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Sample records for center affiliated hospitals

  1. A growing opportunity: Community gardens affiliated with US hospitals and academic health centers

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    George, Daniel R.; Rovniak, Liza S.; Kraschnewski, Jennifer L.; Ryan Hanson; Sciamanna, Christopher N

    2015-01-01

    Background: Community gardens can reduce public health disparities through promoting physical activity and healthy eating, growing food for underserved populations, and accelerating healing from injury or disease. Despite their potential to contribute to comprehensive patient care, no prior studies have investigated the prevalence of community gardens affiliated with US healthcare institutions, and the demographic characteristics of communities served by these gardens. Methods: In 2013, na...

  2. Clinical research participation among adolescent and young adults at an NCI-designated Comprehensive Cancer Center and affiliated pediatric hospital.

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    Sanford, Stacy D; Beaumont, Jennifer L; Snyder, Mallory A; Reichek, Jennifer; Salsman, John M

    2017-05-01

    Minimal clinical trial participation among adolescents and young adults (AYAs) with cancer limits scientific progress and ultimately their clinical care and outcomes. These analyses examine the current state of AYA clinical research participation at a Midwestern comprehensive cancer center and affiliated pediatric hospital to advise program development and increase availability of trials and AYA participation. Enrollment is examined across all diagnoses, the entire AYA age spectrum (15-39), and both cancer therapeutic and supportive care protocols. his study was a retrospective review of electronic medical records via existing databases and registries for all AYAs. Data were collected for AYAs seen by an oncologist at the adult outpatient cancer center or at the pediatric hospital between the years 2010 and 2014. Descriptive statistics and logistic regression analyses were conducted to characterize this sample. In the pediatric setting, 42.3% of AYAs were enrolled in a study compared to 11.2% in the adult setting. Regression analyses in the pediatric setting revealed that AYAs with private insurance or Caucasian race were more likely to participate. Within the adult setting, ethnicity, race, insurance, and diagnosis were associated with study participation; 54.8% of study enrollments were for cancer therapeutic and 43.4% for supportive care studies. These results are comparable to previously published data and support the need for new local and national AYA initiatives to increase the availability of and enrollment in therapeutic clinical trials. The same is true for supportive care studies which play a crucial role in improving quality of life.

  3. Medication Errors in Hospitals: A Study of Factors Affecting Nursing Reporting in a Selected Center Affiliated with Shahid Beheshti University of Medical Sciences

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    HamidReza Mirzaee

    2015-10-01

    Full Text Available Background: Medication errors are mentioned as the most common important challenges threatening healthcare system in all countries worldwide. This study is conducted to investigate the most significant factors in refusal to report medication errors among nursing staff.Methods: The cross-sectional study was conducted on all nursing staff of a selected Education& Treatment Center in 2013. Data was collected through a teacher made questionnaire. The questionnaires’ face and content validity was confirmed by experts and for measuring its reliability test-retest was used. Data was analyzed by descriptive and analytic statistics. 16th  version of SPSS was also used for related statistics.Results: The most important factors in refusal to report medication errors respectively are: lack of reporting system in the hospital(3.3%, non-significance of reporting medication errors to hospital authorities and lack of appropriate feedback(3.1%, and lack of a clear definition for a medication error (3%. there was a significant relationship between the most important factors of refusal to report medication errors and work shift (p:0.002, age(p:0.003, gender(p:0.005, work experience(p<0.001 and employment type of nurses(p:0.002.Conclusion: Factors pertaining to management in hospitals as well as the fear of the consequences of reporting are two broad fields among the factors that make nurses not report their medication errors. In this regard, providing enough education to nurses, boosting the job security for nurses, management support and revising related processes and definitions are some factors that can help decreasing medication errors and increasing their report in case of occurrence.

  4. Improving consistency in student evaluation at affiliated family practice centers.

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    Rabinowitz, H K

    1986-01-01

    The Department of Family Medicine at Jefferson Medical College has since 1974 been successful in administering a required third-year family medicine clerkship, providing students with a structured, didactic, and experiential curriculum in six affiliated family practice centers. Prior analysis (1976-1981) had indicated, however, that variation existed in evaluating similar students, depending on the clerkship training site, i.e., three sites graded students in a significantly different fashion than the three other sites. Utilizing these data to focus on the evaluation process, a comprehensive and specific six-point plan was developed to improve consistency in evaluations at the different training sites. This plan consisted of a yearly meeting of affiliate faculty, assigning predoctoral training administrative responsibility to one faculty member at each training site, increased telephone communication, affiliate-faculty attendance at the university site evaluation session, faculty rotation to spend time at other training sites, and financial reimbursement to the affiliate training sites. After intervention, analysis (1981-1983) indicated that five of the six clerkship sites now grade students in a consistent fashion, with only one affiliate using different grading standards. The intervention was therefore judged to be successful for five of the six training sites, allowing for better communication and more critical and consistent evaluation of medical students.

  5. Are religiously affiliated hospitals more than just nonprofits? A study on stereotypical patient perceptions and preferences.

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    Seemann, Ann-Kathrin; Drevs, Florian; Gebele, Christoph; Tscheulin, Dieter K

    2015-06-01

    Recent research on patients' perceptions of different hospitals predominantly concentrates on whether hospitals are nonprofit or for-profit. Nonprofit hospitals can be subdivided into hospitals that are affiliated with a religious denomination and those that are not. Referring to the stereotypic content model, this study analyzes patients' perceptions of religious hospitals based on the factors of warmth, competence, trustworthiness and Christianity. Using a survey of German citizens (N = 300) with a one-factorial between-subject design (for-profit vs. nonprofit vs. religious nonprofit), we found that religious affiliation increases the perceptions of hospitals' trustworthiness and attractiveness. The study indicated that patients' perceptions of nonprofit hospitals with a religious affiliation differ from patients' beliefs about nonprofit hospitals without a religious affiliation, implying that research into ownership-related differences must account for hospital subtypes. Furthermore, religious hospitals that communicate their ownership status may have competitive advantages over those with a different ownership status.

  6. Senior Service Centers: A Comparison of Affiliated and Nonaffiliated Participants.

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    Kirk, Alan B.; Alessi, Hunter Downing

    2000-01-01

    The authors divided 275 elderly volunteers into 2 groups (affiliated and non-affiliated participants) and examined demographic, emotional, and practical issues that affect elderly people. There were significant differences between the groups on issues of loneliness, nutrition, and overall quality of life. (Contains 20 references and 3 tables.)…

  7. Hospitals report on cancer centers.

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    Rees, T

    2001-01-01

    Woman's Hospital, Baton Rouge, La., is first-place winner among cancer centers. Holy Cross Hospital's Michael and Dianne Bienes Comprehensive Cancer Center, Ft. Lauderdale, Fla., is named second; and, Cardinal Health System's Ball Cancer Center, Muncie, Ind., third.

  8. Hospital affiliations, co-branding, and consumer impact.

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    Gombeski, William R; Claypool, Joe O; Karpf, Michael; Britt, Jason; Birdwhistell, Mark; Riggs, Karen; Wray, Tanya; Taylor, Jan

    2014-01-01

    Alliances, affiliations, and partnerships continue to grow as one way for health care organizations to better serve their customers and compete with other organizations and networks. These organizational relationships are often promoted through co-branding joint programs and services. A study of consumers was conducted and shows that these organizational relationships positively affect consumer future behavior and benefit the organizations involved. Most importantly, the benefits of these organizational relationships grow as familiarity and understanding of the "new" partner in the market increases.

  9. Capital Investment by Independent and System-Affiliated Hospitals.

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    Carroll, Nathan W; Smith, Dean G; Wheeler, John R C

    2015-01-01

    Capital expenditures are a critical part of hospitals' efforts to maintain quality of patient care and financial stability. Over the past 20 years, finding capital to fund these expenditures has become increasingly challenging for hospitals, particularly independent hospitals. Independent hospitals struggling to find ways to fund necessary capital investment are often advised that their best strategy is to join a multi-hospital system. There is scant empirical evidence to support the idea that system membership improves independent hospitals' ability to make capital expenditures. Using data from the American Hospital Association and Medicare Cost Reports, we use difference-in-difference methods to examine changes in capital expenditures for independent hospitals that joined multi-hospital systems between 1997 and 2008. We find that in the first 5 years after acquisition, capital expenditures increase by an average of almost $16,000 per bed annually, as compared with non-acquired hospitals. In later years, the difference in capital expenditure is smaller and not statistically significant. Our results do not suggest that increases in capital expenditures vary by asset age or the size of the acquiring system.

  10. Capital Investment by Independent and System-Affiliated Hospitals

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    Nathan W. Carroll PhD

    2015-06-01

    Full Text Available Capital expenditures are a critical part of hospitals’ efforts to maintain quality of patient care and financial stability. Over the past 20 years, finding capital to fund these expenditures has become increasingly challenging for hospitals, particularly independent hospitals. Independent hospitals struggling to find ways to fund necessary capital investment are often advised that their best strategy is to join a multi-hospital system. There is scant empirical evidence to support the idea that system membership improves independent hospitals’ ability to make capital expenditures. Using data from the American Hospital Association and Medicare Cost Reports, we use difference-in-difference methods to examine changes in capital expenditures for independent hospitals that joined multi-hospital systems between 1997 and 2008. We find that in the first 5 years after acquisition, capital expenditures increase by an average of almost $16 000 per bed annually, as compared with non-acquired hospitals. In later years, the difference in capital expenditure is smaller and not statistically significant. Our results do not suggest that increases in capital expenditures vary by asset age or the size of the acquiring system.

  11. The HOSPITAL score and LACE index as predictors of 30 day readmission in a retrospective study at a university-affiliated community hospital

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    Robert Robinson

    2017-03-01

    Full Text Available Introduction Hospital readmissions are common, expensive, and a key target of the Medicare Value Based Purchasing (VBP program. Validated risk assessment tools such as the HOSPITAL score and LACE index have been developed to identify patients at high risk of hospital readmission so they can be targeted for interventions aimed at reducing the rate of readmission. This study aims to evaluate the utility of HOSPITAL score and LACE index for predicting hospital readmission within 30 days in a moderate-sized university affiliated hospital in the midwestern United States. Materials and Methods All adult medical patients who underwent one or more ICD-10 defined procedures discharged from the SIU-SOM Hospitalist service from Memorial Medical Center (MMC from October 15, 2015 to March 16, 2016, were studied retrospectively to determine if the HOSPITAL score and LACE index were a significant predictors of hospital readmission within 30 days. Results During the study period, 463 discharges were recorded for the hospitalist service. The analysis includes data for the 432 discharges. Patients who died during the hospital stay, were transferred to another hospital, or left against medical advice were excluded. Of these patients, 35 (8% were readmitted to the same hospital within 30 days. A receiver operating characteristic evaluation of the HOSPITAL score for this patient population shows a C statistic of 0.75 (95% CI [0.67–0.83], indicating good discrimination for hospital readmission. The Brier score for the HOSPITAL score in this setting was 0.069, indicating good overall performance. The Hosmer–Lemeshow goodness of fit test shows a χ2 value of 3.71 with a p value of 0.59. A receiver operating characteristic evaluation of the LACE index for this patient population shows a C statistic of 0.58 (95% CI [0.48–0.68], indicating poor discrimination for hospital readmission. The Brier score for the LACE index in this setting was 0.082, indicating good

  12. Assessment of Patient Safety Friendly Hospital Initiative in Three Hospitals Affiliated to Tehran University of Medical Sciences

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    Firoozeh Bairami

    2016-01-01

    Full Text Available Introduction: The aim of this study was to assess the status of patient safety in three hospitals, affiliated to Tehran University of Medical Sciences, based on the critical standards of Patient Safety Friendly Hospital Initiative (PSFHI. Materials and Methods:In this cross-sectional study, conducted in 2014, we used PSFHI assessment tool to evaluate the status of patient safety in three hospitals, affiliated to Tehran University of Medical Sciences; these general referral hospitals were selected purposefully. PSFHI assessment tool is comprised of 140 patient safety standards in five domains, categorized in 24 sub-domains. The five major domains include leadership and management, patient and public involvement, safe evidence-based clinical practices, safe environment, and lifelong learning. Results: All three hospitals met more than 70% of the critical standards. The highest score in critical standards (> 80% was related to the domain of leadership and management in all hospitals. The average score in the domain of safe evidence-based clinical practices was 70% in the studied hospitals. Finally, all the hospitals met 50% of the critical standards in the domains of patient and public involvement and safe environment. Conclusion: Based on the findings, PSFHI is a suitable program for meeting patient safety goals. The selected hospitals in this survey all had a high managerial commitment to patient safety; therefore, they could obtain high scores on critical standards.

  13. Prevalence of hearing loss among high risk newborns hospitalized in hospitals affiliated to Tehran University of Medical Sciences

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    Ali Zamani

    2010-04-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: American pediatric Association proposes to screen all neonates with Oto-Acoustic Emission (OAE. In developing countries, because of several limitations, health policy makers recommend to screen only in high risk patients. This study is performed with the aim to screen hearing loss in 950 high risk newborns hospitalized in hospitals affiliated to Tehran University using the OAE test."n"nMethods: A total of 950 neonates hospitalized in the Neonatal and NICU wards of Vali-e-Asr, Shariati, Medical Center and Bahrami Hospitals during the years 2004-2006 who showed at least one risk factor using TEOAE hearing test were enrolled into this cross-sectional descriptive analytical study and were diagnosed with mild deafness and total deafness. Blood exchange due to hyperbillirubinemia, septicemia, congenital heart disease, the fifth minute apgar scores below six, PROM more than six hours, epilepsia, need to NICU more than five hours, pneumonia and Oto-Toxic drugs were considered as risk factors. Data was past medical history, current disease, admission cause, sign & symptoms and complications of disease."n"nResults: Multivariate logistic regression and paired t-test showed that blood exchange, low birth weight and low

  14. The Survey of Hospitals Affiliated with Kerman University of Medical Sciences in Preparedness Response to Disasters

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    Mahmood Nekoei-Moghadam

    2016-12-01

    Full Text Available Background and Objectives : Natural and man-made disasters always threaten human lives and properties. Iran as one of the disastrous countries has experienced both natural and man-made disasters. Preparedness is one of the vital elements in response to disasters. So, this study was arranged and carried out with the aim of measuring preparedness of hospitals affiliated with Kerman University of Medical Sciences in response to disasters. Material and Methods: This cross-sectional descriptive study was performed in four hospitals affiliated with Kerman University of Medical Sciences in 2015. A satisfactorily valid (kappa: 0.8 and reliable checklist was used. Data were analyzed using descriptive statistics in SPSS version 17. Results: The surveyed hospitals with the total score of 67 % were in good condition in response to disasters. The emergency departments (83%, reception (75%, communication (69%, education (70%, supply services (61%, human sources (71% and command (79% also acquired good scores. Discharge units (60%, traffic (55% and security (53% were in moderate condition in preparedness. In necessary fields for response to disasters, the whole research units acquired 67% which showed good condition in this field. Conclusion: The surveyed hospitals were in prepared and suitable condition in the emergency departments, reception, communication, education, human sources and command. In order to improve and enhance the preparedness, a schedule plan should be programmed for some elements such as discharge, transfer, traffic, security and six-crucial elements of the field.

  15. Anesthesiologists Are Affiliated with Many Hospitals Only Reporting Anesthesia Claims Using Modifier QZ for Medicare Claims in 2013.

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    Miller, Thomas R; Abouleish, Amr; Halzack, Nicholas M

    2016-04-01

    We examined hospitals that exclusively used the billing modifier QZ in anesthesia claims for a 5% sample of Medicare beneficiaries in 2013. We used a national Medicare provider file to identify physician anesthesiologists and nurse anesthetists affiliated with these hospitals. Among the 538 hospitals that exclusively reported the modifier QZ, 47.5% had affiliated physician anesthesiologists. These hospitals accounted for 60.4% of the cases. Our results illustrate the challenges of using modifier QZ to describe anesthesia practice arrangements in hospitals. The modifier QZ does not seem to be a valid surrogate for no anesthesiologist being involved in the care provided.

  16. Students Perceptions on the quality of clinical supervision among the 12 affiliated hospital of Medical Faculty of UNISSULA

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    Dian Apriliana Rahmawatie

    2011-12-01

    Design and Methods: This study involved 181 students of clinical internship of the year 2003, 2004 and 2005 of medical faculty of Islamic Sultan Agung University having the clinical rotation at the stage of surgery, obsgyn, pediatrics, internal medicine, ENT, neurology, dermatology and venerology, psychiatry, across the affiliated hospitals. The subject were divided into groups based on the hospital they were placed. Clinical Teaching Effectiveness Instrument (CTEI adapted in bahasa Indonesia was used. The Descriptive and Kruskal-Wallis test were applied for the data analysis. Results: Means of the effectiveness of clinical supervision for 12 affiliated hospitals ranged from 3.25 to 4.02. Kruskal-Wallis test resulted in the value of Chi-S=13.32 and p=0.27. Conclusion: Over all the clinical supervision for the 12 affiliated hospitals is perceived good and shows no significant difference. However the practice of clinical supervision varies among the hospitals (Sains Medika, 3(2:135-149.

  17. Cost awareness among doctors in an Irish university-affiliated teaching hospital

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    William H.C. Tiong

    2011-11-01

    Full Text Available Previous studies in USA and Canada have found that physicians and physicians in training have a limited understanding of medical care costs. In this study, we set out to survey all grades of doctors in the surgical department, emergency department, and anaesthetic department in a university-affiliated, Irish teaching hospital. Open-ended questionnaires on cost of 25 routinely used items in the hospital were sent to each department. The aims of the study were to assess the present knowledge of cost among the various grades of doctors, and to evaluate the level of professional experience on cost awareness and their confidence in their estimates. We had an overall response rate of 56.8% with 68.5% of doctors admitted to have estimated more than 90% of their responses. Ninety three percent of doctors have no confidence in their estimates on cost of listed items. We found that the lack of cost awareness was universal among doctors of all grades (P = 0.236. The doctors in our study population showed a high level of inaccuracy on their estimates of cost of routinely used items with 84% of the items overestimated. Our results were discouraging and demonstrated that considerable educational activity will be necessary if doctors are to be more cost effective in meeting the national health care budget.

  18. Tribally Affiliated Child-Care Center Environment and Obesogenic Behaviors in Young Children.

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    Sisson, Susan B; Stoner, Julie; Li, Ji; Stephens, Lancer; Campbell, Janis E; Lora, Karina R; Arnold, Sandra H; Horm, Diane; DeGrace, Beth

    2017-03-01

    Child-care centers are an integral part of life for many families with young children. American Indian children are at elevated health risk because of higher levels of obesity and associated health behaviors. Our aim was to assess the child-care environment and children's physical activity (PA) and dietary intake in young children attending tribally affiliated child care. We conducted a cross-sectional study. Participants were from 11 tribally affiliated child-care centers across Oklahoma and included 82 children aged 3 to 5 years old. Classroom observations were conducted using the Environmental and Policy Assessment Observation to measure PA and nutrition environments. Children wore an ActiGraph GT3X accelerometer and lunchtime plate waste was observed. Descriptive statistics, including mean±standard deviation and frequencies, were calculated for the children's behaviors and environment. The total environment score was 23.9±5.2 (maximum=43). The nutrition score was 12.5±3.1 (maximum=21). The PA score was 11.7±2.2 (maximum=22). The participants were 3.8±0.1 years old, 55% were male, 67% were American Indian, and 38% were overweight or obese. Accelerometers were worn for 5.9±1.7 hours, excluding naptime. Children accumulated 4.3±2.2 min/h of moderate to vigorous PA, 4,294±1,883 steps/day, and 12.1±3.7 steps/min. At lunch, children were served 510±241 kcal, and consumed 387±239 kcal. Lunches consisted of 47% carbohydrate, 20% protein, and 33% fat. Total number of F/V served was 2.9±1.9 and consumed was 2.3±1.8, while whole grains served and consumed were 0.3±0.4 and 0.2±0.4, respectively, and lean proteins served and consumed were 0.3±0.4 and 0.2±0.4, respectively. This study describes obesogenic aspects of the child-care environment and identifies areas for improvement. Children did not accumulate adequate PA or consume calories or fat excessively. Children consumed multiple F/V; however, more whole grains and lean proteins could be provided

  19. Birthing Centers and Hospital Maternity Services

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    ... What are the hospital's statistics for cesarean sections, episiotomies, and mortality? (Keep in mind, though, that these ... What are the center's statistics for hospital transfers, episiotomies, and mortality? What procedures are followed after your ...

  20. Prevalence of Diabetes Mellitus in the Surgical Population of the University of Puerto Rico Affiliated Hospitals: A Study using the Surgery Database.

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    Cruz, Norma I; Santiago, Elvis; Abdul-Hadi, Anwar

    2016-09-01

    To evaluate the prevalence of diabetes mellitus in the surgical population of the University of Puerto Rico (UPR)-affiliated hospitals. We examined all the surgical cases that were entered into the Surgical Database from April 1, 2014 through September 30, 2014. This database collects patient and procedural information from different surgical services of various UPR-affiliated hospitals (the University District Hospital, the University Pediatric Hospital, the UPR Carolina Hospital, the Dr. Isaac Gonzalez Oncologic Hospital, the PR Cardiovascular Center [thoracic service], the Pavia Hospital [colorectal service], and the Auxilio Mutuo Hospital [colorectal and oncological services]). The prevalence of diabetes mellitus (types 1 and 2 combined) was estimated, and the nondiabetic and diabetic groups were compared. The difference between groups was evaluated using a Chi2 test, Student's t-test, or ANOVA, whichever was appropriate, with a p-value of less than 0.05 being considered significant. Information from 2,603 surgical patients was available. The mean age of the group was 49 (±23) years. The gender distribution indicated that 56% were women and 44% were men. Diabetes was present in 21% of the surgical population, increasing to 40% in patients aged 65 and over. The surgical procedures most frequently required by diabetic patients were in the categories of general surgery (36%), colorectal surgery (22%), vascular surgery (16%) and oncologic surgery (14%). Complications (5%, diabetic group vs. 2%, nondiabetic group; p surgery than did the non-diabetic patients. Surgeons must consider the specific needs of these diabetic patients in order to provide optimal care.

  1. Evaluation of hospital information systems of the teaching hospitals affiliated to Shiraz University of Medical Sciences, based on the American College of Physicians Criteria

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    E Emami

    2014-01-01

    Full Text Available Introduction: Hospital information system (HIS is a computerized system used for management of hospital information as an electronic device and has an indispensible role in the field of qualified healthcare services. Nevertheless, compared to other industrial and commercial systems, this information system is lagged in using the information technology and applying the controlling standards for satisfying the customers. Therefore, the present study aimed to evaluate HIS, identify its strength and weak points, and improve it in the teaching hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran. Method: The present descriptive, cross-sectional study was conducted in the 8 teaching hospitals of Shiraz University of Medical Sciences which used HIS in 2011. The study data were collected through interview and direct observation using the criteria of American Physician College check-list. Finally, SPSS statistical software was used to analyze the data through descriptive statistics. Results: The study results showed that laboratory and medical records had respectively the most %43.5 and the least %21.03 conformity to the criteria of American College of Physicians. Also, Faghihi and Zeinabiye hospitals respectively had the most %41.8 and the least %25.2 conformity to the American College of Physicians’ criteria. In pharmacy, data entrance mechanism and presentation of reports had complete conformity to the scales of American College of Physicians, while drug interactions showed no conformity. In laboratory, data entrance mechanism had complete conformity to the above-mentioned criteria and keeping the test history had %87.5 conformity. The possibility of receiving information from centers out of laboratory had no conformity to the desired criteria. In the radiology department, data entrance mechanism had complete conformity to the above-mentioned criteria and keeping the test history had %87.5 conformity. Besides, the possibility

  2. The Hospital-Based Drug Information Center.

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    Hopkins, Leigh

    1982-01-01

    Discusses the rise of drug information centers in hospitals and medical centers, highlighting staffing, functions, typical categories of questions received by centers, and sources used. An appendix of drug information sources included in texts, updated services, journals, and computer databases is provided. Thirteen references are listed. (EJS)

  3. The facilitating factors and barriers encountered in the adoption of a humanized birth care approach in a highly specialized university affiliated hospital

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    Behruzi Roxana

    2011-11-01

    Full Text Available Abstract Background Considering the fact that a significant proportion of high-risk pregnancies are currently referred to tertiary level hospitals; and that a large proportion of low obstetric risk women still seek care in these hospitals, it is important to explore the factors that influence the childbirth experience in these hospitals, particularly, the concept of humanized birth care. The aim of this study was to explore the organizational and cultural factors, which act as barriers or facilitators in the provision of humanized obstetrical care in a highly specialized, university-affiliated hospital in Quebec province, in Canada. Methods A single case study design was chosen. The study sample included 17 professionals and administrators from different disciplines, and 157 women who gave birth in the hospital during the study. The data was collected through semi-structured interviews, field notes, participant observations, a self-administered questionnaire, documents, and archives. Both descriptive and qualitative deductive content analyses were performed and ethical considerations were respected. Results Both external and internal dimensions of a highly specialized hospital can facilitate or be a barrier to the humanization of birth care practices in such institutions, whether independently, or altogether. The greatest facilitating factors found were: caring and family- centered model of care, professionals' and administrators' ambient for the provision of humanized birth care besides the medical interventional care which is tailored to improve safety, assurance, and comfort for women and their children, facilities to provide a pain-free birth, companionship and visiting rules, dealing with the patients' spiritual and religious beliefs. The most cited barriers were: the shortage of health care professionals, the lack of sufficient communication among the professionals, the stakeholders' desire for specialization rather than humanization, over

  4. The facilitating factors and barriers encountered in the adoption of a humanized birth care approach in a highly specialized university affiliated hospital.

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    Behruzi, Roxana; Hatem, Marie; Goulet, Lise; Fraser, William

    2011-11-25

    Considering the fact that a significant proportion of high-risk pregnancies are currently referred to tertiary level hospitals; and that a large proportion of low obstetric risk women still seek care in these hospitals, it is important to explore the factors that influence the childbirth experience in these hospitals, particularly, the concept of humanized birth care.The aim of this study was to explore the organizational and cultural factors, which act as barriers or facilitators in the provision of humanized obstetrical care in a highly specialized, university-affiliated hospital in Quebec province, in Canada. A single case study design was chosen. The study sample included 17 professionals and administrators from different disciplines, and 157 women who gave birth in the hospital during the study. The data was collected through semi-structured interviews, field notes, participant observations, a self-administered questionnaire, documents, and archives. Both descriptive and qualitative deductive content analyses were performed and ethical considerations were respected. Both external and internal dimensions of a highly specialized hospital can facilitate or be a barrier to the humanization of birth care practices in such institutions, whether independently, or altogether. The greatest facilitating factors found were: caring and family- centered model of care, professionals' and administrators' ambient for the provision of humanized birth care besides the medical interventional care which is tailored to improve safety, assurance, and comfort for women and their children, facilities to provide a pain-free birth, companionship and visiting rules, dealing with the patients' spiritual and religious beliefs. The most cited barriers were: the shortage of health care professionals, the lack of sufficient communication among the professionals, the stakeholders' desire for specialization rather than humanization, over estimation of medical performance, finally the training

  5. P30 Cancer Center Support Grant Administrative Supplements to NCI-designated Cancer Centers not affiliated with the Experimental Therapeutics Clinical Trials Network (ETCTN) to support participation in the ETCTN

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    P30 Cancer Center Support Grant Administrative Supplements to NCI-designated Cancer Centers not affiliated with the Experimental Therapeutics Clinical Trials Network (ETCTN) to support participation in the ETCTN

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

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

    2010-01-01

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

  7. The Relationship of Centralization, Organizational Culture and Performance Indexes in Teaching Hospitals Affiliated to Tehran University of Medical Sciences

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    Amir Ashkan Nasirpour

    2010-10-01

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

  8. The Relationship of Centralization, Organizational Culture and Performance Indexes in Teaching Hospitals Affiliated to Tehran University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Amir Ashkan Nasirpour

    2010-09-01

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

  9. Changes in Hospital-Physician Affiliations in U.S. Hospitals and Their Effect on Quality of Care.

    Science.gov (United States)

    Scott, Kirstin W; Orav, E John; Cutler, David M; Jha, Ashish K

    2017-01-03

    Growing evidence shows that hospitals are increasingly employing physicians. To examine changes in U.S. acute care hospitals that reported employment relationships with their physicians and to determine whether quality of care improved after the hospitals switched to this integration model. Retrospective cohort study of U.S. acute care hospitals between 2003 and 2012. U.S. nonfederal acute care hospitals. 803 switching hospitals compared with 2085 nonswitching control hospitals matched for year and region. Hospitals' conversion to an employment relationship with any of their privileged physicians. Risk-adjusted hospital-level mortality rates, 30-day readmission rates, length of stay, and patient satisfaction scores for common medical conditions. In 2003, approximately 29% of hospitals employed members of their physician workforce, a number that rose to 42% by 2012. Relative to regionally matched controls, switching hospitals were more likely to be large (11.6% vs. 7.1%) or major teaching hospitals (7.5% vs. 4.5%) and less likely to be for-profit institutions (8.8% vs. 19.9%) (all P values Hospital Association annual questionnaire, yet this measure has been used by others to examine effects of integration. The study examined performance up to 2 years after evidence of switching to an employment model; however, beneficial effects may have taken longer to appear. During the past decade, hospitals have increasingly become employers of physicians. The study's findings suggest that physician employment alone probably is not a sufficient tool for improving hospital care. Agency for Healthcare Research and Quality and National Science Foundation Graduate Research Fellowship.

  10. Maxillary fractures: a review of 56 cases in a university affiliated hospital

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    Farahvash MR

    2009-07-01

    Full Text Available "n Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 st1":*{behavior:url(#ieooui } /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:Arial; mso-bidi-theme-font:minor-bidi;} Background: The aim of this study was to describe the prevalence of different types of maxillary fractures, concurrent fractures and accompanying signs and symptoms. Trauma is the second cause of mortality in Iran, after cardiovascular diseases. In traumatic patients, head, neck and facial bones fractures are common. The maxillary fractures are seen much less commonly than the fractures of the mandible, zygoma, or nose. Maxillary fractures include: (Le fort I, II, III fractures- alveolar process fracture and Sagittal fracture. The most common cause of maxillary fracture is motor vehicle accidents. "n"n Methods: This descriptive cross sectional study designed on 56 patients with maxillary fractures in a referral educational trauma center of Tehran. Sample size was the patients who referred to this hospital with maxillary fracture during past seven years. "n"nResults: Forty eight (86% patients were male and 8(14% were female. Male to female ratio was 6/1. Mean age of patients was 30 years. The most common type of maxillary fracture was infra orbital rim and floor fracture. Among Le fort fracture; Le fort type II was the most common. Paresthesia of infra orbital nerve and malocclusion were

  11. Prevalence, Severity and Factors Related to Mastalgia among Women Referring to Health Centers Affiliated with Shiraz University of Medical Sciences

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    Farideh Vaziri

    2016-04-01

    Full Text Available Background: Mastalgia is a common problem among women. Severe mastalgia can have a negative impact on sexual, physical and sleep activities and behaviors. Regarding the absence of a study on the prevalence and severity of mastalgia in southern Iran, the current study was conducted. Methods: This is an analytical cross-sectional study. The participants were women who referred to health centers affiliated to Shiraz University of Medical Sciences in Shiraz. The inclusion criteria were willingness to participate in the study, not being pregnant and breastfeed. The severity of breast pain was calculated with visual analog scale. The data of 845 questionnaires were analyzed with SPSS software. Results: The participants’ age ranged from 15-50 years; the mean age was 32.84±9.49 years. Among 845 participants, 33% (279 of them had experienced mastalgia in the past three months. Among those who had experienced mastalgia, 81% (226 had cyclical mastalgai and 19% (53 had non-cyclical mastalgia. The mean of pain score was 4.32±2.38 and 12.9% of the participants (36 had pain scores of 8 to 10. The impact of mastalgia on daily and sexual activities and sleep behaviors was reported 9.31% (26, 12.66% (29 and 13.97% (36, respectively. Conclusion: Results of this study showed that the spread of mastalgia in women referred to health centers affiliated to Shiraz University of Medical Sciences is lower than that reported in western studies and has lesser effects on their daily, sexual and sleep activities and behaviors. We suggest further studies about mastalgia in others locations in Iran.

  12. The Impact of VA's Geriatric Research, Education and Clinical Centers on Academic Affiliates

    Science.gov (United States)

    Bragg, Elizabeth J.; Meganathan, Karthikeyan; Shay, Kenneth; Gilman, Stuart C.; Zeiss, Robert A.; Hettler, Debbie L.

    2011-01-01

    The education mission of the Department of Veterans Affairs (VA) is to train health professionals to benefit VA and the United States. One approach for achieving that mission, along with VA's research and clinical missions, was the establishment of Geriatric Research, Education and Clinical Centers (GRECCs) in 1975. These were developed at VA…

  13. Relationships between Organizational Climate and Organizational Silence with Psychological Empowerment of Employees in Hospitals Affiliated with Birjand University of Medical Sciences; 2015

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    Parviz Aghaie Borzabad

    2015-10-01

    Full Text Available Background and Aim: Identifying factors associated with employees empowerment of their working centers can promote organizational performance of hospitals. The current study aimed at investigating the relationship of both organizational climate and organizational silence with psychological empowerment in the public hospitals affiliated with Birjand University of Medical Sciences (BUMS. Materials and Methods: This cross-sectional and correlational study was carried out in 2015. Using a stratified randomized sampling, 400 employees were selected from the public. hospitals affiliated with BUMS.  Data collection tools were. three self-administered questionnaires including organizational climate, organizational silence, and psychological empowerment. . Validity and reliability of the questionnaires were verified using experts judgment and Cronbach alpha coefficients more than 0.7, respectively. Data analysis was done by means of SPSS (V: 18 software using one sample t test, independent t test, Pearson correlation coefficient, and one-way ANOVA. The cut-off point of 70%.of Likert-type scale (3.5 was considered as an acceptable mean for each variable. Results: The mean organizational climate and organizational silence was 2.45 and 3.18, respectively which did not correspond with an acceptable mean (P<0.05. Although the mean psychological construct which was 3.6 had an acceptable value, mean of the two other sub-variables i.e. “trust to others” and “self-determination” were 3.2±0.83 and 3.42±0.67, respectively; and they were not at an acceptable level (P<0.05. It is observed that both organizational climate and organizational silence were positively correlated to psychological empowerment with 0.6 and 0.58 coefficients, respectively (P<0.05. Conclusion:  It is suggested that the hospitals administrators should promote the psychological empowerment of their employees  through improving organizational climate and decreasing organizational

  14. Exploring the Rate and Causes of Deductions Imposed on Social Security and Health Insurance`s Bills Related to Inpatients in Two Hospitals Affiliated with Tabriz University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Hossein Rezvanjou

    2017-02-01

    Full Text Available Background and Objectives: Annually, a large amount of fees that are paid by hospitals, will not be reimbursed as deductions by health insurance which imposes irreparable financial losses on hospitals. The purpose of this study was to determine the amount of deductions imposed on social security and health insurance`s bills and its causes related to inpatients in two hospitals affiliated with Tabriz University of Medical Sciences. Material and Methods: This was a cross-sectional study conducted in Alavi and Madani hospitals affiliated with Tabriz University of Medical Sciences by using 2015 data.  Researcher-designed checklist was used for data collecting. According to population size, census method and random sampling were used in Alavi and Madani hospitals, respectively. Gathered data were analyzed through descriptive statistics assisted by Excel v.13 software. Results: In the studied hospitals, most of the deductions in the Alavi and Madani hospitals were related to charge of surgeon and angioplasty, respectively. Also, in Alavi Hospital among deductions factors, the most repeated one was extra application in contrary to determined tariffs. In both hospitals, the role of the human factor in cases of error cannot be denied. Extra applications, inaccuracy in registration costs and lack of knowledge of the approved insurance tariffs are the main important factors influential on the deduction. Conclusion: Due to high rates of preventable deductions in both hospitals and being given the multiplicity and variety of services offered at the health centers, establishing income monitoring unit in hospitals and use of experienced staff is inevitable.

  15. The Survey of Hospitals Managers’ Attitude about Patient Complaints Investigating System in Hospitals Affiliated to Mashhad University of Medical Sciences

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    Mahboubeh Asadi

    2015-10-01

    Conclusion: According to the findings and relatively positive attitude of managers, it is necessary to organize a team for improving and revising patient complaints investigating system in each hospital. Also managers’ attention to staff satisfaction and their educational needs is important for reducing patient complaints.

  16. Nutritional status among adult patients admitted to an university-affiliated hospital in Spain at the time of genoma.

    Science.gov (United States)

    Planas, M; Audivert, S; Pérez-Portabella, C; Burgos, R; Puiggrós, C; Casanelles, J M; Rosselló, J

    2004-10-01

    Although malnutrition in hospitalized patients is generally associated with increasing morbidity and mortality, it is yet a widely unknown problem in hospitals. The aim of this study was to assess the nutritional status of patients admitted to a university-affiliated hospital in Spain using anthropometry measurements and the Subjective Global Assessment (SGA) technique. We enrolled 400 patients selected at random using a computer software program. The primary end-point was nutritional status determined within 48 h of admission by anthropometric data (body mass index, triceps skinfold thickness, and upper arm muscle circumference) and by the SGA technique. Using anthropometric data, patients were considered to have normonutrition or malnutrition. Those with malnutrition, were subdivided in patients with low (undernutrition) or high (overnutrition) body weight. Through SGA patients were classified as having normonutrition or malnutrition (moderate and severe). Secondary end-points were hospital length of stay (LOS), mortality, and readmissions (total and non-elective readmissions) over the next 6 months. Overall population, patients scheduled admitted, patients admitted from emergency room, and those with any cancer were individually analyzed. The frequency of malnutrition varied from 72.7% assessed by anthropometry (undernutrition in 26.7% and overnutrition in 46.0%), to 46% using SGA. Malnutrition was not related to the type of admission neither to the diagnosis of cancer. Of 400 patients analyzed, two patients died (0.5%). Using SGA, LOS was significantly higher in patients with malnutrition vs. those with normonutrition, in the overall population and in patients scheduled admitted, and there were more total and non-elective readmissions in patients with malnutrition than in patients with normonutrition in the overall population, in patients scheduled admitted and in those with cancer. When we used anthropometric data, LOS was superior in undernutrition compared

  17. 高校附属医院人力资源柔性管理应用的探索%Human Resources Soft Management of Affiliated Hospital of College

    Institute of Scientific and Technical Information of China (English)

    勇前; 司慧捷; 黄贞杰

    2012-01-01

    Modern human resources management of affiliated hospital of college has become the important issue concerning by hospital managers. The article analyzes its situation and the application of soft management in human resources management of affiliated hospital of college.%现代高校附属医院的人力资源管理已成为医院管理者日益关注的重要课题.本文分析了高校医院人力资源管理的现状,并针对现状提出了柔性管理在高校医院人力资源管理中应用的探讨.

  18. Using a qualitative approach for understanding hospital-affiliated integrated clinical and fitness facilities: characteristics and members' experiences.

    Science.gov (United States)

    Yang, Jingzhen; Kingsbury, Diana; Nichols, Matthew; Grimm, Kristin; Ding, Kele; Hallam, Jeffrey

    2015-06-19

    With health care shifting away from the traditional sick care model, many hospitals are integrating fitness facilities and programs into their clinical services in order to support health promotion and disease prevention at the community level. Through a series of focus groups, the present study assessed characteristics of hospital-affiliated integrated facilities located in Northeast Ohio, United States and members' experiences with respect to these facilities. Adult members were invited to participate in a focus group using a recruitment flyer. A total of 6 focus groups were conducted in 2013, each lasting one hour, ranging from 5 to 12 participants per group. The responses and discussions were recorded and transcribed verbatim, then analyzed independently by research team members. Major themes were identified after consensus was reached. The participants' average age was 57, with 56.8% currently under a doctor's care. Four major themes associated with integrated facilities and members' experiences emerged across the six focus groups: 1) facility/program, 2) social atmosphere, 3) provider, and 4) member. Within each theme, several sub-themes were also identified. A key feature of integrated facilities is the availability of clinical and fitness services "under one roof". Many participants remarked that they initially attended physical therapy, becoming members of the fitness facility afterwards, or vice versa. The participants had favorable views of and experiences with the superior physical environment and atmosphere, personal attention, tailored programs, and knowledgeable, friendly, and attentive staff. In particular, participants favored the emphasis on preventive care and the promotion of holistic health and wellness. These results support the integration of wellness promotion and programming with traditional medical care and call for the further evaluation of such a model with regard to participants' health outcomes.

  19. Drug use evaluation of cefepime in the first affiliated hospital of Bengbu medical college: a retrospective and prospective analysis.

    Science.gov (United States)

    Shi, Qingping; Ding, Feng; Sang, Ran; Liu, Yan; Yuan, HaoYu; Yu, Meiling

    2013-04-03

    Cefepime is a fourth generation cephalosporin antimicrobial. Its extended antimicrobial activity and infrequent tendency to engender resistance make it popular for the treatment of infections. However, proper use of cefepime has not been studied adequately. In this study, we used a retrospective cohort and a prospective cohort to evaluate the usage pattern, adverse effects and cost-effectiveness of cefepime by conducting a drug use evaluation (DUE) program in the First Affiliated Hospital of Bengbu Medical College, Anhui, China. The DUE criteria for cefepime were established by applying literature review and expert consultation, an effective method to promote interventions that will improve patient outcomes and the cost-effectiveness of drug therapy. According to the criteria, we performed a cross-sectional retrospective (cycle A) study on 96 hospitalized patients who received cefepime treatment and a prospective (cycle B) study on 111 hospitalized patients with cefepime treatment intervention. After identifying problems with usage and completing a cefepime use evaluation for cycle A, 2 months of educational intervention among professionals were given and a more effective and rational system of cefepime use was set up. During the 2 months, the lectures were arranged and attendance of prescribers was required. The data from cycle A showed that the biggest problem was irrational prescription of cefepime; bacterial culture and drug sensitivity tests for cefepime were also not carried out. Following 2 months of educational intervention among professionals, the results for cycle B showed that the correct indication rate was 94.59%, compared with 84.38% in cycle A. Use of bacterial culture and sensitivity tests also improved, by 88.29% in cycle B compared with 65.22% in cycle A. Compared with cycle A, the significantly improved items (P monitoring, renal function monitoring, dose and duration, dosing frequency and correct medication combinations. Cefepime can be used

  20. 深圳大学附属医院绿色医院设计思考%Shenzhen University Affiliated Hospital Green Hospital Design Thinking

    Institute of Scientific and Technical Information of China (English)

    王岗; 贾敬龙; 田少斌

    2012-01-01

    深圳大学附属学府医院总建筑面积13.5万m2,1300床,位于深圳大学城东侧,其绿色医院思考从总图及建筑单体两个层面展开阐述。总平面以合理的功能分区,清晰的医疗流线.科学的远近期结合,完美的新旧建筑融合阐述了绿色医院的宏观构想。建筑单体以舒展的体形,合理的科室布局.极富特色的人性化关怀诠释了绿色医院的内涵。总之,绿色医院设计的前提基础:科学合理的指标体系。绿色医院设计的核心内涵:建筑节能与人性化关怀,绿色医院设计的终极目标:绿色医院评价标准的实现。%Shenzhen University affiliated universities hospitals with a total construction area of 13. 50000 square meters, with 800 beds, located on the eastern side of the city hospital of Shenzhen University, the green reflections from the general and single buildin g on two levels. General plane with reasonable function division, clear medical streamline, far near future combined with science, perfect architectural fusion elaborated green hospital macro conception. Single building to stretch the body shape, reasonable room layout, highly characteristic of Humane Care explains the connotation of the green hospital. In short, the green hospital design premise: scientific and reasonable index system. Green design of hospital core connotation: building energy conservation and humane care, green hospital design is the ultimate goal: a green hospital evaluation standards implementation.

  1. Jackson Park Hospital Green Building Medical Center

    Energy Technology Data Exchange (ETDEWEB)

    William Dorsey; Nelson Vasquez

    2010-03-31

    Jackson Park Hospital completed the construction of a new Medical Office Building on its campus this spring. The new building construction has adopted the City of Chicago's recent focus on protecting the environment, and conserving energy and resources, with the introduction of green building codes. Located in a poor, inner city neighborhood on the South side of Chicago, Jackson Park Hospital has chosen green building strategies to help make the area a better place to live and work. The new green building houses the hospital's Family Medicine Residency Program and Specialty Medical Offices. The residency program has been vital in attracting new, young physicians to this medically underserved area. The new outpatient center will also help to allure needed medical providers to the community. The facility also has areas designated to women's health and community education. The Community Education Conference Room will provide learning opportunities to area residents. Emphasis will be placed on conserving resources and protecting our environment, as well as providing information on healthcare access and preventive medicine. The new Medical Office Building was constructed with numerous energy saving features. The exterior cladding of the building is an innovative, locally-manufactured precast concrete panel system with integral insulation that achieves an R-value in excess of building code requirements. The roof is a 'green roof' covered by native plantings, lessening the impact solar heat gain on the building, and reducing air conditioning requirements. The windows are low-E, tinted, and insulated to reduce cooling requirements in summer and heating requirements in winter. The main entrance has an air lock to prevent unconditioned air from entering the building and impacting interior air temperatures. Since much of the traffic in and out of the office building comes from the adjacent Jackson Park Hospital, a pedestrian bridge connects the two

  2. "Hospes": The Wabash Center as a Site of Transformative Hospitality

    Science.gov (United States)

    Jones, Carolyn M.

    2007-01-01

    The Wabash Center for Teaching and Learning in Theology and Religion is a place of hospitality and its staff the epitome of the "good host." This essay explores the meaning of hospitality, including its problematic dimensions, drawing on a number of voices and texts: Jacques Derrida's "Of Hospitality"; Henri M. Nouwen's "Reaching Out: The Three…

  3. Jackson Park Hospital Green Building Medical Center

    Energy Technology Data Exchange (ETDEWEB)

    Dorsey, William [Jackson Park Hospital Foundation, Chicago, IL (United States); Vasquez, Nelson [Jackson Park Hospital Foundation, Chicago, IL (United States)

    2010-05-01

    Jackson Park Hospital completed the construction of a new Medical Office Building on its campus this spring. The new building construction has adopted the City of Chicago's recent focus on protecting the environment, and conserving energy and resources, with the introduction of green building codes. Located in a poor, inner city neighborhood on the South side of Chicago, Jackson Park Hospital has chosen green building strategies to help make the area a better place to live and work.

  4. The role of birthing centers in hospital marketing.

    Science.gov (United States)

    Kohler, D L; Bellenger, D N; Whyte, G E

    1990-01-01

    The research reported here investigated the repeat purchase intentions, key decision-making roles, and decision criteria related to hospital birthing centers. The results suggest that a marketing program with an emphasis on quality of care and high comfort standards directed to expectant mothers offers a realistic opportunity for hospital marketers.

  5. Birthing Centers and Hospital Maternity Services

    Science.gov (United States)

    ... necessary to treat sick babies and moms. A birth center can provide natural pain control and pain control with mild narcotic medications, ... be an option. Women who want a natural birth with minimal medical intervention or pain control may feel more comfortable in a birth ...

  6. Readiness of hospitals affiliated with Shiraz university of medical sciences for implementation of radio frequency identification technology

    Directory of Open Access Journals (Sweden)

    Saeid Ebrahimi

    2015-10-01

    Full Text Available Introduction: Applying information technology in healthcare system is one of the most important criteria of the World Health Organization for evaluating the quality of healthcare systems of different countries. Moreover, applying this technology in different parts of health care system can create great potentials for improving the quality of healthcare services. In this regard, Radio Frequency Identification (RFID technology is one of the most practical technologies in identifying and collecting data. The present study aimed to compare the readiness of Shiraz University of medical sciences hospitals for implementation of RFID system in 2014. Method: This was a cross-sectional study conducted in 2014. The research population consisted of 110 senior and middle managers. Due to the limited research population, census method was used. The research tool was a questionnaire prepared by the researcher to investigate the hospitals’ readiness for implementation of RFID technology. Face and content validity of the questionnaire were approved by the experts. Cronbach’s alpha test was run to determine the reliability of the questionnaire (data were considered significant at p <0.05. Also, the data were analyzed in SPSS software using descriptive statistics (mean, standard deviation, and percentage and inferential statistics (one-way ANOVA. Results: The study showed that the readiness level of the hospitals was moderate. Comparing the mean of the total readiness level in the hospitals under the study revealed that there was a statistically significant difference between hospital M and other hospitals (P=0.003. However, the total readiness of hospital I was higher than others. Conclusion: Among 13 hospitals under the study, the hospitals I and A were moderately ready and others were not ready for implementation of RFID technology. Thus, considering various applications and advantages of RFID technology, it is suggested that the hospitals should prepare

  7. Performance Ratio Analysis: A National Study on Iranian Hospitals Affiliated to Ministry of Health and Medical Education

    Directory of Open Access Journals (Sweden)

    Peivand Bastani

    2013-08-01

    Full Text Available Background: This study was designed to present and compare Iranian hospitals` performance applying ratio analysis technique.Methods: This cross-sectional survey was conducted to present an instant image of 139 Iranian hospitals` performance status applying ratio analysis as one of the non parametric technical efficiency assessment methods in 2008. Data was collected using nine dimensional questionnaires supported by world wide web to achieve main hospital ratios. Final analysis was performed applying classic statistics and relevant statistical tests on significant level of 0.05. Results: Four hospital performance indicators were estimated in the studied hospitals as follows: Bed turnover rate (BTR was fluctuated from 64.5 to 114.8 times for hospitals located in rich and poor areas respectively. Moreover Bed Interval Rate (BIT was calculated 1.36 versus 2.4 in the poor and rich areas. Average length of stay (ALS was computed 1.82 for the poor regions but 3.27 for the rich ones furthermore, a positive statistical significant correlation was seen between ALS and the hospital size (P=0.001,r=0.28. Average bed occupancy rate (BOR was 57.8% and its variation was from 31.4% to 64.5% depending on the hospital size so that there was a positive statistical significant relationship between the hospital size and BOR (P=0.006, r=0.32.Conclusion: Regarding that BOR, ALS, BTR and BIT along with mortality rates are mentioned as the most considerable performance indicators, applying analytic frameworks more than considering single and raw indicators are severely recommended.

  8. Randomized trial of a patient-centered hospital unit.

    Science.gov (United States)

    Martin, D P; Diehr, P; Conrad, D A; Davis, J H; Leickly, R; Perrin, E B

    1998-06-01

    Patient-centered hospital units have grown out of the national trend to greater consumerism, but few of these units have been evaluated rigorously. We used a randomized controlled trial to compare patient outcomes on the Planetree Model Hospital Unit with other medical-surgical units in the hospital. Planetree patients were significantly more satisfied than controls with their hospital stay, the unit's environment and nursing care, but did not differ in ratings of physician care. Planetree patients reported more involvement in their care while hospitalized and higher satisfaction with the education they received. There were few differences between Planetree and controls in health behaviors. While Planetree patients reported better mental health status and role functioning after discharge, their health status was similar to controls after 3 to 6 months. There were no differences in length of stay and charges for the index hospitalization, readmissions or outpatient care during the following year.

  9. Surveying the familiarity and usage of up-to-date database among nurses working in the hospitals affiliated with Ahvaz Jundishapur University of Medical Sciences.

    Science.gov (United States)

    Ghassemi, A H; AghazadeAsl, E; Bigdeli, Z; SakiMalehi, A

    2015-01-01

    Background and Objectives: The evidence-based databases provide the details of the latest scientific findings of research on an individual subject. Factual databases have gained a significant attention regarding the importance and application of evidence-based medical information. Therefore, the purpose of present study was to investigate the level of familiarity by using an Up-To-Date database among the nurses working at the hospitals affiliated with Ahvaz Jundishapur University of Medial Sciences, and by this, making ground for cost-efficiency and cost-effectiveness analyses. Materials and Methods: This was a descriptive-analytical research, conducted on a sample of 293 nurses selected from a population of 1246 nurses, working at the hospitals affiliated with Ahvaz Jundishapur University of Medical Sciences. For the data collection, a researcher built questionnaire was used, and its validity and reliability were confirmed, its Cronbach's alpha coefficient being calculated as 0.71. For the data analysis, descriptive statistics and Kruskal-Wallis test were run. Results: According to the findings, the majority of the nurses were female, having a Bachelor's degree. The nurses had a mid-familiarity with the Up-To-Date database, and most of them used this database in a very limited manner. When using the Up-To-Date database, their primary goal was to update their information and to answer to the clinical questions of the patients. Conclusions: According to the findings, it could be concluded that the access to the recent and up-to-date information in the domain of nursing required the training of the nurses with the necessary skills in information use, to be able to obtain updated information from evidence-based databases and other information resources.

  10. Exploring the Rate and Causes of Deductions Imposed on Social Security and Health Insurance`s Bills Related to Inpatients in Two Hospitals Affiliated with Tabriz University of Medical Sciences

    OpenAIRE

    Hossein Rezvanjou; Mobin Sokhanvar; Leila Doshmangir

    2017-01-01

    Background and Objectives: Annually, a large amount of fees that are paid by hospitals, will not be reimbursed as deductions by health insurance which imposes irreparable financial losses on hospitals. The purpose of this study was to determine the amount of deductions imposed on social security and health insurance`s bills and its causes related to inpatients in two hospitals affiliated with Tabriz University of Medical Sciences. Material and Methods: This was a cross-sectional study con...

  11. ON SCIENTIFIC RESEARCH MANAGEMENT OF UNIVERSITY AFFILIATED HOSPITAL%高校附属医院科研管理的几点看法

    Institute of Scientific and Technical Information of China (English)

    肖斌斌; 全韩; 李博

    2015-01-01

    Based on the development trend of the three -in-one system of “medical treatment, teaching and scientific re-search”, the main university affiliated hospitals at home and abroad need to ensure the sustaining development of hospital scientific re-search and improve the core competitiveness of hospital by improving the scientific research management , such as focusing more atten-tion on the scientific research policy , improving the quality of management staff , constructing the diversification mechanism , integra-ting resources, constructing information platform, managing the funds and archives, and strengthening the whole process supervision.%国内外各大型高校附属医院,在现有“医疗、教学、科研”三位一体的发展趋势下,需从科研政策适度倾斜、管理人员素质全面提升、多元化机制的构建、资源整合、信息化平台建设、落实经费与档案管理、加强全程监管等方面不断完善科研管理办法,以保障医院科研工作的持续性发展,提升医院核心竞争力。

  12. Hospital Affiliations with HMOs and PPOs: An Analysis of Organizational and Market Factors Influencing Engagement In Resource Exchange Relationships

    Science.gov (United States)

    1994-01-01

    accommodate the increasing emphasis on outpatient activity, the measure is still somewhat limited ( Serway , Strum & Haug, 1987). The raw number of FTEs...Services •llm•J~i•,32, 403.415. Serway , G. D., Strum, D. W. & Haug, W. F. (1987). Alternative indicators for measuring hospital productivity. Hosi"l

  13. [Development and application of hospital customer service center platform].

    Science.gov (United States)

    Chen, Minya; Zheng, Konglin; Xia, Yong

    2012-01-01

    This paper introduces the construction and application of the platform of client service center in the general hospital and discusses how to provide patients with an entire service including service before clinic, on clinic and after clinic. It can also provide references for a new service mode for clinic service.

  14. Dynamics of ambulatory surgery centers and hospitals market entry.

    Science.gov (United States)

    Housman, Michael; Al-Amin, Mona

    2013-08-01

    In this article, we investigate the diversity of healthcare delivery organizations by comparing the market determinants of hospitals entry rates with those of ambulatory surgery centers (ASCs). Unlike hospitals, ASCs is one of the growing populations of specialized healthcare delivery organizations. There are reasons to believe that firm entry patterns differ within growing organizational populations since these markets are characterized by different levels of organizational legitimacy, technological uncertainty, and information asymmetry. We compare the entry patterns of firms in a mature population of hospitals to those of firms within a growing population of ASCs. By using patient-level datasets from the state of Florida, we break down our explanatory variables by facility type (ASC vs. hospital) and utilize negative binomial regression models to evaluate the impact of niche density on ASC and hospital entry. Our results indicate that ASCs entry rates is higher in markets with overlapping ASCs while hospitals entry rates are less in markets with overlapping hospitals and ASCs. These results are consistent with the notion that firms in growing populations tend to seek out crowded markets as they compete to occupy the most desirable market segments while firms in mature populations such as general hospitals avoid direct competition.

  15. Incidence of nosocomial infections in a big university affiliated hospital in Shiraz, Iran: A six-month experience

    Directory of Open Access Journals (Sweden)

    Mehrdad Askarian

    2013-01-01

    Conclusions: The results of this study showed that the frequency of NI in the investigated hospital was not higher than in many other reported surveillance results from other countries. This, however, might be a bias as the administration of antibiotics was very high in this study and the quality of microbiological investigation might have influenced significantly, resulting in more false-negative results than expected. Overall, the use of the Iranian National Nosocomial Infection Surveillance System Software proved to be useful and allowed both rapid data collection and detailed data analysis.

  16. Investigating the relationship between fatty liver and diabetes in patients admitted to hospitals affiliated to Tehran Shahid Beheshti University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Marzieh Salehi

    2016-07-01

    Full Text Available Fatty liver is the most common chronic liver disease in Western industrialized countries. However, there is evidence on correlation between management of fatty liver risk and diabetes. In this regard, the current study was conducted to find the relationship between fatty liver and diabetes in patients admitted to hospitals affiliated to Tehran Shahid Beheshti University of Medical Sciences . This descriptive correlational study was conducted on 180 patients admitted to the hospitals of Shahid Beheshti University of Medical Sciences in Tehran. The instruments used in this study included demographic and clinical characteristics of patients such as serum levels of cholesterol, LDL, HDL, triglycerides, hemoglobin and liver horns. Results were analyzed using t-test and chi-square tests . According to ANOVA tests, significant difference was found among indicators of LDL, triglycerides, cholesterol and ALT so that with an increase in triglycerides, HbA1c level also increased (05/0> P. On the other hand, by reducing HDL, the indicator of HbA1c increased. In addition, significant relationship was found between indicators of ALP and triglycerides so that with an increase in triglyceride and ALP, FBS level also increases (P<0.05. Due to the great impact of obesity and type 2 diabetes at an increased risk of non-alcoholic fatty liver disease, regular exercise and physical activities appropriate with age, low-fat diet, weight loss and different treatments to control diabetes and hypertension are recommended to reduce nonalcoholic fatty liver disease.

  17. INTESTINAL PARASITIC INFECTION IN FOODHANDLERS: IN THE HOSPITALS AFFILIATED TO ISFAHAN UNIVERSITY OF MEDICAL SCIENCES – 1997

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    P KETABI

    2001-06-01

    Full Text Available Introduction: Foodhandlers can be carriers of organisms such as salmonella, staphylococci and intestinal parasitic infections. Considering that some patients in hospitals may have impaired resistance to infection and the possible role of foodhandlers in this regard, it seems to be necessary to examine the role of foodhandlers in transmission of intestinal parasitic infection. Methods: 152 foodhandlers were evaluated for their intestinal protozoan and helminthic infections in the hospitals of the Isfahan University of Medical Sciences. From each subject, three stool - specimens were taken in three consecutive days. Five methods (Scotch tape, Direct examination, Formalin - Ether, Telleman, Flotation were used to detect ova and cyst. Results: The overall infection rate was (55.3 percent. The most commonly protozoa was Entamoeba Coli (in 33.6 percent of specimens. Others were Endolimax nana (17.8 percent, Blastocystis hominis (9.2 percent, Giardia lamblia (7.9 percent, Iodamoeba butschlii (2 percent and Chilomastix mesnili (0.7 percent respectively. The helminths observed were Enterobius vermicularis (9.1 percent, Hymenolepis nana (1.3 percent, Ascaris lumbricoides (0.7 percent, Trichuris trichiura (0.7 percent and Trichostrongylus spp(0.7 percent. Discussion: Deficiencies in hygienic practices and poor basic environmental sanitation are the contributing factors in the maintenance of the high prevalence of the intestinal protozoan infections found.

  18. Inter-hospital transfers from rural hospitals to an academic medical center.

    Science.gov (United States)

    Nair, Dilip; Gibbs, Mary M

    2013-01-01

    The need for inter-hospital patient transfers from rural hospitals, especially Critical Access Hospitals, to larger, more urban hospitals is predictable considering the limited resources at rural hospitals. No systematic study of the inter-hospital transfers themselves has been published. The aim of this retrospective descriptive chart review was to provide a preliminary look at inter-hospital transfers from rural hospitals to a more urban, academic medical center in West Virginia. Ultimately, the creation of an agenda for further research was in view. A list of study participants was generated from the academic center's electronic health record database. Study participants were patients who had been transferred for acute care, from November 2011 through June 2012, to the receiving hospital from another acute care hospital and had been under the care of the family medicine teaching service. One hundred and thirty-eight patient transfers were included. Medicare was the most common source of health insurance coverage but over a third of the patients were uninsured. Only five of the twenty-four referring hospitals were Critical Access Hospitals. Four institutions alone initiated 49.3% of transfers. Nineteen specialty services were sought with critical care and neurology accounting for 53.9% of requests. Stroke or stroke-like presentation was the most common transfer diagnosis. 24.6% of transfers were transferred for services that were available at the transferring facility. This study has suggested an agenda for further research that includes replication and analysis of the data with larger study samples as well as qualitative research into the transferring physicians' decision-making process.

  19. Evaluation of Collection and Disposal of Hospital Waste in Hospitals and Healthcare Centers

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    Saeid Nazemi

    2012-08-01

    Full Text Available Currently, one of the environmental issues is waste of hospitals and healthcare facilities which due to hazardous, toxic, and disease-causing agents such as pharmaceutical, chemical and infectious disease, is of particular sensitivity. According to a 2002 survey by WHO, it was determined that 22 million people worldwide suffer from infectious diseases annually, because of contacting hospital wastes. Also based on a research conducted in 22 countries, 18 to 64 percent of hospitals wastes are not disposed properly [1]. The purpose f the study is to appraise collection and disposal of hospital wastes in hospitals and healthcare centers of Shahroud.In this sectional study, 3 university hospitals (580 beds and 10 healthcare facilities were investigated for six months (mehr-azar 89 at Shahroud. In order to determine the amount of waste, produced waste of an entire day was weighted in hospitals and health centers. In this research, proposed questionnaires of WHO for developing countries was used to evaluate collection and disposal system of hospitals waste. Collected data was coded and analyzed by SPSS ver.15.

  20. Health literacy skills in type 2 diabetes mellitus outpatients from an university-affiliated hospital in Rio de Janeiro, Brazil.

    Science.gov (United States)

    de Castro, Simone H; Brito, Gilberto N O; Gomes, Marilia B

    2014-01-01

    Type 2 diabetes mellitus is the most common metabolic disorder and has considerable impact on quality of life. Treatment of DM2 is complex and adherence to treatment requires sophisticated cognition which includes literacy skills. Health literacy skills of a cross-sectional nonrandom sample of 164 DM2 outpatients at the Diabetes Unit of the Hospital Universitário Pedro Ernesto at the State University of Rio de Janeiro were evaluated by the short version of the Test of Functional Health Literacy in Adults (s-TOFHLA). Procedures available in the SPSS package were used in data analysis. Fourteen out of 164 patients (8.5%) were completely illiterate and therefore were not further assessed. The remaining 150 patients (75 men and 75 women) were the participants of this study. Data showed that 110 (73.3%) participants had adequate health literacy skills, 17 (11.3%) had marginal skills and 23 (15.3%) had inadequate skills. Moreover, older participants performed worse than younger patients. In addition, Caucasian and multiethnic participants performed better than Afro-Brazilians. Furthermore, participants with higher educational and occupational levels outperformed those with lower levels. However, only age and education, but not ethnic group and occupation, contributed significantly and independently to health literacy. This study showed that almost a quarter of the participants are illiterate or have inadequate health literacy skills. Therefore, our results indicate the need for the development of health care instructions properly calibrated to the health literacy skills of DM2 patients.

  1. An assessment of radiographers’ technical and protective performance in hospitals affiliated to Birjand University of Medical Sciences in 2012

    Directory of Open Access Journals (Sweden)

    Mahmood Reza Tavakkoli

    2014-08-01

    Materials and Methods: In this descriptive-analytical study, all the 26 radiolographers working in the radiology wards of Vali-asr and Imam Reza hospitals of Birjand participated. In order to collect data about their performance, a checklist whose reliability and validity had been approved was provided. For the radiography staff 17 technical and 12 protective items during three work shifts were checked and recorded. In order to measure their awareness of technical and protective principles, a 12-item questionnaire was completed by each of them. The obtained data was statistically analyzed by means of SPSS software using X2. Results: Mean Performance score in the technical area in the three work shifts was 15±1.60, and that of the protective area was 10.9±1.1 both of which were at an average level. Around 46.5% of the subjects gave correct answers to protective and 37.2% of them to the technical questions. The comparison of technical and protective performance scores showed no significant difference in terms of work shifts, education, gender, and type of employment (P>0.05. Conclusion: The radiographers’ awareness of technical and protective principles was at a very low level. Therefore, both quality academic training and in-service education seem necessary.

  2. Focus on: Washington Hospital Center, Biomedical Engineering Department.

    Science.gov (United States)

    Hughes, J D

    1995-01-01

    The Biomedical Engineering Department of the Washington Hospital Center provides clinical engineering services to an urban 907-bed, tertiary care teaching hospital and a variety of associated healthcare facilities. With an annual budget of over $3,000,000, the 24-person department provides cradle-to-grave support for a host of sophisticated medical devices and imaging systems such as lasers, CT scanners, and linear accelerators as well as traditional patient care instrumentation. Hallmarks of the department include its commitment to customer service and patient care, close collaboration with clinicians and quality assurance teams throughout the hospital system, proactive involvement in all phases of the technology management process, and shared leadership in safety standards with the hospital's risk management group. Through this interactive process, the department has assisted the Center not only in the acquisition of 11,000 active devices with a value of more than $64 million, but also in becoming one of the leading providers of high technology healthcare in the Washington, DC metropolitan area.

  3. Information seeking behavior of patients with diabetes mellitus: a cross-sectional study in an outpatient clinic of a university-affiliated hospital in Athens, Greece.

    Science.gov (United States)

    Kalantzi, Sofia; Kostagiolas, Petros; Kechagias, Georgios; Niakas, Dimitrios; Makrilakis, Konstantinos

    2015-02-20

    The purpose of this study is to examine the information behavior of diabetic patients, a relatively unexplored field of diabetes care, including their needs for information, resources used, obstacles encountered and degree of satisfaction for diabetes-related information acquisition. 203 patients (males: 110, type 2:172) followed-up in the outpatient Diabetes Clinics of a University-affiliated hospital in Greece were assessed, using a validated questionnaire. Patients identified diet (61.4%) and diabetic complications (41.9%) as "the most important" for their information needs and the treating physician (94.6%) for information resources. Internet importance and frequency of use ranked low. Main obstacles to information seeking were "lack of time" and "cost". Most patients (71.4%) stated they were "quite" or "very satisfied" with the current possibilities of information seeking. Diabetic patients' stated information needs and information sources, as well as main obstacles to obtaining information could potentially have important implications in designing a future information campaign.

  4. Evaluation of Patients' Rights Observance According to Patients' Rights Charter in Educational Hospitals Affiliated to Mashhad University of Medical Sciences: Medical Staffs' Views.

    Science.gov (United States)

    Sabzevari, Alireza; Kiani, Mohammad Ali; Saeidi, Masumeh; Jafari, Seyed Ali; Kianifar, Hamidreza; Ahanchian, Hamid; Jarahi, Lida; Zakerian, Mohsen

    2016-10-01

    To supply quality services and healthcare, it is evident that medical ethics and patients' rights, while providing medical and healthcare services need to be observed. This study was conducted to evaluate observance of the Patients' Rights Charter among medical staff of educational hospitals affiliated to Mashhad University of Medical Sciences. This cross-sectional study was conducted in four educational hospitals in Mashhad on eighty physicians, nurses, nurse aids and medical students. Data were collected using a two-part inventory of patients' rights, including demographic data and inventory of patients' rights observance. Data analysis was conducted using SPSS-16 as well as descriptive statistics, independent t-test, chi-square, Spearman correlation coefficient and Pearson correlation. Mean age of subjects was 36.3±8.3. Observance of human rights was perfect by 84.4 percent of subjects. The highest amount of observance of patients' rights was related to the area of respecting patients' privacy and observing the principle of confidentiality, which was evaluated to be perfect by all subjects (100%). The lowest value of patients' rights observance was related to presenting appropriate and adequate information for patients, which was perfect among 48.1% of subjects. There was no significant relation between personal details (age, gender, education and career) and observance of patients' rights (p>0.05). Although in this study, the observance of patients' rights by medical staff is optimal in most areas, the area of providing appropriate and adequate information needs to be promoted. Therefore, it is suggested that more stringent regulatory policies be compiled and implemented to the items of Patients' Rights Charter along with training courses, to strengthen medical staff's awareness in this regard.

  5. Development of a Method for Evaluating the Existing Patient Radiation Protection Protocols in Interventional Radiology Unit of University-Affiliated Hospitals in Isfahan

    Directory of Open Access Journals (Sweden)

    Parvaneh Shokrani

    2010-05-01

    Full Text Available Since the late 1960s, the use of interventional procedures utilizing radiology in medicine has increased significantly and continues to grow. There are also possible longer-term effects for surviving patients-mainly induction of cancers. The International Commission on Radiological Protection considers that there is no dose below which there is zero risk and therefore, minimizing the risk by confining the irradiation field and constraining the dose is highly desirable. There are a lot of national and international organs that work regarding radiation protection. These organs suggest a lot of code for patient radiation protection based on research and evidence. Per-sonnel dose monitoring is performed by the radiation safety officer but radiation protection of the patient is the responsibility of the physician and medical physicist. The aim of this research was the evaluation of patient radiation protection protocols in university hospitals in the city of Isfahan with respect to international protocols."nThis investigation was done in two interventional radiology units of Isfahan university-affiliated hospitals. The following international protocols related to patient protection were used as the standard protocols AAPM Report NO. 70, ICRP Publication 85, and IAEA SAFETY GUIDE No. RS-G-1.5. The recommendations of these protocols were ranked and classified into 3 questionnaires. These questionnaires included recommendations about factors that affect the dose to patients, factors that affect staff doses, and procurement. These questionnaires were used to evaluate the patient radiation protection protocols currently used in Isfahan university hospitals against the above international protocols. In this investigation, we used letter 'A' and 'B' for description of the two hospitals. "nFor interventional radiology units the following agreements and disagreements were observed when the local protocols were compared to the international

  6. Incorporating the USAF Flight Center's TQM plan in a hospital.

    Science.gov (United States)

    Bridges, R D; Mathews, K A

    1993-01-01

    A total quality management (TQM) plan has been instituted by the United States Air Force Flight Test Center at Edwards Air Force Base. To determine the feasibility of implementing the same basic TQM plan in a district hospital, a joint industry-government team was established. Five areas of concentration were selected for review: infrastructure, methodology, training, strategic plan, and a "Quality Bill of Rights." The TQM "infrastructure" is intended to match and complement the existing organizational structure and chain of command, not to supplant it. As the overall plan seemed well-adapted for implementation in a hospital setting, a three-phase implementation approach was identified that included conceptual planning, initial training and goal setting, and full-scale implementation. Each phase is described in terms of objectives, staffing, and timing requirements.

