WorldWideScience

Sample records for central supply hospital

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

    Institute of Scientific and Technical Information of China (English)

    周彬; 王亚娟

    2015-01-01

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

  2. 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) ...

  3. 质量追溯系统对医院消毒供应中心的影响%Effect of Traceability System on Central Sterile Supply Department of Hos-pitals

    Institute of Scientific and Technical Information of China (English)

    赵海青

    2016-01-01

    Objective To analyze the effect of the application of traceability system in the central sterile supply department of hospitals. Methods The pre-implementation of traceability system from September 2013 to August 2014 were regarded as the control group, the post-implementation of traceability system from September 2014 to August 2015 were regarded as the observation group, the control group were given conventional quality control, the observation group adopted traceability sys-tem, and the central sterile supply department of hospitals were given informational management by the 2d-barcode tech-nology after the collection of data, and the quality management effects of the two groups were compared. Results The hand sanitation execution rate, standard prevention execution rate and awareness rate of hospital infectious knowledge of the staff in the central sterile supply department of hospitals after the implementation of traceability system were obviously better than those before implementation;the satisfactory degree of working quality, apparatus cleaning effect, disinfection and ster-ilization effect, inspection and packaging management and waste classification treatment score after implementation were higher than those before implementation, and the communication capability, operation capability and theory knowledge of the staff after implementation were obviously better than those before implementation. Conclusion The application of trace-ability system in the central sterile supply department of hospitals can obviously improve the working efficiency, record ac-curacy, safety of aseptic supply , which is worth wide promotion.%目的:分析医院消毒供应中心应用质量追溯系统的效果。方法将2013年9月—2014年8月质量追溯系统实施前作为对照组,2014年9月—2015年8月质量追溯系统实施后作为观察组,对照组仅给予常规质量控制,观察组利用质量追溯系统,采集数据后利用二维条形码技术,对医院

  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. Central Bank Focuses on Money Supply and Commercial Bank Reform

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

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

  6. Perforated duodenal ulcer in Asir central hospital

    Directory of Open Access Journals (Sweden)

    Jastaniah Suleiman

    1997-01-01

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

  7. PDCA 循环法对全院可复用器械集中消毒供应进行质量管理的效果%Effect of PDCA Circulation Method for Quality Management of Reusable Devices Central Sterile Supply of Hospital

    Institute of Scientific and Technical Information of China (English)

    李璟; 宋志慧; 张宁

    2016-01-01

    目的:研究 PDCA 循环法对全院可复用器械集中消毒供应进行质量管理的效果。方法比较应用 PDCA 循环法前后我院可复用器械集中消毒供应质量。结果应用 PDCA 循环法后,知识掌握、包装质量、清洗质量、设备管理、环境管理评分与应用前相比,差异存在统计学意义(P<0.05)。结论 PDCA 循环法对全院可复用器械集中消毒供应进行质量管理有利于保障患者生命健康,降低院内感染发生率,值得临床使用和全面推广。%Objective To study the PDCA circulation method of reusable instrument sterilization supply quality management for the hospital. Methods in our hospital before and after the application of PDCA circulation method can supply quality reused instruments. Results after the application of PDCA circulation method, knowledge, packaging quality, cleaning quality, equipment management, environment management and application score than before, the difference was statistically significant (P< 0.05). Conclusion the PDCA circulation method of hospital can multiplexing equipment Centralized Disinfection and supply quality management is conducive to the protection of the patient’s health and life and to reduce the nosocomial infection rate, worthy of clinical use and the comprehensive promotion.

  8. 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

  9. 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

  10. 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...

  11. Money Supply as the Target of the Central Bank

    Directory of Open Access Journals (Sweden)

    Jędruchniewicz Andrzej

    2014-06-01

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

  12. [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

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

    Science.gov (United States)

    Coustasse, Alberto; Tomblin, Shane; Slack, Chelsea

    2013-01-01

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

  14. 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)

  15. 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

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

    Institute of Scientific and Technical Information of China (English)

    孙丽萍; 杨云海; 朱孝民

    2014-01-01

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

  17. 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...

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

    OpenAIRE

    JAYASINGHE, B. T. D.

    2016-01-01

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

  19. 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

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

    OpenAIRE

    JAYASINGHE, B. T. D.

    2016-01-01

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

  1. 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.

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

    Institute of Scientific and Technical Information of China (English)

    YANG Diange; KONG Weiwei; LI Bing; LIAN Xiaomin

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-07-01

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

  4. 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. 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...

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

  7. 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…

  8. 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

  9. Cob biomass supply for bioenergy in the north central USA

    Science.gov (United States)

    Corn (Zea mays L) cobs are being evaluated as a potential bioenergy feedstock for combined heat and power generation (CHP) and conversion into a liquid biofuel. The objective of this study was to determine corn cob availability in north central U.S. (Minnesota, North Dakota, and South Dakota) using...

  10. 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

  11. 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.

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

    Science.gov (United States)

    Carden, Robert; DelliFraine, Jami L

    2005-01-01

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

  13. 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...

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

    DEFF Research Database (Denmark)

    Turkensteen, Marcel; Klose, Andreas

    consider three measures of dispersion of demand points: the average distance between demand points, the maximum distance and the surface size.In our distribution model, all demand points are restocked from a central facility. The observed logistics costs are determined using the tour length estimations......Organizations regularly face the strategic marketing decision which groups of consumers they should target. A potential problem, highlighted in Steenkamp et al. (2002), is that the target consumers may be so widely dispersed that an organization cannot serve its customers cost-effectively. We...... described in Daganzo (2004). Normal, continuous travel distance estimates require that demand locations are uniformly distributed across the plane, but we also consider scenarios with non-uniformly distributed demand locations. The resulting travel distances are highly correlated with our surface size...

  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. 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.

  17. Appraisal of Rural Water Supply: Case Study of Kwara State, North Central Nigeria

    OpenAIRE

    Peter Aderemi Adeoye; Adesiji Richard Adeolu; Hassana Mustapha Ibrahim

    2013-01-01

    Provision of clean domestic water for both rural and urban dwellers should be seen as a necessity by policy makers. However, this is not so for developing nations where rural dwellers are neglected whenever water supply schemes are been contemplated. This paper assessed rural water supply system in Kwara State, North Central Nigeria. Questionnaires were administered to respondents in the area under investigation for quantitative evaluation while samples were taken from their prevailing water...

  18. 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

  19. 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

  20. 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...

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

    Science.gov (United States)

    Kassaye, W W; Tseng, K C

    1990-01-01

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

  2. HERITAGE SECURITY APPLIED INTO STOCKS IN SUPPLY DEPARTMENT IN UNIVERSITIES HOSPITALS

    Directory of Open Access Journals (Sweden)

    DINO CÉSAR APARECIDO OIJAN

    2010-06-01

    Full Text Available The objective of this project is to suggest improvements to the security of stocks of materials supply sector of the Hospital das Clinicas, Faculty of Medicine of Botucatu. For this investigation was conducted in situ in order to collect data regarding: inflow and exit of people and material, receiving, storage and internal distribution for faults and security holes. Were used in the analysis, historical data, industry supplies, such as: items busiest and most expensive, detailed observation of the operations carried out in the stores, from arrival until the internal distribution of items by the hospital. Interviews conducted through structured questionnaires, in order to know the opinion of employees and clients of this institution, which could contribute greatly to the goals were achieved. The questionnaires were created from theoretical concepts found in books and scholarly articles. Documents and file records were collected and tabulated on a spreadsheet, with all the data at hand, it was possible to develop indicators that can guide future actions. Among the improvements that have been suggested, there is a proposal to develop a booklet with operating instructions that standardizes the procedures regarding the security of stocks, it was felt the need to create a system of indicators to facilitate the interpretation of data in the sector supplies.

  3. 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...

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

    Directory of Open Access Journals (Sweden)

    Davood Azadi

    2014-08-01

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

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

    OpenAIRE

    James Gaughan; Hugh Gravelle; Luigi Siciliani

    2014-01-01

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

  6. 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.

  7. Can inpatient hospital experiences predict central line-associated bloodstream infections?

    Directory of Open Access Journals (Sweden)

    Daniel M Saman

    Full Text Available BACKGROUND: Factors that increase the risk of central line-associated bloodstream infections (CLABSIs are not fully understood. Recently, Hospital Compare began compiling data from hospital-required reporting to the CDC's National Healthcare Safety Network on CLABSIs in intensive care units (ICUs, at over 4,000 Medicare-certified hospitals in the United States, and made this data accessible on a central website. Also available on the same website are results from the Hospital Consumer Assessment of Healthcare Providers and Systems survey of patients' hospital experiences. Utilizing both databases, our objective was to determine whether patients' hospital experiences were significantly associated with increased risk for reported ICU CLABSI. METHODS AND FINDINGS: We conducted a zero-inflated Poisson regression analysis at the hospital level on CLABSI-observed cases by ICUs in acute care hospitals (n = 1987 in the United States between January 1, 2011, and December 31, 2011. During this period there were a total of 10,866 CLABSI cases and 9,543,765 central line days. In our final model, the percent of patients who reported that they "sometimes" or "never" received help as soon as they wanted was significantly associated with an increased risk for CLABSIs. CONCLUSIONS: Using national datasets, we found that inpatients' hospital experiences were significantly associated with an increased risk of ICU reported CLABSIs. This study suggests that hospitals with lower staff responsiveness, perhaps because of an understaffing of nurse and supportive personnel, are at an increased risk for CLABSIs. This study bolsters the evidence that patient surveys may be a useful surrogate to predicting the incidence of hospital acquired conditions, including CLABSIs. Moreover, our study found that poor staff responsiveness may be indicative of greater hospital problems and generally poorly performing hospitals; and that this finding may be a symptom of hospitals

  8. Effect of residential solar and storage on centralized electricity supply systems

    Science.gov (United States)

    Agnew, Scott; Dargusch, Paul

    2015-04-01

    Residential solar photovoltaic systems combined with affordable battery storage are becoming increasingly likely to drive a consumer-led, low-emission evolution of modern electricity supply systems. In the past decade, a multi-billion-dollar boom in solar photovoltaic development across the globe has disrupted the way in which centralized electricity systems operate. At the same time, solar photovoltaic power has begun to make a material contribution to reduction targets for greenhouse gas emissions. Viable electricity storage solutions are now on the cusp of a rapidly declining price trajectory. When coupled with solar photovoltaic systems, battery storage could become one of the most disruptive influences to impact the electricity sector in decades, yet governments and the broader power sector are poorly prepared. In this Perspective, we examine emerging trends and proffer a systems framework to analyse the disruptive influence of residential solar photovoltaic and storage systems on existing centralized electricity supply systems.

