Telemedicine for a Children's Field Hospital in Chechnya.

Science.gov (United States)

Ehrlich, A I; Kobrinsky, B A; Petlakh, V I; Rozinov, V M; Shabanov, V E

2007-01-01

In 2001, the Children's Field Hospital in the Gudermes area of the Chechen Republic was connected to a telemedical centre at the Scientific Institute of Pediatrics and Children's Surgery in Moscow, via the Russian SCA HeliosNet satellite system. An asymmetric satellite link, in which there was a high-speed downlink from the satellite to Gudermes and a low-speed uplink from Gudermes to the satellite was used. In total, 179 teleconsultations were carried out from October 2001 until February 2002, when the field hospital was closed. Of the 179 teleconsultations, 26 were real-time, by videoconference and the rest were asynchronous, by email. Almost half of consultations were carried out for emergency or urgent reasons, thus demonstrating the value of providing access to the necessary experts. The use of satellite communication allowed telemedical support for medical decisions in a wide range of disease and trauma in children and teenage in a conflict situation.

[Introduction of the psychoprophylactic method and its influence on the prenatal care program for institutional parturition in Japan: the practice in the Central Hospital of Maternity of the Japanese Red Cross Society and Oomori Red Cross Hospital, 1953-1964].

Science.gov (United States)

Fujihara, Satoko; Tsukisawa, Miyoko

2014-03-01

The psychoprophylactic method is one of the methods for providing 'painless childbirth without drugs' and was invented by applying I. Pavlov's theory of higher nervous activity. In 1951, it was adopted as a national policy in the Union of Soviet Socialist Republics. This method was then introduced in the People's Republic of China in 1952. In 1953, it was brought to Japan by Masatomo SUGAI, an obstetrician, and was introduced into the Central Hospital of Maternity of the Japanese Red Cross Society with the support of the director, Naotarou KUJI. The practice of this method by the research team, which consisted of the obstetricians and midwives of the Central Hospital of Maternity of the Japanese Red Cross Society and Oomori Red Cross Hospital, resulted in the initiation and characterization of the prenatal care program to encourage the autonomy of the pregnant women for normal parturition in the institutions of Japan.

Examination of cross contamination risks between hospitals by external medical staff via cross-sectional intercept survey of hand hygiene

Directory of Open Access Journals (Sweden)

Schiffers, Hank

2014-08-01

Full Text Available [english] Introduction: Work in hospitals is supported by contributions of life sciences industry representatives (IR in various ways of fields. Close contact between them, caretakers and patients is unavoidable, even in situations where hygiene is critical.The present study investigates whether IR display comparable levels of and methicillin-resistant (MRSA contamination after being exposed to a shared environment for a minimum of 4 hours.Material and methods: An anonymous survey to sample a group of healthcare professionals for traces of fingertip contamination was performed. We used dip slides ( and MRSA to evaluate professionals at the medical exhibition MEDICA. After applying exclusion criteria 298 participants remained valid, they consisted of 208 industry representatives, 49 nurses and 41 physicians.Results: IR where engaged in hospitals, operating rooms and outpatient clinics (82%, 41.8%, 51.9% respectively. 65.9% of IR (vs. 48.8% physicians and 40.8% nurses carried a microbiological burden ≥10 CFU (colony forming units. Neither (≥10 CFU in IR (40.9% did show statistical differences in contamination patterns in comparison to physicians (43.9%, p=0.346 and nurses (36.7%, p=0.878 nor did MRSA (physicians p=0.579, nurses p=0.908. We were unable to differentiate transient from pre-existing permanent colonization.Conclusion: Exposure to the same environment may result in similar hand contamination patterns of IR when compared caregivers. This supports the concern that industry representatives can cause cross infection between hospitals and hygiene sensitive areas like operation room, intensive care unit and central sterilization units particularly. Further study is required to clarify whether pre-existing bacterial colonization is an influencing factor and how industry is taking care of this to create a safe working environment for their employees, the customers and ultimately the patients.

