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.

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 20^th 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.

78 FR 55765 - Compensatory and Alternative Regulatory Measures for Nuclear Power Plant Fire Protection (CARMEN...

Science.gov (United States)

2013-09-11

... Nuclear Power Plant Fire Protection (CARMEN-FIRE) AGENCY: Nuclear Regulatory Commission. ACTION: Draft..., ``Compensatory and Alternative Regulatory Measures for Nuclear Power Plant Fire Protection (CARMEN-FIRE).'' In... caused by impaired fire protection features at nuclear power plants. The report documents the history of...

78 FR 45573 - Compensatory and Alternative Regulatory Measures for Nuclear Power Plant Fire Protection (CARMEN...

Science.gov (United States)

2013-07-29

... Nuclear Power Plant Fire Protection (CARMEN-FIRE) AGENCY: Nuclear Regulatory Commission. ACTION: Notice of... Nuclear Power Plant Fire Protection (CARMEN-FIRE), Draft Report for Comment.'' DATES: Comments on this... caused by impaired fire protection features at nuclear power plants. The report documents the history of...

CARMEN-SYSTEM, Programs System for Thermal Neutron Diffusion and Burnup with Feedback

International Nuclear Information System (INIS)

Ahnert, Carol; Aragones, Jose M.

1983-01-01

1 - Description of problem or function: CARMEN is a system of programs developed for the neutronic calculation of PWR cycles. It includes the whole chain of analysis from cell calculations to core calculations with burnup. The core calculations are based on diffusion theory with cross sections depending on the relevant space-dependent feedback effects which are present at each moment along the cycles. The diffusion calculations are in one, two or three dimensions and in two energy groups. The feedback effects which are treated locally are: burnup, water density, power density and fission products. In order to study in detail these parameters the core should be divided into as many zones as different cross section sets are expected to be required in order to reproduce reality correctly. A relevant difference in any feedback parameter between zones produces different cross section sets for the corresponding zones. CARMEN is also capable to perform the following calculations: - Multiplication factor by burnup step with fixed boron concentration - Buckling and control rod insertion - Buckling search by burnup step - Boron search by burnup step - Control rod insertion search by burnup step. 2 - Method of solution: The cell code (LEOPARD-TRACA) generates the fuel assembly cross sections versus burnup. This is the basic library to be used in the CARMEN code proper. With a planar distribution guess for power density, water density and fluxes, the macroscopic cross sections by zone are calculated by CARMEN, and then a diffusion calculation is done in the whole geometry. With the distribution of power density, heat accumulated in the coolant and the thermal and fast fluxes determined in the diffusion calculation, CARMEN calculates the values of the most relevant parameters that influence the macroscopic cross sections by zone: burnup, water density, effective fuel temperature and fission product concentrations. If these parameters by zone are different from the reference

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

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

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)

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.

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…

Carmen system: a code block for neutronic PWR calculation by diffusion theory with spacedependent feedback effects

International Nuclear Information System (INIS)

Ahnert, C.; Aragones, J.M.

1982-01-01

The Carmen code (theory and user's manual) is described. This code for assembly and core calculations uses diffusion theory (Citation), with feedback in the cross sections by zone due to the effects of burnup, water density, fuel temperature, Xenon and Samarium. The burnup calculation of a full cycle is solved in only an execution of Carmen, and in a reduced computer time. (auth.)

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.

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.

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.

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.

SU-E-T-157: CARMEN: A MatLab-Based Research Platform for Monte Carlo Treatment Planning (MCTP) and Customized System for Planning Evaluation

International Nuclear Information System (INIS)

Baeza, J.A.; Ureba, A.; Jimenez-Ortega, E.; Barbeiro, A.R.; Plaza, A. Leal; Lagares, J.I.

2015-01-01

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

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

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

African Journals Online (AJOL)

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 alcuni scritti di Covito ...

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

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

Directory of Open Access Journals (Sweden)

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

Carmen Dauset Moreno, primera musa del cine estadounidense

OpenAIRE

Mora Contreras, Francisco Javier

2014-01-01

Este artículo se propone analizar la importancia de la bailarina española Carmen Dauset Moreno para la historia del cine. Conocida en el mundo del vaudeville como Carmencita, fue la primera mujer que apareció en dos breves películas para kinetoscopio realizadas en el estudio de Edison en marzo de 1894. En este sentido, el artículo trata de contextualizar la aparición de la artista española en estas películas y plantea cuestiones sobre el significado de las mismas en el desarrollo de las fases...

CARMENES-NIR channel spectrograph cooling system AIV: thermo-mechanical performance of the instrument

Science.gov (United States)

Becerril, S.; Mirabet, E.; Lizon, J. L.; Abril, M.; Cárdenas, C.; Ferro, I.; Morales, R.; Pérez, D.; Ramón, A.; Sánchez-Carrasco, M. A.; Quirrenbach, A.; Amado, P.; Ribas, I.; Reiners, A.; Caballero, J. A.; Seifert, W.; Herranz, J.

2016-07-01

CARMENES is the new high-resolution high-stability spectrograph built for the 3.5m telescope at the Calar Alto Observatory (CAHA, Almería, Spain) by a consortium formed by German and Spanish institutions. This instrument is composed by two separated spectrographs: VIS channel (550-1050 nm) and NIR channel (950- 1700 nm). The NIR-channel spectrograph's responsible is the Instituto de Astrofísica de Andalucía (IAACSIC). It has been manufactured, assembled, integrated and verified in the last two years, delivered in fall 2015 and commissioned in December 2015. One of the most challenging systems in this cryogenic channel involves the Cooling System. Due to the highly demanding requirements applicable in terms of stability, this system arises as one of the core systems to provide outstanding stability to the channel. Really at the edge of the state-of-the-art, the Cooling System is able to provide to the cold mass ( 1 Ton) better thermal stability than few hundredths of degree within 24 hours (goal: 0.01K/day). The present paper describes the Assembly, Integration and Verification phase (AIV) of the CARMENES-NIR channel Cooling System implemented at IAA-CSIC and later installation at CAHA 3.5m Telescope, thus the most relevant highlights being shown in terms of thermal performance. The CARMENES NIR-channel Cooling System has been implemented by the IAA-CSIC through very fruitful collaboration and involvement of the ESO (European Southern Observatory) cryo-vacuum department with Jean-Louis Lizon as its head and main collaborator. The present work sets an important trend in terms of cryogenic systems for future E-ELT (European Extremely Large Telescope) large-dimensioned instrumentation in astrophysics.

[Dementia friendly care services in general hospitals : Representative results of the general hospital study (GHoSt)].

Science.gov (United States)

Hendlmeier, Ingrid; Bickel, Horst; Hessler, Johannes Baltasar; Weber, Joshua; Junge, Magdalena Nora; Leonhardt, Sarah; Schäufele, Martina

2017-11-06

Mostly model projects report on special care services and procedures for general hospital patients with cognitive impairment. The objective of this study was to determine the frequency of special care services and procedures in general hospitals on the basis of a representative cross-sectional study. From a list of all general hospitals in southern Germany we randomly selected a specified number of hospitals und somatic wards. The hospitals were visited and all older patients on the selected wards on that day were included in the study. Information about care services and their utilization was collected with standardized instruments. A total of 33 general hospitals and 172 wards participated in the study. The patient sample included 1469 persons over 65 (mean age 78.6 years) and 40% of the patients showed cognitive impairments. The staff reported that the most frequent measures for patients with cognitive impairments concerned patients with wandering behavior (63.1%), efforts to involve the patients' relatives to help with their daily care (60.1%), conducting nonintrusive interviews to identify cognitive impairments (59.9%), allocation to other rooms (58%) and visual aids for place orientation of patients (50.6%). In accordance with earlier studies our results show that other dementia friendly services implemented in pilot projects were rare. The existing special services for patients with cognitive impairment were rarely used by the patients or their relatives. The results demonstrate the urgent need to improve special care services and routines for identification of elderly patients with cognitive impairment and risk of delirium in general hospitals.

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.

[Leishmaniasis transmission focus in El Hobo, Carmen de Bolívar, Bolívar, Colombia].

Science.gov (United States)

Cortés, Luis Alberto

2006-10-01

The epidemiological characteristics and the importance of the Lutzomyia species present in a leishmaniasis focus in the village El Hobo, Carmen de Bolívar, Department of Bolivar, Colombia, are described. To obtain a preliminary assessment of leishmaniasis transmission in the village of El Hobo, Carmen de Bolívar. Epidemiological data were analyzed and sandflies were collected with CDC traps and on protected human volunteers in the village of El Hobo. Sero prevalence of canine visceral leishmaniasis in dogs was evaluated using indirect inmunofluorescence (IFAT). Nine Lutzomyia species were collected: L. trinidadensis, L. evansi, L. cayennensis, L. venezuelensis, L. gomezi, L. dubitans, L. ylephiletor, L. yuilli, and L. walkeri. The species of greater importance based on their implication in the transmission of cutaneous and visceral leishmaniasis were L. gomezi, and L. evansi respectively. Specimens of L. venezuelensis, L. dubitans, L. ylephiletor, L. yuilli, and L. walkeri are reported for the first time for the Department of Bolivar. The sero prevalence of visceral leishmaniasis in dogs was 36%. According to the epidemiological records, in 2002 the municipality of Carmen de Bolivar presented a 40% increase in cases of cutaneous leishmaniasis and an 80% increase in canine visceral leishmaniasis as compared to 2001, due to the outbreak in the village of El Hobo. The results indicate that the village of El Hobo is an area of potential risk for transmission of both cutaneous and visceral leishmaniasis.

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

"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

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

GENERAL PRACTITIONERS AND HOSPITALS

African Journals Online (AJOL)

In recent years in South Africa the position of the general practi- tioner in hospitals has ... ments, and it is in these hospitals that difficulties have arisen. On the other hand, ... great extent deprived of contact with his colleagues. He comes to ... eventually lose interest in the results of treatment and advances in medicine. In fact ...

Fault kinematics and depocenter evolution of oil-bearing, continental successions of the Mina del Carmen Formation (Albian) in the Golfo San Jorge basin, Argentina

Science.gov (United States)

Paredes, José Matildo; Plazibat, Silvana; Crovetto, Carolina; Stein, Julián; Cayo, Eric; Schiuma, Ariel

2013-10-01

Up to 10% of the liquid hydrocarbons of the Golfo San Jorge basin come from the Mina del Carmen Formation (Albian), an ash-dominated fluvial succession preserved in a variably integrated channel network that evolved coeval to an extensional tectonic event, poorly analyzed up to date. Fault orientation, throw distribution and kinematics of fault populations affecting the Mina del Carmen Formation were investigated using a 3D seismic dataset in the Cerro Dragón field (Eastern Sector of the Golfo San Jorge basin). Thickness maps of the seismic sub-units that integrate the Mina del Carmen Formation, named MEC-A-MEC-C in ascending order, and mapping of fluvial channels performed applying geophysical tools of visualization were integrated to the kinematical analysis of 20 main normal faults of the field. The study provides examples of changes in fault throw patterns with time, associated with faults of different orientations. The "main synrift phase" is characterized by NE-SW striking (mean Az = 49°), basement-involved normal faults that attains its maximum throw on top of the volcanic basement; this set of faults was active during deposition of the Las Heras Group and Pozo D-129 formation. A "second synrift phase" is recognized by E-W striking normal faults (mean Az = 91°) that nucleated and propagated from the Albian Mina del Carmen Formation. Fault activity was localized during deposition of the MEC-A sub-unit, but generalized during deposition of MEC-B sub-unit, producing centripetal and partially isolated depocenters. Upward decreasing in fault activity is inferred by more gradual thickness variation of MEC-C and the overlying Lower Member of Bajo Barreal Formation, evidencing passive infilling of relief associated to fault boundaries, and conformation of wider depocenters with well integrated networks of channels of larger dimensions but random orientation. Lately, the Mina del Carmen Formation was affected by the downward propagation of E-W to ESE-WNW striking

CARMENES. Mining public archives for stellar parameters and spectra of M dwarfs with master thesis students

Science.gov (United States)

Caballero, J. A.; Montes, D.; Alonso-Floriano, F. J.; Cortés-Contreras, M.; González-Álvarez, E.; Hidalgo, D.; Holgado, G.; Martínez-Rodríguez, H.; Sanz-Forcada, J.; López-Santiago, J.

2015-05-01

We are compiling the most comprehensive database of M dwarfs ever built, CARMENCITA, the CARMENES Cool dwarf Information and daTa Archive, which will be the CARMENES 'input catalogue'. In addition to the science preparation with low- and high-resolution spectrographs and lucky imagers, we compile a huge pile of public data on over 2200 M dwarfs, and analyse them, mostly using virtual-observatory tools. Here we describe four specific actions carried out by master students. They mine public archives for additional high-resolution spectroscopy (UVES, FEROS and HARPS), multi-band photometry (FUV-NUV-u-B-g-V-r-R-i-J-H-Ks-W1-W2-W3-W4), X-ray data (ROSAT, XMM-Newton and Chandra), and periods, rotational velocities and Hα pseudo-equivalent widths. As described, there are many interdependences between all these data.

Carmen de Burgos, la APM y aquellas admirables chicas del 98

Directory of Open Access Journals (Sweden)

Hernando, Bernardino M.

2010-06-01

Full Text Available It enters the five women journalists pertaining to the Association of the Press of Madrid (APM was the writer, professor, lecturer and hardened travelling Carmen de Burgos, Colombine call. It and the other four, Jesusa Granda, participant in the foundation of the APM in 1895, Atocha Ossorio and Gallardo, Salomé Núñez de Topete and Consuelo Álvarez Pool trained a made an effort group of admirable women fighters by the culture and the human rights. Identified with the advanced to “generation of 98” if this nonhuibera be as chauvinistic as was almost everything then.

Entre las cinco primeras mujeres periodistas pertenecientes a la Asociación de la Prensa de Madrid (APM estaba la escritora, profesora, conferenciante y empedernida viajera Carmen de Burgos, llamada Colombine. Ella y las otras cuatro, Jesusa Granda, participante en la fundación de la APM en 1895, Atocha Ossorio y Gallardo, Salomé Núñez de Topete y Consuelo Álvarez Pool formaban un grupo esforzado de admirables mujeres luchadoras por la cultura y los derechos humanos. Identificadas con los ideales sociales más avanzados podrían haber pertenecido a la “generación del 98” si esta no hubiera sido tan machista como era casi todo en aquella época.

The CARMENES search for exoplanets around M dwarfs. High-resolution optical and near-infrared spectroscopy of 324 survey stars

Science.gov (United States)

Reiners, A.; Zechmeister, M.; Caballero, J. A.; Ribas, I.; Morales, J. C.; Jeffers, S. V.; Schöfer, P.; Tal-Or, L.; Quirrenbach, A.; Amado, P. J.; Kaminski, A.; Seifert, W.; Abril, M.; Aceituno, J.; Alonso-Floriano, F. J.; Ammler-von Eiff, M.; Antona, R.; Anglada-Escudé, G.; Anwand-Heerwart, H.; Arroyo-Torres, B.; Azzaro, M.; Baroch, D.; Barrado, D.; Bauer, F. F.; Becerril, S.; Béjar, V. J. S.; Benítez, D.; Berdinas˜, Z. M.; Bergond, G.; Blümcke, M.; Brinkmöller, M.; del Burgo, C.; Cano, J.; Cárdenas Vázquez, M. C.; Casal, E.; Cifuentes, C.; Claret, A.; Colomé, J.; Cortés-Contreras, M.; Czesla, S.; Díez-Alonso, E.; Dreizler, S.; Feiz, C.; Fernández, M.; Ferro, I. M.; Fuhrmeister, B.; Galadí-Enríquez, D.; Garcia-Piquer, A.; García Vargas, M. L.; Gesa, L.; Galera, V. Gómez; González Hernández, J. I.; González-Peinado, R.; Grözinger, U.; Grohnert, S.; Guàrdia, J.; Guenther, E. W.; Guijarro, A.; Guindos, E. de; Gutiérrez-Soto, J.; Hagen, H.-J.; Hatzes, A. P.; Hauschildt, P. H.; Hedrosa, R. P.; Helmling, J.; Henning, Th.; Hermelo, I.; Hernández Arabí, R.; Hernández Castaño, L.; Hernández Hernando, F.; Herrero, E.; Huber, A.; Huke, P.; Johnson, E. N.; Juan, E. de; Kim, M.; Klein, R.; Klüter, J.; Klutsch, A.; Kürster, M.; Lafarga, M.; Lamert, A.; Lampón, M.; Lara, L. M.; Laun, W.; Lemke, U.; Lenzen, R.; Launhardt, R.; López del Fresno, M.; López-González, J.; López-Puertas, M.; López Salas, J. F.; López-Santiago, J.; Luque, R.; Magán Madinabeitia, H.; Mall, U.; Mancini, L.; Mandel, H.; Marfil, E.; Marín Molina, J. A.; Maroto Fernández, D.; Martín, E. L.; Martín-Ruiz, S.; Marvin, C. J.; Mathar, R. J.; Mirabet, E.; Montes, D.; Moreno-Raya, M. E.; Moya, A.; Mundt, R.; Nagel, E.; Naranjo, V.; Nortmann, L.; Nowak, G.; Ofir, A.; Oreiro, R.; Pallé, E.; Panduro, J.; Pascual, J.; Passegger, V. M.; Pavlov, A.; Pedraz, S.; Pérez-Calpena, A.; Medialdea, D. Pérez; Perger, M.; Perryman, M. A. C.; Pluto, M.; Rabaza, O.; Ramón, A.; Rebolo, R.; Redondo, P.; Reffert, S.; Reinhart, S.; Rhode, P.; Rix, H.-W.; Rodler, F.; Rodríguez, E.; Rodríguez-López, C.; 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.; Schmitt, J. H. M. M.; Schiller, J.; Schweitzer, A.; Solano, E.; Stahl, O.; Strachan, J. B. P.; Stürmer, J.; Suárez, J. C.; Tabernero, H. M.; Tala, M.; Trifonov, T.; Tulloch, S. M.; Ulbrich, R. G.; Veredas, G.; Vico Linares, J. I.; Vilardell, F.; Wagner, K.; Winkler, J.; Wolthoff, V.; Xu, W.; Yan, F.; Zapatero Osorio, M. R.

2018-04-01

The CARMENES radial velocity (RV) survey is observing 324 M dwarfs to search for any orbiting planets. In this paper, we present the survey sample by publishing one CARMENES spectrum for each M dwarf. These spectra cover the wavelength range 520-1710 nm at a resolution of at least R >80 000, and we measure its RV, Hα emission, and projected rotation velocity. We present an atlas of high-resolution M-dwarf spectra and compare the spectra to atmospheric models. To quantify the RV precision that can be achieved in low-mass stars over the CARMENES wavelength range, we analyze our empirical information on the RV precision from more than 6500 observations. We compare our high-resolution M-dwarf spectra to atmospheric models where we determine the spectroscopic RV information content, Q, and signal-to-noise ratio. We find that for all M-type dwarfs, the highest RV precision can be reached in the wavelength range 700-900 nm. Observations at longer wavelengths are equally precise only at the very latest spectral types (M8 and M9). We demonstrate that in this spectroscopic range, the large amount of absorption features compensates for the intrinsic faintness of an M7 star. To reach an RV precision of 1 m s-1 in very low mass M dwarfs at longer wavelengths likely requires the use of a 10 m class telescope. For spectral types M6 and earlier, the combination of a red visual and a near-infrared spectrograph is ideal to search for low-mass planets and to distinguish between planets and stellar variability. At a 4 m class telescope, an instrument like CARMENES has the potential to push the RV precision well below the typical jitter level of 3-4 m s-1.

Influencia de la marea astronómica sobre las variaciones del nivel del Río Negro en la zona de Carmen de Patagones

Directory of Open Access Journals (Sweden)

Enrique D'Onofrio

2010-12-01

Full Text Available El Río Negro, límite natural entre las provincias de Buenos Aires y Río Negro, es uno de los ríos más importantes de la Patagonia que desemboca en el Océano Atlántico. Es navegable desde su desembocadura hasta Carmen de Patagones por embarcaciones de hasta 2,04 m de calado, dificultándose por irregularidades en la profundidad aguas arriba. La onda de marea proveniente del océano Atlántico ingresa al río haciendo que este adopte un régimen semidiurno hasta Carmen de Patagones. El conocimiento de la onda de marea en este tramo del río es de fundamental importancia para la calibración de modelos numéricos, el perfeccionamiento de los sistemas de alerta de inundaciones y la toma de decisiones relacionadas con el manejo costero. En este trabajo se analizan cuatro series de mediciones de marea, dos obtenidas en el hidrómetro de Carmen de Patagones con una duración de 608 y 731 días, una de 77 días proveniente de un mareómetro instalado en el kilómetro 18 del río y una de 79 días obtenida con un sensor de presión fondeado en proximidades de Punta Redonda (desembocadura del Río Negro. Se calculan y comparan los espectros de potencia de las alturas observadas en los tres sitios para detectar los cambios energéticos producidos en la banda de frecuencias correspondientes a la marea astronómica. De su comparación surge que la energía de las componentes semidiurnas y diurnas disminuye un 22% y un 45% respectivamente desde la desembocadura del Río Negro hasta Carmen de Patagones. En contraposición se observa un ligero aumento de la energía correspondiente a las frecuencias de las componentes cuarto diurnas. Esto se debe fundamentalmente a procesos no lineales inducidos por aguas someras y a irregularidades en la morfología del fondo del río. Para obtener las amplitudes y épocas de la marea se realizan análisis armónicos por el método de cuadrados mínimos. Las amplitudes de las componentes diurnas en Carmen de Patagones

Liderazgo y práctica pedagógica de los docentes en la Institución Educativa"José del Carmen Cabrejo Mejía del distrito de Andabamba, provincia de Santa Cruz, región Cajamarca - 2014

OpenAIRE

Vásquez Milían, Eduin

2017-01-01

La investigación responde a la pregunta ¿Cuál es la relación entre el liderazgo y la práctica pedagógica de los docentes en la institución educativa José del Carmen Cabrejo Mejía del distrito de Andabamba, provincia de santa Cruz, región Cajamarca en el año 2014? El objetivo general es: Determinar la relación entre el liderazgo y la práctica pedagógica de los docentes en la institución educativa José del Carmen Cabrejo Mejía del distrito de Andabamba, provincia de Santa Cruz, región Cajamarca...

La memoria del último exilio español en la escritura de tres mujeres: Victoria Kent, Dolores Ibárruri y Carmen Parga

Directory of Open Access Journals (Sweden)

Bettina Pacheco

2011-11-01

Full Text Available Resumo: Este artigo realiza uma breve análise de três obras de testemunhos do exílio escritas por mulheres: Victoria Kent, destacada advogada socialista cromprometida com o governo da República Espanhola; Dolores Ibárruri, a mítica Pasionária; e Carmen Parga, republicana exilada na Rússia e México. As três dão sua visão, a sua maneira e através da escrita, sobre o drama vivido oferecendo sua concepção particular do exílio. Antes de entrar nas obras aludidas, examina-se brevemente as duas concepções sobre a dramática experiência do exilado que Cláudio Guillén reconheceu na escrita dos clássicos: Ovídio e Plutarco.Palavras-chave: Literatura comparada; literatura espanhola; Victoria Kent; Dolores Ibárruri; Carmen Parga; literatura latina; Ovídio; Plutarco; exílio.Resumen: Este artículo realiza um somero análisis de três obras testimoniales del exílio escritas por mujeres: Victoria Kent, destacada abogada socialista comprometida com el gobierno de la República Española; Dolores Ibárruri, la mítica Pasionaria; y Carmen Parga, republicana exiliada en Rusía y México. Las tres dan su visión, a su manera y a través de la escritura, sobre el drama vivido ofreciendo su concepción particular del exílio. Antes de entrar en las obras aludidas, se examina brevemente las dos concepiones sobre la dramática experiencia del exilado que Cláudio Guillén há reconocido em la escritura de dos clássicos: Ovídio y Plutarco.Palabras-clave: Literatura comparada; literatura española; Victoria Kent; Dolores Ibárruri; Carmen Parga; literatura latina; Ovídio; Plutarco; exílio.Keywords: Comparative literature; Spanish literature; Victoria Kent; Dolores Ibárruri; Carmen Parga; latin literature; Ovid; Plutarch; exile.

Carmen Luisa Letelier Valdés, Premio Nacional de Arte mención Música 2010: su labor como maestra de canto Carmen Luisa Letelier-Valdés, Winner of the National Arts Award in Music 2010: her Work as Professor of the Art of Singing

Directory of Open Access Journals (Sweden)

Gonzalo Cuadra Balagna

2012-06-01

Full Text Available A partir de su experiencia personal como discípulo de Carmen Luisa Letelier Valdés en la Facultad de Artes de la Universidad de Chile, el autor evoca la cualidad vocal de la artista, su aporte al desarrollo de la vida musical chilena y su labor como formadora de importantes cantantes chilenos.The author ofthe article studied singing with Carmen Luisa Letelier-Valdés at the Faculty ofArts ofthe University ofChile. On the basis ofhis direct contact with the artist the author presents a personal view ofthe vocal quality of the artist as well as her contribution to the development ofChilean musical activity and her work as teacher of important Chilean singers.

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.

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.

Un puente entre España y Portugal: Carmen de Burgos y su amistad con Ana de Castro Osório

Directory of Open Access Journals (Sweden)

Núñez Rey, Concepción

2014-04-01

Full Text Available Spain and Portugal experienced a time of intense cultural exchange from 1915 onwards through two major female figures in the two countries who were bound by strong intellectual and personal links. Ana de Castro was a writer prominent in politics, journalism and Portuguese literature from the late 19th century, and Carmen de Burgos was the first professional Spanish woman journalist and one of the most important writers of the first third of the 20th century. They shared the ideals of equality for women and social justice for all, in conjunction with their incessant work in the press and in literary creation: Ana de Castro, more as a political figure, Carmen de Burgos, more as writer. We remember here the intense activity that they shared and the wide echo that it found in the press of both countries.España y Portugal vivieron un tiempo de intenso intercambio cultural a partir de 1915 a través de dos grandes figuras femeninas de ambos países, unidas por fuertes vínculos intelectuales y personales. Ana de Castro fue una escritora muy destacada en la política, en el periodismo y en la literatura lusas desde finales del siglo XIX, y Carmen de Burgos fue la primera periodista profesional española y una de las escritoras más importantes del primer tercio del siglo XX. Ambas compartieron grandes ideales de igualdad para la mujer y de justicia social para todos, unidos a una incesante labor periodística y literaria: Ana de Castro, más como política, Carmen de Burgos, más como escritora. Recordamos aquí la intensa actividad compartida y el amplio eco que encontró en la prensa de los dos países.

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)

Las pautas matrimoniales de los inmigrantes españoles en la ciudad de Carmen de Patagones, prov. de Buenos Aires (1889-1958), Argentina

OpenAIRE

Caratini, Alicia Liliana; Videla, Blanca; Carnese, Francisco R.

2001-01-01

A fines del siglo XVIII la Corona Española concibió la posibilidad de establecerse en forma permanente en la Patagonia. Aproximadamente 2.000 individuos partieron desde el puerto de La Coruña, de los que sólo un 10% llegó a la costa patagónica, fundando la ciudad de Carmen de Patagones. Nuestro objetivo es analizar: 1) los vínculos endo-exogámicos y la edad de acceso al matrimonio de los inmigrantes españoles de Carmen de Patagones; 2) comparar los resultados respecto a los obtenidos en Río G...

Sob a sombra de Carmen Miranda e do carnaval: brasileiras em Los Angeles Under the shadow of Carmen Miranda and carnival: brazilian women in Los Angeles

Directory of Open Access Journals (Sweden)

Bernadete Beserra

2007-06-01

Full Text Available Neste artigo, analiso como brasileiras de classes média e média alta em Los Angeles lidam com o fenômeno da exotização das suas imagens. Observo que, embora originalmente articuladas a partir de Hollywood (Carmen Miranda nos limites da hierarquia entre as nações e do colonialismo, essas imagens são hoje alimentadas e recriadas também pelos próprios brasileiros. Uma das idéias centrais que defendo aqui é que embora tais imagens inicialmente restrinjam a ação das brasileiras, uma vez que sempre impõem o diálogo com os seus conteúdos, elas não o fazem permanentemente, ou seja, no processo de integração há espaço para a negociação de outras imagens e conteúdos e isto depende de fatores que vão além da exotização em si.This article discusses how middle and upper-middle class Brazilian women deal with their exoticized images in Los Angeles. It points out that although originally articulated from Hollywood (Carmen Miranda, within the limits of the hierarchy of nations and colonialism, today these images are also fed and recreated by Brazilians. One of the central ideas presented is that, despite constraining the movements and actions of the women, imposing on them the need to dialogue with their content, these exotic images do not do it permanently. In other words, in the process of integration, there is always room for negotiation of other images and contents that depend on factor other than exoticization itself.

CARMEN: a system Monte Carlo based on linear programming from direct openings

International Nuclear Information System (INIS)

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

2013-01-01

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)

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.

Hospital Web site 'tops' in Louisiana. Hospital PR, marketing group cites East Jefferson General Hospital.

Science.gov (United States)

Rees, Tom

2002-01-01

East Jefferson General Hospital in Metairie, La., launched a new Web site in October 2001. Its user-friendly home page offers links to hospital services, medical staff, and employer information. Its jobline is a powerful tool for recruitment. The site was awarded the 2002 Pelican Award for Best Consumer Web site by the Louisiana Society for Hospital Public Relations & Marketing.

Metafiction and intertextuality in Prénom: Carmen by Jean-Luc Godard

Directory of Open Access Journals (Sweden)

Pujante Segura, Carmen

2009-07-01

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.

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

Directory of Open Access Journals (Sweden)

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.

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.

Psychiatric units in Brazilian general hospitals: a growing philanthropic field.

Science.gov (United States)

Botega, Neury José

2002-06-01

Some countries, mainly in North America and Europe, have adopted psychiatric wards in the general hospital as an alternative to the classic psychiatric hospital. In Brazil there are 6,169 general hospitals, 1.3% of which with a psychiatric unit. This service strategy is scarcely developed in the country and comprises only 4% of all psychiatric admissions. There was no information on the facilities and functioning of the psychiatric units in general hospitals. To determine the main characteristics of psychiatric units in Brazilian general hospitals and to assess the current trends in the services provided. A mailing survey assessed all 94 Brazilian general hospitals which made psychiatric admissions. A two-page questionnaire was designed to determine the main characteristics of each institution and of the psychiatric unit. Seventy-nine (84%) questionnaires were returned. In contrast to the 1970s and 1980s, in the last decade the installation of psychiatric units has spread to smaller philanthropic institutions that are not linked to medical schools. A fifth of hospitals admit psychiatric patients to medical wards because there is no specialist psychiatric ward. They try to meet all the local emergency demands, usually alcohol-dependent patients who need short term admission. This could signal the beginning of a program through which mental health professionals may become an integral part of general health services. The inauguration of psychiatric wards in philanthropic hospitals, as well as the admission of psychiatric patients in their medical wards, is a phenomenon peculiar to this decade. The installation of psychiatric services in these and other general hospitals would overcome two of major difficulties encountered: prejudice and a lack of financial resources.

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.

Foco de leishmaniasis en El Hobo, municipio de El Carmen de Bolívar, Bolívar, Colombia

Directory of Open Access Journals (Sweden)

Luis Alberto Cortés

2006-10-01

Full Text Available Introducción. Se describen las características epidemiológica e importancia de la especies de Lutzomyia presentes en un foco de leishmaniasis en la vereda El Hobo Carmen de Bolívar, departamento de Bolívar. Objetivos. Obtener un conocimiento preliminar de la transmisión de leishmaniasis en la vereda El Hobo Carmen de Bolívar. Materiales y métodos. Se analizaron datos epidemiológicos y se realizaron capturas de flebótomos con trampas CDC y cebo humano en la vereda El Hobo. Para establecer la sero prevalencia de leishmaniasis visceral canina se hizo un estudio en perros mediante la técnica de inmunofluorescencia indirecta. Resultados. Se capturaron nueve especies de Lutzomyia: L. trinidadensis, L. evansi, L .cayennensis, L. venezuelensis, L. gomezi,L. dubitans, L. ylephiletor, L. yuilli, y L. walkeri. Las especie de mayor importancia por sus implicaciones en la transmisión de leishmaniasis cutánea y visceral fueron L. gomezi, y L. evansi respectivamente. Se reporta por primera vez para Bolívar especimenes de L. venezuelensis, L. dubitans, L. ylephiletor, L. yuilli, y L. walkeri. Se determinó una prevalencia de leishmaniasis visceral del 36% en los caninos estudiados. Según los reportes epidemiológicos, en el 2002 en el municipio de Carmen de Bolívar la leishmaniasis cutánea mostró un aumento del 40% y la leishmaniasis visceral canina del 80% de los casos con respecto al 2001, debido al brote presentado en la vereda El Hobo Conclusiones. Los resultados determinan a la vereda El Hobo como una zona de riesgo potencial de transmisión de leishmaniasis cutánea y visceral.

Psychiatric referrals in two general hospitals.

Directory of Open Access Journals (Sweden)

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.

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.

"La herida siempre abierta en un cuerpo" o las políticas de la investidura en Duerme de Carmen Boullosa

Directory of Open Access Journals (Sweden)

Vanessa Viches Norat

2016-03-01

Full Text Available En el ensayo "La herida siempre abierta en un cuerpo" o las políticas de la investidura en Duerme de Carmen Boullosa se exploran los cuestionamientos de las construcciones genéricas en Duenne, novela que presenta una protagonista que juega con las representaciones identitarias. Utilizando planteamientos teóricos de Jacques Derrida y Michele Foucault se cuestiona también la teorización de ludith Butler con respecto al travestismo y las políticas del cuerpo. In her essay "La herida siempre abierta en un cuerpo" o las políticas de investidura en Carmen Boullosa" (the wound ever open in a body, or the politics of investiture " the author explores the questionings of generic constructions in "Duenne", a novel which introduces a protagonist who plays with identity representations. On the basis of theoretical principles from M. Foucault and, Derrida, J. Butler's own theorization on transvestism and the politics of the body are also called in question.

General Practice Teaching--Within the Hospital

Science.gov (United States)

Drury, M.

1976-01-01

A program of integrated teaching by consultants and general practitioners is described. The teaching took place in the hospitals used for the purpose by the Medical Faculty of the University of Birmingham. (Author)

Preparation of the CARMENES Input Catalogue: Mining Public Archives for Stellar Parameters and Spectra of M Dwarfs with Master Thesis Students

Science.gov (United States)

Montes, D.; Caballero, J. A.; Alonso-Floriano, F. J.; Cortes Contreras, M.; Gonzalez-Alvarez, E.; Hidalgo, D.; Holgado, G.; Llamas, M.; Martinez-Rodriguez, H.; Sanz-Forcada, J.