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

    Directory of Open Access Journals (Sweden)

    Nima Rostampour

    2012-10-01

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

  10. 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

  11. 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...

  12. 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.

  13. 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.

  14. The study of the optimal parameter settings in a hospital supply chain system in Taiwan.

    Science.gov (United States)

    Liao, Hung-Chang; Chen, Meng-Hao; Wang, Ya-huei

    2014-01-01

    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. PMID:25250397

  15. 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

  16. 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.

  17. 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.

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

    Science.gov (United States)

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

    2015-01-01

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

  19. Two-tier charging in Maputo Central Hospital: Costs, revenues and effects on equity of access to hospital services

    Directory of Open Access Journals (Sweden)

    Russo Giuliano

    2011-06-01

    Full Text Available Abstract Background Special services within public hospitals are becoming increasingly common in low and middle income countries with the stated objective of providing higher comfort services to affluent customers and generating resources for under funded hospitals. In the present study expenditures, outputs and costs are analysed for the Maputo Central Hospital and its Special Clinic with the objective of identifying net resource flows between a system operating two-tier charging, and, ultimately, understanding whether public hospitals can somehow benefit from running Special Clinic operations. Methods A combination of step-down and bottom-up costing strategies were used to calculate recurrent as well as capital expenses, apportion them to identified cost centres and link costs to selected output measures. Results The results show that cost differences between main hospital and clinic are marked and significant, with the Special Clinic's cost per patient and cost per outpatient visit respectively over four times and over thirteen times their equivalent in the main hospital. Discussion While the main hospital cost structure appeared in line with those from similar studies, salary expenditures were found to drive costs in the Special Clinic (73% of total, where capital and drug costs were surprisingly low (2 and 4% respectively. We attributed low capital and drug costs to underestimation by our study owing to difficulties in attributing the use of shared resources and to the Special Clinic's outsourcing policy. The large staff expenditure would be explained by higher physician time commitment, economic rents and subsidies to hospital staff. On the whole it was observed that: (a the flow of capital and human resources was not fully captured by the financial systems in place and stayed largely unaccounted for; (b because of the little consideration given to capital costs, the main hospital is more likely to be subsidising its Special Clinic

  20. 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.

  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. 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.

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

    Science.gov (United States)

    Rossi, Giuseppe; Garrote, Luis; Caporali, Enrica

    2010-05-01

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

  4. 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...

  5. 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

  6. 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.

  7. 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).

  8. 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.

  9. 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.

  10. 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...

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

    Directory of Open Access Journals (Sweden)

    Vedita Bobde

    2015-02-01

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

  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. Stop the supply chain insanity. Retail as a model for hospitals.

    Science.gov (United States)

    Belkoski, David A

    2008-04-01

    The healthcare supply chain has yet to embrace any single industrywide source for synchronized product data. A synchronized product data system is a keystone in other multibillion-dollar markets. University Health Care System (UHCS), Augusta, Ga., developed a pilot program that demonstrates the benefits of data standardization and synchronization and enabled the system to recognize productivity gains in the supply chain. PMID:18441972

  14. 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

  15. Physical determinants of vesicle mobility and supply at a central synapse

    Science.gov (United States)

    Rothman, Jason Seth; Kocsis, Laszlo; Herzog, Etienne; Nusser, Zoltan; Silver, Robin Angus

    2016-01-01

    Encoding continuous sensory variables requires sustained synaptic signalling. At several sensory synapses, rapid vesicle supply is achieved via highly mobile vesicles and specialized ribbon structures, but how this is achieved at central synapses without ribbons is unclear. Here we examine vesicle mobility at excitatory cerebellar mossy fibre synapses which sustain transmission over a broad frequency bandwidth. Fluorescent recovery after photobleaching in slices from VGLUT1Venus knock-in mice reveal 75% of VGLUT1-containing vesicles have a high mobility, comparable to that at ribbon synapses. Experimentally constrained models establish hydrodynamic interactions and vesicle collisions are major determinants of vesicle mobility in crowded presynaptic terminals. Moreover, models incorporating 3D reconstructions of vesicle clouds near active zones (AZs) predict the measured releasable pool size and replenishment rate from the reserve pool. They also show that while vesicle reloading at AZs is not diffusion-limited at the onset of release, diffusion limits vesicle reloading during sustained high-frequency signalling. DOI: http://dx.doi.org/10.7554/eLife.15133.001 PMID:27542193

  16. 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)

  17. 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

  18. 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)

  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.

  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. 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...

  2. 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.

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

    OpenAIRE

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

    2013-01-01

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

  4. 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...

  5. 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.

  6. 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

  7. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

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

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Amir Ashkan Nasirpour

    2010-10-01

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

  11. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-12-15

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

  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. 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)

  15. 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)

  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 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)

  18. 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)

  19. 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)

  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 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)

  2. Hospitals

    Data.gov (United States)

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

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

    Institute of Scientific and Technical Information of China (English)

    Bruno Peixoto; Isabel Kalei

    2013-01-01

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

  4. Prescribing Albumin in a Central Hospital. New Standards versus Old Habits

    OpenAIRE

    Pasini, J; Marcelino, P

    2012-01-01

    O presente estudo teve como objectivo aferir a adequação da prescrição de albumina humana num hospital central à evidência científica nesta área actualmente disponível. O estudo foi retrospectivo e analisou os pedidos de albumina aos serviços farmacêuticos entre Setembro de 2007 e Agosto de 2008. Analisadas 761 requisições de 619 doentes com idade média de 58,1 +/- 14,7 anos, 510 (77%) dos quais do sexo masculino. Foram avaliados parâmetros analíticos globais (proteínas totais, album...

  5. 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.

  6. 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)

  7. 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)

  8. 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)

  9. 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)

  10. 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)

  11. 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)

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

    Institute of Scientific and Technical Information of China (English)

    朱建成; 夏新; 李朋海

    2016-01-01

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

  13. 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.

  14. 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...

  15. 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...

  16. 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

  17. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. 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

  20. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael

    2013-01-01

    The challenge could be briefly seen in these terms: hospitals as places for treatment where there’s a technology focus and hospitals for healing where there’s a human focus. In the 60s - 70s wave of new hospital building, an emphasis on technology can be seen. It’s time to move from the technology...... 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......’t be doing in hospitals. Design factors which should be carefully considered include: Light, as in daylight, artificial light, its color, its temperature, the level and quality of lighting and the effects of light on circadian rhythms. There is documented evidence in: users’ satisfaction, orientation, 24...

  1. 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。

  2. 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.

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

    Science.gov (United States)

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

    2012-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Lul Raka

    2009-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Tamar Akhvlediani

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

  6. 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

  7. 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 ...

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

    Institute of Scientific and Technical Information of China (English)

    赵明

    2016-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-02-15

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

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

    Directory of Open Access Journals (Sweden)

    Nghia Ho Dang Trung

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

  11. 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.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2013-06-01

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

  13. 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.

  14. 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.

  15. 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

  16. 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

  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. 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

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  20. [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

  1. 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...

  2. 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

  3. 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.

  4. 分散式与集中式供应链演变路径研究%Research on Evolution of Decentralized and Centralized Supply Chains

    Institute of Scientific and Technical Information of China (English)

    张智勇; 李华娟; 石园

    2012-01-01

    The distribution proportion of decentralized and centralized supply chains indicates the maturity of supply chain development. As it is well-known, decentralized and centralized decision-making modes are common in the supply chain game. Decision makers often adjust their decision-making process to the development for themselves day by day according to the changing market. In this paper, a study is conduc-ted for a two-level supply chains composed of manufacturers and retailers. A payoff matrix in the game be-tween the manufacturers and the retailers are constructed. With relevant parameters and numerical exam-ples, evolutionary stable strategies are analyzed by using a Jacobi matrix. The effects of the parameter changes on the evolutionary direction between decentralized and centralized supply chains are discussed in detail. Results show that decision-making results are significantly influenced by parameters such as profits and costs in the supply chains.%探讨了由生产商与零售商组成的两级供应链,分析链上成员之间的博弈从而构建两者的支付矩阵,通过计算雅可比矩阵,掌握供应链的演化稳定策略.通过参数分析与数值算例,详细讨论了参数变化对分散式与集中式供应链演化方向的影响,结果显示,供应链中决策受收益、成本等参数的影响显著.

  5. 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.

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

    Institute of Scientific and Technical Information of China (English)

    康虹; 王丽华; 于静; 高佳

    2014-01-01

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

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

    NARCIS (Netherlands)

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

    2009-01-01

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

  8. 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.

  9. 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)

  10. 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)

  11. 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。

  12. 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...

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

    Institute of Scientific and Technical Information of China (English)

    倪云

    2015-01-01

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

  14. 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 ...

  15. 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...

  16. 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.

  17. 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.

  18. 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)

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

    Institute of Scientific and Technical Information of China (English)

    孙雪莹; 王岩; 邱素红; 高玉华

    2012-01-01

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

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

    Science.gov (United States)

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

    2011-12-01

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

  1. 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.

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

    Science.gov (United States)

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

    2012-04-01

    Economic analysis plays a pivotal role in the management of medical store. The main objectives of this study were to consider always better control-vital, essential and desirable (ABC-VED) analysis with economic order quantity (EOQ), comparison of indexed cost and the actual cost, and to assess the expenditure for the forthcoming years. Based on cost and criticality, a matrix of nine groups by combining ABC and VED analysis was formulated. Drug categories were narrowed down for prioritization to direct supervisory monitoring. The subgroups AE and AV of the categories category I and II should be ordered based on EOQ. The difference between the actual annual drug expenditure (ADE) and the derived indexed cost using the cost inflation index (CII) was calculated. Linear regression was used to assess the expenditure for the forth coming years. The total ADE for the financial year of 2010-2011 was Rs. 1,91,44,253 which was only 7.68% of annual hospital expenditure. Using the inflation index, the indexed cost of acquisition of ADE for year 2010-2011 was Rs. 1,95,10,387. The difference between the two was estimated to be 2.11%. Thus, the CII justifies the demand of increased budget for next year and prompts us for cautious use of drugs. By taking into consideration the ADE of last 10 years, we have forecasted the budget for forthcoming years which will help significantly for making policies according to the available budget. PMID:22754264

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

    Directory of Open Access Journals (Sweden)

    Manohar Pradhan

    2016-08-01

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

  4. 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

  5. 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.

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

    Institute of Scientific and Technical Information of China (English)

    刘阳; 赵道致; 何龙飞

    2012-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Sudhir Babu Karri

    2016-01-01

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

  9. 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

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

    Science.gov (United States)

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

    2009-12-01

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

  11. 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.

  12. 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...

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

    Institute of Scientific and Technical Information of China (English)

    陈伟豪; 谢伟柯; 姜东尧

    2012-01-01

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

  14. 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

  15. 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...