  7. The effects of reflexology on chronic low back pain intensity in nurses employed in hospitals affiliated with Isfahan University of Medical Sciences.

    Science.gov (United States)

    Eghbali, Maryam; Safari, Reza; Nazari, Fatemeh; Abdoli, Samereh

    2012-03-01

    Humans have been involved with the phenomena of pain and pain relief from the ancient times. Back pain is the most common pain. In fact, eight out of ten people experience it in their lifetime. However, individuals with specific jobs, including nurses, are faced with this problem more. Nursing is in the top ten careers suffering from the most severe musculoskeletal injuries. There are non-pharmacologic and pharmacologic treatments to relieve back pain. One of the non-medical treatments of pain is called reflexology which is a branch of complementary and alternative therapies. This research has been conducted to investigate the effect of reflexology on chronic low back pain intensity. This study was a double-blind clinical trial. The study population consisted of 50 female and male nurses suffering from chronic low back pain working in hospitals affiliated with Isfahan University of Medical Sciences. The participants were divided into two groups of reflexology and non-specific massage. A questionnaire was completed through interviews and a 40 minute sessions of interventions were performed three times a week for two weeks. Pain intensity was measured by Numerical Analogue Scale for pain before and after the intervention. Descriptive and inferential statistics, including independent t-test and chi-square test, were used to analyze the data. The results showed a significantly higher reduction in pain intensity scores in the reflexology group after the intervention as compared with the non-specific massage group. However, the non-specific massage was also significantly effective in reducing pain. Reflexology can be effective in reducing the severity of chronic back pain, i.e. it is able to reduce pain from moderate to mild. Thus, this technique is recommended to be performed by nurses as a complementary therapy in patient care.

  8. Syntax Score and Major Adverse Cardiac Events in Patients with Suspected Coronary Artery Disease: Results from a Cohort Study in a University-Affiliated Hospital in Southern Brazil

    Science.gov (United States)

    Fuchs, Felipe C.; Ribeiro, Jorge P.; Fuchs, Flávio D.; Wainstein, Marco V.; Bergoli, Luis C.; Wainstein, Rodrigo V.; Zen, Vanessa; Kerkhoff, Alessandra C.; Moreira, Leila B.; Fuchs, Sandra C.

    2016-01-01

    Background: The importance of coronary anatomy in predicting cardiovascular events is well known. The use of traditional anatomical scores in routine angiography, however, has not been incorporated to clinical practice. SYNTAX score (SXscore) is a scoring system that estimates the anatomical extent of coronary artery disease (CAD). Its ability to predict outcomes based on a baseline diagnostic angiography has not been tested to date. Objective: To evaluate the performance of the SXscore in predicting major adverse cardiac events (MACE) in patients referred for diagnostic angiography. Methods: Prospective cohort of 895 patients with suspected CAD referred for elective diagnostic coronary angiography from 2008 to 2011, at a university-affiliated hospital in Brazil. They had their SXscores calculated and were stratified in three categories: no significant CAD (n = 495), SXscoreLOW-INTERMEDIATE: < 23 (n = 346), and SXscoreHIGH: ≥ 23 (n = 54). Primary outcome was a composite of cardiac death, myocardial infarction, and late revascularization. Secondary endpoints were the components of MACE and death from any cause. Results: On average, patients were followed up for 1.8 ± 1.4 years. The primary outcome occurred in 2.2%, 15.3%, and 20.4% in groups with no significant CAD, SXscoreLOW-INTERMEDIATE, and SXscoreHIGH, respectively (p < 0.001). All-cause death was significantly higher in the SXscoreHIGH compared with the 'no significant CAD' group, 16.7% and 3.8% (p < 0.001), respectively. After adjustment for confounding factors, all outcomes remained associated with the SXscore. Conclusions: SXscore independently predicts MACE in patients submitted to diagnostic coronary angiography. Its routine use in this setting could identify patients with worse prognosis. PMID:27509092

  9. "On the scene": Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

    Science.gov (United States)

    Hoying, Cheryl; Lecher, William T; Mosko, Dee Dee; Roberto, Nancy; Mason, Char; Murphy, Susan Wade; Taylor, Janalee; Cortina, Sandra; Mathison, Elizabeth; Dick, Leaann; Schoettker, Pamela J; Britto, Maria T

    2014-01-01

    Cincinnati Children's Hospital Medical Center is transforming the way it cares for its patients by building a sophisticated model that focuses on accountable care across the continuum. As nurses from different parts of the organization, we act as change agents to develop an integrated structure built around the patient's needs, from prevention to self-management. We demonstrate how organizational structure, fluid staffing, professional practice, and healthy behaviors operationally catalyze the continuum of care, and how we utilize self-management, community-based programs, and care integration to change the outcome for our patients and families. While care coordination is taking on many forms in medical centers around the world, Cincinnati Children's is proud and passionate about sharing its best practices along the way.

  10. Hospital image and the positioning of service centers: an application in market analysis and strategy development.

    Science.gov (United States)

    Smith, S M; Clark, M

    1990-09-01

    The research confirms the coexistence of different images for hospitals, service centers within the same hospitals, and service programs offered by each of the service centers. The images of individual service centers are found not to be tied to the image of the host facility. Further, service centers and host facilities have differential rankings on the same service decision attributes. Managerial recommendations are offered for "image differentiation" between a hospital and its care centers.

  11. The Liver Transplant Program at Tianjin First Center Hospital.

    Science.gov (United States)

    Shen, Zhongyang

    2011-01-01

    The liver transplant program at the transplant center of Tianjin First Center Hospital opened in 1994 and has become a leading center for academic research and development in clinical liver transplantation during the past 18 years. As of Nov 30, 2011, we had performed 4,103 liver transplantations in patients ranging from 6 months to 79 years old. Since 1998, the program has ranked first in mainland China in the annual number of liver transplants performed, the cumulative total liver transplants and the number of long-surviving patients. We've accomplished a number of "firsts" among the Chinese liver transplant centers, including: the first split liver transplantation, the first pediatric liver transplant, the first living donor simultaneous liver-kidney transplant, the first dual-graft liver transplant using a domino right lobe and a living donor left lobe, the first laparoscopic assisted live donor right hepatectomy including the middle hepatic vein and we have assembled the first liver transplant chain comprising multiple donors and recipients. We have performed the largest number of living related and split liver transplantations in mainland China. The combined prophylactic protocol of "Lamivudine and HBIG" to prevent HBV recurrence post transplantation was first used by our center in China and now is utilized by most of the domestic transplant centers. We have begun using livers from donors after cardiac death (DCD) during the past 2 years, with careful donor selection and recipient management. All the approaches and techniques we've developed are aimed at the utilization of all types of available grafts. However, increasing the rate of transplantation with excellent graft and recipient survival are still the challenges facing us.

  12. Proton treatment facility at National Cancer Center Hospital East

    Energy Technology Data Exchange (ETDEWEB)

    Nishio, Teiji [National Cancer Center, Kashiwa, Chiba (Japan). Hospital East

    2002-06-01

    In 1997, the proton- treatment facility that has the therapeutic Azimuthally Varying Field (AVF) cyclotron accelerator (C235) is constructed at National Cancer Center Hospital East. The facility has 3-irradiation ports (rooms) that are 2-rotationg gantry ports and 1-horizontal fixed port. The C235 can accelerate proton to 235 MeV with the beam intensity of 300 nA. The external diameter is a very compact with about 4 m. The radio frequency is 106 MHz, the accelerating voltage is about 60 kV, and the harmonic number is 4. A beam stability of the C235 has an important relation with the uniformity of an irradiation field and is a very difficulty. The measured result indicated that the incident beam position against the 2.5-% dose uniformity must be into the 0.5- and 6.6-mm{phi} circles with the double-scattering and wobbler methods, respectively. The proton beam therapy began at the end of November 1998. It has been curing 97 patients by the present. Also, the proton therapy system at our hospital got an approval as medical equipment from the Japanese government in April 2001. And the proton therapy at our hospital was approved as a high advanced medical technology from the Japanese government in July 2001. The treatment expenses are 2883,000 yen uniformly. (author)

  13. Shift Work and Related Health Problems among Medical and Diagnostic Staff of the General Teaching Hospitals Affiliated to Shiraz University of Medical Sciences, 2012

    Directory of Open Access Journals (Sweden)

    Zahra Sajjadnia

    2015-07-01

    Full Text Available Introduction:Today, shift work is considered as a necessity in many jobs and for some 24-hour services the use of shift-work is growing. However, shift work can lead to physiological and psycho-social problems for shift workers. This study aimed to determine the effects of shift work on the associated health problems, together with the demographic and job characteristics underlying the problems, among the medical and diagnostic staff of the general teaching hospitals affiliated to Shiraz University of Medical Sciences in 2012. Method:This study was an applied, cross-sectional and descriptive-analytical one. The study employed a sample of 205 employees from the medical and diagnostic staff using stratified sampling proportional to the size and simple random sampling methods. Data were collected using the Survey of Shift workers (SOS questionnaire, validity and reliability of which have already been confirmed. Finally, the collected data were analyzed using SPSS 16.0 software through ANOVA, Chi-square, Independent-Samples T-Test, as well as Pearson Correlation Coefficient. A P<0.05 was considered statistically significant. Results: The results showed that among the demographic and job characteristics studied, the individual, family and social problems had significant associations with work schedules, shift work and job satisfaction. In addition, there were significant associations between musculoskeletal disorders and the satisfaction of shift work; cardiovascular disorders and marital status and occupation; digestive disorders and the work schedules; sleep disorders and the satisfaction of shift work; musculoskeletal disorders, cardiovascular disorders and sleep disorders and age, job experience and shift work experience. And finally, there were significant associations among sleep disorders and age, job experience and the shift work experience. Conclusion: Based on the findings of this study, demographic characteristics such as age, marital

  14. Syntax Score and Major Adverse Cardiac Events in Patients with Suspected Coronary Artery Disease: Results from a Cohort Study in a University-Affiliated Hospital in Southern Brazil.

    Science.gov (United States)

    Fuchs, Felipe C; Ribeiro, Jorge P; Fuchs, Flávio D; Wainstein, Marco V; Bergoli, Luis C; Wainstein, Rodrigo V; Zen, Vanessa; Kerkhoff, Alessandra C; Moreira, Leila B; Fuchs, Sandra C

    2016-09-01

    The importance of coronary anatomy in predicting cardiovascular events is well known. The use of traditional anatomical scores in routine angiography, however, has not been incorporated to clinical practice. SYNTAX score (SXscore) is a scoring system that estimates the anatomical extent of coronary artery disease (CAD). Its ability to predict outcomes based on a baseline diagnostic angiography has not been tested to date. To evaluate the performance of the SXscore in predicting major adverse cardiac events (MACE) in patients referred for diagnostic angiography. Prospective cohort of 895 patients with suspected CAD referred for elective diagnostic coronary angiography from 2008 to 2011, at a university-affiliated hospital in Brazil. They had their SXscores calculated and were stratified in three categories: no significant CAD (n = 495), SXscoreLOW-INTERMEDIATE: anatomia coronariana na predição de eventos cardiovasculares é bem conhecida. O uso de escores anatômicos tradicionais na cineangiocoronariografia de rotina, entretanto, não foi incorporado à prática clínica. O SYNTAX escore (SXescore) é um sistema de escore que estima a extensão anatômica da doença arterial coronariana (DAC). Sua capacidade para predizer desfechos com base na cineangiocoronariografia diagnóstica de base ainda não foi testada. Avaliar o desempenho do SXescore para predizer eventos cardíacos adversos maiores (MACE) em pacientes encaminhados para cineangiocoronariografia diagnóstica. Coorte prospectiva de 895 pacientes com suspeita de DAC encaminhados para cineangiocoronariografia diagnóstica eletiva de 2008 a 2011, em hospital universitário no Brasil. Os pacientes tiveram seus SXescores calculados e foram estratificados em três categorias: 'sem DAC significativa' (n = 495); SXescoreBAIXO-INTERMEDIÁRIO: < 23 (n = 346); e SXescoreALTO: ≥ 23 (n = 54). O desfecho primário foi composto de morte cardíaca, infarto do miocárdio e revascularização tardia. Os desfechos secund

  15. Gaps in affiliation indexing in Scopus and PubMed.

    Science.gov (United States)

    Schmidt, Cynthia M; Cox, Roxanne; Fial, Alissa V; Hartman, Teresa L; Magee, Martha L

    2016-04-01

    The authors sought to determine whether unexpected gaps existed in Scopus's author affiliation indexing of publications written by the University of Nebraska Medical Center or Nebraska Medicine (UNMC/NM) authors during 2014. First, we compared Scopus affiliation identifier search results to PubMed affiliation keyword search results. Then, we searched Scopus using affiliation keywords (UNMC, etc.) and compared the results to PubMed affiliation keyword and Scopus affiliation identifier searches. We found that Scopus's records for approximately 7% of UNMC/NM authors' publications lacked appropriate UNMC/NM author affiliation identifiers, and many journals' publishers were supplying incomplete author affiliation information to PubMed. Institutions relying on Scopus to track their impact should determine whether Scopus's affiliation identifiers will, in fact, identify all articles published by their authors and investigators.

  16. Inter-hospital transfers from rural hospitals to an academic medical center

    National Research Council Canada - National Science Library

    Nair, Dilip; Gibbs, Mary M

    2013-01-01

    The need for inter-hospital patient transfers from rural hospitals, especially Critical Access Hospitals, to larger, more urban hospitals is predictable considering the limited resources at rural hospitals...

  17. A tale of two cultures: examining patient-centered care in a forensic mental health hospital

    Science.gov (United States)

    Livingston, James D.; Nijdam-Jones, Alicia; Brink, Johann

    2012-01-01

    Several questions remain unanswered regarding the extent to which the principles and practices of patient-centered care are achievable in the context of a forensic mental health hospital. This study examined patient-centered care from the perspectives of patients and providers in a forensic mental health hospital. Patient-centered care was assessed using several measures of complementary constructs. Interviews were conducted with 30 patients and surveys were completed by 28 service providers in a forensic mental health hospital. Patients and providers shared similar views of the therapeutic milieu and recovery orientation of services; however, providers were more likely to perceive the hospital as being potentially unsafe. Overall, the findings indicated that characteristics of patient-centered care may be found within a forensic mental health hospital. The principles of patient-centered care can be integrated into service delivery in forensic mental health hospitals, though special attention to providers’ perceptions of safety is needed. PMID:22815648

  18. Perception of the nursing team of a Surgical Center regarding Hospital Accreditation at a University Hospital.

    Science.gov (United States)

    Fernandes, Hellen Maria de Lima Graf; Peniche, Aparecida de Cássia Giani

    2015-02-01

    Objective To analyze the perception of nursing teams at a surgical center regarding the process of hospital accreditation, in the evaluative aspects of structure, process, and result. Method The study takes a quantitative and exploratory-descriptive approach, carried out at a university hospital. Result The population consisted of 69 nursing professionals, and the data collection was performed in the months of January and February 2014 by way of a questionnaire, utilizing the Likert scale. The methodology used a Cronbach's Alpha equal to 0.812. In the comparison of the three aspects, the one with the highest favorability score was "result", with an average of 47.12 (dp±7.23), and the smallest was "structure," with an average of 40.70 (dp±5.19). Conclusion This situational diagnostic can assist in the restructuring of the vulnerable areas evaluated in these three aspects, mainly in the aspect of structure, with a goal of level 2 accreditation by the ONA (Brazilian's National Organization for Accreditation) defended by the Institution.

  19. Vessel Owner Affiliation Data

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — These data were created from existing federal fishing permit databases maintained by GARFO. Fishing permit numbers are assigned an affiliation identification number...

  20. Exploring Specialist Physicians' Job Satisfaction and Interests Both to Their Specialties or other Specialties and to Effective Factors on them in Hospitals Affiliated to Shiraz University of Medical Science in 2014

    Directory of Open Access Journals (Sweden)

    Soodabeh Emami

    2016-06-01

    Full Text Available Background and Objectives: To compare the level and determinants of specialist physicians' job satisfaction and working conditions, this study was undertaken to assess the level of job satisfaction among specialist physicians in hospitals affiliated to Shiraz University of medical science. Method: In a cross-sectional study, 82 specialist physicians in in hospitals affiliated to Shiraz University of medical science were surveyed. Socio-demographic data, employment characteristics and job satisfaction data were collected using questionnaire. Numerical and percentage values were used in the evaluation of data. Also, Chi-square was used to show the level of physicians' satisfaction. Findings: There was a significant difference in the level of job satisfaction of specialist physicians. Physicians were found to be significantly satisfied with their job, whereas low salary, poor prospects for promotion, bad time organization, the stress level in the ward, and also inadequate technical and financial support were the main factors for dissatisfaction. After conducting Chi-square, respondents showed average level of satisfaction with their career. Conclusions: The findings reveal that generally the physicians are satisfied with their present career and they agreed to have some changes and freedom in their job. Hence, further research worth to be conducted to identify the relevant reasons.

  1. Investigation of Human Resources Management of an Affiliated Hospital of Military Medical University%某军医大学附属医院人力资源管理调查分析

    Institute of Scientific and Technical Information of China (English)

    陈晓霞; 白秀银; 任家顺

    2015-01-01

    In order to know the current status of Human Resource Management of an Affiliated Hospital of the Military Medical University and find out the key problems in management, questionnaire survey and interview were adopted to fully analyze the four aspects as organization structure and strategic planning, management system and performance appraisal, skill training and academic exchange and cultural atmosphere and working environment for the Human Resources Management of an Affiliated Hospital of the Military Medical University.Finally, the measures and channels planning priority, management innovation, intensified training and communication and im-proved working atmosphere were summarized.%为了解某军医大学附属医院人力资源管理现状,发现其在管理方面的主要问题,分析并提出应对策略,采用问卷调查和访谈相结合的方法,对医院人力资源管理的组织结构与战略规划、管理制度与绩效考核、技能培训与学术交流、文化氛围与工作环境四大方面深入剖析,得出注重规划、创新管理、强化培训交流和优化工作氛围的问题解决结论和路径。

  2. Economies of scale in non-revenue producing cost centers: implications for hospital mergers.

    Science.gov (United States)

    Dranove, D

    1998-01-01

    This paper uses semiparametric methods to estimate the magnitude of economies of scale in 14 non-revenue producing cost centers in hospitals. There are substantial economies of scale in small hospitals, but economies are exhausted in hospitals with over 10,000 discharges annually. In recent hospital mergers challenged by federal antitrust agencies, one or both hospitals had over 10,000 discharges, suggesting that efficiency gains in non-revenue producing cost centers will be small, and could easily be offset by nominal price increases.

  3. [Trends in interhospital transfers from a Swiss university hospital center].

    Science.gov (United States)

    Carron, Pierre-Nicolas; Meylan, Nicolas; Yersin, Bertrand; Wasserfallen, Jean-Blaise; Vallotton, Laurent

    2013-01-01

    Research on interhospital transfers provides a basis for describing and quantifying patient flow and its evolution over time, offering an insight into hospital organization and management and hospital overcrowding. The purpose of this study was to conduct a qualitative and quantitative analysis of patient flow and to examine trends over an eight-year period. A retrospective descriptive study of interhospital transfers was conducted between 2003 and 2011 based on an analysis of demographic, medical and operational characteristics. Ambulance transfers and transfers requiring physician assistance were analyzed separately. The number of interhospital transfers increased significantly over the study period,from 4,026 in 2003 to 6,481 in 2011 (+60.9%). The number of ambulance transfers increased by almost 300% (616 in 2003 compared to 2,460 in 2011). Most of the transfers (98%) were to hospitals located less than 75 km from the university hospital (median: 24 km, 5-44). In 2011, 24% of all transfers were to psychiatric institutions. 26% of all transfer cases were direct transfers from the emergency department. An increasing number of transfers required physician assistance. 18% of these patients required ventilatory support, whole 9.8% required vasoactive drugs. 11.6% of these transfers were due to hospital overcrowding. The study shows that there has been a significant increase in interhospital transfers. This increase is related to hospital overcrowding and to the network-based systems governing patient care strategies.

  4. A Qualitative Study of the Treatment Improvement Protocols (TIPs): An Assessment of the Use of TIPs by Individuals Affiliated with the Addiction Technology Transfer Centers (ATTCs).

    Science.gov (United States)

    Hayashi, Susan W.; Suzuki, Marcia; Hubbard, Susan M.; Huang, Judy Y.; Cobb, Anita M.

    2003-01-01

    Evaluated the Addiction Technology Transfer Centers (ATTCs) of the Center for Substance Abuse Treatment (CSAT) as a means of diffusion of innovations, focusing on use of the Treatment Improvement Protocols (TIPs). Qualitative studies at 6 ATTCs that included 57 interviews show that the CSAT is at the forefront of providing resources to the…

  5. A midwifery-led in-hospital birth center within an academic medical center: successes and challenges.

    Science.gov (United States)

    Perdion, Karen; Lesser, Rebecca; Hirsch, Jennifer; Barger, Mary; Kelly, Thomas F; Moore, Thomas R; Lacoursiere, D Yvette

    2013-01-01

    The University of California San Diego Community Women's Health Program (CWHP) has emerged as a successful and sustainable coexistence model of women's healthcare. The cornerstone of this midwifery practice is California's only in-hospital birth center. Located within the medical center, this unique and physically separate birth center has been the site for more than 4000 births. With 10% cesarean delivery and 98% breast-feeding rates, it is an exceptional example of low-intervention care. Integrating this previously freestanding birth center into an academic center has brought trials of mistrust and ineffectual communication. Education, consistent leadership, and development of multidisciplinary guidelines aided in overcoming these challenges. This collaborative model provides a structure in which residents learn to be respectful consultants and appreciate differences in medical practice. The CWHP and its Birth Center illustrates that through persistence and flexibility a collaborative model of maternity services can flourish and not only positively influence new families but also future generations of providers.

  6. Changing from paper to paperless hospitals in busy academic centers.

    Science.gov (United States)

    Shelman, Keith

    2008-01-01

    To decide to change from paper to a paperless hospital, one decides to go on a journey. This chapter will outline the destination, the reasons to make the journey and describe the best route to the destination. Becoming paperless is the route taken to the destination.

  7. 医学院校附属医院临床科主任绩效考核的实施与体会%Implementation and experience on performance evaluation of clinical directors in hospitals affiliated to medical universities

    Institute of Scientific and Technical Information of China (English)

    王文娟; 李会玲; 孟文娟; 施梅

    2013-01-01

    It is one of the most essential implements in the reform of hospitals affiliated to medical universities to deepen the reform of the cadre and personnel system, perfect the management system of cadres and improve and promote the efficiency in management of directors. The practice of performance evaluation for directors of clinical department in the first affiliated hospital of Harbin medical university which involves formulating different assessment criteria with different levels and requirements, designing different assessment content and methods with different assessment object to assure the democracy and justices. The reform has been made some effectiveness. The assessment system needs to be further improved to make better effectiveness.%  深化干部人事制度改革,建全医院干部管理制度,提高和促进科主任有效的管理科室是医学院校附属医院改革中的一项重要举措。哈尔滨医科大学附属第一医院近几年通过深化临床学科(科室)主任绩效考核改革,按级别不同,要求不同,制定不同的考核标准,根据考核对象确定考核的内容与方法,确保考核的民主公正,对临床学科(科室)主任进行绩效考核,取得了一定成效。同时,认为需进一步完善考核制度,以期达到更好的效果。

  8. A Study to Determine the Feasibility of Establishing a Wellness Center at Martin Army Community Hospital

    Science.gov (United States)

    1987-11-06

    MTF) establish a Wellness/Health Promotion Center to provide the services needed to support the wellness concepto (Department of the Army, 1984). 2...Directive 1010.10 (Health Promotion). 6. It is recommended that a marketing plan be developed for the wellness center. The plan should include articles for...1981). Wellness programs attract new markets for hospitals. Hospitals, 55(22), 115-116, 119. Manring, S.L. (1985). Evaluating corporate wellness and

  9. A study on the Rate of Knowledge, Attitude and Practice of Medical Students towards Method of Medical Records Documentation at Mazandaran University of Medical Sciences Affiliated Therapeutic and Teaching Centers 2003

    Directory of Open Access Journals (Sweden)

    A. Balaghafari

    2005-01-01

    Full Text Available Background and Objectives: History, clinical findings, procedures undertaken, and patients response to treatment are written in clinical records, hence their contents are indicators of physicians’ evaluation. If clinical records are provided precisely, clear and systematized, they indicate the clinical thinking of the staff and facilitate patients diagnosis process. These records have an important role in coordinating professional staff involved in patient care. Since the physicians and medical students are involved more in medical records documentation than the other hospital staff, thus, a study on their knowledge, attitude and practice towards the principles of medical records documentation is undertaken.Materials and Methods: This is a descriptive study, which is done about the rate of knowledge, attitude and practice of 207 Medical students of Mazandaran University of Medical Sciences in university hospitals. Descriptive and inferential statistical analytic methods were used for the collected data. For comparison of the hospitals, regarding observing designed principals in the completion of medical files, according to the filled questionnaires the minimum and maximum score designated as 1-5 which is very poor to excellent. Then the mean score was calculated and considered for the comparison of hospitals. For the determination of the relationship between knowledge, attitude, and practice, β Kendall’s Tau Test was used.Results: The majority of the participants had low knowledge (77.8% about medical records documentation. Most of them did not have good attitude (54.1 about completion of medical records and significance and value of medical records documentation in treatment, education, and research.Conclusion: Results indicate that incompletion of medical records at the university affiliated hospitals are due to lack of awareness of the students towards the method of medical records documentation. In addition, not considering the

  10. Intervention Effect of the Empowerment Education in Urban Community by Affiliated Hospitals of Medical Colleges on the Patients With First Stroke Attack%高校附属医院城市社区授权教育对首发脑卒中患者的干预效果研究

    Institute of Scientific and Technical Information of China (English)

    袁添; 刘沫

    2015-01-01

    Objective To evaluate the intervention effect of the empowerment education in urban community by affiliated hospitals of medical colleges on the patients with first stroke attack. Methods We enrolled 120 patients with stroke who had health records in Jingye Community Health Service Center ( jointly established by the First Affiliated Hospital of Liaoning Medical University and the government of Guta District)from October 2012 to September 2013. Using random number table,the subjects were divided into two groups:intervention group(n=60)and control(n=60). The control group was administrated with conventional health education,and the intervention was administrated with the empowerment education in urban community by affiliated hospitals of medical colleges. The intervention lasted for 6 months. The two groups were compared by systolic pressure, diastolic pressure,SF-36,SAS score and SDS score before and after intervention. Results Before intervention,the two groups were not significantly different(P>0. 05)in systolic and diastolic pressure;after intervention,the two groups were significantly different(P0. 05)in SF-36,SAS and SDS;after intervention,the two groups were significantly different in SF-36,SAS and SDS. Conclusion The empowerment education in urban community by affiliated hospital of medical colleges could effectively control blood pressure,improve the life quality of patients,and alleviate their axeity and depresion. The mode is worth wide application.%目的:了解高校附属医院城市社区授权教育对首发脑卒中患者的干预效果。方法选取2012年10月—2013年9月在敬业社区卫生服务中心(辽宁医学院附属第一医院与锦州古塔区政府联合主办)建立健康档案的脑卒中患者120例。采用随机数字表法,将其分为干预组和对照组各60例。对照组患者采用常规健康教育;干预组患者采用高校附属医院城市社区授权教育。干预时间均为6个月,比较两组患

  11. Evaluation of Collection and Disposal of Hospital Waste in Hospitals and Healthcare Centers

    OpenAIRE

    Saeid Nazemi; Mehdi Raei; Amir Almasi-Hashiani

    2012-01-01

    Currently, one of the environmental issues is waste of hospitals and healthcare facilities which due to hazardous, toxic, and disease-causing agents such as pharmaceutical, chemical and infectious disease, is of particular sensitivity. According to a 2002 survey by WHO, it was determined that 22 million people worldwide suffer from infectious diseases annually, because of contacting hospital wastes. Also based on a research conducted in 22 countries, 18 to 64 percent of hospitals wastes are n...

  12. Healthcare professionals' views on patient-centered care in hospitals

    NARCIS (Netherlands)

    M. Berghout (Mathilde); N.J.A. van Exel (Job); L. Leensvaart (Laszlo); J.M. Cramm (Jane)

    2015-01-01

    textabstractBackground: Patient-centered care (PCC) is a main determinant of care quality. Research has shown that PCC is a multi-dimensional concept, and organizations that provide PCC well report better patient and organizational outcomes. However, little is known about the relative importance of

  13. Situation analysis of trauma based on Arizona trauma center standards in university hospitals of Tehran, Iran

    Institute of Scientific and Technical Information of China (English)

    Mahdi Sharif-Alhoseini; Aliashraf Eghbali; Vafa Rahimi-Movaghar; Soheil Saadat

    2009-01-01

    Objective: Injuries are common and important problem in Tehran, capital of Iran. Although therapeutic centers are not essentially established following the constructional principles of developed countries, the present opportunities and equipments have to be used properly. We should recognize and reduce the deficits based on the global standards.This study deliberates the trauma resources and capacities in university hospitals of Tehran based on Arizona trauma center standards, which are suitable for the assessment of trauma centers.Methods: Forty-one university hospitals in Tehran were evaluated for their conformity with "Arizona trauma center standards" in 2008. A structured interview was arranged with the "Educational Supervisor" of all hospitals regarding their institutional organization, departments, clini-cal capabilities, clinical qualifications, facilities and resources, rehabilitation services, performance improvement, continuing education, prevention, research and additional requirements for pediatric trauma patients. Relative frequencies and percentages were calculated and Student's t test was used to compare the mean values.Results: Forty-one hospitals had the average of 77.7 (50.7%) standards from 153 Arizona trauma center standards and these standards were present in 97.5 out of 153 (63.7%) in 17 general hospitals. Based on the subgroups of the standards, 64.8% items of hospital resources and capabilities were considered as a subgroup with the maximum criteria, and 17.7% items of research section as another subgroup with the minimum standards.Conclusions: On the basis of our findings, no hospital meet all the Arizona trauma center standards completely. The hospitals as trauma centers at different levels must be promoted to manage trauma patients desirably.

  14. Strategic affiliate marketing

    DEFF Research Database (Denmark)

    Goldschmidt, Simon; Junghagen, Sven; Harris, Uri

    and interactions among various participants and agents. Rather than arguing the rights and wrongs in absolute terms, this book presents a strategy for engaging in affiliate marketing. The authors also examine what considerations should be taken into account before doing so, as well as investigating how to optimize......In this guide for both practitioners and academics on how to approach affiliate marketing, the authors explain the core values as well as challenging and combining established marketing theories in the light of new online marketing activities, taking into account the characteristics of the Internet...... resources once fully active in this area. This book focuses on how to build long term relationships with online partners, while gaining value and optimizing resources. As such, it should be of special interest to academics and students of management, marketing and business. Online advertisers and online...

  15. Strategic affiliate marketing

    DEFF Research Database (Denmark)

    Goldschmidt, Simon; Junghagen, Sven; Harris, Uri

    In this guide for both practitioners and academics on how to approach affiliate marketing, the authors explain the core values as well as challenging and combining established marketing theories in the light of new online marketing activities, taking into account the characteristics of the Internet...... and interactions among various participants and agents. Rather than arguing the rights and wrongs in absolute terms, this book presents a strategy for engaging in affiliate marketing. The authors also examine what considerations should be taken into account before doing so, as well as investigating how to optimize...... resources once fully active in this area. This book focuses on how to build long term relationships with online partners, while gaining value and optimizing resources. As such, it should be of special interest to academics and students of management, marketing and business. Online advertisers and online...

  16. Study on the effect of exclusive breastfeeding education on breastfeeding self-efficacy in mothers referring to affiliated hospitals of Medical Sciences Universities in Tehran during 2010-2011

    Directory of Open Access Journals (Sweden)

    Leila Mirshekari

    2016-08-01

    Full Text Available Breastfeeding saves the lives of more than half a million infants in a year and cause strong emotional relationship between mother and child and their psychosocial development of personality. The aim of this study is to evaluate the effect of exclusive breastfeeding education on mothers' breastfeeding self-efficacy and stress. This experimental study with clinical trial has randomly selected three hospitals from hospitals affiliated to medical sciences universities of Tehran with intensive care units for premature infants, and 100 eligible nulliparous mothers were sampled during three months. Mothers are randomly classified into case and control groups (each group with 50 samples. The case group received breastfeeding education and educational booklet, but control group received no education. A month later, the samples reanswered to questionnaires. Data is collected through questionnaires and analyzed by descriptive and inferential statistics, T-test, paired-t, and Chi-Square tests. The results indicate that there is a significant difference between breastfeeding self-efficacy in pre and posteducational case group, so that education has significant effect on breastfeeding self-efficacy (t=10.7, p<0.01. Breastfeeding education especially in premature infants increases the mothers' breastfeeding self-efficacy, and thus the mothers with premature infants require special breastfeeding education.

  17. 对西药制剂室空气净化系统验证方法的探讨%Beijing Capital Medical University Affiliated Beijing Children's Hospital Pharmacy

    Institute of Scientific and Technical Information of China (English)

    张建

    2011-01-01

    Affiliated with Capital Medical University, Beijing Children's Hospital medicine preparation room, and to analyze the authentication method of air purification system, testing programs, concluded between the environmental control and management measures required by clean, validated, inter-hospital medicine preparation room air cleaner in the air purification system precipitating bacterial culture has reached the requirements of purification is in line with requirements.%结合首都医科大学附属北京儿童医院西药制剂室情况,分析空气净化系统的验证方法、检测方案,总结控制管理洁净间环境要求的措施,通过验证,本院西药制剂室洁净间的空气净化系统在空气培养沉降菌方面达到了净化的要求,是符合规定的.

  18. An Investigation of Antibacterial Resistance Patterns Among Acinetobacter baumannii and Pseudomonas aeruginosa Isolates Collected from Intensive Care Units of a University-Affiliated Hospital in Ahvaz, Iran

    Science.gov (United States)

    Izadpour, Farrokh; Ranjbari, Nastaran; Aramesh, Mohammad-Reza; Moosavian, Mojtaba; ShahAli, Shiva; Larki, Farzaneh; Tabesh, Hamed; Morvaridi, Afrooz

    2016-01-01

    Background In recent decades, multidrug-resistant non-fermenting Gram-negative pathogens, particularly Acinetobacter baumannii and Pseudomonas aeruginosa, have been recognized as a major cause of healthcare-associated and nosocomial infections and outbreaks. Objectives The aim of this study was to determine the prevalence and pattern of antibiotic resistance in A. baumannii and P. aeruginosa isolates collected from intensive care units (ICUs). Methods One hundred fifty-five clinical isolates, including 80 (51.6%) isolates of A. baumannii and 75 (48.4%) isolates of P. aeruginosa, from hospitalized patients in the ICUs of a teaching hospital in Ahvaz, Iran, were collected from January 1 to December 30, 2013. The organisms were identified with conventional bacteriological methods, and antimicrobial susceptibility testing was performed on all isolates in accordance with clinical laboratory and standards institute (CLSI) guidelines. Results The maximum resistance rates among A. baumannii isolates were observed for ciprofloxacin and trimethoprim-sulfamethoxazole (96.9% and 95.2%, respectively). For P. aeruginosa isolates, the maximum resistance rates were reported for ceftriaxone and trimethoprim-sulfamethoxazole (97.2% and 92.4%, respectively). Conclusions The majority of A. baumannii and P. aeruginosa isolates were found to be resistant to commonly recommended antibiotics. Therefore, surveillance of antibiotic consumption and proper antibiotic administration guidelines are essential for preventing major outbreaks in the future. PMID:27800136

  19. Utility of telepathology as a consultation tool between an off-site surgical pathology suite and affiliated hospitals in the frozen section diagnosis of lung neoplasms

    Directory of Open Access Journals (Sweden)

    Taisia Vitkovski

    2015-01-01

    Full Text Available Background: Increasingly, as in our institution, operating rooms are located in hospitals and the pathology suite is located at a distant location because of off-site consolidation of pathology services. Telepathology is a technology which bridges the gap between pathologists and offers a means to obtain a consultation remotely. We aimed to evaluate the utility of telepathology as a means to assist the pathologist at the time of intraoperative consultation of lung nodules when a subspecialty pathologist is not available to directly review the slide. Methods: Cases of lung nodules suspicious for a neoplasm were included. Frozen sections were prepared in the usual manner. The pathologists on the intraoperative consultation service at two of our system hospitals notified the thoracic pathologist of each case after rendering a preliminary diagnosis. The consultation was performed utilizing a Nikon™ Digital Sight camera and web-based Remote Medical Technologies™ software with live video streaming directed by the host pathologist. The thoracic pathologist rendered a diagnosis without knowledge of the preliminary interpretation then discussed the interpretation with the frozen section pathologist. The interpretations were compared with the final diagnosis rendered after sign-out. Results: One hundred and three consecutive cases were included. The frozen section pathologist and a thoracic pathologist had concordant diagnoses in 93 cases (90.2%, discordant diagnoses in nine cases (8.7%, and one case in which both deferred. There was an agreement between the thoracic pathologist′s diagnosis and the final diagnosis in 98% of total cases including 8/9 (88.9% of the total discordant cases. In two cases, if the thoracic pathologist had not been consulted, the patient would have been undertreated. Conclusions: We have shown that telepathology is an excellent consultation tool in the frozen section diagnosis of lung nodules.

  20. Board affiliation and pay gap

    Institute of Scientific and Technical Information of China (English)

    Shenglan; Chen; Hui; Ma; Danlu; Bu

    2014-01-01

    This paper examines the effects of board affiliation on the corporate pay gap.Using a sample of Chinese listed firms from 2005 to 2011, we find that boards with a greater presence of directors appointed by block shareholders have lower pay gaps. Furthermore, the governance effects of board affiliation with and without pay are distinguished. The empirical results show that board affiliation without pay is negatively related to the pay gap, while board affiliation with pay is positively related to the pay gap. Overall, the results shed light on how block shareholders affect their companies’ pay gaps through board affiliation.

  1. 大理学院昆明附属医院常用药品剂型分析%Analysis on Commonly Used Pharmaceutical Dosage Forms in Kunming Affiliated Hospital of Dali University

    Institute of Scientific and Technical Information of China (English)

    王学昌

    2011-01-01

    Objective: To analyze commonly used pharmaceutical dosage forms in Kunming Affiliated Hospital of Dali University so as to provide suggestions on a rational use of medicine.Method: Statistics of defined daily dose(DDD) of medicine,medication frequency(DDDs) and frequency analysis of oral controlled release drugs in 2009 were analyzed.Result: Data showed that the oral traditional tablets and capsules accounted for 88.36%,sustained-release tablets and capsules accounted for 5.67%,and controlled-release tablet accounted for 0.6%.The majority of sustained or controlled release tablets were cardiovascular medicine.Conclusion: Traditional tablets and capsules were widely used in Kunming Affiliated Hospital of Dali University.The use of sustained and controlled released drug delivery system should be strengthened.%目的:对大理学院昆明附属医院药剂科常用药品的剂型种类进行调查和分析,为临床合理用药提供参考。方法:统计住院药房2010年在用药品剂型情况。采用限定日剂量(DDD)、用药频率(DDDs)和用药频度排序作为指标,对2009年我院口服缓控释药物的使用情况进行统计、分析。结果:口服普通片剂与胶囊剂占88.36%,缓释片剂与胶囊剂占5.67%,控释片剂约占0.6%。我院口服缓控释药物的应用以心血管系统用药为主。结论:我院住院药房以传统片剂、胶囊剂为主,应加强缓释制剂和控释制剂的应用与推广。

  2. A hospital-centered approach to improve emergency obstetric care in South Sudan.

    Science.gov (United States)

    Groppi, Lavinia; Somigliana, Edgardo; Pisani, Vincenzo; Ika, Michelina; Mabor, Joseph L; Akec, Henry N; Nhial, John A; Mading, Michel S; Scanagatta, Chiara; Manenti, Fabio; Putoto, Giovanni

    2015-01-01

    To assess provision of emergency obstetric care (EmOC) in Greater Yirol, South Sudan, after implementation of a hospital-centered intervention with an ambulance referral system. In a descriptive study, data were prospectively recorded for all women referred to Yirol County Hospital for delivery in 2012. An ambulance referral system had been implemented in October 2011. Access to the hospital and ambulance use were free of charge. The number of deliveries at Yirol County Hospital increased in 2012 to 1089, corresponding to 13.3% of the 8213 deliveries expected to have occurred in the catchment area. Cesareans were performed for 53 (4.9%) deliveries, corresponding to 0.6% of the expected number of deliveries in the catchment area. Among 950 women who delivered a newborn weighing at least 2500 g at the hospital, 6 (0.6%) intrapartum or very early neonatal deaths occurred. Of 1232 women expected to have major obstetric complications in 2012 in the catchment area, 472 (38.3%) received EmOC at the hospital. Of 115 expected absolute obstetric indications, 114 (99.1%) were treated in the hospital. A hospital-centered approach with an ambulance referral system effectively improves the availability of EmOC in underprivileged remote settings. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  3. Sex,age,and annual incidence of primary total knee arthroplasty:a university affiliated hospital survey of 3118 Chinese patients

    Institute of Scientific and Technical Information of China (English)

    YANG Bo; YU Jia-kuo; GONG Xi; CHEN Lian-xu; WANG Yong-jian; WANG Jian; MA Dong

    2012-01-01

    Background In recent years,the number of patients undergoing primary total knee arthroplasty in China has rapidly increased.However,the incidence of primary total knee arthroplasty is unknown.The purpose of this study was to investigate the sex,age and,annual incidence of primary total knee arthroplasty based on 3118 Chinese patients who underwent the procedure during the period of 2000-2011.Methods Total knee arthroplasties were performed on 511 males and 2607 females in our hospital during the period of 2000-2011.The sex,age,and annual incidence of primary total knee arthroplasty were evaluated.Results The annual incidence of primary total knee arthroplasty increased from 35 knees in 2000 to 681 knees in 2011.The average annual percentage increase in incidence was 33.2%.Females accounted for 83.2% of the patients who underwent primary total knee arthroplasty.In both males and females,the highest incidence was observed in the group aged 65-74 years.Conclusions This study demonstrated a rapid increase in the incidence of primary total knee arthroplasty in our Chinese study population.The sex and age incidence of primary total knee arthroplasty in our study population differed from those reported in Western populations.

  4. Workplace interpersonal conflicts among the healthcare workers: Retrospective exploration from the institutional incident reporting system of a university-affiliated medical center

    Science.gov (United States)

    Huang, Szu-Fen; Liang, Huey-Wen; Chen, Li-Chin; Lin, Chia-Kuei; Huang, Hsiao-Fang; Hsieh, Ming-Yuan; Sun, Jui-Sheng

    2017-01-01

    Objective There have been concerns about the workplace interpersonal conflict (WIC) among healthcare workers. As healthcare organizations have applied the incident reporting system (IRS) widely for safety-related incidents, we proposed that this system might provide a channel to explore the WICs. Methods We retrospectively reviewed the reports to the IRS from July 2010 to June 2013 in a medical center. We identified the WICs and typed these conflicts according to the two foci (task content/process and interpersonal relationship) and the three properties (disagreement, interference, and negative emotion), and analyzed relevant data. Results Of the 147 incidents with WIC, the most common related processes were patient transfer (20%), laboratory tests (17%), surgery (16%) and medical imaging (16%). All of the 147 incidents with WIC focused on task content or task process, but 41 (27.9%) also focused on the interpersonal relationship. We found disagreement, interference, and negative emotion in 91.2%, 88.4%, and 55.8% of the cases, respectively. Nurses (57%) were most often the reporting workers, while the most common encounter was the nurse-doctor interaction (33%), and the majority (67%) of the conflicts were experienced concurrently with the incidents. There was a significant difference in the distribution of worker job types between cases focused on the interpersonal relationship and those without (p = 0.0064). The doctors were more frequently as the reporter when the conflicts focused on the interpersonal relationship (34.1%) than not on it (17.0%). The distributions of worker job types were similar between those with and without negative emotion (p = 0.125). Conclusions The institutional IRS is a useful place to report the workplace interpersonal conflicts actively. The healthcare systems need to improve the channels to communicate, manage and resolve these conflicts. PMID:28166260

  5. Data Center Strategy to Increase Medical Information Sharing in Hospital Information Systems

    Directory of Open Access Journals (Sweden)

    Karim Zarour

    2013-05-01

    Full Text Available The sharing of medical information among healthcare providers is a key factor in improving any health care system. By providing opportunities for sharing and exchanging information and knowledge, data center, agent and ontology play a very important role in the field of medical informatics. In this paper, we propose a design of architecture and data center for the development of a Hospital information system (HIS based on agents and ontology.

  6. Social Welfare Centers Protect Outpatients with Mood Disorders from Risk of Hospital Admission.

    Directory of Open Access Journals (Sweden)

    Kyu-Tae Han

    Full Text Available South Korea faces difficulties in the management of mental disorders, and those difficulties are expected to gradually worsen. Therefore, we analyzed the relationship between social welfare centers and hospital admission after outpatient treatment for mood disorders.We used data from the National Health Insurance Service National Sample Cohort 2002-2013, which included all medical claims filed for the 50,160 patients who were newly diagnosed with a mood disorder among the 1,025,340 individuals in a nationally representative sample. We performed a logistic regression analysis using generalized estimating equation (GEE models to examine the relationship between social welfare centers and hospital admission after outpatient treatment for mood disorders (ICD-10: F3.There was a 3.9% admission rate among a total of 99,533 person-years. Outpatients who lived in regions with more social welfare centers were less likely to be admitted to a hospital (per increase of five social welfare centers per 100,000 people; OR: 0.958; 95% CI: 0.919-0.999. Social welfare centers had an especially strong protective effect on patients with relatively mild mood disorders and those who were vulnerable to medical expenditures.Considering the protective role of social welfare centers in managing patients with mood disorders, health-policy makers need to consider strategies for activating mental healthcare.

  7. COMPARISON OF DIFFERENT HELIPORT SOLUTIONS FOR THE CLINICAL HOSPITAL CENTER IN OSIJEK

    Directory of Open Access Journals (Sweden)

    Tatjana Timko

    2017-01-01

    Full Text Available Complexity in takeoff and landing operations of helicopters require careful planning and designing of heliport infrastructure. The world's biggest aviation organization, namely Federal Aviation Administration and International Civil Aviation Organization, published their standards and designing recommendations for heliport designers to implement that are analyzed and compared in this paper. In the Republic of Croatia, helicopters are designed according to the recommendations of National heliport regulations which are based on recommendations of International Civil Aviation Organization (Annex 14. The practical part of the paper deals with the implementation of national heliport standard recommendations in two variants of heliport designs for emergency medical service for the clinical hospital center in Osijek. As a potential location of the new heliport for emergency medical transportation a transit port is analyzed because it is close to the clinical hospital center in Osijek and is well connected with the existing road infrastructure, and it is also possible to make a direct access to the hospital complex from the north side. Two solutions were analyzed and compared upon the criteria of accessibility, security of operations and possibility for instrument flight conditions, size of heliport and necessary areas, costs of building and maintenance and helicopter noise. There is an intention that regional capital cities that have clinical hospital centers need to have infrastructure for emergency helicopter transportation near the hospital.

  8. [ISO 9002 at the Center of Pediatric Intensive Care at the Albert Einstein Israeli Hospital].

    Science.gov (United States)

    Gé Lacerda, D P; Rocha, M L; Santos, R P

    2000-01-01

    This study shows the process of implementation of a quality program in Pediatric Intensive Therapy Center of "Hospital Israelita Albert Einstein" which resulted in the certification of this service for the Standards ISO 9002/94. It points out the nurse's role as a leader in this process.

  9. Touriam Health Care Center of Xiyuan Hospital China Academy of Traditioal Chinese Medicine

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Brief Introduction to Xiyuan Hospital Xiyuan Hospital of China Academy of Traditional Chinese Medicine (TCM) was founded in 1955.It is a large comprehensive hospital directly attached to the Chinese Ministry of Health and State Administration of TOM. This hospital governs First Clinical Medical Institute, Gerontology Institute and Clinical Pharmacological Institute of China Academy of TOM, and Clinical Pharmacological Base of the Health Ministry. It is a component of WHO Collaborating Center for Traditional Medicine. It also administers the Agency of Chinese Journal of Integrated Traditional Chinese and Western Medicine, the Society of Clinical Pharmacology of Chinese Drugs of China TOM Association, the Professional Committee of Hematology and Activating Blood-circulation and Removing Blood Stasis of Chinese Society of Integrated Traditional Chinese and Western Medicine.

  10. [Current status of nosocomial infections in the Lebanese Hospital Center, Beirut].

    Science.gov (United States)

    Al-Hajje, A; Ezedine, M; Hammoud, H; Awada, S; Rachidi, S; Zein, S; Salameh, P

    2012-05-01

    Nosocomial infections are a significant problem and hospitals need to be aware of their nosocomial infection status. This retrospective study aimed to identify nosocomial bacterial infections in patients admitted to the Lebanese Hospital Center from January 2006 to January 2008 and determine the causative micro-organisms, the antibiotic sensitivity of the micro-organisms and evaluate the hospital treatment. In total 96 patients with nosocomial infection were included. Urinary infections were the commonest nosocomial infections (42%) followed by pulmonary infections (28%). Gram-negative bacteria were responsible for 89% of nosocomial infections and staphylococci for 7%, with Escherichia coli and Pseudomonas aeruginosa being the most common (46% and 26% respectively). The organisms were resistant to multiples antibiotics and 18% of the patients were treated with imipenem, 7% with vancomycin, 42% with third-generation cephalosporins and 24% with amikacin. Hospital hygiene measures and antibiotic prescription policies are required to fight nosocomial infections and reduce antibiotic resistance among organisms.

  11. Happy crisis tests hospitals' PR plan. Septuplets' arrival swamps Iowa hospitals with national, international media. Blank Children's Hospital, Iowa Methodist Medical Center, Des Moines.

    Science.gov (United States)

    1998-01-01

    The public relations staff believed the birth of healthy septuplets would become a human interest story for local media. But the staff was stunned at the outpouring of international and national media knocking at their front doors. The staff of both Iowa Methodist Medical Center and Blank Children's Hospital in Des Moines, Iowa, organized a communications plan for 14 official press conferences, constant updates to the media and a website to handle ongoing inquiries from the public. As a result, the story of the McCaughey septuplets was shown in more than 10,000 television stories around the world. The hospitals received more than 36,000 magazine and newspaper articles. The public relations staff not only fielded more than 2,000 phone calls in the days following the Nov. 19 birth, but more than 15 major networks parked their vehicles and satellite dishes in front of the hospital.

  12. Center of nanotechnology for cancer diagnosis and treatment launched in Tianjin

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ On 24 August, a center of nanotechnology for cancer diagnosis and treatment was officially inaugurated in Tianjin. The center was jointly established by the CAS Institute of High-energy Physics, the CAS affiliated National Center for Nanoscience and Technology, and the Tianjin Medical University Cancer Institute and Hospital.

  13. A management plan for hospitals and medical centers facing radiation incidents.

    Science.gov (United States)

    Davari, Fereshteh; Zahed, Arash

    2015-09-01

    Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

  14. Out-of-Hospital ICU Transfers to an Oncological Referral Center.

    Science.gov (United States)

    Gutierrez, Cristina; Cárdenas, Yenny R; Bratcher, Kristie; Melancon, Judd; Myers, Jason; Campbell, Jeannee Y; Feng, Lei; Price, Kristen J; Nates, Joseph L

    2016-01-01

    To determine resource utilization and outcomes of out-of-hospital transfer patients admitted to the intensive care unit (ICU) of a cancer referral center. Single-center cohort. A tertiary oncological center. Patients older than 18 years transferred to our ICU from an outside hospital between January 2013 and December 2015. A total of 2127 (90.3%) were emergency department (ED) ICU admissions and 228 (9.7%) out-of-hospital transfers. The ICU length of stay (LOS) was longer in the out-of-hospital transfers when compared to all other ED ICU admissions ( P = .001); however, ICU and hospital mortality were similar between both groups. The majority of patients were transferred for a higher level of care (77.2%); there was no difference in the amount of interventions performed, ICU LOS, and ICU mortality between nonhigher level-of-care and higher level-of-care patients. Factors associated with an ICU LOS ≥10days were a higher Sequential Organ Failure Assessment (SOFA) score, weekend admissions, presence of shock, need for mechanical ventilation, and acute kidney injury on admission or during ICU stay ( P transferred patients was 17.5% and associated risk factors were older age, higher SOFA score on admission, use of mechanical ventilation and vasopressors during ICU stay, and renal failure on admission ( P transfer such as LOS at the outside facility, time of transfer, delay in transfer, and longer distance traveled were not associated with increased LOS or mortality in our study. Organ failure severity on admission, and not transfer-related factors, continues to be the best predictor of outcomes of critically ill patients with cancer when transferred from other facilities to the ICU. Our data suggest that transferring critically ill patients with cancer to a specialized center does not lead to worse outcomes or increased resource utilization when compared to patients admitted from the ED.

  15. Problems and countermeasures research of the management of medical teaching archives in affiliated hospital%医院医疗教学档案管理中的问题及对策研究

    Institute of Scientific and Technical Information of China (English)

    樊晓昱

    2014-01-01

    Objective: To improve the convenience of using the medical teaching archives and the efficiency of resource sharing as well as to enhance the level of administrative ability through the analysis of the management problems of medical teaching archives in affiliated hospital. Methods: Reinforcing the awareness of medical teaching archives and Perfecting the administrative system and principles so as to develop an united format and formalize the ways of taking care of those archives, accelerating the pace of information age and enhancing Professional quality of management personnel. Results: The rate of complete medical teaching archives is close to 100 percent. The convenience to reach is increased. Conclusion:A qualitative leap is observed in the administration of medical teaching archives. The medical teaching quality has been greatly improved.%目的:通过对医院医疗教学档案管理中存在的问题进行剖析并提出对策,以提高医疗教学档案的利用率,达到提升医院医疗教学档案管理水平和资源共享的目的。方法:提高管理人员业务素质,强化科教档案意识,健全档案管理组织体系和制度,规范档案保管,加快信息化建设步伐。结果:强化医院医疗教学档案管理后使教学档案的完整归档率达到100%,教学档案的利用更加便捷。结论:医疗教学档案完整归档率的提高,可使医院教学质量明显提升。

  16. 77 FR 9665 - Submission for OMB Emergency Review; Comment Request: A Multi-Center International Hospital-Based...

    Science.gov (United States)

    2012-02-17

    ... Multi- Center International Hospital-Based Case-Control Study of Lymphoma in Asia (AsiaLymph) (NCI... Institute (NCI), the National Institutes of Health (NIH), has submitted to the Office of Management and... currently valid OMB control number. Proposed Collection: Title: A Multi-Center International Hospital-...

  17. Neuroanatomical affiliation visualization-interface system.

    Science.gov (United States)

    Palombi, Olivier; Shin, Jae-Won; Watson, Charles; Paxinos, George

    2006-01-01

    A number of knowledge management systems have been developed to allow users to have access to large quantity of neuroanatomical data. The advent of three-dimensional (3D) visualization techniques allows users to interact with complex 3D object. In order to better understand the structural and functional organization of the brain, we present Neuroanatomical Affiliations Visualization-Interface System (NAVIS) as the original software to see brain structures and neuroanatomical affiliations in 3D. This version of NAVIS has made use of the fifth edition of "The Rat Brain in Stereotaxic coordinates" (Paxinos and Watson, 2005). The NAVIS development environment was based on the scripting language name Python, using visualization toolkit (VTK) as 3D-library and wxPython for the graphic user interface. The following manuscript is focused on the nucleus of the solitary tract (Sol) and the set of affiliated structures in the brain to illustrate the functionality of NAVIS. The nucleus of the Sol is the primary relay center of visceral and taste information, and consists of 14 distinct subnuclei that differ in cytoarchitecture, chemoarchitecture, connections, and function. In the present study, neuroanatomical projection data of the rat Sol were collected from selected literature in PubMed since 1975. Forty-nine identified projection data of Sol were inserted in NAVIS. The standard XML format used as an input for affiliation data allows NAVIS to update data online and/or allows users to manually change or update affiliation data. NAVIS can be extended to nuclei other than Sol.

  18. Kliniken auf dem Weg zur digitalen Informationsversorgung: Evaluation und Neustrukturierung der Zeitschriftenbeschaffung eines Klinikkonzern / Hospitals heading for digital information supply: evaluation and restructuring of the journal acquisition of a group of affiliated hospitals (Product Review

    Directory of Open Access Journals (Sweden)

    Stadler Manfred

    2008-12-01

    Full Text Available The provision of professional information in hospitals as well as the need of both physicians and purchasers to streamline the process by means of appropriate solutions challenge all players in the value chain. This article describes a case study from the evaluation of the status quo to the implementation of the resulting project steps.

  19. Cesarean Outcomes in US Birth Centers and Collaborating Hospitals: A Cohort Comparison.

    Science.gov (United States)

    Thornton, Patrick; McFarlin, Barbara L; Park, Chang; Rankin, Kristin; Schorn, Mavis; Finnegan, Lorna; Stapleton, Susan

    2017-01-01

    High rates of cesarean birth are a significant health care quality issue, and birth centers have shown potential to reduce rates of cesarean birth. Measuring this potential is complicated by lack of randomized trials and limited observational comparisons. Cesarean rates vary by provider type, setting, and clinical and nonclinical characteristics of women, but our understanding of these dynamics is incomplete. We sought to isolate labor setting from other risk factors in order to assess the effect of birth centers on the odds of cesarean birth. We generated low-risk cohorts admitted in labor to hospitals (n = 2527) and birth centers (n = 8776) using secondary data obtained from the American Association of Birth Centers (AABC). All women received prenatal care in the birth center and midwifery care in labor, but some chose hospital admission for labor. Analysis was intent to treat according to site of admission in spontaneous labor. We used propensity score adjustment and multivariable logistic regression to control for cohort differences and measured effect sizes associated with setting. There was a 37% (adjusted odds ratio [OR], 0.63; 95% confidence interval [CI], 0.50-0.79) to 38% (adjusted OR, 0.62; 95% CI, 0.49-0.79) decreased odds of cesarean in the birth center cohort and a remarkably low overall cesarean rate of less than 5% in both cohorts. These findings suggest that low rates of cesarean in birth centers are not attributable to labor setting alone. The entire birth center care model, including prenatal preparation and relationship-based midwifery care, should be studied, promoted, and implemented by policy makers interested in achieving appropriate cesarean rates in the United States. © 2016 by the American College of Nurse-Midwives.

  20. Diverticulitis Outcomes are Equivalent Between Level 1 Trauma Centers and Community Hospitals in New Jersey.

    Science.gov (United States)

    Gale, Stephen C; Arumugam, Dena; Dombrovskiy, Viktor Y

    2015-06-01

    Traditionally, general surgeons provide emergency general surgery (EGS) coverage by assigned call. The acute care surgery (ACS) model is new and remains confined mostly to academic centers. Some argue that in busy trauma centers, on-call trauma surgeons may be unable to also care for EGS patients. In New Jersey, all three Level 1 Trauma Centers (L1TC) have provided ACS services for many years. Analyzing NJ state inpatient data, we sought to determine whether outcomes in one common surgical illness, diverticulitis, have been different between L1TC and nontrauma centers (NTC) over a 10-year period. The NJ Medical Database was queried for patients aged 18 to 90 hospitalized from 2001 to 2010 for acute diverticulitis. Demographics, comorbidities, operative rates, and mortality were compiled and analyzed comparing L1TC to NTC. For additional comparison between L1TC and NTC, 1:1 propensity score matching with replacement was accomplished. χ(2), t test, and Cochran-Armitage trend test were used. From 2001 to 2010, 88794 patients were treated in NJ for diverticulitis. 2621 patients (2.95%) were treated at L1TCs. Operative rates were similar between hospital types. Patients treated at L1TCs were more often younger (63.1 ± 0.3 vs 64.7 ± 0.1; P diverticulitis are equivalent between LT1C and NTC in NJ. Trauma centers in NJ more commonly provide care to minority and uninsured patients.

  1. [Perception of the organizational climate in the surgical center of a specialized hospital].

    Science.gov (United States)

    Spiri, W C

    1998-01-01

    The aim of this study is to identify how a new team of the surgical center staff in a specialized hospital perceive the organization climate. A qualitative approach was utilized. As a theoretical reference to measure the organization climate, we have used CHIAVENATO, that defines organization climate as the interior of an organization that influences its members behavior. The organization climate could be favourable, unfavourable or neutral. The speeches showed a favourable organization climate considering the adopted methodology.

  2. Testing family-centered, function-focused care in hospitalized persons with dementia

    Science.gov (United States)

    Boltz, Marie; Chippendale, Tracy; Resnick, Barbara; Galvin, James E

    2015-01-01

    Summary Aim Hospital-acquired disability causes decreased quality of life for patients with dementia and family caregivers, and increased societal costs. Materials & methods A comparative, repeated measures study tested the feasibility and preliminary efficacy of the family-centered, function-focused care intervention (Fam-FFC) in dyads of hospitalized, medical patients with dementia and family caregivers (FCGs). Results The intervention group demonstrated better activities of daily living and walking performance, and less severity/duration of delirium and hospital readmissions, but no significant differences in gait/balance. FCGs showed increased preparedness for caregiving and less anxiety but no significant differences in depression, strain and mutuality. Conclusion Fam-FFC presents a possible pathway to meeting the Triple Aim of improved patient care, improved patient health and reduced costs for persons with dementia. PMID:26107319

  3. Early Hospital Readmission After Simultaneous Pancreas-Kidney Transplantation: Patient and Center-Level Factors.

    Science.gov (United States)

    King, E A; Kucirka, L M; McAdams-DeMarco, M A; Massie, A B; Al Ammary, F; Ahmed, R; Grams, M E; Segev, D L

    2016-02-01

    Early hospital readmission is associated with increased morbidity, mortality, and cost. Following simultaneous pancreas-kidney transplantation, rates of readmission and risk factors for readmission are unknown. We used United States Renal Data System data to study 3643 adult primary first-time simultaneous pancreas-kidney recipients from December 1, 1999 to October 31, 2011. Early hospital readmission was any hospitalization within 30 days of discharge. Modified Poisson regression was used to determine the association between readmission and patient-level factors. Empirical Bayes statistics were used to determine the variation attributable to center-level factors. The incidence of readmission was 55.5%. Each decade increase in age was associated with an 11% lower risk of readmission to age 40, beyond which there was no association. Donor African-American race was associated with a 13% higher risk of readmission. Each day increase in length of stay was associated with a 2% higher risk of readmission until 14 days, beyond which each day increase was associated with a 1% reduction in the risk of readmission. Center-level factors were not associated with readmission. The high incidence of early hospital readmission following simultaneous pancreas-kidney transplant may reflect clinical complexity rather than poor quality of care.

  4. Comparison of CDE data in phacoemulsification between an open hospital-based ambulatory surgical center and a free-standing ambulatory surgical center

    Directory of Open Access Journals (Sweden)

    Ming Chen

    2010-11-01

    Full Text Available Ming Chen1, Mindy Chen21University of Hawaii, Honolulu, HI, USA; 2University of California, Irvine, CA, USAAbstract: Mean CDE (cumulative dissipated energy values were compared for an open hospital-based surgical center and a free-standing surgical center. The same model of phacoemulsifier (Alcon Infiniti Ozil was used. Mean CDE values showed that surgeons (individual private practice at the free-standing surgical center were more efficient than surgeons (individual private practice at the open hospital-based surgical center (mean CDE at the hospital-based surgical center 18.96 seconds [SD = 12.51]; mean CDE at the free-standing surgical center 13.2 seconds [SD = 9.5]. CDE can be used to monitor the efficiency of a cataract surgeon and surgical center in phacoemulsification. The CDE value may be used by institutions as one of the indicators for quality control and audit in phacoemulsification.Keywords: CDE (cumulative dissipated energy, open hospital-based ambulatory surgical center, free-standing surgical center, phacoemulsification 

  5. Patient Outcomes following Subarachnoid Hemorrhage between the Medical Center and Regional Hospital: Whether All Patients Should Be Transferred to Medical Centers

    Directory of Open Access Journals (Sweden)

    Tsung-Ying Lin

    2014-01-01

    Full Text Available Subarachnoid hemorrhage (SAH is a critical illness that may result in patient mortality or morbidity. In this study, we investigated the outcomes of patients treated in medical center and nonmedical center hospitals and the relationship between such outcomes and hospital and surgeon volume. Patient data were abstracted from the National Health Insurance Research Database of Taiwan in the Longitudinal Health Insurance Database 2000, which contains all claims data of 1 million beneficiaries randomly selected in 2000. The International Classification of Diseases, Ninth Revision, subarachnoid hemorrhage (430 was used for the inclusion criteria. We identified 355 patients between 11 and 87 years of age who had subarachnoid hemorrhage. Among them, 32.4% (115/355 were men. The median Charlson comorbidity index (CCI score was 1.3 (SD ± 0.6. Unadjusted logistic regression analysis demonstrated that low mortality was associated with high hospital volume (OR = 3.21; 95% CI: 1.18–8.77. In this study, we found no statistical significances of mortality, LOS, and total charges between medical centers and nonmedical center hospitals. Patient mortality was associated with hospital volume. Nonmedical center hospitals could achieve resource use and outcomes similar to those of medical centers with sufficient volume.

  6. Veteran Religious Affiliation by State

    Data.gov (United States)

    Department of Veterans Affairs — This dataset provide a count of Veteran by their religious affiliation and state of residence. The dataset set covers all 50 states, District of Columbia and other...

  7. The experience of Latino parents of hospitalized children during family-centered rounds.

    Science.gov (United States)

    Walker-Vischer, Lisa; Hill, Constance; Mendez, Suzanne S

    2015-03-01

    The aim of this study is to describe the experience of Latino parents of hospitalized children during family-centered rounds (FCRs). Family-centered rounds provide a mechanism to exchange information and facilitate shared decision making. Latino parents may have a suboptimal experience during FCRs. Understanding this experience helps nurse leaders improve patient satisfaction. Using a convenience sample, written surveys in Spanish were given to 20 parents who had attended at least 2 FCRs. The surveys were translated into English for data analysis. The narrative data were analyzed for common themes using content analysis. Four themes were identified: valued perception, inclusion and care, facilitated communication, and meeting expectations. Parents in this study felt that their participation and input were valued and that these positively impacted care. Family-centered rounds helped them understand the plan and facilitated communication when done in Spanish. Nurse leaders play a key role in improving satisfaction and increasing access to translation services or bilingual staff.

  8. Construction on dynamic competence of hospitals based on strategic flexibility-a case study of the First Affiliated Hospital of Zhengzhou University%基于战略柔性的医院动态竞争力构建--以郑州大学第一附属医院为例

    Institute of Scientific and Technical Information of China (English)

    林恒大; 时郁; 赵杰; 翟运开

    2014-01-01

    Based on the perspective of strategic flexibility, this paper constructs a conceptual model of hospitals' dynamic competence in view of strategic flexibility. It divides the strategic flexibility into three kinds which can be summarized as capability flexibility, resource flexibility and technology flexibility. Taking the First Affiliated Hospital of Zhengzhou University as an example, the application of the model is discussed and gives theory basis for hospital management.%基于战略柔性的视角,构建了基于战略柔性的医院动态竞争力概念模型,将医院的战略柔性分为能力柔性、资源柔性和技术柔性3个方面,并以郑州大学第一附属医院为例,探讨了模型在实践中的应用,为医院的管理实践提供了理论基础。

  9. 湖北民族学院附属民大医院药品不良反应相关因素分析%Related Factors of Adverse Drug Reactions in Hubei University for Nationalities Affiliated Minda Hospital

    Institute of Scientific and Technical Information of China (English)

    李红玲; 庄红玲; 谭娜; 郭淑敏; 覃正碧

    2015-01-01

    OBJECTIVE:To analyze the related factors of the adverse drug reactions ( ADRs) in Hubei University for Nationalities Affiliated Minda Hospital so as to probe into the characteristics of the ADRs for clinical reference of safe medication.METHODS:A total of 75 ADR cases reported from January 2012 to October 2014 in this hospital were analyzed with regard to patients'age, drug type, routes of administration, ADR-involved organs or systems, and medication information and outcomes of the new and severe ADR cases.RESULTS: The ADRs occurred in different age group, and induced mostly by intravenously administered drugs, by anti-infective drugs and traditional Chinese medicine injections, and manifested mostly by the damage of skin and its appendages.The new and serious ADR occurred more often in patients with a history of allergy and in thosev treated with combination of multiple drugs. CONCLUSION:To avoid the risk of medication and reduce the occurrence of ADR in this hospital, it is important to attach great importance to the special population including the infants and elderly and those with hypersensitivity, reduce the ratio of intravenous administration, avoid excessive use of antimicrobial drugs and regulate the use of traditional Chinese medicine injections.%目的:通过对湖北民族学院附属民大医院上报的药品不良反应( ADR)及相关因素进行分析,了解药品不良反应发生特点,为临床安全用药提供依据。方法:收集该院2012年1月至2014年10月上报的200例ADR报告,对发生ADR的患者年龄、药品类别、用药途径、发生部位以及新发严重ADR的用药信息及转归等情况进行汇总统计分析。结果:ADR可涉及任意年龄阶段,静脉给药方式是引起ADR的主要途径,涉及药物以抗感染药物、中药注射剂为主,临床表现以皮肤及其附件损害的表现多见。新发严重ADR多发生在有过敏史的患者,且联合用药品种较多。结论:关

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

    Science.gov (United States)

    Carden, Robert; DelliFraine, Jami L

    2005-01-01

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

  11. Evaluation on Management of Fixed Assets in Hospital --A Case Study in First Affiliated Hospital of Xinjiang Medical University%固定资产管理评价——以新疆医科大学第一附属医院为例

    Institute of Scientific and Technical Information of China (English)

    王明华; 齐新红; 董新文

    2011-01-01

    It is the dominant factor for increasing the economic returns and social benefits and also the basic requirement for achieving the resources - saving society to strengthen the management and raise the allocative efficiency of fixed assets in hospital. In this paper, the working personnel of the First Affiliated Hospital of Xinjiang Medical University are investigated, and the actuality and existing problems of the performance management of fixed assets in the hospital are roundly analyzed and evaluated. Some measures and suggestions are put forward from the aspects of management consciousness of the working personnel, management system of use, management system of maintenance, internal auditing system and network administration of the fixed assets in the hospital. The study results can provide the scientific basis for managing the fixed assets in hospital.%加强固定资产管理,提高配置效率,是提升医院经济效益和社会效益的主导要素,也是实现资源节约型社会的根本要求。本文通过对新疆医科大学第一附属医院进行实践调研,全面分析评价了医院固定资产管理现状和存在的问题,并从医院工作人员固定资产管理意识、使用管理制度、维护管理制度、内部审计制度以及计算机网络管理等方面提出了对策建议,为医院固定资产管理提供科学依据。

  12. Prognostic Implications of Level-of-Care at Tertiary Heart Centers Compared With Other Hospitals After Resuscitation From Out-of-Hospital Cardiac Arrest

    DEFF Research Database (Denmark)

    Søholm, Helle; Kjaergaard, Jesper; Bro-Jeppesen, John

    2015-01-01

    . The adjusted odds of predefined markers of level-of-care were higher in tertiary centers: admission to intensive care unit (odds ratio [OR], 1.8 [95% confidence interval, 1.2-2.5]), temporary pacemaker (OR, 6.4 [2.2-19]), vasoactive agents (OR, 1.5 [1.1-2.1]), acute (...-segment-elevation myocardial infarction in the Copenhagen area even after adjustment for prognostic factors including comorbidity. Level-of-care seems higher in tertiary centers both in the early phase, during the intensive care unit admission, and in the workup before discharge. The varying level-of-care may contribute......BACKGROUND: Studies have found higher survival rates after out-of-hospital cardiac arrest and admission to tertiary heart centers. The aim was to examine the level-of-care at tertiary centers compared with nontertiary hospitals and the association with outcome after out-of-hospital cardiac arrest...