Quality of Public Hospitals Websites: A Cross-Sectional Analytical Study in Iran.

Science.gov (United States)

Salarvand, Shahin; Samadbeik, Mahnaz; Tarrahi, Mohammad Javad; Salarvand, Hamed

2016-04-01

Nowadays, hospitals have turned increasingly towards the Internet and develop their own web presence. Hospital Websites could be operating as effective web resources of information and interactive communication mediums to enhance hospital services to the public. Therefore, the aim of this study was to assess the quality of websites in Tehran's public hospitals. This cross-sectional analysis involved all public hospitals in Iran's capital city, Tehran, with a working website or subsites between April and June, 2014 (N=59). The websites were evaluated using three validated instruments: a localized checklist, Google page rank, and the Alexa traffic ranking. The mentioned checklist consisted of 112 items divided into five sections: technical characteristics, hospital information and facilities, medical services, interactive on-line services and external activities. Data were analyzed using descriptive and analytical statistics. The mean website evaluation score was 45.7 out of 224 for selected public hospitals. All the studied websites were in the weak category based on the earned quality scores. There was no statistically significant association between the website evaluation score with Google page rank (P=0.092), Alexa global traffic rank and Alexa traffic rank in Iran (P>0.05). The hospital websites had a lower quality score in the interactive online services and external activities criteria in comparing to other criteria. Due to the low quality level of the studied websites and the importance of hospital portals in providing information and services on the Internet, the authorities should do precise planning for the appreciable improvement in the quality of hospital websites.

Measurements of crossed-field demagnetisation rate of trapped field magnets at high frequencies and below 77 K

Science.gov (United States)

Baskys, A.; Patel, A.; Glowacki, B. A.

2018-06-01

Design requirements of the next generation of electric aircraft place stringent requirements on the power density required from electric motors. A future prototype planned in the scope of the European project ‘Advanced Superconducting Motor Experimental Demonstrator’ (ASuMED) considers a permanent magnet synchronous motor, where the conventional ferromagnets are replaced with superconducting trapped field magnets, which promise higher flux densities and thus higher output power without adding weight. Previous work has indicated that stacks of tape show lower cross-field demagnetisation rates to bulk (RE)BCO whilst retaining similar performance for their size, however the crossed-field demagnetisation rate has not been studied in the temperature, the magnetic field and frequency range that are relevant for the operational prototype motor. This work investigates crossed-field demagnetisation in 2G high temperature superconducting stacks at temperatures below 77 K and a frequency range above 10 Hz. This information is crucial in developing designs and determining operational time before re-magnetisation could be required.

Density limit and cross-field edge transport scaling in Alcator C-Mod

International Nuclear Information System (INIS)

LaBombard, B.; Greenwald, M.; Hughes, J.W.; Lipschultz, B.; Mossessian, D.; Terry, J.L.; Boivin, R.L.; Carreras, B.A.; Pitcher, C.S.; Zweben, S.J.

2003-01-01

Recent experiments in Alcator C-Mod have uncovered a direct link between the character and scaling of cross-field particle transport in the edge plasma and the density limit, n G . As n-bar e /n G is increased from low values to values approaching ∼1, an ordered progression in the cross-field edge transport physics occurs: first benign cross-field heat convection, then cross-field heat convection impacting the scrape-off layer (SOL) power loss channels and reducing the separatrix electron temperature, and finally 'bursty' transport (normally associated with the far SOL) invading into closed flux surface regions and carrying a convective power loss that impacts the power balance of the discharge. These observations suggest that SOL transport and its scaling with plasma conditions plays a key role in setting the empirically observed density limit scaling law. (author)

Photoionization cross-section of shallow donors impurities at all magnetic fields

International Nuclear Information System (INIS)

Zorkani, I.; Filali, L.

1998-09-01

The dependence of the photoionization cross-section for shallow donors on photon energy is calculated. The effects of strong and weak magnetic fields are considered by means of a variational wave function which is a linear combination of the cylindrical wave function and the oscillator one. Simple analytical expressions, valid for all magnetic fields, are obtained. It has been found that the photoionization cross-section is affected by the magnetic field. We give some results of Germanium. (author)

Mixture model to assess the extent of cross-transmission of multidrug-resistant pathogens in hospitals.