  16. 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.

  17. 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.

  18. 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

  19. 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.

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

    Science.gov (United States)

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

    2009-03-01

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

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

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    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.

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

    Institute of Scientific and Technical Information of China (English)

    尤琼

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-12-01

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

  4. 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.

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

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    Amar M. Taksande

    2015-11-01

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

  6. 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

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

    Institute of Scientific and Technical Information of China (English)

    周志明; 文华; 欧有良

    2012-01-01

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

  8. [Legionella contamination of hospital hot water supply systems in the light of research conducted in 2008-2010 as part of supervision by the Country Sanitary Inspector in Bydgoszcz].

    Science.gov (United States)

    Zborowska-Dobosz, Renata; Kuziemski, Arkadiusz; Maron, Monika; Bahn, Dorota; Owczarek, Aleksandra

    2011-01-01

    The aim of the study was to assess the level of Legionella sp. contamination in the hot water supply systems at the premises of inpatient healthcare facilities. In the years 2008-2010 the State Poviat Sanitary Inspector in Bydgoszcz tested the hot water supply systems in 8 hospitals. A total of 88 samples of hot water were collected in the years 2008-2010. The analysis involved temperature measurements and microbiological testing of the hot water. Contamination levels exceeding the applicable standards were discovered in 6 hospitals. The corrective measures introduced allowed for a significant improvement in each case. The hospital hot water systems revealed Legionella sp. contamination levels considerably exceeding the approved standards. Of the 88 water samples tested, 37 contained excessive numbers of Legionella sp. bacteria (i.e. above 100 CFU in 100 ml of water), which constituted 63.6% of the samples tested. In 6 of the 8 investigated hospitals the Legionella sp. contamination of the hot water supply system was found to be on the medium or high level. The analysis of temperature measurements revealed that the lowest temperature readings were associated with high bacterial colonization of the plumbing system. After the implementation of corrective measures, 50 control samples were collected, and in 37 of them the bacterial levels were below 100 CFU per 100 ml of water. The Legionella sp. contamination was found to be associated with low temperature of the hot water. PMID:22184945

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

    Institute of Scientific and Technical Information of China (English)

    刘敏

    2011-01-01

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

  10. 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.

  11. 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

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

    Institute of Scientific and Technical Information of China (English)

    陈萍; 刘丁

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Torbica Aleksandra

    2010-05-01

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

  14. 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)

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

    Institute of Scientific and Technical Information of China (English)

    于凤玲; 黄俊云; 王华

    2013-01-01

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

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

    Science.gov (United States)

    Popov, A P

    2015-10-01

    The authors present the history of the branch N 6 of the Federal States Organization "the Vishnevsky Central Military Clinical Hospital N 3" of the Ministry of Defense of the Russian Federation, which dates back to November 1, 1974. Over the past years, organizational and staff structure; and the name of the clinic (45th central polyclinic, 45th central consultative-diagnostic polyclinic, 52nd Advisory Diagnostic Center of Defense) has repeatedly changed, but the core the work stays unchangeable--to continually improve patient care technology, to be the leader in the outpatient care for soldiers, reserve officers (retired), members of their families. The. branch consists of 58 medical and 19 specialized diagnostic departments, including 4 hospital departments, 1845 employee work at the branch. Among them 4 doctors of medical science and 43 candidates of medical sciences, 20 honoured physicians and 10 honoured health workers of republic. 70% of doctors and 93% of nurses have the highest qualification category. To health care in the Branch are more than 110 thousand people. PMID:26827510

  17. 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。

  18. 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 ...

  19. 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

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

    Institute of Scientific and Technical Information of China (English)

    何莺; 邢素美; 夏文俊

    2011-01-01

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

  1. 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-

  2. 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

  3. 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

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

    Institute of Scientific and Technical Information of China (English)

    李寅

    2012-01-01

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

  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. 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.

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

    Institute of Scientific and Technical Information of China (English)

    崔吉平; 赵玛丽; 种银保; 刘九零; 曹登秀; 罗鑫

    2012-01-01

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

  8. [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

  9. Fulfilling the electricity demand of electric vehicles in the long term future: An evaluation of centralized and decentralized power supply systems

    NARCIS (Netherlands)

    Brouwer, A.S.; Kuramochi, T.; van den Broek, M.A.; Faaij, A.P.C.

    2013-01-01

    Electric vehicles (EVs) are currently seen as an option for a more sustainable transportation sector, but it is not yet clear how to supply them with electricity whilst striving for low costs and low CO2 emissions. Renewable sources can supply electricity with low emissions, but their penetration ra

  10. 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

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

    Institute of Scientific and Technical Information of China (English)

    赵玲; 郝学安; 姜洪荣; 张华强; 周璞

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Jia Liu

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

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

    Directory of Open Access Journals (Sweden)

    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

  14. 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

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

    Institute of Scientific and Technical Information of China (English)

    温筱煦; 冯端浩; 崔勇

    2012-01-01

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

  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. 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.

  19. 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.

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

    Directory of Open Access Journals (Sweden)

    Stadler Manfred

    2008-12-01

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

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

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    Henry Namme Luma

    2013-01-01

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

  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

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    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. 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.

  5. 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

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

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    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.

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

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    Coskun Erdal

    2006-03-01

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

  8. Analysis of Microbial Indexes in Peripheral Water of Rural Centralized Water Supply in Hunan Province%湖南省农村集中式供水末梢水微生物指标分析

    Institute of Scientific and Technical Information of China (English)

    陈帅; 吴传业; 黄涛; 胡建安

    2012-01-01

    Objective To investigate the microbial contamination of rural centralized water supply and explore efficient preventive measures, so as to provide a basis for the improvement of water quality of rural centralized water supply. Methods The drinking water quality of 2,006 centralized water supply points in rural areas of 93 counties (districts) in Hunan Province in 2011 was monitored according to the relevant national standards of water quality testing. The microbial indicators of samples in different conditions were analyzed statistically. Results The total qualified rate of microbial indicators in 4,012 peripheral water samples of rural centralized water supply was 40.28%. The microbial indicators showed statistically significant difference among centralized water supplies with different water treatment processes as well as various water source types (P < 0.001). The water quality in the dry season was better than that in the wet season (P<0.001). The total number of colonies was positively correlated with turbidity. Conclusions The total qualified rate of microbial indicators in peripheral water of rural centralized water supply is related to the factors like water treatment process and water source types. It suggests that to improve the quality of rural centralized water supply, water treatment should be integrated, sanitary management of water factory should be strengthened, water source protection should be promoted, and health education should be popularized in rural areas.%目的 了解湖南省农村集中式供水微生物污染状况,探讨有效防治措施,为改善农村集中式供水水质提供依据.方法 按国家有关水质检验标准对2011年湖南省93个县(区)2006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微生物指标的影响.结果 4012份农村集中式供水末梢水微生物指标合格率为40.28%,不同水处理工艺、水源类型的集中式供水微生物指

  9. 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.

  10. Discussion on the Supplies Management System and the Integrated Logistics Management Model in the Hospital%我院物资管理系统与物流集成化管理模式探讨

    Institute of Scientific and Technical Information of China (English)

    陈雪

    2014-01-01

    Through analysis of the old and new management models of material supply chains and logistics in Beijing Jishuitan Hospital, this paper pointed out it had been an inevitable tendency for development of the logistics management in the information age to change the traditional logistics model, optimize the logistics management system and implement the integrated logistics management model. Additionally, it also served as a development concept to reduce the costs and strengthen the all-round competitiveness for the hospital.%本文通过对我院物资供应链与物流管理新旧模式分析,提出在信息时代,改变医院传统物流模式,优化物流管理系统,实施物流集成化管理模式是医院物流管理发展的必然趋势,也是降低医院成本,提升医院整体竞争力的发展理念。

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

    Institute of Scientific and Technical Information of China (English)

    陈炜; 杨以雄; 郑洁; 田原

    2016-01-01

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

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

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    Alok Kumar

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    卢敬飞; 宋风兵; 温亮

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Luce Marina Freires Corrêa da Costa

    2008-02-01

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

  15. 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.

    A 2 m-long sediment core from the siliceous ooze domain in the Central Indian Ocean Basin (CIOB; 13 degrees 03'S: 74 degrees 44'E; water depth 5099 m) is studied for calcium carbonate, total organic carbon, total nitrogen, biogenic opal, major...

  16. 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,…

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

    Institute of Scientific and Technical Information of China (English)

    冯鸿雁

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    李盛; 王金玉; 余加琳; 王宇红; 李志强

    2011-01-01

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

  19. Current status of management of central sterile supply department in medical institutions in Guizhou%贵州省医疗机构消毒供应中心管理现状调查与分析

    Institute of Scientific and Technical Information of China (English)

    徐艳; 牟霞; 王萍; 杨怀; 龚廉坚; 陈京; 杨锦玲; 郑金鼎; 石春怀

    2011-01-01

    目的 调查医院实施消毒供应中心(CSSD)行业标准情况,为贵州省卫生行政部门加强CSSD管理提供依据.方法 按照医院CSSD行业标准,设计调查表对贵州省各级医疗机构CSSD、消毒供应室管理现状进行调查.结果 共调查120所医院,集中管理模式的医院仅7所,51.0%的消毒员不具备资质,88.0%医院的手术器械在手术室清洗,仅6.0%医院的临床医疗器械由CSSD、消毒供应室完成,使用外来器械的医院仅18.0%由CSSD、消毒供应室全程清洗灭菌,有非手触式洗手设施的医院仅15所,有65所医院具备独立的敷料打包间,15所医院有带光源放大镜,7所医院有全自动清洗机,59.0%的医院对待灭菌包进行清洗质量检查,压力蒸汽灭菌器每周生物学监测39所.结论 贵州省CSSD、消毒供应室管理滞后,建筑设施不合理,设备不足,器械清洗不规范,监测力度不够,需要加强管理,增加投入,规范培训,持续整改.%OBJECTIVE To investigate the practicing condition of vocation standard of CSSD in medical institution, in order to provide the basis of strengthening the CSSD Management of Medical Administrative Command in Guizhou province. METHODS According to MOH vocation standard of CSSD, we carried out an investigation about Management Current Situation to Medical Institution CSSD of Guizhou. RESULTS A total of 120 hospitals, only 7 hospitals have centralized management mode,51% disinfectioners have not aptitude,there are 88% hospitals which cleaning surgical instruments in operating room,only 6% hospitals make it in CSSD, 18% hospitals having outside instrument make cleaning and sterilizing in CSSD, only 15 hospitals have the non-hand-touch hand washing facilities, 65 hospitals have Singlehanded dressing package room, 15 hospitals have magnifying glass with light,7 hospitals are fully automatic washing machine, there are 59% hospitals to inspect the quality of package which is not sterilized, 39

  20. 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.

