WorldWideScience

Sample records for central supply hospital

  1. Central line infections - hospitals

    Science.gov (United States)

    ... infection; Central venous catheter - infection; CVC - infection; Central venous device - infection; Infection control - central line infection; Nosocomial infection - central line infection; Hospital acquired ...

  2. Accounting and management of aseptic materials at the central sterile supply department of hospital%医院消毒供应中心无菌物品的核算与管理

    Institute of Scientific and Technical Information of China (English)

    周彬; 王亚娟

    2015-01-01

    文章结合原国家卫生部2009年颁布的《消毒供应中心三项标准》和2012年颁布的《医院财务制度》和《医院会计制度》中的相关条款,探讨医院消毒供应中心无菌物品的核算与管理工作。%In the paper, the accounting and management of aseptic materials at the Center Sterile Supply Department of hospital is discussed in accordance with relevant provisions in the Three Standards for Central Sterile Supply Departments promulgated by the former Ministry of Health of China in 2009, as well as the Hospital Financial System and Hospital Accounting System issued in 2012.

  3. [Drug supply chain safety in hospitals: current data and experience of the Grenoble university hospital].

    Science.gov (United States)

    Bedouch, P; Baudrant, M; Detavernier, M; Rey, C; Brudieu, E; Foroni, L; Allenet, B; Calop, J

    2009-01-01

    Drug supply chain safety has become a priority for public health which implies a collective process. This process associates all health professionals including the pharmacist who plays a major role. The objective of this present paper is to describe the several approaches proven effective in the reduction of drug-related problem in hospital, illustrated by the Grenoble University Hospital experience. The pharmacist gets involved first in the general strategy of hospital drug supply chain, second by his direct implication in clinical activities. The general strategy of drug supply chain combines risk management, coordination of the Pharmacy and Therapeutics Committee, selection and purchase of drugs and organisation of drug supply chain. Computer management of drug supply chain is a major evolution. Nominative drug delivering has to be a prior objective and its implementation modalities have to be defined: centralized or decentralized in wards, manual or automated. Also, new technologies allow the automation of overall drug distribution from central pharmacy and the implementation of automated drug dispensing systems into wards. The development of centralised drug preparation allows a safe compounding of high risk drugs, like cytotoxic drugs. The pharmacist should develop his clinical activities with patients and other health care professionals in order to optimise clinical decisions (medication review, drug order analysis) and patients follow-up (therapeutic monitoring, patient education, discharge consultation).

  4. Demographic change and the supply of physicians, hospitals, and hospital beds: marketing implications.

    Science.gov (United States)

    Pol, L G; Tymkiw, D R

    1990-01-01

    Demographic conditions are a major component of the business environment in which health care marketers must compete. The following study assesses the impact of demographic factors on health care supply and finds that population size, population change, age structure, and income are important predictors of physician, hospital, and hospital bed supply. The results are discussed in the context of marketing implications.

  5. Central Bank Focuses on Money Supply and Commercial Bank Reform

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    @@ Money supply index will continue to be the main topic of the annual meeting of Central Bank, this has actually refuted the rumor that the intermediate goal of Central Bank's monetary policy,which has been implementing for 8 years, will be demolished.

  6. Perforated duodenal ulcer in Asir central hospital

    Directory of Open Access Journals (Sweden)

    Jastaniah Suleiman

    1997-01-01

    Full Text Available In a study of 27 cases of perforated duodenal ulcer seen at Asir Central Hospital over a period of seven years, two patients were females and 25 males. The highest incidence was in the fourth decade and the average age was 36.3 years. The Saudi-foreigner ratio was 1:2.9 in an area where the Saudi-foreigner population ratio was 1:3. Nine patients (33.3% were previously diagnosed as having peptic ulcer and had received treatment at one time or the other before perforation. Eighteen patients (66.7% were first diagnosed to peptic ulcer after the perforation. All the identified perforations were located anteriorly and anterosuperiorly. Only one case occurred in the second part of duodenum. The rest occurred in the first part. Two patients were treated successfully conservatively. The month perforations occurred most was the month of Shaaban. The fasting period during the month of Ramadhan did not show any increase in the prevalence of perforation in this hospital.

  7. 综合性医院口腔门诊器械消毒供应中心集中式管理效果%The effect of centralized management used in dental instrument sterilization and supply center in general hospital

    Institute of Scientific and Technical Information of China (English)

    刘慧

    2013-01-01

    目的:探讨综合性医院口腔门诊器械消毒供应中心集中式管理效果.方法:将口腔门诊所有器械统一经消毒供应中心人员按标准流程进行处理.结果:经消毒供应中心处理的器械清洗、包装、灭菌质量均高于口腔科自行处理的口腔器械,减少了口腔护士工作量,提高口腔护理质量.结论:口腔器械经消毒供应中心统一处理,能保证器械质量,有效控制医院内感染,保证患者安全.%Objective:To discuss the effect of oral debate instrument sterilization and supply center for centralized management.Methods:Dental clinic for all devices united by central sterile supply department personnel as standard procedure to handle dental instruments.Results:Central sterile supply processing apparatus of cleaning,disinfection and sterilization quality of packaging,it was higher than themselves in stomatology of dental instruments,reduced oral nursing workload,improved the quality of dental nursing.Conclusion:Dental instrument sterilization and supply center for the integrated treatment,can guarantee the quality of equipment,the effective control of hospital infection,ensure patient's safety.

  8. 研究中心集中式管理模式在供应室控制医院感染管理中的效果分析%Research Center Centralized Management Model in the Supply Room of Hospital Infection Control Management Effectiveness Analysis

    Institute of Scientific and Technical Information of China (English)

    周金菊; 张颖兰; 樊友道

    2016-01-01

    目的:探讨中心集中式管理模式在消毒供应中心控制医院感染管理中的效果。方法随机采集2013年1月至2013年12月期间消毒供应中心相关资料作为对照组,2014年1月至2014年12月期间消毒供应中心相关资料作为研究组,比较两组手术器械清洗合格率、手术器械消毒灭菌合格率、医院感染率、医护人员卫生合格率、手术台卫生合格率、手术服卫生合格率与物品卫生合格率的差异。结果两组临床指标的比较结果显示,手术器械清洗合格率、手术器械消毒灭菌合格率、医护人员卫生合格率、手术台卫生合格率、手术服卫生合格率与物品卫生合格率明显高于对照组,两组比较差异具有统计学意义(P<0.05),观察组医院感染率明显低于对照组,两组比较差异具有统计学意义(P<0.05)。结论中心集中式管理模式在消毒供应中心控制医院感染管理中的效果显著,有助于显著降低医院感染率,提高手术器械与卫生物品合格率。%Objective To investigate the centralized management center in central sterile supply management in hospital infection control effect. Methods Collection from January 2013 to December 2013 during the central sterile supply relevant information as a control group, disinfecting January 2014 to December 2014 period as supply relevant information center study group were compared surgical instrument cleaning pass rate the difference sterilization of surgical instruments passing rate, hospital infection, health care workers health qualified rate, the rate of qualified health operating table, surgical gowns and sanitary goods passing rate of qualified health rates. Results The result of the comparison of clinical indicators show:the passing rate of the surgical instrument cleaning, disinfection and sterilization of surgical instruments passing rate, the rate of qualified medical personnel hygiene, sanitation passing rate operating table

  9. Centralization of Intensive Care Units: Process Reengineering in a Hospital

    Directory of Open Access Journals (Sweden)

    Arun Kumar

    2010-03-01

    Full Text Available Centralization of intensive care units (ICUs is a concept that has been around for several decades and the OECD countries have led the way in adopting this in their operations. Singapore Hospital was built in 1981, before the concept of centralization of ICUs took off. The hospital's ICUs were never centralized and were spread out across eight different blocks with the specialization they were associated with. Coupled with the acquisitions of the new concept of centralization and its benefits, the hospital recognizes the importance of having a centralized ICU to better handle major disasters. Using simulation models, this paper attempts to study the feasibility of centralization of ICUs in Singapore Hospital, subject to space constraints. The results will prove helpful to those who consider reengineering the intensive care process in hospitals.

  10. Hospital Water Supply as a Potential Source of Opportunistic Pathogens

    Directory of Open Access Journals (Sweden)

    H. T. El-Zanfaly

    2012-01-01

    Full Text Available In Egypt as well as in many other developing countries, there are no specific standards for hospital water. Even water is free from the traditional bacterial indicators, it may represent a source of health hazards especially for elderly, children and patients under dialysis due to the presence of opportunistic pathogenic bacteria. The study was carried out on the bacteriological water quality at the intakes as well as the end of water treatment train of two water treatment plants that supplying three hospitals located in Greater Cairo, Egypt with water that used for different purposes. Samples of the raw water supply for the two water treatment plants (Nile River water showed ranges of 102-105 cfu mL-1, 102-104 MPN 100 mL-1, 102-104 MPN 100 mL-1 and 102-103 MPN 100 mL-1 for Heterotrophic Plate Count (HPC bacteria, Total Coliforms (TC, Fecal Coliforms (FC and Fecal Streptococci (FS, respectively. Treated water showed considerable reduction in HPC while the other bacterial indicators reached the undetectable level. The distribution system impact on treated water quality was limited to causing an increase in HPC bacteria. A study was carried out to determine the presence of Pseudomonas aeuginosa, Aeromonas spp. and Staphylococcus aureus in hospitals tap water, water reservoirs, as well as water for preparation of hemodialysis fluids. Although the post-chlorinated water in both water treatment plants was free from bacterial indicators, it still contaminated with the three studied opportunistic pathogenic bacteria. The detected opportunistic pathogens may be attributed to the distribution system condition and/or the presence of storage tanks. Hemodialysis water samples showed the higher percentage of P. aeruginosa isolates which represent a major source of health risk to patient’s attending dialysis process in hospitals and clinics. The presence of opportunistic bacteria in drinking water and dialysate with absence of coliform and low HPC

  11. Money Supply as the Target of the Central Bank

    Directory of Open Access Journals (Sweden)

    Jędruchniewicz Andrzej

    2014-06-01

    Full Text Available The main purpose of the article is a critical analysis of the monetary policy strategy that is based on the adoption of money supply as an intermediate target. The analysis is conducted from the perspective of the theory of the Austrian school. The first part of the article presents an influence of the supply of money on changes of categories in economy according to mainstream theories of economics. The second part discusses the essence of the strategy of monetary policy using money supply as an intermediate target from the point of view of the main trend in economics. It is demonstrated that in order to use it, two elementary conditions must be met: the function of demand for money must be at least relatively stable and the central bank must practically shape changes in the money supply at the planned level. The third part is of key importance for the purpose of this article. It involves the criticism of Friedman’s principle, i.e. a constant increase in money supply as a monetary strategy. According to the Austrian theory, an increase in the quantity of money which is not financed by voluntary savings separates the time structure of production and consumption. Thus, after the period of prosperity there a collapse in production must take place. It is also pointed out that the crisis can be postponed only when the quantity of money increases at an ever faster rate.

  12. Redesigning the supply of gasses : co-makership in a hospital

    NARCIS (Netherlands)

    Donk, D.P. van

    2000-01-01

    Supply chain management in hospitals has been relatively ignored. Due to tight budget constraints attention has been turned to the supply of materials as a possibility to cut costs. This paper describes the operational logistical relation between a hospital an its supplier of gasses and suggests alt

  13. Impact of radio-frequency identification (RFID) technologies on the hospital supply chain: a literature review.

    Science.gov (United States)

    Coustasse, Alberto; Tomblin, Shane; Slack, Chelsea

    2013-01-01

    Supply costs account for more than one-third of the average operating budget and constitute the second largest expenditure in hospitals. As hospitals have sought to reduce these costs, radio-frequency identification (RFID) technology has emerged as a solution. This study reviews existing literature to gauge the recent and potential impact and direction of the implementation of RFID in the hospital supply chain to determine current benefits and barriers of adoption. Findings show that the application of RFID to medical equipment and supplies tracking has resulted in efficiency increases in hospitals with lower costs and increased service quality. RFID technology can reduce costs, improve patient safety, and improve supply chain management effectiveness by increasing the ability to track and locate equipment, as well as monitoring theft prevention, distribution management, and patient billing. Despite ongoing RFID implementation in the hospital supply chain, barriers to widespread and rapid adoption include significant total expenditures, unclear return on investment, and competition with other strategic imperatives.

  14. [The Central Military Hospital of the People's Commissariat for Defence during the Great Patriotic War].

    Science.gov (United States)

    Simonenko, V B; Abashin, V G; Polovinka, V S

    2014-05-01

    The article is devoted to activity of the Central Military Hospital of the People's Commissariat for Defence during the Great Patriotic War. The research is based on declassified orders of PCD and orders of the chef of hospital. Authors presented the role of the hospital in organization of medical aid for officers of PCD, members of their families, Red Army soldiers, junior and senior Red Army commanders; the role of the hospital in organization of medical facilities for combat army; medical supply for evacuation of family members of PCD's officers ( en route and in evacuation places); delivery of child health care to children of officers of PCD in the hospital and education in kindergartens of PCD.

  15. Discussion on Treatment Process of Dental Handpieces in Central Sterile Supplies Department of Hospital%医院消毒供应中心牙科手机处理流程探讨

    Institute of Scientific and Technical Information of China (English)

    胡佩俊; 张殷雷

    2014-01-01

    牙科手机是口腔科医生对牙科类疾病诊断治疗的重要工具,其使用前的无菌且功能完好直接影响临床应用与治疗效果。本文整合了有关牙科手机的处理经验,结合我院的实际情况,对牙科手机预处理、机械热力清洗和消毒、保养及灭菌环节的使用条件、流程进行说明,并分别提出了新的建议和方法。运用新方法对牙科手机进行清洗消毒,既能提高清洗质量确保灭菌效果,又能预防医院感染的发生。%Dental handpieces are important instruments for dentists to diagnose and treat dental diseases. The sterility and good condition of dental hand pieces can directly influence the clinical application and the treatment effect. Through integrating previous experience in disposing dental handpieces and combining with the actual conditions of our hospital, this paper gives a brief introduction for the use of dental handpieces from the aspects of preprocessing, wash and disinfect, using conditions and procedure, then puts forward some suggestions and methods. The new methods not only can improve the cleaning quality and ensure the sterilizing effect, but also can prevent hospital infection.

  16. A way for reducing drug supply chain cost for a hospital district: A case study

    Directory of Open Access Journals (Sweden)

    Leonardo Postacchini

    2016-03-01

    Full Text Available Purpose: This work aims at providing insights to optimise healthcare logistic of the drug management, in order to deal with the healthcare expenditure cut. In this paper the effects of different drug supply chain configurations, on the resulting average stock, service level and Bullwhip effect, of the studied supply chain, is quantitatively assessed. Design/methodology/approach: A case study of an Italian district has been studied, taking into account three echelons: suppliers, central stock, and hospitals. A model of the various supply chain configurations has been created with the use of the simulation. Specifically, 24 supply chain configurations have been examined, stemming from the combination of several supply chain design parameters, namely: transshipment policies (Emergency Lateral Transshipment or Total Inventory Equalization; re-order and inventory management policies (Economic Order Quantity or Economic Order Interval; required service levels (90% or 95%; the number of available vans (one or two. For each configuration, hospital average stock, service level and a “Bullwhip effect” analysis are computed. To know which input variables are statistically significant, a DoE (Design of Experiments analysis has been executed. Findings: The output of this paper provides useful insights and suggestions to optimize the healthcare logistic and drug supply chain. According to the developed DoE analysis, it can be stated that the introduction of transshipment policies provides important improvement in terms of service and stock levels. To reduce the Bullwhip effect, which results in a service level decreasing, and in a managing stock costs increasing, it is worth to adopt an EOQ re-order policy. Practical implications: This research gives practical recommendations to the studied system, in order to reduce costs and maintain a very satisfactory service level. Originality/value: This paper fulfils an identified need to study which combination of

  17. [Central sterile supply department management system design and implementation based on RFID technology].

    Science.gov (United States)

    Li, Lei

    2012-03-01

    With the analysis of the requirements of sterilization and supply center of hospital(referred to as "supply room"), the management system of supply room was developed and integrated into the RFID technology. The?system has achieve disinfection materials circulation process traceability to improve the quality management of disinfection materials and reduce the management costs.

  18. Implementation of the industry standards of central sterile supply depart-ments in 39 hospitals in Jilin Province%吉林省39所医院消毒供应中心行业标准实施调查

    Institute of Scientific and Technical Information of China (English)

    孙丽萍; 杨云海; 朱孝民

    2014-01-01

    目的:了解消毒供应中心(CSSD)三项行业标准的执行情况、成效及存在的问题,为标准的修订和卫生行政部门推进标准的实施提供依据。方法2012年12月,采用卫生部医管所统一的调查方案,对吉林省39所不同级别医院CSSD和医院管理部门两个层面进行调查。结果调查省部级(10所)、地市级(9所)和县区级(20所)医院共39所。2009年4月1日后有28所医院进行了整体扩建或改建,同时全部依据CSSD三项标准对CSSD进行扩建或改建。纳入医疗质量管理的医院38所,占97.44%;采用信息技术建立CSSD质量管理与追溯系统的医院4所,正在开发的医院18所;CSSD平均面积为542 m2,平均配备14.37人,配备人数与100张床位比为1.75:100;检查包装灭菌区的温度符合标准要求的医院25所,合格率为64.10%,湿度符合标准的医院23所,合格率为58.97%;清洗消毒设备配备率79.48%;终末漂洗用水,纯化水使用构成比为51.28%;环氧乙烷灭菌器配备率28.21%,过氧化氢等离子体灭菌器配备率56.41%;包装材料为棉织布的医院39所;按标准频率对压力蒸汽灭菌器进行生物监测的医院占89.74%。结论 CSSD行业标准发布后,吉林省各医院高度重视,在CSSD建筑布局、使用面积、人员配备及个人防护用品、清洗消毒设备和清洗耗材配备方面有较大提高。%Objective To realize the status,effectiveness and existed problems in the implementation of three in-dustry standards of central sterile supply departments (CSSDs),and provide a scientific basis for the revision and execution of standards by public health authorities.Methods In December 2012,CSSDs and administration sections in 39 different level hospitals in Jilin Province were investigated by unified method of National Institute of Hospital Administration.Results A total of 39 hospitals

  19. [Production chain supply management for public hospitals: a logistical approach to healthcare].

    Science.gov (United States)

    Infante, Maria; dos Santos, Maria Angélica Borges

    2007-01-01

    Despite their importance for hospital operations, discussions of healthcare organization logistics and supply and materials management are notably lacking in Brazilian literature. This paper describes a methodology for organizing the supply of medical materials in public hospitals, based on an action-research approach. Interventions were based on the assumption that a significant portion of problems in Brazil's National Health System (SUS) facilities derive from the fact that their clinical and administrative departments do not see themselves as belonging to the same production chain - neither the hospital nor the supply department is aware of what the other produces. The development of the methodology and its main steps are presented and discussed, against a background of recent literature and total quality and supply chain management concepts.

  20. ENERGY SAVING METHODS IN HOT WATER SUPPLY FOR HOSPITALITY INDUSTRY

    OpenAIRE

    JAYASINGHE, B. T. D.

    2016-01-01

    Hotel Industry in Sri Lanka is becoming a vital sector in the economic development in the after the cessation of ethnic conflict that existed in almost 30 years. This has resulted in high demand for energy for enhanced activities in the hotel industry. The prime objective of the hospitality industry is to provide maximum comfort and facilities to its customers. Hence, Hotels utilize more energy to satisfy its visitors which will benefit the hotel as well as the income generated through foreig...

  1. ENERGY SAVING METHODS IN HOT WATER SUPPLY FOR HOSPITALITY INDUSTRY

    OpenAIRE

    JAYASINGHE, B. T. D.

    2016-01-01

    Hotel Industry in Sri Lanka is becoming a vital sector in the economic development in the after the cessation of ethnic conflict that existed in almost 30 years.   This has resulted in high demand for energy for enhanced activities in the hotel industry.    The prime objective of the hospitality industry is to provide maximum comfort and facilities to its customers. Hence, Hotels utilize more energy to satisfy its visitors which will benefit the hotel as well as the income generated through f...

  2. Intelligent Vehicle Electrical Power Supply System with Central Coordinated Protection

    Institute of Scientific and Technical Information of China (English)

    YANG Diange; KONG Weiwei; LI Bing; LIAN Xiaomin

    2016-01-01

    The current research of vehicle electrical power supply system mainly focuses on electric vehicles (EV) and hybrid electric vehicles (HEV). The vehicle electrical power supply system used in traditional fuel vehicles is rather simple and imperfect;electrical/electronic devices (EEDs) applied in vehicles are usually directly connected with the vehicle’s battery. With increasing numbers of EEDs being applied in traditional fuel vehicles, vehicle electrical power supply systems should be optimized and improved so that they can work more safely and more effectively. In this paper, a new vehicle electrical power supply system for traditional fuel vehicles, which accounts for all electrical/electronic devices and complex work conditions, is proposed based on a smart electrical/electronic device (SEED) system. Working as an independent intelligent electrical power supply network, the proposed system is isolated from the electrical control module and communication network, and access to the vehicle system is made through a bus interface. This results in a clean controller power supply with no electromagnetic interference. A new practical battery state of charge (SoC) estimation method is also proposed to achieve more accurate SoC estimation for lead-acid batteries in traditional fuel vehicles so that the intelligent power system can monitor the status of the battery for an over-current state in each power channel. Optimized protection methods are also used to ensure power supply safety. Experiments and tests on a traditional fuel vehicle are performed, and the results reveal that the battery SoC is calculated quickly and sufficiently accurately for battery over-discharge protection. Over-current protection is achieved, and the entire vehicle’s power utilization is optimized. For traditional fuel vehicles, the proposed vehicle electrical power supply system is comprehensive and has a unified system architecture, enhancing system reliability and security.

  3. Intelligent vehicle electrical power supply system with central coordinated protection

    Science.gov (United States)

    Yang, Diange; Kong, Weiwei; Li, Bing; Lian, Xiaomin

    2016-07-01

    The current research of vehicle electrical power supply system mainly focuses on electric vehicles (EV) and hybrid electric vehicles (HEV). The vehicle electrical power supply system used in traditional fuel vehicles is rather simple and imperfect; electrical/electronic devices (EEDs) applied in vehicles are usually directly connected with the vehicle's battery. With increasing numbers of EEDs being applied in traditional fuel vehicles, vehicle electrical power supply systems should be optimized and improved so that they can work more safely and more effectively. In this paper, a new vehicle electrical power supply system for traditional fuel vehicles, which accounts for all electrical/electronic devices and complex work conditions, is proposed based on a smart electrical/electronic device (SEED) system. Working as an independent intelligent electrical power supply network, the proposed system is isolated from the electrical control module and communication network, and access to the vehicle system is made through a bus interface. This results in a clean controller power supply with no electromagnetic interference. A new practical battery state of charge (SoC) estimation method is also proposed to achieve more accurate SoC estimation for lead-acid batteries in traditional fuel vehicles so that the intelligent power system can monitor the status of the battery for an over-current state in each power channel. Optimized protection methods are also used to ensure power supply safety. Experiments and tests on a traditional fuel vehicle are performed, and the results reveal that the battery SoC is calculated quickly and sufficiently accurately for battery over-discharge protection. Over-current protection is achieved, and the entire vehicle's power utilization is optimized. For traditional fuel vehicles, the proposed vehicle electrical power supply system is comprehensive and has a unified system architecture, enhancing system reliability and security.

  4. An unusual outbreak of nontuberculous mycobacteria in hospital respiratory wards: Association with nontuberculous mycobacterial colonization of hospital water supply network.

    Science.gov (United States)

    D'Antonio, Salvatore; Rogliani, Paola; Paone, Gregorino; Altieri, Alfonso; Alma, Mario Giuseppe; Cazzola, Mario; Puxeddu, Ermanno

    2016-06-01

    The incidence and prevalence of pulmonary nontuberculous mycobacterial (NTM) infection is increasing worldwide arousing concerns that NTM infection may become a serious health challenge. We recently observed a significant increase of NTM-positive sputa samples from patients referred to respiratory disease wards of a large tertiary hospital in Rome. A survey to identify possible NTM contamination revealed a massive presence of NTM in the hospital water supply network. After decontamination procedures, NTM presence dropped both in water pipelines and sputa samples. We believe that this observation should encourage water network surveys for NTM contamination and prompt decontamination procedures should be considered to reduce this potential source of infection.

  5. An Exploration of Supply Chain Management Practices in the Central District Municipality

    Science.gov (United States)

    Ambe, I. M.

    2009-01-01

    The main objective of the paper is to explore supply chain management practices in the Central District Municipality, North West province of South Africa, using the grounded theory methodology. Supply chain management was introduced in the South African public sector to alleviate deficiencies related to governance, interpretation and…

  6. Layouts of trigeneration plants for centralized power supply

    Science.gov (United States)

    Klimenko, A. V.; Agababov, V. S.; Il'ina, I. P.; Rozhnatovskii, V. D.; Burmakina, A. V.

    2016-06-01

    One of the possible and, under certain conditions, sufficiently effective methods for reducing consumption of fuel and energy resources is the development of plants for combined generation of different kinds of energy. In the power industry of Russia, the facilities have become widespread in which the cogeneration technology, i.e., simultaneous generation of electric energy and heat, is implemented. Such facilities can use different plants, viz., gas- and steam-turbine plants and gas-reciprocating units. Cogeneration power supply can be further developed by simultaneously supplying the users not only with electricity and heat but also with cold. Such a technology is referred to as trigeneration. To produce electricity and heat, trigeneration plants can use the same facilities that are used in cogeneration, namely, gas-turbine plants, steam-turbine plants, and gas-reciprocating units. Cold can be produced in trigeneration plants using thermotransformers of various kinds, such as vaporcompression thermotransformers, air thermotransformers, and absorption thermotransformers, that operate as chilling machines. The thermotransformers can also be used in the trigeneration plants to generate heat. The main advantage of trigeneration plants based on gas-turbine plants or gas-reciprocating units over cogeneration plants is the increased thermodynamic power supply efficiency owing to utilization of the waste-gas heat not only in winter but also in summer. In the steam-turbine-based trigeneration plants equipped with absorption thermotransformers, the enhancement of the thermodynamic power supply efficiency is determined by the increase in the heat extraction load during the nonheating season. The article presents calculated results that demonstrate higher thermodynamic efficiency of a gas-turbine-based plant with an absorption thermotransformer that operates in the trigeneration mode compared with a cogeneration gas-turbine plant. The structural arrangements of trigeneration

  7. Fatty acid supply of growing pigs in Central Vietnam

    NARCIS (Netherlands)

    Nguyen, Linh Quang

    2002-01-01

    This thesis concerns the influence of essential dietary fatty acids on the fatty acid composition of adipose tissue and growth performance of growing pigs kept on samll holdings in Central Vietnam. Essential fatty acids cannot be synthesized by the body and have to be ingested with the feed. There a

  8. Effects of rainwater harvesting on centralized urban water supply systems

    DEFF Research Database (Denmark)

    Grandet, C.; Binning, Philip John; Mikkelsen, Peter Steen

    2010-01-01

    The potential effect of widespread rainwater harvesting practices on mains water demand and quality management are investigated for three different types of urban areas characterized by different roof area to water demand ratios. Two rainfall patterns are considered with similar average annual de...... if they enable the deferment of requirements for new mains water infrastructure.......The potential effect of widespread rainwater harvesting practices on mains water demand and quality management are investigated for three different types of urban areas characterized by different roof area to water demand ratios. Two rainfall patterns are considered with similar average annual...... depths but very different temporal distributions. Supply reliability and the extent of reliance on the public distribution system are identified as suitable performance indicators for mains water infrastructure. A uniform temporal distribution of rainfall in an oceanic climate like that of Dinard...

  9. The Cost of Supplying Segmented Consumers From a Central Facility

    DEFF Research Database (Denmark)

    Turkensteen, Marcel; Klose, Andreas

    consider three measures of dispersion of demand points: the average distance between demand points, the maximum distance and the surface size.In our distribution model, all demand points are restocked from a central facility. The observed logistics costs are determined using the tour length estimations......Organizations regularly face the strategic marketing decision which groups of consumers they should target. A potential problem, highlighted in Steenkamp et al. (2002), is that the target consumers may be so widely dispersed that an organization cannot serve its customers cost-effectively. We...... measure if there are many stops on a route and with our average distance measure if there are relatively few....

  10. Contamination of Hospital Water Supplies in Gilan, Iran, with Legionella pneumophila, Escherichia coli, and Pseudomonas aeruginosa

    OpenAIRE

    Masoumeh Ahmadi Jalali Moghadam; Hamidreza Honarmand; Sajad Asfaram Meshginshahr

    2015-01-01

    This study is designed to determine the contamination degree of hospital water supplies with Pseudomonas aeruginosa, Legionella pneumophila, and E. coli in Gilan, Iran. Samples were collected directly into sterile containers and concentrated by centrifuge. Half part of any sample transferred to yeast extract broth and the second part transferred to Trypticase Soy Broth and incubated for 3 days. DNA was extracted by using commercial kit. Four rounds of PCR were performed as follows: multiplex ...

  11. Medication supply chain management through implementation of a hospital pharmacy computerized inventory program in Haiti

    Directory of Open Access Journals (Sweden)

    Michelle R. Holm

    2015-01-01

    Full Text Available Background: In the aftermath of the 2010 earthquake in Haiti, St. Luke Hospital was built to help manage the mass casualties and subsequent cholera epidemic. A major problem faced by the hospital system was the lack of an available and sustainable supply of medications. Long-term viability of the hospital system depended largely on developing an uninterrupted medication supply chain. Objective: We hypothesized that the implementation of a new Pharmacy Computerized Inventory Program (PCIP would optimize medication availability and decrease medication shortages. Design: We conducted the research by examining how medications were being utilized and distributed before and after the implementation of PCIP. We measured the number of documented medication transactions in both Phase 1 and Phase 2 as well as user logins to determine if a computerized inventory system would be beneficial in providing a sustainable, long-term solution to their medication management needs. Results: The PCIP incorporated drug ordering, filling the drug requests, distribution, and dispensing of the medications in multiple settings; inventory of currently shelved medications; and graphic reporting of ‘real-time’ medication usage. During the PCIP initiation and establishment periods, the number of medication transactions increased from 219.6 to 359.5 (p=0.055, respectively, and the mean logins per day increased from 24.3 to 31.5, p<0.0001, respectively. The PCIP allows the hospital staff to identify and order medications with a critically low supply as well as track usage for future medication needs. The pharmacy and nursing staff found the PCIP to be efficient and a significant improvement in their medication utilization. Conclusions: An efficient, customizable, and cost-sensitive PCIP can improve drug inventory management in a simplified and sustainable manner within a resource-constrained hospital.

  12. 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.

  13. Supply chain management with cost-containment & financial-sustainability in a tertiary care hospital.

    Science.gov (United States)

    Chandra, Hem; Rinkoo, Arvind Vashishta; Verma, Jitendra Kumar; Verma, Shuchita; Kapoor, Rakesh; Sharma, R K

    2013-01-01

    Financial crunch in the present recession results in the non-availability of the right materials at the right time in large hospitals. However due to insufficient impetus towards systems development, situation remains dismal even when funds are galore. Cost incurred on materials account for approximately one-third of the total recurring expenditures in hospitals. Systems development for effective and efficient materials management is thus tantamount to cost-containment and sustainability. This scientific paper describes an innovative model, Hospital Revolving Fund (HRF), developed at a tertiary care research institute in Asia. The main idea behind inception of HRF was to ensure availability of all supplies in the hospital so that the quality of healthcare delivery was not affected. The model was conceptualized in the background of non-availability of consumables in the hospital leading to patient as well as staff dissatisfaction. Hospital supplies have been divided into two parts, approximately 3250 unit items and 1750 miscellaneous items. This division is based on cost, relative-utility and case-specific utilization. 0.1 Million USD, separated from non-planned budget, was initially used as seed money in 1998. HRF procures supplies from reputed firms on concessional rates (8-25%) and make them available to patients at much lesser rates vis-à-vis market rates, levying minimal maintenance charges. In 2009-10, total annual purchases of 14 Million USD were made. The balance sheet reflected 1.4 Million USD as fixed deposit investment. The minimal maintenance charges levied on the patients along with the interest income were sufficient to pay for all recurring expenses related to HRF. Even after these expenses, HRF boosted of 0.2 Million USD as cash-in-hand in financial year 2009-10. In-depth analysis of 'balance sheet' and 'Income and Expenditure' statement of the fund for last five financial years affirms that HRF is a self-sustainable and viable supply chain

  14. Effects of changes in micro- and macro-environmental factors on the supply of hospitals services.

    Science.gov (United States)

    Kassaye, W W; Tseng, K C

    1990-01-01

    The failures, marketing difficulties and financial hardships hospitals have experienced raises a question as to whether they have been responsive to the changes in the micro and macro-environmental factors. To determine how responsive hospitals have been to these changes, we investigate the impact of a number of selected factors on the supply of hospital services during 1972 through 1978. The findings indicate that despite the fact that the economy went through recessionary periods, and the demographic distribution exhibited both a shift and a change in the aging and birth rates of the nation, the changes in hospitals' responsiveness have been less than satisfactory. It appears that hospitals readily respond to the changes in the micro-environment than to the changes in macro-environment. Their response to the changes in the macro-environment. Their response to the changes in the macro-environment may be characterized as an effort to create a higher level of production whose goal is to create a still higher level of needs and wants.

  15. Professional Nursing Duties in the Central Services: Hospital Pharmacy Nurses

    Directory of Open Access Journals (Sweden)

    Inmaculada Gómez-Villegas

    2015-01-01

    Full Text Available Introduction. The new demands of a fast changing world necessitate expanding the traditional concepts of nursing, extending the classical aspects to cover new areas. Purpose. Based on their professional duties, the nursing team in the pharmacy of a second-level hospital aimed to establish a theoretical and situational framework for nurses working in the central services. Material and Methods. Application of the nursing process to nursing work in an area with no direct contact with patients. Results and Discussion. The application of the NANDA diagnoses to professional practice enabled the establishment of a nursing diagnosis with the implementation of measures designed to overcome a stressful situation with a risk of becoming unmotivated. Main Conclusion. The capacity to adapt the nursing profession to undertake new roles in the field of healthcare and the power of nursing own methodological resources permit the indirect care of “faceless” patients to be complemented with the inclusion of nurses from other services as clients, forming the focus of care, who can thus be helped with their daily care work.

  16. Medication supply chain management through implementation of a hospital pharmacy computerized inventory program in Haiti.

    Science.gov (United States)

    Holm, Michelle R; Rudis, Maria I; Wilson, John W

    2015-01-01

    Background In the aftermath of the 2010 earthquake in Haiti, St. Luke Hospital was built to help manage the mass casualties and subsequent cholera epidemic. A major problem faced by the hospital system was the lack of an available and sustainable supply of medications. Long-term viability of the hospital system depended largely on developing an uninterrupted medication supply chain. Objective We hypothesized that the implementation of a new Pharmacy Computerized Inventory Program (PCIP) would optimize medication availability and decrease medication shortages. Design We conducted the research by examining how medications were being utilized and distributed before and after the implementation of PCIP. We measured the number of documented medication transactions in both Phase 1 and Phase 2 as well as user logins to determine if a computerized inventory system would be beneficial in providing a sustainable, long-term solution to their medication management needs. Results The PCIP incorporated drug ordering, filling the drug requests, distribution, and dispensing of the medications in multiple settings; inventory of currently shelved medications; and graphic reporting of 'real-time' medication usage. During the PCIP initiation and establishment periods, the number of medication transactions increased from 219.6 to 359.5 (p=0.055), respectively, and the mean logins per day increased from 24.3 to 31.5, psupply as well as track usage for future medication needs. The pharmacy and nursing staff found the PCIP to be efficient and a significant improvement in their medication utilization. Conclusions An efficient, customizable, and cost-sensitive PCIP can improve drug inventory management in a simplified and sustainable manner within a resource-constrained hospital.

  17. Isolation and molecular identification of biodegrading Mycobacteria from water supplies of Iranian hospitals.

    Directory of Open Access Journals (Sweden)

    Davood Azadi

    2014-08-01

    Full Text Available Some microorganisms, mainly members of two genera including Pseudomonas and Mycobacterium, were found to be capable of transforming and degrading of polluting agents. We herein report the isolation of a few mycobacteria with the ability to biodegrade organic and inorganic compounds from water supplies of Iranian hospitals.The water samples were collected from hospital water supplies. Isolation processes were done according to standard methods. The colonies were subcultured on Löwenstein-Jensen medium to obtain a pure culture. The identification and characterization of the isolates were based on conventional and molecular methods including direct sequence analysis of almost full length of 16S rRNA gene.The almost complete 16S rRNA gene sequences of the studied strains revealed that the isolates WP16, AW18-1 and AW18-3 were identified as M. fredriksbergense, AW18-2 as M. austroafricanum, AW27-2 as M. obuenseand AW27-6 as M. phocaicum.The relationship between our isolates and standard strains of Mycobacterium was supported by a phylogenetic tree of 16S rRNA gene.In the current study we were able to isolate and characterize six mycobacteria with capability of transforming and degrading polluting agents from Iranian hospital environments. This is indeed the first report on isolation and characterization of mycobacteria with degrading capability of polluting agents from Iranian hospitals. It can be considered as a pioneer study to open up a new horizon in the study of microbial diversity in Iran with an objective-based and applied approach to tackle environmental challenges.

  18. Optimization models of the supply of power structures’ organizational units with centralized procurement

    Directory of Open Access Journals (Sweden)

    Sysoiev Volodymyr

    2013-01-01

    Full Text Available Management of the state power structures’ organizational units for materiel and technical support requires the use of effective tools for supporting decisions, due to the complexity, interdependence, and dynamism of supply in the market economy. The corporate nature of power structures is of particular interest to centralized procurement management, as it provides significant advantages through coordination, eliminating duplication, and economy of scale. This article presents optimization models of the supply of state power structures’ organizational units with centralized procurement, for different levels of simulated materiel and technical support processes. The models allow us to find the most profitable options for state power structures’ organizational supply units in a centre-oriented logistics system in conditions of the changing needs, volume of allocated funds, and logistics costs that accompany the process of supply, by maximizing the provision level of organizational units with necessary material and technical resources for the entire planning period of supply by minimizing the total logistical costs, taking into account the diverse nature and the different priorities of organizational units and material and technical resources.

  19. Testing the bed-blocking hypothesis: does higher supply of nursing and care homes reduce delayed hospital discharges?

    OpenAIRE

    James Gaughan; Hugh Gravelle; Luigi Siciliani

    2014-01-01

    Hospital bed blocking occurs when hospital patients are ready to be discharged to a nursing home but no place is available, so that hospital care acts as a more costly substitute for long-term care. We investigate the extent to which higher supply of nursing home beds or lower prices can reduce hospital bed blocking. We use new Local Authority level administrative data from England on hospital delayed discharges in 2010-13. The results suggest that delayed discharges do respond to the availab...

  20. Supply Chain Network Optimization Based on Fuzzy Multiobjective Centralized Decision-Making Model

    Directory of Open Access Journals (Sweden)

    Xinyi Fu

    2017-01-01

    Full Text Available Supply chain cooperation strategy believes that the integration of the operation process can produce value for customers, optimize the supply chain of the connection between the vertical nodes, and constantly strengthen the performance of the advantages, so as to achieve mutual benefit and win-win results. Under fuzzy uncertain environment and centralized decision-making mode, we study multiobjective decision-making optimization, which focuses on equilibrium and compensation of multiobjective problems; that is to say, the proper adjustment of the individual goal satisfaction level will make other goals’ satisfaction levels change greatly. Through coordination among the multiobjectives, supply chain system will achieve global optimum. Finally, a simulation experiment from Shaoxing textile case is used to verify its efficiency and effectiveness.

  1. The impact of forest thinning on the reliability of water supply in central Arizona.

    Directory of Open Access Journals (Sweden)

    Silvio Simonit

    Full Text Available Economic growth in Central Arizona, as in other semiarid systems characterized by low and variable rainfall, has historically depended on the effectiveness of strategies to manage water supply risks. Traditionally, the management of supply risks includes three elements: hard infrastructures, landscape management within the watershed, and a supporting set of institutions of which water markets are frequently the most important. In this paper we model the interactions between these elements. A forest restoration initiative in Central Arizona (the Four Forest Restoration Initiative, or 4FRI will result in thinning of ponderosa pine forests in the upper watershed, with potential implications for both sedimentation rates and water delivery to reservoirs. Specifically, we model the net effect of ponderosa pine forest thinning across the Salt and Verde River watersheds on the reliability and cost of water supply to the Phoenix metropolitan area. We conclude that the sediment impacts of forest thinning (up to 50% of canopy cover are unlikely to compromise the reliability of the reservoir system while thinning has the potential to increase annual water supply by 8%. This represents an estimated net present value of surface water storage of $104 million, considering both water consumption and hydropower generation.

  2. The effect of the monetary base on money supply – Does the quantity of central bank money carry any information?

    OpenAIRE

    2007-01-01

    In discussing the transmission mechanism, basic macroeconomics textbooks focus on changes in money supply, which the central bank can control by manipulating the monetary base. Modern central banks, however, take a considerably more complex view of the transmission mechanism, and the operational target of most central banks is to set a short-term interest rate. Under such circumstances, the direction of the mutual effect of the monetary base and money supply is rather the reverse in today’s p...

  3. Assessment of Electromagnetic Fields around High Voltage Power Supply in Hamadan Hospital Wards

    Directory of Open Access Journals (Sweden)

    Nima Rostampour

    2012-10-01

    Full Text Available Normal 0 false false false EN-US X-NONE AR-SA MicrosoftInternetExplorer4 Background and Objectives: Biological effects of non-ionizing radiation on the body of living organisms have been studied by researchers in recent years. High Voltage medical equipments are one of the sources generating electromagnetic fields. The electromagnetic field intensity of the medical equipment installed at Hamadan hospitals and the potential hazards were investigated. The main purpose of this study was to determine the intensity of the electromagnetic field around high voltage power supplies in radiology ward of the Hamadan hospitals. Materials and Methods: This was a cross-sectional study and we investigated the electromagnetic fields intensity around high voltage power supplies at Hamadan hospital wards. All measurements were performed using a calibrated Tesla-meter (HI-3603. The measurements were conducted at a range of distances varying from 25 cm to 3 m around the supporting high voltage power supply. Results: We found that the maximum intensity of the magnetic and electric fields at a distance of less than 1 m around the high voltage power supply was 29.625±5.738 mGauss and 25.17±0.92 V/m respectively, which is less than the safe amounts recommended by the ICNIRP for occupational exposure (5000 mG and 10000 V/m and even for public exposure (1000 mG and and 5000 V/m. The minimum intensity of EM fields for a less than 3 m distance was found to be 0.1±0.005 mGauss, which relates to a CT-scanner system installed at Farshchian hospital. Among the whole equipments evaluated in the current survey, the most intense magnetic and electric field was found to be for imaging technician office, which was 3.050±0.004 mGauss and 128.88±0.05 V/m respectively; it is lower than the tolerances recommended by the ICNIRP. Conclusion: According to our results, it seems that the EM field occupational exposure for radiation workers working at Hamadan hospitals does not exceed

  4. Typology of the supply chains of non-wood forest products in central Serbia

    Directory of Open Access Journals (Sweden)

    Nonić Dragan

    2013-01-01

    Full Text Available Modern economies are characterized by a growing importance of cooperation and the creation of networks of enterprises, organizations and institutions, which are all part of a supply chain, in order to achieve competitive advantage in a market. The aim of this study was to determine the structure of the supply chains of non-wood forest products in selected forest areas of Central Serbia (Golijsko, Podrinjsko-kolubarsko, Posavsko-podunavsko, Rasinsko and Tarsko-zlatiborsko FAs. The comparative method was applied in this paper, along with the method of specialization (classification, the method of structural partial analysis (supply chain analysis and the statistical method (analysis of frequencies and two-step cluster. The data collection was conducted in 2011, by using the technique of door-to-door survey. The analysis of the basic types of the supply chains of non-wood forest products and their main stages (purchasing, processing and placement was conducted in the selected areas. A cluster analysis showed that there were six basic types of supply chains in the selected forest areas and one dominant type. [Projekat Ministarstva nauke Republike Srbije, br. 443007/16 –III: Istraživanja klimatskih promena i njihovog uticaja na životnu sredinu -praćenje uticaja, adaptacija i ublažavanje, podprojekat: Socio-ekonomski razvoj, ublažavanje i adaptacija na klimatske promene

  5. The Study of the Optimal Parameter Settings in a Hospital Supply Chain System in Taiwan

    Directory of Open Access Journals (Sweden)

    Hung-Chang Liao

    2014-01-01

    Full Text Available This study proposed the optimal parameter settings for the hospital supply chain system (HSCS when either the total system cost (TSC or patient safety level (PSL (or both simultaneously was considered as the measure of the HSCS’s performance. Four parameters were considered in the HSCS: safety stock, maximum inventory level, transportation capacity, and the reliability of the HSCS. A full-factor experimental design was used to simulate an HSCS for the purpose of collecting data. The response surface method (RSM was used to construct the regression model, and a genetic algorithm (GA was applied to obtain the optimal parameter settings for the HSCS. The results show that the best method of obtaining the optimal parameter settings for the HSCS is the simultaneous consideration of both the TSC and the PSL to measure performance. Also, the results of sensitivity analysis based on the optimal parameter settings were used to derive adjustable strategies for the decision-makers.

  6. The Study of Medical Supplies Automation Replenishment Algorithm in Hospital on Medical Supplies Supplying Chain%基于供应链平台上医院医用耗材自动补货算法研究

    Institute of Scientific and Technical Information of China (English)

    盛禧

    2012-01-01

    Objective The thesis aims to study the automation replenishment algorithm in hospital on medical supplies supplying chain. Method: The mathematical model and algorithm of medical supplies automation replenishment are designed through referring to practical data form hospital on the basis of applying inventory theory, greedy algorithm and partition algorithm. Result The automation replenishment algorithm is proved to realize automatic calculation of the medical supplies distribution amount and optimize medical supplies distribution scheme. Conclusion A conclusion could be arrived that the model and algorithm of inventory theory, if applied in medical supplies circulation field, could provide theorical and technological support for realizing medical supplies automation replenishment of hospital on medical supplies supplying chain.%目的 研究医用耗材供应链上医院自动补货算法.方法 运用存贮理论、贪心算法和分治算法,结合医院医用耗材使用数据,设计医用耗材自动补货的数学模型和算法.结果 该算法经验证,实现医院自动生成医用耗材订货批量,优化医用耗材配送方案.结论 存贮理论的模型和算法,在医用耗材流通领域的应用,为医用耗材供应链上医院自动补货的实现,提供理论和技术支持.

  7. Clinical course, management and in-hospital outcomes of acute coronary syndrome in Central Asian women

    Directory of Open Access Journals (Sweden)

    Ravshanbek Kurbanov

    2011-03-01

    Full Text Available The paper describes features history, risk factors and hospital management of acute coronary syndrome (ACS in women of the Central Asia (829 ACS patients are included, and also comparison of hospital outcomes of ACS in groups of men and women.ACS in women in the Central Asia comprises features as more non Q-wave myocardial infarction frequency, smaller adherence to treatment of dyslipidemia, more obesity degrees. Women arrive to hospital average in 4 hours after men; have more percent of the atypical form. In-hospital outcomes in men and women significantly did not differ because of general tendency to late arriving to the hospital and small quantity of revascularization procedures. The reasons of differences between men and women in the region are mostly connected to social sphere (late arriving, non-treated dyslipidemia than to physiological peculiarities.

  8. Contamination of Hospital Water Supplies in Gilan, Iran, with Legionella pneumophila, Escherichia coli, and Pseudomonas aeruginosa.

    Science.gov (United States)

    Ahmadi Jalali Moghadam, Masoumeh; Honarmand, Hamidreza; Asfaram Meshginshahr, Sajad

    2015-01-01

    This study is designed to determine the contamination degree of hospital water supplies with Pseudomonas aeruginosa, Legionella pneumophila, and E. coli in Gilan, Iran. Samples were collected directly into sterile containers and concentrated by centrifuge. Half part of any sample transferred to yeast extract broth and the second part transferred to Trypticase Soy Broth and incubated for 3 days. DNA was extracted by using commercial kit. Four rounds of PCR were performed as follows: multiplex PCR for detecting Pseudomonas aeruginosa, Integron 1, and Metallo-β-lactamases gene; PCR for detecting Legionella pneumophila and mip gene separately; PCR for detecting E. coli; and another PCR for detecting whole bacterial presence. Contamination rates of cold, warm, and incubator water samples with P. aeruginosa, were 16.6%, 37.5%, and 6.8% consequently. Degrees of contamination with L. pneumophila were 3.3%, 9.3%, and 10.9% and with E. coli were zero, 6.2%, and zero. Total bacterial contamination of cold, warm, and incubator water samples was 93.3%, 84.4%, and 89.0% consequently. Metallo-β-lactamases gene was found in 20.0% of all samples. Contamination degree with P. aeruginosa was considerable and with L. pneumophila was moderate. Metallo-β-lactamases gene was found frequently indicating widespread multiple drug resistance bacteria. We suggest using new decontamination method based on nanotechnology.

  9. Contamination of Hospital Water Supplies in Gilan, Iran, with Legionella pneumophila, Escherichia coli, and Pseudomonas aeruginosa

    Directory of Open Access Journals (Sweden)

    Masoumeh Ahmadi Jalali Moghadam

    2015-01-01

    Full Text Available This study is designed to determine the contamination degree of hospital water supplies with Pseudomonas aeruginosa, Legionella pneumophila, and E. coli in Gilan, Iran. Samples were collected directly into sterile containers and concentrated by centrifuge. Half part of any sample transferred to yeast extract broth and the second part transferred to Trypticase Soy Broth and incubated for 3 days. DNA was extracted by using commercial kit. Four rounds of PCR were performed as follows: multiplex PCR for detecting Pseudomonas aeruginosa, Integron 1, and Metallo-β-lactamases gene; PCR for detecting Legionella pneumophila and mip gene separately; PCR for detecting E. coli; and another PCR for detecting whole bacterial presence. Contamination rates of cold, warm, and incubator water samples with P. aeruginosa, were 16.6%, 37.5%, and 6.8% consequently. Degrees of contamination with L. pneumophila were 3.3%, 9.3%, and 10.9% and with E. coli were zero, 6.2%, and zero. Total bacterial contamination of cold, warm, and incubator water samples was 93.3%, 84.4%, and 89.0% consequently. Metallo-β-lactamases gene was found in 20.0% of all samples. Contamination degree with P. aeruginosa was considerable and with L. pneumophila was moderate. Metallo-β-lactamases gene was found frequently indicating widespread multiple drug resistance bacteria. We suggest using new decontamination method based on nanotechnology.

  10. Risk indicators for water supply systems for a drought Decision Support System in central Tuscany (Italy)

    Science.gov (United States)

    Rossi, Giuseppe; Garrote, Luis; Caporali, Enrica

    2010-05-01

    Identifying the occurrence, the extent and the magnitude of a drought can be delicate, requiring detection of depletions of supplies and increases in demand. Drought indices, particularly the meteorological ones, can describe the onset and the persistency of droughts, especially in natural systems. However they have to be used cautiously when applied to water supply systems. They show little correlation with water shortage situations, since water storage, as well as demand fluctuation, play an important role in water resources management. For that reason a more dynamic indicator relating supply and demand is required in order to identify situations when there is risk of water shortages. In water supply systems there is great variability on the natural water resources and also on the demands. These quantities can only be defined probabilistically. This great variability is faced defining some threshold values, expressed in probabilistic terms, that measure the hydrologic state of the system. They can identify specific actions in an operational context in different levels of severity, like the normal, pre-alert, alert and emergency scenarios. They can simplify the decision-making required during stressful periods and can help mitigate the impacts of drought by clearly defining the conditions requiring actions. The threshold values are defined considering the probability to satisfy a given fraction of the demand in a certain time horizon, and are calibrated through discussion with water managers. A simplified model of the water resources system is built to evaluate the threshold values and the management rules. The threshold values are validated with a long term simulation that takes into account the characteristics of the evaluated system. The levels and volumes in the different reservoirs are simulated using 20-30 years time series. The critical situations are assessed month by month in order to evaluate optimal management rules during the year and avoid conditions

  11. AN ALGORITHM FOR THE DETERMINATION OF THE ECONOMIC ORDER QUANTITY IN A TWO-LEVEL SUPPLY CHAIN WITH TRANSPORTATION COSTS: COMPARISON OF DECENTRALIZED WITH CENTRALIZED DECISION

    Institute of Scientific and Technical Information of China (English)

    Armand BABOLI; Mohammadali Pirayesh NEGHAB; Rasoul HAJI

    2008-01-01

    This paper considers a two-level supply chain consisting of one warehouse and one retailer. In this model we determine the optimal ordering policy according to inventory and transportation costs. We assume that the demand rate by the retailer is known. Shortages are allowed neither at the retailer nor at the warehouse. We study this model in two cases; decentralized and centralized. In the decentralized case the retailer and the warehouse independently minimize their own costs; while in the centralized case the warehouse and the retailer are considered as a whole firm. We propose an algorithm to find economic order quantities for both the retailer and the warehouse which minimize the total system cost in the centralized case. The total system cost contains the holding and ordering costs at the retailer and the warehouse as well as the transportation cost from the warehouse to the retailer. The application of this model into the pharmaceutical downstream supply chain of a public hospital allows obtaining significant savings. By numerical examples, the costs are computed in MATLAB(C) to compare the costs in the centralized case with decentralized one and to propose a saving-sharing mechanism through quantity discount.

  12. [Surgical service at the Central Military Hospital of People's Commissariat of Defence shortly before the Great Patriotic War].

    Science.gov (United States)

    Krainyukov, P E; Efimenko, N A; Abashin, V G

    2015-04-01

    Authors present the article historical data on the foundation and development of surgical service at the 1st Therapeutic Red Cross Hospital (Central Military Hospital of People's Commissariat. of Defense) since its organization. The structure of the hospital surgical service and organization of surgical activity during the pre-war years is presented. Provided information about outstanding surgeons who was working in the hospital.

  13. Predicted pH at the domestic and public supply drinking water depths, Central Valley, California

    Science.gov (United States)

    Rosecrans, Celia Z.; Nolan, Bernard T.; Gronberg, Jo Ann M.

    2017-03-08

    This scientific investigations map is a product of the U.S. Geological Survey (USGS) National Water-Quality Assessment (NAWQA) project modeling and mapping team. The prediction grids depicted in this map are of continuous pH and are intended to provide an understanding of groundwater-quality conditions at the domestic and public supply drinking water zones in the groundwater of the Central Valley of California. The chemical quality of groundwater and the fate of many contaminants is often influenced by pH in all aquifers. These grids are of interest to water-resource managers, water-quality researchers, and groundwater modelers concerned with the occurrence of natural and anthropogenic contaminants related to pH. In this work, the median well depth categorized as domestic supply was 30 meters below land surface, and the median well depth categorized as public supply is 100 meters below land surface. Prediction grids were created using prediction modeling methods, specifically boosted regression trees (BRT) with a Gaussian error distribution within a statistical learning framework within the computing framework of R (http://www.r-project.org/). The statistical learning framework seeks to maximize the predictive performance of machine learning methods through model tuning by cross validation. The response variable was measured pH from 1,337 wells and was compiled from two sources: USGS National Water Information System (NWIS) database (all data are publicly available from the USGS: http://waterdata.usgs.gov/ca/nwis/nwis) and the California State Water Resources Control Board Division of Drinking Water (SWRCB-DDW) database (water quality data are publicly available from the SWRCB: http://www.waterboards.ca.gov/gama/geotracker_gama.shtml). Only wells with measured pH and well depth data were selected, and for wells with multiple records, only the most recent sample in the period 1993–2014 was used. A total of 1,003 wells (training dataset) were used to train the BRT

  14. The Likelihood of Hospital Readmission among Patients with Hospital-Onset Central Line-Associated Bloodstream Infections

    Science.gov (United States)

    Khong, Carolyn; Baggs, James; Kleinbaum, David; Cochran, Ronda; Jernigan, John A.

    2015-01-01

    Objective We sought to determine whether central line-associated bloodstream infections (CLABSI) increase the likelihood of readmission. Design Retrospective matched cohort study for the years 2008–2009. Setting Acute care hospitals. Participants Medicare recipients. CLABSI and readmission status were determined by linking National Healthcare Safety Network surveillance data to the Centers for Medicare & Medicaid Services’ Medical Provider and Analysis Review in eight states. Frequency matching was used on ICD-9-CM procedure code category and intensive care unit status. Methods We compared the rate of readmission among patients with and without CLABSI during an index hospitalization. Cox proportional hazard analysis was used to assess rate of readmission (the first hospitalization within 30 days post-index discharge). Multivariate models included the following covariates: race, sex, length of index hospitalization stay central line procedure code, GAGNE co-morbidity score, and individual chronic conditions. Results Of the 8,097 patients, 2,260 were readmitted within 30 days (27.9%). The rate of first readmission was 7.1 events/person-year (PY) for CLABSI patients and 4.3 events/PY for non-CLABSI patients (p <0.001). The final model revealed a small but significant increase in the rate of 30 day readmissions for patients with a CLABSI compared to similar non-CLABSI patients. In the first readmission for CLABSI patients, we also observed an increase in diagnostic categories consistent with CLABSI including septicemia and complications of a device. Conclusions Our analysis found a statistically significant association between CLABSI status and readmission, suggesting that CLABSI may have adverse health impact that extends beyond hospital discharge. PMID:25990620

  15. How Much Control Dose Central Bank of Iran over Money Supply?

    Directory of Open Access Journals (Sweden)

    Jafar HAGHIGHAT

    2011-12-01

    Full Text Available In discussions about the efficacy of monetary policy instruments, attention is often focused on analyzing the money supply process. Monetarists, in general, argue that the monetary authorities can exercise effective control over the stock of money; others, especially those who share the new view of monetary theory argue that the determination of the stock of money is part of the economy. In this view, the stock of money is the outgrowth of the behavior of the public, the financial sector (banks, the finance ministry, andthe rest of the world as well as of the actions of the central bank. The paper investigated the co-integrating property and stability of the supply of money function in Iran. The paper employed the ARDL approach together with CUSUM and CUSUMSQ tests. The results show that M1 and M2 is cointegrated with net claims on the government, net foreign assets, and rate of profit on bank deposit (interest rate and a major implication of using interest rate elasticity estimates from M2 function is that money is endogenous.

  16. INVESTIGATION OF LEGIONELLA SPECIES IN TEHRAN’S HOSPITAL WATER SUPPLIES

    Directory of Open Access Journals (Sweden)

    MOHAMMAD RAFIEE

    2015-03-01

    Full Text Available The present work was performed to investigate the presence of Legionella spp. and its common species in hospital water supplies. Considering the drawback of culture method, polymerase chain reaction (PCR assays were developed to detect the gene 16S rRNA regardless of the bacterial serotype. Four well-established DNA extraction protocols (freeze & thaw and phenol-chloroform as two manual protocols and two commercial kits were examined and critiqued to release DNA from bacterial cells. A total of 45 samples were collected from seven distinct hospitals’ sites during a period of 10 months. The PCR assay was exploited to amplify a 654-bp fragment of the 16S rRNA gene. Legionella were detected in 13 samples (28.9% by all of the methods applied for DNA extraction. Considerable differences were noted in the yield of extracted nucleic acids. Legionella were not detected in any of the samples when DNA extraction by freeze & thaw was used. Omitting this method and comparing manual protocol with commercial kits, Kappa coefficient was calculated as 0.619 with p < 0.05. Although no meaningful differences were found between the kits, DNA extraction with Bioneer kit displayed a higher sensitivity than classical Qiagen. Showerheads and cold-water taps were the most and least contaminated sources with 55.5 and 9 percent positive samples, respectively. Moreover two positive samples were identified for species by DNA sequencing and submitted to the Gene Bank database with accession Nos. FJ480932 and FJ480933.

  17. Revitalization of Pharmaceutical Supply Management as an Effort to Increase Outpatient Customer Satisfaction in One of Private Hospital in Bandung

    Directory of Open Access Journals (Sweden)

    Nabilla

    2015-03-01

    Full Text Available Hospital pharmacies are required to provide appropriate pharmaceutical preparation. Therefore, hospital needs good pharmacy management system. The aims of this study was to analyze customer satisfaction and revitalization of pharmaceutical management in hospital A to improve customer satisfaction. This study was used cross sectional study with quantitative and qualitative approaches. Quantitative approach used survey method with questionnaires and data was analyzed by Partial Least Square (PLS. The results showed that the response to the IFRS employees of pharmaceutical management in hospital A had a very good categories (88.7% and customer responses to pharmaceutical supply management in hospital A in the category satisfied (75.1%. A qualitative approach using interviews with the head of the hospital pharmacy as well as the head unit of the outpatient pharmacy services and pharmacy warehouse. Pharmaceutical management in hospital A is appropriate to the standards by the government, but still needs improvement in pharmaceutical management. Therefore, revitalization of pharmaceutical management is needed as an effort to increase customer satisfaction.

  18. Magnet® Hospital Recognition Linked to Lower Central Line-Associated Bloodstream Infection Rates.

    Science.gov (United States)

    Barnes, Hilary; Rearden, Jessica; McHugh, Matthew D

    2016-04-01

    Central-line-associated bloodstream infections (CLABSI) are among the deadliest heathcare-associated infections, with an estimated 12-25% mortality rate. In 2014, the Centers for Medicare and Medicaid Services (CMS) began to penalize hospitals for poor performance with respect to selected hospital-acquired conditions, including CLABSI. A structural factor associated with high-quality nursing care and better patient outcomes is The Magnet Recognition Program®. The purpose of this study was to explore the relationship between Magnet status and hospital CLABSI rates. We used propensity score matching to match Magnet and non-Magnet hospitals with similar hospital characteristics. In a matched sample of 291 Magnet hospitals and 291 non-Magnet hospitals, logistic regression models were used to examine whether there was a link between Magnet status and CLABSI rates. Both before and after matching, Magnet hospital status was associated with better (lower than the national average) CLABSI rates (OR = 1.60, 95%CI: 1.10, 2.33 after matching). While established programs such as Magnet recognition are consistently correlated with high-quality nursing work environments and positive patient outcomes, additional research is needed to determine whether Magnet designation produces positive patient outcomes or rewards existing excellence.

  19. Carbapenem Resistance among Enterobacter Species in a Tertiary Care Hospital in Central India

    OpenAIRE

    Atul Khajuria; Ashok Kumar Praharaj; Mahadevan Kumar; Naveen Grover

    2014-01-01

    Objective. To detect genes encoding carbapenem resistance among Enterobacter species in a tertiary care hospital in central India. Methods. Bacterial identification of Enterobacter spp. isolates from various clinical specimens in patients admitted to intensive care units was performed by routine conventional microbial culture and biochemical tests using standard recommended techniques. Antibiotic sensitivity test was performed by standard Kirby Bauer disc diffusion technique. PCR amplificat...

  20. Hospital-wide multidisciplinary, multimodal intervention programme to reduce central venous catheter-associated bloodstream infection.

    Directory of Open Access Journals (Sweden)

    Walter Zingg

    Full Text Available Central line-associated bloodstream infection (CLABSI is the major complication of central venous catheters (CVC. The aim of the study was to test the effectiveness of a hospital-wide strategy on CLABSI reduction. Between 2008 and 2011, all CVCs were observed individually and hospital-wide at a large university-affiliated, tertiary care hospital. CVC insertion training started from the 3rd quarter and a total of 146 physicians employed or newly entering the hospital were trained in simulator workshops. CVC care started from quarter 7 and a total of 1274 nurses were trained by their supervisors using a web-based, modular, e-learning programme. The study included 3952 patients with 6353 CVCs accumulating 61,366 catheter-days. Hospital-wide, 106 patients had 114 CLABSIs with a cumulative incidence of 1.79 infections per 100 catheters. We observed a significant quarterly reduction of the incidence density (incidence rate ratios [95% confidence interval]: 0.92 [0.88-0.96]; P<0.001 after adjusting for multiple confounders. The incidence densities (n/1000 catheter-days in the first and last study year were 2.3/1000 and 0.7/1000 hospital-wide, 1.7/1000 and 0.4/1000 in the intensive care units, and 2.7/1000 and 0.9/1000 in non-intensive care settings, respectively. Median time-to-infection was 15 days (Interquartile range, 8-22. Our findings suggest that clinically relevant reduction of hospital-wide CLABSI was reached with a comprehensive, multidisciplinary and multimodal quality improvement programme including aspects of behavioural change and key principles of good implementation practice. This is one of the first multimodal, multidisciplinary, hospital-wide training strategies successfully reducing CLABSI.

  1. Water supply patterns in two agricultural areas of Central Germany under climate change conditions

    Directory of Open Access Journals (Sweden)

    M. H. Tölle

    2012-04-01

    Full Text Available Increasing emissions of greenhouse gases and increasing prices for fossil fuels have highlighted the demand for CO2 "neutral" renewable energy sources, e.g. short rotation forestry systems used for bioenergy. These systems might be vulnerable to changes in temperature, precipitation and occurrence of extreme weather events. To estimate success or failure of such short rotation coppices in a certain area we need regional climate projections and risk assessment. Changes of water supply patterns in two agriculturally extensively used regions in Central Germany (around Göttingen and Großfahner with different climate conditions but both in the temperate climate zone are explored. The study is carried out under present conditions as well as under projected climate change conditions (1971–2100 using A1B and B1 climate scenarios downscaled for Europe. Analysis of precipitation bias shows regional differences: a strong bias in Göttingen area and a weaker bias in the Großfahner area. A bias correction approach, Quantile mapping, is applied to the ensemble results for both areas for winter and summer seasons. By using quantile regression on the seasonal Standardized Precipitation Indices (SPIs as indicator for water supply conditions we found that precipitation is expected to increase in winter in all quantiles of the distribution for Göttingen area during the 21th century. Heavy precipitation is also expected to increase for Großfahner area suggesting a trend to wetter extremes in winter for the future. This winter precipitation increase could trigger runoff and soil erosion risk enhancing the severity of floods. Increasing winter availability of water could enhance local water supply in spring. For both areas no significant change in summer was found over the whole time period. Although the climate change signal of the SPI indicate mild dryer conditions in summer at the end of the 21st century which may trigger water shortage and

  2. Water supply patterns in two agricultural areas of Central Germany under climate change conditions

    Science.gov (United States)

    Tölle, M. H.; Moseley, C.; Panferov, O.; Busch, G.; Knohl, A.