2015-01-01

We help compiling the most comprehensive database of M dwarfs ever built, CARMENCITA, the CARMENES Cool dwarf Information and daTa Archive, which will be the CARMENES `input catalogue'. In addition to the science preparation with low- and high-resolution spectrographs and lucky imagers (see the other contributions in this volume), we compile a huge pile of public data on over 2100 M dwarfs, and analyze them, mostly using virtual-observatory tools. Here we describe four specific actions carried out by master and grade students. They mine public archives for additional high-resolution spectroscopy (UVES, FEROS and HARPS), multi-band photometry (FUV-NUV-u-B-g-V-r-R-i-J-H-Ks-W1-W2-W3-W4), X-ray data (ROSAT, XMM-Newton and Chandra), periods, rotational velocities and Hα pseudo-equivalent widths. As described, there are many interdependences between all these data.

Renewable energy load assessment for Boquillas Del Carmen Coahuila, Mexico

Energy Technology Data Exchange (ETDEWEB)

Foster, R. [Southwest Technology Development Institute, Las Cruces, NM (United States)

1995-08-01

This report outlines the estimates that were made in 1992 of the potential load requirements for Boquillas del Carmen, a small Mexican village on the northern border of the state of Coahuila, Mexico near Big Bend National Park in southern Texas. The study was made to help determine the possibility that village might be electrified by solar or wind energy. Various estimates of are given of the potential load based on estimates ranging from basic use of lights, radio, television, and small household appliances to microwave ovens, refrigerators, and direct evaporative coolers. The low-energy consumption case was estimated to be at 23.0 kWh/month per residence per month, and the high-energy consumption case (with cooling) was 140.7 kWh/month per residence. On average, the typical residence is occupied by five individuals.

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.

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

Directory of Open Access Journals (Sweden)

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

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 ...

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.

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 ...

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

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...

An educational conference in a general hospital.

Science.gov (United States)

Caldwell, Gordon

2011-12-01

Western Sussex Hospitals National Health Service (NHS) Trust comprises the District General Hospitals of Worthing and Chichester. Both hospitals have successful postgraduate medical education centres, providing training for junior doctors and continuing professional development for senior doctors. Until now, there have been limited multi-professional teaching and learning activities available. The two hospitals have recently merged. The education executive felt that workplace learning had become undervalued since the implementation of Modernising Medical Careers in the UK. The executive wanted to provide a multi-professional conference on Workplace Learning, both to support the merger and to promote the value of workplace and multi-professional learning. The conference topic covering the 'how' of workplace learning was innovative. Many educational conferences concentrate on the organisation and evaluation of classroom learning, rather than on how learning can be facilitated in the workplace during ordinary working practice. It was also innovative to ensure that the presenters were representative of the multi-professional workforce. The presentations were limited to 8 minutes each to promote high-impact short presentations. The talks were recorded for publishing on the trust's intranet and the internet. A committed team in a district general hospital can provide a high-quality educational conference with wide appeal. Local health care professionals can produce short high-impact presentations. The use of modern information technology and audio-visual systems can make the presentations available to both local and worldwide audiences. © Blackwell Publishing Ltd 2011.

[Philanthropic general hospitals: a new setting for psychiatric admissions].

Science.gov (United States)

Larrobla, Cristina; Botega, Neury José

2006-12-01

To understand the process that led Brazilian philanthropic general hospitals to implement psychiatric units and to describe the main characteristics and therapeutic approaches of these services. Ten institutions in three Brazilian states (Minas Gerais, São Paulo e Santa Catarina) were assessed in 2002. Forty-three semi-structured interviews were carried out with health professionals who worked at the hospitals to collect data on service implementation process, therapeutic approaches and current situation. The interviews were audio-recorded and their content was analyzed. There was no mental hospital in the cities where the institutions were located. In five hospitals, psychiatric patients were admitted to general medical wards because there was no psychiatric unit. The therapeutic approach in six hospitals was based on psychopharmacological treatment. Due to lack of resources and more appropriate therapeutic planning, the admission of patients presenting psychomotor agitation increases resistance against psychiatric patients in general hospitals. Financial constraints regarding laboratory testing is still a challenge. There is no exchange between local authorities and hospital administrators of these institutions that are compelled to exceed the allowed number of admissions to meet the demand of neighboring cities. The need for mental health care to local populations combined with individual requests of local authorities and psychiatrists made possible the implementation of psychiatric units in these localities. In spite of the efforts and flexibility of health professional working in these institutions, there are some obstacles to be overcome: resistance of hospital community against psychiatric admissions, financial constraints, limited professional training in mental health and the lack of a therapeutic approach that goes beyond psychopharmacological treatment alone.

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?

Bed blocking by elderly patients in general-hospital wards.

Science.gov (United States)

Rubin, S G; Davies, G H

1975-08-01

A point prevalence survey, using a questionnaire, was performed in three general hospitals to investigate the problem of elderly patients blocking acute-hospital beds. A total of 1010 occupied general beds were surveyed and all patients, over the age of 60 years, who had been in hospital more than four weeks, and who, in the opinion of medical and nursing staff, were no longer in need of the facilities of a general hospital, were investigated. Forty-eight patients (4.8 per cent of the total) were found to be genuinely in bed inappropriate to their needs. Rehabilitation, together with assessment of these patients, appeared disorganized and lacked consistency, and decisions regarding suitable 'disposal' appeared to be made without sufficient consultation and conformed to no detectable pattern. The main reason for the continuing bed occupancy of the patients was the length of the waiting lists for alternative residential accommodation and the main single medical factor preventing discharge home or to a hostel was the problem of mobility. By interviewing staff and patients and scrutinizing the questionnaires, it was found that 23 patients (48 per cent) were only suitable for transfer to a long-stay hospital. Of these, however, 15 (31 per cent) could be placed in specialized accommodation if some degree of nursing care, at present not available, was provided.

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

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).

Images in medicine

African Journals Online (AJOL)

ebutamanya

2015-10-15

Oct 15, 2015 ... Reexpansion pulmonary edema after drainage of tension pneumothorax. Adriá Rosat1,&, Carmen Díaz1. 1Department of General Surgery, Hospital Universitario Nuestra Señora de Candelaria, Ctra, Del Rosario 145, 38010 Sta, Cruz de Tenerife, Spain. &Corresponding author: Adriá Rosat, Department of ...

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.

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)

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.

Consuming Carmen Miranda: Dislocations and Dissonances in the Reception of an Icon

Directory of Open Access Journals (Sweden)

Fernando de Figueiredo Balieiro

2017-02-01

Full Text Available From the perspective of cultural studies, in its dialogs with feminist and queer studies, this article analyzes the identification of various publics with Carmen Miranda based on the consumption of her filmic, musical and artistic products, accessing her professional trajectory in its imbrication with its various forms of reception. The focus will be on the negotiations of the artist with her publics, touching on how her career involved reconfigurations concerning aspects of gender, race and sexuality. It is based on a perspective that considers the dynamism of mass culture, considering possibilities for various forms of appropriation of cultural products, as well as shifts and dissonances in receptions. To analyze these aspects, the paper focuses on feminine receptions in Brazil and the United States, and those of a male homosexual public contemporary to her career.

Los cuentos de Carmen de Burgos publicados en La Esfera. Ilustración Mundial (1914-1930

Directory of Open Access Journals (Sweden)

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.

La narrativa de Carmen Kurtz: compromiso y denuncia de la condición social de la mujer española de posguerra

Directory of Open Access Journals (Sweden)

Montejo Gurruchaga, Lucía

2006-06-01

Full Text Available The entrance of women in the narrative, which takes place at the end of the Spanish Civil War, limits itself to the pink subgenus, although very soon the first novels of an increasing number of female writers will appear dealing with other subjects. From the early Fifties onwards they will gradually create a realistic novel that although in a veiled manner, will show the reality of the subdued situation of women in the Spain of General Franco. Carmen Kurtz will start her narrative work in this line and her long career will last until somewhere in the Seventies. Her complaints of the legal, educational, social and economical situation at women, during her public performances as well as through her novels will not pass unaware by censorship; two of her novels were not allowed to be published, many of her paragraphs were to be suppresed and mutilated, and her work was to be very often obstructed. The files of the censorhip of her work that are in the Archivo General de la Administración as well as other related documents show these effects.La incorporación de la mujer a la narrativa, que se produce al término de la Guerra Civil, se circunscribe al subgénero rosa, aunque pronto aparecerán las primeras novelas de un nutrido número de autoras que plantearán otras propuestas. Desde los inicios de la década de los cincuenta irán paulatinamente creando una novela realista que, aunque de forma encubierta, mostrará la realidad sometida de las mujeres en la España franquista. Carmen Kurtz emprenderá su labor narrativa en esta línea y su larga carrera se prolongará hasta bien entrada la década de los setenta. Sus denuncias de la situación legal, educativa, social y económica de las mujeres, tanto en sus manifestaciones públicas como en sus novelas, no pasarán desapercibidas al órgano censor, que le denegará la publicación de dos de ellas, suprimirá y mutilará muchos de sus párrafos y entorpecerá su labor en varias ocasiones. Los

[Crisis unit at the general hospital: Determinants of further hospitalization].

Science.gov (United States)

Norotte, C; Omnès, C; Crozier, C; Verlyck, C; Romanos, M

2017-10-01

The availability of short-stay beds for brief admission (less than 72hours) of crisis patients presenting to the emergency room is a model that has gained a growing interest because it allows time for developing alternatives to psychiatric hospitalization and favors a maintained functioning in the community. Still, the determinants influencing the disposition decision at discharge after crisis intervention remain largely unexplored. The primary objective of this study was to determine the factors predicting aftercare dispositions at crisis unit discharge: transfer for further hospitalization or return to the community. Secondary objectives included the description of clinical and socio-demographic characteristics of patients admitted to the crisis unit upon presentation to the emergency room. All patients (n=255) admitted to the short-stay unit of the emergency department of Rambouillet General Hospital during a one-year period were included in the study. Patient characteristics were collected in a retrospective manner from medical records: patterns of referral, acute stressors, presenting symptoms, initial patient demand, Diagnostic and Statistical Manual, 5th edition (DSM-5) disorders, psychiatric history, and socio-demographic characteristics were inferred. Logistic regression analysis was used to determine the factors associated with hospitalization decision upon crisis intervention at discharge. Following crisis intervention at the short-stay unit, 100 patients (39.2%) required further hospitalization and were transferred. Statistically significant factors associated with a higher probability of hospitalization (P<0.05) included the patient's initial wish to be hospitalized (OR=4.28), the presence of a comorbid disorder (OR=3.43), a referral by family or friends (OR=2.89), a history of psychiatric hospitalization (OR=2.71) and suicidal ideation on arrival in the emergency room (OR=2.26). Conversely, significant factors associated with a lower probability of

[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

The CARMENES search for exoplanets around M dwarfs. HD147379 b: A nearby Neptune in the temperate zone of an early-M dwarf

Science.gov (United States)

Reiners, A.; Ribas, I.; Zechmeister, M.; Caballero, J. A.; Trifonov, T.; Dreizler, S.; Morales, J. C.; Tal-Or, L.; Lafarga, M.; Quirrenbach, A.; Amado, P. J.; Kaminski, A.; Jeffers, S. V.; Aceituno, J.; Béjar, V. J. S.; Guàrdia, J.; Guenther, E. W.; Hagen, H.-J.; Montes, D.; Passegger, V. M.; Seifert, W.; Schweitzer, A.; Cortés-Contreras, M.; Abril, M.; Alonso-Floriano, F. J.; Eiff, M. Ammler-von; Antona, R.; Anglada-Escudé, G.; Anwand-Heerwart, H.; Arroyo-Torres, B.; Azzaro, M.; Baroch, D.; Barrado, D.; Bauer, F. F.; Becerril, S.; Benítez, D.; Berdiñas, Z. M.; Bergond, G.; Blümcke, M.; Brinkmöller, M.; del Burgo, C.; Cano, J.; Cárdenas Vázquez, M. C.; Casal, E.; Cifuentes, C.; Claret, A.; Colomé, J.; 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 Hernández, J. I.; González-Peinado, R.; Grözinger, U.; Grohnert, S.; Guijarro, A.; de Guindos, E.; Gutiérrez-Soto, J.; Hatzes, A. P.; Hauschildt, P. H.; Hedrosa, R. P.; Helmling, J.; Henning, Th.; Hermelo, I.; Hernández Arabí, R.; Hernández Castaño, L.; Hernández Hernando, F.; Herrero, E.; Huber, A.; Huke, P.; Johnson, E. N.; de Juan, E.; Kim, M.; Klein, R.; Klüter, J.; Klutsch, A.; Kürster, M.; Labarga, F.; Lamert, A.; Lampón, M.; Lara, L. M.; Laun, W.; Lemke, U.; Lenzen, R.; Launhardt, R.; López del Fresno, M.; López-González, M. J.; López-Puertas, M.; López Salas, J. F.; López-Santiago, J.; Luque, R.; Magán Madinabeitia, H.; Mall, U.; Mancini, L.; Mandel, H.; Marfil, E.; Marín Molina, J. A.; Maroto Fernández, D.; Martín, E. L.; Martín-Ruiz, S.; Marvin, C. J.; Mathar, R. J.; Mirabet, E.; Moreno-Raya, M. E.; Moya, A.; Mundt, R.; Nagel, E.; Naranjo, V.; Nortmann, L.; Nowak, G.; Ofir, A.; Oreiro, R.; Pallé, E.; Panduro, J.; Pascual, J.; Pavlov, A.; Pedraz, S.; Pérez-Calpena, A.; Pérez Medialdea, D.; Perger, M.; Perryman, M. A. C.; Pluto, M.; Rabaza, O.; Ramón, A.; Rebolo, R.; Redondo, P.; Reffert, S.; Reinhart, S.; Rhode, P.; Rix, H.-W.; Rodler, F.; Rodríguez, E.; Rodríguez-López, C.; 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.; Schmitt, J. H. M. M.; Schiller, J.; Schöfer, P.; Solano, E.; Stahl, O.; Strachan, J. B. P.; Stürmer, J.; Suárez, J. C.; Tabernero, H. M.; Tala, M.; Tulloch, S. M.; Ulbrich, R.-G.; 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

We report on the first star discovered to host a planet detected by radial velocity (RV) observations obtained within the CARMENES survey for exoplanets around M dwarfs. HD 147379 (V = 8.9 mag, M = 0.58 ± 0.08 M⊙), a bright M0.0 V star at a distance of 10.7 pc, is found to undergo periodic RV variations with a semi-amplitude of K = 5.1 ± 0.4 m s-1 and a period of P = 86.54 ± 0.06 d. The RV signal is found in our CARMENES data, which were taken between 2016 and 2017, and is supported by HIRES/Keck observations that were obtained since 2000. The RV variations are interpreted as resulting from a planet of minimum mass mP sin i = 25 ± 2 M⊕, 1.5 times the mass of Neptune, with an orbital semi-major axis a = 0.32 au and low eccentricity (e ftp://130.79.128.5) or via http://cdsarc.u-strasbg.fr/viz-bin/qcat?J/A+A/609/L5

First 101 Robotic General Surgery Cases in a Community Hospital

Science.gov (United States)

Robertson, Jarrod C.; Alrajhi, Sharifah

2016-01-01

Background and Objectives: 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. Methods: Measured parameters were operative time, console time, conversion rates, complications, surgical site infections (SSIs), surgical site occurrences (SSOs), length of stay, and patient demographics. Results: 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. Conclusion: 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. PMID:27667913

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

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

African Journals Online (AJOL)

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

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...

URGENCIAS PSIQUIÁTRICAS EN EL HOSPITAL GENERAL

Directory of Open Access Journals (Sweden)

Dr. Rodrigo Nieto

2017-11-01

Full Text Available Las urgencias psiquiátricas pueden presentarse en diversos escenarios clínicos, incluyendo la consulta ambulatoria, el servicio de urgencias, o el hospital general. Por este motivo, es importante que tanto psiquiatras como médicos de otras especialidades estén capacitados para su reconocimiento y manejo inicial. Especialmente en el contexto del hospital general, es importante considerar la relación entre enfermedades médicas y psiquiátricas, desde los síntomas físicos que pueden presentarse producto de un trastorno psiquiátrico, hasta los síntomas psiquiátricos que son el resultado de enfermedades orgánicas, medicamentos o abuso de sustancias. Adicionalmente, en este artículo se entregan elementos para el manejo de algunas urgencias psiquiátricas particularmente relevantes, tales como la ideación suicida, la agitación psicomotora o el delirium, donde las intervenciones iniciales pueden ser de gran importancia para la evolución y el pronóstico del paciente.

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

Risk factors for chronic non-communicable diseases and the CARMEN Initiative: a population-based study in the South of Brazil Fatores de risco para doenças crônicas não-transmissíveis e a Iniciativa CARMEN: estudo de base populacional no sul do Brasil

Directory of Open Access Journals (Sweden)

Marcelo Fernandes Capilheira

2008-12-01

Full Text Available The CARMEN Initiative is a strategy of the Pan American Health Organization and the World Health Organization that proposes population-based interventions to reduce risk factors for chronic non-communicable diseases (CNCD by approaching them simultaneously. The present study aims to provide a baseline for further interventions by the CARMEN Initiative based on a cross-sectional population-based study of 3,100 adults (>20 years old in Pelotas, a city in the South of Brazil. Prevalence of smoking, physical inactivity, diabetes mellitus, hypertension, and excess weight were studied and presented separately and aggregated in various combinations. The most frequent risk factor was physical inactivity (73.2%, followed by excess weight (48.1%. Women were less active and thinner than men. More than half of the sample showed two or three risk factors (53.4%. The combination of physical inactivity and excess weight was observed in 34.7% of the sample, while 10.8% presented physical inactivity, excess weight, and hypertension concurrently. The accumulation of risk factors for CNCD is frequent in the study population and the identification of the most common combinations is essential for planning future interventions.A Iniciativa CARMEN é uma estratégia da Organização Pan-Americana da Saúde e da Organização Mundial da Saúde de combate às doenças crônicas não-transmissíveis, que prevê intervenções populacionais para a redução simultânea de seus fatores de risco. Pretende-se fornecer uma linha de base para intervenções da Iniciativa CARMEN valendo-se de um estudo de base populacional com 3.100 adultos (> 20 anos, moradores de Pelotas, Rio Grande do Sul. Os fatores estudados foram: tabagismo, sedentarismo, diabetes mellitus, hipertensão arterial sistêmica e excesso de peso, sendo descritos acumulados, isoladamente e em combinações. O sedentarismo foi o fator de risco mais prevalente (73,2%, seguido do excesso de peso (48,1%. As

El video en el desarrollo de competencias matemáticas, caso: Universidad Autónoma del Carmen

OpenAIRE

Juan José Díaz Perera; Carlos Enrique Recio Urdaneta; Mario Saucedo Fernández

2011-01-01

El presente trabajo tiene la intención de dar a conocer algunos retos que enfrentan las IES, la importancia del desarrollo de las competencias matemáticas y la inserción de los recursos tecnológicos en el currículo matemático. Además se plantea una de las necesidades de la educación matemática en el Estado de Campeche, donde es evidente el desarrollo de competencias matemáticas por parte de los alumnos en el proceso de aprendizaje y como la Universidad Autónoma del Carmen (UNACAR) da respu...

The hospital component of general practice vocational training--the Irish experience.

Science.gov (United States)

Murphy, A W

1992-12-01

All second and third year general practice vocational trainees in the Irish Republic in 1991 were invited to complete a questionnaire concerning the hospital component of their training. The questionnaire was based on specific recommendations published by the I.C.G.P. regarding hospital training posts. Replies were received from 39 trainees constituting 70% of the total number of eligible trainees. In general, hospital posts were perceived to be of relevance and to offer adequate exposure to outpatient management and to the development of useful practical skills. More than 70% of the trainees were free to attend at least 75% of the study release course. Everyone entitled to study leave for examination purposes obtained it. However, 95% of trainees found their hospital teachers unfamiliar with the aims and objectives of Vocational Training. Two-thirds of trainees received less than two hours a week of formal or informal teaching. More than two-thirds did not participate in an introductory general practice period and less than a quarter had their individual needs assessed early on. Substantial realisation of the guidelines issued by the ICGP has been achieved. Further work is necessary in the areas of individual needs assessment, relevant structured teaching and general practice liaison. Three specific recommendations are made to achieve these aims.

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\

Inconsciente genérico, feminismo y Nubosidad variable de Carmen Martín Gaite

Directory of Open Access Journals (Sweden)

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.

Nurses' work-related stress in China: a comparison between psychiatric and general hospitals.

Science.gov (United States)

Qi, Yun-Ke; Xiang, Yu-Tao; An, Feng-Rong; Wang, Jing; Zeng, Jiao-Ying; Ungvari, Gabor S; Newhouse, Robin; Yu, Doris S F; Lai, Kelly Y C; Ding, Yan-Ming; Yu, Liuyang; Zhang, Xiang-Yang; Chiu, Helen F K

2014-01-01

Little is known about the level of work-related stress in nurses in China.This study compared the level of work-related stress between female nurses working in psychiatric and general hospitals in China. A descriptive comparative cross-sectional design was used.A consecutive sample of nurses from two psychiatric hospitals (N = 297) and a medical unit (N = 408) of a general hospital completed a written survey including socio-demographic data and a measure of work-related stress (Nurse Stress Inventory). Compared to the nurses working in the general hospital, those working in the psychiatric setting had a higher level of stress in the domains of working environment and resources (p working experience, and working in psychiatric hospitals were associated with high work-related stress (b = .2, p work-related stress, specific stress management workshops and effective staff supportive initiatives for Chinese nurses are warranted.

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.

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

Science.gov (United States)

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

2018-06-01

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

Care complexity in the general hospital - Results from a European study

NARCIS (Netherlands)

de Jonge, P; Huyse, FJ; Slaets, JPJ; Herzog, T; Lobo, A; Lyons, JS; Opmeer, BC; Stein, B; Arolt, [No Value; Balogh, N; Cardoso, G; Fink, P; Rigatelli, M; van Dijck, R; Mellenbergh, GJ

2001-01-01

There is increasing pressure to effectively treat patients with complex care needs from the moment of admission to the general hospital. In this study, the authors developed a measurement strategy for hospital-based care complexity. The authors' four-factor model describes the interrelations between

Admission rates in a general practitioner-based versus a hospital specialist based, hospital-at-home model

DEFF Research Database (Denmark)

Mogensen, Christian Backer; Ankersen, Ejnar Skytte; Lindberg, Mats J

2018-01-01

. CONCLUSIONS: The GP based HaH model was more effective than the hospital specialist model in avoiding hospital admissions within 7 days among elderly patients with an acute medical condition with no differences in mental or physical recovery rates or deaths between the two models. REGISTRATION: No. NCT......BACKGROUND: Hospital at home (HaH) is an alternative to acute admission for elderly patients. It is unclear if should be cared for a primarily by a hospital intern specialist or by the patient's own general practitioner (GP). The study assessed whether a GP based model was more effective than...... Denmark, including + 65 years old patients with an acute medical condition that required acute hospital in-patient care. The patients were randomly assigned to hospital specialist based model or GP model of HaH care. Five physical and cognitive performance tests were performed at inclusion and after 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

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.

nutritional status in pregnant women attending kiru general hospital

African Journals Online (AJOL)

DR. AMINU

2012-12-02

Dec 2, 2012 ... of pregnant women in General Hospital Kiru, Kiru. Local Government .... AACC, American Association for Clinical Chemistry,. 2012. ... Animal. Reproductive Science. 72: pp. 235. Das, S. C. and Isechei, U. P. (1996). Serum ...

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

Group of family companions of hospitalized patients: an occupational therapy intervention strategy in a general hospital

Directory of Open Access Journals (Sweden)

Daniel Ferreira Dahdah

2013-08-01

Full Text Available There is a consensus in the literature that the company of a family member during the hospitalization period increases patient recovery. However, this can have some negative effects on the caregiver’s health. With the purpose of reducing these negatives effects, it is useful to let family members express themselves. The State Hospital of Ribeirão Preto created a Group of Family Companions coordinated by the Occupational Therapy and Social Service. This study focuses on the assistance offered in a general hospital to families that undergo the whole illness and hospitalization process of their family member, suffering the impacts of this process in their daily lives, and on the intervention of Occupational Therapy in these cases.

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.

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

Carotid Surgery in a District General Hospital

Science.gov (United States)

Fairgrieve, John

1981-01-01

The carotid surgical experience of Cheltenham General Hospital over a 13 year period (1968-81) is presented. This includes 42 operations for stenosis, and 12 further operations for carotid body tumour, carotid aneurysm, subclavian steal syndrome and trauma to the internal carotid artery. The operative techniques and complications are briefly discussed and reasons advanced for a more agressive approach to the problems of extra-cerebral carotid disease in this country. PMID:7185417

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.

Patient characteristics, resource use and outcomes associated with general internal medicine hospital care: the General Medicine Inpatient Initiative (GEMINI) retrospective cohort study.

Science.gov (United States)

Verma, Amol A; Guo, Yishan; Kwan, Janice L; Lapointe-Shaw, Lauren; Rawal, Shail; Tang, Terence; Weinerman, Adina; Cram, Peter; Dhalla, Irfan A; Hwang, Stephen W; Laupacis, Andreas; Mamdani, Muhammad M; Shadowitz, Steven; Upshur, Ross; Reid, Robert J; Razak, Fahad

2017-12-11

The precise scope of hospital care delivered under general internal medicine services remains poorly quantified. The purpose of this study was to describe the demographic characteristics, medical conditions, health outcomes and resource use of patients admitted to general internal medicine at 7 hospital sites in the Greater Toronto Area. This was a retrospective cohort study involving all patients who were admitted to or discharged from general internal medicine at the study sites between Apr. 1, 2010, and Mar. 31, 2015. Clinical data from hospital electronic information systems were linked to administrative data from each hospital. We examined trends in resource use and patient characteristics over the study period. There were 136 208 admissions to general internal medicine involving 88 121 unique patients over the study period. General internal medicine admissions accounted for 38.8% of all admissions from the emergency department and 23.7% of all hospital bed-days. Over the study period, the number of admissions to general internal medicine increased by 32.4%; there was no meaningful change in the median length of stay or cost per hospital stay. The median patient age was 73 (interquartile range [IQR] 57-84) years, and the median number of coexisting conditions was 6 (IQR 3-9). The median acute length of stay was 4.6 (IQR 2.5-8.6) days, and the median total cost per hospital stay was $5850 (IQR $3915-$10 061). Patients received at least 1 computed tomography scan in 52.2% of admissions. The most common primary discharge diagnoses were pneumonia (5.0% of admissions), heart failure (4.7%), chronic obstructive pulmonary disease (4.1%), urinary tract infection (4.0%) and stroke (3.6%). Patients admitted to general internal medicine services represent a large, heterogeneous, resource-intensive and growing population. Understanding and improving general internal medicine care is essential to promote a high-quality, sustainable health care system. Copyright 2017

Transforming Patient Value: Comparison of Hospital, Surgical, and General Surgery Patients.

Science.gov (United States)

Pitt, Henry A; Tsypenyuk, Ella; Freeman, Susan L; Carson, Steven R; Shinefeld, Jonathan A; Hinkle, Sally M; Powers, Benjamin D; Goldberg, Amy J; DiSesa, Verdi J; Kaiser, Larry R

2016-04-01

Patient value (V) is enhanced when quality (Q) is increased and cost (C) is diminished (V = Q/C). However, calculating value has been inhibited by a lack of risk-adjusted cost data. The aim of this analysis was to measure patient value before and after implementation of quality improvement and cost reduction programs. Multidisciplinary efforts to improve patient value were initiated at a safety-net hospital in 2012. Quality improvement focused on adoption of multiple best practices, and minimizing practice variation was the strategy to control cost. University HealthSystem Consortium (UHC) risk-adjusted quality (patient mortality + safety + satisfaction + effectiveness) and cost (length of stay + direct cost) data were used to calculate patient value over 3 fiscal years. Normalized ranks in the UHC Quality and Accountability Scorecard were used in the value equation. For all hospital patients, quality scores improved from 50.3 to 66.5, with most of the change occurring in decreased mortality. Similar trends were observed for all surgery patients (42.6 to 48.4) and for general surgery patients (30.9 to 64.6). For all hospital patients, cost scores improved from 71.0 to 2.9. Similar changes were noted for all surgical (71.6 to 27.1) and general surgery (85.7 to 23.0) patients. Therefore, value increased more than 30-fold for all patients, 3-fold for all surgical patients, and almost 8-fold for general surgery patients. Multidisciplinary quality and cost efforts resulted in significant improvements in value for all hospitalized patients as well as general surgery patients. Mortality improved the most in general surgery patients, and satisfaction was highest among surgical patients. Copyright © 2016 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

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.

Emergency general surgery in Rwandan district hospitals: a cross-sectional study of spectrum, management, and patient outcomes.

Science.gov (United States)

Mpirimbanyi, Christophe; Nyirimodoka, Alexandre; Lin, Yihan; Hedt-Gauthier, Bethany L; Odhiambo, Jackline; Nkurunziza, Theoneste; Havens, Joaquim M; Omondi, Jack; Rwamasirabo, Emile; Ntirenganya, Faustin; Toma, Gabriel; Mubiligi, Joel; Bayitondere, Scheilla; Riviello, Robert

2017-12-01

Management of emergency general surgical conditions remains a challenge in rural sub-Saharan Africa due to issues such as insufficient human capacity and infrastructure. This study describes the burden of emergency general surgical conditions and the ability to provide care for these conditions at three rural district hospitals in Rwanda. This retrospective cross-sectional study included all patients presenting to Butaro, Kirehe and Rwinkwavu District Hospitals between January 1st 2015 and December 31st 2015 with emergency general surgical conditions, defined as non-traumatic, non-obstetric acute care surgical conditions. We describe patient demographics, clinical characteristics, management and outcomes. In 2015, 356 patients presented with emergency general surgical conditions. The majority were male (57.2%) and adults aged 15-60 years (54.5%). The most common diagnostic group was soft tissue infections (71.6%), followed by acute abdominal conditions (14.3%). The median length of symptoms prior to diagnosis differed significantly by diagnosis type (p operated on at the district hospital, either by a general surgeon or general practitioner. Patients were more likely to receive surgery if they presented to a hospital with a general surgeon compared to a hospital with only general practitioners (75% vs 43%, p operation in a hospital with a general surgeon as opposed to a general practitioner. This provides evidence to support increasing the surgical workforce in district hospitals in order to increase surgical availability for patients.

Strategy, leadership and change: the North York General Hospital transformation journey.

Science.gov (United States)

Adamson, Bonnie; Kwolek, Susan

2008-01-01

Improvements in the emergency department and general internal medicine will serve as a case study to examine how North York General Hospital cultural transformation efforts led to improvements in these departments, and why we believe this approach will enable the organization to sustain these improvements over time.

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.

Postnatal gestational diabetes mellitus follow-up: Perspectives of Australian hospital clinicians and general practitioners.

Science.gov (United States)

Kilgour, Catherine; Bogossian, Fiona Elizabeth; Callaway, Leonie; Gallois, Cindy

2018-05-04

The reasons for low postnatal screening rates for women with gestational diabetes mellitus are not well understood. Multiple care providers, settings and changes to diagnostic criteria, may contribute to confusion over postnatal care. Quality of communication between clinicians may be an important influence for the completion of postnatal gestational diabetes mellitus follow-up. Describe and analyse communication processes between hospital clinicians (midwives, medical, allied staff) and general practitioners who provide postnatal gestational diabetes mellitus care. Purposive sampling and convergent interviews explored participants' communication experiences providing gestational diabetes mellitus postnatal follow-up. Data were analysed with Leximancer automated content analysis software; interpretation was undertaken using Communication Accommodation Theory. Clinicians who provided maternity care at a tertiary referral hospital (n=13) in Queensland, Australia, and general practitioners (n=16) who provided maternity shared care with that hospital between December 2012 and July 2013. Thematic analysis identified very different perspectives between the experiences of General Practitioners and hospital clinicians; six themes emerged. General practitioners were concerned about themes relating to discharge summaries and follow-up guidelines. In contrast, hospital clinicians were more concerned about themes relating to gestational diabetes mellitus antenatal care and specialist clinics. Two themes, gestational diabetes mellitus women and postnatal checks were shared. Gestational diabetes mellitus follow-up is characterised by communication where general practitioners appear to be information seekers whose communication needs are not met by hospital clinicians. Midwives are ideally placed to assist in improving communication and postnatal gestational diabetes mellitus follow-up. Copyright © 2018 Australian College of Midwives. Published by Elsevier Ltd. All rights

A new species of Euzetia (Monogenea: Monocotylidae on the gills of Rhinoptera bonasus (Rhinopteridae from Ciudad del Carmen, Campeche, México Una especie nueva de Euzetia (Monogenea: Monocotylidae de las branquias de Rhinoptera bonasus (Rhinopteridae de Ciudad del Carmen, Campeche, México

Directory of Open Access Journals (Sweden)

Griselda Pulido-Flores

2008-08-01

Full Text Available Euzetia lamothei n. sp. (Monogenea: Euzetiinae is described from the gills of the stingray, Rhinoptera bonasus, collected from marine waters near Ciudad del Carmen, Campeche, Mexico. The species is assigned to Euzetia Chisholm and Whittington, 2001 because it has a haptor with 10 peripheral loculi and 1 central loculus flanked by 2 lateral loculi. The species described herein can be distinguished from the only known member of the genus, E.occultum, by the morphology of the male copulatory organ, the vas deferens sigmoid, and the presence of a vaginal chamber. Euzetia lamothei n. sp. was found on 1 of 7 R.bonasus (14%. This species is the first record of a member of the genus from the neotropics, the first from Mexico, and the second report of a monocotylid from Rhinoptera.Se describe Euzetia lamothei n. sp. (Monogenea: Euzetiinae, parásito de la branquias de la mantarraya Rhinoptera bonasus, recolectada en Ciudad del Carmen, Campeche, México. Los ejemplares se asignaron a Euzetia Chisholm y Whittington, 2001 porque presentan un haptor con 10 loculi periféricos y 1 loculus central flanqueado por 2 loculi laterales. La especie aquí descrita se distingue de E.occultum por la morfología del órgano copulador, el vaso deferente sigmoide y la presencia de una cámara vaginal. Euzetia lamothei n. sp. se encontró en 1 de 7 R.bonasus (14%. Esta especie representa el primer registro de un miembro del género en el neotrópico, además es el primer registro en México, y el segundo de un monocotílido de Rhinoptera.

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.

[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

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.

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.

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.