Science.gov (United States)

Mikolajczyk, Rafael T; Kauermann, Göran; Sagel, Ulrich; Kretzschmar, Mirjam

2009-08-01

Creation of a mixture model based on Poisson processes for assessment of the extent of cross-transmission of multidrug-resistant pathogens in the hospital. We propose a 2-component mixture of Poisson processes to describe the time series of detected cases of colonization. The first component describes the admission process of patients with colonization, and the second describes the cross-transmission. The data set used to illustrate the method consists of the routinely collected records for methicillin-resistant Staphylococcus aureus (MRSA), imipenem-resistant Pseudomonas aeruginosa, and multidrug-resistant Acinetobacter baumannii over a period of 3 years in a German tertiary care hospital. For MRSA and multidrug-resistant A. baumannii, cross-transmission was estimated to be responsible for more than 80% of cases; for imipenem-resistant P. aeruginosa, cross-transmission was estimated to be responsible for 59% of cases. For new cases observed within a window of less than 28 days for MRSA and multidrug-resistant A. baumannii or 40 days for imipenem-resistant P. aeruginosa, there was a 50% or greater probability that the cause was cross-transmission. The proposed method offers a solution to assessing of the extent of cross-transmission, which can be of clinical use. The method can be applied using freely available software (the package FlexMix in R) and it requires relatively little data.

Telecommunications in Israeli field hospitals deployed to three crisis zones.

Science.gov (United States)

Finestone, Aharon S; Levy, Gadi; Bar-Dayan, Yaron

2014-10-01

A field hospital overseas requires various types of communication equipment. This study presents the communications equipment used by three Israeli field hospital delegations to earthquake sites at Adapazari, Turkey, in 1999, Port-au-Prince, Haiti, in 2010 and Minamisanriku, Japan, in 2011. The delegations to Turkey and Haiti were relatively large (105-230 personnel) and were on the site early (three to four days after each event). The 55-person delegation to Japan arrived later and was established as an outpatient community hospital. Standard military VHF radios were the only effective tool up to 5 km, until cellular coverage was regained (1-2 weeks after each event). International communication was good. While short-wave communication (telephone and Internet) was used in Turkey, a direct satellite channel was set up in Haiti. In Japan, BGAN Inmarsat provided efficient Wi-Fi for all needs. Motorola walkie talkies were not efficient beyond the immediate vicinity. This paper recommends continued use of military-specification equipment alongside newer modalities, particularly in situations where infrastructure is damaged. © 2014 The Author(s). Disasters © Overseas Development Institute, 2014.

Hospital graduate social work field work programs: a study in New York City.

Science.gov (United States)

Showers, N

1990-02-01

Twenty-seven hospital field work programs in New York City were studied. Questionnaires were administered to program coordinators and 238 graduate social work students participating in study programs. High degrees of program structural complexity and variation were found, indicating a state of art well beyond that described in the general field work literature. High rates of student satisfaction with learning, field instructors, programs, and the overall field work experience found suggest that the complexity of study programs may be more effective than traditional field work models. Statistically nonsignificant study findings indicate areas in which hospital social work departments may develop field work programs consistent with shifting organizational needs, without undue risk to educational effectiveness. Statistically significant findings suggest areas in which inflexibility in program design may be more beneficial in the diagnostic related groups era.