    2012-04-01

    Increasing emissions of greenhouse gases and increasing prices for fossil fuels have highlighted the demand for CO2 "neutral" renewable energy sources, e.g. short rotation forestry systems used for bioenergy. These systems might be vulnerable to changes in temperature, precipitation and occurrence of extreme weather events. To estimate success or failure of such short rotation coppices in a certain area we need regional climate projections and risk assessment. Changes of water supply patterns in two agriculturally extensively used regions in Central Germany (around Göttingen and Großfahner) with different climate conditions but both in the temperate climate zone are explored. The study is carried out under present conditions as well as under projected climate change conditions (1971-2100) using A1B and B1 climate scenarios downscaled for Europe. Analysis of precipitation bias shows regional differences: a strong bias in Göttingen area and a weaker bias in the Großfahner area. A bias correction approach, Quantile mapping, is applied to the ensemble results for both areas for winter and summer seasons. By using quantile regression on the seasonal Standardized Precipitation Indices (SPIs) as indicator for water supply conditions we found that precipitation is expected to increase in winter in all quantiles of the distribution for Göttingen area during the 21th century. Heavy precipitation is also expected to increase for Großfahner area suggesting a trend to wetter extremes in winter for the future. This winter precipitation increase could trigger runoff and soil erosion risk enhancing the severity of floods. Increasing winter availability of water could enhance local water supply in spring. For both areas no significant change in summer was found over the whole time period. Although the climate change signal of the SPI indicate mild dryer conditions in summer at the end of the 21st century which may trigger water shortage and summer drying associated with above

  3. ANALYSIS OF DISCARD OF WHOLE BLOOD AND BLOOD COMPONENTS IN GOVERNMENT HOSPITAL BLOOD BANK IN CENTRAL INDIA

    Directory of Open Access Journals (Sweden)

    Vedita Bobde

    2015-02-01

    Full Text Available BACKGROUND: Transfusion requests are always more than the supply due to advances in health care delivery . Injudicious use of whole blood and blood components strains the transfusion services. This mandates the proper analysis of real need of transfusion and the discard of this scarce resource. MATERIALS & METHODS: Total 31143 voluntary and replacement donors donated blood during January 2012 to December 2014 in blood bank of tertiary care Government hospital in Central India. The donors record, transfusion transmitted infections (TTI testing record, component preparation record & discard record during the same period were screened for analysis. RESULT: Out of total 31143 blood collection during study period TTI positive blood were 377 (1.21% comprising of 13.4% of total discarded blood bags. Components prepared 19545 and discarded 1610 (8.2%. Among components discarded most common units were platelets due to date expiry followed by FFP discarded due to leakage of bag. CONCLUSION: Analysis of reasons of discard of whole blood and blood components helps in forming policies to reduce the gap between demand and supply at local as well as national level

  4. Heterogeneity of farms entering export supply chains: the case of fruit growers from central-south Chile

    OpenAIRE

    J. A. Barrena Ruiz; L. A. Nahuelhual Muñoz; A. Engler Palma; R. Echeverría Pezoa; G. Cofré Bravo

    2013-01-01

    The increasing stringency of world food markets requires farmers to adjust farm structure and commercial strategies to remain integrated in export supply chains. The goal of this study was to identify and characterize different types of fresh fruit farms with regard to farm structural and commercial strategies for a representative sample of fresh fruit growers from central-south Chile exporting to world markets. A typology of farms was constructed based on multivariate analysis, according to ...

  5. [Supporting system for regional medical liaison and role of a central hospital].

    Science.gov (United States)

    Kitano, Seigo

    2003-04-01

    The current status and future development of the supporting system for regional medical liaison and a role of the central hospital in the network were outlined. One of such supportive systems for regional medical network would be tele-medicine or tele-mentoring that include radiological and pathological diagnoses in distance, tele-surgery, and tele-education. Most of these systems are facilitated in the universities and affiliated hospitals and generally need high-cost communication equipment. Another approach is the information sharing system through the modern telecommunication network. Electronic patient record (EPR) systems are the key to achieving this and currently active in several areas. Since the recent progress in information technology (IT) is astonishing, community-based EPR systems are practical with the capability of clinical information exchange between different institutions and even with patients. The role of a central hospital in these systems must be capacious. Management and continuous operation of the system would be the most important affairs. For extending these supporting systems to the ones working in a broader area, the establishment of a "one ID for one patient" system is crucial. Strict security management of the data base and legal institution for distant medical practice still remain as the future tasks.

  6. The perception of safety culture among nurses in a tertiary hospital in Central Saudi Arabia

    Science.gov (United States)

    Alonazi, Aisha A; Saeed, Elshazaly; Mohamed, Sarar

    2016-01-01

    Developing a patient safety culture was one of the recommendations made by the Institute of Medicine (IOM) to assist hospitals in improving patient safety. Nurses are the key to safety improvements in hospitals. It is necessary to know their awareness and perception regarding institutional safety climate. The aim of this study is to explore perceptions of patient safety among nursing staff in a tertiary hospital in Central Saudi Arabia in different discipline units. The current study was conducted at Prince Sultan Military Medical City (PSMMC), a tertiary center in Riyadh, Central Saudi Arabia. In November 2014, five hundred nurses were randomly selected to participate in this study. A survey questionnaire with Likert scale was adopted covering characteristics of participants together with their views on patient safety issues. Two hundred and twenty-four participants filled the questionnaire with a response rate of 44.8%. The overall perception of patient safety among participants was (57.9%). The majority (74.1%) thought that the existing system is good at preventing errors and only one third indicated that they have patient safety problems. Most of the participants were happy with the existing patient safety culture including organizational learning/continuous improvement (95.5%), and errors feedback and communication (76.64%). In conclusion, this study showed that perception of patient safety was sub-optimal among nurses and there are several areas for improvement regarding safety culture. PMID:28096559

  7. Self-Sufficient Healthcare Logistics Systems and Responsiveness: Ten Cases of Foreign Field Hospitals Deployed to Disaster Relief Supply Chains

    Directory of Open Access Journals (Sweden)

    Michael Naor

    2016-06-01

    Full Text Available Recent disasters around the globe illustrate the unpredictability of their timing and the severity of their impact, making aid operations highly uncertain and complex. The aftermath of sudden-impact disasters, such as civil conflicts, wars, and natural disasters, are typically characterized by chaos and the urgent need for medical care for a massive number of casualties; however, damage to local healthcare infrastructures usually render them unable to deliver needed services. Foreign field hospitals, innovative self-sufficient emergency healthcare logistics systems deployed outside the hospitals’ country, constitute a temporary solution until the local facilities are repaired or rebuilt. These types of healthcare logistics system have been deployed with great success. However, not much is known about factors that may account for their success in the supply chain literature. In this study, we investigate military foreign field hospitals and explore general factors that may account for their effectiveness. Specifically, we look into military healthcare logistics systems, specifically foreign field hospitals (FFHs, to explore factors that may account for their responsiveness. We examine ten successful deployments of an experienced and effective military FFH through an exploratory case analysis to shed light into factors that may account for its success. Various propositions and avenues for future research are developed.

  8. Fornecimento de hortifrutigranjeiros para unidades de alimentação e nutrição hospitalares The supply of fruits and vegetables for food and nutrition hospitals units

    Directory of Open Access Journals (Sweden)

    Aline Petter Schneider

    2006-06-01

    Full Text Available O fornecimento de hortifrutigranjeiros para o setor hospitalar é um importante segmento dentro da cadeia de suprimento agroalimentar. Este fornecimento demanda altos padrões de qualidade, incluindo o cumprimento de normas higiênico-sanitárias, padrão do tamanho, da forma, da procedência, da isenção de resíduos e agrotóxicos, entre outros. O objetivo deste estudo foi analisar o processo atual de fornecimento de hortifrutigranjeiros e identificar as necessidades e exigências das unidades hospitalares. A metodologia empregada foi a de estudo de múltiplos casos. Foram analisados os hospitais do município de Porto Alegre (Rio Grande do Sul, Brasil e a Central de Abastecimento e Distribuição de Hortifrutigranjeiros e seus distribuidores. Os resultados obtidos demonstram, por parte dos hospitais, grande preocupação quanto ao atual método de fornecimento, bem como a necessidade de um fornecimento especializado. No que se refere aos fornecedores, verificou-se o descumprimento de fatores considerados indispensáveis pelos hospitais, entre os quais o controle na utilização de agrotóxicos, as condições higiênico-sanitárias, a procedência e as condições de transporte. Como conclusão, verificou-se que o fornecimento atual não é eficiente e se dá de maneira inadequada, não atendendo a maioria dos requisitos hospitalares de fornecimento. Sugere-se a implementação da metodologia de Análise dos Perigos e Pontos Críticos de Controle, das Boas Práticas de Fabricação, do Gerenciamento da Cadeia de Suprimentos e do Cooperativismo, como propostas para a otimização do fornecimento.The food and vegetables supply to hospitals is an important part of food supply channel. This supply demands, among others, high patterns of quality, including size, shape, origin, low levels of residuals and pesticides, as well as the accomplishment of hygiene and sanitary rules. The aim of this study was to evaluate the current process of food and

  9. The role of the hospital pharmacy in the storage and supply of antidotes

    Directory of Open Access Journals (Sweden)

    Luisa Lombardo

    2013-12-01

    Full Text Available Cases of poisoning have been analyzed with the aim of estimating both the incidence and the seriousness of such xenobiotic effects, the major determinant agents, and the related antidotes used in hospital departments. From 2009 to November 2012, a survey of the availability of antidotes in the emergency room services was carried out in all hospital pharmacies under the Palermo Health Authority: Policlinico Paolo Giaccone, ARNAS Civico di Cristina Benefratelli, Azienda Ospedaliera Ospedali Riuniti Villa Sofia-Cervello. Figures show that the majority of poisoning events were caused by the use/abuse of drugs, especially psychopharmaceuticals, alcohol and narcotic substances. This overdose of medical drugs and its various causes is a cause for concern and highlights the fact that this tendency has not regressed over the years. Doctors and pharmacists should raise patients’ awareness about how to use drugs correctly, and make adequate information available to all patients in order to, first, reduce the risks, and second, reduce the cost of treatment for intoxication.

  10. Oxygen saturations of medical inpatients in a Malawian hospital: cross-sectional study of oxygen supply and demand

    Directory of Open Access Journals (Sweden)

    Hywel-Gethin Tudur Evans

    2012-05-01

    Full Text Available Normal 0 false false false EN-GB JA X-NONE Oxygen is a World Health Organisation listed essential drug yet provision of oxygen in developing countries often fails to meet demand.  The aim of this study was to evaluate the need for supplementary oxygen against oxygen delivery capacity at a large teaching hospital in Malawi.  A cross‐sectional study of all adult medical inpatients and assessment of oxygen provision over a 24‐hour period was conducted.    144 patients were included in the study, 14 of whom met local and international criteria for oxygen therapy (oxygen saturations of <90%.  Four were receiving oxygen.  Of the 8 oxygen concentrators available, only 4 were functional.  In conclusion, we identified a need for oxygen that was greater than the supply.

  11. Farmers, Vertical Coordination, and the Restructuring of Dairy Supply Chains in Central and Eastern Europe

    NARCIS (Netherlands)

    Dries, L.K.E.; Germenji, E.; Noev, N.; Swinnen, J.

    2009-01-01

    The combination of transition and globalization since the early 1990s has caused dramatic changes in the dairy chains in Central and Eastern Europe. This paper uses survey evidence from several Central and East European countries to document the growth of vertical coordination in the dairy chain, it

  12. Depression in chronic respiratory disorders in a tertiary rural hospital of Central India

    Institute of Scientific and Technical Information of China (English)

    Sameer singhal; Pankaj Banode; Nitish Baisakhiya

    2009-01-01

    Objective: To determine prevalence of depression in chronic respiratory disorders in a tertiary rural hospital of Central India. Various studies done in past have shown that prevalence of depression in diabetes and hypertension is around 40%-57%. Few studies have been done to screen depression in chronic respiratory disorders. This study was conducted in a tertiary rural hospital of Central India to find out prevalence of depression in indoor patients suffering from chronic respiratory disorders. Methods: Total 68 patients were evaluated for depression. Patients suffering from chronic respiratory disorders (total duration of illness >3 months) were evaluated using Prime MD Questionnaire. Patients suffering from diabetes, heart diseases, stroke, having past history of psychiatric illness, drug abusers, having lack of social support and suffering from chronic upper respiratory tract infections were excluded from this study. Questionnaire was asked when treatment for acute phase of illness is over. Results: Out of 68 patients evaluated, 36 (53%) were found out to be suffering from depression. Female gender (80%) was more prone to depression, inspite of the fact that all alcoholics were male. 39% of all chronic obstructive pulmonary disease (COPD) patients were suffering from depression in comparison to 65% for pulmonary tuberculosis and 44% for other chronic respiratory illness. 54% of patients suffering from depression are 60 yrs of age, suggesting that age has no relation with depression. No association was seen between alcoholism and depression. Conclusion: Prevalence of depression in patients of chronic respiratory illness is very high, like in cases of diabetes and hypertension. Further community and hospital based studies are needed to find out exact prevalence of depression in chronic respiratory illnesses.

  13. Biopsy case mix and diagnostic yield at a Malawian central hospital.

    Science.gov (United States)

    Mtonga, P; Masamba, L; Milner, D; Shulman, L N; Nyirenda, R; Mwafulirwa, K

    2013-09-01

    Cancer is a major disease burden worldwide resulting in high morbidity and mortality. It is the leading cause of mortality in developed countries and is one of the three leading causes of death for adults in developing countries. Pathological examination of tissue biopsies with histological confirmation of a correct cancer diagnosis is central to cancer care. Without an accurate and specific pathologic diagnosis, effective treatment cannot be planned or delivered. In addition, there are marked geographical variations in incidence of cancer overall, and of the specific cancers seen. Much of the published literature on cancer incidence in developing countries reflects gross estimates and may not reflect reality. Performing baseline studies to understand these distributions lays the groundwork for further research in this area of cancer epidemiology. Our current study surveys and ranks cancer diagnoses by individual anatomical site at Queen Elizabeth Central Hospital (QECH) which is the largest teaching and referral hospital in Malawi. A retrospective study was conducted reviewing available pathology reports over a period of one full year from January 2010 to December 2010 for biopsies from patients suspected clinically of having cancer. There were 544 biopsies of suspected cancer, taken from 96 anatomical sites. The oesophagus was the most common biopsied site followed by breast, bladder, bone, prostate, bowel, and cervical lymph node. Malignancies were found in biopsies of the oesophagus biopsies (squamous cell carcinoma, 65.1%; adenocarcinoma, 11.6%), breast (57.5%), bladder (squamous cell carcinoma, 53.1%) and stomach (37.6%). Our study demonstrates that the yield of biopsy for clinically suspected malignancy was greater than 50% for the 11 most common sites and provides a current survey of cancer types by site present in the population reporting to our hospital.

  14. Construction and practice of hospital supplies management system and hospital logistics%医院物资管理系统和院内物流的构建与实践

    Institute of Scientific and Technical Information of China (English)

    朱建成; 夏新; 李朋海

    2016-01-01

    Hospital supplies provision,an important part of hospital operation,has increasingly high requirements for information support with the full cost accounting and fine management requirements.Without information system support,the hospital supplies management department can only settle accounts monthly by using the traditional manual in and out of stock checking,keeping accounts and inventory methods,resulting in low efficiency of management and difficulty in keeping up with the development needs of hospitals and departments.By researching needs of the supplies management depart-ment and using information technology,in this paper we introduce our practice of constructing a practical hospital supplies management system and effective combination with internal logistics to reduce supplies inventory,improve supplies distribution efficiency,and enhance the competitiveness of the hospital.%医院物资供应作为医院运转的重要环节,随着全成本核算和精细化管理要求,对信息化支持的要求越来越高。在缺少信息系统支持的前提下,医院物资管理部门只能通过传统的手工出入库、记账和盘点方式每月结算,导致管理效率低下,难以跟上医院和科室发展需求。文章在调研物资管理部门需求基础上,利用信息技术手段,通过构建一套实用的医院物资管理系统,并与院内物流有效结合,来降低物资库存,提高物资配送效率及医院竞争力。

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

    Science.gov (United States)

    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

  16. 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

    2010-10-01

    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

  17. Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. III. - September of 2001; Asesoria especializada en seguridad radiologica al hospital central norte de alta especialidad, PEMEX III.- Septiembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-12-15

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

  18. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. III.- September of 2001; Asesoria especializada en seguridad radiologica al hospital central sur de alta especialidad, PEMEX III.- Septiembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-12-15

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

  19. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. V. - November of 2001; Asesoria especializada en seguridad radiologica al hospital central sur de alta especialidad, PEMEX. V.- Noviembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-01-15

    The south central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Autho000.

  20. Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. I. - May-June of 2003; Asesoria especializada en seguridad radiologica al hospital central norte de alta especialidad, PEMEX I.- Mayo-Junio de 2003

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Camacho V, B.; Rodriguez A, F

    2003-09-15

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

  1. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. IV. - October of 2001; Asesoria especializada en seguridad radiologica a la clinica al hospital central sur de alta especialidad, PEMEX. IV.- Octubre de 2001

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-01-15

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

  2. Specialized consultant in radiological safety to the clinical north central hospital of high speciality, PEMEX. IV. - December of 2001; Asesoria especializada en seguridad radiologica a la clinica hospital central norte de alta especialidad, PEMEX. IV.- Diciembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-01-15

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

  3. Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. I. - July of 2001; Asesoria especializada en seguridad radiologica al hospital central norte de alta especialidad, PEMEX I.- Julio de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A

    2001-09-15

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

  4. Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. II. - August of 2001; Asesoria especializada en seguridad radiologica al hospital central norte de alta especialidad, PEMEX II.- Agosto de 2001

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-10-15

    The north central hospital of high speciality, dependent of PEMEX, It request consultant of the ININ to be able to maintain their sanitary license for the use of X-ray equipment for the radiologic diagnostic.The proposal of the ININ was to be a program of technical attendance, schedule monthly to be able to solve the observations that are presented in the use of those equipment, and that the hospital can conserve its respective sanitary license.(Author)0.

  5. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. I. - July of 2001; Asesoria especializada en seguridad radiologica al hospital central sur de alta especialidad, PEMEX I.- Julio de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J

    2001-09-15

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

  6. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. II.- August of 2001; Asesoria especializada en seguridad radiologica al hospital central sur de alta especialidad, PEMEX II.- Agosto de 2001

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-12-15

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

  7. 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...

  8. CAPD in Dammam Central Hospital, Saudi Arabia: A Five-Year Experience

    Directory of Open Access Journals (Sweden)

    Youmbissi Joseph

    2001-01-01

    Full Text Available Thirty-one patients with end-stage renal disease (ESRD were offered continuous ambulatory peritoneal dialysis (CAPD at the Dammam Central Hospital, Dammam, Saudi Arabia over a period of five years. The group included 21 women and 10 men with a mean age of 41.3 ± 17.2 years. The main indication for CAPD was poor or failed vascular access (51.4%. Peritonitis remained the major complication with an overall incidence of 0.62 episode per patient year. Staphylococcus epidermidis was the main causative organism. Therapy with CAPD lasted a mean of 26 ± 7.4 months. Our results, showing good technique survival and low peritonitis rate, suggest that CAPD should be promoted to become a full arm of the integrated care of ESRD in Saudi Arabia.

  9. Neurocognitive sequelae of cerebral malaria in adults:A pilot study in Benguela Central Hospital, Angola

    Institute of Scientific and Technical Information of China (English)

    Bruno Peixoto; Isabel Kalei

    2013-01-01

    Objective: To characterize the neurocognitive sequelae of cerebral malaria (CM) in an adult sample of the city of Benguela, Angola. Methods:A neuropsychological assessment was carried out in 22 subjects with prior history of CM ranging from 6 to 12 months after the infection. The obtained results were compared to a control group with no previous history of cerebral malaria. The study was conducted in Benguela Central Hospital, Angola in 2011. Results: CM group obtained lower results on the two last trials of a verbal learning task and on an abstract reasoning test. Conclusions: CM is associated to a slower verbal learning rate and to difficulties in the ability to discriminate and perceive relations between new elements.

  10. Carbon capture and storage as central modules of a strategy toward a sustainable energy supply

    Energy Technology Data Exchange (ETDEWEB)

    Schiffer, Hans-Wilhelm

    2010-09-15

    Sustainable energy supply must do justice to the equal-ranking goals of economic, environmental and social compatibility. A balance must be sought between the degrees of achievement for these aims. In climate protection, approaches must be pursued that promise achievement at the lowest cost. An approximation of energy-management development to climate-policy necessities is only possible if all cost-efficient options are used. CCS can be regarded as a bridging technology toward an energy sector that is increasingly based almost entirely on electricity from renewables. On the road there, the expansion of renewables and power generation based on fossil energies with CCS complement one another.

  11. Comparison of sediment supply to San Francisco Bay from watersheds draining the Bay Area and the Central Valley of California

    Science.gov (United States)

    McKee, L.J.; Lewicki, M.; Schoellhamer, D.H.; Ganju, N.K.

    2013-01-01

    Quantifying suspended sediment loads is important for managing the world's estuaries in the context of navigation, pollutant transport, wetland restoration, and coastal erosion. To address these needs, a comprehensive analysis was completed on sediment supply to San Francisco Bay from fluvial sources. Suspended sediment, optical backscatter, velocity data near the head of the estuary, and discharge data obtained from the output of a water balance model were used to generate continuous suspended sediment concentration records and compute loads to the Bay from the large Central Valley watershed. Sediment loads from small tributary watersheds around the Bay were determined using 235 station-years of suspended sediment data from 38 watershed locations, regression analysis, and simple modeling. Over 16 years, net annual suspended sediment load to the head of the estuary from its 154,000 km2 Central Valley watershed varied from 0.13 to 2.58 (mean = 0.89) million metric t of suspended sediment, or an average yield of 11 metric t/km2/yr. Small tributaries, totaling 8145 km2, in the nine-county Bay Area discharged between 0.081 and 4.27 (mean = 1.39) million metric t with a mean yield of 212 metric t/km2/yr. The results indicate that the hundreds of urbanized and tectonically active tributaries adjacent to the Bay, which together account for just 5% of the total watershed area draining to the Bay and provide just 7% of the annual average fluvial flow, supply 61% of the suspended sediment. The small tributary loads are more variable (53-fold between years compared to 21-fold for the inland Central Valley rivers) and dominated fluvial sediment supply to the Bay during 10 out of 16 yr. If San Francisco Bay is typical of other estuaries in active tectonic or climatically variable coastal regimes, managers responsible for water quality, dredging and reusing sediment accumulating in shipping channels, or restoring wetlands in the world's estuaries may need to more carefully

  12. Research on centralized treatment of dental clinical equipments in central sterile supply department%消毒供应中心集中处理口腔诊疗器械调查

    Institute of Scientific and Technical Information of China (English)

    商玲; 刘秋菊; 张宏岩; 单信芝; 刘亚楠; 周杰

    2012-01-01

    OBJECTIVE To evaluate the effect of centralized treatment on dental clinical equipments in the central supply service department, to eradicate the hospital infection caused by mismanagement. METHODS According to Regulations of Hospital Infection Management and Technical Standard for Medical Institution Dental Clinical Equipment Disinfection, the dental clinical equipments were collected and treated centrally, and the scientific and effective administrative procedures were established. The treatment of dental clinical equipments from Jan 2009 to Dec 2010 were investigated and analyzed. RESULTS The cleaning, disinfection and sterilization quality of dental and medical safety of the patients were ensured. The qualified rate of cleaning was 96. 55% from Jan to Dec 2009, and 98. 88% from Jan to Dec 2010, respectively. The difference was statistically significant (x2 =4. 5,P<0. 05). CONCLUSION Strengthen the management of dental clinical equipments, regulate the treatment procedures, and perfect the infection control system and measures are the important ways to effectively prevent and control the hospital infection in the dental clinical operations.%目的 探讨消毒供应中心对口腔诊疗器械实施集中式管理的处理效果,杜绝因其管理不当引起的医院感染.方法 按照《医院感染管理办法》及《医疗机构口腔诊疗器械消毒技术规范》,将口腔诊疗器械集中回收处理,制定有效科学的管理方法,对2009年1月-2010年12月处理的口腔诊疗器械进行回顾性调查与分析.结果 确保了口腔诊疗器械的清洗、消毒、灭菌质量与患者的医疗安全,2009年1-12月清洗合格率为96.55%,2010年1-12月清洗合格率98.88%,两者合格率比较差异有统计学意义(x2=4.5,P<0.05).结论 加强口腔诊疗器械管理,规范处理流程,完善感染控制制度与措施,是有效地预防和控制口腔诊疗操作过程中医院感染发生的重要途径.

  13. Tuberculosis among HIV-positive patients at Butajira Hospital, South-Central Ethiopia

    Directory of Open Access Journals (Sweden)

    Seada Mohammed

    2015-12-01

    Full Text Available Background: Tuberculosis (TB is the leading cause of morbidity and mortality among people living with Human Immunodeficiency Virus (HIV. This study was carried out to determine the prevalence of tuberculosis and its associated factors among HIV-positive patients at Butajira Hospital, South-Central Ethiopia. Methods: A retrospective review of standardized 222 HIV-positive patient records between July 2011 and June 2012 was conducted. A data sheet was used to collect relevant variables. Data were entered, organized and analysed using SPSS Version 16.0 Software. A p-value 15 years (18.95%. Among 45 TB/HIV cases, 26.7% had smear-positive pulmonary TB; 62.2% had smear-negative pulmonary TB; and 11.1% had extra-pulmonary TB. Malnutrition (OR= 45.7, CD4+ T-cell count <200/μl (OR= 5.4 and WHO clinical stage III or IV (OR= 4.12 were associated with tuberculosis in HIV-positive patients. Conclusion: In conclusion, the prevalence of TB/HIV co-infection at Butajira Zonal Hospital, South-Central Ethiopia was high. The co-infection was associated with malnutrition, low CD4 + T-cell count and WHO clinical stage III or IV. Therefore, compulsory TB screening among HIV-positive patients is mandatory. Besides, public awareness, community mobilization should be encouraged. Moreover, large scale studies on the trends in TB/HIV co-infection and associated factors should also be implemented across the country.

  14. Fatal nosocomial Legionnaires' disease: relevance of contamination of hospital water supply by temperature-dependent buoyancy-driven flow from spur pipes.

    Science.gov (United States)

    Patterson, W J; Seal, D V; Curran, E; Sinclair, T M; McLuckie, J C

    1994-06-01

    The investigation, epidemiology, and effectiveness of control procedures during an outbreak of Legionnaires' disease involving three immunosuppressed patients are described. The source of infection appeared to be a network of fire hydrant spurs connected directly to the incoming hospital mains water supply. Removal of these hydrants considerably reduced, but failed to eliminate, contamination of water storage facilities. As an emergency control procedure the incoming mains water was chlorinated continuously. Additional modifications to improve temperature regulation and reduce stagnation also failed to eliminate the legionellae. A perspex test-rig was constructed to model the pre-existing hospital water supply and storage system. This showed that through the hydraulic mechanism known as 'temperature buoyancy', contaminated water could be efficiently and quickly exchanged between a stagnant spur pipe and its mains supply. Contamination of hospital storage tanks from such sources has not previously been considered a risk factor for Legionnaires' disease. We recommend that hospital water storage tanks are supplied by a dedicated mains pipe without spurs.

  15. Clogging of water supply wells in alluvial aquifers by mineral incrustations, central Serbia

    Directory of Open Access Journals (Sweden)

    Majkić-Dursun Brankica

    2015-01-01

    Full Text Available The formation of incrustations on public water supply well screens reduces their performance considerably. The incrustations increase hydraulic losses, reduce the capacity of the well and screen, affect the quality of the pumped water and increase maintenance costs. In alluvial environments, the most common deposits are iron and manganese hydroxides. However, the rates of formation, compositions and levels of crystallization vary, depending on the geochemical characteristics of the alluvial environment, the microbiological characteristics of the groundwater and the abstraction method. Samples of 15 incrustations were collected from wells that tap shallow alluvial aquifers and were found to be dominated by iron. XRD analyses detected low-crystalline ferrihydrite and manganese hydroxide in the samples collected from the water supply source at Trnovče (Velika Morava alluvial. The incrustations from the Belgrade Groundwater Source revealed the presence of ferrihydrite and a substantial amount of goethite α-FeOOH. Apart from goethite, greigite (Fe3S4 was detected in three samples, while one sample additionally contained bernalite Fe(OH3 and monoclinic sulfur S8. Among carbonates, only siderite was detected. Iron oxidizing bacteria generally catalyze deposition processes in wells, while sulfate reducing bacteria (SRB play a role in the biogenic formation of greigite. Determining the nature of the deposited material allows better selection of rehabilitation chemicals and procedure. [Projekat Ministarstva nauke Republike Srbije, br. TR37014

  16. Detection and identification of Legionella species in hospital water supplies through Polymerase Chain Reaction (16S rRNA).

    Science.gov (United States)

    Rafiee, Mohammad; Jahangiri-Rad, Mahsa; Hajjaran, Homa; Mesdaghinia, Alireza; Hajaghazadeh, Mohammad

    2014-01-01

    Legionella spp. are important waterborne pathogens that are normally transmitted through aerosols. The present work was conducted to investigate the presence of Legionella spp. and its common species in hospital water supplies. Considering the limitations of culture method, polymerase chain reaction (PCR) assays were developed to detect the gene 16S rRNA irrespective of the bacterial serotype. Four well-established DNA extraction protocols (freeze & thaw and phenol-chloroform as two manual protocols and two commercial kits) were tested and evaluated to release DNA from bacterial cells. A total of 45 samples were collected from seven distinct hospitals' sites during a period of 10 months. The PCR assay was used to amplify a 654-bp fragment of the 16S rRNA gene. Legionella were detected in 13 samples (28.9%) by all of the methods applied for DNA extraction. Significant differences were noted in the yield of extracted nucleic acids. Legionella were not detected in any of the samples when DNA extraction by freeze & thaw was used. Excluding this method and comparing manual protocol with commercial kits, Kappa coefficient was calculated as 0.619 with p < 0.05. Although no meaningful differences were found between the kits, DNA extraction with Bioneer kit exhibited a higher sensitivity than classical Qiagen. Showerheads and cold-water taps were the most and least contaminated sources with 55.5 and 9 percent positive samples, respectively. Moreover two positive samples were identified for species by DNA sequencing and submitted to the Gene Bank database with accession Nos. FJ480932 and FJ480933. The results obtained showed that despite the advantages of molecular assays in Legionella tracing in environmental sources, the use of optimised DNA extraction methods is critical.

  17. Analysis of energy wood supply chain in thinning operations: a case study in a pine stand of Central Italy

    Directory of Open Access Journals (Sweden)

    Baldini S

    2010-10-01

    Full Text Available Thinning is an essential practice in Mediterranean pine forests management but is rarely applied because of the high harvesting costs. The new market of bioenergy products could give a profit to wood biomass harvesting activities, though the drawbacks of elevated supply chain costs, related to technical problems and lack of knowledge about the wood quality have to be overcome in advance. This study analyzed technical, economic, energy and environmental factors of a pine stand thinning in Central Italy, where collected biomass was directed to energy, in order to give a decisional support to reach economical profitability and environmental sustainability in thinning practices. The introduction of Full Tree System maximized the recovery of available biomass, full tree chipping produced material with Heating Value superior than single tree components. The use of a felling frame in motor-manual felling in comparison with the traditional chainsaw reduced operator effort, increasing the number of felled trees per hour, when the stump diameter remained under 15 cm. The energy wood supply chain is not sustainable from an economic point of view, the profitability could be reached only acting on suggested technical levers and particularly reducing costs of hauling operation. The estimation of output/input energy ratio in the supply chain underlined the feasibility of thinning practices for energy. The assessment of CO2 emissions confirmed the environmental sustainability of biomass supply chain in energy when compared to traditional fossil fuels. Study conclusions provide the guidelines for thinning treatment in Mediterranean pine stands, in order to reach environmental and economic sustainability of these practices.

  18. Future Availability of Water Supply from Karstic Springs under Probable Climate Change. The case of Aravissos, Central Macedonia, Greece.

    Science.gov (United States)

    Vafeiadis, M.; Spachos, Th.; Zampetoglou, K.; Soupilas, Th.

    2012-04-01

    The test site of Aravissos is located at 70 Km to the West (W-NW) of Thessaloniki at the south banks of mount Païko, in the north part of Central Macedonia The karstic Aravissos springs supply 40% of total volume needed for the water supply of Thessaloniki, Greece. As the water is of excellent quality, it is feed directly in the distribution network without any previous treatment. The availability of this source is therefore of high importance for the sustainable water supply of this area with almost 1000000 inhabitants. The water system of Aravissos is developed in a karstic limestone with an age of about Late Cretaceous that covers almost the entire western part of the big-anticline of Païko Mountain. The climate in this area and the water consumption area, Thessaloniki, is a typical Mediterranean climate with mild and humid winters and hot and dry summers. The total annual number of rainy days is around 110. The production of the Aravissos springs depends mostly from the annual precipitations. As the feeding catchement and the karst aquifer are not well defined, a practical empirical balance model, that contains only well known relevant terms, is applied for the simulation of the operation of the springs under normal water extraction for water supply in present time. The estimation of future weather conditions are based on GCM and RCM simulation data and the extension of trend lines of the actual data. The future evolution of the availability of adequate water quantities from the springs is finally estimated from the balance model and the simulated future climatic data. This study has been realised within the project CC-WaterS, funded by the SEE program of the European Regional Development Fund (http://www.ccwaters.eu/).

  19. 医院消毒供应室质量缺陷管理%Quality Defect Management in the Hospital Disinfection Supply Room

    Institute of Scientific and Technical Information of China (English)

    赵明

    2016-01-01

    Objective To study the work quality defect content and management measures in the hospital disinfection sup-ply room. Methods The disinfection supply room quality management group was established, the existing quality defect kinds and causes in the hospital disinfection supply room were analyzed by the fishbone diagram tool and the corresponding management measures were put forwards in order to improve the work quality defect status in the hospital disinfection sup-ply room. Results A series of improvement measures were worked out and implemented by the brainstorm effect of work staff, and the quality defect in the disinfection supply room was effectively improved and managed. Conclusion The disin-fection supply room is an important support department in the hospital work, and its work quality directly concerns the whole management level of hospitals, the application of fishbone diagram in the quality defect management in the disinfec-tion supply room can effectively reduce the incidence rate of management defect in the disinfection supply room and ensure the strictness and safety in the department work.%目的:探讨医院消毒供应室工作质量缺陷内容及管理措施。方法成立消毒供应室质量管理小组,运用鱼骨图等工具对医院消毒供应室存在的质量缺陷种类及原因进行分析,提出相应管理措施,以改善医院消毒供应室工作质量缺陷现状。结果通过工作人员头脑风暴效应,制定并实施一系列改进措施,消毒供应室存在的质量缺陷得到有效改善管理。结论消毒供应室是医院工作的重要保障科室,其工作质量直接关系着医院的整体管理水平,将鱼骨图运用到消毒供应室的质量缺陷管理中,可有效降低消毒供应室管理缺陷发生率,保障科室工作的严谨性和安全性。

  20. Heterogeneity of farms entering export supply chains: the case of fruit growers from central-south Chile

    Energy Technology Data Exchange (ETDEWEB)

    Barrena, J.; Nahuelhual, L.; Engler, A.; Echeverria, R.; Cofre, G.

    2013-06-01

    The increasing stringency of world food markets requires farmers to adjust farm structure and commercial strategies to remain integrated in export supply chains. The goal of this study was to identify and characterize different types of fresh fruit farms with regard to farm structural and commercial strategies for a representative sample of fresh fruit growers from central-south Chile exporting to world markets. A typology of farms was constructed based on multivariate analysis, according to which five types of farms were differentiated from five distinct factors. Cluster I comprised the smallest and uncertified farms (14.3% of the sample). The remaining four clusters comprised certified farms, but with different farm structural and commercial characteristics. Cluster II (15.1%) was composed of farms located further from market connections. Cluster III (23.9%) comprised farms with the highest number of fruit species, and consequently, more diversified in fruit production. Cluster IV (8.8%) was the smallest group, and comprised the largest firms. Finally, Cluster V (37.8%) was composed of highly specialized fruit farms, with the highest proportion of hectares dedicated to the production of a single fruit species. The results show the heterogeneity among fresh fruit farms and support the need for differentiated incentives and technological transfer schemes from the public sector and fruit companies in order to successfully keep farmers within export supply chains. (Author) 40 refs.

  1. Heterogeneity of farms entering export supply chains: the case of fruit growers from central-south Chile

    Directory of Open Access Journals (Sweden)

    J. A. Barrena Ruiz

    2013-03-01

    Full Text Available The increasing stringency of world food markets requires farmers to adjust farm structure and commercial strategies to remain integrated in export supply chains. The goal of this study was to identify and characterize different types of fresh fruit farms with regard to farm structural and commercial strategies for a representative sample of fresh fruit growers from central-south Chile exporting to world markets. A typology of farms was constructed based on multivariate analysis, according to which five types of farms were differentiated from five distinct factors. Cluster I comprised the smallest and uncertified farms (14.3% of the sample. The remaining four clusters comprised certified farms, but with different farm structural and commercial characteristics. Cluster II (15.1% was composed of farms located further from market connections. Cluster III (23.9% comprised farms with the highest number of fruit species, and consequently, more diversified in fruit production. Cluster IV (8.8% was the smallest group, and comprised the largest firms. Finally, Cluster V (37.8% was composed of highly specialized fruit farms, with the highest proportion of hectares dedicated to the production of a single fruit species. The results show the heterogeneity among fresh fruit farms and support the need for differentiated incentives and technological transfer schemes from the public sector and fruit companies in order to successfully keep farmers within export supply chains.

  2. Molecular epidemiology of Brucella genotypes in patients at a major hospital in central Peru.

    Science.gov (United States)

    Nöckler, Karsten; Maves, Ryan; Cepeda, David; Draeger, Angelika; Mayer-Scholl, Anne; Chacaltana, Jesus; Castañeda, María; Espinosa, Benjamin; Castillo, Rosa; Hall, Eric; Al Dahouk, Sascha; Gilman, Robert H; Cabeza, Franco; Smits, Henk L

    2009-10-01

    The multiple-locus variable-number repeat analysis of 90 human Brucella melitensis isolates from a large urban area in central Peru revealed variations at 4 (Bruce07, Bruce09, Bruce18, and Bruce42) out of 16 loci investigated, of which 1 (Bruce42) also is used for species identification. Ten genotypes were identified, separated by the number of Bruce42 repeats into two groups that may have distinct phenotypic characteristics. Whereas genotypes with five or six Bruce42 repeats were cultured mainly from adult patients, genotypes with three Bruce42 repeats were isolated from children and young adolescents as well as from adults. In addition, the isolates with three Bruce42 repeats were obtained more often from patients with splenomegaly (P = 0.02) or hepatomegaly (P = 0.006). An annual variation in the diversity of genotypes was observed, possibly reflecting changes in sources of fresh dairy products, supply routes to city shops and markets, and the movement of infected dairy goat herds.

  3. Implementation of the WHO multimodal Hand Hygiene Improvement Strategy in a University Hospital in Central Ethiopia

    Directory of Open Access Journals (Sweden)

    Frieder Pfäfflin

    2017-01-01

    Full Text Available Abstract Background The burden of health-care associated infections in low-income countries is high. Adequate hand hygiene is considered the most effective measure to reduce the transmission of nosocomial pathogens. We aimed to assess compliance with hand hygiene and perception and knowledge about hand hygiene before and after the implementation of a multimodal hand hygiene campaign designed by the World Health Organization. Methods The study was carried out at Asella Teaching Hospital, a university hospital and referral centre for a population of about 3.5 million in Arsi Zone, Central Ethiopia. Compliance with hand hygiene during routine patient care was measured by direct observation before and starting from six weeks after the intervention, which consisted of a four day workshop accompanied by training sessions and the provision of locally produced alcohol-based handrub and posters emphasizing the importance of hand hygiene. A second follow up was conducted three months after handing over project responsibility to the Ethiopian partners. Health-care workers’ perception and knowledge about hand hygiene were assessed before and after the intervention. Results At baseline, first, and second follow up we observed a total of 2888, 2865, and 2244 hand hygiene opportunities, respectively. Compliance with hand hygiene was 1.4% at baseline and increased to 11.7% and 13.1% in the first and second follow up, respectively (p < 0.001. The increase in compliance with hand hygiene was consistent across professional categories and all participating wards and was independently associated with the intervention (adjusted odds ratio, 9.18; 95% confidence interval 6.61-12.76; p < 0.001. After the training, locally produced alcohol-based handrub was used in 98.4% of all hand hygiene actions. The median hand hygiene knowledge score overall was 13 (interquartile range 11–15 at baseline and increased to 17 (15–18 after training (p < 0.001. Health

  4. Analysis of 126 hospitalized elder maxillofacial trauma victims in central China

    Science.gov (United States)

    Zhang, Rui; Li, Wenlu; Pei, Fei; He, Wei

    2015-01-01

    Background The aim of this study was to analyzed the characteristics and treatment of maxillofacial injuries in the elder patients with maxillofacial injuries in central China. Material and Methods We retrospectively analyzed the characteristics and treatment of maxillofacial injuries in the patients over the age of 60 to analyze the trends and clinical characteristics of maxillofacial trauma in elder patients from the First Affiliated Hospital of Zhengzhou University (from 2010 to 2013) in central China and to present recommendations on prevention and management. Results Of the 932 patients with maxillofacial injuries, 126 aged over 60 years old accounting for 13.52% of all the patients (male:female, 1.74:1; mean age, 67.08 years old). Approximately 52% of the patients were injured by falls. The most frequently observed type of injuries was soft tissue injuries (100%), followed by facial fractures (83.05%). Of the patients with soft tissue injuries, the abrasions accounted the most, followed by lacerations. The numbers of patients of midface fracture (60 patients) were almost similar to the number of lower face fractures (66 patients). Eighty two patients (65.08%%) demonstrated associated injuries, of which craniocerebral injuries were the most prevalent. One hundred and four patients (82.54%) had other systemic medical conditions, with cardiovascular diseases the most and followed by metabolic diseases and musculoskeletal conditions. Furthermore, the study indicated a relationship between maxillofacial fractures and musculoskeletal conditions. Only 13 patients (10.32%) sustained local infections, of whom had other medical conditions. Most of the facial injuries (85.71%) in older people were operated including debridement, fixing loose teeth, reduction, intermaxillary fixation and open reduction and internal fixation (ORIF). Conclusions Our analysis of the characteristics of maxillofacial injuries in the elder patents may help to promote clinical research to

  5. Etiologic agents of central nervous system infections among febrile hospitalized patients in the country of Georgia.

    Directory of Open Access Journals (Sweden)

    Tamar Akhvlediani

    Full Text Available OBJECTIVES: There is a large spectrum of viral, bacterial, fungal, and prion pathogens that cause central nervous system (CNS infections. As such, identification of the etiological agent requires multiple laboratory tests and accurate diagnosis requires clinical and epidemiological information. This hospital-based study aimed to determine the main causes of acute meningitis and encephalitis and enhance laboratory capacity for CNS infection diagnosis. METHODS: Children and adults patients clinically diagnosed with meningitis or encephalitis were enrolled at four reference health centers. Cerebrospinal fluid (CSF was collected for bacterial culture, and in-house and multiplex RT-PCR testing was conducted for herpes simplex virus (HSV types 1 and 2, mumps virus, enterovirus, varicella zoster virus (VZV, Streptococcus pneumoniae, HiB and Neisseria meningitidis. RESULTS: Out of 140 enrolled patients, the mean age was 23.9 years, and 58% were children. Bacterial or viral etiologies were determined in 51% of patients. Five Streptococcus pneumoniae cultures were isolated from CSF. Based on in-house PCR analysis, 25 patients were positive for S. pneumoniae, 6 for N. meningitidis, and 1 for H. influenzae. Viral multiplex PCR identified infections with enterovirus (n = 26, VZV (n = 4, and HSV-1 (n = 2. No patient was positive for mumps or HSV-2. CONCLUSIONS: Study findings indicate that S. pneumoniae and enteroviruses are the main etiologies in this patient cohort. The utility of molecular diagnostics for pathogen identification combined with the knowledge provided by the investigation may improve health outcomes of CNS infection cases in Georgia.

  6. Carbapenem Resistance among Enterobacter Species in a Tertiary Care Hospital in Central India

    Directory of Open Access Journals (Sweden)

    Atul Khajuria

    2014-01-01

    Full Text Available Objective. To detect genes encoding carbapenem resistance among Enterobacter species in a tertiary care hospital in central India. Methods. Bacterial identification of Enterobacter spp. isolates from various clinical specimens in patients admitted to intensive care units was performed by routine conventional microbial culture and biochemical tests using standard recommended techniques. Antibiotic sensitivity test was performed by standard Kirby Bauer disc diffusion technique. PCR amplification and automated sequencing was carried out. Transfer of resistance genes was determined by conjugation. Results. A total of 70/130 (53.84% isolates of Enterobacter spp. were found to exhibit reduced susceptibility to imipenem (diameter of zones of inhibition ≤13 mm by disc diffusion method. Among 70 isolates tested, 48 (68.57% isolates showed MIC values for imipenem and meropenem ranging from 32 to 64 mg/L as per CLSI breakpoints. All of these 70 isolates were found susceptible to colistin in vitro as per MIC breakpoints (<0.5 mg/L. PCR carried out on these 48 MBL (IP/IPI E-test positive isolates (12 Enterobacter aerogenes, 31 Enterobacter cloacae, and 05 Enterobacter cloacae complex was validated by sequencing for beta-lactam resistance genes and result was interpreted accordingly. Conclusion. The study showed MBL production as an important mechanism in carbapenem resistance in Enterobacter spp. and interspecies transfer of these genes through plasmids suggesting early detection by molecular methods.

  7. Molecular epidemiology of Acinetobacter baumannii in central intensive care unit in Kosova teaching hospital

    Directory of Open Access Journals (Sweden)

    Lul Raka

    2009-12-01

    Full Text Available Infections caused by bacteria of genus Acinetobacter pose a significant health care challenge worldwide. Information on molecular epidemiological investigation of outbreaks caused by Acinetobacter species in Kosova is lacking. The present investigation was carried out to enlight molecular epidemiology of Acinetobacterbaumannii in the Central Intensive Care Unit (CICU of a University hospital in Kosova using pulse field gel electrophoresis (PFGE. During March - July 2006, A. baumannii was isolated from 30 patients, of whom 22 were infected and 8 were colonised. Twenty patients had ventilator-associated pneumonia, one patient had meningitis, and two had coinfection with bloodstream infection and surgical site infection. The most common diagnoses upon admission to the ICU were politrauma and cerebral hemorrhage. Bacterial isolates were most frequently recovered from endotracheal aspirate (86.7%. First isolation occurred, on average, on day 8 following admission (range 1-26 days. Genotype analysis of A. baumannii isolates identified nine distinct PFGE patterns, with predominance of PFGE clone E represented by isolates from 9 patients. Eight strains were resistant to carbapenems. The genetic relatedness of Acinetobacter baumannii was high, indicating cross-transmission within the ICU setting. These results emphasize the need for measures to prevent nosocomial transmission of A. baumannii in ICU.

  8. Hydro, wind and solar power as a base for a 100% renewable energy supply for South and Central America.

    Science.gov (United States)

    Barbosa, Larissa de Souza Noel Simas; Bogdanov, Dmitrii; Vainikka, Pasi; Breyer, Christian

    2017-01-01

    Power systems for South and Central America based on 100% renewable energy (RE) in the year 2030 were calculated for the first time using an hourly resolved energy model. The region was subdivided into 15 sub-regions. Four different scenarios were considered: three according to different high voltage direct current (HVDC) transmission grid development levels (region, country, area-wide) and one integrated scenario that considers water desalination and industrial gas demand supplied by synthetic natural gas via power-to-gas (PtG). RE is not only able to cover 1813 TWh of estimated electricity demand of the area in 2030 but also able to generate the electricity needed to fulfil 3.9 billion m3 of water desalination and 640 TWhLHV of synthetic natural gas demand. Existing hydro dams can be used as virtual batteries for solar and wind electricity storage, diminishing the role of storage technologies. The results for total levelized cost of electricity (LCOE) are decreased from 62 €/MWh for a highly decentralized to 56 €/MWh for a highly centralized grid scenario (currency value of the year 2015). For the integrated scenario, the levelized cost of gas (LCOG) and the levelized cost of water (LCOW) are 95 €/MWhLHV and 0.91 €/m3, respectively. A reduction of 8% in total cost and 5% in electricity generation was achieved when integrating desalination and power-to-gas into the system.

  9. Hydro, wind and solar power as a base for a 100% renewable energy supply for South and Central America

    Science.gov (United States)

    Barbosa, Larissa de Souza Noel Simas; Bogdanov, Dmitrii; Vainikka, Pasi; Breyer, Christian

    2017-01-01

    Power systems for South and Central America based on 100% renewable energy (RE) in the year 2030 were calculated for the first time using an hourly resolved energy model. The region was subdivided into 15 sub-regions. Four different scenarios were considered: three according to different high voltage direct current (HVDC) transmission grid development levels (region, country, area-wide) and one integrated scenario that considers water desalination and industrial gas demand supplied by synthetic natural gas via power-to-gas (PtG). RE is not only able to cover 1813 TWh of estimated electricity demand of the area in 2030 but also able to generate the electricity needed to fulfil 3.9 billion m3 of water desalination and 640 TWhLHV of synthetic natural gas demand. Existing hydro dams can be used as virtual batteries for solar and wind electricity storage, diminishing the role of storage technologies. The results for total levelized cost of electricity (LCOE) are decreased from 62 €/MWh for a highly decentralized to 56 €/MWh for a highly centralized grid scenario (currency value of the year 2015). For the integrated scenario, the levelized cost of gas (LCOG) and the levelized cost of water (LCOW) are 95 €/MWhLHV and 0.91 €/m3, respectively. A reduction of 8% in total cost and 5% in electricity generation was achieved when integrating desalination and power-to-gas into the system. PMID:28329023

  10. 医院改善供应链管理的实践探索%Practice and exploration of hospital supply chain management based on JCI accreditation standard

    Institute of Scientific and Technical Information of China (English)

    方序; 王湘杰

    2016-01-01

    An exploration was made on the content and methodology of supply chain management of a hospital in line with the fifth edition JCI standard.By means of enhanced management of supply chain procurement,tracking validation,risk management and indicators monitoring,the speed and certainty of relevant processes are improved,with hospital operation effectiveness and efficiency enhanced.%结合第5版JCI标准,探索医院供应链管理的内容与方法。通过加强对医院供应链采购、追踪验证、风险管理、指标监控的管理,提高所有相关过程的速度和确定性,提高医院的运作效率和效益。

  11. Percutaneous retrieval of dislodged totally implantable central venous access system in 92 cases: Experience in a single hospital

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, C.-C.; Tsai, T.-N. [Division of Cardiology, Department of Medicine, Tri-Service General Hospital, Taipei, Taiwan (China); Yang, C.-C. [Department of Medicine, Armed Forces Tao-Yuan General Hospital, Taoyuan, Taiwan (China); Han, C.-L. [Division of Cardiology, Department of Medicine, Tri-Service General Hospital, Taipei, Taiwan (China)], E-mail: allexll.cheng@msa.hinet.net

    2009-02-15

    Objective: To investigate the clinical presentation of dislodged totally implantable central venous access system (central venous port-catheter) fragments and the efficacy and safety of percutaneous retrieval of them in our hospital. Materials and methods: Ninety-two cancer patients, mean age of 53.8 years old with 51.1% male, were enrolled from January 2005 to March 2007. They were referred to our catheterization laboratory for retrieval of fractured central venous port-catheter in our hospital. All patients were followed in the outpatient department for at least 1 month after surgical insertion. The characteristics of disrupted central venous port-catheter were recorded. The procedure-related clinical condition was evaluated. Results: The most common presentation of central venous port-catheter dislodgement is irrigation resistance to infusion (51/92). The most common location of fractured fragments is between superior vena cava and right atrium (i.e. proximal end remained in superior vena cava and distal end in right atrium) (22/92). The most common fracture site of the catheter is at the anastomosis between injection port and catheter (77/92). The retrieval set used mostly is loop snare. The success rate of the percutaneous retrieval of dislodged fragment was 97.8% and the complication rate was 3.3% only. Conclusion: The faulty connection between catheter and injection port contributes mainly to dislodgement of central venous port-catheter. Percutaneous retrieval of dislodged catheter is a highly successful, safe and efficient method.

  12. Aetiologies of central nervous system infection in Viet Nam: a prospective provincial hospital-based descriptive surveillance study.

    Directory of Open Access Journals (Sweden)

    Nghia Ho Dang Trung

    Full Text Available BACKGROUND: Infectious diseases of the central nervous system (CNS remain common and life-threatening, especially in developing countries. Knowledge of the aetiological agents responsible for these infections is essential to guide empiric therapy and develop a rational public health policy. To date most data has come from patients admitted to tertiary referral hospitals in Asia and there is limited aetiological data at the provincial hospital level where most patients are seen. METHODS: We conducted a prospective Provincial Hospital-based descriptive surveillance study in adults and children at thirteen hospitals in central and southern Viet Nam between August 2007-April 2010. The pathogens of CNS infection were confirmed in CSF and blood samples by using classical microbiology, molecular diagnostics and serology. RESULTS: We recruited 1241 patients with clinically suspected infection of the CNS. An aetiological agent was identified in 640/1241 (52% of the patients. The most common pathogens were Streptococcus suis serotype 2 in patients older than 14 years of age (147/617, 24% and Japanese encephalitis virus in patients less than 14 years old (142/624, 23%. Mycobacterium tuberculosis was confirmed in 34/617 (6% adult patients and 11/624 (2% paediatric patients. The acute case fatality rate (CFR during hospital admission was 73/617 (12% in adults and to 42/624 (7% in children. CONCLUSIONS: Zoonotic bacterial and viral pathogens are the most common causes of CNS infection in adults and children in Viet Nam.

  13. Legionellaceae in the hospital water-supply. Epidemiological link with disease and evaluation of a method for control of nosocomial legionnaires' disease and Pittsburgh pneumonia.

    Science.gov (United States)

    Best, M; Yu, V L; Stout, J; Goetz, A; Muder, R R; Taylor, F

    1983-08-06

    An epidemiological link was found between contamination of a hospital water-supply by Legionella pneumophila and by Pittsburgh pneumonia agent (PPA) and subsequent cases of nosocomial legionnaires' disease and Pittsburgh pneumonia. The extent of L pneumophila isolation from the water-supply paralleled the occurrence of disease. Whenever L pneumophila was isolated from more than 30% of ten selected water sites, nosocomial legionellosis occurred. The temperature of the hot water tanks was raised to 60-77 degrees C for 72 h, and water outlets were flushed for 30 min with hot water. A decline in numbers of L pneumophila and PPA in the water-supply was followed by a fall in the incidence of legionnaires' disease and Pittsburgh pneumonia. In addition, intermittent raising of the temperature in the hot water system decreased both the number of months in which disease occurred and the proportion of nosocomial pneumonias caused by these organisms.

  14. A multi-criteria assessment of scenarios on thermal processing of infectious hospital wastes: a case study for Central Macedonia.

    Science.gov (United States)

    Karagiannidis, A; Papageorgiou, A; Perkoulidis, G; Sanida, G; Samaras, P

    2010-02-01

    In Greece more than 14,000 tonnes of infectious hospital waste are produced yearly; a significant part of it is still mismanaged. Only one off-site licensed incineration facility for hospital wastes is in operation, with the remaining of the market covered by various hydroclave and autoclave units, whereas numerous problems are still generally encountered regarding waste segregation, collection, transportation and management, as well as often excessive entailed costs. Everyday practices still include dumping the majority of solid hospital waste into household disposal sites and landfills after sterilization, still largely without any preceding recycling and separation steps. Discussed in the present paper are the implemented and future treatment practices of infectious hospital wastes in Central Macedonia; produced quantities are reviewed, actual treatment costs are addressed critically, whereas the overall situation in Greece is discussed. Moreover, thermal treatment processes that could be applied for the treatment of infectious hospital wastes in the region are assessed via the multi-criteria decision method Analytic Hierarchy Process. Furthermore, a sensitivity analysis was performed and the analysis demonstrated that a centralized autoclave or hydroclave plant near Thessaloniki is the best performing option, depending however on the selection and weighing of criteria of the multi-criteria process. Moreover the study found that a common treatment option for the treatment of all infectious hospital wastes produced in the Region of Central Macedonia, could offer cost and environmental benefits. In general the multi-criteria decision method, as well as the conclusions and remarks of this study can be used as a basis for future planning and anticipation of the needs for investments in the area of medical waste management.

  15. Peripherally Inserted Central Catheter-Related Infections in a Cohort of Hospitalized Adult Patients

    Energy Technology Data Exchange (ETDEWEB)

    Bouzad, Caroline, E-mail: caroline.bouzad@gmail.com [Percy Military Teaching Hospital, Radiology Department (France); Duron, Sandrine, E-mail: duronsandrine@yahoo.fr [GSBdD, Military Centre for Epidemiology and Public Health (CESPA) (France); Bousquet, Aurore, E-mail: aurorebousquet@yahoo.fr [Begin Military Teaching Hospital, Bacteriology Department (France); Arnaud, François-Xavier, E-mail: fxa0160@hotmail.com [Percy Military Teaching Hospital, Radiology Department (France); Valbousquet, Laura, E-mail: laura.valbousquet@gmail.com [Begin Military Teaching Hospital, Radiology Department (France); Weber-Donat, Gabrielle, E-mail: weberdonatgabrielle@yahoo.fr; Teriitehau, Christophe, E-mail: cteriitehau@me.com; Baccialone, Jacques, E-mail: jacques.baccialone@wanadoo.fr; Potet, Julien, E-mail: potet-julien@yahoo.fr [Percy Military Teaching Hospital, Radiology Department (France)

    2016-03-15

    PurposeTo determine the incidence and the risks factors of peripherally inserted central catheter (PICC)-related infectious complications.Materials and MethodsMedical charts of every in-patient that underwent a PICC insertion in our hospital between January 2010 and October 2013 were reviewed. All PICC-related infections were recorded and categorized as catheter-related bloodstream infections (CR-BSI), exit-site infections, and septic thrombophlebitis.ResultsNine hundred and twenty-three PICCs were placed in 644 unique patients, mostly male (68.3 %) with a median age of 58 years. 31 (3.4 %) PICC-related infections occurred during the study period corresponding to an infection rate of 1.64 per 1000 catheter-days. We observed 27 (87.1 %) CR-BSI, corresponding to a rate of 1.43 per 1000 catheter-days, 3 (9.7 %) septic thrombophlebitis, and 1 (3.2 %) exit-site infection. Multivariate logistic regression analysis showed a higher PICC-related infection rate with chemotherapy (odds ratio (OR) 7.2–confidence interval (CI) 95 % [1.77–29.5]), auto/allograft (OR 5.9–CI 95 % [1.2–29.2]), and anti-coagulant therapy (OR 2.2–95 % [1.4–12]).ConclusionChemotherapy, auto/allograft, and anti-coagulant therapy are associated with an increased risk of developing PICC-related infections.Clinical AdvanceChemotherapy, auto/allograft, and anti-coagulant therapy are important predictors of PICC-associated infections. A careful assessment of these risk factors may be important for future success in preventing PICC-related infections.

  16. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael

    2013-01-01

    in the navigation experience and wasted time of medical staff in providing directions. Space in hospitals: space can be divided into personal, social and outdoor space. Personal space: single rooms have been well documented in: admission length, mortality rates, comfort levels, sense of privacy, all users...

  17. [Stricture of oxygen outlet of the central piping identified by a decrease in the oxygen supply pressure into the anesthesia machine].

    Science.gov (United States)

    Desaki, Yoko; Yorozuya, Toshihiro; Nakanishi, Kazuo; Soutani, Masao; Nagaro, Takumi

    2011-04-01

    We experienced an incident of the stricture caused by the degradation of an O-ring in the oxygen outlet of the central piping. The event was identified by the intermittent decrease of the central piping oxygen supply pressure into the anesthesia machine. In this case, pressure was judged normal by periodical checking. But the malfunction became clear when the parts of outlet were replaced, because similar incidents frequently had occurred. The cyclical rhythm of the declining oxygen supply pressure means that oxygen supplies decreases with the increase of oxygen consumption, and it may be a sign of serious malfunction. Therefore, it is necessary to check the pressure deviations under use of high-flow oxygen.

  18. Implementation of a children's hospital-wide central venous catheter insertion and maintenance bundle

    NARCIS (Netherlands)

    K. Helder MScN (Onno); R.F. Kornelisse (René); C. van der Starre (Cynthia); D. Tibboel (Dick); C.W.N. Looman (Caspar); R.M.H. Wijnen (René); M.J. Poley (Marten); E. Ista (Erwin)

    2013-01-01

    textabstractBackground: Central venous catheter-associated bloodstream infections in children are an increasingly recognized serious safety problem worldwide, but are often preventable. Central venous catheter bundles have proved effective to prevent such infections. Successful implementation requir

  19. Using Lean Six Sigma Methodology to Improve Quality of the Anesthesia Supply Chain in a Pediatric Hospital.

    Science.gov (United States)

    Roberts, Renée J; Wilson, Ashley E; Quezado, Zenaide

    2017-03-01

    Six Sigma and Lean methodologies are effective quality improvement tools in many health care settings. We applied the DMAIC methodology (define, measure, analyze, improve, control) to address deficiencies in our pediatric anesthesia supply chain. We defined supply chain problems by mapping existing processes and soliciting comments from those involved. We used daily distance walked by anesthesia technicians and number of callouts for missing supplies as measurements that we analyzed before and after implementing improvements (anesthesia cart redesign). We showed improvement in the metrics after those interventions were implemented, and those improvements were sustained and thus controlled 1 year after implementation.

  20. 消毒供应中心质量追溯管理系统设计与应用%Design and Application of Quality Tacing Management System in Central Sterile Supply Department

    Institute of Scientific and Technical Information of China (English)

    曾美凤; 曾宏; 刘承军; 郭国斌

    2011-01-01

    The process of the quality tracing management for the central sterile supply department in the l80th Hospital of PLA is introduced. The development and application of the information management system are explicated. The design functions and operation effectiveness of the system are analyzed selectively, which will provide a certain reference for the informatization management in the similar units.%介绍了解放军第180医院消毒供应中心的质量追溯管理过程,阐述其信息管理系统的开发应用情况,主要分析该系统的功能设计及其运行效果,为同类单位的信息化管理提供一定的借鉴.

  1. Tumores del estroma gastrointestinal (GIST: serie del Hospital Central de la Defensa Gómez Ulla

    Directory of Open Access Journals (Sweden)

    I. Bodega Quiroga

    2013-09-01

    Full Text Available Objetivo: Los tumores del estroma gastrointestinal (GIST se han diferenciado hace poco más de una década de los tumores de músculo liso y de origen neural gracias a métodos de identificación inmunohistoquímica (CD117. Al mismo tiempo, la introducción del Mesylato de Imatinib, fármaco empleado en el tratamiento de la leucemia mieloide crónica (LMC, ha mejorado la expectativa de vida, no sólo en GIST irresecables o metastáticos, sino también para aquéllos de intermedio o alto grado de malignidad como terapia adyuvante e incluso se plantea como tratamiento neoadyuvante. El objetivo de esta comunicación es estudiar los GIST diagnosticados e intervenidos quirúrgicamente en el Servicio de Cirugía General y del Aparato Digestivo del Hospital Central de la Defensa «Gómez Ulla» (Madrid en un periodo de 9 años y realizar una revisión de la literatura enfocada fundamentalmente a los avances en el tratamiento. Material y métodos: Estudio retrospectivo observacional de los pacientes diagnosticados de GIST e intervenidos quirúrgicamente en nuestro Servicio de 2003 a 2012. Se estudia el motivo de consulta inicial, la localización, el grado histológico y el tipo de intervención quirúrgica realizado. Resultados: Se encontraron 11 pacientes entre Noviembre de 2003 y Abril de 2012, todos hombres. La edad media fue de 65´17 años (rango, 53-84. Hay que destacar que en 8 casos (72´7 % el hallazgo fue incidental, sin ninguna sintomatología previa. La localización más frecuente fue el estómago en 6 casos (54´5%, y en el intestino delgado en 5 (45´5%. En cuanto al riesgo de malignidad, 5 casos (45´5% fueron de bajo grado, 4 (36´4% de grado intermedio, 1 (9% de muy bajo grado y 1 (9´1% de alto grado de malignidad. La técnica quirúrgica empleada fue la gastrectomía parcial en 6 casos (54´5% seguida de la resección intestinal segmentaria en 5 casos (45´5%. Conclusiones: La incidencia anual de tumores GIST intervenidos en nuestro

  2. 医院消毒供应中心人员配置与锐器伤相关性研究%Correlation between personnel staffing and sharp injuries in central sterile supply departments

    Institute of Scientific and Technical Information of China (English)

    康虹; 王丽华; 于静; 高佳

    2014-01-01

    目的:探讨集中供应模式下消毒供应中心工作人员结构与锐器伤发生的关系。方法于2011年9月-2012年9月采取问卷调查法对湖南省30所医院的人员配置及342名工作人员的锐器伤发生情况进行调查,分析在不同人员配置下的锐器伤发生率。结果医院消毒供应中心注册护士人员比例平均值达到要求,但工作人员与床位比低于湖南省医院消毒供应中心达标验收标准;消毒供应中心工作人员2011年9月-2012年9月的统计数据中护士的比例、大专学历、护士工作年限>5年、工人工作年限<1年,锐器伤发生率最高(P<0.05)。结论消毒供应中心工作人员数量有待增加,合理的人员结构配置,将有利于降低消毒供应中心工作人员锐器伤的发生。%OBJECTIVE To explore the correlation between the personnel staffing in central sterile supply depart‐ment and the sharp injuries under the centralized supply mode .METHODS From Sep 2011 to Sep 2012 ,a ques‐tionnaire survey was conducted to investigate the personnel staffing in 30 hospitals of Hunan province and the inci‐dence of sharp injuries in 342 staff ,and the incidence of the sharp injuries under different personnel staffing was analyzed .RESULTS The mean value of ratio of the registered nurses in the central sterilized supply departments has met the standard ,however ,the ratio of the staff to bed did not meet the Central Sterile Supply Department Compliance and Acceptance Criteria in Hunan province .The statistical analysis performed from Sep 2011 to Sep 2012 showed the proportion of the nurses ,the junior college education background ,the working lifetime of the nurses more than 5 years ,the working lifetime of the workers less than 1 year ,the incidence of the sharp injuries was the highest (P<0 .05) .CONCLUSION The number of staff in the central sterile supply departments needs to be raised ,and the rational personnel staffing

  3. 医院消毒供应中心落实三项标准的调查%Investigation on implementation of three standards by central sterile sup-ply departments

    Institute of Scientific and Technical Information of China (English)

    张宇; 冯秀兰; 任伍爱; 钱黎明; 巩玉秀

    2014-01-01

    Objective To realize the status in the implementation of three industry standards of central sterile sup-ply department (CSSD),and provide a scientific basis for carrying out of the standards. Methods According to three standards,investigation forms were designed by specialists,written survey on 365 hospitals in 9 provinces and field investigation on 1 5 hospitals in 3 provinces were performed,the implementation of three standards were investi-gated.Results Of 365 hospitals,the number of provincial and ministerial level,municipal level,and county level hospitals were 90,87 and 188 respectively. More than 94% of hospitals established CSSD management system and regulations,>90% of hospitals met the requirements of CSSD layout;All hospitals were equipped with pressure steam sterilizer,all levels of hospitals basically equipped with the necessary equipments and facilities;CSSD respon-sible officers of 94.52% (345/365)of hospitals participated in training on standards;69.61% (252/362)of hospi-tals were using or developing CSSD information systems;>92% of the CSSD responsible officers considered that three standards played an important role in facilitating centralized management,and improving the quality of clean-ing,disinfection and sterilization.Conclusion Hospitals need to strengthen the management and training on stand-ards of CSSD,management of loaner instruments and development of information system need to be standardized.%目的:了解医院消毒供应中心(CSSD)三项强制性行业标准落实现状,为进一步贯彻标准提出科学建议。方法依据三项标准,组织相关专家设计调查表,采用书面调查的方式对9省365所医院进行调查,对3省市15所医院进行实地调研,了解医院CSSD三项标准的执行情况。结果调查的365所医院中,省部级医院90所,地市级医院87所,县区级医院188所。>94%的医院建立了CSSD管理体制与制度;>90%的医院CSSD建筑布局符合要求

  4. Exploration on Increasing the Effective Supply of Private Hospitals%对增加民营医院有效供给问题的探索

    Institute of Scientific and Technical Information of China (English)

    倪云

    2015-01-01

    The article puts forward private hospital act as a very important role in health care system in China. By analysing the current development situation of private hospitals ,the article points out many problems such as invisible threshold,talent bottleneck low integrity,management confusion etc.The development of private hospitals need to adhere to the principle of public welfare ,market mechanism and the combination of incentives and strict supervision.On this basis,innovation of supply model,accelerating flow of teclent,and advanced service concept,etc. are proposed in the problem orientation.%文章提出民营医院在医疗卫生事业发展中承担着不可或缺的任务,通过对民营医院发展现状进行分析,指出民营医院面临着隐形门槛、人才瓶颈诚信度低和管理混乱等问题,对民营医院的发展需要坚持公益性、市场机制和鼓励与严格监管相结合原则,在此基础上,以问题为导向提出创新供给模式、加快人才流动和倡导先进服务理念等政策建议。

  5. Drinking water quality assessment and corrosion mitigation in the hospital water supply system of Chacas Village (Peru

    Directory of Open Access Journals (Sweden)

    Riccardo Bigoni

    2014-07-01

    Full Text Available Rural hospitals in developing countries often lack appropriate water treatments to assure their water needs. In these facilities, due to water different uses and its use with medical equipment, water quality problems can cause very hazardous situations. In particular, corrosion of water distribution systems is a common issue that can cause unwanted changes in water quality and failures of the distribution system’s pipes. These considerations suggest that a complete monitoring program and water treatments to control and guarantee the water quality would be required in each health-care facility. This study assessed the quality of the water at the rural hospital of Chacas (Peru as measured via specific physical-chemical and microbiological parameters. The results show that the chemical and microbiological qualities of the water generally worsen from catchment to the hospital’s taps. Moreover, this work investigated the effects of a dolomite limestone filter installed to adjust the quality of the water distributed at the hospital and thereby mitigate the water’s corrosiveness. Corrosion indices were calculated to provide useful information on the water’s corrosiveness and positive results were obtained in reducing corrosiveness after the installation of the dolomite filter.