Stroke admissions in Kubwa General Hospital: A 30-month review

Directory of Open Access Journals (Sweden)

Osaze Ojo

2017-01-01

Full Text Available >Background: Stroke is a common neurological disorder that contributes significantly to the morbidity and mortality of medical admissions.Objectives: To review the types, risk factors, hemispheric involvement, and outcomes of admitted stroke patients in Kubwa General Hospital, Abuja, Nigeria.Subjects and Methods: We carried out a retrospective study of patients who had a clinical diagnosis of stroke in Kubwa General Hospital, Abuja, Nigeria, between January 2013 and June 2015.Results: A total of 60 patients who had stroke were admitted during this period, accounting for 4.25% of medical admissions. Men and women accounted for 68.3% and 31.7%, respectively, with a male-to-female ratio of 2:1. Their mean age was 54.9 ± 13.5 years while the median age was 52.5 years. The mean hospital stay for these patients was 8.4 ± 5.5 days. Ischemic stroke occurred more frequently (65% compared with hemorrhagic stroke (35%. Hypertension (65%, alcohol (25%, previous stroke (18.3%, diabetes mellitus, and hypercholesterolemia (18.3% were the common identifiable risk factors for stroke. Ten patients (16.7% had two risk factors for stroke, whereas 8 patients (13.3% had three risk factors for stroke. The mean systolic and diastolic blood pressures on admission were 171.5 ± 41.6 mmHg and 103.3 ± 24.0 mmHg, respectively. The left hemisphere (53.3% was more often affected than the right hemisphere in these patients. Majority of the patients (48.3% were discharged following improvement while the case fatality was 11.7%.Conclusion: Stroke is not uncommon as a cause of medical admission in Kubwa General Hospital. Ischemic stroke occurred more commonly and the left hemisphere was more often involved compared with the right hemisphere. Hypertension was the most common risk factor for stroke in these patients.

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.

The first general practitioner hospital in The Netherlands: towards a new form of integrated care?

NARCIS (Netherlands)

Moll van Charante, E.; Hartman, E.; IJzermans, J.; Voogt, E.; Klazinga, N.; Bindels, P.

2004-01-01

Objective: To describe the types of patients admitted to the first Dutch general practitioner (GP) hospital, their health-related quality of life and its substitute function. Design: A prospective observational study. Setting. The remaining 20-bed ward of a former district general hospital west of

The first general practitioner hospital in The Netherlands: towards a new form of integrated care?

NARCIS (Netherlands)

Moll van Charante, Eric; Hartman, Esther; Yzermans, Joris; Voogt, Elsbeth; Klazinga, Niek; Bindels, Patrick

2004-01-01

Objective - To describe the types of patients admitted to the first Dutch general practitioner (GP) hospital, their health-related quality of life and its substitute function. Design - A prospective observational study. Setting - The remaining 20-bed ward of a former district general hospital west

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

Directory of Open Access Journals (Sweden)

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

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.

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

How do NHS general hospitals in England deal with patients with alcohol-related problems? A questionnaire survey.

Science.gov (United States)

Owens, Lynn; Gilmore, Ian T; Pirmohamed, Munir

2005-01-01

Alcohol-related disease represents a major burden on hospitals. However, it is unclear whether hospitals have developed the necessary expertise and guidelines to deal with this burden. The aim of this survey was to determine what measures general hospital NHS Trusts in England had in place to deal with alcohol-related problems, including the employment of dedicated alcohol specialist nurses. Two postal surveys of all NHS general hospital Trusts in England, the first in 2000 (n = 138; 54% response rate) and the second in 2003 after the publication of the Royal College of Physicians (RCP) report on alcohol in secondary care (n = 164; 75% response rate). Between the two surveys, there was a significant increase (P = 0.005) in the number of dedicated alcohol nurses employed by general hospital trusts; however, the numbers remain low (n = 21). Additionally, the availability of prescribing guidelines for the management of alcohol withdrawal increased significantly (P = 0.0001). The survey indicates that most general hospitals do not have appropriate services in place to deal with such patients. Although there is a need and willingness to develop alcohol services in general hospitals, which is one of the key recommendations of the RCP report, the lack of funding is going to act as a major barrier.

RECONOCIMIENTO DEL CUERPO DESDE LA EDUCACIÓN EN SEXUALIDAD EN LOS ESTUDIANTES DE SÉPTIMO DEL COLEGIO VILLEMAR EL CARMEN IED

OpenAIRE

Luz Adriana Prieto Cárdenas

2016-01-01

Este trabajo es el resultado de la práctica de intervención pedagógica e investigativa realizada en el año 2014, en el Colegio Villemar el Carmen ied, con los estudiantes de 705, jornada mañana. El problema investigativo se construyó a partir de los intereses e inquietudes que presentó el grupo de estudiantes respecto a su cuerpo y su sexualidad. El objetivo principal que guio esta investigación fue analizar la incidencia de la educación en sexualidad en el reconocimiento del cuerpo de los es...

EL ARTE ES VIDA Y LA VIDA ES ARTE: LA PINTURA DE JOSÉ DEL CARMEN HERNÁNDEZ

Directory of Open Access Journals (Sweden)

Bogdan Piotrowski

2014-01-01

Full Text Available Se presenta aquí la obra artística de José del Carmen Hernández desde la premisa según la cual, al valorar su pintura podemos hablar del arte de la vida y de la vida artística plena. Se resalta su esforzada trayectoria de vida que lo ha llevado desde un humilde origen campesino hasta la formación artística académica y a través de tertulias de artistas en diferentes partes del mundo. Al destacar su obra pictórica, escultórica, mural y abstracta, se concluye con el vínculo actual del artista con su propia realidad y la esperanza como motor de su obra frente a la constata - ción de las violencias persistentes.

TRANSPORT OF PATIENTS FOR PRIMARY PTCA FROM GENERAL HOSPITAL NOVO MESTO TO LJUBLJANA IN 2002

Directory of Open Access Journals (Sweden)

Renata Okrajšek

2004-12-01

Full Text Available Background. The treatment of acute coronary syndrome (ACS with ST-segment elevation with primary percutaneous transluminal coronary angioplasty (PTCA is the best way to treat these patients. Primary PTCA is also practicable with patients who are admitted into institution without catheter laboratory. The transport of patients into the tertiary institution is safe, but it is important to keep the time of ischemia as short as possible and to reach the time interval of door-balloon as recommended by the guidelines. The ACS patients with ST-segment elevation that were directed into General Hospital Novo mesto after examination at the internistic emergency department have been redirected to KC Ljubljana for realization of PTCA since October 2001.Methods. A prospective analysis of patients with ACS with STsegment elevation, who had been transferred from General Hospital Novo mesto to KC Ljubljana in the period from January 1, 2002 to December 31, 2002 to have a primary PTCA, was performed. The analysis comprised the following: the time interval of handling the patients at Internistic department of General Hospital Novo mesto, the time of transport of patients to Ljubljana and total time interval from the arrival of patients to General Hospital Novo mesto to the first inflation of balloon in Ljubljana. We monitored the complications that occurred during the treatment of the patients.Results. In the above mentioned period 29 patients (24 males and 5 females were transported from the General Hospital Novo mesto to the KC Ljubljana to have a primary PTCA performed. The total time interval measured between the patients’ arrival to General Hospital Novo mesto to the first inflation of balloon in Ljubljana in the year 2002 was 145 minutes, which is 17 minutes better than in the previous period. The time interval recommended by the guidelines was achieved with four patients.Conclusions. By recognizing the problems that had encountered with directing the

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.

El Poema de Almería y el Carmen Campidoctoris desde su condición fragmentaria

Directory of Open Access Journals (Sweden)

Heather Bamford

2013-06-01

Full Text Available En su Poderes de la filología: dinámicas de una práctica académica del texto, Hans Ulrich Gumbrecht define un fragmento como cualquier objeto que podamos identificar como parte de una totalidad mayor sin implicar, sin embargo, que esta parte de una totalidad mayor se entienda como una metonimia de la totalidad. Este trabajo examinará la condición fragmentaria del Poema de Almería y el Carmen Campidoctoris, además de si estas obras se pueden considerar fragmentos de acuerdo con la conceptualización de Gumbrecht. El análisis se centra en tres cuestiones: 1 si hay prueba de que estos panegíricos fueron hechos fragmentarios intencionalmente, en lugar de por casualidad 2 si hay elementos de estas obras fragmentarias que les hacen aparentar más o menos cohesivas, y 3 si en el análisis filológico estos poemas funcionan como metonimias de sus respectivas totalidades perdidas o de otras totalidades.Dans ses Poderes de la filología: dinámicas de una práctica académica del texto, Hans Ulrich Gumbrecht définit un fragment comme un objet que l’on peut identifier comme une partie d’une totalité plus grande sans que cela implique que cette partie soit comprise comme une métonymie de la totalité. Ce travail examinera la condition fragmentaire du Poema de Almería et du Carmen Campidoctoris, ainsi que la possibilité que ces œuvres puissent être considérées comme des fragments conformément à la conceptualisation de Gumbrecht. Cette analyse porte sur trois points : 1 peut-on prouver que ces panégyriques ont été composés de façon fragmentaire volontairement, et non par hasard 2 y a-t-il des éléments dans ces œuvres fragmentaires qui leur donnent plus ou moins de cohésion, et 3 ces poèmes fonctionnent-ils, dans l’analyse philologique, comme des métonymies de leurs totalités perdues respectives ou d’autres totalités ?

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.

The 6-Item Cognitive Impairment Test as a bedside screening for dementia in general hospital patients: results of the General Hospital Study (GHoSt).

Science.gov (United States)

Hessler, Johannes Baltasar; Schäufele, Martina; Hendlmeier, Ingrid; Nora Junge, Magdalena; Leonhardt, Sarah; Weber, Joshua; Bickel, Horst

2017-07-01

The objective of this study was to examine the psychometric quality of the 6-Item Cognitive Impairment Test (6CIT) as a bedside screening for the detection of dementia in general hospital patients. Participants (N = 1,440) were inpatients aged ≥65 of 33 randomly selected general hospitals in Southern Germany. The 6CIT was conducted at bedside, and dementia was diagnosed according to DSM-IV. Nursing staff was asked to rate the patients' cognitive status, and previous diagnoses of dementia were extracted from medical records. Completion rates and validity statistics were calculated. Two-hundred seventy patients had dementia. Cases with delirium but no dementia were excluded. Feasibility was 97.9% and 83.3% for patients without and with dementia, respectively, and decreased from moderate (93.8%) to severe dementia (53%). The area under the curve of the 6CIT was 0.98. Sensitivity, specificity, accuracy, positive predictive value, and negative predictive value were calculated for the cutoffs 7/8 (0.96, 0.82, 0.85, 0.52, 0.99) and 10/11 (0.88, 0.95, 0.94, 0.76, 0.98). The nurse ratings and medical records information had lower validity statistics. Logistic regression analyses revealed that the 6CIT statistically significantly provided information above nurse ratings and medical records. Twenty-five and 37 additional patients were correctly classified by the 7/8 and 10/11 cutoffs, respectively. The 6CIT is a feasible and valid screening tool for the detection of dementia in older general hospital patients. The 6CIT outperformed the nurse ratings of cognitive status and dementia diagnoses from medical records, suggesting that standardized screening may have benefits with regard to case finding. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

The CARMENES Search for Exoplanets around M Dwarfs: A Low-mass Planet in the Temperate Zone of the Nearby K2-18

Science.gov (United States)

Sarkis, Paula; Henning, Thomas; Kürster, Martin; Trifonov, Trifon; Zechmeister, Mathias; Tal-Or, Lev; Anglada-Escudé, Guillem; Hatzes, Artie P.; Lafarga, Marina; Dreizler, Stefan; Ribas, Ignasi; Caballero, José A.; Reiners, Ansgar; Mallonn, Matthias; Morales, Juan C.; Kaminski, Adrian; Aceituno, Jesús; Amado, Pedro J.; Béjar, Victor J. S.; Hagen, Hans-Jürgen; Jeffers, Sandra; Quirrenbach, Andreas; Launhardt, Ralf; Marvin, Christopher; Montes, David

2018-06-01

K2-18 is a nearby M2.5 dwarf, located at 34 pc and hosting a transiting planet that was first discovered by the K2 mission and later confirmed with Spitzer Space Telescope observations. With a radius of ∼2 R ⊕ and an orbital period of ∼33 days, the planet lies in the temperate zone of its host star and receives stellar irradiation similar to that of Earth. Here we perform radial velocity follow-up observations with the visual channel of CARMENES with the goal of determining the mass and density of the planet. We measure a planetary semi-amplitude of K b ∼ 3.5 {{m}} {{{s}}}-1 and a mass of M b ∼ 9 M ⊕, yielding a bulk density around {ρ }b∼ 4 {{g}} {cm}}-3. This indicates a low-mass planet with a composition consistent with a solid core and a volatile-rich envelope. A signal at 9 days was recently reported using radial velocity measurements taken with the HARPS spectrograph. This was interpreted as being due to a second planet. We see a weaker, time- and wavelength-dependent signal in the CARMENES data set and thus favor stellar activity for its origin. K2-18 b joins the growing group of low-mass planets detected in the temperate zone of M dwarfs. The brightness of the host star in the near-infrared makes the system a good target for detailed atmospheric studies with the James Webb Space Telescope.

Una finestra sul passato: Irse de casa di Carmen Martín Gaite

Directory of Open Access Journals (Sweden)

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.

Improving the smoking patterns in a general hospital psychiatric unit

Directory of Open Access Journals (Sweden)

Celso Iglesias García

2009-01-01

Full Text Available Objectives: The purpose of the present paper is to evaluate the effects of a smoking ban in a general hospital psychiatric unit. Methods: We study the effects of smoking ban in 40 consecutive psychiatric inpatients. The staff registered socio-demographic and tobacco-related variables. We also registered any kind of behavioral effects of smoking ban.Results: The patients were willing to stop smoking during their hospital stay (with or without nicotine replacement with two mild behavioural incidences registered throughout the study. Conclusions: The benefits of non-smoking policy in a psychiatric unit can be significant. The introduction of smoking bans in psychiatric inpatients settings is possible and safe.

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

Directory of Open Access Journals (Sweden)

Banwari L. Meel

2009-08-01

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.

Communication at the interface between hospitals and primary care - a general practice audit of hospital discharge summaries.

Science.gov (United States)

Belleli, Esther; Naccarella, Lucio; Pirotta, Marie

2013-12-01

Timeliness and quality of hospital discharge summaries are crucial for patient safety and efficient health service provision after discharge. We audited receipt rates, timeliness and the quality of discharge summaries for 49 admissions among 38 patients in an urban general practice. For missing discharge summaries, a hospital medical record search was performed. Discharge summaries were received for 92% of identified admissions; 73% were received within three days and 55% before the first post-discharge visit to the general practitioner (GP). Administrative information and clinical content, including diagnosis, treatment and follow-up plans, were well reported. However, information regarding tests, referrals and discharge medication was often missing; 57% of summaries were entirely typed and 13% had legibility issues. Completion rates were good but utility was compromised by delays, content omissions and formatting. Digital searching enables extraction of information from rich existing datasets contained in GP records for accurate measurement of discharge summary receipt rate and timing.

Percutaneous injuries among healthcare workers at a general hospital

Directory of Open Access Journals (Sweden)

Ibak Gönen, Mehmet Faruk Geyik

2011-06-01

Full Text Available Objectives: Percutaneous injuries (PCIs remain a common incident among healthcare workers (HCWs despite the introductionof safety programs. The aim of this study was to assess the PCIs, required precautions, and applications after the injuries among healthcare workers in a small general hospital.Materials and methods: We assessed the occurrence of PCIs at a General Hospital (EGH from January 2007 to November2010. During this period, all injury cases among HCWs were reported to the Infection Control Committee (ICC using percutaneous injury notification form. The injury notification forms were evaluated retrospectively.Results: Totally 275 health personnel were working in our hospital, 36 healthy workers have been exposed to PCIs during this period. The incidence of PCIs was 2,9/10000 in 2007, 3,1/10000 in 2008, 3,8/10000 in 2009 and 3,9/10000 patient-days in 2010. Injured staff were recorded as, 16 nurses (44%, 12 cleaning staffs (34%, and eight (22% doctors. The device leading to damage was most frequently the needle-channel. Ten sources (27% were detected positive for hepatitis B virus (HBV, four (11% for hepatitis C virus (HCV, and two (5% for Crimean-Congo hemorrhagic fever virus (CCHFV. No case of seroconversion has been recognized for any of the above mentioned infections.Conclusions: Percutaneous injuries remain to occur among HCWs. Since some the sources were infected, the health personnel are endangered for infections due to PCIs. The health personnel should presume that all patients are infected,and thus should work following universal precautions to avoid complications about the PCIs. J Microbiol Infect Dis 2011;1(1:26-30.

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

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)

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)

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)

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)

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)

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)

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.

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.

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

Directory of Open Access Journals (Sweden)

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

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.

Perceived Transcultural Self-Efficacy of Nurses in General Hospitals in Guangzhou, China

Science.gov (United States)

Li, Juan; He, Zhuang; Luo, Yong; Zhang, Rong

2016-01-01

Background Conflicts arising from cultural diversity among patients and hospital staff in China have become intense. Hospitals have an urgent need to improve transcultural self-efficacy of nurses for providing effective transcultural nursing. Objective The purpose of the research was to (a) evaluate the current status of perceived transcultural self-efficacy of nurses in general hospitals in Guangzhou, China; (b) explore associations between demographic characteristics of nurses and their perceived transcultural self-efficacy; and (c) assess the reliability and validity of scores on the Chinese version of the Transcultural Self-Efficacy Tool (TSET). Methods A cross-sectional survey of registered nurses from three general hospitals was conducted. Quota and convenience sampling were used. Participants provided demographic information and answered questions on the TSET. Results A total of 1,156 registered nurses took part. Most nurses had a moderate level of self-efficacy on the Cognitive (87.9%), Practical (87%), and Affective (89.2%) TSET subscales. Nurses who were older; who had more years of work experience, higher professional titles, higher incomes, and a minority background; and who were officially employed (not temporary positions) had higher perceived transcultural self-efficacy. Reliability estimated using Cronbach’s alpha was .99 for the total TSET score; reliability for the three subscales ranged from .97 to .98. Confirmatory factor analysis of TSET scores showed good fit with a three-factor model. Conclusion The results of this study can provide insights and guidelines for hospital nursing management to facilitate design of in-service education systems to improve transcultural self-efficacy of nurses. PMID:27454552

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

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

Energy Technology Data Exchange (ETDEWEB)

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

2015-02-15

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

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.

Prevalence and cost of hospital medical errors in the general and elderly United States populations.

Science.gov (United States)

Mallow, Peter J; Pandya, Bhavik; Horblyuk, Ruslan; Kaplan, Harold S

2013-12-01

The primary objective of this study was to quantify the differences in the prevalence rate and costs of hospital medical errors between the general population and an elderly population aged ≥65 years. Methods from an actuarial study of medical errors were modified to identify medical errors in the Premier Hospital Database using data from 2009. Visits with more than four medical errors were removed from the population to avoid over-estimation of cost. Prevalence rates were calculated based on the total number of inpatient visits. There were 3,466,596 total inpatient visits in 2009. Of these, 1,230,836 (36%) occurred in people aged ≥ 65. The prevalence rate was 49 medical errors per 1000 inpatient visits in the general cohort and 79 medical errors per 1000 inpatient visits for the elderly cohort. The top 10 medical errors accounted for more than 80% of the total in the general cohort and the 65+ cohort. The most costly medical error for the general population was postoperative infection ($569,287,000). Pressure ulcers were most costly ($347,166,257) in the elderly population. This study was conducted with a hospital administrative database, and assumptions were necessary to identify medical errors in the database. Further, there was no method to identify errors of omission or misdiagnoses within the database. This study indicates that prevalence of hospital medical errors for the elderly is greater than the general population and the associated cost of medical errors in the elderly population is quite substantial. Hospitals which further focus their attention on medical errors in the elderly population may see a significant reduction in costs due to medical errors as a disproportionate percentage of medical errors occur in this age group.

[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.

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.

Feminine and masculine archetypes in Carmen Martín Gaite’s Entre visillos. An analysis from ethnoliterature

Directory of Open Access Journals (Sweden)

Cajade Frías, Sonia

2010-12-01

Full Text Available The aim of this article is to analyze from the perspective of ethnoliterature the novel Entre visillos (1958 by Carmen Martín Gaite in relation to the Spain’s social and cultural context in the 1950s. The objective of the work consists of studying the feminine and masculine archetypes that the novel projects, in connection with the gender-related models that National-Catholicism promoted at the time. Many of these models are still prevalent in Spain. For her the novel, as it encapsulated the socio-cultural context of the 1950s, had by itself, as a specific literary product, the power of impinging upon and re-constructing that social reality, especially by producing new archetypes of gender on which to offer alternate models of identity.

El propósito de este artículo es analizar desde una perspectiva etnoliteraria la novela Entre visillos (1958 de Carmen Martín Gaite en relación con el contexto social y cultural de la España de posguerra de los años cincuenta. El objetivo del trabajo consiste en estudiar los arquetipos femeninos y masculinos que se proyectan a través de la novela y su conexión con los modelos de género propuestos por la ideología dominante del nacional-catolicismo, muchos aún vigentes en la sociedad actual. Se trata así de explorar cómo el contexto sociocultural de la época se refleja en la novela y cómo a su vez la propia obra literaria, como producto cultural específico, posee la capacidad de proyectarse sobre esa misma realidad social, contribuyendo así a re-construirla, concretamente a través de la creación de nuevos arquetipos de género que proponen modelos de identidad alternativos.

Depressive states and adolescent alcohol consumption secondary in Ciudad del Carmen Campeche, México

Directory of Open Access Journals (Sweden)

Juan Yovani Telumbre Terrero

2017-06-01

Full Text Available Introduction: Adolescence is a stage where personal identity is sought and each teenager experiences this period of life in different ways, allowing him to obtain physical, emotional and cognitive maturity. Objective: To determine the relationship between depressive states and alcohol consumption in adolescents from middle school in Ciudad del Carmen, Campeche, México. Methods: A correlational descriptive study, conducted in 327 middle school adolescents. Data collection uses a personal data record and alcohol consumption and the Beck Depression Inventory. Statistical package for the social sciences (SPSS, version 23.0, using descriptive and inferential statistics. Results: 53.5% of adolescents have ever consumed alcohol, 33.9% in the last year, 20.5% in the last month and 10,1% in the last week. 13.4% of adolescents present mild depression, 11% moderate depression and 8.3% severe depression. There is a positive and significant relationship between depressive states and the amount of alcohol consumed by adolescents on a typical day (rs = 0.163, p = 0.003. Conclusion: The phenomenon of addiction represents an area of opportunity for health professionals in education and health promotion and prevention of disease at various levels of health care.

Maribor General Hospital from its foundation until World War II.

Science.gov (United States)

Pivec, Gregor

2006-01-01

The author describes the history of Maribor General Hospital from its foundation in 1799 until the beginning of World War II. In 1799 the magistrate of the town of Maribor issued a memorandum regarding the 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. In the period between its establishment and eventual relocation 26 beds were added. 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 grew rapidly as a consequence of the construction of the Southern Railway. The town 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 were 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 before World War I. In 1914, the first X-ray apparatus was purchased. Between the wars, the hospital's development was boosted by recruitment of the Slovene physicians Ivan Matko, Mirko Cernic, Janko Dernovsek and Hugon Robic. The initial external and medical departments split into several departments: internal medicine, surgery

Impact of hyperglycemia on morbidity and mortality, length of hospitalization and rates of re-hospitalization in a general hospital setting in Brazil

Directory of Open Access Journals (Sweden)

Leite Silmara AO

2010-07-01

Full Text Available Abstract Background Hyperglycemia in hospitalized patients is known to be related to a higher incidence of clinical and surgical complications and poorer outcomes. Adequate glycemic control and earlier diagnosis of type 2 diabetes during hospitalization are cost-effective measures. Methods This prospective cohort study was designed to determine the impact of hyperglycemia on morbidity and mortality in a general hospital setting during a 3-month period by reviewing patients' records. The primary purposes of this trial were to verify that hyperglycemia was diagnosed properly and sufficiently early and that it was managed during the hospital stay; we also aimed to evaluate the relationship between in-hospital hyperglycemia control and outcomes such as complications during the hospital stay, extent of hospitalization, frequency of re-hospitalization, death rates and number of days in the ICU (Intensive Care Unit after admission. Statistical analyses utilized the Kruskall-Wallis complemented by the "a posteriori" d.m.s. test, Spearman correlation and Chi-squared test, with a level of significance of 5% (p Results We reviewed 779 patient records that fulfilled inclusion criteria. The patients were divided into 5 groups: group (1 diabetic with normal glycemic levels according to American Diabetes Association criteria for in-hospital patients (n = 123; group (2 diabetics with hyperglycemia (n = 76; group (3 non-diabetics with hyperglycemia (n = 225; group (4diabetics and non-diabetics with persistent hyperglycemia during 3 consecutive days (n = 57 and group (5 those with normal glucose control (n = 298. Compared to patients in groups 1 and 5, patients in groups 2, 3 and 4 had significantly higher mortality rates (17.7% vs. 2.8% and Intensive Care Unit admissions with complications (23.3% vs. 4.5%. Patients in group 4 had the longest hospitalizations (mean 15.5 days, and group 5 had the lowest re-hospitalization rate (mean of 1.28 hospitalizations. Only

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

Directory of Open Access Journals (Sweden)

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.

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 ...

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.

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...

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.

Acute general hospital admissions in people with serious mental illness.

Science.gov (United States)

Jayatilleke, Nishamali; Hayes, Richard D; Chang, Chin-Kuo; Stewart, Robert

2018-02-28

Serious mental illness (SMI, including schizophrenia, schizoaffective disorder, and bipolar disorder) is associated with worse general health. However, admissions to general hospitals have received little investigation. We sought to delineate frequencies of and causes for non-psychiatric hospital admissions in SMI and compare with the general population in the same area. Records of 18 380 individuals with SMI aged ⩾20 years in southeast London were linked to hospitalisation data. Age- and gender-standardised admission ratios (SARs) were calculated by primary discharge diagnoses in the 10th edition of the World Health Organization International Classification of Diseases (ICD-10) codes, referencing geographic catchment data. Commonest discharge diagnosis categories in the SMI cohort were urinary conditions, digestive conditions, unclassified symptoms, neoplasms, and respiratory conditions. SARs were raised for most major categories, except neoplasms for a significantly lower risk. Hospitalisation risks were specifically higher for poisoning and external causes, injury, endocrine/metabolic conditions, haematological, neurological, dermatological, infectious and non-specific ('Z-code') causes. The five commonest specific ICD-10 diagnoses at discharge were 'chronic renal failure' (N18), a non-specific code (Z04), 'dental caries' (K02), 'other disorders of the urinary system' (N39), and 'pain in throat and chest' (R07), all of which were higher than expected (SARs ranging 1.57-6.66). A range of reasons for non-psychiatric hospitalisation in SMI is apparent, with self-harm, self-neglect and/or reduced healthcare access, and medically unexplained symptoms as potential underlying explanations.

Changing patterns of psychiatric inpatient care for children and adolescents in general hospitals, 1988-1995.

Science.gov (United States)

Pottick, K J; McAlpine, D D; Andelman, R B

2000-08-01

The authors examine patterns in utilization of psychiatric inpatient services by children and adolescents in general hospitals during 1988-1995. National Hospital Discharge Survey data were used to describe utilization patterns for children and adolescents with primary psychiatric diagnoses in general hospitals from 1988 to 1995. During the study period, there was a 36% increase in hospital discharges and a 44% decline in mean length of stay, resulting in a 23% decline in the number of bed-days, from more than 3 million to about 2.5 million. The number of nonpsychotic major depressive disorders increased significantly. Discharges from public hospitals have declined, and those from proprietary hospitals have risen. Concurrently, the role of private insurance declined and the role of Medicaid increased. During the period of study, the mean and median length of stay declined most for children and adolescents who were hospitalized in private facilities and those covered by private insurance. Across the United States, the mean length of stay declined significantly; this decline was almost 60% in the West. Discharges also declined in the West, in contrast to the Midwest and the South, where they significantly increased. Increased numbers of discharges and decreased length of stay may reflect evolving market forces and characteristics of hospitals. Further penetration by managed care into the public insurance system or modifications in existing Medicaid policy could have a profound impact on the availability of inpatient resources.

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...

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.

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.

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

Zolpidem prescribing and adverse drug reactions in hospitalized general medicine patients at a Veterans Affairs hospital.

Science.gov (United States)

Mahoney, Jane E; Webb, Melissa J; Gray, Shelly L

2004-03-01

Zolpidem is prescribed for sleep disruption in hospitalized patients, but data on the incidence of adverse drug reactions (ADRs) are based largely on outpatient studies. Thus, the incidence of ADRs in hospitalized patients may be much higher. The goal of this study was to describe prescribing patterns of zolpidem for hospitalized medical patients aged 50 years, the incidence of ADRs possibly and probably associated with its use, and the factors associated with central nervous system (CNS) ADRs. This case series was conducted in 4 general medicine wards at a Veterans Affairs hospital and was a consecutive sample of patients aged 50 years who were hospitalized between 1993 and 1997 and received zolpidem as a hypnotic during hospitalization, but had not received it in the previous 3 months. Chart review was conducted by 2 evaluators. Data extracted from the medical records included admission demographic characteristics, medications, comorbidities, and levels of function in performing basic and instrumental activities of daily living. The main outcome measure was ADRs possibly or probably related to zolpidem use. The association between zolpidem and the occurrence of CNS ADRs (eg, confusion, dizziness, daytime somnolence) was analyzed separately. The review included 119 medical patients aged > or =50 years who had newly received zolpidem for sleep disruption during hospitalization. The median age of the population was 70 years; 86 (72.3%) patients were aged 65 years. The initial zolpidem dose was 5 mg in 42 patients (35.3%) and 10 mg in 77 patients (64.7%). Twenty-three patients had a respective 16 and 10 ADRs possibly and probably related to zolpidem use (19.3% incidence). Of a total of 26 ADRs, 21 (80.8%) were CNS ADRs, occurring with both zolpidem 5 mg (10.8% of users) and 10 mg (18.3% of users). On univariate analyses, the only factor significantly associated with a CNS ADR was functional impairment at baseline (P = 0.003). Zolpidem was discontinued in 38.8% of

Causes and predictors of mortality in hospitalized lupus patient in Sarawak General Hospital, Malaysia.

Science.gov (United States)

Teh, C L; Ling, G R

2013-01-01

Systemic lupus erythematosus (SLE) is a serious autoimmune disease that can be life threatening and fatal if left untreated. Causes and prognostic indicators of death in SLE have been well studied in developed countries but lacking in developing countries. We aimed to investigate the causes of mortality in hospitalized patients with SLE and determine the prognostic indicators of mortality during hospitalization in our center. All SLE patients who were admitted to Sarawak General Hospital from January 1, 2006 to December 31, 2010, were followed up in a prospective study using a standard protocol. Demographic data, clinical features, disease activities and damage indices were collected. Logistic regression and Cox regression analysis were used to determine the prognostic indicators of mortality in our patients. There were a total of 251 patients in our study, with the female to male ratio 10 to 1. Our study patients were of multiethnic origins. They had a mean age of 30.5 ± 12.2 years and a mean duration of illness of 36.5 ± 51.6 months. The main involvements were hematologic (73.3%), renal (70.9%) and mucocutaneous (67.3%). There were 26 deaths (10.4%), with the main causes being: infection and flare (50%), infection alone (19%), flare alone (19%) and others (12%). Independent predictors of mortality in our cohort of SLE patients were the presence of both infection and flare of disease (hazard ratio (HR) 5.56) and high damage indices at the time of admission (HR 1.91). Infection and flare were the main causes of death in hospitalized Asian patients with SLE. The presence of infection with flare and high damage indices at the time of admission were independent prognostic indicators of mortality.

Our experiences with vancomycin-resistant enterococci in Jesenice General hospital

Directory of Open Access Journals (Sweden)

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.

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

STUDIES OF ADVERSE DRUG REACTION PROFILE OF ANTISNAKE VENOM AT DISTRICT GENERAL HOSPITAL

OpenAIRE

Mulchand Shende *, Sneha Gawali , Kanchan Bhongade , Vivek Bhuskade , Abhijit Nandgaonkar

2017-01-01

Snake bite is a common predominant problem of the rural and periurban areas, neglected and frequently devastating environmental and occupational disease, especially in rural areas of tropical developing countries. This study aimed to investigate of the adverse drug reaction profile of anti-snake venom (ASV) in a district general hospital. An observational study was conducted in hospital for six months. A total number of 142 indoor case papers of snake bite from October 2016 to April 2017 were...

Hospital discharge summary scorecard: a quality improvement tool used in a tertiary hospital general medicine service.

Science.gov (United States)

Singh, G; Harvey, R; Dyne, A; Said, A; Scott, I

2015-12-01

We assessed the impact of completion and feedback of discharge summary scorecards on the quality of discharge summaries written by interns in a general medicine service of a tertiary hospital. The scorecards significantly improved summary quality in the first three rotations of the intern year and could be readily adopted by other units as a quality improvement intervention for optimizing clinical handover to primary care providers. © 2015 Royal Australasian College of Physicians.

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.)

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...

Control interno y su influencia en los procesos de adquisiciones y contrataciones de la Municipalidad Distrital Carmen de la Legua Reynoso - Callao, período: 2010-2012

OpenAIRE

Aquipucho Lupo, Lucy Silvia

2015-01-01

La presente investigación tiene como objetivo analizar y mejorar el sistema de control interno en los procesos de adquisiciones y contrataciones de la Municipalidad Distrital de Carmen de la Legua Reynoso, en el período 2010-2012, así como verificar sus procesos y confiabilidad de acuerdo a sus funciones establecidas en sus instrumentos de gestión cuya finalidad es brindar servicios a la población, asimismo, recomendar a los funcionarios de la municipalidad las acciones correctivas que deben ...

Care of "new" long-stay patients in a district general hospital psychiatric unit. The first two years of a hospital-hostel.

Science.gov (United States)

Gibbons, J S

1986-05-01

The paper describes the need for long-term inpatient care in an English health district whose psychiatric services were based on a unit in a District General Hospital. Patients who became long-stay were placed in a new hospital-hostel in a city centre. Three quarters of those eligible could be managed in the hostel, with those rejected posing more control problems. Patients in the hostel became less withdrawn and increased their activity and use of community facilities.

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.

Lower respiratory tract infection hospitalizations among American Indian/Alaska Native children and the general United States child population

Directory of Open Access Journals (Sweden)

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.

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...

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 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.

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.

[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

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.

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,...

Management of perforated peptic ulcer in a district general hospital.

