WorldWideScience

Sample records for central supply hospital

  1. Supply Chain Coordination in Hospitals

    Science.gov (United States)

    Rego, Nazaré; de Sousa, Jorge Pinho

    This paper presents an innovative approach to support the definition of strategies for the design of alternative configurations of hospital supply chains. This approach was developed around a hybrid Tabu Search / Variable Neighbourhood Search metaheuristic, that uses several neighbourhood structures. The flexibility of the procedure allows its application to supply chains with different topologies and atypical cost characteristics. A preliminary computational experience shows the approach potential in solving large scale supply chain configuration problems. The future incorporation of this approach in a broader Decision Support System (DSS) will provide a tool that can significantly contribute to an increase of healthcare supply chains efficiency and encourage the establishment of collaborative partnerships between their members.

  2. Central line infections - hospitals

    Science.gov (United States)

    ... risk is higher if you: Are in the intensive care unit (ICU) Have a weakened immune system or serious ... unless you have washed your hands. Tell your nurse if your central line: Gets dirty Is coming ...

  3. Pulling Drugs Along the Supply Chain: Centralization of Hospitals’ Inventory

    OpenAIRE

    Raffaele Iannone; Alfredo Lambiase; Salvatore Miranda; Stefano Riemma; Debora Sarno

    2014-01-01

    Due to the economic crisis and the predominance of drug expenditure in healthcare costs, the cooperation of groups of hospitals to negotiate with suppliers and centralize warehouses has been a recent trend in the pharmaceutical supply chain. This paper shows the economic convenience of centralizing the hospitals’ inventory decisions (how much/when to order) based on the sharing of medical prescriptions of patients along the supply chain. The logistic network under investigation (TO BE model) ...

  4. RETAIL SUPPLY CHAIN MANAGEMENT THROUGH CENTRALIZED DISTRIBUTION

    OpenAIRE

    Davor Dujak

    2012-01-01

    The paper reviews the trends in the design of distribution systems in retail supply chain management. Through goals, design decisions and costs of distribution system or distribution network, the paper points to the complexity and importance of this area of supply chain management. The goal of paper is to present modern trends in the distribution system, as well as specify the advantages and disadvantages of the leading distribution systems, with a special emphasis on the central distribution...

  5. Developing hospitality innovation through Supply Chain Collaboration

    OpenAIRE

    O'Brien, Darren

    2009-01-01

    As economic clouds darken and the pressure on hospitality providers to cut costs and maintain competitiveness grows, the requirement for innovation and product development in the tourism sector continues to be of critical importance. The important question for the next decade is not whether hospitality organisations should innovate but rather how can they develop their innovative capability and what steps should they be taking to improve the likelihood of success in their innovation activitie...

  6. Decentralized Heat Supply – Alternative to Centralized One

    OpenAIRE

    Nazarov, V; L. Tarasevich; А. Burov

    2014-01-01

    The paper presents a concrete example that shows comparative characteristics of decentralized and centralized heat supply. It has been shown in the paper that selection of this or that variant of heat supply significantly depends on losses in heat supply networks.

  7. Decentralized Heat Supply – Alternative to Centralized One

    Directory of Open Access Journals (Sweden)

    V. Nazarov

    2014-09-01

    Full Text Available The paper presents a concrete example that shows comparative characteristics of decentralized and centralized heat supply. It has been shown in the paper that selection of this or that variant of heat supply significantly depends on losses in heat supply networks.

  8. Heat Supply of Field Hospital Operating under Emergency Conditions

    OpenAIRE

    A. P. Nesenchuk; T. V. Ryzhova; I. L. Kachar; A. V. Begliak

    2014-01-01

    The paper considers a possibility to use a heat generator in a heat supply system of a field hospital which is operating under emergency conditions. Comparison of heat efficiency with the data existing in the literature has been done in the paper.

  9. Heat Supply of Field Hospital Operating under Emergency Conditions

    Directory of Open Access Journals (Sweden)

    A. P. Nesenchuk

    2014-08-01

    Full Text Available The paper considers a possibility to use a heat generator in a heat supply system of a field hospital which is operating under emergency conditions. Comparison of heat efficiency with the data existing in the literature has been done in the paper.

  10. Expedient arrangement of newly constructed systems for centralized heat supply

    Science.gov (United States)

    Zeigarnik, Yu. A.; Rotinov, A. G.

    2008-11-01

    It is shown that for newly constructed combined-cycle cogeneration plants and nuclear cogeneration plants, the optimum arrangement of the centralized heat supply system is the combination of a cogeneration plant and a district heat-supply station (a boiler house).

  11. 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.

  12. 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

  13. Current Status of Human Resources of Central Sterile Supply Department in 104 Secondary Hospitals and above in Xinjiang%新疆104家二级以上医院消毒供应中心(室)人力资源现状调查分析

    Institute of Scientific and Technical Information of China (English)

    张金梅; 杨薇; 李正英

    2016-01-01

    ObjectiveTo investigate the human resource status of the central sterile supply department (CSSD) in Secondary Hospitals and above in Xinjiang, to provide the basis policy for health administrative department.MethodsBy using questionnaires 104 secondary and above hospital disinfection supply center were investigated.ResultsIIn Xinjiang, the ratio of tertiary hospitals and secondary hospital of nurses to disinfection supply room of the patient were 1.6:100 and 1.8:100; In CSSD of tertiary hospitals, the number of bachelar degree holder ,college degree holder and people graduated from technical secondary school degree, and working age in all different stages were all higher than those of secondary hospital, the difference was statistically significant (P<0.05). Thinking about professional qualifications (the number of workers who has a pressure vessel certificate) aspects, tertiary hospitals had 3.62±2.714 person and above, secondary hospital had 2.38±1.730 person, the difference was statistically significant(P<0.05). ConclusionHuman resource configuration of the disinfection supply centeris is not reasonable in Xinjiang. Medical staff are in low education, low title, long service, and aged. Disinfection workers without pressure vessel license are exist.%目的:了解新疆二级以上医院消毒供应中心(室)(CSSD)的人力资源状况,为卫生行政部门制定政策提供依据。方法采用自设问卷对104家新疆二级以上各医疗机构的消毒供应中心(室)的人力资源现状进行问卷调查。结果新疆三级医院和二级医院消毒供应室护理人员总数与病床之比分别为1.6:100和1.8:100;三级医院CSSD本科、专科、中专学历人数以及均不同阶段工龄人数高于二级医院,差异有统计学意义(P<0.05),专业资质(拥有压力容器上岗证)方面,三级医院拥有3.62±2.714人,高于二级医院2.38±1.730人,差异有统计学意义(P<0.05)。结论新疆

  14. Guidance and Orientation Manual : Internal Diseases Ward 11 - Central Finland Central Hospital

    OpenAIRE

    Hirjaba, Marina

    2009-01-01

    The purpose of this Bachelor’s Thesis is to create an initiation manual for the foreign students, foreign visitors or anyone else interested about Internal Diseases ward 11, Central Finland Central Hospital. The aim of the guidance material is to help the foreign students, who are practicing on ward 11, to become acquainted with the Finnish Healthcare System, Central Finland Central Hospital and to offer orientation upon the nursing and organisation of Internal Diseases ward 11. It is taken i...

  15. Development of a Conceptual Framework for Performance Measurement of Pharmaceutical Supply Chain within Hospital

    OpenAIRE

    Alexis Nsamzinshuti; Alassane Ballé Ndiaye

    2014-01-01

    In recent years, the European hospital sector suffers the brunt of the economic crisis. This sector is now faced with a paradox, which is to reduce costs, related to the decline in government subsidies and an increase in the quality of care required by the regulatory bodies. This paradox can be resolved through the optimization of the hospital supply chain. Despite hospital supply chains having a great impact on hospital budgets, still opportunities for optimization exist and improve the heal...

  16. 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.

  17. [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. PMID:25286563

  18. Impact of Radio-Frequency Identification (RFID) Technologies on the Hospital Supply Chain: A Literature Review

    OpenAIRE

    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 appl...

  19. 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

  20. Gas prices and supply in Central and Eastern European countries

    International Nuclear Information System (INIS)

    The increasing gas significance in the world's energy and economy, as well as overall features of gas industry and trade, call for uniformity of business and development conditions among particular countries and regions. That attracts attention of international institutions, gas companies and particular countries. In this view, also change take place in the Central and Eastern European countries that will have to issue corresponding regulations and implement market conditions in the gas sector as well. One of the basic activities will be a gas policy and price growth, which will enable investments into a new development. Croatia has already started that process due to its dependence on gas imports, which was paid at world prices and on foreign capital. However, as regards the gas sector development, the introduction of market conditions will continue, but at a faster rate and structural changes supply, consumption, property and the like. (author)

  1. The Effect of Information Exchange on Inter-Functional Coordination within Hospital Supply Chain: Case of Moroccan University Hospital

    OpenAIRE

    Mustapha Bouachouch; Fatima Ouazzani Chahdi

    2015-01-01

    This research aims to explore the causal relationship between the information exchanged and inter-functional coordination (IFC) in the Hospital Supply Chain (HSC) context "Case of Moroccan University Hospital (MUH)". Specifically, the research aims to identify the dimensions of information exchanged the most significant and that influencing between services directly involved in the pharmaceutical and information flows associated within the MUH. To achieve this goal, we conducted 20 semi-struc...

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

    OpenAIRE

    Inmaculada Gómez-Villegas; Belén Ruíz-Pérez; Dolores López-del-Pino; Francisco García-España

    2015-01-01

    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. R...

  3. 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. PMID:24159272

  4. ACUTE LIFE-THREATENING ASTHMA IN ASIR CENTRAL HOSPITAL

    OpenAIRE

    Al-Ghamdi, Badr R.; Taklu, Bayu G.

    1997-01-01

    Aim: This study was conducted to analyze the severe acute asthma admissions in Asir Central Hospital (ACH) in Abha, Saudi Arabia. In particular, it aimed to identify risk factors and final outcome of acute life-threatening asthma. Method: All patients admitted to the Intensive Care Unit (ICU) with acute bronchial asthma from June 1989 to May 1995 were analyzed. Total admis-sions to the ICU were obtained to determine the prevalence of asthma admission to the ICU. Results: There were 13 admissi...

  5. Mobile technologies and supply chain management – lessons for the hospitality industry

    OpenAIRE

    Robert Maršanić

    2014-01-01

    The purpose – The purpose of this paper is based on the fact that managing supply chains as a separate area of business management opens up numerous possibilities for improving the competitive position of business systems. Supply chain management is increasingly often named as the key offensive factor to increasing the efficacy and effectiveness of economic systems. Design – The purpose of the paper is to point to the fact that hospitality logistics fulfils its basic mission only then when hi...

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

    Science.gov (United States)

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

    2016-05-01

    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.

  7. Proposition of a framework to reengineer and evaluate the hospital supply chain

    OpenAIRE

    Di Martinelly, Christine

    2008-01-01

    Thèse en co-tutelle FUCaM de Mons (Belgique) et INSA de Lyon (France) The objective of our research is the development of a modeling framework that permits decision makers to reengineer and evaluate their hospital supply chain. This research was first motivated by a strong collaboration with a Belgian hospital of 900 beds that is currently reengineering its logistical activities. The managers of this hospital intend to build a new logistical platform to group the clinical pharmacy, the ste...

  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

    , Northern France, yielded supply reliabilities close to 100% for reasonable tank sizes (0.065 m3/m2 of roof area in Dinard compared with 0.262 m3/m2 in Nice with a RWSO of 30% for a detached house). However, the collection and use of rainfall results in a permanent decrease in mains water demand leading to...... an increase in water age in the distribution network. Investigations carried on a real network showed that water age is greatly affected when rainwater supplies more than 30% of the overall water demand. In urban water utilities planning, rainwater supply systems may however be profitable for the......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...

  9. The changing distribution of a major surgical procedure across hospitals: were supply shifts and disequilibrium important?

    Science.gov (United States)

    Friedman, B; Elixhauser, A

    1995-01-01

    This paper describes and analyzes the changing distribution across hospitals in the U.S. of total hip replacement surgery (THR) for the period 1980-1987. THR is one of the most costly single procedures contributing to health care expenses. Also, the use of THR exhibits a particularly high degree of geographic variation. Recent research pointed to shifts in demand as one plausible economic explanation for increasing use of THR. This paper questions whether shifts in supply may have been large enough to explain changes in patient mix and the relationship of patient mix to the number of procedures performed at a particular hospital. In addition, the relationship between total use of THR and the local availability of orthopaedic surgeons as well as the average allowable Medicare fee for standardized physician services is analyzed. These relationships might yield evidence to support a scenario of induced demand beyond the optimum for patients' welfare, or evidence of supply increase within a disequilibrium scenario. This study, using data for all THR patients in a large sample of hospitals, tends to reject the formulation of a market with independent supply and demand shifts where the supply shifts were the dominant forces. Hospitals with a larger number of THRs performed did not see a higher percentage of older, sicker, and lower income patients. It was more likely that demand shifts generated increases in capacity for surgical services. Moreover, there was little evidence for a persistent disequilibrium and only weak evidence for inducement. Also, we found little evidence that hospitals responded to financial incentives inherent in the Medicare payment system after 1983 to select among THR candidates in favour of those with below average expected cost. We did observe increased concentration over time of THR procedures in facilities with high volume--suggesting plausible demand shifts towards hospitals with a priori quality and cost advantages or who obtained those

  10. 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

  11. 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…

  12. ALGORITHM FOR OPTIMIZATION OF STRUCTURE AND COMPOSITION OF CENTRALIZED HEAT-SUPPLY SYSTEM

    OpenAIRE

    V. Sednin; Korznikov, A.; A. Sednin; I. Shkliar

    2014-01-01

     The paper presents algorithms for structure optimization of centralized heat-supply systems in large cities due to higher heat loads and necessity for equipment change. The algorithms can be applied for elaboration of plans for development of heat supply in cities and human settlements.

  13. ALGORITHM FOR OPTIMIZATION OF STRUCTURE AND COMPOSITION OF CENTRALIZED HEAT-SUPPLY SYSTEM

    Directory of Open Access Journals (Sweden)

    V. Sednin

    2014-09-01

    Full Text Available  The paper presents algorithms for structure optimization of centralized heat-supply systems in large cities due to higher heat loads and necessity for equipment change. The algorithms can be applied for elaboration of plans for development of heat supply in cities and human settlements.

  14. Altruism, Rivalry and Crowding-Out in the Nonprofit Firm's Supply of Charity Services: The Case of Hospitals

    OpenAIRE

    Frank, Richard G.; David S. Salkever

    1988-01-01

    This paper extends previous research on Individuals' supply of charitable donations to the behavior of nonprofit firms. Specifically, we study provision of charity care by private, nonprofit hospitals. We demonstrate that In the absence of large positive income effects on charity care supply, convex preferences for the nonprofit hospital imply crowding out by other private or government hospitals. Extending our model to include patient heterogeneity and impure altruism (rivalry) provides a po...

  15. Drowning in children: Aseer Central Hospital experience, Southwestern Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Suliman H Al-Fifi

    2011-01-01

    Full Text Available Aim: To study the reasons, magnitude and outcome of drowning following submersion in water of children admitted to the Pediatric Intensive Care Unit in Aseer Province, Saudi Arabia. Materials and Methods: A retrospective cohort study of all pediatric patients (0-13 years old who drowned and were admitted to the Pediatric Intensive Care Unit, Aseer Central Hospital, Southwestern Saudi Arabia, between January 1st 1999 and December 31st 2009. Results: A total of 19 cases were admitted following submersion in water. The mean age was 5.2 years ±3.8. Majority of victims (94.1% were from the highland areas. Events most frequently occurred in the summer (46.7%, followed by spring and winter, 33.3% and 20%, respectively. Home events constituted 44.4% of submersion cases. Of these, 55.6% drowned in a washing container, While 53.4% submersed in swimming pools. Twenty-two percent of these accidents occurred in the sea and in wells while 11.1% occurred in a lake. The mean duration of submersion was 4.04 minutes ± 5.35. Cardiac arrest was reported upon arrival at hospital in 42.1% of the victims. There were seven deaths (36.8 % and in one patient (5.2 % there was severe brain injury. In all deceased cases, no adults were watching the children when the accidents occurred. Conclusion: Drowning is a significant risk factor facing our children and can claim lives. The media as well as the authority should play a major role in increasing the public awareness to minimize or prevent such a problem.

  16. Price competition model in decentralized and centralized supply chains with demand disruption

    Directory of Open Access Journals (Sweden)

    Chai Wenlong

    2013-03-01

    Full Text Available Purpose: The paper studies the price competition of a supply chain with one supplier and two competing retailers under occasional demand disruption.Design/methodology/approach: The supply chain is either decentralized or centralized. The demand disruption for two retailers occurs with different probability. We analyze the effect of occurrence probability of demand disruption on the optimal prices of the supplier and two retailers.Findings: We find that the profits of supplier, retailers and supply chain are decreasing with the occurrence probability of demand disruption.Originality/value: It is helpful for supply chain members to adjust the original contracts to demand disruption.

  17. 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.

  18. 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

  19. The effects of pay and job satisfaction on the labour supply of hospital consultants.

    Science.gov (United States)

    Ikenwilo, Divine; Scott, Anthony

    2007-12-01

    There is little evidence about the responsiveness of doctors' labour supply to changes in pay. Given substantial increases in NHS expenditure, new national contracts for hospital doctors and general practitioners that involve increases in pay, and the gradual imposition of a ceiling on hours worked through the European Working Time Directive, knowledge of the size of labour supply elasticities is crucial in examining the effects of these major changes. This paper estimates a modified labour supply model for hospital consultants, using data from a survey of consultants in Scotland. Rigidities in wage setting within the NHS mean that the usual specification of the labour supply model is extended by the inclusion of job quality (job satisfaction) in the equation explaining the optimal number of hours worked. Generalised Method of Moments estimation is used to account for the endogeneity of both earnings and job quality. Our results confirm the importance of pay and non-pay factors on the supply of labour by consultants. The results are sensitive to the exclusion of job quality and show a slight underestimation of the uncompensated earnings elasticity (of 0.09) without controlling for the effect of job quality, and 0.12 when we controlled for job quality. Pay increases in the new contract for consultants will only result in small increases in hours worked. Small and non-significant elasticity estimates at higher quantiles in the distribution of hours suggest that any increases in hours worked are more likely for consultants who work part time. Those currently working above the median number of hours are much less responsive to changes in earnings. PMID:17335100

  20. Anthropogenic warming has decreased water supply in North Central Texas

    Science.gov (United States)

    Brikowski, T. H.

    2015-12-01

    North Central Texas, including Dallas-Ft. Worth, the 4th largest metropolitan area in the U.S., has been in a state of drought for most of this 21st Century. Seven million residents there depend almost exclusively on surface water resources, and net water storage declined precipitously until record rainfall in early 2015. Part of the decline in water availability can be attributed to reduced runoff, where despite slightly above normal precipitation, natural basin runoff has declined almost 20% since its peak in the mid-1990's. These changes have coincided with 0.85oC warming above the historical 20th Century mean. Prevalent Vertisol (cracking) soils in the region make runoff especially sensitive to climate variations, and make it difficult to apply traditional hydrologic models to investigate climate-runoff links. Non-parametric (empirical) runoff elasticity methods circumvent these limitations, and are applied here, focusing on the Upper Trinity River basin (UTB). Diagrammatic assessment of UTB temperature-precipitation (T-Pr) runoff elasticity indicates persistent warming greatly increases the risk of reduced runoff, based on historical experience. Evaluation of individual parameter elasticity indicates dry periods since 2000 have primarily been T-driven, in contrast to the Pr-driven 1951-6 drought of record. Observed decline in runoff during 2000-2010 is entirely attributable to increased T. Additional runoff declines from 2011-14 were driven by reduced Pr, augmenting the T-driven reductions. These T effects are most prominent to the west, and decline to minimal extent just east of the UTB. The observed warming can be related to anthropogenic CO2 increase with >95% certainty based on comparison of CMIP5 climate model results for the UTB with and without CO2 forcing. UTB runoff fraction of Pr decreased after 1980 with >97.5% certainty. These results strongly indicate that 21st Century 20% decline in runoff from previous century norms is largely attributable to

  1. Comparative status and development trends of central electricity supply technologies in the Federal Republic of Germany

    International Nuclear Information System (INIS)

    This paper describes the present situation in the public electricity sector of the FRG with its legal and political constraints, to identify the development trends of the supply technologies for central electricity in regard to their application potential during the forthcoming 10 to 20 years. Summarizing expectations and conclusions are drawn on the foreseeable contribution of the electricity supply sector to the aspired CO2-reductions in the FRG

  2. Supply chain management implementation in the central district municipality / Intaher Marcus Ambe

    OpenAIRE

    Ambe, Intaher Marcus

    2006-01-01

    The aim of this research was to examine whether and to what extent supply chain management (SCM) officials in the Central District Municipality designed and implemented SCM in a manner that encouraged sound financial management and compliance to SCM legislative requirements in local government. The substantive area of research was the Central District Municipality and its five local municipalities. The researcher used both qualitative and quantitative research designs with semi...

  3. Mobile technologies and supply chain management - lessons for the hospitality industry

    OpenAIRE

    Tomislav Car; Ljubica Pilepić; Mislav Šimunić

    2014-01-01

    Purpose – The purpose of this paper is to define preconditions and integration capabilities of the mobile business in supply chain management (SCM) in the hospitality industry via mobile devices and mobile applications. The aims of this paper are to reflect on what mobile technology has to offer and to draw attention to the role of mobile applications and their use in the SCM. Although mobile technologies are present in almost all areas, they are not used to their full potential. Design – The...

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

    OpenAIRE

    Sysoiev Volodymyr

    2013-01-01

    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. Th...

  5. 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.

  6. Central Line-Associated Bloodstream Infections (CLABSI) In Hospitals, 2013

    Data.gov (United States)

    U.S. Department of Health & Human Services — This table shows the Centers for Disease Control and Prevention National Healthcare Safety Network (NHSN) central line-associated bloodstream infection (CLABSI)...

  7. System-Wide Impacts of Hospital Payment Reforms : Evidence from Central and Eastern Europe and Central Asia

    OpenAIRE

    Moreno-Serra, Rodrigo; Wagstaff, Adam

    2009-01-01

    Although there is broad agreement that the way that health care providers are paid affects their performance, the empirical literature on the impacts of provider payment reforms is surprisingly thin. During the 1990s and early 2000s, many European and Central Asian countries shifted from paying hospitals through historical budgets to fee-for-service or patient-based-payment methods (mostly...

  8. 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.

  9. 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.

  10. Investigation of Heat Supply System for Apartment Houses in Zone with Central Thermal Station

    OpenAIRE

    B. A. Bajrashevskij; N. P. Boruchko

    2014-01-01

    A method for calculation of thermal engineering characteristics of central thermal stations (CTS) and heated buildings is developed by organization of systematic processing of measuring results by standard devices. The given method of calculation is used as a basis for the development of mathematical model for a heat supply system with the purpose to try out the investigated modes using a computer. Approximate results of calculations are given in the form of diagrams and tables.

  11. Investigation of Heat Supply System for Apartment Houses in Zone with Central Thermal Station

    Directory of Open Access Journals (Sweden)

    B. A. Bajrashevskij

    2014-06-01

    Full Text Available A method for calculation of thermal engineering characteristics of central thermal stations (CTS and heated buildings is developed by organization of systematic processing of measuring results by standard devices. The given method of calculation is used as a basis for the development of mathematical model for a heat supply system with the purpose to try out the investigated modes using a computer. Approximate results of calculations are given in the form of diagrams and tables.

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

    Science.gov (United States)

    Simonit, Silvio; Connors, John P; Yoo, James; Kinzig, Ann; Perrings, Charles

    2015-01-01

    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. PMID:25835003

  13. 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

  14. European future natural gas demand and supply diversification: key issues for Central and Eastern Europe

    International Nuclear Information System (INIS)

    policy and the activities of the ECE as well as the promoters of the Energy Charter are fostering this process. (3) All European gas industries, in addition, are confronted with the following challenges: to meet the growing gas demand by securing additional gas supplies; to build new pipelines and storage facilities; to diversify gas supplies (eastern and central European countries); to optimize diversification of gas supplies (Western European countries); to interconnect pipeline grids and to strengthen security of supply, as the dominating goal of the whole European gas business

  15. 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.

  16. Splenectomy for hematological diseases: The Qatif Central HospitalExperience

    International Nuclear Information System (INIS)

    In the Eastern Province of Saudi Arabia, an area known for varioushemoglobinopathies, splenectomy is performed rather frequently. This study isan analysis of our experience with splenectomy performed for varioushematological disorders between 1988 and 1997, outlining the indications,complications and outcome. This is a retrospective analysis of all patientswho had splenectomy at our hospital during this period. One hundred andforty-three patients were treated for various hematological disorders at ourhospital. These disorders included sickle cell disease (SCD) (100 patients),sickle thalassemia (S-B-thalassemia) (13 ITP) (5 patients), Gaucher's disease(2 patients), hereditary spherocytosis (1 patient), autoimmune hemolyticanemia (1 patient), thalssemia intermediate (2 patients) and chronic myeloidleukemia (1 patient). The indications for splenectomy in those with SCD andthalassemia were: hypersplenism (26 patients), major splenic sequestrationcrisis (50 patients), splenic abscess (12 patients), and massive splenicinfarction (2 patients). Splenectomy in these patients was beneficial inreducing their transfusion requirements and its attendant risks, eliminatingthe discomfort from mechanical pressure of the enlarged spleen, avoiding therisks of acute splenic sequestration crisis, and managing splenic abscess.For those with Thalassemia, total splenectomy was beneficial in reducingtheir transfusion requirements, while partial splenectomy was beneficial onlyas a temporary measure, as regrowth of splenic remnant in these patientssubsequently led to increase in their transfusion requirements. Those withITP, hereditary spherocytosis, and autoimmune hemolytic anemia showedexcellent response following splenectomy. There was no mortality, and thepostoperative morbidity was 5.6%. With careful perioperative management,splenectomy is both safe and beneficial in a selected group of patients withhematological diseases. (author)

  17. THE INCREASE EFFICIENCY OF THE HEAT SUPPLY PUBLIC SERVICE BY IMPLEMENTING AN INTEGRATED CENTRALIZED HEATING SUPPLY SYSTEM (SACET) IN THE MUNICIPALITY OF BUCHAREST

    OpenAIRE

    Anamaria-Cristina ANDREI

    2013-01-01

    Under the new European regulations, it becomes a necessity and a priority for Romania to take adequate political, legislative and administrative measures to stop the decline of the centralized heat supply systems. The energy efficiency is the most cost-effective and fastest growing method to improve security of energy supply, reduce energy loss and costs, and greenhouse gas emissions which are responsible for global warming. Cogeneration, notably high efficiency cogeneration and the improved ...

  18. Comparative ecobalancing accounting of semi-central house heat supply from wood residues

    International Nuclear Information System (INIS)

    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

  19. Cob biomass supply for combined heat and power and biofuel in the north central USA

    International Nuclear Information System (INIS)

    Corn (Zea mays L.) cobs are being evaluated as a potential bioenergy feedstock for combined heat and power generation (CHP) and conversion into a biofuel. The objective of this study was to determine corn cob availability in north central United States (Minnesota, North Dakota, and South Dakota) using existing corn grain ethanol plants as a proxy for possible future co-located cellulosic ethanol plants. Cob production estimates averaged 6.04 Tg and 8.87 Tg using a 40 km radius area and 80 km radius area, respectively, from existing corn grain ethanol plants. The use of CHP from cobs reduces overall GHG emissions by 60%–65% from existing dry mill ethanol plants. An integrated biorefinery further reduces corn grain ethanol GHG emissions with estimated ranges from 13.9 g CO2 equiv MJ−1 to 17.4 g CO2 equiv MJ−1. Significant radius area overlap (53% overlap for 40 km radius and 86% overlap for 80 km radius) exists for cob availability between current corn grain ethanol plants in this region suggesting possible cob supply constraints for a mature biofuel industry. A multi-feedstock approach will likely be required to meet multiple end user renewable energy requirements for the north central United States. Economic and feedstock logistics models need to account for possible supply constraints under a mature biofuel industry. - Highlights: • Corn cob biomass was estimated for the north central United States region. • Cobs were evaluated for combined heat and power generation and bioethanol. • Co-located ethanol plants showed a reduction in greenhouse gas emissions. • Biomass supply constraints may occur under a mature cellulosic ethanol scenario

  20. SURVEY OF DEMAND AND SUPPLY BALANCE IN LOAN MARKETS: CENTRAL BANK'S EXPERIENCE

    Directory of Open Access Journals (Sweden)

    S. Naumenkova

    2014-09-01

    Full Text Available This article examines the existing Bank Lending Survey (BLS approaches to the assessment of the non-price lending conditions' impact on the credit market balance. BLS responses provided domestic central banks an early and reliable signal about the deterioration of financing conditions and the financial access. The monitoring pattern stipulate by using the core indicators: net percentage, diffusion index, Bank Lending Tightness (BLT. The priority tasks for National Bank of Ukraine for Bank Lending Survey were put forward by author. Senior Loan Officer Opinion Survey (SLOOS on Bank Lending Practices address changes in the supply of, and demand for, bank loans to businesses and households over the past months.

  1. 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. PMID:26809115

  2. 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.

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

    Science.gov (United States)

    Zingg, Walter; Cartier, Vanessa; Inan, Cigdem; Touveneau, Sylvie; Theriault, Michel; Gayet-Ageron, Angèle; Clergue, François; Pittet, Didier; Walder, Bernhard

    2014-01-01

    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. PMID:24714418

  4. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael

    2013-01-01

    is to minimize the negative effects of stress inducing environments based on research results. Which stress inducing factors? We can look around at some old hospitals and see they are noisy, confusing, ugly, monotonous, hard, cold, artificial, and dark; qualitative terms which can indicate what we shouldn...... 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......’ satisfaction. Social space: attention to spatial qualities, volume and interior design in terms of encouraging physical contact between users in wards, waiting areas and semi-private rooms. Outdoor space: Landscape and gardens are not enough in themselves; they should be visible, centrally or strategically...

  5. 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.

  6. Collaborative Inventory Management in Chinese Hospital Supply Chain: Barriers and Implementation

    OpenAIRE

    Wang, Yingfei

    2012-01-01

    With the development of supply chain, the collaborative supply chain management has increasing popular worldwide in recent years. There are many advanced method of achieving supply chain collaboration, such as VMI and CPFR, which focus on inventory management. In addition, it has been adopted by many industries such as manufacture (Dell) and retail (Wal-Mart). With the dramatically increasing of China drug market, more and more supply chain problems have appeared recent years. Due to red...

  7. 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.