  1. 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

  2. Perioperative supply chain management.

    Science.gov (United States)

    Feistritzer, N R; Keck, B R

    2000-09-01

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

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

    Institute of Scientific and Technical Information of China (English)

    尚长浩; 李永生; 程俊佩; 徐海林; 王小广

    2014-01-01

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

  4. Water Supplying Ratio and Influencing Factors Analysis for Centralized Water Plants in China Rural Area%农村集中式供水设施供水率及其影响因素分析

    Institute of Scientific and Technical Information of China (English)

    张琦; 陶勇

    2012-01-01

    目的 调查农村集中式供水设施供水率现状水平并分析其可能影响因素,为优化农村供水工程设计和运行提供依据.方法 于2007-2008年调查我国东、中、西部8省区的1324座农村水厂的设计、运行和管理情况,进行描述性分析和相关性分析.结果 约93%的农村集中式供水工程日供水规模小于1 000m3/d,水厂供水率中位数为65.81%;东部省份水厂供水率高于中西部省区;82.18%的水厂现状受益人口未达到设计水平,平均低于设计水平的34.61%;供水率与现状受益人口/设计受益人口比值呈显著正相关关系(r=0.581,P<0.01).结论农村水厂以小型水厂为主,约60%的调查水厂供水规模在20~200 m3/d;水厂现状受益人口与设计水平存在较大差异,提示水厂设计受益人口数应考虑经济社会影响;受益人口数和运行年限是水厂供水率的主要影响因素.%Objective To investigate the current water supplying ratio for rural centralized water supply facilities and the possible influencing factors for optimizing design and operation for rural water plants.Methods Descriptive and relativity analysis were employed for the data collected from 1 324 rural water facilities in east,middle and west part of China.Results The water supply scale of approximately 93% of the investigated rural water plants was less than 1 000 m3/d,and the median of water supplying ration was 65.81%; The water supplying ratio of the water plants in eastern provinces was higher than that in middle and western provinces; The current beneficiary number of 82.18% rural water plants did not achieve the designed level,which was less than the designed level by 34.61% averagely; Water supplying ratio was positive correlated to the ration of current and designed beneficiary(r=0.581 ,P<0.01).Conclusion The water supply scale for about 60% of the investigated water supply plants was in the range of 20-200 m3/d; There was obvious

  5. ENDOGENEITY OF INDONESIAN MONEY SUPPLY

    Directory of Open Access Journals (Sweden)

    Meutia Safrina Rachma

    2011-09-01

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

  6. Analysis of quality monitoring data for urban and rural centralized water supply in Wenling%温岭市城乡集中式供水水质监测分析

    Institute of Scientific and Technical Information of China (English)

    陈美舜

    2011-01-01

    目的:了解全市城乡集中式供水水质卫生状况,保障居民饮水安全.方法:全市10家集中式供水企业于丰、枯水期,采集水源水和出厂水各1份、末梢水3份,按照GB/T5750-2006、GB5749-2006进行检验和评价.结果:3年共采集水样300份,超标的多为微生物指标、游离余氯、浑浊度、pH值,大小型供水企业水质差异有统计学意义.结论:我市城乡饮用水受地理化学因素和工业污染的影响较小,主要受微生物的污染;卫生监督对象应以小型集中式供水企业为主.%Objective:To investigate the quality of urban and rural centralized water supply in Wenling and ensure drinking water safty for residents. Methods: 1 water source sample, 1 treated water sample and 3 peripheral water samples were collected in the high flow period and in the low flow period from 10 water plants that supply centralized water. Samples were tested and e-valuated according to GB/T 5750 - 2006, GB 5749 - 2006 standards. Results: 300 water samples were collected in 3 years and it was found that microbiological indicators, free chlorine residual, turbidity, pH value did not meet the requirements. The water quality between large and small water plants was statistically different. Conclusion; Drinking water in urban and rural areas is primarily influenced by microbial contamination rather than geographical and industrial pollution, chemical factors; water hygiene monitoring should be targeted to small - scale centralized water supply enterprises.

  7. 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.

  8. 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 ...

  9. 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.)

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

    Institute of Scientific and Technical Information of China (English)

    钱小芳; 刘桂华(综述)

    2015-01-01

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

  11. 2013年闽侯县农村集中式供水卫生状况调查%2013 Centralized Water Supply in Rural Minhou County Health Survey

    Institute of Scientific and Technical Information of China (English)

    欧阳娟

    2015-01-01

    目的:通过对闽侯县农村集中式供水卫生状况的调查分析,了解目前农村集中式供水的卫生质量,为改善农村饮用水水质工程以及卫生监督提供科学依据。方法根据水源类型、集中式供水饮用人口分布按照分层随机抽样原则设立监测点,监测点分丰水期与枯水期分别采集出厂水、末梢水164份水样进行检验,检验方法按照《生活饮用水卫生标准检验方法》(GB/T5750-2006)执行,检测结果依据《生活饮用水卫生标准》(GB5749-2006)进行评价、分析。结果164份水样中合格53份,合格率32.32%,不合格项目主要为总大肠菌群、耐热大肠菌群、菌落总数、浑浊度、肉眼可见物、铁等。结论闽侯县农村集中式供水水质合格率较低,微生物污染严重,供水设施不完善,消毒覆盖率较低,应加大农村饮水安全工程建设投入,加强饮用水卫生管理,规范消毒,确保饮水安全。减少和预防水源性疾病的发生,确保农村群众的身体健康。%Objective Through centralized water supply in rural Minhou county health investigation and analysis, to under-stand the current health of the quality of rural centralized water supply, to improve the quality of drinking water projects in rural areas and provide scientific basis for health supervision. Methods According to the type of water, centralized water supply for drinking population distribution monitoring points established in accordance with the principle of stratified ran-dom sampling, monitoring dotted wet season and dry season water were collected from the factory, peripheral water 164 wa-ter samples to test, test methods according to “Life drinking water sanitation standard test method ”(GB/ T5750-2006) exe-cution, test results based on “ drinking water health standards ”(GB5749-2006) were evaluated and analyzed. Results 164 water samples 53 qualified, qualified rate of 32.32 percent, failed

  12. 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.

  13. 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.

  14. 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...

  15. 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.

  16. 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

  17. 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

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

    Science.gov (United States)

    Zhang, Jian

    2013-07-01

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

  19. 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.

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

    Directory of Open Access Journals (Sweden)

    Graziella Gasparotto Baiocco

    2010-12-01

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

  1. Social and Health Care of Children in Central Europe : The Italian Hospital in Prague in the 17th–18th Century

    Directory of Open Access Journals (Sweden)

    Petr Svobodný

    2007-07-01

    Full Text Available The history of the Italian Hospital in Prague from the end of the 16th to the end of the 18th century is a notable example of the formalisation, professionalisation and medicalisation of care for children: from the provision of a refuge for the most helpless members of society (abandoned newborns and orphans who were completely bereft of the protection of the family, to progressively organisationally and professionally improving care offered by a lay religious congregation, to the ever more stringent supervision and finally the complete transfer of the social-health institution created in this way (a foundling hospital and maternity hospital into a sphere entirely controlled by the authorities of the “State” (Bohemian provincial health institutions and the “Academy” (the Medical Faculty in Prague.

  2. Tying supply chain costs to patient care.

    Science.gov (United States)

    Parkinson, Rosalind C

    2014-05-01

    In September 2014, the FDA will establish a unique device identification (UDI) system to aid hospitals in better tracking and managing medical devices and analyzing their effectiveness. When these identifiers become part of patient medical records, the UDI system will provide a much-needed link between supply cost and patient outcomes. Hospitals should invest in technology and processes that can enable them to trace supply usage patterns directly to patients and analyze how these usage patterns affect cost and quality. PMID:24851451

  3. 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...

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

    Institute of Scientific and Technical Information of China (English)

    王金玉; 李盛; 余加琳; 李志强

    2011-01-01

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

  5. 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.

  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. 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)

  9. 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.

  10. 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.

  11. Risk factors of nasal carriage of Staphylococcus aureus and methicillin-resistant Staphylococcus aureus among health care staff in a teaching hospital in central Saudi Arabia

    OpenAIRE

    Al-Humaidan, Ohoud S.; El-kersh, Talat A; Al-Akeel, Raid A.

    2015-01-01

    Objectives: To investigate possible risk factors of Staphylococcus aureus (S. aureus) and methicillin-resistant S. aureus (MRSA) nasal carriage associated with various health troubles among healthcare workers (HCWs) at King Khalid University Hospital (KKUH). Method: This prospective study was conducted between May 2012 and January 2013 in KKUH, Riyadh, Saudi Arabia. A total of 200 nasal swabs were collected from HCWs. Identification was carried out based on morphology, Gram stain, catalase an...

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

    Institute of Scientific and Technical Information of China (English)

    刘乐斌; 周赤龙; 陈俊国; 李瑛; 王方芳; 陈虹

    2011-01-01

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

  13. 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...

  14. 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...

  15. 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.

  16. 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

  17. 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.

  18. 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。

  19. Risk factors of nasal carriage of Staphylococcus aureus and methicillin-resistant Staphylococcus aureus among health care staff in a teaching hospital in central Saudi Arabia

    Science.gov (United States)

    Al-Humaidan, Ohoud S.; El-Kersh, Talat A.; Al-Akeel, Raid A.

    2015-01-01

    Objectives: To investigate possible risk factors of Staphylococcus aureus (S. aureus) and methicillin-resistant S. aureus (MRSA) nasal carriage associated with various health troubles among healthcare workers (HCWs) at King Khalid University Hospital (KKUH). Method: This prospective study was conducted between May 2012 and January 2013 in KKUH, Riyadh, Saudi Arabia. A total of 200 nasal swabs were collected from HCWs. Identification was carried out based on morphology, Gram stain, catalase and coagulase test, Staphaurex PlusH test, chromogenic medium, oxacillin, and cefoxitin test using disc diffusion method. Characterization was carried out using disk diffusion method and E-test. Polymerase chain reaction was carried out to confirm using GeneXpert® Dx System (Cepheid) to detect mecA gene. Results: Among the 200 isolates, 80 (40%) were S. aureus carriers, and 36 (18%) of all HCWs were identified as MRSA carriers. There was a significant difference of S. aureus according to gender with male carriers (p=0.012), occupation particularly among nurses (p=0.006), and duration of working years in the hospital among 4-6 years group (p=0.002). Moreover, none of the risk factors assessed were significantly associated with the carriage rate of MRSA (p>0.05). Conclusion: The current study revealed that nursing staff was the potential colonizers of S. aureus and MRSA compared with other HCWs. Regular screening of carriers is required for prevention of nosocomial infections. PMID:26318466

  20. 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...