Science.gov (United States)

Critchley, A C; Phillips, A W; Bawa, S M; Gallagher, P V

2011-11-01

Laparoscopic surgery has become increasingly popular for elective surgery but it has gained slow transference to emergency surgery. The management of perforated peptic ulcers (PPU) laparoscopically is an accepted strategy yet it still remains infrequently used. The purpose of this study was to analyse the utility and outcomes of laparoscopy versus open repair for PPU in a district general hospital. In addition, we evaluated whether the subspecialty of the on-call consultant affected the method of repair performed and the training opportunities for trainee surgeons. Between 2003 and 2009, 53 patients underwent laparoscopic repair, 89 patients underwent open repair and a further 20 patients had laparoscopic repair that was converted to open repair for PPU. The results from a prospectively compiled database were analysed with primary outcome measures including operative time, length of hospital stay and mortality. The median operating time in the laparoscopic group was 60.0 minutes compared with 50.5 minutes in the open group. Hospital stay in surviving patients was significantly shorter in patients treated completely laparoscopically (5 days) when compared with the open group (6 days) ( p management of PPU. Our findings support the view that this procedure can be successfully used as a training operation.

Characteristics and outcomes of paracetamol poisoning cases at a general hospital in Northern Malaysia.

Science.gov (United States)

Mohd Zain, Z; Fathelrahman, A I; Ab Rahman, A F

2006-02-01

Paracetamol is available as an over-the-counter medication in many countries including Malaysia. This drug has been implicated in many poisoning cases admitted to hospitals throughout the country. We conducted a three-year retrospective review of 165 medical records of patients admitted to the Penang General Hospital for acute paracetamol poisoning. Cases were identified according to the discharge diagnosis documented in their medical records. Acute paracetamol poisoning occurred in all major ethnic groups. About 70 percent of our patients were female. There was minimal involvement of children. Admissions were more likely to be due to deliberate ingestions rather than accidental poisoning. In most cases, serum concentrations data plotted on the Rumack-Matthew nomogram predicted the majority of cases to be unlikely to be hepatotoxic, which were consistent with their mild clinical courses. Patients who acutely ingested more than 140 mg/kg or predicted to be hepatotoxic, based on their serum concentrations, had a significantly longer hospital stay. Although acute paracetamol poisoning was common, the outcome was generally good.

Cost implication of irrational prescribing of chloroquine in Lagos State general hospitals.

Science.gov (United States)

Aina, Bolajoko A; Tayo, Fola; Taylor, Ogori

2008-02-01

A major share of the hospital budget is spent on drugs. Irrational use of these drugs is a waste of financial and human resources that could have been deployed for another use within the hospital setting especially in cases where such drugs are provided free to patients. Also there is increased morbidity and progression of severity with irrational use. The objective of this study was to determine the irrational use of chloroquine and the subsequent cost implications in Lagos State general hospitals. A retrospective study period of one year (January to December, 2000) was selected. A total of 18,781 prescription forms of "Free Eko Malaria" were sampled for children and adults from all the Lagos State general hospitals. Drug costs in each prescription form were identified. Cost effectiveness analysis of chloroquine tablet and intramuscular injection was undertaken. The average cost of medicine per prescription was 132.071 ($1.03) which should have been 94.22 ($0.73) if prescribed rationally. The total cost of prescriptions for malaria under study was 2,480,425.00 ($19,348.09). About 68% {(1,679,444.00) ($13,100.19)} of the total cost was lost to irrational prescribing. This is a waste of scarce resources. When the prescriptions were differentiated into the different dosage forms prescribed, the prescriptions containing intramuscular injections only had over 90% of the cost lost to irrational prescribing. Cost effectiveness analysis showed that chloroquine tablet was 17 times more cost effective than chloroquine injection (intramuscular) from a health care system perspective while it was 14 times more cost effective from a patient perspective. There is waste of scarce resources with irrational dispensing of drugs and these resources could have been deployed to other uses or areas within the hospitals. The tablet chloroquine was more cost effective than injection chloroquine (intramuscular). Increasing the cost of tablets, decreasing effectiveness of tablets

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.

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 ...

Drug utilization pattern of Chinese herbal medicines in a general hospital in Taiwan.

Science.gov (United States)

Chen, L C; Wang, B R; Chou, Y C; Tien, J H

2005-09-01

Drug utilization studies are important for the optimization of drug therapy and have received a great attention in recent years. Most of the information on drug use patterns has been derived from studies in modern Western medicines; however, studies regarding the drug utilization of traditional Chinese medicine (CM) are few. The present study was the first clinical research to evaluate the drug utilization patterns of Chinese herbal medicines in a general hospital in Taiwan. Data were collected prospectively from the patients attending the Traditional Medicine Center of Taipei Veteran General Hospital under CM drug treatments. The study was carried out over a period of 1 year, from January 2002 to December 2002. Core drug use indicators, such as the average number of drugs per prescriptions, the dosing frequency of prescriptions, and the most common prescribed CM herbs and formulae were evaluated. The primary diagnosis and the CM drugs prescribed for were also revealed. All data were analyzed by descriptive statistics. A total of 10 737 patients, representing 52 255 CM drugs, were screened during the study period. Regarding the prescriptions, the average number of drugs per prescription was 4.87 and 37.21% of prescriptions were composed by five drugs. Most of prescriptions (91.38%) were prescribed for three times a day. The most often prescribed Chinese herb was Hong-Hwa (5.76%) and the most common Chinese herbal formula was Jia-Wey-Shiau-Yau-San (3.80%). The most frequent main diagnosis was insomnia (15.58%), followed by menopause (5.22%) and constipation (5.09%). The survey revealed the drug use pattern of CMs in a general hospital. The majority of CM prescriptions were composed by 3-6 drugs and often prescribed for three times a day. Generally, the rational drug uses of CM drugs were provided with respect to the various diagnoses. (c) 2005 John Wiley & Sons, Ltd.

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

Directory of Open Access Journals (Sweden)

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.

The hospital educational environment and performance of residents in the General Medicine In-Training Examination: a multicenter study in Japan

Directory of Open Access Journals (Sweden)

Shimizu T

2013-07-01

Full Text Available Taro Shimizu,1 Yusuke Tsugawa,2,3 Yusuke Tanoue,4 Ryota Konishi,5 Yuji Nishizaki,6 Mitsumasa Kishimoto,7 Toshiaki Shiojiri,8 Yasuharu Tokuda9 1Hospitalist Division, Department of Medicine, Nerima Hikarigaoka Hospital, Tokyo, Japan; 2Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA; 3Center for Clinical Epidemiology, St Luke's Life Science Institute, 4Department of Vascular and Oncological Surgery, Hospital of Tokyo University, 5Department of General Internal Medicine, Kanto Rousai Hospital, 6Department of Cardiology, Juntendo University School of Medicine, 7Division of Rheumatology, St Luke's International Hospital, Tokyo, Japan; 8Asahi Chuo Hospital, Chiba, Japan; 9Department of Medicine, Tsukuba University Mito Kyodo General Hospital, Mito City, Ibaraki, Japan Background: It is believed that the type of educational environment in teaching hospitals may affect the performance of medical knowledge base among residents, but this has not yet been proven. Objective: We aimed to investigate the association between the hospital educational environment and the performance of the medical knowledge base among resident physicians in Japanese teaching hospitals. Methods: To assess the knowledge base of medicine, we conducted the General Medicine In-Training Examination (GM-ITE for second-year residents in the last month of their residency. The items of the exam were developed based on the outcomes designated by the Japanese Ministry of Health, Labor, and Welfare. The educational environment was evaluated using the Postgraduate Hospital Educational Environment Measure (PHEEM score, which was assessed by a mailed survey 2 years prior to the exam. A mixed-effects linear regression model was employed for the analysis of variables associated with a higher score. Results: Twenty-one teaching hospitals participated in the study and a total of 206 residents (67 women participated and

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.

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)

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

Alcohol dependence and physical comorbidity: Increased prevalence but reduced relevance of individual comorbidities for hospital-based mortality during a 12.5-year observation period in general hospital admissions in urban North-West England.

Science.gov (United States)

Schoepf, D; Heun, R

2015-06-01

Alcohol dependence (AD) is associated with an increase in physical comorbidities. The effects of these diseases on general hospital-based mortality are unclear. Consequently, we conducted a mortality study in which we investigated if the burden of physical comorbidities and their relevance on general hospital-based mortality differs between individuals with and without AD during a 12.5-year observation period in general hospital admissions. During 1 January 2000 and 30 June 2012, 23,371 individuals with AD were admitted at least once to seven General Manchester Hospitals. Their physical comorbidities with a prevalence≥1% were compared to those of 233,710 randomly selected hospital controls, group-matched for age and gender (regardless of primary admission diagnosis or specialized treatments). Physical comorbidities that increased the risk of hospital-based mortality (but not outside of the hospital) during the observation period were identified using multiple logistic regression analyses. Hospital-based mortality rates were 20.4% in the AD sample and 8.3% in the control sample. Individuals with AD compared to controls had a higher burden of physical comorbidities, i.e. alcoholic liver and pancreatic diseases, diseases of the conducting airways, neurological and circulatory diseases, diseases of the upper gastrointestinal tract, renal diseases, cellulitis, iron deficiency anemia, fracture neck of femur, and peripheral vascular disease. In contrast, coronary heart related diseases, risk factors of cardiovascular disease, diverticular disease and cataracts were less frequent in individuals with AD than in controls. Thirty-two individual physical comorbidities contributed to the prediction of hospital-based mortality in univariate analyses in the AD sample; alcoholic liver disease (33.7%), hypertension (16.9%), chronic obstructive pulmonary disease (14.1%), and pneumonia (13.3%) were the most frequent diagnoses in deceased individuals with AD. Multiple forward

Causes of recurrent pneumonia in children in a general hospital.

Science.gov (United States)

Hoving, M F Paulien; Brand, Paul L P

2013-03-01

Because the few previous studies on underlying causes of recurrent pneumonia in children have come from tertiary care referral centres where selection bias may be important, the aim of this study was to examine underlying causes of recurrent pneumonia in children in a general hospital. We performed a retrospective chart review in a general hospital of 62 children with recurrent pneumonia over a 7.5 years period. In 19 patients (30.6%), no cause was identified, commonly because favourable natural history obviated the need for a full and invasive diagnostic work-up. Other underlying causes included recurrent aspiration in 16 patients (25.7%), lung disease (airway stenosis, bronchiectasis, middle lobe syndrome or tracheooesophageal fistula) in 10 patients (16.1%) and immune deficiency in 10 patients (16.1%). In contrast to previous studies, asthma was never diagnosed as an underlying cause, but diagnostic confusion between asthma (or recurrent upper respiratory tract infections) and recurrent pneumonia was common. The cause of recurrent pneumonia in children remains elusive in almost a third of patients, partly because the favourable natural history consistent with immune system maturation eliminates the need for further diagnostic procedures. Asthma is more likely a differential diagnostic consideration than an underlying cause of recurrent pneumonia in children. A standardised diagnostic guideline is needed to improve knowledge on causes of recurrent pneumonia in children. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Excess mortality in general hospital patients with delirium: A 5-year follow-up of 519 patients seen in psychiatric consultation

NARCIS (Netherlands)

A.M. van Hemert (Bert); R.C. van der Mast (Roos); M.W. Hengeveld (Michiel); M. Vorstenbosch (Marielle)

1994-01-01

textabstractMortality was determined in 519 patients with delirium who were seen in psychiatric consultation in two general hospitals. Among 419 patients with simple delirium (DSM-III: 293.00) in-hospital mortality was 26%. As compared to average hospital patients the age adjusted in-hospital excess

Patriachy, indoctrination and education. The therapeutic power of creation in women's literature. Two case studies: Carmen Mart??n Gaite's "The back room" (1978) and Ian McEwan's "Atonnement" (2001)

OpenAIRE

Garc??a Lara, Antonia

2011-01-01

My dissertation deals with the patriarchal education that indoctrinates women and forces them to be domestic angels and how this education provokes a trauma that they try to heal by creation in the form of writing. I will use two case studies to illustrate my point: Carmen Mart??n Gaite???s C., who is Mart??n Gaite???s alter ego in El Cuarto de Atr??s [The Back Room] (1978), and Briony Tallis, who is a fictional character in Ian McEwan???s Atonement (2001). Briony is actually the one who writ...

Dos políticas fronterizas y sus consecuencias: diplomacia, comercio y uso de la violencia en los inicios del fuerte del Carmen de Río Negro (1779‑1785)

OpenAIRE

Alioto, Sebastián Leandro

2014-01-01

Este artículo estudia las políticas practicadas por los dos primeros comisarios superintendentes de Carmen de Patagones respecto de los nativos de la región pampeana y nord-­‐‑patagónica, en cuyo territorio se implantó la colonia. El contraste entre la llevada adelante por Francisco de Viedma, basada principalmente en la diplomacia y el comercio, y la que intentó Juan de la Piedra, apoyada en el uso de la violencia y las incursiones armadas en terreno indígena, permite sacar ciertas...

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.

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)

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)

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)

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)

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)

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)

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.

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,

Viabilidade de unidades psiquiátricas em hospitais gerais no Brasil Viabilidad de unidades psiquiátricas en hospitales generales en Brasil Feasibility of general hospitals psychiatric units in Brazil

Directory of Open Access Journals (Sweden)

Maurício Lucchesi

2009-02-01

Full Text Available OBJETIVO: Compreender o estigma voltado aos portadores de transtornos mentais na cultura de hospitais gerais enquanto fator limitante para a implantação de unidades psiquiátricas em hospitais gerais no Brasil. PROCEDIMENTOS METODOLÓGICOS: Foi delineada uma pesquisa social, de natureza qualitativa. Adotou-se como estratégia a pesquisa-ação para a implantação de uma unidade psiquiátrica em um hospital geral em Taubaté, SP, 2005-2006. As evidências foram obtidas por meio de entrevistas, observação participante e palestras sobre o projeto da unidade psiquiátrica para o corpo clínico do hospital. RESULTADOS: O investimento do órgão gestor possibilitou que as concepções estigmatizantes presentes na cultura do hospital estudado (violência, fraqueza moral e intratabilidade fossem ressignificadas por meio de discussões clínicas e sanitárias, viabilizando a implantação da unidade psiquiátrica. A análise mostrou que essas concepções eram reatualizadas pelo contexto assistencial, no qual o acesso dos portadores de transtornos mentais era restrito. CONCLUSÕES: A postura assumida pelo órgão gestor, que decidiu pelo financiamento adequado da unidade psiquiátrica e exerceu sua ascendência sobre o hospital prestador, foi decisiva para o desfecho do caso. A principal dificuldade para a implantação das unidades psiquiátricas não é o estigma presente na cultura dos hospitais gerais, mas uma limitação de ordem estratégica: a falta de uma política afirmativa para essas unidades.OBJETIVO: Comprender el estigma dirigido a los portadores de trastornos mentales en la cultura de hospitales generales con relación al factor limitante para la implantación de unidades psiquiátricas en hospitales generales en Brasil. PROCEDIMIENTOS METODOLÓGICOS: Fue delineada una pesquisa social, de naturaleza cualitativa. Se adoptó como estrategia la pesquisa-acción para la implantación de una unidad psiquiátrica en un hospital general en

Causes of prolonged hospitalization among general internal medicine patients of a tertiary care center.

Science.gov (United States)

Ruangkriengsin, Darat; Phisalprapa, Pochamana

2014-03-01

Unnecessary days of prolonged hospitalization may lead to the increase in hospital-related complications and costs, especially in tertiary care center Currently, there have not been many studies about the causes of prolonged hospitalization. Some identified causes could, however, be prevented and improved. To identify the prevalence, causes, predictive factors, prognosis, and economic burden of prolonged hospitalization in patients who had been in general internal medicine wards of the tertiary care center for 7 days or more. Retrospective chart review study was conducted among all patients who were admitted for 7 days or more in general internal medicine wards of Siriraj Hospital, the largest tertiary care center in Thailand. The period of this study was from 1 August 2012 to 30 September 2012. Demographic data, principle diagnosis, comorbid diseases, complications, discharge status, total costs of admission and percentage of reimbursement were collected. The causes of prolonged hospitalization at day 7, 14, 30, and 90 were assessed. Five hundred and sixty-two charts were reviewed. The average length of stay was 25.9 days. The two most common causes of prolonged admission at day 7 were treatment of main diagnosed disease with stable condition (27.6%) and waiting for completion of intravenous antibiotics administration with stable condition (19.5%). The causes of prolonged hospitalization at day 14 were unstable condition from complications (22.6%) and those waiting for completion of intravenous antibiotics administration with stable condition (15.8%). The causes of prolonged admission at day 30 were unstable conditions from complications (25.6%), difficulty weaning or ventilator dependence (17.6%), and caregiver problems (15.2%). The causes of prolonged hospitalization at day 90 were unstable condition from complications (30.0%), caregiver problems (30.0%), and palliative care (25.0%). Poor outcomes were shown in the patients admitted more than 90 days. Percentage

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

Directory of Open Access Journals (Sweden)

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.

Higher surgical training opportunities in the general hospital setting; getting the balance right.

Science.gov (United States)

Robertson, I; Traynor, O; Khan, W; Waldron, R; Barry, K

2013-12-01

The general hospital can play an important role in training of higher surgical trainees (HSTs) in Ireland and abroad. Training opportunities in such a setting have not been closely analysed to date. The aim of this study was to quantify operative exposure for HSTs over a 5-year period in a single institution. Analysis of electronic training logbooks (over a 5-year period, 2007-2012) was performed for general surgery trainees on the higher surgical training programme in Ireland. The most commonly performed adult and paediatric procedures per trainee, per year were analysed. Standard general surgery operations such as herniae (average 58, range 32-86) and cholecystectomy (average 60, range 49-72) ranked highly in each logbook. The most frequently performed emergency operations were appendicectomy (average 45, range 33-53) and laparotomy for acute abdomen (average 48, range 10-79). Paediatric surgical experience included appendicectomy, circumcision, orchidopexy and hernia/hydrocoele repair. Overall, the procedure most commonly performed in the adult setting was endoscopy, with each trainee recording an average of 116 (range 98-132) oesophagogastroduodenoscopies and 284 (range 227-354) colonoscopies. General hospitals continue to play a major role in the training of higher surgical trainees. Analysis of the electronic logbooks over a 5-year period reveals the high volume of procedures available to trainees in a non-specialist centre. Such training opportunities are invaluable in the context of changing work practices and limited resources.

Agenda pública local. Los casos de los municipios de El Carmen de Viboral y Turbo, Antioquia-Colombia

Directory of Open Access Journals (Sweden)

Olga Lucía Zapata Cortés

2016-01-01

Full Text Available La conformación de la agenda gubernamental en los municipios de El Carmen de Viboral y Turbo recorrió caminos diferentes. En el primer caso, se propuso una Asamblea Municipal como espacio de participación en el marco de la formulación del Plan de Desarrollo; en el segundo caso, se prefirió la contratación de un consultor externo para la elaboración del Plan de Desarrollo y hubo escasa participación ciudadana. Mediante un estudio de caso, apoyado en el análisis documental y el enfoque de corrientes múltiples para el estudio de la agenda pública, se observan formas diferenciadas de conformar la agenda, así como de aprovechar la participación de las comunidades en este proceso. También se observa que a pesar de las capacidades y fortalezas que trae consigo la presencia de la universidad pública en estos municipios, la incidencia de la Universidad de Antioquia en la configuración de la agenda local es escasa.

Trastornos psicóticos en el servicio de urgencias de un Hospital General.

OpenAIRE

AI González Vázquez; F Battle Battle; E Ferrer Gómez del Valle; MC García Mahía; David Simón Lorda; L Docasar Bertolo; José Mazaira Castro; A Albarrán Barrado; A Rodríguez López

1994-01-01

El presente artículo pretende reflexionar acerca del papel que los Servicios de Urgencia Psiquiátrica están teniendo en la atención del paciente psicótico no institucionalizado, en el marco particular de un Area Sanitaria en plena reestructuración. Para ello se analizan diversos datos de los pacientes atendidos en el Servicio General de Urgencias de un Hospital General que fueron diagnosticados como trastornos psicóticos, tratándose de valorar los factores que influyen en la decisión de ingre...

Locum tenens consultant doctors in a rural general hospital - an essential part of the medical workforce or an expensive stopgap?

Science.gov (United States)

Sim, Andrew Jw

2011-01-01

Maintaining hospital consultant staffing levels often requires the employment of locum tenens to meet service needs. This is particularly so in hospitals where core clinical services are run by a small number of permanently appointed consultants. The problems associated with locum employment are underestimated and little attention has been directed towards addressing the issue in the rural general hospitals of Scotland. This study looked at the permanent and short- and long-term locum consultant usage over an 8 year period in one Scottish rural general hospital, the Western Isles Hospital in Stornoway. Data were extracted from the Human Resources Department of NHS Western Isles' list of locum consultants for most weeks from the beginning of January 2002 to the end of December 2009. The Western Isles Hospital in Stornoway has an establishment of 17 permanent consultants. During the 8 year study period 239 different consultants were employed, 20 held substantive permanent positions, 31 were long-term locums (employed >3 months) and 188 were short-term locums. The short-term locums worked for 535 different locum episodes. The pattern of usage varied according to service configuration. Study data revealed the alarming scope of the locum tenens issue, which will increase unless action is taken. For sustainable medical services to continue in the rural general hospitals of Scotland, staffing models must minimise the need to employ locum consultants.

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

Directory of Open Access Journals (Sweden)

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.

Investigation of Irrigation Reuse Potential of Wastewater Treatment Effluent from Hamedan Atieh-Sazan General Hospital

Directory of Open Access Journals (Sweden)

Mohammad Binavapour

2007-12-01

Full Text Available Hospital wastewater is a type of municipal wastewater which may contain pathogenic agents and different microorganisms. If properly treated, the effluent from hospital wastewater treatment facilities can be used for irrigation purposes. To investigate this, the effluent from Hamedan Atieh-Sazan General Hospital was studied. The existing treatment facility uses an extended aeration system with an average wastewater flow rate of approximately 150 m3/day. In addition to evaluating the performance of the wastewater facility at Atieh-Sazan General Hospital, quality parameters of the raw wastewater and the effluent were measured. The mean values obtained for pH, BOD, COD, MPN for total Coliform/100ml, and Nematode/lit in raw wastewater were about 7.1, 238 mg/l, 352 mg/l, 5.5´106, and 2340, respectively. The mean values obtained for pH, BOD, COD, Na%, MPN for total Coliform/100 ml, and Nematode/lit in the effluent were 7.1, 35 mg/L, 77 mg/L, 61, 1561, and 575, respectively. Based on these results, the efficiency of the existing system in removing BOD, COD, and MPN/100 ml were %85.3, %78.3, and %99.97, respectively. With respect to water quality standards available, the quality of the effluent was considered to be suitable for irrigation except for its Na%, MPN for total Coliform, and Nematodes values.

EL HOMBRE PALABRA Y LA MUJER TRAICIÓN EN LA "LA CILINDRA" DE CARMEN BÁEZ

Directory of Open Access Journals (Sweden)

ADRIANA SÁENZ VALADEZ

2016-01-01

Full Text Available En este trabajo se lleva a cabo un análisis del cuento "La Cilindra" de Carmen Báez. Para ello la metodología propuesta está en el contexto de la filosofía, la literatura y la teoría de género. En este marco se tiene como hipótesis que la autora a través de los recursos literarios realiza una reflexión crítica de los prototipos de género, asumidos como ideales imposibles de cumplir, esto es, que en la relación dialéctica que mantienen la vida vivida y la ficción, los esquemas se asumen, construyen y reproducen desde los supuestos que la racionalidad patriarcal ilumina en la vida vivida y por ende en los productos culturales. Para analizarlo, el artículo se ha dividido en cuatro apartados. En el primero se aborda el concepto de prototipo en la Revolución. En el segundo se estudian los esquemas del ser mujer en "La Cilindra". En el tercero se analizan a Juan Lanas y a su superior como dos formas de ser varón durante el movimiento armado y finalmente se propone un análisis de los elementos expuestos.

Effect of the californian red worm (Eisenia foetida during the composteo and vermicomposteo in properties of the Experimental Station of the Academic Rural Unit Carmen Pampa

Directory of Open Access Journals (Sweden)

Paco Gabriel

2011-08-01

Full Text Available The objective of the present work was to evaluate the biotransformación of the organic residuals, of kitchen (Rc remains, pulp of coffee (Pc and cardboard (C by means of compostaje methods and vermicompostaje. The investigation was taken I end up in the Experimental Station, module of lombricultura of the Career of Agronomic Engineering of Carmen Pampa Unit Academic Campesina, located in the community of Carmen Pampa of the Municipality of Coroico Department of La Paz, Bolivia. The used design was totally at random with 3 treatments and 3 repetitions, to compare among obtaining methods in quality it used the test of fixed effects and it stops quantity the test "t" of Student. The quantity of initial sustrato studied in compostaje was of 1m3 and 0,02m3 vermicompostaje ending up culminating the investigation in 120 days. The results in decomposition are obtained in smaller time by means of the method vermicompostaje in Pc in advance of three months of 98.33% continued by C and Rc; while in compostaje it was the treatment with Rc of 3 months with 3 weeks with 90.40% of decomposition, continued by Pc and C. In quantity, starting from 1m3 of initial sustrato bigger bioabono was obtained with Pc 271.62 kg, 465.83 kg, Rc 249.71 kg, 446.00 kg and C 212.48 kg, 404.00 kg, in compost and vermicompost respectively. The chemical composition of the bioabonos of Rc, Pc, C in N and P is tipificados like first floor, high K, Ca in low compost and half vermicompost, half Mg, MO under and lightly alkaline pH to neuter in the two obtaining methods.

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.

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.

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.

Escribirlo al fin: Visto al pasar. República, guerra y exilio de María del Carmen García Antón. Memoria desde el destierro en Argentina

Directory of Open Access Journals (Sweden)

Adriana Virginia Bonatto

2006-11-01

Full Text Available Visto al pasar. República, guerra y exilio is the autobiographical story of a woman from the Republican faction who was driven to permanent exile in Argentina after the Spanish Civil War. The documentary value of her book resides not only in its detailed reconstruction of life and habits during the years of the war, but also in the experiences of Carmen García Antón with world-wide known writers and artists. Moreover, the book invites a reflection on the strategies to legitimize and construct the subject's identity in contemporary Autobiography.

Mentor Tutoring: An Efficient Method for Teaching Laparoscopic Colorectal Surgical Skills in a General Hospital.

Science.gov (United States)

Ichikawa, Nobuki; Homma, Shigenori; Yoshida, Tadashi; Ohno, Yosuke; Kawamura, Hideki; Wakizaka, Kazuki; Nakanishi, Kazuaki; Kazui, Keizo; Iijima, Hiroaki; Shomura, Hiroki; Funakoshi, Tohru; Nakano, Shiro; Taketomi, Akinobu

2017-12-01

We retrospectively assessed the efficacy of our mentor tutoring system for teaching laparoscopic colorectal surgical skills in a general hospital. A series of 55 laparoscopic colectomies performed by 1 trainee were evaluated. Next, the learning curves for high anterior resection performed by the trainee (n=20) were compared with those of a self-trained surgeon (n=19). Cumulative sum analysis and multivariate regression analyses showed that 38 completed cases were needed to reduce the operative time. In high anterior resection, the mean operative times were significantly shorter after the seventh average for the tutored surgeon compared with that for the self-trained surgeon. In cumulative sum charting, the curve reached a plateau by the seventh case for the tutored surgeon, but continued to increase for the self-trained surgeon. Mentor tutoring effectively teaches laparoscopic colorectal surgical skills in a general hospital setting.

Evolution of the Whipple procedure at the Massachusetts General Hospital.

Science.gov (United States)

Fernández-del Castillo, Carlos; Morales-Oyarvide, Vicente; McGrath, Deborah; Wargo, Jennifer A; Ferrone, Cristina R; Thayer, Sarah P; Lillemoe, Keith D; Warshaw, Andrew L

2012-09-01

Since Allen O. Whipple published his seminal paper in 1935, the procedure that bears his name has been performed widely throughout the world and is now a common operation in major medical centers. The goal of this study was to investigate the evolution of pancreatoduodenectomy at the Massachusetts General Hospital (MGH). We sought to identify all pancreatoduodenectomies performed at the MGH since 1935. Cases were obtained from a computerized database, hospital medical records, and the MGH historical archive. Demographics, diagnosis, intraoperative variables and short-term surgical outcomes were recorded. The first pancreatoduodenectomy at the MGH was carried out in 1941; since then, 2,050 Whipple procedures have been performed. Pancreatic ductal adenocarcinoma was the most frequent indication (36%). Pylorus preservation has been the most important variation in technique, accounting for 45% of Whipple procedures in the 1980s; observation of frequent delayed gastric emptying after this procedure led to decline in its use. Pancreatic fistula was the most frequent complication (13%). Operative blood replacement and reoperation rates have decreased markedly over time; the most frequent indication for reoperation was intra-abdominal bleeding. Mortality has decreased from 45% to 0.8%, with sepsis and hypovolemic shock being the most frequent causes of death. Mean duration of hospital stay has decreased from >30 to 9.5 days, along with an increasing readmission rate (currently 19%). The Whipple procedure in the 21st century is a well-established operation. Improvements in operative technique and perioperative care have contributed in making it a safe operation that continues evolving. Copyright © 2012 Mosby, Inc. All rights reserved.

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...

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...

Relay model for recruiting alcohol dependent patients in general hospitals--a single-blind pragmatic randomized trial

DEFF Research Database (Denmark)

Schwarz, Anne-Sophie; Bilberg, Randi; Bjerregaard, Lene Berit Skov

2016-01-01

- The Relay Model. METHOD/DESIGN: The study is a single-blind pragmatic randomized controlled trial including patients admitted to the hospital. The study group (n = 500) will receive an intervention, and the control group (n = 500) will be referred to treatment by usual procedures. All patients complete......://register.clinicaltrials.gov/by identifier: RESCueH_Relay NCT02188043 Project Relay Model for Recruiting Alcohol Dependent Patients in General Hospitals (TRN Registration: 07/09/2014)....

[Geographical coverage of the Mexican Healthcare System and a spatial analysis of utilization of its General Hospitals in 1998].

Science.gov (United States)

Hernández-Avila, Juan E; Rodríguez, Mario H; Rodríguez, Norma E; Santos, René; Morales, Evangelina; Cruz, Carlos; Sepúlveda-Amor, Jaime

2002-01-01

To describe the geographical coverage of the Mexican Healthcare System (MHS) services and to assess the utilization of its General Hospitals. A Geographic Information System (GIS) was used to include sociodemographic data by locality, the geographical location of all MHS healthcare services, and data on hospital discharge records. A maximum likelihood estimation model was developed to assess the utilization levels of 217 MHS General Hospitals. The model included data on human resources, additional infrastructure, and the population within a 25 km radius. In 1998, 10,806 localities with 72 million inhabitants had at least one public healthcare unit, and 97.2% of the population lived within 50 km of a healthcare unit; however, over 18 million people lived in rural localities without a healthcare unit. The mean annual hospital occupation rate was 48.5 +/- 28.5 per 100 bed/years, with high variability within and between states. Hospital occupation was significantly associated with the number of physicians in the unit, and in the Mexican Institute of Social Security units utilization was associated with additional health infrastructure, and with the population's poverty index. GIS analysis allows improved estimation of the coverage and utilization of MHS hospitals.

Psiquiatría de Enlace. Experiencia en el Hospital General de México

Directory of Open Access Journals (Sweden)

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.

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

Science.gov (United States)

Zhao, Lue-Ping; Yu, Guo-Pei; Liu, Hui; Ma, Xie-Min; Wang, Jing; Kong, Gui-Lan; Li, Yi; Ma, Wen; Cui, Yong; Xu, Beibei; Yu, Na; Bao, Xiao-Yuan; Guo, Yu; Wang, Fei; Zhang, Jun; Li, Yan; Xie, Xue-Qin; Jiang, Bao-Guo; Ke, Yang

2013-01-01

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. 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. There were 651,559 hospitalizations during the period analyzed. Averaged CPS was stable over time, while averaged CPD steadily increased by 41.7% (Phospitalizations 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. 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. However, purely market-oriented health-care reform could also misguide future healthcare reform.

Enfermos del Hospital General de Mallorca a fines del siglo XV

OpenAIRE

Contreras Mas, Antonio

2012-01-01

Introducción: Presentamos un estudio sobre los hombres y mujeres que fueron internados en el Hospital General de Mallorca en los últimos años del siglo XV. Se basa en los listados donde se recogieron los detalles personales de algunos de los sujetos allí acogidos entre los años 1482 y 1494. Tras revisar las causas principales de la fundación del establecimiento y algunas noticias sobre este proceso, se examinan determinadas características de los hombres y mujeres a los que prestó asistencia ...

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.

Lahore general hospital protocol for treatment of neovascular glaucoma caused by retinal disease

International Nuclear Information System (INIS)

Khaqan, H.A.; Haider, S.A.

2013-01-01

To evaluate efficacy of LGH (Lahore General Hospital) protocol for treatment of neovascular glaucoma caused by retinal diseases. Material and Methods: This case series was performed on 9 consecutive eyes of nine patients with uncontrolled neovascular glaucoma at Department of Ophthalmology, Unit II, Lahore General Hospital/PGMI, Lahore. All nine patients completed six months follow up. Among them 6 patients were having PDR (proliferative diabetic retinopathy) and 3 patients having CRVO (central retinal vein occlusion). LGH protocol for treatment of neovascular glaucoma was: To give intravitreal injection of avastin and then PRP (Pan Retinal Photocoagulation) or Trabeculectomy with MMC (Mitomycin C), if PRP and intravitreal avastin fails to control the intra ocular-pressure (IOP). Results: Three patients had IOP control after intravitreal injection of avastin and PRP, 5 patients had uncontrolled IOP after intravitreal avastin and two sessions of PRP, so they under went trabeculectomy with MMC. One patient had uncontrolled IOP despite of full treatment protocol. All other 8 patients IOP remained stable for six months. Conclusion: Significant decrease in intraocular pressure was achieved after observing LGH protocol for treatment of NVG (Neovascular Glaucoma) caused by retinal diseases. (author)

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

OpenAIRE

Hernández-Garduño Adolfo Gabriel; Rosa-Ruiz Leticia de la

2000-01-01

OBJETIVO: Evaluar el cambio de conocimientos acerca de la lactancia entre el personal de enfermería del Hospital General de México que asistió a un curso teórico-práctico sobre lactancia materna de 18 horas de duración. MATERIAL Y MÉTODOS: Se realizó una intervención educativa sobre lactancia materna, con evaluación inicial y final, en el Hospital General de México, de mayo de 1996 a mayo de 1997. Se capacitó a 152 enfermeras. Se aplicó la prueba t de Student para muestras dependientes y anál...

Incidence of variables in the Transfer of Tacit Knowledge of Marketing in the hotel sector of Playa del Carmen city, Mexico.

Directory of Open Access Journals (Sweden)

José Luis Zapata

2017-01-01

Full Text Available Esta investigación permitió validar un modelo de influencia de la intención de aprendizaje de market‑ ing, motivación personal y capacidad de absorción de conocimiento de marketing en la adquisición de conocimien‑ to tácito de marketing y esto a su vez en la transferencia de conocimiento tácito de marketing entre los empleados de pequeñas y medianas empresas hoteleras en la ciudad de Playa del Carmen, Quintana Roo, México. A través de una investigación cuantitativa y transversal, se integraron 229 empleados del sector hotelero. Los resultados mostraron que la motivación personal y la intención de aprender marketing intervienen positivamente en la adquisición de conocimiento tácito de marketing y, con influencia de la capacidad de absorción del conocimiento de marketing, impactan directamente la transferencia de conocimiento tácito de marketing.