  8. Managing drought risk with a computer model of the Raritan River Basin water-supply system in central New Jersey

    Science.gov (United States)

    Dunne, Paul; Tasker, Gary

    1996-01-01

    The reservoirs and pumping stations that comprise the Raritan River Basin water-supply system and its interconnections to the Delaware-Raritan Canal water-supply system, operated by the New Jersey Water Supply Authority (NJWSA), provide potable water to central New Jersey communities. The water reserve of this combined system can easily be depleted by an extended period of below-normal precipitation. Efficient operation of the combined system is vital to meeting the water-supply needs of central New Jersey. In an effort to improve the efficiency of the system operation, the U.S. Geological Survey (USGS), in cooperation with the NJWSA, has developed a computer model that provides a technical basis for evaluating the effects of alternative patterns of operation of the Raritan River Basin water-supply system. This fact sheet describes the model, its technical basis, and its operation.

  9. Hygienic assessment of long-term dynamics of the quality of water supplied to the population with centralized and decentralized water supply

    OpenAIRE

    ATAKHANOVA DILBAR

    2015-01-01

    On the basis of long-term dynamics of the quality of water supplied to the population with centralized and decentralized water supply of the Republic of Karakalpakstan, in assessing the levels of water pollution by chemical parameters as a risk factor for the population as a priority indicator index in terms of Karakalpakstan, can use the amount of total hardness of drinking water 7.0 or 10.0 mEq/l (depending on the presence or absence of structures for special treatment of tap water).

  10. 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.

  11. Clinical Spectrum of Acute Renal Failure in Dammam Central Hospital, Dammam, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Ghacha Reda

    2000-01-01

    Full Text Available Fifty consecutive patients of acute renal failure (ARF seen over a period of two years at the Dammam Central Hospital, Dammam were studied. The mean age of the patients was 39.3 years ranging from 14 to 90 years. The main etiological factors for ARF were acute tubular necrosis (67.5% and obstructive uropathy (30%. The mortality rate was 26% and the poor prognostic factors included sepsis, acidosis, shock and the need for emergency hemodialysis.

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

    OpenAIRE

    Seada Mohammed; Tewelde Tesfaye Gebremariam

    2015-01-01

    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...

  13. Medication supply to residential aged care facilities in Western Australia using a centralized medication chart to replace prescriptions

    OpenAIRE

    Hoti Kreshnik; Hughes Jeffery; Sunderland Bruce

    2012-01-01

    Abstract Background Current model of medication supply to R(RACFs) in Australia is dependent on paper-based prescriptions. This study is aimed at assessing the use of a centralized medication chart as a prescription-less model for supplying medications to RACFs. Methods Two separate focus groups were conducted with general practitioners (GPs) and pharmacists, and another three with registered nurses (RNs) and carers combined. All focus group participants were working with RACFs. Audio-recorde...

  14. Implementation and 8-year follow-up of an uninterrupted oxygen supply system in a hospital in The Gambia

    Science.gov (United States)

    Light, J. D.; Ebonyi, A. O.; N'Jai, P. C.; Ideh, R. C.; Ebruke, B. E.; Nyassi, E.; Peel, D.

    2016-01-01

    SUMMARY SETTING: A 42-bed hospital operated by the Medical Research Council (MRC) Unit in The Gambia. OBJECTIVE: To devise, test and evaluate a cost-efficient uninterrupted oxygen system in the MRC Hospital. DESIGN: Oxygen cylinders were replaced with oxygen concentrators as the primary source of oxygen. An uninterruptable power supply (UPS) ensured continuity of power. Hospital staff were trained on the use of the new system. Eight years post-installation, an analysis of concentrator maintenance needs and costs was conducted and user feedback obtained to assess the success of the system. RESULTS: The new system saved at least 51% of oxygen supply costs compared to cylinders, with savings likely to have been far greater due to cylinder leakages. Users indicated that the system is easier to use and more reliable, although technical support and staff training are still needed. CONCLUSION: Oxygen concentrators offer long-term cost savings and an improved user experience compared to cylinders; however, some technical support and maintenance are needed to upkeep the system. A UPS dedicated to oxygen concentrators is an appropriate solution for settings where power interruptions are frequent but short in duration. This approach can be a model for health systems in settings with similar infrastructure. PMID:27393551

  15. Features of central serous chorioretinopathy presenting at a tertiary care hospital in Lahore

    International Nuclear Information System (INIS)

    Objective: To evaluate the clinical, angiographic and optical coherence tomographic features of central serous chorioretinopathy in patients presenting at a tertiary care centre in Lahore. Methods: The observational study was conducted at the Layton Rehmatulla Benevolent Trust Eye and Cancer Hospital Lahore from July 15, 2010 to December 15, 2011. Patients who had received prior treatment for the condition and allergy to fluorescein were excluded. There were 86 eyes of 64 adult patients with central serous chorioretinopathy. The following data was recorded: history, signs and symptoms, best corrected visual acuity, fundus fluorescein angiography, and central macular thickness measurement with optical coherence tomography. Data was analyzed using SPSS 17. Results: Mean age of patients who presented during the study duration was 39.52+-8.85 years. There were 53(82.8%) males and 11(17.2%) females. Of the total, 42(65.6%) cases had unilateral and 22(34.4%) cases had bilateral involvement. Chronic central serous chorioretinopathy was seen in 27(42.2%) cases while 37 (57.8%) cases were acute presentations. Retinal pigment epithelial detachment was observed in 29 (45.3%) cases. On fundus fluorescein angiography, there were 62 (72.1%) eyes that showed ink blot pattern. Median visual acuity at presentation was 0.25. Median central macular thickness at presentation was 550.5 (meu). Conclusion: Central serous chorioretinopathy in the study sample was associated with pigment epithelial detachment, bilateral involvement, and presence of systemic diseases. (author)

  16. Heating Transfer Investigation of Heater in Heat Supply System of Field Hospital Operating in Emergency

    OpenAIRE

    I. L. Kachar

    2014-01-01

    Criteria dependences for assessment of heat transfer value under conditions natural convection (a horizontal slot) have been obtained in the paper. The dependences are applicable for heaters in heat supply systems.

  17. Heating Transfer Investigation of Heater in Heat Supply System of Field Hospital Operating in Emergency

    Directory of Open Access Journals (Sweden)

    I. L. Kachar

    2014-08-01

    Full Text Available Criteria dependences for assessment of heat transfer value under conditions natural convection (a horizontal slot have been obtained in the paper. The dependences are applicable for heaters in heat supply systems.

  18. 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

  19. [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. PMID:12774744

  20. Status of Thyroid Disorders in Central Nepal: A Tertiary Care Hospital Based Study

    Directory of Open Access Journals (Sweden)

    RV Mahato

    2015-03-01

    Full Text Available Background: Nepal is a Himalayan, landlocked country surrounded by India and China. It is endemic for iodine deficiency disease. Thyroiddysfunction is major health problem among the Nepalese people. Its prevalence increases with age. Screening of thyroid disease is advised inhigh risk population. Objectives: To find out the prevalence of thyroid dysfunction among subjects who attended Biochemistry Departmentof Tribhuwan University Teaching Hospital, Kathmandu, Nepal. Material and Methods: This is a hospital based retrospective studyconducted in the Department of Biochemistry Tribhuwan University Teaching Hospital, Institute of Medicine. This study was designed toinvestigate status of thyroid dysfunction in central Nepal. A total of 5230 cases from all over Nepal were studied in a single year. Blood sampleswere collected, serum separated and thyroid hormones (fT3, fT4 and TSH were assayed by Vitros ECIQ analyser Ortho Clinical DiagonosticsUSA. Result and discussion: Among 5230 subjects prevalence of thyroid dysfunction was 29.0% with subclinical hypothyroidism17%,hypothyroidism 8%, hyperthyroidism 3%, subclinical hyperthyroidism1% and euthyroidism 71%.Higher prevalence was seen in the age group31-45. Conclusion: This study revealed that subclinical and overt hypothyroidism is preponderant followed by sub clinical hyperthyroidism.Females are more vulnerable to the thyroid dysfunction. Since it is a hospital based study, the prevalence of thyroid dysfunction may not beapplicable. So an extensive demographic survey should be done to provide accurate data of thyroid dysfunction in the general population

  1. The Study for Optimizing of the Electricity Power Supply in Central Java Province

    International Nuclear Information System (INIS)

    Electricity planning includes identification of electricity generation potential and problem where solution are being planned through the annual program. Due to correlation between electricity growth and economic growth, the sensitivity study for Central Java province has been done using three scenarios of annual electricity growth, i.e.: 6.7 %, 8 % and 10 % within the study period of 2003-2020. The tool used in this sensitivity study is WASP IV. From result the calculation gives total installed capacity in the end of study period for each electricity growth scenario are 3960 MW, 5500 MW and 8620 MW respectively. Total produced energy in the end of study period for each electricity growth scenario are 32301 G Wh, 39619 G Wh and 54374 G Wh. For total fuel required. Coal still predominate in all scenarios, followed by HSD and Gas. According to this study, Nuclear power plant can be introduced in 2020 for scenario of 8 % growth and 2017 for that of 10 % growth. WASP is utilized for projecting electricity supply. (author)

  2. Factors Promoting and Hindering Performance of Unit Nurse Managers at Kamuzu and Queen Elizabeth Central Hospitals in Malawi

    OpenAIRE

    Caroline Chitsulo; Mercy Pindani; Idesi Chilinda; Alfred Maluwa

    2014-01-01

    Unit nurse managers in Malawi experience many challenges in the course of performing their roles. This affects their performance and service delivery including the quality of nursing care to patients. This study was conducted to determine the factors that hindered performance of unit managers in relation to expected quality of nursing services at two referral facilities (Kamuzu and Queen Elizabeth Central hospitals) in Malawi. These two central hospitals have the same structural settings...

  3. Aetiologies of Central Nervous System infections in adults in Kathmandu, Nepal: A prospective hospital-based study

    OpenAIRE

    Giri, Abhishek; Arjyal, Amit; Koirala, Samir; Karkey, Abhilasha; Dongol, Sabina; Thapa, Sudeep Dhoj; Shilpakar, Olita; Shrestha, Rishav; Van Tan, Le; Thi Thuy Chinh, Bkrong Nguyen; Krishna K. C., Radheshyam; Pathak, Kamal Raj; Shakya, Mila; Farrar, Jeremy; Van Doorn, H. Rogier

    2013-01-01

    We conducted a prospective hospital based study from February 2009-April 2011 to identify the possible pathogens of central nervous system (CNS) infections in adults admitted to a tertiary referral hospital (Patan Hospital) in Kathmandu, Nepal. The pathogens of CNS infections were confirmed in cerebrospinal fluid (CSF) using molecular diagnostics, culture (bacteria) and serology. 87 patients were recruited for the study and the etiological diagnosis was established in 38% (n = 33). The bacter...

  4. Characteristics and visual outcomes of patients hospitalized for ocular trauma in central China: 2006-2011

    Institute of Scientific and Technical Information of China (English)

    Ying; Qi; Feng-Yan; Zhang; Guang-Hua; Peng; Yu; Zhu; Guang-Ming; Wan; Wen-Zhan; Wang; Jing; Ma; Shi-Jie; Ren

    2015-01-01

    AIM: To complete the data of ocular trauma in central China, as a well-known tertiary referral center for ocular trauma, we documented the epidemiological characteristics and visual outcomes of patients hospitalized for ocular trauma in this region.METHODS: A retrospective study of patients hospitalized for ocular trauma in central China from 2006 to 2011 was performed.· RESULTS: This study included 5964 eyes of 5799 patients. The average age was 35.5 ±21.8y with a male-to-female ratio of 2.8:1. The most common age was 45-59 y age group. Most patients were farmers and workers(51.9%). The most common injuries were firework related(24.5%), road traffic related(24.2%), and work related(15.0%). Among the most common causative agents were firecrackers(24.5%), followed by metal/knife/scissors(21.4%). Most injuries occurred in January(14.2%),February(27.0%), and August(10.0%). There were 8.5%patients with ocular injuries combined with other injuries.The incidence of open ocular injuries(4585 eyes, 76.9%)was higher than closed ocular injuries(939 eyes, 15.7%).The incidences of chemical and thermal ocular injuries were 1.2% and 0.6%. Ocular trauma score(OTS)predicted final visual acuity at non light perception(NLP), 20/200-20/50 and 20/40 with a sensitivity of 100%,and light perception(LP) /hand motion(HM) and 1/200-19/200 with a specificity of 100%.· CONCLUSION: This study provides recent epidemiological data of patients hospitalized for ocular trauma in central China. Some factors influencing the visual outcome include time interval between injury and visit to the clinic, wound location, open or closed globe injury, initial visual acuity, and OTS.

  5. We are family? Spanish law and lesbian normalization in Hospital Central.

    Science.gov (United States)

    Calvo, Mónica; Escudero, Maite

    2009-01-01

    After four decades of a repressive dictatorial regime during which homosexuality was banned and punished with prison sentence and electroshock, Spain became a democratic country in 1978. The social, political, and legal debates previous to the passing of the law on same-sex marriage in June 2005 fueled lesbian visibility in the media. Considering that the emergence of lesbian representation has been linked to these social and political changes, our contribution centers on the ways in which the prime time TV series Hospital Central unravels as a vehicle for the normalization of lesbian relationships and families as addressed to a mostly heterosexual audience. PMID:19197662

  6. Evaluation of natural gas supply options for south east and central Europe. Part 1: Indicator definitions and single indicator analysis

    International Nuclear Information System (INIS)

    The need for diversification of energy sources is an immanent goal in long term energy strategy. In particular, this is of great importance for the natural gas supply. In this respect, evaluation and assessment of potential natural gas resources and their relation to consumers is of great importance. The natural gas supply in Europe is one of the main issues of European energy strategy to be followed in the future. In particular, the natural gas supply in the southeast countries is important. This paper provides a framework for understanding how much natural gas is available for use in south east and central Europe as well as the links to the recent supply of natural gas and its transport. The analysis is focused on evaluation of the potential routes for natural gas supply to the south east and central European countries. The potential options included in this analysis are the Yamal Route; Nabucco Route; West Balkan Route; LNG NEUM Route and Gas by Wire Route. In this analysis, attention is focused on the following indicators for assessment of potential options: environmental indicator; NG cost indicator; NG transport and royalty indicator; investment indicator; and NG demand indicator. The first part of this paper is devoted to the definition of the indicators and to single indicator analysis. (author)

  7. Effectiveness of the pharmaceutical supply chain to clinics attached to Mafikeng Provincial Hospital / Moitsoadi Sarah Mokgatlha

    OpenAIRE

    Mokgatlha, Moitsoadi Sarah

    2013-01-01

    The study set out to investigate the factors that led to pharmaceutical outages in clinics attached to Mafikeng Provincial Hospital (MPH). An exploratory research design was adopted for this purpose and a survey that included respondents from Mmabatho Medical Stores (MMS), MPH, clinics attached to MPH and transporters was conducted to address a number of research questions. The findings are displayed in charts and tables. The findings show that there were constraints expe...

  8. 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.

  9. 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...

  10. 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

  11. Analysis of Time-of-Day Energy Demand and Supply in University and Hospital

    Science.gov (United States)

    Shimazaki, Yoichi

    The aim of this study was to estimate the time-of-day energy demand in University of Yamanashi. Our University consisted of Kofu campus (Faculty of Education & Human Sciences and Faculty of Engineering) and Faculty of Medicine campus (Faculty of Medicine and University Hospital). The energy data of 4 facilities were classified into hot water, heating, cooling and electric power demands based on electric power consumptions, city gas and heavy oil from 1996 to 2005. For 10 years, primary energy increased 1.2 times in the whole of the university. The amount of electric power consumption was 63% in the fuel classification. The amount of electric power consumption of faculty reacted to the change in temperature greatly. In 2005, it was found that thermoelectric-ratios for 4 facilities, i.e. Education, Engineering, Medicine and Hospital were 2.3, 1.5, 2.0 and 2.7 respectively. These data are very useful for the energy saving and energy management of university.

  12. Study on Applications of Supply and Demand Theory of Microeconomics and Physics Field Theory to Central Place Theory

    OpenAIRE

    Nien, Benjamin Chih-Chien

    2006-01-01

    This paper attempts to analyze “central place theory” of spatial economics based on “supply and demand theory” in microeconomics and “field theory” in physics, and also discuss their relationship. Three most important research findings are described below. Firstly, the concept of market equilibrium could be expressed in the mathematical form of physics field theory under proper hypothesis. That is because the most important aspect of field theory model is that complex analysis is taken as a k...

  13. 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)

  14. 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)

  15. 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)

  16. 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.

  17. 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)

  18. 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)

  19. 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)

  20. 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.

  1. 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)

  2. 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.

  3. 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.

  4. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. II.- August of 2001

    International Nuclear Information System (INIS)

    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)

  5. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. V. - November of 2001

    International Nuclear Information System (INIS)

    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. IV. - October of 2001

    International Nuclear Information System (INIS)

    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. Specialized consultant in radiological safety to the clinical north central hospital of high speciality, PEMEX. IV. - December of 2001

    International Nuclear Information System (INIS)

    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)

  8. Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. I. - May-June of 2003

    International Nuclear Information System (INIS)

    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)

  9. Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. I. - July of 2001

    International Nuclear Information System (INIS)

    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)

  10. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. I. - July of 2001

    International Nuclear Information System (INIS)

    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)

  11. Specialized consultant in radiological safety to the south central hospital of high speciality, PEMEX. III.- September of 2001

    International Nuclear Information System (INIS)

    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)

  12. Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. III. - September of 2001

    International Nuclear Information System (INIS)

    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)

  13. Specialized consultant in radiological safety to the north central hospital of high speciality, PEMEX. II. - August of 2001

    International Nuclear Information System (INIS)

    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)

  14. Estimation of Warm-Up Period Required for Heat Transfer of Heating Device Used for Heat Supply of Field Hospital Operating in Conditions of Extreme Situations

    OpenAIRE

    A. Nesenchouk; N. Koneva; I. Iokova; T. Ryzhova; D. Shklovchik; M. Yarmolchik

    2014-01-01

    The paper describes experimental investigations of thermal and physical characteristics pertaining to material specimens which has been used for manufacturing the proposed heating device for heat supply system of a field medical hospital. The type of the given material has been determined that is  polyvinyl chloride.A warm-up period required for the heating device and estimation of time required for installation of a heating system for successful operation of the field hospital have been dete...

  15. Medication supply to residential aged care facilities in Western Australia using a centralized medication chart to replace prescriptions

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    Hoti Kreshnik

    2012-07-01

    Full Text Available Abstract Background Current model of medication supply to R(RACFs in Australia is dependent on paper-based prescriptions. This study is aimed at assessing the use of a centralized medication chart as a prescription-less model for supplying medications to RACFs. Methods Two separate focus groups were conducted with general practitioners (GPs and pharmacists, and another three with registered nurses (RNs and carers combined. All focus group participants were working with RACFs. Audio-recorded data were compared with field notes, transcribed and imported into NVivo® where it was thematically analyzed. Results A prescription-less medication chart model was supported and it appeared to potentially improve medication supply to RACF residents. Centralization of medication supply, clarification of medication orders and responding in real-time to therapy changes made by GPs were reasons for supporting the medication chart model. Pharmacists preferred an electronic version of this model. All health professionals cautioned against the need for GPs regularly reviewing the medication chart and proposed a time interval of four to six months for this review to occur. Therapy changes during weekends appeared a potential difficulty for RNs and carers whereas pharmacists cautioned about legible writing and claiming of medications dispensed according to a paper-based model. GPs cautioned on the need to monitor the amount of medications dispensed by the pharmacy. Conclusion The current use of paper prescriptions in nursing homes was identified as burdensome. A prescription-less medication chart model was suggested to potentially improve medication supply to RACF residents. An electronic version of this model could address main potential difficulties raised.

  16. Early management of traumatic brain injury in a Tertiary hospital in Central Kenya: A clinical audit

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    Clifford Chacha Mwita

    2016-01-01

    Full Text Available Background: Traumatic brain injury (TBI is a major cause of death and disability worldwide and is mostly attributed to road traffic accidents in resource-poor areas. However, access to neurosurgical care is poor in these settings and patients in need of neurosurgical procedures are often managed by general practitioners or surgeons. Materials and Methods: A retrospective clinical audit of the initial management of patients with TBI in Thika Level 5 Hospital (TL5H, a Tertiary Hospital in Central Kenya. Seventeen audit criteria divided into five clinical domains were identified and patient case notes reviewed for compliance with each criterion. Data were analyzed separately for those below 13 years owing to differences in response to brain trauma in those below this age. Results: Overall, there was poor compliance with audit criteria in both groups. Among those below 13 years of age, only 3 out of 17 criteria achieved compliance and 4 out of 17 criteria achieved compliance for those above 13 years of age. Assessment for the need for a cervical radiograph (7.1% and 8.8% compliance and administration of oxygen (21.4% and 20.6% compliance had the worst performance in both groups. Conclusion: Poor compliance to audit criteria indicates the low quality of care for patients with TBI in TL5H. Quality improvement strategies with follow-up audits are needed to improve care. There is a need to develop and enforce evidence-based protocols and guidelines for use in the management of patients with TBI in sub-Saharan Africa.

  17. Transformation of central oxygen supply system based on the system of bottle of liquid cryogenic insulation oxygen%基于低温绝热液氧瓶系统的中心供氧系统改造

    Institute of Scientific and Technical Information of China (English)

    王东文; 王碧涛; 王官; 苗文贵

    2015-01-01

    目的:基于低温绝热液氧瓶系统对中心供氧系统进行改造,实现氧气稳定输出的目的。方法:分析医院中心供氧存在问题,探究当前医用氧3种获得方式及其特点,对改造方案进行可行性和成本效益论证。结果:低温绝热液氧瓶供气系统方式改造更适合医院实际,该套系统与原有分子筛制氧机两机共存、交替运行可达到预期效果。结论:中心供氧系统设备的集中,有利于现代化管理,合理的配置和科学管理以及高效运行极大地提高了氧气利用率和经济效益。%Objective:To achieve the transformation of central oxygen supply system, to achieve the purpose of stabilizing the output of oxygen, to create good social and economic benefits. Methods: Analysis of the hospital central oxygen supply problems, introduced the current medical oxygen three kinds of availability and characteristics of the transformation program for feasibility and cost-effectiveness has been demonstrated. Results:The gas supply system is more suitable methods for hospital. The expected effect can be achieved with the systems co-exist with the original molecular sieve oxygen generator, run alternately. Conclusion:Central oxygen supply system equipment concentrated in favor of modern management, high operating efficiency. Through the rational allocation, scientific management, which greatly improves the oxygen utilization, economic benefits are also improved significantly.

  18. Requirements and problems of hospital water drainage and supply design%医院给排水设计的要求及问题

    Institute of Scientific and Technical Information of China (English)

    郑钦炜

    2011-01-01

    In light of hospital characteristics of complicated functions and various facilities, it analyzes and describes the hospital water drainage and supply design data including spraying, water supply, drainage system design and medical wastewater treatment methods etc, and summarizes their technological points. As a result, it has provided guidance for similar engineering water drainage and supply design.%针对现代化医院功能复杂、设备繁多的特点,就医院中给排水专业设计涉及的喷淋、给水、排水系统设计以及医疗污废水处理方法等方面进行了分析阐述,总结了各自的技术要点,从而为类似工程给排水设计提供指导。

  19. College Degree Supply, Productivity Spillovers and Occupational Allocation of Graduates in Central European Countries

    OpenAIRE

    Lovász, Anna; Pertold-Gebicka, Barbara

    2011-01-01

    Public funding drives much of the recent growth of college degree supply in Europe, but few indicators are available to assess its optimal level. In this paper, we investigate an indicator of college skills usage - the fraction of college graduates employed in "college" occupations. Gottschalk and Hansen (2003) propose to identify "college" occupations based on withinoccupation college wage premia; we build on their strategy to study the local-labor-market relationship between the share of co...

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

    OpenAIRE

    Majkić-Dursun Brankica; Vulić Predrag; Dimkić Milan

    2015-01-01

    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 geochemic...

  1. Replacement power supply with micro-hydropower. Case micro central - Pipinta

    International Nuclear Information System (INIS)

    This paper describes the Micro-Hydro Electric Pipinta through its main components and their parameters. An evaluation of the actual power plant costs and a proposed redesign are also given with prices referenced to year 2004. A comparison between the electricity price supplied by the grid and the cost for the electricity in this Micro-Hydro Power Plant let conclude that projects of this type are available in rural areas of Colombia reached by the grid.

  2. A Contingency Perspective on Centralization of Supply Chain Decision-making and its Role in the Transformation of Process R&D into Financial Performance

    OpenAIRE

    Krotov, Konstantin V.; Germain, Richard N.

    2011-01-01

    The research examines whether centralized supply chain decisionmaking within the firm plays a role in how the firm transforms investments in process research and development (R&D) into financial performance. This transformation includes the process investment - financial performance chain, which consists of process R&D funds, applied supply chain knowledge, supply chain process variance, and financial performance. In addition, the model includes production technology routineness, size, and in...

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

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    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.

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

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    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.

  5. Molecular epidemiology of Acinetobacter baumannii in central intensive care unit in Kosova Teaching Hospital.

    Science.gov (United States)

    Raka, Lul; Kalenć, Smilja; Bosnjak, Zrinka; Budimir, Ana; Katić, Stjepan; Sijak, Dubravko; Mulliqi-Osmani, Gjyle; Zoutman, Dick; Jaka, Arbëresha

    2009-12-01

    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 Acinetobacter baumannii 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. PMID:20464330

  6. Assessing the Vulnerability of Public-Supply Wells to Contamination: Central Valley Aquifer System near Modesto, California

    Science.gov (United States)

    Jagucki, Martha L.; Jurgens, Bryant C.; Burow, Karen R.; Eberts, Sandra M.

    2009-01-01

    This fact sheet highlights findings from the vulnerability study of a public-supply well in Modesto, California. The well selected for study pumps on average about 1,600 gallons per minute from the Central Valley aquifer system during peak summer demand. Water samples were collected at the public-supply well and at monitoring wells installed in the Modesto vicinity. Samples from the public-supply wellhead contained the undesirable constituents uranium, nitrate, arsenic, volatile organic compounds (VOCs), and pesticides, although none were present at concentrations exceeding drinking-water standards. Of these contaminants, uranium and nitrate pose the most significant water-quality risk to the public-supply well because human activities have caused concentrations in groundwater to increase over time. Overall, study findings point to four primary factors that affect the movement and (or) fate of contaminants and the vulnerability of the public-supply well in Modesto: (1) groundwater age (how long ago water entered, or recharged, the aquifer); (2) irrigation and agricultural and municipal pumping that drives contaminants downward into the primary production zone of the aquifer; (3) short-circuiting of contaminated water down the public-supply well during the low-pumping season; and (4) natural geochemical conditions of the aquifer. A local-scale computer model of groundwater flow and transport to the public-supply well was constructed to simulate long-term nitrate and uranium concentrations reaching the well. With regard to nitrate, two conflicting processes influence concentrations in the area contributing recharge to the well: (1) Beneath land that is being farmed or has recently been farmed (within the last 10 to 20 years), downward-moving irrigation waters contain elevated nitrate concentrations; yet (2) the proportion of agricultural land has decreased and the proportion of urban land has increased since 1960. Urban land use is associated with low nitrate

  7. Current status of Staphylococcus aureus infection in a central teaching hospital in Shanghai, China

    OpenAIRE

    Li, Tianming; Song, Yan; Zhu, Yuanjun; Du, Xin; Li, Min

    2013-01-01

    Background To control the spread of methicillin-resistant Staphylococcus aureus (MRSA) in hospitals, infection control measures such as hand hygiene practices were introduced into the teaching hospitals in Shanghai, China, in 2008. Currently, there is limited information characterizing the latest hospital-acquired S. aureus infections in this area. Therefore, we sought to determine the prevalence, molecular characteristics, and genotype-phenotype correlation of hospital-acquired S. aureus inf...

  8. 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.

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

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    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.

  10. 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

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

    International Nuclear Information System (INIS)

    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.

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

    International Nuclear Information System (INIS)

    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

  13. Sustainable Transformations of Water Supply Regimes. The Cuvelai-Etosha Basin in Central Northern Namibia.

    OpenAIRE

    Zimmermann, Martin

    2013-01-01

    In this thesis, an interdisciplinary modelling approach for water resources management and its application is presented that is able to deal with socio-technical systems that are characterised by a multiplicity of variables, interdependencies, and actors. The case study area is the Cuvelai-Etosha Basin, which is located in central northern Namibia. Approximately 850,000 people or 40 % of the Namibian population live in this area, which comprises only about 14 % of the country’s area. The regi...

  14. 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.

  15. Central African Republic Uses Isotopes to Investigate Drinking Water Supply Potential

    International Nuclear Information System (INIS)

    The Central African Republic (about 623 000 km2) is located slightly north of the equator in Central Africa (latitude 2 deg. - 11 deg. N; longitude 14 deg. - 28 deg. E); it has no coastal area (see map). Flat plateau savannas constitute a large part of the country, while hills are found in the northeast and the southwest; a granite plateau also exists in the northeast. The Ubangi and Shari river basins cover most of the country, and feature high flooding possibilities. The majority of the country has a tropical climate and desertification only exists in the northern regions. Bangui, the capital, is located in the Ubangi basin, the main tributary of the northern Congo basin. There are two seasons - a rainy season from May to October and a dry season November to March - with a maximum temperature in February-March of 33-34 deg. C (MET office). Although the Central African Republic receives a large quantity of precipitation annually (ca. 1500 mm per year) and has relatively abundant surface water, distribution is temporarily and geographically concentrated. Moreover, urbanization has led to densification of population in the capital and some other areas. Lacking adequate facilities to deal with these conditions, outflows of untreated sewage, agricultural runoff, effluents from mining areas as well as deforestation and soil erosion have degraded water quality. The majority of the population in Bangui does not have access to drinking water that is assured to be clean. Groundwater has been considered to be a great potential source of potable water in urban areas, but the quality and quantity of groundwater is not well known and its sustainable use is not certain

  16. Economic and Water Supply Effects of Ending Groundwater Overdraft in California's Central Valley

    OpenAIRE

    Nelson, Timothy; Chou, Heidi; Zikalala, Prudentia; Lund, Jay; Hui, Rui; Medellín–Azuara, Josué

    2016-01-01

    doi: http://dx.doi.org/10.15447/sfews.2016v14iss1art7 Surface water and groundwater management are often tightly linked, even when linkage is not intended or expected. This link is especially common in semi-arid regions, such as California. This paper summarizes a modeling study on the effects of ending long-term overdraft in California’s Central Valley, the state’s largest aquifer system. The study focuses on economic and operational aspects, such as surface water pumping ...

  17. Estimation of Warm-Up Period Required for Heat Transfer of Heating Device Used for Heat Supply of Field Hospital Operating in Conditions of Extreme Situations

    Directory of Open Access Journals (Sweden)

    A. Nesenchouk

    2013-01-01

    Full Text Available The paper describes experimental investigations of thermal and physical characteristics pertaining to material specimens which has been used for manufacturing the proposed heating device for heat supply system of a field medical hospital. The type of the given material has been determined that is  polyvinyl chloride.A warm-up period required for the heating device and estimation of time required for installation of a heating system for successful operation of the field hospital have been determined and executed in the paper.

  18. 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.