Three-dimensional simulation of the electromagnetic ion/ion beam instability: cross field diffusion

Directory of Open Access Journals (Sweden)

H. Kucharek

2000-01-01

Full Text Available In a system with at least one ignorable spatial dimension charged particles moving in fluctuating fields are tied to the magnetic field lines. Thus, in one-and two-dimensional simulations cross-field diffusion is inhibited and important physics may be lost. We have investigated cross-field diffusion in self-consistent 3-D magnetic turbulence by fully 3-dimensional hybrid simulation (macro-particle ions, massless electron fluid. The turbulence is generated by the electromagnetic ion/ion beam instability. A cold, low density, ion beam with a high velocity stream relative to the background plasma excites the right-hand resonant instability. Such ion beams may be important in the region of the Earth's foreshock. The field turbulence scatters the beam ions parallel as well as perpendicular to the magnetic field. We have determined the parallel and perpendicular diffusion coefficient for the beam ions in the turbulent wave field. The result compares favourably well (within a factor 2 with hard-sphere scattering theory for the cross-field diffusion coefficient. The cross-field diffusion coefficient is larger than that obtained in a static field with a Kolmogorov type spectrum and similar total fluctuation power. This is attributed to the resonant behaviour of the particles in the fluctuating field.

Low-frequency instabilities of electron-hole plasmas in crossed fields

International Nuclear Information System (INIS)

Schneider, W.; Kirchesch, P.

1978-01-01

Using local point-contact probes, we observed two types of low-frequency instabilities in n-InSb at 85 K if the samples were exposed to crossed fields. One is a local density instability with threshold frequencies of f = 1 ... 20 Mc, the other a more turbulent current instability. The threshold values of U 0 and B for the onset of these instabilities and the dependence of their amplitudes on the fields have been measured. If a rectangular semiconductor slab is placed in crossed fields, regions of high electric field strength at opposite edges of the contacts are caused by the distortion of the Hall field, giving rise to the generation of electron-hole plasmas by impact ionization. These plasmas are the sources of the observed instabilities. This is especially evident in the case of the local density instability, which originates at the anode high field corner. Several possible reasons for the development of the instabilities are discussed. (orig.) [de

Perceptions of an 'international hospital' in Thailand by medical travel patients: cross-cultural tensions in a transnational space.

Science.gov (United States)

Whittaker, Andrea; Chee, Heng Leng

2015-01-01

The growing trade in patients seeking health care in other countries, or medical travel, is changing the forms and experiences of health care seeking and producing changes to hospitals in terms of their design, organization and spaces. What is termed in marketing parlance in Thailand as an 'international hospital' oriented to attracting foreign patients, is a hotel-hospital hybrid that is locally produced through the inflexion of local practices to make a therapeutic space for international patients. The paper reports on work undertaken within a Thai hospital in 2012 which included observations and interviews with thirty foreign in-patients and nine informal interviews with hospital staff. Although theorized as a culturally neutral transnational 'space of connectivity', we show how cross-cultural tensions affect the experience of the hospital with implications for the organization of the hospital and notions of 'cultural competence' in care. There is no single universal experience of this space, instead, there are multiple experiences of the 'international hospital', depending on who patients are, where they are from, their expectations and relationships. Such hospitals straddle the expectations of both local patients and international clientele and present highly complex cross-cultural interactions between staff and patients but also between patients and other patients. Spatial organisation within such settings may either highlight cultural difference or help create culturally safe spaces. Copyright © 2014 Elsevier Ltd. All rights reserved.

Response of hard superconductors to crossed magnetic fields: elliptic critical-state model

Energy Technology Data Exchange (ETDEWEB)

Romero-Salazar, C.; Perez-Rodriguez, F

2004-05-01

The behavior of hard superconductors subjected to crossed magnetic fields is theoretically investigated by employing an elliptic critical-state model. Here the anisotropy is induced by flux-line cutting. The model reproduces successfully the collapse of the magnetic moment under the action of a sweeping magnetic field, applied perpendicularly to a dc field, for diamagnetic and paramagnetic initial states. Besides, it explains the transition from the diamagnetic state to the paramagnetic one when the magnitudes of the crossed magnetic fields are of the same order.

Phonon-assisted transitions in crossed electric and magnetic fields

International Nuclear Information System (INIS)

Hassan, A.R.