  13. Work ability among nursing personnel in public hospitals and health centers in Campinas--Brazil.

    Science.gov (United States)

    Monteiro, Inês; Chillida, Manuela de Santana Pi; Moreno, Luciana Contrera

    2012-01-01

    Nursing personnel is essential in hospital, health centers and enterprises and is the large work force in health system. A cross-sectional study was conducted in a large city in two public hospitals and five health centre with the objective of to evaluate the work ability and health aspects of nursing staff. The sample was composed by 570 workers. The Work Ability Index - WAI and a questionnaire with socio-demographic, health and life style data was applied. The majority of workers was women (83%), married (50.4%), and was working in night shift work (65.6%); 61.4% was auxiliary nursing, 22.3% was registered nurses (RN). The average age was 38.9 years (SD 7.8) and the Body Mass Index mean was 25.8 (SD 5.3). Only 17.2% referred to practice at least 150 minutes of physical exercise five times per week or more. 26.8% had a second job. The work ability mean was 39.3 (SD 5.3) points. Age had a negative correlation with WAI (p=0.0052). Public hospital and health centre workers had poor work ability score when compared with workers from another branches. Public policies related to workplace health promotion need to be implemented in public hospital and health centre to improve the work ability.

  14. 2009年重庆医科大学附属第一医院细菌耐药监测%Surveillance of bacterial resistance from the first affiliated hospital of Chongqing Medical University in 2009

    Institute of Scientific and Technical Information of China (English)

    魏晓宇; 贾蓓; 常李军; 黄文祥; 李崇智; 郑行萍

    2011-01-01

    Objective To investigate the bacterial resistance of clinical isolates from the first affiliated hospital of Chongqing Medical University in 2009. Methods Disk diffusion method was used to determine the antimicrobial susceptibility. And WHONET 5.4 and SPSS13.0 softwares were used to analyze the data. Results Of 1608 clinical isolates, Gram-positive organisms accounted for 25.1%, and Gram-negative organisms 74.9%. The detection rates of methicillin-resistant Staphylococcus aureus (MRSA) and coagulase-negative staphylococci (CNS) were 63.7% and 93.7%, respectively. No strains of staphylococci and enterococci were found resistant or intermediate to vancomycin and/or teicoplanin. Extended chain hemoglobinxtended-spectrum p-lactamases (ESBLs) positive rates of Escherichia coli and Klebsiella spp. Were 57.2% and 56.8%, respectively. ESBLs positive rate of Klebsiella spp was higher than that obtained in 2008, and the discrepancy was statistically significant (P0.05). The carbapenem resistance rate in Acinetobacter spp. Was more than 55%. Conclusions In our hospital, gram-positive bacteria are still susceptible to the vancomycin teicoplanin and linezolid. For Enterobacteriaceae spp., carbapenems are the most potent antimicrobialt. Amikacin and cefoperazone/sulbactam rank the first and second efficacious drugs against Pseudomonas aeruginosa. Albeit the resistant rate of Acinetobacter baumannii to carbapenem is high, cefoperazone/sulbactam remains relatively sensitive. No Pan-drug resistant strains are found.%目的 调查我院2009年临床分离病原菌对抗菌药物的耐药性.方法 采用纸片扩散法进行抗菌药物敏感实验,采用WHONET5.4软件及SPSS13.0软件进行数据分析.结果 临床分类的1608株病原菌中,革兰阳性菌占25.1%,革兰阴性菌占74.9%:耐甲氧西林金黄色葡萄球菌和凝固酶阴性葡萄球菌株检出率分别为63.7%和93.7%:未发现对万古霉素或替考拉宁中介或耐药的葡萄球菌和肠球菌菌株.大

  15. 77 FR 56854 - Submission for OMB Review; Comment Request: A Multi-Center International Hospital-Based Case...

    Science.gov (United States)

    2012-09-14

    ... recent decades. Specifically, environmental exposures to industrial emissions, genetic susceptibility... International Hospital-Based Case-Control Study of Lymphoma in Asia (AsiaLymph) (NCI) SUMMARY: Under the... currently valid OMB control number. Proposed Collection: Title: A Multi-Center International Hospital-...

  16. 77 FR 11136 - Proposed Collection; Comment Request; a Multi-Center International Hospital-Based Case-Control...

    Science.gov (United States)

    2012-02-24

    ... International Hospital-Based Case-Control Study of Lymphoma in Asia (AsiaLymph) (NCI) SUMMARY: In compliance... the Office of Management and Budget (OMB) for review and approval. Proposed Collection: Title: A Multi-Center International Hospital- Based Case-Control Study of Lymphoma in Asia (AsiaLymph) (NCI). Type...

  17. The Strategic Value of Affiliation Partnerships in Securing Future Relevance.

    Science.gov (United States)

    Saunders, Ninfa M

    2017-01-01

    Finding the best route to navigate the changing landscape of healthcare has become an obsession for many organizations. Their quest to stay competitive, significant, and ultimately relevant is a continuous discovery process. Many hospitals and health systems have considered affiliations and partnerships as important tactical options. Partnerships can range from loose arrangements, such as nonequity collaborations and management agreements, to total affiliation, as in a merger and acquisition. Whichever option an organization decides to pursue, a comprehensive assessment is necessary to find the best partner-the right fit. Addressing the "why," "when," "how," and "with whom" questions is fundamental. Having the depth and breadth of resources to manage the discovery process is equally important.Learning from others who have experienced this journey is helpful, as is the support of industry experts. However, one task that cannot be delegated is discerning whether affiliation is right for an organization. That is the responsibility of an organization's leadership team, which must consider the dynamic forces in play when evaluating an affiliation partnership. Many of the suggested modalities revolve around how the affiliation partnership can provide a value proposition for the entities involved. Furthermore, inevitable challenges emerge when fiercely independent and successful organizations come together at different levels of need and readiness. Anticipating and providing for the potential exit of any member are matters that the partnership must accept and prepare for, and the ability to execute can make or break the trajectory toward a value proposition. A strong resolve to monitor, measure, calibrate, and recalibrate can give a partnership the agility to pivot toward relevance and sustainability.Stratus Healthcare applied principles of alignment and affiliation in creating the largest collaborative partnership of hospitals in the southeastern United States. Drawing

  18. Analysis of the Service Quality of Medical Centers Using Servqual Model (Case:Shaheed Rahnemoon Hospital

    Directory of Open Access Journals (Sweden)

    H Zare Ahmadabadi

    2007-07-01

    Full Text Available Introduction: Many organizations, especially service oriented ones, relative to their goals and mission, have a special view towards quality phenomena and its management. Methods: This paper analyzes medical service quality in one case; The internal section of Shaheed Rahnemoon Hospital Based on the basis of gap analysis model and Servqual technique. A questionnaire was designed and applied to measure expectations and perceptions of patients and personnel of the hospital. Results: On application of non-parametric statistical tests, we propose certain recommendations. These tests drive on five conceptual dimensions of service quality including intangibility, responsiveness, reliability, assurance and empathy. Results show that patients in this section were satisfied from the service provider’s responsiveness, but there are significant differences between expectations and perceptions in other dimensions. Conclusion: The service quality analysis models are useful for managers of medical centers to distinguish gaps between the two sides of service representation; patients and medical centers personnel. Ultimately, they can reinforce strengths and control weaknesses.

  19. Differences between hospital- and community-acquired blood exposure incidents revealed by a regional expert counseling center.

    NARCIS (Netherlands)

    Wijk, P.T. van; Pelk-Jongen, M.; Boer, E. de; Voss, A.; Wijkmans, C.; Schneeberger, P.M.

    2006-01-01

    OBJECTIVE: One year (2003) regional analysis of all blood exposure incidents from hospitals as well as from the community. DESIGN: Establishment of an easily accessible regional expert counseling center, operating 24 h a day, for all accidental blood exposures. Tasks of the center were to register i

  20. Differences between hospital- and community-acquired blood exposure incidents revealed by a regional expert counseling center.

    NARCIS (Netherlands)

    Wijk, P.T. van; Pelk-Jongen, M.; Boer, E. de; Voss, A.; Wijkmans, C.; Schneeberger, P.M.

    2006-01-01

    OBJECTIVE: One year (2003) regional analysis of all blood exposure incidents from hospitals as well as from the community. DESIGN: Establishment of an easily accessible regional expert counseling center, operating 24 h a day, for all accidental blood exposures. Tasks of the center were to register i

  1. Testing a Family-centered Intervention to Promote Functional and Cognitive Recovery in Hospitalized Older Adults

    Science.gov (United States)

    Boltz, Marie; Resnick, Barbara; Chippendale, Tracy; Galvin, James

    2016-01-01

    A comparative trial using repeated measures design evaluated the feasibility and outcomes of the Family-centered Function-focused Care (Fam-FFC) intervention intended to promote functional recovery in the hospitalized older adult. A three component intervention (1) environmental assessment/ modification, 2) staff education, 3) family/patient education and partnership in care planning with post-acute follow-up) was implemented by a family-centered resource nurse and a facility champion. Control units were exposed to function-focused care education only. Ninety-seven dyads of medical patients age 65 and older and family caregivers (FCGs) were recruited from three medical units of a community teaching hospital. The majority of patients were female (53%); white (89%), married (51%) or widowed (40%), with a mean age of 80.8 (± 7.5). The majority of FCGs were married (78%) daughters (34%), followed by female spouses/partners (31%), in the age range of 46–65 (38%). Outcomes for patients included: functional outcomes (ADL and walking performance, gait, balance), and delirium severity and duration. FCG outcomes included preparedness for caregiving, anxiety, depression, role strain, and mutuality. The intervention group demonstrated less severity and duration of delirium, and better ADL and walking performance, but not gait/balance as compared to the control group. FCG who participated in Fam-FFC showed a significant increase in preparedness for caregiving, less anxiety and less depression from admission to two months post-discharge, but no significant differences in strain and mutuality, as compared to FCG in the control group. Fam-FFC is feasible and has the potential to improve outcomes for hospitalized older adults and family caregivers. PMID:25481973

  2. Direct Transport to a Percutaneous Cardiac Intervention Center and Outcomes in Patients With Out-of-Hospital Cardiac Arrest

    DEFF Research Database (Denmark)

    Sørensen, Kristian Dahl Kragholm; Malta Hansen, Carolina; Dupre, Matthew E

    2017-01-01

    BACKGROUND: Practice guidelines recommend regional systems of care for out-of-hospital cardiac arrest. However, whether emergency medical services should bypass nonpercutaneous cardiac intervention (non-PCI) facilities and transport out-of-hospital cardiac arrest patients directly to PCI centers...... despite longer transport time remains unknown. METHODS AND RESULTS: Using the Cardiac Arrest Registry to Enhance Survival with geocoding of arrest location, we identified out-of-hospital cardiac arrest patients with prehospital return of spontaneous circulation and evaluated the association between direct...... transport to a PCI center and outcomes in North Carolina during 2012 to 2014. Destination hospital was classified according to PCI center status (catheterization laboratory immediately accessible 24/7). Inverse probability-weighted logistic regression accounting for age, sex, emergency medical services...

  3. Satisfaction of oncologic patients hospitalized in centers with and without service of palliative cares: multicentric study

    Directory of Open Access Journals (Sweden)

    Fernando Campaña Castillo

    2013-09-01

    Full Text Available The aim of this study is to determine the satisfaction regarding care of patients suffering advanced stage cancer admitted in Hospital Sant Jaume de Calella, Sant Rafael de Barcelona and San Lorenzo de Viladecans, subject to the presence or absence of Palliative Care Unit during 2012. An observational, descriptive and transversal study will be conducted.The assessed population are patients admitted to these centers that meet the requirements for inclusion and exclusion.In the Hospital Sant Jaume de Calella, which provides Palliative Care service, patients will be check into the Internal Medicine unit and the Medium-Stay unit. In the other two hospitals, there isn’t any Palliative Care Service and patients will be admitted in the Internal Medicine units of both hospitals. Data will be collected during one year with a sample of 200 patients and non-probably sampling case row.The main variables to consider are the presence or absence of palliative service, satisfaction of care and quality of life of patients to be studied. The secondaries are sex, age, pap score, reason for admission, cancer diagnosis and origin. For the collection of the data we used the questionnaire EORTC IN-PASAT32 modified by the research team and the EORTC QLQ C-15 PAL.The analysis of the quantitative variables will be done through centralization and dispersal parameters. Categorical variables satisfaction of care and quality of life will be analysed using frequencies and joined together by the Chi square. The statistical program SPSS v 16.0 will be used.

  4. The ethical leadership challenge: creating a culture of patient- and family-centered care in the hospital setting.

    Science.gov (United States)

    Piper, Llewellyn E

    2011-01-01

    The growing number of medical errors and resulting preventable deaths in hospitals presents an ethical dilemma that must be addressed by health care leaders and managers. These medical errors and deaths raise questions about safety and quality issues resulting in rising public mistrust and patient dissatisfaction. Many of these medical errors and deaths could have been avoided by including the patient and family in the care. The ethical challenge for leadership is creating a culture of patient- and family-centered care as a means to improve quality, safety, patient satisfaction, and public trust. This article addresses ways to improve safety, quality, patient satisfaction, and cost and thereby reduce medical errors and deaths by implementing a patient- and family-centered care culture. The first critical step for improvement is for hospital leaders and managers to answer the ethical call to create a culture centered on patient- and family-centered care in the hospital setting.

  5. Treatment of traumatic carotid-cavernous fistula at the Udon Thani Center Hospital.

    Science.gov (United States)

    Thanapura, Chatchawan

    2004-06-01

    There are many options available in management of traumatic carotid-cavernous fistulae (CCF). The carotid occlusion or the carotid preservation techniques are two basic approaches available. This study evaluated the carotid occlusion technique performed at The Udon Thani Center Hospital. We retrospectively studied 12 consecutive cases of traumatic CCF. The patients varied in terms of their ages, gender, side of lesion and symptoms. The occlusion was performed with muscle occlusion and trapping of the carotid artery. The diagnosis was made clinically and on CT brain. The Matas test was performed clinically with external compression of the contralateral carotid artery. No patient underwent cerebral angiography. From August 1997 to June 2002 the 12 patients were treated by muscle embolization only; muscle embolization with internal carotid ligation (Brooks technique); muscle embolization with trapping (Jaeger-Hamby procedure); or muscle embolization with trapping and external carotid ligation. The patients ranged from 15 to 62 years. Eleven were male. All had unilateral fistulae though only 3 involved the left eye. Eleven patients were cured and there was only one major complication of a patient who developed a second and third nerve palsy. The carotid occlusion technique is less popular in view of the great advances with detachable balloons and success with carotid preservation techniques. Despite this, under extenuating circumstances such as the lack of angiography, poor socio-economic status, or patients wanting to be treated close to home, this procedure is still an appropriate therapeutic option, as reflected by the success at our hospital. The more affluent patients had wider options and thus were sent to other centers for carotid preservation techniques like detachable balloon embolization.

  6. Strategic response by providers to specialty hospitals, ambulatory surgery centers, and retail clinics.

    Science.gov (United States)

    Burns, Lawton R; David, Guy; Helmchen, Lorens A

    2011-04-01

    Radical innovation and disruptive technologies are frequently heralded as a solution to delivering higher quality, lower cost health care. According to the literature on disruption, local hospitals and physicians (incumbent providers) may be unable to competitively respond to such "creative destruction" and alter their business models for a host of reasons, thus threatening their future survival. However, strategic management theory and research suggest that, under certain conditions, incumbent providers may be able to weather the discontinuities posed by the disrupters. This article analyzes 3 disruptive innovations in service delivery: single-specialty hospitals, ambulatory surgical centers, and retail clinics. We first discuss the features of these innovations to assess how disruptive they are. We then draw on the literature on strategic adaptation to suggest how incumbents develop competitive responses to these disruptive innovations that assure their continued survival. These arguments are then evaluated in a field study of several urban markets based on interviews with both incumbents and entrants. The interviews indicate that entrants have failed to disrupt incumbent providers primarily as a result of strategies pursued by the incumbents. The findings cast doubt on the prospects for these disruptive innovations to transform health care.

  7. 2009~2010年上海某高校附属医院业务收入的影响因素%Study on the factors which affect the service revenue in a hospital affiliated to a university in Shanghai from 2009 to 2010

    Institute of Scientific and Technical Information of China (English)

    李敏; 卢洪洲

    2013-01-01

    目的 分析2009~2010 年上海某高校附属医院业务收入并找出影响因素.方法 建立门诊、住院收入的变动因素指数体系,应用多因素分析对医院业务收入进行分析.结果 报告期较基期业务收入增长,主要由于住院病人日均费用、出院人次和门诊人次增加所致.结论 高校附属医院经济效益、综合管理水平稳步上升,但应降低门诊病人药费占比.%Objective To analyze the factors which affect the service revenue in a hospital affiliated to a university in Shanghai from 2009 to 2010. Methods The indicator system showing the fluctuation of income of outpatient and inpatient was established, the service revenue was analyzed through multi—factors analysis. Results The service revenue was significant increased in reporting period than that of basic period, the main causes were the increase of every day cost per person, the number of discharged and outpatients. Conclusion The economic returns and the management level were increased steadily in hospitals affiliated to university, but the proportion of drug cost should be cut down in the service revenue.

  8. Hospital-centered violence intervention programs: a cost-effectiveness analysis.

    Science.gov (United States)

    Chong, Vincent E; Smith, Randi; Garcia, Arturo; Lee, Wayne S; Ashley, Linnea; Marks, Anne; Liu, Terrence H; Victorino, Gregory P

    2015-04-01

    Hospital-centered violence intervention programs (HVIPs) reduce violent injury recidivism. However, dedicated cost analyses of such programs have not yet been published. We hypothesized that the HVIP at our urban trauma center is a cost-effective means for reducing violent injury recidivism. We conducted a cost-utility analysis using a state-transition (Markov) decision model, comparing participation in our HVIP with standard risk reduction for patients injured because of firearm violence. Model inputs were derived from our trauma registry and published literature. The 1-year recidivism rate for participants in our HVIP was 2.5%, compared with 4% for those receiving standard risk reduction resources. Total per-person costs of each violence prevention arm were similar: $3,574 for our HVIP and $3,515 for standard referrals. The incremental cost effectiveness ratio for our HVIP was $2,941. Our HVIP is a cost-effective means of preventing recurrent episodes of violent injury in patients hurt by firearms. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. A comprehensive palliative care center implementation in S.B. Ulus State Hospital

    Directory of Open Access Journals (Sweden)

    Ayla Kabalak

    2012-06-01

    Every people wants to best care and to die painless in their end-stage of life. This is a human right. Therefore, end-of-life care is considered an indicator of health quality all over the world. The ultimate goal of palliative care is to relieve the suffering of patients and their families by the comprehensive assessment and treatment of physical, psychosocial, and spiritual symptoms experienced by patients. After the patient\\s death, palliative care focuses primarily on bereavement of the family. T.C. Ministry of Health to find a solution of this important issue as a first step, the preparations for the establishment of palliative care centers and units, training of health personnel started. S.B. Ulus State Hospital as a team we have set out to open a comprehensive palliative care center. Our goal is to contribute on take place of palliative care organization in health system and to the spread across the country. [J Contemp Med 2012; 2(2.000: 122-126

  10. Performance Evaluation of Hospitals’ Emergency Departments using a Modified American Productivity and Quality Center Approach

    OpenAIRE

    Ronald Zhao; David Paul III

    2012-01-01

    Presented is a modification of the American Productivity and Quality Center (APQC) approach to the performance evaluation of hospital emergency departments. This modified approach allows individual hospitals to make better estimates of cost containment and productivity relative to an industry-wide benchmark, by using patient acuity to convert conventional performance data into two measurements: an efficiency indicator and a price recovery ratio to better facilitate the establishment of a cost...

  11. 5 CFR 919.905 - Affiliate.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Affiliate. 919.905 Section 919.905 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) GOVERNMENTWIDE DEBARMENT AND SUSPENSION (NONPROCUREMENT) Definitions § 919.905 Affiliate. Persons are affiliates...

  12. [New perspective in liaison psychiatry. Experience at the Pediatric Hospital of the National Medical Center Siglo XXI].

    Science.gov (United States)

    Sauceda García, J M; Maldonado Durán, J M; Angel Montoya Cabrera, M

    1994-01-01

    In hospitalized and chronically ill children, the prevalence of psychopathology is very high. It is necessary that in its prevention, diagnosis and treatment not only professionals of the mental health disciplines intervene but also that the pediatricians, nurses and the family of the patient himself participate actively. Consultation Liaison Child Psychiatry activities at the Pediatric Hospital of the National Medical Center "Siglo XXI" are described. Its goal is to incorporate the mental health professional to the team of hospital care and promote that pediatricians gain a greater conscience of psychological and social factors that are crucial for the sick child.

  13. A single center 14 years study of infectious complications leading to hospitalization of patients with primary antibody deficiencies

    Directory of Open Access Journals (Sweden)

    Setareh Mamishi

    2010-08-01

    Full Text Available Primary antibody deficiencies (PADs are a heterogeneous group of disorders, characterized by hypogammaglobulinemia and increased susceptibility to bacterial infections, leading to hospitalizations. This study was performed to determine the main infectious causes of hospital admissions in selective Iranian patients with PADs. Forty patients with PADs, who were admitted to the Infectious Ward of Children's Medical Center Hospital during a 14-year period, were reviewed in this study. There were 115 documented episodes of hospital admission during a 14-year period. The average length of hospital stay was 33.30 ± 25.72 days. Pneumonia was the most prominent infection leading to hospitalization among these patients (n = 48, followed by gastroenteritis (n = 23. Other less frequent causes of hospitalization were fever and neutropenia, septic arthritis, encephalitis, orbital cellulitis, sepsis, urinary tract infection, meningitis, oral ulcer, and lung abscess. The most common causative organisms of diarrhea were: Giardia lamblia, followed by Candida albicans, and Salmonella sp. Many patients with PADs suffer from repeated infections leading to hospitalization, in spite of immunoglobulin replacement therapy. Respiratory tract infections were the prominent cause of hospitalization among studied patients, followed by gastrointestinal infections.

  14. A single center 14 years study of infectious complications leading to hospitalization of patients with primary antibody deficiencies

    Directory of Open Access Journals (Sweden)

    Setareh Mamishi

    Full Text Available Primary antibody deficiencies (PADs are a heterogeneous group of disorders, characterized by hypogammaglobulinemia and increased susceptibility to bacterial infections, leading to hospitalizations. This study was performed to determine the main infectious causes of hospital admissions in selective Iranian patients with PADs. Forty patients with PADs, who were admitted to the Infectious Ward of Children's Medical Center Hospital during a 14-year period, were reviewed in this study. There were 115 documented episodes of hospital admission during a 14-year period. The average length of hospital stay was 33.30 ± 25.72 days. Pneumonia was the most prominent infection leading to hospitalization among these patients (n = 48, followed by gastroenteritis (n = 23. Other less frequent causes of hospitalization were fever and neutropenia, septic arthritis, encephalitis, orbital cellulitis, sepsis, urinary tract infection, meningitis, oral ulcer, and lung abscess. The most common causative organisms of diarrhea were: Giardia lamblia, followed by Candida albicans, and Salmonella sp. Many patients with PADs suffer from repeated infections leading to hospitalization, in spite of immunoglobulin replacement therapy. Respiratory tract infections were the prominent cause of hospitalization among studied patients, followed by gastrointestinal infections.

  15. Incidence of hospital mortality in polytrauma patients in a tertiary center in Bosnia and Herzegovina

    Directory of Open Access Journals (Sweden)

    Hadžan Konjo

    2016-05-01

    Full Text Available Introduction: In the late 70s of the last century, the mortality rate due to polytrauma amounted to 40%. This led to a new approach to this patient category with the goal of improving the treatment outcome.  According to the German trauma register, the rate of mortality in polytrauma at the end of the last century was 18.6%. The goal of this study is to determine the incidence of hospital mortality in polytrauma patients in a tertiary institution in Bosnia and Herzegovina.Methods: We analyzed patient medical records from the Intensive Care Unit of the Clinic of Orthopedics and Traumatology at University Clinical Center Sarajevo, from January 1, 2012 to December 31, 2012.Results:  There were 70 polytrauma patients in 2012, with average age 47.55 (range 8-77 years. Half of the patients were younger than 50 years. Age groups most frequently affected were 61 and older (25.7%, 51-60 years (24.3%, and 31-40 years (21.4%. Lethal outcome occurred in 10 patients (14.3%, while 60 patients (85.7% survived and were treated until discharge or transfer to a different department.  The average Injury Severity Score (ISS in patients with lethal outcome was 71.50, while in survivors was 37.  The largest percentage of lethal outcomes was recorded in cases of traffic accidents.Conclusion: The mortality rate among hospitalized polytrauma patients in the tertiary institution in Bosnia and Herzegovina is similar to reported mortality rates in other countries with developed healthcare system.  

  16. Lessons Learned from Unfavorable Microsurgical Head and Neck Reconstruction: Japan National Cancer Center Hospital and Okayama University Hospital.

    Science.gov (United States)

    Kimata, Yoshihiro; Matsumoto, Hiroshi; Sugiyama, Narusi; Onoda, Satoshi; Sakuraba, Minoru

    2016-10-01

    The risk of surgical site infection (SSI) remains high after major reconstructive surgery of the head and neck. Clinical data regarding SSI in microsurgical tongue reconstruction are described at National Cancer Hospital in Japan, including discussions of unfavorable representative cases, the relationship between SSI and preoperative irradiation at Okayama University Hospital in Japan, and strategies for SSI control in head and neck reconstruction. Local complications are inevitable in patients undergoing reconstruction in the head and neck areas. The frequency of major complications can be decreased, and late postoperative complications can be prevented with the help of appropriate methods.

  17. The user-centered approach in the development of a complex hospital-at-home intervention.

    Science.gov (United States)

    Cafazzo, Joseph A; Leonard, Kevin; Easty, Anthony C; Rossos, Peter G; Chan, Christopher T

    2009-01-01

    We discuss the development of a comprehensive remote patient monitoring system that facilitates the self-care of patients undergoing nocturnal home hemodialysis (NHHD), a complex hospital-at-home therapy. The use of a continuous, iterative approach with user involvement for the validation of assumptions can avoid situations where the system serves a patient poorly. An ethnographic analysis was used to determine specific design principles, which were reviewed with the patients prior to development of the system. Iterative designs were tested through usability testing and further validation was done with a member-checking exercise. Patients expressed concern about the physical obtrusiveness of monitoring which, consequently, led to a lack of adherence. The need for monitoring the integrity of the bloodlines was identified as important because one of the most significant fears among patients was potential blood loss. Patients expressed a need for immediate human intervention in response to an alert. The use of ethnography, usability testing, and member-checking methods in a user-centered approach to design can result in systems that better meet the needs of the patients and caregivers alike.

  18. Estudo prospectivo observacional sobre a incidência de injúria renal aguda em unidade de terapia intensiva de um hospital universitário Observational prospective study on the incidence of acute renal failure in the intensive care unit of a university-affiliated hospital

    Directory of Open Access Journals (Sweden)

    Nara Yamane dos Santos

    2009-09-01

    Full Text Available OBJETIVO: Analisar comparativamente características clínicas e evolução de pacientes com e sem IRA adquirida em UTI geral de um hospital universitário terciário. MÉTODO: Estudo prospectivo observacional com 263 pacientes acompanhados diariamente durante a internação em UTI Geral do Hospital das Clínicas da Faculdade de Medicina de Botucatu no período de julho de 2007 a abril de 2008. RESULTADOS: A incidência de IRA foi de 31,2%. Os grupos foram semelhantes quanto ao sexo e diferiram quanto à etiologia da admissão em UTI (sepse: 31,7% x 13,1%, p OBJECTIVE: To compare the clinical characteristics and outcomes of patients with and without acute renal failure (ARF admitted to the general intensive care unit (ICU of a university-affiliated hospital. METHOD: Prospective observational study comprising 263 patients followed up daily during their stay at the general ICU of the Hospital das Clínicas of the Medical School of Botucatu, from July 2007 to April 2008. RESULTS: The incidence of ARF was 31.2%. The groups were similar regarding gender and differed regarding the following: cause of ICU admission (sepsis: 31.7% x 13.1%, p < 0.0001, post-operative period: 11% x 43%; p < 0.0001; age (59.6 ± 18.1 x 50.2 ± 18.6 years; p < 0.0001; APACHE II: (21 ± 11.1 x 11 ± 4.8; p = 0.002; oliguria (67.7% x 4.5%; p < 0.0001; presence of mechanical ventilation (81.7% x 57.7%; p = 0.0014; use of vasoactive drugs (62.2% x 32.6%; p < 0.0001; and site of origin inside hospital (emergency room: 22% x 14.5%; p = 0.02; operating room: 42.7% x 62.6%; p = 0.03. As for comorbidities, hypertension and chronic renal disease were more frequent among patients with ARF than among those without ARF (42.6% x 35.9%; p = 0.005 and 15.8% x 2.1%; p = 0.04, respectively, but the groups did not differ regarding diabetes and congestive heart failure (19.5% x 11%, and 6% x 1.1%, respectively. Mortality was higher in ARF patients (62.1% x 16.5%; p < 0.0001. CONCLUSION: The

  19. [Motivations of parents taking their children to the hospital in emergencies. Results of a psychosocial survey at the Regional University Hospital Center of Grenoble].

    Science.gov (United States)

    Marguet, M C; Lejosne, G; Berthier, N; Bost, M

    1988-01-01

    A psycho-social survey by questionnaire was conducted among parents accompanying their children to the Pediatric Emergency Ward of the Medical Center of Grenoble, in order to identify the motivations of those who do not seek a medical advice prior to their coming to the hospital. From this survey, several motivating factors were identified: an economical factor, the difficulty to rapidly call a physician, the place of residence, an insufficient knowledge of the medical services, the familiarity of parents with the hospital, the advice of relatives, the anxiety caused by the child's illness and the comforting image of the hospital. In a synthetic analysis, several types of parents are distinguished according to their behavior.

  20. Attitudes and Behavior of Nurses in State and Private Hospitals with Respect to Family-Centered Care

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    Şadiye Dur

    2016-04-01

    Full Text Available Introduction: The study was conducted as descriptive research for purpose of comparing the attitudes of nurses working at private and state hospitals with respect to the concept of having parents participate in the care of their children. Materials and Methods: The universe of the descriptive research comprised 70 nurses working at two state hospitals and one private hospital in city center of Istanbul, between the dates May 1-June 30, 2013. As data collection tools, two forms, namely a Nurses Information Form and a Parent Participation Attitude Scale (PPAS were used in the research. The lowest possible score on the scale is 24; the highest 120. The higher scores on the scale indicate more positive attitudes about having parents participate in the care given to their children. The data were analyzed in terms of numbers, percentages and means. Results: The nurses in the study were found to have similar identifying characteristics (p>0.05. They were asked whether they knew about family-centered care, 64.3% said they were familiar with the subject; when the source of their knowledge was queried, 34.8% stated that they had been informed through scientific publications and courses they took during their professional training. Of the nurses, 54.3% were found to display total parent participation attitude scores of 84 and above. In the evaluation of the PPAS scores of the nurses in terms of the hospital they worked, the scores of nurses working at state hospitals (85.67±6.17 were significantly more positive than the scores of the nurses working at the private hospital (81.88±5.26 (p<0.05. Conclusions: The accepting attitudes of nurses regarding the family-centered care approach indicated that nurses with higher level of education had opportunity to benefit from the focus placed on family-centered care in graduate nursing school programs and that had positive effect on their attitudes.

  1. [The utilization of parenteral nutrition at Hospital de Jerez (Cádiz): a description and comparison with other hospital centers].

    Science.gov (United States)

    Gómez Henry, J C; Méndez Martínez, C; Blanco Rodríguez, D; Rodríguez Quirós, M

    1996-01-01

    This retrospective study aims to analyze, and compare with other Spanish hospitals, the use of parenteral nutrition, its characteristics and complications, in a general hospital with 610 beds, during 1992. To conduct this study, we have used clinical histories and follow up sheets made up by the Department of Pharmacy for each patient, as well as the results of the sample processing in the microbiology laboratory. Between 1992 and 1993 we have seen an increase in the use of parenteral nutrition, with the number of bags increasing from 2134 to 2575. The departments which have used parenteral nutrition most, were Surgery (57.3%), and ICU (24.8%), with the mean duration being 10.4 days 8SD = +/- 9.3 days). The most frequently used access route in the hospital was the drum, but there are significant differences between the departments. Gastroenterological pathology was, with 71.4% the most frequent indication for its use, and within this, the neoplasias stand out with 26.3% of the total of parenteral nutrition. The complications which affected most patients are: increases of the liver enzymes, hypokalemias, hyponatremias, and hyperglycemias.

  2. Hospitals

    Data.gov (United States)

    Department of Homeland Security — This database contains locations of Hospitals for 50 states and Washington D.C. , Puerto Rico and US territories. The dataset only includes hospital facilities and...

  3. Study of Bacterial Infections among Burn Patients Hospitalized in Isfahan Burn Center

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    J. Faghri

    2007-10-01

    Full Text Available Introduction & Objective: Burn patients are at risk of acquiring infection because of destroy skin barrier, suppression of immunity, prolonged hospitalization, and invasive therapeutic and diagnostic procedure, risk of acquiring infection is high among burned patients. The aim of this study was to assess the incidence rate of bacterial etiology and infections among burn patients in the burn center of Isfahan. Materials & Methods: The study was conducted descriptive – cross sectional during a period of one year, (from august 2004 until September 2005. A total of 106 patients presenting with no signs and symptoms of infection within the first 48 hours of admission were included. CDC definition for nosocomial infections was applied. Each patient’s clinical examinations and records investigated daily. Swab culture, blood culture (during fever time, tissue culture from biopsy specimen of burn wound and urine culture obtained. The data were analyzed and interpreted using SPSS 10 Software, using Chi – square and Kappa Coefficient. P.value < 0.05 was significant. Results: One-hundred and six patients met the inclusion criteria, 91 (85/8% acquired at least one type of infection, including, urinary tract 28 (26/4%, blood stream 30 (28/3%, and burn wound 91(85/8%. Pseudomonas aeroginosa was the most common causative agent isolated from blood culture and swab culture, 27/42% and 54/4% respectively. Also, E.coli was the major casautive agent of urinary tract infections (6.4% isolated from urine culture of these burn patients.Conclusion: The results indicated that, biopsy from burn wounds and study of histopathologic specimen day by other day depends on blood and urine culture conditions overall can be effective for early detection of burn wounds infections.

  4. Study of the outcome of suicide attempts: characteristics of hospitalization in a psychiatric ward group, critical care center group, and non-hospitalized group

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    Kemuyama Nobuo

    2010-01-01

    Full Text Available Abstract Background The allocation of outcome of suicide attempters is extremely important in emergency situations. Following categorization of suicidal attempters who visited the emergency room by outcome, we aimed to identify the characteristics and potential needs of each group. Methods The outcomes of 1348 individuals who attempted suicide and visited the critical care center or the psychiatry emergency department of the hospital were categorized into 3 groups, "hospitalization in the critical care center (HICCC", "hospitalization in the psychiatry ward (HIPW", or "non-hospitalization (NH", and the physical, mental, and social characteristics of these groups were compared. In addition, multiple logistic analysis was used to extract factors related to outcome. Results The male-to-female ratio was 1:2. The hospitalized groups, particularly the HICCC group, were found to have biopsychosocially serious findings with regard to disturbance of consciousness (JCS, general health performance (GAS, psychiatric symptoms (BPRS, and life events (LCU, while most subjects in the NH group were women who tended to repeat suicide-related behaviors induced by relatively light stress. The HIPW group had the highest number of cases, and their symptoms were psychologically serious but physically mild. On multiple logistic analysis, outcome was found to be closely correlated with physical severity, risk factor of suicide, assessment of emergent medical intervention, and overall care. Conclusion There are different potential needs for each group. The HICCC group needs psychiatrists on a full-time basis and also social workers and clinical psychotherapists to immediately initiate comprehensive care by a medical team composed of multiple professionals. The HIPW group needs psychological education to prevent repetition of suicide attempts, and high-quality physical treatment and management skill of the staff in the psychiatric ward. The NH group subjects need a

  5. [Hospitals' evolution through the ages].

    Science.gov (United States)

    de Micheli, Alfredo

    2005-01-01

    The predecessor institutions of modern hospitals--Byzantine nosocómeion, European hospitale and Islamic maristan--were dissimilar both in their patients and their aims. The first charitable organizations in West Europe (Rome) and in the East (Cesarea in Cappadocia) were rather hospices. After the collapse of the Western Roman Empire (476 A.D.), some monastic centers were prepared to provide medical assistance to religious and secular patients. Since the XI and XII Centuries in all of Christian Europe the charitable institutions, designated as hospitale, multiplied. Among the Italian ones, the Roman Santo Spirito (Holy Ghost) Hospital, built in the 1201-1204 period, reached a preeminet position. This one soon became the most important of the entire Christendom (archihospital), with a lot of affiliated hospitals in Europe and later in America. The first American hospital, Saint Nicholas Hospital, opened on December 29, 1503 in Santo Domingo, obtained in 1541 its affiliation to the Santo Spirito archihospital. Regarding continental America, the first health centers were established in Mexico: the Immaculate Conception Hospital and the Saint Lazarus Hospital, both established by Hernán Cortés. For its part, clinical teaching was systematized at the Saint Francis Hospital in Padua and by there moved to Leyden. In Mexico, the chair of medical clinics or practical medicine was established in 1806 at the Saint Andrew Hospital. During the XX century, Dr. Ignacio Chávez was the driving force behind the creation of the modern Mexican Health Institutes. These ones are dedicated to the treatment of poor patients, as well as to medical teaching and research.

  6. Management of Intelectual Property in Affiliated Medical College Hospitals%关于高等医药院校附属医院知识产权管理的思考

    Institute of Scientific and Technical Information of China (English)

    刘晓晶; 吴海燕

    2012-01-01

    加强高等医药院校附属医院知识产权管理,对于建设创新型国家和实现高校与医院自身的可持续发展具有重大战略意义.在分析当前存在的主要问题的同时,提出加强高等医药院校附属医院知识产权管理的对策和建议.%To strengthen the intellectual properties management of hospitals attached to medical colleges has fundamental strategic importance to both establishment of creative country and the sustainable development of the hospital itself. Through analyzing the current major issues, countermeasures and suggestions are proposed to the, intellectual properties management of these hospitals.

  7. Implementing PDA technology in a medical library: experiences in a hospital library and an academic medical center library.

    Science.gov (United States)

    Morgen, Evelyn Breck

    2003-01-01

    Personal digital assistants (PDAs) have grown from being a novelty in the late 1990s to an essential tool for healthcare professionals in the 2000s. This paper describes the experiences of a librarian who implemented PDA technology first in a hospital library, and then at an academic medical center library. It focuses on the role of the library in supporting PDA technology and resources. Included are programmatic issues such as training for library staff and clinicians, and technical issues such as Palm and Windows operating systems. This model could be used in either a hospital or academic health sciences library.

  8. Role of water quality assessments in hospital infection control: Experience from a new oncology center in eastern India

    Directory of Open Access Journals (Sweden)

    Ramkrishna Bhalchandra

    2014-01-01

    Full Text Available Water quality assessment and timely intervention are essential for health. Microbiology, total dissolved solids (TDS and free residual chlorine were measured for water quality maintenance in an oncology center in India. Impact of these interventions over a period of 22 months has been demonstrated with four cardinal events. Pseudomonas in hospital water was controlled by adequate chlorination, whereas high TDS in the central sterile supply department water was corrected by the installation of electro-deionization plant. Contaminated bottled water was replaced using quality controlled hospital supply. Timely detection and correction of water-related issues, including reverse osmosis plant was possible through multi-faceted approach to water quality.

  9. 医务人员流失问题的实证探讨-以珠海市中山大学附属第五医院为例%An Empirical Study on the Loss of Medical Personnel--Taking Zhuhai the Fifth Hospital Affiliated to Zhongshan University as an Example

    Institute of Scientific and Technical Information of China (English)

    解彦; 周欣

    2015-01-01

    目的:对医院人员流失的原因进行分析,同时提出相应的解决措施。方法选择珠海市中山大学附属第五医院的340例医务人员作为研究对象,对工作人员的所有临床资料进行统计分析。结果人员流失的原因多种多样,医院的工作量非常繁重,提供的物质基础达不到工作人员的期望,同时医院的人员编制存在一定的问题,发展空间有一定的限制。结论医院应当不断完善薪酬制度,重视医务人员的未来发展,提供公平公正的晋升机会,以此提供医务人员的积极主动性。%Objective To analyze the causes of the loss of the hospital staff,and put forward the corresponding solutions. Methods 340 cases of medical personnel in the fifth hospital affiliated to zhongshan university of zhuhai city were selected as the research object. Results The reason of the loss of personnel is varied,the workload of the hospital is very heavy,the material basis can not reach the expectation of the staff,and the staff of the hospital have some problems,and the development space has certain limitation. Conclusion Hospitals should continuously improve the pay system,pay attention to the future development of medical personnel,provide a fair and equitable promotion opportunity,in order to provide medical personnel with the initiative.

  10. Malnutrition Matters in Canadian Hospitalized Patients: Malnutrition Risk in Hospitalized Patients in a Tertiary Care Center Using the Malnutrition Universal Screening Tool.

    Science.gov (United States)

    Rahman, Adam; Wu, Thomas; Bricknell, Ryan; Muqtadir, Zack; Armstrong, David

    2015-10-01

    Malnutrition is common in Canadian hospitalized patients, yet system-wide malnutrition screening is not mandatory in Canada. Our goal was to define the point prevalence of malnutrition risk at a major tertiary care center in Hamilton, Ontario, using the Malnutrition Universal Screening Tool (MUST) to determine feasibility of hospital-wide screening in the Canadian context. After research ethics approval was obtained, we arranged for a clinical nutrition support team to conduct the MUST screening on all inpatients at Hamilton Health Sciences, Juravinski site, a large academic acute care hospital. A total of 315 patients were included (female, n = 160 [51%]; male, n = 155 [49%]; average age, 71 years). We identified 31% at high risk for malnutrition and 14% at medium risk, keeping with reported rates of malnutrition in the literature. Survey of dietitians and interns indicated that the MUST was easy to use and perform and that they had support of their unit supervisors. All respondents thought that the screen was useful and they wanted to repeat it. The MUST is an easy and efficient way to define point prevalence of malnutrition risk in Canadian hospitalized patients. Moving to system-wide nutritional screening will bring about the best practices in nutrition care with the involvement of key stakeholders and decision makers. Nutritional screening will allow us to utilize nutrition resources more efficiently, engage administrators in addressing shortfalls in nutrition care, and form a baseline for which to measure the efficacy of future nutritional interventions. © 2015 American Society for Parenteral and Enteral Nutrition.

  11. Safe medication management and use of narcotics in a Joint Commission International-accredited academic medical center hospital in the People’s Republic of China

    Directory of Open Access Journals (Sweden)

    Fang X

    2016-04-01

    Full Text Available Xu Fang,1,2 Ling-ling Zhu,3 Sheng-dong Pan,4 Ping Xia,4 Meng Chen,5 Quan Zhou51Office of Hospital Administration, 2Office of Party and Administration Council, 3Geriatric VIP Care Ward, Division of Nursing, 4Division of Medical Administration, 5Department of Pharmacy, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of ChinaAbstract: Safe medication management and use of high-alert narcotics should arouse concern. Risk management experiences in this respect in a large-scale Joint Commission International (JCI-accredited academic medical center hospital in the People’s Republic of China during 2011–2015, focusing on organizational, educational, motivational, and information technological measures in storage, prescribing, preparing, dispensing, administration, and monitoring of medication are summarized. The intensity of use of meperidine in hospitalized patients in 2015 was one-fourth that in 2011. A 100% implementation rate of standard storage of narcotics has been achieved in the hospital since December 2012. A “Plan, Do, Check, Act” cycle was efficient because the ratio of number of inappropriate narcotics prescriptions to total number of narcotics prescriptions for inpatients decreased from August 2014 to December 2014 (28.22% versus 2.96%, P=0.0000, and it was controlled below 6% from then on. During the journey to good pain management ward accreditation by the Ministry of Health, People’s Republic of China, (April 2012–October 2012, the medical oncology ward successfully demonstrated an increase in the pain screening rate at admission from 43.5% to 100%, cancer pain control rate from 85% to 96%, and degree of satisfaction toward pain nursing from 95.4% to 100% (all P-values <0.05. Oral morphine equivalent dosage in the good pain management ward increased from 2.3 mg/patient before June 2012 to 54.74 mg/patient in 2014. From 2011 to 2015, the oral morphine

  12. A rural cancer outreach program lowers patient care costs and benefits both the rural hospitals and sponsoring academic medical center.

    Science.gov (United States)

    Desch, C E; Grasso, M A; McCue, M J; Buonaiuto, D; Grasso, K; Johantgen, M K; Shaw, J E; Smith, T J

    1999-01-01

    The Rural Cancer Outreach Program (RCOP) between two rural hospitals and the Medical College of Virginia's Massey Cancer Center (MCC) was developed to bring state-of-the-art cancer care to medically underserved rural patients. The financial impact of the RCOP on both the rural hospitals and the MCC was analyzed. Pre- and post-RCOP financial data were collected on 1,745 cancer patients treated at the participating centers, two rural community hospitals and the MCC. The main outcome measures were costs (estimated reimbursement from all sources), revenues, contribution margins and profit (or loss) of the program. The RCOP may have enhanced access to cancer care for rural patients at less cost to society. The net annual cost per patient fell from $10,233 to $3,862 associated with more use of outpatient services, more efficient use of resources, and the shift to a less expensive locus of care. The cost for each rural patient admitted to the Medical College of Virginia fell by more than 40 percent compared with only an 8 percent decrease for all other cancer patients. The rural hospitals experienced rapid growth of their programs to more than 200 new patients yearly, and the RCOP generated significant profits for them. MCC benefited from increased referrals from RCOP service areas by 330 percent for cancer patients and by 9 percent for non-cancer patients during the same time period. While it did not generate a major profit for the MCC, the RCOP generated enough revenue to cover costs of the program. The RCOP had a positive financial impact on the rural and academic medical center hospitals, provided state-of-the-art care near home for rural patients and was associated with lower overall cancer treatment costs.

  13. Does procedure profitability impact whether an outpatient surgery is performed at an ambulatory surgery center or hospital?

    Science.gov (United States)

    Plotzke, Michael Robert; Courtemanche, Charles

    2011-07-01

    Ambulatory surgery centers (ASCs) are small (typically physician owned) healthcare facilities that specialize in performing outpatient surgeries and therefore compete against hospitals for patients. Physicians who own ASCs could treat their most profitable patients at their ASCs and less profitable patients at hospitals. This paper asks if the profitability of an outpatient surgery impacts where a physician performs the surgery. Using a sample of Medicare patients from the National Survey of Ambulatory Surgery, we find that higher profit surgeries do have a higher probability of being performed at an ASC compared to a hospital. After controlling for surgery type, a 10% increase in a surgery's profitability is associated with a 1.2 to 1.4 percentage point increase in the probability the surgery is performed at an ASC.

  14. Diversity and Adaptation of Human Respiratory Syncytial Virus Genotypes Circulating in Two Distinct Communities: Public Hospital and Day Care Center

    Directory of Open Access Journals (Sweden)

    Gustavo Rocha Garcia

    2012-10-01

    Full Text Available HRSV is one of the most important pathogens causing acute respiratory tract diseases as bronchiolitis and pneumonia among infants. HRSV was isolated from two distinct communities, a public day care center and a public hospital in São José do Rio Preto – SP, Brazil. We obtained partial sequences from G gene that were used on phylogenetic and selection pressure analysis. HRSV accounted for 29% of respiratory infections in hospitalized children and 7.7% in day care center children. On phylogenetic analysis of 60 HRSV strains, 48 (80% clustered within or adjacent to the GA1 genotype; GA5, NA1, NA2, BA-IV and SAB1 were also observed. SJRP GA1 strains presented variations among deduced amino acids composition and lost the potential O-glycosilation site at amino acid position 295, nevertheless this resulted in an insertion of two potential O-glycosilation sites at positions 296 and 297. Furthermore, a potential O-glycosilation site insertion, at position 293, was only observed for hospital strains. Using SLAC and MEME methods, only amino acid 274 was identified to be under positive selection. This is the first report on HRSV circulation and genotypes classification derived from a day care center community in Brazil.

  15. Variability in Criteria for Emergency Medical Services Routing of Acute Stroke Patients to Designated Stroke Center Hospitals

    Science.gov (United States)

    Dimitrov, Nikolay; Koenig, William; Bosson, Nichole; Song, Sarah; Saver, Jeffrey L.; Mack, William J.; Sanossian, Nerses

    2015-01-01

    Introduction Comprehensive stroke systems of care include routing to the nearest designated stroke center hospital, bypassing non-designated hospitals. Routing protocols are implemented at the state or county level and vary in qualification criteria and determination of destination hospital. We surveyed all counties in the state of California for presence and characteristics of their prehospital stroke routing protocols. Methods Each county’s local emergency medical services agency (LEMSA) was queried for the presence of a stroke routing protocol. We reviewed these protocols for method of stroke identification and criteria for patient transport to a stroke center. Results Thirty-three LEMSAs serve 58 counties in California with populations ranging from 1,175 to nearly 10 million. Fifteen LEMSAs (45%) had stroke routing protocols, covering 23 counties (40%) and 68% of the state population. Counties with protocols had higher population density (1,500 vs. 140 persons per square mile). In the six counties without designated stroke centers, patients meeting criteria were transported out of county. Stroke identification in the field was achieved using the Cincinnati Prehospital Stroke Screen in 72%, Los Angeles Prehospital Stroke Screen in 7% and a county-specific protocol in 22%. Conclusion California EMS prehospital acute stroke routing protocols cover 68% of the state population and vary in characteristics including activation by symptom onset time and destination facility features, reflecting matching of system design to local geographic resources. PMID:26587100

  16. Variability in Criteria for Emergency Medical Services Routing of Acute Stroke Patients to Designated Stroke Center Hospitals

    Directory of Open Access Journals (Sweden)

    Nikolay Dimitrov

    2015-10-01

    Full Text Available Introduction: Comprehensive stroke systems of care include routing to the nearest designated stroke center hospital, bypassing non-designated hospitals. Routing protocols are implemented at the state or county level and vary in qualification criteria and determination of destination hospital. We surveyed all counties in the state of California for presence and characteristics of their prehospital stroke routing protocols. Methods: Each county’s local emergency medical services agency (LEMSA was queried for the presence of a stroke routing protocol. We reviewed these protocols for method of stroke identification and criteria for patient transport to a stroke center. Results: Thirty-three LEMSAs serve 58 counties in California with populations ranging from 1,175 to nearly 10 million. Fifteen LEMSAs (45% had stroke routing protocols, covering 23 counties (40% and 68% of the state population. Counties with protocols had higher population density (1,500 vs. 140 persons per square mile. In the six counties without designated stroke centers, patients meeting criteria were transported out of county. Stroke identification in the field was achieved using the Cincinnati Prehospital Stroke Screen in 72%, Los Angeles Prehospital Stroke Screen in 7% and a county-specific protocol in 22%. Conclusion: California EMS prehospital acute stroke routing protocols cover 68% of the state population and vary in characteristics including activation by symptom onset time and destination facility features, reflecting matching of system design to local geographic resources.

  17. Making hospital preparation child-centered (with a little help from Emily).

    Science.gov (United States)

    Ferguson, F; Robertson, J

    1979-01-01

    Helping youg children learn about the hospital shoould, ideally, involve a multifaceted approach that utilizes tools appropriate to the child's age and needs. The hospital preparation process at Alberta Children's Hospital that has attempted to achieve this end through the coordinated efforts of the Recreation/Child Life and Nursing departments is discussed. Our preparation process consists of several phases, commencing prior to admission and carrying right through until discharge, with the "thread" that draws it all together being a whimsical kitten named Emily.

  18. 山东省护理院校教学医院带教老师的核心能力及其影响因素%Core Competency and Its Influencing Factors of Clinical Teachers in Affiliated Teaching Hospitals of Universities in Shandong Province

    Institute of Scientific and Technical Information of China (English)

    高晖; 王贞慧; 冯晨秋; 娄凤兰

    2012-01-01

    目的 了解山东省本科护理院校教学医院临床带教老师的核心能力及其影响因素.方法 采用注册护士核心能力量表对山东省6所本科护理院校附属教学医院的358名带教老师(以多阶段抽样法选取)进行问卷调查,共发放问卷358份,回收有效问卷355份,问卷有效率回收率为99.2%.结果 山东省本科护理院校带教老师核心能力总均分为(3.06±0.47)分,法律/伦理实践评分最高,批判性思维/科研评分最低;不同年龄、工作年限、带教年限、职称、第一学历、科室、工作满意度护士核心能力评分差异均有统计学意义;带教老师核心能力受技术职称、工作满意度、带教年限等因素影响.结论 山东省护理院校临床带教老师核心能力水平中等偏上,医院管理部门应重视其批判性思维及科研能力的培养,主动关心带教老师的身心特点和从业心态,多角度地提高临床带教师资的核心能力.%Objective To know the core competency and its influencing factors of clinical teachers in the affiliated teaching hospitals of universities in Shandong Province. Methods Totally 358 clinical teachers in the affiliated hospitals of 6 universities were investigated with the competency inventory for registered nurses. Of the 358 questionnaires,355 were valid and the effective rate was 99. 2%. Results The mean score of core competency was 3. 06±0. 47,and the highest score was detected in dimensions of legal/ethical practice and the lowest score was in dimensions of critical thinking/research aptitude. The core competency of nurse was statistically different in the dimensions in terms of nurses with different age,working time,teaching time,job title,education,department and job satisfaction. The demographic influencing factors were job title,job satisfaction and teaching time. Conclusion The overall core competency is at the upper middle level for clinical teachers from the affiliated hospitals of

  19. [Present frequency of the different Serratia species isolated in Grenoble University Hospital Center (author's transl)].

    Science.gov (United States)

    Croize, J; Le Noc, P

    1977-11-01

    Our study concerns 111 Serratia isolated during a period of seven months in a Grenoble hospital. The different species of Serratia are present with a high predominance of S. marcescens. Distribution, particular biochemical characteristics are discussed, and results of sensitivity to antibiotics, as well for antibiotics used against Gram negative bacteria as for the three quinolines against urinary bacteria. The place of Serratia in the hospital infections is discussed in the last part of this study.

  20. Gender differences in dominance and affiliation during a demanding interaction.

    Science.gov (United States)

    Luxen, Marc F

    2005-07-01

    Evolution theory predicts that in social situations, men will show more behavioral dominance, whereas women will show more behavioral affiliation. To ensure maximum ecological validity, observation in a real-life situation that calls for uniform behavior is the strongest test. To reduce bias because of stereotyping within observers, the author used molecular behavioral observations, in which the verbal and nonverbal behavior of 10 men and 10 women was observed in an executive job selection assessment center where they were actual applicants. Men showed more dominance, especially head shaking, sitting in a closed posture, and using closed questions and directive remarks. Women showed more affiliation, especially in frequency of laughing, sitting in an open posture, and posing open questions.

  1. hospital

    African Journals Online (AJOL)

    Pattern of congenital orthopaedic malformations in an African teaching hospital ... malformation in this environment while congenital hip dislocation (CDH) is rare when .... malformations of radial dysplasia and other congenital malformations.

  2. The first private-hospital based proton therapy center in Korea; status of the Proton Therapy Center at Samsung Medical Center

    OpenAIRE

    Chung, Kwangzoo; Han, Youngyih; Kim, Jinsung; Ahn, Sung Hwan; Ju, Sang Gyu; Jung, Sang Hoon; Chung, Yoonsun; Cho, Sungkoo; Jo, Kwanghyun; Shin, Eun Hyuk; Hong, Chae-Seon; Shin, Jung Suk; Park, Seyjoon; Kim, Dae-Hyun; Kim, Hye Young

    2015-01-01

    Purpose The purpose of this report is to describe the proton therapy system at Samsung Medical Center (SMC-PTS) including the proton beam generator, irradiation system, patient positioning system, patient position verification system, respiratory gating system, and operating and safety control system, and review the current status of the SMC-PTS. Materials and Methods The SMC-PTS has a cyclotron (230 MeV) and two treatment rooms: one treatment room is equipped with a multi-purpose nozzle and ...

  3. Cytomegalovirus colitis in hospitalized inflammatory bowel disease patients in Taiwan: a referral center study.

    Science.gov (United States)

    Weng, Meng-Tzu; Tung, Chien-Chih; Lee, Yi-Shuan; Leong, Yew-Loong; Shieh, Ming-Jium; Shun, Chia-Tung; Wang, Cheng-Yi; Wong, Jau-Min; Wei, Shu-Chen

    2017-02-13

    Colitis is exacerbated in patients with concurrent cytomegalovirus (CMV) infection and inflammatory bowel disease (IBD). We assessed the prevalence and clinical features of CMV colitis in hospitalized IBD patients. A retrospective study reviewed the data from January 1, 1998 through December 31, 2013 compiled at the National Taiwan University Hospital. The CMV colitis patients' demographic data, clinical information, treatment regimens, pathologic findings, and outcome were analyzed. A total of 673 IBD patients were hospitalized during the study period. There were 312 patients diagnosed with Crohn's disease (CD) and 361 with ulcerative colitis (UC). CMV colitis was diagnosed as having positive inclusion bodies in colonic tissue. Six of the 312 CD patients (1.9%) and five of the 361 UC patients (1.4%) were diagnosed with CMV colitis. Compared to CD patients without CMV colitis, patients with CMV colitis were more often older (p colitis flare-ups after the index admission. The prevalence of CMV colitis in hospitalized IBD inpatients was 1.6% in Taiwan. Two associated factors for CMV colitis in hospitalized IBD patients were that they were elderly in CD and were on higher doses of steroids. Routine histopathology studies and/or PCR for refractory colitis patients are suggested to diagnose CMV colitis. Once the diagnosis is made, antiviral treatment is recommended to decrease the colitis relapse rate.

  4. Social traits modulate attention to affiliative cues

    Directory of Open Access Journals (Sweden)

    Sarah R. Moore

    2014-06-01

    Full Text Available Neurobehavioral models of personality suggest that the salience assigned to particular classes of stimuli vary as a function of traits that reflect both the activity of neurobiological encoding and relevant social experience. In turn, this joint influence modulates the extent that salience influences attentional processes, and hence learning about and responding to those stimuli. Applying this model to the domain of social valuation, we assessed the differential effects on attentional guidance by affiliative cues of (i a higher-order temperament trait (Social Closeness, and (ii attachment style in a sample of 57 women. Attention to affiliative pictures paired with either incentive or neutral pictures was assessed using camera eye-tracking. Trait social closeness and attachment avoidance interacted to modulate fixation frequency on affiliative but not on incentive pictures, suggesting that both traits influence the salience assigned to affiliative cues specifically.

  5. Social traits modulate attention to affiliative cues.

    Science.gov (United States)

    Moore, Sarah R; Fu, Yu; Depue, Richard A

    2014-01-01

    Neurobehavioral models of personality suggest that the salience assigned to particular classes of stimuli vary as a function of traits that reflect both the activity of neurobiological encoding and relevant social experience. In turn, this joint influence modulates the extent that salience influences attentional processes, and hence learning about and responding to those stimuli. Applying this model to the domain of social valuation, we assessed the differential effects on attentional guidance by affiliative cues of (i) a higher-order temperament trait (Social Closeness), and (ii) attachment style in a sample of 57 women. Attention to affiliative pictures paired with either incentive or neutral pictures was assessed using camera eye-tracking. Trait social closeness and attachment avoidance interacted to modulate fixation frequency on affiliative but not on incentive pictures, suggesting that both traits influence the salience assigned to affiliative cues specifically.

  6. STUDY ON SOLID WASTE COLLECTION AND DISPOSAL IN HOSPITALS AND HEALTA CARE CENTERS OF TEHRAN PROVINCE

    Directory of Open Access Journals (Sweden)

    A. Omrani

    1998-10-01

    Full Text Available The main objective of this investigation was to achieve a clear pattern of solid waste collection and disposal in selected hospital and health care establishments in certain cities of Tehran province. This study was done in more than 82 percent of all hospitals with 3017 beds during the year 1996. Solid waste produced per bed was evaluated to be 2.87 kg per day which was 8670 kg per day, for all beds, comprising less than 1% of the total solid waste generated in the same cities during the same period. According to the information gathered in the 84.2% hospitals and health care centres, solid wastes were collected manually by labourers from various sections. Detention time of the waste in 89.5% of the cases was nearly 24 h. Densities of this type of waste were estimated to be 193.18kg/m3 with plastic bag and 247.72 kg/m3 without bag. Physical analysis of the wastes indicated 15.1% plastic and rubbery, 9.6% linen, 12.45% paper and cardboard, 8.5% various types of metals, 1.7% glass and 52.4% other different materials. In Iran, hospital administrations are directly responsible for collection transport and ultimate disposal of hospital wastes. Incinerators installed in 21.1% of the clinical centres, were not operating at all. Overall conclusion is that, solid wastes collection transportation and disposal in Tehran district is not satisfactory, according to the health and management criteria.

  7. Research for Hospital Data Center Construction%医院数据中心建设研究

    Institute of Scientific and Technical Information of China (English)

    白国刚; 杨宏桥

    2012-01-01

    为了充分利用医院数据信息资源,挖掘出对医院管理有用的模型、规律和知识,本文就医院数据中心建设进行研究,运用商业智能技术建设医院数据中心.通过数据仓库(DataWarehouse,DW)、数据萃取、转换、载入(Extraction-Transformation-Loading,ETL)工具、联机分析处理(Online Analytical Process,OLAP)和数据的多维度分析与展现技术,形成统一的数据视图和综合决策分析支持系统,并以此为基础,结合医院的战略管理和业务运营,对医疗数据资源进行充分的应用、分析与挖掘.%In order to make full use of hospital information resources, explore a useful model, rule and knowledge for hospital management, this paper researched the construction of hospital data center, and built hospital data center with business intelligence. By using technology of data warehouse, Extraction-Transformation-Loading, Online Analytical Process, Data Multi-dimensional Analysis and display technology, we have realized uniform data views and decision support system, then together with strategy management and business operations, make full application, analysis and mining of the medical data resources.

  8. Organizational culture and the implementation of person centered care: results from a change process in Swedish hospital care.

    Science.gov (United States)

    Alharbi, Tariq Saleem J; Ekman, Inger; Olsson, Lars-Eric; Dudas, Kerstin; Carlström, Eric

    2012-12-01

    Sweden has one of the oldest, most coherent and stable healthcare systems in the world. The culture has been described as conservative, mechanistic and increasingly standardized. In order to provide a care adjusted to the patient, person centered care (PCC) has been developed and implemented into some parts of the health care industry. The model has proven to decrease patient uncertainty. However, the impact of PCC has been limited in some clinics and hospital wards. An assumption is that organizational culture has an impact on desired outcomes of PCC, such as patient uncertainty. Therefore, in this study we identify the impact of organizational culture on patient uncertainty in five hospital wards during the implementation of PCC. Data from 220 hospitalized patients who completed the uncertainty cardiovascular population scale (UCPS) and 117 nurses who completed the organizational values questionnaire (OVQ) were investigated with regression analysis. The results seemed to indicate that in hospitals where the culture promotes stability, control and goal setting, patient uncertainty is reduced. In contrast to previous studies suggesting that a culture of flexibility, cohesion and trust is positive, a culture of stability can better sustain a desired outcome of reform or implementation of new care models such as person centered care. It is essential for health managers to be aware of what characterizes their organizational culture before attempting to implement any sort of new healthcare model. The organizational values questionnaire has the potential to be used as a tool to aid health managers in reaching that understanding. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  9. Affiliate marketing programs: A study of consumer attitude towards affiliate marketing programs among Indian users

    OpenAIRE

    Zia Ul Haq

    2012-01-01

    Affiliate marketing has seen fewer studies even being a multibillion dollar industry and one of the most expanding online advertising lead generators for direct marketers. The aim of this survey described in this paper is to evaluate the attitude of respondents towards affiliate programs or affiliate marketing, used as a source of information, advertisement and a connecting link between the online marketer and the customer. In this regard a survey was conducted among 300 Indian internet users...

  10. Statistical Machines for Trauma Hospital Outcomes Research: Application to the PRospective, Observational, Multi-Center Major Trauma Transfusion (PROMMTT Study.

    Directory of Open Access Journals (Sweden)

    Sara E Moore

    Full Text Available Improving the treatment of trauma, a leading cause of death worldwide, is of great clinical and public health interest. This analysis introduces flexible statistical methods for estimating center-level effects on individual outcomes in the context of highly variable patient populations, such as those of the PRospective, Observational, Multi-center Major Trauma Transfusion study. Ten US level I trauma centers enrolled a total of 1,245 trauma patients who survived at least 30 minutes after admission and received at least one unit of red blood cells. Outcomes included death, multiple organ failure, substantial bleeding, and transfusion of blood products. The centers involved were classified as either large or small-volume based on the number of massive transfusion patients enrolled during the study period. We focused on estimation of parameters inspired by causal inference, specifically estimated impacts on patient outcomes related to the volume of the trauma hospital that treated them. We defined this association as the change in mean outcomes of interest that would be observed if, contrary to fact, subjects from large-volume sites were treated at small-volume sites (the effect of treatment among the treated. We estimated this parameter using three different methods, some of which use data-adaptive machine learning tools to derive the outcome models, minimizing residual confounding by reducing model misspecification. Differences between unadjusted and adjusted estimators sometimes differed dramatically, demonstrating the need to account for differences in patient characteristics in clinic comparisons. In addition, the estimators based on robust adjustment methods showed potential impacts of hospital volume. For instance, we estimated a survival benefit for patients who were treated at large-volume sites, which was not apparent in simpler, unadjusted comparisons. By removing arbitrary modeling decisions from the estimation process and concentrating

  11. [Requirements of optimal working conditions and patient-centered care in hospital nursing].

    Science.gov (United States)

    Walter, A; Merboth, H; Böger, S

    1997-12-01

    Nursing--a human service increasing in size and significance--is facing deep changes. The organization of hospital wards is also influenced by these profound changes. The aim of this psychological research project sponsored by the German Federal Ministry for Education and Science, Research and Technology (BMBF) and part of the Saxonian Public Health Association was to determine the external and individual working conditions that put the personnel's health at risk, particularly in regard to burnout syndromes. Investigations should show possibilities in work organization that minimize such risks. Organizational designs have to ensure high quality levels of nursing care, as well as high quality of working conditions in nursing for the individual employee. This empirical study presents the results of an investigation of 53 medical, surgical and intensive care units of 7 Saxonian hospitals with 336 employees of the nursing departments. The size of the hospital, the service profile, the nursing standards and the organizational conditions of the nursing service influence work pressure and working attitude.

  12. Appropriateness of gastrointestinal consultations for hospitalized patients in an academic medical center

    Directory of Open Access Journals (Sweden)

    Cohen M

    2010-01-01

    Full Text Available Background: Consultation of experts in the internal medicine or surgery subspecialties is needed in the hospitalized population according to decisions of the house staff. Sometimes the referrals are not justified, consuming time and money without a significant change in the patient outcome. Objectives: The aim of our retrospective study was to evaluate justification of consecutive referrals of hospitalized patients for gastroenterology consultation. Materials and Methods: Request for consultation was deemed not justified when at least one of the following parameters was found: No contribution to case management, discharge before consultation, cancellation at the last minute, and a recommendation for ambulatory management or surgery. Results: In August-September 2006, there were 232 requests for gastroenterology consultations. Of them 127 (54.7% were men. The average age was 64.13±20.33 years. Ninety-four (40.2% of the cases had been hospitalized because of other reasons than the consultation issue. Consultation was not justified in 60 patients (25.9%. Ambulatory management was a possibility in 151 cases (65.0%. Request for colonoscopy and gastrointestinal background disease were the only significant predictive factors for justification of consultation, P < 0.0001 for both. Conclusions: In one fourth of the cases, gastroenterology consultation was not justified according to our strict criteria.