Dextrose infusion and glucose disorders in people without diabetes hospitalized in general wards.

Science.gov (United States)

Feldman-Billard, Sylvie; Joubert, Michael; Reznik, Yves

2013-11-01

We measured fasting plasma glucose (FPG) on a single day in all persons without diabetes history admitted in general wards (N=1922). After age and length of stay adjustment, dextrose infusion was associated with a 3-fold increase (p<0.001) of hospital-related hyperglycemia (FPG ≥ 7 mmol/l), highlighting the need to interpret glucose disorders cautiously. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

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...

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.

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

Dysphagia referrals to a district general hospital gastroenterology unit: hard to swallow.

Science.gov (United States)

Melleney, Elizabeth Mary-Ann; Subhani, Javaid Mohammed; Willoughby, Charles Peter

2004-01-01

The aim of our study was to audit dysphagia referrals received by a specialist gastroenterology unit during an entire year. We used a prospective audit carried out over a 12-month period at the District General Hospital gastroenterology unit. The audit included 396 consecutive patients who were referred with swallowing difficulties. We found that 60 referrals (15.2%) were inaccurate and the patients had no swallowing problem. Of the 336 patients with genuine dysphagia, only 29 (8.6%) were new cancer cases. The large majority of subjects had benign disease mostly related to acid reflux. Weight loss was significantly associated with malignancy but also occurred in one third of patients with reflux alone. The temporal pattern of dysphagia was not significantly predictive of cancer. All the cancer patients were above the age of 50 years. Although patients were in general assessed rapidly after hospital referral, the productivity, in terms of early tumor diagnosis, was extremely low. We conclude that there is a substantial rate of inaccurate referrals of dysphagia patients. Most true cases of swallowing difficulty relate to benign disease. Even the devotion of considerable resources to the early diagnosis of esophago gastric malignancy in an attempt to conform with best practice guidelines results in a very low success rate in terms of the detection of potentially curable tumors.

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.

Nurses' experiences of inpatients suicide in a general hospital*

Directory of Open Access Journals (Sweden)

Mirriam Matandela

2016-10-01

Full Text Available When suicide occurs, it is regarded as an adverse event. Often, little attention is given to the nurses who cared for the patients prior to the adverse event. Instead the affected nurses are expected to write statements and incident reports about the adverse event. The aim was to explore the experiences of nurses who cared for patients who successfully committed suicide whilst admitted at a specific general hospital in Gauteng Province, South Africa. A qualitative exploratory research was conducted. Data were collected through in-depth interviews with a purposive sample of six nurses and content analysis was done. Nurses experienced feelings of shock; blame and condemnation; inadequacy and feared reprisal. This study suggests a basis for development of support strategies to assist the nurses to deal with their emotions following experience of adverse events.

[Prevalence of depressive and anxiety disorders in cardiovascular outpatients from 14 tertiary general hospitals of 5 Chinese cities].

Science.gov (United States)

Li, Guo; Jiang, Ronghuan; Guo, Chengjun; Liu, Meiyan; Zhang, Lijun

2014-12-01

To explore the prevalence of depression and (or) anxiety disorders among cardiovascular outpatients of tertiary general hospitals of five Chinese cities. A hospital-based cross-sectional survey was conducted in the cardiovascular out-patient departments of 14 tertiary general hospitals in five Chinese cities. The patients aged 18 years and over were recruited consecutively, who were conscious and with informed consent, and can finish the questionnaire independently. All the subjects were screened with Hospital Anxiety Depression Scale (HADS). The subjects with HADS score of 8 and over were interviewed and diagnosed by psychiatrists using mini international neuropsychiatric interview (MINI). The physicians made the diagnosis and management without knowing the results of MINI and HADS score. Subjects who refused MINI were defined as the case of loss of follow-up. A total 2 123 subjects were included in the survey. The adjusted prevalence rate of depressive and anxiety disorder was 4.05% (86/2 123), the depressive and/or anxiety disorder was 14.27 % (303/2 123), depressive and anxiety disorder and mixed depressive or anxiety disorder was 14.37% (305/2 123) according to MINI. The adjusted prevalence of lifetime depressive and anxiety disorder was 5.37% (114/2 123), depressive and/or anxiety disorder was 16.91% (359/2 123), depressive and anxiety disorder and mixed depressive-anxiety disorder was 17.00% (361/2 123). There is a high prevalence of depressive and anxiety disorder among cardiovascular outpatients from tertiary general hospitals in China. Therefore, doctors must pay attention to this disorder and try to reduce the impact of this disorder in cardiovascular patients.

[A cross-sectional survey of the prevalence of depressive-anxiety disorders among general hospital outpatients in five cities in China].

Science.gov (United States)

He, Yan-ling; Ma, Hong; Zhang, Lan; Liu, Zhe-ning; Jia, Fu-jun; Zhang, Ming-yuan

2009-09-01

To find the prevalence of depressive and anxiety disorders among general hospital outpatients and to evaluate the diagnoses and treatment provided by physicians in China. A multi-center, hospital-based cross-sectional study was conducted. A total of 8478 subjects were screened by using HADS and PHQ-15 together with medical history review list and were followed by regular clinical visit process. Physician's diagnoses and management were recorded. Mini International Neuropsychiatric Interview (MINI) was used to evaluate by psychiatrists afterwards for 4172 subjects scored >or= 8 on HADS. The adjusted prevalence rates of MINI-diagnosed depressive disorder, anxiety disorder, depression and anxiety, depression or anxiety disorders were 12.0%, 8.6%, 4.1% and 16.5%, respectively. The prevalence of depressive and/or anxiety disorder in outpatients visiting department of neurology and digestive diseases were higher than that in patients visiting departments of cardiovascular diseases and gynecology with statistical significance (P depressive and/or anxiety disorders were found in the general hospitals. In order to improve the status quo, training program for physicians and specialists other than psychiatric professionals in general hospitals should be enhanced together with psychiatric consultation.

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

Readmissions due to traffic accidents at a general hospital.

Science.gov (United States)

Paiva, Luciana; Monteiro, Damiana Aparecida Trindade; Pompeo, Daniele Alcalá; Ciol, Márcia Aparecida; Dantas, Rosana Aparecida Spadotti; Rossi, Lídia Aparecida

2015-01-01

to verify the occurrence and the causes of hospital readmissions within a year after discharge from hospitalizations due to traffic accidents. 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. 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. 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.

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.

Vascular disease in women: comparison of diagnoses in hospital episode statistics and general practice records in England

Directory of Open Access Journals (Sweden)

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

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.

Negative illness perceptions associated with low mental and physical health status in general hospital outpatients in China.

Science.gov (United States)

Wu, Heng; Zhao, Xudong; Fritzsche, Kurt; Salm, Florian; Leonhart, Rainer; Jing, Wei; Yang, Jianzhong; Schaefert, Rainer

2014-01-01

In western countries, negative illness perceptions are associated with poor health status and affect health outcomes in primary care populations. The aim of this study is to examine the relationship between illness perception and mental and physical health status in general hospital outpatients in China. This multicentre, cross-sectional study analysed a total of 281 consecutive patients from four general hospital outpatient departments of internal medicine and traditional Chinese medicine in Beijing and Kunming. The patients answered questionnaires concerning illness perception (Brief-IPQ), somatic symptom severity (Patient Health Questionnaire-15), illness behaviour (Scale for the Assessment of Illness Behaviour), emotional distress (Hospital Anxiety and Depression Scale) and health-related quality of life (Twelve-Item Short Form Health Survey). Negative illness perception, especially negative emotional reactions, perceived illness consequences, encumbering illness concerns, and strong illness identity were significantly associated with high emotional distress, impairing illness consequences, and a low mental and physical quality of life. Using a multiple linear regression model, five strongest correlates of negative illness perception were high anxiety, seeking diagnosis verification, low mental and physical quality of life and high somatic symptom severity. The variance explained by this model was 35%. Chinese general hospital outpatients showed associations between negative illness perceptions and poor mental and physical health status that were similar to those of primary care patients in western countries. The main difference was that no association with perceived illness control was found in Chinese patients. Chinese physicians should be sensitised to their patients' negative illness perceptions and should focus on helping patients cope with uncertainty and anxiety by providing an understandable illness model and increasing control beliefs.

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

Directory of Open Access Journals (Sweden)

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.

The attitudes of general hospital doctors toward patients with comorbid mental illness.

Science.gov (United States)

Noblett, Joanne E; Lawrence, Robert; Smith, Jared G

2015-01-01

What are the attitudes of general hospital doctors toward patients with comorbid mental illness? Do certain characteristics of the health professional related to attitude valence to patients with comorbid mental illness? An anonymous questionnaire was sent out to a cohort of doctors working in three General Hospitals in South West London. The questionnaire included vignettes to assess the respondents' attitudes toward eight patients presenting with a physical compliant with different clinical histories, including depression, schizophrenia, personality disorder, diabetes, and criminal behavior. A total of 52 participants completed the questionnaire; 40 females and 12 males. Across all domains, the most positive attitudes were held toward patients without a diagnosis of mental illness. The least positive attitudes were toward patients with schizophrenia, personality disorder, and those classified as "criminals," and negative attitudes relating to the unpredictability of patients was identified in these categories. There was no statistically significant difference in attitudes depending on age or level of training. However, female participants tended to endorse more positive attitudinal responses, most clearly toward patients with depression and heroin addiction. Negative attitudes of doctors were identified toward certain mental illness diagnoses and are likely to contribute the physical health disparity between patients with and without a comorbid mental illness. This raises the question as to how these attitudes can be changed in order to improve the parity of physical health care between patient with and without mental illness. © The Author(s) 2015.

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.

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

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)

Incidence rates of in-hospital carpal tunnel syndrome in the general population and possible associations with marital status

Directory of Open Access Journals (Sweden)

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.

Incidence rates of in-hospital carpal tunnel syndrome in the general population and possible associations with marital status.

Science.gov (United States)

Mattioli, Stefano; Baldasseroni, Alberto; Curti, Stefania; Cooke, Robin M T; Bena, Antonella; de Giacomi, Giovanna; dell'Omo, Marco; Fateh-Moghadam, Pirous; Melani, Carla; Biocca, Marco; Buiatti, Eva; Campo, Giuseppe; Zanardi, Francesca; Violante, Francesco S

2008-10-28

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. 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 chiscore 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. 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). 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.

Nurses and care workers’ perceptions of their nurse-patient therapeutic relationship in private general hospitals, Gauteng, South Africa

Directory of Open Access Journals (Sweden)

Anna E. van den Heever

2013-09-01

Full Text Available Facilitation of a therapeutic relationship is an essential skill in nursing, particularly in mental-health care. Nurses and care workers in private general hospitals are exposed to the emotional effects of physical illness as well as the increase in admission of patients with mental-health needs. Poor nurse-patient relationships have been reported by patients and in the media. The researchers experienced incidents of apparent misunderstandings during nurse-patient interactions whilst working in private general hospitals. No studies have been done regarding how nurses and care workers perceive a therapeutic relationship with patients in terms of the patients’ emotional and mental-health needs. A quantitative, contextual and deductive study was conducted in three private general hospitals in Gauteng, South Africa with a purposive sample of 154 nurses and 30 care workers. Based on the concepts of a therapeutic relationship, empathy, positive regard, genuineness, concreteness and self-exploration, nurses and care workers’ perceptions of facilitating a therapeutic relationship were self-assessed using five-point scales in a questionnaire. Data were analysed using descriptive statistics and non-parametric statistical techniques. Specific hypotheses were tested to identify whether statistically-significant differences existed between the perceptions of two or more groups of nurses and care workers. Results showed a general insensitivity and lack of awareness and reflection on the part of nurses and care workers with regard to the patients’ emotional needs. When categories of nurses were compared, no statistically-significant differences were found between the perceptions of the various groups tested. There is a need for self-awareness, continued interpersonal skills training and supervision of nurses and care workers. A large percentage of the participants were younger than 40 years, subprofessional, with less than 10 years’ experience as

The Impact of the Hospital Volume on the Performance of Residents on the General Medicine In-Training Examination: A Multicenter Study in Japan.

Science.gov (United States)

Mizuno, Atsushi; Tsugawa, Yusuke; Shimizu, Taro; Nishizaki, Yuji; Okubo, Tomoya; Tanoue, Yusuke; Konishi, Ryota; Shiojiri, Toshiaki; Tokuda, Yasuharu

2016-01-01

Objective Although several studies have been conducted worldwide on factors that might improve residents' knowledge, the relationship between the hospital volume and the internal medicine residents' knowledge has not been fully understood. We conducted a cross-sectional study to compare the relationships of the hospital volume and hospital resources with the residents' knowledge assessed by the In-training Examination. Methods We conducted a retrospective survey and a clinical knowledge evaluation of postgraduate year 1 and 2 (PGY-1 and -2) resident physicians in Japan by using the General Medicine In-training Examination (GM-ITE) in 2014. We compared the ITE score and the hospital volume. Results A total of 2,015 participants (70.6% men; age, 27.3±2.9 years old) from 208 hospitals were retrospectively analyzed. Generalized estimating equations were used, and the results revealed that an increasing number of hospitalizations, decreasing staff number, decreasing age and PGY-2 were significantly associated with higher GM-ITE scores. Conclusion The hospital volume, such as the number of hospitalizations, is thus considered to have a positive impact on the GM-ITE scores.

An Outcomes Study on the Effects of the Singapore General Hospital Burns Protocol.

Science.gov (United States)

Liang, Weihao; Kok, Yee Onn; Tan, Bien Keem; Chong, Si Jack

2018-01-01

The Singapore General Hospital Burns Protocol was implemented in May 2014 to standardize treatment for all burns patients, incorporate new techniques and materials, and streamline the processes and workflow of burns management. This study aims to analyze the effects of the Burns Protocol 2 years after its implementation. Using a REDCap electronic database, all burns patients admitted from May 2013 to April 2016 were included in the study. The historical preimplementation control group composed of patients admitted from May 2013 to April 2014 (n = 96). The postimplementation prospective study cohort consisted of patients admitted from May 2014 to April 2016 (n = 243). Details of the patients collected included age, sex, comorbidities, total body surface area (TBSA) burns, time until surgery, number of surgeries, number of positive tissue and blood cultures, and length of hospital stay. There was no statistically significant difference in the demographics of both groups. The study group had a statistically significant shorter time to surgery compared with the control group (20.8 vs 38.1, P burns, was statistically significant (number of surgeries/TBSA, 0.324 vs 0.506; P = 0.0499). The study group also had significantly shorter length of stay (12.5 vs 16.8, P = 0.0273), a shorter length of stay/TBSA burns (0.874 vs 1.342, P = 0.0101), and fewer positive tissue cultures (0.6 vs 1.3, P = 0.0003). The study group also trended toward fewer positive blood culture results (0.09 vs 0.35, P = 0.0593), although the difference was just shy of statistical significance. The new Singapore General Hospital Burns Protocol had revolutionized Singapore burns care by introducing a streamlined, multidisciplinary burns management, resulting in improved patient outcomes, lowered health care costs, and improved system resource use.

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

Characteristics of patients who are admitted with or acquire Pressure Ulcers in a District General Hospital; a 3 year retrospective analysis

NARCIS (Netherlands)

Worsley, P.R.; Smith, G.; Schoonhoven, L.; Bader, D.L.

2016-01-01

AIM: The study aimed to characterize demographic and clinical practice factors associated with community (CAPU) and hospital acquired pressure ulcers (HAPU). DESIGN: A comparative retrospective evaluation of pressure ulcer data, collected from a district general hospital. METHODS: Demographic and

Antibiotic Conformity with Culture Results of Hospitalized Pneumonia Patients in Melati Ward at Dr. Hasan Sadikin General Hospital Bandung, Indonesia

Directory of Open Access Journals (Sweden)

Randhi Rinaldi

2016-12-01

Full Text Available Background: Pneumonia is an infection with the highest mortality rate in Indonesian hospitals. According to The American Thoracic Society and The Infectious Diseases Society of America (ATS/IDSA, empirical use of antibiotics is still effective for pneumonia treatment. Inappropriate use of antibiotics would cause negative effects such as prolonged hospitalization, a high cost of treatment, and increased antibiotic-resistant bacteria. The goal of this study was to clarify the empirical use of antibiotic conformity with a bacteria culture. Methods: This study was conducted from August to October 2013 using a descriptive retrospective method based on 116 medical records of pneumonia patients hospitalized in Melati Ward, Dr. Hasan Sadikin General Hospital Bandung during 2011–2012. The type of bacteria, conformity with antibiotics given to patients, and type of antibiotics were analyzed. The conformity of antibiotics was assessed based on the resistance test. If the results were sensitive, they would be put in the conforming group and in the non-conforming group if the results were resistant or intermediate. Data was derived with descriptive statistics, using percentage and frequency distribution, illustrated in tables and figures. Results: Based on culture results and sensitivity of antibiotic empirical therapy given, 55.17% cases were conformed. The most widely used antibiotic group was Third-generation Cephalosporin (60.34%. The most common bacterias were Klebsiella pneumonia (34.5% and Acinetobacter baumanni (13.8%. Conclusions: Most of the antibiotics given to pneumonia patients are still appropriate with results of the bacteria culture test and resistance test.

[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.

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.

El Diccionario morfológico de francés medieval de Carmen Cortés Zaborras

Directory of Open Access Journals (Sweden)

Rodrigo López Carrillo

2005-04-01

Full Text Available El sitio web del grupo de investigación Traductología, formado por profesores de las Universidades de Málaga y Granada y de la Escuela de Traductores de Toledo de la Universidad de Castilla-La Mancha, contiene en una de sus páginas la editorial virtual del grupo, en la que se hallan publicados libros en formato electrónico accesibles a cualquier usuario de la red que entre en la dirección http://traductolog.filosofia.uma.es. Entre ellos encontramos los dos primeros tomos, en formato .pdf, del Diccionario morfológico de francés medieval realizado por Carmen Cortés Zaborras, profesora del Departamento de Filología Inglesa, Francesa y Alemana, área de Filología Francesa, de la Universidad de Málaga.Tal como indica la autora en la introducción al primer tomo, que lo es a su vez a la obra completa, la finalidad de este trabajo es eminentemente pedagógica; pretende ser una herramienta para aquellos estudiantes de Filología francesa que se acercan a los textos en lengua medieval. Se trata de un complemento muy útil a los diccionarios de naturaleza léxico-semántica en los que las informaciones gramaticales suelen reducirse a la clase y a la categoría del género y, sólo excepcionalmente, cuando el nominativo y el acusativo son diferentes se recogen como tales...

The Japanese Version of the Massachusetts General Hospital Acupuncture Sensation Scale: A Validation Study

OpenAIRE

Masako Nishiwaki; Miho Takayama; Hiroyoshi Yajima; Morihiro Nasu; Jian Kong; Nobuari Takakura

2017-01-01

Acupuncture sensations are considered essential in producing the treatment effect of acupuncture. The Massachusetts General Hospital Acupuncture Sensation Scale (MASS) is a frequently used scale in acupuncture research to measure acupuncture sensations. We translated the MASS into Japanese (Japanese MASS) based on Beaton's guidelines. 30 acupuncturists evaluated the relevancy and meaning of the 12 descriptors included in the Japanese MASS. The content validity ratios for 10 of the 12 descript...

THE EFFECT OF STORYTELLING IN A PLAY THERAPY ON ANXIETY LEVEL IN PRE-SCHOOL CHILDREN DURING HOSPITALIZATION IN THE GENERAL HOSPITAL OF BUTON

Directory of Open Access Journals (Sweden)

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.

Diagnosis and first-line treatment of breast cancer in Italian general hospitals

International Nuclear Information System (INIS)

Interdisciplinary Group for Cancer Care Evaluation, Milan

1986-01-01

The quality of the diagnostic and therapeutic process of 1262 newly diagnosed breast cancer patients was evaluated in 63 Italian general hospital over the period March 1983 - April 1984. Most of the patients (91%) discovered their own lesion, which was a nodule in 83% of the cases. Practice of breast self examination was reported by 418 (33%) patients, only 28% of whom did that on a regular monthly basis. A diagnostic delay>3 months was present in 36% of the patients. Among the preoperative work-up examinations, skeletal X-ray or bone scan was not performed in 20% of patients, whereas other essential examinations were done in most. The Patey type of radical mastectomy was the most frequent surgical procedure; quadrantectomy was performed in only 26% of eligible patients, more frequently in younger (34%) than in older patients (21%). Adjuvant chemotherapy was recommended for 11% and 6% of pre- and postmenopausal N- patients, and for 78% and 47% of pre- and postmenopausal N+ patients. Forty-three of the 63 participating hospitals reported they adhered to the guidelines defined by the Italian Breast Cancer Task Force (F.O.N.Ca.M.) but this was not associated with substantial evidence of better quality of care. Similary, no associations emerged between several hospitals' organizational features and adherence to recommended treatment guidelines. The study is ongoing to assess the quality of postsurgical treatment and to measure its impact on patients' survival

[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.

Dos políticas fronterizas y sus consecuencias: diplomacia, comercio y uso de la violencia en los inicios del fuerte del Carmen de Río Negro (1779-1785

Directory of Open Access Journals (Sweden)

Sebastián L. Alioto

2014-06-01

Full Text Available Este artículo estudia las políticas practicadas por los dos primeros comisarios superintendentes de Carmen de Patagones respecto de los nativos de la región pampeana y nord-patagónica, en cuyo territorio se implantó la colonia. El contraste entre la llevada adelante por Francisco de Viedma, basada principalmente en la diplomacia y el comercio, y la que intentó Juan de la Piedra, apoyada en el uso de la violencia y las incursiones armadas en terreno indígena, permite sacar ciertas conclusiones atinentes al éxito relativo de cada una de ellas, a su contenido ideológico y estratégico, y al destino final de sus impulsores

Anxiety Level in Dyspeptic Patients at the Gastroenterohepatology Outpatient Clinic of Dr. Hasan Sadikin General Hospital Bandung, Indonesia

Directory of Open Access Journals (Sweden)

Radistrya Sekaranti Brahmanti

2015-03-01

Full Text Available Background: Dyspepsia is a disease with a high worldwide prevalence, including in Asia; however, the pathophysiology of the disease is still unclear. Recent studies suggest adapting a biopsychosocial model to understand the pathophysiology of dyspepsia that proposes the important role of anxiety. The aim of this study was to assess the anxiety level in dyspeptic patients who visited the Gastroenterohepatology Outpatient Clinic in Dr. Hasan Sadikin General Hospital Bandung. Methods: A cross-sectional descriptive study using total sampling method was conducted from September–November 2012 to 19 patients aged 36−85 years old who consisted of 11 women and 8 men patients dyspepsia syndrome in the Gastroenterohepatology outpatient clinic Dr Hasan Sadikin General Hospital Bandung. The anxiety levels were measured using the Zung Self-Rating Anxiety Scale. All data were analyzed based on gender, age, and occupational status of the patients. Results: Eleven of the nineteen patients had high anxiety levels. Women were more likely to experience high anxiety levels (8 of 11. The group with the highest number of patients with high anxiety was the 46−55 years old group, the high anxiety level was more common among patients who were government or private sector employees. Conclusion: The anxiety level in dyspeptic patients who visited the Gastroenterohepatology outpatient clinic in Dr. Hasan Sadikin General Hospital Bandung was high.

Determination of Budget Expenditures for Hospital Units, Using Econometric Techniques. Case General Hospital “Dr. Juan Bruno Zayas”

Directory of Open Access Journals (Sweden)

Rafael Ángel Formigo–Tejera

2015-12-01

Full Text Available In the Guidelines for Economic and Social Policy of the Party and the Revolution adopted at the Sixth Congress of the PCC is a need to raise the quality of health care services and improve the attention to the health personnel. In this regard, it has prioritized improving budget planning spending at all levels. The results obtained by applying the method of Exponential Smoothing for 2012, in the General Hospital "Dr. Juan Bruno Zayas Alfonso" will meet the aforementioned objectives. Comparing these results with what really executed in the first quarter, the estimate is closer, in relation with the traditional method, meaning a decrease in expenses of 1,8 %. 

Producción científica institucional y posicionamiento nacional: el caso del Hospital General de México

Directory of Open Access Journals (Sweden)

Macías-Chapula, C. A.

2004-12-01

Full Text Available The purpose of this work was to identify the scientific output, position and visibility of Mexico’s General Hospital (Hospital General de México-HGM. A literature search in the following databases was conducted for the period 1990-2003, in order to obtain the hospital’s scientific production: NCR, MEDLINE, LILACS, ARTEMISA, PERIODICA, and CLASE. The hospital scientific visibility was identified through the analysis of 140 documents retrieved from MEDLINE, for the period 1999-2003. Similarly, in order to obtain the scientific position of HGM at the national level, a bibliographic search was conducted in NCR and MEDLINE. Data were analyzed both manually and through BIBEXCEL 2001 and EXCEL 2000. Results included the retrieval of 1.647 references from the above mentioned databases. The subject content visibility indicated that the scientific production of the hospital was mainly related to comparative studies, treatment, and retrospective studies. As for the scientific position of the hospital, a rank 9 (r = 1-78in NCR and rank 12 (r = 1-74 in MEDLINE, was obtained. The study obtained the production, scientific position and visibility of the hospital through the databases used. HGM scientific production showed a high trend in the clinical medicine area and a low productivity in the social and humanistic fields. The thematic production of the hospital does not coincide with its main mortality causes; however, the hospital remains within the main 15 health research institutions at a national level. Finally, the document describes the implications of the study and the needed research actions, in order to support the adequate science policy lines of the hospital.

El propósito de este trabajo fue el de identificar la producción, visibilidad y posicionamiento científico del Hospital General de México (HGM. Para la identificación de la producción del hospital, se condujo una investigación bibliográfica en las siguientes bases de datos

[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.

High diversity of beta-lactamases in the General Hospital Vienna verified by whole genome sequencing and statistical analysis.

Science.gov (United States)

Barišić, Ivan; Mitteregger, Dieter; Hirschl, Alexander M; Noehammer, Christa; Wiesinger-Mayr, Herbert

2014-10-01

The detailed analysis of antibiotic resistance mechanisms is essential for understanding the underlying evolutionary processes, the implementation of appropriate intervention strategies and to guarantee efficient treatment options. In the present study, 110 β-lactam-resistant, clinical isolates of Enterobacteriaceae sampled in 2011 in one of Europe's largest hospitals, the General Hospital Vienna, were screened for the presence of 31 β-lactamase genes. Twenty of those isolates were selected for whole genome sequencing (WGS). In addition, the number of β-lactamase genes was estimated using biostatistical models. The carbapenemase genes blaKPC-2, blaKPC-3, and blaVIM-4 were identified in carbapenem-resistant and intermediate susceptible isolates, blaOXA-72 in an extended-spectrum β-lactamase (ESBL)-positive one. Furthermore, the observed high prevalence of the acquired blaDHA-1 and blaCMY AmpC β-lactamase genes (70%) in phenotypically AmpC-positive isolates is alarming due to their capability to become carbapenem-resistant upon changes in membrane permeability. The statistical analyses revealed that approximately 55% of all β-lactamase genes present in the General Hospital Vienna were detected by this study. In summary, this work gives a very detailed picture on the disseminated β-lactamases and other resistance genes in one of Europe's largest hospitals. Copyright © 2014 Elsevier B.V. All rights reserved.

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 markup compared to public/private not-for-profit status in unconcentrated markets (95%CI: +45.4% - +81.1%; p 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.

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.

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

Development of a likelihood of survival scoring system for hospitalized equine neonates using generalized boosted regression modeling.

Directory of Open Access Journals (Sweden)

Katarzyna A Dembek

Full Text Available BACKGROUND: Medical management of critically ill equine neonates (foals can be expensive and labor intensive. Predicting the odds of foal survival using clinical information could facilitate the decision-making process for owners and clinicians. Numerous prognostic indicators and mathematical models to predict outcome in foals have been published; however, a validated scoring method to predict survival in sick foals has not been reported. The goal of this study was to develop and validate a scoring system that can be used by clinicians to predict likelihood of survival of equine neonates based on clinical data obtained on admission. METHODS AND RESULTS: Data from 339 hospitalized foals of less than four days of age admitted to three equine hospitals were included to develop the model. Thirty seven variables including historical information, physical examination and laboratory findings were analyzed by generalized boosted regression modeling (GBM to determine which ones would be included in the survival score. Of these, six variables were retained in the final model. The weight for each variable was calculated using a generalized linear model and the probability of survival for each total score was determined. The highest (7 and the lowest (0 scores represented 97% and 3% probability of survival, respectively. Accuracy of this survival score was validated in a prospective study on data from 283 hospitalized foals from the same three hospitals. Sensitivity, specificity, positive and negative predictive values for the survival score in the prospective population were 96%, 71%, 91%, and 85%, respectively. CONCLUSIONS: The survival score developed in our study was validated in a large number of foals with a wide range of diseases and can be easily implemented using data available in most equine hospitals. GBM was a useful tool to develop the survival score. Further evaluations of this scoring system in field conditions are needed.

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.

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

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

Directory of Open Access Journals (Sweden)

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

[Prevalence of negative stereotypes towards old age among personnel of a general hospital].

Science.gov (United States)

Franco S, Mireya; Villarreal R, Enrique; Vargas D, Emma R; Martínez G, Lidia; Galicia R, Liliana

2010-08-01

Social representations are value systems. Social stereotypes are a social consensus of traits associated with a specific group. Stereotypes about older subjects, generally have negative connotations. To assess the prevalence of negative stereotypes towards older subjects among health care personnel. A questionnaire about stereotypes towards old age, with Likert type questions that included health, social motivations and personality-character domains, was applied to 52 doctors, 12 residents, 80 general nurses, 36 auxiliary nurses, four social workers and 10 medical assistants, working at a general hospital. The mean age of the professionals who answered the questionnaire was 38 years (95% confidence intervals (CI) 37-39 years) and 78% were women. The prevalence of a Global negative stereotype was 65.0%(95% CI: 59.5-70.5). The figure for the health domain was 64.5% (IC95%; 59.0-70.0), for the social motivation domain was 60%(5%CI: 54.3-65.7) and for the character personality domain was 64% (95%CI: 58.4-69.6). There is a high prevalence of a negative stereotype towards old age among health care personnel.

A qualitative study on nurses' reactions to inpatient suicide in a general hospital

Directory of Open Access Journals (Sweden)

Shujie Wang

2016-12-01

Conclusions: Nurses who experienced inpatient suicide became stressed. Effective interventions must be implemented to improve the coping mechanisms of nurses against the negative consequences of inpatient suicide. The findings of this study will allow administrators to gain insight into the impacts of inpatient suicides on nurses in general hospitals. Such information can be used to develop effective strategies and provide individual support and ongoing education. Consequently, nurses will acquire suicide prevention skills and help patients achieve swift recovery.

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...

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.

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

Hospital General y el Colegio Médico en la historia de la Neurocirugía y la Ortopedia en Camagüey

Directory of Open Access Journals (Sweden)

Gretel Mosquera Betancourt

Full Text Available Fundamento. La historia de la Neurocirugía en el territorio está estrechamente relacionada con la de otras especialidades como la Cirugía General y la Ortopedia. Tiene sus primeras referencias establecidas en la etapa colonial en el Hospital General, documentadas en el Boletín del Colegio Médico de Camagüey. Objetivo es resaltar la importancia que tuvieron el Hospital General y el Colegio Médico de Camagüey con su boletín en la historia de la Neurocirugía y la Ortopedia. Método. Es una investigación histórica que se basa en la revisión documental y utiliza el submétodo cronológico para establecer el orden de los hechos que se describen. Desarrollo. El Hospital General a partir de su reconstrucción a finales del siglo XIX, se convirtió en el principal centro médico quirúrgico de la provincia en la época colonial. Muchos de los resultados de la actividad asistencial y científica de sus médicos apareció publicada en el Boletín del Colegio Médico de Camagüey, prestigiosa revista científica que se encargó de divulgar los resultados de la medicina camagüeyana y donde aparecen artículos que evidencian cómo cirujanos generales realizaron las primeras intervenciones neuroquirúrgicas y ortopédicas. Conclusiones. Se consideran al Hospital General y al Colegio Médico de Camagüey y su boletín, como elementos indispensables al escribir la historiografía de la Neurocirugía y la Ortopedia en el territorio.

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.

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...

Radiographic quality and radiation protection in general medical practice and small hospitals

International Nuclear Information System (INIS)

Williamson, B.D.P.; Le Heron, J.C.

1988-01-01

Radiation protection and image quality were assessed in a survey of 22 general medical practices (GP) and the 24 smallest hospitals with x-ray facilities. Limited radiography, usually of extremities for trauma, was being performed in these facilities since access to regular radiology services was restricted, mainly for geographic reasons. An anthropomorphic phantom foot and ankle with two simulated fractures of the lateral and medical malleoli was presented at each facility for radiography, and the resulting films assessed for radiographic technique and basic diagnostic usefulness. The x-ray equipment was adequate for the range of procedures performed. While the standard of radiographic techniques was lower than in regular x-ray departments, most films of the phantom ankle were still diagnostically useful and only four were rejected entirely. The principal deficiency in general practice x-ray was in darkrooms and x-ray film processing. Consultation in this regard with registered medical radiation technologists is recommended. Generally, the x-ray equipment and working procedures complied with the National Radiation Laboratory Code of Safe Practice for the Use of X-rays in Diagnosis (Medical). Radiation doses to the phantom ankle ranged widely for effectively the same procedure, although none was excessive. Improved x-ray film processing, and tighter x-ray beam collimation, would result in a narrower range of doses to patients. Personnel exposures to radiation were satisfactorily low and special shieldings are not required in general practice. (author). 7 refs., 4 figs., 2 tabs

SEASONAL VARIATION OF Perkinsus marinus IN THE AMERICAN OYSTER Crassostrea virginica FROM THE CARMEN-MACHONA PAJONAL LAGOON SYSTEM IN TABASCO, MEXICO

Directory of Open Access Journals (Sweden)

Sergio Curiel-Ramírez-Gutiérrez

2012-11-01

Full Text Available In the Gulf of Mexico, the fishery of the oyster Crassostrea virginica is the main resource for you capture volume (42, 796 t. This resource is affected by the disease of the Dermo, which has been little studied in the Gulf of Mexico. The objective of the study was to determine the prevalence and grade of infection of Perkinsus marinus in Tabasco. Samples were realized by Fluid Thioglycolate medium (MFT, histopathology and PCR in oysters of six banks in the lagoon system Carmen-Machona-Pajonal, Tabasco. The results of the MFT after incubation, showed hipnosporas of blue-black. The histopathological analysis revealed alterations in the tissues connective and epithelial, as well as the forms characteristic of P. marinus, such as tomontes and trophozoites. The identity of the parasite was confirmed by PCR analysis. The prevalence of P. marinus registered in times of rain, north-wind and dry was 73.3, 90 and 100%; the degree of infection was 2, 3 and 5 on the scale of Mackin, respectively. There is a relationship of the prevalence and intensity of the infection with respect to increased temperature and salinity, where the dry season was most critical.

