primera mujer redactora de un periódico (Diario Universal, 1903, y más tarde en nuestra primera corresponsal de guerra (Heraldo de Madrid, 1909. Acumuló una vasta y rica cultura, hecha de erudición y de

  2. Historia de una amistad: Ramón Sender y Carmen Laforet desde sus exilios

    Directory of Open Access Journals (Sweden)

    Emilia De Zuleta

    2006-11-01

    Full Text Available Carmen Laforet's Nada received the first prize in the Nadal Awards in 1944. Although the novel was highly praised inside Spain, two of its interpretations made in the exile raise more interest. The first one is an article by Francisco Ayala published in the first number of Realidad, a magazine in Buenos Aires. The second interpretation, consists of a letter by Ramón Sender. This letter has been published, together with 76 other letters exchanged by him and Laforet, in Puedo contar contigo. Throughout these texts, both writers build up a sort of confesion-dialogue from which the reader can have a glimpse of their silhouettes, full of existential ups-anddowns of pain, nostalgia, depression and hope. Rolón Parada's book also illustrates a relationship between the Spain of the "inside" and that of the "outside" which took place during the Franquism.

  3. CaRMeN: a tool for analysing and deriving kinetics in the real world.

    Science.gov (United States)

    Gossler, H; Maier, L; Angeli, S; Tischer, S; Deutschmann, O

    2018-04-25

    This paper presents the concepts of an open software tool (CaRMeN) that can be used to rapidly analyse and derive models, in particular chemical kinetics. The software automates the workflow of comparing model vs. experiment, which must currently be done manually and is thus a time-consuming and error-prone task. The capabilities of the software are illustrated through a case study. Experimental data for the conversion of methane over rhodium catalysts in a wide range of conditions and experimental setups are numerically simulated using five different mechanisms from the literature. The applicability of the mechanisms as well as differences between flow and diffusion models are evaluated. The results show that no single mechanism reliably predicts the chemical conversions of all of the experiments. Although the software was initially developed for chemical kinetics applications, it can also be extended to run any simulation code, and can therefore be applied in other scenarios.

  4. A controlled trial of electronic automated advisory vital signs monitoring in general hospital wards.

    Science.gov (United States)

    Bellomo, Rinaldo; Ackerman, Michael; Bailey, Michael; Beale, Richard; Clancy, Greg; Danesh, Valerie; Hvarfner, Andreas; Jimenez, Edgar; Konrad, David; Lecardo, Michele; Pattee, Kimberly S; Ritchie, Josephine; Sherman, Kathie; Tangkau, Peter

    2012-08-01

    Deteriorating ward patients are at increased risk. Electronic automated advisory vital signs monitors may help identify such patients and improve their outcomes. A total of 349 beds, in 12 general wards in ten hospitals in the United States, Europe, and Australia. Cohort of 18,305 patients. Before-and-after controlled trial. We deployed electronic automated advisory vital signs monitors to assist in the acquisition of vital signs and calculation of early warning scores. We assessed their effect on frequency, type, and treatment of rapid response team calls; survival to hospital discharge or to 90 days for rapid response team call patients; overall type and number of serious adverse events and length of hospital stay. We studied 9,617 patients before (control) and 8,688 after (intervention) deployment of electronic automated advisory vital signs monitors. Among rapid response team call patients, intervention was associated with an increased proportion of calls secondary to abnormal respiratory vital signs (from 21% to 31%; difference [95% confidence interval] 9.9 [0.1-18.5]; p=.029). Survival immediately after rapid response team treatment and survival to hospital discharge or 90 days increased from 86% to 92% (difference [95% confidence interval] 6.3 [0.0-12.6]; p=.04). Intervention was also associated with a decrease in median length of hospital stay in all patients (unadjusted p<.0001; adjusted p=.09) and more so in U.S. patients (from 3.4 to 3.0 days; unadjusted p<.0001; adjusted ratio [95% confidence interval] 1.03 [1.00-1.06]; p=.026). The time required to complete and record a set of vital signs decreased from 4.1±1.3 mins to 2.5±0.5 mins (difference [95% confidence interval] 1.6 [1.4-1.8]; p<.0001). Deployment of electronic automated advisory vital signs monitors was associated with an improvement in the proportion of rapid response team-calls triggered by respiratory criteria, increased survival of patients receiving rapid response team calls, and

  5. Otro paso ‘fuera del tiempo’: Al volver la esquina de Carmen Laforet

    Directory of Open Access Journals (Sweden)

    Noè, Elisabetta

    2007-12-01

    Full Text Available This work deals with Carmen Laforet’s novel Al volver la esquina, which was published posthumous by Destino in 2004 when the writer herself died. In this novel the organization and the complexity of the narrative text represent a new and interesting stage in the stylistic evolution of Laforet’s writing. This article wants to analyse some aspects of the narrative structure of the novel (focusing, time dealing and characterization in order to include it in the unfinished trilogy, called «Tres pasos fuera del tiempo», of which it is its second part, after the publication of La insolación in 1963.Se estudia aquí la novela Al volver la esquina, de Carmen Laforet, publicada de manera póstuma por la editorial Destino en 2004, el mismo año de la muerte de la escritora. En esta obra, la articulación y la complejidad de la estructura narrativa representa una nueva e interesante etapa de la evolución estilística de Laforet. Este artículo se propone analizar ciertos aspectos de la organización narrativa de esta obra (focalización, tratamiento del tiempo y fisonomía de los personajes, insertándola en el contexto de una trilogía inacabada, titulada «Tres pasos fuera del tiempo», de la que representa la segunda parte, tras la publicación, en 1963, de La insolación.

  6. La novelística feminista de Carmen Laforet y el género negro

    Directory of Open Access Journals (Sweden)

    Johnson, Roberta

    2006-08-01

    Full Text Available In her five long novels, Carmen Laforet consistently attempted to find new narrative means of framing a feminist message. There exist studies of her use of the Bildungsroman, the Gothic, and Expressionism in Nada. This essay focuses on elements of detective fiction, especially the noir subgenre, in Laforet’s novelistic production, concentrating on Al volver la esquina published posthumously in 2004. The masculine protagonistnarrator moves in a world that is akin to those of North American noir films and novels in order to reveal his dilemma as a man of traditional Spanish masculinist values in a Spain that is beginning to experience the influence of other countries where gender roles are changing.En sus cinco novelas largas, Carmen Laforet intentaba consistentemente encontrar nuevos modos narrativos para enmarcar un mensaje feminista. Ya se ha estudiado su incorporación de la Bildungsroman, lo gótico y lo expresionista en Nada. Este ensayo se enfoca en los elementos de la novela detectivesca, sobre todo el subgénero negro, en la novelística de Laforet. Se concentra en Al volver la esquina publicada póstumamente en 2004, y en la que el protagonista- narrador masculino se mueve en un mundo que se asemeja a los del cine y novela negros norteamericanos, para revelar su dilema de hombre de valores tradicionales masculinistas en una España que está empezando a sentir la influencia de otros países donde los papeles de los géneros sexuales están cambiando.

  7. Bloodstream infection among children presenting to a general hospital outpatient clinic in urban Nepal.

    Directory of Open Access Journals (Sweden)

    Rahul Pradhan

    Full Text Available BACKGROUND: There are limited data on the etiology and characteristics of bloodstream infections in children presenting in hospital outpatient settings in South Asia. Previous studies in Nepal have highlighted the importance of murine typhus as a cause of febrile illness in adults and enteric fever as a leading bacterial cause of fever among children admitted to hospital. METHODS: We prospectively studied a total of 1084 febrile children aged between 2 months and 14 years presenting to a general hospital outpatient department in Kathmandu Valley, Nepal, over two study periods (summer and winter. Blood from all patients was tested by conventional culture and by real-time PCR for Rickettsia typhi. RESULTS: Putative etiological agents for fever were identified in 164 (15% patients. Salmonella enterica serovar Typhi (S. Typhi was identified in 107 (10%, S. enterica serovar Paratyphi A (S. Paratyphi in 30 (3%, Streptococcus pneumoniae in 6 (0.6%, S. enterica serovar Typhimurium in 2 (0.2%, Haemophilus influenzae type b in 1 (0.1%, and Escherichia coli in 1 (0.1% patient. S. Typhi was the most common organism isolated from blood during both summer and winter. Twenty-two (2% patients were PCR positive for R. typhi. No significant demographic, clinical and laboratory features distinguished culture positive enteric fever and murine typhus. CONCLUSIONS: Salmonella infections are the leading cause of bloodstream infection among pediatric outpatients with fever in Kathmandu Valley. Extension of immunization programs against invasive bacterial disease to include the agents of enteric fever and pneumococcus could improve the health of children in Nepal.

  8. Medical identity theft: prevention and reconciliation initiatives at Massachusetts General Hospital.

    Science.gov (United States)

    Judson, Timothy; Haas, Mark; Lagu, Tara

    2014-07-01

    Medical identity theft refers to the misuse of another individual's identifying medical information to receive medical care. Beyond the financial burden on patients, hospitals, health insurance companies, and government insurance programs, undetected cases pose major patient safety challenges. Inaccuracies in the medical record may persist even after the theft has been identified because of restrictions imposed by patient privacy laws. Massachusetts General Hospital (MGH; Boston) has conducted initiatives to prevent medical identity theft and to better identify and respond to cases when they occur. Since 2007, MGH has used a notification tree to standardize reporting of red flag incidents (warning signs of identity theft, such as suspicious personal identifiers or account activity). A Data Integrity Dashboard allows for tracking and reviewing of all potential incidents of medical identity theft to detect trends and targets for mitigation. An identity-checking policy, VERI-(Verify Everyone's Identity) Safe Patient Care, requires photo identification at every visit and follow-up if it is not provided. Data from MGH suggest that an estimated 120 duplicate medical records are created each month, 25 patient encounters are likely tied to identity theft or fraud each quarter, and 14 patients are treated under the wrong medical record number each year. As of December 2013, 80%-85% of patients were showing photo identification at appointments. Although an organization's policy changes and educational campaigns can improve detection and reconciliation of medical identity theft cases, national policies should be implemented to streamline the process of correcting errors in medical records, reduce the financial disincentive for hospitals to detect and report cases, and create a single point of entry to reduce the burden on individuals and providers to reconcile cases.

  9. Postoperative complications of pediatric dental general anesthesia procedure provided in Jeddah hospitals, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Almushayt Abdullah

    2009-02-01

    Full Text Available Abstract Background Review of post-operative morbidity reports for pediatric dental care under general anesthesia (GA show great variations. Until now, no morbidity data has been available to estimate the safety of pediatric patients under GA for dental rehabilitation in Saudi Arabia. The purposes of this study were to (1 investigate post-operative complications associated with dental care under GA and (2 correlate morbidity reports with patient's characteristics, dental procedures, and hospital protocol. Methods Study sample included 90 children attending GA for dental treatment at major governmental hospitals in Jeddah. Data were collected from every patient on three occasions, intra-operatively at the operating room, and post-operatively via phone calls in the first and third days after operation. Results Results showed that 99% of the children had one or more complaints in the first day in contrast to only 33% in the third day. Inability to eat (86%, sleepiness (71%, and pain (48% were the most common complaints in the first day, followed by bleeding (40%, drowsiness (39%, sore throat (34%, vomiting (26%, psychological changes (24%, fever (21%, cough (12%, and nausea (8%. A great significant complaints reduction was reported by the third post-operative day. Age, gender, admission type of the patients and GA duration were the factors that showed a significant relationship with post-operative complaints. Conclusion Post-operative morbidity was common, but mostly of mild severity and limited to the first day. Hospital staff efforts should be directed to control commonly reported postoperative complaints.

  10. Profile of Vitamin D in patients attending at general hospital Mahad India

    Directory of Open Access Journals (Sweden)

    Parag Himatrao Bawaskar

    2017-01-01

    Full Text Available Background: Despite abundant sunshine, Vitamin D deficiency is prevalent in urban India. However, reports on analyzing Vitamin D status from rural Indian population are scanty. Here, we have evaluated Vitamin D status in patients attending outpatient department (OPD in a rural Indian hospital setting. Methods: A hospital-based cross-sectional study was conducted at a secondary level rural hospital in patients attending medicine OPD. After obtaining informed consent, demographic information was collected from consecutive adult patients along with 3 ml blood sample for Vitamin D analysis using electro chemiluminescene on cobas elecys E411 fully automated system. Vitamin D levels were compared across various groups by using Mann–Whitney or Kruskal–Wallis tests, and multiple linear regression analysis was performed to identify the predictors of Vitamin D level. Results: A total of 640 patients were enrolled in the study, and the prevalence of Vitamin D deficiency (<20 ng/ml was found to be 65.4% with 95% confidence interval of 61.7–69.1%. On univariate analysis, Vitamin D levels were statistically significantly lower among younger age group, those who have dark complexion, wearing Burkha (veil, and those who were not adequately exposed to sunlight. After multiple linear regressions, dark complexion, wearing Burkha, inadequate exposure to sunlight, and presence of diabetes were identified as statistically significant predictors of Vitamin D deficiency. Conclusion: We report a high prevalence of Vitamin-D deficiency in patients attending medicine OPD. Thus, patients with generalized complaints may be evaluated for serum Vitamin D levels.

  11. Reglamento del Instituto Universitario "Carmen Vidal Ballester" sobre desarrollo empresarial, aprobado por el Consejo de Gobierno en sesión de 3 de diciembre de 2004.

    OpenAIRE

    Universidad Carlos III de Madrid. Consejo de Gobierno

    2004-01-01

    El "Instituto universitario Carmen Vidal Ballester sobre desarrollo empresarial" pasó a denominarse "Instituto para el desarrollo empresarial (INDEM)" tras la sesión del Consejo de Gobierno de 16 de mayo de 2013.

  12. [Obstetric hysterectomy in the General Hospital Dr. Aurelio Valdivieso: three-year review].

    Science.gov (United States)

    Calvo-Aguilar, O; Vásquez-Martínez J; Hernández-Cuevas, P

    2016-02-01

    Post-cesarean hysterectomy is the most extensive procedure used during the postpartum stage. This is an indicator of quality substantially associated with extreme obstetric morbidity. To determine the incidence, indications, and complications associated with obstetric hysterectomy in a hospital, after three years to implement the program of prevention and management of massive obstetric hemorrhage. Observational, transversal, retrospective and descriptive study conducted from January 2011 to November 2013. We records patients who underwent obstetric hysterectomy, of any age and at any time during pregnancy were reviewed. The results are expressed as frequencies, percentages and central tendency measures. 38 patients were recorded with obstetric hysterectomy. We found prevalence of 18.4 per 10,000, and incidence per year of 1.7, 1.4 and 2.6 per 1,000 births for 2011, 2012 and 2013. The prevalence of post-cesarean hysterectomy was 63.05 per 10,000 while postpartum was 9.05 per 10,000 births. The only difference between scheduled and emergency surgery was operating time. The procedure is associated with anemia in postpartum 13 times and the main indications for the procedures were hypo/atony and placenta accrete. The prenatal diagnoses of placenta accrete and improvement in the use of blood products and surgical technique has eliminated maternal mortality by massive obstetric hemorrhage in the last three years at the General Hospital "Dr. Aurelio Valdivieso".

  13. Finger Replantation in Sanglah General Hospital: Report of Five Cases and Literature Review

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    Agus Roy Rusly Hariantana Hamid

    2016-11-01

    Full Text Available Background: Replantation is the prime treatment for amputated hands and fingers due to functional and aesthetic advantages. The absolute indications for replantation are amputations of the thumb, multiple fingers, trans metacarpal or hand, and any upper extremity in a child, regardless of the amputation level. A fingertip amputation distal to the insertion of the flexor digitorum superficialis (FDS is also a good indication. Indications have been expanded to include amputation at nail level, and when there is a request from the patient, replantation is attempted even for a single finger amputation regardless of the amputation level. Based on the mechanism of injury, a clean-cut sharp amputation is more likely replanted compare to a crush and avulsion injuries. With a proper management of the amputated finger, replantation can be attempted even after 24 hours. This report was written to provide examples of finger replantation cases and the measures that can be taken in a resource-limited hospital in order to conduct a replantation. Case Series: We reported five out of nine digital replantation cases in Sanglah General Hospital between January and July 2014. Two patients were a six and an eleven years old boys who accidentally cut their finger while playing, the rests were male labors between 20-30 years old whose amputations due to machine injuries. Result: A 100% replant survival was achieved. After a period of follow up with occupational therapy, all patients regain good functional and cosmetic results. 

  14. Child abuse and neglect as seen in General Hospital, Kuala Lumpur--a two year study.

    Science.gov (United States)

    Kassim, M S; George, R; Kassim, K; Begum, M; Cherian, M P; Tajudin, A K; Chandran, V; Anan, A; Reddy, R; Singh, J

    1989-06-01

    Eighty-six children diagnosed as child abuse and/or neglect were admitted to the Paediatric wards of the General Hospital, Kuala Lumpur during 1985 and 1986. Of these cases, 62 were of physical abuse, six of sexual abuse, one case of both physical and sexual abuse and 17 of neglect. There were 25 boys and 61 girls. Thirty-four of these children were Malays, 16 Chinese, 26 Indians, three mixed and seven illegal immigrants. Twenty-one were below the age of one year, 24 from one to four years, 25 from five to nine years and 16 were ten years and above. The abusers were mainly close members of the family. Of these children, 24 were sent back to their parents and 11 to their relatives home. Twenty-seven were taken into care by the Ministry of Social Welfare and the remaining seven children who were illegal immigrants, were deported with their parents. Only one child was successfully fostered. Eleven children were taken away from the hospital by their parents or guardians without the knowledge of the health staff. There were five deaths in the series.

  15. A review of Orang Asli newborns admitted to a neonatal unit in a Malaysian general hospital.

    Science.gov (United States)

    Kandasamy, Y; Somasundram, P

    2007-10-01

    The Orang Asli are the indigenous population in peninsular Malaysia and are in fact a diverse sub-ethnic group with different languages. Our aim was to collect data on Orang Asli newborns, from western and central Pahang, that were admitted to a general hospital with paediatric specialist services. This is a retrospective study of all Orang Asli neonates admitted to the Neonatal Unit in Temerloh Hospital over a one-year period (2003). There were 65 Orang Asli admissions out of a total of 1,543 admissions to our Neonatal Unit. The average birth weight was 2,569 g. The commonest indication for admission was neonatal jaundice secondary to glucose-6-phosphate dehydrogenase deficiency. Ten babies were ventilated, seven for prematurity and three for mild-moderate perinatal asphyxia. There were three deaths: a baby with a lethal congenital abnormality, one with congenital rubella syndrome with cardiac failure, and a preterm baby delivered at 28 weeks gestation, with late neonatal sepsis. This is the first attempt to assess the health status of Orang Asli neonates in peninsular Malaysia. There are no published reports on the health status of this group of neonates. A larger multicentre study is needed to determine the exact health status of Malaysian Orang Asli newborns.

  16. Pediatrics chest x-ray examination in general hospitals in Khartoum State

    International Nuclear Information System (INIS)

    Elawad, S. O. A.

    2011-01-01

    Study was performed to evaluate radiation dose for pediatric patients undergoing chest x-ray examination in selected general radiography hospitals in Khartoum State in seven x-ray machines. x-ray tube output measurements were made in the range of typical exposure parameters using calibrated dose rate meter. To estimate entrance surface air kerma (ESA K), the radiographer in charge of the facility was asked to provide typical exposure parameters (kV, m As and FSD) for each age category (newborn (1-30 days), 1,5.10 and years). ESA K was estimated using the x-ray tube output measurements and the recorded exposure parameters. The obtained mean ESA K range from /27/ to 57/ μGy, /25 -103/ μGy, /45-128/ μGy, /47-139/ μGy and from /68-299/ μGy for newborn, 1,5,10, and 15 years patients, respectively. The estimated ESA K were within the established international reference dose values and also the values obtained in previous studies. However, variations were observed in ESA K values among hospitals under study which could be due to the differences in exposure parameters used. Also tube output has some difference on the obtained ESA K. (Author)

  17. Motivation and job satisfaction among medical and nursing staff in a Cyprus public general hospital.

    Science.gov (United States)

    Lambrou, Persefoni; Kontodimopoulos, Nick; Niakas, Dimitris

    2010-11-16

    The objective of this study was to investigate how medical and nursing staff of the Nicosia General Hospital is affected by specific motivation factors, and the association between job satisfaction and motivation. Furthermore, to determine the motivational drive of socio-demographic and job related factors in terms of improving work performance. A previously developed and validated instrument addressing four work-related motivators (job attributes, remuneration, co-workers and achievements) was used. Two categories of health care professionals, medical doctors and dentists (N = 67) and nurses (N = 219) participated and motivation and job satisfaction was compared across socio-demographic and occupational variables. The survey revealed that achievements was ranked first among the four main motivators, followed by remuneration, co-workers and job attributes. The factor remuneration revealed statistically significant differences according to gender, and hospital sector, with female doctors and nurses and accident and emergency (A+E) outpatient doctors reporting greater mean scores (p job satisfaction compared to the nursing staff. Surgical sector nurses and those >55 years of age reported higher job satisfaction when compared to the other groups. The results are in agreement with the literature which focuses attention to management approaches employing both monetary and non-monetary incentives to motivate health care professionals. Health care professionals tend to be motivated more by intrinsic factors, implying that this should be a target for effective employee motivation. Strategies based on the survey's results to enhance employee motivation are suggested.

  18. Motivation and job satisfaction among medical and nursing staff in a Cyprus public general hospital

    Directory of Open Access Journals (Sweden)

    Kontodimopoulos Nick

    2010-11-01

    Full Text Available Abstract Background The objective of this study was to investigate how medical and nursing staff of the Nicosia General Hospital is affected by specific motivation factors, and the association between job satisfaction and motivation. Furthermore, to determine the motivational drive of socio-demographic and job related factors in terms of improving work performance. Methods A previously developed and validated instrument addressing four work-related motivators (job attributes, remuneration, co-workers and achievements was used. Two categories of health care professionals, medical doctors and dentists (N = 67 and nurses (N = 219 participated and motivation and job satisfaction was compared across socio-demographic and occupational variables. Results The survey revealed that achievements was ranked first among the four main motivators, followed by remuneration, co-workers and job attributes. The factor remuneration revealed statistically significant differences according to gender, and hospital sector, with female doctors and nurses and accident and emergency (A+E outpatient doctors reporting greater mean scores (p 55 years of age reported higher job satisfaction when compared to the other groups. Conclusions The results are in agreement with the literature which focuses attention to management approaches employing both monetary and non-monetary incentives to motivate health care professionals. Health care professionals tend to be motivated more by intrinsic factors, implying that this should be a target for effective employee motivation. Strategies based on the survey's results to enhance employee motivation are suggested.

  19. Can sonographers offer an accurate upper abdominal ultrasound service in a district general hospital?

    International Nuclear Information System (INIS)

    Dongola, N.A.; Guy, R.L.; Giles, J.A.; Ward, S.

    2003-01-01

    Purpose: This study was performed to evaluate the accuracy of upper abdominal ultrasound (US) scanning performed by sonographers in a district general hospital, to identify potential areas of weakness and to make recommendations to improve the service. Materials and methods: Upper abdominal US examinations performed and reported by sonographers over a 4-week period were retrospectively reviewed. The accuracy of the imaging findings and reports were assessed against other imaging, surgical, histological or laboratory findings and against clinical outcome. Results: A heterogenous group of 104 patients were included in the study, 62 of whom had an US abnormality. Errors of scanning or interpretation were identified in 10 patients (9.6%) of whom five (4.8%) were felt to be potentially significant. Conclusions: The sonographers' accuracy in reporting upper abdominal US scans was 90%. However, on the basis of this study we have implemented specific recommendations to improve the quality of the service

  20. Development of the FISH technique for biological dosimetry applications in the Gregorio Maranon General University Hospital

    International Nuclear Information System (INIS)

    Moreno, M.; Jesus Prieto, M.; Olivares, P.; Gomez, M.; Herranz, R.

    1997-01-01

    Since 1989 cytogenetic analysis for dose estimation has been regularly used In the Gregorio Maranon General University Hospital (HGUGM) of Madrid on individuals suspected of having accidentally been exposed to ionizing radiation. The method used is the study of chromosomal aberrations found in lymphocytes of peripheral blood. The technique recommended by the IAEA in 1986 permits to establish a dicentrics/dose ratio through an effective dose calibration curve prepared in-vitro. This methodology of dose estimation presents serious limitations which can partially be eliminated by means of new molecular cytogenetic techniques, such as chromosomal painting through in-situ hybridization with fluorescence (FISH). At HGUGM, research work has been finished for standardization of the above mentioned technique including effective dose calibration curves, the utilization of adequate aberrations and the intercomparision of the results with other centres

  1. Contributions of general hospital psychiatric units to psychiatric research in India.

    Science.gov (United States)

    Bera, Sagar Chandra; Sood, Mamta; Chadda, R K; Sathyanarayana Rao, T S

    2014-07-01

    General hospital psychiatric units (GHPUs) are one of the major service and training providers in the field of mental health in India. However, there has not been any systematic attempt at their contributions toward research. The present paper reports on contributions of the GHPUs toward the psychiatric research based on analysis of publications in the Indian Journal of Psychiatry (IJP). All the issues of IJP of the last 25 years (1989-2013) were manually searched for original research papers, brief reports, and case reports. A semi-structured performa was used to collect information on various parameters. About two-thirds of the papers were contributed by the GHPUs, most being multi-authored and from tertiary care centers. The research covered a variety of psychiatric disorders including schizophrenia, mood disorders, and common mental disorders. Most of the research reported was self-funded. GHPUs have contributed significantly to psychiatric research in India in the last 25 years.

  2. Monitoring of the general population with an installed whole body counter at West Cumberland Hospital, Whitehaven

    International Nuclear Information System (INIS)

    Boddy, K.; Francis, R.A.; Fenwick, J.D.; McKenzie, A.L.

    1989-03-01

    Body radioactivity in the general public has been measured in 395 volunteers in the Whitehaven area, using a whole-body monitor at West Cumberland Hospital. Between October 1986 and October 1987, estimates of total body radiocaesium in 240 volunteers ranged from below detection level to 1844 Bq with a mean of 415 Bq. From October 1987 until May 1988, a further 155 volunteers were monitored, and radiation levels ranged from 34 Bq to 685 Bq, with a mean of 257 Bq. In all volunteers, the ratio of body radiocaesium to body potassium, was well below unity. The average ratio of caesium-137 to caesium-134 from October 1987 to May 1988 was 3.28, corresponding to a ratio of 1.99 at the date of Chernobyl accident. This is consistent with a Chernobyl origin as the primary source for the radiocaesium. There were discernible, but not marked, trends of increasing body radiocaesium with milk and meat/fish consumption. (author)

  3. Quality of stroke care at an Irish Regional General Hospital and Stroke Rehabilitation Unit.

    LENUS (Irish Health Repository)

    Walsh, T

    2012-01-31

    BACKGROUND: Robust international data support the effectiveness of stroke unit (SU) care. Despite this, most stroke care in Ireland are provided outside of this setting. Limited data currently exist on the quality of care provided. AIM: The aim of this study is to examine the quality of care for patients with stroke in two care settings-Regional General Hospital (RGH) and Stroke Rehabilitation Unit (SRU). METHODS: A retrospective analysis of the stroke records of consecutive patients admitted to the SRU between May-November 2002 and April-November 2004 was performed applying the UK National Sentinel Audit of Stroke (NSAS) tool. RESULTS: The results of the study reveal that while SRU processes of care was 74% compliant with standards; compliance with stroke service organisational standards was only 15 and 43% in the RGH and SRU, respectively. CONCLUSION: The quality of stroke care in our area is deficient. Comprehensive reorganisation of stroke services is imperative.

  4. The Experience of a District General Hospital with a Large Outdoor Music Festival in England.

    Science.gov (United States)

    Kamour, A; Yardley, R; Longshaw, M; Stuart, J

    2017-01-01

    To assess the impact of the Parklife annual music festival on the local hospital, North Manchester General. Data was obtained retrospectively by analysis of emergency department records during the weekend of Parklife 2015. 32 patients were identified, 56% reported taking drugs. 34% were admitted for overnight observation. 4 patients presented with methaemoglobinaemia following oral ingestion of amyl nitrate. One patient had a methaemoglobin fraction of 90.6%, which is amongst the most extreme recorded in literature. Music festivals can impose a burden on local health services. Organisers should operate an efficient surveillance system in order to prevent the sale and use of recreational drugs, providing adequate on-site health services and working in collaboration with local emergency services.

  5. [A proposal to improve nursing fee differentiation policy for general hospitals using profitability-analysis in the national health insurance].

    Science.gov (United States)

    Kim, Sungjae; Kim, Jinhyun

    2012-06-01

    The purpose of this study was to propose optimal hospitalization fees for nurse staffing levels and to improve the current nursing fee policy. A break-even analysis was used to evaluate the impact of a nursing fee policy on hospital's financial performance. Variables considered included the number of beds, bed occupancy rate, annual total patient days, hospitalization fees for nurse staffing levels, the initial annual nurses' salary, and the ratio of overhead costs to nursing labor costs. Data were collected as secondary data from annual reports of the Hospital Nursing Association and national health insurance. The hospitalization fees according to nurse staffing levels in general hospitals are required to sustain or decrease in grades 1, 2, 3, 4, and 7, and increase in grades 5 and 6. It is suggested that the range between grade 2 and 3 be sustained at the current level, the range between grade 4 and 5 be widen or merged into one, and the range between grade 6 and 7 be divided into several grades. Readjusting hospitalization fees for nurse staffing level will improve nurse-patient ratio and enhance the quality of nursing care in hospitals. Follow-up studies including tertiary hospitals and small hospitals are recommended.

  6. Herniated Nucleus Pulposus in Dr. Hasan Sadikin General Hospital Bandung Indonesia

    Directory of Open Access Journals (Sweden)

    Annisa Ikhsanawati

    2015-06-01

    Full Text Available Background: Herniated nucleus pulposus (HNP is one of the most common diseases of the spine. For an optimal management and prevention, there’s a need for data on factors related to the onset of complaints because this disease lowers the quality of life and increases morbidity. This study is aimed to see the scale and pattern of the HNP in Dr. Hasan Sadikin General Hospital, Bandung. Methods: This is a descriptive study with the design of case series, data was obtained from medical records of patients with the diagnosis of HNP in the inpatient care of Dr. Hasan Sadikin General Hospital in the period of 2007–2011. Results: According to the study on 79 patients, with 43 men and 36 women, the highest incidence was at the age group of 51–60 years old (31.6% and most common occupation was civil servant (11.4%. The most common clinical symptoms were sciatica (51.9% and low back pain (51.9%. Most frequent location was in the lumbar vertebrae at the level of L5–S1 (58.2%. Trauma was found to be the highest relatable history in the patients (39.2%. Therapy of choice was primarily conservative (58.2% and most patients went home after the progression (84.8%. The year 2007 showed the highest prevalence of HNP at 25.3%. The most common clinical symptoms were sciatica (51.9% and low back pain (51.9% Conclusions: The most common clinical symptoms were sciatica and low back pain. Most frequent location was in the lumbar vertebrae at the level L5–S1.

  7. [Influenza H1N1 in obstetric population of a general hospital in Oaxaca].

    Science.gov (United States)

    Calvo Aguilar, Omar; Canalizo Mendoza, Yazmín Ruth; Hernández Cuevas, Maritza Jenny

    2011-06-01

    In April 2009 are reported the first cases of H1N1 influenza in Mexico, presenting the first death from this cause in the city of Oaxaca in the same month. Different epidemiological reports of pandemics brought to the pregnant and high risk population for complications secondary to infection with influenza H1N1 due to immune status. describe the obstetric population infected with H1N1 influenza in the Hospital General Dr. Aurelio Valdivieso of Oaxaca. Retrospective and observational study conducted in pregnant women with suspected infection by the virus of the influenza A/H1N1 served in the General Hospital Aurelio Valdivieso of Oaxaca, Oax in 13 patients with influenza H1N1 confirmed by RT-PCR during the pandemic occurred from May 2009 to April 2010. We reported 27 suspected cases of H1N1 influenza in pregnant women of which 13 were positive by RT-PCR, the cumulative incidence was 1.6 per 1000 pregnant women during the period. The fatality rate was 7.6 per hundred pregnant women affected, one case of maternal death indirectly by fluid and electrolyte imbalance occurred and the attack rate was 0.16 per 100 pregnant women, the main complication of atypical pneumonia occurred in four cases followed by three cases of preeclampsia, infants showed no defects and perinatal outcomes were good to present two cases of admission to the NICU for iatrogenic prematurity without deaths. H1N1 influenza infection has a high fatality rate in late pregnancy. Perinatal outcomes did not worsen the condition or management.

  8. Supplement Consumption among Post stroke Patients in Dr. Hasan Sadikin General Hospital Bandung

    Directory of Open Access Journals (Sweden)

    Annisa Rahayu

    2016-09-01

    Full Text Available Background: Stroke is one of the leading causes of global disability. Post stroke rehabilitation program becomes the key to gain functional recovery. Thus it minimizes disabilities. Multiple studies have been carried out to gain greater functional outcomes for post stroke patients, including medical therapy such as supplements. However, supplement effectiveness in providing stroke recovery or prevention is still debatable. There is no data of supplement consumption among post stroke patients; therefore, the aim of this study was to determine the supplement consumption among post stroke patients. Methods: This study was a cross sectional descriptive study using primary data with a consecutive sampling method. Minimum samples for this study were 42 post stroke respondents who followed rehabilitation program. This study was conducted at Physical Medicine and Rehabilitation Clinic of Dr. Hasan Sadikin General Hospital Bandung from June until November 2013. The interviews were done after written informed consent was obtained. Descriptive statistics such as frequency distributin and proportion were used to analyze the data. Results: From 42 respondents, 23 (55% respondents consumed the supplement. From 34 supplements recorded, 56% were herbs supplements; followed by multivitamin (29%, mineral (6%, multivitamin and mineral (6%, and other supplement (3%. The most frequent ingredients composed in the supplements were B1, B6 and B12 vitamin (7%. Conclusions: More than a half of post stroke patients at Physical Medicine and Rehabilitation Clinic Dr. Hasan Sadikin General Hospital are supplement users, with herbal supplements as the majority. The most frequent ingredients used are B1, B6 and B12 vitamin.

  9. Intestinal helminth infections amongst HIV-infected adults in Mthatha General Hospital, South Africa

    Directory of Open Access Journals (Sweden)

    Olukayode A. Adeleke

    2015-02-01

    Full Text Available Background: In South Africa, studies on the prevalence of intestinal helminth co-infection amongst HIV-infected patients as well as possible interactions between these two infection sare limited.Aim: To investigate the prevalence of intestinal helminth infestation amongst adults living with HIV or AIDS at Mthatha General Hospital.Setting: Study participants were recruited at the outpatient department of Mthatha General Hospital, Mthatha, South Africa.Methods: This cross-sectional study was conducted between October and December 2013 amongst consecutive consenting HIV-positive adult patients. Socio-demographic and clinical information were obtained using data collection forms and structured interviews. Stool samples were collected to investigate the presence of helminths whilst blood samples were obtained for the measurement of CD4+ T-cell count and viral load.Results: Data were obtained on 231 participants, with a mean age of 34.9 years, a mean CD4 count of 348 cells/μL and a mean viral load of 4.8 log10 copies/mL. Intestinal helminth prevalence was 24.7%, with Ascaris Lumbricoides (42.1% the most prevalent identified species. Statistically significant association was found between CD4 count of less than 200 cells/ μLand helminth infection (p = 0.05. No statistically significant association was found between intestinal helminth infection and the mean CD4 count (p = 0.79 or the mean viral load (p = 0.98.Conclusion: A high prevalence of intestinal helminth infections was observed amongst the study population. Therefore, screening and treatment of helminths should be considered as part of the management of HIV and AIDS in primary health care.

  10. Using path analysis to examine causal relationships among balanced scorecard performance indicators for general hospitals: the case of a public hospital system in Taiwan.

    Science.gov (United States)

    Yang, Ming-Chin; Tung, Yu-Chi

    2006-01-01

    Examining whether the causal relationships among the performance indicators of the balanced scorecard (BSC) framework exist in hospitals is the aim of this article. Data were collected from all twenty-one general hospitals in a public hospital system and their supervising agency for the 3-year period, 2000-2002. The results of the path analyses identified significant causal relationships among four perspectives in the BSC model. We also verified the relationships among indicators within each perspective, some of which varied as time changed. We conclude that hospital administrators can use path analysis to help them identify and manage leading indicators when adopting the BSC model. However, they should also validate causal relationships between leading and lagging indicators periodically because the management environment changes constantly.

  11. Patient Perception Influence on the Food Service Quality of the Image of Jayapura Regional General Hospital

    OpenAIRE

    Gustiani Pakendek; A. L. Rantetampang; Arry Pongtiku

    2017-01-01

    Competition strict hospital competitiveness requires high hospital. One way is to improve the quality of food service. The quality of hospital food service will affect the image of the hospital. This study was to analyze the effect of perceived quality food service consisting of quality food menu, quality of food appearance, taste quality of food, quality of food presenter, timeliness of presentation of the food on the image of the hospital. This study was descriptive quantitative approach cr...