  6. Molecular Epidemiology of Brucella Genotypes in Patients at a Major Hospital in Central Peru

    NARCIS (Netherlands)

    K. Noeckler; R. Maves; D. Cepeda; A. Draeger; A. Mayer-Scholl; J. Chacaltana; M. Castaneda; B. Espinosa; R. Castillo; E. Hall; S. Al Dahouk; R.H. Gilman; F. Cabeza; H.L. Smits

    2009-01-01

    The multiple-locus variable-number repeat analysis of 90 human Brucella melitensis isolates from a large urban area in central Peru revealed variations at 4 (Bruce07, Bruce09, Bruce18, and Bruce42) out of 16 loci investigated, of which 1 (Bruce42) also is used for species identification. Ten genotyp

  7. 沿海消毒供应中心建筑设计与感染控制的探讨%Design and building of coastal central sterile supply department and study on infection control

    Institute of Scientific and Technical Information of China (English)

    孙雪莹; 王岩; 邱素红; 高玉华

    2012-01-01

    目的 探讨沿海医院消毒供应中心的建筑设计与感染控制.方法 遵循医院感染预防与控制的原则及国家法律、法规对医院建筑和职业防护的相关要求,进行充分论证,并结合国内外消毒供应中心建筑布局的优点,依照《医院消毒供应室验收标准》及《综合医院建筑规范》等国家相关标准,进行专业设计和施工;引进先进的消毒灭菌、空气层流净化设备;物品实行ERP系统信息化管理;分区以双扉式全自动清洗消毒器、灭菌器作隔离屏障;严格的人流、物流、气流管理.结果 拥有现代化、标准化、科学化及专业化的建筑设计,使整个操作流程形成相对封闭的不可逆的运行过程,控制了再次污染的机会,有效地控制医院感染,为医院各个临床科室的医疗安全提供了重要保证;各项质量监测指标均符合建筑设计标准与感染控制要求.结论 建筑设计符合现代化消毒供应中心标准要求,制定出合理的流程管理制度及质控措施,能有效控制医院感染.%OBJECTIVE To explore the design and building of central sterile supply department and the infection control. METHODS By following the hospital infection prevention and control and the principle of state laws and regulations on hospital buildings and the relevant requirement of occupational protection, the professional design and building were carried out through the complete demonstration and combining domestic and foreign architectural layout of the center of sterilization supply advantages in accordance with the national standards ' hospital sterilization supply& distribution acceptance standard' and the general hospital building codes; the advanced disinfection and laminar air purification equipments were introduced; the management of the items was performed by ERP information system; the partition was conducted by double hired type automatic washer disinfector, sterilizer was used as isolated

  8. 医院集团财务集中管理探讨%Discussion into the Centralization of Financial Management of Hospital Group

    Institute of Scientific and Technical Information of China (English)

    罗庆华

    2015-01-01

    In order to configure the hospital asset rationally, exert the advantage of group and enhance the efficiency of capital operations, the financial management of hospital group must be centralized. The advantages of centralization of financial management were analyzed. The feasible schemes for centralization of financial management of hospital group were put forward. The attentive questions in the course of centralization of financial management were pointed out.%医院集团财务集中管理能更合理地配置医院资产、发挥集团优势及提高资本运营效率。该文分析财务集中管理的优点,提出医院集团财务集中管理的切实可行的实施方案,指出实行财务集中管理中应注意的问题。

  9. Five-year outbreak of community- and hospital-acquired Mycobacterium porcinum infections related to public water supplies.

    Science.gov (United States)

    Brown-Elliott, Barbara A; Wallace, Richard J; Tichindelean, Carmen; Sarria, Juan C; McNulty, Steven; Vasireddy, Ravikaran; Bridge, Linda; Mayhall, C Glenn; Turenne, Christine; Loeffelholz, Michael

    2011-12-01

    Mycobacterium porcinum is a rarely encountered rapidly growing Mycobacterium (RGM). We identified M. porcinum from 24 patients at a Galveston university hospital (University of Texas Medical Branch) over a 5-year period. M. porcinum was considered a pathogen in 11 (46%) of 24 infected patients, including 4 patients with community-acquired disease. Retrospective patient data were collected, and water samples were cultured. Molecular analysis of water isolates, clustered clinical isolates, and 15 unrelated control strains of M. porcinum was performed. Among samples of hospital ice and tap water, 63% were positive for RGM, 50% of which were M. porcinum. Among samples of water from the city of Galveston, four of five households (80%) were positive for M. porcinum. By pulsed-field gel electrophoresis (PFGE), 8 of 10 environmental M. porcinum were determined to belong to two closely related clones. A total of 26 of 29 clinical isolates subjected to PFGE (including isolates from all positive patients) were clonal with the water patterns, including patients with community-acquired disease. Fifteen control strains of M. porcinum had unique profiles. Sequencing of hsp65, recA, and rpoB revealed the PFGE outbreak clones to have identical sequences, while unrelated strains exhibited multiple sequence variants. M. porcinum from 22 (92%) of 24 patients were clonal, matched hospital- and household water-acquired isolates, and differed from epidemiologically unrelated strains. M. porcinum can be a drinking water contaminant, serve as a long-term reservoir (years) for patient contamination (especially sputum), and be a source of clinical disease. This study expands concern about public health issues regarding nontuberculous mycobacteria. Multilocus gene sequencing helped define clonal populations.

  10. A Research on Coordination of VMI & TPL Supply Chain under Centralized Control%集中控制型VMI&TPL供应链的协调研究

    Institute of Scientific and Technical Information of China (English)

    刘阳; 赵道致; 何龙飞

    2012-01-01

    以基本的RS契约为基础,研究了如何实现随机需求下集中控制型VMI&TPL供应链的协调.鉴于基本的RS契约失效,设计了一种由各成员共担库存风险的风险共担型RS契约,进一步提出了基于不对称Nash协商的风险共担型RS契约.研究表明,风险共担型RS契约仅能实现供应链整体期望收益的Pareto最优,而基于不对称Nash协商的风险共担型RS契约则能同时实现供应链整体期望收益的Pareto最优和各成员期望收益的Pareto改进.%The coordination problem of a supply chain under vendor managed inventory (VMI) mode with third party logistics (TPL) is studied in this paper. In the supply chain, the demands are subject to random disturbance. It is assume that the supply chain is coordinated by revenue sharing (RS) contract and it is operated under centralized control mode. Consider that the basic RS contract is no longer effective, an RS contract with the stock risk shared by retailer, supplier, and TPL is proposed to coordinate the supply chain. This contract is further extended to the RS contract combined with risk-sharing under Asymmetric Nash Negotiation. With these contracts, analysis is carried out. Results show that while the RS contract with risk-sharing can maximize the expected revenue of whole supply chain, the one with risk-sharing under Asymmetric Nash Negotiation can coordinate the supply chain well and at the same time the Pareto improvement for every member's expected revenue can be achieved.

  11. Specialized consulting in radiological safety to the south central hospital of high specialty, PEMEX. VI. December of 2001; Asesoria especializada en seguridad radiologica al hospital central sur de alta especialidad. PEMEX. VI. Diciembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J.A.; Garcia A, J.; Rodriguez A, F. [ININ, 52045 Ocoyoacac, Estado de Mexico (Mexico)

    2002-01-15

    It is a report of a specialized consulting in radiological safety that to be carried the ININ to PEMEX for the South Central Hospital of High Specialty, to maintain the sanitary license for the use of X-ray equipment of medical diagnostic, and guarantee these services with a program of quality assurance. To give fulfilment to that requests it is programmed a technical assistance monthly, with reports of results during the development of the service. In this document it is carried a report of the advances and results in the month of december of the 2001, where the following documents are analyzed: Manual of radiological safety, program of quality assurance, operation procedures, procedure of maintenance team, procedure of medical radiological control of the specialized personnel; also are annotate the obtained results and their observations. (Author)

  12. Specialized consulting in radiological safety to the North Central Hospital of high specialty, PEMEX. V. November of 2001; Asesoria especializada en seguridad radiologica al Hospital Central Norte de alta especialidad, PEMEX. V. Noviembre de 2001

    Energy Technology Data Exchange (ETDEWEB)

    Angeles C, A.; Vizuet G, J.; Benitez S, J. A.; Garcia A, J.; Rodriguez A, F. [ININ, 52045 Ocoyoacac, Estado de Mexico (Mexico)

    2002-01-15

    It is a report of a specialized consulting in radiological safety that to be carried the ININ to PEMEX for the North Central Hospital of High Specialty, to maintain the sanitary license for the use of X ray equipment of medical diagnostic, and guarantee these services with a program of quality assurance. To give fulfilment to that requests it is programmed a technical assistance monthly, with reports of results during the development of the service. In this document it is carried a report of the advances and results in the month of November of the 2001, where the following documents are analyzed: Manual of radiological safety, program of quality assurance, operation procedures, procedure of maintenance team, procedure of medical radiological control of the specialized personnel; also are annotate the obtained results and their observations. (Author)

  13. Biological productivity, terrigenous influence and noncrustal elements supply to the Central Indian Ocean Basin: Paleoceanography during the past ∼1Ma

    Indian Academy of Sciences (India)

    J N Pattan; Toshiyuki Masuzawa; D V Borole; G Parthiban; Pratima Jauhari; Mineko Yamamoto

    2005-02-01

    A 2 m-long sediment core from the siliceous ooze domain in the Central Indian Ocean Basin (CIOB; 13° 03′S: 74° 44′E; water depth 5099 m) is studied for calcium carbonate, total organic carbon, total nitrogen, biogenic opal, major and few trace elements (Al, Ti, Fe, K, Mg, Zr, Sc,V, Mn, Cu, Ni, Zn, Co, and Ba) to understand the productivity and intensity of terrigenous supply. The age model of the sediment core is based on U-Th dating, occurrence of Youngest Toba Tuff of ∼74 ka and Australasian microtektites of ∼770ka. Low carbonate content (> 1%) of sediment core indicates deposition below the carbonate compensation depth. Organic carbon content is also very low, almost uniform (mean 0.2 wt%) and is of marine origin. This suggests a well-oxygenated bottom water environment during the past ∼1100 ka. Our data suggest that during ∼1100 ka and ∼400 ka siliceous productivity was lower, complimented by higher supply of terrigenous material mostly derived from the metasedimentary rocks of High Himalayan crystalline. However, during the last ∼400ka, siliceous productivity increased with substantial reduction in the terrigenous sediment supply. The results suggest that intensity of Himalayan weathering, erosion associated with monsoons was comparatively higher prior to 400 ka. Manganese, Ba, Cu, Ni, Zn, and Co have around 90% of their supply from noncrustal (excess) source and their burial to seafloor remained unaffected throughout the past ∼1100ka.

  14. 组长负责制在消毒供应中心环节质量控制中的作用%Role of Group Leader Responsibility System in Link Quality Control of Central Sterile Supply Department

    Institute of Scientific and Technical Information of China (English)

    江楠; 李璟; 张帆

    2016-01-01

    Objective to analyze the leader responsibility system in disinfection supply center (CSSD) in the role of quality control. Methods the implementation of team leader responsibility system in disinfection supply center in our hospital, according to the division of the District, compared before and after the implementation of department satisfaction. Results after the implementation of the implementation of the satisfaction was significantly higher than before the implementation, the significant difference between the groups was statistically significant (P< 0.05). Conclusion the leader responsibility system should be used in the quality control of the central sterile supply center, which can significantly improve the quality of work, it is worthy of clinical choice and further promotion.%目的:分析组长负责制在消毒供应中心(CSSD)环节质量控制中的作用。方法在我院消毒供应中心实施组长责任制,进行按区划分,比较实施前后科室满意度情况。结果实施后科室满意度明显高于实施前,组间显著性差异具有统计学意义(P<0.05)。结论组长负责制应用于消毒供应中心环节质量控制工作中,可显著提高工作质量,值得临床选择和进一步推广。

  15. The pratice and effect evaluation of layered staff training in Central Sterile Supply Department%消毒供应中心工作人员分层培训实践效果评价

    Institute of Scientific and Technical Information of China (English)

    夏小莲; 周凤莲; 江婷

    2015-01-01

    The staffs in Central Sterile Supply Department of the First Afifliated Hospital of Nanchang University were divided into ifve levels to receive sterile and supply theoretical and skill training. The training focused on pecialized position training besides various kinds of training. After two years of training, the staffs'scores improved signiifcantly than those before training, and the examination pass rate is currently 100%. Therefore, layered staff training could optimize training resources, save training costs, improve training efifcacy, and comply with the characteristics of sterile supply decipline and regularity of personnel growth.%将南昌大学第一附属医院消毒供应中心工作人员分为5个层次进行消毒供应专业理论和技能培训,培训形式以岗位培训为主、多样化方式相结合。经过两年培训实践,各层级护士专科理论成绩明显提高,差异有统计学意义;专科技能培训后考试成绩合格率为100%。因此,建立分层次、分级别的培训,可优化培训资源、节约培训成本、提高培训效果,符合消毒供应专业特点和人才成长规律。

  16. Principle of the central liquid supply system and its common failure analysis%中央供液系统原理及常见故障分析

    Institute of Scientific and Technical Information of China (English)

    陈伟豪; 谢伟柯; 姜东尧

    2012-01-01

    To improve the 4008s normal operation time and reduce the failure. We summarized all equipment failures in this paper and analyzed the reasons, Then we decided how to maintain the device according to results of the analysis. Through fault classification summary and decision of maintenance mehtods, the failure rate was reduced greatly. The 4008s' faults are caused by the pressure problem in the central liquid supply. The pressure is related to the liquid supply equipment and pipeline.%通过对中央供液系统原理及常见故障的分析,总结归纳具体原因,按照分析结果进行保养,提高费森尤斯4008S血透机正常运行时间,减少故障率.

  17. CLINICAL AND ANTIMICROBIAL PROFILE OF ACINETOBACTER SPECIES AT TERTIARY CARE HOSPITAL IN CENTRAL INDIA

    Directory of Open Access Journals (Sweden)

    Apoorva

    2014-07-01

    Full Text Available BACKGROUND: Acinetobacter are the “superbugs” of the modern hospital environment causing significant proportion of infections and in particular nosocomial infections with high mortality rates. The aim of this study was to isolate Acinetobacter species from clinical specimens and to study the antimicrobial susceptibility pattern of Acinetobacter isolates. MATERIAL AND METHODS: Two hundred and four clinical isolates of Acinetobacter species were processed for species identification by standard microbiological procedures. Antimicrobial susceptibility of these isolates was performed by Kirby-Bauer disc diffusion method. RESULTS: Out of 204 Acinetobacter isolates, 125(61.27% isolates were from ICU and 79(38.72% were from general wards. A baumannii was the most common species isolated (74.50%, followed by A.lwoffii (24.50% and A.haemolyticus (0.98%. A.baumannii showed maximum sensitivity to IPM (52.63% followed by MRP(36.18%, AK(28.28%, PIT(26.31%, TCC(21.71%, CIP(21.05% G(17.76% and COT(05.26%. Maximum resistance was observed to CTX(1.31% followed by CAZ(1.97%, CTR(1.97% and CPM(1.97% respectively. A.lwoffii showed maximum sensitivity to IPM(94% followed by AK(90%, and MRP(84%. Statistically significant difference (p value <0.001 was noticed between antibiotic resistance of A.baumannii and A.lwoffii. CONCLUSION: Continued surveillance of drug resistant strains in ICUs, combined with preventive measures remains absolutely essential to prevent or limit the spread of Acinetobacter species in hospital.

  18. Motorcycle-related injuries at a university teaching hospital in north central Nigeria

    Directory of Open Access Journals (Sweden)

    Itodo C Elachi

    2014-01-01

    Full Text Available Background: Motorcycle-related injuries lead to considerable morbidity and mortality. The aim of this study is to determine the pattern and outcome of motorcycle-related injuries at Benue State University Teaching Hospital, Makurdi, Nigeria. Patients and Methods: Case records of all patients who presented to the accident and emergency department with motorcycle-related injuries between July 2012 and June 2013 were analysed for age, gender, injury host status (i.e. rider, pillion or pedestrian, nature of collision (motorcycle versus other vehicles, motorcycle versus motorcycle, motorcycle versus pedestrian or lone riders, body region injured, injury severity score (ISS at arrival, length of hospital stay (LOS and mortality. Results: Seventy - nine patients with motorcycle-related injuries were included in the study. They consisted of 63 males (61.8% and 16 females (15.7%. The age range was 5-65 years with a mean of 32.4 ± 14.0. Motorcycle versus vehicle collisions were the most common mechanism of injury (n = 46, 58.2%. Musculoskeletal injuries constituted the most common injuries sustained (n = 50, 47.6% and the tibia was the most frequently fractured bone (n = 14, 35.9%. The majority of patients (57.0% sustained mild/moderate injuries ( ISS ≤ 15. There was no statistically significant difference between the sexes for sustaining mild/moderate injuries or severe/profound injuries (P > 0.05. Mortality rate was 6.3% with head injuries being involved in all cases. Conclusion: Young males were mostly injured in motorcycle-related trauma. Musculoskeletal injuries were the most common injuries sustained and head injuries were involved in all the deaths. Enforcement of motorcycle crash bars and helmet usage is recommended.

  19. Ocular biometry and central corneal thickness in children: a hospital-based study

    Directory of Open Access Journals (Sweden)

    Adem Gul

    2014-06-01

    Full Text Available Objetivo: Investigar a distribuição do comprimento axial, profundidade da câmara anterior, espessura do cristalino, profundidade da câmara vítrea e espessura corneal central em crianças em diferentes faixas etárias. Métodos: Foram estudados 364 olhos de 182 crianças entre 1 e 12 anos de idade. O comprimento axial, a profundidade da câmara anterior , a espessura do cristalino e a profundidade da câmara vítrea foram medidos por biometria ultrassônica. A espessura corneal central foi medida por paquimetria ultrassônica em todas as crianças. Resultados: A idade média foi de 6,54 ± 3,42 anos. O comprimento axial foi 20,95 mm no grupo de 1-2 anos de idade e 22,95 mm no grupo de 11-12 anos de idade. A espessura corneal central foi 556 µm no grupo de 1-2 anos de idade e 555 µm no grupo de 11-12 anos de idade. A profundidade da câmara anterior média e profundidade da câmara vítrea aumentou com a idade (3,06 mm a 3,44 mm de profundidade da câmara anterior, 13,75 mm a 15,99 mm de profundidade da câmara vítrea e da espessura do cristalino diminuiu com o aumento da idade (3,67 mm a 3,51 mm. Conclusões: Em nosso estudo, os valores do comprimento axial aumentou com a idade e atingiu os níveis adultos aos 9-10 anos de idade. A espessura do cristalino diminuiu gradualmente até os 12 anos de idade. As medições de espessura corneal central não seguiu um algoritmo linear.

  20. The EASTR Study: indications for transfusion and estimates of transfusion recipient numbers in hospitals supplied by the National Blood Service.

    Science.gov (United States)

    Wells, A W; Llewelyn, C A; Casbard, A; Johnson, A J; Amin, M; Ballard, S; Buck, J; Malfroy, M; Murphy, M F; Williamson, L M

    2009-12-01

    This study provides data on National Blood Service (NBS) red blood cell (RBC, n = 9142), platelet (PLT, n = 4232) and fresh frozen plasma (FFP, n = 3584) recipients independently sampled by monthly quota from 29 representative hospitals over 12 months in 2001-2002. Hospitals were stratified by size according to total yearly RBC issues. Transfusion indications were chosen from diagnostic and procedural codes, and recipients grouped into Epidemiology and Survival of Transfusion Recipients Case-mix Groups (E-CMGs). The main E-CMGs were digestive [19% of RBC recipients; including 5% gastrointestinal (GI) bleeds and 3% colorectal surgery], musculoskeletal (15%; 12% hip and knee replacement), haematology (13%) and obstetrics and gynaecology (10%). Renal failure, fractured neck of femur, cardiac artery by-pass grafting (CABG) and paediatrics, each accounted for 3-4% recipients. FFP recipients: the main E-CMGs were digestive (21% of FFP recipients; including 7% GI bleeds and 3% colorectal surgery), hepatobiliary (15%; 7% liver disease and 2% liver transplant), cardiac (12%) and paediatrics (9%) The renal, paediatrics, vascular and haematology E-CMGs each had 6-7% of recipients. PLT recipients: the main E-CMGs were haematology (27% of PLT recipients; including 9% lymphoma and 8% acute leukaemia), cardiac (17%), paediatrics (13%), hepatobiliary (10%) and digestive (9%). Back-weighting gave national estimates of 433 000 RBC, 57 500 FFP and 41 500 PLT recipients/year in England and North Wales, median age 69, 64 and 59 years, respectively. Digestive and hepatobiliary indications emerged as the top reason for transfusion in RBC and FFP recipients, and was also a frequent indication in PLT recipients.

  1. Comparative ecobalancing accounting of semi-central house heat supply from wood residues; Vergleichende Oekobilanzierung der semi-zentralen Hauswaermebereitstellung aus Holzreststoffen

    Energy Technology Data Exchange (ETDEWEB)

    Biemann, Kirsten

    2015-07-01

    In 2008 almost 40 percent of the German final energy demand was used for room heating and hot water supply. To decrease environmental burdens and to save fossil resources a restructuring of the heating sector is needed. Therefore legislation enforces higher insulation standards of buildings and a more frequent use of renewable energies as well as heating networks. Wood as a renewable and storable energy source is an attractive fuel. However, it must be used as efficiently as possible because of limited wood supplies. Connecting buildings via a heating network is a good option since bigger heating plants can operate at higher efficiencies than small heaters. However, the higher insulation standards of the buildings often oppose the construction of a heating network, because heating networks work best with high energy demands and low network lengths. Therefore the environmental and economic feasibility of new heating networks needs to be checked beforehand. This thesis explores the environmental burdens of different semi- centralized heating networks using wood residues as fuel. A semi- centralized heating network is a network with no more than 500 customers and a heating plant with less than 5 MWth. While wood residues are used in the base load plant, peak load is covered by a gas heating plant. As a method to analyze the potential environmental burdens of the heat supply a life cycle assessment according to ISO 14040/44 is used. Opposed to former life cycle assessment studies, construction and operation of the network is included in the assessment. Even though the environmental impacts of the semi- centralized heating from wood residues are dominated by the heat supply, an observation of the impacts solely at the heating plant is not sufficient. By varying the boundary conditions of the heating network two main contributors to the environmental impacts are found. In addition to the heat production at the plant the type of the buildings in the settlement has a huge

  2. Medical store management: an integrated economic analysis of a tertiary care hospital in central India.

    Science.gov (United States)

    Mahatme, Ms; Dakhale, Gn; Hiware, Sk; Shinde, At; Salve, Am

    2012-04-01

    Economic analysis plays a pivotal role in the management of medical store. The main objectives of this study were to consider always better control-vital, essential and desirable (ABC-VED) analysis with economic order quantity (EOQ), comparison of indexed cost and the actual cost, and to assess the expenditure for the forthcoming years. Based on cost and criticality, a matrix of nine groups by combining ABC and VED analysis was formulated. Drug categories were narrowed down for prioritization to direct supervisory monitoring. The subgroups AE and AV of the categories category I and II should be ordered based on EOQ. The difference between the actual annual drug expenditure (ADE) and the derived indexed cost using the cost inflation index (CII) was calculated. Linear regression was used to assess the expenditure for the forth coming years. The total ADE for the financial year of 2010-2011 was Rs. 1,91,44,253 which was only 7.68% of annual hospital expenditure. Using the inflation index, the indexed cost of acquisition of ADE for year 2010-2011 was Rs. 1,95,10,387. The difference between the two was estimated to be 2.11%. Thus, the CII justifies the demand of increased budget for next year and prompts us for cautious use of drugs. By taking into consideration the ADE of last 10 years, we have forecasted the budget for forthcoming years which will help significantly for making policies according to the available budget.

  3. Evaluation of prescribing indicators and pattern among dermatological outpatients in a teaching hospital of central Nepal

    Directory of Open Access Journals (Sweden)

    Manohar Pradhan

    2016-08-01

    Full Text Available Background: Evaluation of prescribing indicators by proper analysis of prescriptions under the guidelines of World Health Organization enables us to detect some of the common problems of prescribing.Methodology: This study was conducted on randomly selected 325 prescriptions of dermatological outpatients of teaching hospital of College of Medical Sciences Bharatpur (Nepal with an objective to detect the problems of prescribing as well as to delineate the pattern of medicines prescribing.Results: Total number of medicines prescribed on these prescriptions was 743. The average number of medicines per encounter was 2.28. Antihistamines, antifungals, corticosteroids and antibiotics were four most frequently prescribed therapeutic classes. One systemic as well as one topical medicine belonging to same therapeutic class was prescribed on about one-third of totally analyzed prescriptions. Cetrizine was the most common individually prescribed medicine and fluconazole was the most commonly prescribed antifungal. Medicines prescribed by their generic name were 15.07% and those prescribed from national essential medicines list were 23.42%.Conclusion: This study reveals polypharmacy, inclination of prescribers for branded medicines and prescribing out of national formulary as problems. Educational and managerial interventions are required to rationalize the prescribing practice.JCMS Nepal. 2016;12(2:44-9.

  4. ON REASONABLE ESTIMATE OF ENERGY PERFORMANCE OF THE RESIDENTIAL BUILDINGS SUSTENANCE WITH CENTRALIZED HEAT-SUPPLY SYSTEM

    Directory of Open Access Journals (Sweden)

    S. N. Osipov

    2016-01-01

    Full Text Available As consisted with Directive No 3 of President of the Republic of Belarus of June, 14th 2007 ‘Economy and Husbandry – the Major Factors of Economic Security of the Republic of Belarus’, saving fuel-and-energy resources over the republic in 2010–2015 should amount to 7,1–8,9 MIO tons of fuel equivalent including 1,00–1,25 MIO tons of fuel equivalent at the expense of heat-supply optimization and 0,25–0,40 MIO tons of fuel equivalent at the expense of increasing enclosing structures heat resistance of the buildings, facilities and housing stock. It means, where it is expected to obtain around 18 % of general thermal resources economy in the process of heat-supply optimization, then by means of enhancing the cladding structure heat resistance of the buildings and constructions of various applications – only about 3–5 % and even a bit less so of the housing stock. Till 1994, in residential sector of the Republic of Belarus, the annual heat consumption of the heating and ventilation averaged more than 130 kW×h/(m2×year (~56 %, of the hot-water supply – around 100 kW×h/(m2×year (~44 %. In residential houses, built from 1994 to 2009, heat consumption of the heating and ventilation is already 90 kW×h/(m2×year, of the hot-water supply – around 70 kW×h/(m2×year. In buildings of modern mainstream construction, they expend 60 kW×h/(m2×year (~46 % on heating and ventilation and 70 kW×h/(m2×year (~54 % on hot-water supply. In some modern residential buildings with the exhausted warm air secondary energy resource utilization, the heating and ventilation takes around 30–40 kW×h/(m2×year of heat. Raising energy performance of the residential buildings by means of reducing heat expenses on the heating and ventilation is the last segment in the system of energy resources saving. The first segments in the energy performance process are producing heat and transporting it over the main lines and outside distribution networks. In

  5. Ascii grids of predicted pH in depth zones used by domestic and public drinking water supply depths, Central Valley, California

    Science.gov (United States)

    Zamora, Celia; Nolan, Bernard T.; Gronberg, JoAnn M.

    2017-01-01

    The ascii grids associated with this data release are predicted distributions of continuous pH at the drinking water depth zones in the groundwater of Central Valley, California. The two prediction grids produced in this work represent predicted pH at the domestic supply and public supply drinking water depths, respectively and are bound by the alluvial boundary that defines the Central Valley. A depth of 46 m was used to stratify wells into the shallow and deep aquifer and were derived from depth percentiles associated with domestic and public supply in previous work by Burow et al. (2013). In this work, the median well depth categorized as domestic supply was 30 meters below land surface and the median well depth categorized as public supply is 100 meters below land surface. Prediction grids were created using prediction modeling methods, specifically Boosted Regression Trees (BRT) with a gaussian error distribution within a statistical learning framework within R's computing framework (http://www.r-project.org/). The statistical learning framework seeks to maximize the predictive performance of machine learning methods through model tuning by cross validation. The response variable was measured pH from 1337 wells, and was compiled from two sources: US Geological Survey (USGS) National Water Information System (NWIS) Database (all data are publicly available from the USGS: http://waterdata.usgs.gov/ca/nwis/nwis) and the California State Water Resources Control Board Division of Drinking Water (SWRCB-DDW) database (water quality data are publicly available from the SWRCB: http://www.waterboards.ca.gov/gama/geotracker_gama.shtml). Only wells with measured pH and well depth data were selected, and for wells with multiple records, only the most recent sample in the period 1993-2014 was used. A total of 1003 wells (training dataset) were used to train the BRT model and 334 wells (hold-out dataset) were used to validate the prediction model. The training r-squared was

  6. Suicide in rural central India: Profile of attempters of deliberate self harm presenting to padhar hospital in Madhya Pradesh

    Directory of Open Access Journals (Sweden)

    Johann Alex Ebenezer

    2016-01-01

    Full Text Available Background: Suicide is a significant public health issue. India currently has the largest number of suicides in the world and has a disproportionate number of youth suicides including young women. The studies on patterns of suicide in rural central India are sparse, particularly among tribal communities. Aims: The aim of this study is to describe the profile of suicide attempters presenting to a secondary-level hospital in rural central India and identify areas for potential future research toward preventive strategies. Materials and Methods: A retrospective chart review was carried out of eighty patients who were admitted with presenting complaints of deliberate self-harm and survived until psychiatric consultation. Descriptive statistics was employed to generate the results. Results and Conclusions: 86% of the attempts were isolated impulsive attempts following triggers, the most common of which was interpersonal disputes (71%. Only 67% of patients had a mental health condition, the most common syndrome being alcohol use disorder, followed by depression, and personality disorders. Although 45% of attempters had background interpersonal conflicts, only 5% reported financial stressors as contributory. Psychosocial stressors, especially interpersonal conflicts within the family, appear to be at least as important factors as mental illnesses in contributing to suicide attempts in the area.

  7. Infecciones del sistema nervioso central por enterovirus en niños atendidos en un hospital de Lima, Perú Enteroviral central nervous system infections in children treated at a hospital in Lima, Peru

    Directory of Open Access Journals (Sweden)

    Iván O Espinoza

    2011-12-01

    Full Text Available Objetivos. Determinar la frecuencia y las características clínicas de las infecciones del sistema nervioso central por enterovirus en niños atendidos en el Hospital Nacional Cayetano Heredia de Lima, Perú. Materiales y métodos. Se realizó un estudio prospectivo y descriptivo desde abril 2008 hasta marzo 2010. Se enrolaron pacientes de un mes a 14 años con diagnóstico clínico de encefalitis o meningitis asépticas. Se investigó la presencia de enterovirus, virus herpes simple 1 (VHS-1, virus herpes simple 2 (VHS-2 y virus varicela-zoster (VZV mediante reacción en cadena de polimerasa (PCR. Resultados. Se enrolaron 97 pacientes de los cuales 69 % presentaron encefalitis aguda y 31 % meningitis aguda. Se identificó enterovirus en 52,6 % del total de infecciones agudas no bacterianas del sistema nervioso central; encontrándose en 83,3 % de las meningitis y en 38,8 % de las encefalitis. No hubo casos de infección por VHS-1, VHS-2 ni VZV. Las infecciones por enterovirus alcanzaron el 82,9 % en los meses cálidos de noviembre a enero y el 28,6 % en los meses fríos de mayo a julio. Conclusiones. Los enterovirus fueron los principales agentes etiológicos en las encefalitis y meningitis asépticas agudas en pacientes pediátricos de Lima, Perú. Los enterovirus tienen un comportamiento epidemiológico estacional con un claro aumento del número de casos en los meses de verano. Resulta útil tener disponible un método de diagnóstico rápido, como una ayuda para el manejo de las infecciones agudas del sistema nervioso.Objectives. To determine the frequency and clinical features of central nervous system infections caused by enterovirus in children treated at the Hospital Nacional Cayetano Heredia in Lima, Peru. Materials and methods. A prospective, descriptive study was performed from April 2008 to March 2010. Patients aged 1 month - 14 years with clinical diagnosis of encephalitis or aseptic meningitis were included. We investigated the

  8. Vascular malformations of central nervous system: A series from tertiary care hospital in South India

    Science.gov (United States)

    Karri, Sudhir Babu; Uppin, Megha S.; Rajesh, A.; Ashish, K.; Bhattacharjee, Suchanda; Rani, Y. Jyotsna; Sahu, B. P.; Saradhi, M Vijaya; Purohit, A. K.; Challa, Sundaram

    2016-01-01

    Aims and Objectives: To describe clinicopathological features of surgically resected vascular malformations (VMs) of central nervous system (CNS). Materials and Methods: Histologically diagnosed cases of VMs of CNS during April 2010–April 2014 were included. Demographic data, clinical and radiological features were obtained. Hematoxylin and eosin slides were reviewed along with Verhoeff-Van Gieson (VVG), Masson's trichrome, periodic acid-Schiff, and Perls' stains. Morphologically, cavernomas and arteriovenous malformations (AVMs) were distinguished on the basis of vessel wall features on VVG and intervening glial parenchyma. Results: Fifty cases were diagnosed as VMs of CNS with an age range of 14–62 years. These included 36 cavernomas, 12 AVMs, 2 mixed capillary-cavernous angiomas. Most of the cavernoma patients (15/36) presented with seizures, whereas AVM patients (8/12) had a headache as the dominant symptom. Twenty-nine patients were reliably diagnosed on radiological features. Microscopic evidence of hemorrhage was seen in 24/36 cavernomas and 6/12 AVMs, as opposed to radiologic evidence of 10 and 4, respectively. Reactive gliosis was seen in 16 cavernomas. Conclusions: Histological features are important for classifying the VMs of CNS as there are no specific clinical and radiological features. Type of VM has a bearing on management, prognosis, and risk of hemorrhage. PMID:27114659

  9. Vascular malformations of central nervous system: A series from tertiary care hospital in South India

    Directory of Open Access Journals (Sweden)

    Sudhir Babu Karri

    2016-01-01

    Full Text Available Aims and Objectives: To describe clinicopathological features of surgically resected vascular malformations (VMs of central nervous system (CNS. Materials and Methods: Histologically diagnosed cases of VMs of CNS during April 2010–April 2014 were included. Demographic data, clinical and radiological features were obtained. Hematoxylin and eosin slides were reviewed along with Verhoeff-Van Gieson (VVG, Masson's trichrome, periodic acid-Schiff, and Perls' stains. Morphologically, cavernomas and arteriovenous malformations (AVMs were distinguished on the basis of vessel wall features on VVG and intervening glial parenchyma. Results: Fifty cases were diagnosed as VMs of CNS with an age range of 14–62 years. These included 36 cavernomas, 12 AVMs, 2 mixed capillary-cavernous angiomas. Most of the cavernoma patients (15/36 presented with seizures, whereas AVM patients (8/12 had a headache as the dominant symptom. Twenty-nine patients were reliably diagnosed on radiological features. Microscopic evidence of hemorrhage was seen in 24/36 cavernomas and 6/12 AVMs, as opposed to radiologic evidence of 10 and 4, respectively. Reactive gliosis was seen in 16 cavernomas. Conclusions: Histological features are important for classifying the VMs of CNS as there are no specific clinical and radiological features. Type of VM has a bearing on management, prognosis, and risk of hemorrhage.

  10. 消毒供应中心包装材料的合理应用%Reasonable use of packaging materials in central sterile supply department

    Institute of Scientific and Technical Information of China (English)

    侯玉英; 王素英; 马红娟

    2014-01-01

    OBJECTIVE To investigate the status of application of sterile packaging materials in the central sterile supply department so as to provide guidance for reasonable use of packaging materials in the hospital .METHODS The related features of the commonly used cotton cloth ,rigid containers ,paper and plastic bags ,and disposable non-woven were observed and compared .RESULTS The sterilant penetration effect of the cotton cloth was excel-lent ,the rigid containers general ,the paper and plastic bags excellent ,the disposable non-woven excellent .The bacteria barrier level of the cotton cloth was zero or low ,the rigid containers general ,the paper and plastic bags excellent ,the disposable non-woven excellent .The sterilization validity period of the cotton cloth was 14 days ,the rigid containers 14 days ,the paper and plastic bags 180 days ,the disposable non-woven 180 days .The physical tolerance of the cotton cloth was excellent ,the rigid containers excellent ,the paper and plastic bags general ,the disposable non-woven excellent .The contamination degree of the cotton cloth was cotton dust contamination ,the rigid containers 0 ,the paper and plastic bags mild ,the disposable non-woven 0 .The use cost of the cotton cloth was low ,the rigid containers low ,the paper and plastic bags relatively high ,the disposable non-woven high . CONCLUSION It is an effective way to choose appropriate sterile packaging materials so as to not only ensure the quality of sterilization but also save the cost .%目的:探究消毒供应中心灭菌包装材料的应用情况,为医院合理使用包装材料提供参考。方法对医院常用的纯棉包布、硬质容器、纸塑包装袋及一次性无纺布4类灭菌包装材料的相关特性进行比较。结果纯棉包布、硬质容器、纸塑包装纸、一次性无纺布的灭菌剂穿透效果分别为优、一般、优、优;细菌屏障水平分别为无或低、一般、优、优;灭菌有效期分别为14、14

  11. Application of Delphi Method to Establish Yancheng the Third People's Hospital Disinfection Supply Center Staff Training Evaluation Index%应用Delphi法建立盐城第三人民医院消毒供应中心人员培训评价指标

    Institute of Scientific and Technical Information of China (English)

    尤琼

    2015-01-01

    目的:该文主要是对应用Delphi法建立盐城第三人民医院消毒供应中心人员培训评价指标的分析。方法根据消毒供应科目前的情况采用Delphi法确定盐城第三人民医院消毒供应中心人员培训的评价指标。结果专家的积极性很高(回收率为100%),专家权威性很高(系数为0.87);各个指标的变异系数范围都在0.00~0.23之间;协调系数各级指标分别为0.353、0.462、0.696,差异有统计学意义(P<0.01)。最后确立了盐城第三人民医院消毒供应中心人员培训评价指标。为人员资质、培训资源、培训管理、培训效果4个山鸡指标,以及12个二级指标,40个三级指标。结论该次研究采用Delphi法对该院消毒供应中心的人员培训指标进行确定符合该医院消毒供应中心临床工作的实际需求,同时对促进医院消毒供应中心的培训体制的建设以及提高培训质量都具有重要的意义。%Objective This paper is mainly based analysis Yancheng Third People's Hospital disinfection supply center per-sonnel training evaluation of the application of the Delphi method. Methods According to the current situation sterile sup-ply department determined using the Delphi method Yancheng Third People's Hospital sterile supply center staff training evaluation. Results Experts highly motivated (recovery of 100%), high expert authority (coefficient of 0.87); coefficient of variation range of each index are between 0.00 to 0.23; coordination at all levels of index coefficients were 0.353,0.462,0.696 The difference was statistically significant (P<0.01). Finally established the Third People's Hospital of Yancheng disinfection supply center personnel training evaluation. As qualified personnel, training resources, training man-agement, training effect four pheasant indicators and 12 secondary indicators, 40 three indicators. Conclusion The study used the Delphi method for staff training hospital central sterile

  12. Foreign Bodies in the Ear, Nose and Throat: An Experience in a Tertiary Care Hospital in Central Nepal

    Directory of Open Access Journals (Sweden)

    Parajuli, Ramesh

    2015-01-01

    Full Text Available Introduction A foreign body (FB is an object or substance foreign to the location where it is found. FBs in the ear, nose, and throat are a common problem frequently encountered in both children and adults. Objective To analyze FBs in terms of type, site, age, and gender distribution and method of removal. Methods A retrospective study was performed in a tertiary care hospital in the central part of Nepal. The study period was from June 2013 to May 2014. The information was obtained from hospital record books. Results A total of 134 patients had FBs in the ear, nose, or throat; 94 were males and 40 were females. Of the 134 patients, 70 (52.23% had FB in the ear, 28 (20.89% in the nose, and 36 (26.86% in the throat. The FB was animate (living in 28 (40% patients with FB in the ear and 1 (3.5% patient with FB in the nose, but the FB was inanimate (nonliving in any patient with FB in the throat, in 42 (60% patients with FB in the ear FB, and in 27 (96.4% patients with FB of the nose. The FB was removed with or without local anaesthesia (LA in 98 (73.13% patients, and only 36 patients (26.86% required general anaesthesia (GA. The most common age group affected was <10 years. Conclusion FBs in the ear and nose were found more frequently in children, and the throat was the most common site of FB in adults and elderly people. Most of the FBs can be easily removed in emergency room or outpatient department.

  13. 消毒供应中心实行集中管理及全程质控的实践与效果%Effect of Centralized management and the entire quality control for disinfection supply center

    Institute of Scientific and Technical Information of China (English)

    张定洁; 张爱容; 黄玉洁

    2015-01-01

    Objective To explore the effect of Centralized management and the entire quality control for disinfection supply center ( CSSD) . Methods The hospital should strengthen its hardware construction and cultivate the quality of employees. Strengthening the management of the high risk medical instrument by callback, clean out, antisepsis, sterilization, deposit, supply the surgical instruments and sterilize items timely. Strictly follow the operation procedure and set up a quality control team carrying out entire quality control work. Results After a year of centralized management,all the quality indicators were statistically improved (P< 0.05).Conclusion Centralized management and entire quality control can provide qualified clinical sterile items and ensure the quality of medical treatment and nursing.%目的:探讨消毒供应中心( CSSD)实行集中管理及全程质控的效果。方法医院加强CSSD的硬件建设,培养员工的整体素质,对手术室、全院多个专科的手术器械及消毒物品通过及时回收、清洗、消毒、包装、灭菌、储存发放,加强对外来器械的管理,严格执行各项操作流程;并成立质控小组,开展全程质控工作。结果实行集中管理一年后的各项工作质量指标与实行集中管理前比较差异有统计学意义(P<0.05)。结论 CSSD只有实行集中管理及全程质控,才能为临床提供合格的无菌物品,保证医疗及护理质量。

  14. Bloodstream infection in patients with end-stage renal disease in a teaching hospital in central-western Brazil

    Directory of Open Access Journals (Sweden)

    Tamara Trelha Gauna

    2013-08-01

    Full Text Available Introduction Vascular access in patients undergoing hemodialysis is considered a critical determinant of bloodstream infection (BSI and is associated with high morbidity and mortality. The purpose of this study was to investigate the occurrence of BSI in patients with end-stage renal disease using central venous catheters for hemodialysis. Methods A cohort study was conducted in a public teaching hospital in central-western Brazil from April 2010 to December 2011. For every patient, we noted the presence of hyperemia/exudation upon catheter insertion, as well as fever, shivering, and chills during hemodialysis. Results Fifty-nine patients were evaluated. Thirty-five (59.3% patients started dialysis due to urgency, 37 (62.7% had BSI, and 12 (20% died. Hyperemia at the catheter insertion site (64.9% was a significant clinical manifestation in patients with BSI. Statistical analysis revealed 1.7 times more cases of BSI in patients with hypoalbuminemia compared with patients with normal albumin levels. The principal infective agents identified in blood cultures and catheter-tip cultures were Staphylococcus species (24 cases, non-fermentative Gram-negative bacilli (7 cases of Stenotrophomonas maltophilia and 5 cases of Chryseobacterium indologenes, and Candida species (6. Among the Staphylococci identified, 77.7% were methicillin-resistant, coagulase-negative Staphylococci. Of the bacteria isolated, the most resistant were Chryseobacterium indologenes and Acinetobacter baumannii. Conclusions Blood culture was demonstrated to be an important diagnostic test and identified over 50% of positive BSI cases. The high frequency of BSI and the isolation of multiresistant bacteria were disturbing findings. Staphylococcus aureus was the most frequently isolated microorganism, although Gram-negative bacteria predominated overall. These results highlight the importance of infection prevention and control measures in dialysis units.

  15. Profile of adults seeking voluntary HIV testing and counseling in rural Central India: results from a hospital-based study.

    Science.gov (United States)

    Pai, Nitika Pant; Joshi, Rajnish; Moodie, Erica E M; Taksande, Bharati; Kalantri, S P; Pai, Madhukar; Tulsky, Jacqueline P; Reingold, Arthur

    2009-03-01

    Rural India has an undetected load of HIV-positive individuals. Few rural adults present for HIV testing and counseling due to stigma, discrimination, and fear of social ostracization. In this rural hospital clinic-based study, we document profiles of rural adults seeking voluntary testing and counseling, and analyze correlates of HIV seropositivity. This cross-sectional study was conducted in 450 participants presenting to the outpatient clinics of Mahatma Gandhi Institute of Medical Sciences, Sevagram, Central India. After informed consent, pre- and post-test counseling, HIV testing, and face-to-face interviews were conducted. Data were collected using a structured questionnaire. The median age of the 450 study participants was 34 years (range 18-88 years); the majority (74%) was married. The overall proportion of HIV seropositivity was 32% [95% CI 28%, 37%]. The proportions of HIV seropositivity in married women, married men, and single men were 41%, 37%, 18%, respectively. No single woman was found seropositive in the study. Very few married women were aware of their husbands' HIV status. In a multivariate analysis, correlates of HIV seropositivity in men were: age 30-39 years, being married, having sex with multiple partners, use of alcohol before sex, and testing positive for HIV in the past. In married women, the only predictor of seropositivity was being married. Although limited by the non-random nature of the sampling method, this pilot study is unique in that it is the first from this rural region of Central India. It provides baseline data on marginalized, largely unstudied populations that may aid in designing probabilistic community-based surveys in this neglected population.

  16. Weighted Marking, Clique Structure and Node-Weighted Centrality to Predict Distribution Centre’s Location in a Supply Chain Management

    Directory of Open Access Journals (Sweden)

    Amidu A. G. Akanmu

    2014-12-01

    Full Text Available Despite the importance attached to the weights or strengths on the edges of a graph, a graph is only complete if it has both the combinations of nodes and edges. As such, this paper brings to bare the fact that the node-weight of a graph is also a critical factor to consider in any graph/network’s evaluation, rather than the link-weight alone as commonly considered. In fact, the combination of the weights on both the nodes and edges as well as the number of ties together contribute effectively to the measure of centrality for an entire graph or network, thereby clearly showing more information. Two methods which take into consideration both the link-weights and node-weights of graphs (the Weighted Marking method of prediction of location and the Clique/Node-Weighted centrality measures are considered, and the result from the case studies shows that the clique/node-weighted centrality measures give an accuracy of 18% more than the weighted marking method, in the prediction of Distribution Centre location of the Supply Chain Management.

  17. [Determination of serologic markers of hepatitis B virus in high risk areas at the Central Air Force Hospital of Peru].

    Science.gov (United States)

    Valladares Alvarez, G; Galarza, J; Espinoza, J; Nieri, A; Makino, R; Berrocal, A; Grados, N

    1989-01-01

    In the present paper, the serologic markers of Hepatitis B virus were studied in 123 people belonging to the Hospital Central de la Fuerza Aérea del Perú that had been working in areas of high risk to get contact with this virus. The determination was done with the enzimo inmuno assay (EIA Abbot) and the results were the following: In 15 individuals (12.1%), at least one positive marker was found, evidence which proved to have been in contact with the virus in some moment of his life. Only one carrier (0.8%) was found, in 6 (4.8%) the presence of anti-HBc as only marker was found and in 8 (6.5%) the presence of Anti-HBc and Anti-HBs was observed which means post infection immunity. The great number of the individuals in which the markers were found, were male: 13 (16.0%) against only 2 (4.7%) female. There wasn't great difference with relation to the prevalency of markers according to the years of work like there has been observed in other greater series. It can be concluded that in this group the incidence of infection due to VHB was no greater than that of general population, which indicates us the little contact that they have had with the contaminating material during their professional life.

  18. The Role of Necropsy in Diagnostic Dilemmas as Seen in a Tertiary Hospital in North Central Nigeria

    Directory of Open Access Journals (Sweden)

    Olugbenga A. Silas

    2009-01-01

    Full Text Available Background. Necropsy (autopsy has helped medical science and law. It has given rise to numerous diagnostic surprises as it explains cause of death, pathogenesis of diseases, and circumstances of death. It also explains reasons for most therapeutic failures. In spite of its usefulness, the rate has dropped worldwide and Africa is worse hit. This work aims to highlight the role autopsy (Necropsy plays in demystifying diagnostic dilemmas and to encourage its patronage by medical practitioners, law enforcement agents and society. Methods. This is a retrospective review of autopsy and clinical reports of cases seen by pathologists and physicians in the Jos University Teaching Hospital (JUTH, Jos, North central Nigeria. Results. A total 166 cases were studied out of which 52 had same diagnosis for both attending physician and pathologist, 106 had different diagnoses and in eight cases diagnoses remained unknown even after autopsy was performed. Conclusions. Autopsy remains an important tool for obtaining definitive diagnosis, determining cause of death to explain pathogenesis of diseases, medical auditing and a vital source of data for health statistics and planning.

  19. Whole-course Management and Application of Chargeable Medical Supply of Hospital Based on the Information Technology%基于信息技术医院收费卫材的全程化管理和应用

    Institute of Scientific and Technical Information of China (English)

    尚秋菊; 唐振涛; 张希富

    2014-01-01

    Whole-course management of chargeable medical supply of hospital includes purchasing of medical supply, acceptance and warehousing, receiving of use department, use of patient, financial cost accounting and supplier's money return. Quantity management of real-time inventory of chargeable medical supply is realized. Logistics and money flow are consistent in real time. The expiry date of medical supply is managed.%医院收费卫材全程化管理,包括卫材采购、验收入库、使用科室请领、患者使用、财务成本核算、供应商返款。实现收费卫材的实时实库存的数量管理,物流财流实时一致并进行卫材效期的管理。

  20. Occupational exposure in central sterilization supply department and its preventive measures%消毒供应室职业暴露及防范措施

    Institute of Scientific and Technical Information of China (English)

    刘敏

    2011-01-01

    目的 探讨消毒供应室工作人员职业暴露及防护措施.方法 根据消毒供应室工作人员暴露的危险因素,制定并落实规范化的防护措施.结果 提高了职业暴露防护意识,加强了职业安全管理,有效地防止职业感染的发生,确保了工作人员身心健康.结论 重视工作人员的职业暴露教育,减少或消除造成职业暴露的各种因素是防范措施的关键.%OBJECTIVE To discuss the risk factors and treatment measures of the occupational exposure and protection among the staff in the disinfecting supply division.METHODS The standardized treatment measures were formulated and implemented according to the risk factors for the occupational exposure among the staff in central sterilization supply department.RESULTS The awareness about the protection of occupational infection was improved, the management of occupational safety was strengthened, the occupational infections were effectively prevented, and the health of medical workers was guarranteed.CONCLUSION To think highly of the safety caution of occupational exposure among the staff, to reduce or eliminate the various factors causing occupational exposur e are crucial preventive measures.

  1. 南县农村集中式供水现状调查%Survey on Actuality of Sanitation of Centralized Water Supply in Rural Areas of Nanxian

    Institute of Scientific and Technical Information of China (English)

    周志明; 文华; 欧有良

    2012-01-01

    目的 了解南县农村生活饮用水现状,探讨卫生监督管理方法. 方法 制定统一的问卷调查表格,对全县58个水厂进行现场调查. 结果 有77.6%的水厂持有卫生许可证,有70.7%的水厂对水质进行了消毒,水质净化和除铁锰处理分别为43.1%和82.8%.乡、村水厂没有自检能力. 结论 农村集中式供水还存在诸多问题.必须强化监督管理,提高企业卫生意识,加大资金投入,提高水质消毒净化处理和水质自检能力.%Objective To investigate the current status of sanitation of centralized water supply in rural areas of Nanxian, and to discuss the methods of health supervision and management. Method Self "designed uniform questionnaires were used to survey 58 waterworks in Nanxian. Results Among the investigated waterworks, the qualified rate of hygiene license was 77.6% , the percentage of water disinfection was 70.7% , and the percentages of water purification and the removal of iron and manganese processing were 43. 1% and 82. 8% , respectively. The township and village waterworks did not have self- check ability. Conclusions Centralized water supply in the rural areas has many problems. It is necessary to enhance supervision and management, improve the health consciousness of enterprises, increase the investment, and improve the abilities in water disinfection, purification, treatment and water-quality self-test.

  2. Cost of drugs manufactured by the University Hospital - role of the Central Pharmacy Custo de medicamentos produzidos pelo Hospital Universitário, papel da Farmácia Central

    Directory of Open Access Journals (Sweden)

    Marcia Lucia M. Marin

    2001-04-01

    Full Text Available The hospital pharmacy in large and advanced institutions has evolved from a simple storage and distribution unit into a highly specialized manipulation and dispensation center, responsible for the handling of hundreds of clinical requests, many of them unique and not obtainable from commercial companies. It was therefore quite natural that in many environments, a manufacturing service was gradually established, to cater to both conventional and extraordinary demands of the medical staff. That was the case of Hospital das Clinicas, where multiple categories of drugs are routinely produced inside the pharmacy. However, cost-containment imperatives dictate that such activities be reassessed in the light of their efficiency and essentiality. METHODS: In a prospective study, the output of the Manufacturing Service of the Central Pharmacy during a 12-month period was documented and classified into three types. Group I comprised drugs similar to commercially distributed products, Group II included exclusive formulations for routine consumption, and Group III dealt with special demands related to clinical investigations. RESULTS: Findings for the three categories indicated that these groups represented 34.4%, 45.3%, and 20.3% of total manufacture orders, respectively. Costs of production were assessed and compared with market prices for Group 1 preparations, indicating savings of 63.5%. When applied to the other groups, for which direct equivalent in market value did not exist, these results would suggest total yearly savings of over 5 100 000 US dollars. Even considering that these calculations leave out many components of cost, notably those concerning marketing and distribution, it might still be concluded that at least part of the savings achieved were real. CONCLUSIONS: The observed savings, allied with the convenience and reliability with which the Central Pharmacy performed its obligations, support the contention that internal manufacture of

  3. 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

  4. Experience of the reengineering of the pharmaceutical supply chain in hospital drug storehouse%我院药库药品供应链再造的实践体会

    Institute of Scientific and Technical Information of China (English)

    林娜; 易博; 高朝; 徐文彤

    2012-01-01

    目的 提高药库工作效率,对药库药品供应链进行再造.方法 借鉴物联网技术,引人手持机设备,构建医药供应链协同服务平台,制作电子发票等,优化了医院药库药品采购、供应和管理的流程.结果 完成了药库药品供应链的再造,提高了药库的工作效率和药品供应保障的信息化自动化水平.结论 在医院信息化水平提高的基础上,引人物联网技术对药品供应链进行优化和再造是提高医院药品保障能力和管理水平的有效方法.%Objective To reengineer the pharmaceutical supply chain and to improve the efficiency of drag storehouse. Methods Learning from the Internet of Things technology, the process of drug procurement, supply and management had been optimized by introducing handheld devices, building a pharmaceutical supply chain collaboration services platform and creating the electronic invoice. Results The reengineering of the pharmaceutical supply chain was completed, which improved the information level of automation and the efficiency of hospital drug storehouse. Conclusion On the basis of improved hospital information level, the introduction of the Internet of Things technology for the optimization and reengineering of pharmaceutical supply chain was one of the effective methods to improve the capabilities of hospital pharmaceutical supply and the level of drug management.

  5. Risk factors of Acute Respiratory Infection (ARI in under-fives in a rural hospital of Central India

    Directory of Open Access Journals (Sweden)

    Amar M. Taksande

    2015-11-01

    Full Text Available Introduction: Acute Respiratory Infection (ARI is a major cause of morbidity and mortality in developing countries in children especially in under-fives. Every year in the world, about 13 million under-5 children dies, 95% from developing countries; one third of total deaths are due to ARI. The aim of this study was to identify the significant risk factors for ARI in children less than five years of age living in rural areas of Central India.Methods: A hospital based case control study was undertaken to determine risk factors associated with respiratory tract infections in children. Children less than 5 years admitted in a pediatric ward with diagnosis of ARI were enrolled in the study as cases (n = 300 while the same number of controls (n = 300 were selected from neighborhood and were matched for age, sex and religion. Details of risk factors in cases and controls were recorded in pre-designed proforma. Results: A significant association was found between ARI and lack of breastfeeding, nutritional status, immunization status, delayed weaning, prelactal feeding, living in overcrowded conditions, mothers’ literacy status, low birth weight and prematurity. Among the environmental variables, inadequate ventilation, improper housing condition, exposure to indoor air pollution in form of combustion from fuel used for cooking were found as significant risk factors for ARI in under-fives.Conclusions: ARIs are affected by socio-demographic and socio-cultural risk factors, which can be modified with simple interventions. The various risk factors identified in this study were lack of breastfeeding, undernutrition, delayed weaning, overcrowding and prelactal feeding.

  6. Clinical characteristics of patients with atrial fibrillation at a tertiary care hospital in the central region of Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Salih A Bin Salih

    2011-01-01

    Full Text Available Objective: To report on the clinical presentation, etiology, and laboratory features of acute and chronic atrial fibrillation (AF in a tertiary hospital in Riyadh, Saudi Arabia. Materials and Methods: We retrospectively studied records of 720 patients with AF seen in outpatients and inpatients departments at King Abdulaziz Medical City, Riyadh, during the period of 1 January 2002 to 31 August 2008. Results: Documented acute and chronic AF was present in 157 (21.8% and 563 (78.1% patients, respectively. Palpitations, dizziness and syncope were the most frequent symptoms in acute AF, while dyspnea and palpitations were the most common symptoms in the chronic type. Acute respiratory problems and acute myocardial infarction were significantly more common in acute AF, while congestive heart failure and acute respiratory problems (chest infection, bronchial asthma, and pulmonary embolism were significantly more common in chronic AF. The most common causes of both types of AF were diabetes mellitus (DM in 68.8%, hypertension (HTN in 59.3%, chronic lung diseases (bronchial asthma, chronic obstructive pulmonary disease and interstitial lung disease in 31.8%, valvular heart disease in 23.6%, and ischemic heart disease (IHD in 23.1%. In 9 (1.3% patients, no cause was detected. The echocardiographic findings of left ventricular hypertrophy, valve lesions, and depressed left ventricular function were significantly more common in chronic AF (P<0.01. Conclusions : Nowadays, DM, HTN, and IHD are becoming the most common predisposing factors for AF in the central region of Saudi Arabia and require prevention and control

  7. Prevalence of hemolytic anemia and hemoglobinopathies among the pregnant women attending a tertiary hospital in central India

    Directory of Open Access Journals (Sweden)

    Ranbir S. Balgir

    2015-10-01

    Full Text Available Anemia in pregnancy is one of the causes of maternal morbidity and, maternal and fetal mortality in India. Hemoglobin transports oxygen to different parts of the body. Any defect in hemoglobin structure leads to its adverse functions. Screening of pregnant women for hemoglobinopahties helps in early intervention for reducing morbidity and mortality. Although the prevalence of hemoglobinopathies especially of the sickle cell disorders is high in Madhya Pradesh but any study on pregnant women is lacking. This study had set the objectives to find the prevalence of anemia and hemoglobin disorders in pregnant women, and to determine the health status through hematological indices profile in central India. Hospital based a cross-sectional study showed 12.26% prevalence of hemoglobinopathies among 416 pregnant women, the sickle cell trait being 7.45%, followed by β-thalassemia trait (2.89%, hemoglobin E trait (0.24%, and sickle cell disease (1.68%. About 88% of the pregnant women were found free of hemoglobinopathies. Of the 9.13% pregnant women included in the study were suffering from sickle cell disorders. However, the overall 47.11% anemia was observed in pregnant women, ranging in between 45% to 66% and seemed to show a reduction in anemia after nutritional supplementations and improvement in maternal health care at antenatal check up due to accessibility to medical health facilities. A comparison of hematological indices of pregnant women afflicted with and without sickle cell disorders have revealed much reduced hemoglobin level, red blood cells count, mean corpuscular volume, hematocrit, and mean corpuscular hemoglobin; and raised leucocytosis in sickle cell disorder cases than among the normal pregnant women. A more vigorous and realistic campaign of prophylactic regime of supplementations for these pregnant women and child health care is suggested.

  8. Construction of the intensive management mode among the clean operating departmnet,central sterile supply department and washing center%构建洁净手术部-消毒供应中心-洗涤中心集约化管理模式研究

    Institute of Scientific and Technical Information of China (English)

    方茜; 孙卫卫; 王萍; 李娟

    2015-01-01

    目的建立洁净手术部-消毒供应中心-洗涤中心集约化管理模式,以减少医院感染,提高工作效率和医疗质量。方法在洁净手术部-消毒供应中心一体化管理的基础上实行洁净手术部-消毒供应中心-洗涤中心集约化管理模式,进行环境管理、流程管理和人员管理。结果手术器械及手术敷料质量、手术包灭菌合格率提高(P﹤0.01),消毒供应中心清洁区空气洁净度、洗涤中心消毒隔离措施落实率改善明显(P﹤0.01或P﹤0.05)。结论洁净手术部-消毒供应中心-洗涤中心集约化管理模式能充分利用资源,有效提高手术器械质量、灭菌效果、敷料清洁度、减少医院感染机会,提高工作效率和医疗质量。%Objective To build the intensive management mode among clean operating department,central sterile supply department and washing center, in order to reduce hospital infection,improve work efficiency and quality of health care. Methods Based on the integrative management between clean surgical department and central sterile supply department,applied intensive management among the first two departments and washing center,which included management of environment,process and staff. Results The disinfection quality of surgical instruments and surgical dressings,the sterilization rate of operating package were significantly improved(P﹤ 0. 01),implementation rates of disinfection and quarantine measures in washing center and air cleanness of clean zone in supply cen-ter both got better(P﹤0. 01 or P﹤0. 05). Conclusion Intensive management mode among clean operating department,central sterile supply department and washing center can make full use of resources,effectively improve the disinfection quality of surgical instruments,operating department effects,cleanliness of dressings untial sterile supply department and reduce hospital infection,so as to improve working efficiency and quality of health

  9. Propuesta de mejora para el Complejo Hospitalario de Navarra, Hospital D: manual de procedimientos para la Central de Esterilización

    OpenAIRE

    2014-01-01

    La esterilización es una ciencia en la que se emplean tecnologías muy variadas con el fin de lograr la destrucción de todos los microorganismos. Una vez que se ha esterilizado todo el material, debe mantenerse esa condición hasta el momento de “uso” de los equipos. La central de esterilización (en adelante CE o Central), es una unidad de vital importancia dentro de la estructura de un hospital. Recibe una enorme cantidad y variedad de instrumental quirúrgico que debe ser recogido, limpiad...

  10. Current status and management strategies on central sterile supply depart-ments inmedical institutes%医疗机构消毒供应中心现状调查与管理对策

    Institute of Scientific and Technical Information of China (English)

    陈萍; 刘丁

    2014-01-01

    Objective To realize the current status of central sterile supply departments(CSSDs)in hospitals,and provide the basis for making improvement measures.Methods Field investigation was adopted to study the resource distribution,personnel structure,and the quality of medical instrument cleaning in 78 hospitals in Chongqing.Re-sults Qualified results of 78 hospitals was 24.36% (19/78),basically qualified rate 52.56% (41/78),unqualified rate 23.08% (18/78);inspection results of different types of hospitals were significantly different(Hc= 16.643,P=0.002),qualified hospitals mainly concentrated on city- and county-level hospitals.Unqualified rate of CSSD con-struction area was 78.21% (n= 61),unqualified rate of personal allocation was 75.64% (n= 59),concentrated man-agement of operating rooms and CSSDs was 52.56% (n= 41),mainly concentrated on city- and county-level hospi-tals;decentralized management accounted for 47.44% (n= 37),58(74.36% )hospitals used repeated cleaning stain-less steel tables for receiving,50% didn’t install automated cleaning machine and drying cabinet,42.31% (33/78) performed manual cleaning,40(51.28% )didn’t equip with water treatment system;12(15.38% )hospitals used patched or worn clothing for packing,47 didn’t equip with hard metal container,37(47.44% )had no heat sealing machine,21(26.92% )had no detection equipment for cleaning quality,41(52.56% )had no low temperature sterili-zation instruments;52(66.67% )hospitals performed biological monitoring on high pressure steam sterilizer.Conclu-sion Clean and disinfection equipments in CSSDs in city- and county-level hospitals are well-appointed,procedures of clean and disinfection are standard,and can achieve the standard of clean quality;while hospitals affiliated to fac-tories and private hospitals are not well-appointed,procedures of clean and disinfection are not standard. Construc-tion of CSSD should be standard,so as to ensure the effectiveness of clean,disinfection and sterilization of

  11. Correspondence: risk factors of acute respiratory infection in under-fives in a rural hospital of Central India – Authors’ reply

    Directory of Open Access Journals (Sweden)

    Amar Taksande

    2016-07-01

    Full Text Available Dear Editor,We thank the authors for their interest and comments on our paper. They have raised some very valid points. This corrispondence refers to the following article:Taksande AM, Yeole M. Risk factors of Acute Respiratory Infection (ARI in under-fives in a rural hospital of Central India. J Pediatr Neonat Individual Med. 2016;5(1:e050105. doi: 10.7363/050105 br />Comments can be found in the following article:Mandal A, Sahi PK. Correspondence: risk factors of acute respiratory infection in under-fives in a rural hospital of Central India. J Pediatr Neonat Individual Med. 2016;5(2:e050207. doi: 10.7363/050207

  12. A GIS-based methodology for highlighting fuelwood supply/demand imbalances at the local level: A case study for Central Mexico

    Energy Technology Data Exchange (ETDEWEB)

    Ghilardi, Adrian; Guerrero, Gabriela; Masera, Omar [CIECO, Center for Ecosystems Research, Universidad Nacional Autonoma de Mexico, Antigua carretera a Patzcuaro 8701, 58 190 Morelia (Mexico)

    2009-06-15

    When fuelwood is harvested at a rate exceeding natural growth and inefficient conversion technologies are used, negative environmental and socio-economic impacts, such as fuelwood shortages, natural forests degradation and net GHG emissions arise. In this study, we argue that analyzing fuelwood supply/demand spatial patterns require multi-scale approaches to effectively bridge the gap between national results with local situations. The proposed methodology is expected to help 1) focusing resources and actions on local critical situations, starting from national wide analyses and 2) estimating, within statistically robust confidence bounds, the proportion of non-renewable harvested fuelwood. Starting from a previous work, we selected a county-based fuelwood hot spot in the Central Highlands of Mexico, identified from a national wide assessment, and developed a grid-based model in order to identify single localities that face concomitant conditions of high fuelwood consumption and insufficient fuelwood resources. By means of a multi-criteria analysis (MCA), twenty localities, out of a total of 90, were identified as critical in terms of six indicators related to fuelwood use and availability of fuelwood resources. Fuelwood supply/demand balances varied among localities from -16.2 {+-} 2.5 Gg y{sup -1} to 4.4 {+-} 2.6 Gg y{sup -1}, while fractions of non-renewable fuelwood varied from 0 to 96%. These results support the idea that balances and non-renewable fuelwood fractions (mandatory inputs for Clean Development Mechanism (CDM) cookstoves projects) must be calculated on a locality by locality basis if gross under or over-estimations want to be avoided in the final carbon accounting. (author)

  13. BACTERIAL CAUSES OF LOWER RESPIRATORY TRACT INFECTIONS IN PATIENTS ATTENDING CENTRAL REFERRAL HOSPITAL, GANGTOK WITH REFERENCE TO ANTIBIOTIC RESISTANCE PATTERN

    OpenAIRE

    Priyanka Paul; Tukaram Prabhu

    2013-01-01

    ABSTRACT: BACKGROUND: There is inadequate information from India on various lower respiratory tract pathogens and their resistance pattern in hospital settings. The present study was undertaken to see the bacteriological profile an d the antibiotic resistance pattern of the isolates causing LRTI from this geographic region. OBJECTIVE: To identify and characterize bacterial pathogens causing community acquired and hospital acquired infections with reference to ant...