  1. 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...

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

    Directory of Open Access Journals (Sweden)

    Longhua Hu

    2016-08-01

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

  3. 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

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

    Science.gov (United States)

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

    2016-01-01

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

  5. 供应链集权管理模式下的RFID在VMI系统中应用的效益分析%Benefit Analysis of Applications of the RFID in the VMI System in Centralized Supply Chain Management Model

    Institute of Scientific and Technical Information of China (English)

    张凯; 马金平

    2012-01-01

    针对在供应链集权管理模式下的RFID在供应商管理库存(VMI)系统中应用的效益分析问题,建立了VMI系统效益分析的概率分布函数。通过对模型的理论分析和数值计算,文章的结论是:当企业保持库存水平一定时,随着RFID标签成本降低,VMI系统利润增加;当RFID标签成本一定时,随着库存容量增加,VMI系统利润降低。这个结论为企业应用RFID的决策提供了科学依据。%Aiming at benefit analysis issue of Applications of the RFID in the VMI System in Centralized-Supply Chain Management Model, this article established probability distribution function of the benefit analysis for VMI system. By the theory analysis of the model and numerical calcu- lation, the conclusion of the article is that firms keep stock level be the same, with reduction of RFID tag cost, profits of the VMI system be in- creased; and that cost of the RFID tag cost is not changed, with stock capacity be increased, profits of the VMI system to decrease. This conclu- sion of the article provided Scientific basis of decision for firm to use RFID.

  6. The epidemiology of rotavirus disease in under-five-year-old children hospitalized with acute diarrhea in central Uganda, 2012-2013.

    Science.gov (United States)

    Bwogi, Josephine; Malamba, Samuel; Kigozi, Brian; Namuwulya, Prossy; Tushabe, Phionah; Kiguli, Sarah; Byarugaba, Denis Karuhize; Desselberger, Ulrich; Iturriza-Gomara, Miren; Karamagi, Charles

    2016-04-01

    A cross-sectional study was undertaken during 2012-2013 to determine the prevalence, strains and factors associated with rotavirus infection among under-5-year-old children hospitalized with acute diarrhea in Uganda. Rotaviruses were detected in 37 % (263/712) of the children. The most prevalent strains were G9P[8] (27 %, 55/204) and G12P[4] (18.6 %, 38/204). Mixed infections were detected in 22.5 % (46/204) of the children. The study suggests that consumption of raw vegetables (OR = 1.45, 95 % CI = 1.03-2.03) and family ownership of dogs (OR = 1.9, 95 % CI = 1.04-3.75) increases the risk of rotavirus infection. The study findings will be used to assess the impact of RV vaccination in Uganda. PMID:26724820

  7. 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

  8. 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

  9. Additive manufacturing technology in spare parts supply chain

    DEFF Research Database (Denmark)

    Li, Yao; Jia, Guozhu; Yang, Cheng;

    2016-01-01

    Additive Manufacturing (AM) technology has the potential to significantly improve supply chain dynamics. The purpose of this paper is to investigate the impact of AM on spare parts supply chain. Three supply chain scenarios are investigated in this paper, namely conventional supply chain, central......Additive Manufacturing (AM) technology has the potential to significantly improve supply chain dynamics. The purpose of this paper is to investigate the impact of AM on spare parts supply chain. Three supply chain scenarios are investigated in this paper, namely conventional supply chain...

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

    Directory of Open Access Journals (Sweden)

    Jacinta Sanchez Pelayo

    2006-10-01

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

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

    Institute of Scientific and Technical Information of China (English)

    鲁晶; 彭承琳; 牟帮易

    2012-01-01

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

  12. 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

  13. 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.

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

    Directory of Open Access Journals (Sweden)

    Cristine Ruviaro de Oliveira

    2014-09-01

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

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

    Directory of Open Access Journals (Sweden)

    Kazuko Uchikawa Graziano

    2009-12-01

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

  16. 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)

  17. 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

  18. 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.

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

    Institute of Scientific and Technical Information of China (English)

    童海潮; 李志娟

    2012-01-01

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

  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. 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.

  2. 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

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

    Science.gov (United States)

    Kotilainen, H

    2001-01-01

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

  4. 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...

  5. 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...

  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. Structural determinants of hospital closure.

    Science.gov (United States)

    Longo, D R; Chase, G A

    1984-05-01

    In a retrospective case-control study, structural characteristics of hospitals that closed during the years 1976-1980 were contrasted with three comparison groups: hospitals that were acquired in a merger; hospitals that joined a multihospital system; and hospitals that remained autonomously opened, to investigate these characteristics as predictors of closure. Characteristics investigated included environmental, structural, and process variables. The independent variables were measured 5 years prior to outcome. Findings indicate that closed hospitals resemble hospitals acquired in a merger ("failure"), and likewise autonomous hospitals resemble hospitals that join a multihospital system ("success"). The most important predictors of hospital failure were the physician-to-population ratio, the East North Central and West North Central census regions, the level of diversification, low occupancy rate, location in a standard metropolitan statistical area, the chief executive officer's lack of affiliation in the American College of Hospital Administrators, profit status, bed size of less than 50, and presence in a state with a rate-setting agency. Surprisingly, this study shows the bed-to-population ratio to be unrelated to closure. In addition, the findings strongly support the open-system perspective, which, unlike the closed-system perspective, is concerned with the vulnerability of the organization to the uncontrollable and often unpredictable influences of the environment.

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

    Institute of Scientific and Technical Information of China (English)

    张国华; 封梅姣; 申帅; 文学斌

    2016-01-01

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

  9. 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.

  10. 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 ( ...

  11. 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.

  12. 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

  13. 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.

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

    Institute of Scientific and Technical Information of China (English)

    吴佳伟; 周染云; 张莹; 杨春燕; 徐丽丽; 王国权

    2013-01-01

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

  15. 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

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

    Institute of Scientific and Technical Information of China (English)

    吴玲; 黄雪玉

    2015-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-01-01

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

  18. 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...

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

    Directory of Open Access Journals (Sweden)

    Patrícia Alves Evangelista

    2008-04-01

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

  20. 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.

  1. 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.

  2. 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

  3. 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

  4. 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

  5. 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.

  6. 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

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

    Institute of Scientific and Technical Information of China (English)

    黄璞洁; 李艳霞; 何耀炳; 许伊那

    2011-01-01

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

  8. 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

  9. 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....

  10. Facility management in German hospitals.

    Science.gov (United States)

    Gudat, H

    2000-04-01

    Facility management and optimum building management offer for hospitals a chance to reduce costs and to increase quality, process sequences, employee motivation and customer satisfaction. Some years ago simple services such as cleaning, catering or laundry were outsourced. Now, German hospitals progress to more complex fields such as building and medical technology, clinical support processes such as pharmacy, central laboratory and sterilization, goods and logistics services. PMID:11066999

  11. Organizational centralization in radiology.

    Science.gov (United States)

    Aas, I H Monrad

    2006-01-01

    Traditionally, hospitals have a radiology department, where images are taken and interpretation occurs. Teleradiology makes it possible to capture images in one location and transmit them elsewhere for interpretation. Organizational centralization of radiology interpretations is therefore of interest. Empirical data have been collected in qualitative interviews of 26 resource persons with substantial experience with picture archiving and communication systems and teleradiology, from 12 departments of radiology in Norway. The response rate was 90%. A total of 21 theoretically possible types of centralization of image interpretation were identified, representing combinations of three categories of geographical centralization, and seven categories of centralization according to function. Various advantages and disadvantages of centralization were identified. Organizational changes may be decisive for the future of teleradiology, but it may be wise to plan for change in small steps, since we know little about how broad future organizational changes based on teleradiology will be, or what will decide how far particular organizations will go. PMID:16438776

  12. Hospital Inspections

    Data.gov (United States)

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

  13. 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?”

  14. 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 ...

  15. Hospital marketing.

    Science.gov (United States)

    Carter, Tony

    2003-01-01

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

  16. Transformation strategies of fossil central district heating supply to grids with an enhanced portion of renewable energies; Transformationsstrategien von fossiler zentraler Fernwaermeversorgung zu Netzen mit hoeheren Anteilen erneuerbarer Energien

    Energy Technology Data Exchange (ETDEWEB)

    Paar, Angelika; Herbert, Florian; Pehnt, Martin [ifeu-Institut fuer Energie- und Umweltforschung GmbH, Heidelberg (Germany); Ochse, Susanne; Richter, Stephan; Maier, Stefanie; Kley, Magalie [GEF Ingenieur AG, Leimen (Germany); Huther, Heiko; Kuehne, Jens; Weidlich, Ingo [AGFW - Der Energieeffizienzverband fuer Waerme, Kaelte und KWK e.V., Frankfurt am Main (Germany)

    2013-04-15

    A considerable portion of the primary energy consumption in Germany is used to provide process heat and space heating as well as for the hot water processing. The heat supply and the enhancement of the portion of renewable energy sources are particularly important for the reduction of greenhouse gas emissions. The contribution under consideration deals with the question of how the portion of renewable energy can be increased in existing district heating systems. The potential utilization of renewable energy sources in the district heating is analyzed systematically.

  17. Supply regimes in fisheries

    DEFF Research Database (Denmark)

    Nielsen, Max

    2006-01-01

    -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......Supply in fisheries is traditionally known for its backward bending nature, owing to externalities in production. Such a supply regime, however, exist only for pure open access fisheries. Since most fisheries worldwide are neither pure open access, nor optimally managed, rather between the extremes......, the traditional understanding of supply regimes in fisheries needs modification. This paper identifies through a case study of the East Baltic cod fishery supply regimes in fisheries, taking alternative fisheries management schemes and mesh size limitations into account. An age-structured Beverton-Holt based bio...

  18. Visualization of hospital cleanliness in three Japanese hospitals with a tendency toward long-term care

    OpenAIRE

    Watanabe, Reina; Shimoda, Tomoko; Yano, Rika; Hayashi, Yasuhiro; Nakamura, Shinji; Matsuo, Junji; Yamaguchi, Hiroyuki

    2014-01-01

    Background Hospital cleanliness in hospitals with a tendency toward long-term care in Japan remains unevaluated. We therefore visualized hospital cleanliness in Japan over a 2-month period by two distinct popular methods: ATP bioluminescence (ATP method) and the standard stamp agar method (stamp method). Methods The surfaces of 752 sites within nurse and patient areas in three hospitals located in a central area of Sapporo, Japan were evaluated by the ATP and stamp methods, ...