  19. Micro satellite instability in colorectal cancer stage II. Hospital Central de las fuerzas armadas

    International Nuclear Information System (INIS)

    Introduction: micro satellite instability (MSI) is a good prognostic factor in colorectal cancer (CRC) located. Its value as a predictive marker against adjuvant treatment of chemotherapy (CT) has been shown fluoropyrimidine in various publications. The MSI occurs in 15% of colorectal tumors and sporadic in 90% of tumors in the context of colorectal cancer syndrome hereditary nonpolyposis. In Uruguay there are no studies about this phenomenon. Objective: To determine the incidence of micro satellite instability in a sample of patients using the Hospital Central de las fuerzas armadas oncology service, association with a compatible family history and the histological features of the tumors associated therewith. Methods: The medical records of patients were analyzed with CRC diagnosed stage II between 01/2001 and 12/2009. Data of the patients were analyzed which had complete histology and evolution. Results: 30/52 patients (57.6%) were analyzed. 40% had a detected MSI by kits for Pcr (polymerase chain reaction) to D2S123, D5S250, D17S346, BAT25 and BAT26 according to the Bethesda criteria. In those patients they filed a MSI: the median age was 70 years; 58.3% male. No patient had a family history consistent with HNPCC. 5.6% (3) they received Adjuvant chemotherapy treatment. Regarding tumor characteristics: 75% (9) were T3, and T4 were 25% (3); 8.3% histologic grade I (1) II 58.3% (7) 8.3% III (1) without Data 33% (6). This tumor lymphocyte infiltration was reported in 25% (3), absent 33.3% (4), not reported in 41.6% (5). Conclusions: This is the first analysis of these characteristics carried out in Uruguay. The same has been detected MSI percentage higher than reported in the literature International. In either case a compatible family history met HNPCC

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

    International Nuclear Information System (INIS)

    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

  1. One Rural Hospital's Experience Implementing the Society for Healthcare Epidemiology of America Guidelines to Decrease Central Line Infections.

    Science.gov (United States)

    Curlej, Maria H; Katrancha, Elizabeth

    2016-01-01

    In an effort to take advantage of the Highmark Quality Blue Initiative () requiring information from hospitals detailing their central line-associated blood stream infections (CLABSIs) surveillance system, quality improvement program, and statistics regarding the CLABSI events, this institution investigated the latest evidence-based recommendations to reduce CLABSIs. Recognizing the baseline rate of 2.4 CLABSIs per 1,000 central line days and its effect on patient outcomes and medical costs, this hospital made a commitment to improve their CLABSI outcomes. As a result, the facility adopted the Society for Healthcare Epidemiology of America (SHEA) guidelines. The purpose of this article is to review the CLABSI rates and examine the prevention strategies following implementation of the SHEA guidelines. A quantitative, descriptive retrospective program evaluation examined the hospital's pre- and post-SHEA implementation methods of decreasing CLABSIs and the subsequent CLABSI rates over 3 time periods. Any patient with a CLABSI infection admitted to this hospital July 2007 to June 2010 (N = 78). CLABSI rates decreased from 1.9 to 1.3 over the study period. Compliance with specific SHEA guidelines was evaluated and measures were put into place to increase compliance where necessary. CLABSI rates at this facility remain below the baseline of 2.4 for calendar year 2013 (0.79), 2014 (0.07), and 2015 (0.33). PMID:27618377

  2. 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.

  3. Tracking atmospheric and riverine terrigenous supplies variability during the last glacial and the Holocene in central Mediterranean

    Directory of Open Access Journals (Sweden)

    V. Bout-Roumazeilles

    2012-07-01

    Full Text Available The objectives were to retrace the eolian and fluvial terrigenous supplies in a sediment core from the Sicilian-Tunisian Strait by coupling mineralogical, grain-size and geochemical approaches, in order to get informations on the atmospheric versus riverine contributions to sedimentation on the southern side of central Mediterranean since the last glacial. The eolian supply is dominant over the whole interval, excepted during the sapropel S1 when riverine contribution apparently became significant, and particles provenance has been modified since Last Glacial. Saharan contribution increased during the Bølling-Allerød, evidencing the persistence of aridity over North Africa although the northern Mediterranean already experienced moister and warmer conditions. The Younger Dryas is marked by proximal dust inputs highlighting intense regional eolian activity. A southward migration of dust provenance toward Sahel occurred at the onset of the Holocene, likely resulting from a southward position of the Inter Tropical Convergence Zone, probably associated with a large-scale atmospheric reorganization. Finally, a peculiar high terrigenous flux associated with drastic modifications of the mineralogical and geochemical sediment signature occurred during the sapropel S1, suggesting the propagation of fine-particles derived from major floodings of the Nile River – resulting from enhanced rainfall on northeastern Africa – and their transportation across the Sicilian-Tunisian Strait by intermediate water-masses.

  4. [Evaluation of the oropharyngeal tularemia cases admitted to our hospital from the provinces of Central Anatolia].

    Science.gov (United States)

    Uyar, Melek; Cengiz, Buğra; Unlü, Murat; Celebi, Bekir; Kılıç, Selçuk; Eryılmaz, Adil

    2011-01-01

    Tularemia caused by the bacterium Francisella tularensis is a zoonotic infection which has re-emerged in Turkey in recent years as water-borne endemics. Oropharyngeal form is the most frequently reported form of the disease from Turkey. The aim of this study was to evaluate the clinical and laboratory findings of oropharyngeal tularemia patients admitted to ear, nose & throat outpatient clinic between January-March 2010. A total of 10 patients (age range: 16-80 years, mean age: 43.9 years; nine were male) inhabiting in the provinces in Central Anatolia, Turkey, were admitted to our hospital with the complaints of fever, sore throat and painful cervical lump. They have been previously diagnosed as tonsillo-pharyngitis at different medical centers and empirical antibiotic therapy has initiated, however, their complaints have not recovered. Endoscopic laryngoscopic examination revealed that oropharynx, larynx and hypopharynx were normal. Physical examination of the neck yielded localized fixed masses with diameters between 2-7 cm. The lesions were localized at right submandibular (n= 4), upper jugular (n=3) and one of each at left posterior cervical, left submandibular and left jugulodigastric regions. The patients were hospitalized with the pre-diagnosis of "neck mass with unknown origin" for further investigation and treatment. The mean white blood cell count of the cases was 9730 (7500-15.100) cells/µl; the mean erythrocyte sedimantation rate was 68.7 (46-85) mm3/hours and the mean C-reactive protein level was 4.3 (1.5-7.4) µg/dl. Salmonella, Brucella, Toxoplasma gondii, rubella, cytomegalovirus, herpes simplex virus, Epstein-Barr virus and viral hepatitis serology did not indicate acute infections. Serum and tissue samples were sent to Refik Saydam National Public Health Agency in order to test for tularemia, namely culture, microagglutination test (MAT), direct fluorescence antibody (DFA) test and in-house polymerase chain reaction (PCR). All of the patients

  5. 18FDG synthesis and supply: a journey from existing centralized to future decentralized models.

    Science.gov (United States)

    Uz Zaman, Maseeh; Fatima, Nosheen; Sajjad, Zafar; Zaman, Unaiza; Tahseen, Rabia; Zaman, Areeba

    2014-01-01

    Positron emission tomography (PET) as the functional component of current hybrid imaging (like PET/ CT or PET/MRI) seems to dominate the horizon of medical imaging in coming decades. 18Flourodeoxyglucose (18FDG) is the most commonly used probe in oncology and also in cardiology and neurology around the globe. However, the major capital cost and exorbitant running expenditure of low to medium energy cyclotrons (about 20 MeV) and radiochemistry units are the seminal reasons of low number of cyclotrons but mushroom growth pattern of PET scanners. This fact and longer half-life of 18F (110 minutes) have paved the path of a centralized model in which 18FDG is produced by commercial PET radiopharmacies and the finished product (multi-dose vial with tungsten shielding) is dispensed to customers having only PET scanners. This indeed reduced the cost but has limitations of dependence upon timely arrival of daily shipments as delay caused by any reason results in cancellation or rescheduling of the PET procedures. In recent years, industry and academia have taken a step forward by producing low energy, table top cyclotrons with compact and automated radiochemistry units (Lab- on-Chip). This decentralized strategy enables the users to produce on-demand doses of PET probe themselves at reasonably low cost using an automated and user-friendly technology. This technological development would indeed provide a real impetus to the availability of complete set up of PET based molecular imaging at an affordable cost to the developing countries. PMID:25556425

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

    OpenAIRE

    Nabilla; Supriyatna; Emma Surahman

    2015-01-01

    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 ...

  7. Motivation and Factors Affecting It among Health Professionals in the Public Hospitals, Central Ethiopia

    OpenAIRE

    Dagne, Tesfaye; Beyene, Waju; Berhanu, Negalign

    2015-01-01

    Background Motivation is an individual's degree of willingness to exert and maintain an effort towards organizational goals. This study assessed motivational status and factors affecting it among health professionals in public hospitals of West Shoa Zone, Oromia Region. Method Facility based cross-sectional survey was employed. All health professionals who served at least for 6 months in Ambo, Gedo and Gindeberet hospitals were included. Self-administered Likert scale type questionnaire was u...

  8. Early management of traumatic brain injury in a Tertiary hospital in Central Kenya: A clinical audit

    OpenAIRE

    Clifford Chacha Mwita; Johnstone Muthoka; Stephen Maina; Phillip Mulingwa; Samson Gwer

    2016-01-01

    Background: Traumatic brain injury (TBI) is a major cause of death and disability worldwide and is mostly attributed to road traffic accidents in resource-poor areas. However, access to neurosurgical care is poor in these settings and patients in need of neurosurgical procedures are often managed by general practitioners or surgeons. Materials and Methods: A retrospective clinical audit of the initial management of patients with TBI in Thika Level 5 Hospital (TL5H), a Tertiary Hospital in Cen...

  9. 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

    OpenAIRE

    Iván O Espinoza; Ochoa, Theresa J.; Susan Mosquito; Francesca Barletta; Roger Hernández; María del Pilar Medina; María Luisa Stiglich; Claudia Ugarte; Daniel Guillén

    2011-01-01

    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 h...

  10. 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

  11. Comparison of Total Hospital-Acquired Bloodstream Infections to Central Line-Associated Bloodstream Infections and Implications for Outcome Measures in Infection Control

    OpenAIRE

    Leekha, Surbhi; Li, Shanshan; Thom, Kerri A.; Anne Preas, Michael; Caffo, Brian S.; Morgan, Daniel J.; Harris, Anthony D.

    2013-01-01

    Validity of the central line-associated bloodstream infection (CLABSI) measure is compromised by subjectivity. We observed significant decreases in both CLABSI and total hospital-acquired bloodstream infection (BSI) following a CLABSI prevention intervention in adult intensive care units. Total hospital-acquired BSI could be explored as an adjunct, objective CLABSI measure.

  12. Bacterial-resistance among outpatients of county hospitals in China: significant geographic distinctions and minor differences between central cities.

    Science.gov (United States)

    Xiao, Yonghong; Wei, Zeqing; Shen, Ping; Ji, Jinru; Sun, Ziyong; Yu, Hua; Zhang, Tiantuo; Ji, Ping; Ni, Yuxing; Hu, Zhidong; Chu, Yunzhuo; Li, Lanjuan

    2015-06-01

    The purpose of this study was to survey antibacterial resistance in outpatients of Chinese county hospitals. A total of 31 county hospitals were selected and samples continuously collected from August 2010 to August 2011. Drug sensitivity testing was conducted in a central laboratory. A total of 2946 unique isolates were collected, including 634 strains of Escherichia coli, 606 Klebsiella pneumoniae, 476 Staphylococcus aureus, 308 Streptococcus pneumoniae, and 160 Haemophilus influenzae. Extended-spectrum β-lactamases were detected in E. coli (42.3% strains), K. pneumoniae (31.7%), and Proteus mirabilis (39.0%). Ciprofloxacin-resistance was detected in 51.0% of E. coli strains. Salmonella spp. and Shigella spp. were sensitive to most antibacterial agents. Less than 8.0% of Pseudomonas aeruginosa isolates were resistant to carbapenem. For S. aureus strains, 15.3% were resistant to methicillin, and some strains of S. pneumoniae showed resistance to penicillin (1.6%), ceftriaxone (13.0%), and erythromycin (96.4%). β-lactamase was produced by 96.5% of Moraxella catarrhalis strains, and 36.2% of H. influenzae isolates were resistant to ampicillin. Azithromycin-resistant H. influenzae, imipenem-resistant but meropenem-sensitive Proteus, and ceftriaxone- and carbapenem non-sensitive M. catarrhalis were recorded. In conclusion, cephalosporin- and quinolone-resistant strains of E. coli and Klebsiella pneumonia and macrolide-resistant Gram-positive cocci were relatively prominent in county hospitals. The antibacterial resistance profiles of isolates from different geographical locations varied significantly, with proportions in county hospitals lower than those in their tertiary counterparts in the central cities, although the difference is diminishing. PMID:25708671

  13. Rational use of Medicines in Relation to Pharmaceutical Supply System in Municipal Hospitals of Dar-es-salaam Region

    OpenAIRE

    Protas, Bwile PB

    2011-01-01

    Pharmaceutical management involves set of practices aiming at ensuring timely availability and appropriate use of safe, effective and quality pharmaceuticals and services in any health care setting. Rational use of medicines is often associated efficiency of pharmaceutical supply system that operates in the health care system. Pharmaceutical supply system involves planning and programming for pharmaceutical requirements, procurement, storage and distribution which are the necessary steps towa...

  14. Evaluation of natural gas supply options for Southeast and Central Europe: Part 2. Multi-criteria assessment

    International Nuclear Information System (INIS)

    Decision making methods are used as a tool for the selection of alternatives to be evaluated on the basis of several criteria. Evaluation of the potential routes for natural gas supply to the Southeast and Central European countries is studied using single and multi-criteria evaluation. The potential options included in this analysis are the: Yamal Route; Nabucco Route; West Balkan Route; LNG Neum Route; and Gas by Wire Route. In part 1, the paper was devoted to the definition of the indicators and to single indicator analysis. In part 2, the analysis is based on multi-criteria evaluation, which comprises the possibility to assess the options under predefined constraints amongst indicators. The paper also describes different methods used for multi-criteria evaluation. This analysis focuses on cases with different priorities defined among individual weighting coefficients with the others having the same value. It was shown that all options under specific constraints can be qualified as promising in the decision making process. It is also concluded that favourite indicator constraints may exaggerate some options

  15. INTRODUCTION OF CENTRAL USER MANAGEMENT IN A LARGE UNIVERSITY HOSPITAL - A CASE STUDY

    OpenAIRE

    Jürgen Klutke, Peter; Mertens, Tobias

    2002-01-01

    The department “organization and information technology” (OIT) of the Faculty of Medicine of the “Ludwig-Maximilians-Universität München” introduced a system to centrally manage user accounts and security during the last two years. The initial state was that we had several user directories for different services, resulting in high operating expense. We describe the aims, the concepts, the techniques, the realization and the difficulties we had introducing a central user directory. The new cen...

  16. 自动设别技术在医院药品供应和管理体系中的应用%Application of Electronic Pharmaceutical Supplies in Hospital Drug Supply and Management System

    Institute of Scientific and Technical Information of China (English)

    沈烽; 张健; 黄源; 吴颖坤; 金樑; 梁斌; 徐卫国

    2012-01-01

    运用医院电子化药品物流平台,贯穿整个医院药品物流供应过程,并结合运用条形码扫描自动识别技术,判别调配药品以及数量的准确性,同时客观记录人员绩效管理数据.盘点误差由使用前的0.24%降至0;2011年度验收拒收药品共74次;专业技术人员配备由7名降至5名.整个电子化药品物流平台贯穿医院药品物流始终,能确保入院药品信息准确,杜绝调剂差错,有效提升人员绩效管理水平,真正发挥药师应有的专业特长,更好地为患者服务.%The bar code scanning technology is widely applied in the whole hospital drug logistics supply under the help of Electronic Pharmaceutical Supplies platform. Meanwhile, the staff workload is recorded accurately. The inventory error is reduced from 0.24% to 0 after this system being used. 74 drugs were rejected in 2011. Pharmacists are reduced from 7 to 5. The Electronic Pharmaceutical Supplies system, which is applied to the hospital cling logistics, ensures the information accuracy of the drugs, puts an end to drug dispensing and enhance staff performance management effectively. As a result, the expertise of the pharmacists can be applied to the patients.

  17. 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.

  18. Incidence and Predictive Factors of Central Nervous System Dysfunction in Patients Consulting for Dengue Fever in Cayenne Hospital, French Guiana

    Science.gov (United States)

    Djossou, Félix; Vesin, Guillaume; Bidaud, Bastien; Mosnier, Emilie; Simonnet, Christine; Matheus, Séverine; Prince, Christelle; Balcaen, John; Donutil, Gerd; Egmann, Gérald; Okandze, Antoine; Malvy, Denis; Nacher, Mathieu

    2016-01-01

    Introduction The frequency, the clinical characteristics, and the prognosis of dengue is highly variable. Dengue fever is associated with a range of neurological manifestations. The objective of the present study was to determine the incidence of neurological signs and their predictive factors using data from cases of dengue seen and followed in Cayenne Hospital during the Dengue 2 epidemic in 2013. Methods In 2013, a longitudinal study using data from all cases of dengue seen in Cayenne hospital was collected. Medical records used a standardized form to collect demographic information, clinical signs and biological results and the date at which they were present. The analysis used Cox proportional modeling to obtain adjusted Hazard ratios. Results A total of 1574 patients were included 221 of whom developed central nervous system signs. These signs were spontaneously resolutive. There were 9298person days of follow-up and the overall incidence rate for central nervous system signs was 2.37 per 100 person-days. The variables independently associated with central nervous system anomalies were headache, Adjusted Hazard ratio (AHR) = 1.9(95%CI = 1.4–2.6), bleeding AHR = 2 ((95%CI = 1.3–3.1), P = 0.001, abdominal pain AHR = 1.9 ((95%CI = 1.4–2.6), P<0.001, aches AHR = 2.1 ((95%CI = 1.5–2.9), P<0.001, and fatigue AHR = 1.5 ((95%CI = 1.3–1.7), P<0.001. Discussion Overall, the present study suggests that neurological signs of dengue are not exceptional even in patients without the most severe features of dengue. These manifestations were spontaneously resolutive. Here it was not possible to distinguish between encephalitis or encephalopathy. Further studies would require more in depth exploration of the patients. PMID:26981859

  19. 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)

  20. 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)

  1. ABC分类法在我院药品库存控制中的应用%Application of activity based classification in hospital drug supply chain transformation

    Institute of Scientific and Technical Information of China (English)

    高朝; 黎雅茹; 易博; 申志辉; 林娜; 王萍; 唐静; 徐文彤

    2014-01-01

    Objective To speed up the cash flow in the hospital, improve the work efficiency and optimize the quantity of drugs inventory by using activity based classification (ABC). Methods The ABC method was used to classify and manage the inventory drugs. Reasonable drug purchase lists had been automatically generated based on the drug supply chain platform. Results The application of ABC method could effectively increase the turnover rate of inventory drug and make the drug purchase cash use more efficient, which also could bring a reasonable inventory quantum. Conclusion During the improvement of the hospital drug supply chain, the application of ABC method makes the level of limited quantity of drugs more reasonable, improves the level of drug management, and ensures the drug supply.%目的:探讨应用ABC法优化药品库存,提高资金使用效率和药库工作效率。方法运用ABC分类法对药库药品进行分类管理,结合药品供应链平台自动制定合理采购计划。结果 ABC分类法能有效提升药品周转效率,提高采购资金使用效能,使药品库存趋于合理。结论在药库药品供应链的自动化改造中,利用ABC分类法使药品高低限量的设定更为合理,提高药品管理水平和保障能力。

  2. HISTOPATHOLOGICAL STUDY OF SPECTRUM OF THE LESIONS OF CENTRAL NERVOUS SYSTEM IN A TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Kasa

    2015-01-01

    Full Text Available The aim of our study was to establish the relative frequency of biopsy proven tumors of central nervous system (CNS. Two hundred and forty two (242 CNS Biopsy specimens were studied in a one year period. Out of 72 CNS tumors, 66 were primary 4 were metastatic. Among 4 metastatic tumors, the most common histological type is adenocarcinoma. The most frequent type of CNS tumour was astrocytoma followed by meningioma.

  3. Five-Year Outbreak of Community- and Hospital-Acquired Mycobacterium porcinum Infections Related to Public Water Supplies ▿ †

    OpenAIRE

    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

    2011-01-01

    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 ...

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

    OpenAIRE

    Riccardo Bigoni; Sabrina Sorlini; Maria Cristina Collivignarelli; Paolo Berbenni

    2014-01-01

    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 wate...

  5. Evaluation of the medicine procurement and supply management system in public hospitals in Lesotho / Matsepo Aniva Tema

    OpenAIRE

    Tema, Matsepo Aniva

    2014-01-01

    In a well-functioning medicine supply chain management system, procurement forms an integral part that needs to be closely monitored and integrated with other functions. Good procurement practices in the public health sector ensure that good quality efficacious medicines are distributed in the country in the right quantities and at reasonable costs. Pharmaceutical procurement is a major determinant of drug availability and total health costs. It is indicated that medicine expenditure represen...

  6. 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.

  7. 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.

  8. Specialized consulting in radiological safety to the south central hospital of high specialty, PEMEX. VI. December of 2001

    International Nuclear Information System (INIS)

    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)

  9. Specialized consulting in radiological safety to the North Central Hospital of high specialty, PEMEX. V. November of 2001

    International Nuclear Information System (INIS)

    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)

  10. Addressing the Child and Maternal Mortality Crisis in Haiti through a Central Referral Hospital Providing Countrywide Care.

    Science.gov (United States)

    Jacobs, Lee D; Judd, Thomas M; Bhutta, Zulfiqar A

    2016-01-01

    The neonatal, infant, child, and maternal mortality rates in Haiti are the highest in the Western Hemisphere, with rates similar to those found in Afghanistan and several African countries. We identify several factors that have perpetuated this health care crisis and summarize the literature highlighting the most cost-effective, evidence-based interventions proved to decrease these mortality rates in low- and middle-income countries.To create a major change in Haiti's health care infrastructure, we are implementing two strategies that are unique for low-income countries: development of a countrywide network of geographic "community care grids" to facilitate implementation of frontline interventions, and the construction of a centrally located referral and teaching hospital to provide specialty care for communities throughout the country. This hospital strategy will leverage the proximity of Haiti to North America by mobilizing large numbers of North American medical volunteers to provide one-on-one mentoring for the Haitian medical staff. The first phase of this strategy will address the child and maternal health crisis.We have begun implementation of these evidence-based strategies that we believe will fast-track improvement in the child and maternal mortality rates throughout the country. We anticipate that, as we partner with private and public groups already working in Haiti, one day Haiti's health care system will be among the leaders in that region. PMID:26934625

  11. 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. PMID:22754264

  12. 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

  13. Prescription pattern of antimicrobials in tertiary care hospital in central India

    Directory of Open Access Journals (Sweden)

    Pallavi Dnyaneshwar Admane

    2015-03-01

    Full Text Available Objective: Antimicrobial agents are the greatest contribution to 20th century, which are used for cure and prevention of infections. Widespread use of antimicrobials has facilitated the development of resistance.Aim: the study was to assess the use of antimicrobials in tertiary care hospital in Maharashtra.Method: Prescription audit was done to assess the use of antimicrobials. Total 1942 prescriptions were analyzed for average number of drugs prescribed, antimicrobials prescribed by generic name or brand name, percentage of antibiotics among the prescribed drugs, use of fixed drug combinations, if any.Statistical analysis used: Data was analyzed by percentage.Result: Demographic analysis showed that out of 1942 patients in OPD, most were male (56.38 and in the age group between 35 to 50 years.  In 1942 prescription, 30.25% drugs were antimicrobials. Three drugs were prescribed in 52.15% of the prescription, followed by 4 drugs in 19.78% prescriptions.  79.18% prescriptions were prescribed by generic name while 20.82% were prescribed by brand name. 29.18% of drugs were fixed dose combinations of all the antibiotics were prescribed empirically on the basis of provisional diagnosis. Of the total of antibiotics prescribed, amoxicillin was prescribed in 50.66% of patients, followed by cotrimoxazole in 26.05 % patients, cephalexin (8.50%   were used commonly.  Conclusion: The rational use of antimicrobial agents is one of the main contributors to control worldwide emergence of antibacterial resistance, side effects and reduced cost of the treatment.

  14. Effectiveness of different methods to control legionella in the water supply: ten-year experience in an Italian university hospital.

    Science.gov (United States)

    Marchesi, I; Marchegiano, P; Bargellini, A; Cencetti, S; Frezza, G; Miselli, M; Borella, P

    2011-01-01

    We report our ten-year experience of hyperchlorination, thermal shock, chlorine dioxide, monochloramine, boilers and point-of-use filters for controlling legionella contamination in a hospital hot water distribution system. Shock disinfections were associated with a return to pre-treatment contamination levels within one or two months. We found that chlorine dioxide successfully maintained levels at boilers at temperatures of >58°C and no cases of nosocomial legionellosis were detected in the ten-year observation period. Our performance ranking in reducing legionella contamination was filter, boiler, chlorine dioxide, hyperchlorination and thermal shock. Chlorine dioxide was the least expensive procedure followed by thermal shock, hyperchlorination, boiler and filter. We suggest adopting chlorine dioxide and electric boilers in parallel. PMID:21131100

  15. Carotid intima-media thickness and apolipoproteins in patients of ischemic stroke in a rural hospital setting in central India: A cross-sectional study

    OpenAIRE

    Jyoti Jain; Tejal Lathia; Om Prakash Gupta; Vishakha Jain

    2012-01-01

    Context: Carotid intima-media thickness (CIMT) and apolipoproteins have been found as a risk factor for ischemic stroke . Objective: The objective was to study the carotid intima-media thickness, apolipoproteins, and their relation in patients of ischemic stroke in central rural India. Settings and Design: A cross-sectional study was performed in a rural hospital in central India. Materials and Methods: In all patients of ischemic stroke proven by computerized tomography (CT), CIMT, apolipopr...

  16. Hospital- and Laboratory-Based Investigations of Hospitalized Children with Central Nervous System-Related Symptoms To Assess Japanese Encephalitis Virus Etiology in Cuddalore District, Tamil Nadu, India

    OpenAIRE

    Kabilan, Lalitha; Ramesh, S; Srinivasan, S; Thenmozhi, V.; S. Muthukumaravel; Rajendran, R

    2004-01-01

    A collaborative investigation of hospitalized encephalitic children in south India, between July 2002 and February 2003, has indicated that Japanese encephalitis was confirmed in 27.3% of these children. In developing countries, assessment of actual Japanese encephalitis disease burden requires strengthening of diagnostic laboratory capacities at hospitals.

  17. 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 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 is not recommended. PMID:26717371

  18. Radiation hygienic assessment of centralized heat and hot water supply of Bilibino village from Bilibin central nuclear heating- and power plant

    International Nuclear Information System (INIS)

    The experience in using an atomic power plant for heat and hot water supply of the village of Bilibino is outlined. Particular attention is given to the population radiation safety. It has been demonstrated that radiation safety of the system is ensured by maintaining fixed pressure levels in the heating media and by the hermetic state of heat exchanges. Water in the heat and hot water supply network meets the requirements for drinking water. Radioactive corrosion products were not detected in the test water. Gamma-radiation dose rate from the surface of heating devices and pipe-lines in the test premises did not exceed the natural background, that is, U.U1-0.025 mrad

  19. 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.

  20. 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.

  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. 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.

  3. Hospitals for sale.

    Science.gov (United States)

    Costello, Michael M; West, Daniel J; Ramirez, Bernardo

    2011-01-01

    The pace of hospital merger and acquisition activity reflects the economic theory of supply and demand: Publicly traded hospital companies, private equity funds, and large nonprofit hospital systems are investing capital to purchase and operate freestanding community hospitals at a time when many of those hospitals find themselves short of capital reserves and certain forms of management expertise. But the sale of those community hospitals also raises questions about the impact of absentee ownership on the communities which those hospitals serve. PMID:21864058

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

    OpenAIRE

    Baldini S; Di Fulvio F; Laudati G

    2010-01-01

    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 Cent...

  5. 集中管理模式在消毒供应中心的应用%The Application of Centralized Model in Central Sterile Supply Department

    Institute of Scientific and Technical Information of China (English)

    黄金芳; 黎婷; 何华聪

    2013-01-01

    目的:探讨再生器械的清洗质量。方法:选取供应室实施集中管理模式前后的清洗消毒器械600件分别取样监测,比较清洗效果。结果:供应室实施集中管理模式后(实验组)再生器械的清洗合格率明显高于集中管理模式实施之前(对照组),两者比较差异有统计学意义(p<0.01)。结论:再生医疗器械集中管理模式能有效提高再生医疗器械清洗质量、消毒灭菌效果。%Objective To investigate the cleaning quality of regenerated medical instrument. Methods 6oo sterilized instruments were monitored before and after the implementation of centralized model respectively to compare the cleaning effects. Results The qualified rate of the washing after the implementation of centralized model (the experimental group) was higher than that before (the control group). The difference between two groups was statisticstical y significant (P<0.01) . Conclusions The centralized model of regenerated medical instruments can effectively improve the cleaning quality and the sterilization effect.

  6. 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

  7. 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.

  8. Water supply

    International Nuclear Information System (INIS)

    Options and methodologies for the development of fresh water supplies on Bikini Atoll are much the same as those practiced in the rest of the Marshall Islands and for that matter, most atolls in the central Pacific Ocean Basin. That is, rainfall distribution on Bikini produces a distinct wet season, lasting from about May through November, with the remaining months being generally dry. As a result, fresh water from surface catchments tends to be plentiful during the wet season? but is usually scarce during the dry months, and alternative sources such as groundwater must be utilized during this time. On Bikini the problems of fresh water supply are somewhat more difficult than for most Marshall Island atolls because rainfall is only about half the Marshall Island's average. Tus water supply is a critical factor limiting the carrying capacity of Bikini Atoll. To address this problem BARC has undertaken a study of the Bikini Atoll water supply. Te primary objectives of this work are to determine: (1) alternatives available for fresh water supply, 2 the amounts, location and quality of available supplies and 3 optimal development methods. The study planned for one's year duration, has been underway only since the summer of 1985 and is thus not yet fully completed. However, work done to date, which is presented in this report of preliminary findings, provides a reasonably accurate picture of Bikini's fresh water supplies and the various options available for their development. The work remaining to be completed will mainly add refinements to the water supply picture presented in the sections to follow

  9. 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

  10. 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.

  11. 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.