An email-based intervention to improve the number and timeliness of letters sent from the hospital outpatient clinic to the general practitioner: A pair-randomized controlled trial

NARCIS (Netherlands)

Medlock, Stephanie; Parlevliet, Juliette L.; Sent, Danielle; Eslami, Saeid; Askari, Marjan; Arts, Derk L.; Hoekstra, Joost B.; de Rooij, Sophia E.; Abu-Hanna, Ameen

2017-01-01

Letters from the hospital to the general practitioner are important for maintaining continuity of care. Although doctors feel letters are important, they are often not written on time. To improve the number and timeliness of letters sent from the hospital outpatient department to the general

Appropriateness of hospitalization for CAP-affected pediatric patients: report from a Southern Italy General Hospital

Directory of Open Access Journals (Sweden)

Antonelli Fabio

2009-09-01

Full Text Available Abstract Background Community-acquired pneumonia (CAP is a common disease, responsible for significant healthcare expenditures, mostly because of hospitalization. Many practice guidelines on CAP have been developed, including admission criteria, but a few on appropriate hospitalization in children. The aim of this study was to evaluate appropriate hospital admission for CAP in a pediatric population. Methods We evaluated appropriate admission to a Pediatric Unit performing a retrospective analysis on CAP admitted pediatric patients from a Southern Italy area. Diagnosis was made based on clinical and radiological signs. Appropriate hospital admission was evaluated following clinical and non-clinical international criteria. Family ability to care children was assessed by evaluating social deprivation status. Results In 2 winter seasons 120 pediatric patients aged 1-129 months were admitted because of CAP. Median age was 28.7 months. Raised body temperature was scored in 68.3% of patients, cough was present in 100% of cases, and abdominal pain was rarely evidenced. Inflammatory indices (ESR and CRP were found elevated in 33.3% of cases. Anti-Mycoplasma pneumoniae antibodies were found positive in 20.4%. Trans-cutaneous (TC SaO2 was found lower than 92% in 14.6%. Dyspnoea was present in 43.3%. Dehydration requiring i.v. fluid supplementation was scored in 13.3%. Evaluation of familial ability to care their children revealed that 76% of families (derived from socially depressed areas were "at social risk", thus not able to appropriately care their children. Furthermore, analysis of CAP patients revealed that "at social risk" people accessed E.D. and were hospitalized more frequently than "not at risk" patients (odds ratio = 3.59, 95% CI: 1,15 to 11,12; p = 0.01, and that admitted "at social risk" people presented without clinical signs of severity (namely dyspnoea, and/or SaO2 ≤ 92%, and/or dehydration more frequently than "not at risk" population

[Cytostatic hyperthermic isolated limb perfusion (HILP) in VFN (General Faculty Hospital in Prague)].

Science.gov (United States)

Spacek, M; Mitás, P; Lacina, L; Krajsová, I; Hodková, G; Salmay, M; Spunda, R; Brlicová, L; Lindner, J

2011-01-01

Hyperthermic isolated limb perfusion (HILP) is a standardized method of treatment in selected patients with in-transient locoregional recurrence/methastasis of melanoma or, some other soft tissue tumors (incl. sarcoma etc.) Authors present history and current status of this treatment modality in General University Hospital in Prague. During one year period (7/2009-6/2010) 10 patients were indicated for this procedure. We performed 13 procedures (3x redo), 11 in lower extremity and 2 in upper extremity. There was no serious complication in this cohort of patiens. Multidisciplinar approach is indicated in melanoma patients care.

Hand hygiene compliance in patients under contact precautions and in the general hospital population.

Science.gov (United States)

Almaguer-Leyva, Martín; Mendoza-Flores, Lidia; Medina-Torres, Ana Gabriela; Salinas-Caballero, Ana Gabriela; Vidaña-Amaro, Jose Antonio; Garza-Gonzalez, Elvira; Camacho-Ortiz, Adrián

2013-11-01

Hand hygiene (HH) is the single most important intervention for preventing hospital-acquired infections. Contact precautions are a series of actions that infection control units take to reduce the transmission of nosocomial pathogens. We conducted an observational study of HH compliance. Observations were stratified as opportunities in patients under contact precautions and in the general hospital population. Trained infection control personnel performed all direct evaluations. A total of 3,270 opportunities were recorded. HH compliance was statistically higher in patients on contact precautions than in the overall population (70.3% vs 60.4%; P = .0001). Critical care areas had higher HH compliance when patients were isolated by contact precautions. Medical wards were statistically lower in HH when patients were under contact precautions. Respiratory technicians had the highest HH compliance in both overall performance and in patients under contact precautions. Medical students had a lower HH compliance in both evaluations (P Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Injection laryngoplasty using BIOPEX calcium phosphate cement. The Sanokousei General Hospital experience

International Nuclear Information System (INIS)

Okubo, Keisuke; Shinnabe, Akihiro; Saito, Koichiro; Shiotani, Akihiro

2008-01-01

The calcium phosphate bone paste BIOPEX is an injectable material developed as a bone replacement that hardens into a hydroxylapatite block after injection. BIOPEX offers many advantages as a material for injection laryngoplasty: it induces little foreign-material reaction, is minimally absorbed, and is easy to prepare in the OR. Between 2004 and 2007, 14 patients, including 13 with vocal fold paralysis and 1 with severe atrophy of the vocal folds, were treated with BIOPEX-injection laryngoplasty at Sanokousei General Hospital. The injection of BIOPEX is usually performed through a direct laryngoscopy under general anesthesia, and no adverse effects were observed in any of the cases. A postoperative three-dimensional CT revealed successful injection of the BIOPEX into the paraglottic space in all cases. BIOPEX is minimally absorbed over long time periods, and this procedure results in a dramatic improvement of glottic function immediately after surgery. We consider this operative technique, which aims at medialization of the vocal fold by injection of a sclerotic agent into the lateral side of the vocal fold, as 'type I thyroplasty from inside the laryngeal framework.' (author)

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.

Total hip arthroplasty in Jesenice General hospital 1985–2006 – what has been done and look forward

Directory of Open Access Journals (Sweden)

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.

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%.

Evaluation of the carboniferous resources of the sectors El Jupal, El Carmen y Guayabal. Zone Chinavita, Umbita, Tibana, Department of Boyaca; Evaluacion de los recursos carboniferos de los sectores, El Jupal, El Carmen y Guayabal. Zona Chinavita, Umbita, Tibana, Departamento de Boyaca

Energy Technology Data Exchange (ETDEWEB)

Mejia, Luis Jorge; Pulido Gonzalez, Orlando

1985-01-01

The area of the sub-project Chinavita-Umbita-Tibana, located in the Southwest part of the Department of Boyaca was object of a geologic exploration with the purpose of evaluating its carboniferous resources. It was defined an stratigraphic interval of 250 m denominated, middle member from the Guaduas Formation of Maestrichtian to Paleocene age; in which they were determined until 9 coal layers, that were recognized total or partially in 7 chosen sectors during the exploration stage. In them it was made the quantification of the resources and the determination of the physical-chemical characteristics of the coal. The results of 4 of these denominated, El Arenal, Quina, Chiguata and Sisa sectors, they were presented in previous reports. In this report the 3 remaining, denominated El Jupal, El Carmen and Guayabal sectors are studied. The certain coal is bituminous high volatile, capable for thermal use and their importance are in the use that can be given inside the plan of national electrification, of the future amplifications of the thermoelectric of Paipa or Zipaquira. Keeping in mind that resources of the order of 148 million tons were calculated with a power heating average of 6.000 kcal/kg. It is possible to planning a new thermoelectric in this area that could serve as energy source in the critical times of the hydroelectric of Chivor.

(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

RISK FACTORS AFFECTING THE INCIDENCE OF CORONARY HEART DISEASE AT THE DR. WAHIDIN SUDIROHUSODO GENERAL HOSPITAL IN MAKASSAR IN 2010

OpenAIRE

arsin, A. Arsunan

2011-01-01

Dipresentasikan pada kegiatan " The 43rd APACPH Conference" di Graduate School of Public Health, Yonsei University, Korea. pada tanggal 20-22 Oktober 2011 RISK FACTORS AFFECTING THE INCIDENCE OF CORONARY HEART DISEASE AT THE DR. WAHIDIN SUDIROHUSODO GENERAL HOSPITAL IN MAKASSAR IN 2010 A. Arsunan Arsin, Wiwik, Ridwan Amiruddin Hasanuddin University, Indonesia Coronary heart disease is the first cause of death in the world and the fifth cause of death in all hospitals in Indonesi...

Exploring barriers to accessing physiotherapy services for stroke patients at Tema general hospital, Ghana.

Science.gov (United States)

Nketia-Kyere, Mercy; Aryeetey, Genevieve Cecilia; Nonvignon, Justice; Aikins, Moses

2017-01-01

Physiotherapy has been shown to reduce the risk of disability among stroke patients. Poor adherence to physiotherapy can negatively affect outcomes and healthcare cost. However, very little is known about barriers especially to physiotherapy services in Ghana. The objective of this study was to assess the barriers to physiotherapy services for stroke patients at Tema General Hospital (TGH). The individual/personal and health system barriers to physiotherapy services at TGH were determined. A cross-sectional study design was employed. A simple random sampling technique was used to recruit 207 respondents for a face-to-face interview. Interviewer-administered questionnaires were used to collect data on individual/personal barriers of respondents to physiotherapy services and were described using the Likert's scale. Health system barriers were assessed using a self-structured questionnaire which had section under the following heading: human factors, physiotherapy modalities, physical barriers and material/equipment factors. The time spent waiting for physiotherapy and attitude of physiotherapist towards patients; physiotherapy modality such as electrotherapy, exercise therapy and massage therapy among others were some of the indices measured. Respondents' adherence to Medication was assessed with the Morisky 8-item medication adherence questionnaire. Data were entered and analysed using Epi info 7 and STATA 12.0. Associations between the variables were determined using a chi-square test and logistic regression model was used to test the strength of associations between the independent and the dependent variables. The level of statistical significance was set at p  Tema General Hospital.

[Hospital clinical engineer orientation and function in the maintenance system of hospital medical equipment].

Science.gov (United States)

Li, Bin; Zheng, Yunxin; He, Dehua; Jiang, Ruiyao; Chen, Ying; Jing, Wei

2012-03-01

The quantity of medical equipment in hospital rise quickly recent year. It provides the comprehensive support to the clinical service. The maintenance of medical equipment becomes more important than before. It is necessary to study on the orientation and function of clinical engineer in medical equipment maintenance system. Refer to three grade health care system, the community doctors which is called General practitioner, play an important role as the gatekeeper of health care system to triage and cost control. The paper suggests that hospital clinical engineer should play similar role as the gatekeeper of medical equipment maintenance system which composed by hospital clinical engineer, manufacture engineer and third party engineer. The hospital clinical engineer should be responsible of guard a pass of medical equipment maintenance quality and cost control. As the gatekeeper, hospital clinical engineer should take the responsibility of "General engineer" and pay more attention to safety and health of medical equipment. The responsibility description and future transition? development of clinical engineer as "General Engineer" is discussed. More attention should be recommended to the team building of hospital clinical engineer as "General Engineer".

Compromiso y clima organizacional: caso de estudio del hospital general de rio verde, S.L.P.

OpenAIRE

Ramón Gerardo Recio Reyes; David Gómez Sánchez; Héctor López Gama; Eugenia Inés Martínez López

2012-01-01

The present study aims to identify the relationship between organizational climate, measured in four dimensions (motivation, leadership, participation and reciprocity), and organizational commitment studied in three dimensions (affective, normative and continuity), as well as associating them with the sociodemographic characteristics of workers Rioverde General Hospital, S. L. P is a crosssectional study on the type of descriptive and correlational research, in addition to focusing on quantit...

Intervention pattern in crisis: mental health as a nursing care approach at a general hospital

OpenAIRE

Oliveira, Elias Barbosa; Kestenberg, Célia Caldeira Fonseca; Silva, Alexandre Vicente

2013-01-01

Objective: Testing and validating the application of Intervention in Crisis theory as an approach in mental health on HIV/AIDS patients care who are interned at a general hospital. Method: Help Interview has been accomplished as an activity for Mental Health subject according to an applied guide by graduation in nursing students in order to identify this illness psycho-social repercussion and draft therapeutic plan for patients under their care. The outcomes were the reports results presented...

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...

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.

Exploring hospitality within hospital meals by means of visual methodologies

DEFF Research Database (Denmark)

Justesen, Lise

2016-01-01

ABSTRACT This paper reflects the application of visual methodologies adapted in an explorative study on hospitality and hospital meals. It takes point of departure in a multi-sited ethnographic fieldwork placed at a general hospital in 2012. Visual methodologies were applied in multiple ways....... This includes visual methodologies as part of observation and interview strategies. The paper presents and discusses how the application of different visual methodologies can contribute to the construction of ethnographical knowledge on hospitality and hospital meals. Finally ethical considerations as well...

Perfil social de los cuidadores familiares de pacientes dependientes ingresados en el Hospital General Universitario de Elche Social profile of the family caregiver of dependant patients in the University General Hospital of Elche

Directory of Open Access Journals (Sweden)

Pablo López-Casanova

2009-12-01

Full Text Available El objetivo de este estudio es describir el perfil social de los cuidadores familiares en el Hospital General Universitario de Elche y conocer el tipo de necesidades que cubren. Metodología: Investigación de tipo descriptivo y transversal, mediante 32 encuestas realizadas entre enero y febrero de 2008, en el Servicio de Medicina Interna. Se efectuó un análisis descriptivo y las variables fueron edad, sexo, ingresos económicos, vivienda, trabajo, parentesco del cuidador y permanencia en el centro hospitalario. Resultados: El perfil del cuidador informal corresponde a una mujer, con una media de edad de 54 años y que permanece todo el día en el hospital. Las necesidades que el cuidador distingue como más importantes estuvieron relacionadas con la compañía, la vigilancia y las necesidades básicas. Conclusiones: El perfil del cuidador familiar es de cónyuges o madres. La realización de las tareas de cuidador supone un gasto de tiempo, dinero, desgaste físico, psicológico y social. Parte de las necesidades del paciente son cubiertas por los cuidadores informales, que reciben poca información y asesoramiento del personal de enfermería sobre cómo realizarlas. Por tanto, ampliar la mirada enfermera es una exigencia y demanda de nuestra sociedad.The aim of this study is to describe the social profile of the family caregivers in the University General Hospital of Elche, and to know the sort of needs that they cater for. Methodology: This is a descriptive and transversal piece of research, performed by means of 32 surveys done between January and February 2008 in the Internal Medicine service. A descriptive analysis was carried out; such analysis bore in mind the following variables: the caregivers´ age, sex, income, dwelling, employment, their kinship with the patient and the lenght of stay at the hospital. Results: The profile of the average informal caregiver corresponds to a woman of approximately 54 years old who stays all day in

Admission of foreign citizens to the general teaching hospital of Bologna, northeastern Italy: an epidemiological and clinical survey.

Science.gov (United States)

Sabbatani, Sergio; Baldi, Elena; Manfredi, Roberto; Chiodo, Francesco

2006-04-01

The emergency regarding recent immigration waves into Italy makes continued healthcare monitoring of these populations necessary. 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. 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 (5.2%), and metabolic (4

Admission of foreign citizens to the general teaching hospital of bologna, northeastern Italy: An epidemiological and clinical survey

Directory of Open Access Journals (Sweden)

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

A combination of process of care and clinical target among type 2 diabetes mellitus patients in general medical clinics and specialist diabetes clinics at hospital levels.

Science.gov (United States)

Sieng, Sokha; Hurst, Cameron

2017-08-07

This study compares a combination of processes of care and clinical targets among patients with type 2 diabetes mellitus (T2DM) between specialist diabetes clinics (SDCs) and general medical clinics (GMCs), and how differences between these two types of clinics differ with hospital type (community, provincial and regional). Type 2 diabetes mellitus patient medical records were collected from 595 hospitals (499 community, 70 provincial, 26 regional) in Thailand between April 1 to June 30, 2012 resulting in a cross-sectional sample of 26,860 patients. Generalized linear mixed modeling was conducted to examine associations between clinic type and quality of care. The outcome variables of interest were split into clinical targets and process of care. A subsequent subgroup analysis was conducted to examine if the nature of clinical target and process of care differences between GMCs and SDCs varied with hospital type (regional, provincial, community). Regardless of the types of hospitals (regional, provincial, or community) patients attending SDCs were considerably more likely to have eye and foot exam. In terms of larger hospitals (regional and provincial) patients attending SDCs were more likely to achieve HbA1c exam, All FACE exam, BP target, and the Num7Q. Interestingly, SDCs performed better than GMCs at only provincial hospitals for LDL-C target and the All7Q. Finally, patients with T2DM who attended community hospital-GMCs had a better chance of achieving the blood pressure target than patients who attended community hospital-SDCs. Specialized diabetes clinics outperform general medical clinics for both regional and provincial hospitals for all quality of care indicators and the number of quality of care indicators achieved was never lower. However, this better performance of SDC was not observed in community hospital. Indeed, GMCs outperformed SDCs for some quality of care indicators in the community level setting.

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

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.

Preparation to care for confused older patients in general hospitals: a study of UK health professionals.

Science.gov (United States)

Griffiths, Amanda; Knight, Alec; Harwood, Rowan; Gladman, John R F

2014-07-01

in the UK, two-thirds of patients in general hospitals are older than 70, of whom half have dementia or delirium or both. Our objective was to explore doctors, nurses and allied health professionals' perceptions of their preparation to care for confused older patients on general hospital wards. : using a quota sampling strategy across 11 medical, geriatric and orthopaedic wards in a British teaching hospital, we conducted 60 semi-structured interviews with doctors, nurses and allied healthcare professionals and analysed the data using the Consensual Qualitative Research approach. : there was consensus among participants that education, induction and in-service training left them inadequately prepared and under-confident to care for confused older patients. Many doctors reported initial assessments of confused older patients as difficult. They admitted inadequate knowledge of mental health disorders, including the diagnostic features of delirium and dementia. Handling agitation and aggression were considered top priorities for training, particularly for nurses. Multidisciplinary team meetings were highly valued but were reported as too infrequent. Participants valued specialist input but reported difficulties gaining such support. Communication with confused patients was regarded as particularly challenging, both in terms of patients making their needs known, and staff conveying information to patients. Participants reported emotional and behavioural responses including frustration, stress, empathy, avoidance and low job satisfaction. : our findings indicate that a revision of training across healthcare professions in the UK is required, and that increased specialist support should be provided, so that the workforce is properly prepared to care for older patients with cognitive problems. © The Author 2013. Published by Oxford University Press on behalf of the British Geriatrics Society.

Comportamiento clínico de la celulitis facial odontógena. Hospital Universitario "General Calixto García" Clinical behavior of odontogenic facial cellulitis: "General Calixto García" University Hospital

Directory of Open Access Journals (Sweden)

Denia Morales Navarro

2009-12-01

Full Text Available Las infecciones dentarias afectan a un gran número de personas a nivel mundial, a pesar de ser prevenibles, por lo que nos sentimos motivados a realizar un estudio observacional, descriptivo, transversal para caracterizar el comportamiento de la celulitis facial odontogénica en los pacientes hospitalizados en el Hospital "General Calixto García". La muestra estuvo constituida por 75 pacientes que presentaron síntomas y signos de celulitis para lo cual se les realizó un minucioso examen físico general y regional, tanto extraoral como intraoral. El sexo masculino resultó ser el más afectado con 42 pacientes y el grupo de edades más dañado fue el de 35 a 59 años. La región anatómica superficial externa mentoniana estuvo involucrada en 36 casos. La misma región mentoniana pero en su porción vestibular inferior se destacó con 51 pacientes. De las regiones anatómicas profundas, la submandibular predominó en 51 individuos para un 68,0 %. Predominó la pulpa dental necrótica y los restos radiculares como mecanismos patogénicos fundamentales. El diagnóstico clínico de celulitis facial odontógena moderada resaltó en 40 pacientes (53,3 %.Dental infections involved many persons at worldwide level, being in many occasions avoidable, thus, a cross-sectional, descriptive and observational study was conducted to characterize the odontogenic facial cellulitis course in patients admitted in "General Calixto García" University Hospital. Sample included 75 patients with symptoms and signs of cellulitis underwent a meticulous intraoral and extraoral regional and general physical examination, where male sex was the more involved with 42 patients and the age group of 35-39 years with 35 patients. The menton external superficial anatomical region includes 36 cases, and of this kind but the internal one, the inferior vestibular sulcus had 51 cases. From the deep anatomical regions, the submandibular one had 51 cases for a 68.0 % with

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.

Patients' Care Needs: Documentation Analysis in General Hospitals.

Science.gov (United States)

Paans, Wolter; Müller-Staub, Maria

2015-10-01

The purpose of the study is (a) to describe care needs derived from records of patients in Dutch hospitals, and (b) to evaluate whether nurses employed the NANDA-I classification to formulate patients' care needs. A stratified cross-sectional random-sampling nursing documentation audit was conducted employing the D-Catch instrument in 10 hospitals comprising 37 wards. The most prevalent nursing diagnoses were acute pain, nausea, fatigue, and risk for impaired skin integrity. Most care needs were determined in physiological health patterns and few in psychosocial patterns. To perform effective interventions leading to high-quality nursing-sensitive outcomes, nurses should also diagnose patients' care needs in the health management, value-belief, and coping stress patterns. © 2014 NANDA International, Inc.

Nurses caring for ENT patients in a district general hospital without a dedicated ENT ward score significantly less in a test of knowledge than nurses caring for ENT patients in a dedicated ENT ward in a comparable district general hospital.

Science.gov (United States)

Foxton, C R; Black, D; Muhlschlegel, J; Jardine, A

2014-12-01

To assess whether there is a difference in ENT knowledge amongst nurses caring for patients on a dedicated ENT ward and nurses caring for ENT patients in a similar hospital without a dedicated ENT ward. A test of theoretical knowledge of ENT nursing care was devised and administered to nurses working on a dedicated ENT ward and then to nurses working on generic non-subspecialist wards regularly caring for ENT patients in a hospital without a dedicated ENT ward. The test scores were then compared. A single specialist ENT/Maxillo-Facial/Opthalmology ward in hospital A and 3 generic surgical wards in hospital B. Both hospitals are comparable district general hospitals in the south west of England. Nursing staff working in hospital A and hospital B on the relevant wards were approached during the working day. 11 nurses on ward 1, 10 nurses on ward 2, 11 nurses on ward 3 and 10 nurses on ward 4 (the dedicated ENT ward). Each individual test score was used to generate an average score per ward and these scores compared to see if there was a significant difference. The average score out of 10 on ward 1 was 6.8 (+/-1.6). The average score on ward two was 4.8 (+/-1.6). The average score on ward three was 5.5 (+/-2.1). The average score on ward 4, which is the dedicated ENT ward, was 9.7 (+/-0.5). The differences in average test score between the dedicated ENT ward and all of the other wards are statistically significant. Nurses working on a dedicated ENT ward have an average higher score in a test of knowledge than nurses working on generic surgical wards. This difference is statistically significant and persists despite banding or training. © 2014 John Wiley & Sons Ltd.

Antimicrobial Suspectibility of Bacterial Isolated from Burn Unit in Dr. Hasan Sadikin General Hospital Bandung, Indonesia from June to September 2013

Directory of Open Access Journals (Sweden)

Yodya Evila

2015-09-01

Full Text Available Background: Development of infection in burned patients is a crucial matter because it may increase morbidity and mortality. Factors contributing to high risk for infections are disrupted skin barrier, dysfunction of the immune system and prolonged hospitalization. Crowded hospital condition and transfer of patients from one unit to another can affect development of infection caused by environmental factors. The aim of the study was to identify the antimicrobial suspectibility of bacterial isolated from Burn Unit in Dr. Hasan Sadikin General Hospital, Bandung. Methods: A descriptive study was carried out in Burn Unit Dr. Hasan Sadikin General Hospital Bandung, Indonesia, from June to September 2013. A total of 30 environment samples were collected and cultured to identify the bacterias. Futhermore, the colonies found, underwent antimicrobial susceptibility test. Results: Most common bacteria found from the environmental samples in Burn Unit was Staphylococcus saprophyticus (24%. Other bacterias found were Klebsiella pneumonia (17%, Acinetobacter baumanii (15%, Staphylococcus epidermidis (12%, Bacillus sp.(12%, Pseudomonas sp.(7%, Staphylococcus aureus (5%, Enterobacter aerogenes (5% and Serratia sp. (2%. Some bacteria still had good sensitivity to antibiotics while the Enterobacteriaceae were almost completely resistant to antimicrobial used in the study. Conclusions: The most common bacteria found from the environment samples in Burn Unit is Staphylococcuss aprophyticus. Additionally, Klebsiella pneumoniae as one of the Enterobacteriaceae groups, appears as an emerging hospital associated infection pathogen with their resistant to many antimicrobials.

Characteristic of Gastric Perforation Type and The Histopathology at Haji Adam Malik General Hospital Medan-Indonesia

Directory of Open Access Journals (Sweden)

Kamsir Koto

2016-10-01

Full Text Available Background: According to BPPK of health department in 2008, gastric ulcers ranks 10 in cause of mortality on male with age group 45-54 at Indonesia. To date, there is no report of gastric perforation characteristic at Haji Adam Malik General Hospital Medan. Methods: This was a non-experimental study with descriptive retrospective design. Data retrieved from patients’ medical record with diagnosis of gastric perforation at Haji Adam Malik General Hospital Medan on January 2011-December 2014. Results: Majority of patients involved in this study was male with 44 subjects (78.6%, while female was 12 subjects (21.4%. The most frequent age group with gastric perforation was 47-53 and 61-67 years old and the least frequent age group was 40-46 years old and 75-81 years old. 28 subjects were patients with type 3 gastric perforation and no type 2 gastric perforation was found. Histopathology examination revealed that no malignancy was found. Majority of subjects both in male and female use NSAID. Conclusions: Majority of subjects was male. The most frequent age group with gastric perforation was 47-53 and 61-67 years old. The most frequent type of gastric perforation was type 3. Histopathology examination showed that all subjects were with chronic inflammation.

Hospital-acquired malnutrition in children at a tertiary care hospital

African Journals Online (AJOL)

Del-Rossi Sean Quadros

As such, there is a need for hospitals to monitor its occurrence using cost- effective but accurate tools. Table 1: General .... Malades Hospital, France.2. Our study ... daily weight loss, which is the critical threshold for an adverse clinical outcome ...

Economic impact of surgery cancellation in a general hospital, Iran

African Journals Online (AJOL)

unhcc

cause of inefficient use of operating room (OR) time and a drain on finite .... of total hospitalizations. In this hospital (270 beds ... Preoperative instructions not followed or patient not instructed. Change in .... concrete possibilities of reducing the level of surgical cancellations by .... room case-mix problem under uncertainty and.

Transfusion practice in anemic, non-bleeding patients: Cross-sectional survey of physicians working in general internal medicine teaching hospitals in Switzerland.

Science.gov (United States)

von Babo, Michelle; Chmiel, Corinne; Müggler, Simon Andreas; Rakusa, Julia; Schuppli, Caroline; Meier, Philipp; Fischler, Manuel; Urner, Martin

2018-01-01

Transfusion practice might significantly influence patient morbidity and mortality. Between European countries, transfusion practice of red blood cells (RBC) greatly differs. Only sparse data are available on transfusion practice of general internal medicine physicians in Switzerland. In this cross-sectional survey, physicians working in general medicine teaching hospitals in Switzerland were investigated regarding their self-reported transfusion practice in anemic patients without acute bleeding. The definition of anemia, transfusion triggers, knowledge on RBC transfusion, and implementation of guidelines were assessed. 560 physicians of 71 hospitals (64%) responded to the survey. Anemia was defined at very diverging hemoglobin values (by 38% at a hemoglobin Switzerland. Identifying and subsequently correcting this deficit in knowledge translation may have a significant impact on patient care.

Kass ja poisid kinnisvaraäris / Inno Tähismaa

Index Scriptorium Estoniae

Tähismaa, Inno, 1970-

2004-01-01

Supermodell Carmen Kass arendab koos kolme koolivennaga kinnisvaraäri Eestis, Lätis ja Leedus. Diagrammid: OÜ Kvaliteetvara majandusnäitajad; Portfelli jaotus. Lisad: Carmen Kassi tähelend; Carmen Kassi ärid Eestis

Evaluation of the appropriate use of a CIWA-Ar alcohol withdrawal protocol in the general hospital setting.

Science.gov (United States)

Eloma, Amanda S; Tucciarone, Jason M; Hayes, Edmund M; Bronson, Brian D

2018-01-01

The Clinical Institute Withdrawal Assessment-Alcohol, Revised (CIWA-Ar) is an assessment tool used to quantify alcohol withdrawal syndrome (AWS) severity and inform benzodiazepine treatment for alcohol withdrawal. To evaluate the prescribing patterns and appropriate use of the CIWA-Ar protocol in a general hospital setting, as determined by the presence or absence of documented AWS risk factors, patients' ability to communicate, and provider awareness of the CIWA-Ar order. This retrospective chart review included 118 encounters of hospitalized patients placed on a CIWA-Ar protocol during one year. The following data were collected for each encounter: patient demographics, admitting diagnosis, ability to communicate, and admission blood alcohol level; and medical specialty of the clinician ordering CIWA-Ar, documentation of the presence or absence of established AWS risk factors, specific parameters of the protocol ordered, service admitted to, provider documentation of awareness of the active protocol within 48 h of initial order, total benzodiazepine dose equivalents administered and associated adverse events. 57% of patients who started on a CIWA-Ar protocol had either zero or one documented risk factor for AWS (19% and 38% respectively). 20% had no documentation of recent alcohol use. 14% were unable to communicate. 19% of medical records lacked documentation of provider awareness of the ordered protocol. Benzodiazepine associated adverse events were documented in 15% of encounters. The judicious use of CIWA-Ar protocols in general hospitals requires mechanisms to ensure assessment of validated alcohol withdrawal risk factors, exclusion of patients who cannot communicate, and continuity of care during transitions.

Surveillance for hospital-acquired infections on surgical wards in a Dutch university hospital

NARCIS (Netherlands)

Kamp-Hopmans, Titia E. M.; Blok, Hetty E. M.; Troelstra, Annet; Gigengack-Baars, Ada C. M.; Weersink, Annemarie J. L.; Vandenbroucke-Grauls, Christina M. J. E.; Verhoef, Jan; Mascini, Ellen M.

2003-01-01

OBJECTIVES: To determine incidence rates of hospital-acquired infections and to develop preventive measures to reduce the risk of hospital-acquired infections. METHODS: Prospective surveillance for hospital-acquired infections was performed during a 5-year period in the wards housing general and

Virtual Pediatric Hospital

Science.gov (United States)

... Thoracopaedia - An Imaging Encyclopedia of Pediatric Thoracic Disease Virtual Pediatric Hospital is the Apprentice's Assistant™ Last revised ... pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com Virtual Pediatric Hospital is curated by Donna M. D' ...

[General surgery in a rural hospital in the State of Quintana Roo, Mexico].

Science.gov (United States)

Padrón-Arredondo, Guillermo

2006-01-01

The general surgeon maintains extraordinary validity worldwide, especially in countries like the United States, Canada, India, and continents such as Australia and Africa. In addition to their role as a general surgeon, they assist with surgical pathologies in rural areas where there is generally a lack of technology to carry out complicated procedures. Therefore, we undertook this study to determine the number and type of surgical procedures carried out in a rural hospital with three general surgeons, as well as to determine morbidity and respective mortality. The study was retrospective and longitudinal, using descriptive statistics during a 5.5-year period. During the period of June 1999 to December 2004, a total of 651 (100%) surgical procedures were carried out. There were 351 males (53%) and 300 females (47%) with average age of 28.5 +/- 16.0 years. There were 408 (63%) minor surgical procedures accomplished in the operating room: 150 (45%) for females with average age of 25.8 +/- 13.8 years old and 258 (55%) for males with average age of 27.7 +/- 15.5 years old. There were 243 major surgical procedures (37%): for females there were 150 (60%) with average age of 28.4 +/- 11.8 years old and for males there were 93 (40%) with average age of 29.5 +/- 16.6 years old [morbidity, six cases (0.9%) and mortality, two cases (0.3%)]. The demand for surgery in rural areas is not different from the surgery carried out in large cities, although there are limitations. It is important in this regard to adequately prepare the general surgeon in Mexico.

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 (pphysical problems (phealth (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.

Ambiente de Aprendizaje Apoyado en el Uso de WebQuest, como Mediador en la Construcción de Conocimientos Geométricos, en Estudiantes de Sexto Grado del Colegio Villemar el Carmen, de la Ciudad de Bogotá, Colombia

OpenAIRE

Barajas Carrillo, Nery J.

2016-01-01

El presente trabajo de investigación es de tipo mixto y aborda la enseñanza de la geometría en estudiantes de sexto grado de básica secundaria del colegio Villemar El Carmen, ubicado en Bogotá Colombia, por medio del uso de las WebQuest. El proyecto se plantea para optimizar el proceso de enseñanza aprendizaje de la geometría a partir de experiencias significativas y motivadoras para los estudiantes. La pregunta guía de la investigación es ¿Qué ventajas cognitivas y actitudinales se obtienen...

[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.

Applicability of the Chinese version of the Hypomania Symptom Checklist (HCL-32 scale for outpatients of psychiatric departments in general hospitals.

Directory of Open Access Journals (Sweden)

Xiao Huang

Full Text Available OBJECTIVES: This study aimed to determine the suitability of the Chinese version of the Hypomania Symptom Checklist (HCL-32 scale for psychiatric department outpatients with mood disorders in Chinese general hospitals, and provide a theoretical basis for the application of the HCL-32 scale. METHODS: Outpatients with mood disorders receiving continuous treatment in the psychiatric medicine department of three top-ranking general hospitals in three cities completed scoring the HCL-32 scale. RESULTS: A total of 1010 patients were recruited. 417 were diagnosed with bipolar disorder (236 for type I and 181 for type II and 593 were depression. Four factors with eigenvalues >1 were considered. Factor 1 with an eigenvalue of 5.5 was labeled "active/cheerful". Factor 2 with an eigenvalue of 2.7 was labeled "adventurous/irritable." The coefficient of internal consistency reliability of the HCL-32 total scale was 0.84, and the coefficients for factors 1 and 2 were 0.84 and 0.88, respectively. With the total score of HCL-32≥14 as positive standard, the sensitivity of HCL-32 was calculated at 69.30% and the specificity was 97.81%. CONCLUSIONS: Results showed that HCL-32 had a preferable reliability and validity and was suitable as auxiliary means for bipolar disorder screening in general hospitals.