  14. Hospitals as health educators

    Science.gov (United States)

    ... look no further than your local hospital. From health videos to yoga classes, many hospitals offer information families need to stay healthy. You also may be able to find ways to save money on health supplies and services.

  15. Pattern and prevalence of tobacco use and associated oral mucosal lesions: a hospital based cross sectional study at a tertiary care hospital in central India

    Directory of Open Access Journals (Sweden)

    Ambrish Mishra

    2015-09-01

    Conclusions: The number of tobacco users visiting the dental hospital is reasonably high; Tobacco consumption is a common cause of addiction, preventable illness, disability and death. The public health system should be strengthened for effectively designing, implementing and evaluating tobacco control and prevention programs. All health care professionals should be sensitized and educated for implementing measures for tobacco control and cessation. [Int J Res Med Sci 2015; 3(9.000: 2169-2173

  16. Study on efficacy of air purification sterilizer in central sterile supply department%消毒供应中心使用空气净化消毒器的效果研究

    Institute of Scientific and Technical Information of China (English)

    于凤玲; 黄俊云; 王华

    2013-01-01

    OBJECTIVE To study the efficacy of air purification sterilizer applied in various regions of the central sterile supply department, to explore related sterilization performance of air purification sterilizer and to promote the improvement of controllable methods. METHODS Under the normal room temperature and humidity, three methods were employed. The first method:laboratory disinfection, the second method: the on-site air disinfection assay under people absence circumstance, the third way: on-site disinfection assay under people attendance circumstance. RESULTS Laboratory disinfection: the killing rate of Staphylococcus albus in the aerosol was more than 99. 94%. The on-site air disinfection assay under people absence circumstance: the average elimination rate of natural bacteria ranged from 93. 68% to 96. 00% in each area. The on-site disinfection assay under people attendance circumstance: static disinfection group could not continue to keep air quality but the dynamic disinfection group could make the number of bacteria keep in a normal low level in each area. CONCLUSION Under the condition of each area of the central sterile supply department that remains clean, using multi-functional air purification sterilizer to disinfect persistently can not only reduce the cost of the hospital operation but also ensure the effectiveness of air disinfection and effectively prevent the hospital infections.%目的 对消毒供应中心各个区域使用空气净化消毒器效果进行研究,探讨空气净化消毒器杀菌相关性能,并促进其改良可控的方式方法.方法 在常温常湿状态下采用3种方法分别进行试验,第1种实验室消毒试验,第2种无人情况下现场空气消毒试验,第3种在有人情况下现场消毒试验.结果 在实验室消毒试验,对气雾中白色葡萄球菌杀灭率>99.94%;无人现场空气消毒试验在各个区域平均消除率在93.68%~96.00%;在有人的情况下现场消毒试验,静态消

  17. Boosting Farm Produce Supply

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    In the wake of escalating inflation,securing farm produce supply and stablizing grain prices could help to alleviate economic pressure The Chinese Government has pledged to secure a stable supply of farm produce.According to a document released after the annual Central Rural Work Conference held on December 22-23 in Beijing,preventing short supplies of farm produce and avoiding"ex-

  18. Present and future water resources supply and demand in the Central Andes of Peru: a comprehensive review with focus on the Cordillera Vilcanota

    Science.gov (United States)

    Drenkhan, Fabian; Huggel, Christian; Salzmann, Nadine; Giráldez, Claudia; Suarez, Wilson; Rohrer, Mario; Molina, Edwin; Montoya, Nilton; Miñan, Fiorella

    2014-05-01

    Glaciers have been an important element of Andean societies and livelihoods as direct freshwater supply for agriculture irrigation, hydropower generation and mining activities. Peru's mainly remotely living population in the Central Andes has to cope with a strong seasonal variation of precipitations and river runoff interannually superimposed by El Niño impacts. Direct glacier and lake water discharge thus constitute a vital continuous water supply and represent a regulating buffer as far as hydrological variability is concerned. This crucial buffer effect is gradually altered by accelerated glacier retreat which leads most likely to an increase of annual river runoff variability. Furthermore, a near-future crossing of the 'peak water' is expected, from where on prior enhanced streamflow decreases and levels out towards a new still unknown minimum discharge. Consequently, a sustainable future water supply especially during low-level runoff dry season might not be guaranteed whereas Peru's water demand increases significantly. Here we present a comprehensive review, the current conditions and perspectives for water resources in the Cusco area with focus on the Vilcanota River, Cordillera Vilcanota, Southern Peru. With 279 km2 the Cordillera Vilcanota represents the second largest glacierized mountain range of the tropics worldwide. Especially as of the second half of the 1980s, it has been strongly affected by massive ice loss with around 30% glacier area decline until present. Furthermore, glacier vanishing triggers the formation of new lakes and increase of lake levels and therefore constitutes determining hazardous drivers for mass movements related to deglaciation effects. The Vilcanota River still lacks more profound hydrological studies. It is likely that its peak water has already been or might be crossed in near-future. This has strong implications for the still at 0.9% (2.2%) annually growing population of the Cusco department (Cusco city). People mostly

  19. [Children's department and child care institutions of the Central military, hospital of People's commissariat during the Great Patriotic War].

    Science.gov (United States)

    Simonenko, V B; Krainyukov, P E; Abashin, V G

    2016-01-01

    The article presents historical data about paediatric health care delivery and escort of children of the Command of the Red Army during their evacuation from Moscow in 1941. Data on foundation of kindergartens of People's commissariat in 1942-1943, their support and foundation of children's department in the hospital is given. Special subdivision governed by the head of child care institutions of the hospital was formed for managing child care institutions.

  20. 探讨医院消毒供应室护理工作中应注意的细节问题%To Discuss the Nursing Work in Disinfection Supply Room in Hospital

    Institute of Scientific and Technical Information of China (English)

    王秀英

    2015-01-01

    目的:探讨医院消毒供应室护理工作中应注意的细节问题,在此基础上给出相应对策,不断提高消毒供应室的护理质量。方法对医院消毒供应室护理工作的各个流程进行分析,总结出每个环节需注意的细节问题。结果对消毒供应室护理工作质量管理、器械管理和护理人员职业防护中的细节问题进行了总结,并在此基础上给出了相应的对策。结论在消毒供应室的护理工作中,需对清洗、包装、消毒等各个环节中的细节问题给予科学管理,才能够有效地避免院内感染。%ObjectiveTo study the nursing work in disinfection supply room in hospital, improve the nursing quality of the disinfection supply room on the basis of the corresponding countermeasures.MethodsThe hospital disinfection supply room nursing work of each process were analyzed, and concluded that we should pay attention to each link of the details. Results The quality of disinfection supply room nursing management, equipment management and nursing staff in the occupational protection details were summarized, and on this basis, presents the corresponding countermeasures. ConclusionThe disinfection supply room in the nursing work, must to be cleaning, packaging, sterilization for the details of each link such as scientiifc management, it can effectively avoid nosocomial infection.

  1. Hospital costs of central line-associated bloodstream infections and cost-effectiveness of closed vs. open infusion containers. The case of Intensive Care Units in Italy

    Directory of Open Access Journals (Sweden)

    Torbica Aleksandra

    2010-05-01

    Full Text Available Abstract Objectives The aim was to evaluate direct health care costs of central line-associated bloodstream infections (CLABSI and to calculate the cost-effectiveness ratio of closed fully collapsible plastic intravenous infusion containers vs. open (glass infusion containers. Methods A two-year, prospective case-control study was undertaken in four intensive care units in an Italian teaching hospital. Patients with CLABSI (cases and patients without CLABSI (controls were matched for admission departments, gender, age, and average severity of illness score. Costs were estimated according to micro-costing approach. In the cost effectiveness analysis, the cost component was assessed as the difference between production costs while effectiveness was measured by CLABSI rate (number of CLABSI per 1000 central line days associated with the two infusion containers. Results A total of 43 cases of CLABSI were compared with 97 matched controls. The mean age of cases and controls was 62.1 and 66.6 years, respectively (p = 0.143; 56% of the cases and 57% of the controls were females (p = 0.922. The mean length of stay of cases and controls was 17.41 and 8.55 days, respectively (p Conclusions CLABSI results in considerable and significant increase in utilization of hospital resources. Use of innovative technologies such as closed infusion containers can significantly reduce the incidence of healthcare acquired infection without posing additional burden on hospital budgets.

  2. Benefit of hospital pharmacy intervention on the current status of dry powder inhaler technique in patients with asthma and COPD: a study from the Central Development Region, Nepal

    Directory of Open Access Journals (Sweden)

    Poudel RS

    2016-12-01

    Full Text Available Ramesh Sharma Poudel,1 Rano Mal Piryani,2 Shakti Shrestha,3 Aastha Prajapati1 1Hospital Pharmacy, 2Department of Internal Medicine, Chitwan Medical College Teaching Hospital, 3Department of Pharmacy, Shree Medical and Technical College, Chitwan, Nepal Background: The majority of patients with asthma and chronic obstructive pulmonary disease (COPD have been known to perform inhaler technique inadequately. We aimed to evaluate the benefit of hospital pharmacy intervention on the current status of dry powder inhaler (Rotahaler® technique in such patients and the factors associated with the correct use. Methods: A pre–post interventional study was conducted at the outpatient pharmacy in a teaching hospital of the Central Development Region, Nepal, in patients with asthma and COPD currently using a Rotahaler device. Patients’ demographics and Rotahaler technique were assessed before intervention. Those who failed to demonstrate the correct technique were educated and trained by the pharmacist, and their technique was reassessed after 2 weeks of intervention. Descriptive statistics, including Wilcoxon signed rank test, Mann–Whitney U test, Spearman’s correlations and Kruskal–Wallis test, were performed for statistical analysis. Results: Before intervention, only 5.7% (10 of 174 of the patients demonstrated the correct Rotahaler technique and the most common errors observed were failure to breathe out gently before inhalation (98.8% and failure to hold breath for about 10 seconds after inhalation (84.8%. After the intervention (n=164, 67.1% of the patients showed their technique correctly (p≤0.001 and failure to breathe out gently before inhalation was the most common error (27.44%. Age (p=0.003, previous instruction (p=0.007, patient’s education level (p=0.013 and source of instruction (p<0.001 were associated with an appropriate technique before intervention, while age (p=0.024, duration of therapy (p=0.010 and gender (p=0.008 were

  3. Tenosinovitis piógena flexora de la mano: experiencia en el Hospital Universitario Central de Asturias

    Directory of Open Access Journals (Sweden)

    Irene García-Martínez

    Full Text Available Introducción y Objetivos. La tenosinovitis piógena flexora de la mano es una infección severa de los tejidos blandos de la mano. Se asocia a secuelas funcionales graves que varían desde rigideces de las articulaciones interfalángicas y metacarpofalángicas hasta la necesidad de amputaciones digitales. La rapidez en la instauración de tratamiento antibiótico endovenoso de amplio espectro y el drenaje quirúrgico urgente son las claves para minimizar la aparición de secuelas. Nuestro objetivo es estudiar las características de los pacientes con dicha patología en nuestro medio. Material y método. Presentamos un estudio retrospectivo de 24 casos de infección de la vaina sinovial flexora diagnosticados y tratados por el Servicio de Cirugía Plástica del Hospital Universitario Central de Asturias (Oviedo, España durante un periodo de 8 años. Resultados. Los dedos más afectados fueron el índice y el medio y en todos los casos estuvo presente alguno de los 4 signos de Kanavel. Un 71% de nuestros pacientes precisó intervención quirúrgica urgente: 88% drenaje abierto, 76% abordaje volar tipo Bruner, 6% abordaje mediolateral longitudinal, y otro 6% desbridamiento amplio incluyendo piel. Los demás fueron tratados con antibioticoterapia endovenosa de amplio espectro, inmovilización y elevación de la extremidad afecta. En todos los casos se realizó lavado intraoperatorio con suero salino y/o antiséptico, y en el 65% irrigación postoperatoria continua. El germen más frecuénteme aislado fue Staphylococus aureus si bien en el 75% de los casos no se obtuvo crecimiento microbiológico. La media de estancia hospitalaria fue de 7.3 días. Todos siguieron rehabilitación precoz; el 42% lograron recuperación completa, el 29% sufrió limitación de extensión y el 16% déficit de flexio-extensión del dedo afecto. Conclusiones. Nuestros hallazgos ponen de manifiesto que la tenosinovitis piógena flexora es una patología poco frecuente en

  4. Patologías tratadas con oxigenoterapia hiperbárica en el Hospital Central de la Defensa

    Directory of Open Access Journals (Sweden)

    J.M. Torres León

    2015-06-01

    Full Text Available Introducción: La oxigenoterapia hiperbárica (OHB es una modalidad terapéutica que se fundamenta en la obtención de presiones parciales de oxígeno elevadas en sangre, al respirar oxígeno puro, en el interior de una cámara hiperbárica a una presión superior a la atmosférica. Sus acciones incluyen efectos hemodinámicos, acciones sobre la inmunidad y el transporte de O2. Este amplio espectro de efectos facilita que sus recomendaciones puedan incluir una gran variedad de indicaciones, algunas de ellas controvertidas. Objetivos: Conocer las patologías de los pacientes tratados con OHB en la Comunidad Autónoma de Madrid (CAM y revisar la evidencia científica al respecto. Método: En la actualidad la cámara hiperbárica del Servicio de MSB (Medicina Subacuática del HCD (Hospital Central de la Defensa es la de referencia en la CAM. Se revisaron las historias clínicas de los pacientes atendidos entre Febrero 2013 y Junio 2014. Se recogieron las siguientes variables: 1 Enfermos aceptados y desestimados para el tratamiento. 2 Edad y sexo de los pacientes tratados. 3 Patología por la que se indicaba el tratamiento. 4 Complicaciones observadas en relación con la OHB. Resultados: Se aceptaron para tratamiento 113 enfermos procedentes de 15 Hospitales de la CAM. Se desestimaron para tratamiento con OHB a 22 pacientes por patologías o tratamientos activos que no hacían aconsejable el tratamiento con OHB en ese momento. El 59,82 % eran hombres y el 40,18 % mujeres. Edad media 64,72 años. Las indicaciones principales de tratamiento fueron las lesiones radio inducidas 52,21 % de los casos (n=59 y las úlceras y heridas de evolución tórpida con mala respuesta a tratamiento convencional 23 % de los casos (n=26. El tratamiento tuvo que ser suspendido en 8 pacientes (7,14 % de los tratados por mala tolerancia o complicaciones leves. Discusión y conclusiones: Las indicaciones de OHB en nuestra muestra comprenden un amplio número de patolog

  5. Large Comprehensive Hospital Drug Separation of Purchasing and Supply Management Mode of Exploration%大型综合性医院药品采购与供应分离管理模式探索

    Institute of Scientific and Technical Information of China (English)

    江艳

    2016-01-01

    With the deepening reform of public large comprehensive hospital, in order to achieve the purpose of lowering the operating costs for the hospital, the hospital has drugs zero sales rate. Therefore, through the establishment of many large comprehensive hospital drug separation and supply and supply management mode, further clarify the responsibilities of each department, responsibility to the people, improve the work efficiency, increase the economic benefit and social benefit, and in combating corruption has played a very important role. And information technology of fast, accurate and flexible fea-tures, such as help contact separation of purchasing and supply of both communication not smooth flaws, and effectively op-timize drug management process, improve the efficiency of management. In this paper, the information technology in large comprehensive hospitals drug separation of purchasing and supply management mode of use as a starting point, probe into the management model in the drug management and service improvements in the quality of the meaning of existence.%随着大型综合性医院公改革的不断深化,为了实现降低医院运营成本的目的,医院实行药品零差率销售。为此,不少大型综合性医院通过建立药品采供与供应分离管理的模式,进一步明确各个部门的职责,使得责任到人,有效提高了工作效率,增加了经济效益和社会效益,并在防治腐败滋生方面起到了非常重要的作用。而信息技术的快捷、精确、灵活等特性,有助于联系采购与供应分离带来的两者沟通不顺畅的缺点,并有效优化药品管理流程,提升管理效率。为此,该研究以信息技术在大型综合性医院药品采购与供应分离管理模式中的运用为出发点,探究该管理模式在对药品管理和服务的质量的改进方面存在的意义。

  6. [Hi-tech center of outpatient care (To the 40th anniversary of the Branch N 6 of the Vishnevsky Central military clinical hospital N 3)].

    Science.gov (United States)

    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.

  7. Central Sterile Supply Department Management System Design and Implementation Based on RFID Technology%基于RFID技术的医院消毒供应中心管理系统设计与实现

    Institute of Scientific and Technical Information of China (English)

    李磊

    2012-01-01

    With the analysis of the requirements of sterilization and supply center of hospital(referred to as "supply room" ), the management system of supply room was developed and integrated into the RFID technology. The?system has achieve disinfection materials circulation process traceability to improve the quality management of disinfection materials and reduce the management costs.%分析医院消毒供应中心(以下简称"供应室")的需求,设计了集成RFID 技术的供应室管理系统,实现消毒物品在医院流通过程追溯,达到提高消毒物品管理质量和降低管理成本的目的.

  8. The Analysis on the Cost of Hospital Supply Chain Based on the Theory of TCO%基于TCO理论的医院供应链成本分析

    Institute of Scientific and Technical Information of China (English)

    李寅

    2012-01-01

    Aiming at the present condition of supply chain cost in hospital management, this paper constructs an model of analysis based on TCO (Total Cost of Ownership), by referring to the business background of domestic hospital. And by using this model, this paper not only works out the minimal cost and the best solution for the supply chain of hospital,but also evaluates the effect of cost management based on each detailed cost.%文章结合国内医院所处的经营背景,针对医院目前供应链成本管理现状,利用总所有权成本理论(Total Cost of Ownership,TCO),建立了供应链成本分析模型.通过这个模型,不仅可以获得医院供应链的最小成本及实施方案,还可以根据各项的详尽成本对成本管理效果进行评价.

  9. Effects of centralized management of cleaning and disinfection of cupping in the disinfection supply center%火罐在消毒供应中心集中清洗消毒效果探讨

    Institute of Scientific and Technical Information of China (English)

    孙雪莹; 高玉华; 史安云; 甘志连; 寇凤霞; 侯军华

    2016-01-01

    OBJECTIVE To explore the effects of centralized management of cleaning and disinfection of cupping in the disinfection supply center ,so as to provide guarantee for safety and convenience of diagnosis and treatment . METHODS A total of 190 used cupping in Mar .2015 were randomly divided into experimental group (150 cases) and control group (40 cases) .The cupping in control group was taken department dispersed disinfection manage‐ment style ,using chlorine disinfectant for immersion and disinfection ,and natural drying .The cupping in experi‐mental group was taken the centralized management style of cleaning and disinfection in the disinfection supply center ,using automatic ultrasonic cleaning machine with low foam multiple enzyme detergent for cleaning ,disin‐fection ,and drying treatment .Then disposable paper‐plastic packaging was used independently ,and high pressure steam sterilization was applied .Five cupping in each group were randomly selected for bacterial culture every 3 days ,and the bacterial qualified rates the two groups of cupping at different time points within 90 d after disinfec‐tion were compared .RESULTS The qualified rates of experimental group were 100% ,80 .0% ,and 20 .0% on the 1st ,4th ,7th day ,and 0% after 10 days ,and the bacterial count was >70 CFU/piece .The bacteria were not de‐tected in cupping of experimental group within 90 days ,with the qualified rate of 100% .The qualified rate of ex‐perimental group was significantly higher than that of control group (P<0 .05) .CONCLUSION Using centralized management of cleaning and disinfection of cupping in the disinfection supply center can strengthen the disinfection effect ,effectively reduce the hospital infection risks ,prolong the storage time ,improve the sterile retention rate , also can reduce labor costs ,save material resources ,so as to meet the requirements of hospital infection control .%目的:探讨火罐在消毒供应中心集中清洗消毒的管理效果

  10. Mobile central heating plant ensures the supply during the power-plant modernization. Planning-safe reconstruction; Mobile Heizzentrale sichert Versorgung waehrend Kraftwerksmodernisierung. Planungssicherer Umbau

    Energy Technology Data Exchange (ETDEWEB)

    Bernhard, Petra [Mobiheat GmbH, Friedberg (Germany). Presse- und Oeffentlichkeitsarbeit

    2012-09-15

    During the comprehensive energetic retrofitting of district heating plants in the spa resort of Badenweiler (Federal Republic of Germany) a mobile 2-MW heating plant from Mobilheat (Ebersberg, Federal Republic of Germany) was used for the heat supply. Thus, the installation of environmental friendly energy supply based on cogeneration plants could be implemented with planning security. This particularly was important because, among other things, the traditional spa resort, the Kurhaus as well as hotels and private customers depend on the heat supply system. These buildings have be supplied with thermal water also in the summer.

  11. Sulfato de magnesio y respuesta hemodinámica en laringoscopia e intubación endotraqueal. Hospital Militar Central 2015

    OpenAIRE

    Rojas Farfán, Gissela Roxana

    2015-01-01

    Objetivos: Identificar los efectos del sulfato de magnesio en la respuesta hemodinámica durante la laringoscopia e intubación endotraqueal en pacientes sometidos a anestesia general en el Hospital Militar Central del Perú durante el periodo setiembre - octubre del 2015. Material y Métodos: Estudio de cohortes, retrospectivo, analítico, cuantitativo y no experimental en 60 pacientes sometidos a cirugía electiva bajo anestesia general; divididos en dos grupos: un grupo recibió 10 mg/kg de sulfa...

  12. The Centralized Management and Clinical Application of Ventilators in Modern Hospital%现代医院呼吸机的集中管理与临床应用

    Institute of Scientific and Technical Information of China (English)

    何莺; 邢素美; 夏文俊

    2011-01-01

    目的 探讨现代医院呼吸机的集中管理模式及在临床中的推广应用.方法 观察、总结、分析近3年195例机械通气患者呼吸机集中管理的效果.结果 集中专人负责呼吸机的保管、供应、调试、保养、维护、消毒及故障排除,195例机械通气患者虽遇到各类报警950例,但由于发现及时、处理得当,均未对患者造成重大影响,呼吸机的完好率及使用率均达百分之百.结论 加强现代医院呼吸机的集中科学管理,培养造就一支高素质的专业人才队伍,将显著提高呼吸机的使用率和重症患者救治的成功率.%Objective To investigate the centralized management mode and clinical promotion of ventilators in modern hospitals.Methods 0bserved,9ummarized,and analyzed the centralized ventilators management effects of 195 patients with mechanical ventilation.Results Set persons specially designated for the jobs of storage, supply, debugging, maintenance, protection, disinfection and troubleshooting. 195 cases of patients with mechanical ventilation encountered 950 cases of various types of alarm,because of dealing with these problems timely and properly ,there was no significant loss on the patients, and the rate of the ventilators in good condition and urilization reached 100 percent.Conclsion By strengthening the centralized modern hospital ventilator scientific management,training and fostering a high quality team of professionals,we will significantly improve the utilization rate of the ventilator and the success rate rescue of critical patients.

  13. 医用气体中心供应系统及应急安全质量控制%Medical gas central supply system and safety quality control in emergency response

    Institute of Scientific and Technical Information of China (English)

    崔吉平; 赵玛丽; 种银保; 刘九零; 曹登秀; 罗鑫

    2012-01-01

    Objective: To introduce the components and operation process of the medical gas central supply system of the modern hospital based on the safe operation of the system. Methods: and combine this unit depot center expansion design and application, it was recommended that the expaned medical gas central supply system should be connected with the original system according to the expansion design and application of the system. Results: Both the systems played an important role in emergency response, which complied with the national requirements for emergency response of medical gas and guarantee the safe use of oxygen in emergency situations. Meanwhile, quality and safety control of emergency response should be emphasized in the processes of design, materials, installation as well as the daily inspection and maintenance; systematic training for technical personnel should be strengthened; safety records should be well managed, and emergency measures should be implemented step by step the responsibility to the people. Conclusion: The medical gas system engineering is cheap, safe, and reliable, and the system has achieved the purpose of safety use in emergency response.%目的:针对医院医用气体中心供应系统安全运行实际情况,介绍现代医院医用气体中心供应系统构成和运行流程。方法:结合本单位医用气体中心供应站的扩建设计及运用,推荐扩建系统设计与原中心供气系统链接。结果:两系统互为应急作用,既符合国家对医用气体一用一备一应急标准要求,又有效保证了突发事件出现时医院的安全用氧。同时在应急安全质量控制上从设计、材质、安装以及在日常检查和维护中强化过程质量安全管理;加强工程技术人员的系统培训;做好安全档案管理,逐级落实应急措施,责任到人。结论:提出本单位所运用的设计不但工程量不大,经费不高,且安全可靠,在全院医用气体系统工程的应

  14. Auch Führen will gelernt sein: Angebot und Nachfrage nach Weiterbildung in Betriebswirtschaftslehre für Krankenhausärzte [Leading does not come naturally: supply and demand for further training in hospital aministration for medical professionals

    Directory of Open Access Journals (Sweden)

    Lueke, Sven

    2009-08-01

    Full Text Available [english] The leadership of departments and hospitals requires qualifications in the fields of personnel and financial management, marketing and strategy, but only few medical experts in leadership positions have been trained in these subjects. This is especially the case in leadership as a part of the management process. This paper discusses the results of two studies analyzing the supply and demand with respect to training in the fields of hospital administration and management for medical experts in hospitals, with a particular emphasis on leadership training. It is shown that these professionals are aware of the fact that they need further training in these and other fields, but their willingness to pay for it is quite limited. At the same time, there is a broad supply of general courses, but hardly any programs specially designed for medical professionals in leadership positions in hospitals. [german] Die Führung von Fachabteilungen und von ganzen Krankenhäusern erfordert Kompetenzen in den Bereichen Personalführung, Finanzmanagement, Marketing und Strategie, aber die wenigsten Chef- und Oberärzte haben während ihrer medizinischen Ausbildung eine entsprechende Qualifizierung erfahren. Dies ist insbesondere der Fall bei Führung als Teil des Managementprozesses. Der vorliegende Artikel stellt Ergebnisse zweier Studien vor, in der die Nachfrage und das Angebot an Weiterbildung in den Bereichen Betriebswirtschaft und Management für im Krankenhaus tätige Mediziner analysiert werden mit schwerpunktmäßiger Betrachtung der Führungskompetenzen. Es zeigt sich ein hohes Bewusstsein der Chef- und Oberärzte für die Notwendigkeit an Weiterbildung in diesem und anderen Bereichen und eine hohe Bereitschaft, hierfür Zeit zu investieren. Gleichzeitig besteht jedoch eine geringe Zahlungsbereitschaft. Gleichzeitig bestehen aber auch zahlreiche Angebote für eine allgemeine Fortbildung in diesem Bereich, jedoch kaum maßgeschneiderte Programme f

  15. 医院耗材采购与供应商信息互动管理平台的研发及其应用%Development and application of hospital supplies procurement and supplier information ;management platform for interactive

    Institute of Scientific and Technical Information of China (English)

    申倩; 秦弦; 汪长岭; 于春华; 朱兴喜; 高宝军; 陈光真; 李铁柱; 刘玲玲

    2014-01-01

    Objective: To solve the problems that the difficulties which hospital consumables procurement management interactive management with supplier, and realize that the hospital for medical consumables in real time, rapid procurement and purchasing process efficiently, fast and orderly management. Methods: Based on the Android platform application research and development, and practical application in the management of medical consumable purchase. Results: The hospital and suppliers of material supply and demand information real-time sharing comes true, raise the level of hospital consumables management informationization. Conclusion:The application of the hospital procurement management system saves manpower and material, and can be popularized to the other hospitals.%目的:解决当前医院耗材采购管理过程中与供应商信息互动管理的问题,实现医院对医疗耗材实时、快速的采购,并对采购过程进行高效、快捷和有序的管理。方法:应用Android系统研发信息互动管理平台,并在医疗耗材采购管理中实际运用。结果:实现了医院与供应商之间耗材供求信息的实时共享,提高医院的耗材信息化管理水平。结论:医院耗材采购管理系统的应用节省了人力、物力,值得推广应用。

  16. Strategic Supply

    Science.gov (United States)

    2003-01-01

    March 7, 2003. [29] Velis, Lil. “ Publishing Industry : Supply Chain Strategy in Action,” briefing presented to ICAF Strategic Supply Seminar, May 6...Lambert and Stock, page 48. [32] Velis, Lil. “ Publishing Industry : Supply Chain Strategy in Action,” briefing presented to ICAF Strategic Supply

  17. Management of sterile supplies in light car-disaster rescue hospital%轻型车载式灾害救援医院无菌物品安全管理措施的研究

    Institute of Scientific and Technical Information of China (English)

    曹力; 郑静晨; 杨炯; 万琼

    2013-01-01

    OBJECTIVE To explore the safety and quality of the sterile supplies in the non-war military operation car-disaster relief hospital so as to promote the medical service of the combat readiness medical equipment supply and reserve and ensure the regular replacement.METHODS The vehicle-mounted mobile hospital was established in the Armed Police General Hospital in 2005,the vehicle-mounted mobile hospital was equipped with state-of-theart equipment standardization of disaster medical relief and sterile supply department with sterile cardinality so as to develop valid and early warning mechanism,select appropriate reserve packaging,identify the fixed placed space,and identify the suitable parking sites.RESULTS Through effective reserves and regular track inspections,the quality and validity period have met the three-in-time during the storage,the immediate recall and the timely replacement have ensured a timely supplement and circulation turnover of the medical supplies and have not caused any expired waste,pulling the drill bumpy damage,season temperature,or metamorphism.CONCLUSION It is of great significance to strengthen the management of medical supplies in the light car disaster relief hospital and is conducive to the reserve of best state.To achieve the emergency operation during the wartime and high-efficient,smooth and refined first aid may promote the medical support of the light car disaster relief hospital in non-war military operations and lay the management performance.%目的 探讨非战争军事行动车载式灾害救援医院无菌物品质量安全,提升卫勤战备医疗器材供应、储备、定期更换等保障.方法 自2005年武警总医院自主改装的车载式移动医院,配备了先进的灾害医疗救援的标准化装备,消毒供应科采用建立无菌物品基数、制定效期预警机制、选择适宜储备包装、找准固定放置空间、停放适合地点环境等.结果 通过有效储备、定期巡查跟踪,在储存

  18. Central nervous system tuberculosis in children: review of 35 cases at the Hospital Universitario San Vicente de Paúl in Medellín, Colombia.1997-2004. Meningoencefalitis tuberculosa en niños: Revisión de 35 casos en el Hospital Universitario San Vicente de Paúl en Medellín, Colombia. 1997-2004

    OpenAIRE

    José William Cornejo Ochoa; Dagoberto Nicanor Cabrera Hémer; Rodrigo Andrés Solarte Mila

    2005-01-01

    Objetive. To document the clinical and diagnostic features and to explore factors associated with central nervous system tuberculosis at the “Hospital San Vicente de Paúl (HUSVP)” in Medellín-Colombia. Patients and methods. Review of the patient’s records to obtain information on demographic data, medical history, clinical manifestations, laboratory results, treatment and complications of 35 children with central nervous system tuberculosis admitted to the hospital between July 1997 and July ...

  19. Disposal modes of recyclable disposable medical supplies in hospitals%医院可回收一次性使用医疗用品处置模式研究

    Institute of Scientific and Technical Information of China (English)

    赵玲; 郝学安; 姜洪荣; 张华强; 周璞

    2014-01-01

    OBJECTIVE To investigate the amounts of the recyclable disposable medical supplies in various levels of hospitals and explore the scientific recyclable management mode of the medical supplies .METHODS Totally 40 hospitals were randomly extracted from two jurisdiction areas including Jining and Qingdao ,including 4 three A hospitals ,20 two A hospitals ,and 16 one A hospitals ,and the management of the recyclable disposable medical supplies under various disposable modes was investigated by means of onsite survey and distribution of question-naires .RESULTS The average bed-yield per day was 95 .44 g in the three A hospitals ,118 .46 g in the two A hos-pitals ,80 .16 g in the one A hospitals ,and the average bed-yield per day of the two cities was 98 .02 g .Among the 40 extracted hospitals ,only 14 hospitals conducted the standardized disposal of the recyclable disposable medical supplies ,accounting for 35 .0% ;all of the 10 hospitals that were operated under the management mode of infec-tion control department conducted the standard disposal ,with the rate of standard disposal of 100 .0% .Of the 26 hospitals that were operated under the management mode of logistics department ,only 1 hospital conducted the standard disposal ,accounting for 3 .8% .CONCLUSION It is feasible to conduct the management mode of the recy-clable disposable medical supplies taken charge by the infection control department ,which can not only reduce the environmental pollution and cut the disposal cost but also remarkably increase the economic benefits .%目的:了解各级医院可回收一次性使用医疗用品产生数量,探讨其科学回收管理模式。方法从济宁和青岛两市辖区内分别随机抽取40所医院作为研究对象,其中三级医院4所,二级医院20所,一级医院16所,通过现场和发放调查问卷两种方式,掌握各种处置模式运行下的医院对于可回收一次性使用医疗用品的管理现况。结果可回收一次性

  20. Design of Supply Chain Solution of Drug Stockroom in Hospital%医院药库供应链管理方案设计

    Institute of Scientific and Technical Information of China (English)

    温筱煦; 冯端浩; 崔勇

    2012-01-01

    针对医院药库与药品供应商之间存在的供应信息传递效率低、手工重复操作多等问题,设计了以药库和采购为核心环节的供应链信息管理系统.利用安全网关和条码扫描等手段,使药品采购计划和配送信息在医院内网HIS系统、外网服务器平台和供应商业务系统之间及时传输.药品实物可以直接配送到终端子库房,配送信息则逐级传递,既减少了人工核对的工作强度,实现快速验收,又可以加强药品监管和绩效评估,有效提高药库的物流工作效率.%To solve the problems between drug stockroom and drug supply enterprise, such as slow transmission of supply information and repetitive manual operations, a supply chain information management system is designed based on drug stockroom and purchase. By safety gateway and barcode scanning methods, drug purchase plans and delivery information are transmitted in time through HIS, internet server platform and drug supply enterprise' s business system. Drugs are sent to terminal stockrooms directly while supply information is delivered through each level. It results in reduced manual work density and fast inspection and acceptance. Drug regulation and performance evaluation can be strengthened and drug stockroom logistic work efficiency can be improved.

  1. ENDOGENEITY OF INDONESIAN MONEY SUPPLY

    OpenAIRE

    Meutia Safrina Rachma

    2011-01-01

    There has been a long debate about the endogeneity of money supply. The main objective of this article is to identify whether money supply in Indonesia is an exogenous or an endogenous variable. Using a Vector Autoregressive model and monthly data 1997(5)-2010(6), the estimation result shows that money supply in Indonesia is an endogenous variable. The movement of broad money supply does influence the movement of base money and Consumer Price Index. Consequently, the central bank does not hav...

  2. [Organization of scientific-methodological work in Central Military Clinical Hospital named after A.A. Vishnevskiĭ].

    Science.gov (United States)

    Beliakin, S A; Fokin, Iu N; Kokhan, E P; Frolkin, M N

    2009-09-01

    There was congested a wide experience of organization and management of scientific work in the 3rd CMCH by Vishnevsky A.A. for a term of more than 40 years. This experience is subjected to generalization, analyze for the purpose of determination of it's priority orientations of improvement. Scientific-methods work in hospital is rated as a complex of measures, organisationaly-planed and coordinated by purpose and reinforcement of scientific schools of the 3rd CMCH by Vishnevsky A.A., as a basis of effective delivery of specialized medical aid. The vector of scientific researches is directed, generally, to solving questions of military and field medicine.

  3. A Rare case of bear attack on the face and the treatment in a tertiary hospital in Central Nepal

    Directory of Open Access Journals (Sweden)

    Ashutosh Kumar Singh

    2015-11-01

    Full Text Available This case report presents a case of wild bear attack in the central region of Nepal causing extensive maxillofacial injuries and its management. The patient suffered bilateral comminuted midface fractures with extensive soft tissue lacerations. Management included multidisciplinary approach including maxillofacial surgeons, ENT surgeons and cosmetic surgeon to realign the injured soft tissue and bone to pre injury state. Outcome was satisfactory given the initial presentation of patient.JCMS Nepal. 2015; 11(2:31-33

  4. Spontaneous intracerebral hemorrhage: Clinical and computed tomography findings in predicting in-hospital mortality in Central Africans

    Directory of Open Access Journals (Sweden)

    Michel Lelo Tshikwela

    2012-01-01

    Full Text Available Background and Purpose: Intracerebral hemorrhage (ICH constitutes now 52% of all strokes. Despite of its deadly pattern, locally there is no clinical grading scale for ICH-related mortality prediction. The first objective of this study was to develop a risk stratification scale (Kinshasa ICH score by assessing the strength of independent predictors and their association with in-hospital 30-day mortality. The second objective of the study was to create a specific local and African model for ICH prognosis. Materials and Methods: Age, sex, hypertension, type 2 diabetes mellitus (T2DM, smoking, alcohol intake, and neuroimaging data from CT scan (ICH volume, Midline shift of patients admitted with primary ICH and follow-upped in 33 hospitals of Kinshasa, DR Congo, from 2005 to 2008, were analyzed using logistic regression models. Results: A total of 185 adults and known hypertensive patients (140 men and 45 women were examined. 30-day mortality rate was 35% (n=65. ICH volume>25 mL (OR=8 95% CI: 3.1-20.2; P 7 mm, a consequence of ICH volume, was also a significant predictor of mortality. The Kinshasa ICH score was the sum of individual points assigned as follows: Presence of coma coded 2 (2 × 2 = 4, absence of coma coded 1 (1 × 2 = 2, ICH volume>25 mL coded 2 (2 × 2=4, ICH volume of ≤25 mL coded 1(1 × 2=2, left hemispheric site of ICH coded 2 (2 × 1=2, and right hemispheric site of hemorrhage coded 1(1 × 1 = 1. All patients with Kinshasa ICH score ≤7 survived and the patients with a score >7 died. In considering sex influence (Model 3, points were allowed as follows: Presence of coma (2 × 3 = 6, absence of coma (1 × 3 = 3, men (2 × 2 = 4, women (1 × 2 = 2, midline shift ≤7 mm (1 × 3 = 3, and midline shift >7 mm (2 × 3 = 6. Patients who died had the Kinshasa ICH score ≥16. Conclusion: In this study, the Kinshasa ICH score seems to be an accurate method for distinguishing those ICH patients who need continuous and special management

  5. 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.

  6. A retrospective clinical audit of 696 central venous catheterizations at a tertiary care teaching hospital in India

    Directory of Open Access Journals (Sweden)

    Sanjay Agrawal

    2012-01-01

    Full Text Available Background: Malpositions after central venous cannulation are frequently encountered and may need a change in catheter. The incidence of malpositions are varied according to various studies and depend on the experience of the operator performing the cannulation. Aim: To access the incidence of malpositions and related complications associated with landmark-guided central venous cannulation in a 15-bedded medical surgical ICU over a period of three years. Settings and Design: Retrospective analysis of records of all the central venous cannulation done in a 15- bedded medical- surgical ICU over the period of three years (April 2008 to June 2011 were evaluated for the site and side of insertion, number of attempts of puncture, arterial puncture as well as the malpositions on post procedural chest X-ray. The records were also evaluated for the experience of the operator performing cannulation and relationship between experience of operator to malpositions of catheter. Statistical Analysis: Analysis was done using SPSS v 17.0 for Windows. Chi-square test was applied to evaluate the statistical significance. P > 0.05 was significant. Results: Records of 696 cannulations were evaluated. Malpositions occurred in 40 patients. Subclavian vein cannulation resulted in increased malpositions in relation to internal jugular vein cannulation. More common with left sided cannulation. Experience of operator had positive correlation with malpositions and arterial puncture. Arterial puncture was common in 6%, while more than one attempt for cannulation was taken in 100 patients. Conclusion: Incidence of malpositions was low. We conclude that experience of operator improves successful catheterization with lesser number of complications.

  7. BACTERIAL CAUSES OF LOWER RESPIRATORY TRACT INFECTIONS IN PATIENTS ATTENDING CENTRAL REFERRAL HOSPITAL, GANGTOK WITH REFERENCE TO ANTIBIOTIC RESISTANCE PATTERN

    Directory of Open Access Journals (Sweden)

    Priyanka Paul

    2013-10-01

    Full Text Available ABSTRACT: BACKGROUND: There is inadequate information from India on various lower respiratory tract pathogens and their resistance pattern in hospital settings. The present study was undertaken to see the bacteriological profile an d the antibiotic resistance pattern of the isolates causing LRTI from this geographic region. OBJECTIVE: To identify and characterize bacterial pathogens causing community acquired and hospital acquired infections with reference to antibiogram pattern. MET HODS: A total of 137 samples from patients suffering from lower respiratory tract infections were studied. All the sputum samples were subjected to gram staining, culture. Various organisms were identified by standard methods. The Kirby – Bauer method was e mployed to perform the antibiotic sensitivity on Mueller Hinton agar [MHA]. For Streptococcus pneumoniae blood agar was used. MHA with 4% NaCl was used to detect methicillin resistant Staphylococcus aureus [MRSA]. RESULTS: Growth of pathogens was obtained in 66.4% of sputum samples in case of inpatients and in 33.5% outpatients. Klebsiella pneumonia [15.3%] was the predominant isolate among the inpatients whereas Streptococcus pneumonia [8.5%] was the most common pathogen isolated from outpatients. Haemophi lus influenzae was not isolated. Quinolone was found to be most effective antibiotic against gram negative organi sms. A single isolate of Morax ella catarrhalis was isolated from a case of MDR - TB. CONCLUSION : Culture and susceptibility reports should be enc ouraged before therapy to combat the problem of emergence of MDR, ESBL and MRSA strains and to subside the economic burden due to increase in cost according to the consequence of development of antibiotic resistant microbial strains

  8. Prevalence and correlation of infectious agents in hospitalized children with acute respiratory tract infections in Central China.

    Directory of Open Access Journals (Sweden)

    Jia Liu

    Full Text Available Acute respiratory tract infections (ARTIs are associated with significant morbidity and mortality worldwide, especially in children under the age of 5 years. Almost 2 million children die from ARTIs each year, and most of them are from developing countries. The prevalence and correlation of pathogens in ARTIs are poorly understood, but are critical for improving case prevention, treatment, and management. In this study, we investigated the prevalence and correlation of infectious agents in children with ARTIs. A total of 39,756 children with one or more symptoms, including fever, cough, sore throat, tonsillitis, pharyngitis, herpangina, pneumonia, and bronchiolitis, were enrolled in the study. All patients were hospitalized in Wuhan Children's Hospital between October 1, 2010 and September 30, 2012, and were evaluated for infectious agents. Pathogens, including Mycoplasma pneumoniae, influenza A virus, influenza B virus, adenoviruses, respiratory syncytial virus, parainfluenza virus, Legionella pneumophila, Chlamydophila pneumoniae, and Coxiella burnetii, were screened simultaneously in patient blood samples using anti-pathogen IgM tests. Regression analysis was used to reveal correlations among the pathogens. Our results showed that one or more pathogens were identified in 10,206 patients, and that Mycoplasma pneumoniae, adenoviruses, and influenza B virus were the leading infectious agents. Mixed-infections of pathogens were detected in 2,391 cases, with Mycoplasma pneumoniae as the most frequent pathogen. The most common agents in the co-infections were Mycoplasma pneumoniae and influenza B virus. Regression analysis revealed a linear correlation between the proportion of mixed infections and the incidence of multi-pathogen infections. The prevalence of infectious agents in children with ARTIs was determined. Equations were established to estimate multiple infections by single-pathogen detection. This revealed a linear correlation for

  9. Etiology and Epidemiology of Diarrhea in Hospitalized Children from Low Income Country: A Matched Case-Control Study in Central African Republic.

    Directory of Open Access Journals (Sweden)

    Sébastien Breurec

    2016-01-01

    Full Text Available In Sub-Saharan Africa, infectious diarrhea is a major cause of morbidity and mortality. A case-control study was conducted to identify the etiology of diarrhea and to describe its main epidemiologic risk factors among hospitalized children under five years old in Bangui, Central African Republic.All consecutive children under five years old hospitalized for diarrhea in the Pediatric Complex of Bangui for whom a parent's written consent was provided were included. Controls matched by age, sex and neighborhood of residence of each case were included. For both cases and controls, demographic, socio-economic and anthropometric data were recorded. Stool samples were collected to identify enteropathogens at enrollment. Clinical examination data and blood samples were collected only for cases.A total of 333 cases and 333 controls was recruited between December 2011 and November 2013. The mean age of cases was 12.9 months, and 56% were male. The mean delay between the onset of first symptoms and hospital admission was 3.7 days. Blood was detected in 5% of stool samples from cases. Cases were significantly more severely or moderately malnourished than controls. One of the sought-for pathogens was identified in 78% and 40% of cases and controls, respectively. Most attributable cases of hospitalized diarrhea were due to rotavirus, with an attributable fraction of 39%. Four other pathogens were associated with hospitalized diarrhea: Shigella/EIEC, Cryptosporidium parvum/hominis, astrovirus and norovirus with attributable fraction of 9%, 10%, 7% and 7% respectively. Giardia intestinalis was found in more controls than cases, with a protective fraction of 6%.Rotavirus, norovirus, astrovirus, Shigella/EIEC, Cryptosporidium parvum/hominis were found to be positively associated with severe diarrhea: while Giardia intestinalis was found negatively associated. Most attributable episodes of severe diarrhea were associated with rotavirus, highlighting the urgent

  10. California GAMA Special Study: An isotopic and dissolved gas investigation of nitrate source and transport to a public supply well in California's Central Valley

    Energy Technology Data Exchange (ETDEWEB)

    Singleton, M J; Moran, J E; Esser, B K; Roberts, S K; Hillegonds, D J

    2010-04-14

    This study investigates nitrate contamination of a deep municipal drinking water production well in Ripon, CA to demonstrate the utility of natural groundwater tracers in constraining the sources and transport of nitrate to deep aquifers in the Central Valley. The goal of the study was to investigate the origin (source) of elevated nitrate and the potential for the deep aquifer to attenuate anthropogenic nitrate. The site is ideal for such an investigation. The production well is screened from 165-325 feet below ground surface and a number of nearby shallow and deep monitoring wells were available for sampling. Furthermore, potential sources of nitrate contamination to the well had been identified, including a fertilizer supply plant located approximately 1000 feet to the east and local almond groves. A variety of natural isotopic and dissolved gas tracers including {sup 3}H-{sup 3}He groundwater age and the isotopic composition of nitrate are applied to identify nitrate sources and to characterize nitrate transport. An advanced method for sampling production wells is employed to help identify contaminant contributions from specific screen intervals. Nitrate transport: Groundwater nitrate at this field site is not being actively denitrified. Groundwater parameters indicate oxic conditions, the dissolved gas data shows no evidence for excess nitrogen as the result of denitrification, and nitrate-N and -O isotope compositions do not display patterns typical of denitrification. Contaminant nitrate source: The ambient nitrate concentration in shallow groundwater at the Ripon site ({approx}12 mg/L as nitrate) is typical of shallow groundwaters affected by recharge from agricultural and urban areas. Nitrate concentrations in Ripon City Well 12 (50-58 mg/L as nitrate) are significantly higher than these ambient concentrations, indicating an additional source of anthropogenic nitrate is affecting groundwater in the capture zone of this municipal drinking water well. This

  11. Research on Development Trends of the Supply and Marketing Logistics in the Central China's Economic Zone%中原经济区供销物流发展趋势研究

    Institute of Scientific and Technical Information of China (English)

    孙宏岭; 李金峰

    2012-01-01

    The Economic Region of Central China development is inseparable from strategic support of the modem logistics industry, especially the promotion of the supply and marketing logistics with the advantages of resources and networks.Cur- rently, the supply and marketing logistics of the Economic Region of Central China has made great achievements, but there are still small-scale ,weak competitiveness and scattered perience of the United States and Japan, the development issues. By drawing on the cooperation logistics development ex- trends of the supply and marketing logistics of the Economic Re- gion of Central China has been defined:to nurture and develop the bigger and stronger "aircraft carrier" group of the supply and marketing logistics;to construct and develop "digital supply and marketing logistics" ;further to improve network sys- tem of the supply and marketing logistics ;to develop the low-carbon lozistics.%中原经济区的发展离不开现代物流业的战略支撑,尤其需要具有资源优势和网络优势的供销物流的推动。目前,中原经济区供销物流已经取得较大成就,但仍然存在规模偏小、竞争力弱、分布散的问题。通过借鉴美国、日本等经济发达国家发展合作物流的经验,明确中原经济区供销物流的发展趋势:做大做强培育发展“航母”式供销物流企业集团;建设发展“数字化供销物流”;进一步健全完善供销物流网络体系;大力发展低碳物流。

  12. IMPACT OF EDUCATIONAL INTERVENTION ON KNOWLEDGE, ATTITUDE AND PRACTICE OF PHARMACOVIGILANCE AMONG MEDICAL GRADUATES OF RURAL TERTIARY CARE, TEACHING HOSPITAL OF CENTRAL INDIA

    Directory of Open Access Journals (Sweden)

    VARMA SUSHIL KUMAR

    2013-01-01

    Full Text Available To assess the awareness of Pharmacovigilance among the medical graduates and to evaluate the need of inclusion of KAP (Knowledge, Attitude and Practice of Pharmacovigilance in Internship Training Programme as an educational intervention.Material and Methods: The present study was conducted in the Internship orientation program in a rural hospital of central India. It was a Hospital Based Cross Sectional Study in which 65 Interns (medical graduates were participated. Semi-structured, Pre-Designed, Pre-tested Questionnaire was used for data collection. Data was entered and analyzed using statistical software ‘EPI INFO 3.5.3’.Results: In our study a total of 65 medical graduates were responded and involved in the pre KAP and post KAP survey questionnaires. The overall response rate between pre intervention and post intervention was statistically significant and that shows effectiveness of educational intervention for improving awareness of Pharmacovigilance among medical graduates.Conclusion: Imparting the knowledge and awareness of Pharmacovigilance among the medical graduates by mean of continuous educational intervention would bring update of knowledge for drug safety into their everyday clinical practice and also bring the adverse drug reactions(ADRs reporting culture among them.

  13. Vitamin D deficiency in medical patients at a central hospital in Malawi: a comparison with TB patients from a previous study.

    Directory of Open Access Journals (Sweden)

    Yamikani Mastala

    Full Text Available OBJECTIVES: To determine the prevalence of vitamin D deficiency (VDD in adult medical, non-tuberculous (non-TB patients. To investigate associations with VDD. To compare the results with a similar study in TB patients at the same hospital. DESIGN: Cross-sectional sample. SETTING: Central hospital in Malawi. PARTICIPANTS: Adult non-TB patients (n = 157, inpatients and outpatients. OUTCOME MEASURES: The primary outcome was the prevalence of VDD. Potentially causal associations sought included nutritional status, in/outpatient status, HIV status, anti-retroviral therapy (ART and, by comparison with a previous study, a diagnosis of tuberculosis (TB. RESULTS: Hypovitaminosis D (≤75 nmol/L occurred in 47.8% (75/157 of patients, 16.6% (26/157 of whom had VDD (≤50 nmol/L. None had severe VDD (≤25 nmol/L. VDD was found in 22.8% (23/101 of in-patients and 5.4% (3/56 of out-patients. In univariable analysis in-patient status, ART use and low dietary vitamin D were significant predictors of VDD. VDD was less prevalent than in previously studied TB patients in the same hospital (68/161 = 42%. In multivariate analysis of the combined data set from both studies, having TB (OR 3.61, 95%CI 2.02-6.43 and being an in-patient (OR 2.70, 95%CI 1.46-5.01 were significant independent predictors of VDD. CONCLUSIONS: About half of adult medical patients without TB have suboptimal vitamin D status, which is more common in in-patients. VDD is much more common in TB patients than non-TB patients, even when other variables are controlled for, suggesting that vitamin D deficiency is associated with TB.

  14. HIV-Associated Central Nervous System Disease in Patients Admitted at the Douala General Hospital between 2004 and 2009: A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Henry Namme Luma

    2013-01-01

    Full Text Available Background. Studies on HIV-associated central nervous system (CNS diseases in Cameroon are rare. The aim of this study was to describe the clinical presentation, identify aetiological factors, and determine predictors of mortality in HIV patients with CNS disease. Methods. From January 1, 2004 and December 31, 2009, we did at the Douala General Hospital a clinical case note review of 672 admitted adult (age ≥ 18 years HIV-1 patients, and 44.6% (300/672 of whom were diagnosed and treated for HIV-associated CNS disease. Results. The mean age of the study population was years, and median CD4 count was 49 cells/mm3 (interquartile range (QR: 17–90. The most common clinical presentations were headache (83%, focal signs (40.6%, and fever (37.7%. Toxoplasma encephalitis and cryptococcal meningitis were the leading aetiologies of HIV-associated CNS disease in 32.3% and 25% of patients, respectively. Overall mortality was 49%. Primary central nervous system lymphoma (PCNSL and bacterial meningitis had the highest case fatality rates of 100% followed by tuberculous meningitis (79.8%. Low CD4 count was an independent predictor of fatality (AOR: 3.2, 95%CI: 2.0–5.2. Conclusions. HIV-associated CNS disease is common in Douala. CNS symptoms in HIV patients need urgent investigation because of their association with diseases of high case fatality.

  15. Frequency of Antiseptic Resistance Among Staphylococcus aureus and Coagulase-Negative Staphylococci Isolated From a University Hospital in Central Iran

    Science.gov (United States)

    Taheri, Nona; Ardebili, Abdollah; Amouzandeh-Nobaveh, Alireza; Ghaznavi-Rad, Ehsanollah

    2016-01-01

    Objectives Reduced biocide susceptibility in Staphylococci is associated with various antiseptic resistance genes encoding efflux systems. Our aim was to determine the susceptibility to three disinfectant agents, including benzalkonium chloride (BAC), benzethonium chloride (BZT), and chlorhexidine digluconate (CHDG) among clinical isolates of Staphylococcus aureus and coagulase-negative Staphylococci (CoNS). Methods The minimum inhibitory concentration (MIC) of 60 methicillin-resistant S. aureus (MRSA), 54 methicillin-sensitive S. aureus (MSSA) and 51 CoNS isolates from a single hospital to three biocidal agents (BAC, BZT, and CHDG) was determined. Biocide resistance genes (qacA/B, smr, qacG, qacH, qacJ, and norA) were analyzed by the polymerase chain reaction assay. Results All isolates had MICs for BAC and BZT from 0.25 to 8 µg/mL, and for CHDG from 0.5 to 64 µg/mL. qacA/B was the most common biocide resistance gene among all 165 Staphylococcus isolates (76; 46%), which comprised 38 (63.3%) MRSA, 14 (25.9%) MSSA, and 24 (47%) CoNS. Eleven (6.7%) and 24 (14.5%) isolates among the 165 Staphylococci carried smr and norA genes, respectively. In contrast, other resistance genes such as qacG, qacH, and qacJ were absent in all Staphylococci studied. The qacA/B and smr genes were detected concomitantly in 3% of isolates, and 23.6% strains of the total 165 Staphylococcus isolates were negative for each studied gene. Conclusions The carriage of several biocide resistance genes, including qacA/B, smr, and norA, alone or concurrently, is associated with reduced susceptibility. Use of antiseptics may select for antibiotic-resistant strains and assist their survival in the healthcare environment. PMID:27974958

  16. Estudo clínico de 35 pacientes com diagnóstico de erisipela internados no Hospital Central da Irmandade da Santa Casa de Misericórdia de São Paulo Erysipelas: a clinical study of 35 pacients hospitalized at the São Paulo Central Hospital of Irmandade da Santa Casa de Misericórdia

    Directory of Open Access Journals (Sweden)

    Renata Mie Oyama Okajima

    2004-05-01

    Full Text Available FUNDAMENTOS: Erisipela e celulite são infecções cutâneas freqüentes. OBJETIVOS: Com o objetivo de avaliar incidência, fatores de risco, principais complicações, esquemas terapêuticos utilizados e evolução. MÉTODOS: Foram estudados 35 pacientes com diagnóstico de erisipela internados nas enfermarias do Hospital Central da Irmandade da Santa Casa de Misericórdia de São Paulo no período de abril a agosto de 2002. RESULTADOS: A incidência de pacientes com diagnóstico de erisipela no período estudado foi de 0,87%. O fator de risco local mais encontrado foi o linfedema, seguido por episódios prévios de erisipela. Dos fatores de risco gerais, aqueles que comprometem a imunidade, como diabetes mellitus, etilismo e neoplasias, foram os mais observados em associação ao quadro de infecção dermatológica. Sinais inflamatórios locais foram encontrados em 97,8% dos casos. Verificaram-se quatro casos com complicações: necrose, abscesso, trombose venosa profunda e septicemia. A evolução dos pacientes foi satisfatória em mais de 97% dos casos. CONCLUSÕES: O tratamento com penicilina cristalina foi associado ao menor número de complicações (pBACKGROUND: Erysipelas and cellulitis are common skin infections. OBJECTIVES: The aim of this paper is to investigate the frequency, risk factors, clinical features, complications, principal drugs used for treatment and the disease course. METHODS: The authors studied 35 ward patients who had been diagnosed with erysipelas, and were admitted to the Central Hospital of Irmandade da Santa Casa de Misericórdia de São Paulo between April and August 2002. RESULTS: Among the patients in the ward during the study 0.87% had been diagnosed with erysipelas. The most common local risk factor was lymphedema, followed by previous episodes of erysipelas. Among the general risk factors, diabetes mellitus, alcohol abuse and cancer were most frequently observed. Local inflammatory signs were found in 97

  17. Evaluación de las causas de los eventos adversos o incidentes que afectan la seguridad del paciente, en el hospital central de la policía de enero 2012 a diciembre 2013

    OpenAIRE

    Alarcon Ruiz, Diego Jesus; Gil Vargas, Luis Fabio

    2016-01-01

    TITULO DEL TRABAJO: Evaluación de las causas de los eventos adversos o incidentes que afectan la seguridad del paciente, en el hospital central de la policía de enero 2012 a diciembre 2013. OBJETIVO: Determinar y analizar la causa raíz de los principales factores de riesgo que afectan la seguridad del paciente que puedan ocasionar eventos adversos en la atención de los pacientes, con el uso de la teoría de restricciones TOC en el Hospital Central de la Policía HOCEN. MATERIALES Y METODO: Se r...

  18. A retrospective study of central nervous system shunt infections diagnosed in a university hospital during a 4-year period

    Directory of Open Access Journals (Sweden)

    Coskun Erdal

    2006-03-01

    Full Text Available Abstract Background Ventriculoperitoneal (VP shunts are used for intracranial pressure management and temporary cerebrospinal fluid (CSF drainage. Infection of the central nervous system (CNS is a major cause of morbidity and mortality in patients with CSF shunts. The aim of the present study was to evaluate the clinical features, pathogens, and outcomes of 22 patients with CSF shunt infections collected over 4 years. Methods The patients with shunt insertions were evaluated using; age, sex, etiology of hydrocephalus, shunt infection numbers, biochemical and microbiological parameters, prognosis, clinical infection features and clinical outcome. Results The most common causes of the etiology of hydrocephalus in shunt infected patients were congenital hydrocephalus-myelomeningocele (32% and meningitis (23%. The commonest causative microorganism identified was Staphylococcus (S. aureus, followed by Acinetobacter spp., and S. epidermidis. Conclusion In a case of a shunt infection the timely usage of appropriate antibiotics, according to the antimicrobial susceptibility testing, and the removal of the shunt apparatus is essential for successful treatment.

  19. Notes from the field: hospitalizations for respiratory disease among unaccompanied children from Central America - multiple States, June-July 2014.

    Science.gov (United States)

    Nyangoma, Edith N; Arriola, Carmen Sofia; Hagan, Jose; Socias, Christina; Tomczyk, Sara; Watkins, Louise Francois; Westercamp, Matthew; Kim, Curi

    2014-08-15

    During October 2013-June 2014, approximately 54,000 unaccompanied children, mostly from the Central American countries of El Salvador, Guatemala, and Honduras, were identified attempting entry into the United States from Mexico, exceeding numbers reported in previous years. Once identified in the United States, U.S. Customs and Border Protection, an agency of the U.S. Department of Homeland Security, processes the unaccompanied children and transfers them to the Office of Refugee Resettlement (ORR), an office of the Administration for Children and Families, U.S. Department of Health and Human Services. ORR cares for the children in shelters until they can be released to a sponsor, typically a parent or relative, who can care for the child while their immigration case is processed. In June 2014, in response to the increased number of unaccompanied children, U.S. Customs and Border Protection expanded operations to accommodate children at a processing center in Nogales, Arizona. ORR, together with the U.S. Department of Defense, opened additional large temporary shelters for the children at Lackland Air Force Base, Texas; U.S. Army Garrison Ft. Sill, Oklahoma; and Naval Base Ventura County, California.

  20. Comparability of Point-of-Care versus Central Laboratory Hemoglobin Determination in Emergency Patients at a Supra-Maximal Care Hospital

    Science.gov (United States)

    Dolscheid-Pommerich, Ramona C.; Dolscheid, Sarah; Grigutsch, Daniel; Stoffel-Wagner, Birgit; Graeff, Ingo

    2016-01-01

    Fulfilling the requirements of point-of-care testing (POCT) training regarding proper execution of measurements and compliance with internal and external quality control specifications is a great challenge. Our aim was to compare the values of the highly critical parameter hemoglobin (Hb) determined with POCT devices and central laboratory analyzer in the highly vulnerable setting of an emergency department in a supra maximal care hospital to assess the quality of POCT performance. In 2548 patients, Hb measurements using POCT devices (POCT-Hb) were compared with Hb measurements performed at the central laboratory (Hb-ZL). Additionally, sub collectives (WHO anemia classification, patients with Hb 85y.) were analyzed. Overall, the correlation between POCT-Hb and Hb-ZL was highly significant (r = 0.96, p2.5g/dl occurred. McNemar´s test revealed significant differences regarding anemia diagnosis according to WHO definition for male, female and total patients (♂ p<0.001; ♀ p<0.001, total p<0.001). Hb-ZL resulted significantly more often in anemia diagnosis. In samples with Hb<8g/dl, McNemar´s test yielded no significant difference (p = 0.169). In suprageriatric patients, McNemar´s test revealed significant differences regarding anemia diagnosis according to WHO definition in male, female and total patients (♂ p<0.01; ♀ p = 0.002, total p<0.001). The difference between Hb-ZL and POCT-Hb with Hb<8g/dl was not statistically significant (<8g/dl, p = 1.000). Overall, we found a highly significant correlation between the analyzed hemoglobin concentration measurement methods, i.e. POCT devices and at the central laboratory. The results confirm the successful implementation of the presented POCT concept. Nevertheless some limitations could be identified in anemic patients stressing the importance of carefully examining clinically implausible results. PMID:27880783

  1. 基于延迟定价策略的供应链分散与集中决策%Decentralized and centralized decision-making of supply chain based on price-postponement strategy

    Institute of Scientific and Technical Information of China (English)

    陈炜; 杨以雄; 郑洁; 田原

    2016-01-01

    For the uncertainty of consumer demand, price-postponement is considered to be an effect measure to cope with demand fluctuation and facilitate market clearing. Based on the two-echelon supply chain consisting of a supplier and a retailer, the optimal retail price is proposed, then the retailer profit function of the decentralized supply chain and the supply chain profit function model of the centralized supply chain are established, respectively. The existence and uniqueness of order quantity are proved by unimodality conditions, and optimal solutions are obtained. Comparative and numerical analysis show that, using price-postponement can significantly increase the gross profit of the decentralized supply chain compared to the fixed price, although the income is lower than that of the centralized supply chain.%针对消费者市场需求不确定性大的特征,采用延迟定价策略应对需求波动和实现产品售罄。基于供应商和零售商的两级供应链,探讨最优零售价格的确立,分别建立分散决策下的零售商利润函数模型和集中决策下的供应链系统利润函数模型,通过函数单峰性分析证明最优订货量的存在性和唯一性,并求得最优解。比较和数值分析表明,在分散决策下,采用延迟定价策略虽然未必能达到集中决策时的供应链系统最优,但相比固定售价,可以显著提高供应链的总利润。

  2. Molecular Phylogenetic Diversity of Dermatologic and Other Human Pathogenic Fusarial Isolates from Hospitals in Northern and Central Italy▿

    Science.gov (United States)

    Migheli, Quirico; Balmas, Virgilio; Harak, Henry; Sanna, Silvana; Scherm, Barbara; Aoki, Takayuki; O'Donnell, Kerry

    2010-01-01

    Fifty-eight fusaria isolated from 50 Italian patients between 2004 and 2007 were subject to multilocus DNA sequence typing to characterize the spectrum of species and circulating sequence types (STs) associated with dermatological infections, especially onychomycoses and paronychia, and other fusarioses in northern and central Italy. Sequence typing revealed that the isolates were nearly evenly divided among the Fusarium solani species complex (FSSC; n = 18), the F. oxysporum species complex (FOSC; n = 20), and the Gibberella (Fusarium) fujikuroi species complex (GFSC; n = 20). The three-locus typing scheme used for members of the FSSC identified 18 novel STs distributed among six phylogenetically distinct species, yielding an index of discrimination of 1.0. Phylogenetic analysis of the FOSC two-locus data set identified nine STs, including four which were novel, and nine isolates of ST 33, the previously described widespread clonal lineage. With the inclusion of eight epidemiologically unrelated ST 33 isolates, the FOSC typing scheme scored a discrimination index of 0.787. The two-locus GFSC typing scheme, which was primarily designed to identify species, received the lowest discrimination index, with a score of 0.492. The GFSC scheme, however, was used to successfully identify 17 isolates as F. verticillioides, 2 as F. sacchari, and 1 as F. guttiforme. This is the first report that F. guttiforme causes a human mycotic infection, which was supported by detailed morphological analysis. In addition, the results of a pathogenicity experiment revealed that the human isolate of F. guttiforme was able to induce fusariosis of pineapple, heretofore its only known host. PMID:20107100

  3. 基于供应链模式的医院采购流程再造与管理实践%Process Reengineering and Management Practice of Hospital Procurement Based on Supply Chain

    Institute of Scientific and Technical Information of China (English)

    金伟; 吉建伟; 郑孔林; 姜玮; 杨俊

    2011-01-01

    Hospital purchasing management based on supply chain mode is an effective management, which can ensure the normal operation of hospital, improve medical quality, reduce medical cost and increase operation benefit.System, which is accorded with morden management conception and supplier relationship, can be gradually established by the practices of strenghening supplier's management and of cooperation strategy and of optimizing purchasing process to improve procurement efficiency and decrease purchasing cost.%医院的采购管理是保障医院运行、提高运营效率、保证医疗质量、降低医疗成本的重要工作,供应链模式的采购管理是一个有效的管理模式.通过加强供应商管理与合作策略、采购流程优化采购两个方面的实践,逐步建立起符合现代管理学理念的采购流程与供应商关系管理体系,从而实现提高工作效率、降低医院成本的目的.