  19. Visualization of hospital cleanliness in three Japanese hospitals with a tendency toward long-term care

    OpenAIRE

    Watanabe, Reina; Shimoda, Tomoko; Yano, Rika; Hayashi, Yasuhiro; Nakamura, Shinji; Matsuo, Junji; Yamaguchi, Hiroyuki

    2014-01-01

    Background Hospital cleanliness in hospitals with a tendency toward long-term care in Japan remains unevaluated. We therefore visualized hospital cleanliness in Japan over a 2-month period by two distinct popular methods: ATP bioluminescence (ATP method) and the standard stamp agar method (stamp method). Methods The surfaces of 752 sites within nurse and patient areas in three hospitals located in a central area of Sapporo, Japan were evaluated by the ATP and stamp methods, and each surface w...

  20. 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.

  1. Modelling Hospital Materials Management Processes

    Directory of Open Access Journals (Sweden)

    Raffaele Iannone

    2013-06-01

    integrated and detailed analysis and description model for hospital materials management data and tasks, which is able to tackle information from patient requirements to usage, from replenishment requests to supplying and handling activities. The model takes account of medical risk reduction, traceability and streamlined processes perspectives. Second, the paper translates this information into a business process model and mathematical formalization.The study provides a useful guide to the various relevant technology‐related, management and business issues, laying the foundations of an efficient reengineering of the supply chain to reduce healthcare costs and improve the quality of care.

  2. 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

  3. Central Station Design Options

    DEFF Research Database (Denmark)

    2011-01-01

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

  4. 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.

  5. 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...

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

    Institute of Scientific and Technical Information of China (English)

    龚晓辉; 唐曼娟; 谭菊香

    2012-01-01

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

  7. 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)

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

    Institute of Scientific and Technical Information of China (English)

    蔡宏伟; 谭小云; 朱长发

    2015-01-01

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

  9. 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…

  10. 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.

  11. Hospitality Management.

    Science.gov (United States)

    College of the Canyons, Valencia, CA.

    A project was conducted at College of the Canyons (Valencia, California) to initiate a new 2-year hospitality program with career options in hotel or restaurant management. A mail and telephone survey of area employers in the restaurant and hotel field demonstrated a need for, interest in, and willingness to provide internships for such a program.…

  12. 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.

  13. 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...

  14. Supply chain reliability modelling

    OpenAIRE

    Eugen Zaitsev

    2012-01-01

    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 ...

  15. 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...

  16. 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)

  17. 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...

  18. 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...

  19. 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.

  20. 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.

  1. 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 ...

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

    Directory of Open Access Journals (Sweden)

    Sun Guohua

    2013-01-01

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

  3. 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...

  4. [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

  5. Design of sustainable second-generation biomass supply chains

    NARCIS (Netherlands)

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

    2016-01-01

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

  6. 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 ...

  7. 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.

  8. An Integrated Framework for Assessment of Hybrid Water Supply Systems

    Directory of Open Access Journals (Sweden)

    Mukta Sapkota

    2015-12-01

    Full Text Available Urban water managers around the world are adopting decentralized water supply systems, often in combination with centralized systems. While increasing demand for water arising from population growth is one of the primary reasons for this increased adoption of alternative technologies, factors such as climate change, increased frequency of extreme weather events and rapid urbanization also contribute to an increased rate of adoption of these technologies. This combination of centralized-decentralized water systems approach is referred to as “hybrid water supply systems” and is based on the premise that the provision of alternative water sources at local scales can both extend the capacity of existing centralized water supply infrastructures, and improve resilience to variable climatic conditions. It is important to understand, however, that decentralized water production and reuse may change the flow and composition of wastewater and stormwater, thereby potentially also having negative impacts on its effectiveness and performance. This paper describes a framework to assess the interactions between decentralized water supply systems and existing centralized water servicing approaches using several analytical tools, including water balance modelling, contaminant balance modelling and multi-criteria decision analysis. The framework enables the evaluation of impacts due to change in quantity and quality of wastewater and stormwater on the existing centralized system arising from the implementation of hybrid water supply systems. The framework consists of two parts: (1 Physical system analysis for various potential scenarios and (2 Ranking of Scenarios. This paper includes the demonstration of the first part of the framework for an area of Melbourne, Australia by comparing centralized water supply scenario with a combination of centralized water supply and reuse of treated waste water supply scenario.

  9. [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

  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. 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...

  12. 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.

  13. 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.

  14. 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 ...

  15. Supply shortage; Nachschub gefaehrdet

    Energy Technology Data Exchange (ETDEWEB)

    Pries, P.D.; Rentzing, S.

    2006-08-15

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

  16. 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

  17. 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.  

  18. 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...

  19. 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 ...

  20. 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...

  1. 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.

  2. 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...

  3. 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...

  4. Hospital Presbiteriano Valley

    Directory of Open Access Journals (Sweden)

    Luckman, Charles

    1964-12-01

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

  5. MASTERING SUPPLY CHAIN RISKS

    Directory of Open Access Journals (Sweden)

    Borut Jereb

    2012-11-01

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

  6. 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.

  7. [Hospital clinical ethics committees].

    Science.gov (United States)

    Gómez Velásquez, Luis; Gómez Espinosa, Luis Néstor

    2007-01-01

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

  8. 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...

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

    Institute of Scientific and Technical Information of China (English)

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

    2014-01-01

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

  10. 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...

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

    Institute of Scientific and Technical Information of China (English)

    饶冬霞; 彭晓珍; 庞明月; 刘会芬; 喻征群; 熊晓云

    2015-01-01

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

  12. 76 FR 65891 - Medicare and Medicaid Programs; Reform of Hospital and Critical Access Hospital Conditions of...

    Science.gov (United States)

    2011-10-24

    ... devices and equipment such as central lines, endotracheal tubes, and nasogastric tubes. CMS is not aware...) and Rural Primary Care Hospitals (RPCHs)'' (58 FR 30630) that implemented sections 6003(g) and 6116 of... Participation: Patients' Rights'' (71 FR 71378). In that final rule we revised the hospital standards for...

  13. Sustainable Supply Chain Design: A Configurational Approach

    Directory of Open Access Journals (Sweden)

    S. Maryam Masoumik

    2014-01-01

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

  14. 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.

  15. 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...

  16. [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.

  17. Application analysis of intraoperative blood salvage in various kinds of surgical operations in Changsha Central Hospital%回收式自体输血在各类手术中的应用情况分析

    Institute of Scientific and Technical Information of China (English)

    许靖; 高利臣; 陆昊昌

    2015-01-01

    目的:分析回收式自体输血在各类手术中的使用频率,发现回收式自体输血使用的优势术种,了解该技术在所有手术中使用的概况。方法:回顾性收集我院2012年1月~2015年5月全部术中用血病例(包括回收式自体输血和异体输血),按不同手术分类(27类)。对自体血液回输和异体血液使用例次进行统计,分析回收式自体输血在各类手术中的情况。结果:回收式自体输血(522例)占同期术中(1211例)用血例次的43.10%,回输血量363170mL,占术中用血量的35.21%。其中,分布于神经外科手术(包括颅骨修补,颅脑外伤和非创伤性颅内出血)236例,异位妊娠手术69例,非感染类脊柱手术39例,骨折内固定手术42例,髋关节置换术24例,胸、腹部闭合性损伤手术91例;以上8类手术中应用自体血液回输例次占术中用血总例次的61.17%(501/819),占同期自体血回输例次(522)的95.98%。结论:回收式自体输血在神经外科等8类手术中有较高的使用频率,特别在急诊手术中具有其优势。充分理解和遵循自体血液回输适应证将进一步提高其临床应用价值。%Objective By analysis of the application frequency of intraoperative blood salvage (IBS) in various kinds of surgical operations, to discover the most benefited operation kinds, and to understand the situation of IBS in all kinds of surgi-cal operations. Methods All retrospective cases (including salvage autologous and allogeneic blood transfusion) from January, 2012 to May, 2015 in Changsha Central Hospital were collected and classified according to surgical operation classification (27 kinds). Cases of autologous and allogeneic blood transfusion were counted to analyze the situation of IBS in all kinds of surgical operations. Results 522 cases of IBS accounted for 43.10% of all blood transfusion in the same period. The amount of IBS blood

  18. 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.

  19. 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.

  20. 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.

  1. The Market for Hospital Medicine in Denmark

    DEFF Research Database (Denmark)

    Hostenkamp, Gisela

    2012-01-01

    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 h...... 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....... 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...

  2. 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.

  3. Enterprise resource planning for hospitals.

    Science.gov (United States)

    van Merode, Godefridus G; Groothuis, Siebren; Hasman, Arie

    2004-06-30

    Integrated hospitals need a central planning and control system to plan patients' processes and the required capacity. Given the changes in healthcare one can ask the question what type of information systems can best support these healthcare delivery organizations. We focus in this review on the potential of enterprise resource planning (ERP) systems for healthcare delivery organizations. First ERP systems are explained. An overview is then presented of the characteristics of the planning process in hospital environments. Problems with ERP that are due to the special characteristics of healthcare are presented. The situations in which ERP can or cannot be used are discussed. It is suggested to divide hospitals in a part that is concerned only with deterministic processes and a part that is concerned with non-deterministic processes. ERP can be very useful for planning and controlling the deterministic processes. PMID:15171978

  4. 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.

  5. Environmental Retail Supply Chains

    DEFF Research Database (Denmark)

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

    2011-01-01

    been undertaken through an investigative approach applying a web-scan framework which included the analysis of web sites and publicly published documents such as annual reports and corporate social responsibility reports. Findings – The authors identified 34 environmental sustainability initiatives......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...

  6. 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.

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

    Science.gov (United States)

    Langabeer, Jim

    2005-01-01

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

  8. 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.

  9. 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.

  10. 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...

  11. 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...... while the effect of orbital velocity skewness is more limited. A 1 year long simulation of sediment transfers between the lower and the upper shorefaces on a natural beach compares well with transport rates estimated from long-term bar migration patterns and aeolian accretion on the same beach....

  12. 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....

  13. 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

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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...

  1. Rechargeable power supply

    NARCIS (Netherlands)

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

    2006-01-01

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

  2. 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

  3. Sustainable Supply Chain Design

    DEFF Research Database (Denmark)

    Bals, Lydia; Tate, Wendy

    A significant conceptual and practical challenge is how to integrate triple bottom line (TBL; including economic, social and environmental) sustainability into global supply chains. Although this integration is necessary to slow down global resource depletion, understanding is limited of how to i...

  4. 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.

  5. 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.

  6. 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...

  7. 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

  8. 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...

  9. 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.

  10. Hospital-acquired pneumonia

    Science.gov (United States)

    ... tends to be more serious than other lung infections because: People in the hospital are often very sick and cannot fight off ... prevent pneumonia. Most hospitals have programs to prevent hospital-acquired infections.

  11. 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...

  12. 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 ...

  13. 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 ...

  14. 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 ...