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%

Prevalence and outcome of injury in patients visiting the emergency Department of Yirgalem General Hospital, Southern Ethiopia.

Science.gov (United States)

Negussie, Abel; Getie, Andarge; Manaye, Elias; Tekle, Tamrat

2018-05-22

Traumatic injuries continue to be an important cause of morbidity and mortality in the developing world. Despite the high burden of injury in Ethiopia, the occurrence and health impact have not received due attention. The aim of the study was to assess the prevalence and outcome of injury among patients visiting the Emergency Department (ED) of Yirgalem General Hospital, southern Ethiopia. A facility-based prospective cross sectional study was conducted from March, 27 - April, 30/2017. The final calculated sample size was 353 and all eligible trauma patients who visited the ED of Yirgalem General Hospital during the study period were included in the study. Data was collected using a checklist which was adapted from the WHO injury surveillance guideline. The data were entered and analyzed using SPSS version 19. A total of 346 patients, who visited the ED during the study period, participated in the study and of them, 171 (49.4%) were injury cases. Unintentional injuries accounted 123 (71.9%) of the total injuries and the age group ≤24 years (48.2%) was the most commonly affected age group. More than half (51.4%) of unintentional injury cases were due to Road Traffic Injuries (RTIs) and 48 (28%) of the cases were attributed to interpersonal violence (assault). The majority of patients, 97 (56.7%), had a minor or superficial injury (like bruises and minor cuts), 44 (25.7%) had a moderate injury and 16 (9.3%) had severe type of injury requiring intensive medical/surgical management; and RTIs accounted for 11 (68%) of all severe injuries. The prevalence of injury was considerably high in Yirgalem General Hospital. Road Traffic Injuries (RTIs) accounted for the majority of severe injury cases; therefore, appropriate prevention strategies should be strengthened and implemented against RTIs. We also suggest that children and young adults should be educated in schools and work environments to prevent injuries/accidents.

Caracterización clínica y epidemiológica de los casos de dengue: experiencia del Hospital General de Culiacán, Sinaloa, México Clinical and epidemiologic characteristics of dengue cases: the experience of a general hospital in Culiacan, Sinaloa, Mexico

Directory of Open Access Journals (Sweden)

María Guadalupe Ramírez-Zepeda

2009-01-01

Full Text Available OBJETIVO: Documentar las características clínicas y epidemiológicas de los pacientes con dengue atendidos en un hospital de Culiacán, Sinaloa, México. MÉTODOS: Estudio transversal, observacional y analítico realizado en el Hospital General Dr. Bernardo J. Gastélum de Culiacán entre el 1 de octubre y el 2 de diciembre de 2003. Se evaluó la asociación entre las variables independientes (las características clínicas y epidemiológicas de los pacientes y la variable dependiente (diagnóstico confirmado de dengue hemorrágico mediante el análisis de regresión simple. Las variables que mostraron una relación significativa (P 100 000/mm3 en casos con cuadros clínicos graves (fuga capilar que no se clasificaron como dengue hemorrágico por no cumplir todos los criterios establecidos por la OMS.OBJECTIVES: To document the clinical and epidemiological characteristics present in dengue patients served by a hospital in Culiacan, Sinaloa, Mexico. METHODS: 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 100000/mm3 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.

Perioperative risk factors for mortality and length of hospitalization in mares with dystocia undergoing general anesthesia: A retrospective study

Science.gov (United States)

Rioja, Eva; Cernicchiaro, Natalia; Costa, Maria Carolina; Valverde, Alexander

2012-01-01

This study investigated associations between perioperative factors and probability of death and length of hospitalization of mares with dystocia that survived following general anesthesia. Demographics and perioperative characteristics from 65 mares were reviewed retrospectively and used in a risk factor analysis. Mortality rate was 21.5% during the first 24 h post-anesthesia. The mean ± standard deviation number of days of hospitalization of surviving mares was 6.3 ± 5.4 d. Several factors were found in the univariable analysis to be significantly associated (P dystocia, intraoperative hypotension, and drugs used during recovery. Type of delivery and day of the week the surgery was performed were significantly associated with length of hospitalization in the multivariable mixed effects model. The study identified some risk factors that may allow clinicians to better estimate the probability of mortality and morbidity in these mares. PMID:23115362

The Treatment of Anorexia Nervosa in a General Hospital: A Case Vignette of a Multi-Disciplinary General Hospital-Based Approach.

Science.gov (United States)

Kronenberg, J.; And Others

1994-01-01

Describes anorexia nervosa as condition variable in etiology and resistant to treatment, which may lead to mortality in 5% of treated cases. Notes that efforts have been made for treating disorder in nonstigmatizing medical units outside psychiatric hospitals. Describes, through presentation of short case vignette, advantages of treating…

Glycemic control and the outcomes of Hispanic patients with diabetes admitted to the general ward of a community hospital in Puerto Rico.

Science.gov (United States)

Torres-Torres, Nancy; Maldonado-Rodríguez, Miguel A; Pérez-López, Shirley; Sierra-Martínez, Kassandra; García, Astrid J

2011-06-01

Uncontrolled glucose, present in 40% of diabetic patients admitted to United States hospitals, has been associated with prolonged length of stay and poorer general outcomes in critically ill and surgical patients. However, past studies of general ward patients have shown there to be no consistent benefits of strict glucose control, and the Hispanic population has been underrepresented in such studies. This work evaluated the association between glycemic control and the outcomes of hospitalized Hispanics with diabetes and to describe physicians' interventions in the treatment of diabetes. This is a retrospective chart review of all patients with diabetes admitted over a period of six months in the general ward of a community hospital in Puerto Rico. We evaluated glucose levels during the first 72 hours, length of stay, and reported complications during admission. Outcomes were evaluated with crude odds ratios and multivariate logistic regression. Uncontrolled blood glucose was observed in 59.1% of the 875 patients whose records were revised; of that 59.1%, treatment modification was not prescribed for 43.2%. Patients with poorly controlled glucose were more likely to develop acute coronary syndrome (corrected OR: 11.46; 95% CI = 1.48-88.50) as a complication and less likely to develop hypoglycemia (corrected OR: 0.57; 95% = CI 0.37-0.88). Our results suggest that hospitalized but non-critically ill Hispanic patients with diabetes are prone to poor outcomes secondary to uncontrolled glucose levels; in addition, those results support the creation of standardized protocols for the management of diabetes in this population.

Trato digno proporcionado por enfermería en unidades para adultos de un hospital general

OpenAIRE

Beltrán López, María Luisa

2016-01-01

El trato digno: Es la percepción que tiene el paciente o familiar del trato y atención proporcionada por el personal de enfermería durante su estancia hospitalaria, se mide a través de indicadores de calidad. Objetivo: Analizar el trato digno que proporciona el personal de enfermería a usuarios adultos hospitalizados en unidades de medicina interna y cirugía de un hospital general. Metodología: Estudio descriptivo transversal, realizado en los servicios de cirugías hombres, mujeres, m...

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...

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.

Retejiendo lo social en el sureste Mexicano; un ejercicio de intervención y acción comunitaria en dos barrios marginales de Ciudad del Carmen, Campeche / Reweaving the social climate in southeastern Mexico: an exercise in intervention and community...

OpenAIRE

Rodríguez, Cristhoper Bogart Márquez; Cortés, Moisés Frutos

2015-01-01

DOI: http://dx.doi.org/10.12957/rdc.2015.16956Trabalho enviado em 29 de janeiro de 2015. Aceito em 02 de abril de 2015. Resumen La Isla del Carmen, ubicada en el sureste mexicano, está inmersa desde los años ochenta en un agresivo proceso de modernización que está llegando a un punto de crisis por la agudización de los problemas sociales, económicos y ambientales. El desarrollo económico de la región está en gran medida determinado por la actividad petrolera, de tal suerte que se ha provocad...

21 CFR 880.5140 - Pediatric hospital bed.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Pediatric hospital bed. 880.5140 Section 880.5140 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use Therapeutic...

Psychiatric aspects of acute withdrawal from gamma-hydroxybutyrate (GHB) and its analogue gamma-butyrolactone (GBL): implications for psychiatry services in the general hospital.

Science.gov (United States)

Choudhuri, Debajeet; Cross, Sean; Dargan, Paul I; Wood, David M; Ranjith, Gopinath

2013-06-01

The objective of this study was to describe the psychiatric symptoms, management and outcomes in a consecutive series of patients being managed medically for symptoms of withdrawal from gamma-hydroxybutyrate (GHB) and its analogue gamma-butyrolactone (GBL) in a general hospital setting. A toxicology database was used to identify patients presenting with a history suggestive of withdrawal from GHB and analogues. Electronic and paper medical records were searched for demographic features, neuropsychiatric symptoms, psychiatric management while in hospital and overall outcome. There were 31 presentations with withdrawal from the drugs involving 20 patients. Of these 17 (54%) were referred to and seen by the liaison psychiatry team. Anxiety (61.3%) and agitation (48.4%) were the most common symptoms. Of the 17 cases seen by the liaison psychiatry team, 52.9% required close constant observation by a mental health nurse and 29.4% required to be detained in hospital under mental health legislation. The significant proportion of patients presenting with neuropsychiatric symptoms and requiring intensive input from the liaison psychiatry team during withdrawal from GHB and its analogues points to the importance of close liaison between medical and psychiatric teams in managing these patients in the general hospital.

Organisation and Evaluation of General Palliative Care in a Danish Hospital

DEFF Research Database (Denmark)

Bergenholtz, Heidi; Hølge-Hazelton, Bibi; Jarlbæk, Lene

2015-01-01

and evaluation of generalist palliative care in hospitals. Therefore the aim of the study was to investigate the organization and evaluation of generalist palliative care in a large regional hospital by comparing results from existing evaluations. Methods: Results from three different data sets, all aiming...... of palliative care in order to identify concordances and/or discrepancies. Results: The triangulation indicated poor validity of the results from existing methods used to evaluate palliativecare in hospitals. When the datasets were compared, several discrepancies occurred with regard to the organizationand...... the performance of generalist palliative care. Five types of discrepancies were found in 35 out of 56 sections inthe fulfilment of the national accreditation standard for palliative care. Responses from the hospital management and the department managements indicated that generalist palliative care was organized...

[The department budget, in the context of the hospital global budget. Initial results in general medicine].

Science.gov (United States)

Besançon, F

1984-02-23

In a general hospital (Hôtel-Dieu, in the center of Paris), run with a global budget, budgets determined for each unit were introduced as an experiment in 1980. Physicians were in charge of certain expenses, mainly: linen, drugs, transportation of patients to and from other hospitals within Paris, and blood fractions. The whole does not exceed 4% of the turnover (FF 20 millions in 1980) of a 67 bed internal medicine unit. Other accounts deal with the stays, admissions, prescriptions of technical acts, laboratory analyses, and X-rays. In 1980, expenses were 11% more than budgeted, but the increase in stays and particularly in admissions was significantly greater. The resulting savings were 8.8% and 18.7% for stays and admissions respectively. Psychic reactions were variable. The subsequent budgets followed the fluctuations of recorded expenses, which were fairly important in both directions. The unit budget may be an advance or a regression, in a restrictive and past-perpetuating context. The coherence between the unit budget and the global hospital budget is questionable. Physicians were willing to take part in accounting and saving. They have good reason for not enlarging their financial responsibilities. Conversely, they may give more attention to diseases of public opinion.

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.

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.

Upper gastrointestinal endoscopy in patients aged 85 years or more. Results of a feasibility study in a district general hospital.

NARCIS (Netherlands)

Kouwen, M.C.A. van; Drenth, J.P.H.; Verhoeven, H.M.; Bos, L.P.; Engels, L.G.

2003-01-01

We performed a cross sectional analysis of the feasibility and yield of upper gastrointestinal endoscopy (UGE) in a cohort of patients aged 85 years or more. The study involved 218 patients who underwent diagnostic upper gastrointestinal endoscopy in a district general hospital between 1994 and

Use of antimicrobial drugs in general hospitals. I. Description of population and definition of methods.

Science.gov (United States)

Townsend, T R; Shapiro, M; Rosner, B; Kass, E H

1979-06-01

The patterns of use of antimicrobial drugs in a random sample of general hosptials in Pennsylvania were studied. The sample was tested for validity, and all deaths and discharges were analyzed for 10 random days drawn across the year spanning July 1973 to June 1974. Methods were developed for abstracting the hospital records and for determining the reproducibility of the findings of the physician and nonphysician chart reviewers. More than 99% of the requested charts were available. In the 5,288 charts reviewed, most of the required data were readily available. The study population was 84% white and 58% female; most patients were in hospitals that had more than 300 beds and that were located in towns with populations of greater than 10,000. In 41% of the 2,070 antimicrobial courses administered to almost 30% of the patients, an explicit clinical statement of why the drug was being given could be found in the chart. The information for review was found in clinical charts, but in half of the charts, the information required was not on face sheets and discharge summaries.

GENERAL SURGERY

African Journals Online (AJOL)

Department of Surgery, University of Cape Town Health Sciences Faculty, Groote Schuur Hospital, Observatory, Cape Town,. South Africa ... included all district, regional and tertiary hospitals in the nine provinces. Clinics and so-called ..... large contingency of senior general surgeons from countries such as Cuba, who have ...

Motivation to change risky drinking and motivation to seek help for alcohol risk drinking among general hospital inpatients with problem drinking and alcohol-related diseases.

Science.gov (United States)

Lau, Katharina; Freyer-Adam, Jennis; Gaertner, Beate; Rumpf, Hans-Jürgen; John, Ulrich; Hapke, Ulfert

2010-01-01

The objective of this study was to analyze motivation to change drinking behavior and motivation to seek help in general hospital inpatients with problem drinking and alcohol-related diseases. The sample consisted of 294 general hospital inpatients aged 18-64 years. Inpatients with alcohol-attributable disease were classified according to its alcohol-attributable fraction (AAF; AAF=1, AAFmotivation between the AAF groups were analyzed. Furthermore, differences in motivation to change, in motivation to seek help and in the amount of alcohol consumed from baseline to follow-up between the AAF groups were evaluated. During hospital stay, motivation to change was higher among inpatients with alcohol-attributable diseases than among inpatients who had no alcohol-attributable diseases [F(2)=18.40, PMotivation to seek help was higher among inpatients with AAF=1 than among inpatients with AAFmotivation to change drinking behavior remained stable within 12 months of hospitalization, motivation to seek help decreased. The amount of alcohol consumed decreased in all three AAF groups. Data suggest that hospital stay seems to be a "teachable moment." Screening for problem drinking and motivation differentiated by AAFs might be a tool for early intervention. Copyright 2010 Elsevier Inc. All rights reserved.

The frequency of smoking and problem drinking among general hospital inpatients in Brazil - using the AUDIT and Fagerström questionnaires

Directory of Open Access Journals (Sweden)

Neliana Buzi Figlie

2000-09-01

Full Text Available CONTEXT: Although the CAGE questionnaire is one of the most widely used alcohol screening instruments, it has been criticized for not identifying people who are drinking heavily or who have alcohol related problems but do not as yet show symptoms of alcohol dependence. The AUDIT (Alcohol Use Disorder Identification Test questionnaire was developed by WHO as a screening instrument specifically designed to identify problem drinkers, as well as those who were already dependent on alcohol. OBJECTIVE: The aim of this study was to use the AUDIT and Fagerström questionnaires in a general hospital inpatient population to measure the frequency of problem drinking and nicotine dependence, and to see if levels varied between medical speciality. DESIGN: Retrospective cross-sectional study. SETTING: Federally funded public teaching hospital. SAMPLE: 275 inpatients from both genders. MAIN MEASUREMENTS: Socio-demographic data, AUDIT (Alcohol Use Disorders Identification Test and Fagerström Test for Nicotine Dependence. RESULTS: We interviewed 275 inpatients, 49% of whom were men and 51% women. Thirty-four patients were identified as "cases" by the Audit questionnaire; 22% of the male patients and 3% of the females. Just over 21% of inpatients were current smokers. The gastroenterology (26% and general medicine (16% inpatient units had the largest number of individual cases. CONCLUSIONS: Only by knowing the prevalence of alcohol abuse/dependence and nicotine dependence in a general hospital can we evaluate the need for a specialized liaison service to identify and treat these patients.

Hospital waste management in nonteaching hospitals of Lucknow City, India

Directory of Open Access Journals (Sweden)

Manish Kumar Manar

2014-01-01

Full Text Available Objective: To assess hospital waste management in nonteaching hospitals of Lucknow city. Materials and Methods: A cross-sectional, descriptive study was conducted on the staffs of nonteaching hospitals of Lucknow from September 2012 to March 2013. A total of eight hospitals were chosen as the study sample size. Simple random sampling technique was used for the selection of the nonteaching hospitals. A pre-structured and pre-tested interview questionnaire was used to collect necessary information regarding the hospitals and biomedical waste (BMW management of the hospitals. The general information about the selected hospitals/employees of the hospitals was collected. Results: Mean hospital waste generated in the eight nonteaching hospitals of Lucknow was 0.56 kg/bed/day. About 50.5% of the hospitals did not have BMW department and colored dustbins. In 37.5% of the hospitals, there were no BMW records and segregation at source. Incinerator was used only by hospital A for treatment of BMW. Hospital G and hospital H had no facilities for BMW treatment. Conclusion: There is a need for appropriate training of staffs, strict implementation of rules, and continuous surveillance of the hospitals of Lucknow to improve the BMW management and handling practices.

EPIDURAL LABOUR ANALGESIA IN IZOLA GENERAL HOSPITAL

Directory of Open Access Journals (Sweden)

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

Evaluation of the carboniferous resources of the sectors El Jupal, El Carmen y Guayabal. Zone Chinavita, Umbita, Tibana, Department of Boyaca

International Nuclear Information System (INIS)

Mejia, Luis Jorge; Pulido Gonzalez, Orlando

1985-01-01

The area of the sub-project Chinavita-Umbita-Tibana, located in the Southwest part of the Department of Boyaca was object of a geologic exploration with the purpose of evaluating its carboniferous resources. It was defined an stratigraphic interval of 250 m denominated, middle member from the Guaduas Formation of Maestrichtian to Paleocene age; in which they were determined until 9 coal layers, that were recognized total or partially in 7 chosen sectors during the exploration stage. In them it was made the quantification of the resources and the determination of the physical-chemical characteristics of the coal. The results of 4 of these denominated, El Arenal, Quina, Chiguata and Sisa sectors, they were presented in previous reports. In this report the 3 remaining, denominated El Jupal, El Carmen and Guayabal sectors are studied. The certain coal is bituminous high volatile, capable for thermal use and their importance are in the use that can be given inside the plan of national electrification, of the future amplifications of the thermoelectric of Paipa or Zipaquira. Keeping in mind that resources of the order of 148 million tons were calculated with a power heating average of 6.000 kcal/kg. It is possible to planning a new thermoelectric in this area that could serve as energy source in the critical times of the hydroelectric of Chivor

The financial performance of rural hospitals and implications for elimination of the Critical Access Hospital program.

Science.gov (United States)

Holmes, George M; Pink, George H; Friedman, Sarah A

2013-01-01

To compare the financial performance of rural hospitals with Medicare payment provisions to those paid under prospective payment and to estimate the financial consequences of elimination of the Critical Access Hospital (CAH) program. Financial data for 2004-2010 were collected from the Healthcare Cost Reporting Information System (HCRIS) for rural hospitals. HCRIS data were used to calculate measures of the profitability, liquidity, capital structure, and financial strength of rural hospitals. Linear mixed models accounted for the method of Medicare reimbursement, time trends, hospital, and market characteristics. Simulations were used to estimate profitability of CAHs if they reverted to prospective payment. CAHs generally had lower unadjusted financial performance than other types of rural hospitals, but after adjustment for hospital characteristics, CAHs had generally higher financial performance. Special payment provisions by Medicare to rural hospitals are important determinants of financial performance. In particular, the financial condition of CAHs would be worse if they were paid under prospective payment. © 2012 National Rural Health Association.

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 morbidity. The objective of this study was to assess the prevalence and correlates of generalized psychological distress among HIV-infected subjects on antiretroviral treatment (ART. Design: An institution-based cross-sectional study was conducted. Interviews were conducted with 500 patients initiating ART at Dilla Referral Hospital. Generalized psychological distress was measured using the Hospital Anxiety and Depression Scale (HADS. A cutoff score ≥19 was used to identify possible cases of patients with generalized psychological distress. Multivariable logistic regression analysis using SPSS Version 20 was performed to identify factors associated with psychological distress. Results: The prevalence of generalized psychological distress among the population of this study was 11.2% (HADS≥19. Factors independently associated with generalized psychological distress were moderate stress (OR=6.87, 95% CI 2.27–20.81, low social support (OR=10.17, 95% CI 2.85–36.29, number of negative life events of six and above (OR=3.99, 95% CI 1.77–8.99, not disclosing HIV status (OR=5.24, 95% CI 1.33–20.62, and CD4 cell count of <200 cells/mm3 (OR=1.98, 95% CI 0.45–0.83 and 200–499 cells/mm3 (OR=3.53, 95% CI 1.62–7.73. Conclusions: This study provides prevalence of psychological distress lower than the prevalence of common mental disorders in Ethiopia and comparable to some other studies in sub-Saharan Africa. The findings are important in terms of their relevance to identifying high-risk groups for generalized psychological distress and preventing distress through integrating mental health

Prevalencia y factores asociados a desnutrición hospitalaria en un hospital general: Perú, 2012

OpenAIRE

L. E. Veramendi-Espinoza; J. H. Zafra-Tanaka; O. Salazar-Saavedra; J. E. Basilio-Flores; E. Millones-Sánchez; G. A. Pérez-Casquino; L. M. Quispe-Moore; M. E. Tapia-Vicente; D. I. Ticona-Rebagliati; N. B. Asato; L. Quispe-Calderón; H. J. Ruiz García; A. Chia-Gil; D. E. Rey-Rodríguez; B. T. Surichaqui

2013-01-01

Introducción: La desnutrición hospitalaria es un problema prevalente que genera mayor morbi-mortalidad, peor respuesta al tratamiento, mayor estancia y costo hospitalario. Objetivos: Determinar la prevalencia y factores asociados a desnutrición hospitalaria en un hospital general peruano. Métodos: Estudio analítico transversal de 211 pacientes en servicios de Medicina y Cirugía. Se analizó variables demográficas, clínicas e indicadores antropométricos. El análisis multivariado fue de regresió...

The Prevalence, Profile, and Risk Factor of Patients with Ulcerative Colitis at Dr. Saiful Anwar Malang General Hospital

Directory of Open Access Journals (Sweden)

Syifa Mustika

2016-05-01

Full Text Available Background: The prevalence ulcerative colitis (UC in RSCM Jakarta in 1991-1995 is 2.5%. The disease affects men and women at similar rates or slightly more common in women than in men. Age of onset follows a bimodal pattern, with a peak at 15-25 years and a smaller one at 55-65 years, although the disease can occur in people of any age. The precise etiology of UC is not well understood. UC is precipitated by a complex interaction of environmental (cigarretes, diet, non-steroidal anti-inflammatory drug/NSAID, etc, genetic, and immunoregulatory factors. This study aimed to identify the prevalence, profile and risk factor of ulcerative colitis in Dr. Saiful Anwar General Hospital Malang. Method: This is a retrospective survey analysis from medical record which was taken from 2170 patients who underwent colonoscopy in Dr. Saiful Anwar General Hospital Malang from January 2010 to December 2014. Demographic setting (sex, age, clinical features, lifestyle, diagnosis based on colonoscopy were analyzed as the variables. Results: Total patients with UC was 176 patients. The prevalence of UC during 2010-2014 was 8.2% at Dr. Saiful Anwar General Hospital. There was a similar prevalence of sex between male and female patients, in which 95 (53.4% were male and 81 (46.6% were female. The average age of patients with UC was 41,6 years. Most patients were presented with abdominal pain (32.90% and weight loss (42.1%. The diagnosis based on colonoscopy were pancolitis (36%, proctosigmoiditis/proctitis (31.81%, and left-sided colitis (21.9%. The risk factors of UC identified in this study were current smoker, use of NSAIDs/traditional herbs/potion and fiber diet. Majority of ulcerative colitis study samples were non-smoker (75%, not consuming herbal treatment/NSAID (60.22%, and rarely consuming fiber (36.93%. There is a significan correlation between frequency of fiber diet and UC (r = -0.106, p = 0.000. Conclusion: The prevalence of UC was 8.2% in our hospital

Oxacilin-resistant Coagulase-negative staphylococci (CoNS) bacteremia in a general hospital at São Paulo city, Brasil

Science.gov (United States)

d’Azevedo, P.A.; Secchi, C.; Antunes, A.L.S.; Sales, T.; Silva, F.M.; Tranchesi, R.; Pignatari, A.C.C.

2008-01-01

In the last decades, coagulase-negative staphylococci (CoNS), especially Staphylococcus epidermidis have become an important cause of bloodstream infections. In addition, rates of methicillin-resistance among CoNS have increased substantially, leading to the use of glicopeptides for therapy. The objective of this study was to evaluate eleven consecutives clinically relevant cases of oxacillin-resistant CoNS bacteremia in a general hospital localized in São Paulo city, Brazil. Five different species were identified by different phenotypic methods, including S. epidermidis (5), S. haemolyticus (3), S. hominis (1), S. warneri (1) and S. cohnii subsp urealyticus (1). A variety of Pulsed Field Gel Electrophoresis profiles was observed by macrorestriction DNA analysis in S. epidermidis isolates, but two of three S. haemolyticus isolates presented the same profile. These data indicated the heterogeneity of the CoNS isolates, suggesting that horizontal dissemination of these microorganisms in the investigated hospital was not frequent. One S. epidermidis and one S. haemolyticus isolates were resistant to teicoplanin and susceptible to vancomycin. The selective pressure due to the use of teicoplanin in this hospital is relevant. PMID:24031279

ESTIGMA EN LA PRÁCTICA PSIQUIÁTRICA DE UN HOSPITAL GENERAL

Directory of Open Access Journals (Sweden)

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.

[Orientation of patients referred by their general practionner to the public or private hospital sector in France: A prospective epidemiologic study].

Science.gov (United States)

Reuter, P-G; Kernéis, S; Turbelin, C; Souty, C; Arena, C; Gavazzi, G; Sarazin, M; Blanchon, T; Hanslik, T

2012-12-01

In-patients characteristics generate cost differences between hospitals. In France, there are few data on the characteristics on the patients referred to hospitals by their general practitioners (GPs) and none on the predictors of referral to the public or for-profit hospitals. The aim of this study was to analyze those characteristics and the predictors of referral to the public or for-profit hospitals. We collected, prospectively, the request for hospitalizations made by the GPs of the Sentinelles network in France, from 2007 to 2009. Patients' characteristics and also the reasons for that request were analyzed. A logistic regression was used to compare the population between local hospitals. Ten thousand seven hundred and eighteen statements were collected. The median age was 73 years. Patients were women in 51% of the cases, and only 14% of the hospitalizations had been planned. Hospitalization in the public sector was preferred for young children and the elderly (Pprivate sector, patients addressed to the public sector were more often seen for emergencies (OR: 2.3 [2.0-2.8]), by a doctor different from their referring GP (OR: 1.7 [1.4-2.1]) and out of the GP's office. The reasons for hospital admission were different depending on the sector of hospitalization (Ppublic sector hospitals presented with greater comorbidity or more complex diagnosis (for example: feeling ill, fainting or syncope and fever) or a greater disability (for example: stroke, neurological and psychiatric diseases). This study suggests that GPs send their patients to the public or for-profit hospitals according to criteria of severity, comorbidity and disability. Copyright © 2012 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

Risk of Post-Discharge Venous Thromboembolism and Associated Mortality in General Surgery: A Population-Based Cohort Study Using Linked Hospital and Primary Care Data in England.

Science.gov (United States)

Bouras, George; Burns, Elaine Marie; Howell, Ann-Marie; Bottle, Alex; Athanasiou, Thanos; Darzi, Ara

2015-01-01

Trends towards day case surgery and enhanced recovery mean that postoperative venous thromboembolism (VTE) may increasingly arise after hospital discharge. However, hospital data alone are unable to capture adverse events that occur outside of the hospital setting. The National Institute for Health and Care Excellence has suggested the use of primary care data to quantify hospital care-related VTE. Data in surgical patients using these resources is lacking. The aim of this study was to measure VTE risk and associated mortality in general surgery using linked primary care and hospital databases, to improve our understanding of harm from VTE that arises beyond hospital stay. This was a longitudinal cohort study using nationally linked primary care (Clinical Practice Research Datalink, CPRD), hospital administrative (Hospital Episodes Statistics, HES), population statistics (Office of National Statistics, ONS) and National Cancer Intelligence Network databases. Routinely collected information was used to quantify 90-day in-hospital VTE, 90-day post-discharge VTE and 90-day mortality in adults undergoing one of twelve general surgical procedures between 1st April 1997 and 31st March 2012. The earliest postoperative recording of deep vein thrombosis or pulmonary embolism in CPRD, HES and ONS was counted in each patient. Covariates from multiple datasets were combined to derive detailed prediction models for VTE and mortality. Limitation included the capture of VTE presenting to healthcare only and the lack of information on adherence to pharmacological thromboprophylaxis as there was no data linkage to hospital pharmacy records. There were 981 VTE events captured within 90 days of surgery in 168005 procedures (23.7/1000 patient-years). Overall, primary care data increased the detection of postoperative VTE by a factor of 1.38 (981/710) when compared with using HES and ONS only. Total VTE rates ranged between 3.2/1000 patient-years in haemorrhoidectomy to 118

The Montreal General Hospital Pain Centre (1974-2000: The Contributions of Ronald Melzack

Directory of Open Access Journals (Sweden)

Mary Ellen Jeans

2000-01-01

Full Text Available This paper chronicles the development of the Montreal General Hospital Pain Centre from its inception in 1974 to the present. Highlighted in particular are the contributions of Ronald Melzack to this history. Data for the article arose, in the main, from an interview with Dr Melzack carried out earlier in the year. Discussions with former and present members of the pain centre team, including former graduate students, provided additional information. The article begins with a recounting of those individuals and events that inspired Ron early in his 'pain career' to pursue his dream of a multidisciplinary pain centre, the first of its kind in Canada. The forces that helped shape the development of this centre and the challenges that had to be overcome are described.

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

Job Demands, Burnout, and Teamwork in Healthcare Professionals Working in a General Hospital that Was Analysed At Two Points in Time

Science.gov (United States)

Mijakoski, Dragan; Karadzhinska-Bislimovska, Jovanka; Stoleski, Sasho; Minov, Jordan; Atanasovska, Aneta; Bihorac, Elida

2018-01-01

AIM: The purpose of the paper was to assess job demands, burnout, and teamwork in healthcare professionals (HPs) working in a general hospital that was analysed at two points in time with a time lag of three years. METHODS: Time 1 respondents (N = 325) were HPs who participated during the first wave of data collection (2011). Time 2 respondents (N = 197) were HPs from the same hospital who responded at Time 2 (2014). Job demands, burnout, and teamwork were measured with Hospital Experience Scale, Maslach Burnout Inventory, and Hospital Survey on Patient Safety Culture, respectively. RESULTS: Significantly higher scores of emotional exhaustion (21.03 vs. 15.37, t = 5.1, p Teamwork levels were similar at both points in time (Time 1 = 3.84 vs. Time 2 = 3.84, t = 0.043, p = 0.97). CONCLUSION: Actual longitudinal study revealed significantly higher mean values of emotional exhaustion and depersonalization in 2014 that could be explained by significantly increased job demands between analysed points in time. PMID:29731948

Nosological Inaccuracies in death certification in Northern Ireland. A comparative study between hospital doctors and general practitioners.

OpenAIRE

Armour, A.; Bharucha, H.

1997-01-01

We aimed to audit nosological inaccuracies in death certification in Northern Ireland and to compare performance of hospital doctors and general practitioners. Nosology is the branch of medicine which treats of the classification of disease. 1138 deaths were registered in Northern Ireland in a 4-week period commencing 3/10/94. 195 of these were either registered by HM Coroners (HMC) or required further investigation by their staff; these cases were excluded from the study. The remaining 943 w...

Toshiba General Hospital PACS for routine in- and outpatient clinics

Science.gov (United States)

Toshimitsu, Akihiro; Okazaki, Nobuo; Kura, Hiroyuki; Nishihara, Eitaro; Tsubura, Shinichi

1996-05-01

The Toshiba General Hospital introduced a departmental RIS/PACS (Radiology Information System/Picture Archiving and Communication System) in the radiology department in May, 1993. It has been used routinely since that time. In order to provide efficient means for clinicians to find and read many images, the system has been expanded to the neurosurgery and urology clinics and wards since May, 1995, and five image referring workstations now provide digital images to clinicians. In this paper we discuss an algorithm for image migration, one of the key issues to accomplish the expansion to outpatient clinics successfully, and propose the WYWIWYG (what you want is what you get) image transfer logic. This is the logic used to transfer images that physicians require refer without increasing the traffic between the image server and referring workstations. We accomplish the WYWIWYG logic by prioritizing exams the physicians have not yet viewed and by finding historical exams according to the modality, anatomy, and marking. Clinicians gave us comments from their first use of the system and suggested that the PACS enables clinicians to review images more efficiently compared to a film-based system. Our experience suggests that it is a key to the effective application of PACS in outpatient clinics to incorporate consideration patterns of clinicians on the migration algorithm.

21 CFR 880.5110 - Hydraulic adjustable hospital bed.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Hydraulic adjustable hospital bed. 880.5110 Section 880.5110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use...

21 CFR 880.5120 - Manual adjustable hospital bed.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Manual adjustable hospital bed. 880.5120 Section 880.5120 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use...

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

Quality of life of gestational trophoblastic neoplasia survivors: a study of patients at the Philippine General Hospital trophoblastic disease section.

Science.gov (United States)

Cagayan, M Stephanie Fay S; Llarena, Raquel T

2010-01-01

To evaluate the quality of life (QOL) of patients who were diagnosed with gestational trophoblastic neoplasia (GTN) at the Philippine General Hospital Trophoblastic Disease Section and who were in remission at the time of this study. A cross-sectional descriptive study designed to measure the QOL of all patients diagnosed as having GTN in remission and following up at the Philippine General Hospital Trophoblastic Disease Outpatient Clinic from May-August 2008 (N = 46). This study used the short form 12-question (SF-12) survey forms to evaluate the QOL of patients diagnosed with GTN. Scores from the SF-12 were analyzed using Pearson's correlation. Statistical significance was assumed for p values educational level and physical functioning. A negative correlation was found between the stage of GTN and patients' general health. In conclusion, the survivors' age, educational level and type of treatment had impact on the QOL among GTN survivors in terms of physical functioning. No relationship was established between the demographic variables and mental status. SF-12 appears to be a reliable instrument, suggesting its potential in measuring health status in GTN survivors. Age, educational attainment and type of treatment were shown to have an impact on the QOL of the surviving GTN patients.