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

    Directory of Open Access Journals (Sweden)

    Pop D

    2013-07-01

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

  13. Factors influencing emergency medical readmission risk in a UK district general hospital: A prospective study

    Directory of Open Access Journals (Sweden)

    Havely Daniel

    2005-01-01

    Full Text Available Abstract Background Over recent years increased emphasis has been given to performance monitoring of NHS hospitals, including overall number of hospital readmissions, which however are often sub-optimally adjusted for case-mix. We therefore conducted a study to examine the effect of various patient and disease factors on the risk of emergency medical readmission. Methods The study setting was a District General Hospital in Greater Manchester and the study period was 4.5-years. All index emergency medical admission during the study period leading to a live discharge were included in the study (n = 20,209. A multivariable proportional hazards modelling was used, based on Hospital Episodes Statistics data, to examine the influence of various baseline factors on readmission risk. Deprivation status was measured with the Townsend deprivation index score. Hazard ratios (HR and associated 95% confidence intervals (CI of unplanned emergency medical admission by sex, age group, admission method, diagnostic group, number of coded co-morbidities, length of stay and patient's deprivation status quartile, were calculated. Results Significant independent predictors of readmission risk at 12 months were male sex (HR 1.13, CI: 1.07–1.2, age (age >75 (HR 1.57, CI 1.45–1.7, number of coded co-morbidities (HR for >4 coded co-morbidities: 1.49 CI: 1.26–1.76, admission via GP referral (HR 0.93, CI 0.88–0.99 and primary diagnosis of heart failure (HR 1.33, CI: 1.16–1.53 and chronic obstructive pulmonary disease/asthma (HR 1.34, CI: 1.21–1.48. Higher level of deprivation was also significantly and independently associated and with increased emergency medical readmission risk at three (HR for the most deprived quartile 1.21, CI: 1.08–1.35, six (HR 1.21, CI: 1.1–1.33 and twelve months (HR 1.25, CI: 1.16–1.36. Conclusions There is a potential for improving health and reducing demand for emergency medical admissions with more effective management of

  14. Carmen Miranda’s white dress: ethnicity, syncretism and subaltern sexualities in springtime in the rockies Carmen Miranda’s white dress: ethnicity, syncretism and subaltern sexualities in springtime in the rockies

    Directory of Open Access Journals (Sweden)

    José Gatti

    2008-04-01

    Full Text Available This essay calls for a reassessment of Carmen Miranda's work in Hollywood. Her singing and dancing can reveal unexpected ethnic and cultural alignments. The focus here is on the costumes she designed for Springtime in the Rockies, a Fox musical in which Brazilian as well as Native American cultural references are made explicit in Miranda's performance. This essay calls for a reassessment of Carmen Miranda's work in Hollywood. Her singing and dancing can reveal unexpected ethnic and cultural alignments. The focus here is on the costumes she designed for Springtime in the Rockies, a Fox musical in which Brazilian as well as Native American cultural references are made explicit in Miranda's performance.

  15. Studies on failure kind analysis of the radiologic medical equipment in general hospital

    International Nuclear Information System (INIS)

    Lee, Woo Cheul; Kim, Jeong Lae

    1999-01-01

    This paper included a data analysis of the unit of medical devices using maintenance recording card that had medical devices of unit failure mode, hospital of failure mode and MTBF. The results of the analysis were as follows : 1. Medical devices of unit failure mode was the highest in QC/PM such A hospital as 33.9%, B hospital 30.9%, C hospital 30.3%, second degree was the Electrical and Electronic failure such A hospital as 23.5%, B hospital 25.3%, C hospital 28%, third degree was mechanical failure such A hospital as 19.6%, B hospital 22.5%, C hospital 25.4%. 2. Hospital of failure mode was the highest in Mobile X-ray device(A hospital 62.5%, B hospital 69.5%, C hospital 37.4%), and was the lowest in Sono devices(A hospital 16.76%, B hospital 8.4%, C hospital 7%). 3. Mean time between failures(MTBT) was the highest in SONO devices and was the lowest in Mobile X-ray devices which have 200 - 400 failure hours. 4. Average failure ratio was the highest in Mobile X-ray devices(A hospital 31.3%, B hospital 34.8%, C hospital 18.7%), and was the lowest in Sono(Ultrasound) devices (A hospital 8.4%, B hospital 4.2%, C hospital 3.5%). 5. Failure ratio results of medical devices according to QC/PM part of unit failure mode were as follows ; A hospital was the highest part of QC/PM (50%) in Mamo X-ray device and was the lowest part of QC/PM(26.4%) in Gastro X-ray. B hospital was the highest part of QC/PM(56%) in Mobile X-ray device, and the lowest part of QC/PM(12%) in Gastro X-ray. C hospital was the highest part of QC/PM(60%) in R/F X-ray device, and the lowest a part of QC/PM(21%) in Universal X-ray. It was found that the units responsible for most failure decreased by systematic management. We made the preventive maintenance schedule focusing on adjustment of operating and dust removal

  16. Kirsten Möller, Inge Stephan, Alexandra Tacke (Hg.: Carmen. Ein Mythos in Literatur, Film und Kunst. Köln u.a.: Böhlau Verlag 2011.

    Directory of Open Access Journals (Sweden)

    Uta Felten

    2011-12-01

    Full Text Available Im vorliegenden Sammelband werden aktuelle Untersuchungen zum Carmen-Mythos in Literatur, Film, Malerei und Musikkultur aus einer genderspezifischen, einer transmedialen und einer transkulturellen Perspektive präsentiert. Als gemeinsame methodische Prämisse des Bandes fungiert die These, dass Carmen als Produkt einer Mythenbricolage und als Projektionsfläche für vornehmlich männlich codierte Exotismus- und Alteritätsfiktionen verstanden werden kann. Kontinuitäten und Diskontinuitäten im Umgang mit dem Carmen-Mythos werden deutlich am Beispiel von filmischen, literarischen, pikturalen, musikalischen und performativen Bearbeitungen des Mythos vom 19. bis zum 21. Jahrhundert.This anthology presents current studies about the Carmen myth in literature, film, art, and music culture from a gender-specific, a transmedial, as well as a transcultural perspective. The thesis that Carmen can be understood as the product of the bricolage of myths and as an object of projection for primarily male coded fictions of exoticism and alterity functions as the common methodological premise of the volume. Filmic, literary, pictorial, musical, and performative realizations of the Carmen myth from the 19th to the 21st century illustrate the continuities and discontinuities in dealing with the myth.

  17. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. II.- August of 2001; Asesoria especializada en seguridad radiologica al hospital general Tula, PEMEX. II.- Agosto de 2001

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-10-15

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

  18. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. I.- July of 2001; Asesoria especializada en seguridad radiologica al hospital general Tula, PEMEX. I.- Julio de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J

    2001-09-15

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

  19. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. IV. - October of 2001; Asesoria especializada en seguridad radiologica al hospital general Tula, PEMEX. IV.- Octubre de 2001

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-01-15

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

  20. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. V. - November of 2001; Asesoria especializada en seguridad radiologica al hospital general Tula, PEMEX. V.- Noviembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-01-15

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

  1. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. VI. - December of 2001; Asesoria especializada en seguridad radiologica al hospital general Tula, PEMEX. VI.- Diciembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-01-15

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

  2. Specialized consultant in radiological safety to the Tula general hospital, PEMEX. III.- September of 2001; Asesoria especializada en seguridad radiologica al hospital general Tula, PEMEX. III.- Septiembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-12-15

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

  3. General surgery day case at a tertiary hospital: A 3-year audit

    Directory of Open Access Journals (Sweden)

    Thomas O Olajide

    2015-01-01

    Full Text Available Background: The concept and practice of day case surgery is becoming popular in the developing world due to certain apparent benefits. Effective audit is a valuable aspect of the progress of this practice. This study aims to carry out an audit of our day case surgery experience at the Lagos University Teaching Hospital, Lagos, Nigeria. Patients and Methods: We retrospectively reviewed the data of all general surgery day cases done between January 2011 and December 2013. The data obtained were patients′ age, sex, diagnosis, surgeries performed, mode of anesthesia, and readmission rate. Results: A total of 453 day case general surgeries were performed. The age range of the patients was 14-82 years, with a median of 31 years. Local anesthesia was used on all patients. The most commonly performed procedures were excision of breast lumps (n = 267, 58.7% and herniorrhaphies (n = 108, 23.8%. Other procedures included incisional biopsies (n = 17, 3.8%, lymph node biopsies (n = 13, 2.9%, and excision of lipomas (n = 10, 2.2%. There was no readmission or fatality. Conclusion: Day case surgery on suitably selected patients is practicable and safe in our environment. The provision of dedicated day case surgical units will greatly improve the practice.

  4. Nurses' experiences of caring for South Asian minority ethnic patients in a general hospital in England.

    Science.gov (United States)

    Vydelingum, Vasso

    2006-03-01

    Healthcare provision for minority ethnic groups in the UK has generally revealed inequalities in access and differential service provision. British healthcare policy has started to address such issues. However, very few studies have specifically examined the experiences of nurses caring for minority ethnic patients. This paper focuses on the focus group interviews of a broader ethnographic study, aimed at describing nurses' experiences of caring for South Asian minority ethnic patients, in a general hospital in the south of England. A sample of 43 nurses of all grades from six medical wards took part in the focus groups: three ward sisters, 22 staff nurses and 18 care assistants; 40 participants were white, one was African-Caribbean and two were South Asian. Data analysis revealed eight themes: changes in service provision; false consciousness of equity; limited cultural knowledge; victim blaming; valuing of the relatives; denial of racism; ethnocentrism, and self-disclosure. The study revealed a good local service response to government policies in addressing inequality. However, there was a tendency to treat all minority ethnic patients the same, with evidence of ethnocentric practices, victim-blaming approaches and poor cultural competence in nursing staff, which raise questions about the quality of service provision. The study indicates that ongoing training and development in the area of cultural competence is necessary.

  5. CLINICAL STUDY ON PA NCREATIC CANCER IN G OVERNMENT GENERAL HOSPITAL, GU NTUR, AP, INDIA

    Directory of Open Access Journals (Sweden)

    Ch. Kalyan

    2015-03-01

    Full Text Available Pancreatic cancer has a lower incidence than many other types of cancer, but is the fourth most common cause of death from cancer, among men and women, being responsible for 6% of all cancer - related deaths. The global annual incidence rate for pancreas cancer is about 8/100,000 persons. Pancreatic cancer disease is notoriously difficult to diagnose in its early stages. Study was carried out in the Department of General Surgery, Government General Hospital, Guntur from October 2010 to 2012, in which 16 cases with a diagnosis of carcinoma pancreas. They were investigated with routine blood investigations. They were treated accordingly with Pylorus preserving pancreaticodenectomy (PPPD or palliative bypass or with non - operative palliative measures. Carcinoma pancreas is an aggressive disease with male preponderance with peak incidence in 5th and 6th decade. Important risk factors are Smoking and alcohol consumption. Nearly 75% of the cases presented in the late stage of the disease. Resection of the tumour had better survival. The limitations of our study are small number of patients and short follow - up

  6. Carpal Tunnel Syndrome Prevalence and Characteristics among Administrative Staff at Dr.Hasan Sadikin General Hospital Bandung

    Directory of Open Access Journals (Sweden)

    Andrian Andrian

    2017-06-01

    Full Text Available Background: Carpal tunnel syndrome (CTS is a neurologic disease affecting hands, which is closely related to work, and is the most prevalent nerve compression disease. The incidence of CTS quite often occur in people working with their hands, for instance the administrative staff, especially in a busy workplace such as Dr.Hasan Sadikin General Hospital Bandung. CTS causes reduction in work productivity, and consequently degrading family welfare and the quality of public service. For that very reason, the prevalence and characteristics of CTS among administrative staff at Dr.HasanSadikin General Hospital Bandung needed to be revealed. Methods: This quantitative descriptive study involved 94 administrative staff in the Medical record department of Dr. Hasan Sadikin General Hospital using the Carpal-tunnel.net questionnaire and further examinations by neurologists. Variables involved in this study were the subject characteristics. Results: Out of the 90 subjects, 22 stated having symptoms related to CTS (prevalence, 24.4%. On further clinical examination, 3 were diagnosed of suffering from CTS (prevalence, 3.3%. Conclusions: Carpal tunnel syndrome is found among the administrative staff at Dr. Hasan Sadikin General Hospital Bandung  and the prevalence is lower than in the general population. A further study is required to reveal ther specific division in the hospital with the most prevalent CTS case. DOI: 10.15850/amj.v4n2.1077

  7. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael

    2013-01-01

    The challenge could be briefly seen in these terms: hospitals as places for treatment where there’s a technology focus and hospitals for healing where there’s a human focus. In the 60s - 70s wave of new hospital building, an emphasis on technology can be seen. It’s time to move from the technology....... Documentation exists in; well-being of patients and staff, sleep disorders, pain distraction, confidentiality and privacy, levels of errors in hospitals. Art and the use of color: Art can be context related so one should be aware whether it is in a private ward or the foyer and related to the experience...... of the patient. Art can be used as a stress reducing factor, pain distracter, and also to orientate and to provide landmarks in the hospital landscape. Air, the use of natural ventilation as much as possible, complemented by mechanical ventilation in most cases, particularly in northern Europe; the emphasis...

  8. Medical psychology services in dutch general hospitals: state of the art developments and recommendations for the future.

    Science.gov (United States)

    Soons, Paul; Denollet, Johan

    2009-06-01

    In this article an overview is presented of the emergence of medical psychology in the care of somatically ill patients. The situation in the Netherlands can be considered as prototypical. For 60 years, clinical psychologists have been working in general, teaching and academic hospitals. Nowadays, they are an integrated non-medical specialism working in the medical setting of hospitals in the Netherlands, and are a full-member of the medical board. This paper discusses several topics: the position of the general hospital in the health care system in the Netherlands, the emergence of medical psychology in Dutch hospitals, the role of the professional association of medical psychologists, and the characteristics of patients seen by clinical psychologists. Following the discussion about the situation of medical psychology in other countries, recommendations are formulated for the further development of medical psychology in the Netherlands as well as in other countries.

  9. Frecuencia e incidencia de la tromboembolia venosa en un hospital general Frequency and incidence of venous thromboembolism in a general hospital

    Directory of Open Access Journals (Sweden)

    Juan A. Mazzei

    2005-08-01

    Full Text Available El objetivo de este estudio fue determinar la frecuencia y la incidencia de la tromboembolia venosa (TEV, objetivamente diagnosticada, en un hospital universitario argentino. Se utilizó un diseño retrospectivo, observacional y longitudinal. Se analizaron las historias clínicas de todos los pacientes mayores de 16 años que habían egresado o fallecido en las unidades de internación clínica, obstétrica y quirúrgica del Hospital de Clínicas José de San Martín con el diagnóstico de TEV durante un período de 24 meses. La frecuencia y la incidencia de TEV fueron 0.92% y 0.40% (intervalo de confianza de 95% (IC95%: 0.37 a 0.42% respectivamente. La incidencia más alta de TEV se presentó en la novena década de la vida (0.80%; IC95%: 0.78% a 0.82%. Solamente el 31% de los pacientes que desarrollaron TEV durante la internación habían recibido tromboprofilaxis con heparina. La mortalidad intrahospitalaria global de los pacientes con TEV fue 19%.The objective of this study was to determine the frequency and incidence of venous thromboembolism (VTE in an Argentine universitary hospital. We used a longitudinal, retrospective, observational design. Participants were all over-16 year patients who were discharged or died in clinical, obstetrical and surgical units in the Hospital de Clínicas José de San Martín during a 24 month period between July 1, 2001 and June 30, 2003, with a diagnosis on release of VTE. VTE frequency reached 0.92% and incidence was 0.40%; 95% confidence interval (95% CI: 0.37 to 0.42%. Incidence was highest in the 9th decade of life (0.80%; 95% CI: 0.78% to 0.82%. Only 31% of patients who developed VTE during hospitalization had received thromboprophylaxis. Total in-hospital mortality of VTE patients was 19%.

  10. End-of-life care in the general wards of a Singaporean hospital: an Asian perspective.

    Science.gov (United States)

    Phua, Jason; Kee, Adrian Chin-Leong; Tan, Adeline; Mukhopadhyay, Amartya; See, Kay Choong; Aung, Ngu Wah; Seah, Angeline S T; Lim, Tow Keang

    2011-12-01

    Despite international differences in cultural perspectives on end-of-life issues, little is known of the care for the dying in the general wards of acute hospitals in Asia. We performed a retrospective medical chart review of all 683 adult patients who died without intensive care unit (ICU) admission in our Singaporean hospital in 2007. We first evaluated the prevalence of do-not-resuscitate (DNR) orders and orders for or against life-sustaining therapies; second, if such orders were discussed with the patients and/or family members; and third, the actual treatments provided before death. There were DNR orders for 66.2% of patients and neither commitment for DNR nor cardiopulmonary resuscitation (CPR) for 28.1%. Orders to limit life-sustaining therapies, including ICU admission, intubation, and vasopressors/inotropes were infrequent. Only 6.2% of the alert and conversant patients with DNR orders were involved in discussions on these orders. In contrast, such discussions with their family members occurred 82.9% of the time. Interventions in the last 24 hours of life included CPR (9.4%), intubation (6.4%), vasopressors/inotropes (14.8%), tube feeding (24.7%), and antibiotics (44.9%). Analgesia was provided in 29.1% of patients. There was a lack of commitment by doctors on orders for DNR/CPR and to limit life-sustaining therapies, infrequent discussions with patients on end-of-life decisions, and excessive burdensome interventions with inadequate palliative care for the dying. These findings may reflect certain Asian cultural biases. More work is required to improve our quality of end-of-life care.

  11. Omisión en el registro de insomnio en pacientes internados en un hospital general

    Directory of Open Access Journals (Sweden)

    Jaime Arias Congrains

    2003-04-01

    Full Text Available Si bien la comunidad médica acepta que el insomnio es un trastorno común, usualmente no se consigna en las evoluciones clínicas, probablemente por la dificultad que tienen los profesionales de la salud para indagar sobre la calidad del sueño en los pacientes. Objetivo: Determinar frecuencia con que ser registraba el insomnio en las evoluciones de las historias clínicas de los pacientes internados en un hospital general. Material y métodos: Para dicho fin aplicamos una encuesta a 97 pacientes internados en los Servicios de Medicina e Infecciosas del Hospital Nacional Cayetano Heredia. La misma registró la edad, sexo, los dos principales diagnósticos médicos, días de hospitalización y días con insomnio inicial, de mantenimiento y de despertar, y si se había registrado el insomnio en la historia clínica en la evolución médica diaria o en las notas de enfermería. Resultados: El 76 (76.8% de los pacientes padecía de algún tipo de insomnio durante su internamiento, pero en solo 3 de ellos se había consignado el insomnio en la historia clínica, en la evolución por el médico. Conclusiones: Casi nunca es reconocido el insomnio por los médicos en la evolución clínica de los pacientes hospitalizados, lo que justificaría la adopción de estrategias docentes y asistenciales para subsanar esta notable omisión. ( Rev Med Hered 2003; 14:59-62 .

  12. Awareness of Stroke Risk after TIA in Swiss General Practitioners and Hospital Physicians.

    Directory of Open Access Journals (Sweden)

    Sven Streit

    Full Text Available Transient ischemic attacks (TIA are stroke warning signs and emergency situations, and, if immediately investigated, doctors can intervene to prevent strokes. Nevertheless, many patients delay going to the doctor, and doctors might delay urgently needed investigations and preventative treatments. We set out to determine how much general practitioners (GPs and hospital physicians (HPs knew about stroke risk after TIA, and to measure their referral rates.We used a structured questionnaire to ask GPs and HPs in the catchment area of the University Hospital of Bern to estimate a patient's risk of stroke after TIA. We also assessed their referral behavior. We then statistically analysed their reasons for deciding not to immediately refer patients.Of the 1545 physicians, 40% (614 returned the survey. Of these, 75% (457 overestimated stroke risk within 24 hours, and 40% (245 overestimated risk within 3 months after TIA. Only 9% (53 underestimated stroke risk within 24 hours and 26% (158 underestimated risk within 3 months; 78% (473 of physicians overestimated the amount that carotid endarterectomy reduces stroke risk; 93% (543 would rigorously investigate the cause of a TIA, but only 38% (229 would refer TIA patients for urgent investigations "very often". Physicians most commonly gave these reasons for not making emergency referrals: patient's advanced age; patient's preference; patient was multimorbid; and, patient needed long-term care.Although physicians overestimate stroke risk after TIA, their rate of emergency referral is modest, mainly because they tend not to refer multimorbid and elderly patients at the appropriate rate. Since old and frail patients benefit from urgent investigations and treatment after TIA as much as younger patients, future educational campaigns should focus on the importance of emergency evaluations for all TIA patients.

  13. Acute Arterial Thromboembolism In The Extremities: A Case Series In Sina General Hospital,1991-97

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    Zafarghandy MRt Nasiri Sheikhani N

    2002-07-01

    Full Text Available "Arterial Thromboembolism" is the most common cause of "Acute Arterial Ischemia" of extremities. In this study, It is attempted to collect retrospectively some documentary information of all "acute arterial thromboembolic occlusions of the limbs"."nMaterials and Methods: In descriptive retrograde study in Sina General hospital, all related records in this regard were collected from March 1991 to March 1997. To reveal the statistical outcomes and analysis the associations between them as well, the statistical tests like nonparametric ones were employed."nResults: Total number of the cases was 24 with " Acute Thromboembolic Arterial limb Ischemia" (3 in upper and 21 in lower limbs. The results were as follows: Female to male ratio =1/2, "Range of Age": 34-91, "Mode"=8th decade of life, "Mean"-64.48, "Etiology"; Cardiac Origin in majority of cases ("A.F" in 57 percent and Unknown Origin in 1/4 of cases. "Pain" was find in 95 percent, Grade HI ischemia in only 38 percent of patients on presentation and the others in Grade n. The most common "site of embolic occlusion" was "Femoral Ar." (76 percent. "Simultaneous Embolic Events" were fined in 29 percent. "Embolectomy" was performed in 79 percent (84 percent success rate and "Primary Amputation" in 12.5 percent. "In hospital Mortality Rate" was fined in 24 percent and "Limb Salvage rate" in 68 percent. In conclusion, there were some logic relationship only between "Limb Salvage rate" and "Ischemic Grading" and also "Delayed diagnosis". There was also some significant direct relationship between "Mortality rate" and "Concomitant Embolic events"."nConclusion: This study was an explorative one that paves the way for further complementary investigations. Although there are many recommendations due to upgrading knowledge, attitude and practice of physicians as well as lay people Besides, the upgrading of educational and curative facilities should not be neglected.

  14. Level of awareness about breast cancer among females presenting to a general hospital in Pakistan

    International Nuclear Information System (INIS)

    Yousaf, A.; Khan, J.S.; Bhopal, F.G.; Iqbal, M.; Minhas, S.; Mahmood, N.; Taj, N.; Rasheed, I.

    2001-01-01

    Majority of the female patients in Pakistan with breast cancer present in advance stages, unawareness being a major factor. As surgery has a limited role in the later stages of breast cancer, the surgeons lose fight against this deadly disease before the fight has even begun, early detection of breast cancer in only possible if patients are made aware and are motivated to present early. A one-year study was carried out in Rawalpindi General Hospital to find out the level of awareness about breast cancer among females presenting to a public hospital. Among 400 patients with a breast problem 84 (21 %) had breast cancer of which 73.81% were in stage III and IV. Average time lapse was 16 months. The underlying cause of delay was ignorance. Six hundred females with no breast problem were also interviewed for their knowledge about breast cancer, 69.80% were totally ignorant, 18.40% were partly aware and only 11.80% were fully aware. 87.75% had no idea about breast self-examination, 68.2% did not understand the significance of a lump in the breast and its lethal potential. Unawareness was even prevalent among the highly educated and well to do (55%) as well as among all age groups although it was less than the illiterate (82%) and lowest income group (85%). The prime source of information were friends or relatives followed by the electronic and print media with health education playing a minor role. The level of awareness about breast cancer among Pakistani females in an urban setting was dismal and majority had a careless attitude towards seeking treatment. To ensure earlier detection of breast cancer there in a dire need of educating our female population about this deadly disease through the media and health care system in Pakistan. (author)

  15. Progressive resistance training (PRT) improves rheumatoid arthritis outcomes: A district general hospital (DGH) model.

    Science.gov (United States)

    Morsley, Klara; Berntzen, Berna; Erwood, Lisa; Bellerby, Toby; Williamson, Lyn

    2018-03-01

    Rheumatoid cachexia is common in rheumatoid arthritis (RA) patients and develops soon after diagnosis, despite adequate drug therapy. It is associated with multiple adverse effects on body composition, function and mortality. Progressive resistance training (PRT) improves these outcomes but is not widely prescribed outside of a research setting. The aim of the present study was to explore the practicality and effectiveness of providing PRT to patients in a district general hospital within the constraints of existing resources. Patients attending a rheumatology clinic were invited to participate in a weekly PRT class for 6 weeks, supervised by a physiotherapist. Outcome measures included: body composition measures (waist and hip circumference, weight, percentage body fat); functional measures (grip strength, 60-s sit-to-stand test, single leg stance, Health Assessment Questionnaire); mood; fatigue and disease activity measures (sleep scale, hospital anxiety and depression scale, Functional Assessment of Chronic Illness Therapy, pain visual analogue scale). These were measured at baseline and at 6 weeks. A total of 83 patients completed the programme (60% female, mean age 51.2 years), of whom 34.9% had early RA. Improvements were seen in multiple measures inpatients with early RA and with established inflammatory arthritis, and were not affected by age or gender. Patients with early and established inflammatory arthritis alike benefited from a 6-week PRT programme provided within a National Health Service setting. Although further work is needed to look at long-term effects, we suggest that this intervention should be more widely available. Copyright © 2017 John Wiley & Sons, Ltd.

  16. Client perception of service quality at the outpatient clinics of a General hospital in Lagos, Nigeria.

    Science.gov (United States)

    Ogunnowo, Babatunde Enitan; Olufunlayo, Tolulope Florence; Sule, Salami Suberu

    2015-01-01

    Service quality assessments have assumed increasing importance in the last two decades. They are useful in identifying gaps in services been provided with the ultimate aim of guaranteeing quality assurance. The objective of this study was to assess the client perception of service quality at the outpatient clinics of Randle General hospital, Lagos. A descriptive cross sectional study was conducted from March to May 2013. A multistage sampling technique was used to select respondents and data was collected with the aid of modified SERVQUAL questionnaires. The data was analysed with aid of EPI-INFO 2002 and statistical significance was set at a P value 0.05 for statistical significance. Total of 400 respondents were interviewed. The mean age was 40 years with a standard deviation of 15.2 yrs. The highest mean score of 4.35 out of a possible maximum of 5 was recorded in assurance domain while the lowest mean score of 4.00 was recorded in the responsiveness domain. The overall mean score of all the domains was 4.20 with standard deviation of 0.51. Overall majority (80.8%) of respondents rated the overall service quality as good/ very good. After linear regression, the assurance domain was the most important predictor of the overall perceived service quality (p< 0.001). The overall perceived service quality was good. The major deficiencies were in the responsiveness domain and especially the waiting time. The hospital management should implement measures to improve the responsiveness of services by ensuring prompt delivery of services.

  17. Mortality Analysis of Trauma Patients in General Intensive Care Unit of a State Hospital

    Directory of Open Access Journals (Sweden)

    İskender Kara

    2015-08-01

    Full Text Available Objective: The aim of this study was to determine the mortality rate and factors affecting the mortality of trauma patients in general intensive care unit (ICU of a state hospital. Material and Method: Data of trauma patients hospitalized between January 2012 and March 2013 in ICU of Konya Numune Hospital were retrospectively analyzed. Demographic characteristics and clinical data of patients were recorded. Patients were divided into two groups as survivors and dead. Mortality rate and factors affectin mortality were examined. Results: A total of 108 trauma patients were included in the study. The mortality rate of overall group was 19.4%. Median age of the patients was 44.5 years and 75.9% of them were males. Median Glasgow Coma Scale of death group was lower (5 (3-8 vs. 15 (13-15, p<0.0001, median APACHE II score was higher (20 (15-26 vs. 10 (8-13, p<0.0001 and median duration of ICU stay was longer (27 (5-62,5 vs. 2 (1-5, p<0.0001 than those in the survival group. The most common etiology of trauma was traffic accidents (47.2% and 52.7% of patients had head trauma. The rate of patients with any fracture was significantly higher in the survival group (66.7% vs. 33.3%, p=0.007. The rate of erythrocyte suspension, fresh frozen plasma, trombocyte suspension and albumin were 38.9%, 27.8%, 0.9% and 8.3%, respectively in all group. The number of patients invasive mechanically ventilated was 27.8% and median length of stay of these patients were 5 (1.75-33.5 days. The rate of operated patients was 42.6%. The rate of tracheostomy, renal replacement therapy, bronchoscopy and percutaneous endoscopic gastrostomy enforcements were higher in the death group. The advanced age (p=0.016, OR: 1.054; 95% CI: 1.010-1100 and low GCS (p<0.0001, OR: 0.583; 95% CI: 0.456-0.745 were found to be independent risk factors the ICU mortality of trauma patients in logistic regression analysis. Conclusion: We believe that the determination of these risk factors affecting

  18. [Retrospective study of hospitalizations for heart failure in elderly patients in a cardiology service of a general hospital center].

    Science.gov (United States)

    Zumer-Meulenbelt, A; Joubert, A; Lefort, J F; Perchet, H

    2002-09-01

    The results of a retrospective study of patients over 70 years of age admitted to the cardiology department of Meaux Hospital for cardiac failure in 1997 are reported. The cases of 143 patients were analysed with respect to two age groups: 70-79 years, and over 80 years of age. The principal aetiology of cardiac failure in all ages was ischaemic heart disease. Hypertensive heart disease was observed in younger patients and valvular heart disease in the more elderly. No significant gender differences were observed in those affected by this pathology or by left ventricular systolic or diastolic dysfunction between the younger and older patients, men having more systolic dysfunction than women. The main causal factor of decompensation in all ages was supraventricular arrhythmias. From the therapeutic point of view, the prescription of ACE inhibitors was relatively common but at low doses. Re-hospitalisation for cardiac failure was common and observed mainly in patients with low ejection fractions. The average hospital stay was 12.58 days. The hospital mortality was high: 15%. Two year survival was 41% with no difference between patients with systolic or diastolic dysfunction. Pluridisciplinary management should reduce the number of re-hospitalisation, improve the quality of life and, perhaps, improve survival.

  19. [What has happened to patient satisfaction with the care in general hospitals in the years from 1993-1995?].

    Science.gov (United States)

    Berg, A; Yuval, D

    1998-03-01

    Patient satisfaction with the hospitalization process is an important element in the measurement of quality of care. Information from a survey of patients' experiences could therefore help hospitals improve their service, and provide decision-makers with relevant information. We present the findings of a study of some 4,500 patients, aged 18+, released from hospitals in the fall of 1993 and of 1995 from the wards of 9 acute care hospitals, psychiatric and geriatric wards excluded. Self-administered questionnaires were sent and returned by mail, with an overall response rate of 82%. Despite the many changes in Israel's health system in general and its hospital system in particular, and the social and demographic changes between those 2 periods, patient satisfaction remained constant. Of those discharged from medical or surgical wards, 70% were satisfied to a "great" or "ver great" extent with their hospital experience. There was improvement in most areas of hospitalization in the course of the 2 years. The greatest improvement was with regard to admission, nursing staff, hotel services, in patient satisfaction food and supplies. On the other hand there was deterioration in visiting conditions and hours. Satisfaction with physicians, nurses and hotel services had the strongest links with general satisfaction.

  20. German authors on Estonian minority rights : Selbstbestimmungsrecht und Minderheitenschutz in Estland, by Carmen Thiele. Berlin : Springer, 1999 ; Das Recht der nationalen Minderheiten in Osteuropa, edited by Georg Brunner and Boris Meissner. Berlin

    Index Scriptorium Estoniae

    Annus, Taavi, 1977-

    2004-01-01

    Arvustus: Thiele, Carmen. Selbstbestimmungsrecht und Minderheitenschutz in Estland. Berlin : Springer, 1999 ; Das Recht der nationalen Minderheiten in Osteuropa. Berlin : Berlin Verlag Arno Spitz, 1999

  1. Rock Magnetic Properties of Laguna Carmen (Tierra del Fuego, Argentina): Implications for Paleomagnetic Reconstruction

    Science.gov (United States)

    Gogorza, C. G.; Orgeira, M. J.; Ponce, F.; Fernández, M.; Laprida, C.; Coronato, A.

    2013-05-01

    We report preliminary results obtained from a multi-proxy analysis including paleomagnetic and rock-magnetic studies of two sediment cores of Laguna Carmen (53°40'60" S 68°19'0" W, ~83m asl) in the semiarid steppe in northern Tierra del Fuego island, Southernmost Patagonia, Argentina. Two short cores (115 cm) were sampled using a Livingstone piston corer during the 2011 southern fall. Sediments are massive green clays (115 to 70 cm depth) with irregularly spaced thin sandy strata and lens. Massive yellow clay with thin sandy strata continues up to 30 cm depth; from here up to 10 cm yellow massive clays domain. The topmost 10 cm are mixed yellow and green clays with fine sand. Measurements of intensity and directions of Natural Remanent Magnetization (NRM), magnetic susceptibility, isothermal remanent magnetization, saturation isothermal remanent magnetization (SIRM), back field and anhysteretic remanent magnetization at 100 mT (ARM100mT) were performed and several associated parameters calculated (ARM100mT/k and SIRM/ ARM100mT). Also, as a first estimate of relative magnetic grain-size variations, the median destructive field of the NRM (MDFNRM), was determined. Additionally, we present results of magnetic parameters measured with vibrating sample magnetometer (VSM). The stability of the NRM was analyzed by alternating field demagnetization. The magnetic properties have shown variable values, showing changes in both grain size and concentration of magnetic minerals. It was found that the main carrier of remanence is magnetite with the presence of hematite in very low percentages. This is the first paleomagnetic study performed in lakes located in the northern, semiarid fuegian steppe, where humid-dry cycles have been interpreted all along the Holocene from an aeolian paleosoil sequence (Orgeira et el, 2012). Comparison between paleomagnetic records of Laguna Carmen and results obtained in earlier studies carried out at Laguna Potrok Aike (Gogorza et al., 2012

  2. Inconsciente genérico, feminismo y Nubosidad variable de Carmen Martín Gaite

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    Zecchi, Barbara

    2006-08-01

    Full Text Available In a context of marked tensions between gynocritics and contemporary Spanish women writers, Carmen Martín Gaite’s novel Nubosidad variable (Variable Cloud,1992 stands out as a curious paradox. As is well known, Martín Gaite repeatedly declared not to be a feminist and even scorned women who fought for equality between both sexes. This article argues that Nubosidad variable, however, constitutes one of the best examples of a consciously feminist text. In this novel Martín Gaite applies some of the most prominent paradigms of feminist literary theory, such as the construction of a non-linear and a-chronological narration (Julia Kristeva, the attempt to create a “language of the body” (Helène Cixous, the foregrounding of a mother-daughter bond (Luisa Muraro, as well as the use of female writing as a means of self-discovery (Elaine Showalter.En un contexto de falta de comunicación entre ginocrítica y escritura femenina, la novela Nubosidad variable (1992 de Carmen Martín Gaite se presenta como una significativa paradoja. Si por un lado su autora declaró repetidas veces no ser feminista —y hasta menospreció con ironía a las mujeres que han luchado por la igualdad—, Nubosidad variable es una innegable aplicación de algunos de los más conocidos paradigmas de la teoría literaria feminista. Desde la narración no-lineal y atemporal que sigue el “tiempo de las mujeres” de Julia Kristeva, hasta el intento de crear una lengua del cuerpo a lo Hélène Cixous; desde el vínculo madre-hija teorizado por Luisa Muraro, hasta la escritura femenina como auto-descubrimiento de Elaine Showalter, esta novela representa uno de los mejores ejemplos, dentro de la narrativa contemporánea española, de lo que llamaría un texto conscientemente feminista.