  12. 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

  13. Development and justification of a scheme for commercial supply of radiopharmpreparation 99mTc using centralized Zr-Mo gel-generator

    International Nuclear Information System (INIS)

    Zr-Mo gel-generator 99mTc on the basis of activated 99Mo is used in modern medical diagnostics as a convenient, safe and reliable local source of 99mTc production in the form of sodium pertechnetate. The methodology and technological process of the wasteless reactor gel-technology of radiopharmpreparation (RPhP) 99mTc production with the use of centralized Zr-Mo gel-generator has been developed in the Institute of Power Engineering Problems, National Academy of Sciences of Belarus in co-operation with Scientific Research institute of Oncology and Medical Radiology of Ministry of Health of the Republic of Belarus. As a result of performed clinical tests the Ministry of Health had approved the clinical application of RPhP 99mTc produced according to this technology. Zr-Mo gel-generator at full load of 150-370 GBq of 99Mo can provide with 99mTc solution such a region as the Republic of Belarus and export the preparation. An optimization of initial irradiation of MoO3 target in a nuclear reactor as well as conditions of the gel-generator operation is important for definition of the price of produced 99mTc. The technological process of delivery of sodium pertechnetate (99mTc) produced according to Zr-Mo gel-technology at centralized generator has been modeled where the main technological steps were considered, such as irradiation of target in reactor, loading into container, transport to the centralized generator, charging of the generator, gel preparation, operation of the centralized generator, and delivery of final product to the hospitals. In developed mathematical model with two-component presentation of 98Mo activation reaction velocity on neutrons the activity value is presented in the form of two multipliers: the first multiplier describes the dependence on neutron thermal flux density, spectrum hardness, enrichment of 98Mo target, target geometry; the second multiplier sets time dependence. On the basis of this model the different irradiation conditions and

  14. Stable isotopes as indicators of sources and processes influencing nitrate distributions in dairy monitoring wells and domestic supply wells in the Central Valley, California

    Science.gov (United States)

    Young, M. B.; Harter, T.; Kendall, C.; Silva, S. R.; Esser, B. K.; Singleton, M. J.; Holstege, D.; Lockhart, K.; Applegate, O.

    2011-12-01

    Nitrate concentrations above the 10 mg/L NO3-N maximum contaminant level (MCL) have been found in many wells throughout the Central Valley, California. This area contains many possible anthropogenic nitrate sources including current and historic agriculture, private septic systems, municipal waste water, and confined animal feeding operations (primarily dairies). In order to better understand the potential contributions of dairy manure derived nitrate to both shallow and deep groundwater, we used a combined chemical, stable isotope, and age-dating approach for water samples collected from a network of shallow groundwater monitoring wells located on seven different dairies, and from a survey of approximately 200 deeper domestic supply wells (used for drinking water and dairy operations). Groundwater from shallow monitoring wells and deep supply wells was collected in two geographic regions. In the northern region, the lower San Joaquin Valley, the water table is shallow (2- 5 m below surface) and therefore considered highly vulnerable to contamination, while in the southern region, the Tulare Lake Basin, the water table is much deeper (20 - 30 m). Mean δ15N of nitrate in dairy monitoring wells in both the north and south regions was significantly higher than the mean δ15N measured in the deeper supply wells, and also showed greater variability. Mean δ15N and δ18O values measured in the deep supply wells were not significantly different between the north and south regions. Mean nitrate concentrations, δ15N, and δ18O were significantly higher in the northern (lower San Joaquin Valley) monitoring wells in comparison to the southern (Tulare Lake Basin) monitoring wells. Nitrate isotope measurements indicated that many of the northern monitoring wells had consistently high contributions of manure-derived nitrate to the shallow groundwater during the 16 month study. Monitoring wells located in relatively new dairies in the south region showed little evidence of

  15. 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

  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

    OpenAIRE

    Renata Mie Oyama Okajima; Thaís Helena Proença de Freitas; Clarisse Zaitz

    2004-01-01

    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 estud...

  17. Tiempo de espera y su relación con la satisfacción de los usuarios de la farmacia central de un hospital general de Lima

    OpenAIRE

    Ericson Gutierrez; Willy Ramos; Martha Uribe; Ortega-Loayza, Alex G; Christian Torres; Montesinos; Oscar León; Carlos Galarza

    2009-01-01

    Para determinar la influencia del tiempo de espera sobre la satisfacción del usuario en la farmacia central del Hospital Nacional Dos de Mayo (HNDM), se realizó un estudio transversal donde se registró los tiempos de espera por cada subproceso de atención (facturación, pago en caja y entrega de medicamentos) mediante la observación directa de los usuarios. Se evaluó el nivel de satisfacción del usuario según una escala Likert. Se incluyó 150 usuarios, 59% fueron mujeres, la edad promedio fue ...

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

    OpenAIRE

    Alok Kumar; Satish Sharma,; Narayan Shyamrao Ingole; Nitin Gangane

    2014-01-01

    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 thes...

  19. 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)

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

    OpenAIRE

    Vedita Bobde; Sanjay Parate; Dinkar Kumbhalkar

    2015-01-01

    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...

  1. Analysis of economic efficiency of decentralized versus centralized reprocessing of patients' beds and practical consequences for a maximum-care hospital

    Directory of Open Access Journals (Sweden)

    Kramer, Axel

    2008-05-01

    Full Text Available Problem: The documentation of hospital services in terms of secondary services is suboptimal. Technical hygiene is one of the secondary services of a hospital. As one aspect of technical hygiene whose realisation is currently a topic of debate, the reprocessing of beds should be analyzed under economic points of view, because up to now no thorough cost analysis exists. The following aspects should be considered: The analysis must include the legal requirements on reprocessing of beds. In addition to statements on output, i.e., on the benefit of the given procedure to the patient, the input is measured with a cost analysis to identify the procedure with the best cost:benefit ratio. Moreover, options for cost reduction based on the cost-cutting potential of a given procedure are emphasized. Additionally, in terms of bed reprocessing, continuing aspects for reducing costs should be indicatedMethod: The three types of reprocessing performed in Germany were analyzed: decentralized, centralized-manual, and centralized-mechanical reprocessing of beds. First, a literature search was done to determine the legal requirements. The analysis of the actual situation was based on plant-site inspections at manufacturers of reprocessing equipment, inspections in hospitals, interviews with manufacturers, operators, and persons responsible for equipment at central bed reprocessing facilities, interviews with those performing the work in and persons responsible for various management areas in the hospital. For the cost analysis, essential cost categories were examined. The cost calculation was based on the fictive description of a maximum provider. If possible, real data were used. The used prices refer to list prices without considering discounts or cash discounts. The data acquired were compared and evaluated in terms of output and input. Results and discussion: Expert opinions in medical hygiene show that each type of reprocessing leads to the necessary

  2. 消毒供应中心常用低温灭菌技术%Common Hypothermia Sterilization Techniques in Central Sterile Supply Department

    Institute of Scientific and Technical Information of China (English)

    何晓滨; 徐习

    2016-01-01

    This paper analyzed the application status of hypothermia sterilization technique in central sterile supply department. A comparison was made among the three sterile techniques: ethylene oxide sterile technique, hydrogen peroxide hypothermia plasma sterile technique, and hypothermia steam formaldehyde sterile technique. The paper analyzed the sterilization principle, sterilization time, temperature, humidity control, sterilization effect, influential factors, and pros and cons of the three common hypothermia sterilization techniques.%本文分析了当前消毒供应中心常用低温灭菌技术的应用现状,对比了环氧乙烷低温灭菌技术、过氧化氢低温等离子灭菌技术、低温蒸汽甲醛灭菌技术3种低温灭菌技术的灭菌原理、时间、温度、湿度控制、灭菌效果、影响因素以及优点与局限性。

  3. Cogeneration plants in hospitals. Cost reduction by efficient electricity and heat supply; Blockheizkraftwerke in Krankenhaeusern. Kostensenkung durch effiziente Strom- und Waermeerzeugung

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-07-01

    The brochure shows how hospitals can reduce the cost of power generation, space and water heating, steam generation and cooling by installing systems for combined heat and power generation. (orig./AKB)

  4. 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

  5. Revelations of supply-side structural reform to hospital management%供给侧结构性改革对医院管理的几点启示

    Institute of Scientific and Technical Information of China (English)

    唐羽

    2016-01-01

    The supply-side structural reform is a major adjustment of macroeconomic policy by the decision-making level under the adaption to “new normal” of economy and has far-reaching impact on future economy of China. Understanding and digestion of the policies of supply-side structural reform and its guidance to hospital management practices are of vital signiifcance to promoting scientiifc development of hospitals. 3 revelations are provided for hospital management by analyzing the theory of supply-side structural reform: 1. We should intensify the strategic vision and deepen and innovate development. We must firmly grasp the supply-side structural reform and accelerate the policy dividends distributed by new medical reform; 2. We should stick to starting from the supply-end, take provision of effective medical service as a key point of hospital development and take various measures to keep improving the total factor productivity of hospitals and enhance core competitiveness; and 3. We should stick to starting from the demand-end. With a foothold at the strategic orientation of hospitals, we should consolidate the target requirements, mine potential demands and solidify driving source for sustainable development of hospitals.%供给侧结构性改革是适应经济新常态下,决策层在宏观经济政策上的一次重大调整,其对未来中国经济的影响深远。了解供给侧结构性改革的政策主张,融会贯通,以此指导医院管理实践,对于推动医院科学发展意义重大。通过对供给侧结构性改革理论的分析,提出对医院管理的3点启示:一是要强化战略眼光,深化创新发展,牢牢把握供给侧结构性改革,加速新医改进程派发的政策红利;二是要坚持供给端发力,把提供有效的医疗服务作为医院发展的关键抓手,多措并举,不断提高医院总和要素生产率,提升核心竞争力;三是要坚持需求端发

  6. 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-

  7. 朔州市人民医院住院楼给排水设计%On design for water-supply and drainage in inpatient building of Shuozhou People's Hospital

    Institute of Scientific and Technical Information of China (English)

    柳常春

    2012-01-01

    针对医院类建筑给排水专业设计的特点,以住院楼为例,就生活给水系统,卫生热水系统,污废水系统,消防系统等进行了论述,以期为类似工程提供参考。%According to the features for the professional design for the water-supply and drainage in hospital buildings,the paper indicates the living water-supply system,the sanitary hot water system,unclean wastewater and fire-fighting system by taking the inpatient building as the example,so as to provide some reference for similar projects in future.

  8. The roles of MCDW and deep water iron supply in sustaining a recurrent phytoplankton bloom on central Pennell Bank (Ross Sea)

    Science.gov (United States)

    Kustka, Adam B.; Kohut, Josh T.; White, Angelicque E.; Lam, Phoebe J.; Milligan, Allen J.; Dinniman, Michael S.; Mack, Stefanie; Hunter, Elias; Hiscock, Michael R.; Smith, Walker O.; Measures, Chris I.

    2015-11-01

    During January-February 2011 standing stocks of phytoplankton (chl a) in the Pennell Bank region of the Ross Sea were variable over 10-100 km spatial scales. One area of elevated chl a on central Pennell Bank (CPB) appeared to be a recurrent mid-summer feature. The western flank (WF) of Pennell Bank had pronounced signatures of Modified Circumpolar Deep Water (MCDW). We evaluated the spatial extent of Fe limitation and net primary production and tested whether MCDW may provide elevated amounts of Fe to the CPB region, through a combination of in situ measurements, shipboard incubations and a horizontally resolved physical model. Regional fluxes of dissolved Fe from deep to surface waters were compared to calculated Fe demands. Low in situ variable to maximum fluorescence (Fv/Fm; 0.24-0.37) and surface water dissolved Fe concentrations (~0.12-0.21 nM) were suggestive of widespread limitation, corroborated by the consistent responses (Fv/Fm, growth, and nutrient removal ratios) of incubation treatments to Fe addition. MCDW from the WF region had lower dissolved Fe concentrations than that measured in CDW (Circumpolar Deep Water), which suggests on-shelf modification with Fe deplete surface waters and is consistent with the lack of stimulation due to incubation amendments with filtered MCDW. Model results and empirical data suggest MCDW from the WF region is further modified and mixed en route to the CPB region, leading to both the erosion of the canonical MCDW signature and an elevated dissolved Fe inventory of CPB region deep water. This suggests the addition of Fe possibly via diagenesis, as suggested by Marsay et al. (2014). Calculated deep water supply rates to the surface waters of CPB were ~0.18-0.43 m d-1, while calculated rates at the WF or northern Pennell Bank (NPB) regions were negative. The CPB populations exhibited ~4.5-fold higher net production rates compared to those in the WF and NPB regions and required 520-3200 nmol Fe m-2 d-1. The modeled vertical

  9. Comparison of particle-tracking and lumped-parameter models for determining groundwater age distributions and nitrate in water-supply wells, Central Valley, California, USA

    Science.gov (United States)

    Jurgens, B. C.; Bohlke, J. K.; Kauffman, L. J.; Belitz, K.

    2013-12-01

    Age distributions for 30 production wells (mostly public-supply) were determined using two methods: 1) calibration of age tracer data with lumped parameter models (LPMs) and 2) by advective particle tracking (PT) simulations using MODPATH and a regional steady-state groundwater flow model. The LPMs were calibrated with measurements of 3H, 3He(trit), and 14C by minimizing the Chi-square test statistic using a non-linear solver. A partial exponential model (PEM) was the primary LPM used in this study and a combination of two PEMs were used in cases where binary age mixtures were identified. The PEM is a reformulated version of the exponential model that is parameterized to simulate the age distribution in a well that is screened over any finite interval within the aquifer. The regional numerical model was calibrated to water-levels and gradients, and simulated PT age tracer concentrations were calibrated to the MODPATH porosity value. Age distributions were then used to predict nitrate concentrations in wells using agricultural application rates of nitrate in the central eastside of the San Joaquin Valley, California. Both methods showed that wells in the study area captured groundwater with a broad range of ages, spanning decades to millennia. Age distributions from the LPMs predicted age tracer and nitrate concentrations more accurately than the regional PT simulation; whereas PT simulations incorporating more detailed information about water-levels and hydraulic gradients near wells also provided good fits. 14C concentrations were not simulated well by the regional steady-state model, especially for wells with a significant fraction of old groundwater, because the model simulates the current, perturbed system and does not simulate recharge rates and velocities of the predevelopment system. Results from the LPMs yielded an average recharge rate of 0.55 m/yr, which was similar to the average recharge rate of 0.54 m/yr determined from a water budget analysis for the

  10. [HEPATIC HIDATIDOSIS: REVIEW OF CASES WITH SURGICAL INTERVENTION IN THE CENTRAL MILITARY HOSPITAL(LIMA 1990-1999)

    Science.gov (United States)

    Correa Tineo, Santos; Culqui Lévano, Carlos; Pinto Paz, M.; Huillca, Lisbeth; Salinas Alva, Edgardo

    2000-01-01

    We present a retrospective and descriptive study of 21 surgeries of echinocociosis of the liver, corresponding to 30% of a universe of 70 patients that were studied at HMC from 1990 to 1999; other places were 67% in the lung, 1.5% in peritoneal cavity and 1.5% in the spleen.We analyzed frequency in relation to sex, age, origin of the patient, clinical findings, serological tests, radiological tests, abdominal ecography, CT, surgical procedure, morbility and mortality and stay at hospital.These are the results:The average age was 29 years; 76.19% male and 23.81 %female; pain of the right superior quadrant was 66%, palpable mass with 38%.57.14% were from endemic region. We did serological test in 52.4% of the patients; V arc 42.8%; ELISA 23.8%; W. Blot in 33% with 100% of positive results. Eosinophilia was found in 80.95%; echographic studies were realized in 100%; CT in 61.9%; hepatic gammagraphy in 14.2%. Surgical treatment was conservative in 95.2% and radical in 4.3%.42.8% were complicated cysts. Postoperative complications were present in 66%; the most frequent was fever. The rate of mortality was 0%. The average of stay at hospital was 74 days. PMID:12140587

  11. 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

  12. Microbial infection and antibiotic patterns among intensive care unit patients in a tertiary hospital in Central Nepal

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    RK Sanjana

    2013-09-01

    Full Text Available Aims The present study is a fundamental effort to evaluate the bacteriological and antibiotic patterns in the Intensive Care Unit (ICU setting in a tertiary care hospital. This study was carried out to guide the clinician in choosing the appropriate antibiotics and to prevent emergence of multidrug resistance bacteria. Materials and Methods Between March 2009 to Feb 2012, the samples from various ICUs that were submitted to the microbiology laboratory for culture and sensitivity were included in this study. All the organisms were identified morphologically and biochemically by standard laboratory procedure and antibiotic susceptibility pattern was determined by disc diffusion methods. Result Of 3,780 specimens, 2,312 (61.1% isolates were recovered. Single organisms were isolated from 1,746 (75.5% samples while the remaining 566 (24.4% had two or more organisms isolated. Pseudomonas aeruginosa was the most common isolate 819 (35.4%, followed by Klebsiella pneumoniae 637 (27.5%. Antibiotics sensitivity of Pseudomonas aeruginosa showed that almost all isolates were resistant to cephalexin (97.8% and ciprofloxacin (80.3%. However (95.8% of the isolates were sensitive to tobramycin, (92.0% to meropenem & (74.80 % to amikacin. Conclusion It is concluded that Pseudomonas aeruginosa is the predominate pathogen isolated from ICUs of this Hospital. Most of the frequently isolated pathogens are resistant to cephalosporins and quinolone antibiotics as compared to aminoglycosides and carbapenem. Regular surveillance of antibiotic susceptibility pattern is very important for setting a guideline to the clinician in choosing an appropriate therapy of infected patients of ICUs. Journal of College of Medical Sciences-Nepal, 2012, Vol-8, No-3, 1-8 DOI: http://dx.doi.org/10.3126/jcmsn.v8i3.8678

  13. 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

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

    Science.gov (United States)

    Breurec, Sébastien; Vanel, Noémie; Bata, Petulla; Chartier, Loïc; Farra, Alain; Favennec, Loïc; Franck, Thierry; Giles-Vernick, Tamara; Gody, Jean-Chrysostome; Luong Nguyen, Liem Binh; Onambélé, Manuella; Rafaï, Clotaire; Razakandrainibe, Romy; Tondeur, Laura; Tricou, Vianney; Sansonetti, Philippe; Vray, Muriel

    2016-01-01

    Background 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. Methods 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. Results 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%. Conclusions 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

  15. An analysis on the delay of cervical cancer patients in seeking medical check up in Dr. Cipto Mangunkusumo National Central General Hospital Jakarta

    Directory of Open Access Journals (Sweden)

    Ni N. Susanti

    2003-09-01

    Full Text Available In Indonesia, most cervical cancer patients seek medical help after the cancer has reached advanced stage (62 %. This has caused cervical cancer to contribute to 66 % of gynecological deaths.1 The objective of this study is to find out factors related to the delay of cervical cancer patients in seeking for medical help. This research employs quantitative and qualitative methods. Samples were obtained from all of the new cervical cancer patients who came for the first time between 2000 to 2001 and returned to the Dr. Cipto Mangunkusumo National Central General Hospital Jakarta from August until October 2001. It is concluded that variables significantly correlated with the delay for medical check up are knowledge, attitude, the availability of Pap smear service and husband support. The availability of Pap smear plays as dominant variabel. (Med J Indones 2003; 12: 162-5 Keywords: Cervical cancer, knowledge, attitude, the availability of Pap smear service, husband support, late medical check up

  16. Epidemiology and medical cost of hospitalization due to rotavirus gastroenteritis among children under 5 years of age in the central-east of Tunisia.

    Science.gov (United States)

    Soltani, M S; Salah, A Ben; Bouanene, I; Trabelsi, A; Sfar, M T; Harbi, A; Gueddiche, M N; Farhat, E Ben

    2015-08-01

    Data on the economic burden of rotavirus infection in Tunisia are needed to inform the decision to include rotavirus in routine childhood immunizations. This study aimed to describe the epidemiological profile of rotavirus disease in central-east Tunisia and to estimate its hospital cost. In the first stage - the prospective collection of epidemiological data - we enrolled all patients cost data were collected retrospectively using an activity-based costing method from the medical records of the children who were positively diagnosed with rotavirus. The average cost of care per child was TD 433 (SD 134). This is a significant economic burden in Tunisia, where a safe and effective vaccine is available but not yet introduced to the immunization schedule. PMID:26446530

  17. 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.

  18. 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.

  19. A retrospective analysis of mature cystic teratomas of the ovary: a cross sectional study from a tertiary care hospital of central region of Nepal

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    Sushna Maharjan

    2014-12-01

    Full Text Available Background Mature cystic teratoma (MCT, usually known as dermoid cysts derived from primordial germ cells. Comparing with different other types of germ cell tumors like dysgerminomas, and endodermal sinus tumors, they are most commonly observed. The aim of this study was to evaluate the prevalence, clinical and pathological characteristics; and complications of MCT of the ovary in Chitwan district, central region of Nepal. Methods A retrospective, hospital based study was carried out in all histopathologically proven cases of MCT from July 2011 to June 2014. Relevant data were retrieved from the records of Pathology Department of Chitwan Medical College-Teaching Hospital. According to the guidelines of World Health Organization (WHO, classification of ovarian tumors was done mainly based on histogenetic principles. Results Seventy four MCTs were studied from 62 patients. Majority of the patients (74.19% were in reproductive age group of 21-40years. Chief complaint was abdominal pain. Ascites was the most common complication found in 6.45% patients. The rate of torsion was 4.84%; larger tumors underwent torsion more frequently than smaller tumors (P <0.05. Right-sided tumors outnumbered the left-sided tumors. The bilaterality rate was 19.35%. Conclusion Integrated MCT accounts for 49% of all ovarian neoplasm and occur principally during the reproductive years. Postmenopausal women or children sometimes affected. Prevalence rates of torsion were relatively less. Larger tumors have more risk of undergoing torsion than smaller tumors.

  20. Awareness of cervical cancer and Pap smear among nursing staff at a rural tertiary care hospital in Central India

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    S M Jain

    2016-01-01

    Full Text Available Background: Cancer cervix is the leading cause of cancer deaths in females in developing countries and one in five women suffering from cervical cancer lives in India. Aims: The aim of this study is to determine the awareness about cervical cancer and Pap smear among nurses working in a tertiary care institute. Study Setting and Design: Cross-sectional survey in a tertiary care institute. Materials and Methods: Nurses working at our institute excluding those who have worked or working in the Obstetrics and Gynecology department were provided with a pre-designed questionnaire testing their knowledge about cervical cancer. Results: Approximately, 86% were aware about cancer cervix and 69% were aware of a pre-cancerous stage. 42.3% were not aware of any risk factor and 27.6% were not aware of any symptom of cancer cervix. 86.2% were aware about Pap smear, but only 58.6% were aware that facilities of Pap smear were available at our hospital. Conclusions: Knowledge about cervical cancer and awareness of Pap smear as screening test was inadequate in nursing staff. Awareness programs about cervical cancer and screening are needed to increase awareness for this preventable condition. Recommendation: There is a need to arrange reorientation programs to sensitize nurses and establish cytology clinics to offer facilities for easily accessible and affordable screening.

  1. Purchasing and selling mode in pharmaceutical industry in China : A case study on the Introduction of Direct Supply Mode in Hubei Zhongshan hospital

    OpenAIRE

    Xu, Liu

    2012-01-01

    Expensive medicine cost is always a thorny livelihood problem that most people complain about in China. From pharmaceutical factories to consumers, medicines prices increases several times during the circulation. Due to this situation, many hospitals launched different pattern of purchasing and selling medicines to decrease patients’ drug costs. Among them, the uniform bidding mode is the mode most commonly used by state-operated institutions in China. However, as a typical innovation pattern...

  2. 院内供应链药品采购模式对改善我院药品库存管理的探讨%Study of the Improvement of Drug Storage Management in Our Hospital by Hospital Supply Chain Drug Purchase Mode

    Institute of Scientific and Technical Information of China (English)

    周玲; 缪丽燕

    2011-01-01

    OBJECTIVE: To reduce drug storage, and to accelerate the speed of the fund turnover. METHODS: In retrospective study, we compared the traditional drug purchase mode (ABC mode) with hospital supply chain drug purchase mode based on ABC mode. RESULTS:Under the new mode, the monthly average drug turnover days were decreased from 14 to 10, totally 4 days were shortened, and the decreasing amplitude was 28.6%. CONCLUSION: Hospital supply chain drug purchase mode can decrease drug turnover days significantly, accelerate the capital turnover rate, and optimize hospital drug storage management.%目的:降低药品库存,加速库存资金周转.方法:采用回顾性研究方法,对传统药品采购模式(ABC模式)和基于ABC管理法的院内供应链药品采购模式进行比较分析.结果:新模式使药品的月平均周转天数从14天下降到了10天,缩短了4天.降幅为28.6%.结论:院内供应链药品采购模式可以显著降低药品周转天数,提高资金周转率,优化了医院药品库存管理.

  3. 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

  4. Analysis on Water Quality Monitoring Results of Centralized Water Supply in Rural Areas of Luoyang City%洛阳市农村集中式供水水质监测结果分析

    Institute of Scientific and Technical Information of China (English)

    孙磊

    2014-01-01

    To investigate the health situation of centralized water supply in rural areas and discuss efficient preventive measures,so as to provide a basis for the improvement of water quality of rural centralized water supply.Method:The drinking water quality of 250 centralized water supply points in rural areas of 9 counties in Luoyang City in 2012 were monitored according to the relevant national standards of water quality testing. The water quality indicators of samples in different conditions were analyzed statistically.Result:In the 500 detected finished water samples of centralized water supply in rural areas,the total qualification rate was 39.80%.In the 500 detected peripheral water samples of centralized water supply in rural areas,the total qualification rate was 38.00%. The water quality indicators showed statistically significant difference among centralized water supplies with different water treatment processes as well as various water source types(P<0.01).The water quality in the dry season was better than that in the wet season(P<0.01). Conclusion:The total qualification rate of centralized water supply in rural areas is related to the factors like water treatment processes and water source types. It suggests that to strengthen management of centralized water supply in rural areas,water treatment processes should be integrated,water source protection should be promoted,and the propaganda on rural drinking water safety should be strengthened,to improve the health awareness of peasants.%目的:了解洛阳市农村集中式供水水质状况,探讨有效防治措施,为改善农村集中式供水饮水安全提供依据。方法:按照国家有关水质检验标准对2012年洛阳市9个县(市)250处农村集中式供水点的饮用水水质进行监测,统计分析不同条件对水质指标的影响。结果:抽检500份农村集中式供水出厂水水样合格率为39.80%,500份末梢水水样合格率为38.00%。不同水处

  5. Tiempo de espera y su relación con la satisfacción de los usuarios de la farmacia central de un hospital general de Lima

    Directory of Open Access Journals (Sweden)

    Ericson Gutierrez

    2009-01-01

    Full Text Available Para determinar la influencia del tiempo de espera sobre la satisfacción del usuario en la farmacia central del Hospital Nacional Dos de Mayo (HNDM, se realizó un estudio transversal donde se registró los tiempos de espera por cada subproceso de atención (facturación, pago en caja y entrega de medicamentos mediante la observación directa de los usuarios. Se evaluó el nivel de satisfacción del usuario según una escala Likert. Se incluyó 150 usuarios, 59% fueron mujeres, la edad promedio fue de 41,4±12,6 años. El promedio de tiempo total de espera fue de 37,1±14,7 minutos. El tiempo de espera fue significativamente mayor en el subproceso de facturación (p<0,001; asimismo el tiempo que los usuarios tardaron en hacer colas fue mayor que el tiempo efectivo (30,1±14.0 frente a 6,3±4,4; p<0,001. El 17,3% de los usuarios de la farmacia central del HNDM mostraron algún grado de satisfacción. El tiempo de espera menor a 20 minutos fue un predictor de satisfacción del usuario (OR: 4,6 [1,1-18,3]; p<0,05 independientemente de los otros factores. En conclusión, el tiempo de espera prolongado principalmente en el subproceso de facturación, condiciona un bajo nivel de satisfacción del usuario en la farmacia central del HNDM.

  6. Innovations in Health Services Delivery from Transition Economies in Eastern Europe and Central Asia

    OpenAIRE

    Fidler, A.; Bredenkamp, C.; Schlippert, S.

    2009-01-01

    During the past fifteen years, the countries of the former Eastern Bloc transformed their centrally planned, supply-driven health care systems. Modernization of service delivery required innovations in financing and insurance and the restructuring of primary care and hospital networks. This review of experiences from Central and Southeast Europe, the Baltic States, Central Asia, and the Caucasus spot lights innovative health reforms in low- and middle-income countries, including contributions...

  7. Time presses for the installation of a central controller [in the energy supply industry]. Strategic re-orientation of the present system

    International Nuclear Information System (INIS)

    The installation of a so-called central controller for the electric power industry has a number of advantages for stakeholders in the energy market: improving the exchange of information between energy utilities, save costs by setting up central registers for connections, meters, measured data and central processes for e.g. reconciliation and management of measured data (in particular with regard to smart metering). As an example attention is paid to the NEMMCO-case (National Electricity Code Administrator) in Australia

  8. 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

  9. 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.

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

    Digital Repository Service at National Institute of Oceanography (India)

    Pattan, J.N.; Masuzawa, T.; Borole, D.V.; Parthiban, G.; Jauhari, P.; Yamamoto, M.

    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 approx. 74...

  11. Application of ERP system in material management in central sterilization supply department%ERP系统在消毒供应中心物资管理中的应用

    Institute of Scientific and Technical Information of China (English)

    邱素红; 陈严伟; 高玉华

    2012-01-01

    OBJECTIVE To use enterprise resource planning (ERP) system for the management of medical consumables in central sterilization supply department. METHODS Standardized process of medical consumables was established. ERP system was adopted for the management of the purchasing application, storage, outbound, and inventory of the medical consumables in central sterilization supply department. RESULTS The application of ERP system has improved the management of medical consumables, raising work efficiency, reduced the loopholes and waste and saved the cost. CONCLUSION Central sterilization supply department has achieved a computerized networking, transparent, and precise management after the use of ERP system.%目的 消毒供中心应用企业资源计划系统(ERP)进行医用耗材管理.方法 采用建立医用耗材的标准化、规范化流程,ERP系统对消毒供应中心医用耗材的采购申请、入库、出库、库存等进行管理.结果 应用ERP系统完善了消毒供应中心对医用耗材的管理方法,提高了工作效率,减少了临床使用过程中的漏洞和浪费,节约了成本.结论 应用耗材ERP系统后,使消毒供应中心达到计算机网络化、透明化、精确化管理.