  4. Factores de riesgo en lesiones intraepiteliales de cuello uterino en las usuarias del Hospital Central de la Policía Nacional, año 2009 al 2010

    Directory of Open Access Journals (Sweden)

    Edith Miyeri Segura Valdés

    2012-01-01

    Full Text Available Explorar las características sociodemográficas y factores de riesgo en lesiones intraepiteliales de cuello uterino en las usuarias del Hospital Central de la Policía Nacional, año 2009 al 2010

  5. Application of continuous quality improvement in central sterilization supply department%持续质量改进在消毒供应中心的应用

    Institute of Scientific and Technical Information of China (English)

    冯鸿雁

    2011-01-01

    OBJECTIVE To apply continuous quality management mode combining the characteristics of the center of sterilization supply, to continuously improve the quality.METHODS Process management mode was adopted,efficient continuous quality control work team was established, quality evaluation system was perfected.RESULTS Various disinfection segregation indexes complied with the ministry of health "disinfect technical specification of line marking requirements".The qualified rate of monitoring asepsis items reached to 100.0%.Monitoring of the center of sterilization supply infection control work was more standardized, standard and scientific.CONCLUSION Continuous quality improvement in the center of sterilization supply has been achieved remarkable effects, and also promoted the level of nursing management.%目的 应用持续质量管理模式,结合消毒供应中心的特点,对其进行持续质量改进.方法 采用过程管理模式,建立高效持续质量控制工作团队,健全质量评价体系.结果 各项消毒隔离指标符合卫生部的行标要求,无菌物品监测合格率达100.O%,消毒供应中心的感染控制工作更规范化、标准化、科学化.结论 持续质量改进在消毒供应中心取得显著成效,提升了护理管理水平.

  6. Perioperative supply chain management.

    Science.gov (United States)

    Feistritzer, N R; Keck, B R

    2000-09-01

    Faced with declining revenues and increasing operating expenses, hospitals are evaluating numerous mechanisms designed to reduce costs while simultaneously maintaining quality care. Many facilities have targeted initial cost reduction efforts in the reduction of labor expenses. Once labor expenses have been "right sized," facilities have continued to focus on service delivery improvements by the optimization of the "supply chain" process. This report presents a case study of the efforts of Vanderbilt University Medical Center in the redesign of its supply chain management process in the department of Perioperative Services. Utilizing a multidisciplinary project management structure, 3 work teams were established to complete the redesign process. To date, the project has reduced costs by $2.3 million and enhanced quality patient care by enhancing the delivery of appropriate clinical supplies during the perioperative experience.

  7. INVESTIGATION ON SANITATION OF RURAL CENTRALIZED WATER SUPPLY OF FIVE URBAN AREAS IN LANZHOU CITY%兰州市五城区农村集中式供水卫生现状调查

    Institute of Scientific and Technical Information of China (English)

    李盛; 王金玉; 余加琳; 王宇红; 李志强

    2011-01-01

    Objective To understand the current situation of rural centralized water supply sanitation of five urban areas in Lanzhou city arid to provide scientific basis for improving water supply. Methods Sampling in spot and water quality detection were used to investigate the water quality of 25 water supply points in five rural areas. Results There were 15 points ( 60% ) without water purification and without disinfection among 25 water supply points. The qualified rate of water samples was 35% and the unqualified rate of bacteriological index was higher than that of others. The unqualified rate of total numbers of colony was 51%. Conclusion The current situation of rural centralized water supply sanitation is bad in five urban areas in Lanzhou city. Measure of water treatment should be taken and administration of drinking water should be strengthened.%目的 了解兰州市五城区农村集中式供水点水质现状,为进一步进行农村改水工作提供科学依据.方法 通过现场采样和水质检测方法,对兰州市五城区25个供水点的水质进行了调查.结果 所调查的兰州市五城区25个供水点中,有15个供水点(占60%)未进行水处理,无任何消毒设备,未进行任何方式消毒.25个供水点抽检水样水质合格率为35%,以细菌学指标超标最为严重,细菌总数超标率高达51%.结论 兰州市五城区农村集中式供水水质卫生状况较差,应限期采取水处理措施,加强居民饮用水管理.

  8. Prevalence of antimicrobial resistance in bacteria isolated from central nervous system specimens as reported by U.S. hospital laboratories from 2000 to 2002

    Directory of Open Access Journals (Sweden)

    Karlowsky James A

    2004-03-01

    Full Text Available Abstract Background Bacterial infections of the central nervous system, especially acute infections such as bacterial meningitis require immediate, invariably empiric antibiotic therapy. The widespread emergence of resistance among bacterial species is a cause for concern. Current antibacterial susceptibility data among central nervous system (CNS pathogens is important to define current prevalence of resistance. Methods Antimicrobial susceptibility of pathogens isolated from CNS specimens was analyzed using The Surveillance Database (TSN® USA Database which gathers routine antibiotic susceptibility data from >300 US hospital laboratories. A total of 6029 organisms derived from CNS specimen sources during 2000–2002, were isolated and susceptibility tested. Results Staphylococcus aureus (23.7% and Streptococcus pneumoniae (11.0% were the most common gram-positive pathogens. Gram-negative species comprised approximately 25% of isolates. The modal patient age was 1 or S. aureus from cerebrospinal fluid (CSF and brain abscesses were 29.9–32.9%. Penicillin resistance rates were 16.6% for S. pneumoniae, 5.3% for viridans group streptococci, and 0% for S. agalactiae. For CSF isolates, ceftriaxone resistance was S. pneumoniae (3.5%, E. coli (0.6%, Klebsiella pneumoniae (2.8%, Serratia marcescens (5.6%, Enterobacter cloacae (25.0%, Haemophilus influenzae (0%. Listeria monocytogenes and N. meningitidis are not routinely susceptibility tested. Conclusions Resistance is commonly detected, albeit still at relatively low levels for key drugs classes such as third-generation cephalosporins. This data demonstrates the need to consider predominant resistance phenotypes when choosing empiric therapies to treat CNS infections.

  9. ENDOGENEITY OF INDONESIAN MONEY SUPPLY

    Directory of Open Access Journals (Sweden)

    Meutia Safrina Rachma

    2011-09-01

    Full Text Available There has been a long debate about the endogeneity of money supply. The main objective of this article is to identify whether money supply in Indonesia is an exogenous or an endogenous variable. Using a Vector Autoregressive model and monthly data 1997(5-2010(6, the estimation result shows that money supply in Indonesia is an endogenous variable. The movement of broad money supply does influence the movement of base money and Consumer Price Index. Consequently, the central bank does not have control power on money supply. The bank is only able to maintain the stability and control the movement of broad money supply. Keywords: Endogenous variable, money supply, vector autoregressionJEL classification numbers: E51, E52, E58

  10. Improvement and application of centralized air supplying system for cigarette makers%卷接机组集中工艺风力系统的改造与应用

    Institute of Scientific and Technical Information of China (English)

    黄深海; 周奇峰; 马臣; 张振峰; 袁国安

    2013-01-01

    对集中工艺风力系统将风力合理分配到每台卷接机组,并根据其自身状态实现风力自动平衡进行了研究。采用PLC和PROFIBUS-DP现场总线控制技术,构建工艺风力自动平衡控制系统,确保卷接机组所需工艺风力连续、有效、稳定的供给。以贵州省某卷烟厂卷包A车间4组卷接机组构建的集中工艺风力与除尘系统平衡控制技术的应用为例,探讨了其集中工艺风力平衡经济型控制系统的构成和应用效果。通过与其它平衡控制模式的比较,得出风力平衡经济型控制系统具有一定的实用性和推广价值。%The air supplying reasonable assigned to each unit in the centralized air supplying system, and achieve homeostasis were studied according to its own state. The PLC and the PROFIBUS-DP BUS control technology has been used, which helps air supply continuously, efficaciously and stably. As the example of 4 cigarette makers in a cigarette factory in Guizhou Province, the composing and effect of economic control system of air supplying system and its uses of balance control technology in dust removal system were analyzed. Compared with other systems, it was concluded that this technology offered many advantages and it was beneficial to technology elevation in middle or small cigarette factories. It has certain practicability and popularization value.

  11. Reform Practice of Centralized Material Purchasing in Military Hospital%军队医院物资集中采购改革实践

    Institute of Scientific and Technical Information of China (English)

    卢敬飞; 宋风兵; 温亮

    2015-01-01

    深化采购制度改革,是贯彻落实军委、总部一系列决策部署的制度创新。军队医院物资采购金额大、品种多、时效强,要重点加强采购决策层、管理层、操作层的组织领导,严格采购管理,规范采购实施,完善人员、信息、档案管理配套建设,推进采购制度改革实践。%Deepening the reform of the purchasing system is one institutional innovation to implement the strategic deployment of the Central Military Commission .The material purchasing of military hospital features enor-mous amount of money , multi-species and timely .Organization and leadership of the decision level , operation level and management level should be strengthened to enhance purchasing management and standardize procurement procedure .Also improving the supporting construction including personnel , information and file management was needed , so as to actively promote the reform of procurement system .

  12. Analysis of reasons for discarding blood and blood components in a blood bank of tertiary care hospital in central India: A prospective study

    Directory of Open Access Journals (Sweden)

    Alok Kumar

    2014-01-01

    Full Text Available Background: Many modern surgical procedures could not be carried out without the use of blood. There are no substitutes for human blood. Thus, proper utilization of blood is necessary with minimal wasting. Materials and Methods: A total of 10,582 donors donated blood during the study period of 19 months in blood bank of a tertiary care hospital, central India from 1 st of November 2009 to 31 st May 2011, which were screened. Results: A total of 346 whole blood bags were discarded. Out of these 346 blood bags, 257 (74.30% were discarded because of seropositivity for transfusion transmissible infectious diseases. A total of 542 blood components were discarded against 3702 blood components prepared during the study period. Among blood components discarded, most common units were platelets. The most common cause of discarding the blood components was expiry of date due to non-utilization (87.00%. Conclusion: A properly conducted donor interview, notification of permanently deferred donors will help in discarding less number of bags from collected units. Similarly, properly implemented blood transfusion policies will also help in discarding less number of blood bags due to expiry. These discarded bags, because they are unutilized are both financially as well as socially harmful to the blood bank.

  13. Hepatitis C as a risk factor for diabetes type 2: lack of evidence in a hospital in central-west Brazil

    Directory of Open Access Journals (Sweden)

    Luce Marina Freires Corrêa da Costa

    2008-02-01

    Full Text Available In order to assess the importance of HCV infection as a possible risk factor for type 2 diabetes mellitus, a case-control study was conducted, comparing the prevalence of HCV infection among diabetic and non-diabetic patients. Diabetic outpatients attending to a University Hospital in Central-West Brazil were evaluated between April and October 2005. A control group composed by patients from the same institution was matched by gender and age. Candidates to control group were included only if fasting glucose measures were under 100 mg/dL. Diabetics and controls had blood samples taken in order to test for antibodies against HCV (anti-HCV by enzyme-immunoassay. Polymerase chain reaction and immunoblot were performed to confirm the anti-HCV status. Each group included 206 participants. Despite of the groups were in general comparable. The diabetics had a greater body mass average and smaller family income. The prevalence of confirmed anti-HCV in the diabetic group was of 1.4%, which was similar to the controls (1%. Finding statistical difference may have been hampered by the low frequency of HCV infection in both groups. It was not possible to demonstrate a role of HCV as an etiologic factor in type 2 diabetes, since HCV infected patients represented a small portion of the overall diabetes cases. This finding does not allow to recommend regular screening for HCV infection in type 2 diabetics in this region.

  14. Nursing Supplies

    Science.gov (United States)

    ... Stages Listen Español Text Size Email Print Share Nursing Supplies Page Content Article Body Throughout most of ... budget. (Nursing equipment also makes wonderful baby gifts.) Nursing Bras A well-made nursing bra that comfortably ...

  15. 减少一次性医用耗材系统性浪费的研究%The study on organizational behavior in reducing hospital disposable medical supplies of waste system

    Institute of Scientific and Technical Information of China (English)

    尚长浩; 李永生; 程俊佩; 徐海林; 王小广

    2014-01-01

    Objective:Study the current situation of the management link in extension, apply, usage, charge etc of the disposable medical supplies, find out the problems and loopholes in waste system, through the improvement of organizational behavior, targeted to solve the extensive management problems of disposable medical supplies in hospital, reduce waste, improve the level of lean management and provide the starting point for supervising of overuse. Methods:Using the method of fishbone diagram, evidence-based management etc, find out the main problem, reference the idea of lean management, raise the optimal management plan. Results:Not forming the closed loop management of the data in the application of disposable medical supplies from clinical, the second level warehouse management of clinical, the diagnosis and treatment of medical staff, the billing of patients, the leak of flow and flow direction management, existing problems and loopholes in waste and overusage supervise, optimize the current process and method redevelop of the information management software system, realizing the closed loop management. Conclusion:The design of information management software based on clinical pathway management and the optimization of management process and method which matched can realize the lean management of disposable medical supplies in hospital, help the nation's new medical reform strategic intentions.%目的:研究一次性医用耗材在医院的发放、请领、使用及收费等管理环节的现状,找出在系统性浪费上存在的问题和漏洞,通过组织行为的改进,有针对性地解决一次性医用耗材在医院传统管理中存在的问题,减少浪费,提高精益化管理水平,为使用监管提供抓手。方法:运用鱼骨图、循证管理等方法,找出主要问题,借鉴精益化管理思路,提出优化管理方案。结果:重新研发了信息化管理软件系统,并对现行的管理流程和方法进行了

  16. 检查表法在农村集中式供水系统风险评价的应用%Application of Checklist Method in Risk Assessment of Rural Centralized Water Supply System in China

    Institute of Scientific and Technical Information of China (English)

    李洪兴; 陶勇; 张荣

    2012-01-01

    目的 探讨检查表法在农村集中式供水系统进行风险评价的应用.方法 选择某省以地面水和地下水为水源的水厂各一家,依据相关的标准规范建立检查表并对两水厂进行现场检查,应用半定量评价模型对风险等级进行评价;综合考虑定性和定量评价的结果,判定“风险易发点”.结果 风险检查结果和半定量评价结果显示,两家水厂水源地均存在一定水质风险;水源的综合评价信息显示,一家水厂的水源风险等级为中度且为“风险易发点”.结论 检查法可以发现了两水厂的潜在风险并进行风险度评价;该方法简单易用,具有一定推广价值.%Objective To assess the risk of rural centralized water supply systems by using the checklist method and semi-quantitative method.Methods A water plant using surface water source and a water plant using underground water source in the same province were selected as the study objects.The sanitary inspection on these two water supply facilities was carried out by the application of Checklist developed according to the current related standards,regulations and semi-quantitative method,and the high risk points were identified based on assessment results.Results There were risk factors in the two water supply facilities,but one of the water plants had high risk in water source,with which had the high risk point.Conclusion The potential risks have been found in water source by the application of the checklist method and semi-quantitative method.The checklist method and semi-quantitative methods are simple for the risk assessment and management of rural centralized water supply system in China.

  17. Application Of Excel In Estimating Central Heating-Supply Project Investment%集中供热工程投资估算中的Excel应用

    Institute of Scientific and Technical Information of China (English)

    杨冬梅

    2012-01-01

    应用Excel计算集中供热工程的投资估算。首先创建估算的模板,再应用模板来计算具体建设规模的投资估算,其应用过程简便、快捷、准确、科学。%This paper use Excel to compute the investment of central heating project.Firstly,it create the estimating template,then used it to compute the investment estimation with specific construction scale.The application process is simple,convenient,rapid,correctly and science.

  18. Mine water supply assessment and evaluation of the system response to the designed demand in a desert region, central Saudi Arabia.

    Science.gov (United States)

    Yihdego, Yohannes; Drury, Len

    2016-11-01

    The efficient use of water resources in arid region has become highly relevant in the evaluation and mining planning, since the exploration phase to closure. The objective of the numerical groundwater model was to assess the potential for groundwater extraction to meet mine water demand from one of the driest area in the world. Numerical groundwater models were used to assess groundwater resource. Modelling was undertaken using MODFLOW-SURFACT code, an advanced MODFLOW based code, within the framework of Visual MODFLOW version 4.6. A steady state model was developed to assess the regional groundwater flow pattern and to calibrate the recharge and hydraulic conductivity parameters in the model. The model was calibrated with a correlation of coefficient of 0.997, and root-mean-squared error is 0.3 m. A transient simulation model was used to predict the impact of 1.5 million cubic metre/year extraction for 10 years on the main aquifer hydrogeological regime, including after cession of pumping. Modelling simulated four hydrogeological scenarios. Model results for the 'worst case' scenario suggested that the Saq Sandstone aquifer should be capable of supplying the mine water demand (1.5 million cubic metre (MCM)/year) for 10 years. However, the long-term water-level drawdown shows a continuous decrease without achieving steady state conditions; thus, the majority of water is being taken from aquifer storage, and in the long term, there will be a mutual interference from a borefield located to the north of the model area. In this area, the hydraulic gradient is relatively steep and over-pumped for more than 28 years. Other scenario shows that there will be a recovery of around 8 m out of the 11.6-m drawdown, after 18 years of cession of pumping, implying that the aquifer will be stressed and a large percentage of water taken from aquifer storage. To minimise hydrogeological impacts, it is recommended to laterally spread out production bores, bores should be located

  19. 细节管理在医院消毒供应室中的应用效果%Application effect of detail management on nursing work in the hospital sterile supply room

    Institute of Scientific and Technical Information of China (English)

    张陵娣

    2013-01-01

    Objective To investigate the effect of detail management on nursing work in the hospital sterile supply room.Methods The detail management was used in nursing work in the sterile supply room from January 2012 to January 2013,and 120 medical staff were randomly selected in this study.The questionnaire survey was implemented before and after the implementation of detail management on nursing work,and the changes of medical staff satisfaction and nursing quality were compared before and after the implementation of detail management on nursing work.Results The medical staff satisfaction rate was 95.00% after the implementation of detail management on nursing work in the hospital sterile supply room,which was higher than 82.50% of pre-implementation,and the difference was statistically significant (x2 =11.41,P < 0.05).The scores of service awareness,error prevention awareness and safety awareness in medical staff were (93.34 ±10.46),(91.57 ± 11.63) and (90.35 ± 10.52) after the implementation of detail management,respectively,which were significantly higher than before the implementation of (81.34 ± 9.62),(80.03 ± 9.38) and (76.63 ± 4.37),respectively,and these differences were statistically significant between before and after the implementation of detail management (t =7.31,6.15,6.06,respectively; P < 0.05).The pass rate of monitoring work after the implementation of detail management was 100%,which was higher than 91% of preimplementation,and the difference was statistically significance (x2 =10.31,P < 0.05).Conclusions The application of detail management in nursing work in the hospital sterile supply room can effectively improve the quality of hospital nursing and medical staff satisfaction.%目的 探讨医院消毒供应室护理中融入细节管理的工作效果.方法 2012年1月至2013年1月在消毒供应室护理中融入细节管理,随机选取120名医务人员进行研究,分别在护理措施实施前后对其进行问卷调查.

  20. Establishment of quality target assessment of drug supply center in our hospital%我院药品供应中心质量目标制定及考核

    Institute of Scientific and Technical Information of China (English)

    杨晓敏; 唐莉华; 袁进

    2011-01-01

    Objective To approach the methods for improving the rate of drugs consistent with the account book, rate of drugs turnover and ensure timely supply of drugs in hospital pharmacy. Methods SO9001 quality management system concept and single -species management were applied to set number of varieties of cargo space. Results and Conclusion The rate of drug consistent with the account book was improved, the amount of inventory of drugs were reduced, and the drug turnover was speed up.%目的 探讨提高医院药房药品帐物相符率、加快药品周转、保障药品及时供应的方法和途径.方法 运用ISO9001质量管理体系的理念,采用单品种管理方法,设置药品货位号.结果与结论 提高了药品帐物相符率,降低了药品库存金额,加快了药品周转.

  1. Clinico-radiological profile and outcome of dengue patients with central nervous system manifestations: A case series in an Eastern India tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Souren Pal

    2016-01-01

    Full Text Available Background and Objective: Dengue, an acute viral disease, transmitted by Aedes mosquitoes, has a variable clinical spectrum ranging from asymptomatic infection to life-threatening dengue hemorrhagic fever and dengue shock syndrome. However, neurological complications, in general, are unusual but have been observed more frequently in the recent past, and some studies highlighted varied neurological complications during the course of illness. Although dengue is classically considered a nonneurotropic virus, there is increasing evidence for dengue viral neurotropism. In this study, we have evaluated clinico-radiological profile and outcome of nine serologically confirmed dengue patients having varied manifestations of central nervous system (CNS involvement. Materials and Methods: All the consecutive patients presented with neurological complications with positive serology for dengue infection (IgM positivity in Department of Medicine, in a tertiary care hospital in Eastern India from August 2013 to October 2014 were included in the study. These patients were subjected to a detailed clinical evaluation, laboratory assessment including complete hemogram, coagulation profile, liver function test, serum electrolytes, and routine CSF (Cerebrospinal Fluid study with the exclusion of other common neuroinvasive pathogens. Results: Out of 9 patients with neurological complications associated with confirmed dengue infection, 2 (22% patients had dengue encephalopathy, 5 (56% patients have dengue encephalitis, 1 (11% patient had dengue meningitis, and 1 (11% patient had postdengue immune-mediated CNS involvement. Conclusion: This case series reaffirms the occurrence of varied CNS manifestations in dengue virus infection and underlines the importance of inclusion of dengue in the differential diagnosis of acute encephalitis syndrome.

  2. 消毒供应中心(室)人力资源配置与管理研究进展%Research progress of human resource allocation and management in central sterli e supply depar tment

    Institute of Scientific and Technical Information of China (English)

    钱小芳; 刘桂华(综述)

    2015-01-01

    [ Absrt act] In order to provide basis for allocating and managing nursing human resources reasonably in central sterile supply department ( CSSD) , we expatiated some relevant concepts of human resource management, reviewed the current situation of human resource allocation and management at home and abroad and predicted prospect of the re-search trend.%阐述人力资源管理相关概念,综述国内外消毒供应中心(室)人力资源配置与管理现状,并展望消毒供应中心人力资源配置与管理研究的趋势,以期为合理配置及管理人力资源提供参考。

  3. Inventory Routing Problem in VMI & TPL Supply Chain under Centralized Control%集中控制VMI&TPL模式下的库存运输集成问题

    Institute of Scientific and Technical Information of China (English)

    汤中明

    2013-01-01

    A supply chain composed of many vendors, one third-party logistics (TPL) , and one manufacturer is addressed. It assumes that, in such a supply chain, it integrates vendor-managed inventory ( VMI) and TPL. For such a supply chain, inventory routing problem under centralized control is studied. How to make the decision of replenishing and vehicle routing plan for suppliers and TPL is a challenging problem. Based on rolling plan period, a new inventory routing model is developed. With the NP-complete nature of the inventory routing problem, a four-step heuristic algorithm based on simulated annealing is presented. The feasibility and effectiveness of the proposed heuristic algorithm is testified by a numerical example.%以“多供应商,单TPL,单制造商”供应链网络为研究环境,研究了集中控制VMI&TPL模式下的库存运输集成优化问题,旨在为供应商和TPL提供补货决策和车辆路线计划.基于滚动计划期,构建了库存运输集成计划模型.鉴于该模型问题是一个NPC问题,提出了基于模拟退火遗传算法的四步骤启发式算法.算例分析结果表明该启发式算法是有效可行的.

  4. 消毒供应中心落实优质护理服务的实践%The practice and effect evaluation of high quality nursing service mode in Central Sterile Supply Department

    Institute of Scientific and Technical Information of China (English)

    刘启华; 郭健

    2011-01-01

    Objective: To explore high quality nursing service mode in Central Sterile Supply Department. Methods: We trained nursing staff by standardized nursing service communicating skills, strengthened the whole department with nursing culture construction,optimized nursing service flow with the center of service objects and implemented high quality nursing service measures. Results: The satisfaction of wards, outpatient clinics,surgical departments were obviously improved (P < 0.01). Conclusion: High quality nursing service mode in Central Sterile Supply Department effectively improves the satisfaction of wards, outpatient clinics and surgical department, mobilizes the enthusiasm and creativity of nursing staff and improves nursing service quality and credibility.%目的:探讨消毒供应中心优质护理服务模式,提升护理服务品质.方法:对工作人员实行规范化护理服务沟通培训,加强科室护理文化建设,以服务对象为中心优化护理服务流程,落实优质护理服务举措.结果:病房、门诊、手术科室满意度提高(P<0.01).结论:消毒供应中心优质护理服务模式有效提高了病房、门诊,手术科室的满意度,调动了工作人员的积极性和创造性,提高了护理工作质量,提升了消毒供应中心护理服务品质及诚信度.

  5. Accuracy and time requirements of a bar-code inventory system for medical supplies.

    Science.gov (United States)

    Hanson, L B; Weinswig, M H; De Muth, J E

    1988-02-01

    The effects of implementing a bar-code system for issuing medical supplies to nursing units at a university teaching hospital were evaluated. Data on the time required to issue medical supplies to three nursing units at a 480-bed, tertiary-care teaching hospital were collected (1) before the bar-code system was implemented (i.e., when the manual system was in use), (2) one month after implementation, and (3) four months after implementation. At the same times, the accuracy of the central supply perpetual inventory was monitored using 15 selected items. One-way analysis of variance tests were done to determine any significant differences between the bar-code and manual systems. Using the bar-code system took longer than using the manual system because of a significant difference in the time required for order entry into the computer. Multiple-use requirements of the central supply computer system made entering bar-code data a much slower process. There was, however, a significant improvement in the accuracy of the perpetual inventory. Using the bar-code system for issuing medical supplies to the nursing units takes longer than using the manual system. However, the accuracy of the perpetual inventory was significantly improved with the implementation of the bar-code system.

  6. Hospitalized Patients and Fungal Infections

    Science.gov (United States)

    ... These types of infections are called healthcare-associated infections (HAIs). Hospital staff and healthcare providers do everything they can ... IV tube) can increase your risk for fungal infection. During your hospital stay you may need a central venous catheter, ...

  7. [Application of supply chain integration management of medical consumables].

    Science.gov (United States)

    Zhang, Jian

    2013-07-01

    This paper introduces the background, the content, the information management system of material supply chain integration management and the consumables management process. The system helps to expand the selection of hospital supplies varieties, to reduce consumables management costs, to improve the efficiency of supplies, to ensure supplies safety, reliability and traceability.

  8. PDCA循环在消毒供应中心质量持续改进中的应用%Application of PDCA cycle in continuous quality improvement of central sterile supply department

    Institute of Scientific and Technical Information of China (English)

    陈洁; 李淑君; 李燕妮; 秦建; 翟智超; 董海蛟; 王聪

    2013-01-01

    OBJECTIVE To explore the application of PDCA cycle management mode in continuous quality improvement of the central sterile supply department and further strengthen the central sterile supply quality management so as to ensure zero defect of the sterile supplies.METHODS The quality control management team was established,the PDCA cycle management responsibility system was implemented,the PDCA cycle management approach was employed to set up the key points of the quality control,the PDCA cycle improvement program was developed to constantly improve the systems; the PDCA group was implemented the PDCA cycle management mode in Nov 2011,while the control group was not implemented the PDCA cycle management mode from Nov 2010 to Oct 2011,there were 96 pieces of data in each group,then the satisfaction rate was compared between the two groups.RESULTS After the implementation of the PDCA cycle management mode,the satisfaction rate of the clinical departments was 97.9% in the PDCA group,significantly higher than 91.7% of the control group,the difference was significant(P<0.05); the qualified rates of the hand hinge,monitoring of disinfectant concentration,cleaning and disinfection of surgical equipments,cleaning and disinfection of pipelines,rust removal,sterile supplies of the PDCA group were respectively 99.0%,95.5%,98.0%,97.5%,97.0%,and 100.0%,significantly higher than those of the control group (P<0.05).CONCLUSION Through the application of PDCA cycle management model and the implementation of comprehensively continuous quality improvement,the overall quality of the CSSD staff,service quality,and quality of the sterile supplies have been substantially improved.%目的 探索PDCA循环管理模式在消毒供应中心(CSSD)质量持续改进中的应用,进一步加强CSSD质量管理,保证无菌物品供应零缺陷.方法 成立质量控制管理小组,实行PDCA循环管理责任制,运用PDCA循环管理方法设定质控重

  9. 2009年昆山市集中式区域供水水质现况调查%Investigation on Water Quality of Centralized Regional Water Supply in Kunshan City in 2009

    Institute of Scientific and Technical Information of China (English)

    蔡见远

    2011-01-01

    目的 了解昆山市集中式供水(区域供水)的水质现况.方法 按照(GB/T 5750-2006)对2009年昆山市集中式供水单位水源水、出厂水、末梢水进行水质检测、分析.结果 2009年共采集水样258份,合格253份,样品合格率99.2%.共检测5 990个项次,合格项次5 982个,项次合格率99.9%.其中水源水和出厂水样品合格率均为100%,末梢水样品合格率为97.5%.对末梢水不合格项目菌落总数和游离余氯按照监测点级别不同进行方差分析,市级及镇级游离余氯含量较高,菌落总数较低;村级余氯含量较低,菌落总数相对较高,甚至不达标.结论 昆山市区域供水水质稳定、合格率高,特别是大大提高了农村饮用水水质状况.但也存在着整个供水管网游离余氯含量分布不均的现象,建议市自来水集团公司根据存在问题及时改进水处理工艺,进一步提高供水水质.%[ Objective ] To understand the water quality of centralized water supply (regional water supply) in Kunshan city.[ Methods] According to the Standard examination methods for drinking water ( GB/T 5750 - 2006 ), the water quality of source water, finished water and tap water of centralized water supply system in Kunshan city in 2009 was tested and analyzed. [ Results ] Among 259 water samples collected in 2009, 253 samples were qualified, and the qualified rate was 99.2%. 5 990 items (times)were detected, 5 982 items ( times ) were qualified with the qualified rate of 99.9%. The qualified rates of source water and finished water were 100% , and that of tap water was 97.5%. Variance analysis was applied toward the unqualifiod indexes of total bacteria count and free residual chlorine according to levels of monitoring points. At city and town level, the content of free residual chlorine was high, and total bacteria count was low. At village level, the content of free residual chlorine was low, and total bacteria count was high, which even did not

  10. Microbial contamination of central supply systems for medical air Contaminação microbiana dos sistemas centrais de abastecimento de ar medicinal

    Directory of Open Access Journals (Sweden)

    Carolina Machado Andrade

    2003-11-01

    Full Text Available There are many standards and recommendations for breathing air quality associated with respiratory protection equipment, but little has been done regarding the possible microbial contamination of medical air. The present study demonstrates quantitatively and qualitatively that pipelines might be incriminated as source of microbial contamination of compressed and synthetic air for medical use. Air samples were drawn into an especially pressure-resistant device and the bacterial and fungi contents were identified after growth on agar plates. The bacterial flora isolated from peripheral air outlets was virtually the same as that found in the central air-generating installations, consisting of a mixture of pathogens and normal skin bacteria. Several factors contributing to microbial contamination of medical air are mentioned and preventive measures are discussed.Existem vários padrões e recomendações para a qualidade do ar respirável relacionado aos equipamentos de proteção respiratória, mas pouco tem sido feito em relação a uma possível contaminação microbiana do ar medicinal. O presente trabalho demonstra quantitativa e qualitativamente que as linhas de ar estão relacionadas à contaminação microbiológica do ar comprimido e ar sintético para uso medicinal. Amostras de ar foram coletadas por um equipamento especialmente resistente a pressão, e o conteúdo bacteriano e fúngico foi identificado após crescimento em placa. A flora bacteriana isolada tanto dos sistema periféricos de ar foi virtualmente a mesma encontrada nas instalações centralizadas, sendo uma mistura de patógenos e bactérias normais da pele. Vários fatores contribuintes para a contaminação microbiana do ar medicinal e medidas preventivas são discutidas.

  11. Study on Risk Management Plans Based on the Hospital Drugs Supply Chain%基于医院药品供应链的风险管理计划研究

    Institute of Scientific and Technical Information of China (English)

    杨晨; 黄海

    2011-01-01

    目的:为尽可能地控制药品供应链流程中的各类风险因素,确保药物治疗的有效性和安全性提供参考.方法:制定风险管理计划,即识别医院药品供应链中各风险事件的发生环节、涉及范围等情况,对涉及范围广的10个风险事件进行可能性、影响力、可控性分析与评估,制定应对措施.结果与结论:风险发生环节有采购、储藏、调配、使用、高危药品管理5处.涉及范围广的10个风险事件发生可能性程度不一,影响力均在中等及以上,可控性由一般到强不等;风险优先级以采购与调配环节优先,储藏环节次之.通过建立责任矩阵、加强沟通协调、加强软硬件建设、着重人力资源管理等措施,可较好地控制风险.%OBJECTIVE: To provide reference for controlling risk factors of drug supply chain as much as possible, and to guarantee the effectiveness and safety of drug therapy. METHODS: Risk management plan was designed, I.e. Identifying the risk event links and range of hospital drugs supply chain, analyzing and evaluating the possibility, impact and controllability of the wide range of 10 risk events, making intervention measures. RESULTS & CONCLUSIONS: Risk events usually happen in links of purchase, storage, distribution, application and high risk drug management. The possibilities of wide range of 10 risk events are different and their impacts are in medium level or above. The controllability degrees of them are common to strong. Risk management gives priority to purchase and distribution, following by storage. Risk can be controlled effectively by establishing responsibility matrix, strengthening communication and coordination, enhancing software and hardware construction, emphasizing human resource management, etc.

  12. 浅谈现代医院物资供应链中二级库管理%Grade Ⅱ Storehouse Management in Material Supply Chains of the Modern Hospital

    Institute of Scientific and Technical Information of China (English)

    李维嘉; 张雷; 钱建国; 吴正灏

    2016-01-01

    The promotion of Grade Ⅱ storehouse in the hospital makes the management of products supply chain more perfect and realizes full-round tracking from the warehouse to the department and from the department to the patient, which provided a powerful data support for accounting management. The function of the Grade Ⅱ storehouse adopted modular design, including department requirement management, Grade Ⅱ storehouse management, comprehensive business queries, statistics report, and basic data maintenance. Moreover, personalized management of Grade Ⅱ storehouse was realized and code management, intelligent reminder function and integration of multi-system interface was developed according to different clinical requirements. In order to realize the medical products elaborating management and zero inventory, modern methods and Grade Ⅱ storehouse management should be adopted to continuously optimize the material supply chain.%二级库管理的推广使得医院在物资供应链上的管理更加全面,完成了从库房到科室、从科室到病人的全跟踪。为核算管理提供了有力的数据支持。二级库管理系统的功能采用模块化设计,包括科室需求管理、二级库管理、综合业务查询、报表统计、基础数据维护。此外实现二级库个性化管理,根据不同临床需求开发一物一码管理、智能化提醒功能和多系统界面整合。用现代化手段和二级库管理不断优化物资供应链,实现医疗物资精细化管理、“零库存”目标。

  13. The supply chain and clinical quality.

    Science.gov (United States)

    Runy, Lee Ann

    2005-03-01

    Improving quality of care has become a major consideration when it comes to buying supplies. Here's how leading-edge hospitals are changing the process, including adding clinicians to their buying staffs and standardizing how they choose and use products.

  14. 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.

  15. Teleconnected food supply shocks

    Science.gov (United States)

    Bren d'Amour, Christopher; Wenz, Leonie; Kalkuhl, Matthias; Steckel, Jan Christoph; Creutzig, Felix

    2016-03-01

    The 2008-2010 food crisis might have been a harbinger of fundamental climate-induced food crises with geopolitical implications. Heat-wave-induced yield losses in Russia and resulting export restrictions led to increases in market prices for wheat across the Middle East, likely contributing to the Arab Spring. With ongoing climate change, temperatures and temperature variability will rise, leading to higher uncertainty in yields for major nutritional crops. Here we investigate which countries are most vulnerable to teleconnected supply-shocks, i.e. where diets strongly rely on the import of wheat, maize, or rice, and where a large share of the population is living in poverty. We find that the Middle East is most sensitive to teleconnected supply shocks in wheat, Central America to supply shocks in maize, and Western Africa to supply shocks in rice. Weighing with poverty levels, Sub-Saharan Africa is most affected. Altogether, a simultaneous 10% reduction in exports of wheat, rice, and maize would reduce caloric intake of 55 million people living in poverty by about 5%. Export bans in major producing regions would put up to 200 million people below the poverty line at risk, 90% of which live in Sub-Saharan Africa. Our results suggest that a region-specific combination of national increases in agricultural productivity and diversification of trade partners and diets can effectively decrease future food security risks.

  16. Application of visual management flow diagram in management of central sterile supply department%目视流程图解在提高消毒供应室管理中的应用

    Institute of Scientific and Technical Information of China (English)

    赵卫萍; 张红超; 庹琨明; 杨涛; 孟玲; 李环

    2015-01-01

    OBJECTIVE To improve the scientific management of central sterile supply department and work quality through the visual management flow diagram .METHODS The visual flow management team was established to de‐velop the visual flow diagram and organize all the staff to learn the concepts ,requirements ,and contents of the visual management flow diagram ,which was served as one of the onsite management modes and was applied for the management of the instruments ,infection control ,and instrument packages .RESULTS As compared with the qualified rate of the instruments in Jul-Sep ,2013 ,it was increased in Jul-Sep ,2014 .The qualified rate of quali‐ty examination of instruments was 97 .57% in 2013 ,99 .75% in 2014 ;the qualified rate of number of instrument packages was 95 .21% in 2013 ,99 .55% in 2014 ;the qualified rate of infection control was 94 .00% in 2013 , 98 .49% in 2014 ;the qualified rate of timely supply of instruments was 95 .80% in 2013 ,99 .44% in 2014 . CONCLUSIONS The visual flow diagram can achieve significant effect on actual management of the central sterile supply department ,raise the work quality and efficiency of the departments ,and make the work flow of the supply department standardized ,the quality control and teaching training visualized;it is a visualized ,high‐efficiency flow management mode .%目的:通过目视流程图解在消毒供应室中的应用,提高供应室科学化管理水平和工作质量。方法科室成立目视流程管理小组,制作目视流程图解,组织全科人员学习目视管理流程图解的概念、要求和内容,将其作为现场管理的模式之一,应用于仪器设备、感染控制、器械包管理。结果器械合格率2013年7-9月与2014年7-9月相比均有提高,其中器械质量检查、器械包装数量、感染控制、器械及时供应等合格率,2013年分别为97.57%、95.21%、94.00%、95.80%;2014年分别为99.75%、99.55%、98

  17. 兰州市农村集中式供水卫生现状调查%Actuality of Sanitation of Centralized Water Supply in Rural Areas in Lanzhou,Gansu

    Institute of Scientific and Technical Information of China (English)

    王金玉; 李盛; 余加琳; 李志强

    2011-01-01

    Objective To know the actuality of sanitation of centralized water supply in rural areas in Lanzhou,Gansu.Methods A survey on the basic conditions (type of water resources,way of water treatment, disinfection,et al) were conducted in 86 rural centralized water supply sites in Lanzhou,and the samples of water sources and tap water were collected in dry season (March to April) and rainy reason (July to August) were analyzed from 2008 to 2010. Results The qualified rate of water samples was 33.4% (115/344). The rate of water samples in rainy season was siguificantly lower than that in dry season (P<0.01), no significant difference was seen in qualified rate between finished water and tap water, pH value, Fe, Mn, As and F were all qualified,and 14 indexes including turbidity and so on were all disqualified. The qualified rate of total numbers of colony was the lowest (50.3%). The qualified rates of total numbers of colony and total coli group in rainy season were all lower than those in dry season (P<0.01). Conclusion Severe microbe contamination is a critical problem in centralized water supply in the rural areas in Lanzhou,which should be paid more attention to.%目的 为了解兰州市农村集中式供水的卫生现状.方法 于2008-2010年对兰州市农村集中式供水点的基本情况(如水源类型、水处理方式、消毒情况等)进行现场调查,并采集枯水期(3-4月)和丰水期(7-8月)出厂水和末梢水水样进行水质检测分析.结果 共采集水样344件,合格115件,合格率为33.4%(115/344).丰水期农村集中式供水水样合格率低于枯水期(P<0.01),末梢水与出厂水合格率间差异无统计学意义.除pH值、铁、锰、砷、氟化物指标均合格外,浑浊度等14项指标均超标.菌落总数合格率最低(50.3%).丰水期水样中菌落总数、总大肠菌群指标的合格率均低于枯水期(P<0.01).结论兰州市农村集中式供水水质微生物污染严重.

  18. Operation Characteristics of Ground Source Heat Pump for Centralized Hot Water Supply in High-rise Buildings%地源热泵用于高层建筑集中供热水的运行特性

    Institute of Scientific and Technical Information of China (English)

    王艳; 胡映宁; 林俊

    2012-01-01

    unit energy efficiency ratio and the system energy efficiency ratio were 4. 8 and 4. 3. The annual power consumption for supplying hot water was 11. 13 kW · h/m3, and the power savings were 74. 69% and 24% compared with electric boiler heating and solar electric heating. It is concluded that ground source heat pump for centralized water supply in high-rise buildings has remarkable energy savings.

  19. Finding gold in the supply chain.

    Science.gov (United States)

    Caudle, Allen

    2009-12-01

    To optimize supply chain performance and achieve savings that enhance the bottom line, hospitals should: Generate purchase orders for every item purchased. Ensure the organization is protected from undue vendor influence. Keep track of where supply chain dollars are going. Review contracts regularly to ensure competitiveness. Have a contract for each product category. Buy only what the organization is sure to use. Get rid of excess inventory. Develop a strategic plan for continued supply chain savings.

  20. 荆州市中心医院新一代HIS系统建设分析%Construction about A New Generation of HIS in Jingzhou Central Hospital

    Institute of Scientific and Technical Information of China (English)

    巴江波; 董卫国; 汤绍迁

    2011-01-01

    目的 通过对医院信息系统及网络结构的分析,以及通过新一代HIS系统的建设,探索地市级医院建立数字化医院的模式与途径.方法 ①通过对医院现有硬软件系统情况的调查,实地或通过资料调研全国部分数字化示范医院,提出对本院数字化医院的模型和规划.通过对HIS系统组成和软件选择的分析.提出"长远规划,分步实施,不断完善"的医院实施数字化的原则.及各阶段的内容和目标;②通过对医院网络结构的整体分析规划,完善医院网络安全体系,建立医院完整合理的有线及无线综合网络系统.结论 新一代HIS系统的建设和完善医院网络体系提高了医院数字化应用水平,提高了工作效率和病人的满意度.%Objective Through the analysis of hospital information sistem and the network structure, and trough the construction of a new generation of HIS, to explore the mode and approach of digital hospital.Methods a. Through the situation investigation of hospital existing hard software system,we put forward mode and programme of digital hospital. Trough analysis of HIS structure and software, we put forward the principle and objectives of digital hospital.b.Through programme analysis of hospital network structure, we perfected the hospital network security system, and constructed a integral and reasonable network system.Conclusion The new generation of HIS system and the consummation hospital network system have raised the hospital digitization application level,and enhanced the working efficiency and patient's degree of satisfaction.

  1. On the Design of Centralized Water Supply Station in the Jiangguanchi Town Xinji Village of Henan Xuchang%河南许昌将官池镇新集村集中供水站设计浅议

    Institute of Scientific and Technical Information of China (English)

    邢小会

    2014-01-01

    In order to improve the benefit the masses living environment and living conditions, the more urgent the rural drinking water project. After the implementation of rural dri-nking water project, take corresponding measures of soil and water conservation, not only to control soil erosion, more can restore and improve the benign ecological environment, prom-ote rural economic development. In this paper, taking the act-ual project as the example, it discusses the feasibility of centr-alized water supply in rural areas.%为改善了受益群众的生存环境、生活条件,农村饮水项目日趋紧迫。农村饮水项目实施后采取相应水土保持措施,不仅能治理水土流失,更可以恢复和健全良性生态环境,促进农村的经济发展。本文以实际工程为例,探讨农村集中供水的可行性。

  2. The Use of the Peripherally Inserted Central Catheter (Picc in the Hospital Environment La utilización del catéter central de inserción periférica (CCIP en el ambiente hospitalario A utilização do cateter central de inserção periférica (CCIP no ambiente hospitalar

    Directory of Open Access Journals (Sweden)

    Graziella Gasparotto Baiocco

    2010-12-01

    Full Text Available The study aimed to analyze the history of the use of the peripherally inserted central catheters in adult patients admitted to hospital from 2000 to 2007. The historical cohort approach was used with retrospective data collection from medical records of the Catheter Group of the Moinhos de Vento Hospital Association in Porto Alegre, RS, totaling 229 catheters inserted. The growth curve in the use of the PICC was from 1 catheter inserted in 2000 to 57 in 2007. The most prevalent pathology was oncology (17.9%, n=41. In relation to the indications of use, antibiotic use prevailed (54.1%, n=124. In the radiological confirmation the vena cava was prevalent (68.1%, n=156. The use of the PICC in the hospital environment is expanding and nursing has a fundamental role in its insertion, maintenance and removal.El estudio objetivó analizar el histórico de la utilización del catéter central de inserción periférica en pacientes adultos e internados en ambiente hospitalario de 2000 a 2007. Tuvo abordaje de cohorte histórico con recolección de datos retrospectivo en fichas del Grupo de Catéteres de la Asociación Hospitalaria Molinos de Viento en Porto Alegre, RS, totalizando 229 catéteres inseridos. La curva de crecimiento en la utilización del CCIP fue de 1 catéter inserido en 2000 a 57 inseridos en 2007. La prevalencia inherente a la patología fue oncológica (17,9%, n=41. En relación a las indicaciones de uso prevaleció la terapia con antibióticos (54,1%, n=124. En la confirmación radiológica la vena cava fue prevalente (68,1%, n=156. La utilización del CCIP en el ambiente hospitalario está en expansión y la enfermería tiene un papel fundamental en la inserción, manutención y remoción.O estudo objetivou analisar o histórico da utilização do cateter central de inserção periférica em pacientes adultos e internados, em ambiente hospitalar, de 2000 a 2007. Teve abordagem de coorte histórica, com coleta de dados retrospectiva em

  3. Hospitals; hospitals13

    Data.gov (United States)

    University of Rhode Island Geospatial Extension Program — Hospital Facilities information was compiled from several various sources. Main source was the RI Department of Health Facilities Regulation database, License 2000....

  4. 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...

  5. Central venous catheter-related blood stream infection rate in critical care units in a tertiary care, teaching hospital in Mumbai

    Directory of Open Access Journals (Sweden)

    K Chopdekar

    2011-01-01

    Full Text Available Blood stream infections related to central venous catheterization are one of the major device-associated infections reported. Patients admitted in critical care units requiring central venous catheterization and presenting with signs of septicemia during catheterization period were investigated for catheter-related blood stream infections (CRBSI. The CRBSI rate was 9.26 per 1000 catheter days in general with highest rate in neonatal intensive care unit (27.02/1000 days. Site of insertion of catheter and duration of catheterization did not show the influence on the CRBSI rate. Coagulase-negative Staphylococci were the predominant cause. Mortality of 33% was observed in patients with CRBSI. Since central venous catheters are increasingly being used in the critical care, regular surveillance for infection associated them are essential.

  6. 生活饮用水应急集中处理设备在洪涝灾区模拟应用研究%RESEARCH ON THE EMERGENCY CENTRAL FILTRATE WATER SUPPLY EQUIPMENT IN SIMULATED FLOOD AREA

    Institute of Scientific and Technical Information of China (English)

    李进; 班海群; 张流波; 彭品章; 叶恒平; 赵淑军; 边三才; 付宏刚

    2012-01-01

    Objective To evaluate the decontamination efficacy of the Emergency Central Filtrate Water Supply Equipment (ECFWSE) in field study. Methods By sampling inspection and filed application, the decontamination efficacy of ECFWSE on river and ditch water was evaluated. Results The microbe, physical and chemical indioes of treated water by two kinds of ECFWSE met Standards for Drinking Water Quality and the treated water was accepted preferably by local residents. Conclusion The two kinds of ECFWSE can eliminate microbes, physical and chemical pollutants and can be used at flood area.%目的 观察生活饮用水应急集中处理设备在洪涝灾区现场处理效果.方法 通过现场实际应用和抽样检测方法,对饮用水应急集中处理设备处理沟渠和河水的效果进行了评价.结果 使用两种应急水处理设备处理的沟渠水和河水,可使水中微生物指标和理化指标达到生活饮用水标准要求.多数灾区居民对处理后的水可接受性较好.结论 所试验的两种饮用水应急集中处理设备可在洪涝灾区使用,并有效消除水源水微生物和化学污染物.

  7. 医院中央空调低碳节能技术的改造措施%Remodeling steps of low carbon energy technology saving for central air conditioning in hospital

    Institute of Scientific and Technical Information of China (English)

    李静; 王金荣; 冯凯林; 郭善水; 邓泽江

    2016-01-01

    Through the analysis of building energy saving at home and broad, we conduct research to explore effective ways of managing, running and energy saving for hospital central air conditioning. With the rapid development of the national economy, building energy consumption has proportionally increased compared to the overall energy consump-tion cost; the share of building energy saving development in China is gradually increasing to compensate for the in-creased energy consumption cost. Effective management of energy saving for central air conditioning will directly influ-ence the realization of building energy-saving goals. After upgrading central air conditioning with low carbon energy and constructing automation systems in hospital, we can save significant amount of money each year and reduce operat-ing costs for the hospital, providing support for a virtuous growth cycle in the long-term development of the hospital.%通过对国内外建筑节能情况分析,掌握现代建筑节能的切入点,结合医院中央空调设备、运行、管理进行节能研究。随着国民经济的飞速发展,建筑能耗占整个能耗的比例逐渐提高,建筑节能在我国的可持续发展中所占比重也在逐渐加大,中央空调设备运行效率的高低、运行策略的好坏都直接影响着能否实现建筑节能的目标。医院中央空调低碳节能与楼宇自控系统升级改造工程完成后,可以为医院每年节约可观的资金,降低医院的运营成本,为医院的良性循环与长远发展提供支持与帮助。

  8. 平衡计分卡在军队中心医院医疗成本控制中的应用%Implementation of Balanced Scorecard in Cost Control of Military Central Hospitals

    Institute of Scientific and Technical Information of China (English)

    刘乐斌; 周赤龙; 陈俊国; 李瑛; 王方芳; 陈虹

    2011-01-01

    将平衡计分卡运用到军队中心医院成本管理中,从财务、患者、内部流程、学习与成长4个维度将军队医院成本控制这一战略目标转变为可衡量的目标和方法,建立起平衡计分卡医院成本控制评价指标体系.有效增加了医院总收入.降低了成本,医院市场竞争活力明显增强.%The application of balanced scorecard in military central hospital cost control effectively increased the total income and reduced the medical cost, and significantly enhanced hospital medical market competition activity, by means of changing strategic management into measurable goal from four dimensions, which were financial, patients,internal processes, learning and growth, in order to establish key performance indicator of military hospital cost control.

  9. Hospital Compare

    Data.gov (United States)

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

  10. HCAHPS - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  11. The application of hospitality elements in hospitals.

    Science.gov (United States)

    Wu, Ziqi; Robson, Stephani; Hollis, Brooke

    2013-01-01

    In the last decade, many hospital designs have taken inspiration from hotels, spurred by factors such as increased patient and family expectations and regulatory or financial incentives. Increasingly, research evidence suggests the value of enhancing the physical environment to foster healing and drive consumer decisions and perceptions of service quality. Although interest is increasing in the broader applicability of numerous hospitality concepts to the healthcare field, the focus of this article is design innovations, and the services that such innovations support, from the hospitality industry. To identify physical hotel design elements and associated operational features that have been used in the healthcare arena, a series of interviews with hospital and hotel design experts were conducted. Current examples and suggestions for future hospitality elements were also sought from the experts, academic journals, and news articles. Hospitality elements applied in existing hospitals that are addressed in this article include hotel-like rooms and decor; actual hotels incorporated into medical centers; hotel-quality food, room service, and dining facilities for families; welcoming lobbies and common spaces; hospitality-oriented customer service training; enhanced service offerings, including concierges; spas or therapy centers; hotel-style signage and way-finding tools; and entertainment features. Selected elements that have potential for future incorporation include executive lounges and/or communal lobbies with complimentary wireless Internet and refreshments, centralized controls for patients, and flexible furniture. Although the findings from this study underscore the need for more hospitality-like environments in hospitals, the investment decisions made by healthcare executives must be balanced with cost-effectiveness and the assurance that clinical excellence remains the top priority.

  12. 区域化消毒供应存在的问题与对策%Problems and strategies of regional sterilization and disinfection in central sterile supply department

    Institute of Scientific and Technical Information of China (English)

    梁飞凤; 宋利芬; 曾苑

    2013-01-01

    目的 保证区域化消毒供应中心供应的无菌物品质量安全,推动区域化消毒供应的良性发展.方法 对某区域化消毒供应中心处理的22所医疗机构61 750件使用后可重复使用医疗器械,分成A组(湿性保存)和B组(干燥保存),比较两组医疗器械的锈蚀率,并对其清洗、包装、运送、存放问题实施纠偏措施.结果 A组医疗器械锈蚀率为11.71%(3 835/32 760),显著高于B组的锈蚀率0.54%(156/28 990),差异有统计学意义(χ2= 244.10,P<0.01).通过1年多的培训学习和改进,各医疗机构工作人员对区域化消毒供应的满意率达 90.91%(20/22),显著高于培训前的45.45%(10/22),差异有统计学意义(χ2=13.26,P<0.01).无纺布或纸塑包装材料较全棉布成本低、有效期长.结论 区域化消毒供应管理过程中持续质量改进,能保证供应物品质量和医疗安全,提高医疗机构的经济效益和社会效益.%Objective To ensure the quality safety of sterile products in regional central sterile supply department (CSSD) , and promote smooth development of CSSD. Methods 61 750 pieces of reusable medical instruments from 22 medical institutes which treated in a regional CSSD were divided into group A(moisture store) and group B(dry store); the rusting rate between two groups was compared, and problems in cleaning, packaging, transportation, and storage were resolved. Results The rusting rate in group A was significantly higher than group B(11. 71% [3 835/32 760]) vs 0. 54% [156/28 990], x2= 244. 10,P<0. 01). After one year training and improvement in CSSD, medical staff's satisfaction with regional CSSD improved significantly compared that before training(90. 91 % [20/22] vs 45. 45%[10/22] ,x2 = 13. 26,P<0. 01)). The cost and expiration date of non-woven fabrics and paper-plastic wrapping material were lower and longer than cotton wrapping. Conclusion Continuous quality improvement of regional CSSD management can ensure the quality

  13. Outbreak by ventilator-associated ST11 K. pneumoniae with co-production of CTX-M-24 and KPC-2 in SICU of a tertiary teaching hospital in central China

    Directory of Open Access Journals (Sweden)

    Longhua Hu

    2016-08-01

    Full Text Available The emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP often responsible for numerous hospital-associated outbreaks has become an important public health problem. From January 2013 to February 2014, a total of 41 non-duplicate K. pneumoniae isolates with carbapenem resistance, were collected at a tertiary teaching hospital in Nanchang, central China. Among 41 K. pneumoniae isolates, 28 were isolated from hospitalized patients including 19 from the patients in surgery intensive care unit (SICU and 13 were isolated from ventilators. Twenty-four of 28 patients infected by CRKP have been submitted to mechanical ventilation using ventilator. More than 95% of the CRKP isolates were resistant to 13 antimicrobials tested.All CRKP isolates were confirmed as carbapenemase producer and were positive for blaKPC-2, with one positive for both blaKPC-2 and blaNDM-1. All carbapenemase-producing isolates harbored at least one of extended spectrum βlactamase genes tested, among which95.1% (39/41 of the tested isolates were found to harbor both blaCTX-M-24 and blaKPC-2, Of note, one isolate harbored simultaneously two carbapenemase genes (blaKPC-2 and blaNDM-1 and two ESBL genes (blaCTX-M-3 and blaTEM-104 . To the best of our knowledge, coexistence of blaKPC-2 and blaCTX-M-24 in one isolate is first reported. MLST results showed that 41 CRKP isolates belonged to 4 sequence types (STs including ST11, novel ST1854, novel ST1855 and ST1224. PFGE results displayed 3 PFGE clusters. Thirty-eight ST11 CRKP isolates (92.7%, 38/41 including all 13 isolates from ventilators and 25 isolates from patients from 7 wards (18 from是ICU belonged to same PFGE cluster, indicating these isolates were clonally related. Fifteen isolates have an identical undistinguished pattern (100% similarity forming a single clonal population. Moreover, this clone was exclusively linked to the cases attended in SICU and linked to the Ventilators. Additionally, the other SICU cases were

  14. Outbreak by Ventilator-Associated ST11 K. pneumoniae with Co-production of CTX-M-24 and KPC-2 in a SICU of a Tertiary Teaching Hospital in Central China.

    Science.gov (United States)

    Hu, Longhua; Liu, Yanling; Deng, Linqiang; Zhong, Qiaoshi; Hang, Yaping; Wang, Zengzeng; Zhan, Lingling; Wang, Liangxing; Yu, Fangyou

    2016-01-01

    The emergence of carbapenem-resistant Klebsiella pneumoniae (CRKP) often responsible for numerous hospital-associated outbreaks has become an important public health problem. From January 2013 to February 2014, a total of 41 non-duplicate K. pneumoniae isolates with carbapenem resistance, were collected at a tertiary teaching hospital in Nanchang, central China. Among 41 K. pneumoniae isolates, 28 were isolated from hospitalized patients including 19 from the patients in surgery intensive care unit (SICU) and 13 were isolated from ventilators. Twenty-four of 28 patients infected by CRKP have been submitted to mechanical ventilation using ventilator. More than 95% of the CRKP isolates were resistant to 13 antimicrobials tested. All CRKP isolates were confirmed as carbapenemase producer and were positive for bla KPC-2, with one positive for both blaKPC-2 and bla NDM-1. All carbapenemase-producing isolates harbored at least one of extended spectrum β-lactamase genes tested, among which 95.1% (39/41) of the tested isolates were found to harbor both bla CTX-M-24 and bla KPC-2, Of note, one isolate harbored simultaneously two carbapenemase genes (bla KPC-2 and bla NDM-1) and two ESBL genes (bla CTX-M-3 and bla TEM-104). To the best of our knowledge, coexistence of bla KPC-2 and bla CTX-M-24 in one isolate is first reported. MLST results showed that 41 CRKP isolates belonged to four sequence types (STs) including ST11, novel ST1854, novel ST1855, and ST1224. PFGE results displayed three PFGE clusters. Thirty-eight ST11 CRKP isolates (92.7%, 38/41) including all 13 isolates from ventilators and 25 isolates from patients from seven wards (18 from SICU) belonged to same PFGE cluster, indicating these isolates were clonally related. Fifteen isolates have an identical undistinguished pattern (100% similarity) forming a single clonal population. Moreover, this clone was exclusively linked to the cases attended in SICU and linked to the Ventilators. Additionally, the other SICU

  15. 唐山市丰南区农村集中式供水现状与管理对策%Situation and management measures of rural central water supply in Fengnan District of Tangshan

    Institute of Scientific and Technical Information of China (English)

    童海潮; 李志娟

    2012-01-01

    目的 探讨我区农村居民饮用水监管对策,确保广大农村居民饮水卫生安全.方法 利用农村饮用水基本情况调查表进行现场卫生学调查和水质实验室分析,对数据进行分析.结果 我区农村生活饮用水水体卫生防护不到位;各项饮水卫生管理制度不健全;均未建立涉水产品索取卫生许可批件档案;农村水质总体合格率为61.6%.结论 农村生活饮用水存在卫生安全隐患,相关职能部门应加强对农村居民饮水卫生监管.争取政府支持,加大财政投入,积极开展农村集中式供水工程改造.建立县、乡、村三级农村饮水安全卫生监管体系,改善农村饮水卫生安全状况,保障农村广大群众的饮水健康.%Objective To discuss the supervision measures of rural residents drinking water, so as to ensure the sanitation and safety of drinking water. Method Do site sanitary survey and water quality laboratory analysis of water quality by a Basic Information Questionnaire of Rural Drinking Water, and analyze the data. Results The sanitation of rural drinking water of our District did not reach the specified standard; all the sanitary management systems were not sound; all the water - related products had not establish sanitary licence approval files; and the overall acceptance rate of rural water was 61.6%. Conclusions The rural drinking water existed potential hygienic risks, so related functional departments should strengthen the supervision of rural water, strive for government support, increase financial investment, and actively develop rural central water supply project reform, establish rural drinking water safety and sanition supervision system at county, township and village level, improve the sanitary and safe situation of rural drinking water and guarantee the water health of rural masses.

  16. Application of lean management in operation processing of central sterile supply department%精益管理在消毒供应中心操作流程中的应用

    Institute of Scientific and Technical Information of China (English)

    张炼英

    2011-01-01

    目的 探讨精益管理在消毒供应中心操作流程中的应用,以促进消毒供应中心的效率与品质改善。方法 通过国内外精益思想、精益医疗管理文献与资料的收集与整理,归纳介绍目前国内外精益管理在医疗领域的应用,对消毒供应中心实施精益管理进行探讨。结果 通过制定价值流图,流动作业,消除浪费,取得最高管理者的全力支持,从组织结构上、人员设置上、技能操作上进行变革,充分保证精益管理成功的实施。结论 通过在消毒供应中心建立价值流图分析,并利用信息技术可改善消毒供应中心消毒供应作业的流动性,重建消毒供应管理系统的业务模型,改进消毒供应的效率和质量。%Objective To study the application of lean management in operation processing of central sterile supply department(CSSD)in order to promote its efficiency and quality improvement. Methods From collecting international and domestic related literatures of lean thoughts, lean medical management, summarizing and introducing the application of lean management in medical domain, discussing the implementation of lean management in CSSD. Results The implementation of lean management was ensured to be successful through establishing value stream mapping, mobile operation, waste elimination, obtaining support of top management, reforming of organization construction, placing personal and technological operation. Conclusions The flow of operation can be improved, the business model will be re-build and the efficiency and quality of CSSD can be improved by establishing the value stream mapping in CSSD and using the information technology.

  17. Hospital central air conditioning ventilation system knowledge about nosocomial infection investigation and countermeasure%医院中央空调通风系统医院感染相关知识现状调查

    Institute of Scientific and Technical Information of China (English)

    汪春云; 朱小平; 凌红; 许晓萍; 丁华

    2012-01-01

    Objective The hospital being ventilated systematically by the (act that the relevance personnel grasps central authority air-conditioning infects the administration request, observe central authority air-conditioning ventilation system cleaning degassing and run administrative working system strictly, be work out simple and direct, have order, safety, pragmatic, have an effect to prevent from controlling measure, guard against yard inner cross-infection , provide a basis. Method Adopi a questionnaire to inquire into the method composing in reply a scene examination (observation) , the systematic air-conditioning ventilation relevance knowledge and central authority air-conditioning usage current situation carrying out central authority on entire 24 yard disease area and 191 staff members investigate whether. Result Relevance personnel cognition to systematic relevance of central authority air-conditioning ventilation degassing managerial know-how, the god of the earth stays in cognition stage, Air-conditioning there exists the sum knowing that the blind area employee takes up investigation in sigmatism and degassing administration to central authority 69.1%. Do not carry out relevance knowledge to the middle acting. Conclusions The behavior regulations that the conclusion asks to promote the relevance personnel, changes central authority air-conditioning ventilation system usage current situation, trains except perfecting the relevance knowledge's, have relevance procedure in hand being hit by key control point and the request, improve hospital infection taking precautions a-gainst and controlling availability, that important being needs to reinforce the functional departments supervision strength besides the standard working out the central authority air-conditioning ventilation system usage upkeep maintenance handles directive rules(SOP),ensures SOP measure feeling at ease, makes infection control a job further scientist , normalizing.%目的 通过相关人员

  18. Duchenne, Charcot and Babinski, three neurologists of La Salpetrière Hospital, and their contribution to concepts of the central organization of motor synergy.

    Science.gov (United States)

    Clarac, François; Massion, Jean; Smith, Allan M

    2009-11-01

    Many currently accepted notions of motor control originate from a few seminal concepts developed in the latter half of the 19th century (see Bennett and Hacker, 2002). The goal of this review is to retrace some current ideas about motor control back to the thought of three French neurologists of Hospital of the Salpetrière hospital in Paris during the latter half of the 19th century and early 20th century (Fig. 1): Guillaume Duchenne de Boulogne (1806-1875), Jean-Martin Charcot (1825-1893), and Joseph Babinski (1857-1932). A common theoretical and methodological thread unites these three men as Charcot was taught neurology by Duchenne, and Babinski was trained by Charcot. The influential concepts developed by these pioneering French neurologists have been neglected for nearly a century and only rediscovered recently. We intend to highlight how these astute clinicians used their meticulous clinical observations of patients to reveal novel and original perspectives of motor co-ordination. Between 1850 and 1930, all three men played a major role in developing and shaping the entire field of normal and pathological motor control in addition to making important contributions to three major scientific issues; the centralist view of muscle sense, the emerging concept of muscle synergy in voluntary movements and in locomotion and finally the specific role of the cerebellum in muscle synergy. The important contributions of these men will be considered in the context of other significant schools of neurology from other countries. Finally, the concept of cerebellar asynergy as proposed by Babinski anticipated the development of the internal models which much later were able to provide a theoretical basis for understanding the mechanism of learned motor co-ordination involving the cerebellum.

  19. Knowledge, attitude and practice about breast cancer and breast self-examination among women seeking out-patient care in a teaching hospital in central India

    Directory of Open Access Journals (Sweden)

    Rao Siddharth

    2016-01-01

    Full Text Available Background: Breast cancer (BC continues to be a major cause of morbidity and mortality throughout the world. Early detection of BC and early treatment increases the chance of survival. According to Breast Health Global Initiative guidelines for low and middle income countries, diagnosing BCs early by promoting breast self-awareness; clinical breast examination (CBE and resource adapted mammographic screening will reduce BC mortality. There is a paucity of data on the knowledge and awareness of BC and self-breast examination in India. We designed this hospital based cross sectional descriptive study to evaluate the current status of knowledge, awareness and practices related to BC and breast self-examination in the female rural population attending a teaching hospital. Materials and Methods: We did a random sampling to identify and enroll 360 women and their female relatives. We excluded a participant from the study if she had already undergone a screening mammography or had had a BC. The data was collected by a self-administered questionnaire in vernacular language. Results: Our study population included 360 women with a mean age of 45.81 (±10.9 years. Only 5 (1.38% females had a family history of BC. A whopping 81% of women did not have any knowledge about BC. All the women thought that CBE by doctors was the only way for screening BC. Conclusions: We concluded that with the results of this study, it is imperative to increase awareness about BC and its detection methods in the community through health education campaigns. We should have major policy changes to increase future screening programs and health education programs which would have an overall positive impact on reducing the disease burden.

  20. Trabalho do enfermeiro no Centro de Material e seu lugar no processo de cuidar pela enfermagem Trabajo del enfermero en el centro de material y su lugar en el proceso de cuidar de la enfermería The nurse's work at a hospital supply center and his/her place in the care for nursing work

    Directory of Open Access Journals (Sweden)

    Silvia Ricci Tonelli Bartolomei

    2006-09-01

    ífico en el CME que por el administrativo.This is a study on nurses' work at central supply units (CSUs with the aim of analyzing his/her social reality and transforming role in the caring process in health and nursing. It's a strategic research, with speech analysis of CSU nurses. Results show that their main activity is management, in a structured process that confirms the traditional nursing practice, having as object the coordination of medical-hospital material processing used for care. Their work is characterized by indirect care, and is instrumental not only for nurses' work, but for the work of other professionals as well. As a result, it not identified as specific nursing care, nor as care provided by the nurse. Its transforming potential upon relations and new production modes of care in health, and by the nurse, will occur first through his/her competence in the specific knowledge about CSUs than through his/her administrative skills.