  3. Cuidado ecológico: o significado para profissionais de um hospital geral Cuidado ecológico: el significado para profesionales de un hospital general Ecological care: meaning for health care professionals from a general hospital

    Directory of Open Access Journals (Sweden)

    Marli Terezinha Stein Backes

    2009-01-01

    Full Text Available OBJETIVO: Compreender à luz do pensamento complexo, o significado do cuidado ecológico e como este vem sendo associado à prática de profissionais que trabalham em um hospital geral. MÉTODOS: Estudo descritivo de natureza qualitativa realizado com 15 profissionais que atuam em três diferentes setores: Serviço de Lavanderia, Serviço de Nutrição e uma Unidade de Internação. Os dados foram coletados por meio de um questionário semi-estruturado e submetidos à análise de conteúdo proposta por Bardin. RESULTADOS: As categorias encontradas foram: Significando o cuidado ecológico, Salientando a importância do cuidado ecológico para a prática profissional e Medidas preventivas em saúde associadas ao cuidado ecológico. CONCLUSÕES: O estudo evidenciou que existe uma preocupação geral, ainda que incipiente, a respeito da problemática ambiental. A preocupação principal está relacionada à separação, reciclagem e destino adequado do lixo, mesmo que alguns profissionais tenham sinalizado para a importância de medidas preventivas como a lavagem das mãos, utilização de produtos biodegradáveis, entre outros.OBJETIVO: Comprender a La luz del pensamiento complejo, el significado del cuidado ecológico y cómo éste viene siendo asociado a la práctica de profesionales que trabajan en un hospital general. MÉTODOS: Estudio descriptivo de naturaleza cualitativa realizado con 15 profesionales que actúan en tres diferentes sectores: Servicio de Lavandería, Servicio de Nutrición y una Unidad de Internamiento. Los datos fueron recolectados por medio de un cuestionario semi-estructurado y sometidos al análisis de contenido propuesto por Bardin. RESULTADOS: Las categorías encontradas fueron: Significando el cuidado ecológico, resaltando la importancia del cuidado ecológico para la práctica profesional y Medidas preventivas en salud asociadas al cuidado ecológico. CONCLUSIONES: El estudio evidenció que existe una preocupaci

  4. Clinical and echocardiographic profile and outcomes of peripartum cardiomyopathy: the Philippine General Hospital experience.

    Science.gov (United States)

    Samonte, Vim I; Ngalob, Queenie G; Mata, Ghea Divina B; Aherrera, Jaime Alfonso M; Reyes, Eugene; Punzalan, Felix Eduardo R

    2013-01-01

    Peripartum cardiomyopathy (PPCM) is a rare disease entity of unknown aetiology. High rates of mortality or poor overall clinical outcome are reported in women with this condition. Certain characteristics are risk factors for this disease. In Asia, there are limited data, especially in the Southeast Asian region. In the Philippines, no data exist regarding the prevalence or risk factors. To determine the prevalence, profile and outcomes of PPCM in Philippine General Hospital and to describe their echocardiographic findings. All patients diagnosed with PPCM in the period of 1 January 2009-31 December 2010 were seen and examined. Demographic data and echocardiogram of the patients were reviewed. 9 were diagnosed with PPCM during the study period. The prevalence is 1 in 1270 live births. Mean age was 29. 78% presented with moderate to severe heart failure symptoms in the prepartum period. Among purported risk factors for PPCM, obesity, multiparity and pre-eclampsia were seen in most. Conversely, only one patient admitted to having more than a single sexual partner. Only one patient had multifetal pregnancy. None were smokers. 44% underwent caesarean section for maternal indication. No mortality was seen. Fetal outcomes were good with all resulting in live births and most were appropriate for gestational age. Echocardiographic findings showed global wall motion abnormalities in the majority, mean ejection fraction of 34% and mean fractional shortening of 20%. PPCM is rare in the Philippines. Compared with international data, our patients are younger with low percentages of promiscuity, multifetal pregnancy, smoking history and tocolytic use. Similar to previous studies, obesity, multiparity and pre-eclampsia were also present in our PPCM patients. Immediate maternal and fetal outcomes were generally good. Adherence to standard heart failure management is high.

  5. Diagnostic imaging to select the candidates to orthotopic transplantation: Experience in a general hospital

    International Nuclear Information System (INIS)

    Pozzato, Carlo; Baldini, Umberto; Gattoni, Filippo; Raiteri, Riccardo; Lazzerini, Francesco; Uslenghi, Carlo Matteo; Mevoli, Alessandra

    1997-01-01

    The authors report the experience of our general hospital in selecting the patients for orthotopic liver transplantation (OLT). The accuracy of duplex Doppler and color flow Doppler for portal and/or mesenteric vein thrombosis was evaluated by correlation with resected livers, computerized tomography and angiographic findings. Pathologic examinations diagnosed HCC in 5/20 transplant recipients: 2 lesions were found in 2 resected specimens (total hepatectomy) and 1 lesion was found in 3 cases. The sensitivity of US, plain and dynamic computerized tomography in identifying HCC patients was 20%; US and computerized tomography specificity rates were 100% and 87%, respectively. CTAP sensitivity was 75% and the sensitivity of Lipiodol computerized tomography and angiography was 100%. Therefore, in our series, US was poorly sensitivity in the detection of liver cancers, which may depend on the small number of patients, lesion size and the radiologists ignoring clinical and laboratory data on purpose. Nevertheless, the patients with a single HCC not exceeding 5 cm in diameter or with no more than 3 tumors, none of them exceeding 3 cm in diameter, are generally considered eligible for transplantation: therefore, our patients chosen for OLT on the basis of US and computerized tomography findings were actually eligible for transplantation in spite of US and computerized tomography false negative results. In conclusion, considering also the long stand-by list for OLT, the first selection of transplant candidates could be performed with US and color flow Doppler, plain and dynamic computerized tomography. The patients who are not ruled out as candidates for OLT on the basis of the findings of these imaging techniques and of clinical and laboratory findings are submitted to no further examination and referred to the transplantation unit. Otherwise, if conventional and color flow Doppler US and conventional computerized tomography are not enough to exclude a patient from OLT, the

  6. Factors contributing to nursing task incompletion as perceived by nurses working in Kuwait general hospitals.

    Science.gov (United States)

    Al-Kandari, Fatimah; Thomas, Deepa

    2009-12-01

    Unfinished care has a strong relationship with quality of nursing care. Most issues related to tasks incompletion arise from staffing and workload. This study was conducted to assess the workload of nurses, the nursing activities (tasks) nurses commonly performed on medical and surgical wards, elements of nursing care activities left incomplete by nurses during a shift, factors contributing to task incompletion and the relationship between staffing, demographic variables and task incompletion. Exploratory survey using a self-administered questionnaire developed from IHOC survey, USA. All full time registered nurses working on the general medical and surgical wards of five government general hospitals in Kuwait. Research assistants distributed and collected back the questionnaires. Four working days were given to participants to complete and return the questionnaires. A total of 820 questionnaires were distributed and 95% were returned. Descriptive and inferential analysis using SPSS-11. The five most frequently performed nursing activities were: administration of medications, assessing patient condition, preparing/updating nursing care plans, close patient monitoring and client health teaching. The most common nursing activities nurses were unable to complete were: comfort talk with patient and family, adequate documentation of nursing care, oral hygiene, routine catheter care and starting or changing IV fluid on time. Tasks were more complete when the nurse-patient load was less than 5. Nurses' age and educational background influenced task completion while nurses' gender had no influence on it. Increased patient loads, resulting in increased frequency of nursing tasks and non-nursing tasks, were positively correlated to incompletion of nursing activities during the shift. Emphasis should be given to maintaining the optimum nurse-patient load and decreasing the non-nursing workload of nurses to enhance the quality of nursing care.

  7. Tromboprofilaxis en pacientes no quirúrgicos internados en un hospital general Venous thromboembolism prevention in non-surgical adult patients admitted in a general hospital

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    Marcelo J. Melero

    2012-10-01

    Full Text Available Los pacientes adultos internados por una enfermedad no quirúrgica tienen un riesgo alto de padecer una tromboembolia venosa y pueden desarrollar alguna forma de esta enfermedad cuando no reciben un tratamiento preventivo adecuado. Los objetivos de este estudio prospectivo, analítico, observacional y transversal, fueron: 1 determinar cuál es el porcentaje de pacientes adultos internados por una enfermedad aguda no quirúrgica en el Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, que tienen indicación de tromboprofilaxis, 2 establecer cuántos de ellos reciben un tratamiento preventivo para la tromboembolia venosa, y 3 comprobar cuántos estaban medicados con alguna forma de tromboprofilaxis sin tener causas que justificaran este tratamiento. Se estudiaron 93 pacientes durante un lapso de 72 horas consecutivas. Se encontró que el 90.3% de ellos necesitaba un tratamiento preventivo para la tromboembolia venosa y el 76.2% de estos enfermos recibían tromboprofilaxis farmacológica. Un 33.3% de los pacientes internados tenía indicado un tratamiento farmacológico preventivo sin tener una causa que justificara esta prescripción. El porcentaje encontrado de pacientes tratados con tromboprofilaxis es más alto que el comunicado en otros estudios observacionales.Adult patients hospitalized for a non-surgical condition, usually have a high risk of venous thromboembolism and may develop some form of this disease when they do not receive appropriate preventive treatment. The objectives of this prospective, analytical, observational and cross-sectional study were: 1 to determine what percentage of adult patients hospitalized for a non-surgical acute condition at the Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, had indication for preventive thromboprophylaxis, 2 to establish how many of them had been prescribed a preventive treatment of venous thromboembolism, 3 to establish how many of them had been

  8. Perceptions of organizational justice among nurses working in university hospitals of shiraz: a comparison between general and specialty settings.

    Science.gov (United States)

    Hatam, Nahid; Fardid, Mozhgan; Kavosi, Zahra

    2013-12-01

    Justice has gained much attention in social and human studies and has many consequences on employees and the organizations, especially on health system workers such as nurses who are among the key factors in health care systems. The purpose of this study was to investigate perception of organizational justice among nurses in educational hospitals of Shiraz University of Medical Sciences (SUMS), and to compare the results of general and specialty hospitals. In this research, 400 nurses at SUMS hospitals were selected by random sampling method. A 19-item questionnaire was applied to measure distributive, procedural and interactional justice. Data analysis was performed using descriptive statistics, including percentage, frequency, mean, and standard deviation. Also, the t-test and one way ANOVA were used to measure the differences between different hospitals and wards. Of 400 nurses, 66% perceived a high level of organizational justice. In this study the mean scores of total perceived organizational justice (P = 0.035), procedural justice (P = 0.031), and interactional justice (P = 0.046) in specialty hospitals were higher than general ones. Furthermore, the mean score of interactional justice was higher than the other components of organizational justice, respectively 3.58 ± 1.02 for general and 3.76 ± 0.86 for specialty hospitals. Significant differences were observed between overall perceived justice (P = 0.013) and its components (P = 0.024, P = 0.013, and P = 0.036) in different wards. Most nurses who participated in this study had a high perception of organizational justice. The mean score of organizational justice was higher in specialty hospitals. Health care policy makers and hospital managers should support their employees, especially nurses through fairness in distributions, procedures, and interactions.

  9. Service quality and patient experiences of ambulatory care in a specialized clinic vs. a general hospital.

    Science.gov (United States)

    De Regge, Melissa; De Groote, Hélène; Trybou, Jeroen; Gemmel, Paul; Brugada, Pedro

    2017-04-01

    Health care organizations are constantly looking for ways to establish a differential advantage to attract customers. To this end, service quality has become an important differentiator in the strategy of health care organizations. In this study, we compared the service quality and patient experience in an ambulatory care setting of a physician-owned specialized facility with that of a general hospital. A comparative case study with a mixed method design was employed. Data were gathered through a survey on health service quality and patient experience, completed with observations, walkthroughs, and photographic material. Service quality and patient experiences are high in both the investigated health care facilities. A significant distinction can be made between the two facilities in terms of interpersonal quality (p = 0.001) and environmental quality (P ≤ 0.001), in favor of the medical center. The difference in environmental quality is also indicated by the scores given by participants who had been in both facilities. Qualitative analysis showed higher administrative quality in the medical center. Environmental quality and patient experience can predict the interpersonal quality; for environmental quality, interpersonal quality and age are significant predictors. Service quality and patient experiences are high in both facilities. The medical center has higher service quality for interpersonal and environmental service quality and is more process-centered.

  10. Maternal Mortality Risk Factors in Dr. Hasan Sadikin General Hospital, Bandung in 2009−2013

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    Shely Karma Astuti

    2017-09-01

    Full Text Available Objective: To discover the factors affecting the occurrence of maternal deaths. The high maternal mortality rate (MMR in Indonesia is still a common problem which needs urgent solution. Methods: This is an analytic observational, cross-sectional study using a case control approach Fifty two cases were selected as cases, another 52 were selected as control. The sampling was performed by simple random sampling. The instruments used in this study were the medical records of mothers who gave birth in Dr. Hasan Sadikin General Hospital Bandung from 1 January 2009–31 December 2013. Data analysis was performed using chi-square test. Results: In this study, the results showed that the risk factors contributing to maternal deaths were pregnancy complication (p<0.001, delivery complication (p<0.001, puerpural complication (p=0.022, age (p=0.030, parity (p=0.427, prior medical history (p<0.001, antenatal care (p=0.007, maternal education (p=0.527, and area of residence (p=0.049. Conclusions: The risk factors that contribute to maternal deaths include pregnancy complication, delivery complication, puerpural complication, maternal age, prior medical history, antenatal care, and area of residence.

  11. Chemical restraint in routine clinical practice: a report from a general hospital psychiatric ward in Greece

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    Papamichael Georgios

    2011-02-01

    Full Text Available Abstract Background There is a dearth of studies regarding chemical restraint in routine clinical psychiatric practice. There may be wide variations between different settings and countries. Methods A retrospective study on chemical restraint was performed in the 11-bed psychiatric ward of the General Hospital of Arta, in northwestern Greece. All admissions over a 2-year-period (from March 2008 to March 2010 were examined. Results Chemical restraint was applied in 33 cases (10.5% of total admissions. From a total of 82 injections, 22 involved a benzodiazepine and/or levomepromazine, whereas 60 injections involved an antipsychotic agent, almost exclusively haloperidol (96.7% of cases, usually in combination with a benzodiazepine (61.7% of cases. In 36.4% of cases the patient was further subjected to restraint or seclusion. Conclusions In our unit, clinicians prefer the combined antipsychotic/benzodiazepine regimen for the management of patients' acute agitation and violent behaviour. Conventional antipsychotics are administrated almost exclusively and in a significant proportion of cases further coercive measures are applied. Studies on the practice of chemical restraint should be regularly performed in clinical settings.

  12. Percutaneous dilational tracheostomy--a 3 year experience in a general hospital in Malaysia.

    Science.gov (United States)

    Tan, C C; Lee, H S; Balan, S

    2004-12-01

    All percutaneous tracheostomies performed in the general intensive care unit (ICU), Hospital Sultanah Aminah, Johor Bahru, Malaysia, from July 1999 to June 2002 were studied. The tracheostomies were performed as an elective bedside technique in the ICU. A total of 352 percutaneous tracheostomies were performed. Eighty-eight percent of the tracheostomies were completed within 15 minutes. The most common complication was bleeding which occurred in 52 patients (14.7%). The rest of the complications encountered were:- transient hypoxia twelve (3.4%), inability/ difficulty to insert tracheostomy tube eight (2.3%), false passage four (1.1%), transient hypotension two (0.6%), pneumothorax two (0.6%), peristomal infection two (0.6%), subcutaneous emphysema one (0.3%), cuff rupture one (0.3%), oesophageal cannulation one (0.3%), and granuloma formation one (0.3%). Conversion to conventional tracheostomies were performed on 7 patients (2%). There was one unfortunate death related to percutaneous tracheostomy. In conclusion, percutaneous dilational tracheostomy can be used safely to manage the airway of critically ill patients.

  13. USE OF THE NEURONAVIGATIONAL SYSTEM AT THE DEPARTMENT OF NEUROSURGERY IN THE GENERAL HOSPITAL MARIBOR

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    Janez Ravnik

    2004-09-01

    Full Text Available Background. Neuronavigational system is a computerised system for intraoperative planning and guidance of neurosurgical procedures using interactive image presentation. The application of such system is denoted as neuronavigation. There are many neuronavigational systems with different technical solutions for intraoperative guidance.Methods. From June 2002 till April 2003 fourteen patients (mean age 52 years were operated using of neuronavigational system on department of neurosurgery in Maribor General Hospital. We used neuronavigational system based on infrared light detection and intraoperative guidance with the help CT imaging in three-planes.Results. The system was used in four cases of biopsy, four cases of lesion reduction and six cases of total lesion removal. 11 brain lesion were situated subcorticaly or deeper, two were cortical and one was osteolitic lesion of the skull bone. Lesions mean diameter was 3.5 cm. Calculated accuracy of interactive image-guidance was good in all 14 cases.Conclusions. Neuronavigational system which we used is simple and quite accurate. Its usage improves speed, safety and accuracy of most neurosurgical procedures.

  14. [Abdominal unplanned reoperations in the Service of General Surgery, University Hospital of Puebla].

    Science.gov (United States)

    León-Asdrúbal, Samuel Báez; Juárez-de la Torre, Juan Carlos; Navarro-Tovar, Fernando; Heredia-Montaño, Mónica; Quintero-Cabrera, José Eduardo

    2016-01-01

    The reoperation is considered as the access to the abdominal cavity before complete healing of the surgical wound from a previous operation within the first 60 days after the first procedure. It occurs in 0.5 to 15% of patients undergoing abdominal surgery and generates significant increase in morbidity and mortality in patients undergoing abdominal surgery. Identify the number of unplanned abdominal surgical reoperations and identify the causes of these unplanned reoperations were performed in our department. This is a retrospective study conducted at the University Hospital of Puebla in the period between April 2009 to February 2012, a total of 1,709 abdominal surgeries performed by the Service of General Surgery were included. Ninety-seven cases of reoperation of which 50 cases were not planned surgery cases were identified; 72% (36 cases) from emergency operations, and 28% of elective surgery. The incidence found in our study is low compared to similar studies. Prospective studies and focus on risk factors and causes of unplanned reoperations are required, in order to know them in detail and, consequently, reduce its incidence and morbidity and mortality they add.

  15. Emotional disturbances among adult diabetic patients attending a diabetic clinic in a Malaysian general hospital

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    Ali SabriRadeef1, Ramli Musa, NikNurFatnoonBintiNik Ahmad, Ghasak Ghazi Faisal

    2014-11-01

    Full Text Available Introduction: Emotional disturbances such as depression, anxiety and stress play an important role in the management of diabetes mellitus since their presence can adversely affect glycemic control, quality of life and compliance with medications. Despite this, emotional disturbances are consistently under-diagnosed and under-treated by physicians in general practice. Objectives: This study aims to determine the prevalence and severity of emotional disturbances among diabetic patients Methodology: This is a cross sectional study conducted on a sample of 200 patients with diabetes mellitus attending the diabetic clinic at the Hospital Tengku Ampuan Afzan, Pahang state, Malaysia. The prevalence and severity of depressive, anxiety and stress symptoms were assessed in those diabetic patients by using the self-rating Bahasa Malaysia version of the Depression, Anxiety and Stress Scales (DASS-42. Results: The prevalence of depression, anxiety, and stress among diabetic patients was 13.5%, 28%, 11% respectively. Most of the patients with emotional disturbances had moderate depression and anxiety symptoms. However, stress symptoms were mild. Although females showed higher prevalence of emotional disturbances, only anxiety was significantly higher than males. Conclusion: Diabetic patients are at risk to develop psychiatric illnesses in the form of depression, anxiety and stress. Anxiety symptoms were more prominent than depression and stress in diabetic patients

  16. Workplace violence directed at nursing staff at a general hospital in southern Thailand.

    Science.gov (United States)

    Kamchuchat, Chalermrat; Chongsuvivatwong, Virasakdi; Oncheunjit, Suparnee; Yip, Teem Wing; Sangthong, Rassamee

    2008-01-01

    This study aimed to document the characteristics of workplace violence directed at nursing staff, an issue which has rarely been studied in a developing country. Two study methods, a survey and a key informant interview, were conducted at a general hospital in southern Thailand. A total of 545 out of 594 questionnaires sent were returned for statistical analysis (response rate=91.7%). The 12-month prevalence of violence experience was 38.9% for verbal abuse, 3.1% for physical abuse, and 0.7% for sexual harassment. Psychological consequences including poor relationships with colleagues and family members were the major concerns. Patients and their relatives were the main perpetrators in verbal and physical abuse while co-workers were the main perpetrators in cases of sexual harassment. Common factors to incidents of violence were psychological setting, illness of the perpetrators, miscommunication, and alcohol use. Logistic regression analysis showed younger age to be a personal risk factor. Working in the out-patient unit, trauma and emergency unit, operating room, or medical or surgical unit increased the odds of violence by 80%. Training related to violence prevention and control was found to be effective and decreased the risk of being a victim of violence by 40%. We recommend providing training to high risk groups as a means of controlling workplace violence directed at nursing staff.

  17. Pathogen Profile of Patients with Sepsis in Internal Medicine, Dr. Hasan Sadikin General Hospital, Bandung 2013

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    Afiq Syazwan Fauzi

    2016-06-01

    Full Text Available Background: Sepsis is a continuous disease which begins with systemic inflammatory response syndrome (SIRS, seen in association with a large number of clinical conditions. These include infectious insults that produce SIRS, such as pancreatitis, ischemia, multiple traumas and tissue injury, hemorrhagic shock, immunemediated organ injury, and the exogenous administration of such putative mediators of the inflammatory process as tumor necrosis factor and other cytokines. A frequent complication of SIRS is the development of organ system dysfunction, including such well-defined clinical conditions as acute lung injury, shock, renal failure, and multiple organ dysfunction syndrome (MODS. Hence, this study was conducted to identify the pathogen profile that often causes sepsis. Methods: A retrospective study was performed to 152 medical records of patients diagnosed as sepsis from Internal Medicine Department Dr. Hasan Sadikin General Hospital from January 2013 to December 2013. The variables observed from the medical records were age, sex, comorbidity, main infection, culture sample, type of gram bacteria, resistant bacteria, and antibiotic susceptibility test. After data collection was completed, the data were analyzed using computer. The data were presented in percentage. Results: Sepsis in male was higher than female. Highest comorbid was chronic kidney disease (CKD. The main infection was health care acquired pneumonia (HCAP. Highest pathogen that caused sepsis was Escherichia coli and highest multidrug-resistant organism (MDRO was extended spectrum beta-lactamase (ESBL Escherichia coli. Conclusions: The most common pathogen that causes sepsis is Escherichia coli.

  18. Factors influencing nurse absenteeism in a general hospital in Durban, South Africa.

    Science.gov (United States)

    Mudaly, P; Nkosi, Z Z

    2015-07-01

    To establish reasons for absenteeism amongst professional nurses, enrolled nurses and enrolled nurse auxiliaries in a general hospital in Durban, in order to recommend strategies that could decrease absenteeism. Nurses endure increased workload, resulting in burnout and absenteeism in workplace environments that already suffer staff shortages. This study was a quantitative, non-experimental survey. The study population consisted of 60 nurses, including professional and enrolled nurses and enrolled nurse auxiliaries. The survey consisted of closed-ended questions to options of 'agree' and 'disagree' and an open-ended section. Family matters, lack of motivation to attend work, illness, finance, favouritism, unfriendly nurse managers, long work hours, increased workload, unsatisfactory work conditions, lack of equipment, unfair promotions and selection of nurses for training, staff shortages, lack of a reward system and incoherent decision-making caused nurse absenteeism. Personal, professional and organisational factors may cause nurse absenteeism, crippling the health sector further against the backdrop of human and mechanical resource shortage. Nurse managers have an important role in reducing absenteeism by addressing the employees' concerns, which can lead to productivity, increased staff morale, decreased medical hazards and satisfied patients. © 2013 John Wiley & Sons Ltd.

  19. BILE DUCT INJURIES FOLLOWING LAPAROSCOPIC CHOLECYSTECTOMY- A RETROSPECTIVE STUDY AT GOVERNMENT GENERAL HOSPITAL, KAKINADA

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    Ravichandra Matcha

    2017-11-01

    Full Text Available BACKGROUND This study aimed at assessing the outcome of laparoscopic cholecystectomy (LC by determining the frequency of complications, especially of bile duct injuries. MATERIALS AND METHODS The case files of all patients undergoing laparoscopic cholecystectomy between January 2008 and December 2016 at Government General Hospital, Kakinada were retrospectively analysed. We evaluated the data according to outcome measures, such as bile duct injury, morbidity, mortality and numbers of patients whose resections had to be converted from laparoscopic to open. RESULTS During the eight years (January 2008 and December 2016, 336 patients underwent LC for chronic cholecystitis (CC, of whom 22 (6.5% developed complications. Among those who developed complications, two patients had major bile duct injuries (0.4%; 43 other patients (12.8% had planned laparoscopic operations converted to open cholecystectomy intra-operatively. None of the patients in this study died as a result of LC. CONCLUSION Bile duct injury is a major complication of LC. Anatomical anomalies, local pathology, and poor surgical techniques are the main factors responsible. The two patients who had severe common bile duct injury in this study had major anatomical anomalies that were only recognized during surgery.

  20. Superficial or cutaneous malignant peripheral nerve sheath tumor--clinical experience at Taipei Veterans General Hospital.

    Science.gov (United States)

    Feng, Chin-Jung; Ma, Hsu; Liao, Wen-Chieh

    2015-05-01

    Primary malignant peripheral nerve sheath tumors (MPNSTs) with a cutaneous or subcutaneous origin represent a small subset of MPNSTs thought to be derived from cutaneous neurofibromas or small peripheral nerves. Few cases of superficial MPNSTs originating from the skin have been reported in the literature. From October 1999 to February 2014, 13 patients were diagnosed with superficial or cutaneous MPNSTs and received treatment at Taipei Veterans General Hospital. Clinical data were collected via retrospective chart review. A retrospective study was performed to compare superficial and deep-seated lesions in terms of local recurrence, distal metastasis, and survival analysis. The relevant literature is also briefly reviewed. The most frequent initial symptoms were local swelling and pain. Ten tumors were found in the extremities, and 3 tumors were located on the trunk. All patients underwent surgery with curative intent. Four patients developed local recurrence, and 3 developed distant metastasis. Three of 13 patients died after a follow-up period of 11 to 180 months (mean, 53.4). Compared to deep-seated MPNSTs, superficial MPNSTs had a lower histopathological grading and better survival rate. Superficial MPNSTs are a rare variant of MPNST. The relatively frequent lack of associated neurofibromatosis and superficial location within the dermis and subcutis may result in this entity being overlooked. According to our clinical experience, superficial MPNSTs might have better prognosis, but similar recurrence and metastasis rates compared with deep-seated lesions. Hence, awareness of this entity should prompt its consideration in the differential diagnosis of cutaneous sarcomas.

  1. Retrospective chart review of elderly patients receiving electroconvulsive therapy in a tertiary general hospital

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    Mosam Phirke

    2015-01-01

    Full Text Available Background: Electroconvulsive therapy (ECT is the one of the oldest and effective treatments in psychiatry today. It has been used in a wide variety of psychiatric disorders in both young and old patients. Aims of the study: The present study is a retrospective chart review of geriatric patients receiving ECT as a treatment option in a tertiary care general hospital psychiatry setting. Methodology: The study evaluated ECT records over a 5-year period between the years 2010 and 2014, and it was observed that 23 elderly patients (aged ≥60 years had received ECT. Results: The patients received modified bitemporal ECT using a brief pulse ECT machine and had no major complications. A total of 184 ECT treatments were administered at an average of 8 treatments per case. The major diagnoses of patients were schizophrenia and major depression. The main indications of ECT were intolerance to medication, suicidal behavior and aggression. Out of the 23 elderly patients, 18 (78.26% showed a good response to ECT. The only complication noted was memory loss and confusion in 3 cases. Patients with medical illnesses like hypertension, diabetes and both together received ECT without any complications. Conclusions: This study adds to the scarce database on the use of ECT in elderly patients in India and adds evidence to the fact that ECT is a safe and effective treatment in the elderly.

  2. NUTRITIONAL ASSESSMENT IN PATIENTS PREDICTED TO MAJOR ABDOMINAL SURGERY AT THE GENERAL HOSPITAL CELJE

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    Ernest Novak

    2001-12-01

    Full Text Available Background. Malnutrition has serious implications for recovery after surgery. Early detection of malnutrition with nutritional support minimizes postoperative complications. Nutritional assessment tools need to be simple and suitable for use in everyday practice. In our study we wanted to determine, how many patients might benefit from nutritional support.Methods. From April to August 1999 fifty consecutively admitted patients predicted to major abdominal surgery have been examined. We used Mini nutritional assessment (MNA, Buzby’s nutrition risk index (NRI, blood albumin level and weight loss in the last 3 months period prior to the examination, to assess nutritional status.Results. We examined 50 patients (27 males and 23 females, age 76.5 ± 16.5 and confirmed malnutrition in 40% of patients with MNA and serum albumin level. The increased risk for nutrition-associated complications was confirmed by NRI and weight loss in 44%.Conclusions. A confident diagnosis of malnutrition and increased risk for nutrition-associated complications can be established by using a combination of simple methods like MNA, NRI, weight loss and serum albumin level. Almost half of the patients admitted for major abdominal surgery in General hospital Celje suffer from malnutrition and they may benefit with early nutritional intervention.

  3. Adaptation and validation of a questionnaire assessing patient satisfaction with pharmacy services in general hospitals

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    Al-Jumah KA

    2014-03-01

    Full Text Available Khalaf Ali Al-Jumah,1 Mohamed Azmi Hassali,2 Ibrahem Al-Zaagi31Al Amal Psychiatric Hospital, Riyadh, Saudi Arabia; 2School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia; 3King Saud Medical City, Riyadh, Saudi ArabiaObjective: The aim of this study was to cross-culturally adapt the Armando Patient Satisfaction Questionnaire into Arabic and validate its use in the general population.Methods: The translation was conducted based on the principles of the most widely used model in questionnaire translation, namely Brisling’s back-translation model. A written authorization allowing translation into Arabic was obtained from the original author. The Arabic version of the questionnaire was distributed to 480 participants to evaluate construct validity. Statistical Package for Social Sciences version 17.0 for Windows was used for the statistical analysis.Results: The response rate of this study was 96%; most of the respondents (52.5% were female. Internal consistency was assessed using Cronbach’s α, which showed that this questionnaire provides a high reliability coefficient (reaching 0.9299 and a high degree of consistency and thus can be relied upon in future patient satisfaction research.Keywords: cross-cultural, Arabic, survey

  4. Burnout Among General Practice Trainees in Ibn Rushd University Hospital: a Cross-Sectional Study

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    A. El kettani,\tZ. Serhier,\tM. Bennani Othmani,\tM. Agoub,\tO. Battas

    2015-02-01

    Full Text Available Introduction : Burnout syndrom is largely widespread among health professionals and It’s further more grave when it comes to young doctors. The aims of this study are to determine burnout prevalence and its associated factors among general practice trainees in Ibn Rushd university hospital. Material and method : A descriptive cross-sectional study was carried out in Mai-June 2013. All the 110 CHU trainees were invited to fill in an anonymous questionnaire including the french language version of the Maslash Burnout Inventory. Results : The response rate was 57%. Responders average age was 24.8 (SD=1.2 (76.2% were female. sub-scales burnout average scores were : ( Emotinal Exaustion : 32.0±9.1, Depersonalisation :13.2±30.0, Personal Accomplishment :29.0±8.1. A total of 39.7% had severe burnout. It was associated with : time spent working (p<0.01, feeling insecurity during guards (p<0.05, having difficulties to communicate informations and to announce diagnosis to the patient and his family (p<0.01, anxiety and depression (p<0.05. Protector factors were feeling equality in the medical team (p<0.01 and having leisure activities (p<0.05. Conclusion : these results are globally similar to those found in previous studies. So, making individual, collective and organizational preventive measures seems to be necessary.

  5. Preparing for the aged in investigative medicine in a General Hospital setting

    International Nuclear Information System (INIS)

    Richards, P.A.C.

    1998-01-01

    Full text: The inequalities which exist today between the health of various sectors of society have grown partly out of the different rates of improvement experienced during the 18th, 19th and 20th Centuries. This is especially so for social class, racial and regional differences. Differential health problems between various age groups and disease groups have probably arisen for other reasons. People can now expect to live well into their 70s or early 80s. Many things have contributed to these health gains, including improved public health measures, high quality clinical treatment services, social and environmental conditions and lifestyle changes. The purpose of this paper is to highlight the major health problems of the community served by the Department of Nuclear Medicine at the Launceston General Hospital (Northern Regional Health) with the following perspectives: (i) How an ageing population is impacting in the level of service; (ii) How the aged are to be managed during investigation, after care and follow-up; and (iii) Major areas of investigations and age group analysis

  6. ESTIGMA EN LA PRÁCTICA PSIQUIÁTRICA DE UN HOSPITAL GENERAL

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    Dr. Renato D. Alarcón

    2017-11-01

    Full Text Available Estigma es un fenómeno socio-cultural de múltiples y poderosas proyecciones en diversos campos, incluido el de salud y salud mental. Históricamente, su arraigo colectivo para calificar y marginar drásticamente a quienes padecen de una enfermedad mental, se ha extendido a todo tipo de escenarios clínicos. El artículo revisa las características e implicancias de estigma en el contexto de un hospital general y sobre la base de las tareas de la Psiquiatría de Enlace. Los actores de todo evento estigmatizante (pacientes, familiares, profesionales, público, entre otros y las formas de presentación del estigma (negación, racionalizaciones, rechazo abierto, silencio se describen con ejemplos pertinentes. Luego de analizar el impacto y las consecuencias del estigma en el cuidado cotidiano y seguimiento de los pacientes afectados, el artículo concluye ofreciendo modalidades variadas de intervención y manejo; y reflexiones en torno al significado de estigma y su futuro en las interacciones medicina-sociedad a nivel global.

  7. Contributing factors to influenza vaccine uptake in general hospitals: an explorative management questionnaire study from the Netherlands

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    Riphagen-Dalhuisen Josien

    2012-12-01

    Full Text Available Abstract Background The influenza vaccination rate in hospitals among health care workers in Europe remains low. As there is a lack of research about management factors we assessed factors reported by administrators of general hospitals that are associated with the influenza vaccine uptake among health care workers. Methods All 81 general hospitals in the Netherlands were approached to participate in a self-administered questionnaire study. The questionnaire was directed at the hospital administrators. The following factors were addressed: beliefs about the effectiveness of the influenza vaccine, whether the hospital had a written policy on influenza vaccination and how the hospital informed their staff about influenza vaccination. The questionnaire also included questions about mandatory vaccination, whether it was free of charge and how delivered as well as the vaccination campaign costs. The outcome of this one-season survey is the self-reported overall influenza vaccination rate of health care workers. Results In all, 79 of 81 hospitals that were approached were willing to participate and therefore received a questionnaire. Of these, 42 were returned (response rate 52%. Overall influenza vaccination rate among health care workers in our sample was 17.7% (95% confidence interval: 14.6% to 20.8%. Hospitals in which the administrators agreed with positive statements concerning the influenza vaccination had a slightly higher, but non-significant, vaccine uptake. There was a 9% higher vaccine uptake in hospitals that spent more than €1250,- on the vaccination campaign (24.0% versus 15.0%; 95% confidence interval from 0.7% to 17.3%. Conclusions Agreement with positive statements about management factors with regard to influenza vaccination were not associated with the uptake. More economic investments were related with a higher vaccine uptake; the reasons for this should be explored further.

  8. Variation in markup of general surgical procedures by hospital market concentration.

    Science.gov (United States)

    Cerullo, Marcelo; Chen, Sophia Y; Dillhoff, Mary; Schmidt, Carl R; Canner, Joseph K; Pawlik, Timothy M

    2018-04-01

    Increasing hospital market concentration (with concomitantly decreasing hospital market competition) may be associated with rising hospital prices. Hospital markup - the relative increase in price over costs - has been associated with greater hospital market concentration. Patients undergoing a cardiothoracic or gastrointestinal procedure in the 2008-2011 Nationwide Inpatient Sample (NIS) were identified and linked to Hospital Market Structure Files. The association between market concentration, hospital markup and hospital for-profit status was assessed using mixed-effects log-linear models. A weighted total of 1,181,936 patients were identified. In highly concentrated markets, private for-profit status was associated with an 80.8% higher markup compared to public/private not-for-profit status (95%CI: +69.5% - +96.9%; p markets was associated with only a 62.9% higher markup compared to public/private not-for-profit status in unconcentrated markets (95%CI: +45.4% - +81.1%; p market concentration and markup. Government and private not-for-profit hospitals employed lower markups in more concentrated markets, whereas private for-profit hospitals employed higher markups in more concentrated markets. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. SU-E-T-157: CARMEN: A MatLab-Based Research Platform for Monte Carlo Treatment Planning (MCTP) and Customized System for Planning Evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Baeza, J.A.; Ureba, A.; Jimenez-Ortega, E.; Barbeiro, A.R.; Plaza, A. Leal [Universidad de Sevilla, Departamento de Fisiologia Medica y Biofisica, Seville (Spain); Lagares, J.I. [Centro de Investigaciones Energeticas, Medioambientales y Tecnologicas (CIEMAT), Madrid (Spain)

    2015-06-15

    Purpose: Although there exist several radiotherapy research platforms, such as: CERR, the most widely used and referenced; SlicerRT, which allows treatment plan comparison from various sources; and MMCTP, a full MCTP system; it is still needed a full MCTP toolset that provides users complete control of calculation grids, interpolation methods and filters in order to “fairly” compare results from different TPSs, supporting verification with experimental measurements. Methods: This work presents CARMEN, a MatLab-based platform including multicore and GPGPU accelerated functions for loading RT data; designing treatment plans; and evaluating dose matrices and experimental data.CARMEN supports anatomic and functional imaging in DICOM format, as well as RTSTRUCT, RTPLAN and RTDOSE. Besides, it contains numerous tools to accomplish the MCTP process, managing egs4phant and phase space files.CARMEN planning mode assist in designing IMRT, VMAT and MERT treatments via both inverse and direct optimization. The evaluation mode contains a comprehensive toolset (e.g. 2D/3D gamma evaluation, difference matrices, profiles, DVH, etc.) to compare datasets from commercial TPS, MC simulations (i.e. 3ddose) and radiochromic film in a user-controlled manner. Results: CARMEN has been validated against commercial RTPs and well-established evaluation tools, showing coherent behavior of its multiple algorithms. Furthermore, CARMEN platform has been used to generate competitive complex treatment that has been published in comparative studies. Conclusion: A new research oriented MCTP platform with a customized validation toolset has been presented. Despite of being coded with a high-level programming language, CARMEN is agile due to the use of parallel algorithms. The wide-spread use of MatLab provides straightforward access to CARMEN’s algorithms to most researchers. Similarly, our platform can benefit from the MatLab community scientific developments as filters, registration algorithms

  10. Western University (No. 10 Canadian Stationary Hospital and No. 14 Canadian General Hospital): a study of medical volunteerism in the First World War.