  12. Viral Aetiology of Central Nervous System Infections in Adults Admitted to a Tertiary Referral Hospital in Southern Vietnam over 12 Years

    Science.gov (United States)

    Tan, Le Van; Thai, Le Hong; Phu, Nguyen Hoan; Nghia, Ho Dang Trung; Chuong, Ly Van; Sinh, Dinh Xuan; Phong, Nguyen Duy; Mai, Nguyen Thi Hoang; Man, Dinh Nguyen Huy; Hien, Vo Minh; Vinh, Nguyen Thanh; Day, Jeremy; Chau, Nguyen Van Vinh; Hien, Tran Tinh; Farrar, Jeremy; de Jong, Menno D.; Thwaites, Guy; van Doorn, H. Rogier; Chau, Tran Thi Hong

    2014-01-01

    Background Central nervous system (CNS) infections are important diseases in both children and adults worldwide. The spectrum of infections is broad, encompassing bacterial/aseptic meningitis and encephalitis. Viruses are regarded as the most common causes of encephalitis and aseptic meningitis. Better understanding of the viral causes of the diseases is of public health importance, in order to better inform immunization policy, and may influence clinical management. Methodology/Principal Findings Study was conducted at the Hospital for Tropical Diseases in Ho Chi Minh City, a primary, secondary, and tertiary referral hospital for all southern provinces of Vietnam. Between December 1996 and May 2008, patients with CNS infections of presumed viral origin were enrolled. Laboratory diagnostics consisted of molecular and serological tests targeted at 14 meningitis/encephalitis-associated viruses. Of 291 enrolled patients, fatal outcome and neurological sequelae were recorded in 10% (28/291) and 27% (78/291), respectively. Mortality was especially high (9/19, 47%) amongst those with confirmed herpes simplex encephalitis which is attributed to the limited availability of intravenous acyclovir/valacyclovir. Japanese encephalitis virus, dengue virus, herpes simplex virus, and enteroviruses were the most common viruses detected, responsible for 36 (12%), 19 (6.5%), 19 (6.5%) and 8 (2.7%) respectively, followed by rubella virus (6, 2%), varicella zoster virus (5, 1.7%), mumps virus (2, 0.7%), cytomegalovirus (1, 0.3%), and rabies virus (1, 0.3%). Conclusions/Significance Viral infections of the CNS in adults in Vietnam are associated with high morbidity and mortality. Despite extensive laboratory testing, 68% of the patients remain undiagnosed. Together with our previous reports, the data confirm that Japanese encephalitis virus, dengue virus, herpes simplex virus, and enteroviruses are the leading identified causes of CNS viral infections in Vietnam, suggest that the

  13. 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.

  14. Measurement of central corneal thickness by ultrasonic pachymeter and oculus pentacam in patients with well-controlled glaucoma: hospital-based comparative study

    Directory of Open Access Journals (Sweden)

    Rashid RF

    2016-03-01

    Full Text Available Riyam Faihan Rashid, Qasim K Farhood Department of Ophthalmology, College of Medicine, University of Babylon, Babylon, Iraq Background: The measurement of central corneal thickness (CCT plays an important role in the diagnosis and treatment of glaucoma and many corneal diseases.Objective of the study: To compare the measurement of CCT by ultrasonic pachymeter with that measured by oculus pentacam in both normal subjects and patients with well-controlled glaucoma.Patients and methods: In 173 eyes of both controls and patients with open-angle glaucoma (normal intraocular pressure attending Ibn Al Haitham Teaching Eye Hospital, CCT was measured by oculus pentacam and then by ultrasound pachymeter at the same morning by the same technicians.Results: The results showed no significant difference in CCT readings measured by the two devices in both glaucoma and control groups (glaucoma group: 547.29±49.32 µm with pentacam vs 547.66±45.24 µm with ultrasound pachymeter; control group: 551.02±36.28 µm with pentacam vs 541.25±34.96 µm with ultrasound pachymeter. P-values were >0.05 in both groups (statistically not significant.Conclusion and recommendation: Ultrasonic pachymeter and oculus pentacam can be used interchangeably in measuring CCT, and we recommend a nontouch method (in this study, pentacam Scheimpflug camera for measuring CCT during assessment of patients with glaucoma or any ocular disease or surgery. Keywords: CCT, open-angle glaucoma, ultrasound pachymeter, Scheimpflug camera

  15. Increasing the Supply of Quality, Accessible, Affordable Child Care: An Economic Development Strategy for the North Central Region. NCRCRD Policy Briefs

    Science.gov (United States)

    Traill, Saskia; Brown, Brentt

    2005-01-01

    The child care industry has not been fully integrated into economic development activities despite its growing importance in the economy. This is, in large part, because child care is not usually thought of as an element of economic development. As a result, states in the North Central region are not maximizing the economic benefits from quality,…

  16. Preliminary Investigations of Hospital Geography and Patient Choice in Iowa

    OpenAIRE

    Imerman, Mark D.; Eathington, Liesl; Jintanakul, Kanlaya; Otto, Daniel

    2006-01-01

    This report provides a spatial representation of hospital geography in Iowa and of the decisions of patients to patronize hospitals. It begins with a brief analysis of hospital proximity and hospital proximity’s relationship to population distributions and existing hospital capacity. This is followed with a discussion of hospital capacity as a proxy for the supply of hospital services and the construction of hospital service area gravity models based upon capacity. Patient patronage of hospit...

  17. FacilitiesHospitals_HOSPITAL

    Data.gov (United States)

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

  18. NGL supply

    International Nuclear Information System (INIS)

    Highlights of the key drivers behind natural gas liquids (NGL) supply were discussed. These include: (1) volume and location of conventional oil and gas reserves, (2) accessibility of gas to reach economic natural gas markets in North America, (3) composition of produced gas stream, and (4) access to economic NGL logistics and processing infrastructure. Supply developments over the last 10 years and the supply outlook were also reviewed. The review showed that the value of Canadian NGL production has risen steadily over the last 10 years with a sharp increase in 1996. There has been continued expansion of NGTL, TCPL and PGT gas infrastructures. NGL supply is driven by natural gas production. Extraction of NGLs from gas is dependent on demand, economics and infrastructure. It was considered very likely that future NGL supply will increase with increased gas production and recovery from upgraders. 5 figs

  19. 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.

  20. Preliminary evaluation of the water-supply potential of the spring-river system in the Weeki Wachee area and the Lower Withlacoochee River, west-central Florida

    Science.gov (United States)

    Sinclair, William C.

    1978-01-01

    Coastal springs and seeps, including Rainbow Springs, a tributary of Withlacoochee River, discharge as much as a billion gallons of water per day to low-lying coastal swamps and estuarine marshes along the Guld Coast of Citrus and Hernando Counties, Florida. Although Weeki Wachee Spring has long been regarded as an obvious source of freshwater supply, long-term diversion of large volumes of water from Weeki Wachee River will cause encroachment of brackish water throughout the residential canals in the lower reach of the river to about 4.4 miles below Weeki Wachee Spring. Weeki Wachee Spring is analogous to a flowering well tapping an artesian aquifer. Flow characteristics of Withlacoochee River and Rainbow Springs indicate that about 600 cubic feet per second is available on a perennial basis, disregarding the downstream requirements for control of saltwater encroachment. (Woodard-USGS)

  1. Application of multi-criteria decision-making model for choice of the optimal solution for meeting heat demand in the centralized supply system in Belgrade

    International Nuclear Information System (INIS)

    The expected growth of living standard, number of inhabitants and development of technology, industry and agriculture will cause a significant increase of energy consumption in cities. Three scenarios of energy sector development until 2030 and corresponding energy consumption for the city of Belgrade are analyzed in this paper. These scenarios consider different level of economic development, investments in energy sector, substitution of fossil fuels, introduction of renewable energy sources and implementation of energy efficiency measures. The proposed model for selection of optimal district heating system compares different options for fulfilling expected new heat demand through eight criteria for each scenario. Proposed options are combination of different energy sources and technologies for their use. The criteria weights are set according to Serbian economy and energy position. The criteria include financial aspects, environmental impact and availability of energy. Multi-criteria method ELECTRE (ELimination Et Choix Traduisant la REalite) is used as a tool for obtaining the optimal option. It is concluded that combination of CHP (combined heat and power) plant and centralized use of geothermal energy is optimal choice in the optimistic scenario. In the pessimistic and business as usual scenario the optimal option is combination of new gas boilers and centralized use of geothermal energy. - Highlights: • Three scenarios for meeting new heat demand are developed and assessed. • Constructing CHP (combined heat and power) is desirable in case of significant electricity price growth. • In all scenarios the chosen option includes using geothermal energy for heating

  2. 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.

  3. 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 ...

  4. Sources of hydrogen for power supply in Germany. Central findings of the roadmap study for Germany; Woher kommt der Wasserstoff? Zentrale Ergebnisse der Roadmap-Studie fuer Deutschland

    Energy Technology Data Exchange (ETDEWEB)

    Buenger, Ulrich [Ludwig Boelkow Systemtechnik GmbH, Ottobrunn (Germany); Fichtner, Maximilian [Forschungszentrum Karlsruhe GmbH, Karlsruhe (Germany). Inst. fuer Nanotechnologie; Joest, Steffen [Deutsche Energie-Agentur GmbH (dena), Berlin (Germany); Merten, Frank [Wuppertal Institut fuer Klima, Umwelt, Energie GmbH, Wuppertal (Germany); Wietschel, Martin [Fraunhofer-Institut fuer Systemtechnik und Innovationsforschung (ISI), Karlsruhe (Germany)

    2008-10-15

    Carried out on behalf of the Federal Ministry of Transport, Building and Urban Affairs and in cooperation with the Nationale Organisation Wasserstoff und Brennstoffzellentechnologie (NOW), the GermanHy project provided answers to the central questions concerning the introduction of hydrogen for mobile applications: How much of the future fuel demand can be covered by hydrogen? What energy sources are available for economically efficient production of hydrogen to meet the increasing demand (time horizons: 2020, 2030, 2050)? How can H2 be transported from the production site to the consumers? What will be the effects of hydrogen in the transportation sector in terms of mobility cost, emissions, the share of renewable energy, and the further dependence on imported energy? The study focuses on the introduction of hydrogen as an alternative fuel for the German traffic sector. Other alternatives were not looked into. (orig.)

  5. 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.

  6. 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...

  7. 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....

  8. 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.

  9. 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.

  10. 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

  11. The room of the X-rays equipment for Siti Aminah Hospital Bumi Ayu Central Java has been designed to achieve 125 kV and 200 mA capacity

    International Nuclear Information System (INIS)

    The room of the X-rays equipment for Siti Aminah Hospital Bumi Ayu Central Java has been designed to achieve 125 kV and 200 mA capacity, so as to provide radiation properly during operation. In order to achieve safe radiation exposure to the operator and patient, analysis and calculation are needed regarding time exposure, distance and shield width as required by radiation standard, procedure and principle. The result of calculation are expected to give exact maximum doses both for operator and patients. The shielding of the room, consist of concrete and Pb. (author)

  12. Occurrence of Selected Organic Compounds in Groundwater Used for Public Supply in the Plio-Pleistocene Deposits in East-Central Nebraska and the Dawson and Denver Aquifers near Denver, Colorado, 2002-2004

    Science.gov (United States)

    Bails, Jeffrey B.; Dietsch, Benjamin J.; Landon, Matthew K.; Paschke, Suzanne S.

    2009-01-01

    The National Water-Quality Assessment Program of the U.S. Geological Survey has an ongoing Source Water-Quality Assessment program designed to characterize the quality of water in aquifers used as a source of drinking-water supply for some of the largest metropolitan areas in the Nation. In addition to the sampling of the source waters, sampling of finished or treated waters was done in the second year of local studies to evaluate if the organic compounds detected in the source waters also were present in the water supplied to the public. An evaluation of source-water quality used in selected groundwater-supplied public water systems in east-central Nebraska and in the south Denver metropolitan area of Colorado was completed during 2002 through 2004. Fifteen wells in the Plio-Pleistocene alluvial and glacial deposits in east-central Nebraska (the High Plains study) and 12 wells in the Dawson and Denver aquifers, south of Denver (the South Platte study), were sampled during the first year to obtain information on the occurrence and distribution of selected organic chemicals in the source waters. During the second year of the study, two wells in east-central Nebraska were resampled, along with the associated finished water derived from these wells, to determine if organic compounds detected in the source water also were present in the finished water. Selection of the second-phase sampling sites was based on detections of the most-frequently occurring organic compounds from the first-year Source Water-Quality Assessment study results. The second-year sampling also required that finished waters had undergone water-quality treatment processes before being distributed to the public. Sample results from the first year of sampling groundwater wells in east-central Nebraska show that the most-frequently detected organic compounds were the pesticide atrazine and its degradate, deethylatrazine (DEA, otherwise known as 2-chloro-4-isopropylamino-6-amino-s-triazine or CIAT

  13. 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...

  14. 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...

  15. 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. PMID:23424818

  16. Norovirus - hospital

    Science.gov (United States)

    Gastroenteritis - norovirus; Colitis - norovirus; Hospital acquired infection - norovirus ... fluids ( dehydration ). Anyone can become infected with norovirus. Hospital patients who are very old, very young, or ...

  17. Supply Chain Management with Guaranteed Delivery

    OpenAIRE

    Eric Logan Huggins; Tava Lennon Olsen

    2003-01-01

    We consider a two-stage supply chain under centralized control. The downstream facility faces discrete stochastic demand and passes supply requests to the upstream facility. The upstream facility always meets the supply requests from downstream. If the upstream facility cannot meet the supply requests from inventory on hand, the shortage must be filled by expediting, which will incur per unit and setup costs. Such expediting may take the form of overtime production, which occurs at the end of...

  18. Analysis of rubber supply in Sri Lanka

    Energy Technology Data Exchange (ETDEWEB)

    Hartley, M.J.; Nerlove, M.; Peters, R.K. Jr.

    1987-11-01

    An analysis of the supply response for perennial crops is undertaken for rubber in Sir Lanka, focusing on the uprooting-replanting decision and disaggregating the typical reduced-form supply response equation into several structural relationships. This approach is compared and contrasted with Dowling's analysis of supply response for rubber in Thailand, which is based upon a sophisticated reduced-form supply function developed by Wickens and Greenfield for Brazilian coffee. Because the uprooting-replanting decision is central to understanding rubber supply response in Sri Lanka and for other perennial crops where replanting activities dominate new planting, the standard approaches do not adequately capture supply response.

  19. Mo-99 supply issues: Status report and lessons learned

    International Nuclear Information System (INIS)

    The worldwide supply of 99Mo relies on a limited number of research reactors and processing facilities. Its production is essential for the nuclear medicine as 99mTc, obtained from 99Mo/99mTc generators, is used in about 80% of the diagnostic nuclear imaging procedures. These applications represent yearly approximately 30 million examinations worldwide. The short half-life's of 99Mo (66 hours) and its daughter 99mTc (6 hours) require a regular supply of 99Mo/99mTc generators to hospitals or central radiopharmacies. Currently, there are only five nuclear reactors involved in the production of 99Mo on industrial scale: NRU (Canada), HFR (Netherlands), BR2 (Belgium), OSIRIS (France) and SAFARI (South Africa). They irradiate highly enriched uranium targets for the production of about 95% of the available 99Mo by four processing facilities: AECL/MDS NORDION (Canada), COVIDIEN (Netherlands), IRE (Belgium) and NTP (South Africa). However, these ageing reactors are subject to unscheduled shutdowns and longer maintenance periods making the 99Mo supply chain vulnerable and unreliable. Several severe disruptions have been experienced since the fall 2005 due to the occurrence of problems at different stages of the supply chain: reactor outages, release of activity from processing facilities, recall of 99Mo/99mTc generators by the manufacturers, ... It is not expected that the situation will improve significantly in the near future. Therefore, several workshops have been organized in 2009 by the OECD Nuclear Energy Agency (NEA), the International Atomic Energy Agency (IAEA) and the Association of Imaging Producers and Equipment Suppliers (AIPES) to define measures that should be taken to secure the 99Mo supply in the short, medium and long term. This paper summarizes the current status of the 99Mo supply, discusses the ongoing plans for additional 99Mo production capacity and outlines the issues for a reliable global supply chain. (author)

  20. 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.

  1. Fuel supply security

    International Nuclear Information System (INIS)

    Stable fuel supply is a prerequisite for any nuclear power program including ISER-PIUS. It encompasses procurement of uranium ore, enriched uranium and fuel elements. Uranium is different from oil in that it can be stockpiled for more than a decade besides the fact that the core residence time is as long as six years, for example in the case of ISER-PIUS. These basic fuel characteristics are favoring nuclear fuel over others in terms of supply security. The central concern will be a gradual increase in prices of uranium and enrichment. Under the present glut situation with the worldwide prevalence of LWRs, fuel supply security seems ensured for the time being till the middle of 21st century. It is estimated that by the turn of the century, the free world will have roughly 450 GWe capacity of nuclear power. If 10 % is supplied for ISER-PIUS, more than 200 modules of 200 MWe ISER-PIUS may be deployed all over the world probably starting around 2000. As part of the fuel supply security consideration, heavy water reactor (HWR) may seem interesting to such a country as Indonesia where there is uranium resources but no enrichment capability. But it needs heavy water instead and the operation is not so easy as of LWR, because of the positive void coefficient as was seen at the Chernobyl-4. Safeguarding of the fuel is also difficult, because it lends itself to on line refueling. The current and future situation of the fuel supply security for LWR seem well founded and established long into the future. (Nogami, K.)

  2. Determinants of hospital utilization in the Netherlands.

    Science.gov (United States)

    van der Gaag, J; Rutten, F F; van Praag, B M

    1975-01-01

    Hospital use in the Netherlands is examined in a cross-section analysis of 1969 and 1971 data for 120 service regions. Elasticities of admissions with respect to bed supply and supply of general practitioners are calculated, and the substitutability of first level care (by general practitioners) for hospital care is considered. Substitution effects found indicate that the Dutch government's plan to reduce the ratio of hospital beds to population is feasible. PMID:1225868

  3. 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.

  4. 某军队中心医院2007-2013年科研课题立项的规范化管理%Standardized Management of Scientific Research Projects from 2007 to 2013 in Certain Military Central Hospital

    Institute of Scientific and Technical Information of China (English)

    桑秋菊; 周培立; 范文超; 张现格; 沈慧; 王光辉

    2014-01-01

    Objective To discuss the existing problems on the approval and management of scientific re-search projects in hospitals , to put forward the strategies and measures for sustainable development .Methods the number and grade of various scientific research subjects approved by a certain central army hospital in 2007 -2013 , and the age , degree , technical titles structure of project directors as well as other main indexes related were analyzed retrospectively .Results Young and middle-aged scientific and technological personnel is the backbone of scientific research teams of hospitals , highly educated and titled research talents cultivated emphasized have dominant effects on the declarations of research projects .Conclusion speeding up the construction of comprehen-sive hospital disciplines comprehensively , training young professionals , standardizing research management , exploi-ting the military and local resources availability , strengthening the advantages and comprehensively improving the scientific level of the building hospitals , are important measures to achieve sustainable development and enhance hospital core competitiveness .%目的:探讨医院科研课题立项与管理存在的问题,提出可持续发展的策略与措施。方法对军队某中心医院2007-2013年各级各类中标科研课题数量、等级、课题负责人的年龄、学位、专业技术职称结构情况等主要指标进行回顾性分析。结果中青年科技人才是医院科技队伍的中坚力量,高学历、高职称、重点培养的学科人才对课题的申报具有主导作用。结论全面加快医院学科建设,注重人才培养,规范科研管理,有效利用军地资源,强化自身优势,全面提高医院科研建设水平,是实现可持续发展,增强核心竞争能力的重要举措。

  5. Measurement of central corneal thickness by ultrasonic pachymeter and oculus pentacam in patients with well-controlled glaucoma: hospital-based comparative study

    OpenAIRE

    Rashid RF; Farhood QK

    2016-01-01

    Riyam Faihan Rashid, Qasim K Farhood Department of Ophthalmology, College of Medicine, University of Babylon, Babylon, Iraq Background: The measurement of central corneal thickness (CCT) plays an important role in the diagnosis and treatment of glaucoma and many corneal diseases.Objective of the study: To compare the measurement of CCT by ultrasonic pachymeter with that measured by oculus pentacam in both normal subjects and patients with well-controlled glaucoma.Patients and methods: In 17...

  6. 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 blaKPC-2, with one positive for both blaKPC-2 and blaNDM-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 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 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 cases

  7. The anaesthesia gas supply system

    Directory of Open Access Journals (Sweden)

    Sabyasachi Das

    2013-01-01

    Full Text Available The anaesthesia gas supply system is designed to provide a safe, cost-effective and convenient system for the delivery of medical gases at the point of-use. The doctrine of the anaesthesia gas supply system is based on four essential principles: Identity, continuity, adequacy and quality. Knowledge about gas supply system is an integral component of safe anaesthetic practice. Mishaps involving the malfunction or misuse of medical gas supply to operating theatres have cost many lives. The medical gases used in anaesthesia and intensive care are oxygen, nitrous oxide, medical air, entonox, carbon dioxide and heliox. Oxygen is one of the most widely used gases for life-support and respiratory therapy besides anaesthetic procedures. In this article, an effort is made to describe the production, storage and delivery of anaesthetic gases. The design of anaesthesia equipment must take into account the local conditions such as climate, demand and power supply. The operational policy of the gas supply system should have a backup plan to cater to the emergency need of the hospital, in the event of the loss of the primary source of supply.

  8. 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

  9. Maintaining Power Relations in Supply Chain

    OpenAIRE

    Ibishukcu, Ozlem; Datar, Aniket

    2016-01-01

    Managing supply chain relations has evolved over a decade and many companies have given importance to regulate their relations in supply chain relations to stay competitive in the market. In this context of adjusting relations among supply chain members, central point of discussion is the role of power. Power can be a component that persuades one member of supply chain to do certain things that he/she wouldn’t agree on doing it voluntarily. The implication of that power among supply chain mem...

  10. 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

  11. 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.

  12. Gas supplies

    International Nuclear Information System (INIS)

    Of all the main sources of fossil fuels, natural gas stands as a newcomer. While it has already reached an age of maturity in the New World, due to the seniority of its development there, it is marked by the hopes and growth rates of a new energy source in European and Asia. As it becomes a major world energy source, natural gas has to secure consumer confidence, and thereby its own future development. To do so, a reliable supply of it must remain available, and at prices compatible with users' needs. How does natural gas resemble other sources of energy. And what specific features distinguish it in many ways from the others. The answers to these questions are themselves basis elements for understanding the physical process linking the gas field to the client's appliance. They also shed some light on the evolving commercial ties among producers and gas companies on the large regional markets around the world - North America, Europe and the Far East

  13. 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.

  14. The Hygiene Evaluation of Central Air Conditioning Ventilation Systems of Hospital and Hotel in Shenzhen City%深圳市罗湖区医院、宾馆集中式空调系统卫生学评价

    Institute of Scientific and Technical Information of China (English)

    吴浩生; 林奕嘉; 余伟欣; 曹惠珍; 方丽芳; 陈延妮

    2012-01-01

    目的 了解深圳市罗湖区医院及宾馆集中空调通风系统的卫生状况,探索有效的卫生管理对策.方法 于2009~2010年随机抽取深圳市罗湖区6家宾馆及2家医院集中空调通风系统的卫生管理状况进行调查,检测新风量、冷却水军团菌、送风中可吸入颗粒物(PM10)、采集风管内表面积尘和空调送风进行微生物检测.结果 6家宾馆送风中PM10、细菌总数、真菌总数和β -溶血性链球菌的合格率分别为81.2%、82.9%、51.4%、100.0%;2家医院送风中PM10、细菌总数、真菌总数和β -溶血性链球菌的合格率分别为46.8%、33.3%、53.3%、100.0%.医院和宾馆在PM10(χ2=19.4 P=0.000 1)和真菌总数(P=0.001 9)上合格率不同,差异有统计学意义.6家宾馆冷却水军团菌的检出率为20.0%,冷凝水嗜肺军团菌的检出率为0;2家医院冷却水、冷凝水军团菌的检出率为0.结论 深圳市罗湖区医院及宾馆集中空调通风系统存在一定程度的污染,并且医院的污染比宾馆更严重.因此,应该加强空调系统的运行管理,提高空调环境卫生状况,促进人群健康.%Objectives The study was aimed to detect the sanitary conditions of central air conditioning ventilation systems of hospital and hotel in Luohu district in Shenzhen, and to explore some effective supervision measures for central air conditioning ventilation systems. Methods In this randomized study, 6 hotels and 2 hospitals in Shenzhen were selected to determine the total count of bacteria and fungi in internal surface of pipe and blowing air, the air change flow, legionella in cooling tower water, inhalable particulate matter (PM10) in air blow and the dust volume of internal surfaces of pipes. Results The 6 hotels' qualified rate of the total count of PM10 , bacteria, fungi and β-hemolytic streptococcus were respectively 81. 2% , 82. 9 % , 51. 4 % , 100. 0% in air blow; the 2 hospitals' qualified rate of the total count of PM10

  15. Clinico-pathological pattern, classification and staging of urinary bladder carcinomas - a five years experience at a tertiary care hospital in central punjab

    International Nuclear Information System (INIS)

    In Pakistan, urinary bladder carcinoma is the 8th commonest malignancy while being the fourth commonest cancer in men. The relative occurrence of a particular histological type of bladder carcinoma depends on the clinical setting. Both grade and stage of these cancers are highly correlated with recurrence, progression and patient survival rates. Methods: This cross-sectional study comprised of 122 patients with newly diagnosed operable primary bladder carcinomas who underwent cystoscopy associated transurethral resection of bladder tumour at the Urology Department of Punjab Employees Social Security Hospital, Lahore. All participants completed a detailed questionnaire and underwent an in-depth interview to obtain data. The surgical specimens were referred to the Pathology department. Gross observations of the tumour recorded. Result: A total of 114 cases, classified according to WHO/ISUP criteria, low-grade papillary lesions, comprising Papillary Urothelial Neoplasm of Low Malignant Potential (PUNLMP) and Papillary Low Grade carcinomas, accounted for 43% of tumours. Male to female ratio being 5.3:1 (74%). Lateral walls were involved in 44%, posterior wall in 25.3%, trigone in 10.7%, bladder neck in 7.2%, dome in 5.8%, ureteric orifice in 4.13%, anterior wall in 2% and left ureter in 0.87% cases. Tumour staging revealed an overall 11.5% of tumours with stage Ta and 31.5% with stage T3-4. About 29% tumours were non invasive. About n=13 of low-grade carcinomas and n=68 of high-grade carcinomas were invasive. For tumours classified by WHO/ISUP criteria, the percentage of women was larger for PUNLMP than for the other categories of urothelial tumours (p-value 0.006); no statistically significant difference was found by age or gender with respect to tumour stage (p-value 0.138 and 0.452). Conclusion: Transitional Cell Carcinoma (TCC) is the commonest among middle aged men. (author)

  16. 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.

  17. 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

  18. 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%Design and application on post definition mode in public hospital: case study on Shaoyang Central Hospital

    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.

  19. CENTRALIZED OPTIMAL ENDOGENOUS POLLUTION TAXES PROBLEM FOR CLOSED-LOOP SUPPLY CHAIN NETWORK%集权制下闭环供应链网络最优内生污染税问题

    Institute of Scientific and Technical Information of China (English)

    杨玉香; 黄祖庆; 周根贵

    2012-01-01

    为激励生产企业积极参与逆向物流活动、自发回收处理废旧产品,对其废旧产品的排放实施税收政策是控制污染的一项有效措施.通过对闭环供应链网络中各决策者间相互关系的分析,并结合环境政策,建立集权制下废旧产品排放内生污染税均衡模型,研究网络中各主体的竞争行为及均衡条件,解决集权制下既能使网络中各主体利润最大化又能达到预期环境目标的废旧产品排放内生污染税设计问题,并全面分析环境政策的变化对网络中各主体的产品生产量、交易量、交易价格、需求量和废旧产品回收量等经济指标的影响.%In order to encourage manufacturers to take on reverse logistics and take the initiative in recycling EOL (End-of-Life) products, EOL products emission pollution taxes are levied on these enterprises, which is an effective measure to control pollution. A centralized EOL products emission endogenous pollution tax equilibrium model is developed through analyzing interactions among decision-makers in closed-loop supply chain network, coupled with the incorporation of environmental policies. The competitive behaviors and the equilibrium conditions of the various decision-makers are studied. The EOL products emission endogenous pollution tax can maximize the profits of all decision-makers and achieve the desired environmental goal. Finally, the impact of the environmental policy on the equilibrium values of various economic indicators (the amount of products transacted, prices transacted and demands, etc) of all decision-makers is analyzed.

  20. 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.

  1. 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

  2. 基层医院消毒供应室的职业危害与防护对策%Occupational hazards and preventive measures in disinfection supply room of primary hospital

    Institute of Scientific and Technical Information of China (English)

    黄兰

    2015-01-01

    科学、合理的管理可以提高消毒供应室护士的自我防护意识,严格操作规程是减少预防职业性危害的有效方法。本文主要介绍常见的生物性因素、化学性因素、物理性因素、功能性和心理性因素对供应室护士的危害。通过加强自我防护措施,严格操作规程,以及被污染后的应急处理,降低供应室护士的职业危害。%Scientific and reasonable management can improve the self-protection awareness of nurses in disinfection supply room,and strict operation regulations are effective methods to reduce the occupational hazard.In this paper,the author introduced the harm of common biological factors,chemical factors,physical factors,functional and psychological factors of nurses in supply room.Strengthening the self-protection measures and strict rules, and contaminated after the emergency treatment can reduce the supply room nurse occupational hazards.

  3. Benchmarking as a tool for the improvement of health services' supply departments.

    Science.gov (United States)

    Dacosta-Claro, Ivan; Lapierre, Sophie D

    2003-11-01

    This paper presents a benchmarking study carried out on the supply departments of Quebec's health services. The paper begins with the definition of a methodology to collect the information needed, both environmental (to enable institutions to be sorted into homogenous groups) and performance related. The analysis of indicators and the data envelopment analysis (DEA) models allowed classification of each hospital's performance and explained the operational approaches used, either at a general level or for each subprocess of the supply chain. It was observed that important economies of scale may be achieved with better co-ordination and with the regrouping of the supplying activities, both for purchasing management and central store management. The study showed that the best performance of central store services comes with flexible administrative structures, by receiving packages as small as possible and by using employees from the lowest range of the hierarchy. Purchasing services should employ highly qualified and well-paid staff. Although such services are relatively small with respect to their purchase volume, they show a higher activity rate. As a result of the discovered performing strategies, the possible economies range from 20% to 30% of the actual supply-chain management cost. PMID:14613619

  4. Centrally Banked Cryptocurrencies

    OpenAIRE

    Danezis, G.; Meiklejohn, S.

    2016-01-01

    Current cryptocurrencies, starting with Bitcoin, build a decentralized blockchain-based transaction ledger, maintained through proofs-of-work that also serve to generate a monetary supply. Such decentralization has benefits, such as independence from national political control, but also significant limitations in terms of computational costs and scalability. We introduce RSCoin, a cryptocurrency framework in which central banks maintain complete control over the monetary supply, but rely on...

  5. Centrally Banked Cryptocurrencies

    OpenAIRE

    Danezis, George; Meiklejohn, Sarah

    2015-01-01

    Current cryptocurrencies, starting with Bitcoin, build a decentralized blockchain-based transaction ledger, maintained through proofs-of-work that also generate a monetary supply. Such decentralization has benefits, such as independence from national political control, but also significant limitations in terms of scalability and computational cost. We introduce RSCoin, a cryptocurrency framework in which central banks maintain complete control over the monetary supply, but rely on a distribut...

  6. 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.