  13. Affiliate marketing programs: A study of consumer attitude towards affiliate marketing programs among Indian users

    Directory of Open Access Journals (Sweden)

    Zia Ul Haq

    2012-04-01

    Full Text Available Affiliate marketing has seen fewer studies even being a multibillion dollar industry and one of the most expanding online advertising lead generators for direct marketers. The aim of this survey described in this paper is to evaluate the attitude of respondents towards affiliate programs or affiliate marketing, used as a source of information, advertisement and a connecting link between the online marketer and the customer. In this regard a survey was conducted among 300 Indian internet users to know their attitude towards affiliate programs and the various factors that affect the effectiveness of these programs. The findings of this survey demonstrate a positive view of affiliate marketing. This research also found that the stronger predictor of the consumer attitude of affiliate marketing is the usefulness, informativeness, incentive and perceived trust. In short the future of affiliate marketing is to a greater extent affected by the consumer’s perception of affiliate program usefulness and control over it. This study recommends a need for direct marketers to develop more innovative affiliate links that will elicit a more positive response from the consumers.

  14. 穿透性角膜移植术治疗中晚期圆锥角膜的围手术期护理%Perioperative nursing of keratoconus patients with keratoplasty The first affiliated hospital of Nanchang university

    Institute of Scientific and Technical Information of China (English)

    王燕

    2014-01-01

    目的:探讨穿透性角膜移植术治疗中晚期圆锥角膜的围手术期护理方法。方法:对27例(30眼)中晚期圆锥角膜患者进行穿透性角膜移植术,进行充分有效的心理护理、术前准备及全面的术中配合、术后护理,正确的出院指导。结果:本组病例手术效果满意,视力均有不同程度的提高,临床刺激症状明显改善,术后26眼视力较术前提高,原发病复发1例,排斥反应2例,继发性青光眼1例,经及时处理均治愈。结论:中晚期圆锥角膜行穿透性角膜移植术患者,心理护理可取得患者的信任与合作,是手术成功的基础,术中严格无菌技术操作及全面的配合是手术成功的保障,严密观察病情变化,发现异常积极采取有效措施是手术成功的关键,出院指导是巩固治疗成果的重要环节。%objective:to investigate nursing care interventions for keratoconus patients with keratoplasty and outcomes.Methods:twenty—seven cases of keratoconus patients were admited to our hospital from January of 2011 to January of 2013 al of them under went keratoplasty proceedure and was provided perioperative nursing care.Results:the degree of visual acuity improved and the clinical symptoms were relieved significantly without prominent complications.Conclusion:keratoplasty could control the development of keratoconus.Prompt operation quality psychological care, preoperative preparation and postoperative nursing interventions could help these patients to achieve optimal outcomes.

  15. The exploration and practice of the post management for nurses in the first affiliated hospital of Baotou medical college%护理人员岗位管理的探索与实践

    Institute of Scientific and Technical Information of China (English)

    徐金梅; 张建梅; 王金玲

    2015-01-01

    Objective:To investigate the present situation of the post management for nurses in our hospital , so as to provide a reference for the optimizing of nursing management.Methods:The post of 1,079 nursing staff from 33 clinical departments and 18 functional departments was scien-tifically determined, and the management post of nurses was put into practice after the carrying out of job training, as well as the evaluating of posts.Results:After the implementation of the post management for nurses, the control of the quality of care was improved, the degree of patients'satisfaction improved, nurses'initiative awareness of reporting adverse events enhanced, complaints reduced annually and nurses'overall quality im-proved.Conclusion:Post management for nursing staff, which is the direction of development and research of nursing management in the future, is an inherent impetus to quality nursing and is the key to guarantee nursing quality and nursing service quality .%目的:探讨我院护理人员岗位管理的现状,为优化护理管理提供参考依据。方法:通过科学设置全院33个临床科室和18个职能科室1079名护理人员的岗位,开展岗位培训,实施岗位评价,落实护理人员岗位管理工作。结果:开展护理人员岗位管理,进一步完善了护理质量控制,提高了患者满意度,增强了护理人员主动上报护理不良事件的意识,且投诉事件逐年减少,提高了护理人员的综合素质。结论:护理人员岗位管理是优质护理服务工作持续发展的内在推动力,是保障护理质量和护理服务品质的关键,是护理管理未来发展和研究的方向。

  16. The first private-hospital based proton therapy center in Korea; status of the Proton Therapy Center at Samsung Medical Center.

    Science.gov (United States)

    Chung, Kwangzoo; Han, Youngyih; Kim, Jinsung; Ahn, Sung Hwan; Ju, Sang Gyu; Jung, Sang Hoon; Chung, Yoonsun; Cho, Sungkoo; Jo, Kwanghyun; Shin, Eun Hyuk; Hong, Chae-Seon; Shin, Jung Suk; Park, Seyjoon; Kim, Dae-Hyun; Kim, Hye Young; Lee, Boram; Shibagaki, Gantaro; Nonaka, Hideki; Sasai, Kenzo; Koyabu, Yukio; Choi, Changhoon; Huh, Seung Jae; Ahn, Yong Chan; Pyo, Hong Ryull; Lim, Do Hoon; Park, Hee Chul; Park, Won; Oh, Dong Ryul; Noh, Jae Myung; Yu, Jeong Il; Song, Sanghyuk; Lee, Ji Eun; Lee, Bomi; Choi, Doo Ho

    2015-12-01

    The purpose of this report is to describe the proton therapy system at Samsung Medical Center (SMC-PTS) including the proton beam generator, irradiation system, patient positioning system, patient position verification system, respiratory gating system, and operating and safety control system, and review the current status of the SMC-PTS. The SMC-PTS has a cyclotron (230 MeV) and two treatment rooms: one treatment room is equipped with a multi-purpose nozzle and the other treatment room is equipped with a dedicated pencil beam scanning nozzle. The proton beam generator including the cyclotron and the energy selection system can lower the energy of protons down to 70 MeV from the maximum 230 MeV. The multi-purpose nozzle can deliver both wobbling proton beam and active scanning proton beam, and a multi-leaf collimator has been installed in the downstream of the nozzle. The dedicated scanning nozzle can deliver active scanning proton beam with a helium gas filled pipe minimizing unnecessary interactions with the air in the beam path. The equipment was provided by Sumitomo Heavy Industries Ltd., RayStation from RaySearch Laboratories AB is the selected treatment planning system, and data management will be handled by the MOSAIQ system from Elekta AB. The SMC-PTS located in Seoul, Korea, is scheduled to begin treating cancer patients in 2015.

  17. The first private-hospital based proton therapy center in Korea; Status of the proton therapy center at Samsung Medical Center

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Kwang Zoo; Han, Young Yih; Kim, Jin Sung [Dept. of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); and others

    2015-12-15

    The purpose of this report is to describe the proton therapy system at Samsung Medical Center (SMC-PTS) including the proton beam generator, irradiation system, patient positioning system, patient position verification system, respiratory gating system, and operating and safety control system, and review the current status of the SMC-PTS. The SMC-PTS has a cyclotron (230 MeV) and two treatment rooms: one treatment room is equipped with a multi-purpose nozzle and the other treatment room is equipped with a dedicated pencil beam scanning nozzle. The proton beam generator including the cyclotron and the energy selection system can lower the energy of protons down to 70 MeV from the maximum 230 MeV. The multi-purpose nozzle can deliver both wobbling proton beam and active scanning proton beam, and a multi-leaf collimator has been installed in the downstream of the nozzle. The dedicated scanning nozzle can deliver active scanning proton beam with a helium gas filled pipe minimizing unnecessary interactions with the air in the beam path. The equipment was provided by Sumitomo Heavy Industries Ltd., RayStation from RaySearch Laboratories AB is the selected treatment planning system, and data management will be handled by the MOSAIQ system from Elekta AB. The SMC-PTS located in Seoul, Korea, is scheduled to begin treating cancer patients in 2015.

  18. Hospital survival upon discharge of ill-neonates transported by ground or air ambulance to a tertiary center

    Directory of Open Access Journals (Sweden)

    Jorge Luis Alvarado-Socarras

    2016-06-01

    Full Text Available Abstract Objective: To evaluate the differences in hospital survival between modes of transport to a tertiary center in Colombia for critically ill neonates. Methods: Observational study of seriously ill neonates transported via air or ground, who required medical care at a center providing highly complex services. Data on sociodemographic, clinical, the Transport Risk Index of Physiologic Stability (TRIPS, and mode of transport were collected. Patients were described, followed by a bivariate analysis with condition (live or dead at time of discharge as the dependent variable. A multiple Poisson regression with robust variance model was used to adjust associations. Results: A total of 176 neonates were transported by ambulance (10.22% by air over six months. The transport distances were longer by air (median: 237.5 km than by ground (median: 11.3 km. Mortality was higher among neonates transported by air (33.33% than by ground (7.79%. No differences in survival were found between the two groups when adjusted by the multiple model. An interaction between mode of transport and distance was observed. Live hospital discharge was found to be associated with clinical severity upon admittance, birth weight, hemorrhaging during the third trimester, and serum potassium levels when admitted. Conclusions: Mode of transport was not associated with the outcome. In Colombia, access to medical services through air transport is a good option for neonates in critical condition. Further studies would determine the optimum distance (time of transportation to obtain good clinical outcomes according type of ambulance.

  19. Drug utilisation study in a tertiary care center: Recommendations for improving hospital drug dispensing policies

    Directory of Open Access Journals (Sweden)

    Niti Mittal

    2014-01-01

    Full Text Available Drug therapy accounts for a major portion of health expenditure. A useful strategy for achieving cost efficient healthcare is drug utilisation research as it forms the basis for making amendments in drug policies and helps in rational drug use. The present observational study was conducted to generate data on drug utilization in inpatients of our tertiary care hospital to identify potential targets for improving drug prescribing patterns. Data was collected retrospectively from randomly selected 231 medical records of patients admitted in various wards of the hospital. WHO Anatomical Therapeutic Chemical/Defined Daily Dose methodology was used to assess drug utilisation data and drug prescriptions were analysed by WHO core drug indicators. Antibiotics were prescribed most frequently and also accounted for majority of drug costs. The prescribed daily dose for most of the antibiotics corresponded to defined daily dose reflecting adherence to international recommendations. Brand name prescribing and polypharmacy was very common.78% of the total drugs prescribed were from the National List of Essential Medicines 2003. Restricting the use of newer and costlier antibiotics, branded drugs and number of drugs per prescription could be considered as targets to cut down the cost of drug therapysignificantly.

  20. Tissue procurement system in Japan: the role of a tissue bank in medical center for translational research, Osaka University Hospital.

    Science.gov (United States)

    Ohkawara, H; Fukushima, N; Kitagawa, T; Ito, T; Masutani, Y; Sawa, Y

    2010-01-01

    Although organ procurement has been regulated by The Organ Transplantation Law (brain-dead donors since 1997, donors after cardiac death since 1979), there has been no law or governmental procurement network (except for cornea) in Japan. Since the late 1980s, some university hospitals have developed original banks. Finally, in 2001 guidelines for tissue procurement were established by The Japanese Society of Tissue Transplantation and Japan Tissue Transplant Network (JTTN) to coordinate tissue harvesting. Five tissue banks were joined to the tissue transplant network (skin in one, heart valves in two, and bone in two). As the number of tissue banks is small, each bank cooperates on procurement, but cannot cover the entire country. With regard to skin transplantation, only one skin bank-The Japan Skin Bank Network (JSBN), which is located in Tokyo-has organized skin procurement. Therefore, it has been difficult to procure skin in areas distant from Tokyo, especially around Osaka. In order to improve such a situation, a tissue bank collaborating with the JSBN was established at The Medical Center for Translational Research (MTR), Osaka University Hospital in April 2008. The bank has played a role in skin procurement center in western Japan and supported procurement and preservation at the time of the skin procurement. Between April 2008 and September 2009, the bank participated in eight tissue procurements in the western area. In the future, the bank is planning to procure and preserve pancreatic islets and bones. Moreover, there is a plan to set up an induced pluripotent stem cells center and stem cell bank in MTR. This tissue bank may play a role to increase tissue procurement in Japan, especially in the western area.

  1. Religious Affiliation, Religious Service Attendance, and Mortality.

    Science.gov (United States)

    Kim, Jibum; Smith, Tom W; Kang, Jeong-han

    2015-12-01

    Very few studies have examined the effects of both religious affiliation and religiosity on mortality at the same time, and studies employing multiple dimensions of religiosity other than religious attendance are rare. Using the newly created General Social Survey-National Death Index data, our report contributes to the religion and mortality literature by examining religious affiliation and religiosity at the same time. Compared to Mainline Protestants, Catholics, Jews, and other religious groups have lower risk of death, but Black Protestants, Evangelical Protestants, and even those with no religious affiliation are not different from Mainline Protestants. While our study is consistent with previous findings that religious attendance leads to a reduction in mortality, we did not find other religious measures, such as strength of religious affiliation, frequency of praying, belief in an afterlife, and belief in God to be associated with mortality. We also find interaction effects between religious affiliation and attendance. The lowest mortality of Jews and other religious groups is more apparent for those with lower religious attendance. Thus, our result may emphasize the need for other research to focus on the effects of religious group and religious attendance on mortality at the same time.

  2. Center for Beam Physics, 1992

    Energy Technology Data Exchange (ETDEWEB)

    1993-06-01

    This report contains the following information on the center for beam physics: Facilities; Organizational Chart; Roster; Profiles of Staff; Affiliates; Center Publications (1991--1993); and 1992 Summary of Activities.

  3. Does implementation of ISO standards in hospitals improve patient satisfaction?

    Directory of Open Access Journals (Sweden)

    Vahid Keshtkar

    2017-01-01

    Full Text Available Introduction: Around the world, a large number of projects have been developed with the aim of assessing patient satisfaction especially in hospitals. As an important indicator of the quality of health care system, Patients’ perception of health care has been the center of attention over the recent 20 years. Method: 402 patients who were hospitalized in teaching hospitals affiliated to the Shiraz University of Medical Sciences were investigated. Patients’ satisfactions of the health care services were assessed using the translated and modified version of the KQCAH consisted of 44 questions divided to7 categories of Respect and Caring, Effectiveness and Continuity, Appropriateness, Information, Efficiency, Meals, First Impression, Staff Diversity. All of the patients were asked to fill out the questionnaire (with written informed consents at the time of discharge from the hospitals. Results: Regarding total score of patient satisfaction the ISO-certified hospitals did not show advantages over the uncertified hospitals. The total score of patients’ satisfaction ranged from 66.5 to 77.5 in. Overall, only in one ISO-certified hospital the total score of patient satisfaction representing all dimensions, was significantly higher comparing to other hospitals included in the study. Conclusion: It seems that solitary application of ISO standards could not improve patient satisfaction in hospitals affiliated to Shiraz University of Medical Sciences.

  4. Motorcycle-related hospitalization of adolescents in a Level I trauma center in southern Taiwan: a cross-sectional study.

    Science.gov (United States)

    Liang, Chi-Cheng; Liu, Hang-Tsung; Rau, Cheng-Shyuan; Hsu, Shiun-Yuan; Hsieh, Hsiao-Yun; Hsieh, Ching-Hua

    2015-08-28

    The aim of this study was to investigate and compare the injury pattern, mechanisms, severity, and mortality of adolescents and adults hospitalized for treatment of trauma following motorcycle accidents in a Level I trauma center. Detailed data regarding patients aged 13-19 years (adolescents) and aged 30-50 years (adults) who had sustained trauma due to a motorcycle accident were retrieved from the Trauma Registry System between January 1, 2009 and December 31, 2012. The Pearson's chi-squared test, Fisher's exact test, or the independent Student's t-test were performed to compare the adolescent and adult motorcyclists and to compare the motorcycle drivers and motorcycle pillion. Analysis of Abbreviated Injury Scale (AIS) scores revealed that the adolescent patients had sustained higher rates of facial, abdominal, and hepatic injury and of cranial, mandibular, and femoral fracture but lower rates of thorax and extremity injury; hemothorax; and rib, scapular, clavicle, and humeral fracture compared to the adults. No significant differences were found between the adolescents and adults regarding Injury Severity Score (ISS), New Injury Severity Score (NISS), Trauma-Injury Severity Score (TRISS), mortality, length of hospital stay, or intensive care unit (ICU) admission rate. A significantly greater percentage of adolescents compared to adults were found not to have worn a helmet. Motorcycle riders who had not worn a helmet were found to have a significantly lower first Glasgow Coma Scale (GCS) score, and a significantly higher percentage was found to present with unconscious status, head and neck injury, and cranial fracture compared to those who had worn a helmet. Adolescent motorcycle riders comprise a major population of patients hospitalized for treatment of trauma. This population tends to present with a higher injury severity compared to other hospitalized trauma patients and a bodily injury pattern differing from that of adult motorcycle riders, indicating the

  5. Concomitant pulmonary tuberculosis in hospitalized healthcare-associated pneumonia in a tuberculosis endemic area: a multi-center retrospective study.

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    Jia-Yih Feng

    Full Text Available BACKGROUND: In tuberculosis (TB endemic areas, Mycobacterium tuberculosis is an important but easily misdiagnosed pathogen in community-acquired pneumonia (CAP. However, the occurrence of concomitant pulmonary tuberculosis (PTB in hospitalized healthcare-associated pneumonia (HCAP has never been investigated. METHODS AND FINDINGS: Seven hundred and one hospitalized HCAP and 934 hospitalized CAP patients from six medical centers in Taiwan were included in this nationwide retrospective study. Concomitant PTB was defined as active PTB diagnosed within 60 days of admission due to HCAP or CAP. The predictors for concomitant PTB and the impact of PTB on the outcomes of pneumonia were investigated. Among the enrolled subjects, 21/701 (3% of the HCAP patients and 25/934 (2.7% of the CAP patients were documented to have concomitant PTB. In multivariate analysis, a history of previous anti-TB treatment (OR = 5.84, 95% CI: 2.29-20.37 in HCAP; OR = 3.33, 95% CI: 1.09-10.22 in CAP and escalated pneumonia severity index (PSI scores (OR = 1.014, 95% CI: 1.002-1.026, in HCAP; OR = 1.013, 95% CI: 1.001-1.026, in CAP were independent predictors for concomitant PTB in both CAP and HCAP patients. Regarding treatment outcomes, HCAP patients with concomitant PTB were associated with more acute respiratory failure within 48 hours of admission (47.6% vs. 22.6%, p = 0.008, higher intensive care unit admission rate (61.9% vs. 35.7%, p = 0.014, longer hospitalization (39.6±34.1 vs. 23.7±27 days, p = 0.009, and higher in-hospital mortality (47.6% vs. 26.3%, p = 0.03 than those without concomitant PTB. Exposure to certain groups of antibiotics for the treatment of pneumonia was not associated with the occurrence of concomitant PTB. CONCLUSIONS: In HCAP patients, the occurrence of concomitant PTB is comparable with that in CAP patients and associated with higher PSI scores, more acute respiratory failure, and higher in-hospital mortality.

  6. The evaluation of time performance in the emergency response center to provide pre-hospital emergency services in Kermanshah.

    Science.gov (United States)

    Mohammadi, Mohsen; Nasiripour, Amir Ashkan; Fakhri, Mahmood; Bakhtiari, Ahad; Azari, Samad; Akbarzadeh, Arash; Goli, Ali; Mahboubi, Mohammad

    2014-09-28

    This study evaluated the time performance in the emergency response center to provide pre-hospital emergency services in Kermanshah. This study was a descriptive retrospective cross-sectional study. In this study 500 cases of patients from Shahrivar (September) 2012 to the end of Shahrivar (September) 2013 were selected and studied by the non-probability quota method. The measuring tool included a preset cases record sheet and sampling method was completing the cases record sheet by referring to the patients' cases. Data were analyzed using SPSS version 18 and the concepts of descriptive and inferential statistics (Kruskal-Wallis test, benchmark Eta (Eta), Games-Howell post hoc test). The results showed that the interval mean between receiving the mission to reaching the scene, between reaching the scene to moving from the scene, and between moving from the scene to a health center was 7.28, 16.73 and 7.28 minutes. The overall mean of time performance from the scene to the health center was 11.34 minutes. Any intervention in order to speed up service delivery, reduce response times, ambulance equipment and facilities required for accuracy, validity and reliability of the data recorded in the emergency dispatch department, Continuing Education of ambulance staffs, the use of manpower with higher specialize levels such as nurses, supply the job satisfaction, and increase the coordination with other departments that are somehow involved in this process can provide the ground for reducing the loss and disability resulting from traffic accidents.

  7. A survey of the attitude and practice of research among doctors in Riyadh Military Hospital primary care centers, Saudi Arabia

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    Saad H Al-Abdullateef

    2012-01-01

    Full Text Available Objectives: To assess the attitude and practice of doctors in the Military Hospital Primary Care Centers in Riyadh (RMH toward research and to identify the main barriers to conduct research. Materials and Methods: A cross-sectional study was conducted from March to April, 2010, at RMH primary care centers. The sample included all general practitioners (GPs working in primary healthcare centers. A self-administered questionnaire was formulated from different sources and used as a tool for data collection. Results: The response rate was 75%. Among the respondents 96.9% agreed that research in primary care was important for different reasons. Most of the GPs had a positive attitude toward research: 68% had been influenced by research in their clinical practice and 66% had an interest in conducting research, and74.2% of the respondents had plans to do research in the future. Insufficient time was the most frequently cited barrier (83.5% for participating in research, followed by the lack of support (58.8%. Conclusions: Many of the GPs had a positive attitude toward research, but had no publications or plan for new research. Lack of time, support, and money were the main constraints for carrying out research.

  8. Evaluation of 809 Cases Applicated to A Rabies Vaccination Center of Diyarbakır Government Hospital

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    Hakan Temiz

    2008-09-01

    Full Text Available In this study; 809 cases applicated to rabies vaccination center ofDiyarbakır Government Hospital between May 2006 and May 2007 wereevaluated. Human diploid cell vaccine was applicated as 3 doses in 708cases (%87.5 and 5 doses in 101 cases (%12.5. In 66 cases (%8.2 rabiesantiserum was also used. The sites of injury were head-neck in 45 cases(%5.6, body-arm-leg in 563 (%69.6 cases and hand in 201 (%24.8 cases.477 cases (%59 were evaluated as superficial and 332 cases (%41 wereevaluated as deep injury. 626 cases (%77.4 had dog bite, 142 cases (%17.6had cat bite. While 689 cases (%85.2 visited the rabies vaccination center atthe first day of injury, 115 cases (%14.2 visited in 2-5 days and 5 cases(%0.6 visited after 5 days. In conclusion; the sensitivity and the rate of theearly visit of the vaccination center because of suspicious animal contactare high and when compared with developed countries there must be a greateffort in reducing the incidence of suspicious bites.

  9. [Computerized medical register of venous thromboembolic disease at the Grenoble University Hospital Center: description and evaluation].

    Science.gov (United States)

    Michoud, E; Bosson, J L; Pichot, O; Vidal, F; Rossignol, S; Schwartzmann, J; Carpentier, P H

    1994-01-01

    The number of vascular exams for venous thromboembolic disease increases dramatically in the vascular medicine unit at the Grenoble University Hospital (France). In order to improve the efficiency and the homogeneity of all the medical staff involved, a computerized register has been created. It automatically provides a letter for the prescriber of the consultation. This database, working on a computer network, has three main functions: office automation (medical folder, report), education, and clinical research. The office automation evaluation is performed after a 6 month experience, comparing 100 medical reports about venous thrombosis assisted by the computer to 100 medical reports written before the installation of the system. The introduction of digitized register is real, still this evaluation has induced some modification in the system in order to be more efficient.

  10. Report of 84 cases of penile Fracture inBeheshti Hospital center

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    H. Shafi

    2005-01-01

    Full Text Available Background and purpose : Penile fracture is the rupture of the corpus cavernousum due to trauma to the erect penis , which has various background etiologies in different countries according to their habits. The aim of this study was to determine and evaluate the frequency, etiologies and complications of penile fracture in our geographic area.Material and Methods : This analytical-cross sectional study was performed via census sampling among men referred to Sh. Beheshti Hospital of Babol Medical University during 1995 to 2004. Data were analyzed by Chi-Square, Fisher`s exact and T-test using SPSS release 12.Results : 84 patients with penile fracture (mean age of 18.1 years were studied. The frequency was higher in single patients (78% than married ones. The most important complaint of patients with penile fracture was penile pain (36%, hematoma (30%, and penile swelling (12%. Background factors were manipulation of erect penis (74%, sexual intercourse (18% trauma to erect pennies (8%. Urethral ruptures were seen in 8% of all patients with feacture. There were significant differences between urethral rupture and background etiologies (P=0.000 and marrital status (p=0.000 as 90% of the cases were single patient, referred to hospital due to manipulation of erect pennies (P=0.000.Conclusion : High frequency of penile manipulation among young boys in the study area in comparison with other studies results in penile fracture but subsequent urethral rupture was uncommon among men. Better and earlier diagnosis of penile fracture is related to determination of background etologies in the patients.

  11. Outlaw biker affiliations and criminal involvement

    DEFF Research Database (Denmark)

    Klement, Christian

    2016-01-01

    This study investigates the effect of being an outlaw biker on criminal involvement in Denmark. Using a unique dataset, 297 outlaw bikers are matched on various background characteristics with 181,931 control individuals and effects are estimated in difference-in-difference regressions. This appr......This study investigates the effect of being an outlaw biker on criminal involvement in Denmark. Using a unique dataset, 297 outlaw bikers are matched on various background characteristics with 181,931 control individuals and effects are estimated in difference-in-difference regressions....... This approach reduces the risk of selection bias and helps isolate the effect of affiliation on criminal involvement. The results suggest that affiliation with an outlaw motorcycle club may increase involvement in overall crime, specifically property crime, drug crime, and weapons crime. Results regarding...... violent crimes are inconclusive. It is concluded that an outlaw biker affiliation may increase criminal involvement....

  12. Impact of management on employees communication in medical and hospital centers in Sarajevo

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    Munib Smajović

    2013-12-01

    Full Text Available Introduction: A person’s response and functioning under condition of stress and confl ict is fundamentally different from its usual behavior. Aim: To point out what type of attitude toward the management of healthcare institutions is worth developing as well as to determine which psychological dimensions of employed the best refl ect the efficacy of the management.Methods: The study included a sample of 52 subjects employed at the Clinical center at University of Sarajevo and 64 subjects employed in Healthcare clinic in Sarajevo Canton. Survey method and a method of a theoretical analysis were used in the data collection and processing.Results: The study concluded that there is no statistically significant gender difference in attitude about the value of talent development at managerial level as a factor in development of attitude toward communicationin healthcare. We find t-value of 2,213 for the Clinical center at University of Sarajevo and 2,210 for Healthcare clinic in Sarajevo Canton.Conclusion: No statistically significant results have been found for any of the factors considered in the study with respect to the gender differences.

  13. Two-year hospital records of burns from a referral center in Western Iran: March 2010-March 2012

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    Touraj Ahmadijouybari

    2014-01-01

    Full Text Available Abstract: Background: Burns are among the most common injuries affecting a great number of people worldwide annually. In Iran, especially in its western region and in Kermanshah province, burns have a relatively high incidence. The present study was aimed at investigating epidemiological characteristics in Western Iran. Methods: Within a cross-sectional study, the data on all patients attending the Burns Center at Imam Khomeini Hospital (Kermanshah, Iran during 2010-2011 and 2011-2012 (24 months were collected. Then, age, gender, cause of burns, total body surface area, and time of the occurrence were extracted from the hospital records. The data were analyzed using the SPSS statistical package (Version 19, for Windows. We used chi-squared test when we compared the categorical responses between two or more groups. For comparing means between two groups we used t-test. In addition, trends were investigated using linear regression. Results: Overall 13 248 people were referred to the Burns Center at Imam Khomeini Hospital (Kermanshah, Iran during the period of study, including 328 cases of self-immolation. The mean age of the patients was 27±19 years and 29±13 years for unintentional burns and self-immolation respectively. Out of the total number of unintentional cases, 6 519 (50.5% were men, while the corresponding percentage of men among the self-immolation cases was 16.6% (p less than 0.001. Trends in the number of cases were cyclic, with the highest and lowest number of burns cases being in March and May. Overall, hot liquids and flammable materials were the two most important causes of unintentional burns. However, flammable materials were the main cause of burns among self-immolation cases. During hospital admission, 168 (51% self-immolation victims and 43 (0.33% unintentional burn victims died. Conclusions: While major preventive measures are not adequately used in developing countries, burns and their burden can be significantly reduced

  14. Hospital Performance Indicators and Their Associated Factors in Acute Child Poisoning at a Single Poison Center, Central Saudi Arabia.

    Science.gov (United States)

    Alanazi, Menyfah Q; Al-Jeriasy, Majed I; Al-Assiri, Mohammed H; Afesh, Lara Y; Alhammad, Fahad; Salam, Mahmoud

    2015-12-01

    Admission rate and length of stay (LOS) are two hospital performance indicators that affect the quality of care, patients' satisfaction, bed turnover, and health cost expenditures. The aim of the study was to identify factors associated with higher admission rates and extended average LOS among acutely poisoned children at a single poison center, central Saudi Arabia.This is a cross-sectional, poison and medical chart review between 2009 and 2011. Exposures were child characteristics, that is, gender, age, body mass index (BMI), health history, and Canadian 5-level triage scale. Poison incident characteristics were, that is, type, exposure route, amount, form, home remedy, and arrival time to center. Admission status and LOS were obtained from records. Chronic poisoning, plant allergies, and venomous bites were excluded. Bivariate and regression analyses were applied. Significance at P Poison substances were pharmaceutical drugs (63%) versus chemical products (37%). Main exposure route was oral (98%). Home remedy was observed in (21.9%), which were fluids, solutes, and/or gag-induced vomiting. Almost (52%) arrived to center >1 h. Triage levels: non-urgent cases (58%), less urgent (11%), urgent (18%), emergency (12%), resuscitative (1%). Admission rate was (20.6%) whereas av. LOS was 13 ± 22 h. After adjusting and controlling for confounders, older children (adj.OR = 1.19) and more critical triage levels (adj.OR = 1.35) were significantly associated with higher admission rates compared to younger children and less critical triage levels (adj.P = 0.006) and (adj.P = 0.042) respectively. Home remedy prior arrival was significantly associated with higher av. LOS (Beta = 9.48, t = 2.99), compared to those who directly visited the center, adj.P = 0.003.Hospital administrators are cautioned that acutely poisoned children who received home remedies prior arrival are more likely to endure an extended LOS. This non-conventional practice

  15. Six years analysis of cleft palate in a university hospital center

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    Farahvash M

    1999-08-01

    Full Text Available Cleft palate is a congenital condition that occurs with the incidence rate of one out of 2000 births. This anomaly produces intraoral pressure changes (increase or decrease, can cause speech, sucking and feeding problems of involved patient. On the other hand, if cleft palate is associated with cleft of the lip or alveolar area, growth and alignment of teeth may change the appearance of the patient and affect the psychologic and occupational future of the patient. Eustatian tube malfunction in involved neonates increase. Many procedures are used to repair the cleft palate and correction of palatal muscles which are: 1 Von Langenbeck (18.5%. 2 Veau-Wardil-Kilner (72.5%. 3 Double opposing Z-Plasty (9%. In this research the demographic criteria of patients including age of the patient at operation rime (mean age 30.14 months, city of residence, family history of cleft palate (12.4%, familial relation of parents (15.2%, associated anomalies, complete or incomplete lesion, weight of patients at the time of surgery (mean 11.28 Kg, hemoglobin (11.3 mg/dl, complications, otitis media and the side of cleft palate are studied in 178 admitted patients to Imam General Hospital between 1989 and 1995.

  16. Registry of kidney biopsy in a single center in Puerto Rico: university district hospital.

    Science.gov (United States)

    Báez Bonilla, Rafael; Parrilla, Francisco; Kidd, Ortiz; Cangiano, José L

    2011-01-01

    Glomerular diseases continue to be the leading cause of end-stage renal disease globally. Renal biopsy plays a fundamental role in the evaluation of glomerular diseases not only to establish an accurate diagnosis but also help deciding on appropriate treatment and assessing prognosis. The prevalence of glomerular disease and the clinical indications for kidney biopsies are poorly delineated in Puerto Rico. We undertook a retrospective analysis of the indications, clinical presentation and pathologic reports in renal biopsies performed at the University District Hospital in San Juan, Puerto Rico from the year 1995 to 2008. A total of 208 kidney biopsies showed a predominance of membranous nephropathy representing 20% of the studied population. Women were more frequently biopsied than men (57.2% vs. 42.7%). Lupus nephritis, a condition affecting mostly women was identified in 16.9% of the patients. Minimal change disease was reported in 13.6% of the patients, a condition that affects mostly children and adolescents. In contrast to other geographical areas IgAN was reported only in 6.3% and FSG in 0.9% of patients. In our biopsied patient population, membranous nephropathy is the most common primary glomerular disease and lupus erythematosus the most frequent secondary glomerular disease.

  17. [Management of HIV infected patients. Experience of the Liege University Hospital Center].

    Science.gov (United States)

    Nkoghe, D; Léonard, P; Nnegue, S; Moutschen, M; Demonty, J

    2002-08-01

    We present data from 112 patients followed in the Infectious Diseases Unit of the Liege University Hospital (CHU Sart-Tilman). The primary goal of this study was to evaluate the efficiency of highly active antiretroviral therapy (HAART) on surrogate immunological and virological parameters. The study also aimed at determining the prevalence of opportunistic infections and iatrogenic metabolical abnormalities in the era of HAART. Data from HIV infected patients under combined treatment were collected from March 1996 till July 1999. The follow-up focused on the variation of the CD4 cell counts and viral load, and the occurrence of opportunistic infections. The average age was 39 +/- 10 years and the sex ratio (M/F) was 2.3. At baseline, the CD4 count was 352 +/- 244/mm3 and the viral load was 4.1 +/- 1.2 log. After 12 months, the CD4 cells were at 540 +/- 374 and the viral load at 2.5 +/- 1.5 log. This favourable outcome was observed in 70% of patients (naive and experienced). Clinically, patients in therapeutic success presented few opportunistic infections, but many drugs related toxicity. Our data demonstrate the efficiency of combined treatment in the management of HIV infected patients. However, the apparition of toxicity problems could limit the benefit brought by these drugs.

  18. Spanish-Latin American multicenter study of attitudes toward organ donation among personnel from hospital healthcare centers.

    Science.gov (United States)

    Ríos, Antonio; López-Navas, Ana; Ayala-García, Marco Antonio; Sebastián, María José; Abdo-Cuza, Anselmo; Alán, Jeannina; Martínez-Alarcón, Laura; Ramírez, Ector Jaime; Muñoz, Gerardo; Suárez-López, Juliette; Castellanos, Roberto; Ramírez, Ricardo; González, Beatriz; Martínez, Miguel Angel; Díaz, Ernesto; Ramírez, Pablo; Parrilla, Pascual

    2014-01-01

    if one were needed (OR= 2.808; P<.001). Hospital personnel in Spanish and Latin American healthcare centers had a favorable attitude toward donation, although 21% of respondents were not in favor of donating. This attitude was more favorable among Latin American workers and was very much conditioned by job-related and psychosocial factors. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

  19. Studies on retrospective analysis of leading primary cancers and improvement of cancer treatment method in Korea cancer center hospital

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong In; Lee, Kang Hyun; Choi, Soo Yong; Kim, Ki Wha; Kang, Sung Mok

    2000-12-01

    a. Retrospective studies included cancers of the stomach, breast, bladder, salivary gland, thyroid, esophagus, endometrium and ovary. (1) Study cancers were analyzed about clinical characteristics, prognostic factors influenced on survival time, survival rate, etc. (2) Among 5,305 study patients, 1,405(26.5%) were identified with death, 3,485(65.7%) were alive and 415(7.8%) were not identified. b. Prospective studies included 10 subjects such as bladder cancer, retinoblastoma, malignant patients, gastric cancer, uterine cervix cancer and ovary cancer. We are continuing registering eligible study patients. c. Results for 11 papers were published at the journal. d. We established follow-up system in order to identify the survival for study subjects through National Statistical Office, Government Provincial Office and Cancer Registration System at Korea Cancer Center Hospital. e. At present, we are establishing computerized registration system about case report form for study cancers.

  20. 医院数据资源融合分析与设计%Analysis and design of data fusion center in hospital

    Institute of Scientific and Technical Information of China (English)

    周芃; 刘道践; 郝晓刚

    2014-01-01

    目的:建立医院信息资源融合中心,解决医院业务系统与管理系统数据不兼容、数据共享服务不完整的问题。方法:根据医院数据资源融合中心的需求进行方案设计分析,提出医院数据资源融合中心的设计方案。结果:通过医院数据资源融合中心方案设计,提出了解决医院数据融合的具体方法。结论:医院数据资源融合中心方案可解决医院对内和对外信息资源共享服务和数据综合利用的问题,从而提高医院信息资源利用的水平。%Objective:To create hospital data fusion centers to solve the problems involving data incompatibility between business system and administration system and incomplete data-sharing service.Methods:The needs for hospital data fusion center were analyzed, and the protocol design for creating hospital data fusion center was put forward according to the needs.Results:The protocol design for creating hospital data fusion center facilitates the specific methods of promoting hospital data fusion.Conclusion: The protocol design for creating hospital data fusion center may promote in-and out-hospital data-sharing service and comprehensive data utilization, so as to improve hospital information utilization.

  1. Readiness of Health Centers and Primary Hospitals for the Implementation of Proposed Health Insurance Schemes in Southwest Ethiopia.

    Science.gov (United States)

    Abazinab, Sabit; Woldie, Mirkuzie; Alaro, Tesfamichael

    2016-09-01

    In response to the 2005 World Health Assembly, many low income countries developed different healthcare financing mechanisms with risk pooling stategy to ensure universal coverage of health services. Accordingly, service availability and readiness of the health system to bear the responsibility of providing service have critical importance. The objective of this study was to assess service availability and readiness of health centers and primary hospitals to bear the responsibility of providing service for the members of health insurance schemes. A facility based cross sectional study design with quantitative data collection methods was employed. Of the total 18 districts in Jimma Zone, 6(33.3%) districts were selected randomly. In the selected districts, there were 21 functional public health facilities (health centers and primary hospitals) which were included in the study. Data were collected by interviewer administered questionnaire. Descriptive statistics were calculated by using SPSS version 20.0. Prior to data collection, ethical clearance was obtained. Among the total 21 public health facilities surveyed, only 38.1% had all the categories of health professionals as compared to the national standards. The majority, 85.2%, of the facilities fulfilled the criteria for basic equipment, but 47.7% of the facilities did not fulfill the criteria for infection prevention supplies. Moreover, only two facilities fulfilled the criteria for laboratory services, and 95.2% of the facilities had no units/departmenst to coordinate the health insurance schemes. More than nine out of ten facilities did not fulfill the criteria for providing healthcare services for insurance beneficiaries and are not ready to provide general services according to the standard. Hence, policy makers and implementers should devise strategies to fill the identified gaps for successful and sustainable implementation of the proposed insurance scheme.

  2. Prevalence of Hepatitis B surface antigen (HBsAg among visitors of Shashemene General Hospital voluntary counseling and testing center

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    Medhin Girmay

    2011-02-01

    Full Text Available Abstract Background Hepatitis B virus (HBV infection is significant health problem, as it can lead to chronic hepatitis, liver cirrhosis, and hepatic carcinoma. Due to shared routes of transmission, HBV and human immunodeficiency virus (HIV co-infection is common and is an emerging concern in the clinical management of patients because of increased mortality, accelerated hepatic disease progression, and the frequent hepatotoxicity caused by anti-retroviral therapy. The aim of this study was to determine the prevalence of Hepatitis B surface antigen (HBsAg and its risk factors, among individuals visiting Shashemene General Hospital VCT center. Findings Institution based cross-sectional study was performed from November 3, 2008 to December 29, 2008 and 384 voluntary counseling and testing (VCT clients were investigated. Data on socio demographic and HBV risk factors was collected using structured questionnaires. Blood samples were collected and screened for hepatitis B surface antigen (HBsAg and HIV by commercially available rapid test kits. The prevalence of HBsAg in this study group was 5.7%. Fourteen percent of HIV positive subjects (8/57 and 4.3% (14/327 of HIV negative subjects were positive for HBsAg. Significantly high prevalence of HBsAg was observed among individuals who had history of invasive procedures, like tooth extraction, abortion and ear piercing; history of hospital admission, history of unsafe inject and HIV positives. Conclusions Although HBsAg prevalence is much higher among subjects who are HIV positive (14.0% versus 4.3%, the prevalence of HBsAg in HIV negative subjects is high enough to warrant a recommendation to screen all clients at VCT centers irrespective of HIV status.

  3. Hospital survival upon discharge of ill-neonates transported by ground or air ambulance to a tertiary center.

    Science.gov (United States)

    Alvarado-Socarras, Jorge Luis; Idrovo, Alvaro Javier; Bermon, Anderson

    2016-01-01

    To evaluate the differences in hospital survival between modes of transport to a tertiary center in Colombia for critically ill neonates. Observational study of seriously ill neonates transported via air or ground, who required medical care at a center providing highly complex services. Data on sociodemographic, clinical, the Transport Risk Index of Physiologic Stability (TRIPS), and mode of transport were collected. Patients were described, followed by a bivariate analysis with condition (live or dead) at time of discharge as the dependent variable. A multiple Poisson regression with robust variance model was used to adjust associations. A total of 176 neonates were transported by ambulance (10.22% by air) over six months. The transport distances were longer by air (median: 237.5km) than by ground (median: 11.3km). Mortality was higher among neonates transported by air (33.33%) than by ground (7.79%). No differences in survival were found between the two groups when adjusted by the multiple model. An interaction between mode of transport and distance was observed. Live hospital discharge was found to be associated with clinical severity upon admittance, birth weight, hemorrhaging during the third trimester, and serum potassium levels when admitted. Mode of transport was not associated with the outcome. In Colombia, access to medical services through air transport is a good option for neonates in critical condition. Further studies would determine the optimum distance (time of transportation) to obtain good clinical outcomes according type of ambulance. Copyright © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  4. The patient experience of patient-centered communication with nurses in the hospital setting: a qualitative systematic review protocol.

    Science.gov (United States)

    Newell, Stephanie; Jordan, Zoe

    2015-01-01

    care. However, current methods used to collect and use information from patients about their care is often retrospective, provides inadequate real time data and is not effective in creating action to produce change at the individual patient level. Methods which focus on including the patient and their information in real-time are considered by many to be crucial to the advancement of improved health outcomes and the reduced costs that are required of health care to be sustainable. One such method is patient-centered communication.The nurse-patient interaction is a core component of nursing science and high quality nursing care. Fleisher et al. contend that 'the main intention of communication and interaction, in the health setting, is to influence the patient's health status or state of well-being'. As a profession, nursing predominately requires communicating with, and relating to, patients at the individual level. In the hospital setting nurses undertake many of their patient related duties in a face-to-face manner with the patient at the bedside and these moments can facilitate effective interaction to occur between the nurse and the patient, which is patient-centered. McCabe et al. state that patient-centered communication as "defined by Langewitz et al. as 'communication that invites and encourages the patient to participate and negotiate in decision-making regarding their own care'.''However, qualitative studies by McCabe and Wellard et al, highlighted that nurses interact with patients only when performing administrative or functional activities and nursing 'practice was predominately task-orientated'. The outcome of these studies are supported by Maurer et al. in their report on the tools and strategies available to support patient and family engagement in the hospital setting. Maurer et al. identified that current strategies 'are not attuned to patient and family member experiences of hospitalization' and that most tools and strategies were 'more reflective of

  5. Drug abuse in hospitalized trauma patients in a university trauma care center: an explorative study

    Directory of Open Access Journals (Sweden)

    A.R. Soroush

    2006-08-01

    Full Text Available Background: Drug abuse has been known as a growing contributing factor to all types of trauma in the world. The goal of this article is to provide insight into demographic and substance use factors associated with trauma and to determine the prevalence of drug abuse in trauma patients. Methods: Evidence of substance abuse was assessed in trauma patients presenting to Sina trauma hospital over a 3-month period. They were interviewed and provided urine samples to detect the presence of drug/metabolites of opium, morphine, cannabis and heroin by “Morphine Check” kits. Demographic data, mechanisms of injury, history of smoking and drug abuse were recorded. Results: A total of 358 patients with a mean age of 28.4 years were studied. The Patients were predominantly male (94.7%. There was a history of smoking in 136 cases (38%. 58 cases (16.2% reported to abuse drugs (91.5% opium. The commonest route of administration was smoke inhalation (37.2%. Screening by Morphine Check test revealed 95 samples to be positive (26.5%. The preponderance of test-positive cases was among young people (of 20-30 years of age with a history of smoking. Victims of violence and those with penetrating injuries also showed a higher percentage of positive screens (P=0.038 and P<0.001, respectively. Conclusion: These results suggest that drug abuse is a contributing factor to trauma especially in violent injuries and among the young. Regarding the considerable prevalence of drug abuse among trauma patients, it’s highly recommended that all trauma patients be screened for illicit drugs

  6. Surveillance of poisoning and drug overdose through hospital discharge coding, poison control center reporting, and the Drug Abuse Warning Network.

    Science.gov (United States)

    Blanc, P D; Jones, M R; Olson, K R

    1993-01-01

    There is no gold standard for determining poisoning incidence. We wished to compare four measures of poisoning incidence: International Classification of Diseases 9th Revision (ICD-9) principal (N-code) and supplemental external cause of injury (E-code) designations, poison control center (PCC) reporting, and detection by the Drug Abuse Warning Network (DAWN). We studied a case series at two urban hospitals. We assigned ICD-9 N-code and E-code classifications, determining whether these matched with medical records. We ascertained PCC and DAWN system reporting. A total of 724 subjects met entry criteria; 533 were studied (74%). We matched poisoning N-codes for 278 patients (52%), E-code by cause in 306 patients (57%), and E-code by intent in 171 patients (32%). A total of 383 patients (72%) received any poisoning N-code or any E-code. We found that PCC and DAWN reporting occurred for 123 of all patients (23%) and 399 of 487 eligible patients (82%), respectively. In multiple logistic regression, factors of age, hospital admission, suicidal intent, principal poisoning or overdose type, and mixed drug overdose were statistically significant predictors of case match or report varying by surveillance measure. Our findings indicate that common surveillance measures of poisoning and drug overdose may systematically undercount morbidity.

  7. Methicillin-resistant Staphylococcus aureus nasal cariage among hospitalized patients and healthcare workers in the Clinical center of Serbia

    Directory of Open Access Journals (Sweden)

    Ćirković Ivana

    2014-01-01

    Full Text Available The aim of the present study was to provide the first comprehensive analysis of methicillin-resistant Staphylococcus aureus (MRSA carriage among patients and healthcare workers (HCWs in the largest healthcare facility in Serbia. Specimens from anterior nares obtained from 195 hospitalized patients and 105 HCWs were inoculated after broth enrichment onto chromogenic MRSA-ID medium. In total, 21 of 300 specimens yielded MRSA. Among hospitalized patients, 7.7% were colonized with MRSA, and 5.7% HCWs were colonized with MRSA. Five out of 21 (23.8% tested MRSA strains were classified as community-associated MRSA (CA-MRSA, and four of them were isolated from HCWs. The remaining 16 MRSA strains had characteristics of healthcare-associated MRSA (HA-MRSA, and two of them were isolated from HCWs. The HA-MRSA strains isolated from HCWs were indistinguishable from HA-MRSA of the same cluster isolated from patients. This finding reveals the circulation of HA-MRSA strains between patients and HCWs in the Clinical Center of Serbia. [Projekat Ministarstva nauke Republike Srbije, br. ON 175039

  8. 2009~2012年重庆医科大学附属第一医院粪肠球菌和屎肠球菌耐药性监测%The resistance surveillance of Enterococcus faecalis and Enterococcus faecium from the First Affiliated Hospital of Chongqing Medical University between 2009 and 2012

    Institute of Scientific and Technical Information of China (English)

    黎七绮; 牛司强

    2014-01-01

    Objective To investigate the antimicrobial resistance of Enterococcus f aecalis and Enterococcus f aecium isolated from the First Affiliated Hospital of Chongqing Medical University between 2009 and 2012 .Methods Antimicrobial susceptibility testing was carried out according to the unified protocol .The dates were analyzed by WHONET 5 .6 software according to clinical and laboratory standards institute(CLSI) of 2012 .Results A total of 783 non-repetitive Enterococcus f aecalis and 664 non-repeti-tive Enterococcus f aecium isolates were collected .The strains were still highly susceptible to linezolid and vancomycin .The resist-ance rates were all less than 2 .0% .The resistance rates of vancomycin to Enterococcus f aecalis and Enterococcus f aecium were 0 .1% and 1 .4% ,respectively .The percentage of Enterococcus f aecalis resistant to ampicillin ,penicilin and nitrofurantoin were 5 .7% ,2 .6% and 2 .2% ,respectively .About 32 .9% of Enterococcus f aecalis isolates were resistant to gentamicin .The resistance rates of ampicillin and penicillin to Enterococcus f aecium were more than 90 .0% .Conclusion Enterococcus f aecalis is main En-terococcus in the First Affiliated Hospital of Chongqing Medical University .There is an obvious difference between the antibiotic re-sistance of the Enterococcus f aecalis and Enterococcus f aecium .So ,monitoring drug resistance of the Enterococcus shows great sig-nificance to the clinical treatment .%目的:了解2009~2012年重庆医科大学附属第一医院临床分离的粪肠球菌和屎肠球菌对各类抗菌药物的耐药性。方法临床分离病原菌按统一方案进行细菌药物敏感试验,根据2012年版临床实验室标准化协会(CLSI)指导原则判读细菌的药物敏感试验结果,采用WHONET5.6软件对数据进行分析。结果共分离到非重复粪肠球菌783株,屎肠球菌664株,二者对利奈唑胺和万古霉素非常敏感(耐药率均低于2.0%),粪肠球菌

  9. 2015年天津中医药大学第二附属医院下呼吸道感染病原菌的分布及耐药性分析%Analysis on distribution and drug resistance of pathogenic bacteria causing lower respiratory tract infection in Second Affiliated Hospital of Tianjin University of TCM in 2015

    Institute of Scientific and Technical Information of China (English)

    杨小敏; 闫卫利; 李小娟

    2016-01-01

    Objective To understand the distribution and drug resistance analysis of pathogenic bacteria causing lower respiratory tract infection in Second Affiliated Hospital of Tianjin University of TCM, and to provide reference for clinical rational drug use. Methods The distribution and drug resistance analysis of pathogenic bacteria causing lower respiratory tract infection in Second Affiliated Hospital of Tianjin University of TCM in 2015 were analyzed retrospectively. Results Total 662 strains of pathogens were isolated, in which Gram-negative bacteria were 504 strains (76.13%). Gram-positive bacteria (60 strains) accounted for 9.06%. While there were also 98 strains of fungus (14.80%) isolated. The sensitive rate of main Gram-negative bacteria against meropenem was above 82%. Different bacteria had different sensitive rates against the same antibacterial drug. And Gram-negative bacteria and Gram-negative bacteria generally had the phenomenon of multiple drug resistance. The sensitive rates of Candida albicans against amphotericin B, 5-fluorocytosine, fluconazole, itraconazole, and voriconazole were above 98%. Conclusion The main pathogens causing lower respiratory tract infection is Gram-negative bacteria. The different drug resistance exists in different kinds of bacteria. The physician should understand local pathogenic bacteria distribution and drug resistance timely, in order to guide the clinical empirical use of antibacterial drugs.%目的:了解天津中医药大学第二附属医院下呼吸道感染病原菌的分布及细菌耐药情况,为临床合理用药提供依据。方法对2015年天津中医药大学第二附属医院分离下呼吸道感染病原菌的分布及药敏结果进行回顾性分析。结果共分离病原菌662株,其中革兰阴性菌504株,占76.13%;革兰阳性菌60株,占9.06%;真菌98株,占14.80%。主要革兰阴性菌对美罗培南的敏感率均达82%以上,不同的菌株对同种抗菌药物的敏感率不

  10. Analysis of HIV Antibody Screening in the First Affiliated Hospital of China Medical University%中国医科大学附属第一医院就诊患者HIV抗体筛查试验结果分析

    Institute of Scientific and Technical Information of China (English)

    孙洪军

    2016-01-01

    Objective To understand the current situation of HIV infection in the First affiliated Hospital of China Medical Uni-versity;to analyze the department distribution and the abnormality of common laboratory indexes among people with HIV and false posi-tive HIV in screening tests;to explore the influence of routine laboratory indexes on early HIV screening results. Methods By collec-ting clinic information of patients early screening positive for HIV from May 2012 to March 2013 in the First Affiliated Hospital of China Medical University, and analyzing HIV infection positive rate, the population distribution of those with HIV and negative HIV, and the correlation between conventional laboratory indexes and HIV screening to be false positive. Results Among 40,833 patients screened for HIV, 67 were confirmed as positive, and the positive rate was 0. 156%. In laboratory tests for qualitative testing, TP and GGT in the frequency of HIV infection were higher than those being false positive (P=0. 0039, P=0. 0010). There was a trend that A19-9 in HIV screening false positive frequency was higher than HIV infection (P=0. 062 4, P=0. 096 9). In quantitative detection labora-tory index quantity, ASO, GGT and AST were statistically significant. The Mean value of ALB in false - positive HIV screening was higher than that of HIV infection (P=0. 022). Conclusion The abnormality of ALP, CA19-9 and ALB in the laboratory test results may be associated with HIV screening to be false positive.%目的:了解目前中国医科大学附属第一医院就诊患者中HIV感染发生情况,分析HIV感染者及HIV筛查试验呈假阳性反应者在各科室的分布情况及常见的实验室指标异常情况,探讨常规实验室指标对HIV初筛结果的影响。方法收集中国医大一院2012年5月至2013年3月就诊患者中HIV初筛阳性者的就诊信息,统计分析HIV感染阳性率, HIV感染者及HIV阴性患者的人群分布,及常规实验室指标与HIV初筛假阳

  11. Bacteriological profile of burn wound isolates in a burns center of a tertiary hospital

    Directory of Open Access Journals (Sweden)

    Amankwa Richcane

    2017-07-01

    Full Text Available Objective: To determine the bacteriological profile and antimicrobial susceptibility patterns of burn wound isolates. Methods: Swabs were taken from burn wound of patients admitted to Ward D2C and Burns Intensive Care Unit (BICU from December 2014 to November 2015. Samples were processed at the Microbiology Laboratory for identification and sensitivity. Bacteria isolated were identified using their morphological characteristics, Gram staining reaction and biochemical tests. The antimicrobial susceptibility testing was done using KirbyBauer disc diffusion method. Questionnaires were also administered to study participants to obtain information on demography, kind of first aid received, antibiotics received prior to culture and sensitivity. Results: A total of 86 patients comprising 45 patients from Ward D2C and 41 from BICU participated in the study. Males were 51(59.3% and females 35 (40.7%. Age of participants ranged from 0–56+ years. Pseudomonas aeruginosa was the commonest pathogen isolated 26(30.2%, followed by Pseudomonas spp. 21(24.4%, Escherichia coli 17(19.8%, Klebsiella spp. 12(14.0%. Coagulase negative Staphylococcus accounted for 2(2.3%. Overall prevalence of infection in the study was 90.7%. Conclusions: Burn wound infection continues to be a major challenge in burn centers. Regular surveillance of commonly identified pathogens in the ward and their antimicrobial susceptibility will guide proper empiric selection of antibiotics for management of burn wounds.

  12. Affiliation of Opposite-Sexed Strangers

    Science.gov (United States)

    Crouse, Bryant Bernhardt; Mehrabian, Albert

    1977-01-01

    Examines the effects of physical attractiveness on live verbal interactions between males and females. It was assumed that if opposite-sexed individuals primarily base their liking of the other on physical attractiveness, then subjects should be more positive and affiliative with attractive than unattractive others. (Author/RK)

  13. Nonconsolidated Affiliates, Bank Capitalization, and Risk Taking

    NARCIS (Netherlands)

    Gong, Di; Huizinga, Harry; Laeven, L.A.H.

    2017-01-01

    This paper is the first to show that financial institutions may be effectively undercapitalized as a result of incomplete consolidation of minority ownership. Using two approaches – consolidating the minority-owned affiliates with the parent or deducting equity investments in minority ownership from

  14. Teaching Responsibility to Gang-Affiliated Youths

    Science.gov (United States)

    Buckle, Michael E.; Walsh, David S.

    2013-01-01

    Teaching youths who affiliate with a gang can be a daunting task. Risk factors for gang membership often compound across life domains and affect pro-social connectedness, cause feelings of marginalization, and hinder life-skill development. Sports and physical activities that are structured within a positive youth-development framework provide an…

  15. 18 CFR 35.39 - Affiliate restrictions.

    Science.gov (United States)

    2010-04-01

    ... energy and all other affiliate provisions, must be satisfied on an ongoing basis, unless otherwise authorized by Commission rule or order. Failure to satisfy these conditions will constitute a violation of... electric energy or capacity may be made between a franchised public utility with captive customers and...

  16. [Post-transplant lymphoproliferative disease in liver transplant recipients--Merkur University Hospital single center experience].

    Science.gov (United States)

    Filipec-Kanizaj, Tajana; Budimir, Jelena; Colić-Cvrlje, Vesna; Kardum-Skelin, Ika; Sustercić, Dunja; Naumovski-Mihalić, Slavica; Mrzljak, Anna; Kolonić, Slobodanka Ostojić; Sobocan, Nikola; Bradić, Tihomir; Dolić, Zrinka Misetić; Kocman, Branislav; Katicić, Miroslava; Zidovec-Lepej, Snjezana; Vince, Adriana

    2011-09-01

    favoring the diagnosis. The management of PTLD poses a major therapeutic challenge and although there is reasonable agreement about the overall principles of treatment, there is still considerable controversy about the optimal treatment of individual patients. EBV-related PTLDs are a significant cause of mortality in patients undergoing orthotopic liver transplantation with the observed mortality rate of up to 50%. This paper presents the experience acquired at Merkur University Hospital in the diagnosis and treatment of patients with liver transplantation and PTLD.

  17. Clinical outcomes of 11,436 kidney transplants performed in a single center - Hospital do Rim.

    Science.gov (United States)

    Pestana, José Medina

    2017-08-28

    Kidney transplantation is considered a cost-effective treatment compared to dialysis but accounts for a significant percentage of the public health care resources. Therefore, efficient systems capable of performing high number of procedures are attractive and sustainable. The aim of this study was to evaluate clinical outcomes of 11,436 kidney transplants regularly performed in a single transplant dedicated center over the last 18 years. This was a retrospective study performed in a single specialized transplant center. All consecutive patients who underwent transplantation between 08/18/1998 and 12/31/2015 were included in the analysis. The annual number of transplants increased from 394 in 1999 to 886 in 2015, with a progressive reduction in the proportion of living donor kidney transplants (70% vs. 23%) and yielding over 8869 patients in regular follow up. Of 11,707 kidney transplants performed, 5348 (45.7%) were from living, 3614 (30.9%) standard and 1618 (13.8%) expanded criteria deceased donors, 856 (7.3%) pediatric and 271 (2.3%) simultaneous kidney-pancreas transplants. Comparing 1998-2002 and 2011-2014, five-years graft survival increased for kidney transplants performed with living donors (83.3% vs. 93.1%, p transplants, in the cumulative number of patients in follow up and a shift from living related to deceased donor kidney transplants, with associated progressive increase in patient and graft survivals. Transplante renal é considerado um tratamento custo-efetivo comparado à diálise e representa uma porcentagem significativa dos recursos de saúde pública. Dessa forma, sistemas eficientes e capazes de realizar um elevado número de procedimentos, são atraentes e sustentáveis. O objetivo deste estudo foi avaliar os desfechos clínicos de 11.436 transplantes renais realizados em um centro único de transplante nos últimos 18 anos. Trata-se de um estudo retrospectivo realizado em centro único e especializado em transplante renal. Todos os pacientes

  18. A Decomposition of Hospital Profitability

    Directory of Open Access Journals (Sweden)

    Jason Turner

    2015-06-01

    Full Text Available Objectives: This paper evaluates the drivers of profitability for a large sample of U.S. hospitals. Following a methodology frequently used by financial analysts, we use a DuPont analysis as a framework to evaluate the quality of earnings. By decomposing returns on equity (ROE into profit margin, total asset turnover, and capital structure, the DuPont analysis reveals what drives overall profitability. Methods: Profit margin, the efficiency with which services are rendered (total asset turnover, and capital structure is calculated for 3,255 U.S. hospitals between 2007 and 2012 using data from the Centers for Medicare & Medicaid Services’ Healthcare Cost Report Information System (CMS Form 2552. The sample is then stratified by ownership, size, system affiliation, teaching status, critical access designation, and urban or non-urban location. Those hospital characteristics and interaction terms are then regressed (OLS against the ROE and the respective DuPont components. Sensitivity to regression methodology is also investigated using a seemingly unrelated regression. Results: When the sample is stratified by hospital characteristics, the results indicate investor-owned hospitals have higher profit margins, higher efficiency, and are substantially more leveraged. Hospitals in systems are found to have higher ROE, margins, and efficiency but are associated with less leverage. In addition, a number of important and significant interactions between teaching status, ownership, location, critical access designation, and inclusion in a system are documented. Many of the significant relationships, most notably not-for-profit ownership, lose significance or are predominately associated with one interaction effect when interaction terms are introduced as explanatory variables. Results are not sensitive to the alternative methodology. Conclusion: The results of the DuPont analysis suggest that although there appears to be convergence in the behavior of

  19. Integration of the clinical engineering specialist at a high complexity children's hospital. Our professional experience at a surgical center

    Energy Technology Data Exchange (ETDEWEB)

    Vargas Enriquez, M J; Chazarreta, B; Emilio, D G; Fernandez Sarda, E [Surgical Center-Neurophysiology Division of Medical Tecnology Department, Garrahan Children' s Hospital, Combate de los Pozos 1881, Buenos Aires (Argentina)

    2007-11-15

    This document aims to find relating points between the current and future Clinical Engineer professional in order to discuss about the hospital environment, its characteristics and its realities which lead to our professional development. The main aim is to depict our experience through a retrospective analysis based on the underwriting experience and consequently to arrive at conclusions that will support the inclusion and active interaction of the Clinic Engineer Specialist as part of a Hospital's Surgical Center.

  20. FacilitiesHospitals_HOSPITAL

    Data.gov (United States)

    Vermont Center for Geographic Information — This data layer contains point locations of all major community, regional, comprehensive health, and healthcare provider hospitals in the state of Vermont. The...

  1. Protection behaviors for cytotoxic drugs in oncology nurses of chemotherapy centers in Shiraz hospitals, South of Iran.

    Science.gov (United States)

    Abbasi, Khadijeh; Hazrati, Maryam; Mohammadbeigi, Abolfazl; Ansari, Jasem; Sajadi, Mahboubeh; Hosseinnazzhad, Azam; Moshiri, Esmail

    2016-01-01

    The use of antineoplastic agents for the treatment of cancer is an increasingly common practice in hospitals. As a result, workers involved with handling antineoplastic drugs may be accidentally exposed to these agents, placing them at potential risk for long-term adverse effects. This study aimed to determine the occupational protection status of clinical nursing staff exposed to cytotoxic drugs. The study was designed as an analytic descriptive survey. The research settings took place in six centers of chemotherapy in Shiraz, Iran. The participants were 86 nurses who worked in oncology units and administered cytotoxic drugs. Data were collected using a questionnaire and a checklist which was developed by the investigators to determine occupational protection status of clinical nursing staff exposed to cytotoxic drugs. Percentage calculations and the independent samples t-test were used to see the general distribution and analysis of data. To statistically analyze of the data, SPSS software (version 16) was applied. The mean age of participants was 30.52 ± 6.50 years and 66.27% of the nurses worked on inpatient oncology wards. The mean practice score was 21.1 ± 3.76 that ranged from 12.5 to 31. The independent samples t-test showed the outpatient nurses were weaker in practice (17.2 ± 2.52) in comparison with university hospitals (23.35 ± 3.02, P < 0.001). Occupational protection status of clinical nursing staff exposed to cytotoxic drugs especially during administration and disposal of medicines was poor and rarely trained with this subject and was observed under the standard conditions. There is deficiency in the understanding and related protection practices of clinical nursing staff vocationally exposed to cytotoxic drugs. It is recommended that all clinical nursing staff should receive full occupational protection training about these matters and the authorities provide standard conditions of oncology wards.

  2. Assessing performance of Guilan university hospitals (2012

    Directory of Open Access Journals (Sweden)

    M. Alijanzadeh

    2016-08-01

    Full Text Available Background: Performance assessment could provide information to control and monitor of the current status and activities in hospitals. Objective: To assess the performance of hospitals affiliated with Guilan University of Medical Sciences in 2012. Methods: This cross-sectional study covered all the 22 public hospitals in the Guilan province, with 3760 registered beds. Using standard data-gathering form, verified by the Iranian Ministry of Health, performance indicators of 22 hospitals were recorded from the Statistical Services Center at Guilan University of Medical Sciences. Bed Occupancy Rate, Average Length of Stay and Bed Turnover Ratio were calculated and Pabon Lasso chart was drawn using SPSS statistics 17.0. Findings: On average, the Bed Turnover Ratio (time/year, Bed Occupancy Rate (% and Average Length of Stay (day were 78 times per year, 60% and 3.70 days, respectively. Based on the Pabon Lasso chart, 27 percentage hospitals were located in zone 1, 23 percentage hospitals in zone 2, 36 percentage hospitals in zone 3 and 14 percentage hospitals in zone 4. Conclusion: The performance of the hospitals was in a moderate level.

  3. Strengthening an affiliation without a merger.

    Science.gov (United States)

    Hegwer, Laura Ramos

    2015-04-01

    Froedtert Health and the Medical College of Wisconsin have created a shared governance structure with joint committees focused on value, IT, marketing, strategic planning, and other areas. A new funds-flow model shifts a percentage of the health system's bottom line to the medical college to support physician recruitment,joint initiatives, academic programs, and a strategic reserve. The strengthened affiliation has enhanced the ability of the organizations to engage in accountable care and population health initiatives, among other benefits.

  4. Political party affiliation, political ideology and mortality.

    Science.gov (United States)

    Pabayo, Roman; Kawachi, Ichiro; Muennig, Peter

    2015-05-01

    Ecological and cross-sectional studies have indicated that conservative political ideology is associated with better health. Longitudinal analyses of mortality are needed because subjective assessments of ideology may confound subjective assessments of health, particularly in cross-sectional analyses. Data were derived from the 2008 General Social Survey-National Death Index data set. Cox proportional analysis models were used to determine whether political party affiliation or political ideology was associated with time to death. Also, we attempted to identify whether self-reported happiness and self-rated health acted as mediators between political beliefs and time to death. In this analysis of 32,830 participants and a total follow-up time of 498,845 person-years, we find that political party affiliation and political ideology are associated with mortality. However, with the exception of independents (adjusted HR (AHR)=0.93, 95% CI 0.90 to 0.97), political party differences are explained by the participants' underlying sociodemographic characteristics. With respect to ideology, conservatives (AHR=1.06, 95% CI 1.01 to 1.12) and moderates (AHR=1.06, 95% CI 1.01 to 1.11) are at greater risk for mortality during follow-up than liberals. Political party affiliation and political ideology appear to be different predictors of mortality. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  5. Knowledge of Social Affiliations Biases Economic Decisions.

    Science.gov (United States)

    Martinez, Joel E; Mack, Michael L; Gelman, Bernard D; Preston, Alison R

    2016-01-01

    An individual's reputation and group membership can produce automatic judgments and behaviors toward that individual. Whether an individual's social reputation impacts interactions with affiliates has yet to be demonstrated. We tested the hypothesis that during initial encounters with others, existing knowledge of their social network guides behavior toward them. Participants learned reputations (cooperate, defect, or equal mix) for virtual players through an iterated economic game (EG). Then, participants learned one novel friend for each player. The critical question was how participants treated the friends in a single-shot EG after the friend-learning phase. Participants tended to cooperate with friends of cooperators and defect on friends of defectors, indicative of a decision making bias based on memory for social affiliations. Interestingly, participants' explicit predictions of the friends' future behavior showed no such bias. Moreover, the bias to defect on friends of defectors was enhanced when affiliations were learned in a social context; participants who learned to associate novel faces with player faces during reinforcement learning did not show reputation-based bias for associates of defectors during single-shot EG. These data indicate that when faced with risky social decisions, memories of social connections influence behavior implicitly.

  6. Demonstrating a Conceptual Framework to Provide Efficient Wound Management Service for a Wound Care Center in a Tertiary Hospital

    Science.gov (United States)

    Chen, Yu-Tsung; Chang, Chang-Cheng; Shen, Jen-Hsiang; Lin, Wei-Nung; Chen, Mei-Yen

    2015-01-01

    Abstract Although the benefits of wound care services and multidisciplinary team care have been well elaborated on in the literature, there is a gap in the actual practice of wound care and the establishment of an efficient referral system. The conceptual framework for establishing efficient wound management services requires elucidation. A wound care center was established in a tertiary hospital in 2010, staffed by an integrated multidisciplinary team including plastic surgeons, a full-time coordinator, a physical therapist, occupational therapists, and other physician specialists. Referral patients were efficiently managed following a conceptual framework for wound care. This efficient wound management service consists of 3 steps: patient entry and onsite immediate wound debridement, wound re-evaluation, and individual wound bed preparation plan. Wound conditions were documented annually over 4 consecutive years. From January 2011 to December 2014, 1103 patients were recruited from outpatient clinics or inpatient consultations for the 3-step wound management service. Of these, 62% of patients achieved healing or improvement in wounds, 13% of patients experienced no change, and 25% of patients failed to follow-up. The outcome of wound treatment varied by wound type. Sixty-nine percent of diabetic foot ulcer patients were significantly healed or improved. In contrast, pressure ulcers were the most poorly healed wound type, with only 55% of patients achieving significantly healed or improved wounds. The 3-step wound management service in the wound care center efficiently provided onsite screening, timely debridement, and multidisciplinary team care. Patients could schedule appointments instead of waiting indefinitely for care. Further wound condition follow-up, education, and prevention were also continually provided. PMID:26554805

  7. Demonstrating a Conceptual Framework to Provide Efficient Wound Management Service for a Wound Care Center in a Tertiary Hospital.