    Science.gov (United States)

    Istl, Alexandra C; McAlister, Vivian C

    2016-12-01

    The Canadian government depended on chaotic civilian volunteerism to staff a huge medical commitment during the First World War. Offers from Canadian universities to raise, staff and equip hospitals for deployment, initially rejected, were incrementally accepted as casualties mounted. When its offer was accepted in 1916, Western University Hospital quickly adopted military decorum and equipped itself using Canadian Red Cross Commission guidelines. Staff of the No. 10 Canadian Stationary Hospital and the No. 14 Canadian General Hospital retained excellent morale throughout the war despite heavy medical demand, poor conditions, aerial bombardment and external medical politics. The overwhelming majority of volunteers were Canadian-born and educated. The story of the hospital's commanding officer, Edwin Seaborn, is examined to understand the background upon which the urge to volunteer in the First World War was based. Although many Western volunteers came from British stock, they promoted Canadian independence. A classical education and a broad range of interests outside of medicine, including biology, history and native Canadian culture, were features that Seaborn shared with other leaders in Canadian medicine, such as William Osler, who also volunteered quickly in the First World War.

  11. An observational study in psychiatric acute patients admitted to General Hospital Psychiatric Wards in Italy

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    Margari Francesco

    2007-01-01

    Full Text Available Abstract Objectives this Italian observational study was aimed at collecting data of psychiatric patients with acute episodes entering General Hospital Psychiatric Wards (GHPWs. Information was focused on diagnosis (DSM-IV, reasons of hospitalisation, prescribed treatment, outcome of aggressive episodes, evolution of the acute episode. Methods assessments were performed at admission and discharge. Used psychometric scales were the Brief Psychiatric Rating Scale (BPRS, the Modified Overt Aggression Scale (MOAS and the Nurses' Observation Scale for Inpatient Evaluation (NOSIE-30. Results 864 adult patients were enrolled in 15 GHPWs: 728 (320 M; mean age 43.6 yrs completed both admission and discharge visits. A severe psychotic episode with (19.1% or without (47.7% aggressive behaviour was the main reason of admission. Schizophrenia (42.8% at admission and 40.1% at discharge and depression (12.9% at admission and 14.7% at discharge were the predominant diagnoses. The mean hospital stay was 12 days. The mean (± SD total score of MOAS at admission, day 7 and discharge was, respectively, 2.53 ± 5.1, 0.38 ± 2.2, and 0.21 ± 1.5. Forty-four (6.0% patients had episodes of aggressiveness at admission and 8 (1.7% at day 7. A progressive improvement in each domain/item vs. admission was observed for MOAS and BPRS, while NOSIE-30 did not change from day 4 onwards. The number of patients with al least one psychotic drug taken at admission, in the first 7 days of hospitalisation, and prescribed at discharge, was, respectively: 472 (64.8%, 686 (94.2% and 676 (92.9%. The respective most frequently psychotic drugs were: BDZs (60.6%, 85.7%, 69.5%, typical anti-psychotics (48.3%, 57.0%, 49.6%, atypical anti-psychotics (35.6%, 41.8%, 39.8% and antidepressants (40.9%, 48.8%, 43.2%. Rates of patients with one, two or > 2 psychotic drugs taken at admission and day 7, and prescribed at discharge, were, respectively: 24.8%, 8.2% and 13.5% in mono-therapy; 22.0%, 20

  12. Clinical decision support systems at the Vienna General Hospital using Arden Syntax: Design, implementation, and integration.

    Science.gov (United States)

    Schuh, Christian; de Bruin, Jeroen S; Seeling, Walter

    2015-12-01

    The Allgemeines Krankenhaus Informations Management (AKIM) project was started at the Vienna General Hospital (VGH) several years ago. This led to the introduction of a new hospital information system (HIS), and the installation of the expert system platform (EXP) for the integration of Arden-Syntax-based clinical decision support systems (CDSSs). In this report we take a look at the milestones achieved and the challenges faced in the creation and modification of CDSSs, and their integration into the HIS over the last three years. We introduce a three-stage development method, which is followed in nearly all CDSS projects at the Medical University of Vienna and the VGH. Stage one comprises requirements engineering and system conception. Stage two focuses on the implementation and testing of the system. Finally, stage three describes the deployment and integration of the system in the VGH HIS. The HIS provides a clinical work environment for healthcare specialists using customizable graphical interfaces known as parametric medical documents. Multiple Arden Syntax servers are employed to host and execute the CDSS knowledge bases: two embedded in the EXP for production and development, and a further three in clinical routine for production, development, and quality assurance. Three systems are discussed; the systems serve different purposes in different clinical areas, but are all implemented with Arden Syntax. MONI-ICU is an automated surveillance system for monitoring healthcare-associated infections in the intensive care setting. TSM-CDS is a CDSS used for risk prediction in the formation of cutaneous melanoma metastases. Finally, TacroDS is a CDSS for the manipulation of dosages for tacrolimus, an immunosuppressive agent used after kidney transplantation. Problems in development and integration were related to data quality or availability, although organizational difficulties also caused delays in development and integration. Since the inception of the AKIM

  13. Perfil clínico del adulto mayor atendido ambulatoriamente en un hospital general

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    Paola Casas

    2012-10-01

    Full Text Available Objetivo: Describir el perfil clínico del adulto mayor atendido ambulatoriamente en un hospital general. Material y métodos: Estudio descriptivo, transversal, realizado a través de encuestas aplicadas a pacientes en la consulta ambulatoria de geriatría del Hospital Nacional Cayetano Heredia (HNCH, entre agosto de 2011 y enero 2012. Resultados: Se evaluaron 290 pacientes, el 69,3% fueron mujeres; el 65,5% tenía entre 60 y 79 años. La hipertensión arterial fue el diagnóstico más frecuente (55,5%. El 83,1% consumía algún tipo de medicamento y el 45% más de 3 fármacos. En la valoración por esferas: el 83,5% era autónomo, el 18,1% tenía deterioro cognitivo, el 7,7% depresión, el 79,3% riesgo social, el 23,8% disfunción familiar, el 31,4% riesgo de malnutrición, el 23,4% obesidad, el 96% mala higiene del sueño y el 4,9% riesgo de caídas. El síndrome geriátrico más frecuente fue caídas en 23,8% y de los problemas geriátricos, el edentulismo en 77,6%; 17,4% eran frágiles según la velocidad de la marcha; se encontró asociación entre fragilidad y edad avanzada, género femenino y la presencia de riesgo social. Conclusión: Los pacientes que acuden a la consulta externa de Geriatría fueron mayoritariamente mujeres, funcionalmente autónomos, sin deterioro cognitivo, con riesgo social y adecuada funcionalidad familiar, prefrágiles y con enfermedades crónicas no transmisibles principalmente.

  14. Una finestra sul passato: Irse de casa di Carmen Martín Gaite

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    Giulia Tosolini

    2015-01-01

    Full Text Available Beyond historical and social implications, migration represents the possibility of crossing a threshold and opening oneself up to new empirical and emotional spaces. Amparo, the main character of Carmen Martín Gaite’s Irse de casa (1998, is the perfect personification of the gaitian feminine canon. After leaving Spain and settling in New York, she became a successful fashion designer, and seemed happy and easy-going. The bond with memory and the past is the main topic of this novel, as it is in most of Martín Gaite’s production. The window on the past that Amparo closed moving to the US suddenly reappears when she needs to discover herself and her origins. This inconvenience in an anonymous life brings huge changes that will condition her and her loved ones. Travelling to Spain and interacting with places and people connected with her childhood, Amparo goes through the window she had closed forty years before, restoring the order. The window connects the present and the past, symbolizes the emigrant’s transience, personified in the novel by Amparo, who can definitely find the lost serenity and heart’s-ease.

  15. Geology of Cerro Carmen prospect; uranium and rare earth element mineralization

    International Nuclear Information System (INIS)

    Fortin Medina, Heriberto; Alarcon Farias, Boris

    2008-01-01

    The prospect Cerro Carmen is an skarn deposit with uranium (U) and Rare Earth Elements (REE )hosted in intermediate to basic volcanic rocks. The associated elements involved are Th, Ti, Fe, Y and Sc. The main mineral specie is davidite, it represent a formation temperature near to 1500 o C. The first radiometric anomalies of this prospect were discovered through aerial radiometric survey in 1982, latter in 1995, the interest expressed by Empresa Nacional de Mineria (ENAMI) and CCHEN, on REE and Uranium elements, resulted in the sign of an agreement between both parties to study this prospect,in which ENAMI provided operational resources and CCHEN provided professional resources. From geological point of view, the prospect is located at contact of volcanic rocks, that correspond to La Negra Formation of Pliensbachiano age to upper Jurassic age, with igneous rocks of Pluton Sierra Aspera of Neocomian age, in a structural lineament NW with emplacements of monzonitic and aplitic intrusive rocks from upper Cretaceous age with potassium metasomatism and mineralization of U and REE. In III and IV Regions, similar mineralization to the described one, marks a regional lineament coincidental with the axis of the iron metallogenic province, supporting the need to realize studies to improve the estimation of the potential of radioactive minerals of the country

  16. Implementation of a model of quality control program in the radiodiagnostic service at the general hospital Dos de Mayo

    International Nuclear Information System (INIS)

    Acosta Reginfo, N.; Ramirez Quijada, R.

    1998-01-01

    In order to implement a model of quality control program, the General Hospital Dos de Mayo was selected, since it manages a specialized radiology service - defined according to the OMS criteria - This radiology service attends nearly 60 % of total patients of the Hospital. This program intends to be a model for application to another hospitals havings similar characteritics, since any formal quality control program has been implemented in neither private nor public hospitals in the country. The model, while allowing to make measurements of main parameters, also allows to verify that radiation doses to patients, radiation workers and public trend to a level as low as reasonably achievable, and also to yield images with enough diagnostic quality, and to induce work environment with shared responsibility and commitment

  17. Alcohol-related hospital admissions: Missed opportunities for follow up? A focus group study about general practitioners' experiences

    DEFF Research Database (Denmark)

    Lid, Torgeir Gilje; Oppedal, Kristian; Pedersen, Bolette

    2012-01-01

    Aims: To explore general practitioners' (GPs') follow-up experiences with patients discharged from hospital after admittance for alcohol-related somatic conditions. Design and participants: Two focus groups with GPs (four women and 10 men), calling for stories about whether the intervention given...

  18. Serviço de Emergência Psiquiátrica em hospital geral: estudo retrospectivo Servicio de emergencia psiquiátrica en hospital general: estudio retrospectivo Emergency psychiatric service in general hospitals: a retrospective study

    Directory of Open Access Journals (Sweden)

    Fernando Sérgio Pereira de Sousa

    2010-09-01

    Full Text Available O Serviço de Emergência Psiquiátrica em Hospital Geral (SEPHG é uma proposta articulada com o movimento da reforma psiquiátrica. Objetivou-se caracterizar os clientes com sofrimento psíquico assistidos no SEPHG Dr. Estevam, em Sobral-CE. Este é um estudo do tipo documental, com abordagem quantitativa, envolvendo 191 clientes atendidos no SEPHG no período de janeiro a dezembro de 2007. Os dados foram coletados a partir de um livro de registro, cujas informações nele contidas foram retiradas dos prontuários dos clientes. Observou-se predomínio de pacientes do sexo masculino (70,15%, com idade entre 30-49 anos (48,71% e solteiros (74,86%. A maioria era proveniente da cidade de Sobral (69,64 %. Em 42,40% dos casos, o diagnóstico foi transtorno do uso de álcool. Grande parte da clientela (66,50% deu entrada no serviço por demanda espontânea. Após avaliação do SEPHG, 43,45% desses clientes foram encaminhados ao CAPS-ad. Pelos resultados, depreende-se o quão imprescindíveis são os serviços de saúde mental.El Servicio de Emergencia Psiquiátrica en Hospital General (SEPHG es una propuesta vinculada al movimiento de la reforma psiquiátrica. Se objetivó caracterizar a los pacientes con trastornos psiquiátricos atendidos en el SEPHG Dr. Estevam, en Sobral-Ceará-Brasil. Estudio de tipo documental con abordaje cualitativa, involucrando 191 pacientes atendidos en el SEPHG entre enero y diciembre de 2007. Los datos fueron recogidos a partir de un libro de registro, cuyas informaciones fueron extraídas de las historias clínicas de los pacientes. Se observó prevalencia de pacientes de sexo masculino (70,15%, con edad entre 30-49 años (48,71% y solteros (74,86%. La mayoría provenía de la ciudad de Sobral (69,64%. En el 42,40% de los casos, el diagnóstico fue trastorno provocado por abuso de alcohol. Una gran cantidad de pacientes (66,50% se presentó en el servicio en forma espontánea. Con posterioridad a la evaluación del

  19. The Warrens and other pioneering clinician pathologists of the Massachusetts General Hospital during its early years: an appreciation on the 200th anniversary of the hospital founding.

    Science.gov (United States)

    Young, Robert H; Louis, David N

    2011-10-01

    To celebrate the bicentennial of the 1811 charter to establish the Massachusetts General Hospital, we tell the stories of the physicians and surgeons of the hospital who practiced pathology until the discipline was more firmly established with the recruitment of James Homer Wright who became the first full-time pathologist at the hospital in 1896. One of the two co-founders of the hospital, John Collins Warren (famed primarily for being the surgeon at the first public demonstration of ether anesthesia) had a major interest in pathology; he published a book focused on gross pathology (1837) and began the important specimen collection subsequently known as the Warren Anatomical Museum at Harvard Medical School (HMS). An early physician, John Barnard Swett Jackson, became the first professor of pathology in the United States (1847) and was a noted collector whose specimens were added to the Warren Museum. Dr Jackson showed no interest in microscopy when it became available, but microscopy was promoted from circa the late 1840s at Harvard and likely at the hospital by Oliver Wendell Holmes, the famed essayist who was on the staff of the hospital and faculty at the medical school. Microscopy was probably first used at the Hospital with any frequency on examination of fluids by the first officially designated 'Microscopist,' John Bacon Jr, in 1851, and after the mid-1850s by Calvin Ellis on anatomic specimens; Ellis went on to pioneering reform of the HMS curriculum. Reginald Heber Fitz succeeded Ellis in 1871 and was the first to be officially designated as 'Pathologist' at the hospital. Fitz is remembered for two major contributions: his paper showing the nature of, and potential surgical cure for, the disease that he termed 'appendicitis'; and his description of acute pancreatitis. With the microscope now firmly entrenched and with the increase in surgery after Fitz's work on appendicitis, surgical pathology grew quickly. J Collins Warren, the grandson of the co

  20. Stakeholder perspectives on handovers between hospital staff and general practitioners: An evaluation through the microsystems lens

    NARCIS (Netherlands)

    Gobel, B.; Zwart, D. De; Hesselink, G.J.; Pijnenborg, L.; Barach, P.; Kalkman, C.J.; Johnson, J.K.

    2012-01-01

    BACKGROUND: Much of the research on improving patient handovers has focused on enhancing communication within the hospital system, but there have been relatively few efforts aimed at addressing the challenges at the interface between the hospital and the primary care setting. METHODS: A qualitative

  1. Histopathologic Distribution of Appendicitis at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, in 2012

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    Tara Zhafira

    2017-03-01

    Full Text Available Background: Appendicitis is a medical emergency and a common cause of emergency surgeries worldwide. Its frequency is varied based on many factors, including age and sex. Histopathologic examination is a gold standard for diagnosis, and complications like gangrene formation and perforation lead to high mortality and morbidity in almost all age groups. This study was conducted to describe the distribution pattern of appendicitis according to age, sex, and histopathologic type. Methods: This cross-sectional study was carried out in the Department of Pathology Anatomy, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, from August–October 2013. Secondary data were obtained from medical records of January 1st to December 31st, 2012. A total of 503 out of 516 cases were included to be reviewed. Age, sex, and histopathologic type from medical records were then evaluated. Any specific case and perforation were also noted. Results: Data showed the highest prevalence of appendicitis occurred in the 10- 19 age group (28.4% and in the female group (52.3%. Acute appendicitis was more common than chronic appendicitis in both sexes and all age groups. Perforation rate was high (41.4%, and was more prevalent in male (54.9% and in the 0–9 age group (65.7%. Conclusions: Appendicitis, both acute and chronic, is more distributed in the second decade, and is slightly more prevalent in females. Acute cases are more common than chronic. Perforation rate is significant and peaks in the first decade and in males. [AMJ.2017;4(1:36–41

  2. Retrospective study of pressure ulcer prevalence in Dutch general hospitals since 2001.

    Science.gov (United States)

    Amir, Y; Meijers, J; Halfens, R

    2011-01-01

    To investigate whether factors such as patient characteristics, pressure ulcer (PU) prevention strategies and the structural quality indicators used by institutions and wards can explain an apparent decline in PU prevalence from 2001 to 2008. The Dutch National Prevalence Survey of Care Problems (known as LPZ) database from 2001 to 2008 was used to explore differences in patient characteristics, PU prevention strategies and structural quality indicators used by institutions and wards between two periods, 2001-2004 (PU as an internal health-care quality indicator) and 2005-2008 (PU as an external health-care quality indicator). Compared with 2001-2004, fewer participants with CVA /hemiparesis (OR 0.485), infectious diseases (OR 0.861), surgery lasting >2 hours (OR 0.637), at-risk Braden scale scores (OR 0.844), and more participants with diabetes mellitus (OR 1.693) were found in the 2005-2008 group. More special beds/mattresses (OR 2.216) and special cushions in wheelchairs (OR 2.277) were used in the 2005- 2008 period, as well as slightly more repositioning, dehydration/malnutrition prevention and PU prevention and treatment information. More institutions had information leaflets (OR 5.894), PU prevention guidelines (OR 4.625), a PU committee (OR 2.503), and a PU-wound care nurse at ward level (OR 2.434) in the 2005-2008 period. The decline in PU prevalence at Dutch general hospitals after 2004 may be partly explained by differences in patient characteristics, improved structural quality indicators and a slight improvement in PU prevention. Further research is needed to find evidence of which individual factors can explain the decline in PU prevalence after 2004 and whether any changes in health care policy have impacted on these prevalence rates.

  3. The effectiveness of consultation-liaison psychiatry in the general hospital setting: a systematic review.

    Science.gov (United States)

    Wood, Rebecca; Wand, Anne P F

    2014-03-01

    The aim of this study was to review how the effectiveness of consultation liaison psychiatry (CLP) services has been measured and to evaluate the strength of the evidence for effectiveness. Systematic review of medical databases using broad search terms as well as expert opinion was sought. The literature search was restricted to studies of general, whole-of-hospital inpatient CLP services. Forty articles were found and grouped into five measurements of effectiveness: cost effectiveness including length of stay, concordance, staff and patient feedback, and follow-up outcome studies. All measurements contributed to the evaluation of CLP services, but no one measure in isolation could adequately cover the multifaceted roles of CLP. Concordance was the only measurement with an established, consistent approach for evaluation. Cost effectiveness and follow-up outcome studies were the only measures with levels of evidence above four, however the three follow-up outcome studies reported conflicting results. Subjective evidence derived from patient and staff feedback is important but presently lacking due to methodological problems. The effectiveness of CLP services was demonstrated by cost-effectiveness, earlier referrals to CLP predicting shorter length of stay, and concordance with some management recommendations. There is evidence that some CLP services are cost-effective and reduce length of stay when involved early and that referrers follow certain recommendations. However, many studies had disparate results and were methodologically flawed. Future research should focus on standardising patient and staff feedback, and short-term patient outcomes. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

  4. Evaluation of generalized pruritus in patients without primary skin lesions in Razi Hospital

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    Jomhori P

    2001-09-01

    Full Text Available Pruritus is an unpleasant sensation that provokes the desire to scratch. It has long been recognized as a presenting or concomitant symptom of many systemic diseases. Indeed, generalized pruritus is reported to be associated with underlying diseases in 10-50 percent of cases. This study was conducted to investigate the underlying diseases in pruritic patients without primary skin lesion. Seventy-five patients with at least one-month history of pruritus with no primary skin lesions, presenting to dermatological clinics of Razi Hospital, from April 97 until December 99 were evaluated. The work up procedure consisted of medical history, physical examination, laboratory findings (CBC, ESR, blood chemistry, thyroid function tests, urinalysis, stool exam, chest X-ray and in selected cases, additional specific tests. Fifty-four patients were female, and 21 male the mean age was 45.7y±16.41, and the mean duration of pruritus, 21.8m±21. In 43 patients (75.4 percent, no abnormal finding was detected. Five patients (6.66 percent had atopy. In the remaining 27 patients (36 percent, the following abnormalities were found: Iron deficiency in 6 patients (8 percent, diabetes mellitus in 6 patients (8 percent, hyperthyroidism in 4 patients (5.33 percent, hypothyroidism in 2 patients (2.66 percent, lymphoma in 3 patients (4 percent, chronic hepatitis, hypocalcaemia, cholelithiasis, psychosis and chronic renal failure each in one patient (1.3 percent. Evaluation of patients with pruritus may be a valuable tool for early detection of underlying systemic diseases.

  5. Evaluation of the Yale New Haven Readmission Risk Score for Pneumonia in a General Hospital Population.

    Science.gov (United States)

    Schaefer, Gabrielle; El-Kareh, Robert; Quartarolo, Jennifer; Seymann, Gregory

    2017-09-01

    The Yale New Haven Readmission Risk Score (YNHRRS) for pneumonia is a clinical prediction tool developed to assess risk for 30-day readmission. This tool was validated in a cohort of Medicare patients; generalizability to a broader patient population has not been evaluated. In addition, it lacks indicators of functional status or social support, which have been shown in other studies to be predictors of readmission. The objective of this study was to evaluate the generalizability of the YNHRRS for pneumonia in a general population of hospitalized patients, and assess the impact of incorporating measures of functional status and social support on its predictive value. This retrospective chart review comprised all patients admitted to a 563-bed academic medical center with a primary diagnosis of pneumonia between March 2014 and March 2015. Abstraction of clinical variables allowed calculation of the YNHRRS and additional indicators of functional status and social support. The primary outcome was 30-day readmission rate. We created a logistic regression model to predict readmission using the YNHRRS, functional status, and social support as covariates. Among 270 discharges with pneumonia, the observed readmission rate was 23%. The YNHRRS was a significant predictor of readmission in our multivariate model, with an odds ratio of 2.20 (95% confidence interval, 1.29-3.73) for each 10% increase in calculated risk. Indicators of functional status and social support were not significant predictors of readmission. The YNHRRS can be applied to an unselected population as a tool to predict patients with pneumonia at risk for readmission. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. A review of maternal deaths at Goroka General Hospital, Papua New Guinea 2005-2008.

    Science.gov (United States)

    Sanga, Karen; de Costa, Caroline; Mola, Glen

    2010-02-01

    Papua New Guinea is a developing country with a population of six million, facing significant geographical, cultural and economic barriers to the provision of antenatal and intrapartum care. The maternal mortality ratio (MMR) is an internationally regarded index of the quality of a country's maternity services; the most recently reported MMR for Papua New Guinea of 773 deaths per 100 000 births is one of the highest in the world. To review information about women who died from pregnancy-related causes, both direct and indirect, in the Goroka General Hospital (GGH) during the period 1st January 2005 to 31st May 2008. A retrospective review was undertaken of the charts of women recorded as dying in the Obstetrics and Gynecology (O&G) ward of GGH in the study period. The charts of 21 women who died from pregnancy-related causes were reviewed and information collated. Puerperal sepsis and sepsis complicating unsafe abortion were the most common causes of maternal death accounting for 48% deaths. Other causes included ectopic pregnancy and postpartum haemorrhage. Contributing factors included residence in a rural area, geographical and transport difficulties accessing care, non-use of family planning services, non-booking for antenatal care and late presentation in pregnancy or labour, and under-resourcing of services at GGH. The socio-economic status of most of the women was low, and where educational attainments were recorded these were also low. 71% of women identified themselves as practising Christians. Better outreach services to provide health information and antenatal care, with specific counselling about the need for supervised delivery, are urgently required in the Eastern Highlands Province that GGH serves if numbers of maternal deaths are to be reduced. Working through churches in the region may be the most appropriate way to provide information and services to women because a majority of women adhere to Christianity and can be reached in this way.

  7. Association between atopy and allergic contact dermatitis in Dr. Sardjito General Hospital Yogyakarta

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    Fitria Retno Danarti Hardyanto Soebono

    2014-04-01

    Full Text Available Association between atopy and development of allergic contact dermatitis (ACD remains controversial. T cell disfunctions in a patient with atopy complicate the process of nickel sensitization. On the other, the decrease of the skin barrier function and overexpression of Langerhans cells in the patient facilitate the sensitization.  This study aimed to evaluate the association between atopy and incidence of nickel ACD. A case-control study was carried out in Allergic and Immunology Sub Department of Dermato-Venereology Policlinic, Dr. Sardjito General Hospital, Yogyakarta, involving 54 nickel ACD patients as case group and 74 healthy subjects as control group. All subjects underwent prick test allergens i.e. house dust, dust mite, cockroach, mixed fungi, nuts and egg white. The skin reaction was considered as a positive result if a wheal diameter of at least 3 mm larger than the negative control or a minimum of half of the positive control. The relationship between atopy and the nickel ACD incidence was analyzed using Chi-Square test with confidence interval (CI of 95%. A significant association between atopy and the nickel ACD incidence was observed in this study. Subjects with atopy to  ≥1 allergen had risk of nickel ACD 3.74 higher than subjects without atopy (odds ratio/OR=3.74; 95%CI = 1.64-8.53.  Furtheremore, subjects with atopy to  ≥2 allergens had risk of nickel ACD 3.74 higher than subjects without atopy (OR=2.08; 95%CI = 1.01-4.29. In conclusion, atopy is a risk factor of nickel ACD. Key words: atopy - allergic contact dermatitis - nickel allergy – prick test – allergen

  8. Dislipidemia en pacientes con artritis reumatoide atendidos en un hospital general

    Directory of Open Access Journals (Sweden)

    Jose Galindo

    2011-04-01

    Full Text Available Objetivo: Determinar la frecuencia de dislipidemia en pacientes con artritis reumatoide (AR atendidos en un hospital general. Material y métodos: Estudio observacional, descriptivo y transversal. Se incluyeron 44 pacientes a quienes se les determinó perfil lipídico sérico. Los resultados se clasificaron según el reporte modificado en el 2004 del tercer panel de tratamiento del adulto (ATP III. Además, se determinó el índice de masa corporal (IMC, la puntuación para la actividad de la enfermedad (DAS-28 y la limitación funcional medida con el cuestionario de evaluación de salud - versión peruana (HAQ-P. Resultados: La frecuencia de dislipidemia en pacientes con AR fue 75%. El 54,5% tuvo un IMC fuera de los límites normales. En el DAS-28, la mayoría de pacientes se encontraron con actividad severa de la enfermedad. Sin embargo, hubo más pacientes con dislipidemia en el grupo con moderada actividad. En la escala de HAQ-P, la mitad tuvo incapacidad funcional moderada a severa y mayor número de sujetos con dislipidemia. El 69,7% de los pacientes con alteraciones en el perfil lipídico presentó dislipidemia mixta. Conclusiones: La dislipidemia en los pacientes con AR del estudio se presentó con una alta frecuencia y con diversas formas de alteración en el perfil lipídico sin un patrón uniforme. Por lo tanto, el tratamiento de la dislipidemia sería individualizado en cada paciente para prevenir eventos cardiovasculares.(Rev Med Hered 2011;22:47-53.

  9. Current status of prescription in type 2 diabetic patients from general hospitals in busan.

    Science.gov (United States)

    Suk, Ji Hye; Lee, Chang Won; Son, Sung Pyo; Kim, Min Cheol; Ahn, Jun Hyeob; Lee, Kwang Jae; Park, Ja Young; Shin, Sun Hye; Kwon, Min Jeong; Kim, Sang Soo; Kim, Bo Hyun; Lee, Soon Hee; Park, Jeong Hyun; Kim, In Joo

    2014-06-01

    Data regarding the prescription status of individuals with diabetes are limited. This study was an analysis of participants from the relationship between cardiovascular disease and brachial-ankle pulse wave velocity in patients with type 2 diabetes (REBOUND) Study, which was a prospective multicenter cohort study recruited from eight general hospitals in Busan, Korea. We performed this study to investigate the current status of prescription in Korean type 2 diabetic patients. Type 2 diabetic patients aged 30 years or more were recruited and data were collected for demographics, medical history, medications, blood pressure, and laboratory tests. Three thousands and fifty-eight type 2 diabetic patients were recruited. Mean age, duration of diabetes, and HbA1c were 59 years, 7.6 years, and 7.2%, respectively. Prevalence of hypertension was 66%. Overall, 7.3% of patients were treated with diet and exercise only, 68.2% with oral hypoglycemic agents (OHAs) only, 5.3% with insulin only, and 19.2% with both insulin and OHA. The percentage of patients using antihypertensive, antidyslipidemic, antiplatelet agents was similar as about 60%. The prevalence of statins and aspirin users was 52% and 32%, respectively. In our study, two thirds of type 2 diabetic patients were treated with OHA only, and one fifth with insulin plus OHA, and 5% with insulin only. More than half of the patients were using each of antihypertensive, antidyslipidemic, or antiplatelet agents. About a half of the patients were treated with statins and one third were treated with aspirin.

  10. Etiology of Diarrhea in Children Younger Than 5 Years Attending the Bengo General Hospital in Angola.

    Science.gov (United States)

    Gasparinho, Carolina; Mirante, Maria Clara; Centeno-Lima, Sónia; Istrate, Claudia; Mayer, António Carlos; Tavira, Luis; Nery, Susana Vaz; Brito, Miguel

    2016-02-01

    Diarrheal disease is among the leading causes of death in children younger than 5 years, especially in developing countries. The aim of this study was to investigate the most frequent etiological agents of diarrhea and its associated factors in children younger than 5 years attending the Bengo General Hospital in Angola. From September 2012 through December 2013, stool samples were collected from 344 children presenting with diarrhea to investigate the presence of viral, bacterial and parasitic agents. Relevant sociodemographic and clinical data were obtained from parents and caregivers. An enteric pathogen was detected in 66.6% of stool samples: Cryptosporidium spp. (30.0%), rotavirus (25.1%), Giardia lamblia (21.6%), diarrheagenic Escherichia coli (6.3%), Ascaris lumbricoides (4.1%), adenovirus (3.8%), Strongyloides stercoralis (3.5%), astrovirus (2.6%), Hymenolepis nana (1.7%), Entamoeba histolytica/dispar (0.9%), Taenia spp. (0.6%), Trichuris trichiura (0.3%) and Entamoeba histolytica (0.3%). Children younger than 12 months were more frequently infected with Cryptosporidium spp. compared with older children (age: 12-59 months), independently of sex, season, lethargy and wasting [odds ratio (OR): 3.5, 95% confidence interval (95% CI): 2.0-6.2]. Age (OR: 5.0, 95% CI: 2.6-9.3), vomiting (OR: 2.7, 95% CI: 1.5-4.8) and type of admission (inpatients, OR: 0.5, 95% CI: 0.3-0.9) were significantly associated with rotavirus infection. This study demonstrates high rates of infection with an enteric pathogen, particularly in children younger than 12 months, emphasizing the need to address diarrheal disease in this age group.

  11. Hospital

    African Journals Online (AJOL)

    Burkitt's lymphoma of the head and neck region in a Nigerian tertiary. Hospital ... Some complications of treatment were noted. Discussion: ..... Cancer. Biother Radiopharm 1999 14: 251-62 (Medline). Reece DE. Evidence based management of Hodgkin's disease. The role of autologous stem cell transplantation. Cancer ...

  12. A STUDY ON COMPLICATIONS OF THYROID SURGERY AT GOVERNMENT GENERAL HOSPITAL KAKINADA

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    Veerabhadra Rao Sirigineedi

    2017-05-01

    Full Text Available BACKGROUND Thyroid disorders are one of the most common causes of metabolic disturbances with surgery forming the main stay of treatment of thyroid swellings. Thyroid surgery in the hands of experienced surgeons is currently one of the safest procedures performed. While complications following thyroidectomy are rare, their consequences can often be debilitating and even life-threatening when they occur. This prospective study intends to assess the occurrence of various postoperative complications following different thyroidectomy procedures and the role of adequate preoperative patient preparation, careful and meticulous surgical technique and early recognition of postoperative complications with the prompt institution of treatment in reducing morbidity and providing the patient with the best chance of a satisfactory outcome. MATERIALS AND METHODS The present clinical study on complications of thyroid surgery has been made over a period of 24 months from August 2014 to August 2016 at Government General Hospital, Kakinada, utilising the cases admitted and treated in the Department of General Surgery. 441 cases were operated during this span of period (n=441, among them 55 complications were observed. RESULTS Thyroid surgeries constituted 8.3% of major surgical procedures carried out at our institution. Solitary thyroid nodule constituted most common thyroid disorder in this study forming 54% of cases followed by MNG (29%. Most of the cases were prevalent in the age group of third and fourth decade. The youngest patient of this series was 18 years and oldest was 65 years. Airway problems in postoperative period were found in 2.3% cases. Haematoma, recurrent laryngeal nerve injury and tracheal collapse secondary to the tracheomalacia were the contributory factors. In this study, 3 cases had permanent/bilateral RLN injury, tracheostomy was done. Postoperative hypocalcaemia constituted the most common complication in this study. Permanent

  13. (In-)formal caregivers' and general practitioners' views on hospitalizations of people with dementia - an exploratory qualitative interview study.

    Science.gov (United States)

    Pohontsch, Nadine Janis; Scherer, Martin; Eisele, Marion

    2017-08-04

    Dementia is an irreversible chronic disease with wide-ranging effects on patients', caregivers' and families' lives. Hospitalizations are significant events for people with dementia. They tend to have poorer outcomes compared to those without dementia. Most of the previous studies focused on diagnoses leading to hospitalizations using claims data. Further factors (e.g. context factors) for hospitalizations are not reproduced in this data. Therefore, we investigated the factors leading to hospitalization with an explorative, qualitative study design. We interviewed informal caregivers (N = 12), general practitioners (GPs, N = 12) and formal caregivers (N = 5) of 12 persons with dementia using a semi-structured interview guideline. The persons with dementia were sampled using criteria regarding their living situation (home care vs. nursing home care) and gender. The transcripts were analyzed using the method of structuring content analysis. Almost none of the hospitalizations, discussed with the (in-)formal caregivers and GPs, seemed to have been preventable or seemed unjustifiable from the interviewees' points of view. We identified several dementia-specific factors promoting hospitalizations (e.g. the neglect of constricted mobility, the declining ability to communicate about symptoms/accidents and the shift of responsibility from person with dementia to informal or formal caregivers) and context-specific factors promoting hospitalizations (e.g. qualification of nursing home personal, the non-availability of the GP and hospitalizations for examinations/treatments also available in ambulatory settings). Hospitalizations were always the result of the interrelation of two factors: illnesses/accidents and context factors. The impact of both seems to be stronger in presence of dementia. Points for action in terms of reducing hospitalization rates were: better qualified nurses, a 24-h-GP-emergency service and better compensation for ambulatory monitoring

  14. THE EFFECT OF STORYTELLING IN A PLAY THERAPY ON ANXIETY LEVEL IN PRE-SCHOOL CHILDREN DURING HOSPITALIZATION IN THE GENERAL HOSPITAL OF BUTON

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    Mimi Yati

    2017-09-01

    Full Text Available Background: Anxiety is one of the psychical stresses experienced by children during hospitalization. A storytelling in a play therapy is considered effective in reducing anxiety. Objective: This study aims to determine the effect of storytelling in a play therapy on anxiety level in pre-school children during hospitalization in the general hospital of Buton. Methods: This was a quasy-experimental study with pretest-posttest control group design. There were 30 pre-school children selected in this study using accidental sampling, with 15 assigned in each group. The Pre School - Spence Children’s Anxiety Scale (SCAS was used to measure anxiety in pre-school children. Wilcoxon matched paired test was used to analyze the data. Results: Findings showed that the mean of anxiety level in the intervention group in pretest was 42 and in posttest was 31.53. Wilcoxon matched paired test showed p-value 0.003 (<0.05, which indicated that there was a statistically significant effect of storytelling on the level of anxiety in pre-school children. Conclusions: There is a significant influence of storytelling in a play therapy on anxiety levels in pre school children during hospitalization. It is suggested that this intervention could be applied as a nursing intervention to reduce anxiety in children.