  1. Indicadores de avaliação do processamento de artigos odonto-médico-hospitalares: elaboração e validação Indicadores para la evaluación del reprocesamiento del productos medicos del hospital: construcción y validación Indicators for evaluation of processing dental-medical-hospital supplies: elaboration and validation

    Directory of Open Access Journals (Sweden)

    Kazuko Uchikawa Graziano

    2009-12-01

    realizar la validación de procesos de evaluación, independiente da existencia de criterios padrón-oro y/o a la relevancia de su repercusión en la práctica asistencial.Methodological study to elaborate and validate measures of evaluation in health contributing to an evaluation system of practices related to the control and prevention of hospital infection. It was elaborated eight dental-medical-hospital supply reprocessing conformity indicators. Indicators are described using items of the structure, process and outcomes that permitted the elaboration of conformity indicators related to the best practices (gold pattern. It was performed the content validity of the attributes of applicability and representativeness by a consensus expert judgment process using a psychometric scale. All the indicators showed to have content validity. Expert judgments, including comments and suggestions, evidenced the importance of perform validity of the evaluation processes, independently of the existence of golden pattern criteria and/or relevancies to the nursing practice.

  2. Microbiological analysis of the central venous catheter tips from hospitalized patients at Hospital Universitário of Universidade Estadual de Londrina Análise microbiológica de pontas de cateteres venosos centrais provenientes de pacientes internados no Hospital Universitário da Universidade Estadual de Londrina

    Directory of Open Access Journals (Sweden)

    Jacinta Sanchez Pelayo

    2006-10-01

    Full Text Available Central Venous Catheters (CVC are used in intravenous therapy in order to facilitate diagnosis and treatment. They allow medicine administration, parenteral nutrition and also vascular access in hemodialysis. However, the use of these catheters offers risks of systemic and local infection, including endocarditis and bacteremia. The aim of this study was to isolate microorganisms from CVC utilizing the semiquantitative culture technique, and to identify them through conventional biochemical tests and an automated system. For the study, 198 CVC tips were evaluated and 105 (53% were considered positive, that is, showed microbial growth ³ 15 CFU. The microorganisms found were the following: 63.8% Grampositive bacteria, 30.5% Gram-negative bacteria, and 5.7% yeast. The most isolated were: coagulasenegative Staphylococci (35.2%, Staphylococcus aureus (25.7%, Klebsiella pneumoniae (8.5%, Pseudomonas aeruginosa (7.6%, Acinetobacter baumannii (7.6% and Candida albicans (4.7%. The increase of infection cases related to catheter has been observed worldwide reflecting the increase of invasive medical procedures used to treat patients. This work allowed the identification of the microorganisms most frequently isolated from CVC tips at a teaching hospital in the region of Londrina- PR. The identification of these microorganisms is extremely important in order to optimize the treatment of the infections and to establish methods of prevention. Cateteres venosos centrais (CVC são utilizados na terapia intravenosa com a finalidade de facilitar o diagnóstico e o tratamento do paciente, pois permitem a administração de medicamentos, nutrição parenteral, além de serem usados como acesso vascular para hemodiálise. Entretanto, o uso desses cateteres oferece riscos de infecção local e sistêmica, incluindo endocardite e bacteremia. O presente estudo teve por objetivo isolar microrganismos de CVC, utilizando a técnica de cultura semi-quantitativa, e

  3. Centralized Purchasing Process for Medical Supplies and Inspection Reagent in Medical Institutions of Xinjiang Uygur Autonomous Region%新疆维吾尔自治区医疗卫生机构医用耗材和检验试剂集中采购工作进展

    Institute of Scientific and Technical Information of China (English)

    陈蕾; 苏雅莉; 付丽红; 徐建国

    2012-01-01

    OBJECTIVE: To provide the basis for carrying out centralized purchasing in Medical Institutions for medical Supplies and Inspection Reagent. METHODS: Combined with the actual situation of Xinjiang Uygur Autonomous Region, we actively explored and carried out centralized purchasing of medical supplies and inspection reagent in medical institution of Xinjiang Uygur Autonomous Region with government as dominant factor and autonomous region as unit. RESULTS & CONCLUSION: Through the task survey, we absorb the experience of online centralized purchasing for medical supplies and inspection reagent. Gradually, we expand the purchase range of low value medical supplies and inspection reagent, explore the way to centralized purchasing of high value medical supplies actively and standard purchasing behavior of medical institution to guarantee the quality of medical supplies and inspection reagent, reduce medical cost and benefit the masses.%目的:为完善我国医疗卫生机构医用耗材和检验试剂集中采购工作提供参考.方法:结合我区实际情况,积极进行实地调研,开展以政府为主导、自治区为单位的医疗卫生机构医用耗材和检验试剂集中采购工作,并进行分析总结.结果与结论:通过课题调研,在汲取医疗卫生机构医用耗材和检验试剂网上集中采购工作经验的基础上,应逐步扩大医疗卫生机构检验试剂、低值医用耗材采购范围,积极探索高值医用耗材集中采购办法,规范医疗卫生机构医用耗材和检验试剂采购行为,保证医用耗材和检验试剂质量,降低医疗成本,使群众得到实惠.

  4. Abasto, surtimiento y gasto de bolsillo en medicamentos en hospitales públicos de México en 2009 Supply prescription filling and out-of-pocket expenditures on medicines in public hospitals in Mexico in 2009

    Directory of Open Access Journals (Sweden)

    Sergio Sesma-Vázquez

    2011-01-01

    Full Text Available OBJETIVO. Analizar la disponibilidad de medicamentos en las farmacias hospitalarias, el surtimiento de prescripciones a pacientes egresados y el gasto de bolsillo en medicamentos de pacientes hospitalizados. MATERIAL Y MÉTODOS. Análisis descriptivo de la Encuesta Nacional de Satisfacción y Trato Adecuado (ENSATA de 2009 con una muestra representativa de hospitales públicos sobre disponibilidad de una lista de 83 medicamentos en el momento de la visita a la farmacia, la proporción del surtimiento de recetas a pacientes en el momento de su alta y su gasto de bolsillo durante su estancia hospitalaria. RESULTADOS. En total se entrevistó a 26 271 pacientes egresados de los 160 hospitales públicos visitados. La disponibilidad de medicamentos en el ámbito nacional fue de 82%. Los hospitales de los Servicios Estatales de Salud (SESA mostraron una disponibilidad de 77% (variación de 30 a 96%. El surtimiento completo de recetas fue de 97% en las instituciones de seguridad social, cifra que contrasta con 56.2% de los hospitales de los SESA, que además presentaron una gran varianza entre estados (13 a 94% La mediana del gasto de pacientes hospitalizados fue de 150 pesos moneda nacional (1% gastó más de 10 000 pesos. CONCLUSIONES. La falta de los medicamentos en los hospitales tiene un impacto económico en el gasto de los hogares, particularmente en aquellos que cuentan con pocos recursos, y puede aumentar la morbilidad o mortalidad de los pacientes hospitalizados en las instituciones públicas.OBJECTIVE. To analyze the availability of drugs in public hospitals, the prescription-filling patterns for in-patients when they are discharged and their out-of-pocket expenditure during their hospitalization. MATERIAL AND METHODS. Using the National Satisfaction and Responsiveness Survey (ENSATA 2009, which includes a representative sample of public hospitals in Mexico in 2009, the availability of 83 essential medicines in the hospital pharmacies at the

  5. Adoption of the Energy-saving Technology of Central Air Conditioner in Modern Hospital%现代医院中央空调节能技术的应用

    Institute of Scientific and Technical Information of China (English)

    鲁晶; 彭承琳; 牟帮易

    2012-01-01

      能源是当今世界性的迫切问题,提高空调的制冷效果对于节约能源和减少医院的运营成本,都具有十分重要的意义。鉴于当前节能环保、全球气候异常等问题,本文对医院中央空调系统如何“节能”问题进行了论述。目前利用废热、余热作为能源的溴化锂吸收式冷水机组越来越受到关注。本文对溴化锂吸收式冷水机组的新技术及应用也进行了介绍,并作了中央空调系统关于节能的几个方面的比较。%  Energy is the most urgent problem in the world. To improve the cooling efficiency of air conditioner plays an important role in saving energy and cost control of hospital operations. As the environmental issues and global climate changes have drawn the concern of governments and people worldwide at present time, this article elaborates energy saving of central air conditioner system in hospital. LiBr absorption chil ers which use the waste heat as the power source are get ing more and more popular today. Some new technologies and applications of LiBr absorption Chil er are also discussed in the article. Energy saving of the central air conditioning system are analyzed and compared in some aspects at the same time.

  6. An audit of obstetric admissions to intensive care unit in a medical college hospital of central India: lessons in preventing maternal morbidity and mortality

    Directory of Open Access Journals (Sweden)

    Manisha Jain

    2015-02-01

    Full Text Available Background: The spectrum of causes leading to maternal morbidity and mortality may be well reflected in the clinical profile of obstetric patients admitted to the Intensive Care Unit (ICU. An audit of these patients may help in devising intervention strategies and implementing preventive measures. This is expected to contribute to the ongoing concerted multipronged efforts towards reducing maternal mortality as a step towards the millennium development goals. The aim was to study the clinical and demographic profile of antenatal and postpartum women requiring admission to the ICU, the interventions required in these women and the final outcome. The overall goal is to identify the contributing factors towards maternal morbidity and mortality. Methods: A retrospective analysis of hospital records of all antenatal, post-abortal and postpartum women admitted to the ICU at People's hospital, Bhopal over a period of 3 years (June 2011 to May 2014. Results: A total of 157 records were identified and analyzed: 22 (14% antenatal, seven (4% post-abortion, 114 (73% postpartum, and 14(9% post-laparotomy women. The mean age was 25 years (Range 18-38 years; SD 4.49, two thirds being from rural areas. Majority (78% had no earlier visit. The gestational age at admission to ICU ranged from 6-43 weeks (Mean 31 weeks; SD 9.06. One third (24% of patients had severe anemia, 18 patients needed ventilation, 25 required inotropic support, 4 required dialysis and 17 underwent surgical intervention. Blood or blood component therapy was needed in 60% cases with total blood units transfused being 225. The average duration of stay in intensive care unit was 79 hours. Analyzing as organ-system dysfunctions: Cardiovascular dysfunction (22%, hematological (20%, hepatic (16%, neurological (11%, septicemia (11%, renal (9%. There were 19 maternal deaths. Conclusions: Maternal anemia and consequences still contribute significantly to maternal morbidity. Non-utilization of

  7. Cessation of In-line Filters in Central Venous Catheters Does Not Significantly Influence the Incidence of Bloodstream Infections and Mortality in a Hospital Hematological Ward.

    Science.gov (United States)

    Tanaka, Hiroaki; Ambiru, Satoshi; Kawaguchi, Takeharu; Sugita, Yasumasa; Kawajiri, Chika; Nagao, Yuhei; Shimura, Takenori

    2016-01-01

    Objective The use of intravenous in-line filters is effective for the mechanical removal of large particles, precipitates, bacteria, fungi, large lipid globules, and air. However, the routine use of in-line filters remains controversial. Many patients with hematological diseases frequently suffer from bloodstream infections (BSIs) with fatal outcomes. Methods The year before cessation of an in-line filter was defined as the "filter period" and the year after its cessation was defined as the "non-filter period." The number of central line-associated bloodstream infections (CLABSIs), which are defined through surveillance, the catheter utilization rate, the number of patient deaths within 7 days after removal of the central venous catheters (CVCs), and the overall survival rate following CVC insertion were measured. Results During both periods, 84 patients had a total of 140 CVCs with a total number of catheter days of 3,407. There were 10 CVCs with CLABSIs, and the overall CLABSI rate was 2.9/1,000 catheter days, including 4 CVCs with CLABSIs (2.5/1,000 catheter days) during the filter period and 6 CVCs with CLABSIs (3.3/1,000 catheter days) during the non-filter period. The CLABSI rate, catheter utilization rate, and mortality did not differ significantly between the two periods. The only independent variable that was found to be significantly associated with the development of CLABSIs was a neutrophil count of line filters from CVCs does not significantly influence the incidence of BSIs and mortality in patients with hematological disease. To confirm our results, however, a large-scale randomized controlled study is warranted.

  8. Rate and time to develop first central line-associated bloodstream infections when comparing open and closed infusion containers in a Brazilian Hospital

    Directory of Open Access Journals (Sweden)

    Margarete Vilins

    2009-10-01

    Full Text Available The objective of the study was to determine the effect of switching from an open (glass or semi-rigid plastic infusion container to a closed, fully collapsible plastic infusion container (Viaflex® on rate and time to onset of central lineassociated bloodstream infections (CLABSI. An open-label, prospective cohort, active healthcare-associated infection surveillance, sequential study was conducted in three intensive care units in Brazil. The CLABSI rate using open infusion containers was compared to the rate using a closed infusion container. Probability of acquiring CLABSI was assessed over time and compared between open and closed infusion container periods; three-day intervals were examined. A total of 1125 adult ICU patients were enrolled. CLABSI rate was significantly higher during the open compared with the closed infusion container period (6.5 versus 3.2 CLABSI/1000 CL days; RR=0.49, 95%CI=0.26- 0.95, p=0.031. During the closed infusion container period, the probability of acquiring a CLABSI remained relatively constant along the time of central line use (0.8% Days 2-4 to 0.7% Days 11-13 but increased in the open infusion container period (1.5% Days 2-4 to 2.3% Days 11-13. Combined across all time intervals, the chance of a patient acquiring a CLABSI was significantly lower (55% in the closed infusion container period (Cox proportional hazard ratio 0.45, p= 0.019. CLABSIs can be reduced with the use of full barrier precautions, education, and performance feedback. Our results show that switching from an open to a closed infusion container may further reduce CLABSI rate as well as delay the onset of CLABSIs. Closed infusion containers significantly reduced CLABSI rate and the probability of acquiring CLABSI.

  9. A STUDY OF PSYCHIATRIC FACTORS IN PATIENTS PRESENTED WITH ATTEMPTED SUICIDE IN A STATE CAPITAL MEDICAL COLLEGE HOSPITAL IN CENTRAL INDIA

    Directory of Open Access Journals (Sweden)

    Keshav

    2016-01-01

    Full Text Available Suicide is one of the commonest psychiatric emergencies. According to WHO report, 1999 suicide was one of the top three leading causes of death among people aged 15-34 years in all countries. In recent years, attempted suicide has become the focus of research as it has been found to be the predictor of suicide. Psychiatric factors are one of the important determinants in attempted suicide. OBEJCTIVES The aim of the present study was to analyse the psychiatric factors in attempted suicide. METHODS The present study was conducted in the Department of Medicine and Department of Psychiatry, Gandhi Medical College and associated Hamidia Hospital Bhopal. Study based on the patients admitted in Medicine/Psychiatry ward or attending Out Patients Department with history of suicidal attempts, during the period December 2006 to November 2007. RESULTS Psychiatric disorders were present in 74.25%, while no psychiatric disorder was present in rest of 25.75%. CONCLUSION Major depressive disorder accounting for 34.69% cases, was the most common concurrent psychiatric illness among the study group.

  10. 重大突发公共事件一线野战医院医疗药品保障标准化模块构建探讨%Standard Modules of Medicine Supply in the Front Field Hospital for Momentous Public Emergency Events

    Institute of Scientific and Technical Information of China (English)

    张璞; 郑咏池; 王斌; 钟明康

    2011-01-01

    OBJECTIVE: To attempt to establish standard modules of medicine supply in the front field hospital for momentous public emergency events, and to provide reference for our country participating in emergency medicine supply for domestic and foreign public emergency events in the future. METHODS: Combined with the practice of earthquake relief work, medicine supply of Chinese-German Field Hospital during Wenchuan Earthquake was analyzed retrospectively and descriptively, and standard modules of medicine supply were investigated. RESULTS & CONCLUSION: Based on the modules of German Red Cross, the standard modules of emergency medicine supply (basic unit and supplement unit), including anesthetic, antibiotic, hormone, antipyretic analgesic were tried to establish in the front field hospital for momentous public emergency events. It could meet the needs of medical care of 10 000 peoples for 3 months. Chinese international medical rescue in heavy disaster can profit from standard modules of medicine supply in the front field hospital for momentous public emergency events. Great efforts should be made to enhance the ability of medical rescue, such as reinforcing international practices and details, focusing on disadvantaged groups.%目的:尝试构建重大突发公共事件一线野战医院医疗药品保障标准化模块,为我国今后参与国内、外重大突发公共事件救援的药品应急保障提供参考.方法:结合抗震救灾实践,对汶川地震期间都江堰中德野战医院药品供应保障情况进行回顾性调查与描述性分析,就药品保障标准化模块进行探讨.结果与结论:在德国红十字会医疗救援标准化模块的基础上,尝试构建了包含麻醉药、抗微生物类药、激素、解热镇痛药等药物在内包括基础单元和补充单元2个部分的我方重大突发公共事件一线野战医院医疗药品保障标准化模块,可保障10 000人约3个月的医疗救治需求.重大突发公共事件

  11. Exploration on the Coordination and Optimization in the Chain of Procurement and Supply of the Hospital Medical Equipment%对医院医疗器械采购供应环节协调优化的探索

    Institute of Scientific and Technical Information of China (English)

    汤黎明; 吴敏; 王卫; 钟添萍

    2011-01-01

    Through analysis of the supply chain of the medical equipment suppliers and the comparison of requirements and objectives between medical equipment purchasers and suppliers,we realized the possibility and the necessity of the coordination and optimization in the chain of procurement and supply.%本文通过对医疗器械供应商供应环节的分析,以及采购与供应双方对医疗器械采购供应要求和目标的对比,进一步了解医疗器械采购、供应环节协调优化的可行性和必要性.

  12. Health supply chain management.

    Science.gov (United States)

    Zimmerman, Rolf; Gallagher, Pat

    2010-01-01

    This chapter gives an educational overview of: * The actual application of supply chain practice and disciplines required for service delivery improvement within the current health environment. * A rationale for the application of Supply Chain Management (SCM) approaches to the Health sector. * The tools and methods available for supply chain analysis and benchmarking. * Key supply chain success factors.

  13. Cateter central de inserção periférica em pediatria e neonatologia: possibilidades de sistematização em hospital universitário

    Directory of Open Access Journals (Sweden)

    Cristine Ruviaro de Oliveira

    2014-09-01

    Full Text Available Objetivo: Descrever a sistematização do uso do cateter central de inserção periférica em neonatos e crianças, em um hospital universitário do sul do Brasil. Métodos: Estudo qualitativo, desenvolvido com o método criativo sensível. Foram desenvolvidas três dinâmicas com dez enfermeiras. Os dados foram submetidos à análise de discurso francesa. Resultados: Os resultados apontaram que, a sistematização da assistência de enfermagem deve ser aplicada durante todo o processo de utilização do cateter central de inserção periférica; deve ser criado um serviço ambulatorial articulado com o setor de internação e as famílias para que as crianças possam fazer uso do cateter ambulatorialmente. Conclusão: Os protocolos institucionais para o uso deste cateter devem ser desenvolvidos a partir da sistematização da assistência de enfermagem, tendo por base as necessidades do paciente, as evidências científicas, a realidade institucional e o diálogo entre a equipe de enfermagem e médica e a família.

  14. Rehabilitation of the hospital infrastructure in a developing country.

    Science.gov (United States)

    Kotilainen, H

    2001-01-01

    Mongolia is in fact not a developing country at all but a country of transitional economy (since 1990) with a fairly comprehensive health care infrastructure. However, the health care is facing great difficulties comparable to those in a developing country. Hospital infrastructure rehabilitation was a part of a wider health sector development project with 3 remote aimags (provinces) as the target areas. The Mongolian system of health care has been built up over many years as a country-wide network of community-based feldschers and doctors, supported by a hierarchy of hospitals and mobile emergency teams. Health standards are also impacted by many factors (better housing, water supplies, better roads and rail links) outside the control of the Ministry of Health, and of health care providers. The majority of the rural hospitals lack the basic facilities. There are operating theatres without running water, hospitals with electricity only from 8 to 10 in the evening etc. The hygienic standard is unacceptable. Central heating systems do not function. Many of the facilities are underutilised and in poor condition due an ongoing lack of maintenance. The project aimed for a network that would offer services for all people, including nomadic people. The number of rural hospitals was slightly reduced and some of them were upgraded to first referral unit with basic clinical services. Approximately one third of the rural hospitals had to be rebuilt. The project recommended and started multiphased long-term master planning for those 3 aimag hospitals, all of which displayed difficulties similar to the rural hospitals.

  15. 消毒供应室无纺布包装湿包问题的改进效果%Improvement in the wet bag problem of the no-woven packing in the central sterile supply

    Institute of Scientific and Technical Information of China (English)

    靳寸朵; 赵小丽; 王苗; 贾桂香; 麻雷

    2013-01-01

    Objective To explore the method of reducing the phenomenon of wet bag in the no-woven packing after sterilization in the central sterile supply .Methods The phenomenon of wet bag in the no-woven operation packing after sterilization was due to the bad absorption of water molecules in the non -woven packaging, movement the non-woven packaging without the given time and poor temperature and humidity in the storage.The improvements were carried out according to the above problems , and the effective method of reducing the phenomenon of wet bagwas summarized .The no-woven packing in the experimental group was packed by no-woven, and filled up a piece of the crepe paper between the instruments and the non-woven and laid the single deck cotton cloth over the sterilization frame in the packaging process .Results The incidence rate of wet bag was decreased from 7.64%to 1.04%three months after improvement.Conclusions Filling up a piece of the crepe paper between the instruments and the non-woven and laying the single deck cotton cloth over the sterilization frame in the packaging process can effectivelyprevent the phenomenon of wet bag in the no -woven operation packing after sterilization .%目的:探讨减少消毒供应室无纺布包装在灭菌完成后湿包现象发生的方法。方法无纺布包装水分子吸收性差、工作中未在规定时间内移动无纺布包及无菌物品存放区温湿度欠佳等原因造成无纺布包装湿包现象。针对以上问题进行改进,总结减少无纺布包装湿包现象发生的有效方法。结果经过3个多月的改进,在器械包打包过程中,将皱纹纸垫于器械与无纺布之间,且铺一层棉布在灭菌架上,湿包率由原来的7.64%降低至1.04%。结论在器械包打包过程中,将皱纹纸垫于器械与无纺布之间,且铺一层棉布在灭菌架上,能有效预防无纺布包装手术包灭菌后湿包现象的发生。

  16. Causes of wet packages of surgical instruments under centralized supply and the countermeasures%集中供应手术器械灭菌湿包原因分析及对策

    Institute of Scientific and Technical Information of China (English)

    吴佳伟; 周染云; 张莹; 杨春燕; 徐丽丽; 王国权

    2013-01-01

    OBJECTIVE To explore the causes of the wet packages of the surgical instruments and the dressing sterilization bags in central sterile supply department so as to put forward the solutions to ensure the sterilization quality. METHODS The surgical instrument packages and dressing kits packed by textile cotton or non-woven fabric were placed into the sterilizer after weighing all of them to run a sterilization cycle in accordance with the standard operation procedure of pulsating vacuum pressure steam sterilizer. The water stains, water droplets, and watermark were observed after the sterilization to see whether they remained on the packages, then all of the packages were weighed after being placed for 10min or 20min, a consecutive monitoring for 3 days. RESULTS Of all the instrument packages, there were two packages being wet at corners, and of all the dressing packages, there were two packages with water droplets remaining outside the packages; demonstrated by the weighing before and after the sterilization, the overweight dressing packages and instrument packages were prone to be wet; the non-woven fabric packages were easier than the textile cotton ones to be wet; 73. 0% of the packages were overweight when weighing immediately after the sterilization, 17. 3% overweight after being placed for 10 min, and none overweight after being placed for 20min. CONCLUSION The wet packages can be reduced by lessening the weight of the packages and by using the textile cotton packages instead of the non-woven fabric packages as well as extending the time of the packages placement in the sterilizer.%目的 探索供应室集中供应手术器械和敷料灭菌包湿包的原因,并讨论解决方法以保证灭菌质量.方法 将使用纺织棉布或无纺布包装的手术器械包和敷料包称重随后放人灭菌器,按脉动真空压力蒸汽灭菌器的正常操作流程运行1个灭菌周期,观察灭菌后的器械包和敷料包是否有

  17. Parâmetros de produtividade de um centro de material e esterilização Los parametros de productividad del centro de material y esterilización Productivity indicators in a sterilization central supply

    Directory of Open Access Journals (Sweden)

    Tânia Regina Sancinetti

    2007-06-01

    posibilitó contrastar resultados y analizar el proceso de trabajo del CME.This study identifies productivity indicators at a Sterilization Central Supply (CME through documents, observation and time counting of the process for two items selected from the sample: a bandage pack and a herniorrhaphy box. The monthly average production was 30,466.42 items, and the production capacity per hour was 10.3 items per employee. The bandage pack averaged 295 minutes from the expurgation area to storage; the manual process lasted 46 minutes and the automated 88 minutes. For the herniorrhaphy box the average was 329 minutes; the manual process lasted 60 minutes and automated 98 minutes. In the bandage kit, the manual process used up 59.23% of the productivity hours in the expurgation area, 3.28% in the preparation, 10.94% in the sterilization process, and 26.31% in storage and distribution. Figures for the manual process of herniorrhaphy box were: expurgation, 11.84%; preparation, 16.20%; storage and distribution, 7.47%; and sterilization, 1.89%. The study made possible to assess the results and to analyze the working process at the CME.

  18. Registered nurses in Israel - workforce employment characteristics and projected supply

    Directory of Open Access Journals (Sweden)

    Nirel Nurit

    2012-03-01

    Full Text Available Abstract Background Surveys of nursing supplies around the world have furnished a better understanding of the structure of the workforce, helped identify shortages, and plan professional training. This study aimed to examine the employment and workforce characteristics of registered nurses and the projected supply in Israel as a tool for planning. Methods 1. A survey of a national sample of 10% of the RNs of working age (3,200 nurses. 2. Analysis of administrative data from the Ministry of Health' Nursing Division and the Central Bureau of Statistics. Results Most registered nurses are employed (89% - 67% work full time. The workforce is mature (45% are above 45, trained (55% qualified beyond the basic course, 48% hold a BA, 18% hold an MA or PhD, and stable: few quit the profession altogether. The likelihood of "survival" in the profession after 10 years is 93%; after 20 years - 88%. 23% have made some transition in the last 10 years (most - a single transition. Most of the transitions are from hospital to community work. Supply projections show a decrease in the total number of RNs in the nursing workforce from 28,500 in 2008 to 21,201 in 2028 - i.e., of 25% by the end of the period. As for the ratio per 1,000 population, the drop is from 4 registered nurses/1,000 in 2008 to 2/1,000 in 2028. Conclusions The study findings provide more rigorous projections of supply than in the past on the declining rates of the nursing workforce in the coming decades, and contribute to decision making about the scope of training and recruitment. The study also points to the implications for policy decisions regarding the findings that the young nursing workforce is less stable, that there are advantages to recruiting a more mature workforce, and that post-basic education is connected with workforce stability.

  19. Knowledge and behavior about hospital infection control of workers of sterilization and supply department: an investigation and analysis%消毒供应室工作人员掌握控制医院感染知识与行为的调查与分析

    Institute of Scientific and Technical Information of China (English)

    杨燕; 张淑北; 陈宏; 吴旗

    2008-01-01

    目的 了解医院消毒供应室工作人员掌握医院感染知识水平,对其控制感染行为做出评价.方法 对消毒供应室50名工作人员,采用自行设计调查表及电话问卷进行调查.结果 去污、洗刷室配备了防护眼镜占60%,去污洗刷时戴防护眼镜占54%;超过90%人员口罩使用时间>4h,6步洗手法知晓率占98%,经常脱手套后不洗手的占4%,经常裸手清点再回收手术器械的占12%,戴手套但不用持物钳清点回收锐利器械的占72%,被锐器伤后能正确处理伤口的占34%,接种过乙肝疫苗的占96%.结论 为保证医疗和护理的质量,增强对消毒供应室人员控制医院感染知识的教育与培训更为重要.%Objective To know about knowledge level of hospital infection of workers of sterilization and supply room, and evaluate their infection control behavior in 10 hospitals of municipal, district level hospital and public health center, Mudanjiang city. Methods Fifty workers were selected from 6 sterilization and supply room of affiliated hospital and 4 of municipal district level hospital in city, and were inquired in the self-administered questionnaires by phone. Results The results indicated 60% decontamination scrubbing room equipped with protective spectacles, and 54% workers used them in decontamination and scrubbing. More than 90% workers wore masks and changed them at least 4 hours. 98% know the six-step washing-hand method,and 4% didn't often wash hands after pulling off gloves, 12% often check the surgery instrument and recycling them by hand without gloves, 72% put on gloves but didnt use grasping forceps to callback sharp instrument,34 %could handle the injuries correctly after needle-stick. 96%of the workers had been immunized against Hepatitis B. Conclusion Sterilization and supply room should build an idea of taking human oriented and ensuring safety services quality as a purpose. The knowledge level of workers of sterilization and supply room has

  20. Hospitality within hospital meals –

    DEFF Research Database (Denmark)

    Justesen, Lise; Gyimóthy, Szilvia; Mikkelsen, Bent Egberg

    2016-01-01

    Hospital meals and their role in nutritional care have been studied primarily from a life and natural science perspective. This article takes a different approach and explores the idea of hospitality inspired by Jacques Derrida’s work on the ontology of hospitality. By drawing on ethnographic...... fieldwork in a Danish hospital, hospitality practices were studied using a socio-material assemblage approach. The study showed that rethinking the meal event could change the wards into temporary “pop-up-restaurants,” transcending the hospital context and providing a scene for shifting host...... and management involved in hospital food service and in nutritional care to work more systematically with the environment for improved hospital meal experiences in the future...

  1. 危机管理在基层医院消毒供应室优质护理服务中的应用探讨%Application Discussion on Crisis Management in High Quality Nursing Service of Disinfection Supply Room of Primary Hospital

    Institute of Scientific and Technical Information of China (English)

    吴玲; 黄雪玉

    2015-01-01

    目的:探讨危机管理在基层医院消毒供应室优质护理服务中的应用效果。方法在未增加人力情况下,对本院消毒供应室在实施危机管理前(2013年6~11月)与开展优质护理服务实施危机管理后(2013年12月~2014年7月)的护理不良事件、科室满意度进行比较。结果在实施危机管理后,护理不良事件从19起下降至6起,自制问卷调查科室满意度从89%提高至98.57%,实施危机管理后护理不良事件及科室满意度均显著高于实施前,差异均具有统计学意义(P<0.05)。结论在基层医院消毒供应室将危机管理与优质护理服务相结合,可以明显提高工作效率与工作质量,降低护理不良事件发生率。%Objective To explore the effect of crisis management in high quality nursing service of disinfection supply room of primary hospital. Methods The nursing adverse events and nursing work satisfaction before(from June 2013 to November 2013)and after(from December 2013 to July 2014)the implementation of crisis management in hospital disinfection supply room were compared without any increase in manpower. Results After the implementation of crisis management,the nursing adverse events decreased from 19 to 6,nursing work satisfaction increased from 89% to 98.57%. Conclusion The crisis management was combined with high quality nursing services in disinfection supply room in primary hospital;it can significantly improve the work efficiency and quality of work,and reduce the incidence of nursing adverse events.

  2. Design and application on post definition mode in public hospital: case study on Shaoyang Central Hospital%公立医院定岗定编模型的设计与运用:以邵阳市中心医院为例

    Institute of Scientific and Technical Information of China (English)

    张国华; 封梅姣; 申帅; 文学斌

    2016-01-01

    Human resource management has been a difficult problem among public hospital operation management. How to comply with the requirements of healthcare reform while taking into account the market operating characteristics, and establishing market requirements of"high quality, efficient, low cost", hospital human resource management system, job preparation management is the foundation. Started with the Central Hospital of Shaoyang innovative management practices and according to the analysis of organization structure, human resources allocation mode in different department which can descried as based on bed and based on integrated doctor and nurse in clinical department, based on workload mode in outpatient medical technology mode and based on post responsibility mode in administrative department has been designed and assessed.%人力资源配置一直是公立医院运营管理的难点所在,如何在顺应医改要求的同时,建立符合医改要求的"优质、高效、低耗"型医院人力资源管理体系,岗位编制管理是基础.笔者从邵阳市中心医院创新岗位编制管理实践入手,阐述了依据组织结构的不同,建立相应的岗位编制测算模型,其中临床科室建立"基于编制床位数配比模型"、"基于医护一体化配比模型";在门诊医技科室建立"基于工作量的医技人员配比模型";在行政后勤部门建立"基于岗位工作量的行政后勤人员配比模型",以及这些模型运行后取得的实际效果.

  3. 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.

  4. Integration of a fuel cell into a hospital's energy-supply system; Integration einer Brennstoffzelle PC25C in die Strom-, Kaelte- und Waermeversorgung eines Krankenhauses

    Energy Technology Data Exchange (ETDEWEB)

    Stahl, K. [T.B.E. Technische Beratung Energie GmbH, Duisburg (Germany)

    2002-01-01

    Since the beginning of 2001, the Saint Agnes Hospital in Bocholt operates a phosphoric acid fuel cell (PAFC) to provide the base load of electrical power as well as heat in Winter and air conditioning in Summer. The project was made possible by a strategic alliance with the local utility company, the Bocholter Energie- und Wasserversorgung GmbH (BEW), and with the gas supplier of BEW, the Thyssengas GmbH. The fuel cell power plant is highly efficient and has an excellent power to heat ratio. The operation during the first Year went smoothly and free of trouble. (orig.)

  5. ASSESSMENT OF IMPROVEMENT IN SPEECH PERCEPTION AND LANGUAGE DEVELOPMENT IN COCHLEAR IMPLANT SURGERY : AN INTERESTING STUDY FROM A TERTIARY CARE HOSPITAL OF CENTRAL INDIA

    Directory of Open Access Journals (Sweden)

    Sunil

    2015-10-01

    Full Text Available Severe to profound prelingual deafness that is either congenital or acquired is estimated to occur in 0.5 to 3 per 1000 live births. This is often associated with early delays in language development, speech perception, socialization and results in lower academic achievement. These de velopmental and behavioral problems are severe as 90 % of children are born to normal patients whereas with deaf parents it is less as they have a mutual communication. After much research in this field the first 22 channel cochlear implant surgery was don e in 1982. The number of prelingually deafened adults seeking cochlear implant is increasing as these individuals can derive substantial benefit, although their performance is poorer than adults with post - lingual deafness. MATERIAL AND METHODS : The present prospective study was conducted in the Department of ENT, Pt. J.N.M. Medical College and Dr. B. R.A.M. Hospital, Raipur (C.G. The subject selected were prelingually deafened individuals who were undergoing post cochlear implant speech therapy in the Depar tment. This study included individuals, who underwent cochlear implant surgery in this Department during the period of July, 2008 to September, 2010 and the age was within 10 years at the time of surgery. The study was designed as a prospective longitudina l analysis to asses functioning of patients, who underwent cochlear implantation. A total 37 cochlear implant surgeries were carried out in Department. Of these 3 cases were outside the age criteria of the present study and another 2 cases were lost in fol low up. Pre - operatively, detailed information of subject including the age, sex and address as well as contact number was collected. Then a General Examination was followed with reference to Built, Nutrition, Pulse, and Blood pressure, Oedema, Cyanosis, Cl ubbing and Citrus. A systemic examination was also performed. A Local Examination with special emphasis to tympanic membrane and any middle ear

  6. Research Methodologies in Supply Chain Management

    DEFF Research Database (Denmark)

    Kotzab, Herbert

    While supply chain management has risen to great prominence in recent year, there are hardly related developments in research methodologies. Yet, as supply chains cover more than one company, one central issue is how to collect and analyse data along the whole or relevant part of the supply chain....... Within the 36 chapters 70 authors bring together a rich selection of theoretical and practical examples of how research methodologies are applied in supply chain management. The book contains papers on theoretical implications as well as papers on a range of key methods, such as modelling, surveys, case...... studies or action research. It will be of great interest to researchers in the area of supply chain management and logistics, but also to neighbouring fields, such as network management or global operations....

  7. Macroeconomic susceptibility, inflation, and aggregate supply

    Science.gov (United States)

    Hawkins, Raymond J.

    2017-03-01

    We unify aggregate-supply dynamics as a time-dependent susceptibility-mediated relationship between inflation and aggregate economic output. In addition to representing well various observations of inflation-output dynamics this parsimonious formalism provides a straightforward derivation of popular representations of aggregate-supply dynamics and a natural basis for economic-agent expectations as an element of inflation formation. Our formalism also illuminates questions of causality and time-correlation that challenge central banks for whom aggregate-supply dynamics is a key constraint in their goal of achieving macroeconomic stability.

  8. Security of supply

    OpenAIRE

    2007-01-01

    Paul Isbell revisits the energy security debate; John Gault considers European security and natural gas supplies; William C. Ramsay discusses security of energy supplies in a global market; Hasan M. Qabazard outlines OPEC’s abiding commitment to energy security.

  9. Suprimento de micronutrientes, adequação energética e progressão da dieta enteral em adultos hospitalizados Adequacy of energy and micronutrient supply and progression of enteral diet in hospitalized adult patients

    Directory of Open Access Journals (Sweden)

    Vivian Cristine Luft

    2008-10-01

    Full Text Available OBJETIVO: Avaliar a adequação da dieta enteral, em termos de micronutrientes e energia e identificar fatores interferentes na progressão da dieta enteral prescrita a adultos hospitalizados em um hospital geral de alta complexidade. MÉTODOS: Entre junho de 2004 e maio de 2005, adultos internados em um hospital de alta complexidade do sul do Brasil foram avaliados quanto às suas características clínicas e da prescrição da nutrição enteral. As características da nutrição enteral foram avaliadas e comparadas às recomendações diárias de ingestão, obtendo-se o percentual de adequação de nutrientes prescritos na dieta enteral em relação aos valores de recomendação para cada paciente. Os fatores associados à prescrição de energia foram identificados por meio de Regressão Linear Múltipla. RESULTADOS: Foram acompanhados 230 pacientes em uso de nutrição enteral. As recomendações diárias foram alcançadas satisfatoriamente para vitaminas hidrossolúveis (exceto ácido fólico, lipossolúveis (exceto vitamina D e minerais (exceto cálcio. Em média, as prescrições iniciais de nutrição enteral ofereceram 24,0kcal/kg/dia (desvio-padrão=10,8, e valores mínimo e máximo de 4,3 a 69,2, e progrediram até 28,4kcal/kg/dia (desvio-padrão=11,8, valores mínimo e máximo de 1,4 a 69,2. A recomendação de 25 a 35kcal/kg/dia foi prescrita para 32,6% dos pacientes. Para 15,7% dos pacientes foram prescritas acima de 40kcal/kg/dia. Somente o índice de massa corporal e o número de dias de hospitalização, ajustados para a quantidade de energia já inicialmente prescrita, associaram-se de forma independente à prescrição energética final. CONCLUSÃO: Pequena proporção das prescrições esteve adequada em relação à quantidade de energia, e a progressão da dieta enteral ocorreu independentemente das características clínicas dos pacientes.OBJECTIVE: To asses the adequacy of enteral diet, in terms of micronutrients and

  10. 集中空调冷凝热回收技术在生活热水供应系统中的应用%Application of central air conditioning condense heat recovery technology to domestic hot water supply system

    Institute of Scientific and Technical Information of China (English)

    黄璞洁; 李艳霞; 何耀炳; 许伊那

    2011-01-01

    介绍\t了空调冷凝热回收技术的工作原理,计算确定了冷凝热回收机组和蓄热水箱的容量,并与传统的空调和生活热水供应系统进行比较.探讨了空调冷凝热回收技术在生活热水供应系统中的设计应用.%Based on the working principle, calculates the capacity of the condense heat recovery unit and heat storage water tank, and compares with the traditional air conditioning and domestic hot water supply system. Discusses the application of air conditioning condense heat recovery technology to the design of domestic hot water supply system.

  11. The Design of Web Things Information Management System for Hospital Central Sterile Supply Department%医院消毒供应中心物联信息管理系统的设计

    Institute of Scientific and Technical Information of China (English)

    郭霞; 谢利德; 王清河; 吕云芳; 王亮

    2015-01-01

    医院消毒供应中心承担着从医院门诊到病房及手术室的医疗器械用品回收、清洗、消毒、检查包装、灭菌和发放等管理,传统的管理模式耗时、费力、效能低下,为了提高医院消毒供应中心的管理效率,设计了物联信息管理系统,本系统根据射频识别技术(Radio Frequency Identification,RFID)通过EPC(电子产品编码)将消毒供应中心的所有物品的信息采集起来,并将消毒供应中心的这些物品及所有相关信息集成于SQL SERVER2005数据库内;通过ADO、SQL语言操作数据库的数据,实现数据查询、统计、审核、分析后,打印报表、显示、提醒等功能;使之更好地服务于医院消毒供应中心的管理,为医院的信息化管理及决策提供基础数据.

  12. New energy directions : a low-cost, low-risk electricity supply strategy for Ontario

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-03-01

    The power system in the province of Ontario is inflexible and vulnerable to system breakdowns. It is also out of step with the needs of customers and technological trends in the electricity sector. This is due to its reliance on a centralized and limited source electricity generation. Ontario is faced with the need to increase its power supplies, modernize the electricity grid, and reduce the environmental impacts of conventional generation sources. This paper proposes a single-track strategy for addressing these issues. The proposal involves the following 3 significant changes to the centralized approach currently in place in Ontario: (1) meet the energy requirements through a combination of energy efficiency programs, new low-impact renewable supplies, and high-efficiency natural gas cogeneration or combined heat and power. The supply sources should be linked together in a distributed supply system which locates power supplies in the vicinity of high demand centres, (2) diversify the pool of power producers by encouraging the entry of power co-ops and investor-owned power companies, and (3) mandate the Independent Market Operator or other agency to secure incremental supply via a competitive bidding process for long-term supply contracts. Seven recommendations were made whereby the Ontario government should: (1) implement policies, regulations, and programs strongly promoting energy conservation and efficiency, (2) adopt policies that encourage the development of sustainable sources of electricity, (3) adopt policies that encourage the development of high-efficiency power plants, (4) ensure that emissions performance of new power plants in Ontario meet or exceed that of new natural gas-fired power plant, (5) direct the Independent Market Operator (IMO) to implement nodal pricing, (6) enter into long-term contracts with power-co-ops, municipal utilities, district energy companies, shopping centres, hospitals, manufacturing companies, and investor-owned power

  13. Hospitality Industry

    Directory of Open Access Journals (Sweden)

    Marian Ionel

    2017-03-01

    Full Text Available Development of accommodation, as basic services offered to tourists, led to the creation of a genuine hospitality industry. Currently, the hospitality industry is no longer just the accommodation service itself but also requires an atmosphere that ensures leisure tourists in the hotel. Thus, hospitable unit manager offers its service in addition to accommodation and catering services, leisure services, treatment services, business services required.. The existence of factors such as revenue growth, increasing leisure time, the development of transport services, the emergence of new tourist attractions have caused increasing international flows of tourists, with consequent development of units hospitable, and therefore a strong hospitality industry. In Romania, after 1990, the tourism sector experienced a true expansion, both through the development of the hotel sector, but also by developing rural hospitality units.

  14. Norovirus - hospital

    Science.gov (United States)

    Gastroenteritis - norovirus; Colitis - norovirus; Hospital acquired infection - norovirus ... are not treated with antibiotics because antibiotics kill bacteria, not viruses. Receiving plenty of extra fluids through ...

  15. Supply regimes in fisheries

    DEFF Research Database (Denmark)

    Nielsen, Max

    2006-01-01

    Supply in fisheries is traditionally known for its backward bending nature, owing to externalities in production. Such a supply regime, however, exist only for pure open access fisheries. Since most fisheries worldwide are neither pure open access, nor optimally managed, rather between the extremes......-economic supply model with mesh sizes is developed. It is found that in the presence of realistic management schemes, the supply curves are close to vertical in the relevant range. Also, the supply curve under open access with mesh size limitations is almost vertical in the relevant range, owing to constant...... recruitment. The implications are that the effects on supply following from e.g. trade liberalisation and reductions of subsidies are small in several and probably most fisheries worldwide. Keywords: backward-bending supply, regulated open access, regulated restricted access, mesh size regulation, Beverton...

  16. Reconstruction of Low Pressure Gas Supply System

    Directory of Open Access Journals (Sweden)

    S. N. Osipov

    2013-01-01

    Full Text Available The current reconstruction of residential areas in large cities especially with the developed heat-supply systems from thermal power stations and reduction of heat consumption for heating due to higher thermal resistance of building enclosing structures requires new technical solutions in respect of gas-supply problems. While making reconstruction of a gas-supply system of the modernized or new buildings in the operating zone of one gas-distribution plant it is necessary to change hot water-supply systems from gas direct-flow water heaters to centralized heat-supply and free gas volumes are to be used for other needs or gas-supply of new buildings with the current external gas distribution network.Selection of additional gas-line sections and points of gas-supply systems pertaining to new and reconstructed buildings for their connection to the current distribution system of gas-supply is to be executed in accordance with the presented methodology.

  17. Debugging on High-voltage Power Supply,Focusing Power Supply and Magnetic Field Power Supply

    Institute of Scientific and Technical Information of China (English)

    TU; Rui

    2015-01-01

    High-voltage power supply,focusing power supply and magnetic field power supply are the main parts of the power supply system of the EMIS(Electro-Magnetic Isotope Separator)supplying the ion source.In 2015,a high-voltage power supply,power supply for focusing and

  18. Central de regulação de leitos do SUS em Belo Horizonte, Minas Gerais, Brasil: avaliação de seu papel pelo estudo das internações por doenças isquêmicas do coração The hospital bed referral center under the Unified National Health System in Belo Horizonte, Minas Gerais State, Brazil: the case of hospitalization for ischemic heart disease

    Directory of Open Access Journals (Sweden)

    Patrícia Alves Evangelista

    2008-04-01

    Full Text Available A Central de Internações de Belo Horizonte, Minas Gerais, Brasil, visa tornar ágil o acesso às internações pelo Sistema Único de Saúde (SUS. Entretanto, muitas internações ocorrem diretamente nos hospitais, sem intermediação da Central de Internação. O estudo comparou as características das internações realizadas em 2002, com relação à via de acesso. Foram selecionadas internações com hipótese diagnóstica de infarto agudo do miocárdio e insuficiência coronariana aguda. De 3.705 internações, 24,9% foram realizadas pela Central de Internação e 75,1% por via direta. As proporções de internações via direta foram maiores que pela Central de Internação para pacientes > 70 anos, internados por insuficiência coronariana aguda, na clínica cirúrgica e no fim de semana. Os percentuais das internações via Central de Internação foram maiores que os feitos por via direta para residentes em outros municípios, em hospitais não públicos e com utilização de UTI. O número de dias de internação também foi diferente entre as vias. O estudo mostrou diferenças nas características das internações realizadas pelas duas vias de acesso.The hospital admissions center in Belo Horizonte, Minas Gerais State, Brazil, aims to assure fast, timely, and equitable access to hospitalization services through the Unified National Health System. However, many patients are admitted directly to the hospitals, without going through the admissions center. This study compared the characteristics of hospitalizations in Belo Horizonte in 2002 according to type of access. All admissions for acute myocardial infarction and acute coronary disease were included. Of 3,705 admissions, 24.9% were processed through the hospital admissions center and 75.1% through direct access. Direct hospitalizations were more common as compared to processing by the hospital admissions center for patients > 70 years , those with presumptive diagnosis of acute

  19. Central nervous system tuberculosis in children: review of 35 cases at the Hospital Universitario San Vicente de Paúl in Medellín, Colombia.1997-2004. Meningoencefalitis tuberculosa en niños: Revisión de 35 casos en el Hospital Universitario San Vicente de Paúl en Medellín, Colombia. 1997-2004

    Directory of Open Access Journals (Sweden)

    José William Cornejo Ochoa

    2005-04-01

    Full Text Available Objetive. To document the clinical and diagnostic features and to explore factors associated with central nervous system tuberculosis at the “Hospital San Vicente de Paúl (HUSVP” in Medellín-Colombia. Patients and methods. Review of the patient’s records to obtain information on demographic data, medical history, clinical manifestations, laboratory results, treatment and complications of 35 children with central nervous system tuberculosis admitted to the hospital between July 1997 and July 2004. Results. Of the 35 patients, 20 were males and 15 females. Mean age was 3.7 years. Thirty (85.7% patients were in stage III of the disease and 5 (14.3% in stage II. A symptomatic respiratory close contact was documented in 19 cases (54.3%. Malnutrition was present in 18 patients (51.4%. Fever was present in 88.6%, vomiting in 62.9%, consciousness alteration in 80%, and seizures in 51.4%. Mean duration of symptoms was 10 days. Physical examination revealed meningeal signs in 77%, movement disorders in 31.4%, stupor or coma in 82.9%, hemiparesis in 60% and fundoscopic abnormalities in 31.4%. Objetivo: documentar los rasgos clínicos y diagnósticos y explorar los factores asociados con la muerte de niños con meningoencefalitis tuberculosa (MT en el Hospital Universitario San Vicente de Paúl, Medellín, Colombia. Método: revisión de las historias clínicas para obtener los datos demográficos, clínicos, de laboratorio, de tratamiento y de las complicaciones de 35 niños con tuberculosis del sistema nervioso central, entre julio de 1997 y julio de 2004. Resultados: veinte de los 35 pacientes eran niños y 15 niñas. La edad promedio era 3.7 años; 30 (85.7% estaban en el estadio III de la enfermedad y 5 (14.3%, en el estadio II. Se documentó un contacto sintomático respiratorio en 19 casos (54.3%. Diez y ocho pacientes (51.4% estaban desnutridos. Hubo fiebre en 88.6%, vómito en 62.9%, alteración de la conciencia en 80% y convulsiones en 51

  20. Supply chain reliability modelling

    Directory of Open Access Journals (Sweden)

    Eugen Zaitsev

    2012-03-01

    Full Text Available Background: Today it is virtually impossible to operate alone on the international level in the logistics business. This promotes the establishment and development of new integrated business entities - logistic operators. However, such cooperation within a supply chain creates also many problems related to the supply chain reliability as well as the optimization of the supplies planning. The aim of this paper was to develop and formulate the mathematical model and algorithms to find the optimum plan of supplies by using economic criterion and the model for the probability evaluating of non-failure operation of supply chain. Methods: The mathematical model and algorithms to find the optimum plan of supplies were developed and formulated by using economic criterion and the model for the probability evaluating of non-failure operation of supply chain. Results and conclusions: The problem of ensuring failure-free performance of goods supply channel analyzed in the paper is characteristic of distributed network systems that make active use of business process outsourcing technologies. The complex planning problem occurring in such systems that requires taking into account the consumer's requirements for failure-free performance in terms of supply volumes and correctness can be reduced to a relatively simple linear programming problem through logical analysis of the structures. The sequence of the operations, which should be taken into account during the process of the supply planning with the supplier's functional reliability, was presented.

  1. Supply Chain Management og Supply Chain costing

    DEFF Research Database (Denmark)

    Nielsen, Steen; Mortensen, Ole

    2002-01-01

    Formålet med denne artikel er at belyse de muligheder som ligger i at integrere virksomhedens økonomiske styring med begrebet Supply Chain Management (SCM). Dette søges belyst ved først at beskrive den teoretiske ramme, hvori SCM indgår. Herefter analyseres begrebet Supply Chain Costing (SCC) som...... Århus. Et resultat er, at via begrebet Supply Chain Costing skabes der mulighed for at måle logistikkædens aktiviteter i kr./øre. Anvendelsen af denne information har også strategisk betydning for at kunne vælge kunde og leverandør. Ved hjælp af integrationen skabes der også helt nye mulighed...

  2. 中心城市周边区域农产品生产与物流供应的粒子群优化模型%Particle Swarm Optimization Model for Agricultural Production and Logistics Supply in Fringe of Central Cities

    Institute of Scientific and Technical Information of China (English)

    杨景祥; 黄永生; 杜化美

    2013-01-01

    In this paper, in view of the cost of agricultural planting in fringes of central cities as well as the different, diversified and complex logistics transportation cost in the supply of the agricultural products to the central cities, we proposed the particle swarm optimization model for the agricultural production and logistics supply of these areas. Then through analyzing the characteristics of the agricultural production and logistics supply in these areas, we designed the relevant parameters, established a particle swarm optimization algorithm, and then through a numerical example, tested the effect of the optimization model in the aspects of planting area selection, plant selection and logistics route selection.%针对中心城市周边区域农产品种植成本及供给中心城市物流运输成本的差异性、多样性和复杂性,提出中心城市周边区域农产品生产与物流供应的粒子群优化模型.通过中心城市周边区域农产品生产与物流供应特性为出发点的模型基础分析,设计中心城市周边区域农产品生产和物流供应相关参数,构建粒子群优化模型,并通过算例和算例分析,验证粒子群优化模型在种植区域选择、种植种类选择、物流去向选择方面的优化效果.

  3. The future of the healthcare supply chain.

    Science.gov (United States)

    Parker, Jeff; DeLay, Dan

    2008-04-01

    To achieve savings in the healthcare supply chain, healthcare organizations need to cooperate instead of compete. By forming a consolidated service center (CSC), healthcare organizations can centralize their contracting, procurement, distribution, and logistical operations. The CSC would enable organizations to improve efficiency and reduce costs.

  4. 我院手术支持中心的药事管理模式探索%Exploration on the New Pharmaceutical Administration Pattern of Central Surgery Service Department in Our Hospital

    Institute of Scientific and Technical Information of China (English)

    戴春雷; 缪旭东; 朱元琴; 卜晓光; 陈金凤

    2012-01-01

    目的:加强手术药品的管理.方法:成立手术支持中心,从工作流程改造、运用信息技术等各环节入手,对其药事管理模式进行探索.结果:该药事管理模式大大减少了医护人员手术准备时间和患者等待时间;保证了手术期间麻醉和精神药品使用情况能及时、准确地登记,便于统一管理;能做好药品数量与金额的双重管理,做到账物相符.结论:该管理模式能保证手术药品供应质量,避免差错.%OBJECTIVE: To strengthen the management of surgical drugs. METHODS: The management of the central surgery service department was guided through drug position, workflow reform and information management to explore the pattern of pharmaceutical administration. RESULTS: The new pharmaceutical administration pattern had reduced the operator's preparing time and the patient's waiting time, ensured that the cases of using narcotic and psychotropic drugs could be booked exactly in time, and manage the amount and sum of drugs to make the account fit the contents. CONCLUSIONS: The pattern can ensure efficiency and quality of drug supply and avoid errors.

  5. Sustainable Supply Chain Design

    DEFF Research Database (Denmark)

    Bals, Lydia; Tate, Wendy

    to implement TBL goals across the supply chain. In supply chain design, the classic economic perspective still dominates, although the idea of the TBL is more widely disseminated. The purpose of this research is to add to the sustainable supply chain management literature (SSCM) research agenda......A significant conceptual and practical challenge is how to integrate triple bottom line (TBL; including economic, social and environmental) sustainability into global supply chains. Although this integration is necessary to slow down global resource depletion, understanding is limited of how...... by incorporating the physical chain, and the (information and financial) support chains into supply chain design. This manuscript tackles issues of what the chains are designed for and how they are designed structurally. Four sustainable businesses are used as illustrative case examples of innovative supply chain...

  6. Study on application of comprehensive index evaluation method to water motoring of small centralized and decentralized water supply in some areas of Qinghai%综合指数评价法在青海省部分地区小型集中和分散式供水水质监测中的应用

    Institute of Scientific and Technical Information of China (English)

    袁露; 付春晓

    2013-01-01

    Objective To analyze and evaluate the monitoring data of small concentrated and decentralized water supply water quality in some areas of Qinghai province by using the comprehensive index.Method Based on the " the part of water quality index and limit value of small central water supply and decentralized water supply" of the " drinking water health standards" (GB5749-2006),the water quality comprehensive evaluation index was calculated with the method and steps of " comprehensive evaluation value of F".According to the water quality monitoring data from small centralized and decentralized water supply of 10 counties in Qinghai of 2008,the water quality comprehensive index was evaluated and the water quality was classified.Results the physicochemical,toxicological indicator index of 10 counties in withered,abundant water period were both less than 1,and the monitoring results were not over " the part of water quality index and limit value of small central water supply and decentralized water supply",The unconventional indicators of water quality index of abundant water period was less than 1,which did not exceed the standards of hygiene.During the dry seasons,9 counties" unconventional indicators of water quality index did not exceed the hygienic standard.In terms of the microbial index,4 counties in dry period and 5 counties in abundant water period had index greater than 1,and the monitoring results were over " the part of water quality index and limit value of small central water supply and decentralized water supply" Among 546 water monitoring points of 10 counties in dry and abundant water period,the points achieved at " excellent" accounted for 21.61%,13.19% respectively,the points achieved at " good" accounted for 54.21%,62.45%,and the points achieved at " not bad" accounted for 11.90%,9.34%.Conclusions Among the 546 small central water supply and decentralized water supply systems,part of which enclosed bad.The water treatment process is simple

  7. Aspectos ergonômicos na transferência de pacientes: um estudo realizado com trabalhadores de uma central de transportes de um hospital universitário Aspectos ergonómicos en la transferencia de enfermos: un estudio hecho com trabajadores de una central de transportes de un hospital universitário The transfer of patients and its ergonomic aspects: a study conducted at a university hospital lifting center

    Directory of Open Access Journals (Sweden)

    Cristiane Gonzales Rossi

    2001-09-01

    Full Text Available Com o objetivo de avaliar aspectos ergonômicos na transferência de pacientes com a utilização de maca e cadeira de rodas, observou-se 249 transferências realizadas por trabalhadores da Seção de Escolta de um Hospital Universitário. Os resultados sugerem que a existência dessa equipe é uma iniciativa que deve ser estimulada mas que esses trabalhadores precisam de treinamento específico sobre movimentação e transporte de pacientes e de terem à disposição materiais auxiliares e equipamentos mecânicos.Com el objetivo de avaliar aspectos ergonómicos de transferencia de enfermos com utilización de maca y silla de ruedas, observarán se 249 transferencias realizadas por trabajadores de la Sección de Escolta (Acompañamiento de un Hospital Universitário. Los resultados sugerem que la existencia desse equipo es una iniciativa que debrá ser estimulada. Pero esos trabajadores necessitan entrenamiento especifico sobre mobilizacion y transporte de enfermos e necessitam tener a disposicion materiales auxiliares y equipamentos mecânicos.The purpose of this study was to evaluate ergonomic aspects involved in using a stretcher and a wheel chair to transfer patients. 249 transfers carried out by the workers of a university hospital lifting sector were observed. The observations showed that the idea of having a team to transfer patients has to be stimulated but the members of the team require specific training in handling and transferring patients. Mechanical equipment and other devices should also be available.

  8. Food supply chains

    OpenAIRE

    Zhou, Qian

    2011-01-01

    The dissertation analyses food waste in global supply chain. From the related managerial literature, the process of supply chain operation, from agriculture, manufacturing, warehouses, retailers to customers are explained clearly. Then the reasons and characteristics of food wastes in any point of food supply chain are analyzed. From some case studies and questionnaire investigation, some corresponding methods to reduce food waste are put forward in the following. Lastly, in terms of method s...

  9. Supply and Marketing Cooperatives

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    @@ China Supply and Marketing Cooperatives Council of CCPIT was established in March 1996. It is an institution under direct leadership of China Supply and Market-ing Cooperatives and at the same time a branch of China Council for Promotion of International Trade, with its major task to promoting and facilitating export-oriented economic trade and technological cooper-ation of the national supply and marketing cooperative system.

  10. Supply chain components

    Directory of Open Access Journals (Sweden)

    Vieraşu, T.

    2011-01-01

    Full Text Available In this article I will go through three main logistics components, which are represented by: transportation, inventory and facilities, and the three secondary logistical components: information, production location, price and how they determine performance of any supply chain. I will discuss then how these components are used in the design, planning and operation of a supply chain. I will also talk about some obstacles a supply chain manager may encounter.

  11. 人力资源的精细化管理在消毒供应中心的应用与探讨%Careful and detailed management of human resources in central sterilization supply department:application and discussion

    Institute of Scientific and Technical Information of China (English)

    高玉华; 郭彩霞; 孙雪莹; 邱素红

    2011-01-01

    OBJECTIVE To use careful and detailed management of human resources to raise the work efficiency! cultivate excellent operation personnel and improve the professional technology, and to establish specialized sterilization supply team. METHODS The effective management measures of human resources were established, the modern theory of management was employed to creatively mobilize the personnel's potential, the corresponding management pattern to the clinical practice was established to make use of the limited human resources reasonably and effectively. RESULTS Through the resource of labour power adjusted the effectively at different levels, the personnel thought carefully his value and position, understood clearly its duty and task and set up the competition. Consciousness and consciousness of quality, transferred at different levels personnels, initiative good quality efficient field completed the task of every security high imitate every supply was completed) the clinical satisfaction was improved. CONCLUSION The effective measures of human resources management can make all levels of personnel be involved and responsible, and ensure that the clinical items are supplied in time.%目的 利用精细化的人力资源管理,提高工作效率、培养优秀专科操作人员,提高消毒供应专业技术含量,建立专业化消毒供应队伍.方法建立人力资源有效管理措施,运用现代管理理论,创造性地调动人员潜能,提出应用现代管理理论,建立适合临床实际情况的护理供应人力资源管理模式,做到合理、有效地使用有限的人力资源.结果 通过人力资源的有效调整,促使各级人员思考自己的价值和位置,明确自己的职责和任务,树立竞争、服务和质量意识,调动了各级人员的积极性,优质、高效地完成各项供应保障任务,提高了临床满意度.结论有效的人力资源管理措施使各级人员各尽其责、各施其能,保证医院临床物品及时有效地消毒供应.

  12. Hospital Inspections

    Data.gov (United States)

    U.S. Department of Health & Human Services — Welcome to hospitalinspections.org, a website run by the Association of Health Care Journalists (AHCJ) that aims to make federal hospital inspection reports easier...

  13. Facility management in German hospitals.

    Science.gov (United States)

    Gudat, H

    2000-04-01

    Facility management and optimum building management offer for hospitals a chance to reduce costs and to increase quality, process sequences, employee motivation and customer satisfaction. Some years ago simple services such as cleaning, catering or laundry were outsourced. Now, German hospitals progress to more complex fields such as building and medical technology, clinical support processes such as pharmacy, central laboratory and sterilization, goods and logistics services.

  14. Hospital marketing.

    Science.gov (United States)

    Carter, Tony

    2003-01-01

    This article looks at a prescribed academic framework for various criteria that serve as a checklist for marketing performance that can be applied to hospital marketing organizations. These guidelines are drawn from some of Dr. Noel Capon of Columbia University's book Marketing Management in the 21st Century and applied to actual practices of hospital marketing organizations. In many ways this checklist can act as a "marketing" balanced scorecard to verify performance effectiveness and develop opportunities for innovation.

  15. Research on the Fresh Agricultural Product Supply Chain Coordination with Supply Disruptions

    Directory of Open Access Journals (Sweden)

    Sun Guohua

    2013-01-01

    Full Text Available This paper develops a dynamic model in a one-supplier-one-retailer fresh agricultural product supply chain that experiences supply disruptions during the planning horizon. The optimal solutions in the centralized and decentralized supply chains are studied. It is found that the retailer’s optimal order quantity and the maximum total supply chain profit in the decentralized supply chain with wholesale price contract are less than that in the centralized supply chain. A two-part tariff contract is proposed to coordinate the decentralized supply chain with which the maximum profit can be achieved. It is found that the optimal wholesale price should be a decreasing piecewise function of the final output. To ensure that the supplier and the retailer both have incentives to accept the coordination contract, a lump-sum fee is offered. The interval of lump-sum fee is given leaving both the supplier and the retailer better off with the two-part tariff contract.

  16. 优质护理在提升消毒供应中心工作质量中的应用效果研究%Effect of high-quality nursing on improvement of work quality in central sterile supply department

    Institute of Scientific and Technical Information of China (English)

    李玉丽; 李玉娟; 聂玉香; 周大燕; 张德勇

    2015-01-01

    目的:探讨应用优质护理之后消毒供应中心工作质量的提高情况,总结能够有效提高供应中心工作质量降低工作人员压力的护理方式。方法选取2015年3-6月消毒供应中心的36名护士参与本研究,对所选人员进行职业道德培训以及专业知识培训,对消毒供应中心进行统筹管理,对医疗物品处理的每个环节制定相应的质量评价标准,并严格按照标准执行;压力评分按照填写Beck‐Srivaatava压力量表(BSSI)的方式,并在实施优质护理前后随机抽取300件医疗器械,分别测定洗涤合格率、灭菌合格率以及包装的合格率。结果实施优质护理之前消毒供应中心内的工作人员的工作压力评分为(62.3±4.6)分,实施优质护理之后为(56.3±3.7)分,实施优质护理后消毒供应中心工作人员的压力下降,差异有统计学意义(P<0.05);实施优质护理服务前医疗用品洗涤合格率为88.00%、灭菌合格率为91.33%、包装合格率为93.67%;实施优质护理服务后医疗器械清洗合格率为96.33%、灭菌合格率为98.33%、包装合格率为98.67%,实施后与实施前相比差异有统计学意义( P<0.05)。结论应用优质护理可以降低消毒供应中心工作人员的工作压力,提高消毒供应中心的工作质量,适合在临床上推广。%OBJECTIVE To explore the improvement of work quality of central sterile supply department (CSSD) after the implementation of high‐quality nursing and summarize the nursing approaches to effectively improve the work quality and relieve the stress of the staff .METHODS Totally 36 nurses of CSSD were enrolled in the study from Mar 2015 to Jun 2015 ,then the professional ethics training and professional knowledge training were deliv‐ered to the participants .The CSSD was planned as a whole and corresponding quality evaluation standards were

  17. Supply Chain Management

    DEFF Research Database (Denmark)

    Wieland, Andreas; Handfield, Robert B.

    Supply chain management has made great strides in becoming a discipline with a standalone body of theories. As part of this evolution, researchers have sought to embed and integrate observed supply chain management phenomena into theoretical statements. In our review, we explore where we have been...

  18. Design of sustainable second-generation biomass supply chains

    NARCIS (Netherlands)

    Yazan, Devrim Yazar; Duren, van Iris; Mes, Martijn; Kersten, Sascha; Clancy, Joy; Zijm, Henk

    2016-01-01

    Operational and economic trade-offs in the design of second-generation biomass (SGB) supply chains guide the decisions about plant scale and location as well as biomass collection routes. This paper compares different SGB supply chain designs with a focus on mobile pyrolysis plants and centralized v

  19. Retrospective analysis of 53 cases of medical supplies quality adverse event

    Directory of Open Access Journals (Sweden)

    Cheng-zu LUO

    2014-04-01

    Full Text Available Medical supplies are the basic material for medical work in the hospital, and in relation to the patient's life.This paper analyzed retrospectively 53 cases of medical supplies quality adverse event in our hospital from 2011 to 2012.Accordingly, it was discussed how to improve the whole quality control system of medical supplies, how to ensure clinical safety, and how to reduce the incidence of adverse events.