1980-05-01

A theory of the effect of a crossed electric, E, and magnetic, H, fields in the indirect transitions in semiconductors is developed. A semi-classical treatment is adopted where the electric field is considered as a small perturbation. A numerical application to GaP gives the limiting values of E/H valid to this approach. (author)

Shaping the Educational Policy Field: "Cross-Field Effects" in the Chinese Context

Science.gov (United States)

Yu, Hui

2018-01-01

This paper theorises how politics, economy and migrant population policies influence educational policy, utilising Bourdieusian theoretical resources to analyse the Chinese context. It develops the work of Lingard and Rawolle on cross-field effects and produces an updated three-step analytical framework. Taking the policy issue of the schooling of…

High voltage series protection of neutral injectors with crossed-field tubes

International Nuclear Information System (INIS)

Hofmann, G.A.; Thomas, D.G.

1976-01-01

High voltage neutral beam injectors for fusion machines require either parallel or series protection schemes to limit fault currents in case of arcing to safe levels. The protection device is usually located between the high voltage supply and beam injector and either crowbars (parallel protection) or disconnects (series protection) the high voltage supply when a fault occurs. Because of its isolating property, series protection is preferred. The Hughes crossed-field tube is uniquely suited for series protection schemes. The tube can conduct 40 A continuously upon application of voltage (approximately 300 V) and a static magnetic field (approximately 100 G). It is also capable of interrupting currents of 1000 A within 10 μs and withstand voltage of more than 120 kV. Experiments were performed to simulate the duty of a crossed-field tube as a series protection element in a neutral injector circuit under fault conditions. Results of on-switching tests under high and low voltage and interruption of fault currents are presented. An example of a possible protection circuit with crossed-field tubes is discussed

Field dosimetry on sterilization area of medical-hospitable materials

International Nuclear Information System (INIS)

Mariano, C.S.T.P.; Campos, L.L.

1992-01-01

The calcium sulfate doped with dysprosium, used in high dose dosimetry by electron paramagnetic resonance (EPR), is studied on field dosimetry for medical-hospitable materials sterilization. The calibration curves of EPR signal in function of absorbed dose in air and the thermal decay of EPR signal at room temperature are also presented. (C.G.C)

Evaluation of psychometric properties of the German Hospital Survey on Patient Safety Culture and its potential for cross-cultural comparisons: a cross-sectional study.

Science.gov (United States)

Gambashidze, Nikoloz; Hammer, Antje; Brösterhaus, Mareen; Manser, Tanja

2017-11-09

To study the psychometric characteristics of German version of the Hospital Survey on Patient Safety Culture and to compare its dimensionality to other language versions in order to understand the instrument's potential for cross-national studies. Cross-sectional multicentre study to establish psychometric properties of German version of the survey instrument. 73 units from 37 departments of two German university hospitals. Clinical personnel (n=995 responses, response rate 39.6%). Psychometric properties (eg, model fit, internal consistency, construct validity) of the instrument and comparison of dimensionality across different language translations. The instrument demonstrated acceptable to good internal consistency (Cronbach's alpha 0.64-0.88). Confirmatory factor analysis of the original 12-factor model resulted in marginally satisfactory model fit (root mean square error of approximation (RMSEA)=0.05; standardised root mean residual (SRMR)=0.05; comparative fit index (CFI)=0.90; goodness of fit index (GFI)=0.88; Tucker-Lewis Index (TLI)=0.88). Exploratory factor analysis resulted in an alternative eight-factor model with good model fit (RMSEA=0.05; SRMR=0.05; CFI=0.95; GFI=0.91; TLI=0.94) and good internal consistency (Cronbach's alpha 0.73-0.87) and construct validity. Analysis of the dimensionality compared with models from 10 other language versions revealed eight dimensions with relatively stable composition and appearance across different versions and four dimensions requiring further improvement. The German version of Hospital Survey on Patient Safety Culture demonstrated satisfactory psychometric properties for use in German hospitals. However, our comparison of instrument dimensionality across different language versions indicates limitations concerning cross-national studies. Results of this study can be considered in interpreting findings across national contexts, in further refinement of the instrument for cross-national studies and in better

Photon - axion conversion cross sections in an electromagnetic field

International Nuclear Information System (INIS)

Dang Van Soa; Ha Huy Bang

1999-12-01

Photon - axion conversions in static magnetic fields and in a periodic field with frequency equal to the axion mass are reconsidered in detail by Feynman methods. The differential cross sections are presented and numerical evaluations are given. It is shown that there is a resonant conversion for the considered process. Some estimates for experiments are given from our results. (author)

The effect of the electric field on the photoionization cross-section

International Nuclear Information System (INIS)

Sali, A.; Loumrhari, H.; Fliyou, M.