  7. Hospital Hints

    Science.gov (United States)

    ... and your family. They can help find homecare, rehabilitation, social services, long-term care, and support groups. Inside the Hospital Hospitals have many patient-care areas. For example, the intensive care unit (also called the ICU) has special equipment and staff to care for ...

  8. Cleaning supplies and equipment

    Science.gov (United States)

    ... gov/ency/patientinstructions/000443.htm Cleaning supplies and equipment To use the sharing features on this page, ... to clean supplies and equipment. Disinfecting Supplies and Equipment Start by wearing the right personal protective equipment ( ...

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

    OpenAIRE

    Aline Petter Schneider

    2006-01-01

    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 hospit...

  10. Hospital fundamentals.

    Science.gov (United States)

    Althausen, Peter L; Hill, Austin D; Mead, Lisa

    2014-07-01

    Under the current system, orthopaedic trauma surgeons must work in some form of hospital setting as our primary service involves treatment of the trauma patient. We must not forget that just as a trauma center cannot exist without our services, we cannot function without their support. As a result, a clear understanding of the balance between physicians and hospitals is paramount. Historical perspective enables physicians and hospital personnel alike to understand the evolution of hospital-physician relationship. This process should be understood upon completion of this chapter. The relationship between physicians and hospitals is becoming increasingly complex and multiple forms of integration exist such as joint ventures, gain sharing, and co-management agreements. For the surgeon to negotiate well, an understanding of hospital governance and the role of the orthopaedic traumatologist is vital to success. An understanding of the value provided by the traumatologist includes all aspects of care including efficiency, availability, cost effectiveness, and research activities. To create effective and sustainable healthcare institutions, physicians and hospitals must be aligned over a sustained period of time. Unfortunately, external forces have eroded the historical basis for the working relationship between physicians and hospitals. Increased competition and reimbursement cuts, coupled with the increasing demands for quality, efficiency, and coordination and the payment changes outlined in healthcare reform, have left many organizations wondering how to best rebuild the relationship. The principal goal for the physician when partnering with a hospital or healthcare entity is to establish a sustainable model of service line management that protects or advances the physician's ability to make impactful improvements in quality of patient care, decreases in healthcare costs, and improvements in process efficiency through evidence-based practices and protocols. PMID

  11. 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.

  12. Respirator Use in a Hospital Setting: Establishing Surveillance Metrics

    Science.gov (United States)

    Yarbrough, Mary I.; Ficken, Meredith E.; Lehmann, Christoph U.; Talbot, Thomas R.; Swift, Melanie D.; McGown, Paula W.; Wheaton, Robert F.; Bruer, Michele; Little, Steven W.; Oke, Charles A.

    2016-01-01

    Information that details use and supply of respirators in acute care hospitals is vital to prevent disease transmission, assure the safety of health care personnel, and inform national guidelines and regulations. Objective To develop measures of respirator use and supply in the acute care hospital setting to aid evaluation of respirator programs, allow benchmarking among hospitals, and serve as a foundation for national surveillance to enhance effective Personal Protective Equipment (PPE) use and management. Methods We identified existing regulations and guidelines that govern respirator use and supply at Vanderbilt University Medical Center (VUMC). Related routine and emergency hospital practices were documented through an investigation of hospital administrative policies, protocols, and programs. Respirator dependent practices were categorized based on hospital workflow: Prevention (preparation), patient care (response), and infection surveillance (outcomes). Associated data in information systems were extracted and their quality evaluated. Finally, measures representing major factors and components of respirator use and supply were developed. Results Various directives affecting multiple stakeholders govern respirator use and supply in hospitals. Forty-seven primary and secondary measures representing factors of respirator use and supply in the acute care hospital setting were derived from existing information systems associated with the implementation of these directives. Conclusion Adequate PPE supply and effective use that limit disease transmission and protect health care personnel are dependent on multiple factors associated with routine and emergency hospital practices. We developed forty-seven measures that may serve as the basis for a national PPE surveillance system, beginning with standardized measures of respirator use and supply for collection across different hospital types, sizes, and locations to inform hospitals, government agencies

  13. 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

  14. 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

  15. 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...

  16. 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. PMID:20407173

  17. 太阳能热水系统在医院洗浴热水供应中的应用%APPLICATION OF SOLAR WATER HEATING SYSTEM TO HOSPITAL BATH WATER SUPPLY

    Institute of Scientific and Technical Information of China (English)

    张芹芹

    2014-01-01

    文章通过太阳能热水系统与热媒换热系统、空气源热泵热水机组系统联合应用于山东省某医院洗浴热水系统中的实例,论述了系统的组成和工作原理,并分析其经济性。%Through the practice of some hospital in Shandong Province that combining solar water heating system, heating medium system and air source heat pump system and applying to the bath water system, the article discusses the composition and working principle of the system and analyze its economical efficiency.

  18. Application of solar heat hot-water system for hospital central hot-water supply%太阳能集中热水供应系统在医院中的应用

    Institute of Scientific and Technical Information of China (English)

    罗琳; 陈郁

    2007-01-01

    由于使用人群的特殊性,在医院的热水使用中,对水温的稳定比普通建筑要求更高.介绍了适合医院院区的太阳能集中热水供应系统,对太阳能储热系统、换热系统的设计及经济技术比较进行了阐述.该系统能充分利用太阳能资源,解决了太阳能热水系统在实际运用中与冷水系统不平衡,水温不恒定的问题.

  19. 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.

  20. Early Mortality during Initial Treatment of Tuberculosis in Patients Co-Infected with HIV at the Yaounde Central Hospital, Cameroon: An 8-Year Retrospective Cohort Study (2006-2013.

    Directory of Open Access Journals (Sweden)

    Jean Joel R Bigna

    Full Text Available Understanding contributors to mortality during the initial phase of tuberculosis (TB treatment in patients co-infected with HIV would guide targeted interventions to improve survival. The aim of this study was to ascertain the incidence of death during the initial 2 months (new cases and 3 months (retreatment cases of TB treatment and to assess correlates of mortality in HIV co-infected patients.We conducted a hospital-based retrospective cohort study from January 2006 to December 2013 at Yaoundé Central Hospital, Cameroon. We reviewed medical records to identify co-infected TB/HIV inpatients aged 15 years and older who died during TB treatment. Death was defined as any death occurring during TB treatment, as per World Health Organization recommendations. We collected socio-demographic, clinical and laboratory data. We conducted multivariable logistic binary regression analysis to identify factors associated with death during the intensive phase of TB treatment. Magnitudes of associations were expressed by adjusted odds ratio (aOR with 95% confidence interval. A p value < 0.05 was considered statistically significant.The 99 patients enrolled had a mean age of 39.5 (standard deviation 10.9 years and 53% were male. Patients were followed for 276.3 person-months of observation (PMO. Forty nine patients were died during intensive phase of TB treatment. Death incidence during the intensive phase of TB treatment was 32.2 per 100 PMO. Having a non-AIDS comorbidity (aOR 2.47, 95%CI 1.22-5.02, p = 0.012, having extra-pulmonary TB (aOR 1.89, 95%CI 1.05-3.43, p = 0.035, and one year increase in duration of known HIV infection (aOR 1.23, 95%CI 1.004-1.49 were independently associated with death during the intensive phase of TB treatment.Mortality incidence during intensive phase of TB treatment was high among TB/HIV co-infected patients during TB treatment; and strongly associated with extra pulmonary TB suggesting advanced stage of immunosuppression and

  1. 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.

  2. Emergency air supply

    International Nuclear Information System (INIS)

    An air supply safety device is described which can operate in an hostile environment. The system ensures that should the ring mains supply or the operator's individual hose fail an emergency air supply is obtained from a compressed air bottle fed to the operator's face mask via a valve. The valve switches from mains/mask to emergency supply/mask when the mains pressure falls below the emergency supply pressure. (U.K.)

  3. 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

    OpenAIRE

    Jacinta Sanchez Pelayo; Leandro Augusto Calixto; Ligia Maira dos Santos Rogeri; Raquel Girardello; Regina Mariuza Borsato Quesada; Claudia Ross

    2006-01-01

    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 t...

  4. Pressurized air supply device

    International Nuclear Information System (INIS)

    Ventilation air-conditioning facilities in a nuclear reactor building are adapted to suck clean external air not containing radioactivity through air supply filters disposed at an air intake port of the nuclear reactor building by means of an air supply blower and then supply the sucked air through an air supply duct and an air supply port to the inside of the power plant. Futher, pipeways for supplying sucked air to a compressor is branched from the air supply duct, through which air is supplied to an air compressor for instrumentation and an air compressor used in the power plant. The air sucked and compressed in the air compressor for instrumentation is further supplied by way of pipeways for supplying air for instrumentation to air-actuated valves, instruments, etc. Further, air sucked and compressed in the air compressor used in the power plant is further supplied by way of air supply pipeways for the power plant to a reservoir, air mask, etc. By supplying clean compressed air in this way, operators exposure dose can be reduced. (T.M.)

  5. 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....

  6. Academic Hospitality

    Science.gov (United States)

    Phipps, Alison; Barnett, Ronald

    2007-01-01

    Academic hospitality is a feature of academic life. It takes many forms. It takes material form in the hosting of academics giving papers. It takes epistemological form in the welcome of new ideas. It takes linguistic form in the translation of academic work into other languages, and it takes touristic form through the welcome and generosity with…

  7. Hospital Malnutrition

    OpenAIRE

    Asumadu-Sarkodie, Samuel

    2012-01-01

    Malnutrition seen in hospitals usually occurs as some form of protein-energy malnutrition (PEM). Primary PEM results from an acute or chronic deficiency of both protein and calories. Secondary PEM, or cachexia, results from a disease or medical condition such as cancer or gastrointestinal disease that alters requirements or impairs utilization of nutrients.

  8. Supply Cain Risk Management

    OpenAIRE

    Goodwin, Les

    2011-01-01

    “The management of supply chain risk is crucial to any business, more so to Rolls Royce who face an almost doubling of load within the next 10 years. So what is supply chain risk management and how well is it deployed within an operational business of Rolls Royce? What are the tools and techniques available and what are the key issues around implementing world class supply chain risk management with a Supply Chain Unit within Rolls Royce?”

  9. Switching mode power supplies

    OpenAIRE

    Beard, David W.

    1980-01-01

    The subject of switching mode power supplies was examined. A comparison between linear regulators and switching mode power supplies was made to show the options available for the various types of convertors. Two switching mode power supplies were constructed and tested. The operating efficiency of both systems was found to be more than eighty percent over the specified input voltage and load current conditions. The switching mode power supply circuits required additional ...

  10. Spatially Characterizing Effective Timber Supply

    Science.gov (United States)

    Berry, J. K.; Sailor, J.

    1982-01-01

    The structure of a computer-oriented cartographic model for assessing roundwood supply for generation of base load electricity is discussed. The model provides an analytical procedure for coupling spatial information of harvesting economics and owner willingness to sell stumpages. Supply is characterized in terms of standing timber; of accessibility considering various harvesting and hauling factors; and of availability as affected by ownership and residential patterns. Factors governing accessibility to timber include effective harvesting distance to haulic roads as modified by barriers and slopes. Haul distance is expressed in units that take into account the relative ease of travel along various road types to a central processing facility. Areas of accessible timber are grouped into spatial units, termed 'timbersheds', of common access to particular haul road segments that belong to unique 'transport zones'. Timber availability considerations include size of ownership parcels, housing density and excluded areas. The analysis techniques are demonstrated for a cartographic data base in western Massachusetts.

  11. Hospitality and hostility in hospitals

    DEFF Research Database (Denmark)

    Jensen, Tina Blegind; Aanestad, Margunn

    2007-01-01

    The purpose of this paper is to discuss the adoption of healthcare information systems (HIS) from a user perspective. Our case study concerns how a group of orthopaedic surgeons experienced and reacted to the adoption and mandatory use of an Electronic Patient Record system in a Danish hospital. We...... propose to use the concepts of hospitality and hostility to turn our attention to the interaction between the host (the surgeons) and the guest (the information system) and consider how the boundaries between them evolved in the everyday work practices. As an alternative to previous studies on technology...

  12. Hospitable radiopharmaceuticals

    International Nuclear Information System (INIS)

    Two types of hospitalary radiopharmaceutical was given in Nuclear Medicine: the centralized and hospitalary radiopharmaceuticals. The good practice in the use, instrumentation and quality control of radiopharmaceuticals are used in nuclear medicine for diagnostic and therapy diseases

  13. 某军队医院聘用制医务人员满意度分析%An Analysis of Income and Job Satisfaction of Employed Healthcare Workers in a Military Central Hospital

    Institute of Scientific and Technical Information of China (English)

    徐蕾; 张运明; 李东华; 吴骋

    2015-01-01

    Objective The article aimed to achieve income satisfaction and job satisfaction of employed healthcare workers in a military central hospital as well as their relationship and to provide advice and policies to improve the professional stability and loyalty of the workers.Methods Questionnaires and interviews were used to survey 642 employed healthcare workers.Statistical methods, such as correlation analysis and logistic regression were used to analyze the data by software SAS9.3.Results Healthcare workers'satisfaction was 3.41, which has no relationship with income(r =0.105,P >0.05), yet has relationship with income satisfaction(r =0.356,P <0.001).Income satisfaction is relatively low.Dissatisfaction rate of workers from surgical departments was 56.41%, which was lower than 76% of medicine departments and 78.26% of accessory departments.Intention of quit was much strong in workers whose work time was less than 2 years or between 5 -8 years.Conclusion It is suggested to follow the orientation of health reform of Shanghai and to build harmonious working surroundings to im-prove job satisfaction.Income allocation system should be modified to improve income satisfaction.Scientific and effective system should be used to evaluate workers'performance and keep talents in military hospital.%目的:了解某军队中心医院聘用制医务人员收入满意度和工作满意度状况,以及两者之间的关系,针对发现的问题提出政策建议,以提高医务人员职业稳定性和忠诚度。方法对642名聘用制医务人员进行满意度开放式问卷调查,对数据运用 SAS 9.3软件进行统计描述,采用相关分析和 logistic 回归分析进行相关检验与影响因素筛选。结果聘用制医务人员工作满意度处于一般水平,为3.41分,与薪酬无相关关系(r =0.105,P >0.05),与收入满意度存在相关关系(r =0.356,P <0.001)。收入满意度总体较低,外科片对收入不

  14. Supply regimes in fisheries

    DEFF Research Database (Denmark)

    Nielsen, Max

    2006-01-01

    -Holt based bio-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...

  15. [The future of hospitals and the hospitals in the future].

    Science.gov (United States)

    Illés, S Tamás

    2016-07-01

    By the end of the 20th century the vertically organized hospitals formed into a closed hierarchical system, in which the healthcare supply significantly fragmented. The existing hospitals in the current organization are not prepared for the increase in longevity, nor for the high growth in the number of chronic and long-term illnesses and the multi-morbidity since they were not designed for extended carry treatments. The fast incorporation of high-tech and very expensive technologies into healthcare generates an economic crisis. Solving the supply and economic crisis at the same time cannot be achieved without changing the structure of hospitals. Future hospitals will be organized in a network, conducting special treatments according to disease profiles. According to present knowledge, this is the only structure that allows for economies in scale, the proper spending of the ever-shrinking resources, and to ensure the effective patient care required after the changing of disorder structures and patient corporate identities. Orv. Hetil., 2016, 157(28), 1099-1104. PMID:27397421

  16. Market Forces and the Public Good: Competition Among Hospitals and Provision of Indigent Care

    OpenAIRE

    Frank, Richard G.; David S. Salkever; Jean Mitchell

    1989-01-01

    The research presented here focuses on the impact of competitive forces on the provision of social or merit goods by non-profit hospitals. We specifically examine the behavior of altruistic non-profit hospitals in the supply of charity care. The effects of competitive pressures and past charity care provision on the supply of philanthropic donations to nonprofit hospitals are also examined. Empirical models of the supply of donations and charity care are specified and estimated using data on ...

  17. Physician treatment decisions in a multiple treatment model. The effect of physician supply.

    Science.gov (United States)

    McCombs, J S

    1984-08-01

    This paper develops a neoclassical utility maximization model of physician behavior in which the physician determines the price of physician office and hospital visits, the utilization rates for physician office and hospital visits and hospital days, and the resources and physician time inputs in the production of visits. The model assumes that the physician acts as a perfect agent for the patient. The analysis traces substitutions between physician office visits, physician hospital visits, and hospital days in response to changes in physician supply. The analysis also traces physician supply induced changes in the input mix used to produce visits. The substitution effects of physician supply are then used to reinterpret previous statistical estimates of the physician supply elasticities of per capita utilization of physician office visits and hospital days, length of visit, waiting time, and physician workloads. PMID:10268370

  18. 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.

  19. 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.

  20. 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 for at...

  1. AC power supply systems

    International Nuclear Information System (INIS)

    An ac power supply system includes a rectifier fed by a normal ac supply, and an inverter connected to the rectifier by a dc link, the inverter being effective to invert the dc output of the receiver at a required frequency to provide an ac output. A dc backup power supply of lower voltage than the normal dc output of the rectifier is connected across the dc link such that the ac output of the rectifier is derived from the backup supply if the voltage of the output of the inverter falls below that of the backup supply. The dc backup power may be derived from a backup ac supply. Use in pumping coolant in nuclear reactor is envisaged. (author)

  2. TFTR CAMAC power supplies reliability

    International Nuclear Information System (INIS)

    Since the expected life of the Tokamak Fusion Test Reactor (TFTR) has been extended into the early 1990's, the issues of equipment wear-out, when to refurbish/replace, and the costs associated with these decisions, must be faced. The management of the maintenance of the TFTR Central Instrumentation, Control and Data Acquisition System (CICADA) power supplies within the CAMAC network is a case study of a set of systems to monitor repairable systems reliability, costs, and results of action. The CAMAC network is composed of approximately 500 racks, each with its own power supply. By using a simple reliability estimator on a coarse time interval, in conjunction with determining the root cause of individual failures, a cost effective repair and maintenance program has been realized. This paper describes the estimator, some of the specific causes for recurring failures and their correction, and the subsequent effects on the reliability estimator. By extension of this program the authors can assess the continued viability of CAMAC power supplies into the future, predicting wear-out and developing cost effective refurbishment/replacement policies. 4 refs., 3 figs., 1 tab

  3. [Evolution of the hospital pharmacies in public and private hospitals in the cancer network in Lorraine: Oncolor].

    Science.gov (United States)

    May, I; Paulus, C; Vigneron, J; Watelet, M; Veyrier, B; Bichet, F; Bideaux, S; Bey, P

    2001-04-01

    With the objective of improvement of quality in oncology, an assessment of chemotherapy practice in hospital pharmacies in public and private hospitals was carried out by the regional committee of oncology in Lorraine. The 36 hospitals reporting using chemotherapy, had varied practices. The results of this survey lead to the elaboration of guideline for hospital pharmacies in the oncology regional network Oncolor. This paper describes the different aspects of the hospital pharmacies in public and private hospitals included in the network Oncolor from 1996 to 2000. In 1996, 9 hospital pharmacies had centralized preparation for chemotherapy, whereas at the end of 2000, 26 pharmacies on 28 will fulfill the guidelines. PMID:11371380

  4. 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...

  5. 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.

  6. Supply Chain Collaboration

    OpenAIRE

    Meca, Ana; Timmer, Judith

    2008-01-01

    In this chaper, we have reviewed and surveyed the literature on supply chain collaboration. As mentioned above, the game theory models that include cooperative behaviour among retailers seem to be a natural framework to model cooperation (collaboration) in supply chains that consist of a supplier and a finite number of retailers. Various researchers in this area have already adopted several cooperative models dealing with supply chain coordination, and it is expected to see many more in the n...

  7. Supply chain components

    OpenAIRE

    Vieraşu, T.; Bălăşescu, M.

    2011-01-01

    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.

  8. Sustainable Supply Chain Management

    OpenAIRE

    Geentjens, Marlies

    2013-01-01

    This project investigates the phenomena Sustainable Supply Chain Management. The point of departure is Supply Chain Management, which we analyse in order to lock into an understanding of the development that occur when implementing sustainability. In the quest for higher understanding of the interlocking mechanisms of supply chain management, we combine a theoretical approach to the developmnent of sustainability with some relevant case-examples (mainly depicting IKEA). This focal point g...

  9. Perspectives of electricity supply

    International Nuclear Information System (INIS)

    The 7 papers read at the symposium discussed the following subjects: Effects of the CO2 problems of fossil energy systems on the world climate; status and perspectives of the German electricity industry in terms of competitiveness; The European electricity market and the integrated power supply system; Power supply without nuclear power; Costs and rates for households and other customers; Renewable energy sources and their contribution to energy supply in the Federal Republic of Germany; Electricity utilities as service partners. (UA)

  10. Demand and Supply Surfaces

    OpenAIRE

    Ruiz Estrada, M.A.

    2008-01-01

    This paper shows a new optical visualization of demand and supply based on the application of surfaces. The objective of initiating the demand and supply surfaces is to propose the application of multi-dimensional graphs among academics, economists and policy makers in the study of microeconomics and macroeconomics analyses in the short and long term. To create the demand and supply surfaces, this research suggests applying “the Infinity Cartesian space (I-Cartesian space)” (Ruiz 2006). In ap...

  11. 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.

  12. SHARED LEARNING IN SUPPLY NETWORKS: EVIDENCE FROM AN EMERGING MARKET SUPPLY NETWORK

    OpenAIRE

    2008-01-01

    Purpose: Firms face the challenge of developing learning capabilities that enable them to work as part of an effective business network. While an extensive literature examines learning capabilities within the firm little research examine the shared learning that occurs between networked firms. The paper explores how a manufacturer and businesses services provider learn to develop their supply network. Specifically, the paper investigates four areas of shared learning, central to supply networ...

  13. 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...

  14. Geothermal heat-pump systems of heat supply

    International Nuclear Information System (INIS)

    The data on the multilayer operation of the objects, located in the climatic conditions of the central area of Russia and equipped with the geothermal heat-pumping systems of the heat supply are presented. The results of the analytical studies on evaluating the geothermal heat-pumping systems of the heat supply integration efficiency into the structure of the energy supply system, prevailing in the country, are presented

  15. The Law of Supply and Demand: Here It Is Finally

    OpenAIRE

    Kakarot-Handtke, Egmont

    2014-01-01

    There is no such thing as a law of human or social behavior. The conceptual consequence of the present paper is therefore to discard the subjectivebehavioral axioms and to take objective-structural axioms as new formal foundations. The central piece of economic theory is the interaction of demand and supply which determines prices and quantities. Demand and supply in turn are determined by subjective factors. In the structural axiomatic paradigm the Law of Supply and Demand follows from objec...

  16. Developments in energy supply

    International Nuclear Information System (INIS)

    After an explanation of the fundamentals (measuring units, energy sources, energy comsumption, energy demand, energy reserves), nuclear and renewable energy sources are investigated with a view to their possible contribution to energy supply in the future. There is a final chapter on problems of energy supply in West Germany. (UA)

  17. The architecture of enterprise hospital information system.

    Science.gov (United States)

    Lu, Xudong; Duan, Huilong; Li, Haomin; Zhao, Chenhui; An, Jiye

    2005-01-01

    Because of the complexity of the hospital environment, there exist a lot of medical information systems from different vendors with incompatible structures. In order to establish an enterprise hospital information system, the integration among these heterogeneous systems must be considered. Complete integration should cover three aspects: data integration, function integration and workflow integration. However most of the previous design of architecture did not accomplish such a complete integration. This article offers an architecture design of the enterprise hospital information system based on the concept of digital neural network system in hospital. It covers all three aspects of integration, and eventually achieves the target of one virtual data center with Enterprise Viewer for users of different roles. The initial implementation of the architecture in the 5-year Digital Hospital Project in Huzhou Central hospital of Zhejiang Province is also described. PMID:17281875

  18. Integrated supply chain risk management

    OpenAIRE

    Riaan Bredell; Jackie Walters

    2007-01-01

    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 ...

  19. 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.

  20. KEKB electromagnet power supply

    International Nuclear Information System (INIS)

    Numbers of electromagnet power supply for KEKB are 2,243 except BT. To satisfy stability, DAC in the current control circuit, current detector, R and D of small thermostatic bath and a calibration method of current using CPU were introduced. They satisfied needs. With producing R and D apparatus of switching source, problems of ripple, stability and noise were solved, so that we began mass production. In this paper, many kinds of R and D and performance and troubles after operation of KEKB power source are described. A plan of design of power supply consisted of seven items such as high accuracy, serial communication of interface, small type, high affectivity, easy maintenance, independence of current setting and current detector for monitor and control of radiation and conduction noise of switching power supply. These items were satisfied by development of interface board of ARCNET communication, introduction of double buffer method for interface through CPU, power supply unit by air-cooled method using a switching method and small thermostatic oven for bending and quadrupole electromagnet. R and D of DCCT, burden and shunt resistance, DAC, thermostatic bath, power supply, offset and gain calibration by double buffer method, specification of power supply, various kinds of measurements of mass production apparatus at rising, after long operation and problems before and after operation are reported. The results of R and D made satisfy the specification of stability and ripple of power supply. Although many switching power supply were operated, there was no noise and troubles at the initial period decreased. However, in order to use many power supply, the performance measurement and maintenance are very important at long shut down. (S.Y.)

  1. WATER SUPPLY ANALYSIS

    International Nuclear Information System (INIS)

    This analysis defines and evaluates the surface water supply system from the existing J-13 well to the North Portal. This system includes the pipe running from J-13 to a proposed Booster Pump Station at the intersection of H Road and the North Portal access road. Contained herein is an analysis of the proposed Booster Pump Station with a brief description of the system that could be installed to the South Portal and the optional shaft. The tanks that supply the water to the North Portal are sized, and the supply system to the North Portal facilities and up to Topopah Spring North Ramp is defined

  2. Feeding premature infants after hospital discharge

    OpenAIRE

    Yuen, Doris E

    1998-01-01

    Supplying adequate nutrition to premature infants is an ongoing challenge. Common medical conditions that premature infants develop and therapies given to them can increase their nutritional requirements or interfere with the delivery of nutrients. This article outlines factors to consider when prescribing appropriate diet and nutritional supplements at hospital discharge.

  3. Foreign uranium supply

    International Nuclear Information System (INIS)

    Known foreign uranium resources are concentrated in a few countries. The resources of many countries are largely unassessed, but the known uranium countries appear to have the best potential for future expansion. Availability of supply from known resources will depend on resolution of national policies regarding uranium production, ownership and export, and actions of the mining industry. Foreign uranium demand projections have decreased markedly in the last few years, and currently planned and attainable production should be adequate through the 1980's. Longer term resources and supply outlook are still a major concern to both those planning electric supply systems based on converter reactors and those considering reprocessing and recycle of uranium and plutonium and development of breeder reactors. Work continues to clarify long-term supply in several countries and internationally, but more effort, and time, will be needed to clarify these issues

  4. 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.  

  5. 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.

  6. Supply and Demand

    Science.gov (United States)

    ... Prenatal Baby Bathing & Skin Care Breastfeeding Crying & Colic Diapers & Clothing Feeding & Nutrition Preemie Sleep Teething & Tooth Care Toddler Preschool Gradeschool Teen Young Adult Healthy Children > Ages & Stages > Baby > Breastfeeding > Supply and ...

  7. 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...

  8. 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...... which were grouped into eight categories; they refer to “fundamental environmental attitude”, “use of energy”, “use of input material”, “product”, “packaging”, “transport”, “consumption” and “waste”. The level of environmental supply chain management can be characterised as very operational and very...... 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...

  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. Rogoff's 'Conservative' Central Banker Restored

    OpenAIRE

    Herrendorf, Berthold; Lockwood, Ben

    1996-01-01

    This paper shows that delegation of monetary policy to a weight-conservative central banker is optimal, although the government can also use an inflation contract, an employment target, an inflation target, or any combination of these, to control the central banker. The key feature of our model is a stochastic inflation bias, arising when wage-setters receive some information about a supply shock prior to signing nominal wage contracts. Weight-conservatism is shown to be desirable if the stoc...

  11. Supply Chain Collaboration

    OpenAIRE

    Guy Rodrigue Ghomsi 1982

    2015-01-01

    Companies are now progressively looking beyond themselves to come up with ways to improve revenue and profit margins. This has resulted in a heightened focus on the efficiency of the supply chains. Inefficient supply chains are being perceived as cavities that can deprive the firm from its cash flows when inventory is not required and sales revenue when product is not available at the point of sales. This has stimulated development of business models that intend to leverage and enhance the su...

  12. Supply portfolio risk

    OpenAIRE

    Haksöz, Çağrı; Haksoz, Cagri; Kadam, Ashay

    2008-01-01

    In a single period framework, we develop a supply portfolio risk assessment tool for raw material procurement in the presence of supply risk (owing to contract breaches), demand risk and the spot price risk. Contract breaches are operational risk events that are classified under the “Clients, Products and Business Practices” category of the Basel II framework. We allow for the negative financial impact of intentional long-term fixed price contract breaches to be mitigated by...

  13. 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.

  14. Supply chain risk management

    OpenAIRE

    Christian Hollstein; Frank Himpel

    2013-01-01

    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-induct...

  15. Editorial: Supply Chain Management

    OpenAIRE

    Aidonis, D.; Folinas, D.; Triantafillou, D.

    2012-01-01

    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 m...

  16. Sourcing Strategy and Supply Chain Risk Management in the Healthcare Sector: A Case Study of Malawi¡¯s Public Healthcare Delivery Supply Chain

    OpenAIRE

    2013-01-01

    The study primarily investigated the role of single sourcing strategy in either exacerbating or mitigating persistent supply failure in Malawi¡¯s public healthcare delivery supply chain. It also investigated the role of the single supplier in recurrent drug stockouts in the country¡¯s public hospitals. The study was conducted at five public healthcare delivery centres in southern Malawi. Data was collected using two sets of self administered questionnaires to, hospital managers and procuremen...

  17. Risks and Coordination Mechanisms in Telecom Supply Chains

    OpenAIRE

    Agrell, Per Joakim; Lindroth, Robert; Norrman, Andreas

    2003-01-01

    Supply chain management involves the selection, coordination and motivation of independently operated suppliers. The central planner's perspective in operations management translates poorly to vertically separated chains, where suppliers recurrently seem to object to benevolent information sharing and centralized decision rights. Seen from the supplier's perspective, such resistance may very well be rational. A downstream assembly line disclosing reliable information on actual and forecasted ...

  18. Dynamic joint investments in supply chains under information asymmetry

    OpenAIRE

    Agrell, Per Joakim; KASPERZEC, Roman

    2010-01-01

    Supply chain management involves the selection, coordination and motivation of independently operated suppliers. However the central planner's perspective in operations management translates poorly to vertically separated chains, where suppliers may have rational myopic reasons to object to full in- formation sharing and centralized decision rights. Particular problems occur when a downstream coordinator demands relation-specific investments (equipment, cost improvements in processes, adaptat...