  20. Clinical characteristics and medical costs of diabetics with amputation at central urban hospitals in China%中国城市医院糖尿病截肢的临床特点及医疗费用分析

    Institute of Scientific and Technical Information of China (English)

    王爱红; 许樟荣; 纪立农

    2012-01-01

    Objective To explore the clinical characteristics,medical costs and its influencing factors in diabetics with amputation.Methods The data of diabetic amputation for the whole year of 2010 at 39 central municipal Class 3A hospitals all across China were retrospectively analyzed according to a unified protocol,including demographic characteristics, diabetic complications, classification of diabetic foot disease,level and prognosis of amputation and medical costs at hospitals.Results Among them,28.2 % of all amputated patients or 39.5% of non-traumatic patients were diabetics.There were 313 males and 162 females.The average age and duration of diabetes were (66 ± 12) years and ( 130 ±94) months.The level of HbA1c was 8.9% ± 2.4%. Among all amputated diabetics,the concurrent conditions included neuropathy ( 50.1% ),peripheral artery disease ( 74.8% ),nephropathy ( 28.4% ) and retinopathy (25.9%).The patients with foot ulcer at Wagner 4 (50.3% ) were more common.Among them,67.5% had minor amputation with a median hospitalization stay of 33.0 (24.0 -45.O)days and a medical cost of 26 138( 16 155 - 46 021 ) yuan RMB. The duration of diabetes,diabetic complications,severity and location of ulcers and amputation level influenced their hospitalization durations and medical costs.Conclusion The patients with diabetes and amputation are elder with more chronic diabetic complications and uncontrolled hyperglycemia. Most of them have complications of local gangrene and require minor amputation at admission.Their hospital stays are longer and medical costs higher significantly correlated with diabetic complications,severity and location of foot ulcers and level of amputations.%目的 调查中国城市医院糖尿病截肢率、分析糖尿病截肢的临床特点、医疗费用及其影响因素.方法 对全国39家三甲医院2010年全年糖尿病截肢患者进行回顾性地调查,分析内容包括人口学特征、糖尿病并发症、糖尿病足

  1. Evaluation of the application effect of cleaning packaging of surgical medical apparatus and instruments in sterilization and supply center of hospital%医院消毒供应中心实施手术医疗器械清洗包装的效果评价

    Institute of Scientific and Technical Information of China (English)

    焦丽玲; 刘文红; 赵俊霞

    2012-01-01

    目的 探讨医院消毒供应中心实施手术医疗器械清洗包装的效果.方法 对我院消毒供应中心实施手术医疗器械清洗包装前后的清洗质量一次合格率、包装质量一次合格率、无菌检查一次合格率、院内感染发生率等指标进行比较,综合评价医院消毒供应中心实施手术医疗器械清洗包装的效果.结果 消毒供应中心实施手术医疗器械清洗包装后,手术器械清洗质量检查一次合格率、包装质量一次合格率、无菌检查合格率均较实施前有明显提高,前后比较差异显著;比较实施前后的院内感染发生率,实施后的院内感染率为1.5%,实施前为5.5%,前后比较差异显著.结论 医院消毒供应中心实施手术医疗器械的清洗包装,可有效控制手术器械的清洗质量及包装质量,保证了后续消毒灭菌的彻底性,大大降低了因手术器械质量不过关而导致的院内感染发生率,为患者创造了可靠、值得信赖的医疗环境,取得了良好的社会效益和经济效益,值得推广应用.%Objective To investigate the application effect of cleaning packaging of surgical medical apparatus and instruments in sterilization and supply center of hospital. Methods The first-time qualification rate of cleaning,packaging and sterility test and incidence rate of nosocomial infection before and after the application of cleaning packaging of surgical medical apparatus and instruments in sterilization and supply center of hospital.The application effect was comprehensively evaluated. Results The first-time qualification rate of cleaning,packaging and sterility test after the application of cleaning packaging of surgical medical apparatus and instruments in sterilization and supply center were significantly increased.The incidence rate of nosocomial infection was 1.5% before and 5.5% after the application of cleaning packaging of surgical medical apparatus and instruments,the difference

  2. Spatial Data Supply Chains

    Science.gov (United States)

    Varadharajulu, P.; Azeem Saqiq, M.; Yu, F.; McMeekin, D. A.; West, G.; Arnold, L.; Moncrieff, S.

    2015-06-01

    This paper describes current research into the supply of spatial data to the end user in as close to real time as possible via the World Wide Web. The Spatial Data Infrastructure paradigm has been discussed since the early 1990s. The concept has evolved significantly since then but has almost always examined data from the perspective of the supplier. It has been a supplier driven focus rather than a user driven focus. The current research being conducted is making a paradigm shift and looking at the supply of spatial data as a supply chain, similar to a manufacturing supply chain in which users play a significant part. A comprehensive consultation process took place within Australia and New Zealand incorporating a large number of stakeholders. Three research projects that have arisen from this consultation process are examining Spatial Data Supply Chains within Australia and New Zealand and are discussed within this paper.

  3. Designing a modern hospital pharmacy.

    Science.gov (United States)

    Kay, B G; Boyar, R L; Raspante, P S

    1986-02-01

    Cooperation between the pharmacy director and the hospital's architects in planning a modern hospital pharmacy is described. The pharmacy director at an 870-bed voluntary nonprofit institution and the hospital's architects planned the design for a new 3250-square foot pharmacy department. They developed a preliminary floor plan based on the following functions that the pharmacy would perform: centralized unit dose drug distribution; compounding; bulk and unit dose prepackaging; preparation of sterile products; controlled substance storage; outpatient and employee prescription dispensing; reserve stock storage; purchasing, receiving, and inventory control; drug information services; and administrative services. A final floor plan was designed that incorporated these functions with structural and utility requirements, such as placement of the computer system and dispensing and lighting fixtures. By integrating modern material management concepts with contemporary hospital pharmacy practice, the pharmacy director and the hospital's architects were able to plan and construct a pharmacy that receives, processes, and dispenses medication efficiently.

  4. Central Station Design Options

    DEFF Research Database (Denmark)

    2011-01-01

    The purpose of EDISON Work Package 4.1 is the evaluation of possible Central (charging) Stations design options for making possible the public charging of Electric Vehicles (EVs). A number of scenarios for EVs are assessed, with special emphasis on the options of Fast Charging and Battery Swapping....... The work identifies the architecture, sizing and siting of prospective Central Stations in Denmark, which can be located at shopping centers, large car parking lots or gas stations. Central Stations are planned to be integrated in the Danish distribution grid. The Danish island of Bornholm, where a high.......g. due to vandalism, the charge supply circuit is disconnected. More electrical vehicles on the market are capable today of quick charging up to 50 kW power level. The feasibility of Central Stations with fast charging/swapping option, their capacity, design, costs and grid impact, as well as battery...

  5. Control of supply temperature

    Energy Technology Data Exchange (ETDEWEB)

    Madsen, H.; Nielsen, T.S.; Soegaard, H.T.

    1996-09-01

    For many district heating systems, e.g. the system in Hoeje Taastrup, it is desirable to minimize the supply temperature from the heat production unit(s). Lower supply temperature implies lower costs in connection with the production and distribution of heat. Factors having impact on the heat demand are for instance solar radiation, wind speed, wind direction and a climate independent part, which is a function of the time of the day/week/year. By applying an optimization strategy, which minimizes the supply temperature, it is assumed that optimal economical operation can be obtained by minimizing the supply temperature and thereby the heat losses in the system. The models and methods described in this report take such aspects into account, and can therefore be used as elements in a more efficient minimization of the supply temperature. The theoretical part of this report describes models and methods for optimal on-line control of the supply temperature in district heating systems. Some of the models and methods have been implemented - or are going to be implemented - in the computer program PRESS which is a tool for optimal control of supply temperature and forecasting of heat demand in district heating systems. The principles for using transfer function models are briefly described. The ordinary generalized predictive control (OGPC) method is reviewed, and several extensions of this method are suggested. New controller, which is called the extended generalized predictive controller (XGPC), is described. (EG) 57 refs.

  6. Supply chain planning classification

    Science.gov (United States)

    Hvolby, Hans-Henrik; Trienekens, Jacques; Bonde, Hans

    2001-10-01

    Industry experience a need to shift in focus from internal production planning towards planning in the supply network. In this respect customer oriented thinking becomes almost a common good amongst companies in the supply network. An increase in the use of information technology is needed to enable companies to better tune their production planning with customers and suppliers. Information technology opportunities and supply chain planning systems facilitate companies to monitor and control their supplier network. In spite if these developments, most links in today's supply chains make individual plans, because the real demand information is not available throughout the chain. The current systems and processes of the supply chains are not designed to meet the requirements now placed upon them. For long term relationships with suppliers and customers, an integrated decision-making process is needed in order to obtain a satisfactory result for all parties. Especially when customized production and short lead-time is in focus. An effective value chain makes inventory available and visible among the value chain members, minimizes response time and optimizes total inventory value held throughout the chain. In this paper a supply chain planning classification grid is presented based current manufacturing classifications and supply chain planning initiatives.

  7. Analysis of exfoliated gastric carcinoma cells attached on surgical supplies

    Directory of Open Access Journals (Sweden)

    Yu XF

    2014-10-01

    Full Text Available Xiao-Fen Yu,1 Ying-Yu Ma,2 Xian-Qin Hu,1 Qin-Fang Zhang,1 Zai-Yuan Ye3 1Operating Theatre, Zhejiang Provincial People’s Hospital, 2Key Laboratory of Gastroenterology of Zhejiang Province, Zhejiang Provincial People’s Hospital, 3Department of Gastrointestinal Surgery, Zhejiang Provincial People’s Hospital, Hangzhou, People’s Republic of China Abstract: Surgery is considered to have a leading role in the treatment of gastric carcinoma. Surgical supplies are used to cut, divide, and ligate during surgery, and are not only in close contact with normal tissues, but may also be contaminated by pathological tissues and cells. This study sought to determine the presence of exfoliated tumor cells on surgical supplies at different stages during the surgical procedure. We collected five types of surgical supplies from 90 patients who underwent D2 radical gastrectomy to find out if there was any cancer cells attached to them. Highest numbers of cancer cells were found on gauze used to clean the surgical instruments and on the gloves of scrub nurses. The likelihood of finding cancer cells increased with advancing clinical stage of disease, lower differentiation of cancer cells, increasing frequency of use of supplies and extent of contact, and was also associated with the characteristic of surgical supplies. Dissemination of tumor cells could be prevented by using a number of methods, depending on the type of surgical supply items. Keywords: exfoliated tumor cells, surgical supplies, gastric carcinoma, metastasis, prevention

  8. Economic Reasonability Analysis for Per Capita Investment in Centralized Water Supply Projects in Rural Areas of Hebei Province%河北省农村集中供水工程人均投资规模的经济合理性分析

    Institute of Scientific and Technical Information of China (English)

    陈雪英; 连少伟; 谢敬芬; 孙雪峰

    2011-01-01

    河北省农村饮水安全工程的供水模式以集中供水工程为主.集中供水工程的费用主要包括折旧费和年运行费;经济效益主要包括医疗费用的减少、副业收入的增加和其它生产性劳动收入.经济合理性分析拟采用项目经济评价指标体系,选用经济净现值、经济内部收益率、效益费用比和动态投资回收期等指标进行分析评价.分析结果表明,各项指标均满足项目合理条件要求,人均投资规模经济合理.%The centralized water supply mode is the main mode for the rural drinking water safety projects in Hebei Province. The cost for centralized water supply mode is composed of depredation charge and annual running cost. The economic benefits include the decline in medical expenses, and the earnings increase from bywork and other physical labor. Economic evaluation index system is adopted for the economic reasonability analysis and the choice of indicators includes the economic net present value, economic internal rate of return, cost-benefit ratio and dynamic investment recovery period. The analysis shows that each index fits the project requirement and the per capita investment is economically reasonable.

  9. SIMULATING THE SUPPLY DISRUPTION FOR THE COORDINATED SUPPLY CHAIN

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    There are many disruptive accidents in the supply chain operations system and achieving the coordination of supply chain is main objective for supply chain research. While disruptive accidents have increasingly influenced the coordinated operation of the supply chain, existing research literature on the supply chain coordination is setting in a stationary environment. The answer for how the disruptive accidents affect the coordinated supply chain is given in this paper. Based on the benchmark supply chain which is coordinated by the negative incentive mechanism, we study the impacts of supply disruption on the supply chain system by using simulation approach in which two different distribution function of random variable are used to express the supply disruption. Comparison between these two simulation results and possible coordination mechanism under the supply disruption are proposed. From the perspective of supply chain risk management, we provide the inspiration for the manager.

  10. Supply shortage; Nachschub gefaehrdet

    Energy Technology Data Exchange (ETDEWEB)

    Pries, P.D.; Rentzing, S.

    2006-08-15

    Producers of solar wafers intend to produce several MW of solar wafers during the next few years. However, indium and tellurium are not in unlimited supply, and prices are rising. A new shortage of raw materials is impending. (orig.)

  11. Supply chain risk management

    Directory of Open Access Journals (Sweden)

    Christian Hollstein

    2013-03-01

    Full Text Available Background: Supply chain risk management increasingly gains prominence in many international industries. In order to strengthen supply chain structures, processes, and networks, adequate potentials for risk management need to be built (focus on effective logistics and to be utilized (focus on efficient logistics. Natural-based disasters, such as the case of Fukushima, illustrate how crucial risk management is. Method: By aligning a theoretical-conceptual framework with empirical-inductive findings, it may be hypothesized that logistical systems do have a positive effect on supply chain risk management activities.  Result/conclusion:  Flexibility and capacity, as well as redundancy and standardization, are often viewed as being conflictionary. It shows, however, that in the light of supply chain risk management, those factors may yield a common benefit if proper logistics systems are applied.  

  12. Radioisotope Power Supply Project

    Data.gov (United States)

    National Aeronautics and Space Administration — Between 1998 and 2003, Hi-Z Technology developed and built a 40 mW radioisotope power supply (RPS) that used a 1 watt radioisotope heater unit (RHU) as the energy...

  13. Dwindling Labor Supply

    Institute of Scientific and Technical Information of China (English)

    HUYONG

    2004-01-01

    this summer, China encountered an unexpected problem-a dwindling supply of migrant labor. In the southeast coastal area in particular, where manufacturing is heavily concentrated, the shortage of labor has become a quite severe problem.

  14. Editorial: Supply Chain Management

    Directory of Open Access Journals (Sweden)

    Aidonis, D.

    2012-01-01

    Full Text Available This special issue has followed up the 2nd Olympus International Conference on Supply Chains held on October 5-6, 2012, in Katerini, Greece. The Conference was organized by the Department of Logistics of Alexander Technological Educational Institution (ATEI of Thessaloniki, in collaboration with the Laboratory of Quantitative Analysis, Logistics and Supply Chain Management of the Department of Mechanical Engineering, Aristotle University of Thessaloniki (AUTH. During the 2-Days Conference more than 50 research papers were presented covering the following thematic areas: (i Business Logistics, (ii Transportation, Telematics and Distribution Networks, (iii Green Logistics, (iv Information and Communication Technologies in Supply Chain Management, and (v Services and Quality. Three keynote invited speakers addressed interesting issues for the Humanitarian Logistics, Green Supply Chains of the Agrifood Sector and the Opportunities and Prospects of Greek Ports chaired Round Tables with other Greek and Foreign Scientists and Specialists.

  15. Drug resistance analysis of Streptococcus pneumoniae isolated from paediatric patients hospitalized for community-acquired pneumonia in Xiangtan central hospital%湘潭市中心医院社区获得性肺炎住院患儿肺炎链球菌的耐药性研究

    Institute of Scientific and Technical Information of China (English)

    龚晓辉; 唐曼娟; 谭菊香

    2012-01-01

    Objective To investigate the drug resistance of Streptococus pneumoniae (SP) isolated from paediatric patients hospitalized for community-acquired pneumonia in Xiangtan central hospital. Methods A total of 115 SP strains isolated from children in hospital from 2010 to 2011 were analyzed. Bacterial susceptibility test was carried out by using Kirby-Bauer and E-test metods. Results The resistance rates of SP against penicillin, erythromycin, clindamycin, levofloxacin, ceftriaxone, vancomycin, linezolid and sulfamethoxazole-trimethoprim were 6.1%, 95.6%, 94.8%, 1.7%, 6.9%, 0%, 0% and 73.9% respectively. Conclusion The susceptible rate of SP to erythromycin and clindamycin is extremely low, but it is very high to penicillin and ceftriaxone.%目的 了解湘潭市中心医院因社区获得性肺炎住院的患儿肺炎链球菌(SP)的耐药情况.方法 对本院2010-2011年住院患儿分离的115株SP进行分析,采用K-B纸片琼脂扩散法及浓度梯度法(E测试)检测SP对青霉素、头孢曲松、红霉素、克林霉素、左氧氟沙星、万古霉素、利奈唑胺、复方磺胺甲噁唑的耐药性.结果 115株SP中青霉素敏感肺炎链球菌(PSSP)占86.1%,青霉素中介肺炎链球菌(PISP)占7.8%,青霉素耐药肺炎链球菌(PRSP)占6.1%.SP对红霉素、克林霉素及复方磺胺甲噁唑的耐药率分别为95.6%、94.8%和73.9%,左氧氟沙星的耐药率为1.7%,头孢曲松的耐药率为6.9%,未发现对万古霉素及利奈唑胺耐药的SP菌株.结论 本院分离的SP对儿科常用抗生素青霉素及头孢曲松钠仍高度敏感,但对大环内酯类抗生素红霉素、林可酰胺类抗生素克林霉素耐药情况严重.

  16. A Computerized Hospital Patient Information Management System

    Science.gov (United States)

    Wig, Eldon D.

    1982-01-01

    The information processing needs of a hospital are many, with varying degrees of complexity. The prime concern in providing an integrated hospital information management system lies in the ability to process the data relating to the single entity for which every hospital functions - the patient. This paper examines the PRIMIS computer system developed to accommodate hospital needs with respect to a central patient registry, inpatients (i.e., Admission/Transfer/Discharge), and out-patients. Finally, the potential for expansion to permit the incorporation of more hospital functions within PRIMIS is examined.

  17. Solar mobile power supply

    OpenAIRE

    Hu, Libian

    2014-01-01

    The solar mobile power supply is a comprehensive energy saving and environment protective product. Besides, it consists of solar panels, storage battery and controller as well as other important components. Based on the traditional solar charging circuit, this solar power supply combines the 5V USB interface and 12V adjustable circuit as well as the 220V inverter and power adapter to greatly improve the function of the power system.

  18. Supply chain quality management

    OpenAIRE

    Hannan Amoozad Mahdiraji; Meysam Arabzadeh; Reza Ghaffari

    2012-01-01

    In recent years, there are several methods introduced for the improvement of operational performances. Total quality management and supply chain management are two methods recommended for this purpose. These two approaches have been studied in most researches separately, while they have objectives in common, and this makes them a strategic means, which can be used, simultaneously. Total quality management and supply chain management play significant roles to increase the organizational compet...

  19. MASTERING SUPPLY CHAIN RISKS

    Directory of Open Access Journals (Sweden)

    Borut Jereb

    2012-11-01

    Full Text Available Risks in supply chains represent one of the major business issues today. Since every organizationstrives for success and uninterrupted operations, efficient supply chain risk management is crucial.During supply chain risk research at the Faculty of Logistics in Maribor (Slovenia some keyissues in the field were identified, the major being the lack of instruments which can make riskmanagement in an organization easier and more efficient. Consequently, a model which captures anddescribes risks in an organization and its supply chain was developed. It is in accordance with thegeneral risk management and supply chain security standards, the ISO 31000 and ISO 28000families. It also incorporates recent finding from the risk management field, especially from theviewpoint of segmenting of the public.The model described in this paper focuses on the risks itself by defining them by different keydimensions, so that risk management is simplified and can be undertaken in every supply chain andorganizations within them. Based on our mode and consequent practical research in actualorganizations, a freely accessible risk catalog has been assembled and published online from the risksthat have been identified so far. This catalog can serve as a checklist and a starting point in supplychain risk management in organizations. It also incorporates experts from the field into a community,in order to assemble an ever growing list of possible risks and to provide insight into the model andits value in practice.

  20. Save $829,000 annually just by reengineering the way you receive products, supplies.

    Science.gov (United States)

    1997-04-01

    Data Benchmarks: Save $829,000 by reengineering the supply chain. A group has finally quantified how much money is spent unnecessarily in the hospital supply chain--and it's staggering. This month's column offers a close-up on specific segments of the supply chain where health care organizations are squandering most of their supply dollars, plus you'll find some best practices for getting the biggest bang for the buck.

  1. Control technology in supply systems. Regelungstechnik in der Versorgungstechnik

    Energy Technology Data Exchange (ETDEWEB)

    Bach, H.; Baumgarth, S.; Forsch, K.; Reeker, J.; Krinninger, H.; Ruosch, E.; Schaefer, A.; Schiele, J.; Schroeder, H.; Treusch, W.

    1983-01-01

    The textbook presents the theoretical fundamentals and practical examples of control technology in supply systems. Practical examples of the fields of heating, air conditioning, and gas supply are presented in detail. The book comprises the following chapters: 1. Introduction to control technology; 2. steady state and time behaviour of control loop elements; 3. controlled systems; 4. control equipment; 5. control elements; 6. closed loops; 7. preset control; 8. meshed control loops; 9. digital control technology; 10. central control systems for supply systems of buildings; 11. examples of supply systems control.

  2. 驻海岛中心医院体系部队健康促进工作做法%Health Promotion Measures of Army Served by Central Hospital Located in Island

    Institute of Scientific and Technical Information of China (English)

    蔡宏伟; 谭小云; 朱长发

    2015-01-01

    建院以来,医院始终立足院区医疗拓展院外服务,方式从巡诊、邮路、电话服务向网络、培训、代职服务转变,有力推动体系部队健康促进工作开展。通过巡诊服务送健康、院内服务给健康、网络互动教健康、院队合作强健康四方面分析,总结医院在体系部队健康促进工作中的做法,提出加强组织领导、开展院队协同、强化人才培训的建议,为进一步做好部队健康促进提供有益的经验方法。%Since hospital establishing, our hospital has always been based on medical school in hospital ar-ea to expand services outside the hospital.Our service mode converts from rounds, postman, telephone service to the network, training and vocational help services.Hospital practiced effectively promotes system health promotion work carried troops.The article summarized the hospital practice in health promotion from itinerant service delivery health, hospital services for health, health education network interaction, teamwork and strong health hospital.We proposed to strengthen the organization and leadership, carried out the hospital team collaboration, strengthened personnel training advice, and provided useful empirical method for further improving health promotion.

  3. Innovation Across the Supply Chain

    DEFF Research Database (Denmark)

    Druehl, Cheryl; Carrillo, Janice; Hsuan, Juliana

    Innovation is an integral part of every firm’s ongoing operations. Beyond product innovation, supply chain innovations offer a unique source of competitive advantage. We synthesize recent research on innovation in the supply chain, specifically, innovative supply chain processes...

  4. Sustainable supply chain design: a configurational approach.

    Science.gov (United States)

    Masoumik, S Maryam; Abdul-Rashid, Salwa Hanim; Olugu, Ezutah Udoncy; Raja Ghazilla, Raja Ariffin

    2014-01-01

    Designing the right supply chain that meets the requirements of sustainable development is a significant challenge. Although there are a considerable number of studies on issues relating to sustainable supply chain design (SSCD) in terms of designing the practices, processes, and structures, they have rarely demonstrated how these components can be aligned to form an effective sustainable supply chain (SSC). Considering this gap in the literature, this study adopts the configurational approach to develop a conceptual framework that could configure the components of a SSC. In this respect, a process-oriented approach is utilized to classify and harmonize the design components. A natural-resource-based view (NRBV) is adopted to determine the central theme to align the design components around. The proposed framework presents three types of SSC, namely, efficient SSC, innovative SSC, and reputed SSC. The study culminates with recommendations concerning the direction for future research.

  5. Building areas of hospitals in Japan and distribution of areas by department--1980's.

    Science.gov (United States)

    Itoh, M; Nakayama, S; Liu, Y Y; Kawaguchi, Y

    1993-07-01

    (1) Areas of entire hospitals which have been continuously increasing in the past 30 years are finally showing signs for slowing down. The areas of the hospitals completed in the 1980's were generally 50 to 80 m2 per bed. (2) The distribution of the nursing department to the entire hospitals in area ratio ranges from 30 to slightly more than 40%, or higher than 35% in most cases. The actual areas of the nursing department has surpassed 20 m2 per bed in a considerably large number of hospitals. (3) The area ratio of the outpatient department tends to concentrate to about 12%. Of this percentage, in almost all hospitals, the proportion of the emergency division was less than 2%. (4) As in the 1970's, the diagnostic and treatment facilities were within the range of 18 to 22% in the majority of the hospitals. The distribution shifted to ratios higher than the previous survey. The distributions for the various sections are as follows: 1) Specimen test rooms 3 to 5% 2) Physiological examination rooms slightly below 1% to slightly above 2% 3) X-ray diagnosis rooms about 4% 4) Radiation therapy rooms about 1% 5) Nuclear medicine rooms about 1% 6) Operating department 3 to 5%, 2 to 3 m2/bed 7) Delivery suite less than 1% 8) Rehabilitation department 1 to 4% 9) Hemodialysis suite about 1% (5) The area ratios of the supply department dispersed substantially between 12 and 25%. About 70% of the hospitals remained in the range of 15 to 20%. The ratios of the various sections in the department are as follows: 1) Pharmacy: slightly less than 2% to slightly less than 3% 2) Central sterile and supply department: about 2% 3) Blood bank: installed in hospitals with more than 500 beds 4) Kitchen: slightly more than 2% to slightly more than 3%, 1.5 to 2.5 m2/bed 5) Laundry: less than 1% 6) Central storage and material hundling unit: about 1% 7) Mechanical plant: 5 to 13% (6) The administration department allocates 7 to 14% of its area to the management division and 2 to 6% to the

  6. Petroleum supply monthly

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-10-01

    The Petroleum Supply Monthly (PSM) is one of a family of four publications produced by the Petroleum Supply Division within the Energy Information Administration (EIA) reflecting different levels of data timeliness and completeness. The other publications are the Weekly Petroleum Status Report (WPSR), the Winter Fuels Report, and the Petroleum Supply Annual (PSA). Data presented in the PSM describe the supply and disposition of petroleum products in the United States and major US geographic regions. The data series describe production, imports and exports, inter-Petroleum Administration for Defense (PAD) District movements, and inventories by the primary suppliers of petroleum products in the United States (50 States and the District of Columbia). The reporting universe includes those petroleum sectors in primary supply. Included are: petroleum refiners, motor gasoline blends, operators of natural gas processing plants and fractionators, inter-PAD transporters, importers, and major inventory holders of petroleum products and crude oil. When aggregated, the data reported by these sectors approximately represent the consumption of petroleum products in the United States.

  7. Petroleum Supply Monthly

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-02-01

    The Petroleum Supply Monthly (PSM) is one of a family of four publications produced by the Petroleum Supply Division within the Energy Information Administration (EIA) reflecting different levels of data timeliness and completeness. The other publications are the Weekly Petroleum Status Report (WPSR), the Winter Fuels Report, and the Petroleum Supply Annual (PSA). Data presented in the PSM describe the supply and disposition of petroleum products in the United States and major U.S. geographic regions. The data series describe production, imports and exports, inter-Petroleum Administration for Defense (PAD) District movements, and inventories by the primary suppliers of petroleum products in the United States (50 States and the District of Columbia). The reporting universe includes those petroleum sectors in primary supply. Included are: petroleum refiners, motor gasoline blenders, operators of natural gas processing plants and fractionators, inter-PAD transporters, importers, and major inventory holders of petroleum products and crude oil. When aggregated, the data reported by these sectors approximately represent the consumption of petroleum products in the United States. Data presented in the PSM are divided into two sections: Summary Statistics and Detailed Statistics.

  8. INTEGRATED AUTOMOTIVE MANUFACTURING SUPPLY

    Directory of Open Access Journals (Sweden)

    P.J.S. Van Dyk

    2012-01-01

    Full Text Available

    ENGLISH ABSTRACT: Supply planning and traffic flow planning are major activities in the automotive manufacturing environment worldwide. Traditionally, the impact of supply planning strategies on plant traffic is rarely considered. This paper describes the development of a Decision Support System (DSS that will assist automotive manufacturers to analyse the effect of supply planning decisions on plant traffic during the supply planning phase of their logistics planning process. In essence, this DSS consists of a Supply Medium Decision Support Tool (SMDST (an interactive MS-Excel model with Visual Basic interfacing and a traffic flow simulation model tool (using eMPlant simulation software.

    AFRIKAANSE OPSOMMING: Verskaffingsbeplanning en verkeersvloeibeplanning is belangrike aktiwiteite in die motorvervaardigingsbedryf wêreldwyd. Tradisioneel word die uitwerking van verskaffings-beplanningsstrategië op aanlegverkeer selde in ag geneem. Hierdie artikel beskryf die ontwikkeling van ’n Besluitnemings Ondersteuningstelsel (DSS wat motorvervaardigers sal ondersteun in die analise van die effek van verskaffingsbeplanningbesluite op aanlegverkeer tydens die verskaffingsbeplanningsfase van hulle logistieke beplanningsproses. Hierdie DSS bestaan hoofsaaklik uit ’n Verskaffings-vervoermiddel Besluitnemingshulpmiddel (SMDST (’n interaktiewe MS-Excel model met “Visual Basic” koppelling asook ’n simulasiemodel van verkeersvloei (met eM-Plant simulasiesagteware.

  9. Supply Chain Connectivity: Enhancing Participation in the Global Supply Chain

    OpenAIRE

    Epictetus E. Patalinghug

    2015-01-01

    Supply chain connectivity is vital for the efficient flow of trade among APEC economies. This paper reviews the literature and supply chain management, describes the barriers to enhancing participation in global supply chain, analyzes the various measures of supply chain performance, and suggests steps for the Philippines to fully reap the benefits of the global value chain.

  10. [Hospital structure and control measures].

    Science.gov (United States)

    Gürkan, I

    1995-01-01

    A new legislation concerning financial matters of hospitals in Germany requires fundamental changes and adjustment. Formerly grown structures of a high-grade centralization erode into a process of change. Despite hospitals will maintain their non-profit character in public health services, modifications of medical care processes will promote elements of cost-centres. All medical care units as well as hospital management are confronted with rising requirements concerning performance and transparency. Increasingly patients and social health insurances behave like self-confident customers not willing to accept rising costs. Public health services loose their character of a planned economy. Hospitals with features of health-entrepreneurship are on the incline. A process of quality-planning and efficient management has been evoqued.

  11. Offshore Supply Industry Dynamics

    DEFF Research Database (Denmark)

    Roslyng Olesen, Thomas

    with companies in the maritime sector. This report “Offshore Supply Industry Dynamics – Business strategies in the offshore supply industry” is the second report in mapping project D. It examines the markets and business strategies of various suppliers and furthermore presents an analysis of the challenges...... at Copenhagen Business School with a focus on value creation in the maritime industries. The project embraces various maritime segments from shipping and offshore to ports and suppliers. The research questions for the individual projects have been formulated by researchers at CBS Maritime in cooperation...... and opportunities for the companies engaged in the different parts of the sector. The report is developed from interviews with top management of key players in the Danish supply industry combined with studies on management literature. The macro- and meso levels of the offshore sector are examined in the CBS...

  12. Environmental Retail Supply Chains

    DEFF Research Database (Denmark)

    Kotzab, Herbert; Munch, Hilde; de Faultrier, Birgitte;

    2011-01-01

    Purpose – The purpose of this paper is to develop a scale that evaluates the environmental elements in retail supply chains and to examine the environmental supply chain management initiatives of the world's largest 100 retailing companies. Design/methodology/approach – The empirical evaluation has...... short-term oriented (green operations). Long-term oriented green design initiatives were hardly observed. Furthermore, the specific environmental activities of three retailers from Denmark, France and the UK were compared. Research limitations/implications – The empirical study investigates supply chain...... operations of retailers and excludes other areas of retail management. The results are based on material that is published by the respective companies and thus do not include internal reports. Originality/value – The main contribution of this paper is to test the proposition that global retailers follow...

  13. 76 FR 4147 - Putnam-Cumberland, TN-Improve Power Supply

    Science.gov (United States)

    2011-01-24

    ... Putnam-Cumberland, TN--Improve Power Supply AGENCY: Tennessee Valley Authority. ACTION: Notice of intent... supply improvements in the Putnam and Cumberland region of east-central Tennessee. The purpose of the... approximately 16,000 miles of transmission lines. TVA supplies bulk electric power to Cumberland and...

  14. Application of 6S management in management of disposable sterile goods warehouse of central sterile supply department%6S 管理在消毒供应中心一次性无菌物品仓库管理中的应用

    Institute of Scientific and Technical Information of China (English)

    饶冬霞; 彭晓珍; 庞明月; 刘会芬; 喻征群; 熊晓云

    2015-01-01

    目的 探讨6S管理在消毒供应中心一次性无菌物品仓库管理中的应用效果 ,为临床治疗提供参考依据.方法 于2014年2月份采用6S管理法对消毒供应中心一次性无菌物品仓库进行管理 ,将其设为6S组 ;2014年1月份未进行6S管理设为常规组 ,按常规方法对消毒供应中心一次性无菌物品仓库进行管理 ;两组均按物品包装28 000件计算 ;评价两组管理应用效果 ,数据采用SPSS 13 .0软件进行统计分析.结果 6S组物品完好率99 .9% ,人员操作合格率99 .8% ,物品相符率100 .0% ,使用科室零投诉 ,一次性无菌物品仓库管理质量和人员质控效果得到大幅度提升和改善 ,仓库管理有条不紊 ,工作人员取物迅速 ,100件物品的取物时间缩短了50 .00% ,真正做到不少发、不错发、不漏发 ,实施6S方法前后差异有统计学意义( P<0 .05 ).结论 消毒供应中心一次性无菌物品仓库运用6S管理 ,提高了仓库管理的品质 ,保证了临床科室一次性无菌物品的安全使用 ,提高了员工的工作效率和整体素养 ,方法切实可行.%OBJECTIVE To explore the effect of 6S management on the management of disposable sterile goods warehouse of central sterile supply department so as to provide guidance for clinical treatment .METHODS The 6S management was adopted for the management of disposable sterile goods warehouse of central sterile supply de-partment in Feb ,2014 ,which was set as the 6S group;the 6S management was not conducted in Jan ,2014 , which was assigned as the conventional group .The management of the disposable sterile goods warehouse of cen-tral sterile supply department was conducted according to the conventional method . Totally 28 000 pieces of packed goods were calculated in both groups .The effects on the management of the disposable sterile goods ware-house of central sterile supply department were evaluated ,and the statistical analysis of data was performed with the use

  15. The geographic distribution of tuberculosis and pyridoxine supply in Ontario.

    Science.gov (United States)

    McGuigan, M A; Yamada, J

    1995-12-01

    Acute poisoning with isoniazid causes generalized convulsions which should be treated with intravenous pyridoxine and a rapidly-acting anticonvulsant. The purpose of this study was to determine the correlation between the distribution of tuberculosis (as a proxy for isoniazid use) and acute care hospital supplies of intravenous pyridoxine (the antidote for isoniazid overdose). The distribution of tuberculosis was based on Ontario public health regions. The study was descriptive using simple linear regression to assess the degree of correlation. Only 15.6% of Ontario acute care hospitals have enough intravenous pyridoxine to treat an average isoniazid overdose. The distribution of tuberculosis and the number of hospitals in the region correlated best with hospital supplies of pyridoxine, although these variables explained only 22% and 23.7%, respectively, of the variation in supply. It does not appear that the distribution of tuberculosis is a major determinant of the availability of the isoniazid antidote, pyridoxine. Acute care hospitals in Ontario should re-evaluate their need for pyridoxine in light of the incidence of tuberculosis in their regions. Each hospital should stock at least 5 Gm of intravenous pyridoxine; additional amounts may be appropriate if there is an increased incidence in the area.

  16. Metagenomic Analysis of Showerhead Biofilms from a Hospital in Ohio

    Science.gov (United States)

    Background: The National Institute of Health estimated that 80% of human microbial infections are associated with biofilms. Although water supplies and hospital equipments are constantly treated with disinfectants, the presence of biofilms in these areas has been frequently obser...

  17. Essentials of supply chain management

    CERN Document Server

    Hugos, Michael H

    2011-01-01

    The latest thinking, strategies, developments, and technologies to stay current in supply chain management Presenting the core concepts and techniques of supply chain management in a clear, concise and easily readable style, the Third Edition of Essentials of Supply Chain Management outlines the most crucial tenets and concepts of supply chain management.

  18. Supply-Chain Optimization Template

    Science.gov (United States)

    Quiett, William F.; Sealing, Scott L.

    2009-01-01

    The Supply-Chain Optimization Template (SCOT) is an instructional guide for identifying, evaluating, and optimizing (including re-engineering) aerospace- oriented supply chains. The SCOT was derived from the Supply Chain Council s Supply-Chain Operations Reference (SCC SCOR) Model, which is more generic and more oriented toward achieving a competitive advantage in business.

  19. Deployable centralizers

    Energy Technology Data Exchange (ETDEWEB)

    Grubelich, Mark C.; Su, Jiann-Cherng; Knudsen, Steven D.

    2017-02-28

    A centralizer assembly is disclosed that allows for the assembly to be deployed in-situ. The centralizer assembly includes flexible members that can be extended into the well bore in situ by the initiation of a gas generating device. The centralizer assembly can support a large load carrying capability compared to a traditional bow spring with little or no installation drag. Additionally, larger displacements can be produced to centralize an extremely deviated casing.

  20. The evolving role of supply chain management technology in healthcare.

    Science.gov (United States)

    Langabeer, Jim

    2005-01-01

    The healthcare supply chain is a vast, disintegrated network of products and players, loosely held together by manual and people-intensive processes. Managing the flow of information, supplies, equipment, and services from manufacturers to distributors to providers of care is especially difficult in clinical supply chains, compared with more technology-intense industries like consumer goods or industrial manufacturing. As supplies move downstream towards hospitals and clinics, the quality and robustness of accompanying management and information systems used to manage these products deteriorates significantly. Technology that provides advanced planning, synchronization, and collaboration upstream at the large supply manufacturers and distributors rarely is used at even the world's larger and more sophisticated hospitals. This article outlines the current state of healthcare supply chain management technologies, addresses potential reasons for the lack of adoption of technologies and provides a roadmap for the evolution of technology for the future. This piece is based on both quantitative and qualitative research assessments of the healthcare supply chain conducted during the last two years.

  1. Current status investigation of nursing support system in the central and eastern of China among the second grade hospitals%我国中、东部二级医院护理工作支持现状的调查

    Institute of Scientific and Technical Information of China (English)

    曹晶; 吴欣娟; 贺茜; 陈亚丹; 徐园; 刘戈

    2015-01-01

    目的:探讨我国中、东部地区的二级医院在人力配置、后勤支持以及护理管理范畴方面对护理工作的支持状况。方法采用自行设计的调查问卷,于2013年4月采用便利抽样方法抽取全国13个省市的63所二级医院的护理管理者进行调查,调查内容包括一般资料、医院的一般情况、护理队伍建设情况、医院后勤保障体系、护理部职能等。结果63所二级医院已100%开展责任制整体护理工作,82.54%的医院处在护士岗位管理“启动、准备、取得成效”阶段。在护理队伍建设方面,二级医院平均床护比为1∶0.54,39.68%的医院大专以上学历护士比例小于50%,58.73%的医院护师及以下职称护士比例大于60%,73.02%的医院中工作3年以下护士比例大于25%,69.84%的医院未配置护理员。在医院后勤保障方面,50%以上医院已开展专人下收下送消毒物品、配送办公物品、取送检验标本、护送患者检查、维护病房秩序和清洁,但只有12.7%的医院有专人配置静脉液体。护理管理范畴方面,做到开展质量控制、院内培训、院内调配护士人力的医院达到90%以上,能参与护士招募与护士长任免的医院61.90%,能实现奖金与绩效分配的医院占41.27%。结论中、东部二级医院已广泛推行责任制整体护理,并逐步推进护士岗位管理。护理人力配置初步改善,但与国家十二五规划要求存在一定差距,队伍结构存在年轻化、低职称、低学历特点;后勤保障配备与护理管理体制需进一步完善。二级医院应立足自身特点,进一步加强对护理工作的支持,推动护理改革进程。%Objective To explore the support status in nursing work among the second grade hospitals from such perspectives as the allocation of nursing human resources, logistics support system and nursing management model in the central and eastern regions of China. Methods Totally 63 second

  2. Integrated supply chain risk management

    Directory of Open Access Journals (Sweden)

    Riaan Bredell

    2007-11-01

    Full Text Available Integrated supply chain risk management (ISCRM has become indispensable to the theory and practice of supply chain management. The economic and political realities of the modern world require not only a different approach to supply chain management, but also bold steps to secure supply chain performance and sustainable wealth creation. Integrated supply chain risk management provides supply chain organisations with a level of insight into their supply chains yet to be achieved. If correctly applied, this process may optimise management decision-making and assist in the protection and enhancement of shareholder value.

  3. Exploration Supply Chain Simulation

    Science.gov (United States)

    2008-01-01

    The Exploration Supply Chain Simulation project was chartered by the NASA Exploration Systems Mission Directorate to develop a software tool, with proper data, to quantitatively analyze supply chains for future program planning. This tool is a discrete-event simulation that uses the basic supply chain concepts of planning, sourcing, making, delivering, and returning. This supply chain perspective is combined with other discrete or continuous simulation factors. Discrete resource events (such as launch or delivery reviews) are represented as organizational functional units. Continuous resources (such as civil service or contractor program functions) are defined as enabling functional units. Concepts of fixed and variable costs are included in the model to allow the discrete events to interact with cost calculations. The definition file is intrinsic to the model, but a blank start can be initiated at any time. The current definition file is an Orion Ares I crew launch vehicle. Parameters stretch from Kennedy Space Center across and into other program entities (Michaud Assembly Facility, Aliant Techsystems, Stennis Space Center, Johnson Space Center, etc.) though these will only gain detail as the file continues to evolve. The Orion Ares I file definition in the tool continues to evolve, and analysis from this tool is expected in 2008. This is the first application of such business-driven modeling to a NASA/government-- aerospace contractor endeavor.

  4. Female Labor Supply

    NARCIS (Netherlands)

    Maassen-van den Brink, te Henriet

    1994-01-01

    To gain insight on factors that impede economic independence of women, this book concentrates on female labor supply in relation to child care, male-female wage differentials, the division of unpaid labor, and marital conflicts between women and men. It may very well be that restrictions on the opti

  5. Aid Supplies Over Time

    DEFF Research Database (Denmark)

    Jones, Edward Samuel

    The recent financial crisis has rekindled interest in the foreign aid supply behaviour of bilateral donors. Using the latest data covering the period 1960-2009, this paper examines how such behaviour is related to domestic factors. Based on a simple empirical model, a distinction is made between ...... substantial heterogeneity between countries. There is also good evidence that donor behaviour continues to evolve over time. As such, past trends in aid supplies are unlikely to provide a good guide to those of the future.......The recent financial crisis has rekindled interest in the foreign aid supply behaviour of bilateral donors. Using the latest data covering the period 1960-2009, this paper examines how such behaviour is related to domestic factors. Based on a simple empirical model, a distinction is made between...... long-run supply trends and short-run dynamics, which motivates use of error correction methods. Panel econometric techniques are employed that are consistent in the presence of parameter heterogeneity and cross-section dependence. Results support the error correction framework, but point to very...

  6. Sediment supply to beaches

    DEFF Research Database (Denmark)

    Aagaard, Troels

    2014-01-01

    and this reduces confidence in predictions of long-term shoreline change. In this paper, field measurements of suspended sediment load and cross-shore transport on the lower shoreface are used to derive a model for sediment supply from the lower to the upper shoreface at large spatial and temporal scales. Data...

  7. Electricity supply contracts: Optimization

    Energy Technology Data Exchange (ETDEWEB)

    Rossi, G.; Vezzoni, M.; Grassani, E. (Sistemi Integrati per il Risparmio Energetico, Pavia (Italy) Necchi Compressori, Pavia (Italy))

    1991-10-01

    This paper presents a computer program, ACEE (Electrical Energy Consumption Analysis), developed to assist industrial firms in Italy to determine their electrical power consumption, optimize it through production process interventions, and then utilize the results to draft up optimum electricity supply contracts with ENEL (Italian National Electricity Board). The program also allows the user to properly budget future allocations for electricity costs.

  8. Rechargeable power supply

    NARCIS (Netherlands)

    Den Uijl, S.; Bouman, C.; Smit, W.

    2006-01-01

    The invention relates to a rechargeable power supply suitable to be used in a battery-operated device comprising at least one supercapacitor and at least a first and a second DC-DC converter connected in series, wherein the supercapacitor is connectable to an entry of the first DC-DC converter and t

  9. REVERSE SUPPLY CHAIN

    Directory of Open Access Journals (Sweden)

    Tomasz DOMAGAŁA

    2013-10-01

    Full Text Available The paper focuses on the presentation of the reverse supply chain, of which the role in the modern business grows along with the increasing number of environmental regulations and possibilities of reducing an operating cost. The paper also describes main problems in developing the profitable chain and possibilities to take an action in order to overcome them.

  10. Mineral Supply Challenges

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Faced with shortcomings in its mineral supply, it’s imperative for China to balance its desire for reserves with its current economic needs Mineral resources are the corner- stone of materials needed for China’s national economic and social development.The country even counts on its mineral resources to satisfy 90 percent of its energy demands and over 95

  11. Innovation in Supply Chains

    DEFF Research Database (Denmark)

    Maier, Maximilian; Korbel, Jakob; Brem, Alexander

    2015-01-01

    . Moreover, along with the fourth industrial revolution – industry 4.0 – new technologies such as cyber physical systems are fast gaining popularity. Hence, based on the analysis of relevant literature, we further develop the supply chain committee model, developed by Kaluza et al. (2003) to demonstrate how...

  12. [Basic research on digital logistic management of hospital].

    Science.gov (United States)

    Cao, Hui

    2010-05-01

    This paper analyzes and explores the possibilities of digital information-based management realized by equipment department, general services department, supply room and other material flow departments in different hospitals in order to optimize the procedures of information-based asset management. There are various analytical methods of medical supplies business models, providing analytical data for correct decisions made by departments and leaders of hospital and the governing authorities.

  13. Modelling healthcare internal service supply chains for the analysis of medication delivery errors and amplification effects

    Directory of Open Access Journals (Sweden)

    Banafsheh Behzad

    2011-12-01

    Full Text Available Purpose: Healthcare is a universally used service that hugely affects economies and the quality of life. The research of service supply chains has found a significant role in the past decade. The main research goal of this paper is to model and simulate the internal service supply chains of a healthcare system to study the effects of different parameters on the outputs and capability measures of the processes. The specific objectives are to analyse medication delivery errors in a community hospital based on the results of the models and to explore the presence of bullwhip effect in the internal service supply chains of the hospital.Design/methodology/approach: System dynamics which is an approach for understanding the behaviour of complex systems, used as a methodology to model two internal service supply chains of the hospital with a sub-model created to simulate medication delivery errors in the hospital. The models are validated using the actual data of the hospital and the results are analyzed based on experimental design techniques.Findings: It is observed that the bullwhip effect may not occur in a hospital’s internal service supply chains. Furthermore the paper points out the conditions for reducing the medication delivery error in a hospital.Research limitations/implications: Because of the community hospital’s data availability the type of service supply chains modelled in this paper, are small service supply chains, representing only the tasks which are done inside the hospital. To better observe the bullwhip effect in healthcare service supply chains, the chains should be modelled more generally.Originality/value: The original system dynamics modelling of the internal service supply chains of a community hospital, with a sub-model simulating the medication delivery error.

  14. Issues on Supply Chain Management

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Although supply chain is regarded as an integrated pr ocess, actually, researchers and practitioners have primarily investigated the v arious processes of the supply chain individually. The competitive field in most markets requires well-designed integrated supply chain instead of individual o perations. In this paper, some traditional thinking of supply chain is given fir st, then SCM (Supply Chain Management) is introduced, which views the entire sup ply chain as a whole rather than individual process a...

  15. Reclasificación histopatológica de los tumores de sistema nervioso central tratados en el Hospital Eugenio Espejo de Quito. En el período 2003-2007

    OpenAIRE

    Ortíz Galarza, Dorys Malena; Quishpe Defaz, Maritza Llovana

    2015-01-01

    Contexto: La Organización Mundial de la Salud realizó una revisión de la Clasificación de los Tumores del Sistema Nervioso Central, publicada en el año 2007, que incluyó nuevas entidades para encasillar a aquellas referidas como inclasificables. Objetivo: Determinar las características histopatológicas y de gradación de las Neoplasias del Sistema Nervioso Central de acuerdo a la Clasificación de Tumores del Sistema Nervioso Central de la Organización Mundial de la Salud publicada en el año 20...

  16. Strategic human resource management issues in hospitals: a study of a university and a community hospital.

    Science.gov (United States)

    Khatri, Naresh; Wells, Jack; McKune, Jeff; Brewer, Mary

    2006-01-01

    The human factor is central to healthcare, yet its proper management has remained beyond the reach of healthcare organizations. This qualitative study examines strategic human resource management (HRM) issues in a university and a community hospital. The findings indicate that the two hospitals lacked a clear understanding of their strategic intent and objectives; as a result, their human resource (HR) practices lacked coherence and direction. Whereas the community hospital understood the interrelationship between culture and HRM, the university hospital did not. Moreover, the university hospital showed only a modest understanding of competencies needed in managing HR function, which hampered its ability to identify competent HR managers and employees. The community hospital made significant gains in the past few years in managing its culture and people by recruiting a competent HR manager. The relationship between HR practices and clinical outcomes was much less clear in the university hospital than it was in the community hospital.

  17. Hospital Presbiteriano Valley

    Directory of Open Access Journals (Sweden)

    Luckman, Charles

    1964-12-01

    Full Text Available This hospital is built on the circular system. This arrangement has economic and functional advantages. The nurses walk 40 % less distance than in a hospital of similar size, of conventional layout. The rooms are situated along the external perimeter and the beds are orientated towards the corridor, rather than towards the window. However, the patients can see out of doors by turning on their side. The hospital is most carefully fitted out, and is very comfortable. There is air conditioning, and patients can control their own TV sets. There are also curtains separating each bed form the rest, thus providing maximum independence. Warm colours have been adopted in the decoration of rooms facing north, whilst those facing south are painted in cooler tones. The circular design arrangement makes the distribution far more flexible, and it will be easier to include further units later on; by adding small adjustments to the central building. To reduce external noise, and to improve the surrounding landscape, small sand hills have been provided in the garden, and the parking site also serves to partially absorb the noise.Presenta esta solución de unidades circulares numerosas ventajas de tipo económico, ahorra espacio y da eficiencia a la circulación— las enfermeras recorren un 40 por 100 menos de camino que en otro hospital de dimensiones similares—. Las habitaciones están distribuidas a lo largo del perímetro exterior y tienen las camas orientadas hacia los corredores, en lugar de hacia las ventanas, pero de tal modo que los pacientes puedan contemplar el exterior al volverse sobre uno de sus costados. Están cuidadosamente diseñadas y dotadas de las máximas comodidades: aire acondicionado y aparatos de televisión controlados por el paciente; así como cortinas divisorias que le proporcionan el grado de aislamiento deseado.

  18. Image acquisition system for a hospital enterprise

    Science.gov (United States)

    Moore, Stephen M.; Beecher, David E.

    1998-07-01

    Hospital enterprises are being created through mergers and acquisitions of existing hospitals. One area of interest in the PACS literature has been the integration of information systems and imaging systems. Hospital enterprises with multiple information and imaging systems provide new challenges to the integration task. This paper describes the requirements at the BJC Health System and a testbed system that is designed to acquire images from a number of different modalities and hospitals. This testbed system is integrated with Project Spectrum at BJC which is designed to provide a centralized clinical repository and a single desktop application for physician review of the patient chart (text, lab values, images).

  19. Food supply reliance on groundwater

    Science.gov (United States)

    Dalin, Carole; Puma, Michael; Wada, Yoshihide; Kastner, Thomas

    2016-04-01

    Water resources, essential to sustain human life, livelihoods and ecosystems, are under increasing pressure from population growth, socio-economic development and global climate change. As the largest freshwater resource on Earth, groundwater is key for human development and food security. Yet, excessive abstraction of groundwater for irrigation, driven by an increasing demand for food in recent decades, is leading to fast exhaustion of groundwater reserves in major agricultural areas of the world. Some of the highest depletion rates are observed in Pakistan, India, California Central Valley and the North China Plain aquifers. In addition, the growing economy and population of several countries, such as India and China, makes prospects of future available water and food worrisome. In this context, it is becoming particularly challenging to sustainably feed the world population, without exhausting our water resources. Besides, food production and consumption across the globe have become increasingly interconnected, with many areas' agricultural production destined to remote consumers. In this globalisation era, trade is crucial to the world's food system. As a transfer of water-intensive goods, across regions with varying levels of water productivity, food trade can save significant volumes of water resources globally. This situation makes it essential to address the issue of groundwater overuse for global food supply, accounting for international food trade. To do so, we quantify the current, global use of non-renewable groundwater for major crops, accounting for various water productivity and trade flows. This will highlight areas requiring quickest attention, exposing major exporters and importers of non-renewable groundwater, and thus help explore solutions to improve the sustainability of global food supply.

  20. [Hospital clinical ethics committees].

    Science.gov (United States)

    Gómez Velásquez, Luis; Gómez Espinosa, Luis Néstor

    2007-01-01

    The scientific and technological advances have been surprising, more in the two last decades, but they don't go united with to the ethical values of the medical professional practice, it has been totally escaped, specially when the biological subsistence, the maintenance of the life through apparatuses and the mechanisms that prolong the existence are who undergoes an alteration that until recently time was mortal shortly lapse. It is common listening that exist a crisis in the medical profession, but what really is it of human values, which as soon and taken into nowadays, actually professional account, which gives rise to a dehumanization towards the life, the health, the disease, the suffering and the death. The ideal of the doctor to give to service to the man in its life and health, as well to be conscious that the last biological process that must fulfill is the death, and when it appears, does not have considered as a actually professional failure. It has protect to the patient as the extreme cruelty therapeutic, that it has right a worthy death. It's taking to the birth of the hospital ethics committees, they have like function to analyze, to advise and to think about the ethical dilemmas that appear actually clinical or in the biomedical investigation. In 1982 in the UEA only 1% of its hospitals had a ethics committees; by 1988, it was 67% and the 100% in 2000. In Mexico the process of the formation by these committees begins, only in the Military Central Hospital, to count the ethics committee on 1983, also the Hospital no. 14 of the IMSS in Guadalajara, it works with regularity from 1995, with internal teaching of bioethic. The Secretariat of Health has asked the formation of the bioethical committees in each hospital, and order the it was be coordinated by the National Committee of Bioética. The integration of these committees is indispensable that their members have the knowledge necessary of bioética. The Mexican Society of Ortopedia, conscious of

  1. 38 CFR 49.35 - Supplies and other expendable property.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Supplies and other expendable property. 49.35 Section 49.35 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS (CONTINUED) UNIFORM ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER...

  2. 40 CFR 30.35 - Supplies and other expendable property.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 1 2010-07-01 2010-07-01 false Supplies and other expendable property. 30.35 Section 30.35 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY GRANTS AND OTHER FEDERAL ASSISTANCE UNIFORM ADMINISTRATIVE REQUIREMENTS FOR GRANTS AND AGREEMENTS WITH INSTITUTIONS OF HIGHER EDUCATION, HOSPITALS, AND OTHER...

  3. Human parechovirus associated sepsis and central nervous system infections in hospitalized children%人副肠孤病毒与儿童脓毒症和中枢神经系统感染的相关性

    Institute of Scientific and Technical Information of China (English)

    罗雷; 朱汝南; 赵林清; 邓洁; 王芳; 孙宇; 宋秦伟; 丁雅馨; 钱渊

    2014-01-01

    family of Picornaviridae.As a possible new pathogen of neonatal sepsis,meningoencephalitis and other infections in young children,HPeV gets more and more attention.This study aimed to better understand the association of HPeV with central nervous system (CNS) infectious diseases and sepsis among hospitalized children in Beijing.Method A total of 577 cerebrospinal fluid (CSF) samples were retrospectively collected from 557 children suspected of CNS infections in 2012.Three hundred and fifty-one of them were male and 206 were female.HPeV was screened by reverse transcription-nested PCR (RT-nPCR) with the universal primers which target the highly conserved 5'UTR.The positive samples were genotyped by amplifying and sequencing for the VP3/VP1 junction region.The sequences were compared with the HPeV sequences from GenBank and performed phylogenetic analysis.Some samples other than CSF from HPeV positive children,including serum,nasopharyngeal aspirate and stool,were collected and carried out screening for HPeV.Result With the RT-nPCR by universal primers,HPeVs were detected in 18 out of 577 CSF samples obtained from 18 children with a positive rate of 3.1%.The ratio of male and female was 2 ∶ 1.There were no statistically significant differences on infection rate between boys (12/351,3.4%) and girls (6/206,2.9%).All of 18 positive CSF samples were negative for enterovirus,Epstein-Barr virus (EBV),human cytomegalovirus (HCMV),and herpes simplex virus 1 and 2 (HSV).HPeVs from 10 positive CSF samples were genotyped successfully,consisting of 7 HPeV3 and 3 HPeV1.In addition,2 of 8 serum samples were positive for HPeV3 and 1 of 2 stool samples were positive for HPeV 1.HPeVs were identified in CSF from children aged from 15 days to 14 years,in which 7 cases were infants younger than 3 months and 5 cases were infants from 3 months to one year.Three children older than the age of 9 years (9,13 and 14 years) were positive for HPeV.Most of the children (6/8) infected with HPe

  4. [Computerization of hospital blood banks in France].

    Science.gov (United States)

    Daurat, G; Py, J-Y

    2012-11-01

    In France, most blood products are delivered by the établissement francais du sang, directly to the recipients, and hospital blood banks deliver a minor part, but are independent from it. However that may be, hospital blood banks are hazardous activities regarding to recipients, blood products, blood supply of the hospital and regional blood supply. Because of the high risk level, a computerized information system is compulsory for all hospital blood banks, except for those only devoted to vital emergency transfusion. On the field, the integration of computerization in the different processes is very heterogeneous. So, it has been decided to publish guidelines for computerizing hospital blood banks information systems and production management. They have been built according to risk assessment and are intended to minimize those risks. The principle is that all acquisition and processing of data about recipients or blood products and tracking, must be fully computerized and that the result of all manual processes must be checked by computer before proceeding to the next step. The guidelines list the different processes and, for each of them, the functions the software must play. All together, they form the basic level all hospital blood banks should reach. Optional functions are listed. Moreover, the guidelines are also aimed to be a common tool for regional health authorities who supervise hospital blood banks.

  5. Uso de água subterrânea em sistema de abastecimento público de comunidades na várzea da Amazônia central The use of groundwater in public water supply system of floodplain communities in the central Amazonia

    Directory of Open Access Journals (Sweden)

    Rainier Pedraça de Azevedo

    2006-01-01

    Full Text Available O paradoxo das águas marca as populações amazônicas que habitam as várzeas. Se na cheia as águas abundam, na seca escasseiam, chegando desfalcar os ribeirinhos seja pela insuficiência e/ou por condições impróprias para consumo. Esse trabalho descreve o aproveitamento do manancial subterrâneo para abastecimento público, através de poço tubular construído na comunidade de várzea de Santo Antônio, no município de Urucará, Estado do Amazonas. O estudo demonstrou a ocorrência de variações nas características físico-químicas da água do poço durante um ciclo das de superfície da região, principalmente a elevação do teor de ferro total no período de cheia máxima, sendo esse um indicativo de falha no processo construtivo do poço, uma vez que a água subterrânea local apresenta condições satisfatórias para o consumo humano. O aproveitamento do manancial subterrâneo em sistemas de abastecimento de água em comunidades de várzea na Amazônia é tecnicamente viável, entretanto, carece de obras de captação corretas, visando a conservação da qualidade da água desse rico ecossistema.The Amazonian populations that live in the floodplains are marked by a water paradox. If in the flood season water is plentiful, during the drought period water is scarce, either not having enough for the people's needs or it is inappropriate for human consumption. This paper describes the use of groundwater for public water supply system through a tubular well built in Santo Antonio floodplain community, in the district of Urucará, Amazonas State. The study has shown the occurrence of variations in the water quality of the well during the cycle of the superficial water, mainly an increase in the level of iron. This indicates a fault in the building process of the well, given that the local groundwater has good quality for consumption. The use of groundwater in public supply system in the floodplain communities in the Amazon is

  6. Towards Intelligent Supply Chains

    DEFF Research Database (Denmark)

    Siurdyban, Artur; Møller, Charles

    2012-01-01

    applied to the context of organizational processes can increase the success rate of business operations. The framework is created using a set of theoretical based constructs grounded in a discussion across several streams of research including psychology, pedagogy, artificial intelligence, learning...... of deploying inapt operations leading to deterioration of profits. To address this problem, we propose a unified business process design framework based on the paradigm of intelligence. Intelligence allows humans and human-designed systems cope with environmental volatility, and we argue that its principles......, business process management and supply chain management. It outlines a number of system tasks combined in four integrated management perspectives: build, execute, grow and innovate, put forward as business process design propositions for Intelligent Supply Chains....

  7. Discontinuous Mode Power Supply

    Science.gov (United States)

    Lagadinos, John; Poulos, Ethel

    2012-01-01

    A document discusses the changes made to a standard push-pull inverter circuit to avoid saturation effects in the main inverter power supply. Typically, in a standard push-pull arrangement, the unsymmetrical primary excitation causes variations in the volt second integral of each half of the excitation cycle that could lead to the establishment of DC flux density in the magnetic core, which could eventually cause saturation of the main inverter transformer. The relocation of the filter reactor normally placed across the output of the power supply solves this problem. The filter reactor was placed in series with the primary circuit of the main inverter transformer, and is presented as impedance against the sudden changes on the input current. The reactor averaged the input current in the primary circuit, avoiding saturation of the main inverter transformer. Since the implementation of the described change, the above problem has not reoccurred, and failures in the main power transistors have been avoided.

  8. Monitoring Global Supply Chains

    OpenAIRE

    2014-01-01

    Firms reliant on supply chains to manufacture their goods risk reputational harm if the working conditions in those factories are revealed to be dangerous, illegal, or otherwise problematic. While firms are increasingly relying on private-sector "social auditors" to assess factory conditions, little had been known about the accuracy of those assessments. We analyzed nearly 17,000 code-of-conduct audits conducted at nearly 6,000 suppliers around the world. We found that audits yield fewer viol...

  9. Supply Chain Interoperability Measurement

    Science.gov (United States)

    2015-06-19

    Base, Ohio DISTRIBUTION STATEMENT A. APPROVED FOR PUBLIC RELEASE; DISTRIBUTION UNLIMITED. The views expressed in this thesis ...chain connections are often hindered by inconsistent vocabularies , terms, ontologies, and semantics utilized by various supply chain members (Ye et...eg.COOPERATION PROCESS)-Don’t address synergies between SC X X X X X X X X Don’t track effectiveness over time-lack of learning by experience Loss of SC

  10. The design of supply chains

    DEFF Research Database (Denmark)

    Bøge Sørensen, Lars

    2004-01-01

    Keywords Supply Chain Management, Supply Chain Design, Literature studyAbstract Argues stability is a design objective for supply chain design alongside cost, leadtime and responsiveness. Performs an extensive literature study on supply chain design,identifies methods, theories and objectives...... in the existing literature. Describes the conceptexternal specificity and how it's used to design supply chains. Using the concept upstream,archetypes of risk minimal and maximal design are identified. Downstream the conceptdescribes two viable scenarios, one minimizing the impact, the other minimizing...... theprobability of (intended) departure of a supply chain partner. Finally, principles for supplychain design are described and managerial outlined....

  11. Decision-Making for Supply Chain Integration Supply Chain Integration

    CERN Document Server

    Lettice, Fiona; Durowoju, Olatunde

    2012-01-01

    Effective supply chain integration, and the tight co-ordination it creates, is an essential pre-requisite for successful supply chain management.  Decision-Making for Supply Chain Integration is a practical reference on recent research in the area of supply chain integration focusing on distributed decision-making problems. Recent applications of various decision-making tools for integrating supply chains are covered including chapters focusing on: •Supplier selection, pricing strategy and inventory decisions in multi-level supply chains, •RFID-enabled distributed decision-making, •Operational risk issues and time-critical decision-making for sensitive logistics nodes, Modelling end to end processes to improve supply chain integration, and •Integrated systems to improve service delivery and optimize resource use. Decision-Making for Supply Chain Integration provides an insight into the tools and methodologies of this field with support from real-life case studies demonstrating successful application ...

  12. Operating SFC Power Supply from Central Console via DECnet

    Institute of Scientific and Technical Information of China (English)

    1995-01-01

    Operating SFC Power Supply from Central Console via DECnetOperatingSFCPowerSupplyfromCentralConsoleviaDECnet¥WangZhen;GuoKeju...

  13. Port supply chain integration : analyzing biofuel supply chains

    NARCIS (Netherlands)

    Stevens, Leonie C. E.; Vis, Iris F. A.

    2016-01-01

    This paper focuses on port supply chain integration to strengthen operational and business performance. We provide a structured and comprehensive method to enable port supply chain integration and demonstrate its applicability to the biofuel supply chain. We define the value proposition, role, activ

  14. An RFID middleware for supply chain management

    Directory of Open Access Journals (Sweden)

    Artur Pinto Carneiro

    2011-12-01

    Full Text Available RFID (Radio Frequency Identification systems for identification and tracking of products and equipments have been progressively adopted as an essential tool for supply chain management, a production environment where the members usually share with each other their own logistic and management systems. Therefore, the development of supply chain RFID systems can be strongly simplified through the inclusion of an intermediate software layer – the middleware – responsible for the creation of interfaces to integrate all the heterogeneous software components. In this article we present a case study developed at IPT (Instituto de Pesquisas Tecnológicas do Estado de São Paulo which gave rise to a middleware prototype able to implement the required software integration on the supply chain of an electric power distribution company. The developed middleware is used to manage the interactions with a heterogeneous group of mobile devices  cell phones, handhelds and data colectors,  operated by different supply chain agents that grab data associated to various processes executed by a given electric power distribution equipment during its life cycle and transfer those data to a central database in order to share them with all the logistic and management corporation systems.

  15. The Market for Hospital Medicine in Denmark

    DEFF Research Database (Denmark)

    Hostenkamp, Gisela

    2012-01-01

    increases and use summary statistics to compare market performance in both sectors. The market for hospital medicine is more concentrated than the pharmaceutical retail sector and the share of generics and parallel imported products is significantly lower. Between 2005 and 2009 expenditures for hospital...... for hospital medicines and their procurement are still poorly understood. The present paper characterises the market for hospital medicines in Denmark in terms of its organisation and developments between 2005 and 2009. In Denmark hospital medicines are publicly financed and procurement is centrally organised....... 98% of all medicines administered at Danish public hospitals are purchased through a public procurement agency by means of public tenders. Using data on actual contract prices we decompose pharmaceutical expenditure growth into the contributions from newly introduced medicines, price and volume...

  16. Establishment and application of RFID information track management system in central sterile supply department%消毒供应中心无线射频识别信息化追溯管理系统的建立与应用

    Institute of Scientific and Technical Information of China (English)

    马俊; 许燕玲; 庄敏; 侯彬; 钱会娟

    2012-01-01

    目的 分析医院消毒供应中心(CSSD)的器械从回收、清洗、检查、包装、灭菌、发放和使用7个关键环节,对其进行可追溯管理.方法 采用无线射频识别(RFID)信息管理技术,通过与医院信息系统(HIS)对接,结合无线网络等技术进行管理.结果 RFID信息管理系统实现了器械从回收到使用的各关键环节信息数据的全程跟踪监控.结论 RFID信息管理实现了无菌器械的可追溯性管理及操作流程的科学监控,保证了再生器械供应链的质量,实现医院消毒供应中心的科学管理.%OBJECTIVE To perform the traceability management of medical instruments from the seven key links including the recycling, cleaning, inspection, packaging, sterilization, distribution and the use. METHODS By means of the radio frequency identification (abbreviated RFID) information management technology, the system was docked with the hospital information system (HIS), combining with the wireless network, middleware and other devices to perform information management. RESULTS RFID information management system realized the equipment information data' follow-up monitoring in every link from the recycling to use. CONCLUSION The RFID information management has achieved the goal of the sterile equipments traceability management and scientific control of the operation procedure, therefore it ensures the quality of supply chain of the recyclable instruments and realize the scientific management.