    Science.gov (United States)

    Chen, Yu-Tsung; Chang, Chang-Cheng; Shen, Jen-Hsiang; Lin, Wei-Nung; Chen, Mei-Yen

    2015-11-01

    Although the benefits of wound care services and multidisciplinary team care have been well elaborated on in the literature, there is a gap in the actual practice of wound care and the establishment of an efficient referral system. The conceptual framework for establishing efficient wound management services requires elucidation.A wound care center was established in a tertiary hospital in 2010, staffed by an integrated multidisciplinary team including plastic surgeons, a full-time coordinator, a physical therapist, occupational therapists, and other physician specialists. Referral patients were efficiently managed following a conceptual framework for wound care. This efficient wound management service consists of 3 steps: patient entry and onsite immediate wound debridement, wound re-evaluation, and individual wound bed preparation plan. Wound conditions were documented annually over 4 consecutive years.From January 2011 to December 2014, 1103 patients were recruited from outpatient clinics or inpatient consultations for the 3-step wound management service. Of these, 62% of patients achieved healing or improvement in wounds, 13% of patients experienced no change, and 25% of patients failed to follow-up. The outcome of wound treatment varied by wound type. Sixty-nine percent of diabetic foot ulcer patients were significantly healed or improved. In contrast, pressure ulcers were the most poorly healed wound type, with only 55% of patients achieving significantly healed or improved wounds.The 3-step wound management service in the wound care center efficiently provided onsite screening, timely debridement, and multidisciplinary team care. Patients could schedule appointments instead of waiting indefinitely for care. Further wound condition follow-up, education, and prevention were also continually provided.

  8. An epidemiologic survey on the causes of infertility in patients referred to infertility center in Fatemieh Hospital in Hamadan

    Directory of Open Access Journals (Sweden)

    Seyedeh Zahra Masoumi

    2015-08-01

    Full Text Available Background: Infertility is considered as a major health care problem of different communities. The high prevalence of this issue doubled its importance. A significant proportion of infertility have been related to environmental conditions and also acquired risk factors. Different environmental conditions emphasized the need to study the different causes of infertility in each area. Objective: The aim of this study was to determine the frequency causes of infertility in infertile couples. Materials and Methods: In this cross sectional descriptive study 1200 infertile men and women that were referred to infertility clinic of Fatemieh Hospital during 2010 to 2011, were examined. This center is the only governmental center for infertility in Hamadan. Sampling was based on census method. Information about the patients was obtained from medical examinations and laboratory findings. To analyze the data, descriptive statistics such as frequencies and the mean were used. Results: The prevalence of primary and secondary infertility was 69.5% and 30.5% respectively. Among the various causes of infertility women factors (88.6% had the highest regard. In the causes of female infertility, menstrual disorders, diseases (obesity, thyroid diseases, and diabetes, ovulation dysfunction, uterine factor, fallopian tubes and cervical factor had the highest prevalence respectively. The causes of male infertility based on their frequency included semen fluid abnormalities, genetic factors, vascular abnormalities, and anti-spermatogenesis factors, respectively. Conclusion: Etiology pattern of infertility in our study is similar with the many other patterns that have been reported by the World Health Organization. However, frequency of menstrual disorders is much higher than other studies that require further consideration.

  9. [Professional values: a strategic component of health professionals. The contribution of decisional research at the Toulouse University Hospital Center].

    Science.gov (United States)

    Péoc'h, Nadia; Ceaux, Christine

    2012-03-01

    The organizational involvement concept is often developed by many researchers and practitioners. This study is in the right inheritance of Allen and Meyer (1990) and Thevenet and Neveu (2002) works who all considered the involvement as "an affective or emotional attachment towards the organization such as an individual strongly involved identifies himself, reinforces his own agreement and enjoys being a member of the organization that employs him". The aim of this study was to demonstrate the impact of professional values (in terms of adherence to the purposes, norms and values of the establishment upon the subject's involvement in professional activities). 1538 health professionals practising in Toulouse academic hospital center have answered a questionnaire upon the subject's individual perception of his personal involvement in his workplace; the possible working impacts upon his own motivation, the perceptions upon professional values. Results indicate that if involvement is subject to professional values, it turns towards a double determination: technical and axiological or ethical. The professional and axiological dimension introduces a moral position and a cognitive framework that participates in the decision-making action : working together, creating a climate of confidence, trusting the group, and progressing for greater cohesion. The ethical dimension joins historic and humanist values: self respect and altruism; developing human values for oneself and for others. Specifying values is already a project in itself, in terms of consciousness. Understanding those impacts upon health professionals involvements' is also the aim to include the historical of our Care Project in collective interaction, alteration and construction purposes.

  10. [Lung disease and HIV infection in children at the Charles de Gaulle university pediatric hospital center in Ouagadougou (Burkina Faso)].

    Science.gov (United States)

    Kouéta, Fla; Yé, Diarra; Dao, Lassina; Zoungrana-Kaboré, Alice; Ouédraogo, Sylvie Armelle P; Napon, M; Sawadogo, Alphonse

    2008-01-01

    To compare the clinical and radiological aspects of lung diseases in HIV-positive and HIV-negative children, we conducted a retrospective case control study covering a 3-year period from January 2003 through December 2005 at Charles de Gaulle University Pediatric Hospital Center in Ouagadougou. HIV-positive patients hospitalised for lung disease were matched to HIV-negative patients controls, hospitalised for the same symptoms, by age and date of hospitalisation. The study included 186 patients (93 HIV-positive and 93 HIV-negative) and collected data on age, sex, clinical signs, radiological signs and short-term course. Of the 93 HIV-positive children suspected to have been contaminated by mother-to-child transmission, 92 had HIV1 and 1 had a double infection of HIV1 and 2. The mean age in both groups was 48 months. Clinically severe lung disease (44%) was more common in HIV-positive children. Radiology showed that interstitial syndrome was significantly more common in HIV-positive children (p=0001) with a sensitivity of 71% and a specificity of 60%. The case-fatality rate was 4.2% among HIV-positive children. This study allows us to remind paediatricians of the importance of lung disease in HIV-infected children. Moreover, the vertical transmission responsible for disease in all our patients shows the need to accelerate the scaling up of the program for prevention of mother-to-child HIV transmission in our country.

  11. Clinical Profile, Predictors of Mortality, and Treatment of Patients after Myocardial Infarction, in an Academic Medical Center Hospital

    Directory of Open Access Journals (Sweden)

    Zornoff Leonardo A. M.

    2002-01-01

    Full Text Available OBJECTIVE: To evaluate clinical profiles, predictors of 30-day mortality, and the adherence to international recommendations for the treatment of myocardial infarction in an academic medical center hospital. METHODS: We retrospectively studied 172 patients with acute myocardial infarction, admitted in the intensive care unit from January 1992 to December 1997. RESULTS: Most patients were male (68%, white (97%, and over 60 years old (59%. The main risk factor for coronary atherosclerotic disease was systemic blood hypertension (63%. Among all the variables studied, reperfusion therapy, smoking, hypertension, cardiogenic shock, and age were the predictors of 30-day mortality. Most commonly used medications were: acetylsalicylic acid (71%, nitrates (61%, diuretics (51%, angiotensin-converting enzyme inhibitors (46%, thrombolytic therapy (39%, and beta-blockers (35%. CONCLUSION: The absence of reperfusion therapy, smoking status, hypertension, cardiogenic shock, and advanced age are predictors of 30-day mortality in patients with acute myocardial infarction. In addition, some medications that are undoubtedly beneficial have been under-used after acute myocardial infarction.

  12. Protocol for the treatment of malignant inoperable bowel obstruction: a prospective study of 80 cases at Grenoble University Hospital Center.

    Science.gov (United States)

    Laval, Guillemette; Arvieux, Catherine; Stefani, Laetitia; Villard, Marie-Laure; Mestrallet, Jean-Phillippe; Cardin, Nicolas

    2006-06-01

    A prospective protocol for treatment of malignant inoperable bowel obstruction was implemented at Grenoble University Hospital Center for 4 years. All 80 episodes of obstruction resulted from peritoneal carcinomatosis and none could expect another treatment cure. The protocol comprised three successive stages. Stage I included treatment for 5 days with a corticosteroid, antiemetic, anticholinergic, and analgesic. Stage II provided a somatostatin analogue if vomiting persisted. After 3 days, Stage III provided a venting gastrostomy. Obstruction relief with symptom control was obtained by medical treatment in 29 cases and symptom control occurred alone in an additional 32 cases. Ten patients were relieved by venting gastrostomy. Symptom control without permanent nasogastric tube (NGT) placement occurred in 72 episodes (90%). Eight patients with refractory vomiting were obliged to continue the NGT until death. Fifty-eight obstruction episodes (73%) were controlled in 10 days or less. Median time before gastrostomy was 17 days. Median survival was 31 days. This series suggests that a staged protocol for the treatment of inoperable malignant bowel obstruction is highly effective in relieving symptoms. A subgroup experiences relief of obstruction using this approach.

  13. How Will Online Affiliate Marketing Networks Impact Search Engine Rankings?

    NARCIS (Netherlands)

    D. Janssen (David); H.W.G.M. van Heck (Eric)

    2007-01-01

    textabstractIn online affiliate marketing networks advertising web sites offer their affiliates revenues based on provided web site traffic and associated leads and sales. Advertising web sites can have a network of thousands of affiliates providing them with web site traffic through hyperlinks on t

  14. Trends and Factors Affecting Hospitalization Costs in Patients with Inflammatory Bowel Disease: A Two-Center Study over the Past Decade

    Directory of Open Access Journals (Sweden)

    Junjie Xu

    2013-01-01

    Full Text Available With the growing number of patients with inflammatory bowel disease (IBD and hospitalization cases, the overall medical care cost elevates significantly in consequence. A total of 2458 hospitalizations, involving 1401 patients with IBD, were included from two large medical centers. Hospitalization costs and factors impacting cost changes were determined. Patients with IBD and frequency of hospitalizations increased significantly from 2003 to 2011 (P<0.001. The annual hospitalization cost per patient, cost per hospitalization, and daily cost during hospitalization increased significantly in the past decade (all P<0.001. However, length of stay decreased significantly (P<0.001. Infliximab was the most significant factor associated with higher hospitalization cost (OR = 44380.09, P<0.001. Length of stay (OR = 1.29, P<0.001, no medical insurance (OR = 1.31, P=0.017, CD (OR = 3.55, P<0.001, inflammatory bowel disease unclassified (IBDU (OR = 4.30, P<0.0001, poor prognosis (OR = 6.78, P<0.001, surgery (OR = 3.16, P<0.001, and endoscopy (OR = 2.44, P<0.001 were found to be predictors of higher hospitalization costs. Patients with IBD and frequency of hospitalizations increased over the past decade. CD patients displayed a special one peak for age at diagnosis, which was different from UC patients. The increased hospitalization costs of IBD patients may be associated with infliximab, length of stay, medical insurance, subtypes of IBD, prognosis, surgery, and endoscopy.

  15. 昆明医科大学第一附属医院铜绿假单胞菌感染的临床分布及耐药性分析%Analysis of Distribution and Drug Resistance of Pseudomonas Aeruginosa in Nosocomial Infection in the 1st Affiliated Hospital of Kunming Medical University

    Institute of Scientific and Technical Information of China (English)

    卯建; 赵滢; 邵天波; 张真铭

    2013-01-01

    Objective To investigate the clinical distribution and the drug resistances of Pseudomonas aeruginosa (PAE) during past 3 years in the 1st Affiliated Hospital of Kunming Medical University, and to provide evidence for clinical treatment of PAE infection.Methods The isolated PAE strains from 2010 to 2012 in the 1st Affiliated Hospital of Kunming Medical University were identified and antimicrobial susceptibility tests were performed using the MIC and the KB method,and thus, the ward distribution and the drug resistance rates and the changing trend were respectively analyzed by WHONET 5.5 software, and statistically analyzed with SPSS 17.0 SOFTWARE. Results Within the three years, a total of 208 strains, 260 strains and 280 strains of Pseudomonas aeruginosa were isolated separately in 2010,2011and 2012. A total of 746 PAE strains were isolated in 3 years,in which the most common specimens were sputum (79.8%), followed by the throat swab (7.6%) and the urine (6.2%) . When it came to the ward distribution , ICU was the primary, which accounted for (32.4%), followed by the department of cadre sanatorium (27.7%), the department of respiratory medicine (12.2%) and the department of neurosurgery (6.8%) . Besides imipenem, Cefoperazone-sulbactam and aztreonam, the others were obviously in a decreasing trend in drug resistances. In 2010, 2011 and 2012, the resistances rates of imipenem were ( 65.2%) , ( 74.2%) and ( 69.5%) , respectively, the resistances rates of Cefoperazone-sulbactam were (48.0%), (48.7%) and (55.8%), and the the resistances rates of aztreonam were (72.2%), (78.2%) and (72.4%) . Amikacin,piperacillin-tazobactam,Cefoperazone-sulbactam were the most active antimicrobial agents against P.aeruginosa. Conclusions The PAE is an important source of infection, ICUs are the focus of interest for resistance monitoring and control. Antimicrobial resistance of PAE is fairly serious. Clinicians should select appropriate antibiotic therapy based on sensitivity testing

  16. 高校附属医院城市社区授权教育对妊娠期糖尿病患者的影响研究%Effect of empowerment education of affiliated hospital of medical college and community used in gestational diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    任菲菲; 刘沫; 王阳; 徐国鑫

    2013-01-01

    Objective:To compare the influence of traditional health education and empowerment education of affiliated hospital of medical college and community on gestational diabetes mellitus (GDM).Methods:The study was a randomized clinical trial (RCT).60 GDM patients were randomly divided into the intervention group and the control group.Patients in intervention group (n =30) received empowerment education,while in the control group (n =30) received traditional health education.Full blood glucose (FBG) and PBG2h were measured at before intervention,3 and 6 months after intervention,SF-36 quality of life scale was measured after intervention 12 months.Results:There were significant differences (P < 0.05) in FBG,PBG2h,the SF-36 quality of life scale and the complication rate of pregnant women and newborns between two groups.Conclusion:After one year of health education intervention,this model has achieved good results,which is worthy to be popularized.%目的:探讨传统健康教育和高校附属医院城市社区授权教育两种方式对妊娠糖尿病患者进行干预的影响.方法:采用随机数字表法将社区的60例妊娠糖尿病患者分为干预组和对照组各30例,干预组采用高校附属医院城市社区授权教育管理,对照组采用常规的健康教育管理.分别在干预前、干预3、6个月后检测患者的空腹血糖和餐后2h血糖,在干预12个月结束后给患者发放生存质量量表SF-36.结果:干预组的空腹血糖、餐后2h血糖、生存质量等指标明显优于对照组,差异有统计学意义(P<0.05);孕妇及新生儿的并发症率明显低于对照组,差异有统计学意义(P<0.05).结论:经1年的社区授权教育管理模式取得了较好的效果,值得推广.

  17. [Childbirth practices and challenges for humanization of care in two public hospitals in Southern Brazil].

    Science.gov (United States)

    Nagahama, Elizabeth Eriko Ishida; Santiago, Silvia Maria

    2008-08-01

    The aim of this study was to characterize hospital care for childbirth in two hospitals affiliated with the Unified National Health System in Maringá, Paraná, Brazil, and identify both obstacles and facilitating factors for the implementation of humanized care, based on women's perception of the care received. This was an exploratory and descriptive study with a cross-sectional design, analyzing hospital patient charts and interviews with 569 women who gave birth at the two hospitals from March 2005 to February 2006. Hospital care was characterized on the basis of WHO quality-of-care guidelines for labor and delivery. The data pointed to a healthcare model marked by the hygienist legacy in physician-centered hospital protocols and professional practices. Institutional factors, identified as difficulties in institutional and infrastructure organization, hospital protocols, and health professionals' individual practices and stances, denote barriers that jointly hinder the implementation of a humanized model for childbirth care.

  18. The Construction of Hospital Data Center Based on Private Cloud%基于私有云构建医院数据中心

    Institute of Scientific and Technical Information of China (English)

    王波

    2012-01-01

    There are some problems existing in current hospital data center, including large scale, complex architecture, low degree of automation, etc. Aiming at the problems, the paper puts forward using IBM SKC cloud technology to construct data center, introduces the construction principles, targets and architectures, elaborates construction contents of data center management domain and resource do- main, so as to provide basis for digital hospital construction.%针对医院现有数据中心规模庞大、架构复杂、自动化程度低等问题,提出利用IBMSKC易云技术建设数据中心,介绍其建设原则、目标与架构,阐述数据中心管理域和数据中心资源域建设内容,为数字化医院建设夯实基础。

  19. Pinterest affiliate-markkinoijan työkaluna

    OpenAIRE

    Ratilainen, Arto

    2016-01-01

    Opinnäytetyön tarkoituksena oli kartoittaa affiliate-markkinoijien Pinterestin käyttöä ja siitä saatuja tuloksia. Opinnäytetyö toteutettiin All About Dumbbellsille, joka harjoittaa affiliate-markkinointia. Tutkimuksessa haettiin vastauksia siihen, miten affiliate-markkinoijat käyttävät Pinterestiä, miten hyödylliseksi he kokevat sen ja miksi Pinterestin ulkopuolelle jääneet affiliate-markkinoijat eivät käytä sitä. Opinnäytetyön keskeisimmät teoriaosuudet olivat affiliate-markkinointi ja P...

  20. [Affiliative achievement motivation and non-affiliative achievement motivation of female students].

    Science.gov (United States)

    Doi, K

    1988-02-01

    The purpose of this study was to investigate the two dimensional theory of achievement motivation (Doi, 1982) in female students. Doi's motivation scale were administered to 81 female university students, 58 female students of school of nursing and 77 female students of school of English Language, and the Yatabe-Guilford personality inventory was also administered to the first and the second groups. Affiliative achievement motivation and non-affiliative achievement motivation were extracted by principal component analyses and canonical correlation analyses. Non-affiliative achievement motivation was found to be related to personality type: emotional instability and introversion. These findings differ from achievement motivation concepts (Murray, 1938; McClelland, Atkinson, Clark, & Lowell, 1953), that include emotional stability and extraversion.

  1. 2011-2013年包头医学院第三附属医院木糖氧化产碱杆菌的分布与耐药性分析%Analysis on distribution and drug resistance ofAlcaligenes xylosoxidans in Third Affiliated Hospital of Baotou Medical College from 2011 to 2013

    Institute of Scientific and Technical Information of China (English)

    嵇晓霞; 任志明

    2014-01-01

    Objective To analyze the distribution and drug resistance ofAlcaligenes xylosoxidans in Third Affiliated Hospital of Baotou Medical College.Methods The distribution and drug resistance ofA. xylosoxidans in Third Affiliated Hospital of Baotou Medical College from 2011 to 2013 were reviewed, retrospectively.Results The specimens were mainly obtained from the sputum, accounting for 90.0%. The minority were from wounds secretions and enterocoelia fester, accounting for 10.0%. The infections distributed widely in ICU and respiratory department, accounting for 47.5% and 25.0%, followed by cerebral surgery department (17.5%) and other departments (10.0%). The drug resistance rates ofAlcaligenes xylosoxidans had increased in three years. The drug resistance rates of amoxicillin/clavulanic acid (100.0%) and aztreonam (90.0%) were higher than others. The drug resistance rates of aminoglycosides varied from 77.5% to 80.0%. Those of ceftriaxone, cefotaxime and cefepime were 57.5%, 82.5%, and 75.0%, respectively. The drug resistance rates of cefoperazone/sulbactam, piperacillin/tazobactam, ceftazidime, cefoperazone and imipenem were 2.5%, 12.5%, 12.5%, 5.0%, and 30%, respectively.ConclusionAlcaligenes xylosoxidans infection mainly occurs in respiratory system and its drug resistance is more and more serious. According to the results of drug resistance, the antibiotics are selected to reduce the occurrence of nosocomial infection and drug resistance strains.%目的:分析包头医学院第三附属医院木糖氧化产碱杆菌的分布与耐药性。方法对2011-2013年包头医学院第三附属医院木糖氧化产碱杆菌的分布及其耐药情况进行回顾性统计分析。结果木糖氧化产碱杆菌主要来自痰液标本,占90.0%,其余来自于伤口分泌物和腹腔脓液,占10.0%。感染区分布主要以重症监护病房和呼吸科为主,分别占47.5%、25.0%,脑外科及其他科室分别占17.5%、10.0%。菌株耐药率3年呈现逐年增

  2. Medicare program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system and fiscal year 2013 rates; hospitals' resident caps for graduate medical education payment purposes; quality reporting requirements for specific providers and for ambulatory surgical centers. final rule.

    Science.gov (United States)

    2012-08-31

    We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems. Some of the changes implement certain statutory provisions contained in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 (collectively known as the Affordable Care Act) and other legislation. These changes will be applicable to discharges occurring on or after October 1, 2012, unless otherwise specified in this final rule. We also are updating the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. The updated rate-of-increase limits will be effective for cost reporting periods beginning on or after October 1, 2012. We are updating the payment policies and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) and implementing certain statutory changes made by the Affordable Care Act. Generally, these changes will be applicable to discharges occurring on or after October 1, 2012, unless otherwise specified in this final rule. In addition, we are implementing changes relating to determining a hospital's full-time equivalent (FTE) resident cap for the purpose of graduate medical education (GME) and indirect medical education (IME) payments. We are establishing new requirements or revised requirements for quality reporting by specific providers (acute care hospitals, PPS-exempt cancer hospitals, LTCHs, and inpatient psychiatric facilities (IPFs)) that are participating in Medicare. We also are establishing new administrative, data completeness, and extraordinary circumstance waivers or extension requests requirements, as well as a reconsideration process, for quality reporting by ambulatory surgical centers

  3. Multiple perpetrator rape among girls evaluated at a hospital-based child advocacy center: seven years of reviewed cases.

    Science.gov (United States)

    Edinburgh, Laurel; Pape-Blabolil, Julie; Harpin, Scott B; Saewyc, Elizabeth

    2014-09-01

    The aim of this study was to describe contextual events, abuse experiences, and disclosure processes of adolescents who presented to a hospital-based Child Advocacy Center for medical evaluation and evidentiary collection as indicated after experiencing multiple perpetrator rape during a single event (n=32) and to compare these findings to a group of single perpetrator sexual assaults (n=534). This study used a retrospective mixed-methods design with in-depth, forensic interviews and complete physical examinations of gang-raped adolescents. Patients ranged from 12 to 17 years (M=14 years). Girls who experienced multiple perpetrator rape during a single event were more likely to have run away, to have drunk alcohol in the past month, and to have participated in binge drinking in the past 2 weeks. Acute presentation of these victims were rare but 30% had hymenal transections and 38% had sexually transmitted infections (STIs). Forensic interviews revealed alcohol was a common weapon used by offenders, and its use resulted in victims experiencing difficulty in remembering and reporting details for police investigation or physical and mental health care. Most victims were raped at parties they attended with people they thought they could trust, and they felt let down by witnesses who could have helped but did not intervene. Although relatively rare, multiple perpetrator rape during a single event is a type of severe sexual assault experience and has significant risks for deleterious health outcomes. These victims require health care by trained providers to diagnose physical findings, treat STIs, screen for trauma, and support victims. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Vitamin D Deficiency among Female Nurses of Children’s Medical Center Hospital and Its Related Factors

    Directory of Open Access Journals (Sweden)

    Hamid Rajebi

    2016-03-01

    Full Text Available Vitamin D deficiency is one of the most preventable challenges worldwide. The aim of this study was to determine the prevalence of vitamin D deficiency among female nurses working at Children’s Medical Center Hospital in Tehran, Iran, due to the risk factor of being a notably long period indoors and the fact that their health status may have consequences on the process of patients’ treatment. A total of 114 female nurses who were at least 20 years old entered the study voluntarily, and a questionnaire was applied to collect information on lifestyle and other factors associated with vitamin D deficiency. A sample of blood was taken to measure 25-hydroxyvitamin D (25-OHD and cut off value to indicate deficiency was considered below 10ng/ml, and the amounts of 10-29ng/ml were declared insufficient. The mean of 25-OHD was 11.7±9.3ng/ml. A total of 79 subjects (69.3% had a deficient level of vitamin D, 28 subjects (24.6% had an insufficient level and only 7 subjects (6.1% had sufficient level of vitamin D. The deficiency was more noticeable in the age group of 26-35 years old. Prevalence of vitamin D deficiency had a significant correlation with younger subjects (P<0.001. There was no significant association among other factors such as body mass index (BMI, health status complications, regular exercise, and duration of sun exposure. High prevalence of vitamin D deficiency in the study population leads to emphasise the need to screen health care workers for vitamin D levels.

  5. Profile of clients tested HIV positive in a voluntary counseling and testing center of a district hospital, Udupi

    Directory of Open Access Journals (Sweden)

    Gupta Megha

    2009-01-01

    Full Text Available Background: The growing menace created by the HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome has alarmed not only the public health officials but also the general community. The Voluntary Counseling and Testing Centre (VCTC services have begun as a cost-effective intervention in reversing this epidemic. Objectives: 1 To study the sociodemographic characteristics of HIV-positive clients and their risk behaviors. 2 To elucidate the reasons for their visit to the VCTC and know the problems anticipated by the clients after revealing their HIV-positive status. Study Design: A cross-sectional record-based study. Materials and Methods: The study was conducted in August 2007 among clients who tested positive for HIV in the VCTC of a district hospital in Karnataka from January to July 2007. Results: Study included 249 individuals of whom 161 were males and rest 88 females. A high percentage of nonresponse regarding the pattern of risk behavior was noted among the subjects (males: 42.8% and females: 90.9%. Of the individuals who responded, 91 males (98.9% and 6 females (75.0% had multiple heterosexual sex partners, while 1 male had homosexual partner. The figures in females show that two (25% of them had a history of blood transfusion. The reason for visiting the VCTC were cited as some form of illness (33.3%, confirmation of test results (32.9%, family members diagnosed as HIV positive (12.9% and 11.6% were referred from Directly Observed Treatment Scheme (DOTS center. More than one-thirds of the sample population anticipated discrimination at the time of medical treatment. Conclusion: People have begun using VCTC services, which reflects a change in their attitude toward HIV. The study provides us a clue to formulate an effective approach to educate people as well as the health personnel who are thought of as one of the important sources of discrimination.

  6. Compliance of district hospitals in the Center Region of Cameroon with WHO/IATSIC guidelines for the care of the injured: a cross-sectional analysis.

    Science.gov (United States)

    Chichom-Mefire, Alain; Mbarga-Essim, Nicole Therese; Monono, Martin Ekeke; Ngowe, Marcelin Ngowe

    2014-10-01

    Injuries are a major cause of death and disability worldwide. Low-income countries, particularly in Africa, are disproportionately affected. The burden of injuries can be alleviated by preventive measures and appropriate management of injury cases. African countries generally lack trauma care systems based on reliable and affordable guidelines. The aim of this study was to assess the compliance of some district hospitals in Cameroon with World Health Organization/International Association for Trauma and Intensive Care (WHO/IATSIC) guidelines for care of the injured. This cross-sectional descriptive survey used items from the WHO/IATSIC "Guidelines for Essential Trauma Care" to develop a checklist for inspection of physical equipment and a questionnaire assessing human resources and organizational capabilities in 25 district hospitals of the Center Region of Cameroon. All hospitals surveyed had at least one doctor available. Each reported treating a mean of 338 ± 214 injury cases every year. Most hospitals (n = 22) were globally either not compliant or partly compliant with the guidelines. Staff generally had received the appropriate basic training but had no additional training specifically directed toward trauma management. Skills for managing specific injuries (e.g., chest injuries) were poor. Availability and utilization of equipment was globally inadequate, and organizational capabilities were almost nonexistent. District hospitals of the Center Region of Cameroon still lack compliance with the WHO/IATSIC guidelines for essential trauma care but have significant potential for improvement. It seems possible to optimize the utilization of existing facilities.

  7. [STRATEGY OF USE AND MAINTENANCE OF CLINICAL HOSPITAL CENTER RIJEKA IN ACCORDANCE WITH KEY PERFORMANCE INDICATORS FOR STRATEGIC HEALTHCARE FACILITIES MAINTENANCE].

    Science.gov (United States)

    Sjekavica, Mariela; Haller, Herman; Cerić, Anita

    2015-01-01

    Building usage is the phase in the building life cycle that is most time-consuming, most functional, most significant due to building purpose and often systematically ignored. Maintenance is the set of activities that ensure the planned duration of facility exploitation phase in accordance with the requirements for quality maintenance of a large number of important building features as well as other elements immanent to the nature of facilities' life. The aim of the study is to show the analysis of the current state of organized, planned and comprehensive managerial approach in hospital utilization and maintenance in the Republic of Croatia, given on the case study of Clinical hospital center in Rijeka. The methodology used consists of relevant literature section of theory of facility utilization, maintenance and management in general, hospital buildings especially, display of practice on case study, and comparison of key performance indicators values obtained through interview with those that author Igal M. Shohet defined in his study by field surveys and statistical analyses. Despite many positive indicators of Clinical hospital center Rijeka maintenance, an additional research is needed in order to define a more complete national hospital maintenance strategy.

  8. Status of respectful and non-abusive care during facility-based childbirth in a hospital and health centers in Addis Ababa, Ethiopia.

    Science.gov (United States)

    Asefa, Anteneh; Bekele, Delayehu

    2015-04-16

    According to the 2011 Ethiopian Demographic and Health Survey, 90.1% of mothers do not deliver in health facilities, with 29.5% citing non-customary service as causative. A low level of skilled attendance at birth is among the leading causes of maternal mortality in low--and middle-income countries. A cross-sectional study was undertaken in four health facilities (one specialized teaching hospital and its three catchment health centers) in Addis Ababa, Ethiopia, to quantitatively determine the level and types of disrespect and abuse faced by women during facility-based childbirth, along with their subjective experiences of disrespect and abuse. A questionnaire was administered to 173 mothers immediately prior to discharge from their respective health facility. Reported disrespect and abuse during childbirth was measured under seven categories using 23 performance indicators. Among multigravida mothers (n = 103), 71.8% had a history of a previous institutional birth and 78% (75.3% in health centers and 81.8% in hospital; p = 0.295) of respondents experienced one or more categories of disrespect and abuse. The violation of the right to information, informed consent, and choice/preference of position during childbirth was reported by all women who gave birth in the hospital and 89.4% of respondents in health centers. Mothers were left without attention during labor in 39.3% of cases (14.1% in health centers and 63.6% in hospital; p right to give birth in woman-centered environment free from disrespect and abuse. Understanding how women define abuse is crucial if Ethiopia is to succeed in increasing the uptake of facility-based births.

  9. Participatory Design and Development of a Patient-centered Toolkit to Engage Hospitalized Patients and Care Partners in their Plan of Care.

    Science.gov (United States)

    Dykes, Patricia C; Stade, Diana; Chang, Frank; Dalal, Anuj; Getty, George; Kandala, Ravali; Lee, Jaeho; Lehman, Lisa; Leone, Kathleen; Massaro, Anthony F; Milone, Marsha; McNally, Kelly; Ohashi, Kumiko; Robbins, Katherine; Bates, David W; Collins, Sarah

    2014-01-01

    Patient engagement has been identified as a key strategy for improving patient outcomes. In this paper, we describe the development and pilot testing of a web-based patient centered toolkit (PCTK) prototype to improve access to health information and to engage hospitalized patients and caregivers in the plan of care. Individual and group interviews were used to identify plan of care functional and workflow requirements and user interface design enhancements. Qualitative methods within a participatory design approach supported the development of a PCTK prototype that will be implemented on intensive care and oncology units to engage patients and professional care team members developing their plan of care during an acute hospitalization.

  10. Determination of prevalence and causes of hyponatremia in patient's admitted in pediatric intensive care unit of the Children's Hospital Medical Center

    Directory of Open Access Journals (Sweden)

    Kadivar M

    1999-06-01

    Full Text Available Among the 708 patients who were admitted in the pediatric intensive care unit (PICU of the children's hospital medical center, there were 100 patients with hyponatermia (Na<130 mEq/L. 62% of these patients had hyponatermia at the beginning of admission and 38% during hospitalization in PICU. According to the classification of hyponatermia in comparison to body fluid, this study revealed 7% pseudohyponatermia, 40% euvolemic hyponatermia, 34% hypovolemic hyponatermia and 10% hypovolemic hyponatermia. In conclusion, the most perevalent causes of hyponatermia in this study were syndrome of inappropriate antidiuretic hormone secretion (SIADH (27%, water intoxication (22% and extrarenal losses (20%

  11. New-Onset Depression Following Hip Fracture Is Associated With Increased Length of Stay in Hospital and Rehabilitation Centers

    Directory of Open Access Journals (Sweden)

    Anna C. Phillips

    2015-05-01

    Full Text Available This article examines the coincident effects of new-onset depression post hip fracture on length of hospital stay, readmission rates, and incidence of infections in older adults. Participants were 101 hip fracture patients aged 60+ years; 38 developed depressive symptoms following their fracture. Infection rates, readmissions to hospital and rehabilitation units, and length of hospital stay were assessed over the 6 months post hip fracture from hospital and general practitioner notes. Patients who developed depression by Week 6 post fracture were likely to spend more time in hospital/rehabilitation wards (p = .02 and more likely to be discharged to a rehabilitation unit (p < .05. There were no group differences in readmissions or infection rates. New-onset depression coincident with hip fracture in older adults is associated with longer hospital ward stays and greater need for rehabilitation.

  12. Hyperlink-Affiliation Network Structure of Top Web Sites: Examining Affiliates with Hyperlink in Korea.

    Science.gov (United States)

    Park, Han Woo; Barnett, George A.; Nam, In-Yong

    2002-01-01

    Discusses Web site hyperlink-affiliation network structures based on a study of Korea's top 152 Web sites. Provides a theoretical framework and literature review; shows through cluster analysis that financial Web sites occupy the most central position in the network; and discusses these findings from the perspective of Web site credibility.…

  13. [Cooperation between the family physician, rheumatologist, hospital and rehabilitation clinic. Contribution of regional cooperative rheumatic disease centers for total quality management].

    Science.gov (United States)

    Hülsemann, J L

    1998-12-01

    The building-up of multipurpose arthritis centers in Germany led to a network including outpatient and inpatient services, primary care physicians, rheumatologists, physiotherapists, occupational therapists, psychologists, acute care clinics, and rehabilitation centers. The structural improvement in the care of patients with chronic inflammatory rheumatic diseases has to be followed by an improvement of processes in the care of these patients and by an improvement of outcome. Coordination offices can help not only to further improve cooperation between primary care physicians, specialized rheumatologists and hospitals but also to establish a comprehensive clinical quality management.

  14. Hospital cultural competency as a systematic organizational intervention: Key findings from the national center for healthcare leadership diversity demonstration project.

    Science.gov (United States)

    Weech-Maldonado, Robert; Dreachslin, Janice L; Epané, Josué Patien; Gail, Judith; Gupta, Shivani; Wainio, Joyce Anne

    2016-10-25

    Cultural competency or the ongoing capacity of health care systems to provide for high-quality care to diverse patient populations (National Quality Forum, 2008) has been proposed as an organizational strategy to address disparities in quality of care, patient experience, and workforce representation. But far too many health care organizations still do not treat cultural competency as a business imperative and driver of strategy. The aim of the study was to examine the impact of a systematic, multifaceted, and organizational level cultural competency initiative on hospital performance metrics at the organizational and individual levels. This demonstration project employs a pre-post control group design. Two hospital systems participated in the study. Within each system, two hospitals were selected to serve as the intervention and control hospitals. Executive leadership (C-suite) and all staff at one general medical/surgical nursing unit at the intervention hospitals experienced a systematic, planned cultural competency intervention. Assessments and interventions focused on three organizational level competencies of cultural competency (diversity leadership, strategic human resource management, and patient cultural competency) and three individual level competencies (diversity attitudes, implicit bias, and racial/ethnic identity status). In addition, we evaluated the impact of the intervention on diversity climate and workforce diversity. Overall performance improvement was greater in each of the two intervention hospitals than in the control hospital within the same health care system. Both intervention hospitals experienced improvements in the organizational level competencies of diversity leadership and strategic human resource management. Similarly, improvements were observed in the individual level competencies for diversity attitudes and implicit bias for Blacks among the intervention hospitals. Furthermore, intervention hospitals outperformed their respective

  15. WellStar Paulding Hospital intensive care unit case study: achieving a research-based, patient-centered design using a collaborative process.

    Science.gov (United States)

    Burns, Georgeann B; Hogue, Vicky

    2014-01-01

    This article describes the processes and tools used by WellStar Paulding Hospital to plan and design a new intensive care unit (ICU) as part of a 108-bed replacement hospital on a new site. Seeking to create a culture of safety centered around patient care, quality, and efficiency, the team used multiple external resources to increase their effectiveness as participants in the design process and to ensure that the new ICU achieves the functional performance goals identified at the beginning of planning and design. Specific focus on evidence-based design was assisted through participation in the Center for Health Design's Pebble Project process as well as the Joint Commission International Safe Health Design Learning Academy Pilot Program.

  16. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... Locator Hospitals and Clinics Vet Centers Regional Benefits Offices Regional Loan Centers Cemetery Locations Search Enter your ... Clinic Locations Hospitals & Clinics Vet Centers Regional Benefits Offices Regional Loan Centers Cemetery Locations Contact Us FAQs ...

  17. [Socioeconomic incidences and prognostic factors of low back pain caused by occupational injuries among the hospital personnel of Grenoble University Hospital Center].

    Science.gov (United States)

    Troussier, B; Lamalle, Y; Charruel, C; Rachidi, Y; Jiguet, M; Vidal, F; Kern, A; De Gaudemaris, R; Phelip, X

    1993-02-01

    Low back pain is generally believed to be common among hospital employees. This cross-sectional, retrospective study was carried out to determine the annual incidence of low back pain ascribable to occupational injuries in hospital employees and to evaluate factors influencing the prognosis of these injuries. In 1989, 70 employees working at the Grenoble Teaching Hospital (GTH) reported an occupational injury responsible for low back pain. Each of these employees filled out an epidemiological questionnaire during a routine evaluation by a rheumatologist. Overall annual incidence of occupational injuries with subsequent low back pain was 1.9% among GTH employees. Higher incidences were seen among employees whose occupations involved patient transfer, as well as among nursing assistants. Activities associated with an increased risk of low back pain included handling of patients or objects and work requiring prolonged periods in uncomfortable positions or in the standing position. A previous history of low back disease and a longer period of time in the current work were also associated with an increased risk of low back pain. Characteristic clinical profiles of patients with low back pain subsequent to occupational injury were determined by occupation and type of hospital department. The analysis of long-duration absence from work and long-term consequences on career confirmed the significant adverse socioeconomic impact of these injuries.

  18. Profile of clients tested HIV positive in a voluntary counseling and testing center of a district hospital, Udupi, South Kannada

    Directory of Open Access Journals (Sweden)

    Kumar A

    2008-01-01

    Full Text Available Background: The growing menace created by the HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome has alarmed not only the public health officials but also the general community. The Voluntary Counseling and Testing Centre (VCTC services have begun as a cost-effective intervention in reversing this epidemic. Objectives: 1. To study the sociodemographic characteristics of HIV-positive clients and their risk behaviors. 2. To elucidate the reasons for their visit to the VCTC and know the problems anticipated by the clients after revealing their HIV-positive status. Study Design: A cross-sectional record-based study. Materials and Methods: The study was conducted in August 2007 among clients who tested positive for HIV in the VCTC of a district hospital in Karnataka from January to July 2007. Results: Study included 249 individuals, of whom 64.7% were males, 88.7% (age, 15-49 years, married (72.7% males and 84.0% females and literate (females 71.5% and males 85.7%. A high percentage of nonresponse regarding the pattern of risk behavior was noted among the subjects (males: 42.8% and females: 90.9%. Of the individuals who responded, 91 males (98.9% and 6 females (75.0% had multiple heterosexual sex partners, while 1 male had homosexual partner. The figures in females show that two (25% of them had a history of blood transfusion. The reason for visiting the VCTC were cited as some form of illness (33.3%, confirmation of test results (32.9%, family members diagnosed as HIV positive (12.9% and 11.6% were referred from Directly Observed Treatment Scheme (DOTS center. More than three quarter of the sample population anticipated discrimination at the time of medical treatment. Conclusion: People have begun using VCTC services, which reflects a change in their attitude toward HIV. The study provides us a clue to formulate an effective approach to educate people as well as the health personnel who are thought of as one of the important

  19. The epidemiology investigation and analysis of acute poisoning in the first affiliated hospital of henan university of science and technology from 2008 to 2013%河南科技大学第一附属医院2008-2013年急性中毒流行病学调查及分析

    Institute of Scientific and Technical Information of China (English)

    张国秀

    2014-01-01

    Objective:To investigate and analyze the epidemiological characteristics of acute poisoning in the First Affiliated Hospital of Henan University of Science and Technology from 2013 to 2008,and provide the theory basis for the disease prevention and control.Methods:We analyzed6246 cases of acute poisoning by retrospective epidemiological investigation.Results:The number of acute poisoning were increasing,the average annual increase is 16.01% from 2008 to 2013,the number increased by 80.03% in 2013 than 2008;the patients are 3040 males(48.67%),female 3206 cases(51.33%),1:1.05 ratio of men to women;the most age of onset were20~60 years old(65% )young adults who live in rural(79.91% );Most of the toxicant category was chemical(38.00%),such as alcohol and carbon monoxide,the followed by pesticides(23.01%);the main reason for poisoning were accidental(61.98% ) and suicide(24.94% );the major route of poisoning were through the mouth(76.00% )and respiratory tract(18.36% )into the body.476 died in 6246 patients,the mortality rate was 7.62% ,mainly for pesticide poisoning(55.88% ). Conclusion:Conclusion:The acute poisoning cases increased year by year and the disease has certain epidemiological characteristics,we should strengthen the health education,improve the level of diagnosis and treatment of emergency department for the relevant characteristics of the disease,so we can reduce the incidence and mortality of acute poisoning.%目的:调查分析河南科技大学第一附属医院急性中毒的流行病学特征,为疾病防控提供理论依据。方法:采用回顾性流行病学调查方法,对收治的6246例急性中毒病例进行分析。结果:近年来收住的急性中毒病例数呈增加趋势,2008-2013年平均每年递增16.01%,2013年比2008年增加了80.03%;患者中男性3040例(48.67%),女性3206例(51.33%),男女比例1:1.05;发病年龄以居住农村(79.91%)的20~60岁(65.00%)青壮年居多;毒物类别以化学物(38

  20. "Wind of change": the role of human centered healthcare factors in the implementation of clinical governance in an Italian University teaching hospital.

    Science.gov (United States)

    Specchia, Maria Lucia; de Belvis, Antonio Giulio; Parente, Paolo; Avolio, Maria; Ricciardi, Walter; Damiani, Gianfranco

    2016-01-01

    Clinical governance (CG) is an approach to quality improvement in healthcare aimed at achieving a patient-centered health care system. The main objective of this study was to highlight human centered healthcare latent factors underlying the results of a CG assessment performed in the teaching hospital "A. Gemelli" of Rome, Italy. CG implementation levels were assessed through OPTIGOV© (OPTimizing healthcare GOVernance), a CG scorecard methodology. In order to identify the variables generating latent factors that can influence the governance of the Hospital, the multiple correspondence analysis (MCA) was applied. The application of OPTIGOV© showed a good CG implementation level in the Gemelli Hospital. By applying MCA, the variables aggregated so as to define 3 latent factors (F1: assessment for people oriented improvement strategy; F2: assessment for people targeted management; F3: tracking for timely accountable people) explaining as a whole 82.68% of the total variance and respectively 48.09% (F1), 24.95% (F2) and 9.64% (F3). The heuristic interpretation of the three latent factors could bring back to the concept of humanization in healthcare. This study shows that in the teaching hospital "A. Gemelli" humanization in healthcare is the driver of health care quality improvement.

  1. Discussion on the Upgrading and Transformation Scheme of Hospital Data Center%医院数据中心升级改造方案探讨

    Institute of Scientific and Technical Information of China (English)

    李晴辉

    2014-01-01

    医院数据中心是医院信息系统的中枢和核心,随着医院信息系统的迅速发展、业务系统不断增加、数据量几何级增长,数据中心服务器、存储、交换机等高能耗设备日益增多,数据中心正普遍面临着能源消耗剧增、高热量、低效率和逐渐老化等一系列问题。对数据中心进行绿色节能改造和虚拟化改造是解决上述问题的有效途径,包括数据中心基础设施绿色节能改造、数据中心虚拟化改造和智能总控中心建设等。%Data center is the core of the hospital information system, with the rapid development of hospital information systems, business systems continue to increase, the amount of data exponentially growing. Data center server, storage, switches and other high energy consumption equipment increasing, data centers are generally faced with the dramatic increase in energy consumption, high-calorie, low efficiency and aging and other issues. The data center green energy-saving reconstruction and virtual innovation is the effective way to solve the above problems, including data center infrastructure green energy-saving transformation, data center virtualization rebuilding and intelligent control center construction.

  2. Therapeutic hypothermia for out-of-hospital cardiac arrest: An analysis comparing cooled and not cooled groups at a Canadian center

    Directory of Open Access Journals (Sweden)

    D Alex MacLean

    2012-01-01

    Full Text Available Background: Out of hospital cardiac arrest is a devastating event and is associated with poor outcomes; however, therapeutic hypothermia (TH is a novel treatment which may improve neurological outcome and decrease mortality. Despite this, TH is not uniformly implemented across Coronary Care and Intensive Care Units in Canada. Objective: The purpose of this study was to compare cerebral recovery and mortality rates between patients in our Coronary Care Unit who received TH with a historical control group. Materials and Methods: A retrospective chart review was performed of patients admitted to a tertiary care center with out-of-hospital cardiac arrest. Twenty patients who were admitted and cooled after December 2006 were compared with 29 noncooled patients admitted in the 5 years prior as a historical control group. The primary outcomes of interest were in-hospital mortality and neurological outcome. Results: Eleven of 20 (11/20, 55% patients who were cooled as per protocol survived to hospital discharge, all having a good neurological outcome. Eleven of 29 (11/29, 38% noncooled patients survived to hospital discharge (Odds Ratio: 0.50, 95% CI: 0.16- 1.60, P=0.26. Eleven of 20 patients who were cooled had a good neurological outcome (CPS I-II, 11/20, 55%, versus 7 of 29 (7/29, 24% of noncooled patients (Odds ratio: 3.84, 95% CI: 1.13- 13.1, P=0.03. One hundred percent (11/11 of survivors in the cooled group had a good neurological outcome. Conclusion: In our center, the use of TH in out-of-hospital cardiac arrest survivors was associated with improved neurological outcome.

  3. The Symmetric Solutions of Affiliated Value Model

    Institute of Scientific and Technical Information of China (English)

    Che Ka-jia; Li Zhi-chen

    2004-01-01

    In a symmetric affiliated value model, this paper analyses High-Technology industrial firms' competitive strategy in research and development (R&D). We obtain the symmetric Bayesian Nash Equilibrium functions with or without government's prize:b1(x)=v(x,x)Fn-1(x|x)-∫x0Fn-1(y|y)dv(y,y), b2(x)=∫x0[v(y,y)+v0]dFn-1(y|y), and b3(x)=∫x0v(y,y)(fn-1(y|y))/(1-Fn-1(y|y))dy. We find the firm's investment level will increase in prize, only when the constant prize v0≥v(y,y)(Fn-1(y|y))/(1-Fn-1(y|y)), does the firm invest more aggressively with constant prize than with variable prize.

  4. The gender specific risk factors for prolonged hospitalization due to acute pyelonephritis in a Japanese tertiary emergency center.

    Science.gov (United States)

    Muneishi, Risa; Tanimoto, Ryuta; Wada, Koichiro; Hsiao, Philip; Eguchi, Jun; Araki, Motoo; Watanabe, Toyohiko; Nasu, Yasutomo; Akebi, Naoki

    2016-02-01

    The aim of this study is to characterize the potential differences between male and female patients with acute pyelonephritis (AP) and to predict the severity of AP based on the length of hospital stay. We conducted a retrospective medical chart review of 172 consecutive adult patients who were hospitalized in Tsuyama Central Hospital due to AP from January 2007 through June 2012. We analyzed the length of hospital stay by the proportional hazard model. A total of 172 patients were identified who were admitted to our hospital with a diagnosis of AP. Of them, 62% (106/172) were female. Except for urological malignancy, there was no significant difference between men and women in underlying disease. Out of 26 variables, univariate analysis in male showed that only urolithiasis (OR 1.75, p = 0.0294) was significantly associated with longer hospital stay, while septic shock (OR 3.18, P = 0.003), urological malignancy (OR 2.94, P = 0.002), age over 65 (OR 1.66, p = 0.018) and neurogenic bladder (OR 1.92, p = 0.014) were all associated with longer hospital stay in female patients. This is the first report to identify the risk factors for prolonged hospital stay for the patients who were admitted with AP in the Japanese population. The risk factors causing prolonged hospital stay were totally different between males and females. Reviewing the medical history based on sex gender might enable a clinician to predict the severity of acute pyelonephritis during the initial evaluation. Copyright © 2015 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  5. Postconflict third-party affiliation in rooks, Corvus frugilegus.

    Science.gov (United States)

    Seed, Amanda M; Clayton, Nicola S; Emery, Nathan J

    2007-01-23

    Conflict features in the lives of many animal species and induces social stress mediated by glucocorticoid hormones [1]. Postconflict affiliation, between former opponents (reconciliation) or between former opponents and a bystander (third-party affiliation), has been suggested as a behavioral mechanism for reducing such stress [2], but has been studied almost exclusively in primates [3]. As with many primates, several bird species live in social groups and form affiliative relationships [4]. Do these distantly related animals also use affiliative behavior to offset the costs of conflict? We studied postconflict affiliation in a captive group of rooks. Unlike polygamous primates, monogamous rooks did not reconcile with former opponents. However, we found clear evidence of third-party affiliation after conflicts. Both initiators and targets of aggression engaged in third-party affiliation with a social partner and employed a specific behavior, bill twining, during the postconflict period. Both former aggressors and uninvolved third parties initiated affiliative contacts. Despite the long history of evolutionary divergence, the pattern of third-party affiliation in rooks is strikingly similar to that observed in tolerant primate species. Furthermore, the absence of reconciliation in rooks makes sense in light of the species differences in social systems.

  6. RELIGIOUS AFFILIATION AND UNDER-FIVE MORTALITY IN MOZAMBIQUE

    Science.gov (United States)

    CAU, BOAVENTURA M.; SEVOYAN, ARUSYAK; AGADJANIAN, VICTOR

    2015-01-01

    Summary The influence of religion on health remains a subject of considerable debate both in developed and developing settings. This study examines the connection between the religious affiliation of the mother and under-five mortality in Mozambique. It uses unique retrospective survey data collected in a predominantly Christian area in Mozambique to compare under-five mortality between children of women affiliated to organised religion and children of non-affiliated women. It finds that mother’s affiliation to any religious organisation, as compared to non-affiliation, has a significant positive effect on child survival net of education and other socio-demographic factors. When the effects of affiliation to specific denominational groups is examined, only affiliation to the Catholic or mainline Protestant churches and affiliation to Apostolic churches are significantly associated with improved child survival. It is argued that the advantages of these groups may be achieved through different mechanisms: the favourable effect on child survival of having mothers affiliated to the Catholic or mainline Protestant churches is likely due to these churches’ stronger connections to the health sector, while the beneficial effect of having an Apostolic mother is probably related to strong social ties and mutual support in Apostolic congregations. The findings thus shed light on multiple pathways through which organised religion can affect child health and survival in sub-Saharan Africa and similar developing settings. PMID:22856881

  7. 上海交通大学附属第六人民医院2010至2013年严重用药错误分析%Analysis of severe medication errors in the Sixth People's Hospital Affiliated to Shanghai Jiao Tong University from 2010 to 2013

    Institute of Scientific and Technical Information of China (English)

    陈志东

    2015-01-01

    目的 了解医院严重用药错误(SME)的发生情况及成因,为制定防范措施提供依据.方法 收集上海交通大学附属第六人民医院2010至2013年药物不良反应/事件报告,从中选出所有E~I级(E级:对患者造成暂时性伤害;F级:导致患者住院或延长住院时间;G级:对患者造成永久性伤害;H级:导致患者生命垂危;I级:导致患者死亡)ME(即SME)报告进行回顾性分析.主要分析指标为SME的分级、临床表现、发生原因、涉及药品和科室. 结果 共收集到药物不良反应/事件报告511份,其中SME报告80份,占15.66%;2010-2013年SME报告在当年药品不良反应/事件报告中的占比分别为22.52%(59/262)、16.67% (10/60)、3.95%(3/76)和7.08% (8/113).80份SME报告中,2010、2011、2012、2013年分别占73.75%(59份)、12.50%(10份)、3.75%(3份)、10.00%(8份);E、H、I级ME报告分别占95.00%(76份)、3.75%(3份)、1.25%(1份).E级ME以皮疹多见;H级ME均为过敏性休克;I级ME造成患者死亡.80份报告涉及81例次ME,发生原因为单次用药剂量过大者78例次(96.30%),日剂量过大、溶媒用量过少和有禁忌证用药各1例次.81例次ME涉及18种药品,其中76例次(93.83%)涉及14种抗菌药物.80份报告涉及14个科室,占比居前3位者分别为急诊科(46.25%,37/80)、骨科(15.00%,12/80)和普外科(11.25%,9/80). 结论 我院SME以E级为主,主要原因为单次用药剂量过大,但也有导致患者死亡的I级ME发生.应采取有效措施加强医院SME的防范.%Objective To understand occurrence and causes of severe medication errors (SME) in hospital and provide a basis for formulating preventive measures.Methods Adverse drug reactions or adverse events cases which were reported by the Sixth People's Hospital Affiliated to Shanghai Jiao Tong University from 2010 to 2013 were collected.And the ME cases of category E to I (Categories E through I were respectively errors occurred

  8. [Care for elderly patients in Africa: Analysis of the financial implications of the SESAME plan on the budget of the regional hospital center in Thies, Senegal].

    Science.gov (United States)

    Faye, A; Diousse, P; Seck, I; Diongue, M; Ndiaye, P; Diagne-Camara, M; Tal-Dia, A; Dia, La

    2010-04-01

    The SESAME plan has been implemented at the Thies Regional Hospital Center (TRHC) for one year. The purpose of this study was to analyze the financial implications of the plan on the hospital budget for the sustainability of care for persons aged 60 and over. This descriptive study included analysis of budget data from October 2006 to September 2007 plus information obtained by interviewing the accountant and head of SESAME plan. The number of patients managed, sources of CHRT funding, grants from various SESAME plan partners, and expenditures for each partner were determined. The weight of the SESAME plan in the CHRT operating budget was determined by calculating the ratio of the overall cost of care for elderly persons in relation to the hospital's revenues and SESAME grants. During the study period, the CHRT received a total of 17375 elderly persons including 89% with no pension or social security. The institute pension scheme (IPRES) covered 21% of the plan as compared to 79% for the state. Utilization plan grants in relation to funding source was 41% for IPRES and 124% for the State. The total cost of services provided to beneficiaries of the SESAME plan exceeded the aggregate amount by 26 083 847 CFA francs. The weight of the SESAME plan in the operating cost of the CHRT was 17%. Prefinancing a plan to cover elderly care in hospitals should be sufficient to prevent deficits from impacting negatively on the operating budget of the hospital.

  9. Laparoscopic Repair of Primary Inguinal Hernia Performed in Public Hospitals or Low-Volume Centers Have Increased Risk of Reoperation for Recurrence

    DEFF Research Database (Denmark)

    Andresen, Kristoffer; Friis-Andersen, Hans; Rosenberg, Jacob

    2016-01-01

    BACKGROUND: Inguinal hernia repair is traditionally carried out as either open or laparoscopic repair. Laparoscopic repair has been shown to be superior in terms of pain and discomfort, but has a higher risk of reoperation. Quality of inguinal hernia repair is related to factors such as method...... of care. METHODS: This study was based on data from the Danish Hernia Database covering the period from January 1, 1998, to December 31, 2013. Hernia repairs included in this study were laparoscopic repair of primary, inguinal hernias in the elective setting, performed on adult male patients. RESULTS...... reoperation rate compared with public centers: 5.36% versus 8.53%, P ≤ .0001. Type of center and center volume were both independent risk factors for reoperation in a Cox regression model. CONCLUSION: Hospital volume had an effect on the reoperation rate for recurrence after laparoscopic inguinal hernia...

  10. Hospitals, Published in 2008, 1:1200 (1in=100ft) scale, North Georgia Regional Development Center.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Hospitals dataset, published at 1:1200 (1in=100ft) scale, was produced all or in part from Field Survey/GPS information as of 2008. Data by this publisher are...

  11. Mortality, length of hospital stay, and nutritional status improvement in severely malnourished children with HIV infection in a tertiary center

    OpenAIRE

    Yoga Devaera

    2012-01-01

    Background Severe malnutrition contributes to child mortality rates, especially in children under five HIV infection further increases the risk of death. Objective To evaluate the impact of HIV infection on mortality, length of hospital stay and improvement of nutritional status in severely malnourished inpatients under five Methods This retrospective study included children aged less than 5 years and admitted to a terti ary hospital for severe malnutrition. We excluded thos...

  12. Mortality, length of hospital stay, and nutritional status improvement in severely malnourished children with HIV infection in a tertiary center

    OpenAIRE

    Yoga Devaera

    2012-01-01

    Background Severe malnutrition contributes to child mortality rates, especially in children under five years of age. Concomitant HIV infection further increases the risk of death. Objective To evaluate the impact of HIV infection on mortality, length of hospital stay and improvement of nutritional status in severely malnourished inpatients under five years of age. Methods This retrospective study included children aged less than 5 years and admitted to a tertiary hospital for severe m...

  13. Commercialization as a recommended approach to hospital restructuring: Case study of Łańcut Medical Center

    OpenAIRE

    Wiktor Patena; Bartłomiej Kaszyk

    2015-01-01

    Our society is on the brink of health care system reorganization and implementation of new medical technology. Hospitals have to be a core component of the medical revolution so they have to be prepared for the upcoming leap in their development. If Poland wants to be a pioneer in providing new medical solutions, the current ineffective system has to be changed. The necessary action should be taken to deal with the financial problems Polish hospitals have faced for over 20 years. The current ...

  14. Commercialization as a recommended approach to hospital restructuring. Case study of Łańcut Medical Center

    Directory of Open Access Journals (Sweden)

    Wiktor Patena

    2015-10-01

    Full Text Available Our society is on the brink of health care system reorganization and implementation of new medical technology. Hospitals have to be a core component of the medical revolution so they have to be prepared for the upcoming leap in their development. If Poland wants to be a pioneer in providing new medical solutions, the current ineffective system has to be changed. The necessary action should be taken to deal with the financial problems Polish hospitals have faced for over 20 years. The current structure of hospitals - SPZOZ, is old-fashioned and cannot adapt to a turbulent social and economic environment. The hospitals should be commercialized and restructured. Being capitalized companies will give incentives and new tools to deal with financial problems. The article presents an example of the commercialized hospital in Łańcut. We make the observations that commercialization increases: a hospital’s profitability, its employment productivity, its capital investment spending and leverage. The case proves that the transformation of hospitals to capital companies proposed by the Ministry of Health may be an appropriate approach and it does work once a reasonable management board is in charge. However, the legal structure alteration should be treated as the first step in the overall restructuring process. The article highlights the problem of managers of Polish hospitals who do not only struggle with financial shortages, but barely know which business model they should follow after commercialization to successfully run the restructuring process. Having examined the LMC the authors are crafting a prelude to the overall research on already commercialized hospitals to find an appropriate business model.

  15. Adoption of new HIV treatment guidelines and drug substitutions within first-line as a measure of quality of care in rural Lesotho: health centers and hospitals compared.

    Science.gov (United States)

    Labhardt, Niklaus D; Sello, Motlalepula; Lejone, Thabo; Ehmer, Jochen; Mokhantso, Mohlaba; Lynen, Lutgarde; Pfeiffer, Karolin

    2012-10-01

    In 2007, Lesotho launched new national antiretroviral treatment (ART) guidelines, prioritising tenofovir and zidovudine over stavudine as a backbone together with lamivudine. We compared the rate of adoption of these new guidelines and substitution of first-line drugs by health centers (HC) and hospitals in two catchment areas in rural Lesotho. Retrospective cohort analysis. Patients aged ≥16 years were stratified into a HC- and a hospital-group. Type of backbone at ART-initiation (i), substitutions within first line (ii) and type of backbone among patients retained by December 2010 (iii). A multiple logistic regression model including HC vs. hospital, patient characteristics (sex, age, WHO-stage, baseline CD4-count, concurrent pregnancy, concurrent tuberculosis treatment) and year of ART-start, was used. Of 3936 adult patients initiated on ART between 2007 and 2010, 1971 started at hospitals and 1965 at HCs. Hospitals were more likely to follow the new guidelines as measured by prescription of backbones without stavudine (Odds-ratio 1.55; 95%CI: 1.32-1.81) and had a higher rate of drug substitutions while on first-line ART (2.39; 1.83-3.13). By December 2010, patients followed at health centres were more likely to still receive stavudine (2.28; 1.83-2.84). Health centers took longer to adopt the new guidelines and substituted drugs less frequently. Decentralised ART-programmes need close support, supervision and mentoring to absorb new guidelines and to adhere to them. © 2012 Blackwell Publishing Ltd.

  16. Hospital organization and importance of an interventional radiology inpatient admitting service: Italian single-center 3-year experience.

    Science.gov (United States)

    Simonetti, Giovanni; Bollero, Enrico; Ciarrapico, Anna Micaela; Gandini, Roberto; Konda, Daniel; Bartolucci, Alberto; Di Primio, Massimiliano; Mammucari, Matteo; Chiocchi, Marcello; D'Alba, Fabrizio; Masala, Salvatore

    2009-03-01

    In June 2005 a Complex Operating Unit of Interventional Radiology (COUIR), consisting of an outpatient visit service, an inpatient admitting service with four beds, and a day-hospital service with four beds was installed at our department. Between June 2005 and May 2008, 1772 and 861 well-screened elective patients were admitted to the inpatient ward of the COUIR and to the Internal Medicine Unit (IMU) or Surgery Unit (SU) of our hospital, respectively, and treated with IR procedures. For elective patients admitted to the COUIR's inpatient ward, hospital stays were significantly shorter and differences between reimbursements and costs were significantly higher for almost all IR procedures compared to those for patients admitted to the IMU and SU (Student's t-test for unpaired data, p organization of the patient pathway that came with it, evidenced more efficient use of resources, with the possibility for the hospital to save money and obtain positive margins (differences between reimbursements and costs). During 3 years of activity, the inpatient admitting service of our COUIR yielded a positive difference between reimbursements and effective costs of 1,009,095.35 euros. The creation of an inpatient IR service and the admission of well-screened elective patients allowed short hospitalization times, reduction of waiting lists, and a positive economic outcome.

  17. 24 CFR 3500.15 - Affiliated business arrangements.

    Science.gov (United States)

    2010-04-01

    ... § 3500.14(g) is a return on an ownership interest or franchise relationship. (i) In an affiliated... interest or franchise relationship, between entities in an affiliate relationship, are permissible; and (B... franchise agreement, will determine whether it is a bona fide return on an ownership interest or...

  18. Cognitive Effects of Greek Affiliation in College: Additional Evidence

    Science.gov (United States)

    Pascarella, Ernest T.; Flowers, Lamont; Whitt, Elizabeth J.

    2009-01-01

    Previous research published in this journal found broad-based negative effects of Greek affiliation on standardized measures of cognitive development after 1 year of college. Following the same sample, and employing essentially the same research design and analytic model, the present study found that the negative effects of Greek affiliation were…

  19. 43 CFR 10.14 - Lineal descent and cultural affiliation.

    Science.gov (United States)

    2010-10-01

    ... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Lineal descent and cultural affiliation... GRAVES PROTECTION AND REPATRIATION REGULATIONS General § 10.14 Lineal descent and cultural affiliation. (a) General. This section identifies procedures for determining lineal descent and...

  20. 27 CFR 53.97 - Constructive sale price; affiliated corporations.

    Science.gov (United States)

    2010-04-01

    ...; affiliated corporations. 53.97 Section 53.97 Alcohol, Tobacco Products and Firearms ALCOHOL AND TOBACCO TAX...; affiliated corporations. (a) In general. Sections 4216(b) (3) and (4) of the Code establish procedures for determining a constructive sale price under section 4216(b)(1)(C) of the Code for sales between...

  1. 13 CFR 121.103 - How does SBA determine affiliation?

    Science.gov (United States)

    2010-01-01

    ....103 How does SBA determine affiliation? (a) General Principles of Affiliation. (1) Concerns and..., by-laws, or shareholder's agreement, to prevent a quorum or otherwise block action by the board of..., foundations, endowments, or similar organizations exempt from Federal income taxation under section 501(c) of...

  2. Developmental Psychology and the Biophilia Hypothesis: Children's Affiliation with Nature.

    Science.gov (United States)

    Kahn, Peter H., Jr.

    1997-01-01

    Reviews literature on biophilia hypothesis that children have fundamental, genetically based propensity to affiliate with other living organisms. Identifies three concerns: (1) genetic basis of biophilia; (2) existence of seemingly negative affiliations with nature; and (3) quality of supporting evidence. Presents structural-developmental approach…

  3. A Prospective Multi-Center Observational Study of Children Hospitalized with Diarrhea in Ho Chi Minh City, Vietnam.

    OpenAIRE

    Thompson, CN; Phan, MV; Hoang, NV; Minh, PV; Vinh, NT; Thuy, CT; Nga, TT; Rabaa, MA; Duy, PT; Dung, TT; Phat, VV; Nga, TV; Tu, leTP; Tuyen, HT; K. Yoshihara

    2015-01-01

    : We performed a prospective multicenter study to address the lack of data on the etiology, clinical and demographic features of hospitalized pediatric diarrhea in Ho Chi Minh City (HCMC), Vietnam. Over 2,000 (1,419 symptomatic and 609 non-diarrheal control) children were enrolled in three hospitals over a 1-year period in 2009-2010. Aiming to detect a panel of pathogens, we identified a known diarrheal pathogen in stool samples from 1,067/1,419 (75.2%) children with diarrhea and from 81/609 ...

  4. Patterns of scheduled follow-up appointments following hospitalization for heart failure: insights from an urban medical center in the United States

    Science.gov (United States)

    Goyal, Parag; Sterling, Madeline R; Beecy, Ashley N; Ruffino, John T; Mehta, Sonal S; Jones, Erica C; Lachs, Mark S; Horn, Evelyn M

    2016-01-01

    Objectives Although postdischarge outpatient follow-up appointments after a hospitalization for heart failure represent a potentially effective strategy to prevent heart failure readmissions, patterns of scheduled follow-up appointments upon discharge are poorly described. We aimed to characterize real-world patterns of scheduled follow-up appointments among adult patients with heart failure upon hospital discharge. Patients and methods This was a retrospective cohort study performed at a large urban academic center in the United States among adults hospitalized with a principal diagnosis of congestive heart failure between January 1, 2013, and December 31, 2014. Patient demographics, administrative data, clinical parameters, echocardiographic indices, and scheduled postdischarge outpatient follow-up appointments were collected. Results Of the 796 patients hospitalized for heart failure, just over half of the cohort had a scheduled follow-up appointment upon discharge. Follow-up appointments were less likely among patients who were white and had heart failure with preserved ejection fraction and more likely among patients with Medicaid and chronic obstructive pulmonary disease. In an adjusted multivariable regression model, age ≥65 years was inversely associated with a scheduled follow-up appointment upon hospital discharge, despite higher rates of several cardiovascular and noncardiovascular comorbidities. Conclusion Just half of the patients discharged home following a hospitalization for heart failure had a follow-up appointment scheduled, representing a missed opportunity to provide a recommended care transition intervention. Despite a greater burden of both cardiovascular and noncardiovascular comorbidities, older adults (age ≥65 years) were less likely to have a follow-up appointment scheduled upon discharge compared with younger adults, revealing a disparity that warrants further investigation. PMID:27713623

  5. Practice and Membership: Reasons for Partisan Affiliation in Cordoba, Argentina

    Directory of Open Access Journals (Sweden)

    Hugo H. Rabbia

    2012-01-01

    Full Text Available We analyze the individual motives of political party affiliation as a central variable that help us to characterize the party affiliation as a practice and as belonging to a party organization. The study was conducted through questionnaires, and the sample was integrated by 428 citizens over 18 and under 65 years old, from Cordoba, Argentina. We propose a categorization of the motives of affiliation, inductively constructed, that recovers the theoretical conceptualization from the sociology of the organizations and the socio-cognitive psychology. Likewise, we analyze the relationship between the different affiliation motives, the party and electoral practices, and the perception of efficiency and importance that the affiliation has for the participants.

  6. Inpatient satisfaction and usage patterns of personalized smart bedside station system for patient-centered service at a tertiary university hospital.

    Science.gov (United States)

    Ryu, Borim; Kim, Seok; Lee, Kee-Hyuck; Hwang, Hee; Yoo, Sooyoung

    2016-11-01

    for patient-centered services. Further research should be directed at developing sophisticated patient-centered services as a communication tool between the hospital and the patient. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Analysis of sleep parameters in patients with obstructive sleep apnea studied in a hospital vs. a hotel-based sleep center.

    Science.gov (United States)

    Hutchison, Kimberly N; Song, Yanna; Wang, Lily; Malow, Beth A

    2008-04-15

    Polysomnography is associated with changes in sleep architecture called the first-night effect. This effect is believed to result from sleeping in an unusual environment and the technical equipment used to study sleep. Sleep experts hope to decrease this variable by providing a more familiar, comfortable atmosphere for sleep testing through hotel-based sleep centers. In this study, we compared the sleep parameters of patients studied in our hotel-based and hospital-based sleep laboratories. We retrospectively reviewed polysomnograms completed in our hotel-based and hospital-based sleep laboratories from August 2003 to July 2005. All patients were undergoing evaluation for obstructive sleep apnea. Hospital-based patients were matched for age and apnea-hypopnea index with hotel-based patients. We compared the sleep architecture changes associated with the first-night effect in the two groups. The associated conditions and symptoms listed on the polysomnography referral forms are also compared. No significant differences were detected between the two groups in sleep onset latency, sleep efficiency, REM sleep latency, total amount of slow wave sleep (NREM stages 3 and 4), arousal index, and total stage 1 sleep. This pilot study failed to show a difference in sleep parameters associated with the first-night effect in patients undergoing sleep studies in our hotel and hospital-based sleep laboratories. Future studies need to compare the first-night effect in different sleep disorders, preferably in multi-night recordings.