1998-01-01

The effect of the electric field on the donor impurity is investigated in the case of a spherical conduction band with the use of a variational procedure. An analytical expression for the photoionization cross-section as a function of photon energy within the effective mass approximation of an impurity atom in an applied field was obtained. The effect of central cell correction by means of a semi-empirical short-range potential is taken into account. It has been found that the binding energy and the spectral dependence of the cross-section are very sensitive to the electric field, the shape of the impurity potential and their combined effect

Impact of a hospital improvement initiative in Bangladesh on patient experiences and satisfaction with services: two cross-sectional studies

Directory of Open Access Journals (Sweden)

Omer Khalid

2011-12-01

Full Text Available Abstract Background The Bangladesh government implemented a pilot Hospital Improvement Initiative (HII in five hospitals in Sylhet division between 1998 and 2003. This included management and behaviour change training for staff, waste disposal and procurement, and referral arrangements. Two linked cross-sectional surveys in 2000 and 2003 assessed the impact of the HII, assessing both patients' experience and satisfaction and public views and use of the hospitals. Methods In each survey we asked 300 consecutive outpatients and a stratified random sample of 300 inpatients in the five hospitals about waiting and consultation time, use of an agent for admission, and satisfaction with privacy, cleanliness, and staff behaviour. The field teams observed cleanliness and privacy arrangements, and visited a sample of households in communities near the hospitals to ask about their opinions and use of the hospital services. Analysis examined changes over time in patients' experience and views. Multivariate analysis took account of other variables potentially associated with the outcomes. Survey managers discussed the survey findings with gender stratified focus groups in each sample community. Results Compared with 2000, an outpatient in three of the hospitals in 2003 was more likely to be seen within 10 minutes and for at least five minutes by the doctor, but outpatients were less likely to report receiving all the prescribed medicines from the hospital. In 2003, inpatients were more likely to have secured admission without using an agent. Although patients’ satisfaction with several aspects of care improved, most changes were not statistically significant. Households in 2003 were significantly more likely to rate the hospitals as good than in 2000. Use of the hospitals did not change, except that more households used the medical college hospital for inpatient care in 2003. Focus groups confirmed criticisms of services and suggested improvements

Photoionization cross-section of donor impurity in spherical quantum dots under electric and intense laser fields

International Nuclear Information System (INIS)

Burileanu, L.M.

2014-01-01

Using a perturbative method we have investigated the behavior of the binding energy and photoionization cross-section of a donor impurity in spherical GaAs–GaAlAs quantum dots under the influence of electric and intense high-frequency laser fields. The dependencies of the binding energy and photoionization cross-section on electric and laser field strength, dot radius and impurity position were investigated. Our results show that the amplitude of photoionization cross-section grows with the dot radius increase and the peak of the cross-section blue shifts with the laser intensity increment. We have found that the binding energy is not a monotonically function of laser intensity: it decreases or increases depending on electric field regime. The studied effects are even more pronounced as the quantum dot radius is smaller. -- Highlights: • A photoionization cross-section study in quantum dots under laser and electric fields. • The photoionization cross-section peaks are red shifted by the electric field. • The photoionization cross-section peaks are blue shifted by the laser field. • The combined effects of applied fields strongly affect the binding energy

APPARENT CROSS-FIELD SUPERSLOW PROPAGATION OF MAGNETOHYDRODYNAMIC WAVES IN SOLAR PLASMAS

Energy Technology Data Exchange (ETDEWEB)