  15. Caring for people with dementia in general hospitals: an education curriculum from the Alzheimer's Society of Lower Saxony, Germany.

    Science.gov (United States)

    Gurlit, S; Thiesemann, R; Wolff, B; Brommer, J; Gogol, M

    2013-04-01

    Since 2006, the Alzheimer's Society of Lower Saxony, Germany, has been working to improve care and medical treatment for people with cognitive impairment or dementia in general hospitals. An interdisciplinary team systematically worked on the topic for several years and presented results at various symposia. In 2011, a two-stage curriculum was completed and sent in combination with additional training documents to all hospitals and nursing training colleges in Lower Saxony, Germany. The manual comprised a two-step approach with a 14-h training for hospital staff and a 160-h training for qualification of trainers and dementia appointees/chaperones. In addition, the manual included a list of 13 essential points for "dealing with demented people in a general hospital," the information sheet of the German Alzheimer's Society on aspects requiring special attention when a demented person is admitted to a hospital, short descriptions of best practice models, a list of established speakers in the field, and a 30-min film. In 2012, the project won the "Preis für Engagement und Selbsthilfe" of the Hertie Foundation and the "Niedersächsischen Gesundheitspreis" awarded by the Lower Saxon Ministry for Social, Women, Family, and Health Affairs.

  16. A família e a internação psiquiátrica em hospital geral La familia y la internación psiquiátrica en hospital general Patient's relatives and the psychiatric hospitalization in a general hospital

    Directory of Open Access Journals (Sweden)

    Rita Mello de Mello

    2011-06-01

    Full Text Available Estudo com abordagem qualitativa de natureza na sociologia fenomenológica, de Alfred Schutz, que teve como objetivo identificar os motivos para- relacionados à Internação Psiquiátrica em um Hospital Geral (UIPHG para os familiares. Para tanto, foram entrevistados 14 familiares que possuíam um de seus membros internados na UIPHP no período de agosto a outubro de 2009. Utilizou-se como questão orientadora da entrevista fenomenológica: "o que você espera da Internação Psiquiátrica em um Hospital Geral?". Para compreensão e interpretação dos depoimentos, utilizou-se o referencial teórico da sociologia fenomenológica. Os discursos revelaram três categorias concretas que remeteram aos motivos para: orientação e continuidade no tratamento; perspectivas de melhora e projeções sobre normalidade. Com essa investigação é possível mostrar o tipo vivido desses familiares e contribuir para que os profissionais de saúde mental reflitam sobre suas ações e sobre o envolvimento da família em uma unidade de internação psiquiátrica em hospital geral.Estudio cualitativo con enfoque en la sociología fenomenológica de Alfred Schutz tiene el objetivo de identificar los motivos relacionados a la internación psiquiátrica en un hospital general de los familiares. Para eso se entrevistaron 14 familiares que tenían uno de sus miembros internados en la unidad psiquiátrica de un hospital general entre Agosto y Octubre del 2009. Se utilizará como pregunta orientadora de la entrevista fenomenológica: "qué espera de la internación psiquiátrica en un hospital general?" Para el análisis de los testimonios se utilizó el referencial de la sociología fenomenológica, surgiendo tres categorías concretas que remitían a los motivos para: orientación y continuidad del tratamiento; perspectivas de mejoría; proyecciones sobre normalidad. Con esta investigación podemos indicar el tipo vivido de esos familiares, contribuyendo para que los

  17. A descriptive study of TB cases finding practices in the three largest public general hospitals in Vietnam

    Directory of Open Access Journals (Sweden)

    Nguyen Binh Hoa

    2012-09-01

    Full Text Available Abstract Background A project was implemented in 2010 to improve TB notification and TB screening and diagnostic routines in large general hospitals. The aims of present study was to assess baseline TB screening and diagnostic practices in the three largest general hospitals in Vietnam. Objectives To assess baseline TB screening and diagnostic practices in the three largest general hospitals in Vietnam. Method The study had three elements: 1 Focus group discussions with hospital physicians; 2 review of hospital records and structured interviews of people who had a chest X-ray on any indication; and 3 record reviews and structured interviews of people newly diagnosed with TB. Results The most commonly reported diagnostic pathway for pulmonary TB was chest X-ray followed by sputum-smear microscopy. Among 599 individuals who had a chest X-ray performed, 391 (65.1% had recorded any abnormality, significantly higher in males (73.8% than in females (54.7%, (p  Of 103 consecutive TB cases enrolled in the study, 92 (90% had chest X-ray as the initial test. Sixty-three (61.2% fulfilled the TB suspect criteria based on respiratory symptoms (productive cough >2 weeks. Conclusion Chest X-ray is the preferred first test for TB in the largest hospitals in Vietnam. Chest X-ray is a sensitive screening tool for TB, which should be followed by a confirmatory TB test. While the majority of those with chest X-ray abnormalities are investigated with smear-microscopy, the high sputum-smear positivity ratio among them suggests that sputum-smear microscopy is done mainly for persons with quite clear TB signs or symptoms. TB screening and use of confirmatory diagnostic tests on wider indications seem warranted.

  18. Implications of the Balanced Budget Act of 1997 for general hospital psychiatry inpatient units providing medical and psychiatric services.

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    Goldberg, R J; Kathol, R

    2000-01-01

    Since 1983, the Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982 has determined payment for services in most psychiatry units located in general hospitals. This system provided reimbursement on a cost-per-discharge basis. In 1997, a Balanced Budget Act (BBA) was passed by Congress which has replaced the TEFRA system of 1982 (H.R 2015). As a result of this law, many general hospital psychiatry units, particularly those that address the needs of elderly patients with high levels of medical comorbidity, will experience a reduction in their reimbursement when compared with the old TEFRA system. This reduction will average 7.8% and affect up to 84% of health care organizations. Those with higher TEFRA target amounts, such as is found with most general hospital programs, will have proportionately greater reductions. This article summarizes legislation affecting Medicare reimbursement and suggests a service reorganization approach that would allow billing to both medical and psychiatric payers. Finally, it encourages active participation in psychiatric access and quality standards development and with legislation, such as The Medicare Psychiatric Hospital Prospective Payment System Act of 1999.

  19. Diagnostic and therapeutic endoscopic retrograde cholangiopancreaticography after Billroth II gastrectomy--safe provision in a district general hospital.

    Science.gov (United States)

    Swarnkar, K; Stamatakis, J D; Young, W T

    2005-07-01

    Endoscopic retrograde cholangiopancreaticography (ERCP) is available in many district general hospitals in the UK. Most of the published literature on ERCP in cases with Billroth II gastrectomy reflects teaching hospital experience. The aim of this study was to evaluate this procedure in the district general hospital setting, over a 10-year period. Details of 41 consecutive patients, whom had previously undergone Billroth II gastrectomy and were referred for ERCP were analysed for presenting symptoms and outcome of their ERCP. All procedures were carried out by a single radiologist using a conventional Olympus side-viewing duodenoscope. 48 examinations and 44 therapeutic procedures were carried out in 41 cases. Afferent loop intubation and cannulation of ampulla was successful in 87.5% and 98%, respectively. Two episodes of minor bleeding occurred after sphincterotomy, not requiring blood transfusion. One case of afferent loop perforation (2%) was repaired surgically. There were no cases of pancreatitis or death in this series. The results show that ERCP after a Bilroth II gastrectomy can be safe and successful in the majority of cases when carried out by clinicians with a special interest, including those in a district general hospital However, experience with this procedure will diminish due to fewer indications for Billroth II gastrectomy and emergence of magnetic resonance cholangiopancreatography. It may be advisable to concentrate this technique in a few designated centres with skill and expertise.

  20. Effective and organ doses from common CT examinations in one general hospital in Tehran, Iran

    Science.gov (United States)

    Khoramian, Daryoush; Hashemi, Bijan

    2017-09-01

    Purpose: It is well known that the main portion of artificial sources of ionizing radiation to human results from X-ray imaging techniques. However, reports carried out in various countries have indicated that most of their cumulative doses from artificial sources are due to CT examinations. Hence assessing doses resulted from CT examinations is highly recommended by national and international radiation protection agencies. The aim of this research has been to estimate the effective and organ doses in an average human according to 103 and 60 ICRP tissue weighting factor for six common protocols of Multi-Detector CT (MDCT) machine in a comprehensive training general hospital in Tehran/Iran. Methods: To calculate the patients' effective dose, the CT-Expo2.2 software was used. Organs/tissues and effective doses were determined for about 20 patients (totally 122 patients) for every one of six typical CT protocols of the head, neck, chest, abdomen-pelvis, pelvis and spine exams. In addition, the CT dosimetry index (CTDI) was measured in the standard 16 and 32 cm phantoms by using a calibrated pencil ionization chamber for the six protocols and by taking the average value of CT scan parameters used in the hospital compared with the CTDI values displayed on the console device of the machine. Results: The values of the effective dose based on the ICRP 103 tissue weighting factor were: 0.6, 2.0, 3.2, 4.2, 2.8, and 3.9 mSv and based on the ICRP 60 tissue weighting factor were: 0.9, 1.4, 3, 7.9, 4.8 and 5.1 mSv for the head, neck, chest, abdomen-pelvis, pelvis, spine CT exams respectively. Relative differences between those values were -22, 21, 23, -6, -31 and 16 percent for the head, neck, chest, abdomen-pelvis, pelvis, spine CT exams, respectively. The average value of CTDIv calculated for each protocol was: 27.32 ± 0.9, 18.08 ± 2.0, 7.36 ± 2.6, 8.84 ± 1.7, 9.13 ± 1.5, 10.42 ± 0.8 mGy for the head, neck, chest, abdomen-pelvis and spine CT exams, respectively

  1. Obstetric regional analgesia in the Jesenice General hospital in year 2006

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    Aleksandra Kern

    2007-11-01

    Full Text Available Background: The aim of this retrospective analysis of the obstetric regional analgesia (ORA in Jesenice General Hospital in year 2006 was to evaluate our work and present results. We analysed workload, quality of the analgesia and patients’ satisfaction. We also estimated the OR for vacuum extraction (VE in nulliparous labouring women having ORA. We compared quality of analgesia and total local analgesic consumption in nulliparous women having VE or spontaneous delivery.Methods: We performed retrospective analysis of labours with ORA in year 2006. All women received epiduraly mixture of 0.1 % bupivacaine with 2 µg of fentanyl per ml in intermittent boluses.The labour pain was assessed using visual analogue scale (VAS. We used median and interquartile range to describe distribution of these values and mean with standard deviation to describe distribution of other data (local anaesthetic consumption. We considered patient with pain VAS 3 or less adequately treated, VAS 4 and 5 sufficiently and VAS 6 and more insufficiently treated. We used odds ratio as measurement of risk for VE, t-test for differences in local anaesthetic consumption and Mann-Whitney test to evaluate differences in pain between tested groups.Results: 225 labouring women opted for ORA or 38 % of all labouring women in year 2006. We performed 224 ORA, 59 % during regular work, 41 % during turn of duty. 18 % of ORA were performed between 10 p.m. and 7.00 a.m. In 98 % of cases epidural analgesia was used. Anaesthesiologic work took 16 minutes in average (SD 6.06. Analgesia was started at VAS median 5 (IQR 4–6.5 and at average cervical dilatation 4.1 cm (SD 1.4. Average consumption of bupivacaine was 55 mg (SD 23.7 and fentanyl 91.7 µg (SD 46.5. Most common complications were inadequate analgesia, and misplacement of epidural catheter (10/222, dural tap (6/222, and unilateral analgesia (2/222. 70 labours were ended with VE (13 %; n = 532. There were 27 (8.7 %; n = 309 VE in

  2. [Clinical and epidemiologic characteristics of dengue cases: the experience of a general hospital in Culiacan, Sinaloa, Mexico].

    Science.gov (United States)

    Ramírez-Zepeda, María Guadalupe; Velasco-Mondragón, Héctor Eduardo; Ramos, Celso; Peñuelas, Javier E; Maradiaga-Ceceña, Marco Antonio; Murillo-Llanes, Joel; Rivas-Llamas, Ramón; Chaín-Castro, Ricardo

    2009-01-01

    To document the clinical and epidemiological characteristics present in dengue patients served by a hospital in Culiacan, Sinaloa, Mexico. A cross-sectional, observational, and analytical study was carried out at the Hospital General Dr. Bernardo J. Gastélum de Culiacan from 1 October to 2 December 2003. Associations between the independent variables (the patients' clinical and epidemiological characteristics) and the dependent variable (confirmed hemorrhagic dengue) were determined through simple regression analysis. The variables that were significantly associated (P 100,000/mm(3) were confirmed in cases with acute clinical symptoms (capillary leak) that were not classified as hemorrhagic dengue due to falling short of the criteria established by WHO.

  3. Lower respiratory tract infection hospitalizations among American Indian/Alaska Native children and the general United States child population

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    Eric M. Foote

    2015-11-01

    Full Text Available Background: The lower respiratory tract infection (LRTI-associated hospitalization rate in American Indian and Alaska Native (AI/AN children aged <5 years declined during 1998–2008, yet remained 1.6 times higher than the general US child population in 2006–2008. Purpose: Describe the change in LRTI-associated hospitalization rates for AI/AN children and for the general US child population aged <5 years. Methods: A retrospective analysis of hospitalizations with discharge ICD-9-CM codes for LRTI for AI/AN children and for the general US child population <5 years during 2009–2011 was conducted using Indian Health Service direct and contract care inpatient data and the Nationwide Inpatient Sample, respectively. We calculated hospitalization rates and made comparisons to previously published 1998–1999 rates prior to pneumococcal conjugate vaccine introduction. Results: The average annual LRTI-associated hospitalization rate declined from 1998–1999 to 2009–2011 in AI/AN (35%, p<0.01 and the general US child population (19%, SE: 4.5%, p<0.01. The 2009–2011 AI/AN child average annual LRTI-associated hospitalization rate was 20.7 per 1,000, 1.5 times higher than the US child rate (13.7 95% CI: 12.6–14.8. The Alaska (38.9 and Southwest regions (27.3 had the highest rates. The disparity was greatest for infant (<1 year pneumonia-associated and 2009–2010 H1N1 influenza-associated hospitalizations. Conclusions: Although the LRTI-associated hospitalization rate declined, the 2009–2011 AI/AN child rate remained higher than the US child rate, especially in the Alaska and Southwest regions. The residual disparity is likely multi-factorial and partly related to household crowding, indoor smoke exposure, lack of piped water and poverty. Implementation of interventions proven to reduce LRTI is needed among AI/AN children.

  4. CASE REPORT OF PATIENTS WITH LEPTOSPIROSIS HOSPITALIZED IN THE DEPARTMENT OF INFECTIOUS DISEASES AT GENERAL HOSPITAL MURSKA SOBOTA IN THE YEAR 2002 – THE SIGNIFICANCE OF BLOOD CULTURE

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    Emil Pal

    2003-05-01

    Full Text Available Background. Leptospirosis is a zoonosis with worldwide distribution. In Slovenia, Pomurje is an endemic area. Manifestations of leptospirosis may be observed as different types of disease. The range from a short-lived febrile state to a severe disease with renal failure, liver impairment, hemorrhage and fulminant course.Patients and methods. Until year 2001 in the Department of infectious diseases at General Hospital Murska Sobota, only serological methods in diagnosis of leptospirosis had been used. Only in 2002 isolation of leptospires from blood was used. Four cases of confirmed leptospirosis hospitalized in our Department in 2002 were presented with broad spectrum of clinical courses and the significance of cultivation of leptospires from blood in the diagnosis.Conclusions. Because of the protean manifestations of leptospirosis, microbiological tests are essential for confirmatory diagnosis. In case of epidemiological data, clinical course and laboratory markers suggesting the diagnosis of leptospirosis, it is advisible to obtain blood cultures.

  5. How do Perceptions of Autonomy Differ in General Surgery Training Between Faculty, Senior Residents, Hospital Administrators, and the General Public? A Multi-Institutional Study.

    Science.gov (United States)

    Kempenich, Jason W; Willis, Ross E; Rakosi, Robert; Wiersch, John; Schenarts, Paul Joseph

    2015-01-01

    Identify barriers to resident autonomy in today's educational environment as perceived through 4 selected groups: senior surgical residents, teaching faculty, hospital administration, and the general public. Anonymous surveys were created and distributed to senior residents, faculty, and hospital administrators working within 3 residency programs. The opinions of a convenience sample of the general public were also assessed using a similar survey. Keesler Medical Center, Keesler AFB, MS; the University of Texas Health Science of San Antonio, TX; and the University of Nebraska Medical Center, Omaha, NE. A total of 169 responses were collected: 32 residents, 50 faculty, 20 administrators, and 67 general public. Faculty and residents agree that when attending staff grant more autonomy, residents' self-confidence and sense of ownership improve. Faculty felt that residents should have less autonomy than residents did (p autonomy at their institution, 47% of residents felt that they had too little autonomy and 38% of faculty agreed. No resident or faculty felt that residents had too much autonomy at their institution. The general public were more welcoming of resident participation than faculty (p = 0.002) and administrators (p = 0.02) predicted they would be. When the general public were asked regarding their opinions about resident participation with complex procedures, they were less welcoming than faculty, administrators, and residents thought (p autonomy as important for resident development. The general public are more receptive to resident participation than anticipated. However, with increasing procedural complexity and resident independence, they were less inclined to have residents involved. The general public also had more concerns regarding quality of care provided by residents than the other groups had. Published by Elsevier Inc.

  6. THE STUDY OF PREVALENCE AND CLINICAL PROFILE OF VALVULAR HEART DISEASES IN GOVERNMENT GENERAL HOSPITAL, KAKINADA

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    H. Vijay Kumar

    2017-03-01

    Full Text Available BACKGROUND Among the cardiovascular diseases acquired, valvular heart disease is one of the common causes of mortality and morbidity in India. An average of 40% of causes is rheumatic valvular heart diseases of all patients admitted with heart diseases. Male preponderance has been noted by most of the physicians in rheumatic heart disease in India. Acquired valvular heart diseases are mitral valve prolapse syndrome, papillary muscle dysfunction, the rupture of chordae tendineae, calcified mitral annulus, calcified aortic stenosis, aortic regurgitation due to syphilis, connective tissue disorders (Marfan’s syndrome, osteogenesis imperfect and systemic lupus erythematosus, atherosclerosis, hypertension and infective endocarditis. Other less common causes are recurrent pulmonary embolism, tuberculosis, cardiac tumours, carcinoid tumours, cardiac surgery for congenital cardiac anomalies and trauma. MATERIALS AND METHODS It is a prospective study on adult patients with valvular abnormalities attending to the Medicine and Cardiology Units of Government General Hospital, Kakinada, between November 2014-May 2017. Total 100 in-patients were included in this study as per inclusion and exclusion criteria. Inclusion Criteria- All patients aged 13 years and above are considered ‘adult’ and are managed by adult medicine. There is no upper age limit. Exclusion Criteria- Patients with congenital valvular heart diseases and cor pulmonale are excluded in the study. RESULTS The incidence of acquired valvular heart disease is higher in the age group of 31-40 years (32% followed by 21-30 years age group (28%. Our study also revealed relatively higher incidence of acquired valvular heart disease among the age groups of 51-60 years and above 60 years, which is due to a relatively higher incidence of mitral regurgitation due to ischaemic heart disease in this same age group. CONCLUSION Out of 100 cases studied mitral valve involvement was noted in 56 cases

  7. Vascular disease in women: comparison of diagnoses in hospital episode statistics and general practice records in England

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    Wright F

    2012-10-01

    Full Text Available Abstract Background Electronic linkage to routine administrative datasets, such as the Hospital Episode Statistics (HES in England, is increasingly used in medical research. Relatively little is known about the reliability of HES diagnostic information for epidemiological studies. In the United Kingdom (UK, general practitioners hold comprehensive records for individuals relating to their primary, secondary and tertiary care. For a random sample of participants in a large UK cohort, we compared vascular disease diagnoses in HES and general practice records to assess agreement between the two sources. Methods Million Women Study participants with a HES record of hospital admission with vascular disease (ischaemic heart disease [ICD-10 codes I20-I25], cerebrovascular disease [G45, I60-I69] or venous thromboembolism [I26, I80-I82] between April 1st 1997 and March 31st 2005 were identified. In each broad diagnostic group and in women with no such HES diagnoses, a random sample of about a thousand women was selected for study. We asked each woman’s general practitioner to provide information on her history of vascular disease and this information was compared with the HES diagnosis record. Results Over 90% of study forms sent to general practitioners were returned and 88% of these contained analysable data. For the vast majority of study participants for whom information was available, diagnostic information from general practice and HES records was consistent. Overall, for 93% of women with a HES diagnosis of vascular disease, general practice records agreed with the HES diagnosis; and for 97% of women with no HES diagnosis of vascular disease, the general practitioner had no record of a diagnosis of vascular disease. For severe vascular disease, including myocardial infarction (I21-22, stroke, both overall (I60-64 and by subtype, and pulmonary embolism (I26, HES records appeared to be both reliable and complete. Conclusion Hospital admission data

  8. Madres e hijas en los Bildungsromane femeninos de Carmen Boullosa: Mejor desaparece, Antes y Treinta años

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    Yolanda Melgar Pernías

    2014-06-01

    Abstract This essay explores the mother-daughter relationship in the female Bildungsromane Mejor desaparece (1987, Antes (1989 and Treinta años (1999, by Carmen Boullosa. Its study argues that the absence and emptiness in the maternal-filial bond portrayed by Boullosa in her texts constitute a key element of the negative development undergone by the protagonists. This article aims to contribute to a vision of these novels that highlights negativity and deprivation as having a central role in the writer’s radical questioning of patriarchal structures.

  9. Carmen Barrenechea, la conciencia feminista de una matrona del siglo XIX en “La ciudad de la muerte”

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    Dolores Ruiz-Berdún

    2015-03-01

    Full Text Available Many scholarly articles have been devoted to the study of the professional exclusion of European midwives at a time when male interest in obstetrics started to grow. There are, however, few references to the strategies adopted by midwives to defend the practice of their profession. In 1899, a midwife named Carmen Barrenechea published a request-like pamphlet, addressed to the major of the capital of Spain, in which she denounced the professional exclusion Spanish midwives were going through and vindicated the advantages of employing such professionals rather than surgeons.

  10. A strategy for enhancing financial performance: a study of general acute care hospitals in South Korea.

    Science.gov (United States)

    Choi, Mankyu; Lee, Keon-Hyung

    2008-01-01

    In this study, the determinants of hospital profitability were evaluated using a sample of 142 hospitals that had undergone hospital standardization inspections by the South Korea Hospital Association over the 4-year period from 1998 to 2001. The measures of profitability used as dependent variables in this study were pretax return on assets, after-tax return on assets, basic earning power, pretax operating margin, and after-tax operating margin. Among those determinants, it was found that ownership type, teaching status, inventory turnover, and the average charge per adjusted inpatient day positively and statistically significantly affected all 5 of these profitability measures. However, the labor expenses per adjusted inpatient day and administrative expenses per adjusted inpatient day negatively and statistically significantly affected all 5 profitability measures. The debt ratio negatively and statistically significantly affected all 5 profitability measures, with the exception of basic earning power. None of the market factors assessed were shown to significantly affect profitability. In conclusion, the results of this study suggest that the profitability of hospitals can be improved despite deteriorating external environmental conditions by facilitating the formation of sound financial structures with optimal capital supplies, optimizing the management of total assets with special emphasis placed on inventory management, and introducing efficient control of fixed costs including labor and administrative expenses.

  11. Promoting mobility and reducing length of stay in hospitalized general medicine patients: A quality-improvement project.

    Science.gov (United States)

    Hoyer, Erik H; Friedman, Michael; Lavezza, Annette; Wagner-Kosmakos, Kathleen; Lewis-Cherry, Robin; Skolnik, Judy L; Byers, Sherrie P; Atanelov, Levan; Colantuoni, Elizabeth; Brotman, Daniel J; Needham, Dale M

    2016-05-01

    To determine whether a multidisciplinary mobility promotion quality-improvement (QI) project would increase patient mobility and reduce hospital length of stay (LOS). Implemented using a structured QI model, the project took place between March 1, 2013 and March 1, 2014 on 2 general medicine units in a large academic medical center. There were 3352 patients admitted during the QI project period. The Johns Hopkins Highest Level of Mobility (JH-HLM) scale, an 8-point ordinal scale ranging from bed rest (score = 1) to ambulating ≥250 feet (score = 8), was used to quantify mobility. Changes in JH-HLM scores were compared for the first 4 months of the project (ramp-up phase) versus 4 months after project completion (post-QI phase) using generalized estimating equations. We compared the relative change in median LOS for the project months versus 12 months prior among the QI units, using multivariable linear regression analysis adjusting for 7 demographic and clinically relevant variables. Comparing the ramp-up versus post-QI phases, patients reaching JH-HLM's ambulation status increased from 43% to 70% (P mobility scores between admission and discharge increased from 32% to 45% (P 7 days), were associated with a significantly greater adjusted median reduction in LOS of 1.11 (95% CI: -1.53 to -0.65, P mobility was not associated with an increase in injurious falls compared to 12 months prior on the QI units (P = 0.73). Active prevention of a decline in physical function that commonly occurs during hospitalization may be achieved with a structured QI approach. In an adult medicine population, our QI project was associated with improved mobility, and this may have contributed to a reduction in LOS, particularly for more complex patients with longer expected hospital stay. Journal of Hospital Medicine 2016. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

  12. Incidence rates of in-hospital carpal tunnel syndrome in the general population and possible associations with marital status

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    Melani Carla

    2008-10-01

    Full Text Available Abstract Background Carpal tunnel syndrome (CTS is a socially relevant condition associated with biomechanical risk factors. We evaluated age-sex-specific incidence rates of in-hospital cases of CTS in central/northern Italy and explored relations with marital status. Methods Seven regions were considered (overall population, 14.9 million over 3–6-year periods between 1997 and 2002 (when out-of-hospital CTS surgery was extremely rare. Incidence rates of in-hospital cases of CTS were estimated based on 1 codified demographic, diagnostic and intervention data in obligatory discharge records from all Italian public/private hospitals, archived (according to residence on regional databases; 2 demographic general population data for each region. We compared (using the χscore test age-sex-specific rates between married, unmarried, divorced and widowed subsets of the general population. We calculated standardized incidence ratios (SIRs for married/unmarried men and women. Results Age-standardized incidence rates (per 100,000 person-years of in-hospital cases of CTS were 166 in women and 44 in men (106 overall. Married subjects of both sexes showed higher age-specific rates with respect to unmarried men/women. SIRs were calculated comparing married vs unmarried rates of both sexes: 1.59 (95% confidence interval [95% CI], 1.57–1.60 in women, and 1.42 (95% CI, 1.40–1.45 in men. As compared with married women/men, widows/widowers both showed 2–3-fold higher incidence peaks during the fourth decade of life (beyond 50 years of age, widowed subjects showed similar trends to unmarried counterparts. Conclusion This large population-based study illustrates distinct age-related trends in men and women, and also raises the question whether marital status could be associated with CTS in the general population.

  13. [Mortality associated with nosocomial infection, occurring in a general hospital of Sumaré-SP, Brazil].

    Science.gov (United States)

    Guimarães, Aline Caixeta; Donalisio, Maria Rita; Santiago, Thaiana Helena Roma; Freire, June Barreiros

    2011-01-01

    This study investigated the socio-demographic profile, clinical procedures and etiology of nosocomial infection associated with deaths in the Hospital Estadual Sumaré, state of São Paulo, Brazil, from 2007 to 2008. The retrospective study of medical records (n = 133) revealed an average of 35 days of hospitalization. Most patients (97%) underwent some invasive procedure associated with nosocomial infection (p ≤ 0.05), including: 90 (67.7%) pneumonia, 62 (46.6%), urinary infections and 97 (73%) septicemia. Infection was the leading cause of death in 75 (56.4%) cases, with defined etiology in 110 (82.7%); 34 (30.9%) because of microorganisms that were multidrug-resistant. The most common was Staphylococcus aureus (25%), related to pneumonia and blood stream infection. The monitoring of hospital infection contributed to intervention at risk situation and death.

  14. The CARMENES search for exoplanets around M dwarfs . First visual-channel radial-velocity measurements and orbital parameter updates of seven M-dwarf planetary systems

    Science.gov (United States)

    Trifonov, T.; Kürster, M.; Zechmeister, M.; Tal-Or, L.; Caballero, J. A.; Quirrenbach, A.; Amado, P. J.; Ribas, I.; Reiners, A.; Reffert, S.; Dreizler, S.; Hatzes, A. P.; Kaminski, A.; Launhardt, R.; Henning, Th.; Montes, D.; Béjar, V. J. S.; Mundt, R.; Pavlov, A.; Schmitt, J. H. M. M.; Seifert, W.; Morales, J. C.; Nowak, G.; Jeffers, S. V.; Rodríguez-López, C.; del Burgo, C.; Anglada-Escudé, G.; López-Santiago, J.; Mathar, R. J.; Ammler-von Eiff, M.; Guenther, E. W.; Barrado, D.; González Hernández, J. I.; Mancini, L.; Stürmer, J.; Abril, M.; Aceituno, J.; Alonso-Floriano, F. J.; Antona, R.; Anwand-Heerwart, H.; Arroyo-Torres, B.; Azzaro, M.; Baroch, D.; Bauer, F. F.; Becerril, S.; Benítez, D.; Berdiñas, Z. M.; Bergond, G.; Blümcke, M.; Brinkmöller, M.; Cano, J.; Cárdenas Vázquez, M. C.; Casal, E.; Cifuentes, C.; Claret, A.; Colomé, J.; Cortés-Contreras, M.; Czesla, S.; Díez-Alonso, E.; Feiz, C.; Fernández, M.; Ferro, I. M.; Fuhrmeister, B.; Galadí-Enríquez, D.; Garcia-Piquer, A.; García Vargas, M. L.; Gesa, L.; Gómez Galera, V.; González-Peinado, R.; Grözinger, U.; Grohnert, S.; Guàrdia, J.; Guijarro, A.; de Guindos, E.; Gutiérrez-Soto, J.; Hagen, H.-J.; Hauschildt, P. H.; Hedrosa, R. P.; Helmling, J.; Hermelo, I.; Hernández Arabí, R.; Hernández Castaño, L.; Hernández Hernando, F.; Herrero, E.; Huber, A.; Huke, P.; Johnson, E.; de Juan, E.; Kim, M.; Klein, R.; Klüter, J.; Klutsch, A.; Lafarga, M.; Lampón, M.; Lara, L. M.; Laun, W.; Lemke, U.; Lenzen, R.; López del Fresno, M.; López-González, M. J.; López-Puertas, M.; López Salas, J. F.; Luque, R.; Magán Madinabeitia, H.; Mall, U.; Mandel, H.; Marfil, E.; Marín Molina, J. A.; Maroto Fernández, D.; Martín, E. L.; Martín-Ruiz, S.; Marvin, C. J.; Mirabet, E.; Moya, A.; Moreno-Raya, M. E.; Nagel, E.; Naranjo, V.; Nortmann, L.; Ofir, A.; Oreiro, R.; Pallé, E.; Panduro, J.; Pascual, J.; Passegger, V. M.; Pedraz, S.; Pérez-Calpena, A.; Pérez Medialdea, D.; Perger, M.; Perryman, M. A. C.; Pluto, M.; Rabaza, O.; Ramón, A.; Rebolo, R.; Redondo, P.; Reinhardt, S.; Rhode, P.; Rix, H.-W.; Rodler, F.; Rodríguez, E.; Rodríguez Trinidad, A.; Rohloff, R.-R.; Rosich, A.; Sadegi, S.; Sánchez-Blanco, E.; Sánchez Carrasco, M. A.; Sánchez-López, A.; Sanz-Forcada, J.; Sarkis, P.; Sarmiento, L. F.; Schäfer, S.; Schiller, J.; Schöfer, P.; Schweitzer, A.; Solano, E.; Stahl, O.; Strachan, J. B. P.; Suárez, J. C.; Tabernero, H. M.; Tala, M.; Tulloch, S. M.; Veredas, G.; Vico Linares, J. I.; Vilardell, F.; Wagner, K.; Winkler, J.; Wolthoff, V.; Xu, W.; Yan, F.; Zapatero Osorio, M. R.

    2018-02-01

    Context. The main goal of the CARMENES survey is to find Earth-mass planets around nearby M-dwarf stars. Seven M dwarfs included in the CARMENES sample had been observed before with HIRES and HARPS and either were reported to have one short period planetary companion (GJ 15 A, GJ 176, GJ 436, GJ 536 and GJ 1148) or are multiple planetary systems (GJ 581 and GJ 876). Aims: We aim to report new precise optical radial velocity measurements for these planet hosts and test the overall capabilities of CARMENES. Methods: We combined our CARMENES precise Doppler measurements with those available from HIRES and HARPS and derived new orbital parameters for the systems. Bona-fide single planet systems were fitted with a Keplerian model. The multiple planet systems were analyzed using a self-consistent dynamical model and their best fit orbits were tested for long-term stability. Results: We confirm or provide supportive arguments for planets around all the investigated stars except for GJ 15 A, for which we find that the post-discovery HIRES data and our CARMENES data do not show a signal at 11.4 days. Although we cannot confirm the super-Earth planet GJ 15 Ab, we show evidence for a possible long-period (Pc = 7030-630+970 d) Saturn-mass (mcsini = 51.8M⊕) planet around GJ 15 A. In addition, based on our CARMENES and HIRES data we discover a second planet around GJ 1148, for which we estimate a period Pc = 532.6 days, eccentricity ec = 0.342 and minimum mass mcsini = 68.1M⊕. Conclusions: The CARMENES optical radial velocities have similar precision and overall scatter when compared to the Doppler measurements conducted with HARPS and HIRES. We conclude that CARMENES is an instrument that is up to the challenge of discovering rocky planets around low-mass stars. Based on observations collected at the European Organisation for Astronomical Research in the Southern Hemisphere under ESO programmes 072.C-0488, 072.C-0513, 074.C-0012, 074.C-0364, 075.D-0614, 076.C-0878, 077.C

  15. [HIV/AIDS patients in a Critical Care Unit: The experience of a general hospital in a developing country].

    Science.gov (United States)

    Verdugo, Fernando; Pinto, Francisco; Charpentier, Paulo; Von Mühlenbrock, Christian; Soto, Andrés; Dabanch, Jeannette; Fica, Alberto

    2015-06-01

    Despite general availability of HAART in Chile, admissions of HIV/AIDS patients to Intensive-Intermediate Care Units (IICU) are still happening, and a characterization of patient's profile, mortality and potentially avoidable admissions is necessary. Observational retrospective study in one general hospital in Chile of HIV/AIDS patients admitted to IICU during 9 years. During 2005-2013, 32 patients were admitted to IICU, with 87,5% in AIDS stage, only 53,1% knew his/her condition, 43,8% were receiving HAART and 16.6% chemoprophylaxis for opportunistic infections, A CD4 count Chile, hospitalizations of patients with HIV/AIDS are still happening, affecting those that either are unaware of his/her condition, are not receiving HAART and/or chemoprophylaxis. These admissions generate premature deaths and happen even after discharge in severely ill patients.

  16. Percutaneous endoscopic gastrostomy in a general hospital: prospective evaluation of indications, outcome, and randomised comparison of two tube designs.

    OpenAIRE

    Panos, M Z; Reilly, H; Moran, A; Reilly, T; Wallis, P J; Wears, R; Chesner, I M

    1994-01-01

    The indications for percutaneous endoscopic gastrostomy (PEG) and patient outcome, were examined prospectively in the setting of a general hospital. In the course of 26 months, 76 patients underwent PEG (median age 62 years (range 18-99)) and were followed up for 6887 patient days. The median (range) duration of PEG feeding was 93 (3-785) days. The procedure was carried out for neurological indications in 76% of cases (stroke 51%) and 53% of patients were severely malnourished (body mass inde...