  19. Understanding the supply chain

    Directory of Open Access Journals (Sweden)

    Aćimović Slobodan

    2006-01-01

    Full Text Available Supply chain management represents new business philosophy and includes strategically positioned and much wider scope of activity in comparison with its "older brother" - management of logistics. Philosophy of the concept of supply chain is directed to more coordination of key business functions of every link in distribution chain in the process of organization of the flow of both goods and information, while logistic managing instruments are focused on internal optimum of flows of goods and information within one company. Applying the concept of integrated supply chain among several companies makes the importance of operative logistics activity even greater on the level of one company, thus advancing processes of optimum and coordination within and between different companies and confirms the importance of logistics performances for the company’s profitability. Besides the fact that the borders between companies are being deleted, this concept of supply chain in one distribution channel influences increasing of importance of functional, i.e. traditional business managing approaches but instead it points out the importance of process managing approaches. Although the author is aware that "there is nothing harder, more dangerous and with uncertain success, but to find a way for introducing some novelties (Machiavelli, it would be even his additional stimulation for trying to bring closer the concept and goals of supply chain implementation that are identified in key, relevant, modern, theoretical and consulting approaches in order to achieve better understanding of the subject and faster implementation of the concept of supply chain management by domestic companies.

  20. 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...

  1. Can hospitals compete on quality? Hospital competition.

    Science.gov (United States)

    Sadat, Somayeh; Abouee-Mehrizi, Hossein; Carter, Michael W

    2015-09-01

    In this paper, we consider two hospitals with different perceived quality of care competing to capture a fraction of the total market demand. Patients select the hospital that provides the highest utility, which is a function of price and the patient's perceived quality of life during their life expectancy. We consider a market with a single class of patients and show that depending on the market demand and perceived quality of care of the hospitals, patients may enjoy a positive utility. Moreover, hospitals share the market demand based on their perceived quality of care and capacity. We also show that in a monopoly market (a market with a single hospital) the optimal demand captured by the hospital is independent of the perceived quality of care. We investigate the effects of different parameters including the market demand, hospitals' capacities, and perceived quality of care on the fraction of the demand that each hospital captures using some numerical examples. PMID:25711185

  2. Supply and Demand Is Not a Neoclassical Concern

    OpenAIRE

    Lima, Gerson P.

    2015-01-01

    The central point of this paper is the demonstration that there is a real world supply and demand theory, supported by an estimate of the US aggregate supply curve. The fundamental idea is that demand and supply interaction is the smallest economic act, an act without which there would be no economics. Paper’s first point is that what neoclassical textbooks call supply and demand is just a disguising device created to justify a given goal and stresses three mistakes that plague all profit max...

  3. Hospitals as health educators

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000862.htm Hospitals as health educators To use the sharing features ... health education, look no further than your local hospital. From health videos to yoga classes, many hospitals ...

  4. 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...

  5. 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...

  6. Critical Access Hospitals (CAH)

    Science.gov (United States)

    ... will not. Each hospital must perform its own financial analysis to determine if being a Prospective Payment System (PPS) hospital or a CAH would result in a better financial return. For financially distressed hospitals, even if CAH ...

  7. Surgery, Hospitals, and Medications

    Science.gov (United States)

    ... OTC products that are not commonly stocked in hospital pharmacies. Examples include: Salagen ® , Evoxac ® , and Restasis ® Eye drops, ... of your medication will be sent to the hospital pharmacy for verification. Depending on hospital policy, you may ...

  8. Intraclass reliability for assessing how well Taiwan constrained hospital-provided medical services using statistical process control chart techniques

    Directory of Open Access Journals (Sweden)

    Chien Tsair-Wei

    2012-05-01

    Full Text Available Abstract Background Few studies discuss the indicators used to assess the effect on cost containment in healthcare across hospitals in a single-payer national healthcare system with constrained medical resources. We present the intraclass correlation coefficient (ICC to assess how well Taiwan constrained hospital-provided medical services in such a system. Methods A custom Excel-VBA routine to record the distances of standard deviations (SDs from the central line (the mean over the previous 12 months of a control chart was used to construct and scale annual medical expenditures sequentially from 2000 to 2009 for 421 hospitals in Taiwan to generate the ICC. The ICC was then used to evaluate Taiwan’s year-based convergent power to remain unchanged in hospital-provided constrained medical services. A bubble chart of SDs for a specific month was generated to present the effects of using control charts in a national healthcare system. Results ICCs were generated for Taiwan’s year-based convergent power to constrain its medical services from 2000 to 2009. All hospital groups showed a gradually well-controlled supply of services that decreased from 0.772 to 0.415. The bubble chart identified outlier hospitals that required investigation of possible excessive reimbursements in a specific time period. Conclusion We recommend using the ICC to annually assess a nation’s year-based convergent power to constrain medical services across hospitals. Using sequential control charts to regularly monitor hospital reimbursements is required to achieve financial control in a single-payer nationwide healthcare system.

  9. [Supply services at health facilities: measuring performance].

    Science.gov (United States)

    Dacosta Claro, I

    2001-01-01

    Performance measurement, in their different meanings--either balance scorecard or outputs measurement--have become an essential tool in today's organizations (World-Class organizations) to improve service quality and reduce costs. This paper presents a performance measurement system for the hospital supply chain. The system is organized in different levels and groups of indicators in order to show a hierarchical, coherent and integrated vision of the processes. Thus, supply services performance is measured according to (1) financial aspects, (2) customers satisfaction aspects and (3) internal aspects of the processes performed. Since the informational needs of the managers vary within the administrative structure, the performance measurement system is defined in three hierarchical levels. Firstly, the whole supply chain, with the different interrelation of activities. Secondly, the three main processes of the chain--physical management of products, purchasing and negotiation processes and the local storage units. And finally, the performance measurement of each activity involved. The system and the indicators have been evaluated with the participation of 17 health services of Quebec (Canada), however, and due to the similarities of the operation, could be equally implemented in Spanish hospitals. PMID:11693070

  10. Contract Coordination Strategy of Supply Chain with Substitution under Supply Disruption and Stochastic Demand

    Directory of Open Access Journals (Sweden)

    Rongfang Yan

    2016-07-01

    Full Text Available Based on two substitute products, we study the inventory and contract coordination strategy of a three-echelon supply chain, which consists of two suppliers, a manufacturer and a retailer, under supply disruption and stochastic demand. We investigate the channel gross profit model of the centralized supply chain and obtain a unique optimal order quantity. Under a decentralized decision, we find that the commonly-used wholesale price contracts cannot coordinate the system. Then, we propose a buy-back contract and prove that this contract can more efficiently coordinate the system than the former. At last, we show that the integrated performance of the decentralized system can be maximized through choosing the buy-back parameter by the manufacturer and reveal that the effects of supply uncertainty and the substitution behavior of customers on the optimal decision by numerical examples.

  11. Supply and demand for telecommunication infrastructure

    OpenAIRE

    Veith, Tobias

    2010-01-01

    The interplay of infrastructure supply and demand is of central interest in line with Web 2.0. As the role of customers turns from a service users’ role to an information providers’ role, the traffic on existing lines increases and, simultaneously, customers’ demand for high-quality infrastructure. On the other hand, infrastructure providers carry investment risks but can hardly internalize the value provided for service providers. In consequence, politicians have to think about how to initia...

  12. 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.

  13. 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.

  14. Preventing catheter-associated infections in the Pediatric Intensive Care Unit: impact of an educational program surveying policies for insertion and care of central venous catheters in a Brazilian teaching hospital

    Directory of Open Access Journals (Sweden)

    Marcelo Luiz Abramczyk

    2011-12-01

    Full Text Available Objectives: To determine the impact of an educational program on the prevention of central venous catheter-related infections in a Brazilian Pediatric Intensive Care Unit. Patients and Methods: All patients admitted to the unit between February 2004 and May 2005 were included in the cohort study in a longitudinal assessment. An educational program was developed based on the Centers for Disease Control and Prevention recommendations for prevention of catheter-associated infections and was adapted to local conditions and resources after an initial observational phase. Incidence of catheter-associated infections was measured by means of on-site surveillance. Results: One hundred eighteen nosocomial infections occurred in 253 patients (46.6 infections per 100 admissions and in 2,954 patient-days (39.9 infections per 1,000 patient-days. The incidence-density of catheter infections was 31.1 episodes per 1.000 venous central catheter-days before interventions, and 16.5 episodes per 1,000 venous central catheter-days afterwards (relative risk 0.53 [95% CI 0.28-1.01]. Corresponding rates for exit-site catheter infections were 8.0 and 2.5 episodes per 1,000 venous central catheter-days [0.32 (0.07-1.49], and the rates for bloodstream infections were 23.1 and 13.9 episodes per 1,000 venous central catheter-days, before and after interventions [0.61 (0.32-1.14]. Conclusion: A prevention strategy targeted at the insertion and maintenance of vascular access can decrease rates of vascular-access infections in pediatric intensive care unit.

  15. Petroleum supply annual 1992

    International Nuclear Information System (INIS)

    The Petroleum Supply Annual (PSA) contains information on the supply and disposition of crude oil and petroleum products. The publication reflects data that were collected from the petroleum industry during 1992 through annual and monthly surveys. The PSA is divided into two volumes. The first volume contains four sections: Summary Statistics, Detailed Statistics, Refinery Capacity, and Oxygenate Capacity each with final annual data. This second volume contains final statistics for each month of 1992, and replaces data previously published in the Petroleum Supply Monthly (PSM). The tables in Volumes 1 and 2 are similarly numbered to facilitate comparison between them. Explanatory Notes, located at the end of this publication, present information describing data collection, sources, estimation methodology, data quality control procedures, modifications to reporting requirements and interpretation of tables. Industry terminology and product definitions are listed alphabetically in the Glossary

  16. Supply chain quality management

    Directory of Open Access Journals (Sweden)

    Hannan Amoozad Mahdiraji

    2012-10-01

    Full Text Available 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 competitiveness power. Moreover, they have only one purpose that is customer satisfaction, and they are different only on their approaches to reach their objectives. In this research, we aim to study both approaches of quality management and supply chain, their positive increasing effects that may be generated after their integration. For this purpose, the concept and definitions of each approach is studied, independently, their similarities and differences are recognized, and finally, the advantages of their integration are introduced.

  17. Sediment supply to beaches

    DEFF Research Database (Denmark)

    Aagaard, Troels

    2014-01-01

    Many beaches have been built by an onshore supply of sand from the shoreface, and future long-term coastal evolution critically depends on cross-shore sediment exchange between the upper and the lower shorefaces. Even so, cross-shore sediment supply remains poorly known in quantitative terms 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 collection took place at five different field sites that exhibit a wide range of wave conditions and sediment characteristics. Data analysis shows that both suspended sediment load and cross-shore sediment transport scale with the grain-related mobility number which ranged up to ψ ≈ 1000 in the...

  18. Offshore Supply Industry Dynamics

    DEFF Research Database (Denmark)

    Roslyng Olesen, Thomas

    challenges 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...... 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 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...

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

    OpenAIRE

    Patalinghug, Epictetus E.

    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.

  20. 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....

  1. GP supply and obesity

    OpenAIRE

    Stephen Morris; Hugh Gravelle

    2006-01-01

    We investigate the relationship between GP supply and body mass index (BMI) in England. Individual level BMI is regressed against area whole time equivalent GPs per 1,000 population plus individual and area level covariates. Using IV models we find that a 10% increase in GP supply is associated with a mean reduction in BMI of around 1 kg/m2 (around 4% of mean BMI). Our study suggests that better primary care in the form of reduced list sizes per GP can improve the management of obesity.

  2. Switch mode power supply

    International Nuclear Information System (INIS)

    This book concentrates on switch mode power supply. It has four parts, which are introduction of switch mode power supply with DC-DC converter such as Buck converter boost converter, Buck-boost converter and PWM control circuit, explanation for SMPS with DC-DC converter modeling and power mode control, resonance converter like resonance switch, converter, multi resonance converter and series resonance and parallel resonance converters, basic test of SMPS with PWM control circuit, Buck converter, Boost converter, flyback converter, forward converter and IC for control circuit.

  3. Laboratory Switching Power Supply

    OpenAIRE

    Slezák, Jakub

    2009-01-01

    This bachelor’s thesis is concerned with design switching power supply based on forward converter with output voltage regulated in the range of 3 to 30V and load current to 1 A. First of all, it discusses the theoretical solution of basic types of converters and switching power supply problems. Followed by a proposal of various parts source, which was first established in the test version on the test board. Then was proposed printed circuit board and complete mechanical solutions. Source is a...

  4. Study on Supply Chain Disruption Management under Service Level Dependent Demand

    Directory of Open Access Journals (Sweden)

    Boqi Li

    2014-06-01

    Full Text Available This paper studied pricing, service level, and production quantity decision problems in a supply chain with one manufacturer and one retailer under demand and production cost disruptions. The joint impact of demand and production cost disruptions on optimal pricing, service level, and production decisions in centralized and decentralized supply chain was analyzed, respectively. By solving the optimization problem, the optimal decisions of the supply chain were obtained under different demand and production cost disruptions scenarios. It is found that the original production quantity and demand-stimulating service level exhibit some robustness under disruptions in both centralized and decentralized supply chains, while the original optimal pricing does not. In centralized supply chains, it is always beneficial for the central decision-maker to knowing of the accurate information of disruptions. However, sharing disruption information is not always beneficial for both the manufacturer and retailer in decentralized supply chain.

  5. 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. PMID:10283019

  6. 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.

  7. Building the resilient supply chain.

    OpenAIRE

    Christopher, Martin; Peck, Helen

    2004-01-01

    In today’s uncertain and turbulent markets, supply chain vulnerability has become an issue of significance for many companies. As supply chains become more complex as a result of global sourcing and the continued trend to ‘leaning-down’, supply chain risk increases. The challenge to business today is to manage and mitigate that risk through creating more resilient supply chains.

  8. Barriers To Supply Network Strategy

    OpenAIRE

    Harland, C; Knight, L.A.

    1998-01-01

    This paper reports on an on-going action research project on supply network strategy. Supply network strategy is a concept integrating operations management, purchasing and supply management, logistics, service management and value chain management (Harland, 1996a). Findings of an interim review of efforts to promote change in the English National Health Service's inter-organizational supply networks are presented.

  9. 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.

  10. 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

  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. Sustainable Supply Chain Design

    DEFF Research Database (Denmark)

    Bals, Lydia; Tate, Wendy

    design for TBL sustainability. These are located in catastrophe-ridden Haiti and supported by the Germany-based investor company Yunus Social Business. Three supply chain archetypes combining physical and support chains are presented that focus on TBL sustainable outputs and outcomes. For SSCM research...

  13. Ethics of Information Supply.

    Science.gov (United States)

    Oppenheim, Charles

    This discussion of the ethics of the information process provides a brief review of the process of information supply and flow, primarily in science and technology; looks at various points in the flow of information; and highlights particular ethical concerns. Facets of the process discussed in more detail include ways in which some scientists…

  14. 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

  15. Oil sands supply outlook

    International Nuclear Information System (INIS)

    In March 2004, The Canadian Energy Research Institute released a report on the expected future supply from Alberta's oil sands. The report indicates that the future for the already well-established oil sands industry is promising, particularly given the outlook for oil prices. The challenges facing the industry include higher industry supply costs and the need for innovative commercial and technological solutions to address the risks of irregularities and changes in crude oil prices. In 2003, the industry produced 874 thousand barrels per day of synthetic crude oil and unprocessed crude bitumen. This represents 35 per cent of Canada's total oil production. Current production capacity has increased to 1.0 million barrels per day (mbpd) due to new projects. This number may increase to 3.5 mbpd by 2017. Some new projects may be deferred due to the higher raw bitumen and synthetic crude oil supply costs. This presentation provided supply costs for a range of oil sands recovery technologies and production projections under various business scenarios. tabs., figs

  16. 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.

  17. Medical Supplies Shortages and Burnout among Greek Health Care Workers during Economic Crisis: a Pilot Study

    OpenAIRE

    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...

  18. 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.

  19. Development of centralized radiopharmacies in Spain: A successful experience in Europe

    International Nuclear Information System (INIS)

    Full text: In Spain, 650.000 nuclear medicine procedures are perfomed every year in more than 120 nuclear medicine departments in public and private hospitals. Traditionally the doses to be administered to patients were prepared by hospital personnel in small hot labs in the departments. However, during the 90's new legislation was developed that triggered the need for a change in the model. The concept of radiopharmaceuticals brought pharmaceutical requirements to the development, fabrication, commercialization, preparation and administration of radiactive compounds to patients. Additionally, Regulatory Authorities imposed quality assurance rules in nuclear medicine practices. In what concerns the preparation and administration of doses, those legal requirements established new specific criteria derived from compliance with Good Manufacturing Practices, in several areas like the following: Premises and equipment; Qualification of personnel; Quality systemes with procedures, records and documentation control; Traceability. The implementation of all these changes meant not only significative investments and time but also important modifications in habits and practices developped during many years. Several initiatives were launched to cope with the need of change and the concept of centralized radiopharmacies was among them, particularly in regions with a high density of nuclear medicine departments, were economies of scale bring efficiencies to these pharmacies. Today a completely new system governs the preparation of unit doses of radiopharmaceuticals in the country. 45% of the units doses are prepared and supplied from 6 centralized radiopharmacies. 20% of the doses are prepared in hospital radiopharmacies but managed and operated by a external contractor. 35% of the doses are prepared in hospital radiopharmacies managed by hospital personnel. It should be outlined the significative penetration of centralized radiopharmacies what makes Spain the european country

  20. Hypoglycemia in the hospital

    OpenAIRE

    Shomali, Mansur

    2011-01-01

    Hypoglycemia is a common adverse event affecting hospitalized patients with diabetes. This paper reviews the data regarding optimization of glucose in hospitalized patients, discusses the scope and significance of hypoglycemia in the hospital, and makes recommendations on how to reduce the risk of this serious adverse event. Keywords: hypoglycemia; hospital; diabetes; insulin(Published: 18 July 2011)Citation: Journal of Community Hospital Internal Medicine Perspectives 2011, 1: 7217 - DOI: 10...

  1. 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...... charging, rated at 50 kW, fast charging would be easier in both Denmark and Bornholm scenarios. For each scenario and charging power level, the possible number of EVs is estimated and finally architectural design options are proposed. Technical assessment is performed for evaluating the benefits.......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...

  2. Supply Theory sans Profit Maximization

    OpenAIRE

    Dasgupta, Indraneel

    2009-01-01

    We utilize the analytical construct of a stochastic supply function to provide an aggregate representation of a finite collection of standard deterministic supply functions. We introduce a consistency postulate for a stochastic supply function that may be satisfied even if no underlying deterministic supply function is rationalizable in terms of profit maximization. Our consistency postulate is nonetheless equivalent to a stochastic expansion of supply inequality, which summarizes the predict...

  3. 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...

  4. 加弹机上油系统“集中供油和单台面控油”的重点改造%Transformatin on Oiling System of Textring Machine with “Central Oil Supply and Each Side Control”

    Institute of Scientific and Technical Information of China (English)

    李淑芳

    2011-01-01

    In order to meet the quality requirements of draw-textured yarn (DTY), the principle of oiling system and operation conditions of different DTY machines in China are analyzed. According to the design conception of "central oil supply, each side oil level control, easy operation, convenience of maintenance ", the oiling system of DTY machine is modified. After the modification, the oiling rate is stable, labor intensity is reduced, product quality is improved, production efficiency is elevated and production capacity can be expanded for further demand.%为满足提高拉伸变形丝(DTY)品质的要求,通过分析国内加弹机主要机型上油系统的工作原理及运行状况,根据“集中供油、单机台面控制油位、操作简单、维护方便”的设计原则,时加弹机原上油系统进行改造.上油系统改造后上油率稳定,产品质量提高,工人劳动强度降低,生产效益增加,而且能够满足生产规模进一步扩大的要求.

  5. Japanese hospitals--culture and competition: a study of ten hospitals.

    Science.gov (United States)

    Anbäcken, O

    1994-01-01

    Japanese health care is characterized by a pluralistic system with a high degree of private producers. Central government regulates the prices and the financing system. All citizens are covered by a mandatory employment-based health insurance operating on a non-profit basis. The consumer has a free choice of physician and hospital. A comparison between Japan, Sweden and some other countries shows significant dissimilarities in the length of stay, number of treatments per hospital bed and year and the staffing of hospitals. About 80 per cent of the hospitals and 94 per cent of the clinics are privately owned. The typical private hospital owned by a physician has less than 100 beds. In this paper, data collected (1992/93) in an empirical study of Japanese hospitals and their leadership is presented. Also discussed are the hospitals' style of management, tools and strategies for competition and competences--personal and formal skills required of the leadership in the hospital. There follows a study of ten hospitals, among which hospital directors and chief physicians were interviewed. Interviews are also made with key persons in the Ministry of Health and Welfare and other organizations in the health care field. The result is also analysed from a cultural perspective--'what kind of impact does the Japanese culture have on the health care organization?' and/or 'what kind of sub-culture is developed in the Japanese hospitals'. Some comparisons are made with Sweden, USA, Canada and Germany. The different roles of the professions in the hospital are included in the study as well as the incentives for different kinds of strategies--specialization, growing in size, investments in new equipment, different kind of ownership and hospitals. Another issue discussed is the attempt to uncover whether there is an implicit distribution of specialties--silent agreements between hospitals, etc. PMID:10137135

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

    DEFF Research Database (Denmark)

    Turkensteen, Marcel; Klose, Andreas

    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...

  7. 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. PMID:25570742

  8. 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.

  9. 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.

  10. Radio frequency identification applications in hospital environments.

    Science.gov (United States)

    Wicks, Angela M; Visich, John K; Li, Suhong

    2006-01-01

    Radio frequency identification (RFID) technology has recently begun to receive increased interest from practitioners and academicians. This interest is driven by mandates from major retailers such as Wal-Mart, Target and Metro Group, and the United States Department of Defense, in order to increase the efficiency and visibility of material and information flows in the supply chain. However, supply chain managers do not have a monopoly on the deployment of RFID. In this article, the authors discuss the potential benefits, the areas of applications, the implementation challenges, and the corresponding strategies of RFID in hospital environments. PMID:16913301

  11. 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.

  12. 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....

  13. Electricity supply in Denmark

    International Nuclear Information System (INIS)

    Electric power was introduced in Denmark in 1891. Recently, the development of the Danish electricity supply industry has been influenced by a number of political measures aiming at a cleaner environment. The booklet gives a general introduction to the industry in Denmark. It reflects the actual supply situation and looks at the future as well as giving a survey of the historical and political background. In addition to relevant statistics, brief information is given on national energy balance, consumption, costs and pricing, distribution and transmission, end-use efficiency, electric power generation, imports and exports, wind power, cogeneration and district heating, pollutive emission, planning and Danish energy policy. There is also a list of useful addresses. (AB)

  14. 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. PMID:15087154

  15. Supply Chain Initiatives Database

    Energy Technology Data Exchange (ETDEWEB)

    None

    2012-11-01

    The Supply Chain Initiatives Database (SCID) presents innovative approaches to engaging industrial suppliers in efforts to save energy, increase productivity and improve environmental performance. This comprehensive and freely-accessible database was developed by the Institute for Industrial Productivity (IIP). IIP acknowledges Ecofys for their valuable contributions. The database contains case studies searchable according to the types of activities buyers are undertaking to motivate suppliers, target sector, organization leading the initiative, and program or partnership linkages.

  16. Tax efficient supply chain

    OpenAIRE

    Borralho, Joana Patrícia Costeira

    2014-01-01

    Master of Science in Business Administration. This case started with the following question: How supply chains and tax policy interact? This question was the starting point for this study and was developed under the areas of Logistics and International Tax Policy. In order to support this study, the adopted methodology was the selection of a Multinational company – LPR Portugal – which has the transportation and distribution in the European Union as a scope of service and...

  17. Uninterruptible power supplies management

    OpenAIRE

    Pojbič, Dejan

    2011-01-01

    The thesis focuses on the equipment for uninterruptible power supply (hereinafter referred to as UPS) and defines their security component. It carefully describes the three most widely used UPS units: waiting, corrective and linear. The device equipped with a waiting UPS unit filters power and loads it, thus charging batteries. Very similar to a waiting UPS is the corrective UPS, except that the latter regulates voltage fluctuations to the required value in the range of – 15 % + 20 % and ther...

  18. The Money Supply Process in India: Identification, Analysis and Estimation

    OpenAIRE

    Goyal, Ashima; Dash, Shridhar

    2000-01-01

    A new specification is employed to test for the degree of endogeneity of commercial bank credit, and its response to structural variables relevant to the Indian context. Our specification allows us to both identify money supply in a single equation, and disentangle the contribution of the Central and the Commercial Banks to the money supply process. Bank credit reacted more to financial variables and had dissimilar responses to food and manufacturing prices and output. Instead of interest rat...

  19. Hospital demand for physicians.

    Science.gov (United States)

    Morrisey, M A; Jensen, G A

    1990-01-01

    This article develops a derived demand for physicians that is general enough to encompass physician control, simple profit maximization and hospital utility maximization models of the hospital. The analysis focuses on three special aspects of physician affiliations: the price of adding a physician to the staff is unobserved; the physician holds appointments at multiple hospitals, and physicians are not homogeneous. Using 1983 American Hospital Association data, a system of specialty-specific demand equations is estimated. The results are consistent with the model and suggest that physicians should be concerned about reduced access to hospitals, particularly as the stock of hospitals declines. PMID:10104050

  20. Hospitable Classrooms: Biblical Hospitality and Inclusive Education

    Science.gov (United States)

    Anderson, David W.

    2011-01-01

    This paper contributes to a Christian hermeneutic of special education by suggesting the biblical concept of hospitality as a necessary characteristic of classroom and school environments in which students with disabilities and other marginalized students can be effectively incorporated into the body of the classroom. Christian hospitality, seen…

  1. 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 ...

  2. 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 such as collabora...... collaborations with customers and suppliers to create new product and process innovations, open innovation, and globally distributed innovation. We conclude with potential areas for future research.......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 such as...

  3. 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)

  4. Skill training for staff working in washing rooms of sterilization and supply center after application of centralized management model%消毒供应中心实行集中管理模式后洗涤区人员岗位技能培训效果评价

    Institute of Scientific and Technical Information of China (English)

    周颂华; 冯瑞萍; 严金霞; 许铁霜

    2008-01-01

    Objective To discuss the effect of skill training for staff working in washing rooms of sterilization and supply center after application of centralized management model.Methods The training objects included all the working staff in the washing rooms and the training procedure covered four steps:preparation,discussion,implementation and evaluation.The evaluation indices involved level of post skill,cleaning and sterilization effect of instruments and satisfaction degree of staff.Results After training the level of post skills were increased dramatically(P<0.01).The cleaning and sterilization effect of instruments was also improved(P<0.01).96% of staff considered their post ability elevated after training.Conclusion After skill training for staff working in washing rooms,the post skill and cleaning and sterilization quality of instruments were both enhanced.It proved valuable for guarantee of cleaning and sterilization quality of medical instruments and improvement of professional skills for staff working in washing rooms of sterilization and supply center.%目的 探讨实行集中管理模式后消毒供应中心洗涤区人员岗位技能的培训方法.方法 选择洗涤区人员作为培训对象,根据制订、讨论、实施、评价4个阶段的培训流程,以洗涤区人员岗位技能、器械清洗消毒效果、人员满意度为评价指标,对洗涤区人员进行岗位技能的培训,并对结果进行评价.结果 培养后洗涤区人员岗位技能有所提高(P<0.01);器械清洗消毒效果较培训前显著提高(P<0.01);96%的人员认为培训后提高了自身在洗涤区的岗位能力.结论 通过对洗涤区人员进行岗位能力的培训,达到了提高洗涤区人员岗位技能和器械清洗消毒质量的目的,对保证医疗器械物品清洗消毒质量,提高洗涤区人员的专业技能具有一定的价值.

  5. Facilitators and Inhibitors of Supply Chain Innovation-prospects for Supply Chain Managment in the Irish Grocery Sector

    OpenAIRE

    Keegan, Joan; O'Callaghan, Edmund; Wilcox, Mary

    2001-01-01

    Supply chain management is one of the most significant strategic challenges currently facing the Irish grocery sector. The UK grocery market with its emphasis on composite deliveries via regional distribution centres is extremely sophisticated; the Irish grocery sector, however, is in the embryonic stage of implementing central distribution. The potential to develop innovative supply chain systems is mediated by both national logistic-related variables and company characteristics. In additio...

  6. The medical record system in acute situations at Okhaldhunga Community Hospital

    OpenAIRE

    Thaulow, Eli Øyen

    2014-01-01

    Background: Okhaldhunga community hospital lies in rural Nepal, and is a hospital with simple equipment and facilities. The supply of power is little, therefore it does not excist any electronical medical record system. Each patient has its own notebook, which serves as their medical record, and each patient is responsible for this medical record. That means that they bring their medical record back home when they are discharged from the hospital, and the hospital has no archive. Two other no...

  7. 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.

  8. Hospital-acquired pneumonia

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/000146.htm Hospital-acquired pneumonia To use the sharing features on this page, please enable JavaScript. Hospital-acquired pneumonia is an infection of the lungs ...

  9. Staph infections - hospital

    Science.gov (United States)

    ... or skin cysts. Anyone can get a staph infection. Hospital patients can get staph infections of the skin: ... for and promptly reporting any sign of wound infections Many hospitals encourage patients to ask their providers if they ...

  10. 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...

  11. 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...

  12. 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.

  13. Interruptions: Derrida and Hospitality

    OpenAIRE

    Mark W. Westmoreland

    2008-01-01

    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...

  14. The activities of hospital nursing unit managers and quality of patient care in South African hospitals: a paradox?

    OpenAIRE

    Armstrong, Susan J; Laetitia C. Rispel; Loveday Penn-Kekana

    2015-01-01

    Background: Improving the quality of health care is central to the proposed health care reforms in South Africa. Nursing unit managers play a key role in coordinating patient care activities and in ensuring quality care in hospitals. Objective: This paper examines whether the activities of nursing unit managers facilitate the provision of quality patient care in South African hospitals. Methods: During 2011, a cross-sectional, descriptive study was conducted in nine randomly selected hospital...

  15. The activities of hospital nursing unit managers and quality of patient care in South African hospitals: a paradox?

    OpenAIRE

    Armstrong, Susan J; Laetitia C. Rispel; Penn-Kekana, Loveday

    2015-01-01

    Background: Improving the quality of health care is central to the proposed health care reforms in South Africa. Nursing unit managers play a key role in coordinating patient care activities and in ensuring quality care in hospitals.Objective: This paper examines whether the activities of nursing unit managers facilitate the provision of quality patient care in South African hospitals.Methods: During 2011, a cross-sectional, descriptive study was conducted in nine randomly selected hospitals ...

  16. 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...

  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. RHIC Power Supply Ramp Diagnostics*

    OpenAIRE

    Morris, J. T.; Clifford, T. S.; Frak, B.; Laster, J.; Marusic, A; van Zeijts, J.

    2001-01-01

    Reliable and reproducible performance of the more than 800 Relativistic Heavy Ion Collider (RHIC) magnet power supplies is essential to successful RHIC operation. In order to support power supply commissioning, a system was developed to capture detailed power supply measurements from all the RHIC ring power supplies during acceleration ramps. Diagnostic tools were developed to allow experts to assess ramp reproducibility and rapidly identify problems. The system has now become a routine part ...