An email-based intervention to improve the number and timeliness of letters sent from the hospital outpatient clinic to the general practitioner : A pair-randomized controlled trial

NARCIS (Netherlands)

Medlock, Stephanie; Parlevliet, Juliette L.; Sent, Danielle; Eslami, Saeid; Askari, Marjan; Arts, Derk L.; Hoekstra, Joost B.; de Rooij, Sophia E.; Abu-Hanna, Ameen

2017-01-01

Objective: Letters from the hospital to the general practitioner are important for maintaining continuity of care. Although doctors feel letters are important, they are often not written on time. To improve the number and timeliness of letters sent from the hospital outpatient department to the

Assessment of Antibiotic Utilization Pattern in Treatment of Acute Diarrhoea Diseases in Bishoftu General Hospital, Oromia Ethiopia.

Science.gov (United States)

Tulu, Selamawit; Tadesse, Tarekegne; Alemayehu Gube, Addisu

2018-01-01

Majority of acute diarrhoeal diseases are self-limiting and do not require routine treatment. Treatment with empirical antimicrobials is recommended only for dysenteric and invasive bacterial diarrhoea. Irrational use of antibiotics in treatment of acute diarrhoea is common in clinical practice worldwide. This study was carried out to assess the pattern of antibiotic use for acute diarrhoeal diseases in Bishoftu General Hospital, East Shewa Ethiopia. Institution based cross-sectional study was conducted from April 1 to April 30, 2016. Data were collected retrospectively from patients treated for diarrhoeal diseases from January 2015 to December 2015 using structured questionnaires and entered into SPSS (IBM 20) and descriptive statistics was carried out. Among the 303 patients, 51.2% were males and 48.8% were females. Of them, 62% were children under five years. Two hundred sixty three (86.8%) patients received eight different types of antibiotics and cotrimoxazole (178 patients, 58.7%) was the most prescribed antibiotics, followed by ciprofloxacin (33, 10.9%) and amoxicillin (14, 4.6%). Based on the presence of blood in stools, 14.5% of cases were of invasive bacterial type. According to the recommendations of WHO, the rate of overuse of antibiotics was 72.3%. This study revealed that there was high overuse of antibiotics for both adults and children under five with acute diarrhoea in Bishoftu General Hospital. And Cotrimoxazole was the most prescribed antibiotic.

Cost-Effective Recruitment need for 24x7 Paediatricians in the State General Hospitals in Relation to the Reduction of Infant Mortality.

Science.gov (United States)

Chatterjee, Ranjana; Chatterjee, Sukanta

2016-10-01

According to World Health Organisation (WHO), improvement of hospital based care can have an impact of upto 30% in reducing Infant Mortality Rate (IMR), whereas, strengthening universal outreach and family-community based care is known to have a greater impact. The study intends to assess how far gaps in the public health facilities contribute towards infant mortality, as 2/3 rd of infant mortality is due to suboptimum care seeking and weak health system. To identify cost-effectiveness of employment of additional paediatric manpower to provide round the clock skilled service to reduce IMR in the present state health facilities at the district general hospitals. A cross-sectional observational study was conducted in a tertiary teaching hospital and district hospitals of 2 districts (Hooghly and Howrah in West Bengal). Factors affecting infant mortality and shift wise analysis of proportion of infant deaths were analysed in both tertiary and district level hospitals. Information was gathered in a predesigned proforma for one year period by verifying hospital records and by personal interview with service personnel in the health establishment. SPSS software version 17 (Chicago, IL) was used. The p-value was calculated by Fischer exact t-test. Available hospital beds per 1000 population were 1.1. Percentage of paediatric beds available in comparison to total hospital bed was disproportionately lower (10%). Dearth of skilled medical care provider at odd hours in district hospitals resulted in significantly greater infant death (p based infant mortality and it is cost-effective.

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

Directory of Open Access Journals (Sweden)

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. 

Prospective casemix-based funding, analysis and financial impact of cost outliers in all-patient refined diagnosis related groups in three Belgian general hospitals.

Science.gov (United States)

Pirson, Magali; Martins, Dimitri; Jackson, Terri; Dramaix, Michèle; Leclercq, Pol

2006-03-01

This study examined the impact of cost outliers in term of hospital resources consumption, the financial impact of the outliers under the Belgium casemix-based system, and the validity of two "proxies" for costs: length of stay and charges. The cost of all hospital stays at three Belgian general hospitals were calculated for the year 2001. High resource use outliers were selected according to the following rule: 75th percentile +1.5 xinter-quartile range. The frequency of cost outliers varied from 7% to 8% across hospitals. Explanatory factors were: major or extreme severity of illness, longer length of stay, and intensive care unit stay. Cost outliers account for 22-30% of hospital costs. One-third of length-of-stay outliers are not cost outliers, and nearly one-quarter of charges outliers are not cost outliers. The current funding system in Belgium does not penalize hospitals having a high percentage of outliers. The billing generated by these patients largely compensates for costs generated. Length of stay and charges are not a good approximation to select cost outliers.

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.

21 CFR 880.6890 - General purpose disinfectants.

Science.gov (United States)

2010-04-01

... (CONTINUED) MEDICAL DEVICES GENERAL HOSPITAL AND PERSONAL USE DEVICES General Hospital and Personal Use... disinfectant is a germicide intended to process noncritical medical devices and equipment surfaces. A general... prior to terminal sterilization or high level disinfection. Noncritical medical devices make only...

[Nosocomial urinary tract and surgical site infection rates in the Maternity Ward at the General Referral Hospital in Katuba, Lubumbashi, Democratic Republic of the Congo].

Science.gov (United States)

Lukuke, Hendrick Mbutshu; Kasamba, Eric; Mahuridi, Abdulu; Nlandu, Roger Ngatu; Narufumi, Suganuma; Mukengeshayi, Abel Ntambue; Malou, Vicky; Makoutode, Michel; Kaj, Françoise Malonga

2017-01-01

In Intertropical Africa hospitalized patients are exposed to a risk of nosocomial infections. The dearth of published data on this subject limits the descriptive analysis of the situation. This study aimed to determine the incidence, the germs responsible for these infections and the risk factors of nosocomial infections in the Maternity Ward at the General Referral Hospital in Katuba, Lubumbashi, Democratic Republic of the Congo. We conducted a descriptive, longitudinal study from 1 October 2014 to 1 January 2015. Our study population consisted of 207 women who had been hospitalized in the Maternity Ward at the General Referral Hospital in Katuba. We carried out a comprehensive data collection. Nosocomial infection rate accounted for 15.5%. Parturient women who had been hospitalized for more than three days were three times more likely to develop a nosocomial infection (p=0.003), while those who had had a complicated delivery were four times more likely to be at risk of developing nosocomial infection (p = 0.000). Escherichia coli was the most isolated causative agent (38.1%), followed by Citrobacter freundi (23.8%), Acinobacter baumani (.18, 2%), Staphylococcus aureus (18.2%), Enterococcus aureus (14.3%) and Pseudomonas aeroginosa (9.1%). Ampicillin was the most prescribed antibiotic, to which isolated microbes were resistant. It is necessary to improve hospital hygiene and to conduct further study to examine the similarity between germs strains in the environment and those in biological fluids.

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

Experiences of family carers of older people with mental health problems in the acute general hospital: a qualitative study.

Science.gov (United States)

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

2013-12-01

To explore the experiences of family carers of people with cognitive impairment during admission to hospital. Providing appropriate care in acute hospitals for people with co-morbid cognitive impairment, especially dementia or delirium or both, is challenging to healthcare professionals. One key element is close working with family members. Qualitative interview study. Semi-structured interviews with family carers of 34 older people who had been admitted to a UK general hospital and had co-morbid cognitive impairment. Interviews conducted in 2009 and 2010. Analysis was undertaken using Strauss and Corbin's framework. The findings elaborate a core problem, 'disruption from normal routine' and a core process, 'gaining or giving a sense of control to cope with disruption'. Family carers responded to disruption proactively by trying to make sense of the situation and attempting to gain control for themselves or the patient. They tried to stay informed, communicate with staff about the patient and plan for the future. The interaction of the core problem and the core process resulted in outcomes where family members either valued the support of hospital staff and services or were highly critical of the care provided. Family carers are not passive in the face of the disruption of hospitalization and respond both by trying to involve themselves in the care and support of their relative and by trying to work in partnership with members of staff. Nurses need to foster this relationship conscientiously. © 2013 John Wiley & Sons Ltd.

Composition and production rate of pharmaceutical and chemical waste from Xanthi General Hospital in Greece.

Science.gov (United States)

Voudrias, Evangelos; Goudakou, Lambrini; Kermenidou, Marianthi; Softa, Aikaterini

2012-07-01

The objective of this work was to determine the composition and production rates of pharmaceutical and chemical waste produced by Xanthi General Hospital in Greece (XGH). This information is important to design and cost management systems for pharmaceutical and chemical waste, for safety and health considerations and for assessing environmental impact. A total of 233 kg pharmaceutical and 110 kg chemical waste was collected, manually separated and weighed over a period of five working weeks. The total production of pharmaceutical waste comprised 3.9% w/w of the total hazardous medical waste produced by the hospital. Total pharmaceutical waste was classified in three categories, vial waste comprising 51.1%, syringe waste with 11.4% and intravenous therapy (IV) waste with 37.5% w/w of the total. Vial pharmaceutical waste only was further classified in six major categories: antibiotics, digestive system drugs, analgesics, hormones, circulatory system drugs and "other". Production data below are presented as average (standard deviation in parenthesis). The unit production rates for total pharmaceutical waste for the hospital were 12.4 (3.90) g/patient/d and 24.6 (7.48) g/bed/d. The respective unit production rates were: (1) for vial waste 6.4 (1.6) g/patient/d and 13 (2.6) g/bed/d, (2) for syringe waste 1.4 (0.4) g/patient/d and 2.8 (0.8) g/bed/d and (3) for IV waste 4.6 (3.0) g/patient/d and 9.2 (5.9) g/bed/d. Total chemical waste was classified in four categories, chemical reagents comprising 18.2%, solvents with 52.3%, dyes and tracers with 18.2% and solid waste with 11.4% w/w of the total. The total production of chemical waste comprised 1.8% w/w of the total hazardous medical waste produced by the hospital. Thus, the sum of pharmaceutical and chemical waste was 5.7% w/w of the total hazardous medical waste produced by the hospital. The unit production rates for total chemical waste for the hospital were 5.8 (2.2) g/patient/d and 1.1 (0.4) g/exam/d. The respective

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

Directory of Open Access Journals (Sweden)

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.

Prevalencia de factores de riesgo de enfermedad coronaria en trabajadores del Hospital General de México

Directory of Open Access Journals (Sweden)

FANGHÄNEL-SALMÓN GUILLERMO

1997-01-01

Full Text Available Objetivo. Conocer la prevalencia de algunos factores de riesgo coronario en trabajadores de una institución de salud. Material y métodos. De 1993 a 1995 se evaluaron 2 228 trabajadores del Hospital General de México, 1 531 mujeres (68.7% y 697 hombres (31.2% con edades entre 16 a 65 años, y se les clasificó por áreas de trabajo: en Intendencia hubo 477 participantes (21.4%; en Administración, 697 (31.2%; en Personal Médico, 495 (22.2%, y en Enfermería, 559 (25.0%. Se les practicó historia clínica, mediciones antropométricas y determinación de glucosa, colesterol total, LDL, HDL y triglicéridos. Resultados. Trescientos sesenta y siete sujetos (14.9% tenían colesterol por arriba de 240 mg/dl, con valores altos en las mujeres del área administrativa (17.1% y en los hombres del departamento de enfermería (26% que presentó la mayor tendencia (26%. Se encontraron niveles de triglicéridos por arriba de los 200 mg/dl en 471 personas (19.1%; obesidad, en 329 (13.5%; hipertensión arterial, en 549 sujetos (22.2%, y tabaquismo positivo, en 32% de los trabajadores. La prevalencia de diabetes mellitus fue de 6.24%. Conclusiones. Se confirma la elevada prevalencia de factores de riesgo de enfermedad cardiovascular entre los trabajadores del Hospital General de México, factores que en muchos casos son modificables, lo que confiere la posibilidad de realizar acciones preventivas.

Job Demands, Burnout, and Teamwork in Healthcare Professionals Working in a General Hospital that Was Analysed At Two Points in Time.

Science.gov (United States)

Mijakoski, Dragan; Karadzhinska-Bislimovska, Jovanka; Stoleski, Sasho; Minov, Jordan; Atanasovska, Aneta; Bihorac, Elida

2018-04-15

The purpose of the paper was to assess job demands, burnout, and teamwork in healthcare professionals (HPs) working in a general hospital that was analysed at two points in time with a time lag of three years. Time 1 respondents (N = 325) were HPs who participated during the first wave of data collection (2011). Time 2 respondents (N = 197) were HPs from the same hospital who responded at Time 2 (2014). Job demands, burnout, and teamwork were measured with Hospital Experience Scale, Maslach Burnout Inventory, and Hospital Survey on Patient Safety Culture, respectively. Significantly higher scores of emotional exhaustion (21.03 vs. 15.37, t = 5.1, p job demands were found at Time 2. Teamwork levels were similar at both points in time (Time 1 = 3.84 vs. Time 2 = 3.84, t = 0.043, p = 0.97). Actual longitudinal study revealed significantly higher mean values of emotional exhaustion and depersonalization in 2014 that could be explained by significantly increased job demands between analysed points in time.

Problems facing Korean hospitals and possible countermeasures.

Science.gov (United States)

Kim, Kwang-Tae

2004-07-01

Korea has a unique health care system, of which the private sector comprises most of the country's health resources: 88% of the beds and 91% of specialists in Korea, but are funded by public financing, such as national health insurance and the national aid program. However, the public financing pays only 50% of actual costs and the patient's co-payment is still high. Healthcare organizations in Korea are categorized into four types; tertiary care hospitals, general hospitals, hospitals and clinics by scale of operator: number of beds. General hospitals must have 100 beds and over, and compulsorily specialties in internal medicine, surgery, obstetrics-gynecology, pediatrics, dental service, other ancillary service units and an emergency care unit. General hospitals with 300 beds and more must operate an intensive care unit. There are many challenges facing the Korean healthcare system, such as reformation of primary healthcare system, enhancing hospitals' competitiveness, and permission of for-profit hospital, introduction of private health insurance, enhancement of geriatric care. These challenges can be resolved with long-term vision, willingness and strategies of the Korean government to ensure equitable financing and access to healthcare, combined with the active participation and utilization of the private sector.

Which types of hospital mergers save consumers money?

Science.gov (United States)

Connor, R A; Feldman, R D; Dowd, B E; Radcliff, T A

1997-01-01

This study analyzes the changes in costs and prices from 1986 to 1994 for more than 3,500 U.S. short-term general hospitals, including 122 horizontal mergers. These mergers were generally financially beneficial to consumers, providing average price reductions of approximately 7 percent. Merger-related price reductions were considerably less in market areas with higher market concentration levels. Merger-related price reductions in areas with higher penetration by health maintenance organizations (HMOs) were approximately twice those in areas with lower HMO penetration. Merger-related price reductions were greater for low-occupancy hospitals, nonteaching hospitals, nonsystem hospitals, similar-size hospitals, and hospitals with greater premerger service duplication.

[Clinical and economic analysis of an internal medicine-infectious disease department at a university general hospital (2005-2006)].

Science.gov (United States)

Gómez, Joaquín; García-Vázquez, Elisa; Antonio Puertas, José; Ródenas, Julio; Herrero, José Antonio; Albaladejo, Carmen; Baños, Víctor; Canteras, Manuel; Alcaraz, Manolo

2009-02-01

Comparative study in patients with infectious diseases admitted to a specialized Internal Medicine-Infectious Diseases Department (IMID) versus those admitted to other medical departments in a university general hospital, investigating quality and cost-effectiveness. Analysis of patients in 10 principle diagnosis-related groups (DRGs) of infectious diseases admitted to the IMID were compared to those admitted to other medical departments (2005-2006). The DRG were divided in 4 main groups: respiratory infections (DGR 88, 89, 90, 540), urinary infections (DRG 320, 321), sepsis (DRG 416, 584), and skin infections (DRG 277, 278). For each group, quality variables (mortality and readmission rate), efficacy variables (mean hospital stay and mean DRG-based cost per patient) and complexity variables (case mix, relative weight, and functional index) were analyzed. 542 patients included in the 10 main infectious disease DRGs were admitted to IMID and 2404 to other medical departments. After adjusting for DRG case mix (case mix 0.99 for IMID and 0.89 for others), mean hospital stay (5.11 days vs. 7.65 days), mortality (3.5% vs. 7.9%) and mean DRG-based economic cost per patient (1521euro/patient vs. 2952euro/patient) was significantly lower in the group of patients hospitalized in IMID than the group in other medical departments (peconomic cost per patient. Creation and development of IMID departments should be an essential objective to improve healthcare quality and respond to social demands.

Investigating an outbreak of non-specific building-related symptoms in workers of a general hospital

Directory of Open Access Journals (Sweden)

Inés Gómez-Acebo

2013-08-01

Full Text Available Objective:To obtain a case definition and to describe variables associated with a cluster of unspecific symptoms in healthcare workers (HCW in a hospital building. Materials and Methods: A cross-sectional study was performed. All people working at the Residencia Cantabria building (a 200-bed building belonging to University Hospital Marqués de Valdecilla in June 2009 were invited to complete a self-administered questionnaire, including questions on demographic data, working place and shift, working conditions and current symptoms. A cluster analysis was developed to obtain the case definition. The strength of the association between the studied variables and accomplishing the case definition was measured using odds ratios (OR with the 95% confidence interval (CI. Multiple logistic regression was used to obtain a predictive model; its general validity was estimated with Receiver Operating Curves (ROC and their Area Under the Curve (AUC. Results: 357 completed questionnaires were obtained. The case was defined as having at least 5 symptoms out of the eleven included. Not being ascribed to a specific shift was the strongest protective variable related with "being a case" (OR = 0.30; 95% CI: 0.17-0.54, whereas the personal antecedent of distal pain or inflammation in arms or legs was the main risk factor (OR = 4.33, 95% CI: 2.75-6.82. A six-variable predictive model has AUC equaling to 0.7378. Conclusions: A disease associated with the indoor environment quality in a hospital was characterized. A multivariate score was drafted for identifying HCW with higher risk of developing the disease in order to apply administrative prevention measures.

A survey of dental treatment under general anesthesia in a Korean university hospital pediatric dental clinic.

Science.gov (United States)

Shin, Bisol; Yoo, Seunghoon; Kim, Jongsoo; Kim, Seungoh; Kim, Jongbin

2016-09-01

In South Korea, the number of cases of dental treatment for the disabled is gradually increasing, primarily at regional dental clinics for the disabled. This study investigated pediatric patients at a treatment clinic for the disabled within a university hospital who received dental treatment under general anesthesia. This data could assist those that provide dental treatment for the disabled and guide future treatment directions and new policies. This study was a retrospective analysis of 263 cases in which patients received dental treatment under general anesthesia from January 2011 to May 2016. The variables examined were gender, age, reason for anesthesia, type of disability, time under anesthesia, duration of treatment, type of procedure, treatment details, and annual trends in the use of general anesthesia. Among pediatric patients with disabilities who received dental treatment under general anesthesia, the most prevalent age group was 5-8 years old (124 patients, 47.1%), and the primary reason for administering anesthesia was dental anxiety or phobia. The mean time under anesthesia was 132.7 ± 77.6 min, and the mean duration of treatment was 101.9 ± 71.2 min. The most common type of treatment was restoration, accounting for 158 of the 380 treatments performed. Due to increasing demand, the number of cases of dental treatment performed under general anesthesia is expected to continue increasing, and it can be a useful method of treatment in patients with dental anxiety or phobia.

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.

Microbial contaminants isolated from items and work surfaces in the post- operative ward at Kawolo general hospital, Uganda.

Science.gov (United States)

Sserwadda, Ivan; Lukenge, Mathew; Mwambi, Bashir; Mboowa, Gerald; Walusimbi, Apollo; Segujja, Farouk

2018-02-06

Nosocomial infections are a major setback in the healthcare delivery system especially in developing countries due to the limited resources. The roles played by medical care equipment and work surfaces in the transmission of such organisms have inevitably contributed to the elevated mortality, morbidity and antibiotic resistances. A total 138 samples were collected during the study from Kawolo general hospital. Swab samples were collected from various work surfaces and fomites which consisted of; beds, sink taps, infusion stands, switches, work tables and scissors. Cultures were done and the susceptibility patterns of the isolates were determined using Kirby Bauer disc diffusion method. Data was analyzed using Stata 13 and Microsoft Excel 2013 packages. A total of 44.2% (61/138) of the collected swab specimens represented the overall bacterial contamination of the sampled articles. Staphylococcus aureus and Klebsiella pneumoniae accounted for the highest bacterial contaminants constituting of 75.4% (46/61) and 11.5% (7/61) respectively. Infusion stands and patient beds were found to have the highest bacterial contamination levels both constituting 19.67% (12/61). The highest degree of transmission of organisms to patients was found to be statistically significant for patient beds with OR: 20.1 and P-value 8X10 - 4 . Vancomycin, ceftriaxone and ciprofloxacin were the most effective antibiotics with 100%, 80% and 80% sensitivity patterns among the isolates respectively. Multi-drug resistant (MDR) Staphylococcus aureus accounted for 52% (24/46) with 4% (1/24) classified as a possible extensively drug resistant (XDR) whereas Gram negative isolates had 27% (4/15) MDR strains out of which 50%(2/4) were classified as possible pan-drug resistant (PDR). The high prevalence of bacterial contaminants in the hospital work environment is an indicator of poor or ineffective decontamination. The study findings reiterate the necessity to formulate drug usage policies and re

Las Teorías de Elton Mayo, La Teoría de las Necesidades Humanas de Abrahan Maslow para Desarrollar las Relaciones Interpersonales, En La Institución Educativa Nº 10103 “Carmen Rosa Fernández Barrera” Del Caserío La Capilla – Pueblo Nuevo - Ferreñafe

OpenAIRE

Duran Chambergo, Elizabeth; Ugaz Castillo, Gustavo

2017-01-01

El objetivo del trabajo es diseñar estrategias para mejorar las relaciones interpersonales de los directivos y docentes de la Institución Educativa Nº 10103 “Carmen Rosa Fernández Barrera” del Caserío la Capilla – Pueblo Nuevo – Ferreñafe, que permita mejorar la gestión institucional, cuyos indicadores dan cuenta de: a) ineficientes relaciones interpersonales, b) equivocados estilos de dirección, c) falta de comunicación laboral, d) exiguas retribuciones y e) escasa disponibilidad de espacios...

Effects of a humor-centered activity on disruptive behavior in patients in a general hospital psychiatric ward

OpenAIRE

Antonio Higueras; Hugo Carretero-Dios; José P. Muñoz; Esther Idini; Ana Ortiz; Francisco Rincón; David Prieto-Merino; María M. Rodríguez del Águila

2006-01-01

El objetivo de este estudio cuasi-experimental es analizar lo efectos de una actividad centrada en el humor sobre las conductas disruptivas de pacientes hospitalizados en un servicio de Psiquiatría. Se han comparado, teniendo en cuenta dos grupos homogéneos de pacientes hospitalizados en un servicio de Psiquiatría de hospital general (unidad de agudos), dos periodos temporales de 83 días cada uno, siendo el período 1 el de línea base, y el período 2, el de intervención. Para am...

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

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.

Financial Analysis of National University Hospitals in Korea.

Science.gov (United States)

Lee, Munjae

2015-10-01

This paper provides information for decision making of the managers and the staff of national university hospitals. In order to conduct a financial analysis of national university hospitals, this study uses reports on the final accounts of 10 university hospitals from 2008 to 2011. The results of comparing 2008 and 2011 showed that there was a general decrease in total assets, an increase in liabilities, and a decrease in total medical revenues, with a continuous deficit in many hospitals. Moreover, as national university hospitals have low debt dependence, their management conditions generally seem satisfactory. However, some individual hospitals suffer severe financial difficulties and thus depend on short-term debts, which generally aggravate the profit and loss structure. Various indicators show that the financial state and business performance of national university hospitals have been deteriorating. These research findings will be used as important basic data for managers who make direct decisions in this uncertain business environment or by researchers who analyze the medical industry to enable informed decision-making and optimized execution. Furthermore, this study is expected to contribute to raising government awareness of the need to foster and support the national university hospital industry.

Orthopedic specialty hospitals: centers of excellence or greed machines?

Science.gov (United States)

Badlani, Neil; Boden, Scott; Phillips, Frank

2012-03-07

Orthopedic specialty hospitals have recently been the subject of debate. They are patient-centered, physician-friendly health care alternatives that take advantage of the economic efficiencies of specialization. Medically, they provide a higher quality of care and increase patient and physician satisfaction. Economically, they are more efficient and profitable than general hospitals. They also positively affect society through the taxes they pay and the beneficial aspects of the competition they provide to general hospitals. Their ability to provide a disruptive innovation to the existing hospital industry will lead to lower costs and greater access to health care. However, critics say that physician ownership presents potential conflicts of interest and leads to overuse of medical care. Some general hospitals are suffering as a result of unfair specialty hospital practices, and a few drastic medical complications have occurred at specialty hospitals. Specialty hospitals have been scrutinized for increasing the inequality of health care and continue to be a target of government regulations. In this article, the pros and cons are examined, and the Emory Orthopaedics and Spine Hospital is analyzed as an example. Orthopedic specialty hospitals provide excellent care and are great assets to society. Competition between specialty and general hospitals has provided added value to patients and taxpayers. However, physicians must take more responsibility in their appropriate and ethical leadership. It is critical to recognize financial conflicts of interest, disclose ownership, and act ethically. Patient care cannot be compromised. With thoughtful and efficient leadership, specialty hospitals can be an integral part of improving health care in the long term. Copyright 2012, SLACK Incorporated.

Depression and suicide risk of outpatients at specialized hospitals for substance use disorder: comparison with depressive disorder patients at general psychiatric clinics.

Science.gov (United States)

Matsumoto, Toshihiko; Matsushita, Sachio; Okudaira, Kenichi; Naruse, Nobuya; Cho, Tetsuji; Muto, Takeo; Ashizawa, Takeshi; Konuma, Kyohei; Morita, Nobuaki; Ino, Aro

2011-12-01

The present study used a self-reporting questionnaire to compare suicide risk in outpatients being treated for substance use disorder at specialized hospitals to suicide risk in outpatients being treated for depressive disorder at general psychiatric clinics. Although patients in both groups exhibited an equal severity of depression, the patients with drug use disorder had a higher suicide risk than those with depressive disorder. These findings indicate that drug-abusing patients at specialized hospitals may have a severe risk of committing suicide, suggesting that carefully assessing the comorbidity of depression with drug abuse may be required for preventing suicide in drug-abusing patients.

Perfil dos idosos internados no Hospital Geral em Belém (Pará Perfil de los ancianos internados en el Hospital General en Belém (Pará Brasil Profile of the elderly admited in a General Hospital at Belém (Pará - Brazil

Directory of Open Access Journals (Sweden)

Maria Izabel Penha de Oliveira Santos

2007-03-01

Full Text Available O estudo objetivou identificar o perfil dos idosos internados em um hospital geral da rede pública de saúde em Belém (Pará. Estudo transversal, retrospectivo, analítico. Foram analisadas variáveis sociodemográficas, causas da internação, tempo de permanência, complicações e dependência para cuidados de enfermagem, em 160 prontuários, em 2001. A análise estatística foi processada pelo programa eletrônico Epi-info 6.04. Os resultados apontam: A idade variou entre 65 e 74 anos (43,1%, e os idosos eram do sexo masculino (53,1%. A maior freqüência das internações foi por doenças respiratórias (53,7%; os sintomas evidentes foram dispnéia, hipertemia e hipertensão; e o tempo médio de permanência foi de 16 dias. O tempo de internação prolongado aparece como um fator de risco no desenvolvimento de incapacidades, pela imobilidade no leito, complicações como úlceras de decúbito e demais iatrogenias. Houve dependência para os cuidados de enfermagem e necessidade de intervenção interdisciplinar.El estudio tiene como objetivo identificar el perfil de ancianos hospitalizados en hospital general de salud pública, en Belém, Estado Pará. Estudio cuantitativo, retrospectivo y analitico. Analizadas variables sócio-demográficas, causas de internación, tiempo de permanencia, complicaciónes y dependencias de la enfermería en muestra de 160 historias en 2001. Analisys estadística fué a través del programa electrónico Epi-info 6.04. Los resultados apuntaran: La edad varió de 64 a 74 años (43, y 85 (53,1% y los ancianos eran del sexo masculino, la major frecuencia de la internaciónes fueron enfermedades respiratorias (53,7%, los síntomas evidentes disnea, hipertermia na hipertensión, tiempo promedio de 16 dias. Los ancianos se internaron en media dos veces al año , tiempo de internación largo aparece como factor de riesgo en el desarrollo de incapacidad, por la inmobilidad en las camas, complicaciónes como úlceras

Hospitality Management Education and Training.

Science.gov (United States)

Brotherton, Bob, Ed.; And Others

1995-01-01

Seven articles on hospitality management training discuss the following: computerized management games for restaurant manager training, work placement, real-life exercises, management information systems in hospitality degree programs, modular programming, service quality concepts in the curriculum, and General National Vocational Qualifications…

In-hospital Mortality due to Respiratory Diseases in the Provincial Hospital of Cienfuegos. 2010-2014

OpenAIRE

Liuva Leyva Rodríguez; Orlando Morera Álvarez; Daylin Madruga Jiménez; Heidy Caridad Cordero Cabrera; Reinaldo José Pino Blanco

2016-01-01

Background: in-hospital mortality is a health indicator commonly used as a measure of quality of care. Respiratory diseases are a major cause of deaths in hospitals. Objective: to describe mortality from respiratory diseases at the Dr. Gustavo Aldereguía Lima University General Hospital in Cienfuegos. Methods: a descriptive study of all patients over 18 years old who died from respiratory diseases in the hospital of Cienfuegos from 2010 to 2014 was conducted. The variables analyzed were: age,...

General hospital costs in England of medical and psychiatric care for patients who self-harm: a retrospective analysis.

Science.gov (United States)

Tsiachristas, Apostolos; McDaid, David; Casey, Deborah; Brand, Fiona; Leal, Jose; Park, A-La; Geulayov, Galit; Hawton, Keith

2017-10-01

costs of psychosocial assessments were £228 for adults and £392 for individuals younger than 18 years. If our findings are extrapolated to England, the estimated overall annual cost of general hospital management of self-harm is £162 million per year. More use of psychosocial assessment and other preventive measures, especially for young people and against self-poisoning, could potentially lower future costs at a time of major cost pressures in the NHS. National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research, Care Oxford at Oxford Health NHS Foundation Trust, and Department of Health. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.

The Prevalence of Accidental Needle Stick Injury and their Reporting among Healthcare Workers in Orthopaedic Wards in General Hospital Melaka, Malaysia

Directory of Open Access Journals (Sweden)

Bhardwaj A

2014-07-01

Full Text Available Accidental needle-stick injuries (NSIs are a hazard for health-care workers and general public health. Orthopaedic surgeons may be more prone to NSIs due to the prevalence of bone spikes in the operative field and the use of sharp orthopaedic instruments such as drills, saws and wires. A hospital-based cross sectional study was conducted in the orthopedic wards of Melaka General Hospital. The prevalence of NSIs was 32 (20.9% and majority of it occurred during assisting in operation theatre 13(37.4%. Among them six (18.8% were specialist, 12(37.5% medical officer, 10 (31.2% house officer and four staff nurses (12.5%. Among the respondents 142 (92.8% had been immunized against Hepatitis B and 148 (96.7% participants had knowledge regarding universal precaution. The incidence of NSI among health care workers at orthopaedics ward was not any higher in comparison with the similar studies and it was found out that the prevalence was more in junior doctors compared with specialist and staff nurses and it was statistically significant.

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.

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

Science.gov (United States)

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

2014-01-01

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

General Considerations on Leadership in the Hospitality Industry. Conceptual Analysis and Practical Studies

OpenAIRE

Andreia ISPAS

2010-01-01

Leadership in the hospitality industry is still an open research field especially in describing the effects of leadership style on hotel employees. The purpose of the paper is to present and analyze the following concepts: leadership and leadership style, hospitality industry; the practical aspects of leadership in the hospitality industry and to identify relevant studies regarding the importance of leadership styles applied in this industry. The research methodology consists of analyzing the...

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

Directory of Open Access Journals (Sweden)

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.

Composition and production rate of pharmaceutical and chemical waste from Xanthi General Hospital in Greece

International Nuclear Information System (INIS)

Voudrias, Evangelos; Goudakou, Lambrini; Kermenidou, Marianthi; Softa, Aikaterini

2012-01-01

Highlights: ► We studied pharmaceutical and chemical waste production in a Greek hospital. ► Pharmaceutical waste comprised 3.9% w/w of total hazardous medical waste. ► Unit production rate for total pharmaceutical waste was 12.4 ± 3.90 g/patient/d. ► Chemical waste comprised 1.8% w/w of total hazardous medical waste. ► Unit production rate for total chemical waste was 5.8 ± 2.2 g/patient/d. - Abstract: The objective of this work was to determine the composition and production rates of pharmaceutical and chemical waste produced by Xanthi General Hospital in Greece (XGH). This information is important to design and cost management systems for pharmaceutical and chemical waste, for safety and health considerations and for assessing environmental impact. A total of 233 kg pharmaceutical and 110 kg chemical waste was collected, manually separated and weighed over a period of five working weeks. The total production of pharmaceutical waste comprised 3.9% w/w of the total hazardous medical waste produced by the hospital. Total pharmaceutical waste was classified in three categories, vial waste comprising 51.1%, syringe waste with 11.4% and intravenous therapy (IV) waste with 37.5% w/w of the total. Vial pharmaceutical waste only was further classified in six major categories: antibiotics, digestive system drugs, analgesics, hormones, circulatory system drugs and “other”. Production data below are presented as average (standard deviation in parenthesis). The unit production rates for total pharmaceutical waste for the hospital were 12.4 (3.90) g/patient/d and 24.6 (7.48) g/bed/d. The respective unit production rates were: (1) for vial waste 6.4 (1.6) g/patient/d and 13 (2.6) g/bed/d, (2) for syringe waste 1.4 (0.4) g/patient/d and 2.8 (0.8) g/bed/d and (3) for IV waste 4.6 (3.0) g/patient/d and 9.2 (5.9) g/bed/d. Total chemical waste was classified in four categories, chemical reagents comprising 18.2%, solvents with 52.3%, dyes and tracers with 18.2% and