  15. 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...

  16. Perceptions of the hospital ethical environment among hospital social workers in the United States.

    Science.gov (United States)

    Pugh, Greg L

    2015-01-01

    Hospital social workers are in a unique context of practice, and one where the ethical environment has a profound influence on the ethical behavior. This study determined the ratings of ethical environment by hospital social workers in large nationwide sample. Correlates suggest by and compared to studies of ethical environment with nurses are explored. Positive ratings of the ethical environment are primarily associated with job satisfaction, as well as working in a centralized social work department and for a non-profit hospital. Religiosity and MSW education were not predictive. Implications and suggestions for managing the hospital ethical environment are provided.

  17. 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.

  18. 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

  19. 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.

  20. Offshore Supply Industry Dynamics

    DEFF Research Database (Denmark)

    Roslyng Olesen, Thomas

    with companies in the maritime sector. This report “Offshore Supply Industry Dynamics – Business strategies in the offshore supply industry” is the second report in mapping project D. It examines the markets and business strategies of various suppliers and furthermore presents an analysis of the challenges......This report is part of the research project “The competitive challenges and strategic development possibilities for The Blue Denmark”, which was launched in 2014. The project is funded by the Danish Maritime Fund and carried out by researchers at CBS Maritime which is a Business in Society Platform...... 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...

  1. 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)

  2. Towards Intelligent Supply Chains

    DEFF Research Database (Denmark)

    Siurdyban, Artur; Møller, Charles

    2012-01-01

    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...... 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......, 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....

  3. 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.

  4. 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...

  5. Heat supply project Sent

    Energy Technology Data Exchange (ETDEWEB)

    Studach, J.

    1981-05-01

    The aim to get back to energy autarky with heat generation plants from 1 to 5 MW capacity and a distribution network is becoming more and more attractive for small communities like the village Sent in Switzerland, especially since energy sources have become more and more scarce. The operation of a communal heating station and the maintenance of a heat distribution network is a task which the community will be able to cope with like water supply and waste disposal. The pilot project was handed in June 1980, all efforts are at the moment directed at realising it at the quickest possible pace. Long-term experience is needed urgently even though there are reality oriented accompanying test projects like wood-gas-dual-purpose power plants and the new collector-air-to-water heat exchanger element and distant heat pipes. A booklet supplies information on the domestic heat demand, heat generation with wood gas, wood supply, ambient air and sun, heat distribution and delivery, building installations, costs of construction and operation.

  6. Design and Implementation of Intelligent the Supply Room Business Flow Based on RFID%基于RFID的智能供应室业务流的设计与实现

    Institute of Scientific and Technical Information of China (English)

    徐向东; 丁铖; 宋永江; 封军

    2013-01-01

    消毒供应室(中心)是医院的重要单位,通过运用RFID高科技技术,不但可以实现手术包的智能化闭环管理和器械追踪,同时可以强化对清洗、消毒和灭菌等流程的质量监测,优化供应室流程,促进手术室和供应室的一体化管理,不但能提高医院的效率,而且可保证患者的安全,也为医院物联网建设积累了经验。%Central sterile supply department(CSSD) is an important unit of hospitals. With the use of RFID technology, it can not only realize intelligent closed-loop management and equipment tracking of operation package, but can also strengthen the quality monitoring of cleaning, disinfection and sterilization process, optimize the supply department process, promote the integration management of operation room and supply department. It can not only improve the efficiency of hospitals, but also can guarantee the safety of patients and accumulate experience for the construction of hospital internet of things.

  7. 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 ...

  8. The design of supply chains

    DEFF Research Database (Denmark)

    Bøge Sørensen, Lars

    2004-01-01

    Keywords Supply Chain Management, Supply Chain Design, Literature studyAbstract Argues stability is a design objective for supply chain design alongside cost, leadtime and responsiveness. Performs an extensive literature study on supply chain design,identifies methods, theories and objectives...... in the existing literature. Describes the conceptexternal specificity and how it's used to design supply chains. Using the concept upstream,archetypes of risk minimal and maximal design are identified. Downstream the conceptdescribes two viable scenarios, one minimizing the impact, the other minimizing...... theprobability of (intended) departure of a supply chain partner. Finally, principles for supplychain design are described and managerial outlined....

  9. 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.

  10. 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...

  11. Port supply chain integration : analyzing biofuel supply chains

    NARCIS (Netherlands)

    Stevens, Leonie C. E.; Vis, Iris F. A.

    2016-01-01

    This paper focuses on port supply chain integration to strengthen operational and business performance. We provide a structured and comprehensive method to enable port supply chain integration and demonstrate its applicability to the biofuel supply chain. We define the value proposition, role, activ

  12. 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.

  13. Hospital marketing revisited.

    Science.gov (United States)

    Costello, M M

    1987-05-01

    With more hospitals embracing the marketing function in their organizational management over the past decade, hospital marketing can no longer be considered a fad. However, a review of hospital marketing efforts as reported in the professional literature indicates that hospitals must pay greater attention to the marketing mix elements of service, price and distribution channels as their programs mature. PMID:10283019

  14. 全自动片剂摆药机在我院中心药房的应用%Application of Full-Automatic Tablet Dispensing Machine in the Central Pharmacy of Our Hospital

    Institute of Scientific and Technical Information of China (English)

    訾梅; 古艳婷

    2015-01-01

    OBJECTIVE:To provide references for rational application of full-automatic tablet dispensing machine in the inpa-tient pharmacy of the hospital. METHODS:According to the work flow and use of the machine,the errors and problems arising from the use thereof by our hospital were summarized and analyzed,and corresponding improvement measures and solutions were put forward. RESULTS & CONCLUSIONS:Common errors in the use of full-automatic tablet dispensing machine included errors for the machine(including in-box drug shortage warnings accounting for 58.61% and abnormal responses to the quantity of in-box drugs accounting for 36.96%),errors caused by human factors(including errors of inputting doctor’s order and errors of pharma-cist’s adding drugs)and errors of material installation and operation. The solutions put forward are as follows as adjusting the tilt angle of the outlet mouth and controlling the quantity of the drugs added to the box to reduce the errors for the machine;two phar-macists’checking doctor’s order in the hospital information system in advance to reduce the errors caused by human factors;carry-ing out operation training for operators to reduce the errors of material installation;designating special personnel to maintain the ma-chine,etc.%目的:为医院住院药房合理应用全自动片剂摆药机提供参考。方法:根据全自动片剂摆药机的工作流程和使用情况,总结分析我院在其使用中发生的差错及问题,并提出改进措施和解决方法。结果与结论:使用全自动片剂摆药机的常见差错包括自动摆药机发生的差错(其中药盒缺药报警占58.61%,药盒内数量反应错误占36.96%)、人为因素产生的差错(包括医嘱录入错误和药师加药错误)以及耗材安装操作差错。提出的解决方法包括调整出药口的倾斜角度、控制贮药盒内药品添加的数量以减少自动摆药机发生的差错;药师提前审核医院信

  15. 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.

  16. 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.

  17. 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...

  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. 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...

  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. 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

  2. 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

  3. 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

  4. Offshore Supply Industry Dynamics

    DEFF Research Database (Denmark)

    Roslyng Olesen, Thomas

    and direct investments. At the center of both value chains are the energy companies. The energy companies have a number of suppliers and sub suppliers which provide a range of equipment and services to the offshore operations. The supply industry is characterized by horizontal cooperation (between suppliers...... the physical location is examined and the installation is planned. (3) An installation phase where the equipment is produced and transported to the site where it is installed. (4) An operation phase where the energy is produced or the energy source is extracted and (5) a decommissioning phase where the field...

  5. 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...

  6. 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.

  7. 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)

  8. Practical switching power supply design

    CERN Document Server

    Brown, Martin C

    1990-01-01

    Take the ""black magic"" out of switching power supplies with Practical Switching Power Supply Design! This is a comprehensive ""hands-on"" guide to the theory behind, and design of, PWM and resonant switching supplies. You'll find information on switching supply operation and selecting an appropriate topology for your application. There's extensive coverage of buck, boost, flyback, push-pull, half bridge, and full bridge regulator circuits. Special attention is given to semiconductors used in switching supplies. RFI/EMI reduction, grounding, testing, and safety standards are also deta

  9. The market for hospital medicine in Denmark

    Directory of Open Access Journals (Sweden)

    Gisela Hostenkamp

    2011-11-01

    Full Text Available Pharmaceutical expenditure growth has outpaced GDP and healthcare expenditure growth rates in Denmark as in most OECD countries for the last decade. A major part of this increase was due to high growth rates in specialist areas that are typically located in hospital settings. Yet the market for hospital medicines and their procurement are still poorly understood. The present paper characterises the market for hospital medicines in Denmark in terms of its organisation and developments between 2005 and 2009. In Denmark hospital medicines are publicly financed and procurement is centrally organised. 98% of all medicines administered at Danish public hospitals are purchased through a public procurement agency by means of public tenders. Using data on actual contract prices we decompose pharmaceutical expenditure growth into the contributions from newly introduced medicines, price and volume increases and use summary statistics to compare market performance in both sectors. The market for hospital medicine is more concentrated than the pharmaceutical retail sector and the share of generics and parallel imported products is significantly lower. Between 2005 and 2009 expenditures for hospital medicines more than doubled -accounting for almost 40% of the total Danish pharmaceutical market in 2009. Price increases however - although positive and higher than in the pharmaceutical retail sector - were only moderate. The majority of the expenditure growth was due to an increase in utilisation and the introduction of new medicines in the hospital sector. Centralised tendering may therefore have important implications for competition and industry structure in the long run.

  10. 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.

  11. 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.

  12. 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…

  13. 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

  14. 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...

  15. An investigation on research and development cost reduction and channel strategies in competing supply chains

    Directory of Open Access Journals (Sweden)

    Qinqin Li

    2014-06-01

    Full Text Available With the intensification of market competition, the competition form of firms is evolving from the competition among firms to the competition among supply chains. This paper considers a market with two competing supply chains consisting of one supplier and one manufacturer. The two supply chains compete on products’ quantities and research and development (R&D level when the two manufacturers conduct technological innovation. This paper analyses the supply chain competition in three scenarios: two decentralized supply chains (DD, one decentralized supply chain and one centralized supply chain (DC and two centralized supply chains (CC. The results indicate that the production quantity, the R&D level and the total profit of the integrated supply chain in DC scenario are the largest, CC scenario comes second, those of the DD scenario come third and those of the decentralized supply chain in DC scenario are the smallest. CC strategy is the supply chain system’s Nash equilibrium, which is good for the both supply chains, and there is no prisoner's dilemma.