  8. Creating a “culture of research” in a community hospital: Strategies and tools from the National Cancer Institute Community Cancer Centers Program

    Science.gov (United States)

    St. Germain, Diane; Nacpil, Lianne M; Zaren, Howard A; Swanson, Sandra M; Minnick, Christopher; Carrigan, Angela; Denicoff, Andrea M; Igo, Kathleen E; Acoba, Jared D; Gonzalez, Maria M; McCaskill-Stevens, Worta

    2015-01-01

    Background The value of community-based cancer research has long been recognized. In addition to the National Cancer Institute’s Community Clinical and Minority-Based Oncology Programs established in 1983, and 1991 respectively, the National Cancer Institute established the National Cancer Institute Community Cancer Centers Program in 2007 with an aim of enhancing access to high-quality cancer care and clinical research in the community setting where most cancer patients receive their treatment. This article discusses strategies utilized by the National Cancer Institute Community Cancer Centers Program to build research capacity and create a more entrenched culture of research at the community hospitals participating in the program over a 7-year period. Methods To facilitate development of a research culture at the community hospitals, the National Cancer Institute Community Cancer Centers Program required leadership or chief executive officer engagement; utilized a collaborative learning structure where best practices, successes, and challenges could be shared; promoted site-to-site mentoring to foster faster learning within and between sites; required research program assessments that spanned clinical trial portfolio, accrual barriers, and outreach; increased identification and use of metrics; and, finally, encouraged research team engagement across hospital departments (navigation, multidisciplinary care, pathology, and disparities) to replace the traditionally siloed approach to clinical trials. Limitations The health-care environment is rapidly changing while complexity in research increases. Successful research efforts are impacted by numerous factors (e.g. institutional review board reviews, physician interest, and trial availability). The National Cancer Institute Community Cancer Centers Program sites, as program participants, had access to the required resources and support to develop and implement the strategies described. Metrics are an important

  9. [Use of a neutral paraffin dressing (Jelonet) at the Burn Care Center at the Saint Luc Hospital in Lyon].

    Science.gov (United States)

    Foyatier, J L; Hezez, G; Masson, C L; Latarjet, J

    1990-01-01

    Several thousand dressings are performed each year to treat the patients admitted to the St Luc Hospital Burn Care Unit. The use of paraffin gauze dressing (Jelonet) allowed standardization and rationalization of the four different types of dressings used in burns. Positive features of this product include ease of use, good tolerance, and low cost.

  10. Mortality, length of hospital stay, and nutritional status improvement in severely malnourished children with HIV infection in a tertiary center

    Directory of Open Access Journals (Sweden)

    Yoga Devaera

    2012-11-01

    Full Text Available Background Severe malnutrition contributes to child mortality rates, especially in children under five years of age. Concomitant HIV infection further increases the risk of death. Objective To evaluate the impact of HIV infection on mortality, length of hospital stay and improvement of nutritional status in severely malnourished inpatients under five years of age. Methods This retrospective study included children aged less than 5 years and admitted to a tertiary hospital for severe malnutrition. We excluded those with incomplete data, as well as those transferred to other hospitals or discharged against medical advice. Outcome measures were live/death status, length of hospital stay and improvement of nutritional status (weight gain and improved weight-for-height Z score. Results Of 104 eligible patients, 97 were included as study subjects. Their mean ages were 25.8 (SD 17.3 months for HIV-infected children and 16.3 (SD 15.3 months for HIV-uninfected children. Death occurred in 31.8% and 18.7% of HIV-infected and uninfected subjects, respectively. Median length of hospital stay was 14.5 (range 5-51 days and 11 (range 1-99 days, respectively. There were no statistically significant differences in death rates or length of hospital stay between the two groups. Weight-for-height Z scores (WHZ on admission and discharge in HIV-infected children were lower than those of uninfected children, but the weight gain (median weight gain of 0.45 (-0.26 to 1.9 kg vs 0.38 (-0.81 to 2.2 kg in HIV-infected and uninfected children, respectively and improvement of WHZ [1 (SD 1.1 vs 0.9 (SD 1, respectively] were similar. Conclusion Severely malnourished children with HIV infection had higher mortality rate, and longer hospitalizations than the uninfected group, although the differences were not statistically significant. They also had lower mean WHZ scores at admission and discharge, but nutritional improvement was similar to those who were HIV-negative.

  11. Prevalence and correlates of depression and anxiety among patients with tuberculosis at WolaitaSodo University Hospital and Sodo Health Center, WolaitaSodo, South Ethiopia, Cross sectional study

    National Research Council Canada - National Science Library

    Duko, Bereket; Gebeyehu, Abebaw; Ayano, Getnet

    2015-01-01

    ....A total of 417 TB patients, who had regular follow up at WolaitaSodo University Hospital and Sodo Health Center, WolaitaSodo, South Ethiopia, were recruited to assess depression and anxiety and its associated correlates...

  12. Renovating Charity Hospital or building a new hospital in post-Katrina New Orleans: economic rationale versus political will.

    Science.gov (United States)

    Leleu, Hervé; Moises, James; Valdmanis, Vivian Grace

    2013-02-01

    Since September 2005, Charity Hospital of New Orleans has been closed due to Hurricane Katrina. A debate following the closing arose about whether this public hospital should be renovated or a new medical center affiliated with the Louisiana State University should be built. Using academic literature, government statistics, and popular press reports, we describe the economic implications that support the view that Charity Hospital should have been renovated. We also address why this policy was not pursued by demonstrating the influence politics and individual stakeholders (specifically, Louisiana State University) had on the eventual policy pursued. In this commentary we also note the political identity movement away from public-sector provision of services to private-sector interests.

  13. Independent Predictive Factors of Hospitalization in a North-West Burn Center of Iran; an Epidemiologic Study

    Directory of Open Access Journals (Sweden)

    Samad Shams Vahdati

    2015-01-01

    Full Text Available Introduction: A high grade burn is one of the most devastating injuries with several medical, social, economic, and psychological effects. These injuries are the most common cause of accidental deaths after traffic injuries in both the developed and developing countries. Therefore this research was aimed to determine demographic characteristics of patients with burn injury admitted to the emergency department and identify predictive factors of hospitalization. Methods: This is a cross sectional descriptive study, which is done in 20 March up to 20 September 2011 in emergency department of Sina Hospital, Tabriz, Iran. Patients’ information including demographic characteristic, cause of burn, place of accident, anatomical areas burned, grading and percent of burning and disposition were gathered and analyzed using SPSS version 18.0 statistical software. Stepwise multivariate regression analysis was used for recognition of independent predictive factors of hospitalization in burned patients. Results: One hundred and sixty patients were enrolled (54.4% female. The average age of those was 20.47±13.5 years. The prevalence of burn was significantly higher in ages under 20 years (p<0.001. Lower limb (37.5%, head and neck (21.25% and upper limb (17.5% were three frequent site of burn. The most common cause of burns was boiling water scalding (34.4%. Home related burn was significantly higher than other place (p<0.001. The most frequent percent of burn was <5% (46.25%. Finally 50 (31.25% cases hospitalized. Univariate analysis demonstrated that age under 20 years old (p=0.02 female gender (p=0.02, burning site (p=0.002, cause (p=0.005, place (p<0.001, grade (p<0.001, and percent (p<0.001 was related to disposition of patients. Stepwise multiple logistic regression showed female gender (OR=3.52; 95% CI: 1.57-7.88; p=0.002, work related burning (OR=1.78; 95% CI: 1.26-2.52; p=0.001, and burning over 5 percent (OR=2.15; 95% CI: 1.35-3.41; p=0.001 as

  14. Secular trends in the etiology and comorbidity of hospitalized patients with congestive heart failure: A single-center retrospective study

    Institute of Scientific and Technical Information of China (English)

    Zhi-Yong Pei; Yu-Sheng Zhao; Jia-Yue Li; Qiao Xue; Lei Gao; Shi-Wen Wang

    2012-01-01

    Objective To assess the secular trends in the etiology and comorbidity of patients hospitalized with congestive heart failure (CHF). Methods Data of 7,319 patients (mean age 59.6 years, 62.1% male) with a primary discharge diagnosis of CHF, hospitalized from January 1, 1993 to December 31, 2007 at the Chinese People's Liberation Army (PLA) General Hospital were extracted and analyzed. These patients were divided into three groups according to hospitalization period: 1993-1997 (n = 1623), 1998-2002 (n = 2444), and 2003-2007 (n = 3252). The etiological characteristics and comorbidities were assessed. Results Over the study period, the proportion of patients with ischemic heart disease (IHD) increased from 37.2% during the period 1993-1997 to 46.8% during the period 2003-2007, while that with valvular heart disease (VHD) decreased from 35.2% during the period 1993-1997 to 16.6% during the period 2003-2007 (both P < 0.05). Atrial fibrillation (AF) was the most common comorbidity of heart failure (23.2%, 23.0% and 20.6%, respectively, in the three periods). Compared to that of the period of 1993-1997 with that of, the proportion of patients with myocardial infarction, pneumonia, renal function impairment and hepatic cirrhosis of the period of 2003-2007 increased significantly (P < 0.05) and the proportion of patients with chronic obstructive pulmonary disease and atrial fibrillation decreased significantly (P < 0.05). Conclusions This study implies that IHD has became a more common etiology of CHF, while VHD has deceased as an etiology of CHF in Chinese patients during the last two decades.

  15. [Mountain sports: their role in 2200 facial injuries occurring over 4 years at the University Hospital Center in Grenoble].

    Science.gov (United States)

    Le Bescond, Y; Lebeau, J; Delgove, L; Sadek, H; Raphael, B

    1992-01-01

    Injuries caused by mountain sports account for many of the injuries admitted to the University Hospital of Grenoble. Out of 4,490 traumas, 470 were injuries sustained during the practice of mountain sports. While the frequency of these accidents does not evolve much, the etiological distribution depends on fashion. Thus an increasing number of lesions caused by cross-country biking has been noted during the past two years. We find it urgent to propose protective measures adapted to this new sport.

  16. CHANGING BACTERIAL ORGANISMS AND ANTIMICROBIAL RESISTANCE PATTERN AMONG HOSPITALIZED COMMUNITY ACQUIRED PNEUMONIA PATIENTS IN A TERTIARY CARE CENTER

    Directory of Open Access Journals (Sweden)

    Raveendra Kodur

    2013-04-01

    Full Text Available ABSTRACT: BACKGROUND: Most of the times a Community Acquired Pneumonia (CAP patient is being treated with empirical antibiotics by best guess method by the clinician.MDR strains are being reported from c/s reports and Gram negative rods are fast increasing both in the etiolog y and mortality of CAP patients AIM OF STUDY: 1. To find out the profile of different bacteria causing CAP at a tertiary hospital. 2. To know the treatment outcome & drug resistance pattern among culture positive CAP patients. MATERIALS & METHODS: 450 CAP patients admitted & treated between Jan. to Dec.2012 at Victoria Hospital, Bangalore were included in this hospitalized cross sectional study. All relevant investigations including sputum c/s were done. RESULTS: Positive culture reports were obtained in 165(36.33% out of 450 patients Following are the isolates - Strept.pnemoniae 32.7%, Klebsiella 18.2%, Staph.aureas 10.9%, Psedomonas 10.9%, E.coli 5.4%, Acinetobacter 7.3%, H.influenza 5.4%, Mixed growth 10%. 76% of patients recovered from CAP, 6% went a gainst medical advice, 6.6% showed unresolved pneumonia & deaths in 5.33% of patients. High degree of resistance was noted to many antibiotics including to latest cephalosporins. CONCLUSION: This study highlights the importance of culture tests and selection of proper antibiotics and to avoid misuse & abuse of higher antibiotics to prevent the emergence of MDR strains. An antibiotic policy at every level may help.

  17. Research and Development in Foreign Affiliates: Evidence from Japanese Firms

    OpenAIRE

    Belderbos, R.A.; Iwasa, T

    1999-01-01

    This paper analyzes the determinants of the R&D intensity of 434 foreign affiliates, drawing on MITI''s benchmark survey of Japanese multinational firms in 1993. Acquired affiliates are responsible for more than half of overseas R&D expenditure and have significantly higher R&D intensities than wholly and majority owned greenfield affiliates. Non-majority owned joint ventures are R&D intensive in case the investing firm lacks substantial R&D capabilities in Japan. In contrast, R&D intensive J...

  18. The Quality of Pre-hospital Circulatory Management in Patients With Multiple Trauma Referred to the Trauma Center of Shahid Beheshti Hospital in Kashan, Iran, in the First Six Months of 2013

    Directory of Open Access Journals (Sweden)

    Maghaminejad

    2016-05-01

    Full Text Available Background Circulatory management is a critical issue in pre-hospital transportation phase of multiple trauma patients. However, the quality of this important care did not receive enough attention. Objectives The aim of this study was to investigate the quality of pre-hospital circulatory management in patients with multiple trauma. Patients and Methods This was a cross-sectional study conducted in 2013. The study population consisted of all patients with multiple trauma who had been transferred by emergency medical services (EMS to the central trauma department in Kashan Shahid Beheshti medical center, Kashan, Iran. We recruited a convenience sample of 400 patients with multiple trauma. Data were collected using the circulatory assessment questionnaire and controlling hemorrhage (CAQCH that were designed by the researchers and were described by using frequency tabulations, central tendency measures, and variability indices. The chi-square test was used to analyze the data. Results The study sample consisted of 263 males (75.2%; 57.75% had lower levels of education and 28.75% were workers. The most common mechanism of trauma was traffic accident (85.4%. We found that the quality of circulatory management was unfavorable in 61% of the cases. A significant relationship was observed between the quality of circulatory management and type of trauma and staff’s employment status. Conclusions The quality of pre-hospital circulatory management provided to patients with multiple trauma was unfavorable. Therefore, establishment of in-service training programs on circulatory management is recommended.

  19. Visual Acuity Before and After Treatment in Patients with Chemical Injuries at the National Eye Center, Cicendo Eye Hospital, Bandung from 2010 to 2011

    Directory of Open Access Journals (Sweden)

    Endi Pramudya Laksana

    2015-09-01

    Full Text Available Background: Chemical trauma is one of the emergency cases in ophthalmology since it can lead to severe, permanent blindness if not immediately treated. This study aimed to reveal pre- and post-therapy visual acuity on patients with chemical trauma at theNational Eye Center, Cicendo Eye Hospital, Bandung. Methods: This study was performed on 40 patients’ medical records from the National Eye Center, Cicendo Eye Hospital Bandung from January 2010 to January 2011 as secondary data, using the descriptive retrospective method. The data were divided into two groups: acid and alkali trauma. The collected data were analyzed and presented in tables. Results: Chemical trauma cases were mostly caused by caustic soda (17/40 whereas the least were caused by vinegar (3/40 and commonly occurred on adult patients in the right eye on alkali trauma. Patients with chemical trauma generally had normal eyesight before therapy.The number of patients with acid and alkali trauma who experienced improved eyesight after therapy alkali were similar (3 patients while worsening symptoms occurred in one patient with alkali chemical trauma from mild to medium low vision. Conclusions: There are some improvements of visual acuity after treatment in patients with chemical injuries.

  20. Medicare program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system and fiscal year 2015 rates; quality reporting requirements for specific providers; reasonable compensation equivalents for physician services in excluded hospitals and certain teaching hospitals; provider administrative appeals and judicial review; enforcement provisions for organ transplant centers; and electronic health record (EHR) incentive program. Final rule.

    Science.gov (United States)

    2014-08-22

    are participating in Medicare. We are updating policies relating to the Hospital Value-Based Purchasing (VBP) Program, the Hospital Readmissions Reduction Program, and the Hospital-Acquired Condition (HAC) Reduction Program. In addition, we are making technical corrections to the regulations governing provider administrative appeals and judicial review; updating the reasonable compensation equivalent (RCE) limits, and revising the methodology for determining such limits, for services furnished by physicians to certain teaching hospitals and hospitals excluded from the IPPS; making regulatory revisions to broaden the specified uses of Medicare Advantage (MA) risk adjustment data and to specify the conditions for release of such risk adjustment data to entities outside of CMS; and making changes to the enforcement procedures for organ transplant centers. We are aligning the reporting and submission timelines for clinical quality measures for the Medicare HER Incentive Program for eligible hospitals and critical access hospitals (CAHs) with the reporting and submission timelines for the Hospital IQR Program. In addition, we provide guidance and clarification of certain policies for eligible hospitals and CAHs such as our policy for reporting zero denominators on clinical quality measures and our policy for case threshold exemptions. In this document, we are finalizing two interim final rules with comment period relating to criteria for disproportionate share hospital uncompensated care payments and extensions of temporary changes to the payment adjustment for low-volume hospitals and of the Medicare-Dependent, Small Rural Hospital (MDH) Program.

  1. Situation of Drug Information Centers and Services in Costa Rica

    Directory of Open Access Journals (Sweden)

    Hall V

    2006-06-01

    Full Text Available PAHO establishes guidelines that must be met by drug information centers (DIC and the drug information services (DIS. Objective: To describe the operations, activities, and resources of the DICs and the DISs affiliated with public institutions of Costa Rica, and their adjustment to the provisions set forth by the PAHO. Methods: Descriptive study conducted in May 2003. The officers in charge of each of the seven public DICs or DISs in Costa Rica were interviewed, and inquiries were made regarding aspects of the structure and process of their centers. Results: In Costa Rica there are seven public drug information units, that is, four DICs and three DISs. One of the DICs is located in this university, and the remaining six centers and services are in located in hospitals. Five of the centers do not have the primary sources required by the PAHO. Fifteen out of the 36 tertiary sources recommended are not available in any of the centers. 100% of the information units carry out four main activities: answering inquiries from the hospital community, answering inquiries from users outside the hospital, implementing education programs for patients and risk groups, and rotation programs for student training. Conclusions: The activities developed by the DISs and the DICs in Costa Rica are similar to each other; they respond not only to the PAHO’s guidelines, but they also have similarities with the activities and operations of other DICs worldwide. Primary, secondary, and tertiary bibliographical support must be strengthened.

  2. VHA Patient-Centered Medical Home Associated With Lower Rate of Hospitalizations and Specialty Care Among Veterans With Posttraumatic Stress Disorder.

    Science.gov (United States)

    Randall, Ian; Mohr, David C; Maynard, Charles

    The Veterans Health Administration (VHA) implemented a patient-centered medical home (PCMH) model, termed Patient Aligned Care Teams (PACT), in 2010. We assessed the association between PACT and the use of health services among U.S. veterans with posttraumatic stress disorder (PTSD). VHA clinical and administrative data were obtained for the pre-PACT period of April 1, 2009 to March 31, 2010 and post-PACT period of June 1, 2011 to May 31, 2012. Outcomes included hospitalizations, primary, specialty and mental health visits, and emergency department and urgent care visits. We utilized negative binomial regression and extended estimating equation models for the full sample. The analysis contained 696,379 unique veterans in both pre- and post-PACT periods. We estimated the linear incremental effect of PACT on utilization outcomes. PACT were associated with a decrease in hospitalizations (incremental effect [IE]: -0.02; 95% confidence interval [CI]: -0.03, -0.01), a decrease in specialty care visits (IE: -0.45; 95% CI: -0.07, -0.23), and an increase in primary care visits (IE: 0.96; 95% CI: 0.67, 1.25). The period following PACT implementation was associated with a lower rate of hospitalizations and specialty care visits, and a higher rate of primary care visits for veterans with PTSD, indicating enhanced access to primary care.

  3. Dissemination and Molecular Epidemiology of KPC-Producing Klebsiella pneumoniae Collected in Puerto Rico Medical Center Hospitals during a 1-Year Period

    Directory of Open Access Journals (Sweden)

    Iraida E. Robledo

    2011-01-01

    Full Text Available During a 2003-2004 PCR-based surveillance study conducted in 6 Puerto Rico Medical Center hospitals, 27/92 multi-beta-lactam-resistant Klebsiella pneumoniae strains were identified as carbapenemase (KPC positive in 4 hospitals. The objectives of this study were to identify the KPC variants, their genetic relatedness, and any other beta-lactamases present. Susceptibility testing, pulsed field gel electrophoresis (PFGE, isoelectric focusing, PCR, and DNA sequencing were performed. KPC variants -2, -3, -4, and -6 were identified. Additional beta-lactamases detected were TEM, DHA, OXA-9 and -30. Antimicrobial susceptibility to carbapenems varied depending on the KPC variant. Five PFGE genetically related groups were identified in 15 isolates and 12 unrelated types. PFGE profiles suggested that both clonal and horizontal transfer are contributing to the dissemination of these isolates among the various hospitals. Comparison of the 2003 and a 2009 surveillance studies showed a significant increase in the KPC-positive K. pneumoniae isolates in the latter.

  4. A retrospective study of administration of vaccination for hepatitis B among newborn infants prior to hospital discharge at a midwestern tertiary care center.

    Science.gov (United States)

    Myers, Helen I; Spracklen, Cassandra N; Ryckman, Kelli K; Murray, Jeffrey C

    2015-05-11

    Infants are at high risk of developing chronic, life-threatening disease as a result of hepatitis B virus infection. Universal vaccination of infants against hepatitis B virus, before discharge from the hospital after delivery is recommended as a measure to eradicate infection and associated mortality and morbidity. The purpose of this study was to determine rates of perinatal hepatitis B vaccine (Hep B) administration at a tertiary care center in Iowa and to assess the impact of maternal factors on Hep B uptake. Data concerning mother-infant pairs that received care at one institution from 1/2009 to 4/1/2013 were extracted from the system's electronic medical record. Characteristics of study participants were compared using chi-square tests. Multivariate logistic regression was used to assess the association between each factor and vaccination status, controlling for other characteristics. Of 5663 mother-infant pairs, 5175 (91.4%) infants received Hep B within 7 days after delivery. The majority of those not vaccinated had a medical indication to delay vaccination. Single women were significantly more likely to have an infant not vaccinated, after adjustment for all other factors. Women of minority groups were significantly less likely to have an infant who lacked Hep B at hospital discharge than Caucasian women. Significant improvements have occurred in Hep B rates in the state and region. Infants of single mothers may be at the greatest risk for lacking vaccination at hospital discharge. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. 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...

  6. Epidemiology and mortality of burned patients treated in the University Hospital Center in Tirana, Albania: an analysis of 2337 cases during the period 1998-2008.

    Science.gov (United States)

    Belba, Monika Kristaq; Petrela, Elizana Ylber

    2012-03-01

    The basis for qualitative changes concerning everyday clinical practice are created from epidemiological studies, which not only generalize situations but at the same time provide specific details of the country's features; especially during periods of social transition. The aim of this study was to present demographic and epidemiological features of severe burns treated in the Service of Burns in UHC (University Hospital Center) in Albania and to analyze burn mortality as an important outcome measure. The data used was obtained by the analysis of the medical records of 2337 patients hospitalized in Burns Service ICU near in Tirana, Albania during 1998-2008. Statistical analysis is done with SPSS 15 software. Descriptive analyses, inferential statistics and Chi-square test and Kendall's tau_b are calculated. Logistic regression is used for the prediction of death probability by two risk variables, BSA burned and age. The severe burn incidence was 7 patients per 100,000 persons/year. The overall mean estimated BSA (%) is 22.8±14.7. The main causes of the burn were found to be the scalds in 61.8% of the cases followed by flame (23%), chemicals (10.7%) and electrical injury in 4.5% of the cases. The mean hospital period is 11.6±10. The overall mortality is 10.5%. Based on probability of death, we noticed that older age and larger burn size were associated with a higher likelihood of mortality. The long-term studies and the comparison of our results with the ones of other burn centers has allowed us to determine the actual level of care and as well as to build up contemporary protocols in order to improve the treatment with the objection of decreasing the mortality. Copyright © 2011 Elsevier Ltd and ISBI. All rights reserved.

  7. Emergent Patterns of Social Affiliation in Primates, a Model

    NARCIS (Netherlands)

    Puga-Gonzalez, Ivan; Hildenbrandt, Hanno; Hemelrijk, Charlotte K.

    2009-01-01

    Many patterns of affiliative behaviour have been described for primates, for instance: reciprocation and exchange of grooming, grooming others of similar rank, reconciliation of fights, and preferential reconciliation with more valuable partners. For these patterns several functions and underlying c

  8. Professed religious affiliation and the practice of euthanasia.

    Science.gov (United States)

    Baume, P; O'Malley, E; Bauman, A

    1995-01-01

    Attitudes towards active voluntary euthanasia (AVE) and physician-assisted suicide (PAS) among 1,238 doctors on the medical register of New South Wales varied significantly with self-identified religious affiliation. More doctors without formal religious affiliation ('non-theists') were sympathetic to AVE, and acknowledged that they had practised AVE, than were doctors who gave any religious affiliation ('theists'). Of those identifying with a religion, those who reported a Protestant affiliation were intermediate in their attitudes and practices between the agnostic/atheist and the Catholic groups. Catholics recorded attitudes most opposed to AVE, but even so, 18 per cent of Catholic medical respondents who had been so requested, recorded that they had taken active steps to bring about the death of patients. PMID:7776349

  9. High Performance Home Building Guide for Habitat for Humanity Affiliates

    Energy Technology Data Exchange (ETDEWEB)

    Lindsey Marburger

    2010-10-01

    This guide covers basic principles of high performance Habitat construction, steps to achieving high performance Habitat construction, resources to help improve building practices, materials, etc., and affiliate profiles and recommendations.

  10. The Export Intensity of Foreign Affiliates in Transition Economies

    DEFF Research Database (Denmark)

    Nielsen, Jørgen Ulff-Møller; Pawlik, Konrad

    2007-01-01

    of their affiliates. We find that labour intensity and foreign control are the main explanatory variables for the export intensity of the affiliates. Given the overall rise in export intensity over the period of investigation, our findings suggest that export-platform FDI has become a more important mode...... of organization for multinational enterprises (MNEs) as Poland has evolved into a relatively stable economic environment where MNEs feel comfortable basing their regional operations.    ...

  11. Patterns of scheduled follow-up appointments following hospitalization for heart failure: insights from an urban medical center in the United States

    Directory of Open Access Journals (Sweden)

    Goyal P

    2016-09-01

    Full Text Available Parag Goyal,1 Madeline R Sterling,2 Ashley N Beecy,2 John T Ruffino,2 Sonal S Mehta,3 Erica C Jones,1 Mark S Lachs,3 Evelyn M Horn1 1Division of Cardiology, Department of Medicine, 2Department of Medicine, 3Division of Geriatrics, Department of Medicine, Weill Cornell Medicine, New York, NY, USA Objectives: Although postdischarge outpatient follow-up appointments after a hospitalization for heart failure represent a potentially effective strategy to prevent heart failure readmissions, patterns of scheduled follow-up appointments upon discharge are poorly described. We aimed to characterize real-world patterns of scheduled follow-up appointments among adult patients with heart failure upon hospital discharge.Patients and methods: This was a retrospective cohort study performed at a large urban academic center in the United States among adults hospitalized with a principal diagnosis of congestive heart failure between January 1, 2013, and December 31, 2014. Patient demographics, administrative data, clinical parameters, echocardiographic indices, and scheduled postdischarge outpatient follow-up appointments were collected.Results: Of the 796 patients hospitalized for heart failure, just over half of the cohort had a scheduled follow-up appointment upon discharge. Follow-up appointments were less likely among patients who were white and had heart failure with preserved ejection fraction and more likely among patients with Medicaid and chronic obstructive pulmonary disease. In an adjusted multivariable regression model, age ≥65 years was inversely associated with a scheduled follow-up appointment upon hospital discharge, despite higher rates of several cardiovascular and noncardiovascular comorbidities.Conclusion: Just half of the patients discharged home following a hospitalization for heart failure had a follow-up appointment scheduled, representing a missed opportunity to provide a recommended care transition intervention. Despite a greater

  12. [Interdisciplinarity and chronic pain therapy--implementation of a new Interdisciplinary Center at the University Hospital Dresden on the basis of an integrated health care contract].

    Science.gov (United States)

    Michel, Sabine; Günther, Klaus-Peter; Joraschky, Peter; Reichmann, Heinz; Koch, Thea; Eberlein-Gonska, Maria

    2007-01-01

    Due to the bio-psycho-social complexity and presence of various health departments, chronic pain requires interdisciplinary cooperation which enables the accurate evaluation of the clinical findings and is a prerequisite for an individual and resource-oriented therapeutic concept focusing on both physical and mental activation. This concept forms the basis of medical care at the University Pain Center, which was founded in April 2004 at the Carl Gustav Carus University Hospital in Dresden. Since then, day care and inpatient services have been provided in addition to well-established outpatient care. The motive behind the foundation of the Pain Center was to sensitize health insurers to the complex problems of chronic pain and existing regional structural deficits. Following a draft version of a coherent multimodal, interdisciplinary healthcare concept along with full cost accounting after 1 1/2 years, an integrative healthcare contract got signed by two health insurances (AOK-Sachsen and VdAK) in June 2004. After two years of existence, the first experiences, results and especially the Pain Center's treatment spectrum ought to be demonstrated.

  13. Profile of patients receiving medical care at a reference, support, and treatment center for psoriasis patients at a university hospital*

    Science.gov (United States)

    Cordeiro Júnior, Túlio Germano Machado; Andrade, Bruno D' Paula; Palitot, Esther Bastos; Piuvezam, Márcia Regina; Mascarenhas, Sandra Rodrigues

    2016-01-01

    Psoriasis is a chronic, inflammatory, immune-mediated disease affecting 1-3% of the population worldwide. This work seeks to draw a profile of patients with psoriasis, analyzing socioeconomic, anthropometric, and clinical aspects. For this, medical records from 81 individuals who received medical care in a university hospital in 2014 were consulted. It was observed that the patients were mostly dark-skinned black adult men, with a low education level and a low income, who were sedentary, former smokers, obese, with an increase in waist circumference, and who did not consume alcohol. Psoriasis vulgaris predominated, beginning mainly on the scalp, hands, and feet. In addition, many presented some type of associated comorbidity and had relatives with psoriasis. PMID:27828656

  14. [Noma and Burkitt disease; a particular association about three observations seen in the Teaching Hospital Center Yalgado Ouedraogo (Burkina Faso)].

    Science.gov (United States)

    Konsem, T; Millogo, M; Gare, J; Ouedraogo, D; Ouoba, K

    2014-08-01

    Cancrum oris is a gangrenous stomatitis arising from a periodontal infection and leading to severe soft tissue and bone destruction. The pathology involves numerous factors including local thrombosis, vascularitis, necrotizing gingivitis, immunodeficiency, Gram negative and anaerobic infection. It is usually a disease of infants and malnourished children in tropical areas often occurring after a debilitating disease like measles [3]. Burkitt lymphoma is a highly aggressive non-Hodgkin lymphoma first described by Burkitt in 1958 in African children from areas holoendemic for malaria. It is the first cancer of African child [6]. The association between Burkitt lymphoma and cancrum oris is non common. We report in the present study three cases of this association at the Academic Hospital Yalgado Ouedraogo of Ouagadougou. This association poses a problem of late diagnosis with difficulties in therapeutic management.

  15. [Percutaneous transluminal coronary angioplasty. The experience of the Hospital de Especialidades of the La Raza Medical Center, IMSS].

    Science.gov (United States)

    Murillo, H; Ayala, F; Almazán, A; Madrid, R; Rangel, A; Valdespino, A; Solorio, S; Lepe, L; Badui, E

    1993-01-01

    We analyzed the initial results of the PTCA program at the Hospital de Especialidades CMR, IMSS. During the last year we studied 33 patients in whom we performed 35 PTCA procedures with total of 45 lesions. The age of the patients varied from 27 to 75 years of age (average 57 year +/- 10.9). Among them, 84.8% were males and 15.2% females. In 54.5% of the patients, stable angina was present, whereas in 45.5% unstable angina was observed. Multivessel disease was detected in 39.4% of the cases. In 17.8% the coronary lesions were type "A", in 77.8% type "B" and in 4.4% type C. The most frequent lesions were present at the left anterior descending artery in 46.6%, right coronary artery in 40% and circumflex in 13.4%. The global procedural success was 88.5% (32/35 procedure) whereas the procedural success by isolated lesion was 88.8% (40/45 lesions). The average artery stenosis was decreased from 85 +/- 10.4% to 23 +/- 16%. A procedural failure occurred in 4 instances (11.4%), among them, 2 (5.71%) without complications and 2 more, associated to acute myocardial infarction. In the present study there were no emergency operation neither deaths. Although the number of PTCA performed in our hospital is limited, we consider that the initial results are good, with a success rate of 88.5% with a minimal complications.

  16. A multi-center prospective cohort study of patient transfers from the intensive care unit to the hospital ward.

    Science.gov (United States)

    Stelfox, Henry T; Leigh, Jeanna Parsons; Dodek, Peter M; Turgeon, Alexis F; Forster, Alan J; Lamontagne, Francois; Fowler, Rob A; Soo, Andrea; Bagshaw, Sean M

    2017-08-29

    To provide a 360-degree description of ICU-to-ward transfers. Prospective cohort study of 451 adults transferred from a medical-surgical ICU to a hospital ward in 10 Canadian hospitals July 2014-January 2016. Transfer processes documented in the medical record. Patient (or delegate) and provider (ICU/ward physician/nurse) perspectives solicited by survey 24-72 h after transfer. Medical records (100%) and survey responses (ICU physicians-80%, ICU nurses-80%, ward physicians-46%, ward nurses-64%, patients-74%) were available for most transfers. The median time from initiation to completion of transfer was 25 h (IQR 6-52). ICU physicians and nurses reported communicating with counterparts via telephone (78 and 75%) when transfer was requested (82 and 24%) or accepted (31 and 59%) and providing more elements of clinical information than ward physicians (mean 4.7 vs. 3.9, p transfer when they received more information (OR 1.32, 95% CI 1.18-1.48), had their questions addressed (OR 3.96, 95% CI 1.33-11.84), met the ward physician prior to transfer (OR 4.61, 95% CI 2.90-7.33), and were assessed by a nurse within 1 h of ward arrival (OR 4.70, 95% CI 2.29-9.66). Recommendations for improvement included having a documented care plan travel with the patient (all stakeholders), standardized face-to-face handover (physicians), avoiding transfers at shift change (nurses) and informing patients about pending transfers in advance (patients). ICU-to-ward transfers are characterized by failures of patient flow and communication; experienced differently by patients, ICU/ward physicians and nurses, with distinct suggestions for improvement.

  17. Frailty as a Predictor of Acute Kidney Injury in Hospitalized Elderly Patients: A Single Center, Retrospective Cohort Study.

    Directory of Open Access Journals (Sweden)

    Seon Ha Baek

    Full Text Available Elderly patients have an increased risk for acute kidney injury (AKI. However, few studies have reported on predictors for AKI in geriatric patients. Therefore, we aimed at determining the effect of frailty as a predictor of AKI.We retrospectively enrolled 533 hospitalized elderly patients (aged ≥ 65 years who had their creatinine levels measured (≥ 1 measurement during admission for a period of 1 year (2013 and conducted a comprehensive geriatric assessment (CGA within 1 year before the index hospitalization. We examined five variables (activity of daily living [ADL] and instrumental ADL dependence, dementia, nutrition, and polypharmacy from CGA. We categorized the patients into 3 groups according to the tertile of aggregate frailty scores: Group 1, score 1-2; Group 2, score 3-4; Group 3, score 5-8.Fifty-four patients (10.1% developed AKI (median duration, 4 days. The frailest group (Group 3 showed an increased risk of AKI as compared to Group 1, (hazard ratio [HR] = 3.536, P = 0.002. We found that discriminatory accuracy for AKI improved with the addition of the tertile of aggregate frailty score to covariates (area under the receiver operator characteristics curves [AUROC] 0.641, AUROC 0.739, P = 0.004. Forty-six patients (8.6% were transferred to nursing facilities and 477 patients (89.5% were discharged home. The overall 90-day and 1-year mortality for elderly inpatients were 7.9% and 26.3%. The frailest group also demonstrated an increased risk of discharge to nursing facilities, and 90-day and 1-year mortality as compared to Group 1, independent of AKI severity (nursing facilities: odd ratio = 4.843, P = 0.002; 90-day mortality: HR = 6.555, P = 0.002; 1-year mortality: HR = 3.249, P = 0.001.We found that frailty may independently predict the development of AKI and adverse outcomes in geriatric inpatients.

  18. Barriers and facilitators influencing self-management among COPD patients: a mixed methods exploration in primary and affiliated specialist care

    Directory of Open Access Journals (Sweden)

    Hillebregt CF

    2016-12-01

    Full Text Available Chantal F Hillebregt,1 Auke J Vlonk,1 Marc A Bruijnzeels,1 Onno CP van Schayck,2 Niels H Chavannes3 1Jan van Es Institute (JVEI, Netherlands Expert Center Integrated Primary Care, Almere, 2Department of General Practice, School for Public Health and Primary Care (CAPHRI, Maastricht University Medical Center, Maastricht, 3Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands Abstract: Self-management is becoming increasingly important in COPD health care although it remains difficult to embed self-management into routine clinical care. The implementation of self-management is understood as a complex interaction at the level of patient, health care provider (HCP, and health system. Nonetheless there is still a poor understanding of the barriers and effective facilitators. Comprehension of these determinants can have significant implications in optimizing self-management implementation and give further directions for the development of self-management interventions. Data were collected among COPD patients (N=46 and their HCPs (N=11 in three general practices and their collaborating affiliated hospitals. Mixed methods exploration of the data was conducted and collected by interviews, video-recorded consultations (N=50, and questionnaires on consultation skills. Influencing determinants were monitored by 1 interaction and communication between the patient and HCP, 2 visible and invisible competencies of both the patient and the HCP, and 3 degree of embedding self-management into the health care system. Video observations showed little emphasis on effective behavioral change and follow-up of given lifestyle advice during consultation. A strong presence of COPD assessment and monitoring negatively affects the patient-centered communication. Both patients and HCPs experience difficulties in defining personalized goals. The satisfaction of both patients and HCPs concerning patient centeredness during

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

    Directory of Open Access Journals (Sweden)

    Antonio Higueras

    2006-01-01

    Full Text Available 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 ambos periodos, se codificaron y registraron un total de diez conductas disruptivas. En los 83 días del periodo de intervención, y con una frecuencia de dos días semanales, dos actores profesionales llevaban a cabo las actividades centradas en el humor. Se calculó un Indice de Disrupción Global (IGD, teniendo en cuenta conjuntamente todas las conductas disruptivas, al igual que un Indice de Disrupción Específico (IDE para cada una de las conductas disruptivas. Usando para las comparaciones la corrección de Bonferroni, los resultados indican que el IGD descendió significativamente durante el periodo de intervención, siendo tres las conductas disruptivas que mostraron un descenso significativo (intentos de fuga, autolesiones y peleas.

  20. Etiological prevalence of epilepsy and epileptic seizures in hospitalized elderly in a Brazilian tertiary center – Salvador - Brazil

    Directory of Open Access Journals (Sweden)

    Telma Rocha de Assis

    2015-02-01

    Full Text Available Epilepsy in the elderly has high incidence and prevalence and is often underecognized. Objective To describe etiological prevalence of epilepsy and epileptic seizures in elderly inpatients. Methods Retrospective analysis was performed on elderly patients who had epilepsy or epileptic seizures during hospitalization, from January 2009 to December 2010. One hundred and twenty patients were enrolled. They were divided into two age subgroups (median 75 years with the purpose to compare etiologies. Results The most common etiology was ischemic stroke (36.7%, followed by neoplasias (13.3%, hemorrhagic stroke (11.7%, dementias (11.4% and metabolic disturbances (5.5%. The analysis of etiological association showed that ischemic stroke was predominant in the younger subgroup (45% vs 30%, and dementias in the older one (18.9% vs 3.8%, but with no statistical significance (p = 0.23. Conclusion This study suggests that epilepsy and epileptic seizures in the elderly inpatients have etiological association with stroke, neoplasias and dementias.

  1. [Prevalence of severe periodontal disease and its association with respiratory disease in hospitalized adult patients in a tertiary care center].

    Science.gov (United States)

    Fernández-Plata, Rosario; Olmedo-Torres, Daniel; Martínez-Briseño, David; García-Sancho, Cecilia; Franco-Marina, Francisco; González-Cruz, Herminia

    2015-01-01

    Severe periodontal disease is a chronic inflammatory gingival process associated with systemic diseases. To determine the prevalence of severe periodontal disease and its association with respiratory diseases among hospitalized patients at the Institute of Respiratory Diseases "Ismael Cosio Villegas" (INER) in 2011. A cross-sectional study was developed. The severe periodontal disease was diagnosed by the Department of Stomatology. The International Classification of Diseases 10th revision was used. A multinomial logistic was fit to estimate relative-risk. Three thousand and fifty-nine patients were included; 772/3,059 (25.2%) had severe periodontal disease. After controlling for age, sex, inpatient days, death, and socioeconomic status, the infectious respiratory diseases that were significantly associated with severe periodontal disease were: HIV/AIDS (RR: 10.6; 95% CI: 9.1-23.3; p diseases were also significantly associated with severe periodontal disease. High prevalence of severe periodontal disease was observed in the different respiratory diseases. Severe periodontal disease was associated with both infectious and non-infectious respiratory diseases. It is important to study an oral health intervention.

  2. [Hospital maternal mortality: causes and consistency between clinical and autopsy diagnosis at the Northeastern Medical Center of the IMSS, Mexico].

    Science.gov (United States)

    Calderón-Garcidueñas, Ana Laura; Martínez-Salazar, Griselda; Fernández-Díaz, Héctor; Cerda-Flores, Ricardo M

    2002-02-01

    The aim was to study the causes of maternal mortality (MM) and the percent of concordance between the clinical diagnosis and the autopsy findings. The autopsies of maternal death (1980-1999) from the Hospital de Especialidades, Centro Médico del Noreste, IMSS in Monterrey, México, were analyzed. The cases were classified in directly obstetric maternal mortality (DOM) and indirectly obstetric maternal mortality (IOM), the causes were studied and the percent of concordance between pre- and post-mortem diagnosis was determined. There were 124 deaths. Autopsy was performed in 61 (49.1%) women. In 55 cases the clinical file and the autopsy protocol were available. This was our sample for study. Sixty percent of the cases were DO. Causes of DOM were: specific hypertensive pregnancy disease (SHPD) (51.6%), sepsis (35.5%), hypovolemic shock (9.7%), anesthetic accidents (3%); causes of IOM were: sepsis (41.7%), malignancies (16.7%), hematological diseases (12.5%), cardiopathy and systemic arterial hypertension (12.5%), hepatic disorders (12.5%), and Superior Longitudinal Sinus thrombosis (4%). A 100% clinical-pathological concordance was observed in DOM cases, while only a 41.6% was found in IOM cases. In those cases of sepsis (IOM), the etiologic agents were identified only in 20% before death. The early detection and treatment of SHPD and the prevention of sepsis should decrease the MM. This study showed some weakness in the Health Services that should be improved.

  3. Pediatric Diabetes Outpatient Center at Rhode Island Hospital: The impact of changing initial diabetes education from inpatient to outpatient.

    Science.gov (United States)

    Pingul, Mia M; Mulvihill, Erin M; Reinert, Steven E; Gopalakrishnan, Geetha; Plante, Wendy A; Boney, Charlotte M; Bialo, Shara R; Quintos, Jose Bernardo

    2017-02-01

    This study compared outcomes and costs for new-onset Type 1 diabetes mellitus (T1DM) patients educated at the outpatient versus inpatient settings. Retrospective study examining the following variables: 1) hemoglobin A1c (HbA1c), 2) severe hypoglycemia, 3) admissions for diabetic ketoacidosis (DKA) or ER visits, and 4) healthcare cost. 152 patients with new-onset T1DM from September 2007-August 2009. There were no differences between outpatient group (OG) and inpatient group (IG) in mean HbA1c levels at 1, 2 and 3 years post-diagnosis (OG 8%, 8.5%, 9.3%; IG 8.3%, 8.9%, 9%, p=0.51). Episodes of severe hypoglycemia, DKA, and ER visits were not different between the two groups. Mean total hospital costs for OG and pure OG were significantly less than IG (OG: $2886 vs. IG: $4925, p<0.001), (pure OG: $1044 vs. IG: $4925, p<0.0001). Our study demonstrates that outpatient- based pediatric diabetes education lowers healthcare cost without compromising medical outcomes. [Full article available at http://rimed.org/rimedicaljournal-2017-02.asp].

  4. The strategic role of cross-sectoral research in the design of hospitals: the contribution of TESIS* research center

    Directory of Open Access Journals (Sweden)

    Romano Del Nord

    2014-05-01

    Full Text Available The design of buildings, such as hospitals where the complexity concerns as much the interpretation of the requirements framework as their required permeability to the ever accelerated dynamics of bio-technological innovations proposed by the market, requires continuous research which in- creasingly goes beyond the boundaries of the architectural discipline as it is currently codified. Constant dialogue with what scientific research produces in the international sphere and with culturally differentiated approaches becomes an imperative for those – professionals or institutions – wishing to operate with real time up-dating in order to increase the performance quality of their products. Scientific organizations that set themselves these objectives cannot disregard the constraints imposed by this scenario, with the consequent require- ment to actively position themselves in international networks which, with their constant cross-sectoral production, fuel the debate on foreseeable trends and the implications that all this determines with regard to design. The following article seeks to represent the coordinates of this new operating scenario of scientific research, highlighting the methods and the operating practices put in place by the TESIS Interuniversity Centre for Re- search of Florence.

  5. Comparison of condition specific indicators among illegal induced abortion: septic and non-septic abortion in Songkla Center Hospital.

    Science.gov (United States)

    Phaumvichit, Tatpong; Chandeying, Verapol

    2012-05-01

    Determine the clinical indications of illegal induced abortion, comparison between septic and non-septic abortion. The present retrospective descriptive study was conducted among pregnant women who were admitted in the hospital with the illegal induced abortion. The demographic data, gestational age, the method used, and personnel performing were gathered, as well as symptomatology, basic laboratory, condition progression, and medical and surgical intervention. There were 92 patients with illegal induced abortion between March 2009 and December 2010. The three main induced methods for termination of pregnancy was vaginal suppository, likely to be misoprostol-a synthetic prostaglandin E, analog (43.5%), oral Thai herbal medicine (19.6%) and combined medication (16.3%), respectively. Of septic/non-septic abortion, the first visit body temperature of 38.0 degrees Celsius or more (74.1/12.3%), heart rate of 100 per minutes or more (74.1/12.3%), fever index 3 degree-hours or more in the first 24 hours (81.5/12.3%) and fever index 5 degree-hours or more in the first 24 hours (59.3/1.5%), were statistically significant (all p-values of abortion was incomplete abortion 68 in 92 cases (73.9%). The first visit body temperature of 38.0 degrees C or more, heart rate of 100 per minutes or more and fever index of 3 and 5 degree-hours, are clinically helpful in the early diagnosis and treatment of septic abortion.

  6. [Noma and HIV infection: apropos of a case at the National Hospital Center in Bobo-Dioulasso (Burkina Faso)].

    Science.gov (United States)

    Ki-Zerbo, G A; Guigma, Y

    2001-12-01

    Noma (Cancrum oris) is a gangrenous stomatitis arising from a periodontal infection and leading to severe soft tissue and bone destruction. The pathology involves numerous factors including local thrombosis, vascularitis, necrotizing gingivitis, immunodeficiency, gram negative and anaerobic infection. It is usually a disease of infants and malnourished children in tropical areas often occurring after a debilitating disease like measles. Recently, cases have been reported in adults especially elderly patients or during immunodeficiency states. Reconstructive surgery is often necessary to deal with destruction and sequel but is rarely accessible in developing countries. We report one case of noma (cancrum oris) in an HIV seropositive patient at the National Hospital in Bobo-Dioulasso. The noma was inaugural of AIDS in a 40 years old labourer coming back from Ivory Coast and no major opportunistic infection was associated. The course was fulminant leading to extensive facial gangrene with recurrent bacterial infections. The disease was fatal in this depressive, malnourished and diarrhoeic patient despite local surgical treatment, prolonged antibiotherapy and supportive care. Pathogenic mechanisms, management and preventive issues are discussed.

  7. [Long-term results of mitral percutaneous valvuloplasty with Inoue technique. Seven-years experience at the Cardiology Hospital of the National Medical Center "Siglo XXI", IMSS].

    Science.gov (United States)

    Flores Flores, Jesús; Ledesma Velasco, Mariano; Palomo Villada, José Antonio; Montoya Guerrero, Silvestre; Estrada Gallegos, Joel; Astudillo Sandoval, Raúl; Abundes Velasco, Arturo; González Díaz, Belinda; Argüero Sánchez, Rubén; Farell Campa, Javier

    2006-01-01

    Since the last decade, percutaneous balloon mitral valvuloplasty with Inoue catheter is considered the treatment of choice for selected patients (mobile valve, no calcification and minimal subvalvular disease) with rheumatic mitral stenosis. We present the seven-year follow-up experience of 456 patients treated with this technique in the catheter laboratory of the Cardiology Hospital in National Medical Center SXXI. It is a retrospective, transversal and observational study performed with data obtained from January 1994 and December 2000, with a follow-up of 58.5 +/- 26.6 months (range 12-96 mean 22). We achieve an initial success of 82.8%, improvement of initial mitral valve area from 0.9 +/- 0.1 to 1.8 +/- 0.3 cm2, with a gain area from 88 to 106% (p 90%. From these patients, 93.1% remained in NYHA-II or -I functional class and the incidence of restenosis decreased.

  8. Association of admission serum calcium levels and in-hospital mortality in patients with acute ST-elevated myocardial infarction: an eight-year, single-center study in China.

    Directory of Open Access Journals (Sweden)

    Xin Lu

    Full Text Available OBJECTIVE: The relationship between admission serum calcium levels and in-hospital mortality in patients with acute ST-segment elevation myocardial infarction (STEMI has not been well definitively explored. The objective was to assess the predictive value of serum calcium levels on in-hospital mortality in STEMI patients. METHODS: From 2003 to 2010, 1431 consecutive STEMI patients admitted to the First Affiliated Hospital of Nanjing Medical University were enrolled in the present study. Patients were stratified according to quartiles of serum calcium from the blood samples collected in the emergency room after admission. Between the aforementioned groups,the baseline characteristics, in-hospital management, and in-hospital mortality were analyzed. The association of serum calcium level with in-hospital mortality was calculated by a multivariable Cox regression analysis. RESULTS: Among 1431 included patients, 79% were male and the median age was 65 years (range, 55-74. Patients in the lower quartiles of serum calcium, as compared to the upper quartiles of serum calcium, were older, had more cardiovascular risk factors, lower rate of emergency revascularization,and higher in-hospital mortality. According to univariate Cox proportional analysis, patients with lower serum calcium level (hazard ratio 0.267, 95% confidence interval 0.164-0.433, p<0.001 was associated with higher in-hospital mortality. The result of multivariable Cox proportional hazard regression analyses showed that the Killip's class≥3 (HR = 2.192, p = 0.026, aspartate aminotransferase (HR = 1.001, p<0.001, neutrophil count (HR = 1.123, p<0.001, serum calcium level (HR = 0.255, p = 0.001, and emergency revascularization (HR = 0.122, p<0.001 were significantly and independently associated with in-hospital mortality in STEMI patients. CONCLUSIONS: Serum calcium was an independent predictor for in-hospital mortality in patients with STEMI. This widely

  9. Epidemiology of Urban Traffic Accident Victims Hospitalized More Than 24 Hours in a Level III Trauma Center, Kashan County, Iran, During 2012-2013

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    Mahdian

    2015-06-01

    Full Text Available Background Urban traffic accidents are an extensively significant problem in small and busy towns in Iran. This study tried to explore the epidemiological pattern of urban traffic accidents in Kashan and Aran-Bidgol cities, Iran. Objectives This study aimed to assess various epidemiological factors affecting victims of trauma admitted to a main trauma center in Iran. Patients and Methods During a retrospective study, data including age, sex, injury type and pattern, outcome, hospital stay and treatment expenditures regarding urban Road Traffic Accidents (RTAs for one year (March 2012-March 2013 were obtained from the registry of trauma research center, emergency medical services and deputy of health of Kashan University of Medical Sciences. One-way ANOVA and chi-square tests were used to analyze data using SPSS version 16.0. P value < 0.05 was considered significant. Results A total of 1723 victims (82.6% male, sex ratio of almost 5:1 were considered in this study. Mortality rate in trauma cases hospitalized more than 24 hours during our study was 0.8%. Young motorcyclist men with the rate of more than 103 per 10000 were the most vulnerable group. The most common injury was head injury (73.6% followed by lower limb injury (33.2%. A significant association was found between mechanism of injury and head, lower limb, multiple injuries and high risk age group. Conclusions Urban RTAs are one of the most important problems in Kashan and Aran-Bidgol cities, which impose a great economic burden on health system. Motorcyclists are the most vulnerable victims and multiple trauma and head injury are seen among them extensively.

  10. Characteristics and Predisposing Factors of Bacterial Corneal Ulcer in the National Eye Center, Cicendo Eye Hospital, Bandung from January to December 2011

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    Astrid Maharani Putri

    2015-09-01

    Full Text Available Background: Corneal ulcer is an emergency condition in ophthalmology, causing visual impairment, mostly by bacterial infection with rapid pathogenesis. The aim of this study was to discover the characteristics of bacterial corneal ulcer patients in the National Eye Center, Cicendo Eye Hospital, Bandung. Methods: A total of 99 medical records consisted of patients diagnosed with bacterial corneal ulcer were selected in this descriptive study. The clinical patterns and predisposing factors of the patients were analyzed. The study also identified the pathogenic bacteria of the cases. This study was carried out in the National Eye Center, Cicendo Eye Hospital, Bandung from January to December 2011 Clinical patterns. The collected data were analyzed and presented in frequency tabulation. Results: The male to female ratio was 2:1, with the average age of 44.4 years. The most common presenting symptom was eye pain (70.7%. Most patients came with decreased visual acuity that was categorized as (near- blindness (78.8% and the location of the ulcer was in central area of the cornea (56.5%. The most common predisposing factor was ocular trauma (74.7% that was caused by exposed to plants. Single-bacterial infection (67.7% was predominant, with 56 cases (56.6% of Gram-positive cocci infection. Conclusions: Bacterial corneal ulcer contributes to 48.8% of all microbial corneal ulcers. Most patients came with mild condition, centralized location, and poor visual function. The common predisposing factor was trauma associated with exposed to plants.

  11. Remote Sonography in Routine Clinical Practice Between Two Isolated Medical Centers and the University Hospital Using a Robotic Arm: A 1-Year Study.

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    Georgescu, Monica; Sacccomandi, Arnaud; Baudron, Bernard; Arbeille, Philippe L

    2016-04-01

    A robotic arm was developed by our laboratory for tele-operated echography on patients in locations isolated from a trained sonographer. The objective of the study was to evaluate, over a 1-year period, the use of the robotic arm for telesonography performed by a sonographer located at the University Hospital (Tours, France) on patients in two isolated medical centers 50 km away linked via the Internet. A nonsonographer operator (physician or paramedic) located the ultrasound probe attached to the robotic arm over the appropriate acoustic window for the organ of interest by rolling the whole robotic arm and mechanical support across the floor. The expert sonographer then telemanipulated the robotic arm via an Internet connection and adjusted the orientation of the probe until the most appropriate organ view for delivering a diagnosis was obtained. Three hundred telesonography examinations were performed within 1 year: 68 (22.7%) on abdominal organs, 20 (6.7%) on pelvic organs, 138 (46%) on supraaortic vessels (carotid artery), 33 (11%) on the thyroid, 30 (10%) on leg veins, and 11 (3.7%) on the kidney and urinary tract. Telesonography could not be achieved in 10 of the 300 cases due to poor image quality on obese patients or those presenting poor echogenicity. These cases were re-examined at the university hospital by a sonographer. The rate of telesonography exams over the 1-year period was 1.5 per day for the "general population" medical site and 1 per week for the "elderly patient" medical site. This study demonstrated that telesonography using a robotic arm can be routinely used for providing echographic diagnoses on patients isolated from imaging centers.

  12. Chromogranin A as a Biochemical Marker for Neuroendocrine Tumors: A Single Center Experience at Royal Hospital, Oman

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    Elham S. Al-Risi

    2017-09-01

    Full Text Available Objectives: To evaluate the significance of serum chromogranin A (CgA status in patients with and without different neuroendocrine tumors (NETs by conducting a retrospective assessment of the diagnostic utility and limitations of CgA as a biomarker for NETs in a tertiary care hospital in Oman. Methods: We conducted a retrospective analysis of CgA requests referred to the Clinical Biochemistry Laboratory, Royal Hospital, Oman over a 24-month period (April 2012 to March 2014. During this time, 302 CgA tests for 270 patients (119 males and 151 females; age range 11–86 years and mean±standard deviation (SD 44.0±18.0 years, were requested. Of these CgA tests, 245 tests were performed for 245 patients investigated for the diagnosis of NETs, and 57 CgA tests were performed for 25 patients with diagnosed NETs who were undergoing follow-up. Serum CgA levels were analyzed using the enzyme-linked immunosorbent assay based on a cut-off value of 22 IU/L. Results: Of the 302 CgA tests reviewed, 197 (65.2% were within the quoted normal range; however, 105 (34.8% had CgA > 22 IU/L. Of the 245 patients with first-line CgA, 38 patients (15.5% had NET that included carcinoid, pheochromocytoma, pancreatic NET, adrenal adenoma, prostatic adenocarcinoma, gastrointestinal NET, medullary thyroid carcinoma, Schwannoma, lung small cell carcinoma, parathyroid adenoma, and pituitary macroadenoma. The mean±SD of CgA in these patients with NETs was 205.0±172.0 IU/L. Meanwhile, there were 45 (18.3% patients with CgA > 22 IU/L (83.0±116.0 IU/L who did not have NETs. The conditions/diseases included: essential hypertension, chronic kidney disease, heart failure, peptic ulcer, chronic diarrhea, use of proton pump inhibitors, and other chronic diseases (hypothyroidism, asthma, diabetes mellitus. Of the 25 patients with known NET who were followed-up, there were 57 CgA results (29 with CgA ≤ 22 IU/L and 28 with CgA > 22 IU/L. The overall clinical sensitivity of CgA in the

  13. Diagnostic whole body scan (pre-therapy scan in differentiated thyroid cancer: A single center community hospital experience

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    P Santhanam

    2016-01-01

    Full Text Available Objective: Diagnostic whole body scan (pre-therapy scan with either I-123 or I-131 (radioactive isotopes of iodine is performed to assess the extent of thyroid cancer especially distant metastasis prior to administering the therapeutic dose of I-131. Our aim of the following study was to determine the utility of the diagnostic pre-therapy scan in the management of differentiated thyroid cancer. Materials and Methods: It was a case-control study carried out by retrospective chart review, of a randomly selected 100 patients with differentiated thyroid cancer who had followed in our community hospital over the course of 1 year. We collected data on multiple variables in the subjects - including age, gender, pre-operative size of the nodules, diagnosis, stage of the malignancy, size of the tumor, multifocality, lymphovascular invasion, dose of radioiodine used for remnant ablation, recurrence rates and persistence rates. Continuous variables were compared using the independent sample Mann-Whitney U-test whereas the Chi-square test was used for nominal variables. Results: The mean dose of radioactive iodine administered was 97.56 (±27.98 in the pre-therapy scan group and it was 97.23 (±32.40 in the control group. There was no difference between the two groups (P - 0.45. There was also no difference in the recurrence rates between the groups (P = 1.0. There was a trend toward a higher degree of persistent cancer in the group that had the pre-therapy scans (P - 0.086. Conclusion: Pre-therapy scan may not affect the dose of radio-iodine I-131 used for remnant ablation of differentiated thyroid cancer and does not influence the recurrence rates. This was especially true with respect to I-131 remnant ablation for low risk tumors.

  14. Evaluation of the peer teaching program at the University Children´s Hospital Essen - a single center experience.

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    Büscher, Rainer; Weber, Dominik; Büscher, Anja; Hölscher, Maite; Pohlhuis, Sandra; Groes, Bernhard; Hoyer, Peter F

    2013-01-01

    Since 1986 medical students at the University Children's Hospital Essen are trained as peers in a two week intensive course in order to teach basic paediatric examination techniques to younger students. Student peers are employed by the University for one year. Emphasis of the peer teaching program is laid on the mediation of affective and sensomotorical skills e.g. get into contact with parents and children, as well as manual paediatric examination techniques. The aim of this study is to analyse whether student peers are able to impart specific paediatric examination skills as good as an experienced senior paediatric lecturer. 123 students were randomly assigned to a group with either a senior lecturer or a student peer teacher. Following one-hour teaching-sessions in small groups students had to demonstrate the learned skills in a 10 minute modified OSCE. In comparison to a control group consisting of 23 students who never examined a child before, both groups achieved a significantly better result. Medical students taught by student peers almost reached the same examination result as the group taught by paediatric teachers (21,7±4,1 vs. 22,6±3,6 of 36 points, p=0,203). Especially the part of the OSCE where exclusively practical skills where examined revealed no difference between the two groups (7,44±2,15 vs. 7,97±1,87 of a maximum of 16 points, p=0,154). The majority of students (77%) evaluated peer teaching as stimulating and helpful. The results of this quantitative teaching study reveal that peer teaching of selected skills can be a useful addition to classical paediatric teaching classes.

  15. Liver Transplantation without Perioperative Transfusions Single-Center Experience Showing Better Early Outcome and Shorter Hospital Stay

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    Nicolás Goldaracena

    2013-01-01

    Full Text Available Background. Significant amounts of red blood cells (RBCs transfusions are associated with poor outcome after liver transplantation (LT. We report our series of LT without perioperative RBC (P-RBC transfusions to evaluate its influence on early and long-term outcomes following LT. Methods. A consecutive series of LT between 2006 and 2011 was analyzed. P-RBC transfusion was defined as one or more RBC units administrated during or ≤48 hours after LT. We divided the cohort in “No-Transfusion” and “Yes-Transfusion.” Preoperative status, graft quality, and intra- and postoperative variables were compared to assess P-RBC transfusion risk factors and postoperative outcome. Results. LT was performed in 127 patients (“No-Transfusion” = 39 versus “Yes-Transfusion” = 88. While median MELD was significantly higher in Yes-Transfusion (11 versus 21; P=0.0001 group, platelet count, prothrombin time, and hemoglobin were significantly lower. On multivariate analysis, the unique independent risk factor associated with P-RBC transfusions was preoperative hemoglobin (P<0.001. Incidence of postoperative bacterial infections (10 versus 27%; P=0.03, median ICU (2 versus 3 days; P=0.03, and hospital stay (7.5 versus 9 days; P=0.01 were negatively influenced by P-RBC transfusions. However, 30-day mortality (10 versus 15% and one- (86 versus 70% and 3-year (77 versus 66% survival were equivalent in both groups. Conclusions. Recipient MELD score was not a predictive factor for P-RBC transfusion. Patients requiring P-RBC transfusions had worse postoperative outcome. Therefore, maximum efforts must be focused on improving hemoglobin levels during waiting list time to prevent using P-RBC in LT recipients.

  16. Clinical Features and Laboratory Findings of Visceral Leishmaniasis in Children Referred To Children Medical Center Hospital, Tehran, Iran during 2004-2011.

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    Azam Tofighi Naeem

    2014-03-01

    Full Text Available Visceral leishmaniasis (VL is one of the most important parasitic diseases endemic in northwestern and southern areas of Iran. The aim of the present study was to review the records of children hospitalized with VL in order to characterize the clinical features of children as well as laboratory finding in Children Medical Center Hospital, Tehran, Iran.The medical records of all children with a final diagnosis of VL were reviewed from 2004 to 2011. Demographic, clinical information, laboratory finding and treatment were considered.A total number of 34 children with confirmed VL through 2004-2011 were included in the study. The most prevalent sign and symptoms were fever (97.1%, pallor and weakness (97.1%, appetite loss (61.8%, splenomegaly (97.1% and hepatomegaly (88.2%. The most frequent laboratory abnormalities were hematological including anemia (97.1%, thrombocytopenia (91.2% and leukopenia (67.6%. Direct agglutination test (DAT was performed in 23 cases and all of them showed anti-Leishmania antibodies with titers of ≥ 1: 3200. In addition, 90% of patients had positive rK39 results. Identification of Leishmania in the aspirates of the bone marrow was found in 83.3% of patients.Regional surveillance system in order to monitoring of leishmaniasis trends as well as detection of new emerging foci is recommended.

  17. Characteristics of Travel-Related Severe Plasmodium vivax and Plasmodium falciparum Malaria in Individuals Hospitalized at a Tertiary Referral Center in Lima, Peru.

    Science.gov (United States)

    Llanos-Chea, Fiorella; Martínez, Dalila; Rosas, Angel; Samalvides, Frine; Vinetz, Joseph M; Llanos-Cuentas, Alejandro

    2015-12-01

    Severe Plasmodium falciparum malaria is uncommon in South America. Lima, Peru, while not endemic for malaria, is home to specialized centers for infectious diseases that admit and manage patients with severe malaria (SM), all of whom contracted infection during travel. This retrospective study describes severe travel-related malaria in individuals admitted to one tertiary care referral hospital in Lima, Peru; severity was classified based on criteria published by the World Health Organization in 2000. Data were abstracted from medical records of patients with SM admitted to Hospital Nacional Cayetano Heredia from 2006 to 2011. Of 33 SM cases with complete clinical data, the mean age was 39 years and the male/female ratio was 2.8. Most cases were contracted in known endemic regions within Peru: Amazonia (47%), the central jungle (18%), and the northern coast (12%); cases were also found in five (15%) travelers returning from Africa. Plasmodium vivax was most commonly identified (71%) among the severe infections, followed by P. falciparum (18%); mixed infections composed 11% of the group. Among the criteria of severity, jaundice was most common (58%), followed by severe thrombocytopenia (47%), hyperpyrexia (32%), and shock (15%). Plasmodium vivax mono-infection predominated as the etiology of SM in cases acquired in Peru.

  18. [Hi-tech center of outpatient care (To the 40th anniversary of the Branch N 6 of the Vishnevsky Central military clinical hospital N 3)].

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    Popov, A P

    2015-10-01

    The authors present the history of the branch N 6 of the Federal States Organization "the Vishnevsky Central Military Clinical Hospital N 3" of the Ministry of Defense of the Russian Federation, which dates back to November 1, 1974. Over the past years, organizational and staff structure; and the name of the clinic (45th central polyclinic, 45th central consultative-diagnostic polyclinic, 52nd Advisory Diagnostic Center of Defense) has repeatedly changed, but the core the work stays unchangeable--to continually improve patient care technology, to be the leader in the outpatient care for soldiers, reserve officers (retired), members of their families. The. branch consists of 58 medical and 19 specialized diagnostic departments, including 4 hospital departments, 1845 employee work at the branch. Among them 4 doctors of medical science and 43 candidates of medical sciences, 20 honoured physicians and 10 honoured health workers of republic. 70% of doctors and 93% of nurses have the highest qualification category. To health care in the Branch are more than 110 thousand people.

  19. Quality improvements in decreasing medication administration errors made by nursing staff in an academic medical center hospital: a trend analysis during the journey to Joint Commission International accreditation and in the post-accreditation era.

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    Wang, Hua-Fen; Jin, Jing-Fen; Feng, Xiu-Qin; Huang, Xin; Zhu, Ling-Ling; Zhao, Xiao-Ying; Zhou, Quan

    2015-01-01

    Medication errors may occur during prescribing, transcribing, prescription auditing, preparing, dispensing, administration, and monitoring. Medication administration errors (MAEs) are those that actually reach patients and remain a threat to patient safety. The Joint Commission International (JCI) advocates medication error prevention, but experience in reducing MAEs during the period of before and after JCI accreditation has not been reported. An intervention study, aimed at reducing MAEs in hospitalized patients, was performed in the Second Affiliated Hospital of Zhejiang University, Hangzhou, People's Republic of China, during the journey to JCI accreditation and in the post-JCI accreditation era (first half-year of 2011 to first half-year of 2014). Comprehensive interventions included organizational, information technology, educational, and process optimization-based measures. Data mining was performed on MAEs derived from a compulsory electronic reporting system. The number of MAEs continuously decreased from 143 (first half-year of 2012) to 64 (first half-year of 2014), with a decrease in occurrence rate by 60.9% (0.338% versus 0.132%, Pefficiency of multidiscipline collaboration among physicians, pharmacists, nurses, information engineers, and hospital administrators are pivotal to safety in medication administration. JCI accreditation may help health systems enhance the awareness and ability to prevent MAEs and achieve successful quality improvements.

  20. [Epidemiological retrospective survey intestinal parasitism in the Provincial Hospital Center (Kenitra, Morocco): review of 10 years (1996-2005)].

    Science.gov (United States)

    El Guamri, Y; Belghyti, D; Achicha, A; Tiabi, M; Aujjar, N; Barkia, A; El Kharrim, K; Barkia, H; El-Fellaki, E; Mousahel, R; Bouachra, H; Lakhal, A

    2009-01-01

    The survey drew up the epidemiological situation of intestinal parasitism in the center of health El Idrissi (Kenitra, Morocco). The number of reviews has decreased between 1996 and 2005. A correlation between the number of examinations and years of the study period was observed (p parasited by one or several species, say an infestation index of 14.15%. Amoeba were frequently observed (47.04%) with prevalence of Entamoeba histolytica (23.74%), followed by Flagella (28.79%) represented by: Giardia intestinalis (22.71%), Trichomonas intestinalis (5.49%) and Chilomastix mesnilii (0.60%). Helminthes were less found. Ascaris lumbricoides was frequent among helminthes (11.87%), followed by Trichuris trichiura (5.64%), Hymenolepis nana (2.68%), Enterobius vermicularis (2.08%), Taenia saginata (0.75%) and Stronyloides stercoralis (0.45%). The clinical symptoms were observed in 110 subjects with parasites (110/606 or 18.15%) characterized by abdominal pain (75 cases) and association diarrhea more abdominal pain (35 cases). The relationship between the infestation index calculed, sex, age, the annual and seasonal changes, polyparasitism and intestinal parasitic infection is discussed.