  17. Measurement of Pulsed Power Supply

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Power supply system is an important subsystem of CSR. To apply for running, the parameters of power supply must be fit the design’s demands. We have tested all prototype of power supply as follows.The DC stability measurement is that the power supply runs in certain current level from the lower value to the normal value. In every current level, we acquire about 550 data by digital meter (model 7081) in 8 h.

  18. Supply chain dynamics in Asia

    OpenAIRE

    Banomyong, Ruth

    2010-01-01

    Supply chain management in Asia is a relatively novel topic but a key challenge for all Asian based manufacturers and traders when trying to integrate into the "global market". The purpose of the paper is to describe key supply chain issues faced in Asia. These issues are related to supply chain security that forces Asian firms to comply with numerous requirements as well as the importance of a properly managed supply chain in enhancing firms' competitiveness. The critical role played by Asia...

  19. Clinical experience of supplying sodium chloride for the treatment of patients with severe heart failure

    Institute of Scientific and Technical Information of China (English)

    贺丽霞

    2012-01-01

    Objective To observe the effect and safety of supplying sodium chloride in the treatment of patients with severe heart failure. Methods Consecutive 51 hospitalized patients with severe heart failure and cardiac edema were included in this study. Normal diet (6g NaCl/d) was supplied

  20. Designing structural supply chain flexibility

    NARCIS (Netherlands)

    Mulinski, Ksawery Jan

    2012-01-01

    In a continuously changing business environment the role of supply chain flexibility is constantly increasing. A flexible supply chain can ensure survival in quickly changing market conditions as well as enable sustainable growth. This thesis explores the topic of supply chain flexibility with focus

  1. Participatory Demand-supply Systems

    NARCIS (Netherlands)

    Rezaee, S.A.; Oey, M.A.; Nevejan, C.I.M.; Brazier, F.M.

    2015-01-01

    Introducing the notion of Participatory Demand-Supply (PDS) systems as socio-technical systems, this paper focuses on a new approach to coordinating demand and supply in dynamic environments. A participatory approach to demand and supply provides a new frame of reference for system design, for which

  2. Supply Chain Costing

    DEFF Research Database (Denmark)

    Asmussen, Jesper Normann; Kristensen, Jesper; Wæhrens, Brian Vejrum

    2016-01-01

    Based Costing (ABC) på et forsyningskædeniveau – heri benævnt Supply Chain Costing (SCC). Udoverdefordelederfindesved ABCtilføjerSCCogså et økonomisk grundlag til det strategiske rationale, der ofte ligger bag opbygningen af virksomhedens forsyningskæde, og kan dermed medvirke til konkret....... Virksomhedens evne til at udarbejde relevantinformation fremstår derfor som en vigtig parameter, såfremt virksomheden skal forblive konkurrencedygtig i en stadig mere kompleks verden, hvor udviklingen foregår stadig hurtigere. Denne arbejdsboggiverindsigtidemuligheder,der eksisterer ved at anvende Activity...

  3. Food and water supply

    Science.gov (United States)

    Popov, I. G.

    1975-01-01

    Supplying astronauts with adequate food and water on short and long-term space flights is discussed based on experiences gained in space flight. Food consumption, energy requirements, and suitability of the foodstuffs for space flight are among the factors considered. Physicochemical and biological methods of food production and regeneration of water from astronaut metabolic wastes, as well as wastes produced in a closed ecological system, or as a result of technical processes taking place in various spacecraft systems are suggested for long-term space flights.

  4. Design and Implementation of Intelligent the Supply Room Business Flow Based on RFID%基于RFID的智能供应室业务流的设计与实现

    Institute of Scientific and Technical Information of China (English)

    徐向东; 丁铖; 宋永江; 封军

    2013-01-01

    消毒供应室(中心)是医院的重要单位,通过运用RFID高科技技术,不但可以实现手术包的智能化闭环管理和器械追踪,同时可以强化对清洗、消毒和灭菌等流程的质量监测,优化供应室流程,促进手术室和供应室的一体化管理,不但能提高医院的效率,而且可保证患者的安全,也为医院物联网建设积累了经验。%Central sterile supply department(CSSD) is an important unit of hospitals. With the use of RFID technology, it can not only realize intelligent closed-loop management and equipment tracking of operation package, but can also strengthen the quality monitoring of cleaning, disinfection and sterilization process, optimize the supply department process, promote the integration management of operation room and supply department. It can not only improve the efficiency of hospitals, but also can guarantee the safety of patients and accumulate experience for the construction of hospital internet of things.

  5. Neo-adjuvant chemotherapy followed by radiotherapy adapted to the tumour response in the primary seminoma of the central nervous system: experience of the Pitie-Salpetriere Hospital and review of literature; Chimiotherapie neoadjuvante suivie d'une radiotherapie adaptee a la reponse tumorale dans les tumeurs germinales seminomateuses du systeme nerveux central: experience de l'hopital de la Pitie-Salpetriere et revue de la litterature

    Energy Technology Data Exchange (ETDEWEB)

    Calugaru, V.; Taillibert, S.; Lang, P.; Simon, J.M.; Mazeron, J.J. [Groupe Hospitalier de la Pitie-Salpetriere, APHP, Service de Radiotherapie Oncologique, 75 - Paris (France); Taillibert, S.; Delattre, J.Y. [Groupe Hospitalier de la Pitie-Salpetriere, APHP, Service de Neuro-Oncologie, 75 - Paris (France)

    2007-05-15

    Purpose. Retrospective analysis of ten cases of germinoma of the central nervous system treated in Pitie Salpetriere Hospital, Paris. Patients and methods- - Ten male patients were treated from 1997 to 2005 for histologically verified primary seminoma of the central nervous system. The median age was 27 years (range 18 0 years). Our option for the treatment was the association of 3 cycles of neo-adjuvant chemotherapy (cisplatin and etoposide) to radiotherapy. Five patients received a craniospinal radiotherapy of 30 Gy (for one patient 36 Gy) followed by a tumoral boost from 20 to 24 Gy. For five patients, irradiated volume was limited to the tumour, total dose from 24 to 54 Gy (for three patients the total dose was from 24 to 30 Gy). Surgery was used for five patients, but only in one case was macroscopic complete. Results. Six patients were in situation of complete remission after neo-adjuvant chemotherapy. All the patients were in situation of complete remission after the irradiation. All the patients were alive free of disease with a median follow-up 46 months (range 13 0 months). Conclusion. In spite of the fact that the intracranial germinal tumours are not the subject of a consensual treatment strategy, this retrospective analysis pleads in favour of chemotherapy followed by limited dose and volume irradiation. (authors)

  6. Risikobasiertes Supply-Chain-Management

    DEFF Research Database (Denmark)

    Wieland, Andreas; Schinz, Philipp

    2015-01-01

    Das Management erlebt seit einigen Jahren dahingehend einen Paradigmenwechsel, dass nicht mehr Unternehmen als einzelne autonome Einheiten im Wettbewerb zueinander stehen, sondern die Supply Chains, in denen diese Unternehmen eingebunden sind. Ursachen hierfür sind beispielsweise die Auslagerung...... von Nicht-Kernprozessen auf vorgelagerte Stufen der Supply Chain oder auf Supply-Chain-Dienstleister sowie die Internationalisierung der Beschaffung. Dieser Paradigmenwechsel hat traditionelles Denken in den Schranken des Systems „Unternehmen“ abgelöst und zum Supply- Chain-Denken geführt, das vor......- und nachgelagerte Stufen des Systems „End-to-End-Supply-Chain“ einbezieht, etwa auch die Lieferanten von Lieferanten....

  7. Integrating the healthcare supply chain.

    Science.gov (United States)

    Brennan, C D

    1998-01-01

    Today's integrated delivery systems (IDSs) require efficient supply chain processes to speed products to users at the lowest possible cost. Most excess costs within the supply chain are a result of inefficient and redundant processes involved in the transport and delivery of supplies from suppliers to healthcare providers. By integrating and assuming control of these supply chain processes, improving supply chain management practices, and organizing and implementing a disciplined redesign plan, IDSs can achieve substantial savings and better focus their organizations on their core patient care mission.

  8. Practical switching power supply design

    CERN Document Server

    Brown, Martin C

    1990-01-01

    Take the ""black magic"" out of switching power supplies with Practical Switching Power Supply Design! This is a comprehensive ""hands-on"" guide to the theory behind, and design of, PWM and resonant switching supplies. You'll find information on switching supply operation and selecting an appropriate topology for your application. There's extensive coverage of buck, boost, flyback, push-pull, half bridge, and full bridge regulator circuits. Special attention is given to semiconductors used in switching supplies. RFI/EMI reduction, grounding, testing, and safety standards are also deta

  9. Hospital Outpatient PPS Partial Hospitalization Program LDS

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Outpatient Prospective Payment System (OPPS) Partial Hospitalization Program LDS This file contains select claim level data and is derived from 2010 claims...

  10. Structural Measures - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospitals and the availability of structural measures at that hospital. A structural measure reflects the environment in which hospitals care for patients....

  11. Hospital-acquired pneumonia

    Science.gov (United States)

    ... tends to be more serious than other lung infections because: People in the hospital are often very sick and cannot fight off ... prevent pneumonia. Most hospitals have programs to prevent hospital-acquired infections.

  12. Patient survey (HCAHPS) - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospital ratings for the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). HCAHPS is a national, standardized survey of hospital...

  13. Atividades de enfermagem em centro de material e esterilização: contribuição para o dimensionamento de pessoal Actividades de enfermería en centro de material y esterilización: contribución para el tamaño del personal Nursing activities in central supply and sterilization: a contribution to personnel design

    Directory of Open Access Journals (Sweden)

    Janaína Anchieta Costa

    2011-01-01

    sometidas a la nueva evaluación del grupo, resultando en la validación de seis áreas de trabajo, 25 sub procesos, 110 actividades y 25 actividades específicas de la enfermera. CONCLUSIÓN: Con esta investigación se evidencian perspectivas para la realización de nuevas investigaciones que contribuyan a la determinación de parámetros que subsidien el proceso de establecer el tamaño del personal de enfermería en estas unidades.OBJECTIVES: To identify and validate the activities performed by nursing staff in the Central Supply and Sterilization department, in order to define the workload of nurses on this unit. METHODS: Nursing activities were identified through a review of literature and statements made by official agencies on the subject. To validate these identified activities, we used the Delphi technique to achieve content validation. RESULTS: 11 nurse experts working in Central Supply and Sterilization participated in the study. Comments and suggestions made in the first phase of the Delphi technique led to changes in the content of these activities. These changes were then re-assessed by the experts, resulting in the validation of six areas of work, 25 sub-processes, 110 activities and 25 specific nursing activities. CONCLUSION: This research identified prospects for new investigations that contribute to parameters supporting the process of scaling the nursing staff in these units.

  14. Perceptions of the hospital ethical environment among hospital social workers in the United States.

    Science.gov (United States)

    Pugh, Greg L

    2015-01-01

    Hospital social workers are in a unique context of practice, and one where the ethical environment has a profound influence on the ethical behavior. This study determined the ratings of ethical environment by hospital social workers in large nationwide sample. Correlates suggest by and compared to studies of ethical environment with nurses are explored. Positive ratings of the ethical environment are primarily associated with job satisfaction, as well as working in a centralized social work department and for a non-profit hospital. Religiosity and MSW education were not predictive. Implications and suggestions for managing the hospital ethical environment are provided.

  15. An investigation on research and development cost reduction and channel strategies in competing supply chains

    Directory of Open Access Journals (Sweden)

    Qinqin Li

    2014-06-01

    Full Text Available With the intensification of market competition, the competition form of firms is evolving from the competition among firms to the competition among supply chains. This paper considers a market with two competing supply chains consisting of one supplier and one manufacturer. The two supply chains compete on products’ quantities and research and development (R&D level when the two manufacturers conduct technological innovation. This paper analyses the supply chain competition in three scenarios: two decentralized supply chains (DD, one decentralized supply chain and one centralized supply chain (DC and two centralized supply chains (CC. The results indicate that the production quantity, the R&D level and the total profit of the integrated supply chain in DC scenario are the largest, CC scenario comes second, those of the DD scenario come third and those of the decentralized supply chain in DC scenario are the smallest. CC strategy is the supply chain system’s Nash equilibrium, which is good for the both supply chains, and there is no prisoner's dilemma.

  16. Sustainable Biomass Supply Systems

    Energy Technology Data Exchange (ETDEWEB)

    Erin Searcy; Dave Muth; Erin Wilkerson; Shahab Sokansanj; Bryan Jenkins; Peter Titman; Nathan Parker; Quinn Hart; Richard Nelson

    2009-04-01

    The U.S. Department of Energy (DOE) aims to displace 30% of the 2004 gasoline use (60 billion gal/yr) with biofuels by 2030 as outlined in the Energy Independence and Security Act of 2007, which will require 700 million tons of biomass to be sustainably delivered to biorefineries annually. Lignocellulosic biomass will make an important contribution towards meeting DOE’s ethanol production goals. For the biofuels industry to be an economically viable enterprise, the feedstock supply system (i.e., moving the biomass from the field to the refinery) cannot contribute more that 30% of the total cost of the biofuel production. The Idaho National Laboratory in collaboration with Oak Ridge National Laboratory, University of California, Davis and Kansas State University are developing a set of tools for identifying economical, sustainable feedstocks on a regional basis based on biorefinery siting.

  17. NNSA TRITIUM SUPPLY CHAIN

    Energy Technology Data Exchange (ETDEWEB)

    Wyrick, Steven [Savannah River National Laboratory, Aiken, SC, USA; Cordaro, Joseph [Savannah River National Laboratory, Aiken, SC, USA; Founds, Nanette [National Nuclear Security Administration, Albuquerque, NM, USA; Chambellan, Curtis [National Nuclear Security Administration, Albuquerque, NM, USA

    2013-08-21

    Savannah River Site plays a critical role in the Tritium Production Supply Chain for the National Nuclear Security Administration (NNSA). The entire process includes: • Production of Tritium Producing Burnable Absorber Rods (TPBARs) at the Westinghouse WesDyne Nuclear Fuels Plant in Columbia, South Carolina • Production of unobligated Low Enriched Uranium (LEU) at the United States Enrichment Corporation (USEC) in Portsmouth, Ohio • Irradiation of TPBARs with the LEU at the Tennessee Valley Authority (TVA) Watts Bar Reactor • Extraction of tritium from the irradiated TPBARs at the Tritium Extraction Facility (TEF) at Savannah River Site • Processing the tritium at the Savannah River Site, which includes removal of nonhydrogen species and separation of the hydrogen isotopes of protium, deuterium and tritium.

  18. Offshore Supply Industry Dynamics

    DEFF Research Database (Denmark)

    Roslyng Olesen, Thomas

    and direct investments. At the center of both value chains are the energy companies. The energy companies have a number of suppliers and sub suppliers which provide a range of equipment and services to the offshore operations. The supply industry is characterized by horizontal cooperation (between suppliers....... Traditional manufacturers are often 2nd or 3rd tier suppliers in the installation phase. But by providing after sales services these companies also become direct suppliers to the energy company in the operations phase. Finally a supplier can have different positions in different geographical markets....... A supplier can thus be a direct (1st tier) supplier in one market but needs to go through a local contractor (as a 2nd tier supplier) in another market – even if the provided service is exactly the same in both cases....

  19. Information in the supply chain: measuring supply chain performance

    OpenAIRE

    Bytheway, Andrew

    1995-01-01

    Information is one of many factors in the development of supply chain operations. It is a key factor in a number of new initiatives, such as: business process management. partnership development, efficient customer response, tighter integration of supply chain operations and outsourcing of ancillary operations. Improvement of the supply chain takes place at different levels: simple efficiency (the Improvement of existing processes), improved quality of service (the redesign of ...

  20. Optimize the Management of Sterilization Supply Center with the Trace System%利用追溯系统进行消毒供应中心管理优化

    Institute of Scientific and Technical Information of China (English)

    张睿; 俞刚

    2015-01-01

    Central sterile supply department is the place where supply sterile articles for hospital. It' s the center dealing with disinfection and sterilization. By using traceability system, the central sterile supply department can improve their management and reduce the nosocomial infection, ensure medical safety. This article mainly discuss how to make more work efficiency of supply room by using traceability system.%消毒供应中心是医院为临床科室提供一次性无菌材料以及医疗器械集中统一处理的部门.通过引进追溯系统,可以使消毒供应中心的管理水平大幅提高,从而降低院内感染,保障医疗安全.通过儿童医院追溯系统的开发和实施,讨论了如何更有效地利用对器械和流程的追溯来优化整个科室的管理质量.

  1. Security of supply since 2009. An opinion survey; Die Versorgungssicherheit seit 2009. Ein Stimmungsbild

    Energy Technology Data Exchange (ETDEWEB)

    Flues, Florens; Loeschel, Andreas; Massier, Philipp; Woelfing, Nikolas [Zentrum fuer Europaeische Wirtschaftsforschung GmbH (ZEW), Mannheim (Germany). Forschungsbereich Umwelt- und Ressourcenoekonomik, Umweltmanagement

    2013-04-15

    Security of supply is a central aspect of the concept of public energy supply and it plays an important role in German energy policy. But how can security of supply be measured? Since 2009 the ZEW Energy Market Barometer, a periodical survey carried out by the Centre for European Business Research among some 200 experts from the energy sector, has recorded opinions on the status of security of supply. Its development over the past years gives an instructive picture of how the decisions taken in 2011 to initiate an energy turnaround have impacted on the perceived security of supply.

  2. Decentralization Policies for Supply Chain Investments under Asymmetric Information

    DEFF Research Database (Denmark)

    Agrell, Per Joakim; Bogetoft, Peter

    2017-01-01

    Supply chains need specific investments for improved performance in terms of lead-time, cost, and quality. We study the contractual choice of a coordinator to either centralize or delegate the investment decision in a three-stage chain. The analysis derives closed-form results for the economic...

  3. Developing sustainable food supply chains.

    Science.gov (United States)

    Smith, B Gail

    2008-02-27

    This paper reviews the opportunities available for food businesses to encourage consumers to eat healthier and more nutritious diets, to invest in more sustainable manufacturing and distribution systems and to develop procurement systems based on more sustainable forms of agriculture. The important factors in developing more sustainable supply chains are identified as the type of supply chain involved and the individual business attitude to extending responsibility for product quality into social and environmental performance within their own supply chains. Interpersonal trust and working to standards are both important to build more sustainable local and many conserved food supply chains, but inadequate to transform mainstream agriculture and raw material supplies to the manufactured and commodity food markets. Cooperation among food manufacturers, retailers, NGOs, governmental and farmers' organizations is vital in order to raise standards for some supply chains and to enable farmers to adopt more sustainable agricultural practices.

  4. New roles & responsibilities of hospital biomedical engineering.

    Science.gov (United States)

    Frisch, P H; Stone, B; Booth, P; Lui, W

    2014-01-01

    Over the last decade the changing healthcare environment has required hospitals and specifically Biomedical Engineering to critically evaluate, optimize and adapt their operations. The focus is now on new technologies, changes to the environment of care, support requirements and financial constraints. Memorial Sloan Kettering Cancer Center (MSKCC), an NIH-designated comprehensive cancer center, has been transitioning to an increasing outpatient care environment. This transition is driving an increase in-patient acuity coupled with the need for added urgency of support and response time. New technologies, regulatory requirements and financial constraints have impacted operating budgets and in some cases, resulted in a reduction in staffing. Specific initiatives, such as the Joint Commission's National Patient Safety Goals, requirements for an electronic medical record, meaningful use and ICD10 have caused institutions to reevaluate their operations and processes including requiring Biomedical Engineering to manage new technologies, integrations and changes in the electromagnetic environment, while optimizing operational workflow and resource utilization. This paper addresses the new and expanding responsibilities and approach of Biomedical Engineering organizations, specifically at MSKCC. It is suggested that our experience may be a template for other organizations facing similar problems. Increasing support is necessary for Medical Software - Medical Device Data Systems in the evolving wireless environment, including RTLS and RFID. It will be necessary to evaluate the potential impact on the growing electromagnetic environment, on connectivity resulting in the need for dynamic and interactive testing and the growing demand to establish new and needed operational synergies with Information Technology operations and other operational groups within the institution, such as nursing, facilities management, central supply, and the user departments.

  5. Reliability Estimates for Power Supplies

    Energy Technology Data Exchange (ETDEWEB)

    Lee C. Cadwallader; Peter I. Petersen

    2005-09-01

    Failure rates for large power supplies at a fusion facility are critical knowledge needed to estimate availability of the facility or to set priorties for repairs and spare components. A study of the "failure to operate on demand" and "failure to continue to operate" failure rates has been performed for the large power supplies at DIII-D, which provide power to the magnet coils, the neutral beam injectors, the electron cyclotron heating systems, and the fast wave systems. When one of the power supplies fails to operate, the research program has to be either temporarily changed or halted. If one of the power supplies for the toroidal or ohmic heating coils fails, the operations have to be suspended or the research is continued at de-rated parameters until a repair is completed. If one of the power supplies used in the auxiliary plasma heating systems fails the research is often temporarily changed until a repair is completed. The power supplies are operated remotely and repairs are only performed when the power supplies are off line, so that failure of a power supply does not cause any risk to personnel. The DIII-D Trouble Report database was used to determine the number of power supply faults (over 1,700 reports), and tokamak annual operations data supplied the number of shots, operating times, and power supply usage for the DIII-D operating campaigns between mid-1987 and 2004. Where possible, these power supply failure rates from DIII-D will be compared to similar work that has been performed for the Joint European Torus equipment. These independent data sets support validation of the fusion-specific failure rate values.

  6. Optics Supply Planning System

    Energy Technology Data Exchange (ETDEWEB)

    Gaylord, J

    2009-04-30

    The purpose of this study is to specify the design for an initial optics supply planning system for NIF, and to present quality assurance and test plans for the construction of the system as specified. The National Ignition Facility (NIF) is a large laser facility that is just starting operations. Thousands of specialized optics are required to operate the laser, and must be exchanged over time based on the laser shot plan and predictions of damage. Careful planning and tracking of optic exchanges is necessary because of the tight inventory of spare optics, and the long lead times for optics procurements and production changes. Automated inventory forecasting and production planning tools are required to replace existing manual processes. The optics groups members who are expected to use the supply planning system are the stakeholders for this project, and are divided into three groups. Each of these groups participated in a requirements specification that was used to develop this design. (1) Optics Management--These are the top level stakeholdersk, and the final decision makers. This group is the interface to shot operations, is ultimately responsible for optics supply, and decides which exchanges will be made. (2) Work Center Managers--This group manages the on site optics processing work centers. They schedule the daily work center operations, and are responsible for developing long term processing, equipment, and staffing plans. (3) Component Engineers--This group manages the vendor contracts for the manufacture of new optics and the off site rework of existing optics. They are responsible for sourcing vendors, negotiating contracts, and managing vendor processes. The scope of this analysis is to describe the structure and design details of a system that will meet all requirements that were described by stakeholders and documented in the analysis model for this project. The design specifies the architecture, components, interfaces, and data stores of the system

  7. 77 FR 45061 - Hospital Outpatient Prospective and Ambulatory Surgical Center Payment Systems and Quality...

    Science.gov (United States)

    2012-07-30

    ... neutral. The frontier State wage index would only affect hospitals in the West North Central and Mountain... budget neutrality adjustments. Classifying hospitals by teaching status or type of ownership...

  8. Social Media and Supply Chain

    Directory of Open Access Journals (Sweden)

    Sonja Markova

    2013-02-01

    Full Text Available Web 2.0, also referred to as social media, is the use of the World Wide Web to increase creativity, information sharing, and collaboration among users. Social media is driving the rethinking of many of the principles of economics. The use of social media within supply chains is lagging behind their usage for other operational functions, however supply chain management is evolving into supply chain management 2.0.The purpose of this article is to provide researches of the supply chain management a reference with the main concepts of social media: social profiles, social applications, brand outposts and communities, and the social ecosystem.

  9. Cholangiocytes and blood supply

    Institute of Scientific and Technical Information of China (English)

    Eugenio Gaudio; Antonio Franchitto; Luigi Pannarale; Guido Carpino; Gianfranco Alpini; Heather Francis; Shannon Glaser; Domenico Alvaro; Paolo Onori

    2006-01-01

    The microvascular supply of the biliary tree, the peribiliary plexus (PBP), stems from the hepatic artery branches and flows into the hepatic sinusoids. A detailed three-dimensional study of the PBP has been performed by using the Scanning Electron Microscopy vascular corrosion casts (SEMvcc) technique. Considering that the PBP plays a fundamental role in supporting the secretory and absorptive functions of the biliary epithelium, their organization in either normalcy and pathology is explored. The normal liver shows the PBP arranged around extra- and intrahepatic biliary tree.In the small portal tract PBP was characterized by a single layer of capillaries which progressively continued with the extrahepatic PBP where it showed a more complex vascular network. After common duct ligation (BDL), progressive modifications of bile duct and PBP proliferation are observed. The PBP presents a threedimensional network arranged around many bile ducts and appears as bundles of vessels, composed by capillaries of homogeneous diameter with a typical round mesh structure. The PBP network is easily distinguishable from the sinusoidal network which appears normal. Considering the enormous extension of the PBP during BDL, the possible role played by the Vascular Endothelial Growth Factor (VEGF) is evaluated. VEGF-A,VEGF-C and their related receptors appeared highly immunopositive in proliferating cholangiocytes of BDL rats. The administration of anti-VEGF-A or anti-VEGF-C antibodies to BDL rats as well as hepatic artery ligation induced a reduced bile duct mass. The administration of rVEGF-A to BDL hepatic artery ligated rats prevented the decrease of cholangiocyte proliferation and VEGF-A expression as compared to BDL control rats. These data suggest the role of arterial blood supply of the biliary tree in conditions of cholangiocyte proliferation, such as it occurs during chronic cholestasis. On the other hand,the role played by VEGF as a tool of cross-talk between cholangiocytes

  10. Study on the Dynamic Pricing Revenue Distribution Model of Fresh Agricultural Products Supply Chain

    Directory of Open Access Journals (Sweden)

    Haoran Shi

    2013-12-01

    Full Text Available This study divides the sales cycle of fresh agricultural products into two stages according to the features of fresh agricultural products, establishes two pricing strategies according to its sales and through constructing an centralized-control model of supply chain under the constraints of revenue sharing contract and through analyzing different prices in the two stages, it summarizes the sales strategies of retailers and supplier and the anticipated sales, proposes to coordinate the operation of fresh agricultural products supply chain by adjusting the revenue coefficient in the revenue sharing contract. After comparing the revenue of decentralized-control supply chain model and centralized-control supply chain model, this study concludes that centralized-control supply chain model will have higher revenue.

  11. Time-based analysis of the apheresis platelet supply chain in England.

    Science.gov (United States)

    Wilding, R; Cotton, S; Dobbin, J; Chapman, J; Yates, N

    2011-10-01

    During 2009/2010 loss of platelets within NHS Blood and Transplant (NHSBT) due to time expiry was 9.3%. Hospitals remain reluctant to hold stocks of platelets due to the poor shelf life at issue. The purpose of this study was to identify areas for time compression in the apheresis platelet supply chain to extend the shelf life available for hospitals and reduce wastage in NHSBT. This was done within the context of NHSBT reconfiguring their supply chain and moving towards a consolidated and centralised approach. Time based process mapping was applied to identify value and non-value adding time in two manufacturing models. A large amount of the non-value adding time in the apheresis platelet supply chain is due to transportation and waiting for the next process in the manufacturing process to take place. Time based process mapping provides an effective 'lens' for supply chain professionals to identify opportunities for improvement in the platelet supply chain.

  12. Establishment and Application of Quality Control Traceability System in Sterilization Supply Center%消毒供应中心质量控制可追溯系统的构建与应用

    Institute of Scientific and Technical Information of China (English)

    何晓滨; 樊彦红

    2013-01-01

      目的:探讨医院中建立消毒供应中心质量控制可追溯系统的临床价值。方法:利用信息技术、网络技术,研发了信息化条码标签,将信息系统与消毒灭菌生产供应链管理有效结合,建立了质量控制可追溯软件系统,实现消毒供应器械物品监控。结果:2011年7月至2012年12月共扫描供应监控手术器械包667735个,敷料包53520个,合格率为100%,无因灭菌质量问题引发感染事故发生。结论:质量控制可追溯软件系统加强了消毒灭菌生产供应链管理过程控制,保障了消毒供应产品质量和医疗安全,实现了感染控制的追溯管理,为临床和科学研究提供方便,具有实用价值。%Objective: To discuss clinic value how to establish the central sterile supply quality control traceability system in the military hospitals. Methods: The informatization bar code label was developed independently by adopting Information technology, network technology, the central sterile supply quality control traceability system was established through scanning, combine effectively the information system with the disinfection antiseptic production supplying chain management, and the scanning supply monitoring was performed for the disinfection and supply of instruments and materials. Results:From July 2011 to Dec 2012, the scanning supply monitoring was performed for to tally 667735 surgery instrument packages and 53520 cloth packages no package recalled and no infection events occurred due to the sterilization quality. Conclusions With the central sterile supply quality control traceability system, the process of disinfection antiseptic production supply chain management has been strengthened, the quality of disinfection supply product and medical security have been ensured, and the traceability management of infection control has been achieved, provide conditions for clinical and scientific research.

  13. Hospital marketing revisited.

    Science.gov (United States)

    Costello, M M

    1987-05-01

    With more hospitals embracing the marketing function in their organizational management over the past decade, hospital marketing can no longer be considered a fad. However, a review of hospital marketing efforts as reported in the professional literature indicates that hospitals must pay greater attention to the marketing mix elements of service, price and distribution channels as their programs mature.

  14. 全自动片剂摆药机在我院中心药房的应用%Application of Full-Automatic Tablet Dispensing Machine in the Central Pharmacy of Our Hospital

    Institute of Scientific and Technical Information of China (English)

    訾梅; 古艳婷

    2015-01-01

    OBJECTIVE:To provide references for rational application of full-automatic tablet dispensing machine in the inpa-tient pharmacy of the hospital. METHODS:According to the work flow and use of the machine,the errors and problems arising from the use thereof by our hospital were summarized and analyzed,and corresponding improvement measures and solutions were put forward. RESULTS & CONCLUSIONS:Common errors in the use of full-automatic tablet dispensing machine included errors for the machine(including in-box drug shortage warnings accounting for 58.61% and abnormal responses to the quantity of in-box drugs accounting for 36.96%),errors caused by human factors(including errors of inputting doctor’s order and errors of pharma-cist’s adding drugs)and errors of material installation and operation. The solutions put forward are as follows as adjusting the tilt angle of the outlet mouth and controlling the quantity of the drugs added to the box to reduce the errors for the machine;two phar-macists’checking doctor’s order in the hospital information system in advance to reduce the errors caused by human factors;carry-ing out operation training for operators to reduce the errors of material installation;designating special personnel to maintain the ma-chine,etc.%目的:为医院住院药房合理应用全自动片剂摆药机提供参考。方法:根据全自动片剂摆药机的工作流程和使用情况,总结分析我院在其使用中发生的差错及问题,并提出改进措施和解决方法。结果与结论:使用全自动片剂摆药机的常见差错包括自动摆药机发生的差错(其中药盒缺药报警占58.61%,药盒内数量反应错误占36.96%)、人为因素产生的差错(包括医嘱录入错误和药师加药错误)以及耗材安装操作差错。提出的解决方法包括调整出药口的倾斜角度、控制贮药盒内药品添加的数量以减少自动摆药机发生的差错;药师提前审核医院信

  15. Zapping the food supply

    Energy Technology Data Exchange (ETDEWEB)

    Louria, D.B. (New Jersey Medical School, Newark (USA))

    1990-09-01

    The idea of exposing food to gamma radiation is over 30 years old, and in 1963 the Food and Drug Administration (FDA) began to permit the irradiation of wheat. Over the years, a few more foodstuffs such as spices and tea were added, but in 1984 the FDA started to approve irradiation of a much broader list of products which now includes meat, poultry, and fresh fruits and vegetables. Simultaneously the FDA has increased the levels of radiation that may be used. The FDA's recent willingness to allow most of the food supply to be irradiated - and at high doses - has triggered an acrimonious debate. The amount of radiation involved is substantial, with intensities millions of times greater than that of an ordinary chest X-ray. The announced goal of promoters of food irradiation is to obtain general approval for the use of up to one million rad. Irradiation does not make food radioactive, nor has alleged radioactivity been at issue in the debate. But there is concern that foods processed by irradiation may contain radiolytic products that could have toxic effects. 12 refs.

  16. Investigation in related influencing factors of satisfaction degree with nursing in central injection room of our hospital%影响医院中心注射室护理工作满意度的相关因素调查

    Institute of Scientific and Technical Information of China (English)

    陶风英; 侯静

    2012-01-01

    目的 对中心注射室护理工作的满意度进行调查,了解影响医院护理工作满意度的因素.方法 选择2011年1~12月在中心注射室接受治疗的患者252例为研究对象,采用问卷法对患者进行调查,并分析影响注射室护理工作满意度的因素.结果 接受调查的住院患者中,患者的满意度得分与患者的年龄、受教育程度、收入水平、住院科室、住院天数以及是否手术存在相关性.结论 护理人员应重视和加强护理工作质量和效率,提高临床患者对护理工作的满意程度.%Objective To understand the influencing factors of satisfaction degree with nursing in our hospital by investigation in satisfaction degree in central injection room.Methods 252 patients were selected in our hospital from January to December 2011 as the research object,questionnaires were used to investigate the patients,and the influencing factors of satisfaction degree of nursing work were analyzed.Results Among the patients who accepted the investigation,patients' satisfaction scores were correlated with the patients' age,education level,income level,inpatient department,hospital stay time and whether they accepted an operation.Conclusions Nursing staff should pay attention to and strengthen the nursing work quality and efficiency,improve the satisfaction degree with nursing of clinical patients.

  17. Intracranial germ cell tumors. The experience of the Bordeaux University Hospital and a literature review; Les dysgerminomes du systeme nerveux central. Experience du centre hospitalier universitaire de Bordeaux et analyse de la litterature

    Energy Technology Data Exchange (ETDEWEB)

    Bonichon, N.; Dahan, O.; Maire, J.P.; Caudry, M. [Hopital Saint-Andre, 33 - Bordeaux (France); San Galli, F.; Dautheribes, M.; Perel, Y. [Hopital Pellegrin, 33 - Bordeaux (France)

    1999-08-01

    Retrospective analysis of 17 patients with intracranial germ cell tumors treated in a multidisciplinary consultation at the Bordeaux University Hospital a and literature review. Seventeen consecutive patients were treated from 1978 to 1995 for a primary intracranial germ cell tumor. Median age was 14 (range 3-29 years). There were two malignant teratoma, six proved germinoma and nine presumed germinoma (diagnostic based on biological, radiological and treatment criteria). All received radiotherapy from 30 to 60 Gy (median 40 Gy) in different volumes. Chemotherapy was administered in 15 cases, three after surgery and 12 after radiotherapy. All tumours were in complete remission after initial treatment. The two malignant teratomas recurred in non-irradiated area after nine and 48 months, and the patients died. None of the germinoma recurred within a follow-up period of two to 17 years (median 65 months). Five and 10 year actuarial overall survival rates were the same: 84 % for all histories and 100 % for germinomas. Only two patients developed school difficulties and six presented an hypopituitarism, of which one was consecutive to radiotherapy. Chemotherapy was well tolerated. This retrospective study and literature analysis are in favor of limited dose and volume of radiation therapy associated with chemotherapy. (authors)

  18. LEAN HEALTHCARE SUPPLY CHAIN MANAGEMENT: MINIMIZING WASTE AND COSTS

    Directory of Open Access Journals (Sweden)

    Catia M L Machado

    2014-12-01

    Full Text Available The purpose of this research is to investigate the management models applied in the supply chain providing services in healthcare organizations, considering the lenses of lean. The aim of this is to develop a model of supply chain management focusing on the identification and minimization of waste, assisting in decision making and contributing to the quality of services and as a consequence the reduction of the costs involved in healthcare supply chain. The philosophies of continuous improvement and lean techniques have a role to play in helping healthcare to provide quality service and support to reduce costs in the current budget constraints. In the supply chain of hospitals the financial costs can be around 40% of its budget (MASOUMI et al. 2012; SOUZA et al., 2013. This article sheds light on the improvement in decision making and the effect of reducing costs in the healthcare supply chain. In this sense, the research intend to expand knowledge related to supply chain management in the area of ​​provision of healthcare services through the use of the philosophy of continuous improvement and lean principles, helping healthcare to provide quality service within their current budget constraints.

  19. CSR Pulsed Switching Power Supplies

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    In 2001, CSR power supply system made a great progress. Three prototypes were designed for CSR quadruple and correct magnet. Three different companies provided the three prototypes, but the same circuit-chopper were employed. The simplified diagram is showed in Fig.1. All pulsed switching power supply prototypes were tested successfully before the end of 2001.

  20. Essays on sustainable supply management

    NARCIS (Netherlands)

    Koster, H.R.

    2014-01-01

    The growing concern for organizations’ social responsibility and sustainable behavior has been accompanied by considerable awareness of how organizations manage their supply chains. For many organizations, a large proportion of their sustainability impact comes from their inbound supply chain, an ar

  1. LEAN SUPPLY CHAIN DESIGN PRINCIPLES

    OpenAIRE

    Kozlov, Aleksandr

    2015-01-01

    The article presents a set of principles, which can guide the design of lean supply chains. The author divides design principles into 3 main categories. The first two sets describe internal production processes while the 3-rd set relates to the entire supply chain.

  2. Negotiations in Supply Chain Management

    DEFF Research Database (Denmark)

    Zachariassen, Frederik

    2008-01-01

    negotiation literature. Subsequently, an empirical case study is presented, which explicitly aims at exploring the role of negotiations between members of a supply chain. Based on the findings, the paper concludes on specific, normative guidelines for negotiations for improved supply chain competitiveness...

  3. Smart Power Supply for Battery-Powered Systems

    Science.gov (United States)

    Krasowski, Michael J.; Greer, Lawrence; Prokop, Norman F.; Flatico, Joseph M.

    2010-01-01

    A power supply for battery-powered systems has been designed with an embedded controller that is capable of monitoring and maintaining batteries, charging hardware, while maintaining output power. The power supply is primarily designed for rovers and other remote science and engineering vehicles, but it can be used in any battery alone, or battery and charging source applications. The supply can function autonomously, or can be connected to a host processor through a serial communications link. It can be programmed a priori or on the fly to return current and voltage readings to a host. It has two output power busses: a constant 24-V direct current nominal bus, and a programmable bus for output from approximately 24 up to approximately 50 V. The programmable bus voltage level, and its output power limit, can be changed on the fly as well. The power supply also offers options to reduce the programmable bus to 24 V when the set power limit is reached, limiting output power in the case of a system fault detected in the system. The smart power supply is based on an embedded 8051-type single-chip microcontroller. This choice was made in that a credible progression to flight (radiation hard, high reliability) can be assumed as many 8051 processors or gate arrays capable of accepting 8051-type core presently exist and will continue to do so for some time. To solve the problem of centralized control, this innovation moves an embedded microcontroller to the power supply and assigns it the task of overseeing the operation and charging of the power supply assets. This embedded processor is connected to the application central processor via a serial data link such that the central processor can request updates of various parameters within the supply, such as battery current, bus voltage, remaining power in battery estimations, etc. This supply has a direct connection to the battery bus for common (quiescent) power application. Because components from multiple vendors may have

  4. Managing the Global Supply Chain

    DEFF Research Database (Denmark)

    Hsuan, Juliana; Skjøtt-Larsen, Tage; Kinra, Aseem

    edition has been fully updated with recent changes in concepts, technology and practice. Integration and collaboration are keywords in future competition. Firms must be agile and lean at the same time. The book gives an insightful overview of the conceptual foundations of the global supply chain, as......The world today faces global competition. The supply chain is vital part of the globalization process. Presenting a global view of the scope and complexity of supply chain management, this book reflects the rapid change that has taken place within the supply chain and its environment. This new...... well as current examples of best practice of managing supply chains in a global context....

  5. Petroleum supply monthly, August 1993

    Energy Technology Data Exchange (ETDEWEB)

    1993-09-01

    This publication the Petroleum Supply Monthly (PSM) is one of a family of four publications produced by the Petroleum Supply Division within the Energy Information Administration (EIA) reflecting different levels of data timeliness and completeness. The other publications are the Weekly Petroleum Status Report, (WPSR), the Winter Fuels Report, and the Petroleum Supply Annual (PSA). Data presented describe the supply and disposition of petroleum products in the United States and major US geographic regions. The data series describe production, imports and exports, inter-Petroleum Administration for Defense (PAD) District movements, and inventories by the primary suppliers of petroleum products in the United States (50 States and the District of Columbia). The reporting universe includes those petroleum sectors in primary supply. Included are: petroleum refiners, motor gasoline blenders, operators of natural gas processing plants and fractionators, inter-PAD transporters, importers, and major inventory holders of petroleum products and crude oil. Data presented are divided into Summary Statistics and Detailed Statistics.

  6. Managing the Global Supply Chain

    DEFF Research Database (Denmark)

    Skjøtt-Larsen, Tage; Schary, Philip B.; Mikkola, Juliana Hsuan

    The world today faces global competition. The supply chain is vital part of the globalization process. Presenting a global view of the scope and complexity of supply chain management, this book reflects the rapid change that has taken place within the supply chain and its environment. This new...... edition has been fully updated with recent changes in concepts, technology and practice. Integration and collaboration are keywords in future competition. Firms must be agile and lean at the same time. The book gives an insightful overview of the conceptual foundations of the global supply chain, as...... well as current examples of best practice of managing supply chains in a global context....

  7. A Study to Assess the Factors and Out of Pocket Expenditures in the Patients of Road Traffic Accidents Admitted in a Tertiary Care Hospital in a Central India District

    Directory of Open Access Journals (Sweden)

    Srivastava DK

    2014-12-01

    Full Text Available Background: Road traffic injuries are estimated to be the eighth leading cause of death globally, with an impact similar to that caused by many communicable diseases, such as malaria. road traffic injuries are estimated to cost low- and middle-income countries between 1–2 % of their Gross Domestic Product (GDP, an estimate of about US$ 100 billion a year. Objectives: To study the epidemiological profile of Road Traffic Injuries among the patients admitted in a tertiary care centre and too find out the various out of pocket expenditure in the patients of Road Traffic Accidents. Material and Method: The present study was a hospital based Descriptive Prospective Study. A list of all the patients admitted due to Road Traffic Accident in last one week was obtained from the ward sisters of Orthopedic Department. All the selected participants were interviewed on the two fixed days. A pre tested structured open ended questionnaire was used for data collection. Results: Of the 48 participants interviewed, 34male and 14 females. Most common age group affected was 21-25 years followed by 16-20 years. The rate of accidents was most common on the weekends. The rate of accidents was more in users of two wheelers. Majority of the expenditure in the First week of admission was on the purchase of medicines followed by diagnosis. Majority of the victims also suffered huge financial loss due to loss of salary, closure of shop, loss due to daily wages etc. Conclusion: The present study hereby concludes that there is an urgent need for creating awareness about Road Traffic Accident. The study also concludes that majority of the out of pocket expenditure in the first week of admission is on the medication.

  8. Preparedness planning for pandemic influenza among large US maternity hospitals

    Directory of Open Access Journals (Sweden)

    A Akers

    2009-01-01

    Full Text Available The objective of this investigation was to determine the state of pandemic influenza preparedness and to delineate commonly reported challenges among a sample of larger US national maternity hospitals. This was done given the recent emphasis on hospital disaster planning and the disproportionate morbidity and mortality that pregnant women have suffered in previous influenza pandemics. An internet-based survey was sent to all 12 members of the Council of Women's and Infants' Specialty Hospitals. Questions addressed hospital demographics and overall pandemic preparedness planning, including presence of a pandemic planning committee and the existence of written plans addressing communications, surge capacity, degradation of services, and advance supply planning. Nine of 12 (75% hospitals responded. All had active pandemic planning committees with identified leadership. The majority (78% had written formal plans regarding back-up communications, surge/overflow capacity, and degradation of services. However, fewer (44% reported having written plans in place regarding supply-line/stockpiling of resources. The most common challenges noted were staff and supply coordination, ethical distribution of limited medical resources, and coordination with government agencies. In conclusion, the majority of the Council of Women's and Infants' Specialty Hospitals maternity hospitals have preliminary infrastructure for pandemic influenza planning, but many challenges exist to optimize maternal and fetal outcomes during the next influenza pandemic.

  9. The market for hospital medicine in Denmark

    Directory of Open Access Journals (Sweden)

    Gisela Hostenkamp

    2011-11-01

    Full Text Available Pharmaceutical expenditure growth has outpaced GDP and healthcare expenditure growth rates in Denmark as in most OECD countries for the last decade. A major part of this increase was due to high growth rates in specialist areas that are typically located in hospital settings. Yet the market for hospital medicines and their procurement are still poorly understood. The present paper characterises the market for hospital medicines in Denmark in terms of its organisation and developments between 2005 and 2009. In Denmark hospital medicines are publicly financed and procurement is centrally organised. 98% of all medicines administered at Danish public hospitals are purchased through a public procurement agency by means of public tenders. Using data on actual contract prices we decompose pharmaceutical expenditure growth into the contributions from newly introduced medicines, price and volume increases and use summary statistics to compare market performance in both sectors. The market for hospital medicine is more concentrated than the pharmaceutical retail sector and the share of generics and parallel imported products is significantly lower. Between 2005 and 2009 expenditures for hospital medicines more than doubled -accounting for almost 40% of the total Danish pharmaceutical market in 2009. Price increases however - although positive and higher than in the pharmaceutical retail sector - were only moderate. The majority of the expenditure growth was due to an increase in utilisation and the introduction of new medicines in the hospital sector. Centralised tendering may therefore have important implications for competition and industry structure in the long run.

  10. Medical supplies shortages and burnout among greek health care workers during economic crisis: a pilot study.

    Science.gov (United States)

    Rachiotis, George; Kourousis, Christos; Kamilaraki, Maria; Symvoulakis, Emmanouil K; Dounias, George; Hadjichristodoulou, Christos

    2014-01-01

    Greece has been seriously affected by the economic crisis. In 2011 there were reports of 40% reduction to public hospital budgets. Occasional shortages of medical supplies have been reported in mass media. We attempted to pivotally investigate the frequency of medical supplies shortages in two Greek hospital units of the National Health System and to also assess their possible impact on burnout risk of health care workers. We conducted a cross-sectional study (n=303) of health care workers in two Greek hospitals who were present at the workplace during a casually selected working day (morning shift work). The Maslach Burnout Inventory (MBI) was used as the measure of burnout. An additional questionnaire was used about demographics, and working conditions (duration of employment, cumulative night shifts, type of hospital including medical supplies shortages and their impact on quality of healthcare. The prevalence of emotional exhaustion, depersonalization and low personal accomplishment was 44.5%, 43.2% and 51.5%, respectively. Medical supply shortages were significantly associated with emotional exhaustion and depersonalization. This finding provides preliminary evidence that austerity has affected health care in Greece. Moreover, the medical supply shortages in Greek hospitals may reflect the unfolding humanitarian crisis of the country.

  11. Central Solenoid

    CERN Multimedia

    2002-01-01

    The Central Solenoid (CS) is a single layer coil wound internally in a supporting cylinder housed in the cryostat of the Liquid Argon Calorimeter. It was successfully tested at Toshiba in December 2000 and was delivered to CERN in September 2001 ready for integration in the LAr Calorimeter in 2003. An intermediate test of the chimney and proximity cryogenics was successfully performed in June 2002.

  12. Economies of scale and scope in Vietnamese hospitals.

    Science.gov (United States)

    Weaver, Marcia; Deolalikar, Anil

    2004-07-01

    Hospitals consume a large share of health resources in developing countries, but little is known about the efficiency of their scale and scope. The Ministry of Health of Vietnam and World Bank collected data in 1996 from the largest sample ever surveyed in a developing country. The sample included 654 out of 815 public hospitals, six categories of hospitals and a broad range of sizes. These data were used to estimate total variable cost as a function of multiple products, such as admissions and outpatient visits. We report results for two specifications: (1) estimates with a single variable for beds and (2) estimates with interaction terms for beds and the category of hospital. The coefficient estimates were used to calculate marginal costs, short-run returns to the variable factor, economies of scale, and economies of scope for each category of hospital. There were important differences across categories of hospitals. The measure of economies of scale was 1.09 for central general and 1.05 for central specialty hospitals with a mean of 516 and 226 beds, respectively, indicating roughly constant returns to scale. The measure was well below one for both provincial general and specialty hospitals with a mean of 357 and 192 beds, respectively, indicating large diseconomies of scale. The measure was 1.16 for district hospitals and 0.89 other ministry hospitals indicating modest economies and diseconomies of scale, respectively. There were large economies of scope for central and provincial general hospitals. We conclude that in a system of public hospitals in a developing country that followed an administrative structure, the variable cost function differed significantly across categories of hospitals. Economies of scale and scope depended on the category of the hospital in addition to the number of beds and volume of output.

  13. Europa central

    Directory of Open Access Journals (Sweden)

    Karel BARTOSEK

    2010-02-01

    Full Text Available La investigación francesa continúa interesándose por Europa Central. Desde luego, hay límites a este interés en el ambiente general de mi nueva patria: en la ignorancia, producto del largo desinterés de Francia por este espacio después de la Segunda Guerra Mundial, y en el comportamiento y la reflexión de la clase política y de los medios de comunicación (una anécdota para ilustrar este ambiente: durante la preparación de nuestro coloquio «Refugiados e inmigrantes de Europa Central en el movimiento antifascista y la Resistencia en Francia, 1933-1945», celebrado en París en octubre de 1986, el problema de la definición fue planteado concreta y «prácticamente». ¡Y hubo entonces un historiador eminente, para quién Alemania no formaría parte de Europa Central!.

  14. "Bullwhip Effect" in Supply Chains

    Directory of Open Access Journals (Sweden)

    Anđelko Ščukanec

    2007-09-01

    Full Text Available The system which connects all the elements between theproducer and the consumer is called the supply chain. This definitionof the supply chain shows its complexity, dynamics anduncertainty. Successful operation of supply chains requires thebest possible coordination of its elements, which obviously indicatesthe utmost importance of the information flow alongthem. The operation of supply chains on the whole has to bemore successful than the operation of their individual elements.It should be noted that such a complex process may give rise toa series of problems, unwanted events, as well as substantial reductionin profits and the level of service. One of such unwantedphenomena which may occur in the supply chain is the"bullwhip effect". This is a possible increase in the diversity oforders which occurs when we move along the elements of thesupply chain (from the customers' orders to the producers' orders.The work analyses the processes within the supply chainsand the occurrence of the bullwhip effect. The main causes ofthe bullwhip effect that we encounter daily in the supply chainshave been clearly defined. The paper also presents the mainnegative consequences of such a disturbance within the supplychains, and provides possible solutions for avoiding the bullwhipeffect.

  15. Bacteriological assessment of the hospital environment in two referral hospitals in Yaoundé-Cameroon

    OpenAIRE

    Gonsu, Kamga Hortense; Guenou, Etienne; Toukam, Michel; Ndze, Valantine Ngum; Mbakop, Calixte Didier; Tankeu, Dongmo Norbert; Mbopi-Keou, Francois Xavier; Takongmo, Samuel

    2015-01-01

    Introduction Many studies still show significant numbers of surgical patients contracting nosocomial infections each year globally with high morbidity and mortality. The aim of this study was to identify potential bacteria reservoirs that may be responsible for nosocomial infection in surgical services in the Yaoundé University Teaching Hospital (YUTH) and the Central Hospital Yaoundé (CHY). Methods A cross sectional descriptive study was conducted from June to August 2012. Air, water, and su...

  16. Water supply and demand in an energy supply model

    Energy Technology Data Exchange (ETDEWEB)

    Abbey, D; Loose, V

    1980-12-01

    This report describes a tool for water and energy-related policy analysis, the development of a water supply and demand sector in a linear programming model of energy supply in the United States. The model allows adjustments in the input mix and plant siting in response to water scarcity. Thus, on the demand side energy conversion facilities can substitute more costly dry cooling systems for conventional evaporative systems. On the supply side groundwater and water purchased from irrigators are available as more costly alternatives to unappropriated surface water. Water supply data is developed for 30 regions in 10 Western states. Preliminary results for a 1990 energy demand scenario suggest that, at this level of spatial analysis, water availability plays a minor role in plant siting. Future policy applications of the modeling system are discussed including the evaluation of alternative patterns of synthetic fuels development.

  17. Traceability in food supply chain:: Towards the synchronised supply chain

    OpenAIRE

    Lindh, Helena; Skjöldebrand, Christina; Olsson, Annika

    2008-01-01

    Today, food products are distributed all over the world. This has led to advantages in terms of availability but disadvantages in terms of more complex food supply chains. Global food competition is intense and therefore actors have started to adapt their mindsets toward a more holistic view and a supply chain perspective. In addition, food scares during recent years have turned focus towards food safety and traceability in a “farm-to-fork” perspective. The aim of this study is to explore...

  18. Incentives in Supply Function Equilibrium

    DEFF Research Database (Denmark)

    Vetter, Henrik

    2014-01-01

    The author analyses delegation in homogenous duopoly under the assumption that the firm-managers compete in supply functions. In supply function equilibrium, managers’ decisions are strategic complements. This reverses earlier findings in that the author finds that owners give managers incentives...... to act in an accommodating way. As a result, optimal delegation reduces per-firm output and increases profits to above-Cournot profits. Moreover, in supply function equilibrium the mode of competition is endogenous. This means that the author avoids results that are sensitive with respect to assuming...

  19. Petroleum supply monthly, April 1994

    Energy Technology Data Exchange (ETDEWEB)

    1994-04-01

    Data presented in the Petroleum Supply Monthly (PSM) describe the supply and disposition of petroleum products in the United States and major US geographical regions. The data series describe production, imports and exports, inter-Petroleum Administration for Defense (PAD) District movements, and inventories by the primary suppliers of petroleum products in the US. The reporting universe includes those petroleum sectors in primary supply. Included are: petroleum refiners, motor gasoline blenders, operators of natural gas processing plants and fractionators, inter-PAD transporters, importers, and major inventory holders of petroleum products and crude oil. When aggregated, the data reported by these sectors approximately represent the consumption of petroleum products in the US.

  20. DISRUPTION MANAGEMENT FOR SUPPLY CHAIN COORDINATION WITH EXPONENTIAL DEMAND FUNCTION

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    The coordination problem of a supply chain comprising one supplier and one retailer under market demand disruption is studied in this article. A novel exponential demand function is adopted, and the penalty cost is introduced explicitly to capture the deviation production cost caused by the market demand disruption. The optimal strategies are obtained for different disruption scale under the centralized mode. For the decentralized mode, it is proved that the supply chain can be fully coordinated by adjusting the price discount policy appropriately when disruption occurs. Furthermore, the authors point out that similar results can be established for more general demand functions that represent different market circumstances if certain assumptions are satisfied.

  1. Ground-water quality in quaternary deposits of the central high plains aquifer, south-central Kansas, 1999

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Water samples from 20 randomly selected domestic water-supply wells completed in the Quaternary deposits of south-central Kansas were collected as part of the High...

  2. 看板法应用下的医院二级药房药品运营实践与策略探讨%Practice and Strategy Study on Hospital Pharmacy Management Based on Kanban Method in the Drug Supply Chain

    Institute of Scientific and Technical Information of China (English)

    彭婕; 葛卫红; 方芸; 韩飞; 沈国平

    2013-01-01

    Kanban method was introduced into the hospital pharmacy management process.It can help optimize the hospital overall inventory and improve the level of logistics management.%我院将看板法引入二级药房药品运营过程,压缩了库存周转率,减少了药房物流作业工作量,降低差错.使二级药房药品物流管理水平得到提高,并优化了医院药品供应链整体库存.

  3. Factors associated with financial distress of nonprofit hospitals.

    Science.gov (United States)

    Kim, Tae Hyun

    2010-01-01

    Financial distress can have a detrimental influence on the performance of hospitals. Hospital management needs to monitor potential financial distress effectively and know how it will respond depending on the severity of the circumstances. This study examined the multiple factors that may explain the financial distress of nonprofit hospitals during 1998 to 2001 and discussed their importance. To obtain more robust results, financial distress was assessed in 2 ways: first, financial strength index was used to incorporate 4 financial dimensions including profitability, liquidity, leverage, and physical facilities; second, cash flow (CF) was used to address the issues of accrual-based accounting in hospitals. This study finds that decrease in occupancy rate and increase in Medicaid payer mix, health maintenance organization penetration, market competition, physician supply, and percentage of the elderly are associated with increased likelihood of financial distress of urban hospitals. Increases in both Medicare and Medicaid payer mix, however, are related to higher likelihood of financial distress of rural hospitals.

  4. Hospital Compare - Archived Data

    Data.gov (United States)

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

  5. HCAHPS Hospital Survey

    Data.gov (United States)

    U.S. Department of Health & Human Services — Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Hospital Survey The intent of the HCAHPS initiative is to provide a standardized survey...

  6. A Perspective for Supply Chain Management: Building a Conceptual Framework

    Directory of Open Access Journals (Sweden)

    Jraisat, L.E.

    2011-01-01

    Full Text Available Supply chain relationships play a significant role in supply chain management to respond to dynamic export market changes. If the dyadic exporter-producer relationships are still weak, they impede the emergence of a high performance supply chain within an export market. This paper develops a conceptual framework for understanding how exporter-producer relationships include not only the relationship system but also network and transaction systems; and thus introduces a more integrated way of looking at supply chain management based on information sharing as a key process between exporters and producers. To achieve this aim, supply chain relationships are reviewed from the perspectives of relationship marketing theory, network theory and transaction cost theory. Findings from previous research are discussed to provide a better understanding of how these relationships have evolved. A conceptual framework is built by offering a central proposition that specific dimensions of relationships, networks and transactions are the key antecedents of information sharing, which in turn influences export performance in supply chain management.

  7. Central pain.

    Science.gov (United States)

    Singh, Supreet

    2014-12-01

    Questions from patients about pain conditions and analgesic pharmacotherapy and responses from authors are presented to help educate patients and make them more effective self-advocates. The topic addressed in this issue is central pain, a neuropathic pain syndrome caused by a lesion in the brain or spinal cord that sensitizes one's perception of pain. It is a debilitating condition caused by various diseases such as multiple sclerosis, strokes, spinal cord injuries, or brain tumors. Varied symptoms and the use of pharmacological medicines and nonpharmacological therapies will be addressed.

  8. central t

    Directory of Open Access Journals (Sweden)

    Manuel R. Piña Monarrez

    2007-01-01

    Full Text Available Dado que la Regresión Ridge (RR, es una estimación sesgada que parte de la solución de la regresión de Mínimos Cuadrados (MC, es vital establecer las condiciones para las que la distribución central t de Student que se utiliza en la prueba de hipótesis en MC, sea también aplicable a la regresión RR. La prueba de este importante resultado se presenta en este artículo.

  9. Water uptake and water supply

    NARCIS (Netherlands)

    Sonneveld, C.; Voogt, W.

    2009-01-01

    The water uptake and the water supply do not directly affect the mineral absorption of plants. However, many connections exist between the management of minerals and water. The most evident of those connections are following

  10. Public Water Supply Systems (PWS)

    Data.gov (United States)

    Kansas Data Access and Support Center — This dataset includes boundaries for most public water supply systems (PWS) in Kansas (525 municipalities, 289 rural water districts and 13 public wholesale water...

  11. Supply Chain Shipment Pricing Data

    Data.gov (United States)

    US Agency for International Development — This data set provides supply chain health commodity shipment and pricing data. Specifically, the data set identifies Antiretroviral (ARV) and HIV lab shipments to...

  12. TRANSISTOR HIGH VOLTAGE POWER SUPPLY

    Science.gov (United States)

    Driver, G.E.

    1958-07-15

    High voltage, direct current power supplies are described for use with battery powered nuclear detection equipment. The particular advantages of the power supply described, are increased efficiency and reduced size and welght brought about by the use of transistors in the circuit. An important feature resides tn the employment of a pair of transistors in an alternatefiring oscillator circuit having a coupling transformer and other circuit components which are used for interconnecting the various electrodes of the transistors.

  13. Modeling Continuous IED Supply Chains

    Science.gov (United States)

    2014-03-27

    criminals, pirates, drug traffickers and terrorists. Moreover, JIEDDO has pointed out the spread of IED use to places such as Thailand and Norway. U.S... human networks that place IEDs. Dekker categorizes two main human aspects of IED placement. The first is motivation which 8 affects the number of...methods provided in this thesis and apply them to combat other threats. For example, drug trafficking supply chains. IED and drug trafficking supply

  14. Petroleum supply monthly, April 1990

    Energy Technology Data Exchange (ETDEWEB)

    None

    1990-06-26

    The Petroleum Supply Monthly (PSM) is one of a family of three publications produced by the Petroleum Supply Division within the Energy Information Administration (EIA) reflecting different levels of data timeliness and completeness. The other two publications are the Weekly Petroleum Status Report (WPSR) and the Petroleum Supply Annual (PSA). Data presented in the Petroleum Supply Monthly describe (PSM) the supply and disposition of petroleum products in the United States and major US geographic regions. The data series describe production, imports and exports, inter-Petroleum Administration for Defense (PAD) District movements, and inventories by the primary suppliers of petroleum products in the United States (50 States and the District of Columbia). The reporting universe includes those petroleum sectors in Primary Supply.'' Included are: petroleum refiners, motor gasoline blenders, operators of natural gas processing plants and fractionators, inter-PAD transporters, importers, and major inventory holders of petroleum products and crude oil. When aggregated, the data reported by these sectors approximately represent the consumption of petroleum products in the United States. Data presented in the PSM are divided into two sections: (1) the Summary Statistics and (2) the Detailed Statistics.

  15. Reinforcement learning in supply chains.

    Science.gov (United States)

    Valluri, Annapurna; North, Michael J; Macal, Charles M

    2009-10-01

    Effective management of supply chains creates value and can strategically position companies. In practice, human beings have been found to be both surprisingly successful and disappointingly inept at managing supply chains. The related fields of cognitive psychology and artificial intelligence have postulated a variety of potential mechanisms to explain this behavior. One of the leading candidates is reinforcement learning. This paper applies agent-based modeling to investigate the comparative behavioral consequences of three simple reinforcement learning algorithms in a multi-stage supply chain. For the first time, our findings show that the specific algorithm that is employed can have dramatic effects on the results obtained. Reinforcement learning is found to be valuable in multi-stage supply chains with several learning agents, as independent agents can learn to coordinate their behavior. However, learning in multi-stage supply chains using these postulated approaches from cognitive psychology and artificial intelligence take extremely long time periods to achieve stability which raises questions about their ability to explain behavior in real supply chains. The fact that it takes thousands of periods for agents to learn in this simple multi-agent setting provides new evidence that real world decision makers are unlikely to be using strict reinforcement learning in practice.

  16. Regional power supply with decentral and renewable energy sources; Regionale Energieversorgung mit dezentralen und erneuerbaren Energien

    Energy Technology Data Exchange (ETDEWEB)

    Bonow, Martin [Genossenschaftsverband, Neu-Isenburg/Zeppelinheim-Ost (Germany); George, Wolfgang [GenoPortal, Neu-Isenburg (Germany); Klement, Martin [Kassel Univ. (Germany). Fachbereich 6 - Architektur, Stadtplanung, Landschaftsplanung

    2009-04-15

    The contribution starts by assuming a region as a business organisation; on this basis, the authors develop the idea of a regional value-adding chain with regard to regional power supply. After presenting the central actors and their manner of integration, the contribution discusses concepts for sustainable power supply as well as the central parameters of such a development in terms of quality of life, attractivity of the region, future success of technologies, and criteria of value-adding. Finally, the implementation of regional power supply with the aid of a so-called 'balanced scorecard' is explained, which involves balancing of the various perspectives of the process up to the establishment of the final regional power supply concept. Finally, the contribution briefly discusses co-operative models for the establishment of a regional power supply concept. (orig.)

  17. Medicare Hospital Spending Per Patient - Hospital

    Data.gov (United States)

    U.S. Department of Health & Human Services — The "Medicare hospital spending per patient (Medicare Spending per Beneficiary)" measure shows whether Medicare spends more, less or about the same per Medicare...

  18. Ten Year Trend of Percutaneous Coronary Intervention in Central-western Urban Hospitals of China--Results From China PEACE-Retrospective CathPCI Study%中国中西部城市医院经皮冠状动脉介入治疗十年趋势--China PEACE回顾性CathPCI研究结果

    Institute of Scientific and Technical Information of China (English)

    郑昕; 白雪珂; 王斌; 霍西茜; 王思铭; 苏萌; 李静; 李希; 蒋立新

    2016-01-01

    Objective: To assess the trends in clinical characteristics, treatment, and outcomes for hospitalized patients undergoing percutaneous coronary intervention (PCI) in central-western urban hospitals of China in 2001, 2006 and 2011. Methods: We used a 2-stage, random sampling strategy to create a Chinese central-western urban hospital representative sample of 2152 patients undergoing PCI at 26 hospitals in China PEACE- retrospective CathPCI study and calculated the weighted data of clinical information in each year. Results: Between 2001 and 2011, the admission rate for PCI increased by 46 folds. Compared with 2001, the patients undergoing PCI were more likely to be female, older than 80 years, and to have history of diabetes, dyslipidemia and PCI in 2011. The proportion of trans-radial PCIs increased from 3.5% in 2001 to 87.6% in 2011 (Ptrend < 0.0001); the proportion of drug eluting stents (DES) among all the implanted stents increased from 16.4% in 2001 to 95.7% in 2011 (Ptrend < 0.0001), largely due to increased use of domestic DES. Less than 5% of medical record of admission for PCI documented door time and balloon time. The median length of stay decreased from 13 days in 2001 to 10 days in 2011 (Ptrend < 0.0001). In-hospital mortality did not change signiifcantly, but both any bleeding and access bleeding events were decreased signiifcantly over time (Ptrend < 0.05). Conclusion: There has been a rapid increase in the volume and significant change in treatment patterns of PCI over the 10-year period from 2001 to 2011 in Chinese central-western urban hospitals. We identiifed quality gaps that represent opportunities to improve medical care.%目的:评价2001年至2011年间中国中西部城市医院行经皮冠状动脉介入治疗(PCI)患者的临床特征、治疗模式和院内结局的变化趋势。方法:使用“冠心病医疗结果评价和临床转化(China PEACE)研究”——回顾性冠脉造影和介入治疗(Cath

  19. Interruptions: Derrida and Hospitality

    Directory of Open Access Journals (Sweden)

    Mark W. Westmoreland

    2008-06-01

    Full Text Available Come in. Welcome. Be my guest and I will be yours. Shall we ask, in accordance with the Derridean question, "Is not hospitality an interruption of the self?" What is the relationship between the interruption and the moment one enters the host's home? Derrida calls us toward a new understanding of hospitality - as an interruption. This paper will illuminate the history of hospitality in the West as well as trace Derrida's discussions of hospitality throughout many of works. The overall goal of this project is to provide readers of Derrida with a sort of reference guide for his discussions on and deconstructive approach to hospitality.

  20. Towards the collaborative hospital

    DEFF Research Database (Denmark)

    Prætorius, Thim; Hasle, Peter; Edwards, Kasper;

    2015-01-01

    of the collaborative hospital concern the creation of an appropriate balance between standardization and local autonomy, shared purpose centred around providing the best possible care, and use of enabling structures that sustain the new ways of collaborative work. The chapter builds on the theoretical framework...... for the collaborative hospital as new organizational form which is better equipped to respond to the challenges facing modern hospitals. The collaborative hospital is an ambidextrous organization that opens for pursuing both exploration and exploitation within the same organizational structure. The basic principles...... of the collaborative organization which is used for a discussion of theoretical and empirical aspects of the collaborative hospital....