  16. 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

  17. 医院中央空调循环水系统生物膜检测及控制措施%Detection of biofilm and control measures for circulating water system of central air conditioning in hospital

    Institute of Scientific and Technical Information of China (English)

    李春玲; 顾翔宇; 于志臻; 江海峰

    2015-01-01

    Objective To investigate the effect of new comprehensive treatment scheme on the treatment of central air-conditioning circulating water,and compared with the original treatment scheme,so as to take more effective measures to prevent and control the source of healthcare-associated infection.Methods After the implementation of two water treatment schemes,biofilm dynamic trend,microorganisms,and corrosion rate were detected by online microbial analyzer and biofilm detection kit.Results After the implementation of original scheme,biofilm trend value of central air-conditioning circulating water was continuously high,maintaining at 200-500;pathogens (Pseudomonas aeruginosa)exis-ted in the circulating cooling water;corrosion testing showed that corrosion coupons were severely corroded.After the im-plementation of new scheme,biofilm trend value declined continuously,and finally stably maintained below 20;pathogens were not detected after 6 days,which was corresponded to biofilm trend value;corrosion coupons were slightly corroded, corrosion rate was<0.075 mm/a.Conclusion New comprehensive treatment scheme is definitely effective for reducing and controlling the growth of pathogens,biofilm and corrosion.%目的:了解新型综合性处理方案对中央空调循环水处理的效果,并与原有的水处理方案进行对比,以便采用更有效的措施从源头预防和控制医院感染的发生。方法采用两种水处理方案后,应用在线微生物分析仪和生物膜测试盒进行生物膜动态趋势检测以及微生物和腐蚀速率的测定。结果经检测,原方案处理后,中央空调循环水中的生物膜趋势值一直比较高,维持在200~250之间;循环冷却水中存在致病菌(铜绿假单胞菌);系统腐蚀检测发现试片严重腐蚀。新方案处理后,中央空调循环水中的生物膜趋势值持续下降并最终稳定在20以下;6 d 后水系统中致病菌消失,与生物膜趋势值相对应

  18. Service differentiation in spare parts supply through dedicated stocks

    NARCIS (Netherlands)

    Alvarez, E.M.; Heijden, van der M.C.; Zijm, W.H.M.

    2012-01-01

    We investigate keeping dedicated stocks at customer sites in addition to stock kept at some central location as a tool for applying service differentiation in spare parts supply. We study the resulting two-echelon system in a multi-item setting, both under backordering and under emergency shipments

  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. 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...

  2. 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 ...

  3. 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...

  4. 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...

  5. 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...

  6. Establishment and Application of Quality Control Traceability System in Sterilization Supply Center%消毒供应中心质量控制可追溯系统的构建与应用

    Institute of Scientific and Technical Information of China (English)

    何晓滨; 樊彦红

    2013-01-01

      目的:探讨医院中建立消毒供应中心质量控制可追溯系统的临床价值。方法:利用信息技术、网络技术,研发了信息化条码标签,将信息系统与消毒灭菌生产供应链管理有效结合,建立了质量控制可追溯软件系统,实现消毒供应器械物品监控。结果:2011年7月至2012年12月共扫描供应监控手术器械包667735个,敷料包53520个,合格率为100%,无因灭菌质量问题引发感染事故发生。结论:质量控制可追溯软件系统加强了消毒灭菌生产供应链管理过程控制,保障了消毒供应产品质量和医疗安全,实现了感染控制的追溯管理,为临床和科学研究提供方便,具有实用价值。%Objective: To discuss clinic value how to establish the central sterile supply quality control traceability system in the military hospitals. Methods: The informatization bar code label was developed independently by adopting Information technology, network technology, the central sterile supply quality control traceability system was established through scanning, combine effectively the information system with the disinfection antiseptic production supplying chain management, and the scanning supply monitoring was performed for the disinfection and supply of instruments and materials. Results:From July 2011 to Dec 2012, the scanning supply monitoring was performed for to tally 667735 surgery instrument packages and 53520 cloth packages no package recalled and no infection events occurred due to the sterilization quality. Conclusions With the central sterile supply quality control traceability system, the process of disinfection antiseptic production supply chain management has been strengthened, the quality of disinfection supply product and medical security have been ensured, and the traceability management of infection control has been achieved, provide conditions for clinical and scientific research.

  7. 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...

  8. 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.

  9. Developing sustainable food supply chains.

    Science.gov (United States)

    Smith, B Gail

    2008-02-27

    This paper reviews the opportunities available for food businesses to encourage consumers to eat healthier and more nutritious diets, to invest in more sustainable manufacturing and distribution systems and to develop procurement systems based on more sustainable forms of agriculture. The important factors in developing more sustainable supply chains are identified as the type of supply chain involved and the individual business attitude to extending responsibility for product quality into social and environmental performance within their own supply chains. Interpersonal trust and working to standards are both important to build more sustainable local and many conserved food supply chains, but inadequate to transform mainstream agriculture and raw material supplies to the manufactured and commodity food markets. Cooperation among food manufacturers, retailers, NGOs, governmental and farmers' organizations is vital in order to raise standards for some supply chains and to enable farmers to adopt more sustainable agricultural practices. PMID:17766237

  10. Concurrent Product & Supply Chain Creation

    DEFF Research Database (Denmark)

    Gubi, Ebbe

    it is a structural premise. We also know that logistics costs generally are estimated 15-20% of total product costs. Accordingly, it stands to reason that a company can reduce costs, and thereby gain an edge on its competitors, by tailoring the supply chain in question to an individual product or product family; i......The purpose of this thesis is to increase the understanding of interplays between products and supply chains. In academia, there seem to be an acknowledgement that the nature of a given product has a major influence on the performance of the supply chain associated with it – for one.......e. by creating Focused Supply Chains. At the same time, customer satisfaction can be increased. As a second means to achieving a better fit between product and supply chain, the firm can deploy Design for Logistics, the discipline of considering the supply chain during product creation. The thesis sets out...

  11. central t

    Directory of Open Access Journals (Sweden)

    Manuel R. Piña Monarrez

    2007-01-01

    Full Text Available Dado que la Regresión Ridge (RR, es una estimación sesgada que parte de la solución de la regresión de Mínimos Cuadrados (MC, es vital establecer las condiciones para las que la distribución central t de Student que se utiliza en la prueba de hipótesis en MC, sea también aplicable a la regresión RR. La prueba de este importante resultado se presenta en este artículo.

  12. Optics Supply Planning System

    Energy Technology Data Exchange (ETDEWEB)

    Gaylord, J

    2009-04-30

    The purpose of this study is to specify the design for an initial optics supply planning system for NIF, and to present quality assurance and test plans for the construction of the system as specified. The National Ignition Facility (NIF) is a large laser facility that is just starting operations. Thousands of specialized optics are required to operate the laser, and must be exchanged over time based on the laser shot plan and predictions of damage. Careful planning and tracking of optic exchanges is necessary because of the tight inventory of spare optics, and the long lead times for optics procurements and production changes. Automated inventory forecasting and production planning tools are required to replace existing manual processes. The optics groups members who are expected to use the supply planning system are the stakeholders for this project, and are divided into three groups. Each of these groups participated in a requirements specification that was used to develop this design. (1) Optics Management--These are the top level stakeholdersk, and the final decision makers. This group is the interface to shot operations, is ultimately responsible for optics supply, and decides which exchanges will be made. (2) Work Center Managers--This group manages the on site optics processing work centers. They schedule the daily work center operations, and are responsible for developing long term processing, equipment, and staffing plans. (3) Component Engineers--This group manages the vendor contracts for the manufacture of new optics and the off site rework of existing optics. They are responsible for sourcing vendors, negotiating contracts, and managing vendor processes. The scope of this analysis is to describe the structure and design details of a system that will meet all requirements that were described by stakeholders and documented in the analysis model for this project. The design specifies the architecture, components, interfaces, and data stores of the system

  13. 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.

  14. 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...

  15. 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...

  16. 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...

  17. 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.

  18. 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...

  19. Cholangiocytes and blood supply

    Institute of Scientific and Technical Information of China (English)

    Eugenio Gaudio; Antonio Franchitto; Luigi Pannarale; Guido Carpino; Gianfranco Alpini; Heather Francis; Shannon Glaser; Domenico Alvaro; Paolo Onori

    2006-01-01

    The microvascular supply of the biliary tree, the peribiliary plexus (PBP), stems from the hepatic artery branches and flows into the hepatic sinusoids. A detailed three-dimensional study of the PBP has been performed by using the Scanning Electron Microscopy vascular corrosion casts (SEMvcc) technique. Considering that the PBP plays a fundamental role in supporting the secretory and absorptive functions of the biliary epithelium, their organization in either normalcy and pathology is explored. The normal liver shows the PBP arranged around extra- and intrahepatic biliary tree.In the small portal tract PBP was characterized by a single layer of capillaries which progressively continued with the extrahepatic PBP where it showed a more complex vascular network. After common duct ligation (BDL), progressive modifications of bile duct and PBP proliferation are observed. The PBP presents a threedimensional network arranged around many bile ducts and appears as bundles of vessels, composed by capillaries of homogeneous diameter with a typical round mesh structure. The PBP network is easily distinguishable from the sinusoidal network which appears normal. Considering the enormous extension of the PBP during BDL, the possible role played by the Vascular Endothelial Growth Factor (VEGF) is evaluated. VEGF-A,VEGF-C and their related receptors appeared highly immunopositive in proliferating cholangiocytes of BDL rats. The administration of anti-VEGF-A or anti-VEGF-C antibodies to BDL rats as well as hepatic artery ligation induced a reduced bile duct mass. The administration of rVEGF-A to BDL hepatic artery ligated rats prevented the decrease of cholangiocyte proliferation and VEGF-A expression as compared to BDL control rats. These data suggest the role of arterial blood supply of the biliary tree in conditions of cholangiocyte proliferation, such as it occurs during chronic cholestasis. On the other hand,the role played by VEGF as a tool of cross-talk between cholangiocytes

  20. Antecedents for the Adoption and Execution of Supply Chain Management

    DEFF Research Database (Denmark)

    Kotzab, Herbert; Teller, Christoph; Grant, David B.;

    2011-01-01

    Purpose – The purpose of this paper is to develop a conceptual model that includes drivers of supply chain management (SCM) adoption and execution identified in the literature, provide a set of measurement scales that operationalise constructs within this model, empirically verify a hierarchical...... through a survey of 174 senior supply chain managers representing the biggest organisations within a central European country. Findings – Using structural equation modelling the hypothesised hierarchical order of three proposed antecedents is verified: “internal SCM conditions”, that affect “joint......-specific supply chain setting. Practical implications – The findings provide a hierarchical focus for financial, personnel and management initiatives to increase integration within a supply chain and improve competitiveness. Originality/value – The major contribution of this paper is that it provides empirical...