  17. Total hip arthroplasty in Jesenice General hospital 1985–2006 – what has been done and look forward

    OpenAIRE

    Tomaž Silvester; Boris Rjazancev; Andrej Prlja; Peter Ješe

    2007-01-01

    Background: Total arthroplasty is one of the most interesting and fast developing fields in orthopaedic surgery. Practically every joint in the human body is involved, total hip arthroplasties (THA) being most frequent and with the longest history. Information on long-term results and survival of different types of prosthesis is invaluable for both patients and surgeons.Patients and methods: Between 1985 and 2006 there were 1563 THAs performed in Jesenice General Hospital. Average age at the ...

  18. Accuracy of Triple Diagnostic Test in Patients with Thyroid Nodule at Dr. Cipto Mangunkusumo General Hospital

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    Diani Kartini

    2017-04-01

    Full Text Available The aim of the study is to evaluate the accuracy of triple diagnostic test on thyroid nodules. The data from patients’ medical records who came to Cipto Mangunkusumo General Hospital for the first time or for evaluation of thyroid nodule and patients who underwent thyroidectomy during 2010 to 2011. Clinical examination was scored by McGill Thyroid Nodule Score. ROC procedure was performed to obtain clinical cut-off scores of diagnosis of malignant. Ultrasonography (USG result was considered malignant for TIRADS 4, 5, and 6. If clinical, USG and histopathology examinations of triple diagnostic give positive results, it will be classified as concordant malignant whereas if all those three show benign results, the classification is benign. Thyroid carcinoma was found in 134 out of 161 patients with thyroid nodule. There were 84 patients with concordant results for all three elements of the triple test. Out of 84 patients with concordant triple diagnostic results, there were 53 malignant cases (32.9% and 31 benign cases (19.3%. Main histopathological findings among patients with thyroid carcinoma was papillary (90.3%, follicular (3%, medullary (0.7%, and anaplastic (6%. The sensitivity and specificity of triple diagnostic was 77% and 94%, with positive predictive value of 98%, negative predictive value of 51,6% and accuracy of 80.9%. Combination of clinical findings, USG, and FNAB gave malignant probability of 92%, better than combination of clinical findings and USG (81.6% or clinical findings and FNAB (87%. Triple diagnostic cannot be used as an ideal test to replace frozen section examination in managing thyroid nodule. However, in cases with concordant results of each triple diagnostic’s element, the positive predictive value (98% and malignant probability (92% is high. Keywords: thyroid nodule, triple diagnostic, accuracy.   Akurasi Metode Triple Diagnostic pada Pasien Nodul Tiroid  di RSUPN Dr. Cipto Mangunkusumo   Abstrak Tujuan

  19. Clinical pharmacology and general patient care in two teaching hospitals1

    OpenAIRE

    Wood, Susan M; Turner, Paul; Vere, Duncan

    1980-01-01

    The clinical responsibilities and activities over 12-month periods of the Departments of Clinical Pharmacology of two London teaching hospitals have been analysed. The results suggest that clinical pharmacology should not be regarded only as an academic specialty but that it has an important role in patient care.

  20. Generalization of the Right Acute Stroke Prevention Strategies in Reducing in-Hospital Delays.

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    Qiang Huang

    Full Text Available The aim of this study was to reduce the door-to-needle (DTN time of intravenous thrombolysis (IVT in acute ischemic stroke (AIS through a comprehensive, hospital-based implementation strategy. The intervention involved a systemic literature review, identifying barriers to rapid IVT treatment at our hospital, setting target DTN time intervals, and building an evolving model for IVT candidate selection. The rate of non-in-hospital delay (DTN time ≤ 60 min was set as the primary endpoint. A total of 348 IVT cases were enrolled in the study (202 and 146 in the pre- and post-intervention group, respectively. The median age was 61 years in both groups; 25.2% and 26.7% of patients in the pre- and post-intervention groups, respectively, were female. The post-intervention group had higher rates of dyslipidemia and minor stroke [defined as National Institutes of Health Stroke Scale (NIHSS ≤ 3]; less frequent atrial fibrillation; higher numbers of current smokers, heavy drinkers, referrals, and multi-model head imaging cases; and lower NIHSS scores and blood sugar level (all P 0.05. These findings indicate that it is possible to achieve a DTN time ≤ 60 min for up to 60% of hospitals in the current Chinese system, and that this logistical change can yield a notable improvement in the outcome of IVT patients.

  1. Neutropenia relacionada con la quimioterapia en tumores sólidos. Hospital General Universitario Camilo Cienfuegos Enero 2009- 2013

    OpenAIRE

    Yania Luisa Jiménez Madrigal; Jorge Manuel Álvarez Blanco; María de los Ángeles Vázquez Rodríguez

    2015-01-01

    Se realizó un estudio descriptivo de corte transversal y retrospectivo referente al comportamiento de la neutropenia relacionada con la quimioterapia en tumores sólidos en el período comprendido Enero 2009- 2013 atendido en el servicio de oncología del Hospital General Universitario Camilo Cienfuegos de la provincia Sancti-Spíritus. La población la conformaron 230 enfermos neutropénicos relacionados con la quimioterapia. La investigación describe de forma general la relación existente entre l...

  2. Categorising Patients Mental Illness by Medical Surgical Nurses in the General Hospital Ward: A Focus Group Study.

    Science.gov (United States)

    Brunero, Scott; Buus, Niels; West, Sandra

    2017-12-01

    To gain insight into medical surgical nurses' process(es) of categorising mental illness in general hospitals. Categorising patients is a daily social practice that helps medical surgical nurses understand their work and actions. Medical surgical nurses' categorising of mentally ill patients in general hospitals is a means in which they articulate their understanding of mental illness and perform their clinical practice. How medical surgical nurses categorise, and the impact that categorising can have on their work practices is poorly understood. A focus group study. Focus group discussions (n=2) of medical surgical nurses' understanding and experience of delivering care to patients with mental illness in a general tertiary referral hospital were conducted in November 2014. Discourse analysis was used to analyse the transcribed data to uncover how participants made discursive evaluations and how this related to their daily clinical practice. The analysis uncovered participant's use of four categories of mentally ill patients: the managed, the unpredictable, the emotional and the dangerous. For participants these categories explained and justified their clinical practice as linked to the challenges and barriers they experienced in providing effective care within the larger healthcare organisation. The language used by medical/surgical reflects the wider discourse of managerialism in healthcare organisations. The recognition of these categories can be used by educators, liaison mental health services and policy makers to reconsider service design and learning opportunities for medical surgical nurses to reduce stigmatisation of patients with mental illness. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. The experiences of adults with intellectual disabilities and their carers in general hospitals: a focus group study.

    Science.gov (United States)

    Gibbs, S M; Brown, M J; Muir, W J

    2008-12-01

    People with intellectual disabilities (ID) have higher levels of health needs compared with the general population, many of which are unrecognised and unmet. While there has been interest and research into the primary health provision for this group, there has been a more limited focus on addressing their care received in general hospitals. Access to health care has predominated in the literature, with less attention being paid to the experiences of people with ID as users of general hospital care. A qualitative focus group methodology was used. Eleven adults with ID, nine parents and five paid carers of adults with ID participated. The focus groups were audiotaped and transcriptions were analysed using principles of grounded theory. The analysed data highlighted key themes identified from the experiences of participants. These were the interrelated issues of feelings, particularly anxiety and fear, communication and behaviour problems; the practicalities of being in or attending hospitals, including the role played by carers; and issues around perceived discrimination and negative comments. The experiences of participants in this study concur with and add to concern expressed in recent reports and published research. Wide ranging implications are discussed for further research, wider policy development, clinical practice, local health service provision and education of health professionals.

  4. [Carotid endarterectomy: review of 10 years of practice of general and locoregional anesthesia in a tertiary care hospital in Portugal].

    Science.gov (United States)

    Lobo, Mercês; Mourão, Joana; Afonso, Graça

    2015-01-01

    Retrospective and prospective randomized studies have compared general and locoregional anesthesia for carotid endarterectomy, but without definitive results. Evaluate the incidence of complications (medical, surgical, neurological, and hospital mortality) in a tertiary center in Portugal and review the literature. Retrospective analysis of patients undergoing endarterectomy between 2000 and 2011, using a software for hospital consultation. A total of 750 patients were identified, and locoregional anesthesia had to be converted to general anesthesia in 13 patients. Thus, a total of 737 patients were included in this analysis: 74% underwent locoregianal anesthesia and 26% underwent general anesthesia. There was no statistically significant difference between the two groups regarding perioperative variables. The use of shunt was more common in patients undergoing general anesthesia, a statistically significant difference. The difference between groups of strokes and mortality was not statistically significant. The average length of stay was shorter in patients undergoing locoregional anesthesia with a statistically significant difference. We found that our data are overlaid with the literature data. After reviewing the literature, we found that the number of studies comparing locoregional and general anesthesia and its impact on delirium, cognitive impairment, and decreased quality of life after surgery is still very small and can provide important data to compare the two techniques. Thus, some questions remain open, which indicates the need for randomized studies with larger number of patients and in new centers. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  5. Carotid endarterectomy: review of 10 years of practice of general and locoregional anesthesia in a tertiary care hospital in Portugal.

    Science.gov (United States)

    Lobo, Mercês; Mourão, Joana; Afonso, Graça

    2015-01-01

    Retrospective and prospective randomized studies have compared general and locoregional anesthesia for carotid endarterectomy, but without definitive results. Evaluate the incidence of complications (medical, surgical, neurological, and hospital mortality) in a tertiary center in Portugal and review the literature. Retrospective analysis of patients undergoing endarterectomy between 2000 and 2011, using a software for hospital consultation. A total of 750 patients were identified, and locoregional anesthesia had to be converted to general anesthesia in 13 patients. Thus, a total of 737 patients were included in this analysis: 74% underwent locoregional anesthesia and 26% underwent general anesthesia. There was no statistically significant difference between the two groups regarding per operative variables. The use of shunt was more common in patients undergoing general anesthesia, a statistically significant difference. The difference between groups of strokes and mortality was not statistically significant. The average length of stay was shorter in patients undergoing locoregional anesthesia with a statistically significant difference. We found that our data are overlaid with the literature data. After reviewing the literature, we found that the number of studies comparing locoregional and general anesthesia and its impact on delirium, cognitive impairment, and decreased quality of life after surgery is still very small and can provide important data to compare the two techniques. Thus, some questions remain open, which indicates the need for randomized studies with larger number of patients and in new centers. Copyright © 2014 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  6. Carotid endarterectomy: review of 10 years of practice of general and locoregional anesthesia in a tertiary care hospital in Portugal

    Directory of Open Access Journals (Sweden)

    Mercês Lobo

    2015-08-01

    Full Text Available BACKGROUND: Retrospective and prospective randomized studies have compared general and locoregional anesthesia for carotid endarterectomy, but without definitive results.OBJECTIVES: Evaluate the incidence of complications (medical, surgical, neurological, and hospital mortality in a tertiary center in Portugal and review the literature.METHODS: Retrospective analysis of patients undergoing endarterectomy between 2000 and 2011, using a software for hospital consultation.RESULTS: A total of 750 patients were identified, and locoregional anesthesia had to be converted to general anesthesia in 13 patients. Thus, a total of 737 patients were included in this analysis: 74% underwent locoregional anesthesia and 26% underwent general anesthesia. There was no statistically significant difference between the two groups regarding per operative variables. The use of shunt was more common in patients undergoing general anesthesia, a statistically significant difference. The difference between groups of strokes and mortality was not statistically significant. The average length of stay was shorter in patients undergoing locoregional anesthesia with a statistically significant difference.CONCLUSIONS: We found that our data are overlaid with the literature data. After reviewing the literature, we found that the number of studies comparing locoregional and general anesthesia and its impact on delirium, cognitive impairment, and decreased quality of life after surgery is still very small and can provide important data to compare the two techniques. Thus, some questions remain open, which indicates the need for randomized studies with larger number of patients and in new centers.

  7. A representação do sujeito feminino em Carmen, de Prosper Mérimée

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    Felipe dos Santos Matias

    2016-12-01

    Full Text Available O presente artigo realiza uma análise acerca da representação que o narrador-protagonista de Carmen (1845, Don José, faz da mulher amada, Carmen, com o intuito de desnudar a forma unilateral pela qual a constituição do sujeito feminino é desenvolvida na narrativa, procurando detectar também as práticas discursivas e socioculturais que o narrador veicula. Este conto, do escritor francês Prosper Mérimée, possibilita um estudo a respeito do estabelecimento de questionamentos relativos à sociedade patriarcal e às convenções que regem os padrões comportamentais ligados à mulher, visto que na linguagem de Don José estão implícitas práticas e valores da ordem social falocêntrica. Esta investigação é fundamentada pelas teorias dos estudos culturais e dos estudos de gênero, focalizando o discurso e as práticas socioculturais na abordagem teórica.

  8. A randomized controlled trial of hospital-based case management in cancer care: a general practitioner perspective.

    Science.gov (United States)

    Wulff, Christian N; Vedsted, Peter; Søndergaard, Jens

    2013-02-01

    Case management (CM) models based on experienced nurses are increasingly used to improve coordination and continuity of care for patients with complex health care needs. Anyway, little is known about the effects of hospital-based CM in cancer care. Aim. To analyse the effects of hospital-based CM on (i) GPs' evaluation of information from the hospital and collaboration with the hospital staff and (ii) patients' contacts with GPs during daytime and out of hours. A randomized controlled trial allocated 280 colorectal cancer patients 1:1 to either a control group or CM intervention. Patients were recruited at a Danish surgical department. An ad hoc piloted questionnaire was sent to all patients' GPs 30 weeks after patients' recruitment and the responses from the two groups of GPs were compared. Registry data on patients' contacts with general practice during daytime and out of hours were collected 9 months after recruitment and the data from the two groups were compared quarterly. CM was associated with an overall tendency towards more positive GP evaluations, which for 3 of 20 items reached statistical significance. Statistically significantly fewer GPs of CM patients reported contacting the hospital. CM did not affect the number of patient contacts with the GPs during the daytime, but CM patients showed a tendency towards more contacts to the out-of-hours GP services than non-CM patients. CM was appreciated by the GPs and reduced their need for subsequent hospital contact. CM increased the number of patient contacts to the out-of-hours GP services.

  9. Orthogeriatric activity in a general hospital of Castilla-La Mancha, Spain.

    Science.gov (United States)

    Fernández-Ibáñez, J M; Morales-Ballesteros, M C; Crespo-Romero, E; Gómez-Gómez, S; Fraga-Fuentes, M D; Cruz-Tejado, J; Hernández-Zegarra, P A; Arias-Arias, Á; García-Baltasar, M M

    To describe the orthogeriatric activity in the elderly with hip fractures in the Hospital Mancha Centro, based on the recommendations of the main guidelines. Observational prospective study, comprising all patients over 65 years of age admitted to the Traumatology Unit with a hip fracture between April 2015 and December 2015. Patients were admitted under the care of the Traumatology Unit with cross-consultation carried out with the Geriatrics Department, which then carried out a pre-operative geriatric assessment and the post-operative follow-ups. The mean pre-surgery waiting time was 48h and the overall time in hospital was 10.3±8.2 days. Patients who suffered from delirium (42.1%) did not improve as well, and were referred to nursing homes. Blood transfusions were received by 54.7% of the patients, despite 53.5% of them having received intravenous and/or oral iron after the surgery. Treatment with calcium and vitamin D was prescribed in 79% of the patients on discharge. The Rehabilitation Unit assessed 36% of the patients, with 4.8% fully, and 16.7% partially recovering their prior functional status. Upon discharge, 55% of the patients returned to their homes, and 22% were referred to short-term assisted living facilities. This article describes how the main clinical problems are handled in the elderly with hip fractures in our hospital, based on recommendations of the main guidelines and publications. Our hospital follows the recommended guidelines. Aspects for improvement include the management of anaemia during admission and rehabilitation. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Factors Affecting The Adoption Of Mhealth In Maternal Health Care In Nakuru Provincial General Hospital

    OpenAIRE

    Simon Munyua; Dr. Gladys Rotich; Dr. Michael Kimwele

    2015-01-01

    Abstract Access to timely and quality maternal health care remains to be a major development challenge in many developing economies particularly in Kenya. The countrys system of providing maternal health care also continue to be anchored on conventional methods of physical presence of the patient and the doctor in a hospital setup. The countrys ICT and health policies also place very little emphasis on the use of these platforms. This study therefore sought to establish the factors affecting...

  11. Antibiotic sensitivity pattern of bacteria from diabetic foot infections Haji Adam Malik central general hospital

    Science.gov (United States)

    Bulolo, B. A.; Pase, M. A.; Ginting, F.

    2018-03-01

    Increasing rate of Diabetic Foot Infections (DFIs) caused by multi-drug-resistance pathogens plays a huge role in the duration of hospitalization, morbidity, and mortality of diabetic patients. The aim of the study is to assess the antibiotic sensitivity pattern of bacteria in DFIs and causative microorganisms. Using cross-sectional retrospective study, data were collected from medical records of DFIs patients previously hospitalized atHaji Adam Malik Hospital, Medan from January to July 2017. 33 patients met the criteria and got enrolled in the study. The classification of DFIs was evaluated according to Wagner’s Classification. Evaluation of antibiotic sensitivity and identification of causative microorganisms were performed in standard microbiologic methods. The most common grade of DFIs was Grade-4 (48.5%), followed by Grade-3 (39.4%) and Grade-5 (9.1%). A total of 12 pathogens were identified. The most common infecting microorganism isolated on pus cultures was Klebsiella pneumonia (33.3%), followed by Escherichia coli (24.2%), Acinetobacter baumanni (12.1%), and Staphylococcus aureus (9.1%). Frequent susceptible antibiotics were Amikacin (88.8%), Imipenem (87%), Meropenem (84.6%), Erythromycin (75%), and Cefoperazone/Sulbactam (68.9%). DFIs are polymicrobial infections in this study K. pneumonia was the most common cause microorganism.

  12. Impact of cerebral cardiopulmonary resuscitation maneuvers in a general hospital: prognostic factors and outcomes

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    Bartholomay Eduardo

    2003-01-01

    Full Text Available OBJECTIVE: To assess survival of patients undergoing cerebral cardiopulmonary resuscitation maneuvers and to identify prognostic factors for short-term survival. METHODS: Prospective study with patients undergoing cardiopulmonary resuscitation maneuvers. RESULTS: The study included 150 patients. Spontaneous circulation was re-established in 88 (58% patients, and 42 (28% were discharged from the hospital. The necessary number of patients treated to save 1 life in 12 months was 3.4. The presence of ventricular fibrillation or tachycardia (VF/VT as the initial rhythm, shorter times of cardiopulmonary resuscitation maneuvers and cardiopulmonary arrest, and greater values of mean blood pressure (BP prior to cardiopulmonary arrest were independent variables for re-establishment of spontaneous circulation and hospital discharge. The odds ratios for hospital discharge were as follows: 6.1 (95% confidence interval [CI] = 2.7-13.6, when the initial rhythm was VF/VT; 9.4 (95% CI = 4.1-21.3, when the time of cerebral cardiopulmonary resuscitation was 70 mmHg. CONCLUSION: The presence of VF/VT as the initial rhythm, shorter times of cerebral cardiopulmonary resuscitation and of cardiopulmonary arrest, and a greater value of BP prior to cardiopulmonary arrest were independent variables of better prognosis.

  13. [Geriatric emergencies versus adult emergencies: retrospective analysis of medical emergencies at a general hospital].

    Science.gov (United States)

    Rodríguez Artalejo, F; González Montalvo, J I; Sanz Segovia, F; Jaramillo Gómez, E; Banegas Banegas, J R; Rodríguez Mañas, L; Carbonell Collar, A

    1989-10-14

    The aim of the study was to evaluate the process of the attention to emergencies in patients older than 65 years and to compare it with the same process in adult patients. To this end, 965 clinical records of medical emergencies from the Hospital Central de la Cruz Roja in Madrid were retrospectively evaluated, and data were obtained regarding age, the cause for consultation, the investigations performed and their yield, the administration of drug therapy, the major diagnosis at the time of discharge from the service and the clinical course. It was found that all evaluated diagnostic investigations were carried out with equal or higher frequency in patients older than 65 years and that their mean clinical effectiveness was also higher. In addition, it was found that the patients older than 65 years were more commonly admitted to the hospital through the emergency service than the rest of the population. It was concluded, therefore, that the process of attention to emergencies has differential characteristics in the elderly population, and that if the number and proportion of old people increase as it will presumably happen during the two next decades, the cost of attention to emergencies and the number of emergency hospital admissions will also increase.

  14. The treatment outcomes of tuberculosis among health care workers in a general hospital in the Mpumalanga province, South Africa

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    Idongesit S. Ukpe

    2009-04-01

    Full Text Available Background: South Africa is one of the countries in the world with a high burden of tuberculosis (TB. High rates of unfavourable treatment outcomes have remained a feature of TB control in the country. The objective of the current study was to examine the treatment outcomes of TB among health care workers (HCWs at a rural general hospital in the Mpumalanga province of the country, as well as the clinical care that was provided to the HCWs. The purpose of the study was to identify possible areas for improvement in the TB care services provided to HCWs in the hospital, especially with regard to their clinical management.Method: The research described in this article consists of a retrospective descriptive study. Relevant data on HCWs diagnosed with TB in the hospital during 2007, the TB care services offered to the HCWs, and the treatment outcomes of the HCWs were captured from the occupational health and TB control programme registers at the hospital onto a data capture sheet for the study and were subsequently analysed manually.Results: Nine HCWs, eight females and one male, were diagnosed and treated for TB in the hospital during 2007, an incidence rate of 941/100 000. Their ages ranged from 39 to 54 years, with a mean age of 48 years. By occupation, the nine HCWs consisted of six nurses (67%, one porter (11%, one general assistant (11%, and one clerk (11%. Of those treated for TB, seven (78% had smearpositive pulmonary TB (PTB and two (22% had extra-pulmonary TB (EPTB. TB culture and drug susceptibility testing (DST was undertaken for only one HCW. The HIV status was known for only two (22% of the nine HCWs under review. Neither of the two HCWs with EPTB had the diagnosis confirmed by bacteriological or histopathological method. The seven HCWs with smear- positive PTB achieved a cure, and the two HCWs with EPTB successfully completed treatment, resulting in a treatment success rate of 100% for the nine HCWs.Conclusion: The HCWs at Themba

  15. Admission of foreign citizens to the general teaching hospital of bologna, northeastern Italy: An epidemiological and clinical survey

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    Sergio Sabbatani

    Full Text Available BACKGROUND: The emergency regarding recent immigration waves into Italy makes continued healthcare monitoring of these populations necessary. METHODS: Through a survey of hospital admissions carried out during the last five years at the S. Orsola-Malpighi General Hospital of Bologna (Italy, all causes of admission of these subjects were evaluated, together with their correlates. Subsequently, we focused on admissions due to infectious diseases. All available data regarding foreign citizens admitted as inpatients or in Day-Hospital settings of our teaching hospital from January 1, 1999, to March 31, 2004, were assessed. Diagnosis-related group (DRG features, and single discharge diagnoses, were also evaluated, and a further assessment of infectious diseases was subsequently made. RESULTS: Within a comprehensive pool of 339,051 hospitalized patients, foreign citizen discharges numbered 7,312 (2.15%, including 2,542 males (34.8% and 4,769 females (65.2%. Males had a mean age of 36.8±14.7 years, while females were aged 30.8±12.2 years. In the assessment of the areas of origin, 34.6% of hospitalizations were attributed to patients coming from Eastern Europe, 15.3% from Northern Africa, 7.3% (comprehensively from Western Europe and United States, 6.9% from the Indian subcontinent, 5.9% from sub-Saharan Africa, 5.7% from Latin America, 4.1% from China, 2.5% from the Philippines, and 1.1% from the Middle East. Among women, most hospitalizations (58.8% were due to obstetrical-gynecological procedures or diseases, including assistance with delivery (27.1%, and pregnancy complications (18.7%, followed by psycho-social disturbances (5.9%, malignancies (5.1%, gastrointestinal diseases (4.7%, and voluntary pregnancy interruption (4.4%. Among men, the most frequent causes of admissions were related to trauma (15.9%, followed by gastroenteric disorders (12%, heart-vascular diseases (8.9%, psycho-social disorders (8.4%, respiratory (7.1%, kidney (6.1%, liver

  16. Risk factors associated with struvite urolithiasis in dogs evaluated at general care veterinary hospitals in the United States.

    Science.gov (United States)

    Okafor, Chika C; Pearl, David L; Lefebvre, Sandra L; Wang, Mansen; Yang, Mingyin; Blois, Shauna L; Lund, Elizabeth M; Dewey, Cate E

    2013-12-15

    To identify factors associated with development of struvite urolithiasis in dogs evaluated at general care veterinary hospitals in the United States. Retrospective case-control study. 508 dogs with a first-time diagnosis of struvite urolithiasis and 7,135 control dogs. Electronic medical records of all dogs evaluated at 787 general care veterinary hospitals in the United States between October 2007 and December 2010 were reviewed to identify dogs that developed struvite urolithiasis and 2 groups of control dogs with no history of urolithiasis. Information extracted included diet, age, sex, neuter status, breed size category, hospital location, and date of diagnosis. Urinalysis results, urolith composition, and other disease conditions were recorded if applicable. Potential risk factors were assessed with univariable and multivariable regression analysis. Toy- or small-sized breeds had significantly greater odds of struvite urolithiasis, compared with medium- or large-sized breeds. Neutering significantly increased the odds of this outcome in females only; sexually intact females were more likely to develop struvite urolithiasis than were sexually intact males, but only up to 5 years of age. Urinary factors significantly associated with the outcome were basic (vs acidic) pH, presence of RBCs or WBCs, protein concentration > 30 mg/dL, and ketone concentration ≥ 5 mg/dL. Evaluation of demographic characteristics and urinalysis results may be useful in the early identification of struvite urolithiasis in dogs. Periodic urinalysis in dogs is recommended because of the potential health impact of a late diagnosis of urolithiasis.

  17. Relationship between dental anxiety, general anxiety level and depression in patients attending a university hospital dental clinic in Turkey.

    Science.gov (United States)

    Pekkan, G; Kilicoglu, A; Hatipoglu, H

    2011-06-01

    To evaluate the relationship between dental anxiety, general anxiety and depression levels in patients attending a university hospital dental clinic in Turkey. A cross sectional study. 250 first visit patients seeking dental treatment. Modified Dental Anxiety Scale (MDAS), Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI) were used to assess the dental anxiety, general anxiety and depression level in these patients. The mean MDAS, BAI, and BDI scores were 10.5, 9.4, and 10.7, respectively. The prevalence of dental anxiety was found to be 20.8% (52/250) at the cut-off point > or = 15 and 6.8% (17/250) at the cut-off point > or = 19 according to MDAS score evaluation. MDAS and BAI scores were significantly higher in women (p or = 19 (p Dental anxiety was positively correlated with patients' general anxiety level and was higher in women and at younger age.

  18. Histerectomia Laparoscópica em um Hospital Geral Comunitário Experiência Inicial e Comparação de Custos Hospitalares Laparoscopic Hysterectomy in a Community General Hospital Initial Experience and Comparison of Hospital Costs

    Directory of Open Access Journals (Sweden)

    Randal Henrique de Oliveira

    2000-03-01

    Full Text Available Objetivo: comparar os custos hospitalares entre a histerectomia vaginal assistida por laparoscopia (HVAL e a histerectomia total abdominal (HTA, relatando a experiência inicial com a nova abordagem em um hospital geral comunitário. Pacientes e Métodos: foram comparados 11 casos de HVAL e 23 de HTA, realizados de setembro de 1998 a julho de 1999. Prontuários e demonstrativos das despesas hospitalares de cada paciente foram revistos para coletar as variáveis analisadas. Resultados: não houve diferença estat��stica entre os grupos quanto à idade, paridade e cirurgia abdominal prévia. A principal indicação cirúrgica para ambos os grupos foi leiomiomatose uterina. O grupo das HVAL apresentou tempo de internação menor, com mediana de 1 dia e o das HTA, de 2 dias (pPurpose: to compare hospital costs between laparoscopically assisted vaginal hysterectomy (LAVH and total abdominal hysterectomy (TAH, reporting the initial experience with the new approach in a communitary general hospital. Patients and Methods: eleven cases of LAVH and 23 of TAH, carried out from September 1998 to July 1999, were compared. Each patient's records and hospital charges were reviewed to collect the analyzed variables. Results: there was no statistical difference between the groups in relation to age, parity, and previous abdominal surgery. The main surgical indication for both groups was uterine leiomyomatosis. The LAVH group presented a shorter hospital stay with a median of one day, and the TAH group, of two days (p<0.01. LAVH showed to be 40.2% more expensive than TAH (p<0.01. Operating room charges contributed to the major part of hospital costs for both groups, corresponding to 79.8 and 57.9% of the total, for LAVH and TAH, respectively. LAVH infirmary charges were smaller than for TAH, with a statistically significant difference (p = 0.002. Conclusion: with shorter hospital stay and smaller infirmary costs, we demonstrated that LAVH provides better

  19. How did General Surgery Department of a Training Hospital Change in Ten Years?

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    Zafer Ergül

    2012-07-01

    Full Text Available  Aim: To investigate the changes in a training hospital’s surgical patient profile in ten years. To delineate the effects of the transfer of Social Security Institution Hospitals to the Ministry of Health on this process. Material and Method: Ten-year apart, two-year periods were selected and all elective and emergency cases were retrospectively searched. In between periods, the hospital was transferred from Social Security Institution Hospital to the Ministry of Health and then became a trauma center. The indications, techniques, the number of performed surgeries, and the patient related factors were compared. The ratio of the number emergency cases and the number of cases performed by residents in training to the total number of cases were investigated. Results: The number of elective and emergent operations during the former and the latter periods were 2668 and 2041, respectively. The percentage of the decrease was 23.5%. After ten years, the patients were younger, more commonly male, emergency cases were more common, and operations performed primarily by the residents in training were less frequent than the former period (p<0,05. Oncological surgery of stomach, colon-rectum, breast, thyroid and primary-metastatic-malign carcinoma were more frequent during former period whereas urgent operations except peptic ulcer perforation and upper gastrointestinal bleeding and benign anorectal diseases were more common during later period (p<0,05. Discussion: The comparison revealed a significant decrease in the number of operations in ten years. The number of oncological patients increased whereas the number of emergency cases declined. The changes were thought to be related more to the transition in health and becoming a trauma center than to major developments in the country and the world.

  20. [Craniocerebral trauma in acute surgical management. Primary care in a general community hospital].

    Science.gov (United States)

    Friedl, W; Karches, C

    1996-11-01

    Head traumas frequently occur in polytrauma patients but are also found as isolated injuries. In our hospital trauma center without a neurosurgical department, in a 21-month period, 489 patients with head/brain trauma were treated. This represents 6.5% of all patients treated in the trauma and reconstructive surgery clinic. In commotio cerebri (CC = 89.5% of the patients) constant conservative management and an uneventful course were observed; in 69 patients with contusio cerebri, 18 craniotomy operations had to be performed. In contrast, in only two cases was reoperation because of recurrent hematoma necessary. In four cases with complex and/or additional injuries, transfer to a neurosurgical center took place, and in two cases photophone consultation with that center was used. The mortality was 14.5%. The diagnostic and therapeutic regimens for the different types of injury and the requirements for the management of head/brain trauma in trauma centers without neurosurgical departments are presented: emergency service and medical staff, emergency room management, intensive care management, qualified neurological examination, X-ray imaging, including CT scan, OP-room equipment and trained surgeons. If these requirements are not available in a given hospital, early transfer of all patients for whom surgical management could be necessary to a neurosurgical department should be attempted. Only in patients with severe bleeding must immediate craniotomy be performed even in hospitals which do not have all the above mentioned facilities. In patients with intracerebral bleeding, bleeding in the dorsal fossa, injury of brain nerves, carotid artery or sinus cavernosus injuries, frontobasal injuries with liquor fistula or pneumonencephalon, transfer of the patients to specialized neurosurgical centers is indicated. With this selection, we obtained the same results in a trauma center without a neurosurgical department as reported in the literature. This avoids overloading

  1. Resenha do Livro: BARBOSA, Maria Carmen Silveira. Por amor e por força: rotinas na educação infantil. Porto Alegre: Artmed, 2006.

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    Thaís Regina de Carvalho

    2013-06-01

    Full Text Available http://dx.doi.org/10.5007/1980-4512.2013n28p185   Trata-se de uma resenha do livro: BARBOSA, Maria Carmen Silveira. Por amor e por força: rotinas na educação infantil. Porto Alegre: Artmed, 2006.

  2. El ancón: una identidad reterritoria en las fiestas de la virgen del carmen en la bahia de santa marta

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    Angela Bernal

    2014-02-01

    Full Text Available El objetivo de este ensayo es dar cuenta de los procesos y las dinamicas de unas gentes que representan y retrerorizan su identidad a traves de la  celebracion las fiestas de la virgen del carmen del Ancón.

  3. Developing a General Decision Tool for Future Cancer Care: Getting Feedback from Users in Busy Hospital Environments

    DEFF Research Database (Denmark)

    Dankl, Kathrina; Akoglu, Canan; Dahl Steffensen, Karina

    2017-01-01

    Background and Aims: During the last decade more and more design researchers and practitioners have been collaborating with clinicians, patients and relatives in order to improve healthcare systems. Shared decision making has thereby been one field, attracting increased attention. Hospitals pose...... Hospital in Vejle and Design School Kolding in Denmark with the main objective of creating a general decision aid for future cancer care. The aims of the collaborative design development are twofold: to enhance clarity and understanding of the decision aid via communication design and to decrease barriers...... for successful implementation via extensive involvement of patients, relatives and clinicians in the design process. The present abstract puts forward a participatory method of getting feedback from different stakeholder groups on the illustration design of the decision aid. Methods: The decision aid...

  4. [The Asahi Model-Regional Mental Health Services at Department of Psychiatry and Child Psychiatry, Asahi General Hospital].

    Science.gov (United States)

    Aoki, Tsutomu

    2015-01-01

    The Asahi model, Psychiatric Services of Department of Psychiatry and Child Psychiatry, Asahi General Hospital, is characterized by multiple dimensions of mental health services, such as multidisciplinary team approach, medical cooperation, specialized psychiatric treatment of acute care, clozapine and modified ECT, outreach services of home nursing and assertive community treatment, and the close and mutual coordination with housing services and social welfare services. The Asahi Model makes it possible to be deinstitutionalized, to improve patients satisfaction, to shorten hospitalization, to decrease psychiatric emergency visits and to be of service in a natural disaster. It also might prevent the relapse of schizophrenics within twelve months after discharge and improve the quality of mental health staffs trainings to support patients better. In the future, we will need to work on providing sectorized care, early psychosis intervention programs, to construct networking systems of clozapine and modified ECT, to strengthen growth of home nursing, and to take place mental health anti-stigma campaigns.

  5. Occult cancer in patients with deep-vein thrombosis in a general hospital at Mexico City: A pilot study

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    Christian O Ramirez-Serrano Torres

    2017-01-01

    Full Text Available Background: We aimed to explore the frequency of occult cancer in patients with deep-vein thrombosis (DVT at a general hospital in Mexico City. Materials and Methods: From March 2012 to February 2015, all patients with primary DVT of lower extremities attended in the emergency department of our hospital were studied. Initially, all patients were evaluated with clinical history, physical examination, basic laboratories, abdominal ultrasound, chest X-ray, and duplex venous ultrasonography. In a case-by-case approach, if necessary, computed tomography, endoscopy, colonoscopy, and tumor markers were done. Results: From 182 patients with primary DVT, 30 (16.5% presented occult cancer: Thirteen males and 17 females, with an average age of 61 years. In males, prostate cancer prevailed (6/13, 46%; meanwhile, in females, pelvic gynecologic cancers predominated (7/17, 41%. Conclusion: Our results suggest that in Mexican patients with primary DVT, occult cancer is frequent.

  6. Occult cancer in patients with deep-vein thrombosis in a general hospital at Mexico City: A pilot study.

    Science.gov (United States)

    Ramírez-Serrano Torres, Christian O; Román-Guzmán, Edgardo; Ortiz-Mendoza, Carlos-Manuel

    2017-01-01

    We aimed to explore the frequency of occult cancer in patients with deep-vein thrombosis (DVT) at a general hospital in Mexico City. From March 2012 to February 2015, all patients with primary DVT of lower extremities attended in the emergency department of our hospital were studied. Initially, all patients were evaluated with clinical history, physical examination, basic laboratories, abdominal ultrasound, chest X-ray, and duplex venous ultrasonography. In a case-by-case approach, if necessary, computed tomography, endoscopy, colonoscopy, and tumor markers were done. From 182 patients with primary DVT, 30 (16.5%) presented occult cancer: Thirteen males and 17 females, with an average age of 61 years. In males, prostate cancer prevailed (6/13, 46%); meanwhile, in females, pelvic gynecologic cancers predominated (7/17, 41%). Our results suggest that in Mexican patients with primary DVT, occult cancer is frequent.