  19. Sustainability clauses in international supply chain contracts

    DEFF Research Database (Denmark)

    Peterkova, Katerina

    2014-01-01

    also to do business exclusively with socially responsible partners. Unawareness, either intentional or negligent, of unethical behaviour within a company’s supply chain may lead to an assumption that the company is complicit in such a conduct. The paper discusses a hypothesis that sustainability...... contractual clauses (SCCs) in international supply chain agreements may help to overcome the regulatory gap in relation to global sustainability while concurrently protect companies against potential social, economic and legal risks threatening in connection to unethical behaviour of their suppliers. As parts...... another corporate social responsibility tool ‘without teeth’. The central questions are: why SCCs are presumed to be effective regulatory means for global sustainability, how these clauses are seen through the lenses of international contract law and whether they can actually contribute to a positive...

  20. India China Supply Chain

    OpenAIRE

    Danendran, Rahul

    2014-01-01

    This research report addresses the topic of India China supply chain. This study would be looking at the existing policies among the China India trade and a real life scenario of this trade will be analysed. By conducting this study, the current situation of trades can be put forward and it will give an idea to what extent trade policies are useful when it comes to trading and to what extent the policies aid the bottlenecks faced by a trader. The objectives of the research are to understa...

  1. Aggregate Demand and Supply

    OpenAIRE

    Farmer, Roger E.A.

    2007-01-01

    This paper is part of a broader project that provides a microfoundation to the General Theory of J.M. Keynes. I call this project 'old Keynesian economics' to distinguish it from new-Keynesian economics, a theory that is based on the idea that to make sense of Keynes we must assume that prices are sticky. I describe a multi-good model in which I interpret the definitions of aggregate demand and supply found in the General Theory through the lens of a search theory of the labor market. I argue...

  2. 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.

  3. The Oil Supply and Demand Context for Security of Oil Supply to the EU from the GCC Countries

    OpenAIRE

    Robert Skinner; Robert Arnott

    2005-01-01

    In examining the prospects for oil and gas supply from the GCC countries, we draw on the evidence that the supply of oil and gas from the region has been relatively reliable, notwithstanding the region’s perceived political instability. The approach taken here starts from this empirical observation; namely, that supply from the region will be available when called upon, as it has in the past. Oil and gas are of central importance to the economies of most GCC countries. Hydrocarbons provide th...

  4. 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

  5. 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

  6. Concurrent Product & Supply Chain Creation

    DEFF Research Database (Denmark)

    Gubi, Ebbe

    that product and supply chains should be created concurrently and integrated. The concept of Concurrent Product & Supply Chain Creation is introduced, and the two main components Focused Supply Chains and Design For Logistics are explained and exemplified by use of Bang & Olufsen....

  7. Supply and demand perspectives

    International Nuclear Information System (INIS)

    The outlook for the European gas market is one of steady growth. This growth will manifest itself in all regions and in all sectors of the market, but most strongly in the power generating sector. To meet future demand, it is necessary to bring gas to Western Europe from remote sources in Russia, North Africa and Norway. These new gas supplies require heavy investments in production and transportation, which can only be undertaken on the basis of long-term take-or-pay contracts. Famous examples of such contracts are the development of the Troll field, the Yamal-Europe pipeline connection, and the bringing on stream of Nigerian LNG for Europe. Tensions are likely to arise between the nature of these long-term gas contracts and the dynamic nature of demand in the gas market, and more specifically in the main growth market, the power sector. The presentation further elaborates on the tensions underlying supply and demand in the years to come

  8. 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.

  9. 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...

  10. 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....

  11. 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

  12. Offshore Supply Industry Dynamics

    DEFF Research Database (Denmark)

    Roslyng Olesen, Thomas

    of services including includes legal advice, financing, insurance etc. The two value chains have a number of activities in common. Both include (1) a tender and concession phase where the energy company obtains the right to explore and produce energy from the authorities. (2) An exploration phase...... at the same level) and vertical cooperation (between suppliers in different layers). Finally the suppliers and the energy companies are supported by a number of companies which are usually not considered as part of the offshore sector but are important none the less. These companies provide a number...... 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...

  13. Supply chain reaction

    International Nuclear Information System (INIS)

    'Logic' (Leading Oil and Gas Industry Competitiveness) is a government-industry supply chain management initiative which aims to improve the competitiveness of the UK's North Sea business by 1 billion UK pounds by 2002 and its export performance by 50% inside 5 years. Much of the article is devoted to the background and views of Logic's chief executive Chris. Freeman. Freeman makes clear that 'unlike Crine, we are not a cost-reduction initiative: that may be one of the outcomes, but we are really focusing on the co-operation side of things'. Logic aims to change the culture of the UK offshore industry through example. Freeman believes that the creation of collaborative success will flag up industry and give credence to Logics objectives

  14. Central serous chorioretinopathy: a pathogenetic model

    OpenAIRE

    et al; Manuela Imparato; Filippo Romanazzi; Antonio Caccavale

    2011-01-01

    Antonio Caccavale1, Filippo Romanazzi1, Manuela Imparato1, Angelo Negri2, Anna Morano3, Fabio Ferentini21Department of Ophthalmology, Neuropthalmology and Ocular Immunology Service, 2Department of Ophthalmology, Hospital “C. Cantù”, Abbiategrasso, Milan, Italy; 3University Eye Clinic, Foundation IRCCS San Matteo Hospital, Pavia, ItalyAbstract: Despite numerous studies describing predominantly its demography and clinical course, many aspects of central serous cho...

  15. [Evaluation of the efficiency and quality of hospitals publicly owned with private management and hospitals of the public sector].

    Science.gov (United States)

    Giraldes, Maria Do Rosário

    2007-01-01

    , and by the Garcia de Orta Hospital, which are the less efficient hospitals. In Group V, with central hospitals and hospitals with functions of central hospital, it is the Hospital of Vila Real/Régua, EPE, to present the best situation of the Composite Efficiency Indicator, followed by the Santo António Hospital, EPE, the Santa Maria Hospital, EPE, and the HUC, while the hospitals with a worst situation of the Composite Efficiency Indicator are the Hospitals of Faro, Evora and S. José. In Group VI hospitals with a better Composite Efficiency Indicator are the hospitals of Santa Marta, Gama Pinto Institute and Orthopedic Hospital of Outão, while the Estefânia Hospital is the most inefficient. Tondela, Valongo and Peniche Hospitals (Group I), have a good value of the Composite Efficiency and Quality Indicator, while Barcelos, Oliveira de Azeméis and Póvoa de Varzim/Vila do Conde Hospitals (Group II) present also good values of this indicator. The Hospitals of Vila Franca de Xira, Bragança and Setúbal (Group III), the Hospitals of Santarém, Garcia de Orta, and Curry Cabral (Group IV), the Hospital of Vila Real/Régua, the Egas Moniz Hospital and the Santa Maria Hospital (Group V), and the Gama Pinto Institute, the Orthopedic Hospital of Outão, and the Santa Cruz Hospital (Group VI) are the best classified in their groups. EPE Hospitals (Hospitals publicly owned with private management) are the best classified in their groups in what efficiency is concerned, what is a better result tan the one shown in 2003. The lower inequality in relation to management indicators, in all hospital groups, exists in the areas of expenditure with inpatient care by user, what shows the existence of a norm of proceeding, in this traditional hospital area. The higher inequalities are those of day hospital, drugs in day hospital, drugs in outpatient care and rehabilitation by user. In what management indicators are concerned incentives must be created. The most efficient hospitals

  16. Hospital diversification strategy.

    Science.gov (United States)

    Eastaugh, Steven R

    2014-01-01

    To determine the impact of health system restructuring on the levels of hospital diversification and operating ratio this article analyzed 94 teaching hospitals and 94 community hospitals during the period 2008-2013. The 47 teaching hospitals are matched with 47 other teaching hospitals experiencing the same financial market position in 2008, but with different levels of preference for risk and diversification in their strategic plan. Covariates in the analysis included levels of hospital competition and the degree of local government planning (for example, highly regulated in New York, in contrast to Texas). Moreover, 47 nonteaching community hospitals are matched with 47 other community hospitals in 2008, having varying manager preferences for service-line diversification and risk. Diversification and operating ratio are modeled in a two-stage least squares (TSLS) framework as jointly dependent. Institutional diversification is found to yield better financial position, and the better operating profits provide the firm the wherewithal to diversify. Some services are in a growth phase, like bariatric weight-loss surgery and sleep disorder clinics. Hospital managers' preferences for risk/return potential were considered. An institution life cycle hypothesis is advanced to explain hospital behavior: boom and bust, diversification, and divestiture, occasionally leading to closure or merger. PMID:25223156

  17. 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.

  18. 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!.

  19. Modern Solutions for Automation of Electrical Traction Power Supply Systems

    OpenAIRE

    Ana Mihaela Andreica

    2011-01-01

    This paper presents modern solutions for the automation of the electrical traction power supply system used in urban public transport (trams, trolleybuses and subway trains). The monitoring and control of this process uses SCADA distributed architectures, grouped around a central point (dispatcher) who controls all field sensors, transmitters and actuators using programmable logical controllers. The presented applications refer to the Bucharest electrical transport infrastru...

  20. Strategy for securing the national supply of radioisotopes

    International Nuclear Information System (INIS)

    Background: The global supply shortage of medical radioisotopes caused by the unscheduled shutdown of the aged reactors which supply over 90% of radioisotopes overall the world, has severely affected the normal healthcare system which depend on the technology of molecular imaging for diagnoses and therapy as well as the development of nuclear molecular imaging technology. Purpose: It is urgently needed to develop new alternative technologies to solve the problem of global radioisotope supply shortage. Methods: The proton cyclotron is a potential alternative technology to produce the 99mTc and the most of medical radioisotopes of clinical importance. Results: The quality of 99mTc produced by cyclotron, such as nuclide purity, specific activity and nonradioisotope impurities, has reached and/or exceeded that eluted from 99Mo/99mTc generator produced by reactor. Conclusions: It is the most operational and sustainable way to substitute the conventional global centralized supply by reactors with local centralized supply of radioisotopes by proton cyclotrons for securing the national supply of radioisotopes. (author)

  1. [ABC supplies classification: a managment tool of costs in nursing].

    Science.gov (United States)

    Lourenço, Karina Gomes; Castilho, Valéria

    2006-01-01

    The implementation of costs management systems has been extremely helpful to healthcare area owing to their efficacy in cutting expenditures as well as improving service quality. The ABC classification is an applied strategy to stocktaking and control. The research, which consists of an exploratory/descriptive quantitative analysis, has been carried out in order to identify, in a year time period, the demand for supplies at Universidade de Sao Paulo's Hospital. Of 1938 classified materials, 67 itens had been classified that they correspond to the materials with bigger costs for the hospital. 31.3% of these A-Class supplies catalogued items are the nursing materials, more used for the nursing team. PMID:16915729

  2. Towards the collaborative hospital

    DEFF Research Database (Denmark)

    Prætorius, Thim; Hasle, Peter; Edwards, Kasper;

    2015-01-01

    Hospitals are increasingly faced with conflicting demands as they have to respond to increasing patient demands as well as financial, clinical and quality challenges. To handle these demands the hospital need to reconfigure its organization, and we propose to build on a concept 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 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...

  3. Optics Supply Planning System

    International Nuclear Information System (INIS)

    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

  4. Magnet power supply for ISABELLE

    Energy Technology Data Exchange (ETDEWEB)

    Nawrocky, R.J.; Frankel, R.F.; Thomas, M.G.

    1979-01-01

    The power supply system which will energize the superconducting magnets in the ISABELLE machine consists of some 520 computer-programmable power supplies with outputs ranging from 50 A to 4500 A. Most of the power supplies will be used for the correction of field harmonics, orbit correction and adjustment of the machine working line. During acceleration, currents in various magnet correction coils will be controlled in real time to track the main field; all power supplies must be highly stable during the stacking and storage of the beam (in some cases current regulation must be in the order of 0.001%). PS reference programs will be stored in microprocessor based function generators embedded in each power supply. Due to the large amount of stored energy in the system, the magnets must be protected during quenches. Details of the power supply and of the magnet quench protection system are described.

  5. Supply Chain Management and Hypercompetition

    OpenAIRE

    Kotzab, H,; Grant, DB; Teller, C.; Halldorsson, A

    2008-01-01

    Firms nowadays face significant challenges in their operating environments, which have been characterised in two different ways. From a strategic management perspective these environments are in a state of hypercompetition while from a logistics or supply chain perspective these environments require market responsiveness predicated upon agile supply chains. However, firms must also rely on many interorganizational relationships to ensure efficient and effective movements within their supply c...

  6. Supply chain collaboration under uncertainty

    OpenAIRE

    Hasan, Saad; Eckert, Claudia; Earl, Chris

    2012-01-01

    In fluctuating economic conditions such as global recession, supply chains operate under changing conditions of uncertainty. The impact of this uncertainty and associated risk might be mitigated by collaboration. This paper proposes a model of supply chain collaboration based on information exchange and decision coordination at both the strategic and tactical levels. However, a collaborative supply chain can be exposed to associated risks such as the failure of individual actors. Governance r...

  7. Relative Pay and Labor Supply

    OpenAIRE

    Anat Bracha; Uri Gneezy; George Loewenstein

    2015-01-01

    We examine the impact of relative wages on labor supply in a laboratory experiment. We test the hypothesis that, ceteris paribus, making a given wage high (low) relative to other wage levels will lead to an increase (decrease) in labor supply. We find that labor supply does respond significantly to relative pay, and in the expected direction. However, when a strong enough reason for the relative low pay is given, this difference disappears.

  8. Participatory Demand-supply Systems

    OpenAIRE

    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 the engagement of all stakeholders plays an important role, as does distributed ICT. This approach has been applied to an industrial case to explore new opportunities enabled by distributed ICT fo...

  9. Product Classification in Supply Chain

    OpenAIRE

    Xing, Lihong; Xu, Yaoxuan

    2010-01-01

    Oriflame is a famous international direct sale cosmetics company with complicated supply chain operation but it lacks of a product classification system. It is vital to design a product classification method in order to support Oriflame global supply planning and improve the supply chain performance. This article is aim to investigate and design the multi-criteria of product classification, propose the classification model, suggest application areas of product classification results and intro...

  10. Reliability Estimates for Power Supplies

    International Nuclear Information System (INIS)

    Failure rates for large power supplies at a fusion facility are critical knowledge needed to estimate availability of the facility or to set priorities 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

  11. 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. PMID:24688306

  12. 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.

  13. Estimating Swedish biomass energy supply

    International Nuclear Information System (INIS)

    Biomass is suggested to supply an increasing amount of energy in Sweden. There have been several studies estimating the potential supply of biomass energy, including that of the Swedish Energy Commission in 1995. The Energy Commission based its estimates of biomass supply on five other analyses which presented a wide variation in estimated future supply, in large part due to differing assumptions regarding important factors. In this paper, these studies are assessed, and the estimated potential biomass energy supplies are discusses regarding prices, technical progress and energy policy. The supply of logging residues depends on the demand for wood products and is limited by ecological, technological, and economic restrictions. The supply of stemwood from early thinning for energy and of straw from cereal and oil seed production is mainly dependent upon economic considerations. One major factor for the supply of willow and reed canary grass is the size of arable land projected to be not needed for food and fodder production. Future supply of biomass energy depends on energy prices and technical progress, both of which are driven by energy policy priorities. Biomass energy has to compete with other energy sources as well as with alternative uses of biomass such as forest products and food production. Technical progress may decrease the costs of biomass energy and thus increase the competitiveness. Economic instruments, including carbon taxes and subsidies, and allocation of research and development resources, are driven by energy policy goals and can change the competitiveness of biomass energy

  14. Social Media and Supply Chain

    OpenAIRE

    Sonja Markova; Tatjana Petkovska-Mirčevska

    2013-01-01

    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 manageme...

  15. Managing your eye unit's supplies

    Directory of Open Access Journals (Sweden)

    RD Thulsiraj

    2011-12-01

    Full Text Available In order to deliver eye care, many resources have to be in place at the right time: your patients, your staff, your facilities, your equipment, and your supplies. In this article, we focus on how you can manage your supplies to ensure that your eye service runs smoothly. These supplies, or consumables, include every little thing needed in the course of your daily work: IOLs, medicines, gloves, forms used for patient care, housekeeping supplies, and equipment spares. If any of these items become unavailable, your eye centre will be unable to provide the same high quality of services, and you may even have to turn patients away.

  16. Fuel assurance and supply security

    International Nuclear Information System (INIS)

    Differences between uncertainties relating to uranium and to petroleum supplies are analyzed. Uranium is linked simultaneously to energy and to non-proliferation policies. The differences between the countries from which supplies are obtained are also discussed. Efforts of various international organizations to secure assured supplies are considered. The discussions at INFCE (International Nuclear Fuel Cycle Evaluation) are referred to. The part played by USA is outlined: U.S. fuel assurance proposals; analysis of the U.S. proposal. The relationship between petroleum and uranium supplies is examined, and new trends in the petroleum and uranium industries are discussed. (U.K.)

  17. 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.

  18. Klystron power supply for KOMAC

    International Nuclear Information System (INIS)

    A switching mode power supply (SMPS) is a hopeful candidate for the 1 MW CW klystron power supply of KOMAC (KOrea Multi-purpose Accelerator Complex). The merits of the SMPS are low stored energy, small size, high rating efficiency and possible cost saving whereas the demerits are EMI problem and system complexities. The proposed power is 2 MW and it is considered that the modules, each of which has the power of 200 kW, are connected in series to supply the total power. As a first step, a 200 kW SMPS is studied and designed. An overview of the power supply designed so far is presented. (author)

  19. The blood supply of normal and diseased navicular bones

    International Nuclear Information System (INIS)

    Contrast medium was used to fill the sesamoidian canal through the coffin joint as well as the arterial blood supply to the navicular bone in 90 navicular bone-coffin bone specimens. The radiological examinations of the arterial blood supply was done with a new technique (fine-focus) which allows enlargements of up to 200 fold. The material was divided into the following 4 groups on radiological and pathomorphological grounds: 1. normal navicular bones (46), 2. navicular bones with changed sesamoidian canals (33), 3. navicular bones with central collapse (9) and 4. navicular bones after a penetrating injury (2). The characteristic radiological picture of the arterial blood vessel distribution is described for each group. By comparing and differentiating the radiological arterial blood supply of the different groups, it can be concluded that the blood supply to the navicular bone changes with radiological and patho-morphological changes

  20. Present questions and problems in district-heating supply

    International Nuclear Information System (INIS)

    District-heating supply has now become of interest to the general public since its applications via heat-electric stations has resulted in considerable savings in energy and a power supply which protects the environment. For power and heat supply to congested areas nuclear power stations will become more important. But independent of this the construction and operation of heat-electric stations of conventional design is economic and requisite. This must not be hindered by the new immission law. The immediate aim must be to set up new connections in areas which already have district-heating supply, in particular by means of the oil central-heating installations which are available in large numbers. The District-heating Committee of the VDEW has put forward proposals for promoting district heating to the Federal Government. Finally the author reports on the studies put in hand by the Government. (orig.)

  1. Zapping the food supply

    International Nuclear Information System (INIS)

    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

  2. Supply, demand and costs

    International Nuclear Information System (INIS)

    Most of the proven reactor types envisaged for commercial operation over the next two decades require enriched uranium. Even assuming a larger share for natural uranium fueled heavy water systems and an early date of introduction for breeders on a commercial scale, enriched uranium fueled stations are likely to represent the bulk of the new nuclear capacity to be installed between now and the turn of the century. Hence the problem of ensuring an adequate supply of enrichment services at the lowest possible cost is just as important as that of securing a solid basis of uranium ore reserves. The present enrichment capacity available in the western world is likely to be exhausted in the early 1980's, the exact date depending on the rate of growth of nuclear capacity and on plausible variations in the proportions of different reactor types. Since the lead time between consideration and commissioning of an enrichment plant is of the order of 8 to 10 years, and since the issue has significant national, regional and international aspects on the commercial and political levels, it has recently been in the forefront of interest, and no review of nuclear power prospects would be complete without its consideration. The demand for separative work depends on the demand for enriched uranium, on the enrichment levels of the fuel and of the enrichment plant tails. The demand for enriched uranium is in turn determined by the nuclear power demand, the reactor strategy, reactor characteristics, capacity factor, delay times, and plutonium recycle policy

  3. Economy of wood supply

    International Nuclear Information System (INIS)

    Research and development of wood fuels production was vigorous in the beginning of the 1980's. Techniques and working methods used in combined harvesting and transportation of energy and merchantable wood were developed in addition to separate energy wood delivery. After a ten year silent period the research on this field was started again. At present the underutilization of forest supplies and the environmental effects of energy production based on fossil fuels caused the rebeginning of the research. One alternative for reduction of the price of wood fuels at the utilization site is the integration of energy and merchantable wood deliveries together. Hence the harvesting and transportation devices can be operated effectively, and the organizational costs are decreased as well. The wood delivery costs consist of the stumpage price, the harvesting and transportation costs, and of general expenses. The stumpage price form the largest cost category (over 50 %) of the industrial merchantable wood delivery, and the harvesting and transportation costs in the case of thinningwood delivery. Forest transportation is the largest part of the delivery costs of logging residues. The general expenses, consisting of the management costs and the interest costs of the capital bound to the storages, form a remarkable cost category in delivery of low-rank wood for energy or conversion purposes. The costs caused by the harvesting of thinningwood, the logging residues, chipping and crushing, the lorry transportation are reviewed in this presentation

  4. An Overview of Hybrid Water Supply Systems in the Context of Urban Water Management: Challenges and Opportunities

    OpenAIRE

    Mukta Sapkota; Meenakshi Arora; Hector Malano; Magnus Moglia; Ashok Sharma; Biju George; Francis Pamminger

    2014-01-01

    This paper presents a critical review of the physical impacts of decentralized water supply systems on existing centralized water infrastructures. This paper highlights the combination of centralized and decentralized systems, which is referred to as hybrid water supply systems. The system is hypothesized to generate more sustainable and resilient urban water systems. The basic concept is to use decentralized water supply options such as rainwater tanks, storm water harvesting and localized w...

  5. Anatomic adaptation of seedlings of woody plants to various levels of soil water supply

    OpenAIRE

    I. P. Grigoryuk; V. I. Tkachov; P. P. Yavorivskyi

    2005-01-01

    Tree seedlings anatomical parameters adaptation to different soil water supply levels were studied. Differences in stomata number and shape and fiber length for leaf-bearing species and central cylinder area for coniferous species have been determined.

  6. 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.

  7. Supply Chain Coordination with Buy-back and Wholesale-price Contracts under Random Demand

    Directory of Open Access Journals (Sweden)

    Azamat Rajapov

    2016-02-01

    Full Text Available In order to increase supply chain total profit, we design a supply chain collaboration mechanism between one supplier and one retailer. Throughout the paper we present one supplier and one retailer set up with random demand in a decentralized supply chain. An incentive function on the buy-back cost and wholesale price cost is presented and scheme through the buy-back contract and wholesale-price contract has been developed to enrich the retailer take part in the collaboration ways. Furthermore, the paper shows that, how corporation between buy-back contract and wholesale contract could coordinate the supply chain in both a decentralized and centralized supply chain. Lastly, we set up numerical analyses and the result shows the implied collaboration mechanism is not permit the decentralized system to achieve the same performance as the centralized decision however it allows both members in the supply chain gains profit sharing by setting up the contract parameters.

  8. Central diffractive resonance production at the LHC

    Science.gov (United States)

    Fiore, Roberto; Jenkovszky, Laszlo; Schicker, Rainer

    2016-07-01

    Central production of resonances resulting from the scattering of Pomerons in the central rapidity region of proton-proton scattering is studied. Estimates for relevant cross sections are presented. L.J. gratefully acknowledges an EMMI visiting Professorship at the University of Heidelberg for completion of this work. He is grateful to the organizers of this meeting for their hospitality and support. His work was supported also by DOMUS, Hungarian Academy of Sciences

  9. Thrombolysis in acute ischemic stroke: a simulation study to improve pre- and in-hospital delays in community hospitals.

    Directory of Open Access Journals (Sweden)

    Maarten M H Lahr

    Full Text Available BACKGROUND: Various studies demonstrate better patient outcome and higher thrombolysis rates achieved by centralized stroke care compared to decentralized care, i.e. community hospitals. It remains largely unclear how to improve thrombolysis rate in decentralized care. The aim of this simulation study was to assess the impact of previously identified success factors in a central model on thrombolysis rates and patient outcome when implemented for a decentral model. METHODS: Based on a prospectively collected dataset of 1084 ischemic stroke patients, simulation was used to replicate current practice and estimate the effect of re-organizing decentralized stroke care to resemble a centralized model. Factors simulated included symptom onset call to help, emergency medical services transportation, and in-hospital diagnostic workup delays. Primary outcome was proportion of patients treated with thrombolysis; secondary endpoints were good functional outcome at 90 days, Onset-Treatment-Time (OTT, and OTT intervals, respectively. RESULTS: Combining all factors might increase thrombolysis rate by 7.9%, of which 6.6% ascribed to pre-hospital and 1.3% to in-hospital factors. Good functional outcome increased by 11.4%, 8.7% ascribed to pre-hospital and 2.7% to in-hospital factors. The OTT decreased 17 minutes, 7 minutes ascribed to pre-hospital and 10 minutes to in-hospital factors. An increase was observed in the proportion thrombolyzed within 1.5 hours; increasing by 14.1%, of which 5.6% ascribed to pre-hospital and 8.5% to in-hospital factors. CONCLUSIONS: Simulation technique may target opportunities for improving thrombolysis rates in acute stroke. Pre-hospital factors proved to be the most promising for improving thrombolysis rates in an implementation study.

  10. Labour Markets and Training in Central and Eastern Europe.

    Science.gov (United States)

    Nesporova, Alena

    1997-01-01

    Economic upheaval in Central and Eastern Europe has led to excessive labor supply, increased unemployment, and enforced economic inactivity. Economic policies promoting growth, efficiency, and education and training to improve the quality and adaptability of the workforce are needed. (SK)

  11. Water demand and supply

    International Nuclear Information System (INIS)

    Major international conferences have dealt with the growing concern over the ever increasing use of limited fresh water resources on the planet, including the United Nations Water Conference held in Mar del Plata (1977), the Dublin Conference (1992) and the UN Conference on Environment and Development held in Rio de Janeiro (1992). In April 1997, the UN Commission on Sustainable Development was presented with a report on a Comprehensive Assessment of the Freshwater Resources of the World, in which all UN agencies concerned with water participated. Matching the ever growing demands with the limited supply of a finite resource has led to tremendous stress on natural fresh water. This starts with low water stress, when about 10% of the available fresh water is being used. Use of more than 40% of the available water indicates serious scarcity, and usually increasing dependence on desalination and overexploitation of aquifers. On the basis of population increase projections for the year 2025, and extrapolating current trends, as much as two-thirds of the world's population may be living in moderate or high water stress situations. With increasing water stress and scarcity, drastic changes in the way water business is being done will have to be introduced, particularly in low income countries. Agricultural practices, in particular, have to be introduced that reduce losses. Improved strategies have to make use of rigorously enforced demand management, better resource management, waste water reuse to the extent possible, and finally desalination of sea water and brackish groundwaters. Some of the current water intensive patterns of development may even have to be abandoned. (author)

  12. ROLE OF HOSPITAL ADMINISTRATION

    OpenAIRE

    UDAYSINH R. MANEPATIL

    2013-01-01

    Hospital administration is the management of the hospital as a business. The administration is made up of medical and health services managers (sometimes called health care executives and health care administrators) and assistant administrators. Administrations range in size and the duties of the administrator depends on the size of the administration.

  13. Mental hospitals in India.

    Science.gov (United States)

    Krishnamurthy, K; Venugopal, D; Alimchandani, A K

    2000-04-01

    This review traces the history of the mental hospital movement, initially on the world stage, and later in India, in relation to advances in psychiatric care. Mental hospitals have played a significant role in the evolution of psychiatry to its present statusThe earliest hospital in India were established during the British colonial rule. They served as a means to isolate mentally ill persons from the societal mainstream and provide treatments that were in vogue at the time. Following India's independence, there has been a trend towards establishing general hospital psychiatry units and deinstitutionalization, while at the same time improving conditions in the existing mental hospitals.Since 1947, a series of workshops of superintendents was conducted to review the prevailing situations in mental hospitals and to propose recommendations to improve the same. Implementation of the Mental Health Act, 1987, and grovernmental focus upon mental hospital reform have paved way for a more specific and futuristic role for mental hospitals in planning psychiatric services for the new millenium, especially for severe mental illnesses. PMID:21407925

  14. Hospitality, Tourism, and Recreation.

    Science.gov (United States)

    Novachek, James

    The Northern Arizona Hospitality Education Program is an exemplary three-year project designed to help students, mainly Indian, obtain job skills and attitudes necessary for successful employment in the hospitality industry. Nine high schools from Apache, Coconino, and Navajo Counties participated in the project. Objectives included providing an…

  15. Hospitality Services. Curriculum Guide.

    Science.gov (United States)

    Texas Tech Univ., Lubbock. Home Economics Curriculum Center.

    This guide, which was developed as part of Texas' home economics education program, is intended to assist teachers of a hospitality services course focusing on the food and lodging segments of the hospitality and tourism industry. The first 40% of the approximately 600-page guide consists of strategies for teaching each of 29 essential…

  16. Quantity Discount Supply Chain Models with Fashion Products and Uncertain Yields

    OpenAIRE

    Hongjun Peng; Meihua Zhou

    2013-01-01

    This paper explores the quantity discount coordination models in the fashion supply chain with uncertain yields and random demand. The paper proves that, under the independent and noncoordinated decision patterns, there exists a Nash equilibrium between the supplier and the manufacturer which reduces the supply chain's profit margin. In order to achieve the “optimal” centralized supply chain expected profit margin, new quantity discount models have been established. Both the supplier-oriented...

  17. Apartment individual heating unit in design of heat and water supply

    OpenAIRE

    Ivan Sergeevich Kuzmin

    2015-01-01

    The method of increasing the efficiency of heat and water supply systems by using apartment individual heating unit describes in this article Apartment individual heating unit is a prefabricated module, which could be put in or on the wall, modifying heat conductor, separate flows of heat conductor into heat system and into hotwater supply, and controls heat demands of this systems. Apartment individual heating unit makes possible not to use central hot-water supply. The article p...

  18. Implications of supply chain visibility : benefits in transaction execution and resource network management

    OpenAIRE

    Auramo, Jaana

    2006-01-01

    The research context of this thesis is supply chain integration in manufacturing industry. This thesis examines how improved visibility in supply chain management can be exploited. The central proposition is that improved visibility brings new demands in supply chain management on the one hand, and gives rise to opportunities in innovative new business processes on the other. The thesis consists of five individual studies and a summary. Three of these studies focus on the post-adoption us...

  19. 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...

  20. 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...