Kaneko, T.; Yokoyama, T. [Department of Earth and Planetary Science, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 (Japan); Goossens, M.; Doorsselaere, T. Van [Centre for Mathematical Plasma Astrophysics, Katholieke Universiteit Leuven, Celestijnenlaan 200B, Bus 2400, B-3001 Herverlee (Belgium); Soler, R.; Terradas, J. [Departament de Física, Universitat de les Illes Balears, E-07122 Palma de Mallorca (Spain); Wright, A. N., E-mail: kaneko@eps.s.u-tokyo.ac.jp [School of Mathematics and Statistics, University of St Andrews, St Andrews, KY16 9SS (United Kingdom)

2015-10-20

In this paper we show that the phase-mixing of continuum Alfvén waves and/or continuum slow waves in the magnetic structures of the solar atmosphere as, e.g., coronal arcades, can create the illusion of wave propagation across the magnetic field. This phenomenon could be erroneously interpreted as fast magnetosonic waves. The cross-field propagation due to the phase-mixing of continuum waves is apparent because there is no real propagation of energy across the magnetic surfaces. We investigate the continuous Alfvén and slow spectra in two-dimensional (2D) Cartesian equilibrium models with a purely poloidal magnetic field. We show that apparent superslow propagation across the magnetic surfaces in solar coronal structures is a consequence of the existence of continuum Alfvén waves and continuum slow waves that naturally live on those structures and phase-mix as time evolves. The apparent cross-field phase velocity is related to the spatial variation of the local Alfvén/slow frequency across the magnetic surfaces and is slower than the Alfvén/sound velocities for typical coronal conditions. Understanding the nature of the apparent cross-field propagation is important for the correct analysis of numerical simulations and the correct interpretation of observations.

Magnetohydrodynamic free convection in a strong cross field

NARCIS (Netherlands)

Kuiken, H.K.

1970-01-01

The problem of magnetohydrodynamic free convection of an electrically conducting fluid in a strong cross field is investigated. It is solved by using a singular perturbation technique. The solutions presented cover the range of Prandtl numbers from zero to order one. This includes both the important

Internet Hospitals in China: Cross-Sectional Survey.

Science.gov (United States)

Xie, Xiaoxu; Zhou, Weimin; Lin, Lingyan; Fan, Si; Lin, Fen; Wang, Long; Guo, Tongjun; Ma, Chuyang; Zhang, Jingkun; He, Yuan; Chen, Yixin

2017-07-04

The Internet hospital, an innovative approach to providing health care, is rapidly developing in China because it has the potential to provide widely accessible outpatient service delivery via Internet technologies. To date, China's Internet hospitals have not been systematically investigated. The aim of this study was to describe the characteristics of China's Internet hospitals, and to assess their health service capacity. We searched Baidu, the popular Chinese search engine, to identify Internet hospitals, using search terms such as "Internet hospital," "web hospital," or "cloud hospital." All Internet hospitals in mainland China were eligible for inclusion if they were officially registered. Our search was carried out until March 31, 2017. We identified 68 Internet hospitals, of which 43 have been put into use and 25 were under construction. Of the 43 established Internet hospitals, 13 (30%) were in the hospital informatization stage, 24 (56%) were in the Web ward stage, and 6 (14%) were in full Internet hospital stage. Patients accessed outpatient service delivery via website (74%, 32/43), app (42%, 18/43), or offline medical consultation facility (37%, 16/43) from the Internet hospital. Furthermore, 25 (58%) of the Internet hospitals asked doctors to deliver health services at a specific Web clinic, whereas 18 (42%) did not. The consulting methods included video chat (60%, 26/43), telephone (19%, 8/43), and graphic message (28%, 12/43); 13 (30%) Internet hospitals cannot be consulted online any more. Only 6 Internet hospitals were included in the coverage of health insurance. The median number of doctors available online was zero (interquartile range [IQR] 0 to 5; max 16,492). The median consultation fee per time was ¥20 (approximately US $2.90, IQR ¥0 to ¥200). Internet hospitals provide convenient outpatient service delivery. However, many of the Internet hospitals are not yet mature and are faced with various issues such as online doctor scarcity and

Electric field measurements at subcritical, oblique bow shock crossings

International Nuclear Information System (INIS)

Wygant, J.R.; Bensadoun, M.; Mozer, F.S.