  7. General Practitioners' and Hospital Physicians' Preference for Morphine or Oxycodone as First-Time Choice for a Strong Opioid

    DEFF Research Database (Denmark)

    Poulsen, Karen K; Andersen, Stig E; Moreno, Søren I

    2013-01-01

    opioid naive. The odds ratio (OR) was calculated to investigate whether general practitioners (GPs) and hospital physicians had similar preferences for oxycodone over morphine for strong opioid-naive patients. We included 69,110 first-time prescriptions, of which 59,316 (86%) were for strong opioid......-naive patients. Opioid-naive patients received 79% of the first-time prescriptions for morphine and 91% of the prescriptions for oxycodone. Hospital physicians had a greater preference for oxycodone over morphine than GPs (OR 1.34, 95% CI 1.29-1.39). However, GPs were responsible for approximately 61% of all...... were analysed. If a patient had not had a prescription filled for the same drug within the last 2 years, the prescription was defined as a first-time prescription. Patients who had not received a prescription for strong opioids for 6 months prior to the date of redemption were classified as strong...

  8. Serial Palliative Performance Scale Assessment in a University General Hospital: A Pilot Study.

    Science.gov (United States)

    de Medeiros, Rafael Barone; Stamm, Ana Maria Nunes de Faria; Moritz, Rachel Duarte; Freitas, Paulo Fontoura; Kretzer, Lara Patrícia; Gomes, Juliana Vieira

    2018-01-19

    Serial Palliative Performance Scale (PPS) assessments may predict functional decline and prognosis in cancer and noncancer patients and help with end-of-life decision making. To evaluate the functional status of using serial PPS assessments of patients being assisted in collaboration with the palliative care team (PCT). Prospective cohort pilot study. The sample consisted of 64 cancer and noncancer inpatients being assisted in collaboration with the PCT during the period from 2012 to 2016 (included 12 months). Patients' PPS scores were assessed in three sequential stages: prehospital, first PCT assessment, and outcome (discharge, transference to another unit or death). Functional performance was classified in categories as stable (PPS scores between 70% and 100%), transitional (PPS scores between 40% and 60%), and end of life (PPS scores between 10% and 30%). The mean PPS score during the three assessment stages (respectively, 60.5%, 38.9%, and 25.9%) was significantly different (p PPS scores than noncancer patients; however, both groups exhibited a functional decline along the hospital stay. In both groups there was a negative correlation between the time frame between the different assessment stages and PPS scores (respectively, Pearson -0.4 and -0.6; p PPS assessments are feasible and predicted functional decline in cancer and noncancer patients in this sample. Cancer patients exhibited higher initial functional scores but both cancer and noncancer patients declined in functionality along hospitalization. Earlier deaths occurred in the terminal PPS category than in the transitional PPS category.

  9. Laparoscopic management of pancreatic pseudocysts: experience at a general hospital in Mexico City.

    Science.gov (United States)

    Crisanto-Campos, B A; Arce-Liévano, E; Cárdenas-Lailson, L E; Romero-Loera, L S; Rojano-Rodríguez, M E; Gallardo-Ramírez, M A; Cabral-Oliver, J; Moreno-Portillo, M

    2015-01-01

    Invasive management of pancreatic pseudocysts (PP) is currently indicated in those patients with symptoms or complications. Treatment options are classified as surgical (open and laparoscopic) and non-surgical (endoscopic and radiologic). To describe the morbidity, mortality, and efficacy in terms of technical and clinical success of the laparoscopic surgical approach in the treatment of patients with PP in the last 3 years at our hospital center. We included patients with PP treated with laparoscopic surgery within the time frame of January 2012 and December 2014. The morbidity and mortality associated with the procedure were determined, together with the postoperative results in terms of effectiveness and recurrence. A total of 38 patients were diagnosed with PP within the last 3 years, but only 20 of them had invasive treatment. Laparoscopic surgery was performed on 17 of those patients (mean pseudocyst diameter of 15.3, primary drainage success rate of 94.1%, complication rate of 5.9%, and a 40-month follow-up). The results obtained with the laparoscopic technique used at our hospital center showed that this approach is feasible, efficacious, and safe. Thus, performed by skilled surgeons, it should be considered a treatment option for patients with PP. Copyright © 2015 Asociación Mexicana de Gastroenterología. Published by Masson Doyma México S.A. All rights reserved.

  10. Organizational culture in general hospitals and its relationship with job satisfaction

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    Katja Skinder Savić

    2014-06-01

    Full Text Available Introduction: Organizational culture is formed via communication, resolving conflicts, team work and interconnection. The aim of the study was to present the connections between organizational culture and job satisfaction indicators. Methods: A quantitative descriptive approach was used. The study included nursing employees and medical practitioners in six Slovenian hospitals. A 30 per cent quota sample was used, with a response rate of 35.2 % (n = 310. The Organization Culture Assessment Instrument (OCAI (α = 0,818 and Index of Work Satisfaction (α = 0,921 questionnaires were used. The data was processed with SPSS 20.0 statistical software by using the t-test, single variance analysis, correlation, factor and regression analysis. Results: The greatest total average value among employees of both job groups with regard to organizational culture was the market (x = 28.21 and hierarchy (x = 27.57. Job satisfaction indicators (collaboration, leadership, decision-making, autonomy can be explained in 20 % of cases with adhocracy organizational culture (β = 0.318, p < 0.001, market (β = 0.219, p < 0.001 and clan (β = 0.161, p = 0.006. Discussion and conclusion: In Slovenian hospitals, control over work, abiding by the rules and attaining, goals prevails. An overview of the literature reveals the influence of culture on satisfaction. Other factors affecting satisfaction, including stress and abuse of hierarchical power, should be studied.

  11. Pediatric dental care in a tertiary public hospital. Four years of experience in the Service of Stomatology of Valencia University General Hospital (Valencia, Spain).

    Science.gov (United States)

    Poveda, Rafael; Jiménez, Yolanda; Gavaldá, Carmen; Sanchís, José María; Carbonell, Enrique; Margaix, María; Sarrión, Gracia

    2008-05-01

    A study is made of the experience gained with the Child Oral Care Program (Plan de Atención Dental Infantil, PADI) in the Service of Stomatology of Valencia University General Hospital (Valencia, Spain) after four years in operation (July 2003 - July 2007). The sample comprised 2626 children between 5-14 years of age, pertaining to department 9 of the Valencian public health system. A clinical history was compiled in each case, a radiological study was made, and a treatment plan was elaborated including fillings, extractions, and control visits. Of the 2626 designated children, 2369 visited our Service - mostly referred from the Preventive Dental Care Units. A total of 5784 fillings were carried out (93.3% with silver amalgam, 5.6% with composites and the rest as provisional fillings). The permanent first molars were the teeth with the largest number of fillings (70.2% of the total). These were followed in order of frequency by the second molars (19.1%). As regards composite resin fillings, most involved the upper central incisors, followed by the upper lateral incisors. A total of 644 extractions were performed, corresponding to 110 permanent teeth and 534 temporary teeth. In the case of the permanent dentition, the first molars were the most commonly removed teeth. In the temporary dentition, the most frequently removed teeth were the second molars. The response of the population to this program has been very good, and reinforces the preventive measures already in place, with the provision of restorative treatments to improve the oral and dental health of the pediatric population, and yielding good results in terms of the program quality indicators. The Service of Stomatology (Valencia University General Hospital) is able to address the demand and offers the public health network integrated and continuous patient care.

  12. The financial impact of a nurse-led telemedicine service for inflammatory bowel disease in a large district general hospital.

    Science.gov (United States)

    Squires, Seth Ian; Boal, Allan John; Naismith, Graham Douglas

    2016-07-01

    It has become increasingly recognised that outpatient management is more cost-effective in inflammatory bowel disease (IBD). IBD Standards (Revised 2013) recommend telephone advice for patients with regard to symptoms and medication management. This report attempts to quantify the net financial impact of this service at our hospital since it was introduced in August 2013. The Royal Alexandra Hospital in Paisley (National Health Service, Greater Glasgow and Clyde) is a district general hospital with a catchment population of 200 000 with approximately 2500 patients with IBD. Data relating to the use of the IBD telemedicine service were prospectively recorded on a daily basis for a period of 5 months. We documented reasons for calling and the likely action taken by the patient had the telephone advice line not been available. Cost savings based on alternative outcomes were made in accordance with the Department of Health figures (Department of Health reference costs 2011-2012). The mean number of calls per month was 88 (IQR 24)-(the mean number of calls which were deemed non-IBD issues was 30 calls per month (IQR 8.0)) The mean cost of staffing the IBD advice line with an IBD clinical nurse specialist was £482.00 per month (IQR 195.5). The mean time spent on calls per month was 28.5 h (IQR 11.5). Cost savings over 5 months for avoidance of general practitioner (GP) consultation was £3408.00. Savings for avoidance of a consultant appointment made over the 5-month period was £27 454.00. Savings made from patients avoiding either an accident and emergency (A&E) or a hospital admission were £540.00 and £11 488.00, respectively, over the 5-month period. The net saving was £42 890.00. A nurse-led telephone advice line appears to be a cost-effective intervention. It may prevent patients from unnecessary hospital attendance. Savings can be made to both primary care and secondary care. Overall, it appears that the advice line is providing a highly valuable

  13. The correlation of pain intensity and quality of life in chronic LBP patients in Adam Malik general hospital

    Science.gov (United States)

    Nasution, I. K.; Lubis, N. D. A.; Amelia, S.; Hocin, K.

    2018-03-01

    Low back pain (LBP) is a world health problems and a major cause of disability. The study is to determine the correlation between pain intensity and quality of life (QoL) in patients with chronic LBP. This study was a descriptive, analytical research with the cross sectional design. Twenty-nine chronic LBP outpatients that have visited the Neurology Clinic of Adam Malik General Hospital Medan. Patients from July to November 2015 were selected by consecutive sampling. A questionnaire and interview are asking the information about subjects’ characteristics, diagnosis, medical history, pain intensity and quality of life-based on WHO QoL criteria were used to collect the data. Using Spearman correlation test, we found correlation among VAS and physical function (p<0.001, r=-0.606), limitations due to physical problems (p<0.001, r=-0.837), limitations due to emotional problems (p=0.007, r=-0,477), vitality (p=0.021, r=-0.380), social function (p=0.015, r=-0.403), the feeling of pain (p=0.003, r=-0.499) and general health (p=0.040, r=-0.330). On the other hand, there was no correlation between VAS and mental health (p=0.110, r=-0.235). We concluded that pain intensity in outpatients with chronic LBP in the Neurology Clinic at Adam Malik General Hospital Medan correlates with the patients’ quality of life.

  14. Embedding integrated mental health assessment and management in general hospital settings: feasibility, acceptability and the prevalence of common mental disorder.

    Science.gov (United States)

    Rayner, L; Matcham, F; Hutton, J; Stringer, C; Dobson, J; Steer, S; Hotopf, M

    2014-01-01

    To assess the feasibility and acceptability of routine web-based screening in general hospital settings, and describe the level of common mental disorder. A service development platform to integrate mental and physical healthcare was implemented in six specialties (rheumatology, limb reconstruction, hepatitis C, psoriasis, adult congenital heart disease (ACHD), chronic pain) across three general hospitals in London, UK. Under service conditions, patients completed a web-based questionnaire comprising mental and physical patient-reported outcome measures, whilst waiting for their appointment. Feasibility was quantified as the proportion of patients who completed the questionnaire. Acceptability was quantified as the proportion of patients declining screening, and the proportion requiring assistance completing the questionnaire. The prevalence of probable depression and anxiety was expressed as the percentage of cases determined by the Patient Health Questionnaire-9 and Generalised Anxiety Disorder Questionnaire-7. The proportion of patients screened varied widely across specialties (40.1-98.2%). The decline rate was low (0.6-9.7%) and the minority required assistance (11.7-40.4%). The prevalence of probable depression ranged from 60.9% in chronic pain to 6.6% in ACHD. The prevalence of probable anxiety ranged from 25.1% in rheumatology to 11.4% in ACHD. Web-based screening is acceptable to patients and can be effectively embedded in routine practice. General hospital patients are at increased risk of common mental disorder, and routine screening may help identify need, inform care and monitor outcomes. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  15. CRYPTOCOCCAL ANTIGENEMIA IN HIV/AIDS PATIENTS USING LATERAL FLOW IMMUNOASSAY DETECTION AT Dr. SOETOMO GENERAL HOSPITAL SURABAYA

    Directory of Open Access Journals (Sweden)

    sajuni Widjaja

    2018-04-01

    Full Text Available Cryptococcus infection in HIV / AIDS patients results in cryptococcal meningitis, a major cause of subacute meningitis with 100% mortality if not receiving appropriate antifungal therapy. An examination of cryptococcal antigen will provide risk information for patients who will experience cryptococcal meningitis. Better diagnosis in asymptomatic and symptomatic phases of cryptococcosis are key components to reduce morbidity and mortality. This study aims to determine the proportion of cryptococcal antigenemia in HIV / AIDS patients treated at Intermediate Treatment-Infectious Diseases Unit of Dr. Soetomo General Hospital Surabaya. Cryptococcal antigenemia was examined in HIV / AIDS patients with suspected Cryptococcus infection and CD4+ T cell lymphocyte count <200 cell /μl. The examination used a lateral flow assay diagnostic tool, a simple FDA(Food and Drug Administration-approved immunochromatographic test system for detection of capsular polysccharide antigens of Cryptococcus species complex (Cryptococcus neoformans and Cryptococcus gattii in blood. This test meets all of the World Health Organization ASSURED criteria (affordable, sensitive, specific, user friendly, rapid/robust, equipment-free, and delivered. Sensitivity and specifiticy of this method from serum are both 100%. There were 3 positive cryptococcal antigenemia from 41 serum HIV / AIDS patients with suspected cryptococcus infection at Intermediate Treatment- Infectious Diseases Unit of Dr. Soetomo General Hospital Surabaya. All of these patients were male aged over 36 years, had CD4+ T cell lymphocytes <100 cell /μl and had never received antiretroviral therapy before. The proportion of cryptococcal antigenemia in HIV / AIDS patients with suspected Cryptococcus infection at Intermediate Treatment-Infectious Diseases Unit of Dr. Soetomo General Hospital Surabaya was 7.32%.

  16. Total hip arthroplasty in Jesenice General hospital 1985–2006 – what has been done and look forward

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    Tomaž Silvester

    2007-11-01

    Full Text Available Background: Total arthroplasty is one of the most interesting and fast developing fields in orthopaedic surgery. Practically every joint in the human body is involved, total hip arthroplasties (THA being most frequent and with the longest history. Information on long-term results and survival of different types of prosthesis is invaluable for both patients and surgeons.Patients and methods: Between 1985 and 2006 there were 1563 THAs performed in Jesenice General Hospital. Average age at the time of operation was 67 years, almost two thirds of patients were women. The reason for operation was in 72 % idiopathic arthrosis and in 14 % sequaele of dysplasia.Results: There were 1370 primary procedures and 193 revisions (12.6 %. Aseptic loosening of the implant was the most frequent reason for revision (74 % and infection was observed in 1.5 %. In the first ten years of this research hybrid type of prosthesis was most frequently used, but nowadays, non-cemented prosthesis is used in majority of cases.Conclusions: Total hip arthroplasty is well established procedure at the Jesenice General Hospital. It considerably improves quality of life of the patient, for both, short- and long term, results are very good. New minimal invasive surgical techniques make postoperative rehabilitation faster and easier. The Register of prosthesis enables us to regularly analyze the results and provides treatment outcome information concerning the choice of prosthesis and the optimal surgical technique. Jesenice General Hospital is well recognized as one of the centers for arthroplasties in our country.

  17. SPECTRUM OF ACUTE GLOMERULO NEPHRITIS IN CHILDREN AT GOVERNMENT GENERAL HOSPITAL, ANANTAPURAMU

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    Ravi Kumar

    2015-04-01

    Full Text Available AIM: Aim of the study is to study the spectrum of AGN in children and to assess the age, sex and seasonal incidence and prognostic factors. Acute glomerulonephritis is one of the most common condition seen in children. The study group included 50 children. In most of the children presenting complaints s of are puffiness of face, haematuria and oliguria. METHODS AND MATERIALS: Fifty children who were admitted in the government hospital during the period of September 2013 to January 2015 were included in the stud y. RESULTS: The maximum admissions were seen from the months of September to December. Common age group was between 3 and 8 years. Rare age group was below 2 years. Hypertension was noticed in 32 out of 50 children. Albuminuria and hematuria were commonest urinary abnormalities. CONCLUSION: acute glomerulonephritis is less common below 2 years. Hypertension was of varying degree. Cardiomegaly by x - ray was an added feature.

  18. Uso de concentrado de hematíes en el Hospital General Universitario de Castellón

    OpenAIRE

    Pérez Bastida, Leire

    2017-01-01

    Treball Final de Grau en Medicina. Codi: MD1158. Curs acadèmic: 2016-2017 JUSTIFICACIÓN Y OBJETIVOS: La donación de productos sanguíneos es en un gesto altruista de mucha importancia. La transfusión de hemoderivados es un recurso terapéutico y en ocasiones preventivo, de vital importancia. Dada la actual escasez de dichos productos y el constante aumento de la complejidad asistencial, este trabajo tiene como fin el conocer cómo, cuanto y porqué se transfunde en el Hospital General Universi...

  19. An assessment of the utility of unselected coagulation screening in general hospital practice.

    LENUS (Irish Health Repository)

    McHugh, Johnny

    2011-03-01

    Coagulation screening using prothrombin time (PT) and activated partial thromboplastin time (APTT) is widely used. We performed an audit of coagulation screening in an Irish teaching hospital. We analysed PT and\\/or APTT results received during normal working hours during a 1-week period in our hospital. Abnormal results due to anticoagulants were excluded from further study. In samples with PT longer than 15.5 s and\\/or APTT longer than 42 s, we proceeded to 1: 1 mixing studies if the PT was prolonged and 1: 1 mixing studies, factor XII assay and lupus screen if the APTT was prolonged. We also obtained referral source for all samples and clinical details for abnormal samples. Six hundred and seventy-one coagulation requests were received during the study period. Three hundred and eighteen of 671 (47.4%) coagulation requests were for monitoring of anticoagulation. Three hundred and fifty-three of 671 (52.6%) requests were for coagulation screening rather than anticoagulant monitoring. In the coagulation screens received, PT was prolonged in 19 of 353 (5.4%). PT was longer than 20 s in four of 353 cases (1.1%). APTT was prolonged in 19 of 353 (5.4%). APTT was longer than 50 s in four of 353 (1.1%). No patients with abnormal PT or APTT had any bleeding sequelae during the study period. Unregulated coagulation screening has a low yield of abnormal results; the majority of these abnormal results show mild prolongation of PT or APTT with no evidence that they are associated with an increased bleeding risk.

  20. [Evidence of the validity of the Emergency Severity Index for triage in a general hospital emergency department].

    Science.gov (United States)

    Hernández Ruipérez, Tomás; Leal Costa, César; Adánez Martínez, María de Gracia; García Pérez, Bartolomé; Nova López, Daniel; Díaz Agea, José Luis

    2015-10-01

    To determine whether the Emergency Severity Index (ESI) is valid for triage according to evidence based on classifying real patients in a general referral hospital's emergency department. Observational, cross-sectional descriptive study carried out in the emergency department of Hospital Clínico Universitario Virgen de la Arrixaca in Murcia. Thirty-two nurses used the ESI algorithm to triage 410 patients as they arrived seeking care. The results were compared to a gold standard (a triage expert's opinion, which was later confirmed by an expert committee after discussion, if necessary, of cases for which opinions were not unanimous). We calculated sensitivity, specificity, under- and over-triage rates, as well as descriptive statistics about resource assignment, exitus, patients who left without being seen, destination on discharge, and times. ESI was highly correlated with resources (ρ = -0.717, P < .01) and moderately correlated with destination on discharge (ρ = -0.437, P < .01). Regarding time spent in the department, we found that patients assigned ESI levels 1 and 2 had significantly longer stays, and those assigned ESI levels 4 and 5 had significantly shorter stays (p < 0,001). Interobserver agreement was good or very good, indicating that this triage tool is reliable. This pilot of the ESI triage algorithm in the emergency department of a referral hospital found evidence supporting the system's validity.

  1. [Cooperative medical care by physicians of general hospitals and psychiatrists of an alcoholism treatment unit in Mie Prefecture].

    Science.gov (United States)

    Ino, A; Endo, T; Hirofuji, H; Takase, K; Watanabe, S

    2001-12-01

    Clinical practice of psychiatric liaison with physicians is the first step for an early treatment of alcohol dependence. Screening patients with alcohol dependence in general hospitals, carrying out intervention, and referring them to psychiatric specialists are running smoothly by the cooperation of member of the Mie Association for the Study of Alcohol-related Diseases. This association is being conducted by managers constituted of doctors, nurses, and medical social workers and the meeting is held every 6 months at district general hospitals to achieve three objectives; 1) evoking a sense of responsibility for alcoholic patients in the mind of general hospital staffs, 2) developing a network for psychiatric liaison with physicians to care patients of their alcohol dependence, and 3) keeping up activities of the association. We have already held the regular meeting 12 times, and prepared pamphlets for screening alcohol misuse and for early intervention. A course for learning skills of early intervention in this summer won the favor of participants. Through case conference of alcoholism and full accounts of the experiences given by recovered patients or their families, meeting attendants know patients' distress, families' sorrow, and their delight brought by the recovery, and are motivated to assist patients with alcohol dependence. Thus, "Spirit to Spirit" is a keyword to develop a network of the cooperative medical care for supporting patients with alcohol dependence. Referral of alcoholic patients to psychiatrists and/or psychiatric liaison therapy is promoted by a reliable, faithful, and face to face relationship between physicians and psychiatrists. Physicians' learning the skill for early intervention in alcohol dependence is followed by an increase in referral of patients to psychiatrists, and which suggests the importance of providing teaching and training of medical care for alcohol dependence to medical staffs including doctors of emergency care units

  2. Mental health literacy survey of non-mental health professionals in six general hospitals in Hunan Province of China.

    Science.gov (United States)

    Wu, Qiuxia; Luo, Xiaoyang; Chen, Shubao; Qi, Chang; Long, Jiang; Xiong, Yifan; Liao, Yanhui; Liu, Tieqiao

    2017-01-01

    Mental illness has brought great economic burden related to misdiagnosis by non-mental health professionals in general hospitals. The aim of this study was to explore non-mental health professionals' conceptions related to the identification of mental illness and perceived treatments, first aid and prognosis. In 2014-2015, we presented 1123 non-mental health professionals from six general hospitals in Hunan Province with one of three vignettes describing a person with schizophrenia, depression, or generalized anxiety disorder. Identification rates, beliefs about various interventions, best methods, and the prognosis with or without treatment were measured. Less than 60% of the non-mental health professionals could identify the mental disorders correctly. Psychiatrists and psychologists were considered to be the people who would be most helpful in all vignettes. Over 70% of participants identified the correct medication for each vignette. Participants gave higher ratings to lifestyle interventions than to psychological and medical interventions, especially in the depression and generalized anxiety disorder vignettes. For the question about how the person could best be helped, about half of the participants rated listening or talking with the person more highly than accompanying the person to professional help or encouraging the person to visit a psychiatrist or psychologist. Participants believed that, with professional help, the people in the vignettes would fully recover but that problems would probably reoccur and that, without professional help, the people described would get worse. The beliefs that non-mental health professionals hold about mental disorders are inadequate to provide appropriate help. There is an urgent need for mental health education campaigns to improve non-mental health professionals' mental health knowledge in mainland China in order to provide better support for mental health service users.

  3. Risk of hospitalization among survivors of childhood and adolescent acute lymphoblastic leukemia compared to siblings and a general population sample.

    Science.gov (United States)

    Ou, Judy Y; Smits-Seemann, Rochelle R; Kaul, Sapna; Fluchel, Mark N; Sweeney, Carol; Kirchhoff, Anne C

    2017-08-01

    Acute Lymphoblastic Leukemia (ALL) has a high survival rate, but cancer-related late effects in the early post-treatment years need documentation. Hospitalizations are an indicator of the burden of late effects. We identify rates and risk factors for hospitalization from five to ten years after diagnosis for childhood and adolescent ALL survivors compared to siblings and a matched population sample. 176 ALL survivors were diagnosed at ≤22 years between 1998 and 2008 and treated at an Intermountain Healthcare facility. The Utah Population Database identified siblings, an age- and sex-matched sample of the Utah population, and statewide inpatient hospital discharges. Sex- and birth year-adjusted Poisson models with Generalized Estimating Equations and robust standard errors calculated rates and rate ratios. Cox proportional hazards models identified demographic and clinical risk factors for hospitalizations among survivors. Hospitalization rates for survivors (Rate:3.76, 95% CI=2.22-6.36) were higher than siblings (Rate:2.69, 95% CI=1.01-7.18) and the population sample (Rate:1.87, 95% CI=1.13-3.09). Compared to siblings and population comparisons, rate ratios (RR) were significantly higher for survivors diagnosed between age 6 and 22 years (RR:2.87, 95% CI=1.03-7.97 vs siblings; RR:2.66, 95% CI=1.17-6.04 vs population comparisons). Rate ratios for diagnosis between 2004 and 2008 were significantly higher compared to the population sample (RR:4.29, 95% CI=1.49, 12.32), but not siblings (RR:2.73, 95% CI=0.54, 13.68). Survivors originally diagnosed with high-risk ALL did not have a significantly higher risk than siblings or population comparators. However, high-risk ALL survivors (Hazard ratio [HR]:3.36, 95% CI=1.33-8.45) and survivors diagnosed from 2004 to 2008 (HR:9.48, 95% CI=1.93-46.59) had the highest risk compared to their survivor counterparts. Five to ten years after diagnosis is a sensitive time period for hospitalizations in the ALL population. Survivors of

  4. The pattern of completed suicides seen in Kuala Lumpur General Hospital 1999.

    Science.gov (United States)

    Hayati, A N; Salina, A A; Abdullah, A A; Eusni, R T; Mansar, A H

    2004-06-01

    A study was done on 76 suicide cases managed by the Forensic Pathology Department of Hospital Kuala Lumpur (HKL) from January till December 1999 to explore the pattern of suicide and psychiatric history. The Chinese contributed 52% (n=40) of cases followed by the Indians (29%, n=22) and the Malays (12%, n=9). After the age of sixty, 84.6% of the subjects were Chinese. The common methods of suicide were poisoning (39%), hanging (34%) and jumping from height (22%). Four out of 12 case-notes traced had documented psychiatric history i.e. schizophrenia. the suicide rate for Kuala Lumpur is estimated at 7.4 per 100,000. The Indians has the highest suicide rate of 21.1 per 100,000 in keeping with other local studies. The suicide rate for the Chinese is 8.6 per 100,000, but it increased to 23 per 100,000 among the elderly Chinese. The suicide rate for Malays is 2.6 per 100,000, higher than what was cited in previous local studies. The incidence of jumping from height as a suicide method had doubled over the last 2 decades.

  5. Child and Adolescent Inpatient Unit in General Hospital “Tzaneio”

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    E. Tseva

    2017-01-01

    Full Text Available The Child and Adolescent Psychiatry Inpatient Service offers comprehensive diagnostic evaluation and treatment of children and adolescents (typical age ranges from 3-16 years old with a variety of emotional and behavioral problems including mood disorders, anxiety disorders, psychotic disorders, severe disruptive behavior, and suicide attempts. Treatment Team. The inpatient treatment team includes psychiatrists, psychologists, registered nurses, special education teacher, social worker, speech and occupational therapists. In addition, pediatricians from a full range of medical subspecialties are available for consultations. The multi-disciplinary staff emphasizes a family-oriented approach and parents and care-givers are encouraged to be active participants in the treatment team throughout a child’s stay. Treatment Program. The program offers developmentally appropriate therapeutic activities in a closely supervised environment. Extensive opportunities for observation, assessment, and intervention are possible in this intensive setting. Specialized assessments including neuropsychological testing, speech and language testing, and occupational therapy assessments are all available. Treatment plans typically include a combination of individual psychotherapy, behavior management, family counseling and medications. Staff members develop an individualized treatment plan emphasizing safety for each patient during the hospital stay. The plan is closely coordinated with families, outpatient providers, and resource programs to coordinate aftercare plans and facilitate a smooth transition to home.

  6. Extracorporeal shockwave lithotripsy using Storz Modulith SL20--the Singapore General Hospital experience.

    Science.gov (United States)

    Wong, M Y; Li, M K; Foo, K T

    1993-11-01

    The Storz Modulith SL20 is a third-generation lithotripter which was installed in our hospital in March 1991. The aim of this paper is to evaluate our results in the management of renal calculi using this machine. We report our experience in the treatment of the first 215 renal units (118 renal and 83 ureteric) in 190 patients with a minimum follow-up period of three months. Success for renal stones was defined as stone-free or with insignificant residual fragments of less than 4 mm in size post therapy. Success for ureteric stones was defined as stone-free after therapy. The success rate for renal calculi was 88% and for ureteric calculi 71%. The mean number of sessions to achieve these results for renal calculi was 1.6 and for ureteric calculi 1.4. Of the failures, only 1.9% required open surgery whilst the remainder were dealt with using minimally invasive procedures like intracorporeal laser lithotripsy. There was no mortality in our series. Complications occurred in four patients, who required hospitalisation for renal colic (n = 1), urinary tract infection (n = 1) and obstructive uropathy (n = 2).

  7. Pediatric referrals to psychiatry in a Tertiary Care General Hospital: A descriptive study

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    Bheemsain Tekkalaki

    2017-01-01

    Full Text Available Background: Children with chronic physical illnesses frequently have psychiatric comorbidities, which often go un-noticed and may lead to more resource utilization and morbidity. Pediatric liaison services can be effectively used to bridge this gap. Literature on pediatric liaison services is sparse. Aims: To study the referral patterns, reasons for referrals, psychiatric diagnoses and interventions in children and adolescents referred to psychiatry department in a tertiary care hospital. Materials and Methods: A retrospective chart analysis of all children and adolescents below 19 years of age, referred to psychiatry department from 2010 to 2015, was done. Data was collected and statistical analysis was done. Results: Two hundred and nine subjects were included in the study. Mean age of sample was 12.15 (±4.20 years, with about 66.02% being males. About 54.06% of the participants were referred from pediatricians. Almost three fourth (72.25% of children had no diagnosable physical illness. Intellectual disability (19.62% was the most common psychiatric diagnosis, followed by depressive disorders (14.35%, and dissociative disorders (12.92%. Conclusions: In our study, majority of the referrals were the adolescent males from pediatric department. Intellectual disability, depressive disorder, and stress-related disorders were the common diagnoses. The fact that three-fourth of the referred children had no physical illness implies lack of awareness, stigma toward mental illness, and pathway of care.

  8. Tromboprofilaxis en pacientes no quirúrgicos internados en un hospital general

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    Marcelo J. Melero

    2012-10-01

    Full Text Available Los pacientes adultos internados por una enfermedad no quirúrgica tienen un riesgo alto de padecer una tromboembolia venosa y pueden desarrollar alguna forma de esta enfermedad cuando no reciben un tratamiento preventivo adecuado. Los objetivos de este estudio prospectivo, analítico, observacional y transversal, fueron: 1 determinar cuál es el porcentaje de pacientes adultos internados por una enfermedad aguda no quirúrgica en el Hospital de Clínicas José de San Martín, Universidad de Buenos Aires, que tienen indicación de tromboprofilaxis, 2 establecer cuántos de ellos reciben un tratamiento preventivo para la tromboembolia venosa, y 3 comprobar cuántos estaban medicados con alguna forma de tromboprofilaxis sin tener causas que justificaran este tratamiento. Se estudiaron 93 pacientes durante un lapso de 72 horas consecutivas. Se encontró que el 90.3% de ellos necesitaba un tratamiento preventivo para la tromboembolia venosa y el 76.2% de estos enfermos recibían tromboprofilaxis farmacológica. Un 33.3% de los pacientes internados tenía indicado un tratamiento farmacológico preventivo sin tener una causa que justificara esta prescripción. El porcentaje encontrado de pacientes tratados con tromboprofilaxis es más alto que el comunicado en otros estudios observacionales.

  9. The phenomenology of self-mutilation in a general hospital setting.

    Science.gov (United States)

    Simpson, M A

    1975-10-01

    Comparison of a series of twenty-four wrist-cutters with a control group of self-poisoners showed a number of significant differences. The wrist-cutters were younger and their acts were regarded as being of low lethality; they are no more likely to have made previous suicide attempts; they complain less often of depression, and more frequently of 'emptiness' and tension as primary complaints. Sudden, unpredictable mood swings are common and there is a greater tendency for their physicians to diagnose personality disorders, often in pejorative terms. They frequently have substantial medical interests and paramedical occupations. A high proportion complain of dysorectic symptoms (anorexia or overeating or combinations of both), use drugs and/or alcohol in excess; show sexual disturbance and distress, and also promiscuity. They more frequently have a negative reaction to menarche and menstruation; have come from broken homes and have experienced parental deprivation. A proportion of the group exhibit difficulty in verbal communication, and absconding from hospital was more common in the group of cutters. Painless cutting after a period of depersonalization, followed by relaxation and repersonalization after bleeding, was the typical pattern.

  10. Psychosocial risks in Psychiatry and Anaesthesiology residents in a Portuguese General and University Hospital.

    Science.gov (United States)

    Alves de Moura, Pedro; Serranheira, Florentino; Sacadura-Leite, Ema

    2016-03-24

    Medical Doctors (MD), although at the front line of response to patients and their families, are seldom study subjects for occupational psychosocial risks and work related stress. Assess psychiatry and anaesthesiology residents in a central and university Portuguese Hospital for the presence of psychosocial risks at work. We used the Copenhagen Psychosocial Questionnaire version 2 (COPSOQ), which was applied face-to-face in two group settings, in April 2014. It comprised a sample of 19 Psychiatry residents and 20 Anaesthesiology residents. Statistical analysis was done by correlational analysis using Pearson's coefficient (r) and the t-student test for categorical variables. An occupational health risk (red flag) was found for residents in the "Cognitive demands" dimension of COPSOQ and a health risk (red flag) in the "Work influence" dimension for the female Anaesthesiology sub-group. A possible risk (yellow flag) was found in 17 dimensions. Results also showed moderate correlations between various COPSOQ dimensions and the emergency department workload, workload, home study, number of children, year of training and the medical specialty variables. These results suggest that residents have a health risk which derives from the cognitive demands of their work and that it increases with the workload.  This implicates the need for occupational health measures to be taken to manage and reduce these psychological risks.

  11. Texas hospitals with higher health information technology expenditures have higher revenue: A longitudinal data analysis using a generalized estimating equation model.

    Science.gov (United States)

    Lee, Jinhyung; Choi, Jae-Young

    2016-04-05

    The benefits of health information technology (IT) adoption have been reported in the literature, but whether health IT investment increases revenue generation remains an important research question. Texas hospital data obtained from the American Hospital Association (AHA) for 2007-2010 were used to investigate the association of health IT expenses and hospital revenue. The generalized estimation equation (GEE) with an independent error component was used to model the data controlling for cluster error within hospitals. We found that health IT expenses were significantly and positively associated with hospital revenue. Our model predicted that a 100% increase in health IT expenditure would result in an 8% increase in total revenue. The effect of health IT was more associated with gross outpatient revenue than gross inpatient revenue. Increased health IT expenses were associated with greater hospital revenue. Future research needs to confirm our findings with a national sample of hospitals.

  12. Prospective multicentre systematic guideline-based management of patients referred to the Syncope Units of general hospitals.

    Science.gov (United States)

    Brignole, Michele; Ungar, Andrea; Casagranda, Ivo; Gulizia, Michele; Lunati, Maurizio; Ammirati, Fabrizio; Del Rosso, Attilio; Sasdelli, Massimo; Santini, Massimo; Maggi, Roberto; Vitale, Elena; Morrione, Alessandro; Francese, Giuseppina Maura; Vecchi, Maria Rita; Giada, Franco

    2010-01-01

    Although an organizational model for syncope management facilities was proposed in the 2004 guidelines of the European Society of Cardiology (ESC), its implementation in clinical practice and its effectiveness are largely unknown. This prospective study enrolled 941 consecutive patients referred to the Syncope Units of nine general hospitals from 15 March 2008 to 15 September 2008. A median of 15 patients per month were examined in each unit, but the five older units had a two-fold higher volume of activity than the four newer ones (instituted diagnosis was established on initial evaluation in 191 (21%) patients and early by means of 2.9 +/- 1.6 tests in 541 (61%) patients. A likely reflex cause was established in 67%, orthostatic hypotension in 4%, cardiac in 6% and non-syncopal in 5% of the cases. The cause of syncope remained unexplained in 159 (18%) patients, despite a mean of 3.5 +/- 1.8 tests per patient. These latter patients were older, more frequently had structural heart disease or electrocardiographic abnormalities, unpredictable onset of syncope due to the lack of prodromes, and higher OESIL and EGSIS risk scores than the other groups of patients. The mean costs of diagnostic evaluation was 209 euro per outpatient and 1073 euro per inpatient. The median cost of hospital stay was 2990 euro per patient. We documented the current practice of syncope management in specialized facilities that have adopted the management model proposed by the ESC. The results are useful for those who wish to replicate this model in other hospitals. Syncope remains unexplained during in-hospital evaluation in more complex cases at higher risk.