  1. Epidemiology of Urban Traffic Accident Victims Hospitalized More Than 24 Hours in a Level III Trauma Center, Kashan County, Iran, During 2012-2013

    Science.gov (United States)

    Mahdian, Mehrdad; Sehat, Mojtaba; Fazel, Mohammad Reza; Moraveji, Alireza; Mohammadzadeh, Mahdi

    2015-01-01

    Background: Urban traffic accidents are an extensively significant problem in small and busy towns in Iran. This study tried to explore the epidemiological pattern of urban traffic accidents in Kashan and Aran-Bidgol cities, Iran. Objectives: This study aimed to assess various epidemiological factors affecting victims of trauma admitted to a main trauma center in Iran. Patients and Methods: During a retrospective study, data including age, sex, injury type and pattern, outcome, hospital stay and treatment expenditures regarding urban Road Traffic Accidents (RTAs) for one year (March 2012-March 2013) were obtained from the registry of trauma research center, emergency medical services and deputy of health of Kashan University of Medical Sciences. One-way ANOVA and chi-square tests were used to analyze data using SPSS version 16.0. P value Young motorcyclist men with the rate of more than 103 per 10000 were the most vulnerable group. The most common injury was head injury (73.6%) followed by lower limb injury (33.2%). A significant association was found between mechanism of injury and head, lower limb, multiple injuries and high risk age group. Conclusions: Urban RTAs are one of the most important problems in Kashan and Aran-Bidgol cities, which impose a great economic burden on health system. Motorcyclists are the most vulnerable victims and multiple trauma and head injury are seen among them extensively. PMID:26101765

  2. A STUDY TO EVALUATE THE EFFECT OF NUTRITIONAL INTERVENTION MEASURES ON CHILDREN WITH SEVERE ACUTE MALNUTRITION ADMITTED IN NUTRITION REHABILITATION CENTER AT CIVIL HOSPITAL BAIRAGARH, BHOPAL, MADHYA PRADESH

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    Ritesh

    2015-02-01

    Full Text Available BACKGROUND: The state of Madhya Pradesh has 1.3 million severely malnourished children. Nutrition rehabilitation centers (NRCs were started in the state to control severe malnutrition and decrease the prevalence of severe malnourished children to less than 1% among c hildren aged 1 – 5 years. OBJECTIVE: To assess the effect of nutritional interventional measures for children with severe acute malnutrition (SAM admitted in Nutrition Rehabilitation Center by reviewing anthropometric indicators. Material and methods: The p resent study was conducted from July 2014 to December 2014; all children admitted during the study period in NRC civil hospital Bairagarh, Bhopal were observed during their stay at NRC to analyze the effect of interventional measures on select anthropometr ic and outcome indicators. The data were entered into Microsoft excel spreadsheet and analyzed. RESULT: 61.8 % of the total 102 children admitted were female, 42.1% were in the age group of 13 – 24 months and 34.3% in the age group of 0 - 12 months. About 60% of the population belonged to schedule caste and tribe. The mean weight at admission was 6.4 kg and on discharge 7.09 kg. Of the total 102, 8 children defaulted and 92 were discharged amongst them 66.3% were recovered. CONCLUSION: The study reveals a propo rtion of 66.3% children amongst the study group recovered with at least 15% weight gain of initial weight

  3. Characterization of Pseudomonas aeruginosa strains isolated from burned patients hospitalized in a major burn center in Tehran, Iran.

    Science.gov (United States)

    Ranjbar, Reza; Owlia, Parviz; Saderi, Horie; Mansouri, Sadegh; Jonaidi-Jafari, Nematollah; Izadi, Morteza; Farshad, Shohreh; Arjomandzadegan, Mohammad

    2011-01-01

    Pseudomonas aeruginosa is an important life-threatening nosocomial pathogen and plays a prominent role in serious infections in burned patients. The current study was undertaken to characterize P. aeruginosa strains isolated from burned patients in Tehran, Iran. The study was conducted in a major burn center in Tehran, Iran in 2007. A total of seventy specimens obtained from different clinical origin with positive culture results for P. aeruginosa were included in the study. Antimicrobial susceptibility test was performed according to the standard CLSI guideline. The relationship between the strains was also determined using antimicrobial drug resistance pattern analysis and plasmid profiling. All strains were multi drug resistant. The percentage of resistance to tested antibiotics was: imipenem 97.5%, amikacin 90%, piperacillin 87.5%, ceftizoxime 72.7%, gentamicin 67.5%, ciprofloxacin 65%, ceftriaxone 60%, and ceftazidime 57.5%. Thirteen resistant phenotypes were recognized, R3 (TET, IPM, AMK, CIP, PIP, GM, CAZ, CRO, CT) was the predominant resistance pattern seen in 27.5% of isolates. Results obtained from E-test showed that 100% of P. aeruginosa strains were resistant to cefoxitin, 97% to cefotetan, 93% to ticarcillin, 89% to ticarcillin/clav, 76% to gentamicin and imipenem, 63% to piperacillin, 49% to tetracycline, and 20% to meropenem. Nine different plasmid profiles were observed among the strains. The current study showed an increase rate of resistance for some antibiotics tested among P. aeruginosa strains isolated from burned patients in Tehran. A combination of antibiotic susceptibility testing and profile plasmid analysis, which are relatively cheap and available methods, showed to be useful to characterize the clinical strains of P. aeruginosa isolated from burned patients in Iran.

  4. Characterization of Pseudomonas Aeruginosa Strains Isolated from Burned Patients Hospitalized in A Major Burn Center in Tehran, Iran

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    Mohammad Arjomandzadegan

    2011-10-01

    Full Text Available Pseudomonas aeruginosa is an important life-threatening nosocomial pathogen and plays a prominent role in serious infections in burned patients. The current study was undertaken to characterize P. aeruginosa strains isolated from burned patients in Tehran, Iran. The study was conducted in a major burn center in Tehran, Iran in 2007. A total of seventy specimens obtained from different clinical origin with positive culture results for P. aeruginosa were included in the study. Antimicrobial susceptibility test was performed according to the standard CLSI guideline. The relationship between the strains was also determined using antimicrobial drug resistance pattern analysis and plasmid profiling. All strains were multi drug resistant. The percentage of resistance to tested antibiotics was: imipenem 97.5%, amikacin 90%, piperacillin 87.5%, ceftizoxime 72.7%, gentamicin 67.5%, ciprofloxacin 65%, ceftriaxone 60%, and ceftazidime 57.5%. Thirteen resistant phenotypes were recognized, R3 (TET, IPM, AMK, CIP, PIP, GM, CAZ, CRO, CT was the predominant resistance pattern seen in 27.5% of isolates. Results obtained from E-test showed that 100% of P. aeruginosa strains were resistant to cefoxitin, 97% to cefotetan, 93% to ticarcillin, 89% to ticarcillin/clav, 76% to gentamicin and imipenem, 63% to piperacillin, 49% to tetracycline, and 20% to meropenem. Nine different plasmid profiles were observed among the strains. The current study showed an increase rate of resistance for some antibiotics tested among P. aeruginosa strains isolated from burned patients in Tehran. A combination of antibiotic susceptibility testing and profile plasmid analysis, which are relatively cheap and available methods, showed to be useful to characterize the clinical strains of P. aeruginosa isolated from burned patients in Iran.

  5. 76 FR 43879 - Business Affiliate Marketing and Disposal of Consumer Information Rules

    Science.gov (United States)

    2011-07-22

    ... COMMISSION 17 CFR Part 162 RIN 3038-AD12 Business Affiliate Marketing and Disposal of Consumer Information... Definitions. Subpart A--Business Affiliate Marketing Rules 162.3 Affiliate marketing opt out and exceptions..., and includes any person registered as such thereunder. Subpart A--Business Affiliate Marketing...

  6. Specific Antigens by Federal Entity in Patients at the Transplant Unit of Specialities Hospital, National Medical Center Twenty-First Century, Mexico.

    Science.gov (United States)

    Hernández Rivera, J C H; Ibarra Villanueva, A; Espinoza Pérez, R; Cancino López, J D; Silva Rueda, I R; Rodríguez Gómez, R; García Covarrubias, L; Reyes Díaz, E; Pérez López, M J; Salazar Mendoza, M

    2016-03-01

    The study of the kidney transplant involves understanding the immunologic basis, such as histocompatibility and the genetic basis of a population. In Mexico, the study of the genetic basis has led to a genetic map by federal entities. We performed an HLA study with 1,276 kidney transplant patients (recipients and donors) in the Hospital of the National Medical Center Twenty-First Century, determining HLA class I (A, B, and Cw) and class II (DRβ1 and DQβ1) antigens with the use of SSOP-PCR. A descriptive analysis was conducted with measures of central tendency (mean, SD). Of 1,276 HLA patients studied, we obtained 2,552 results for each class by the composition of the 2 haplotypes, and for HLA-Cw we processed 796 patients, for a total of 1,592 antigens for this class. We found antigens specific to each federal entity, and it was found that the Federal District had the highest number of specific antigens (10) followed by Morelos (7), Querétaro and Mexico State (3 each), and Tamaulipas, Aguascalientes, Michoacán, Guerrero, Puebla, and Oaxaca (1 each). The genetic map allows us to know proportions of antigens in every state in the center and south of Mexico owing to the diversity and area of influence of the National Medical Center XXIst Century, as well as the wide number of patients. Furthermore, there are still preserved proportionally distinct genetic roots in every entity. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Competing Claims: Religious Affiliation and African Americans' Intolerance of Homosexuals.

    Science.gov (United States)

    Ledet, Richard

    2016-09-15

    Literature on religion and political intolerance indicates competing expectations about how Black Protestant church affiliation affects African Americans' attitudes about civil liberties. On the one hand, Black Protestant theology emphasizes personal freedom and social justice, factors generally linked to more tolerant attitudes. On the other hand, Black Protestants tend to be conservative on family and social issues, factors often linked to intolerance of gays and lesbians. Data from the General Social Survey are used to examine the influence of religious group identification, as well as other relevant aspects of religiosity, on political intolerance among African Americans. Results indicate that although other aspects of religion (beliefs and behaviors) help explain variation in political intolerance, Black Protestant church affiliation has no relationship with attitudes about the civil liberties of homosexuals. However, additional tests show that Black Protestant church affiliation significantly predicts intolerance of other target groups (atheists and racists).

  8. Subculture affiliation is associated with substance use of adolescents.

    Science.gov (United States)

    Bobakova, Daniela; Madarasova Geckova, Andrea; Reijneveld, Sijmen A; van Dijk, Jitse P

    2012-01-01

    Youth subcultures (hip-hop, punk, skinhead, techno scene, metal) are known for specific lifestyles, music preferences, shared values and behaviours of their members. The aim of this study was to assess the association between subculture affiliation and substance use (tobacco, alcohol and cannabis), and whether gender, family affluence and substance use by peers explain this association. Subculture affiliation was significantly associated with substance use (OR/95% CI: smoking 3.13/2.30-4.24; drinking 2.58/1.95-3.41; drunkenness 2.02/1.54-2.66; cannabis use 2.42/1.46-4.00). Only a part of this risk runs via gender, family affluence and peer substance use. Health promotion should be targeted in particular at adolescents with a subculture affiliation as they are at higher risk of substance use.

  9. Differences in epidemiological and molecular characteristics of nasal colonization with Staphylococcus aureus (MSSA-MRSA in children from a university hospital and day care centers.

    Directory of Open Access Journals (Sweden)

    Erika A Rodríguez

    Full Text Available BACKGROUND: Clinical significance of Staphylococcus aureus colonization has been demonstrated in hospital settings; however, studies in the community have shown contrasting results regarding the relevance of colonization in infection by community-associated MRSA (CA-MRSA. In Colombia there are few studies on S. aureus colonization. The aim of this study was to determine the molecular and epidemiological characteristics of nasal colonization by S. aureus (MSSA-MRSA in children from a university hospital and day care centers (DCCs of Medellin, Colombia. METHODS: An observational cross-sectional study was conducted in 400 children (200 in each setting, aged 0 months to 5 years, during 2011. Samples were collected from each nostril and epidemiological information was obtained from the parents. Genotypic analysis included spa typing, PFGE, MLST, SCCmec typing, detection of genes for virulence factors and agr groups. RESULTS: Frequency of S. aureus colonization was 39.8% (n = 159 (hospital 44.5% and DCCs 35.0% and by MRSA, 5.3% (n = 21 (hospital 7.0% and DCCs 3.5%. Most S. aureus colonized children were older than two years (p = 0.005, the majority of them boys (59.1%, shared a bedroom with a large number of people (p = 0.028, with history of β-Lactamase inhibitors usage (p = 0.020. MSSA strains presented the greatest genotypic diversity with 15 clonal complexes (CC. MRSA isolates presented 6 CC, most of them (47.6% belonged to CC8-SCCmec IVc and were genetically related to previously reported infectious MRSA strains. CONCLUSION: Differences in epidemiological and molecular characteristics between populations may be useful for the understanding of S. aureus nasal colonization dynamics and for the design of strategies to prevent S. aureus infection and dissemination. The finding of colonizing MRSA with similar molecular characteristics of those causing infection demonstrates the dissemination capacity of S. aureus and the risk of

  10. Emergent patterns of social affiliation in primates, a model.

    Directory of Open Access Journals (Sweden)

    Ivan Puga-Gonzalez

    2009-12-01

    Full Text Available Many patterns of affiliative behaviour have been described for primates, for instance: reciprocation and exchange of grooming, grooming others of similar rank, reconciliation of fights, and preferential reconciliation with more valuable partners. For these patterns several functions and underlying cognitive processes have been suggested. It is, however, difficult to imagine how animals may combine these diverse considerations in their mind. Although the co-variation hypothesis, by limiting the social possibilities an individual has, constrains the number of cognitive considerations an individual has to take, it does not present an integrated theory of affiliative patterns either. In the present paper, after surveying patterns of affiliation in egalitarian and despotic macaques, we use an individual-based model with a high potential for self-organisation as a starting point for such an integrative approach. In our model, called GrooFiWorld, individuals group and, upon meeting each other, may perform a dominance interaction of which the outcomes of winning and losing are self-reinforcing. Besides, if individuals think they will be defeated, they consider grooming others. Here, the greater their anxiety is, the greater their "motivation" to groom others. Our model generates patterns similar to many affiliative patterns of empirical data. By merely increasing the intensity of aggression, affiliative patterns in the model change from those resembling egalitarian macaques to those resembling despotic ones. Our model produces such patterns without assuming in the mind of the individual the specific cognitive processes that are usually thought to underlie these patterns (such as recordkeeping of the acts given and received, a tendency to exchange, memory of the former fight, selective attraction to the former opponent, and estimation of the value of a relationship. Our model can be used as a null model to increase our understanding of affiliative

  11. Model for a merger: New York-Presbyterian's use of service lines to bring two academic medical centers together.

    Science.gov (United States)

    Corwin, Steven J; Cooper, Mary Reich; Leiman, Joan M; Stein, Dina E; Pardes, Herbert; Berman, Michael A

    2003-11-01

    NewYork-Presbyterian Hospital is the result of the 1998 merger of two large New York City academic medical centers, the former New York and Presbyterian Hospitals, and is affiliated with two independent medical schools, the Columbia University College of Physicians and Surgeons and the Joan and Sanford J. Weill Medical College of Cornell University. At the time of the merger, the hospital faced a number of significant challenges, chief among them the clinical integration of the two medical centers. Size, separate medical schools, geography, and different histories and cultures all presented barriers to collaboration. To bring about the needed clinical alignment, the hospital turned to service lines as a way to realize the benefits of clinical integration without forcing the consolidation of departments. In this article, members of the hospital's senior management review the thinking behind the hospital's use of the service lines, their development and operation, and the significant, positive effects they have had on volume, clinical quality, clinical efficiency, best practices, and revenue management. They discuss how the service lines were used to bring together the two clinical cultures, the impact they have had on the way the hospital is operated and managed, and why service lines have worked at NewYork-Presbyterian in contrast to other hospitals that tried and abandoned them. Service lines play an increasingly central role in the hospital's clinical and business strategies, and are being extended into the NewYork-Presbyterian health care system.

  12. Multinational Parent Companies' Influence over Human Resource Decisions of Affiliates: U.S. Firms in Mexico

    OpenAIRE

    Zaida L. Martinez; David A Ricks

    1989-01-01

    This study provides empirical evidence for the relationship between the degree of influence U.S. parent companies have over the human resource decisions of their Mexican affiliates and the affiliates' resource dependencies on the parent company. Both wholly-owned and Joint venture affiliates are examined. Resource dependence was the factor most closely related to parent influence over affiliate human resource decisions. The importance of an affiliate to a parent company, the nationality of af...

  13. Debt Financing and Sharp Currency Depreciations: Wholly vs. Partially Owned Multinational Affiliates

    OpenAIRE

    Hebous, Shafik; Weichenrieder, Alfons J.

    2009-01-01

    This paper provides empirical evidence on two potential costs of shared ownership of German affiliates abroad. First, in periods of currency crises, wholly-owned affiliates, in contrast to partially-owned affiliates, seem to circumvent financial constraints by accessing capital from their parent companies. In terms of differences in performance regarding sales of both types of firms, wholly-owned affiliates have a significantly better sales performance than partially-owned affiliates in perio...

  14. [Eating disorder and confession. Is there a correlation between the type of eating disorder and specific religious affiliation?].

    Science.gov (United States)

    Jacoby, G E

    1993-02-01

    At the Klinik am Korso in Bad Oeynhausen, a special center for eating disorders, 789 patients from the years 1989 and 1990 were subdivided according to their diagnosis and religious affiliation and analyzed. The most striking result was a higher incidence of anorectic abstainers among Protestants and of bulimia with vomiting among Roman Catholics. This was linked up with the more internalized drive control of the Protestants. Further investigations are encouraged to analyze the essence of this connection.

  15. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... a Question Toll Free Numbers Media Contact Locator Hospitals and Clinics Vet Centers Regional Benefits Offices Regional ... TEE) Tournament Wheelchair Games Winter Sports Clinic Locations Hospitals & Clinics Vet Centers Regional Benefits Offices Regional Loan ...

  16. Identification of Class-1 Integron and Various Β-Lactamase Classes among Clinical Isolates of Pseudomonas aeruginosa at Children's Medical Center Hospital

    Directory of Open Access Journals (Sweden)

    Hossein Fazeli

    2015-10-01

    Full Text Available Background: Pseudomonas aeruginosa is one of the most important oppor- tunistic pathogens responsible for various types of infections. Children suffer significant morbidity and mortality due to nosocomial infections. The aim of this study was to investigate the presence of Class-1 integron, blaBEL, blaPER, blaKPC, blaVIM, blaIMP and blaOXA-group-1  genes among P. aeruginosa isolates at Children's Medical Center Hospital in Iran and to determine phenotypic evi- dence of ESBL and MBL production.Methods: Antibiotic susceptibility tests were analyzed for 72 P. aeruginosa clinical isolates. Isolates were identified by using biochemical tests and con- firmed by PCR assay for oprL gene. ESBL and MBL producer isolates were identified  by phenotypic  tests (double disc synergy tests. Detection of β- lactamase genes and class-1 integron were performed by PCR method. Results: All of the isolates were susceptible to ceftazidime / clavulanate, me- ropenem, imipenem and ciprofloxacin. About 83.3% and 16.7% of isolates were  resistant  to  ceftazidime  and  amikacin  respectively.  Approximately,83.3% of isolates were considered as potential ESBL producers. None of the clinical isolates showed above β-lactamase genes. It seems that, the reason is the absence of class-1 integron in all of isolates. About 16.7% of strains were identified  as multidrug  resistant.  Fortunately,  all of the isolates were sus- ceptible to meropenem and imipenem which are effective against ESBL pro- ducing strains.Conclusion:  The absences of class-1 integron decreases the probability of acquired β-lactamase especially MBL. Thus, absolute susceptibility to carba- penems and ciprofloxacin among P. aeruginosa isolates in pediatric hospital has important implications for empirical antimicrobial therapy. It seems that these properties help to decrease mortality of nosocomial infections within children.

  17. Priming Third-Party Ostracism Increases Affiliative Imitation in Children

    Science.gov (United States)

    Over, Harriet; Carpenter, Malinda

    2009-01-01

    Human beings are intensely social creatures and, as such, devote significant time and energy to creating and maintaining affiliative bonds with group members. Nevertheless, social relations sometimes collapse and individuals experience exclusion from the group. Fortunately for adults, they are able to use behavioral strategies such as mimicry to…

  18. Examination of a University-Affiliated Safe Ride Program

    Science.gov (United States)

    Gieck, D. Joseph; Slagle, David M.

    2010-01-01

    A university-affiliated safe ride program was evaluated to determine whether these programs can reduce drunk-driving related costs. Data was collected from 187 safe ride passengers during three nights of operation. Among the passengers, 93% were enrolled at a local University, 31% were younger than 21, and 40% reported a prior alcohol-related…

  19. Third-party postconflict affiliation of aggressors in chimpanzees.

    Science.gov (United States)

    Romero, Teresa; de Waal, Frans B M

    2011-04-01

    Postconflict management strategies have been defined as any postconflict interaction that mitigates the negative consequences of the preceding agonistic conflict. Although most studies have investigated postconflict interactions between former opponents or between victims and uninvolved bystanders, interactions between aggressors and bystanders have received much less attention. In this study, we examined a database of 1,102 agonistic interactions and their corresponding postconflict periods in two outdoor-housed groups of captive chimpanzees in order to test the occurrence of postconflict third-party affiliation of aggressors. Our results confirmed the occurrence of appeasement, i.e. postconflict affiliation by a bystander toward an aggressor, but failed to detect the occurrence of postconflict affiliation directed from aggressors toward bystanders. Appeasement rates did not differ according to the sex of the involved individuals. In addition, appeasement occurred more often in the absence of reconciliation than after its occurrence suggesting that appeasement may act as an alternative to reconciliation when the latter fails to occur. Both study groups showed behavioral specificity for appeasement, i.e. context-specific use of certain behaviors, supporting the view that chimpanzees exhibit highly visible explicit postconflict affiliation.

  20. Birth Order, Gender and Affiliation in Various Situations.

    Science.gov (United States)

    Fox, Shaul

    1981-01-01

    Administered two questionnaires to 800 Israeli subjects which examine the affiliation need in four groups of situations. No differences were found between first and later-borns in their tendency to associate with others. Results showed significant interaction between sex and specific situational factors. (Author/RC)

  1. Music Listening, Coping, Peer Affiliation and Depression in Adolescence

    Science.gov (United States)

    Miranda, Dave; Claes, Michel

    2009-01-01

    This study was conducted with 418 French-Canadian adolescents from Montreal (Canada) and had three objectives: (1) to find empirical evidence that music listening in adolescence can lead to peer affiliation based upon music preferences; (2) to find out whether three styles of coping by music listening (original self-report scale: emotion-oriented,…

  2. 12 CFR 41.32 - Sharing medical information with affiliates.

    Science.gov (United States)

    2010-01-01

    ... (b) to an affiliate: (1) In connection with the business of insurance or annuities (including the activities described in section 18B of the model Privacy of Consumer Financial and Health Information Regulation issued by the National Association of Insurance Commissioners, as in effect on January 1,...

  3. Affiliative Structures and Social Competence in Portuguese Preschool Children

    Science.gov (United States)

    Daniel, João R.; Santos, António J.; Peceguina, Inês; Vaughn, Brian E.

    2015-01-01

    The goal of this study was to determine whether peer social competence (SC), defined as the capacity to use behavioral, cognitive, and emotional resources in the service of achieving personal goals within preschool peer groups, was related to the type of affiliative subgroups to which children belonged. Two hundred forty Portuguese preschool…

  4. Music Listening, Coping, Peer Affiliation and Depression in Adolescence

    Science.gov (United States)

    Miranda, Dave; Claes, Michel

    2009-01-01

    This study was conducted with 418 French-Canadian adolescents from Montreal (Canada) and had three objectives: (1) to find empirical evidence that music listening in adolescence can lead to peer affiliation based upon music preferences; (2) to find out whether three styles of coping by music listening (original self-report scale: emotion-oriented,…

  5. Educational Franchising (Once More about the Status of the Affiliate)

    Science.gov (United States)

    Kovalenko, A.

    2006-01-01

    Issues relating to the organization of the process of education via the network system is being discussed vigorously among specialists in the field of social economic theory and economic sociology. An example of network education is seen in the network of affiliates and branch offices of institutions of higher learning. This journal has already…

  6. Author Affiliation Index: A New Approach to Marketing Journal Ranking

    Science.gov (United States)

    Pan, Yue; Chen, Carl R.

    2011-01-01

    Previous research has adopted various methods to assess the relative quality of academic marketing journals. This study, as a replication and extension of Chen and Huang (2007), introduces the Author Affiliation Index (AAI) as an alternative approach to assessing marketing journal quality. The AAI is defined as the ratio of articles authored by…

  7. Gender differences in dominance and affiliation during a demanding interaction

    NARCIS (Netherlands)

    Luxen, MF

    2005-01-01

    Evolution theory predicts that in social situations, men will show more behavioral dominance, whereas women will show more behavioral affiliation. To ensure maximum ecological validity, observation in a real-life situation that calls for uniform behavior is the strongest test. To reduce bias because

  8. Classroom Emotional Climate, Teacher Affiliation, and Student Conduct

    Science.gov (United States)

    Brackett, Marc A.; Reyes, Maria Regina; Rivers, Susan E.; Elbertson, Nicole A.; Salovey, Peter

    2011-01-01

    Using a multi-method, multi-level approach, this study examined the link between classroom emotional climate and student conduct, including as a mediator the role of teacher affiliation, i.e., students' perceptions of their relationships with their teachers. Data were collected from 90 fifth- and sixth-grade classrooms (n = 2,000 students) and…

  9. Author Affiliation Index: A New Approach to Marketing Journal Ranking

    Science.gov (United States)

    Pan, Yue; Chen, Carl R.

    2011-01-01

    Previous research has adopted various methods to assess the relative quality of academic marketing journals. This study, as a replication and extension of Chen and Huang (2007), introduces the Author Affiliation Index (AAI) as an alternative approach to assessing marketing journal quality. The AAI is defined as the ratio of articles authored by…

  10. An Examination of Drunkorexia, Greek Affiliation, and Alcohol Consumption

    Science.gov (United States)

    Ward, Rose Marie; Galante, Marina; Trivedi, Rudra; Kahrs, Juliana

    2015-01-01

    The purpose of this study is to examine the relation between Greek affiliation, the College Life Alcohol Salience Scale, alcohol consumption, disordered eating, and drunkorexia (i.e., using disordered eating practices as compensation for calories consumed through alcohol). A total of 349 college students (254 females, 89 males) participated in the…

  11. Gender differences in dominance and affiliation during a demanding interaction

    NARCIS (Netherlands)

    Luxen, MF

    Evolution theory predicts that in social situations, men will show more behavioral dominance, whereas women will show more behavioral affiliation. To ensure maximum ecological validity, observation in a real-life situation that calls for uniform behavior is the strongest test. To reduce bias because

  12. A Developmental Inquiry into Biophilia: Children's Affiliation with Nature.

    Science.gov (United States)

    Kahn, Peter H., Jr.

    This paper examines the biophilia hypothesis put forth by E. O. Wilson, which asserts the existence of a fundamental, genetically-based human need and propensity to affiliate with other living organisms and lifelike processes. It reviews research by Wilson and others that supports the biophilia hypothesis, and examines some of the issues and…

  13. Subculture Affiliation Is Associated with Substance Use of Adolescents

    NARCIS (Netherlands)

    Bobakova, Daniela; Geckova, Andrea Madarasova; Reijneveld, Sijmen A.; van Dijk, Jitse P.

    2012-01-01

    Youth subcultures (hip-hop, punk, skinhead, techno scene, metal) are known for specific lifestyles, music preferences, shared values and behaviours of their members. The aim of this study was to assess the association between subculture affiliation and substance use (tobacco, alcohol and cannabis),

  14. An Examination of Drunkorexia, Greek Affiliation, and Alcohol Consumption

    Science.gov (United States)

    Ward, Rose Marie; Galante, Marina; Trivedi, Rudra; Kahrs, Juliana

    2015-01-01

    The purpose of this study is to examine the relation between Greek affiliation, the College Life Alcohol Salience Scale, alcohol consumption, disordered eating, and drunkorexia (i.e., using disordered eating practices as compensation for calories consumed through alcohol). A total of 349 college students (254 females, 89 males) participated in the…

  15. 75 FR 20796 - Market-Based Rate Affiliate Restrictions

    Science.gov (United States)

    2010-04-21

    ... requires that, as a condition of receiving and retaining market-based rate authority, sellers comply with...-based rate sellers to share employees that may not currently be shared under the affiliate restrictions... requirements for market-based rate sellers were approved under FERC-919 ``Market-Based Rates for...

  16. Safe medication management and use of narcotics in a Joint Commission International-accredited academic medical center hospital in the People's Republic of China.

    Science.gov (United States)

    Fang, Xu; Zhu, Ling-Ling; Pan, Sheng-Dong; Xia, Ping; Chen, Meng; Zhou, Quan

    2016-01-01

    Safe medication management and use of high-alert narcotics should arouse concern. Risk management experiences in this respect in a large-scale Joint Commission International (JCI)-accredited academic medical center hospital in the People's Republic of China during 2011-2015, focusing on organizational, educational, motivational, and information technological measures in storage, prescribing, preparing, dispensing, administration, and monitoring of medication are summarized. The intensity of use of meperidine in hospitalized patients in 2015 was one-fourth that in 2011. A 100% implementation rate of standard storage of narcotics has been achieved in the hospital since December 2012. A "Plan, Do, Check, Act" cycle was efficient because the ratio of number of inappropriate narcotics prescriptions to total number of narcotics prescriptions for inpatients decreased from August 2014 to December 2014 (28.22% versus 2.96%, P=0.0000), and it was controlled below 6% from then on. During the journey to good pain management ward accreditation by the Ministry of Health, People's Republic of China, (April 2012-October 2012), the medical oncology ward successfully demonstrated an increase in the pain screening rate at admission from 43.5% to 100%, cancer pain control rate from 85% to 96%, and degree of satisfaction toward pain nursing from 95.4% to 100% (all P-values <0.05). Oral morphine equivalent dosage in the good pain management ward increased from 2.3 mg/patient before June 2012 to 54.74 mg/patient in 2014. From 2011 to 2015, the oral morphine equivalent dose per discharged patient increased from 8.52 mg/person to 20.36 mg/person. A 100% implementation rate of independent double-check prior to narcotics dosing has been achieved since January 2013. From 2014 to 2015, the ratio of number of narcotics-related medication errors to number of discharged patients significantly decreased (6.95% versus 0.99%, P=0.0000). Taken together, continuous quality improvements have been

  17. Hospital outpatient perceptions of the physical environment of waiting areas: the role of patient characteristics on atmospherics in one academic medical center

    Directory of Open Access Journals (Sweden)

    Sun Pi-hung

    2007-12-01

    Full Text Available Abstract Background This study examines hospital outpatient perceptions of the physical environment of the outpatient waiting areas in one medical center. The relationship of patient characteristics and their perceptions and needs for the outpatient waiting areas are also examined. Method The examined medical center consists of five main buildings which house seventeen primary waiting areas for the outpatient clinics of nine medical specialties: 1 Internal Medicine; 2 Surgery; 3 Ophthalmology; 4 Obstetrics-Gynecology and Pediatrics; 5 Chinese Medicine; 6 Otolaryngology; 7 Orthopedics; 8 Family Medicine; and 9 Dermatology. A 15-item structured questionnaire was developed to rate patient satisfaction covering the four dimensions of the physical environments of the outpatient waiting areas: 1 visual environment; 2 hearing environment; 3 body contact environment; and 4 cleanliness. The survey was conducted between November 28, 2005 and December 8, 2005. A total of 680 outpatients responded. Descriptive, univariate, and multiple regression analyses were applied in this study. Results All of the 15 items were ranked as relatively high with a range from 3.362 to 4.010, with a neutral score of 3. Using a principal component analysis' summated scores of four constructed dimensions of patient satisfaction with the physical environments (i.e. visual environment, hearing environment, body contact environment, and cleanliness, multiple regression analyses revealed that patient satisfaction with the physical environment of outpatient waiting areas was associated with gender, age, visiting frequency, and visiting time. Conclusion Patients' socio-demographics and context backgrounds demonstrated to have effects on their satisfaction with the physical environment of outpatient waiting areas. In addition to noticing the overall rankings for less satisfactory items, what should receive further attention is the consideration of the patients' personal

  18. Hospital ICUs May Be Overused

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_162801.html Hospital ICUs May Be Overused Single medical center study ... While this is a study of just one hospital and results may differ at other medical centers, ...

  19. The future size of religiously affiliated and unaffiliated populations

    Directory of Open Access Journals (Sweden)

    Conrad Hackett

    2015-04-01

    Full Text Available Background: People who are religiously unaffiliated (including self-identifying atheists and agnostics, as well as those who say their religion is "nothing in particular" made up 16.4Š of the world's population in 2010. Unaffiliated populations have been growing in North America and Europe, leading some to expect that this group will grow as a share of the world's population. However, such forecasts overlook the impact of demographic factors, such as fertility and the large, aging unaffiliated population in Asia. Objective: We project the future size of religiously affiliated and unaffiliated populations around the world. Methods: We use multistate cohort-component methods to project the size of religiously affiliated and unaffiliated populations. Projection inputs such as religious composition, differential fertility, and age structure data, as well as religious switching patterns, are based on the best available census and survey data for each country. This research is based on an analysis of more than 2,500 data sources. Results: Taking demographic factors into account, we project that the unaffiliated will make up 13.2Š of the world's population in 2050. The median age of religiously affiliated women is six years younger than unaffiliated women. The 2010-15 Total Fertility Rate for those with a religious affiliation is 2.59 children per woman, nearly a full child higher than the rate for the unaffiliated (1.65 children per woman. Conclusions: The religiously unaffiliated are projected to decline as a share of the world's population in the decades ahead because their net growth through religious switching will be more than offset by higher childbearing among the younger affiliated population.

  20. NIH Clinical Centers

    Data.gov (United States)

    Federal Laboratory Consortium — The NIH Clinical Center consists of two main facilities: The Mark O. Hatfield Clinical Research Center, which opened in 2005, houses inpatient units, day hospitals,...

  1. Evaluation of Patient-Oriented Standards of Joint Commission International in Gilan and Mazandaran Teaching Hospitals

    Directory of Open Access Journals (Sweden)

    Ghaseminejhad

    2016-08-01

    Full Text Available Background Medical tourism, a multi-million-dollar industry, has had a significant effect in economic flourishing, creating jobs, and preventing the outflow of currency. Objectives The aim of this study was to evaluate teaching hospitals affiliated to Gilan and Mazandaran University of Medical Sciences, according to joint commission international (JCI standards. Methods This was a descriptive cross sectional study conducted among teaching hospitals affiliated to Gilan and Mazandaran University of Medical Sciences during year 2015. To collect data and evaluate the hospitals, patient-oriented standards of JCI was applied. Results Amongst the eight standards, international patient safety goals (IPSG (with a score of 87.5% had the highest, and patient and family education (PFE (with a score of 53.75% had the lowest score. Hospital “4” with a score of 90.41%, had the highest, and hospital “7” with 58.90%, had the lowest rate of compliance to the standards. According to the Mann-Whitney test, the observed statistics considering a P value of ≤ 0.05 level, was not significant, therefore on a 95% certainty level, there was no significant difference between hospitals in Gilan and Mazandaran, regarding compliance with standards. Overall, the hospitals under study were relatively prepared for attracting medical tourists. Conclusions According to the results, it seems that more planning and implementation of projects is required to strengthen the axes of the joint commission regarding accreditation of hospitals and attraction of medical tourists to these centers, especially foreign tourists. Researchers are recommended to pay special attention to the university of medical sciences of two provinces for the establishment of standards and utilization of professional consultants.

  2. Hazard-evaluation and technical-assistance report HETA 90-122-l2073, technical assistance to San Francisco General Hospital and Medical Center, San Francisco, California

    Energy Technology Data Exchange (ETDEWEB)

    Moss, C.E.; Seitz, T.

    1990-10-01

    In response to a request from the Director of the Environmental Health and Safety Department of the San Francisco General Hospital and Medical Center, located in San Francisco, California, an evaluation was undertaken of possible hazardous working conditions at that site. Concern existed about exposures to hazards while operating the germicidal lamp at the facility. Germicidal lamps were used to disinfect the air in tuberculosis and aerosolized pentamidine clinics. The workers wore no protective eye wear. All rooms used a 30 watt germicidal lamp. Lower wattage bulbs in the smaller rooms would have reduced occupational ultraviolet (UV) exposure. Reflectance levels of UV radiation were quite high and varied. Worker exposure to germicidal lamp UV levels was dependent on many factors, some of the most important ones being the position of the bulb in the room, age of the bulb, obstruction of the UV radiation by objects near the bulb, and the height of the worker. While there are no consensus guidelines available on ventilation systems designed for areas where germicidal lamps are used, the provision of good room air distribution and mixing is recommended to prevent stagnant air conditions or short circuiting of supply air within the room. Bulb changers need to be aware of the need for protective clothing and gloves for protection from both the UV radiation levels as well as possible glass breakage.

  3. Knowledge, Attitude, and Performance of Radiographers about the Principles of Radiation Protection and Following Protective Standards in Medical Imaging Centers of Hospitals in Fasa in 2015

    Directory of Open Access Journals (Sweden)

    Reza Alipoor

    2016-03-01

    Full Text Available Background & Objectives: Although ionizing radiation is effective in the diagnosis of illnesses, it is dangerous from the perspective of protection for patients and radiographers working in radiology sections. Therefore, knowledge, understanding, and application of radiation protection can play an important role. The aim of this study is to assess the knowledge, attitude, and practice of the radiation protection principles in radiation workers in medical imaging centers and hospitals in Fasa, Fars, Iran. Materials & Methods: The present study is a cross-sectional one among all 50 radiation workers employed in radiology departments of this city. A questionnaire was the means of evaluation which contained demographic information and questions about the knowledge, attitude, and practice of radiology staff regarding the radiation protection. All of the completed questionnaires were analyzed, using SPSS19 software. Results: Radiographers’ participation rate was 100%, and the mean score of knowledge, attitude, and practice of radiation workers in the field of radiation protection was 42.36, 62.4, and 48.54, respectively. Depending on the degree of their knowledge, there was no statistically significant difference between the radiographers’ age, gender, and work experience, and the relationship between the following factors was not substantial. Conclusion: The results showed that by increasing the level of education, the awareness of radiation workers increases, too. To raise awareness of radiation protection for radiation workers, it is better to hold training courses.

  4. The Function Transition of Information Center in Digital Hospital%数字化医院形势下信息中心职能的转变

    Institute of Scientific and Technical Information of China (English)

    曾霞

    2013-01-01

    In the current situation of Digital Hospital, the functions of information center have produced a very big change, from the executive department to the planning department; from the statistics department to the leadership decision-making support department; from the technology sector to the comprehensive management department;from the terminal maintenance department to the skil s training department;from the traditional library into the digital library.%在数字化医院的新形势下,信息中心的职能职能发生了很大转变,从执行部门转变为信息化建设规划部门;从统计部门转化为医院领导决策支持部门;从技术部门转变为综合性管理部门;从终端维护部门转变为技能培训部门;从传统图书馆转变为综合性数字图书馆。

  5. Exploitation of resources and cardiovascular outcomes in low-risk patients with chest pain hospitalized in coronary care units

    Directory of Open Access Journals (Sweden)

    Saadat H

    2011-10-01

    Full Text Available Habibollah Saadat¹, Hossein Shiri², Zahra Salarpour², Tahereh Ashktorab² , Hamid Alavi Majd², Zahra Saadat¹, Hosein Vakili¹ 1Cardiovascular Research Center, Modarres Hospital, Shaheed Beheshti University of Medical Sciences, Tehran; 2Nursing School, Shaheed Beheshti University of Medical Sciences, Tehran, Iran Background: Most patients who present to medical centers due to chest pain do not suffer from acute coronary syndromes and do not need to be hospitalized in coronary care units (CCUs. This study was done to determine exploitation of resources and cardiovascular outcomes in low-risk patients with chest pain hospitalized in CCUs of educational hospitals affiliated with a major medical university. Methods: Over a 4-month period, 550 patients with chest pain who were hospitalized in the CCUs belonging to six hospitals affiliated to the authors' medical university were recruited by census method. Using Thrombolysis in Myocardial Infarction risk score, 95 patients (17.27% were categorized as low-risk patients. This group was evaluated with respect to demographics, bed occupancy rate, mean hospitalization period, expenses during admission, and cardiovascular outcomes in the 30-day period postdischarge. Results: Mean (± standard deviation hospitalization duration was 3.04 (±0.71 days. No significant difference was seen between the six surveyed hospitals regarding hospitalization duration (P = 0.602. The highest bed occupancy rate was seen in Taleghani and Shohada Tajrish hospitals and the lowest was in Modarres Hospital. The mean paid treatment expenses by low-risk patients was IRR 2,050,000 (US$205. Mean total hospitalization expenses was US$205. No significant difference was seen between the six surveyed hospitals (P = 0.699. Of the patients studied, 89.5% did not show any cardiovascular complications in 1 month and no deaths occurred. Conclusion: Given the high bed-occupancy rate by low-risk patients, associated high hospitalization

  6. "Just" blood donors? A study on the multi-affiliations of blood donors.

    Science.gov (United States)

    Alfieri, Sara; Pozzi, Maura; Marta, Elena; Saturni, Vincenzo; Aresi, Giovanni; Guiddi, Paolo

    2017-07-25

    The present work proposes to explore a phenomenon well known in the world of blood donation, but little explored by literature: multi-affiliations. By that term, in this paper we mean blood donors' engagement in multiple associations of various natures (donation, recreation, sports, etc.) simultaneously. The first objective proposes to explore the phenomenon of multi-affiliations in descriptive terms; the second is to look into the differences-in terms of motivations, family-work-volunteerism reconciliation, life satisfaction, and membership satisfaction-between those who "only" carry out blood donation activity and those who instead participate in multiple associative realities concurrently. Participating in the research were 2674 donors from the Italian Association of Blood Donors (AVIS) (age range 18-65; 66.6% male) to which a self-report questionnaire was administered in the waiting rooms of numerous blood donation centers. Regarding the first objective, it emerged that only 35.9% of the participants "only" donate blood, while a good 64.1% is engaged also in other associations. Regarding the second objective, statistically significant differences emerge regarding many of the variables considered: social, values, ego-protection, and career motivation; capacity to reconcile family-volunteering and work-volunteering; life satisfaction; and membership satisfaction. The study offers precious information to the agencies that handle recruiting and retaining of donors. The agencies in fact can take away information on how to improve the multi-affiliations of their donors, an aspect that can facilitate their long-term retention. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. [Short- and long-term results in operable pancreatic ductal adenocarcinomas from a cooperation between two departments gastroenterology-visceral surgery at non-university hospitals benchmarked to results of expert-centers].

    Science.gov (United States)

    Dippold, Wolfgang; Sivanathan, Visvakanth; Statt, Katharina; Roitman, Marc; Link, Karl Heinrich

    2017-02-01

    The only curative approach in pancreatic ductal adenocarcinoma (PDAC) is resection, which is possible only in 15 - 30 % of patients. Local tumor spread or distant metastases are contraindications for resection in the majority of patients. Surgical-oncological quality with short- and long-term results are varying tremendously, so that "expertise/quality" are associated to hospital- or surgeon's volume and/or center formation. The treatment results also depend, to a great extent, on the medical diagnostic quality. With our retrospective study, we aim to compare the results-quality of cooperative pancreatic cancer treatment based on an extensive preoperative diagnostic procedure for staging and risk estimation in a specialized GI-medical department and visceral surgical-oncological expertise in pancreatic cancer surgery at a general hospital with the results-quality of expert centers. Fifty-three patients with PDAC had diagnosis and resection of their cancer between 1/2002 and 12/2009. The 30 day hospital-mortality was 3.8 % and the median survival time after demission from the hospital was 23.1 months. The 5-year-survival rate of R0-resected patients, all of whom had received adjuvant chemotherapy, was high with 31 %. The survival data and the extraordinarily high resection rate of 98.1 % in the patient group, whose primary tumor stage was pT3 in 81 %, reflects the excellent cooperation of high standards in medical diagnostic processes, visceral pancreatic surgery, and adjuvant medical chemotherapy. The results are well comparable to those of "high volume centers". The responsible heads of the two departments have been trained at university expert centers. Expertise in the treatment of pancreatic cancer patients may be successfully transferred from an expert center to a general hospital, if the team has high expertise. © Georg Thieme Verlag KG Stuttgart · New York.

  8. American Hospital Association

    Science.gov (United States)

    ... replay of the AHA’s breakdown of the 2016 election results and what they mean for hospitals. Click ... Forum Trustee and Community Leadership Volunteers and Auxiliary Leaders Workforce Center News Center Press Releases AHA Awards ...

  9. The Efficiency and Effectiveness of the K-12 Energy Technology Education Promotion Centers in Taiwan

    Science.gov (United States)

    Lee, Lung-Sheng

    2013-01-01

    In order to promote energy literacy for graders K-12, the Ministry of Education (MOE) in Taiwan initiated a K-12 Energy Technology Education Project in September 2010. This 40-month project has one project office affiliated to a university, and 18 promotion centers affiliated to 18 schools--including 5 regional centers for upper-secondary schools…

  10. [Dispensing prescriptions to persons affiliated with the Seguro Popular de Salud de México].

    Science.gov (United States)

    Garrido-Latorre, Francisco; Hernández-Llamas, Héctor; Gómez-Dantés, Octavio

    2008-01-01

    Measure and compare the percentage of prescriptions fully dispensed to persons with and without Popular Health Insurance (SPS in Spanish) who use ambulatory and general hospital services associated with the Mexico State Health Services (SESA in Spanish), and taking into account insurance status. SESA user satisfaction was also measured with respect to access to medication. Information for the study was taken from four surveys of SESA ambulatory and hospital units that included probabilistic samples with state representativity. Samples of ambulatory units were selected by stratification according to level of care and association to the SPS service network. The findings indicate that the percentage of prescriptions fully dispensed in SESA ambulatory units has improved, reaching approximately 90%, especially among those units offering services to persons affiliated with SPS. Nevertheless, these percentages continue to be lower than those of ambulatory units associated with social security institutions. Percentages of prescriptions fully dispensed have also improved in SESA hospital units, but continue to be relatively low. In nearly all states, as the percentage of prescriptions fully dispensed has increased, user satisfaction with access to medication has also improved. In 2006 more than 50% of the states had high levels of fully dispensed prescriptions among persons with SPS (> or =90%). The more significant problem exists among hospitals, since only 44% of users who received a prescription in SESA hospitals in 2006 had their prescriptions fully dispensed. This finding requires a review of SPS medication policies, which have favored highly prescribed low-cost medications at ambulatory services at the expense of higher cost and more therapeutically effective medications for hospital care, the latter having a greater impact on household budgets.

  11. Kin Group Affiliation and Marital Violence Against Women in Ghana.

    Science.gov (United States)

    Sedziafa, Alice Pearl; Tenkorang, Eric Y

    2016-01-01

    The socialization of men and women in Ghana often confers either patrilineal or matrilineal rights, privileges, and responsibilities. Yet, previous studies that explored domestic and marital violence in sub-Saharan Africa, and Ghana, paid less attention to kin group affiliation and how the power dynamics within such groups affect marital violence. Using the 2008 Ghana Demographic and Health Survey and applying ordinary least squares (OLS) techniques, this study examined what influences physical, sexual, and emotional violence among matrilineal and patrilineal kin groups. Results indicate significant differences among matrilineal and patrilineal kin groups regarding marital violence. Socioeconomic variables that capture feminist and power theories were significantly related to sexual and emotional violence in matrilineal societies. Also, variables that tap both cultural and life course epistemologies of domestic violence were strongly related to physical, sexual, and emotional violence among married women in patrilineal kin groups. Policymakers must pay attention to kin group affiliation in designing policies aimed at reducing marital violence among Ghanaian women.

  12. Performance assessment of health posts affiliated with Ahvaz University of medical sciences using data envelopment analysis technique from 2013 to 2015

    Directory of Open Access Journals (Sweden)

    Ali Feizi

    2016-06-01

    Full Text Available Introduction: Data envelopment analysis is the most important and most common way to assess and measure the performance and efficiency of hospital and health centers. The aim of this study is performance analysis of health posts in Ahvaz University of medical sciences. Methods: This is cross-sectional and linear programming study that was performed from 2013 to 2015. The study population included 600 health posts were affiliated with Ahvaz University of medical sciences Ahvaz University of medical sciences. Based on the visit and the number of services, 39 health posts were selected as samples. Data were analyzed using data envelopment analysis technique. In this method, technical, scale, and managerial efficiency are calculated based on input and output variables. Data were analyzed by Deap.2 software. Results: The findings showed that average technical, managerial, and scale efficiency of health posts increased during from 2013 to 2015. Average technical efficiency of health posts was 0.92, managerial efficiency was 0.949 and the scale efficiency was 0.968. Herkeleh health post with an average scale efficiency 0.667 and Parchestan goroui with an average technical efficiency and administrative 0.597 had the lowest efficiency. Conclusion: In this study we concluded that most health posts had good technical and scale efficiency.

  13. Racial Encounters: Queer Affiliations in Black and South Asian Diasporas

    OpenAIRE

    Kini, Ashvin Rathnanand

    2016-01-01

    Racial Encounters: Queer Affiliations in Black and South Asian Diasporas examines diasporic Black and South Asian cultural production to chart the shifting politics of race, gender, and sexuality in British and U.S. imperial projects. I argue that diasporic Black and South Asian cultural production together comprise an important body of work that collectively archives histories of British colonialism in South Asia, Africa, the Caribbean, and the United Kingdom, and the post-World War II ascen...

  14. Foreign Affiliate Sales and Trade in Both Goods and Services

    OpenAIRE

    Chunding Li; John Whalley; Yan Chen

    2010-01-01

    Because of the differing forms that international agreements on trade in goods and trade in services take in the GATT (1994) and the GATS there is an incompatibility between measures of world trade in goods and services. Measures of goods trade reflecting GATT (1994) are restricted to trade that crosses borders. Service trade, however, under GATS mode 3 (commercial presence) includes both cross border delivery and foreign affiliate sales within borders. As a result, present comparisons of ser...

  15. Malpractice Issues in the Academic Medical Center.

    Science.gov (United States)

    Rich, Ben A.

    1986-01-01

    A discussion of legal issues in the academic medical center focuses on standards of care applicable to practitioners, special problems of patient care delivery, and the special status of public academic medical centers. Informed consent to care, relations with affiliated institutions, and private/non-private patient status are also considered.…

  16. [Prevalence of reactions secundary to mosquito bites Aedes aegypti at en el Regional Center of Allergy and Clinical Immunology, University Hospital, de Monterrey, Nuevo Leon].

    Science.gov (United States)

    González Diaz, Sandra Nora; Cruz, Alfredo Arias; Sedó Mejía, Giovanni A; Rojas Lozano, Antonio A; Valenzuela, Enrique Avitia; Vidaurri Ojeda, Alma C

    2010-01-01

    although systemic reactions resulting from hymenoptera stings have been studied extensively, the prevalence of allergic reactions to mosquitoes is unknown. to investigate the prevalence of allergic reactions to Aedes aegypti bites in patients seeking treatment at the Allergy and Clinical Immunology Regional Center of Jose E Gonzalez University Hospital in Monterrey, Mexico. we carried out a cross-sectional, descriptive study that included patients receiving skin tests for aeroallergens; skin sensitivity to mosquito bites was also tested. A questionnaire was used to obtain information about previous allergic reactions to mosquito bites. a total of 482 patients between 2 and 60 years of age were included; 53% were female, 407 (84.4%) had a history of local reactions to mosquito bites. Twelve patients (2.4%) stated a history of large local reaction; three (0.6%) of them with a positive skin prick test, one (0.2%) of those had systemic reaction history to mosquito. Eighty five (17.6%) patients had a positive mosquito skin test and 307 (63.6%) had a positive skin test for at least one aeroallergen. Seventy-eight (91.7%) of the 85 patients with a positive mosquito skin test had a history of local skin reactions to mosquito bite (odds ratio: 2.303 [confidence interval (CI) 1.037-5.10]. There was no statistically significance association between allergic diseases and mosquito allergy. adverse reactions and allergic reactions to mosquito bites occur frequently. However mosquito allergy is low. Further studies are required to determine the prevalence of mosquito allergy in the general population.

  17. Debt financing and sharp currency depreciations: wholly versus partially-owned multinational affiliates

    OpenAIRE

    Hebous, Shafik; Weichenrieder, Alfons J.

    2010-01-01

    Abstract This paper provides empirical evidence on two potential costs of shared ownership of German affiliates abroad. First, in periods of currency crises, wholly-owned affiliates, in contrast to partially-owned affiliates, seem to circumvent financial constraints by accessing capital from their parent companies. In terms of differences in performance regarding sales of both types of firms, wholly-owned affiliates have a significantly better sales performance than partially-owned...

  18. The Start-Up of the first Hematopoietic Stem Cell Transplantation Center in the Iraqi Kurdistan: a Capacity-Building Cooperative Project by the Hiwa Cancer Hospital, Sulaymaniyah, and the Italian Agency for Development Cooperation: an Innovative Approach

    Science.gov (United States)

    Majolino, Ignazio; Othman, Dosti; Rovelli, Attilio; Hassan, Dastan; Rasool, Luqman; Vacca, Michele; Abdalrahman, Nigar; Abdullah, Chra; Ahmed, Zhalla; Ali, Dlir; Ali, Kosar; Broggi, Chiara; Calabretta, Cinzia; Canesi, Marta; Ciabatti, Gloria; Del Fante, Claudia; De Sapio, Elisabetta; Dore, Giovanna; Frigato, Andrea; Gabriel, Marcela; Ipsevich, Francesco; Kareem, Harem; Karim, Dana; Leone, Rosa; Mahmood, Tavan; Manna, Annunziata; Massei, Maria Speranza; Mastria, Andrea; Mohammed, Dereen; Mohammed, Rebar; Najmaddin, Khoshnaw; Noori, Diana; Ostuni, Angelo; Palmas, Angelo; Possenti, Marco; Qadir, Ali; Real, Giorgio; Shrif, Rebwar; Valdatta, Caterina; Vasta, Stefania; Verna, Marta; Vittori, Mariangela; Yousif, Awder; Zallio, Francesco; Calisti, Alessandro; Quattrocchi, Sergio; Girmenia, Corrado

    2017-01-01

    We describe the entire process leading to the start-up of a hematopoietic stem cell transplantation center at the Hiwa Cancer Hospital, in the city of Sulaymaniyah, Kurdistan Iraqi Region. This capacity building project was funded by the Italian Development Cooperation Agency and implemented with the support of the volunteer work of Italian professionals, either physicians, nurses, biologists and technicians. The intervention started in April 2016, was based exclusively on training and coaching on site, that represent a significant innovative approach, and led to a first autologous transplant in June 2016 and to the first allogeneic transplant in October. At the time of reporting, 9 months from the initiation of the project, 18 patients have been transplanted, 15 with an autologous and 3 with an allogeneic graft. The center at the HCH represents the first transplantation center in Kurdistan and the second in wide Iraq. We conclude that international development cooperation may play an important role also in the field of high-technology medicine, and contribute to improved local centers capabilities through country to country scientific exchanges. The methodology to realize this project is innovative, since HSCT experts are brought as volunteers to the center(s) to be started, while traditionally it is the opposite, i.e. the local professionals to be trained are brought to the specialized center(s). PMID:28512560

  19. 12 CFR 717.21 - Affiliate marketing opt-out and exceptions.

    Science.gov (United States)

    2010-01-01

    ... established by the affiliate relating to the marketing of your products or services; (D) Your affiliate is... the federal credit union relating to the marketing of the products and services of all affiliates... used by the service provider in marketing products or services to the federal credit union's...

  20. 12 CFR 334.21 - Affiliate marketing opt-out and exceptions.

    Science.gov (United States)

    2010-01-01

    ... solicitation for marketing purposes to a consumer with whom you have a pre-existing business relationship; (2... 12 Banks and Banking 4 2010-01-01 2010-01-01 false Affiliate marketing opt-out and exceptions. 334... OF GENERAL POLICY FAIR CREDIT REPORTING Affiliate Marketing § 334.21 Affiliate marketing opt-out...

  1. Surgery center joint ventures.

    Science.gov (United States)

    Zasa, R J

    1999-01-01

    Surgery centers have been accepted as a cost effective, patient friendly vehicle for delivery of quality ambulatory care. Hospitals and physician groups also have made them the vehicles for coming together. Surgery centers allow hospitals and physicians to align incentives and share benefits. It is one of the few types of health care businesses physicians can own without anti-fraud and abuse violation. As a result, many surgery center ventures are now jointly owned by hospitals and physician groups. This article outlines common structures that have been used successfully to allow both to own and govern surgery centers.

  2. Quality improvements in decreasing medication administration errors made by nursing staff in an academic medical center hospital: a trend analysis during the journey to Joint Commission International accreditation and in the post-accreditation era

    Directory of Open Access Journals (Sweden)

    Wang HF

    2015-03-01

    Full Text Available Hua-fen Wang,1 Jing-fen Jin,1 Xiu-qin Feng,1 Xin Huang,1 Ling-ling Zhu,2 Xiao-ying Zhao,3 Quan Zhou4 1Division of Nursing, 2Geriatric VIP Ward, Division of Nursing, 3Office of Quality Administration, 4Department of Pharmacy, the Second Affiliated Hospital of Zhejiang University, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People’s Republic of China Background: Medication errors may occur during prescribing, transcribing, prescription auditing, preparing, dispensing, administration, and monitoring. Medication administration errors (MAEs are those that actually reach patients and remain a threat to patient safety. The Joint Commission International (JCI advocates medication error prevention, but experience in reducing MAEs during the period of before and after JCI accreditation has not been reported. Methods: An intervention study, aimed at reducing MAEs in hospitalized patients, was performed in the Second Affiliated Hospital of Zhejiang University, Hangzhou, People’s Republic of China, during the journey to JCI accreditation and in the post-JCI accreditation era (first half-year of 2011 to first half-year of 2014. Comprehensive interventions included organizational, information technology, educational, and process optimization-based measures. Data mining was performed on MAEs derived from a compulsory electronic reporting system. Results: The number of MAEs continuously decreased from 143 (first half-year of 2012 to 64 (first half-year of 2014, with a decrease in occurrence rate by 60.9% (0.338% versus 0.132%, P<0.05. The number of MAEs related to high-alert medications decreased from 32 (the second half-year of 2011 to 16 (the first half-year of 2014, with a decrease in occurrence rate by 57.9% (0.0787% versus 0.0331%, P<0.05. Omission was the top type of MAE during the first half-year of 2011 to the first half-year of 2014, with a decrease by 50% (40 cases versus 20 cases. Intravenous administration error was the

  3. ONER: Tool for Organization Named Entity Recognition from Affiliation Strings in PubMed Abstracts

    CERN Document Server

    Jonnalagadda, Siddhartha; Gonzalez, Graciela

    2010-01-01

    Automatically extracting organization names from the affiliation sentences of articles related to biomedicine is of great interest to the pharmaceutical marketing industry, health care funding agencies and public health officials. It will also be useful for other scientists in normalizing author names, automatically creating citations, indexing articles and identifying potential resources or collaborators. Today there are more than 18 million articles related to biomedical research indexed in PubMed, and information derived from them could be used effectively to save the great amount of time and resources spent by government agencies in understanding the scientific landscape, including key opinion leaders and centers of excellence. Our process for extracting organization names involves multi-layered rule matching with multiple dictionaries. The system achieves 99.6% f-measure in extracting organization names.

  4. Molecular epidemiology of Mycobacterium tuberculosis in the United States-Affiliated Pacific Islands.

    Science.gov (United States)

    Bamrah, Sapna; Desmond, Edward; Ghosh, Smita; France, Anne Marie; Kammerer, J Steve; Cowan, Lauren S; Heetderks, Andrew; Forbes, Alstead; Moonan, Patrick K

    2014-01-01

    The United States-Affiliated Pacific Islands (USAPI) are part of the US National Tuberculosis (TB) Surveillance System and use laboratory services contracted through a cooperative agreement with the Centers for Disease Control and Prevention (CDC). In 2004, the CDC established the National Tuberculosis Genotyping Service, a system to genotype 1 isolate from each culture-confirmed case of TB. To describe the molecular epidemiology of TB in the region, we examined all Mycobacterium tuberculosis isolates submitted for genotyping from January 1, 2004, to December 31, 2008. Over this time period, the USAPI jurisdictions reported 1339 verified TB cases to the National Tuberculosis Surveillance System. Among 419 (31%) reported culture-confirmed TB cases, 352 (84%) had complete genotype results. Routine TB genotyping allowed, for the first time, an exploration of the molecular epidemiology of TB in the USAPI.

  5. 厦门市医院承办社区卫生服务中心人力资源现状调查%Investigation on human resources of municipal hospital delivered community health center in Xiamen

    Institute of Scientific and Technical Information of China (English)

    林民强

    2014-01-01

    Objectives:To learn status quo and problems on human resources of municipal hospital delivered community health center in Xiamen and give evidence on human resources reform in community health center. Methods:Self designed questionnaire was used in 15 municipal hospital delivered community health centers to investigate human resources status. Data were analyzed by Excel. Results:Problems in Xiamen community health centers can be described as insufficient and under qualified of human resources. Primary education and title staffs are still the main body. Conclusions:It needs to transfer the conception of high value on hospital and look down upon community health center, make active human resources policy, strengthen integrated hospital and community health center management and continuous improve community health center human resources training to promote human resources' capacity in community health center.%目的:了解厦门市医院承办社区卫生服务中心人力资源的现状及存在问题,为社区卫生服务中心人力资源的改革发展提供依据。方法:采用自制调查问卷,对2012年厦门市15家医院承办社区卫生服务中心人员状况进行调查,运用Excel进行数据统计分析。结果:厦门市社区卫生服务中心人力资源总量不足,人员的质量较差,仍以低学历和低职称人员为主。结论:通过转变“重医院、轻社区”观念、制定积极的人才政策、强化医院-社区一体化管理、不断完善社区人才的培养政策等策略加强社区卫生服务中心人才队伍建设,提高其卫生服务水平。

  6. Manipulating the affiliative interactions of group-housed rhesus macaques using positive reinforcement training techniques.

    Science.gov (United States)

    Schapiro, S J; Perlman, J E; Boudreau, B A

    2001-11-01

    Social housing, whether continuous, intermittent, or partial contact, typically provides many captive primates with opportunities to express affiliative behaviors, important components of the species-typical behavioral repertoire. Positive reinforcement training techniques have been successfully employed to shape many behaviors important for achieving primate husbandry goals. The present study was conducted to determine whether positive reinforcement training techniques could also be employed to alter levels of affiliative interactions among group-housed rhesus macaques. Twenty-eight female rhesus were divided into high (n = 14) and low (n = 14) affiliators based on a median split of the amount of time they spent affiliating during the baseline phase of the study. During the subsequent training phase, half of the low affiliators (n = 7) were trained to increase their time spent affiliating, and half of the high affiliators (n = 7) were trained to decrease their time spent affiliating. Trained subjects were observed both during and outside of training sessions. Low affiliators significantly increased the amount of time they spent affiliating, but only during nontraining sessions. High affiliators on the other hand, significantly decreased the amount of time they spent affiliating, but only during training sessions. These data suggest that positive reinforcement techniques can be used to alter the affiliative behavior patterns of group-housed, female rhesus monkeys, although the two subgroups of subjects responded differently to the training process. Low affiliators changed their overall behavioral repertoire, while high affiliators responded to the reinforcement contingencies of training, altering their proximity patterns but not their overall behavior patterns. Thus, positive reinforcement training can be used not only as a means to promote species-typical or beneficial behavior patterns, but also as an important experimental manipulation to facilitate systematic

  7. Economic Burden of Road Traffic Accidents; Report from a Single Center from South Eastern Iran

    Directory of Open Access Journals (Sweden)

    Aliyeh Sargazi

    2016-01-01

    Full Text Available Objective: To determine the economic burden of road traffic accidents (RTAs in patients admitted to a single center in south eastern Iran. Methods: This cross-sectional study was conducted in Amir-Al-Momenin hospital of Zabol affiliated with Zabol University of Medical Sciences during a 12-month period from April 2012 to April 2013. All the RTAs patients who were admitted to our emergency department were included. The direct expenses of hospital care were recorded according to their medical charts and the accountant registration information. Data are presented according to different RTAs characteristics. Results: Overall 1155 patients were included in the current study with mean age of 36.7 ± 5.14 years among whom there were 673(58.3% men and 482 (41.7% women. The annual incidence of RTAs were calculated to be 288 per 100,000 population. The RTAs economic burden in our center was 589,448.49 USD which accounted for 10.4% of total hospital expenses during the study period. The money spend on RTAs in our center was 130 times more than gross national income per capita. Cost of each patient in road traffic was 15 times more than cost of an average patient of the hospital in other sections. Conclusion: With considerable high ratio of accidents in Zabol, proper intervention is needed for controlling and preventing RTAs in order to decrease its injuries, impact and the associated economic burden.

  8. Hospital infection and nursing measures in hemodialysis center%血液透析患者医院感染分析与护理措施

    Institute of Scientific and Technical Information of China (English)

    金素萍; 王如

    2011-01-01

    Objective To explore hospital infection of patients with chronic renal failure in hemodialysis center, investigate its risk factors and develop appropriate nursing measures. Methods The data of 109 cases who received hemodialysis from January 2007 to September 2009. Were retrospectively analyzed Results There were 51 infection cases in 109 hemodialysis patients. The infection rate was 46.78%. The main site of infection was respiratory tract (39. 7%), followed by vascular access (22.4%), urinary tract (15.5%), blood virus infection (10.3%) and intestinal tract (6.9%). The infection rate was closely related to diabetic nephropathy, anemia, hypopro-teinemia and senility. There were statistically significant differences (P<0.05). Conclusion The key to prevent hospital infection is the strengthening of the environmental management, reasonable nutrition for better immunity and good catheter nursing, and the strengthening of nursing management of HBV, HCV, HIV-positive patients, good hand hygiene and etc.%目的 了解慢性肾衰竭血液透析患者医院感染的情况,探讨其相关危险因素,制定相应护理措施.方法 对2007年1月~2009年9月行血液透析治疗的109例患者资料进行回顾性分析.结果 109例血液透析患者发生医院感染51例,感染率为46.78%,感染发生的主要部位是呼吸道(39.7%)、其次是血管通路感染(22.4%)、泌尿道感染(15.5%)、血液病毒感染(10.3%)、肠道感染(6.9%);原发病为糖尿病肾病、贫血越严重、白蛋白越低、年龄越大者医院感染率越高,差异均有统计学意义(P<0.05).结论 加强环境管理、合理营养提高抵抗力、做好深静脉置管患者的导管护理、加强HBV、HCV、HIV阳性患者护理管理、强化手卫生等护理措施的落实是减少血液透析患者医院感染发生的关键.

  9. [Hydatid fertility and protoscolex viability in humans: study of 78 hydatid samples collected between 2005 and 2012 and analyzed at the parasitology laboratory of the Mustapha University Hospital Center of Algiers].

    Science.gov (United States)

    Zait, H; Boulahbel, M; Zait, F; Achir, I; Guerchani, M T; Chaouche, H; Ladjadje, Y; Hamrioui, B

    2013-05-01

    An analysis at the Mustapha University Hospital Center of Algiers examined 78 hydatid samples collected between 2005 and 2012 to determine the fertility rate of metacestodes and the viability of protoscolices. The fertility rate of the hydatid cysts in humans was 88.4% and the protoscolex viability rate 74.5%. The fertility and viability rates found here are high, despite the use of scolicides.

  10. Low glycemic index treatment for seizure control in Angelman syndrome: A case series from the Center for Dietary Therapy of Epilepsy at the Massachusetts General Hospital.

    Science.gov (United States)

    Grocott, Olivia R; Herrington, Katherine S; Pfeifer, Heidi H; Thiele, Elizabeth A; Thibert, Ronald L

    2017-03-01

    The low glycemic index treatment, a dietary therapy that focuses on glycemic index and reduced carbohydrate intake, has been successful in reducing seizure frequency in the general epilepsy population. Epilepsy is a common feature of Angelman syndrome and seizures are often refractory to multiple medications, especially in those with maternal deletions. Dietary therapy has become a more frequently used option for treating epilepsy, often in combination with other antiepileptic drugs, due to its efficacy and favorable side effect profile. This study aimed to assess the effectiveness of the low glycemic index treatment for seizure control in Angelman syndrome. Through a retrospective medical record review of 23 subjects who utilized the low glycemic index treatment at the Clinic and Center for Dietary Therapy of Epilepsy at the Massachusetts General Hospital, we found that the high level of seizure control and favorable side effect profile make the low glycemic index treatment a viable treatment for seizures in Angelman syndrome. The majority of subjects in our cohort experienced some level of seizure reduction after initiating the diet, 5 (22%) maintained complete seizure freedom, 10 (43%) maintained seizure freedom except in the setting of illness or non-convulsive status epilepticus, 7 (30%) had a decrease in seizure frequency, and only 1 (4%) did not have enough information to determine seizure control post-initiation. The low glycemic index treatment monotherapy was successful for some subjects in our cohort but most subjects used an antiepileptic drug concurrently. Some subjects were able to maintain the same level of seizure control on a liberalized version of the low glycemic index treatment which included a larger amount of low glycemic carbohydrates. No correlation between the level of carbohydrate restriction and level of seizure control was found. Few subjects experienced side effects and those that did found them to be mild and easily treated. The

  11. Non-tuberculous mycobacteria I: one year clinical isolates identification in Tertiary Hospital Aids Reference Center, Rio de Janeiro, Brazil, in pre highly active antiretroviral therapy era

    Directory of Open Access Journals (Sweden)

    Ferreira Rosa Maria Carvalho

    2002-01-01

    Full Text Available The aim of this study was to determine the prevalence of non-tuberculous mycobacteria (NTM isolates at University Hospital, Reference Center for Aids in Rio de Janeiro, Brazil, during one year. We used standard biochemical tests for species identification and IS1245 PCR amplification was applied as a Mycobacterium avium specific identification marker. Four hundred and four specimens from 233 patients yielded acid-fast bacilli growth. M. tuberculosis was identified in 85% of the patients and NTM in 15%. NTM disseminated infection was a common event correlated with human immunodeficiency virus (HIV infected patients and only in HIV negative patients the source of NTM was non sterile site. M. avium complex (MAC was biochemically identified in 57.8% (49/83 of NTM isolates, most of them from sterile sites (75.5%, and in 94% (46/49 the IS 1245 marker specific for M. avium was present. Twenty NTM strains showed a MAC biochemical pattern with the exception of a urease-positive (99% of MAC are urease-negative, however IS1245 was detected in 96% of the strains leading to their identification as M. avium. In this group differences in NTM source was not significant. The second most frequently isolated NTM was identified as M. scrofulaceum (7.2%, followed by M. terrae (3.6%, M. gordonae (2.4%, M. chelonae (1.2%, M. fortuitum (1.2% and one strain which could not be identified. All were IS1245 negative except for one strain identified as M. scrofulaceum. It is interesting to note that non-sterile sites were the major source of these isolates (92.8%. Our finding indicated that M. avium is still the major atypical species among in the MAC isolates recovered from Brazilian Aids patients without highty active antiretroviral therapy schema. Some discrepancies were seen between the identification methods and further investigations must be done to better characterize NTM isolates using other phenotypic and genotypic methods.

  12. Implementation of a program for type 2 diabetes based on the Chronic Care Model in a hospital-centered health care system: "the Belgian experience".

    Science.gov (United States)

    Sunaert, Patricia; Bastiaens, Hilde; Feyen, Luc; Snauwaert, Boris; Nobels, Frank; Wens, Johan; Vermeire, Etienne; Van Royen, Paul; De Maeseneer, Jan; De Sutter, An; Willems, Sara

    2009-08-23

    Most research publications on Chronic Care Model (CCM) implementation originate from organizations or countries with a well-structured primary health care system. Information about efforts made in countries with a less well-organized primary health care system is scarce. In 2003, the Belgian National Institute for Health and Disability Insurance commissioned a pilot study to explore how care for type 2 diabetes patients could be organized in a more efficient way in the Belgian healthcare setting, a setting where the organisational framework for chronic care is mainly hospital-centered. Process evaluation of an action research project (2003-2007) guided by the CCM in a well-defined geographical area with 76,826 inhabitants and an estimated number of 2,300 type 2 diabetes patients. In consultation with the region a program for type 2 diabetes patients was developed. The degree of implementation of the CCM in the region was assessed using the Assessment of Chronic Illness Care survey (ACIC). A multimethod approach was used to evaluate the implementation process. The resulting data were triangulated in order to identify the main facilitators and barriers encountered during the implementation process. The overall ACIC score improved from 1.45 (limited support) at the start of the study to 5.5 (basic support) at the end of the study. The establishment of a local steering group and the appointment of a program manager were crucial steps in strengthening primary care. The willingness of a group of well-trained and motivated care providers to invest in quality improvement was an important facilitator. Important barriers were the complexity of the intervention, the lack of quality data, inadequate information technology support, the lack of commitment procedures and the uncertainty about sustainable funding. Guided by the CCM, this study highlights the opportunities and the bottlenecks for adapting chronic care delivery in a primary care system with limited structure. The

  13. Implementation of a program for type 2 diabetes based on the Chronic Care Model in a hospital-centered health care system: "the Belgian experience"

    Directory of Open Access Journals (Sweden)

    Van Royen Paul

    2009-08-01

    Full Text Available Abstract Background Most research publications on Chronic Care Model (CCM implementation originate from organizations or countries with a well-structured primary health care system. Information about efforts made in countries with a less well-organized primary health care system is scarce. In 2003, the Belgian National Institute for Health and Disability Insurance commissioned a pilot study to explore how care for type 2 diabetes patients could be organized in a more efficient way in the Belgian healthcare setting, a setting where the organisational framework for chronic care is mainly hospital-centered. Methods Process evaluation of an action research project (2003–2007 guided by the CCM in a well-defined geographical area with 76,826 inhabitants and an estimated number of 2,300 type 2 diabetes patients. In consultation with the region a program for type 2 diabetes patients was developed. The degree of implementation of the CCM in the region was assessed using the Assessment of Chronic Illness Care survey (ACIC. A multimethod approach was used to evaluate the implementation process. The resulting data were triangulated in order to identify the main facilitators and barriers encountered during the implementation process. Results The overall ACIC score improved from 1.45 (limited support at the start of the study to 5.5 (basic support at the end of the study. The establishment of a local steering group and the appointment of a program manager were crucial steps in strengthening primary care. The willingness of a group of well-trained and motivated care providers to invest in quality improvement was an important facilitator. Important barriers were the complexity of the intervention, the lack of quality data, inadequate information technology support, the lack of commitment procedures and the uncertainty about sustainable funding. Conclusion Guided by the CCM, this study highlights the opportunities and the bottlenecks for adapting chronic care

  14. Length of stay and cost for surgical site infection after abdominal and cardiac surgery in Japanese hospitals: multi-center surveillance.

    Science.gov (United States)

    Kusachi, Shinya; Kashimura, Nobuichi; Konishi, Toshiro; Shimizu, Junzo; Kusunoki, Masato; Oka, Masaaki; Wakatsuki, Toshiro; Kobayashi, Junjiro; Sawa, Yoshiki; Imoto, Hiroshi; Motomura, Noboru; Makuuchi, Haruo; Tanemoto, Kazuo; Sumiyama, Yoshinobu

    2012-08-01

    This study evaluated the influence of surgical site infections (SSIs) after abdominal or cardiac surgery on the post-operative duration of hospitalization and cost. A retrospective 1:1 matched case-control study of length of stay and healthcare expenditures for patients who were discharged from nine hospitals, between April 1, 2006 and March 31, 2008, after undergoing abdominal or cardiac surgery and who did and did not have a SSI. Information was obtained from 246 pairs of patients who had undergone abdominal surgery and 27 pairs of patients who had undergone cardiac surgery. Overall, the mean post-operative hospitalization was 20.7 days longer and the mean post-operative healthcare expenditure was $8,791 higher in the SSI group than for the SSI-free group. Among the patients who had undergone abdominal surgery, development of SSI extended the average hospitalization by 17.6 days and increased the average healthcare expenditure by $6,624. Among the patients who had undergone cardiac surgery, SSI extended the post-operative hospitalization by an average of 48.9 days and increased the post-operative healthcare expenditure by an average of $28,534. Under the current healthcare system in Japan, the development of SSI after abdominal surgery necessitates extension of hospitalization two-fold and increases the post-operative healthcare expenditure 2.5-fold. Development of SSI after cardiac surgery necessitates extension of hospitalization fourfold and increases the healthcare expenditure six-fold.

  15. Information System Training, Usage, and Satisfaction: An Exploratory Study of the Hospitality Industry.

    Science.gov (United States)

    Gardner, William L., III; Gundersen, David E.

    1995-01-01

    Discusses use of a mail survey to study the extent to which the hospitality industry employs various information technologies, including computer-mediated communication systems. Finds that hotel/motel size and chain affiliation are related to information system complexity, and that chain-affiliated hotels provide less computer and…

  16. Towards Producing Black Nobel Laureates Affiliated with ``African Universities''

    Science.gov (United States)

    Kenneth, Jude

    While Africa has produced a handful Nobel laureate in literature and peace, it has continued to shy away from producing any in the other categories. The reason is not farfetched; our university system is not up to standard. It is saddening that in this century, African countries place emphasis on certificates and not on knowledge. This has made the continent produce students that lack the intellectual capability, experimental ability, fundamental training, creativity, and motivation to excel except they get a foreign training. It is this backdrop that precipitated the research into the methods of teaching and research in universities across Africa. The study is designed to identify the problems and proffer solution to them. Two important questions immediately come to mind. (1) What factors account for the difficulty in producing Nobel laureates affiliated with African universities? (2) What strategies could be adopted to improve teaching and research in African universities? Several factors were investigated which revolve around funding, the competence of the lecturers, quality of students admitted, attitude of the students, parents and government. Nigerian universities were investigated and important deductions were made. During the study an inquiry was made on the method of instruction at various universities, from result obtained, the study therefore concluded that adequate funding, the presence of erudite scholars and brilliant minds will produce future Nobel laureate affiliated with the continent. The study therefore recommended admission and employment of only students and lecturers who have got a thing for academics into the universities and adequate funding of universities and research centres.

  17. Characterizing socially avoidant and affiliative responses to social exclusion

    Directory of Open Access Journals (Sweden)

    Katherine Elizabeth Powers

    2012-07-01

    Full Text Available Humans have a fundamental need for social relationships. From an evolutionary standpoint, the drive to form social connections may have evolved as an adaptive mechanism to promote survival, as group membership afforded the benefits of shared resources and security. Thus, rejection from social groups is especially detrimental, rendering the ability to detect threats to social relationships and respond in adaptive ways critical. Previous research indicates that social exclusion alters cognition and behavior in specific ways that may initially appear contradictory. That is, although some studies have found that exclusionary social threats lead to withdrawal from the surrounding social world, other studies indicate that social exclusion motivates affiliative social behavior. Here, we review the existing evidence supporting accounts of avoidant and affiliative responses, and highlight the conditions under which both categories of responses may be simultaneously employed. Then, we review the neuroimaging research implicating specific brain regions underlying the ability to detect and adaptively respond to threats of social exclusion. Collectively, these findings are suggestive of neural system highly attuned to social context and capable of motivating flexible behavioral responses.

  18. Characterizing socially avoidant and affiliative responses to social exclusion.

    Science.gov (United States)

    Powers, Katherine E; Heatherton, Todd F

    2012-01-01

    Humans have a fundamental need for social relationships. From an evolutionary standpoint, the drive to form social connections may have evolved as an adaptive mechanism to promote survival, as group membership afforded the benefits of shared resources and security. Thus, rejection from social groups is especially detrimental, rendering the ability to detect threats to social relationships and respond in adaptive ways critical. Previous research indicates that social exclusion alters cognition and behavior in specific ways that may initially appear contradictory. That is, although some studies have found that exclusionary social threats lead to withdrawal from the surrounding social world, other studies indicate that social exclusion motivates affiliative social behavior. Here, we review the existing evidence supporting accounts of avoidant and affiliative responses, and highlight the conditions under which both categories of responses may be simultaneously employed. Then, we review the neuroimaging research implicating specific brain regions underlying the ability to detect and adaptively respond to threats of social exclusion. Collectively, these findings are suggestive of neural system highly attuned to social context and capable of motivating flexible behavioral responses.

  19. A Decomposition of Hospital Profitability: An Application of DuPont Analysis to the US Market.

    Science.gov (United States)

    Turner, Jason; Broom, Kevin; Elliott, Michael; Lee, Jen-Fu

    2015-01-01

    This paper evaluates the drivers of profitability for a large sample of U.S. hospitals. Following a methodology frequently used by financial analysts, we use a DuPont analysis as a framework to evaluate the quality of earnings. By decomposing returns on equity (ROE) into profit margin, total asset turnover, and capital structure, the DuPont analysis reveals what drives overall profitability. Profit margin, the efficiency with which services are rendered (total asset turnover), and capital structure is calculated for 3,255 U.S. hospitals between 2007 and 2012 using data from the Centers for Medicare & Medicaid Services' Healthcare Cost Report Information System (CMS Form 2552). The sample is then stratified by ownership, size, system affiliation, teaching status, critical access designation, and urban or non-urban location. Those hospital characteristics and interaction terms are then regressed (OLS) against the ROE and the respective DuPont components. Sensitivity to regression methodology is also investigated using a seemingly unrelated regression. When the sample is stratified by hospital characteristics, the results indicate investor-owned hospitals have higher profit margins, higher efficiency, and are substantially more leveraged. Hospitals in systems are found to have higher ROE, margins, and efficiency but are associated with less leverage. In addition, a number of important and significant interactions between teaching status, ownership, location, critical access designation, and inclusion in a system are documented. Many of the significant relationships, most notably not-for-profit ownership, lose significance or are predominately associated with one interaction effect when interaction terms are introduced as explanatory variables. Results are not sensitive to the alternative methodology. The results of the DuPont analysis suggest that although there appears to be convergence in the behavior of NFP and IO hospitals, significant financial differences remain

  20. Analysis of Administrative Information Flow in a Military Medical Center Pursuant to Design of a Data Base Management System That will Ultimately Support a Hospital Information System.

    Science.gov (United States)

    1983-12-01

    Myers, neurosurgeon, has noted symp- toms of bradicardia in a six month old female. The symtoms suggest pressure is occurring in the posterior fossa...Direct- orate Aerospace Medicine, Directorate Physiological Train- ing, Directorate Hospital Services, Directorate Veterinary Services, Directorate

  1. Introduction for "Reiki at University Medical Center, Tucson, Arizona, a magnet hospital": Mega R. Mease is interviewed by William Lee Rand.

    Science.gov (United States)

    Vitale, Anne

    2011-01-01

    There is a sustained interest in the use of Reiki among US consumers and health care providers and lay practitioners alike. As a result, hospitals and other health care institutions are incorporating Reiki into patient care services toward the promotion of caring-healing environments. Variations in hospital-based program structures with Reiki are possible and can enhance the use of Reiki into traditional care settings.

  2. Hospital Variation in Home-Time After Acute Ischemic Stroke: Insights From the PROSPER Study (Patient-Centered Research Into Outcomes Stroke Patients Prefer and Effectiveness Research).

    Science.gov (United States)

    O'Brien, Emily C; Xian, Ying; Xu, Haolin; Wu, Jingjing; Saver, Jeffrey L; Smith, Eric E; Schwamm, Lee H; Peterson, Eric D; Reeves, Mathew J; Bhatt, Deepak L; Maisch, Lesley; Hannah, Deidre; Lindholm, Brianna; Olson, DaiWai; Prvu Bettger, Janet; Pencina, Michael; Hernandez, Adrian F; Fonarow, Gregg C

    2016-10-01

    Stroke survivors identify home-time as a high-priority outcome; there are limited data on factors influencing home-time and home-time variability among discharging hospitals. We ascertained home-time (ie, time alive out of a hospital, inpatient rehabilitation facility, or skilled nursing facility) at 90 days and 1-year post discharge by linking data from Get With The Guidelines-Stroke Registry patients (≥65 years) to Medicare claims. Using generalized linear mixed models, we estimated adjusted mean home-time for each hospital. Using linear regression, we examined associations between hospital characteristics and risk-adjusted home-time. We linked 156 887 patients with ischemic stroke at 989 hospitals to Medicare claims (2007-2011). Hospital mean home-time varied with an overall unadjusted median of 59.5 days over the first 90 days and 270.2 days over the first year. Hospital factors associated with more home-time over 90 days included higher annual stroke admission volume (number of ischemic stroke admissions per year); South, West, or Midwest geographic regions (versus Northeast); and rural location; 1-year patterns were similar. Lowest home-time quartile patients (versus highest) were more likely to be older, black, women, and have more comorbidities and severe strokes. Home-time variation decreased after risk adjustment (interquartile range, 57.4-61.4 days over 90 days; 266.3-274.2 days over 1 year). In adjusted analyses, increasing annual stroke volume and rural location were associated with significantly more home-time. In older ischemic stroke survivors, home-time post discharge varies by hospital annual stroke volume, severity of case-mix, and region. In adjusted analyses, annual ischemic stroke admission volume and rural location were associated with more home-time post stroke. © 2016 American Heart Association, Inc.

  3. In-hospital Surgical Delay Does Not Increase the Risk for Perforated Appendicitis in Children: A Single-center Retrospective Cohort Study.

    Science.gov (United States)

    Almström, Markus; Svensson, Jan F; Patkova, Barbora; Svenningsson, Anna; Wester, Tomas

    2017-03-01

    To investigate the correlation between in-hospital surgical delay before appendectomy for suspected appendicitis and the finding of perforated appendicitis in children. All children undergoing acute appendectomy for suspected acute appendicitis at Karolinska University Hospital, Stockholm, Sweden from 2006 to 2013 were reviewed for the exposure of surgical delay. Primary endpoint was the histopathologic finding of perforated appendicitis. The main explanatory variable was in-hospital surgical delay, using surgery within 12 hours as reference. Secondary endpoints were postoperative wound infection, intra-abdominal abscess, reoperation, length of hospital stay, and readmission. To adjust for selection bias, a logistic regression model was created to estimate odds ratios for the main outcome measures. Missing data were replaced using multiple imputation. The study comprised 2756 children operated for acute appendicitis. Six hundred sixty-one (24.0%) had a histopathologic diagnosis of perforated appendicitis. In the multivariate logistic regression analysis, increased time to surgery was not associated with increased risk of histopathologic perforation. There was no association between the timing of surgery and postoperative wound infection, intra-abdominal abscess, reoperation, or readmission. In-hospital delay of acute appendectomy in children was not associated with an increased rate of histopathologic perforation. Timing of surgery was not an independent risk factor for postoperative complications. The results were not dependent on the magnitude of the surgical delay. The findings are analogous with previous findings in adults and may aid the utilization of available hospital- and operative resources.

  4. 加强120急救中心院前急救医疗服务体系的管理%Strengthening administration of pre-hospital care medical service system in 120 first-aid center

    Institute of Scientific and Technical Information of China (English)

    赵明锐

    2012-01-01

    OBJECTIVE To enhance emergency management and establish and further improve pre-hospital emergency medical service center management system,so as to provide better service to patients. METHODS This article summarized the common security risks of the work in 120 emergency centers, and targeted to explore the corresponding emergency medical service management solutions. RESULTS To improve 120 emergency operations and management, it was necessary to establish and improve pre-hospital emergency medical service system, improve the care management system, emergency aid mechanism and regulate treatment. CONCLUSION 120 emergency center pre-hospital emergency medical service system plays an important role in the rescue capabilities of hospitals.%目的 加强急救管理,建立并完善急救中心院前急救医疗服务体系,进一步为患者服务.方法 总结120急救中心园区急救工作中的常见安全隐患,并有针对性急救医疗服务管理对策.结果 主要安全隐患为急救人员急救意识不强、信息提取不清晰、操作技能不熟练等;针对上述问题,应建立并完善院前急救医疗服务体系,健全护理管理体系,加强教育与培训,完善紧急救援机制和规范救治工作.结论 做好120急救中心院前急救医疗服务体系的运行和管理,对提升突发事件医疗救援能力具有重要意义.

  5. Desvendando uma história de exclusão: a experiência do Centro de Documentação e Pesquisa do Hospital-Colônia Itapuã Revealing a history of exclusion: the experience at Hospital-Colônia Itapuã Data and Research Center

    Directory of Open Access Journals (Sweden)

    Arselle de Andrade da Fontoura

    2003-01-01

    Full Text Available Fundado em maio de 1940, no município de Viamão, Rio Grande do Sul, o Hospital Colônia Itapuã foi criado para abrigar os portadores do mal de Hansen. Construído para funcionar como uma microcidade, o hospital foi palco de inúmeras histórias de vida e trabalho. Os fragmentos destas trajetórias coletivas e individuais estão sendo resgatados desde 1999, quando foi implementado o Centro de Documentação e Pesquisa (Cedope/HCI. É através das atividades deste centro que propomos apresentar uma aproximação com a história do hospital e daqueles que viveram e ainda vivem nesta instituição.Inaugurated in May 1940, in Viamão Municipality in Rio Grande do Sul, Hospital Colônia Itapuã was meant to shelter Hansen's disease patients. Built in order to work as a small town, the hospital was the stage of several life and work histories. The fragments of these collective and individual experiences have been recovered since 1999, when Centro de Documentação e Pesquisa (Cedope/HCI was first implemented. It is through the center activities that we propose a comparative study of the history of the hospital and the history of those who lived and those who still live in it.

  6. Noninvasive positive-pressure ventilation in clinical practice at a large university-affiliated Brazilian hospital

    Directory of Open Access Journals (Sweden)

    Liria Yuri Yamauchi

    2012-07-01

    Full Text Available OBJECTIVES: To describe noninvasive positive-pressure ventilation use in intensive care unit clinical practice, factors associated with NPPV failure and the associated prognosis. METHODS: A prospective cohort study. RESULTS: Medical disorders (59% and elective surgery (21% were the main causes for admission to the intensive care unit. The main indications for the initiation of noninvasive positive-pressure ventilation were the following: post-extubation, acute respiratory failure and use as an adjunctive technique to chest physiotherapy. The noninvasive positive-pressure ventilation failure group was older and had a higher Simplified Acute Physiology Score II score. The noninvasive positive-pressure ventilation failure rate was 35%. The main reasons for intubation were acute respiratory failure (55% and a decreased level of consciousness (20%. The noninvasive positive-pressure ventilation failure group presented a shorter period of noninvasive positive-pressure ventilation use than the successful group [three (2-5 versus four (3-7 days]; they had lower levels of pH, HCO3 and base excess, and the FiO2 level was higher. These patients also presented lower PaO2:FiO2 ratios; on the last day of support, the inspiratory positive airway pressure and expiratory positive airway pressure were higher. The failure group also had a longer average duration of stay in the intensive care unit [17 (10-26 days vs. 8 (5-14 days], as well as a higher mortality rate (9 vs. 51%. There was an association between failure and mortality, which had an odds ratio (95% CI of 10.6 (5.93 -19.07. The multiple logistic regression analysis using noninvasive positive pressure ventilation failure as a dependent variable found that treatment tended to fail in patients with a Simplified Acute Physiology Score II$34, an inspiratory positive airway pressure level > 15 cmH2O and pH 34, pH<7.40 and higher inspiratory positive airway pressure levels were associated with failure.

  7. 75 FR 12305 - Application Nos. and Proposed Exemptions; D-11500, Carle Foundation Hospital & Affiliates Pension...

    Science.gov (United States)

    2010-03-15

    ... are received, and they can be retrieved by most Internet search engines. The Department will make no..., and in accordance with procedures set forth in 29 CFR part 2570, subpart B (55 FR 32836, 32847, August... accordance with the procedures set forth in 29 CFR part 2570 subpart B (55 FR 32836, 32847, August 10,...

  8. Cost analysis of awake versus asleep deep brain stimulation: a single academic health center experience.

    Science.gov (United States)

    Jacob, R Lorie; Geddes, Jonah; McCartney, Shirley; Burchiel, Kim J

    2016-05-01

    OBJECT The objective of this study was to compare the cost of deep brain stimulation (DBS) performed awake versus asleep at a single US academic health center and to compare costs across the University HealthSystem Consortium (UHC) Clinical Database. METHODS Inpatient and outpatient demographic and hospital financial data for patients receiving a neurostimulator lead implant (from the first quarter of 2009 to the second quarter of 2014) were collected and analyzed. Inpatient charges included those associated with International Classification of Diseases, Ninth Revision (ICD-9) procedure code 0293 (implantation or replacement of intracranial neurostimulator lead). Outpatient charges included all preoperative charges ≤ 30 days prior to implant and all postoperative charges ≤ 30 days after implant. The cost of care based on reported charges and a cost-to-charge ratio was estimated. The UHC database was queried (January 2011 to March 2014) with the same ICD-9 code. Procedure cost data across like hospitals (27 UHC hospitals) conducting similar DBS procedures were compared. RESULTS Two hundred eleven DBS procedures (53 awake and 158 asleep) were performed at a single US academic health center during the study period. The average patient age ( ± SD) was 65 ± 9 years old and 39% of patients were female. The most common primary diagnosis was Parkinson's disease (61.1%) followed by essential and other forms of tremor (36%). Overall average DBS procedure cost was $39,152 ± $5340. Asleep DBS cost $38,850 ± $4830, which was not significantly different than the awake DBS cost of $40,052 ± $6604. The standard deviation for asleep DBS was significantly lower (p ≤ 0.05). In 2013, the median cost for a neurostimulator implant lead was $34,052 at UHC-affiliated hospitals that performed at least 5 procedures a year. At Oregon Health & Science University, the median cost was $17,150 and the observed single academic health center cost for a neurostimulator lead implant was

  9. MRI-Arthroscopic Correlation in Rotator Cuff Tendon Pathologies; A Comparison between Various Centers

    Directory of Open Access Journals (Sweden)

    Sepideh Sefidbakht

    2016-04-01

    Full Text Available Background: Magnetic resonance imaging (MRI has long been considered a perfect imaging study for evaluation of shoulder pathologies despite occasional discrepancies between MR reports and arthroscopic findings. In this study we aim to evaluate impact of imaging center as an indicator of image quality on accuracy of MRI reports in diagnosis of rotator cuff tendon pathologies. Methods: We reviewed MR reports of 64 patients who underwent arthroscopy in university center hospital. MRIs were done in various centers including both university-affiliated and out-centers. All studies were reported by two radiologists in consensus unaware of the arthroscopic results or previous reports. An inter-observer agreement analysis using the kappa statistics was performed to determine consistency among imaging and surgical reports. Results: Kappa values for out-centers were as follows: 0.785 for biceps, 0.469 for suscapularis, 0.846 for supraspinatus and 0.785 for infraspinatus tendons. In university centers values were 0.799 for biceps, 0.802 for suscapularis, 0.789 for supraspinatus and 0.770 for infraspinatus tendons. Conclusion: Image reporting in university centers with proficient sequences increased accuracy of diagnosis in 3/4 of evaluated features and showed subtle decreased inter-observer agreement in 1/4 of features. Uniformity of the scanners and protocols as well as evaluation on a workstation rather than hard copies cumulatively resulted in a meaningful increase in the accuracy of the same radiologists in diagnosis of rotator cuff tendon tear.

  10. College/school of pharmacy affiliation and community pharmacies' involvement in public health activities.

    Science.gov (United States)

    Westrick, Salisa C; Mount, Jeanine; Watcharadamrongkun, Suntaree

    2009-11-12

    To examine the relationship between pharmacy college/school affiliation and community pharmacies' involvement in immunization and emergency preparedness activities. Telephone interviews were completed with 1,704 community pharmacies randomly sampled from 17 states to determine the pharmacies' involvement in immunization promotion, vaccine distribution, in-house immunization delivery, and health emergency preparedness and response, affiliation with college/school of pharmacy, and selected pharmacy and public health-related characteristics. Pharmacy college/school-affiliated community pharmacies were more likely than non-affiliated pharmacies to participate in immunization and emergency preparedness when controlling for pharmacy characteristics. College/school affiliation generally became nonsignificant, however, when public health-related characteristics were included in the analysis. Affiliation with a college/school of pharmacy was related to community pharmacies' involvement in immunization and emergency preparedness.

  11. Comparing Affiliate Stigma Between Family Caregivers of People With Different Severe Mental Illness in Taiwan.

    Science.gov (United States)

    Chang, Chih-Cheng; Yen, Cheng-Fang; Jang, Fong-Lin; Su, Jian-An; Lin, Chung-Ying

    2017-07-01

    The family caregivers of people with mental illness may internalize the public stereotypes into the affiliate stigma (i.e., the self-stigma of family members). This study aimed to compare the affiliate stigma across schizophrenia, bipolar disorder, and major depressive disorder, and to investigate potential factors associated with affiliate stigma. Each caregiver of family members with schizophrenia (n = 215), bipolar disorder (n = 85), and major depressive disorder (n = 159) completed the Affiliate Stigma Scale, Rosenberg Self-Esteem Scale, Caregiver Burden Inventory, Taiwanese Depression Questionnaire, and Beck Anxiety Inventory. After controlling for potential confounders, the hierarchical regression models showed that caregivers of a family member with schizophrenia had a higher level of affiliate stigma than those of bipolar disorder (β = -0.109; p stigma. The affiliate stigma of caregivers is associated with their self-esteem, caregiver burden, and by the diagnosis.

  12. "Affective contingencies in the affiliative domain: Physiological assessment, associations with the affiliation motive, and prediction of behavior": Correction to Dufner et al. (2015).

    Science.gov (United States)

    2016-06-01

    Reports an error in "Affective contingencies in the affiliative domain: Physiological assessment, associations with the affiliation motive, and prediction of behavior" by Michael Dufner, Ruben C. Arslan, Birk Hagemeyer, Felix D. Schönbrodt and Jaap J. A. Denissen (Journal of Personality and Social Psychology, 2015[Oct], Vol 109[4], 662-676). In this article an erroneous statement was made regarding the high cutoff filter for the EMG raw signal. The high cutoff filter reported in Appendix B in the Technical Details of the EMG Recording Procedure section should be 300 Hz. (The following abstract of the original article appeared in record 2015-37761-001.) According to classical motive disposition theory, individuals differ in their propensity to derive pleasure from affiliative experiences. This propensity is considered a core process underlying the affiliation motive and a pervasive cause of motivated behavior. In this study, we tested these assumptions. We presented participants with positive affiliative stimuli and used electromyography to record changes in facial muscular activity that are indicative of subtle smiling. We were thus able to physiologically measure positive affect following affiliative cues. Individual differences in these affective contingencies were internally consistent and temporally stable. They converged with affiliation motive self- and informant reports and picture story exercise scores, indicating that they are partly accessible to the self, observable to outsiders, and overlap with implicit systems. Finally, they predicted affiliative behavior in terms of situation selection and modification across a wide variety of contexts (i.e., in daily life, the laboratory, and an online social network). These findings corroborate the long-held assumption that affective contingencies represent a motivational core aspect of affiliation. (PsycINFO Database Record

  13. Retrivability in The Danish National Hospital Registry of HIV and hepatitis B and C coinfection diagnoses of patients managed in HIV centers 1995-2004

    DEFF Research Database (Denmark)

    Obel, N.; Reinholdt, H.; Omland, L.H.;

    2008-01-01

    in the current analysis. We used the DHCS as a reference to examine the completeness of HIV and of HBV and HCV coinfections recorded in DNHR. Cox regression analysis was used to estimate hazard ratios of time to diagnosis of HIV in DNHR compared to DHCS. RESULTS: Of the 2,033 HIV patients in DHCS, a total of 2......BACKGROUND: Hospital-based discharge registries are used increasingly for longitudinal epidemiological studies of HIV. We examined completeness of registration of HIV infections and of chronic hepatitis B (HBV) and hepatitis C (HCV) coinfections in the Danish National Hospital Registry (DNHR......) covering all Danish hospitals. METHODS: The Danish HIV Cohort Study (DHCS) encompasses all HIV-infected patients treated in Danish HIV clinics since 1 January 1995. All 2,033 Danish patients in DHCS diagnosed with HIV-1 during the 10-year period from 1 January 1995 to 31 December 2004 were included...

  14. How people interact in evolving online affiliation networks

    CERN Document Server

    Gallos, Lazaros K; Liljeros, Fredrik; Havlin, Shlomo; Makse, Hernan A

    2011-01-01

    The study of human interactions is of central importance for understanding the behavior of individuals, groups and societies. Here, we observe the formation and evolution of networks by monitoring the addition of all new links and we analyze quantitatively the tendencies used to create ties in these evolving online affiliation networks. We first show that an accurate estimation of these probabilistic tendencies can only be achieved by following the time evolution of the network. For example, actions that are attributed to the usual friend of a friend mechanism through a static snapshot of the network are overestimated by a factor of two. A detailed analysis of the dynamic network evolution shows that half of those triangles were generated through other mechanisms, in spite of the characteristic static pattern. We start by characterizing every single link when the tie was established in the network. This allows us to describe the probabilistic tendencies of tie formation and extract sociological conclusions as...

  15. Parenting practices and peer group affiliation in adolescence.

    Science.gov (United States)

    Brown, B B; Mounts, N; Lamborn, S D; Steinberg, L

    1993-04-01

    Social scientists have often assumed that parental influence is sharply curtailed at adolescence because of the rising counterinfluence of peer groups, over which parents have little control. The present study tested a conceptual model that challenged this view by arguing that parents retain a notable but indirect influence over their teenage child's peer associates. Data from a sample of 3,781 high school students (ages 15-19) indicated that specific parenting practices (monitoring, encouragement of achievement, joint decision making) were significantly associated with specific adolescent behaviors (academic achievement, drug use, self-reliance), which in turn were significantly related to membership in common adolescent crowds (jocks, druggies, etc). Findings encourage investigators to assess more carefully parents' role in adolescents' peer group affiliations.

  16. Aggression and affiliation during social conflict in pigs.

    Science.gov (United States)

    Camerlink, Irene; Turner, Simon P; Ursinus, Winanda W; Reimert, Inonge; Bolhuis, J Elizabeth

    2014-01-01

    Social conflict is mostly studied in relation to aggression. A more integral approach, including aggressive and affiliative behaviour as well as physiology, may however give a better understanding of the animals' experience during social conflict. The experience of social conflict may also be reflected in the spatial distribution between conspecifics. The objective was to assess the relationship between behaviour, physiology, and spatial integration in pigs (Sus scrofa) during social conflict. Hereto, 64 groups of pigs (9 wk of age) were studied in a 24 h regrouping test whereby pairs of familiar pigs were grouped with 2 unfamiliar pairs, in either barren or straw-enriched housing. Data on aggressive and affiliative behaviour, skin lesions, body weight, and haptoglobin could be summarized into three principal component analysis factors. These three factors were analysed in relation to spatial integration, i.e. inter-individual distances and lying in body contact. Pigs stayed up to 24 h after encounter in closer proximity to the familiar pig than to unfamiliar pigs. Pigs with a high factor 1 score were more inactive, gave little social nosing, had many skin lesions and a high body weight. They tended to space further away from the familiar pig (b = 1.9 cm; P = 0.08) and unfamiliar ones (b = 0.7 cm; P = 0.05). Pigs that were involved in much aggression (factor 2), and that had a strong increase in haptoglobin (factor 3), tended to be relatively most far away from unfamiliar pigs (b = 0.03 times further; P = 0.08). Results on lying in body contact were coherent with results on distances. Pigs in enriched housing spaced further apart than pigs in barren housing (Psocial conflict.

  17. Vertical interlocks of executives and performance of affiliated firms in state owned Chinese business groups

    DEFF Research Database (Denmark)

    Arnoldi, Jakob; Chen, Xin; Na, Chaohong

    Using a dataset of Chinese listed firms affiliated with state-controlled business groups, we examine how vertical interlocks of executives affect firm performance. We find that vertical interlocks of affiliated firm chairmen are positively associated with performance of the affiliated firms...... of interlocks and adds to a small body of literature on the dynamics of state owned business groups in emerging markets generally and China particularly....

  18. Intra-Industry Affiliate Trade of Foreign-Owned Companies in Transition Economies:

    DEFF Research Database (Denmark)

    Nielsen, Jørgen Ulff-Møller; Pawlik, Konrad

    2008-01-01

    of their affiliates (IIAT). We find labour intensity; scale economies and absorptive capacity of affiliates are the main explanatory variables for IIAT. Given the overall rise in export and import intensities of foreign affiliates over the period of investigation, our findings suggest that export-platform FDI has...... become a more important mode of organization for multinational enterprises as Poland has evolved into a relatively stable economic environment where MNEs feel comfortable basing their regional operations....

  19. HSIP Hospitals in New Mexico

    Data.gov (United States)

    Earth Data Analysis Center, University of New Mexico — Hospitals in New Mexico The term "hospital" ... means an institution which- (1) is primarily engaged in providing, by or under the supervision of physicians, to...

  20. A substantial number of scientific publications originate from non-university hospitals

    DEFF Research Database (Denmark)

    Fedder, Jens; Nielsen, Gunnar Lauge; Petersen, Lars Michael Jelstrup

    2011-01-01

    As we found no recent published reports on the amount and kind of research published from Danish hospitals without university affiliation, we have found it relevant to conduct a bibliometric survey disclosing these research activities....

  1. Antitrust and affiliations among healthcare providers: the need for a level playing field.

    Science.gov (United States)

    Heightchew, A

    1997-01-01

    Under pressure to remain competitive in the rapidly changing healthcare industry, policy leaders and healthcare administrators face the challenge of resolving antitrust matters arising from the creation of innovative healthcare provider affiliations. Although guidance from the Federal Trade Commission (FTC) is available, development of new affiliations is hindered due to contradictory rulings and ambiguous guidelines. Provider associations are further disadvantaged by a federal act granting insurance companies antitrust exemption, which enables insurance companies to affiliate more easily. Current antitrust regulations create unequal market powers, resulting in the development of inefficient systems. Softening antitrust laws in favor of provider-sponsored healthcare affiliations will provide for the flexibility necessary for effective healthcare reform.

  2. Seroprevalence of Antibodies to Pandemic (H1N1 2009 Influenza Virus Among Hospital Staff in a Medical Center in Taiwan

    Directory of Open Access Journals (Sweden)

    Yu-Jiun Chan

    2010-02-01

    Conclusion: The SPR of antibodies against the pandemic (H1N1 2009 virus in the hospital staff was higher than that in the general population, reflecting a higher contact risk. Prevaccination surveillance of the immune status of different risk groups may help to prioritize which groups should be vaccinated first.

  3. Assessment of the Usefulness of Multiplex Real-Time PCR Tests in the Diagnostic and Therapeutic Process of Pneumonia in Hospitalized Children: A Single-Center Experience

    Directory of Open Access Journals (Sweden)

    Ewelina Gowin

    2017-01-01

    Full Text Available The aim of the study was assessment of the usefulness of multiplex real-time PCR tests in the diagnostic and therapeutic process in children hospitalized due to pneumonia and burdened with comorbidities. Methods. The study group included 97 children hospitalized due to pneumonia at the Karol Jonscher Teaching Hospital in Poznań, in whom multiplex real-time PCR tests (FTD respiratory pathogens 33; fast-track diagnostics were used. Results. Positive test results of the test were achieved in 74 patients (76.3%. The average age in the group was 56 months. Viruses were detected in 61 samples (82% of all positive results; bacterial factors were found in 29 samples (39% of all positive results. The presence of comorbidities was established in 90 children (92.78%. On the basis of the obtained results, 5 groups of patients were established: viral etiology of infection, 34 patients; bacterial etiology, 7 patients; mixed etiology, 23 patients; pneumocystis, 9 patients; and no etiology diagnosed, 24 patients. Conclusions. Our analysis demonstrated that the participation of viruses in causing severe lung infections is significant in children with comorbidities. Multiplex real-time PCR tests proved to be more useful in establishing the etiology of pneumonia in hospitalized children than the traditional microbiological examinations.

  4. Assessment of the Usefulness of Multiplex Real-Time PCR Tests in the Diagnostic and Therapeutic Process of Pneumonia in Hospitalized Children: A Single-Center Experience.

    Science.gov (United States)

    Gowin, Ewelina; Bartkowska-Śniatkowska, Alicja; Jończyk-Potoczna, Katarzyna; Wysocka-Leszczyńska, Joanna; Bobkowski, Waldemar; Fichna, Piotr; Sobkowiak, Paulina; Mazur-Melewska, Katarzyna; Bręborowicz, Anna; Wysocki, Jacek; Januszkiewicz-Lewandowska, Danuta

    2017-01-01

    The aim of the study was assessment of the usefulness of multiplex real-time PCR tests in the diagnostic and therapeutic process in children hospitalized due to pneumonia and burdened with comorbidities. Methods. The study group included 97 children hospitalized due to pneumonia at the Karol Jonscher Teaching Hospital in Poznań, in whom multiplex real-time PCR tests (FTD respiratory pathogens 33; fast-track diagnostics) were used. Results. Positive test results of the test were achieved in 74 patients (76.3%). The average age in the group was 56 months. Viruses were detected in 61 samples (82% of all positive results); bacterial factors were found in 29 samples (39% of all positive results). The presence of comorbidities was established in 90 children (92.78%). On the basis of the obtained results, 5 groups of patients were established: viral etiology of infection, 34 patients; bacterial etiology, 7 patients; mixed etiology, 23 patients; pneumocystis, 9 patients; and no etiology diagnosed, 24 patients. Conclusions. Our analysis demonstrated that the participation of viruses in causing severe lung infections is significant in children with comorbidities. Multiplex real-time PCR tests proved to be more useful in establishing the etiology of pneumonia in hospitalized children than the traditional microbiological examinations.

  5. Assessment of the Usefulness of Multiplex Real-Time PCR Tests in the Diagnostic and Therapeutic Process of Pneumonia in Hospitalized Children: A Single-Center Experience

    Science.gov (United States)

    Bartkowska-Śniatkowska, Alicja; Jończyk-Potoczna, Katarzyna; Wysocka-Leszczyńska, Joanna; Bobkowski, Waldemar; Fichna, Piotr; Sobkowiak, Paulina; Mazur-Melewska, Katarzyna; Bręborowicz, Anna; Wysocki, Jacek; Januszkiewicz-Lewandowska, Danuta

    2017-01-01

    The aim of the study was assessment of the usefulness of multiplex real-time PCR tests in the diagnostic and therapeutic process in children hospitalized due to pneumonia and burdened with comorbidities. Methods. The study group included 97 children hospitalized due to pneumonia at the Karol Jonscher Teaching Hospital in Poznań, in whom multiplex real-time PCR tests (FTD respiratory pathogens 33; fast-track diagnostics) were used. Results. Positive test results of the test were achieved in 74 patients (76.3%). The average age in the group was 56 months. Viruses were detected in 61 samples (82% of all positive results); bacterial factors were found in 29 samples (39% of all positive results). The presence of comorbidities was established in 90 children (92.78%). On the basis of the obtained results, 5 groups of patients were established: viral etiology of infection, 34 patients; bacterial etiology, 7 patients; mixed etiology, 23 patients; pneumocystis, 9 patients; and no etiology diagnosed, 24 patients. Conclusions. Our analysis demonstrated that the participation of viruses in causing severe lung infections is significant in children with comorbidities. Multiplex real-time PCR tests proved to be more useful in establishing the etiology of pneumonia in hospitalized children than the traditional microbiological examinations. PMID:28182108

  6. Clinical characteristics of synthetic cannabinoid-induced psychosis in relation to schizophrenia: a single-center cross-sectional analysis of concurrently hospitalized patients

    Directory of Open Access Journals (Sweden)

    Altintas M

    2016-08-01

    Full Text Available Merih Altintas,1 Leman Inanc,2 Gamze Akcay Oruc,1 Selim Arpacioglu,1 Huseyin Gulec1 1Department of Psychiatry, Erenköy Mental and Neurological Diseases Training and Research Hospital, Istanbul, 2Department of Psychiatry, Dr Cevdet Aykan Mental Health and Diseases Hospital, Tokat, Turkey Background: This study aimed to evaluate synthetic cannabinoid (SC-induced psychosis in terms of patient profile and clinical characteristics with reference to concurrently hospitalized schizophrenic patients. Methods: A total of 81 male patients diagnosed with psychotic disorder induced by the use of SCs (n=50; mean (standard deviation [SD] age: 25.9 (5.5 years or with schizophrenia (n=31, mean (SD age: 42.9 (11.6 years based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, diagnosis criteria who were concurrently hospitalized at Erenköy Mental and Neurological Diseases Training and Research Hospital were included in this cross-sectional study. Data on sociodemographic characteristics, Brief Psychiatric Rating Scale (BPRS, Positive and Negative Syndrome Scale (PANSS, Frontal Assessment Battery (FAB, Hamilton Rating Scale for Depression (HRSD, and Hamilton Anxiety Rating Scale (HAM-A were recorded in all the patients. Results: Mean (SD age at disease onset in SC-induced psychosis patients was 22.3 (5.6 years; 26.0% had suicidal ideation and 58.4% were hospitalized involuntarily. Marijuana was the most common first used substance (72.0%, and solitary use of SC was noted in 38.0% of patients. SC-induced psychosis patients had similar PANSS positive, BPRS, HRSD, and FAB scores and significantly lower PANSS negative scores (18.0 [6.5] vs 22.3 [6.0], P=0.004 than patients with schizophrenia, while they had similar HAM-A scores (17.8 [10.3] vs 21.6 [5.5], P=0.085 as young schizophrenics. Age at onset for SC (r=0.364, P=0.05 or substance (r=0.395, P=0.01 use was correlated positively with total FAB scores.Conclusion: In conclusion, our

  7. Estudo sobre a percepção do clima organizacional do centro cirúrgico de um hospital especializado Estudio sobre la percepción del clima organizacional del centro quirúrgico de un hospital especializado Study on the perception of the organization climate of the surgical center in a specialized hospital

    Directory of Open Access Journals (Sweden)

    Wilza Carla Spiri

    1998-01-01

    Full Text Available O presente estudo tem o objetivo de identificar como o grupo de funcionários recém-admitidos no centro cirúrgico de um hospital especializado, percebe o clima organizacional existente, utilizando uma abordagem qualitativa. Como referencial teórico para interpretar o clima organizacional utilizamos os conceitos de CHIAVENATO, que define clima organizacional como meio interno de uma organização e que através de sua experienciação pelos participantes influencia o comportamento dos mesmos, podendo ser favorável, desfavorável e neutro. Os discursos reiteram um clima organizacional favorável, considerando o referencial teórico adotado.El presente estudio tiene el objetivo de identificar cómo el grupo de funcionarios recién admitidos en el centro quirúrgico denota el clima organizacional existente, utilizando un abordaje cualitative. Como referencial teórico para interpretar el clima organizacional utilizamos los conceptos de CHIAVENATO, que define clima organizacional como el medio interno de una organización y que a través de su experiencia los participantes influéncian el comportamiento de los mismos, pudiendo ser favorable, desfavorable y neutro. Los discursos revelaron un clima organizacional favorable, considerándo el referencial teórico adoptado.The aim of this study is to identify how a new team of the surgical center staff in a specialized hospital perceive the organization climate. A qualitative approach was utilized. As a theoretical reference to measure the organization climate, we have used CHIAVENATO, that defines organization climate as the interior of an organization that influences its members´ behavior. The organization climate could be favourable, unfavourable or neutral. The speechs showed a favourable organization climate considering the adopted methodology.

  8. The outcome of requests for empty CCU beds by the hospital from medical emergency headquarters Tehran (Year 2000

    Directory of Open Access Journals (Sweden)

    "Asle Soleimani H

    2002-11-01

    Full Text Available Introduction: Inter-hospital transport constitutes one of the important parts of the emergency system in every country. Materials and methods: To determine the outcome of requested CCU beds from the medical emergency headquarters in year 2000 by the hospitals affiliated to Tehran university of medical sciences, we have reviewed retrospectively 2688 clinical files of patients for whom a request for an empty CCU bed in other hospitals had been sent to the medical emergency headquarters. The main measure was the success rate of being admitted to CCU in other hospitals. Results: On the whole 68.5 percent of requests were followed by a CCU admission to other hospitals. Using logistic regression method, variables including season of the year, shift diagnosis of the patient and the original hospital were shown to be related with the success rate. Conclusion: Increasing the number of available CCU beds and providing the centers with the necessary equipment is of high priority in hospitals located in city of Tehran.

  9. Assessment of Patient Safety Culture in a Selected Number of Pharmacies Affiliated to Mashhad University of Medical Sciences Using the Pharmacy Survey on Patient Safety Culture (SOPS)

    OpenAIRE

    Sara Jamili; Hossein Ebrahimipour; Elaheh Hooshmand; Habibollah Esmaeli; Ali Vafaee Najar

    2016-01-01

    Introduction: Patient safety culture plays a pivotal role in the improvement of patient safety level in health centers. This study aimed to assess patient safety culture in the pharmacies affiliated to Mashhad University of Medical Sciences, Iran using a standard questionnaire developed by the American Agency for Healthcare Research and Quality (AHRQ). Materials and Methods This analytic, descriptive, cross-sectional study was conducted on 108 pharmacists and pharmacy technicians in Mashha...

  10. Community health service center and the municipal hospital disinfection quality monitoring results%社区卫生服务中心与市级医院消毒质量监测结果比较

    Institute of Scientific and Technical Information of China (English)

    王志刚

    2014-01-01

    objective to understand the community health service center and municipal hospital disinfection quality gap, in order to improve and enhance Methods adopted the spot sampling method, the community health service centers in Zhengzhou city and the city of quality of hospital disinfection monitoring. Results the community health service center and a municipal hospital average disinfection qualified rate respectively was77.5% and 94.5%. The 84.0% and 97.3% surfaces, hands of medical staff in 78.1% and 88.8%, the use of disinfectant in 88.5% and 100%, the indoor air in 59.6% and 81.8%, 81.5% and 100% high pressure sterilizer, UV lamp 60.9% and 100%. Conclusions community health service centers in Zhengzhou city average disinfection qualified rate was significantly lower in municipal hospitals, especial y in indoor air, ultraviolet lamp qualified rate is too low. Disinfection work existence weak link, should strengthen management, improve the quality .%了解社区卫生服务中心与市级医院消毒质量差距,以便改进和提高。方法:采用现场抽样检测方法,对郑州市社区卫生服务中心与市级医院消毒质量进行了监测。结果:社区卫生服务中心与市级医院平均消毒合格率分别为77.5%和94.5%。物体表面84.0%和97.3%,医护人员手78.1%和88.8%,使用中消毒液88.5%和100%,室内空气59.6%和81.8%,高压灭菌器81.5%和100%,紫外线灯60.9%和100%。结论:郑州市社区卫生服务中心平均消毒合格率明显低于市级医院,尤其是室内空气、紫外线灯合格率明显偏低。消毒工作存在薄弱环节,应加强管理,提高质量。

  11. The impact of nutritional status, nutritional risk, and nutritional treatment on clinical outcome of 2248 hospitalized cancer patients: a multi-center, prospective cohort study in Chinese teaching hospitals.

    Science.gov (United States)

    Pan, Hongming; Cai, Sanjun; Ji, Jiafu; Jiang, Zhiwei; Liang, Houjie; Lin, Feng; Liu, Xiyong

    2013-01-01

    To better understand the impact of undernutrition, nutritional risk, and nutritional treatment on the clinical outcomes of hospitalized cancer patients in China, the authors conducted a multicenter, cross-sectional study with 2248 cancer patients from 20 hospitals from January to June 2010. The authors defined 19.7% and 26.8% patients as undernourished at baseline and reassessment, respectively. Patients with gastrointestinal malignancies had a higher rate of undernutrition than other patients. The nutritional risk rate was 24.6% and 40.2% at baseline and reassessment, respectively. For patients with nutritional risk, the relative risk (RR) of adverse events (AEs) significantly increased with and without nutritional treatment. In comparison with the nonnutritional treatment subgroup, patients who received enteral nutrition (EN) or total parenteral nutrition (TPN) significantly reduced the RR of AE development. The RR of AEs for EN and TPN were 0.08 (95% CI: 0.01-0.62) and 0.56 (95% CI: 0.33-0.96), respectively. Separated nutrient infusion increased the risk of AEs. The authors concluded that undernutrition and nutritional risk are general problems that impact the outcomes of hospitalized cancer patients in China. Higher NRS2002 scores are related to AE risk but not weight loss. In nutritional treatment, EN and TPN can significantly reduce the risk of AEs.

  12. 现代综合医院介入治疗中心设计浅析%Analysis of the Modern Comprehensive Hospital Interventional Treatment Center Design

    Institute of Scientific and Technical Information of China (English)

    栗树凯

    2014-01-01

    Interventional treatment center is the concept of interventional radiology in spatial properties with DSA gra-dual y produce department in the development many diseases diagnosis and treatment. This article takes the interventional therapy center as the research object, combines with the actual engineering case to analysis and hope to provide reference for interventional treatment center design.%介入治疗中心是介入放射学在空间属性上的概念,是随着 DSA 在多种疾病诊断治疗方面的不断发展而逐步产生的科室,本文以介入治疗中心为研究对象,结合实际工程案例进行分析,希望为介入治疗中心设计提供参考。

  13. Allegheny County Diabetes Hospitalization

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — This data includes the number of people hospitalized with diabetes between 2013-2015, by age group, for Allegheny County Zip Codes.

  14. Critical Access Hospitals (CAH)

    Science.gov (United States)

    ... CAH designation is designed to reduce the financial vulnerability of rural hospitals and improve access to healthcare ... MDH) Rural Referral Center (RRC) What types of facilities are eligible for CAH status? Facilities applying to ...

  15. VT Hospital Site Locations

    Data.gov (United States)

    Vermont Center for Geographic Information — (Link to Metadata) This data layer contains point locations of all major community, regional, comprehensive health, and healthcare provider hospitals in the state of...

  16. Allegheny County Hospitals

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — The data on health care facilities includes the name and location of all the hospitals and primary care facilities in Allegheny County. The current listing of...

  17. Hospital Compare Data

    Data.gov (United States)

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

  18. Structural determinants of hospital closure.

    Science.gov (United States)

    Longo, D R; Chase, G A

    1984-05-01

    In a retrospective case-control study, structural characteristics of hospitals that closed during the years 1976-1980 were contrasted with three comparison groups: hospitals that were acquired in a merger; hospitals that joined a multihospital system; and hospitals that remained autonomously opened, to investigate these characteristics as predictors of closure. Characteristics investigated included environmental, structural, and process variables. The independent variables were measured 5 years prior to outcome. Findings indicate that closed hospitals resemble hospitals acquired in a merger ("failure"), and likewise autonomous hospitals resemble hospitals that join a multihospital system ("success"). The most important predictors of hospital failure were the physician-to-population ratio, the East North Central and West North Central census regions, the level of diversification, low occupancy rate, location in a standard metropolitan statistical area, the chief executive officer's lack of affiliation in the American College of Hospital Administrators, profit status, bed size of less than 50, and presence in a state with a rate-setting agency. Surprisingly, this study shows the bed-to-population ratio to be unrelated to closure. In addition, the findings strongly support the open-system perspective, which, unlike the closed-system perspective, is concerned with the vulnerability of the organization to the uncontrollable and often unpredictable influences of the environment.

  19. Construction of integrated hospital quality data management center under big data framework%大数据思维框架下医院“质量数据管理中心”的集成构建

    Institute of Scientific and Technical Information of China (English)

    张萍; 邱立; 刘慧

    2015-01-01

    目的:应用大数据思维集成构建医院“质量数据管理中心”,实现医院质量管理从数据化运营到运营大数据的适应性变革。方法:将医院医保科、质量管理科、病案室、统计室、计算机中心等数据管理密集的职能科室集成构建为医院“质量数据管理中心”。对其职能重新整合分工,逐步建立对医疗、护理、行政管理等全方位质量考核评价的独立机构,定期向医院党委及机关各部门提供一致、准确的决策数据分析报告,用于宏观决策。结果:集成构建的“质量数据管理中心”其原有职能作用可实现1+1>2,且由于数据信息集中采集、应用、分析、释放,医院决策速度加快、问题管理到位、效益扩增显著。结论:大数据思维框架下集成构建的医院“质量数据管理中心”可重新整合职能分工,高效利用信息资源,减少跨部门管理、控制信息衰减及流失,可为现代医院管理者借鉴应用。%Objectives: To construct integrated hospital quality data management center under big data framework and fit for the changes from data operation to operate big data. Method: The data management functions such as hospital insurance department, quality control department, medical records department, statistical department, computer center and other department were integrated as hospital quality data management center and the functions were re-constructed to full assess the quality of medical, nursing and administration and provide accurate, constant data analysis reports for macro- policy-making. Results: The integrated "quality data management center" can be achieved 1+1 > 2. Hospital decision making, problem management and benefit are significantly promoted by integrated data collection, application, analysis and sending. Conclusions: Integrated hospital quality data management center under big data framework can re-construct functions

  20. 2013年北京市急救中心院前急救儿童患者流行病学研究%Epidemiological studies on children patients with pre-hospital emergency in Beijing Emergency ;Center in 2013

    Institute of Scientific and Technical Information of China (English)

    刘杉; 高丁

    2014-01-01

    Objective To summarize the age, gender, and the regularity of disease classification of children patients with pre-hospital emergency in Beijing Emergency Center in 2013, provide the basis for improving children's quality of pre-hospital first aid. Methods Based on the Beijing emergency center scheduling information database, of pre-hospital emergency first aid center in Beijing in 2013 children patients were retrospectively analyzed. Results 2013 emergency center of Beijing children pre-hospital emergency patients, male:female was 1.6∶1. In every age group, 4 to 7 years old preschool children, most patients with a total of 2 492 cases, accounting for 25.31%;Neonatal patients at least within 28 days, a total of 251 cases, accounting for 2.55%. Disease to constitute the top five of the respiratory system disease, trauma, respectively, digestive system disease, neuromuscular disease, airway foreign bodies. Respiratory system disease, trauma, in 4 to 7 years old preschool children group, most patients with digestive system disease, neuromuscular disease, patients with airway foreign bodies in 1 to 3 years old infants group most. Conclusion Pre-hospital emergency according to the emergency center of Beijing children patients with age, sex and characteristics of disease classification, targeted to carry out the related work, can make patients get better pre-hospital emergency services.%目的:总结2013年北京市急救中心院前急救儿童患者的年龄、性别及病种分类规律,为提高儿童的院前急救质量提供依据。方法以北京急救中心调度信息数据库为基础,对2013年北京市急救中心院前急救儿童患者进行回顾性分析。结果2013年北京市急救中心院前急救9845例儿童患者中,男∶女为1.6∶1。各年龄组中,4~7岁的学龄前儿童患者最多,共2492例,占25.31%;28 d以内的新生儿组患者最少,共251例,占2.55%。病种构成前五位分别为呼吸系统疾病、

  1. Hospital Quality Initiative - Outcome Measures

    Data.gov (United States)

    U.S. Department of Health & Human Services — In the interest of promoting high-quality, patient-centered care and accountability, the Centers for Medicare and Medicaid Services (CMS) and Hospital Quality...

  2. Retrivability in The Danish National Hospital Registry of HIV and hepatitis B and C coinfection diagnoses of patients managed in HIV centers 1995–2004

    Directory of Open Access Journals (Sweden)

    Sørensen Henrik T

    2008-04-01

    Full Text Available Abstract Background Hospital-based discharge registries are used increasingly for longitudinal epidemiological studies of HIV. We examined completeness of registration of HIV infections and of chronic hepatitis B (HBV and hepatitis C (HCV coinfections in the Danish National Hospital Registry (DNHR covering all Danish hospitals. Methods The Danish HIV Cohort Study (DHCS encompasses all HIV-infected patients treated in Danish HIV clinics since 1 January 1995. All 2,033 Danish patients in DHCS diagnosed with HIV-1 during the 10-year period from 1 January 1995 to 31 December 2004 were included in the current analysis. We used the DHCS as a reference to examine the completeness of HIV and of HBV and HCV coinfections recorded in DNHR. Cox regression analysis was used to estimate hazard ratios of time to diagnosis of HIV in DNHR compared to DHCS. Results Of the 2,033 HIV patients in DHCS, a total of 2,006 (99% were registered with HIV in DNHR. Of these, 1,888 (93% were registered in DNHR within one year of their first positive HIV test. A CD4 = 100,000 copies/ml and being diagnosed after 1 January 2000, were associated with earlier registration in DNHR, both in crude and adjusted analyses. Thirty (23% HIV patients registered with chronic HBV (n = 129 in DHCS and 126 (48% of HIV patients with HCV (n = 264 in DHCS were registered with these diagnoses in the DNHR. Further 17 and 8 patients were registered with HBV and HCV respectively in DNHR, but not in DHCS. The positive predictive values of being registered with HBV and HCV in DHCS were thereby estimated to 0.88 and 0.97 and in DNHR to 0.32 and 0.54. Conclusion The study demonstrates that secondary data from national hospital databases may be reliable for identification of patients diagnosed with HIV infection. However, the predictive value of co-morbidity data may be low.

  3. Budesonide Use and Hospitalization Rate in Crohn’s Disease: Results From a Cohort at a Tertiary Care IBD Referral Center

    Science.gov (United States)

    Orr, Jordan; Venkata, Krishna V. R.; Young, Steven; Xie, Fenglong; Malik, Talha A.

    2016-01-01

    Background Budesonide is generally not used for periods > 90 days in Crohn’s disease (CD). We sought to study the association between cumulative outpatient budesonide use in days and hospitalization rate in CD patients seen at our institution. Methods Using a retrospective cohort study design, we selected CD patients > 19 years old and followed for at least 1 year. Days of outpatient budesonide use were calculated by reviewing outpatient clinic notes. Treatment groups included patients who were not given budesonide, received budesonide from 1 to 90 days, and received budesonide > 90 days. We performed univariate analyses and developed generalized Poisson regression models for rate data to estimate incidence rate ratios (IRRs) and 95% confidence intervals (95% CIs) for CD-related hospitalization. Results Of 767 CD patients, 664 did not receive budesonide, 45 received budesonide from 1 to 90 days, and 58 received budesonide for > 90 days. Incidence rates of hospitalization in patients who received no budesonide vs. 1 - 90 days of budesonide vs. > 90 days of budesonide were 31, 26, and 19 per 100 person-years, respectively. Adjusted models demonstrated that receiving outpatient budesonide from 1 to 90 days and for > 90 days was associated with a lower likelihood of being admitted for a CD exacerbation (1 - 90 days: IRR 0.85; 95% CI 0.65 - 1.10; > 90 days: IRR 0.71; 95% CI 0.56 - 0.91). Conclusions Outpatient budesonide use appears to be associated with a lower likelihood of a CD-related hospitalization, notably when used for > 90 days. This association needs to be further assessed before recommending this agent for routine use for > 90 days. PMID:27635174

  4. Critical access hospital ED to quaternary medical center: successful implementation of an integrated Picture Archiving and Communications System for patient transfers by air and sea.

    Science.gov (United States)

    Prabhakar, Anand M; Harvey, H Benjamin; Brinegar, Katelyn N; Raja, Ali S; Kelly, James R; Brink, James A; Saini, Sanjay; Oklu, Rahmi

    2016-08-01

    The purpose of this study was to investigate the role of imaging in transfers between an island Critical Access Hospital (CAH) emergency department (ED) and a quaternary care hospital. Electronic medical records were reviewed to identify all patients who were transferred from an island CAH to our quaternary care hospital in 2012 and 2013. Medical history, transfer diagnosis, and the type of imaging performed at the CAH prior to transfer were reviewed. During the study period, a total of 22075 ED visits were made to the CAH and 696 (3.2%) of these patients were transferred for higher level of care, with 424 (60.9%) of the patients transferred to our quaternary care hospital. The most common reasons for transfer were cardiac (121; 28.5%), trauma (82; 19.3%), gastrointestinal (63; 14.9%), and neurologic conditions (54; 12.7%). 349 patients (82.3%) had imaging prior to transfer (56.4% radiograph, 33.5% computed tomography, 4.7% magnetic resonance imaging, 8.0% ultrasound). Of patients that had imaging, 53.6% had positive imaging findings related to the transfer diagnosis, and patients transferred for noncardiac etiologies were significantly more likely to have imaging findings related to their transfer diagnosis compared with patients transferred for cardiac etiologies (72.9% vs 6.9%, respectively; Ptransfer for higher level of care, with nearly three-quarters of noncardiac transferred patients having a positive imaging finding related to the reason for transfer. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. A Study to Determine the Best Way for Letterman Army Medical Center to Comply with the 1981 JCAH (Joint Commission on Accreditation of Hospitals) Quality Assurance Standard

    Science.gov (United States)

    1980-08-01

    shall be cut off.4 In another time and place--ancient China--subscribers to a kind of national health insurance paid the acupuncture doctor to keep them...risk management endeavors is the review of incident reports. The usual initial signal of a genuine potential 33 hospital liability case is the receipt...Commander. Feedback The decisions of the Commander are next translated into some form of feedback--the return of output signals into the system. These

  6. A Qualitative Analysis of Resource Sharing Agreements Between Naval Hospital Great Lakes and North Chicago Veterans Affairs Medical Center: The Iron Triangle Theory of Healthcare Integration

    Science.gov (United States)

    2005-05-19

    in Healthcare Administration ) 3151 Scott Road, Suite 1411- 11. SPONSOR/MONITOR’S REPORT Fort Sam Houston, TX 78234-6135 NUMBER(S) --32-05 12...the Requirements for A Master in Health Administration By Lieutenant Melissa J. Harnly, MSC Naval Hospital Great Lakes, Illinois May 19, 2005 20060315...Services Capital Asset Realignment for Enhanced Services, announced on May 7, 2004, by former Secretary of Veterans Affairs Anthony J. Principi , is a

  7. A Comparison of the impact of family-centered and patient-centered education methods on attitude toward and adherence to diet and fluid restriction in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Asgari P

    2015-02-01

    Full Text Available Background and Objective: One of the major issues in hemodialysis patients is adherence to diet and fluid restriction. In order to reduce the adverse consequences of the disease and improve quality of life, educating these patients is of great importance. Therefore, the present study was conducted in order to compare the impact of two methods of education (patient-centered and family–centered on attitude toward and adherence to diet and fluid restriction in hemodialysis patients. Materials and Method: This clinical trial was performed on patients referred to the hemodialysis ward of hospitals affiliated with Tehran University of Medical Sciences, Iran, during May to October 2012. Through purposive sampling method, 60 patients were selected and randomly assigned to two groups patient-centered (n = 30 and family-centered (n = 30. Patients’ attitude toward and adherence to diet regime and fluid restriction were assessed using a researcher-made self-report questionnaire in 3 stages (before the intervention, and 2 and 4 weeks after the intervention. The reliability and validity of the questionnaire were approved. Data analysis was performed using SPSS software version 16 and independent t-test, chi-square, Fisher’s exact test, and repeated measures ANOVA. Results: Before the intervention, the findings showed no significant difference between the 2 groups in terms of adherence to diet and fluid restriction. In the second week after the intervention, mean adherence to diet in the family-centered group was significantly higher than the patient-centered group (P = 0.010. Moreover, at the end of the second (P = 0.001 and fourth weeks (P = 0.002, the attitude toward adherence to diet and fluid restriction was more positive in the family-centered group, in comparison to the patient-centered group. Conclusion: Family-centered education is more effective on patient adherence to the treatment regimen. Thus, it is recommended that family-centered

  8. Aggression and affiliation during social conflict in pigs.

    Directory of Open Access Journals (Sweden)

    Irene Camerlink

    Full Text Available Social conflict is mostly studied in relation to aggression. A more integral approach, including aggressive and affiliative behaviour as well as physiology, may however give a better understanding of the animals' experience during social conflict. The experience of social conflict may also be reflected in the spatial distribution between conspecifics. The objective was to assess the relationship between behaviour, physiology, and spatial integration in pigs (Sus scrofa during social conflict. Hereto, 64 groups of pigs (9 wk of age were studied in a 24 h regrouping test whereby pairs of familiar pigs were grouped with 2 unfamiliar pairs, in either barren or straw-enriched housing. Data on aggressive and affiliative behaviour, skin lesions, body weight, and haptoglobin could be summarized into three principal component analysis factors. These three factors were analysed in relation to spatial integration, i.e. inter-individual distances and lying in body contact. Pigs stayed up to 24 h after encounter in closer proximity to the familiar pig than to unfamiliar pigs. Pigs with a high factor 1 score were more inactive, gave little social nosing, had many skin lesions and a high body weight. They tended to space further away from the familiar pig (b = 1.9 cm; P = 0.08 and unfamiliar ones (b = 0.7 cm; P = 0.05. Pigs that were involved in much aggression (factor 2, and that had a strong increase in haptoglobin (factor 3, tended to be relatively most far away from unfamiliar pigs (b = 0.03 times further; P = 0.08. Results on lying in body contact were coherent with results on distances. Pigs in enriched housing spaced further apart than pigs in barren housing (P<0.001. The combined analysis of measures revealed animals that may either promote or slow down group cohesion, which may not have become clear from single parameters. This emphasizes the importance of an integral approach to social conflict.

  9. Hospitalization, a risk factor for antibiotic-resistant Escherichia coli in the community?

    NARCIS (Netherlands)

    Bruinsma, N; Filius, PMG; van den Bogaard, AE; Nys, S; Degener, J; Endtz, HP; Stobberingh, EE

    2003-01-01

    Objective: The impact of hospitalization on the prevalence of resistant Escherichia coli in the intestinal flora of patients admitted to the surgical wards of three Dutch university-affiliated hospitals was analysed prospectively. Methods: Faecal samples were obtained on admission to the hospital, a

  10. Acute-on-chronic kideny injury in hospitalized patients:a clinical survey

    Institute of Scientific and Technical Information of China (English)

    王琴

    2013-01-01

    Objective To investigate the incidence and risk factors of acute-on-chronic kidney(A-on-C) in hospitalized patients. Methods We did a retrospective study on the clinical profiles of patients with A-on-C hospitalized in Affiliated Renji Hospital of Shanghai Jiaotong University

  11. Development and implementation of a comprehensive strategic plan for medical education at an academic medical center.

    Science.gov (United States)

    Schwartzstein, Richard M; Huang, Grace C; Coughlin, Christine M

    2008-06-01

    Despite their vital contributions to the training of future physicians, many academic teaching hospitals have grown operationally and financially distinct from affiliated medical schools because of divergent missions, contributing to the erosion of clinical training. Some institutions have responded by building hybrid organizations; others by creating large health care networks with variable relationships with the affiliated medical school. In this case, the authors wished to establish the future educational mission of their medical center as a core element of the institution by creating data-driven recommendations for reorganization, programs, and financing. They conducted a self-study of all constituents, the results of which confirmed the importance of education at their institution but also revealed the insufficiency of incentives for teaching. They underwent an external review by a committee of prominent educators, and they involved administrators at the hospital and the medical school. Together, these inputs composed an informed assessment of medical education at their teaching hospital, from which they developed and actualized an institution-wide strategic plan for education. Over the course of three years, they centralized the administrative structure for education, implemented programs that cross departments and reinforce the UME-GME continuum, and created transparency in the financing of medical education. The plan was purposefully aligned with the clinical and research strategic plans by supporting patient safety in programs and the professional development of faculty. The application of a rigorous strategic planning process to medical education at an academic teaching hospital can focus the mission, invigorate faculty, and lead to innovative programs.

  12. Strategic planning in healthcare: the experience of the University of Wisconsin Hospital and Clinics.

    Science.gov (United States)

    Sollenberger, Donna K

    2006-01-01

    In 1999, after 25 years of stable leadership from a single CEO, the University of Wisconsin Hospital and Clinics (UWHC) Authority Board named a new CEO. The 471-bed academic medical center had recently experienced significant change and challenges. In 1996, it had emerged as a public authority, a statutory designation by the state of Wisconsin that moved the hospital and clinics from the University of Wisconsin and the state of Wisconsin, and created it as a quasi-public entity with its own board. In 1999, when the new CEO was named, the hospital was experiencing a loss of revenue and market share, operating deficits, a 22 percent nurse vacancy rate, and patient satisfaction scores below the 40th percentile. The first task assigned to the new CEO by the board was the development of a new strategic plan that would reverse these trends and position UWHC as a premier academic hospital. The CEO began a strategic planning process that involved leaders, physicians, and staff from throughout the hospital and clinics, its affiliated medical school, and the physician practice plan. This article describes the collaborative, integrative, and communicative strategic planning process UWHC used; details the organization of the process; describes the results achieved by UWHC; and lists the lessons learned along the way.

  13. Boys Affiliate More than Girls with a Familiar Same-Sex Peer

    Science.gov (United States)

    Benenson, Joyce F.; Quinn, Amanda; Stella, Sandra

    2012-01-01

    Evidence from ethnographic, observational, and experimental studies with humans converges to suggest that males affiliate more than females with unrelated, familiar same-sex peers, but this has never been examined directly. With this aim, we compared frequency of affiliation with a single, randomly chosen, familiar same-sex peer for the two sexes…

  14. 12 CFR 41.21 - Affiliate marketing opt-out and exceptions.

    Science.gov (United States)

    2010-01-01

    ... relationship with the depository institution's securities affiliate for management of the consumer's securities... institution does not have a pre-existing business relationship with the consumer and none of the other... affiliate that has or has previously had a pre-existing business relationship with the consumer; or (ii)...

  15. 16 CFR 680.21 - Affiliate marketing opt-out and exceptions.

    Science.gov (United States)

    2010-01-01

    ... has a relationship with the creditor's securities affiliate for management of the consumer's.... The creditor does not have a pre-existing business relationship with the consumer and none of the... affiliate that has or has previously had a pre-existing business relationship with the consumer; or (ii)...

  16. Post-conflict affiliation by chimpanzees with aggressors: other-oriented versus selfish political strategy.

    Directory of Open Access Journals (Sweden)

    Teresa Romero

    Full Text Available Consolation, i.e., post-conflict