  13. A new management of syncope: prospective systematic guideline-based evaluation of patients referred urgently to general hospitals.

    Science.gov (United States)

    Brignole, Michele; Menozzi, Carlo; Bartoletti, Angelo; Giada, Franco; Lagi, Alfonso; Ungar, Andrea; Ponassi, Irene; Mussi, Chiara; Maggi, Roberto; Re, Giuseppe; Furlan, Raffaello; Rovelli, Gianni; Ponzi, Patrizia; Scivales, Alessandro

    2006-01-01

    The guidelines of the European Society of Cardiology (ESC) define the current standard for the management of syncope, but are still incompletely applied in the clinical setting. Prospective systematic evaluation, on strict adherence to the guidelines, of consecutive patients referred for syncope to the emergency departments of 11 general hospitals. In order to maximize the application, a decision-making guideline-based software was used and trained core medical personnel were designated-both locally in each hospital and centrally-to verify adherence to the diagnostic pathway and give advice on its correction. A diagnostic work-up consistent with the guidelines was completed in 465/541 patients (86%). A definite diagnosis was established in 98% (unexplained in 2%): neurally mediated syncope accounted for 66% of diagnosis, orthostatic hypotension 10%, primary arrhythmias 11%, structural cardiac or cardiopulmonary disease 5%, and non-syncopal attacks 6%, respectively. The initial evaluation (consisting of history, physical examination, and standard electrocardiogram) established a diagnosis in 50% of cases. Hospitalization for the management of syncope was appropriate in 25% and was required for other reasons in a further 13% of cases. The median in-hospital stay was 5.5 days (interquartile range, 3-9). Apart from the initial evaluation, a mean of 1.9+/-1.1 appropriate tests per patient was performed in 193 patients and led to a final diagnosis in 182 of these (94%). The results of this study assess the current standard for the management of syncope on the basis of a rigorous adherence to guidelines of the ESC and provide a frame of reference for daily activity when dealing with syncope.

  14. Malnutrition in patients admitted to the medical wards of the Douala General Hospital: a cross-sectional study.

    Science.gov (United States)

    Luma, Henry Namme; Eloumou, Servais Albert Fiacre Bagnaka; Mboligong, Franklin Ngu; Temfack, Elvis; Donfack, Olivier-Tresor; Doualla, Marie-Solange

    2017-07-03

    Malnutrition is common in acutely ill patients occurring in 30-50% of hospitalized patients. Awareness and screening for malnutrition is lacking in most health institutions in sub-Saharan Africa. This study aimed at screening for malnutrition using anthropometric and laboratory indices in patients admitted to the internal medicine wards. A cross-sectional study. We screened for malnutrition in 251 consecutive patients admitted from January to March 2013 in the internal medicine wards. Malnutrition defined as body mass index (BMI) less than 18.5 kg/m 2 and/or mid upper arm circumference (MUAC) less than 22 cm in women and 23 cm in men. Weight loss greater than 10% in the last 6 months prior to admission, relevant laboratory data, diagnosis at discharge and length of hospital stay (LOS) were also recorded. Mean age was 47 (SD 16) years. 52.6% were male. Mean BMI was 24.44 (SD 5.79) kg/m 2 and MUAC was 27.8 (SD 5.0) cm. Median LOS was 7 (IQR 5-12) days. 42.4% of patients reported weight loss greater than 10% in the 6 months before hospitalization. MUAC and BMI correlated significantly (r = 0.78; p malnutrition by the two methods showed moderate agreement (κ = 0.56; p malnutrition was 19.34% (35/251). Blood albumin and hemoglobin were significantly lower in malnourished patients. Malnourished patients had a significantly longer LOS (p = 0.019) when compared to those with no malnutrition. Malnutrition was most common amongst patients with malignancy. Malnutrition is common in patients admitted to the medical wards of the Douala General Hospital. Nutritional screening and assessment should be integrated in the care package of all admitted patients.

  15. Hospital Discharge Information After Elective Total hip or knee Joint Replacement Surgery: A clinical Audit of preferences among general practitioners

    Directory of Open Access Journals (Sweden)

    Andrew M Briggs

    2012-05-01

    Full Text Available AbstractThe demand for elective joint replacement (EJR surgery for degenerative joint disease continues to rise in Australia, and relative to earlier practices, patients are discharged back to the care of their general practitioner (GP and other community-based providers after a shorter hospital stay and potentially greater post-operative acuity. In order to coordinate safe and effective post-operative care, GPs rely on accurate, timely and clinically-informative information from hospitals when their patients are discharged. The aim of this project was to undertake an audit with GPs regarding their preferences about the components of information provided in discharge summaries for patients undergoing EJR surgery for the hip or knee. GPs in a defined catchment area were invited to respond to an online audit instrument, developed by an interdisciplinary group of clinicians with knowledge of orthopaedic surgery practices. The 15-item instrument required respondents to rank the importance of components of discharge information developed by the clinician working group, using a three-point rating scale. Fifty-three GPs and nine GP registrars responded to the audit invitation (11.0% response rate. All discharge information options were ranked as ‘essential’ by a proportion of respondents, ranging from 14.8–88.5%. Essential information requested by the respondents included early post-operative actions required by the GP, medications prescribed, post-operative complications encountered and noting of any allergies. Non-essential information related to the prosthesis used. The provision of clinical guidelines was largely rated as ‘useful’ information (47.5–56.7%. GPs require a range of clinical information to safely and effectively care for their patients after discharge from hospital for EJR surgery. Implementation of changes to processes used to create discharge summaries will require engagement and collaboration between clinical staff

  16. Telemedicine in general neurology: use of audiovisual consultation for on call back-up service in an acute care hospital.

    Science.gov (United States)

    Janssen, Frank; Awadallah, Mohammed; Alhalabi, Awed; Körber, Barbara; Lang, Reinhard; Scibor, Mateusz; Handschu, René

    2018-02-09

    While telemedicine is in expanding use in acute stroke care, little is known about its use in general neurology, especially in acute care. We sought to investigate the feasibility and possible effects of a telemedicine device within the neurological back-up service of an acute care hospital. In a 450 bed academic teaching hospital an experienced neurologist (EN) is on call to support the junior doctor at the hospital. Support was possible whether by standard telephone advice (TA) or by audiovisual consultations (AVC). In AVC the expert used a mobile telemedicine device and so he could establish audiovisual contact from his home to the emergency room and examine newly admitted patients. Technical and patient details including timing and diagnosis were recorded. Video and audio quality as well as impact of AVC on diagnosis was rated by the EN. Out of about 1200 cases in off peak times, during the study period, 164 AVC including remote video examination were done (13.6%). Also 48 cases were documented by pure TA. Video quality was rated to a medium of 1.7, audio quality to 2.1. In 36 cases the audiovisual consultation was influenced by technical issues leading to cessation of AVC in 8 cases. Duration of teleconsultation was 17.3 min in AVC compared to 8.7 min for TA. The consultation diagnosis in AVC was confirmed in 74.4% of all cases compared to 57.7% in TA. AVC was rated as a valuable contribution to the diagnostic workup in 74.3% of all cases seen. In about 40% of all cases AVC was not possible due to technical or organizational reasons. Audiovisual consultation seems to be a feasible and useful support in routine neurology back-up service of an acute care hospital. Better mobility of devices and flexibility of service is needed to improve availability and quality of this valuable tool.

  17. [From the Principle of Beneficence to the Principle of Autonomy. Assessment of Patients' Mental Competency in the General Hospital].

    Science.gov (United States)

    Diana, Restrepo B; Carlos, Cardeño C; Marle, Duque G; Santiago, Jaramillo

    2012-06-01

    Refusing a medical procedure is a valid way of exercising every patient's right to autonomy. From the legal point of view, autonomy is based on the right to privacy. In recent decades the legal right to self-determination has gradually expanded and today patients in full possession of their mental faculties, have the moral and legal right to make their own decisions and these decisions take precedence over physician and family. Often liaison psychiatrists are called in to assess the mental competence of patients in the general hospital. To determine the psychiatrist's role in evaluating these patients. The assessment of a patient's ability to decide and self-determine is a common clinical problem in general hospitals. Evaluation of these patients requires a proper understanding of the philosophical, ethical, and legal issues that guide the appropriate treatment of these complex clinical problems. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  18. Nurse managers: Determinants and behaviours in relation to patient and visitor aggression in general hospitals. A qualitative study.

    Science.gov (United States)

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

    2017-12-01

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

  19. Clinical and Histopathological Characteristic of Salivary Gland Carcinoma in Dr. Hasan Sadikin General Hospital in 2009–2012

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    Fatimah Lidya Andriani

    2016-03-01

    Full Text Available Background: Salivary gland neoplasm is one of the rare neoplasm. The frequency of this neoplasm is lower than 2% of all type of tumors in human. Malignant salivary gland tumor comprises 6% of all head and neck tumors. Data about salivary gland carcinoma are still limited. The aim of this study was to determine the frequency of malignant salivary gland based on the patients’ age, gender, site of lesion and histopathology type. Methods: This study was conducted descriptively. There were 97 subjects found from histopathological form that had been examined in Department of Anatomical Pathology, Dr. Hasan Sadikin General Hospital in 2009–2012. Total sampling technique was used and all data about patients’ age, gender, site of lesion and histopathology type were collected and analyzed. Results: Of 97 cases, age group 50–59 years old had the highest frequency (29%. The prevalence in male was more frequent than female with male:female ratio was 1.4:1. The most common site of carcinoma was found in parotid gland (45%. Mucoepidermoid carcinoma was the most common histopathology type found in this study (28%. Conclusions: Salivary gland carcinoma is still a rare malignant case in Dr. Hasan Sadikin General Hospital. Carcinoma in parotid gland was the most common site and mucoepidermoid carcinoma was the most common histopathology type.

  20. Scarf-Akin osteotomy correction for hallux valgus: short-term results from a district general hospital.

    Science.gov (United States)

    Kerr, Hui-Ling; Jackson, Rosalyn; Kothari, Paresh

    2010-01-01

    This study assessed the radiological measurements, American Orthopaedic Foot and Ankle Society (AOFAS) scores, and patient satisfaction associated with performance of the scarf osteotomy, combined with an Akin osteotomy, for the treatment of hallux valgus in patients at a general hospital. Thirty-five patients were assessed before surgery, and at 6 months following performance of the scarf first metatarsal osteotomy plus Akin osteotomy. The mean first intermetatarsal and hallux abductus angles reduced from 14.1 degrees +/- 3.5 degrees to 10.0 degrees +/- 3.2 degrees and 32.1 degrees +/- 9.9 degrees to 16.4 degrees +/- 7.9 degrees , respectively, and these differences were statistically significant (P .05). The mean global AOFAS Hallux Metatarsophalangeal-Interphalangeal score increased from 58.8 +/- 11.6 to 86.4 +/- 11.6, and this difference was statistically significant (P surgery. Based on these results, we concluded that the improved radiographic angles and AOFAS scores observed in this study were comparable to previously reported results, and our findings indicated that, in the setting of a general hospital, the scarf osteotomy combined with the Akin osteotomy is a safe, versatile and useful procedure for the treatment of hallux valgus. Copyright 2010 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Associations between intimate partner violence, depression, and suicidal behavior among women attending antenatal and general outpatients hospital services in Thailand.

    Science.gov (United States)

    Peltzer, K; Pengpid, S

    2017-07-01

    Battered women are exposed to multiple types and different severity of intimate partner abuse, however, little is known about the relationship between severity and different types of intimate partner violence (IPV) (physical, sexual, psychological, and danger) and symptoms of depression and suicidal behavior in a sample of women attending antenatal care or general outpatient hospital services in Thailand. A cross-sectional study was conducted among adult women who were consecutively sampled and screened for IPV in antenatal care and general outpatient clinics in nine randomly selected hospitals in two provinces in the central region. The measures included the "Severity of Violence Against Women Scale," "Edinburgh Postnatal Depression Scale 10," "Danger Assessment Scale," and one item for suicidal behavior. Hierarchical regressions were used to assess the effects of the different types of IPV on depression and suicidal behavior. Of the final sample (N = 207) that screened positive for IPV, 49.3% scored positive for depression, and 17.6% reported suicidal threats or attempts in the past 12 months. One type of IPV (sexual) was significantly associated with depression, whereas psychological abuse and femicide risk or danger was correlated with suicidal behavior. A high proportion of women with IPV suffered from depression and suicidal behavior. The study provides evidence of an association between the severity of IPV and mental health problems (depression and suicidal behavior). In assessing IPV, the different identified dimensions contributing to poor mental health should be incorporated.

  2. Impostación del patio del Embajador Vich en el ex-convento del Carmen (Valencia

    Directory of Open Access Journals (Sweden)

    Julián Estaban Chapapría

    2001-12-01

    Full Text Available La demolición del singular Palacio del Embajador Vich en 1859 trajo consigo la dispersión de los restos de su magnífico patio renacentista que, en parte, fueron impostados en el refectorio gótico del ex-Convento del Carmen de Valencia en 1909. El hallazgo de otro conjunto de fragmentos del patio en el Museo de Bellas Artes de la ciudad ha despertado la iniciativa del desmontaje de las piezas integradas en el refectorio y la recomposición museística del patio con los fragmentos que se conservan. El presente artículo defiende la intervención ecléctica de principios de siglo y plantea dudas sobre la oportunidad de esta doble operación.

  3. Monte-Carlo Simulations of the Nuclear Energy Deposition Inside the CARMEN-1P Differential Calorimeter Irradiated into OSIRIS Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Amharrak, H.; Reynard-Carette, C.; Carette, M. [Aix Marseille Universite, CNRS, Universite de Toulon, IM2NP UMR 7334, 13397, Marseille (France); Lemaire, M.; Vaglio-Gaudard, C. [CEA, DEN, DER, SPRC, LPN, Cadarache, F-13108 Saint Paul Lez Durance (France); Fourmentel, D.; Lyoussi, A. [CEA, DEN, Departement d' Etudes des Reacteurs, Service de Physique Experimentale, Laboratoire Dosimetrie Capteurs Instrumentation, 13108 Saint-Paul-lez-Durance (France)

    2015-07-01

    The nuclear heating measurements in Material Testing Reactors (MTRs) are crucial for the study of nuclear materials and fuels under irradiation. The reference measurements of this nuclear heating are especially performed by a differential calorimeter including a graphite sample material. These measurements are then used for other experimental conditions in order to predict the nuclear heating and thermal conditions induced in the irradiation devices. Nuclear heating is a great deal of interest at the moment as the measurement of such heating is an important issue for MTRs reactors. This need is especially generated by the new Jules Horowitz Reactor (JHR), under construction at CEA/Cadarache 'French Alternative Energies and Atomic Energy Commission'. This new reactor, that will be operational in late 2019, is a new facility for the nuclear research on materials and fuels. Indeed the expected nuclear heating rate is about 20 W/g for nominal capacity of 100 MW. The present Monte Carlo calculation works belong to the IN-CORE (Instrumentation for Nuclear radiation and Calorimetry On line in Reactor): a joint research program between the CEA and Aix- Marseille University in 2009. One scientific aim of this program is to design and develop a multi-sensors device, called CARMEN, dedicated to the measurements of main physical parameters simultaneously encountered inside JHR's experimental channels (core and reflector) such as neutron fluxes, photon fluxes, temperature, and nuclear heating. A first prototype was already developed. This prototype includes two mock-ups dedicated respectively to neutronic measurements (CARMEN-1N) and to photonic measurements (CARMEN-1P) with in particular a specific differential calorimeter. Two irradiation campaigns were performed successfully in the periphery of OSIRIS reactor (a MTR located at Saclay, France) in 2012 for nuclear heating levels up to 2 W/g. First Monte Carlo calculations reduced to the graphite sample of the

  4. Risk factors associated with calcium oxalate urolithiasis in dogs evaluated at general care veterinary hospitals in the United States.

    Science.gov (United States)

    Okafor, Chika C; Lefebvre, Sandra L; Pearl, David L; Yang, Mingyin; Wang, Mansen; Blois, Shauna L; Lund, Elizabeth M; Dewey, Cate E

    2014-08-01

    Calcium oxalate urolithiasis results from the formation of aggregates of calcium salts in the urinary tract. Difficulties associated with effectively treating calcium oxalate urolithiasis and the proportional increase in the prevalence of calcium oxalate uroliths relative to other urolith types over the last 2 decades has increased the concern of clinicians about this disease. To determine factors associated with the development of calcium oxalate urolithiasis in dogs evaluated at general care veterinary hospitals in the United States, a retrospective case-control study was performed. A national electronic database of medical records of all dogs evaluated between October 1, 2007 and December 31, 2010 at 787 general care veterinary hospitals in the United States was reviewed. Dogs were selected as cases at the first-time diagnosis of a laboratory-confirmed urolith comprised of at least 70% calcium oxalate (n=452). Two sets of control dogs with no history of urolithiasis diagnosis were randomly selected after the medical records of all remaining dogs were reviewed: urinalysis examination was a requirement in the selection of one set (n=1808) but was not required in the other set (n=1808). Historical information extracted included urolith composition, dog's diet, age, sex, neuter status, breed size category, hospital location, date of diagnosis, and urinalysis results. Multivariable analysis showed that the odds of first-time diagnosis of calcium oxalate urolithiasis were significantly (P30 mg/dL (OR: 1.55, 1.04-2.30). Patient demographics and urinalysis results are important factors that can support risk assessment and early identification of canine oxalate urolithiasis. Therefore, periodic urolith screening and monitoring of urine parameters should be encouraged for dogs at risk of developing these uroliths. Copyright © 2014 Elsevier B.V. All rights reserved.

  5. Epidemia de influenza A(H1N1 en la Argentina: Experiencia del Hospital Nacional Profesor Alejandro Posadas Influenza A(H1N1 epidemic in Argentina: Experience in a National General Hospital (Hospital Nacional Profesor Alejandro Posadas

    Directory of Open Access Journals (Sweden)

    2009-10-01

    Full Text Available Se describe la preparación y la atención médica durante la epidemia de influenza A(H1N1 (junio 2009 en un hospital general de agudos, público, de alta complejidad; con diagnóstico de laboratorio, internación general y cuidados intensivos (UCI. Se elaboró un plan para aumentar la capacidad asistencial, reasignar recursos y garantizar la bioseguridad. La consulta fue 7.1 ± 3.8 veces mayor que en 2006-2008. La detección de casos de A(H1N1 fue confirmada por PCR-RT en 186/486 (38.3% pacientes internados y en 56/176 (31.8% ambulatorios. Internados: mediana de edad 20 años; 75% menores de 45 y 32.3% menores de 15. Mortalidad global: 6.8%; 9.1% en los positivos. Adultos: recepción en un área de atención ambulatoria, internación (aislamiento y ventilación mecánica. Sala general: ingresaron 110 pacientes (5 veces más que 1999-2006 con saturación de oxígeno The preparation and medical care during the influenza A(H1N1 outbreak (June 2009 in a high complexity level, public, general hospital with laboratory diagnosis, general and intensive care (ICU hospitalization is described. A plan was designed to increase the hospital's surge capacity, reallocate resources and guarantee bio-safety. The number of consultations was 7.1 ± 3.8 times higher than during June 2006-2008. Detection of A(H1N1 cases were confirmed by PCR-RT in 186/486 (38.3% in-patients and 56/176 (31.8% out-patients. Median age among in-patients was 20 years; 75% < 45 and 32.3% < 15. Global mortality: 6.8%; 9.1% among confirmed cases. Adults were directed to a reception area of out-patient care, hospitalization (isolation and mechanical ventilation. General ward: 110 patients with oxygen saturation < 96% and/or risk factors (65.5% had asthma, chronic obstructive pulmonary disease, obesity, pregnancy or other were admitted (5 times more than in 1999-2006. Chest X-ray showed lung infiltrates and/or lung consolidation in 97.3%. Severe hypoxemia: 43.5%. There were no significant

  6. General

    Indian Academy of Sciences (India)

    Page S20: NMR compound 4i. Page S22: NMR compound 4j. General: Chemicals were purchased from Fluka, Merck and Aldrich Chemical Companies. All the products were characterized by comparison of their IR, 1H NMR and 13C NMR spectroscopic data and their melting points with reported values. General procedure ...

  7. Employment and satisfaction trends among general surgery residents from a community hospital.

    Science.gov (United States)

    Cyr-Taro, Amy E; Kotwall, Cyrus A; Menon, Rema P; Hamann, M Sue; Nakayama, Don K

    2008-01-01

    Physician satisfaction is an important and timely issue in health care. A paucity of literature addresses this question among general surgeons. To review employment patterns and job satisfaction among general surgery residents from a single university-affiliated institution. All general surgery residents graduating from 1986 to 2006, inclusive, were mailed an Institutional Review Board-approved survey, which was then returned anonymously. Information on demographics, fellowship training, practice characteristics, job satisfaction and change, and perceived shortcomings in residency training was collected. A total of 31 of 34 surveys were returned (91%). Most of those surveyed were male (94%) and Caucasian (87%). Sixty-one percent of residents applied for a fellowship, and all but 1 were successful in obtaining their chosen fellowship. The most frequent fellowship chosen was plastic surgery, followed by minimally invasive surgery. Seventy-one percent of residents who applied for fellowship felt that the program improved their competitiveness for a fellowship. Most of the sample is in private practice, and of those, 44% are in groups with more than 4 partners. Ninety percent work less than 80 hours per week. Only 27% practice in small towns (population job. Twenty-three percent agreed that they had difficulty finding their first job, and 30% had fewer job offers than expected. Thirty-five percent of the graduates have changed jobs: 29% of the residents have changed jobs once, and 6% have changed jobs at least twice since completing training. Reasons for leaving a job included colleague issues (82%), financial issues (82%), inadequate referrals (64%), excessive trauma (64%), and marriage or family reasons (55% and 55%, respectively). One half to three fourths of the graduates wished they had more teaching on postresidency business and financial issues, review of contracts, and suggestions for a timeline for finding a job. Although general surgical residencies prepare

  8. Los cuentos de Carmen de Burgos publicados en La Esfera. Ilustración Mundial (1914-1930

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    Arbona Abascal, Guadalupe

    2010-06-01

    Full Text Available This paper addresses the study of nine short-stories by Carmen de Burgos, Colombine, published in the arts magazine La Esfera. Ilustración de Madrid between 1914 and 1930. All of them have descriptive value and are written in different styles corresponding to the spaces depicted in them. This allows a classification in three groups according to the main traits of the stories. The first group is within a poetic naturalism. The second group is representative of a critical realism perspective, while the third one, more innovative, belongs in a humorous-cosmopolitan realism. All nine short-stories express a socially critical view, structurally ordered, and which reveals itself as the meaning of the texts.Este trabajo aborda el estudio de nueve cuentos de Carmen de Burgos, Colombine, publicados en la revista de arte La Esfera. Ilustración Mundial entre 1914 y 1930. Todos ellos tienen un valor descriptivo y se modulan con diferentes estilos a partir de la visión del espacio. Esto permite una clasificación según los rasgos predominantes de cada uno de ellos: los primeros se enmarcan en una tendencia al naturalismo poético, los segundos son representativos de un realismo-crítico y los terceros, más innovadores, se inscriben en un realismo humorístico-cosmopolita. En todos ellos se descubre un fondo de crítica social, que se ordena en una estructura y se revela como el significado de los textos.

  9. Electroconvulsive therapy in the elderly: Retrospective analysis from an urban general hospital psychiatry unit

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    Dimple D Dadarwala

    2017-01-01

    Full Text Available Introduction: The number of elder patients with severe psychiatric illnesses other than depression is increasing. Electroconvulsive therapy (ECT has a special role in the treatment of late-life depression and other psychiatric conditions in the elderly. Using ECTs in the elderly could be difficult. In an Indian setting, ECT in the geriatric population is used as last resort of treatment which is in contrast to Western countries. There is dearth of data available for the use of ECT in the elderly in India. Methodology: Retrospective data review was carried out to identify patients 55 years or older who had received ECT from January 2014 to June 2016 in tertiary care teaching hospital in a metropolitan city in India. Results: A total of 304 ECTs were administered to 25 elderly aged> 55 years with average of 12 ECTs per patient. Schizophrenia (56% was the most common diagnosis among patients who were considered for ECT, and this was followed by major depression without psychotic features (24% and major depression with psychotic features (8%. The most common indication to start ECT was nonresponsiveness to medications (92%. There was an increase in mean Mini-Mental State Examination (MMSE scores from baseline (23.42 to the end of the sixth (24.60 and last ECT (24.60. Duration of current used during ECT had positive correlation with MMSE. Patients with comorbid medical illness (20% received ECT without any complication. Conclusions: This study adds to scarce database on the use of ECT in old-age patients in India and adds to evidence that ECT is safe and effective treatment in old age with no negative impact on cognition.

  10. Improving the workflow of nursing assistants at a general hospital in Japan.

    Science.gov (United States)

    Isono, Hiroki; Suzuki, Sayuri; Ogura, Jun; Haruta, Junji; Maeno, Tetsuhiro

    2017-01-01

    Transferring non-specialised tasks from registered nurses to nursing assistants may help registered nurses focus on specialised tasks. Optimising the workflow of nursing assistants by making their tasks more efficient may improve problems associated with the shortage of registered nurses. The nursing assistants at our hospital were stressed about referring inpatients to outpatient specialty clinics. Therefore, we initiated a project to optimise the referral process and reduce the time spent by nursing assistants on this task, with the collaboration of physicians, registered nurses and administrative assistants. The Training for Effective & Efficient Action in Medical Service-Better Process (TEAMS-BP) method, which was developed by modifying the Japanese Training Within Industry-Job Method, was used for the optimisation process. TEAMS-BP teaches users how to break each task down into its individual components, to scrutinise the details, and then to develop new processes by eliminating, combining, rearranging and simplifying tasks. At baseline, each referral took 10 min and was performed 39 times over 10 days in six wards. The first TEAMS-BP cycle did not yield satisfactory results for the nursing assistants. In the second TEAMS-BP cycle, participants included inpatient and outpatient physicians, registered nurses and administrative assistants. As a result, we changed the referral process from paper to electronic records and streamlined referrals that were ordered by inpatient physicians to outpatient physicians. The use of this method saved the equivalent of 175 hours of nursing assistants' time per year at no additional cost. If we had been able to define the referral process as an interdisciplinary task and show the merits to each department from the beginning, we may have been able to form the interprofessional team in the first TEAMS-BP. Improving the efficiency of nursing assistants can allow other professionals to focus on their specialised tasks more

  11. Intimate partner violence among female drug users admitted to the general hospital: screening and prevalence.

    Science.gov (United States)

    Caldentey, Clara; Tirado Muñoz, Judit; Ferrer, Tessie; Fonseca Casals, Francina; Rossi, Paola; Mestre-Pintó, Juan Ignacio; Torrens Melich, Marta

    2017-06-28

    Intimate partner violence (IPV) is a public health problem worldwide. Several factors have been found to be associated with an increased prevalence of IPV, such as substance use. A cross-sectional study was conducted with the aim of determining the prevalence of IPV among women entering Hospital del Mar (Barcelona) for any medical/surgical reason, and who had a diagnosis of substance use disorder. Secondly, it was intended to psychometrically validate the Spanish version of the Hurt, Insulted, Threatened with Harm, Screamed (HITS) questionnaire. All patients were assessed by two IPV questionnaires, the Composite Abuse Scale (CAS) and HITS. Out of 52 patients interviewed, 46 answered both questionnaires. According to the CAS questionnaire, 23 patients (50%) experienced IPV at some point in their lives and 11 (23.9%) in the last year. Cannabis consumption was also associated with an increased severity of IPV (95% CI 3.5-28.9, p = .013).According to the HITS questionnaire, there was a prevalence of 39.1% (18 patients) in the last 12 months. HITS had a specificity of 100% and a sensitivity of 78% relative to the CAS questionnaire. A cut-off score x∈ [6.7], derived through ROC analysis, correctly discriminated 91% of the victims and 100% of the non-victims. The results obtained showed that the prevalence of IPV was very high among women who suffered from more than one substance use disorder. Therefore, it is highly recommended to systematically screen for IPV victimization by putting the HITS questionnaire into practice.

  12. [Infections during the first posttransplant year--experience at Sibenik General Hospital].

    Science.gov (United States)

    Gulin, Marijana; Čivljak, Rok; Bilić, Blanša; Sušić, Edita; Gulin, Marko

    2014-04-01

    The aim of this study was to assess the frequency and type of infective complications in kidney recipients during the first year after transplantation. We retrospectively analyzed data on the diagnosis and treatment of infective complications in 36 patients transplanted from 2004 until September 2012 (22 men and 14 women), age at the time of transplantation 19-73 years. We recorded the incidence of urinary tract infections, clinical variants (asymptomatic bacteriuria, acute pyelonephritis, sepsis) and etiology, i.e. causes, pneumonia, viral infections and cytomegalovirus infections (CMV) (with special reference to the use or no use of prophylactic valganciclovir), polyoma virus infection, BKV, JC, Epstein-Barr virus, and herpes zoster virus. The most common infective complication, uroinfection, was recorded in 69% of patients, of which 68% had one or more relapses. The most common clinical form of the infection was acute tubulointerstitial nephritis, caused by Klebsiella pneumoniae (of which 4 cases of ESBL Klebsiella pneumoniae). Pneumonia occurred in 4 transplant patients, one CMV pneumonia, other of bacterial origin. CMV infection and BKV occurred in 17% and herpes zoster infection in 11% of patients. One patient was diagnosed with EBV meningoencephalitis. One-year graft survival was 100% in patients without urinary tract infections in the first year after transplantation (31% of all patients) and 96% in patients with infections (69% of all patients).Three-year graft survival rate was 100% in patients without infection and 96% in patients with infections in the first year after transplantation. One- and three-year graft survival in patients with chronic hepatitis C was 100%. It was a small group of patients (5/36, 14%); the incidence of urinary tract infections amounted to 60%, and of CMV and BK virus to 20%. Infections are a common problem after kidney transplantation, which can be treated in a secondary care hospital.

  13. Workload and clinical significance of the isolation of zygomycetes in a tertiary general hospital.

    Science.gov (United States)

    Torres-Narbona, M; Guinea, J; Martínez-Alarcón, J; Muñoz, P; Peláez, T; Bouza, E

    2008-05-01

    Several reports of increases in invasive zygomycosis (IZ) at individual institutions across the USA and Europe have contributed to a generalized concept that IZ is an increasing problem and the overestimation of the clinical significance of the isolation of zygomycetes in microbiology departments. We assessed the workload and clinical significance of zygomycetes isolates recovered from clinical samples in our institution over a 19-year period (1988-2006). We retrospectively reviewed the charts of those patients from who isolates of zygomycetes were obtained and calculated the workload of its isolation, the incidence of IZ during this period and the positive predictive value (PPV) of a positive culture. Zygomycetes were recovered from 210 samples (176 patients), i.e., 0.086/1,000 clinical samples processed and 6.3/1,000 samples submitted for fungal isolation. Zygomycetes represented 0.6% of the total fungi recovered. The mean incidence of the disease was 1.2 cases/100,000 admissions (range 0-20). Only 16 of the samples which grew zygomycetes (7.6%) were from infected patients. The workload generated by zygomycetes in our institution and the PPV for IZ of their isolation in our laboratory were very low and the disease was not found to have significantly increased in recent years in our institution. Data from specific institutions cannot be generalized.

  14. General self-efficacy and the effect of hospital workplace violence on doctors' stress and job satisfaction in China.

    Science.gov (United States)

    Yao, Yongcheng; Wang, Wei; Wang, Faxuan; Yao, Wu

    2014-06-01

    This study aims at exploring associations of general self-efficacy (GSE), workplace violence and doctors' work-related attitudes. In this study a cross-sectional survey design was applied. Questionnaires were administrated to 758 doctors working in 9 hospitals of Zhengzhou, Henan province, China, between June and October 2010. General information on age, gender, and years of working was collected, and the doctors' experience and witnessing workplace violence, job satisfaction, job initiative, occupational stress as well as GSE were measured. General linear regression analysis was performed in association analyses. Both experiencing and witnessing workplace violence were significantly positively correlated with the level of occupational stress but significantly negatively correlated with job satisfaction, job initiative, and GSE. General self-efficacy significantly modified relationships between both experiencing and witnessing workplace violence with occupational stress (β = 0.49 for experiencing violence; β = 0.43 for witnessing violence; p workplace violence with job initiative (p > 0.05). The levels of occupational stress declined significantly with the increase of GSE, while job satisfaction increased significantly along with its increase. The effects of GSE on occupational stress and job satisfaction weakened as the frequency of violence increased. The findings suggest that GSE can modify effects of workplace violence on health care workers' stress and job satisfaction. Enhancing GSE in combination with stress reduction may lead to facilitating health care workers' recovery from workplace violence, and thereby improving their work-related attitudes.

  15. Cost accounting of radiological examinations. Cost analysis of radiological examinations of intermediate referral hospitals and general practice.

    Science.gov (United States)

    Lääperi, A L

    1996-01-01

    The purpose of this study was to analyse the cost structure of radiological procedures in the intermediary referral hospitals and general practice and to develop a cost accounting system for radiological examinations that takes into consideration all relevant cost factors and is suitable for management of radiology departments and regional planning of radiological resources. The material comprised 174,560 basic radiological examinations performed in 1991 at 5 intermediate referral hospitals and 13 public health centres in the Pirkanmaa Hospital District in Finland. All radiological departments in the hospitals were managed by a specialist in radiology. The radiology departments at the public health care centres operated on a self-referral basis by general practitioners. The data were extracted from examination lists, inventories and balance sheets; parts of the data were estimated or calculated. The radiological examinations were compiled according to the type of examination and equipment used: conventional, contrast medium, ultrasound, mammography and roentgen examinations with mobile equipment. The majority of the examinations (87%) comprised conventional radiography. For cost analysis the cost items were grouped into 5 cost factors: personnel, equipment, material, real estate and administration costs. The depreciation time used was 10 years for roentgen equipment, 5 years for ultrasound equipment and 5 to 10 years for other capital goods. An annual interest rate of 10% was applied. Standard average values based on a sample at 2 hospitals were used for the examination-specific radiologist time, radiographer time and material costs. Four cost accounting versions with varying allocation of the major cost items were designed. Two-way analysis of variance of the effect of different allocation methods on the costs and cost structure of the examination groups was performed. On the basis of the cost analysis a cost accounting program containing both monetary and

  16. Is the Current Management of Patients Presenting With Spinal Trauma to District General Hospitals Fit for Purpose? Our Experience of Delivering a Spinal Service Using an Electronic Referral Platform in a Large District General Teaching Hospital Without Onsite Spinal Services.

    Science.gov (United States)

    Hill, Daniel S; Marynissen, Hans

    2018-04-12

    A retrospective cross-sectional analysis. To describe the provision of a spinal service using an electronic platform to direct management from an external spinal unit, and quantify time taken to obtain definitive management plans whilst under prescribed spinal immobilization. Most attending district general hospitals following spinal trauma will have stable injuries and normal neurology, with only a small proportion requiring urgent transfer to a specialist centre. A retrospective review of 104 patients admitted following vertebral during a 12-month period. The British Orthopaedic Association Standards for Trauma consensus that "spinal immobilisation is not recommended for more than 48 hours" was the standard of care measured against. 100 patients occupied a total of 975 hospital inpatient bed days. 117 radiological investigations were requested after the point of external referral (47 CT-scans, 37 MRI-scans, and 33 weight bearing radiographs). The period between initial referral to the regional spinal service and then receiving a definitive final management had a median value of 72 hours and a range of 0 - 33 days. Patients will have been under some form of prescribed spinal immobilisation until the definitive management plan was communicated. 34 patients (34% of the overall cohort) had a definitive management plan in place within 48 hours. 80 patients had vertebral injuries (73 stable, 6 unstable), 3 patients had prolapsed intervertebral disks, 1 had metastatic disease, and 17 had not evidence of an acute injury following evaluation. Patients are being placed under prescribed immobilisation for longer than is recommended. Delays in obtaining radiological imaging were an important factor, together with the time taken to receive a definitive management plan. Limitations in social care provision and delays in arranging this were additional barriers to hospital discharge following the final management plan. 4.

  17. Generalized psychological distress among HIV-infected patients enrolled in antiretroviral treatment in Dilla University Hospital, Gedeo zone, Ethiopia

    Directory of Open Access Journals (Sweden)

    Solomon H. Tesfaye

    2014-05-01

    Full Text Available Background: Psychological disorders like depression and anxiety are potentially dangerous conditions. In the context of HIV/AIDS, this can influence health-seeking behavior or uptake of diagnosis and treatment for HIV/AIDS, add to the burden of disease for HIV patients, create difficulty in adherence to treatment, and increase the risk of mortality and morbid