1987-01-01

Electric field measurements at oblique, subcritical bow shock crossings are presented from the ISEE 1 University of California, Berkeley, double-probe electric field experiment. The measurements averaged over the 3-s spin period of the spacecraft provide the first observations of the large-scale (100 km) laminar oscillations in the longitudinal component of the electric field associated with the whistler precursor which is characteristic of these dispersive shocks. The amplitude of the oscillations increases from ∼0.5 mV/m to a maximum of 6 mV/m across the magnetic ramp of the shock (directed along the shock normal). The calculated electric potential drops across the shocks varied from 340 to 550 volts, which is 40-60% of the observed loss of kinetic energy associated with the bulk flow of the ions. These measurements suggest that at these shocks the additional deceleration of incident ions is due to the Lorentz force. The contributions to the normal component of the large-scale electric field at the shock due to the parallel and perpendicular components (relative to the magnetic field) of the electric field are evaluated. It is shown that the perpendicular component of the electric field dominates, accounting for most of the cross-shock potential, but that there is a nonnegligible parallel component. This large-scale parallel component has a magnitude of 1-2 mV/m which sometimes results in a potential well for electrons with a depth of ∼150 eV. It is experimentally demonstrated that the dominance of the perpendicular over the parallel component of the electric field resulted in a correlation between the longitudinal component of the large-scale electric field and the fluctuations in the magnetic field component perpendicular to the coplanarity plane

ENERGETIC PARTICLE CROSS-FIELD PROPAGATION EARLY IN A SOLAR EVENT

Energy Technology Data Exchange (ETDEWEB)

Laitinen, T.; Dalla, S.; Marsh, M. S. [Jeremiah Horrocks Institute, University of Central Lancashire, PR1 2HE Preston (United Kingdom)

2013-08-20

Solar energetic particles (SEPs) have been observed to easily spread across heliographic longitudes, and the mechanisms responsible for this behavior remain unclear. We use full-orbit simulations of a 10 MeV proton beam in a turbulent magnetic field to study to what extent the spread across the mean field can be described as diffusion early in a particle event. We compare the full-orbit code results to solutions of a Fokker-Planck equation including spatial and pitch angle diffusion, and of one including also propagation of the particles along random-walking magnetic field lines. We find that propagation of the particles along meandering field lines is the key process determining their cross-field spread at 1 AU at the beginning of the simulated event. The mean square displacement of the particles an hour after injection is an order of magnitude larger than that given by the diffusion model, indicating that models employing spatial cross-field diffusion cannot be used to describe early evolution of an SEP event. On the other hand, the diffusion of the particles from their initial field lines is negligible during the first 5 hr, which is consistent with the observations of SEP intensity dropouts. We conclude that modeling SEP events must take into account the particle propagation along meandering field lines for the first 20 hr of the event.

ENERGETIC PARTICLE CROSS-FIELD PROPAGATION EARLY IN A SOLAR EVENT

International Nuclear Information System (INIS)

Laitinen, T.; Dalla, S.; Marsh, M. S.

2013-01-01

Solar energetic particles (SEPs) have been observed to easily spread across heliographic longitudes, and the mechanisms responsible for this behavior remain unclear. We use full-orbit simulations of a 10 MeV proton beam in a turbulent magnetic field to study to what extent the spread across the mean field can be described as diffusion early in a particle event. We compare the full-orbit code results to solutions of a Fokker-Planck equation including spatial and pitch angle diffusion, and of one including also propagation of the particles along random-walking magnetic field lines. We find that propagation of the particles along meandering field lines is the key process determining their cross-field spread at 1 AU at the beginning of the simulated event. The mean square displacement of the particles an hour after injection is an order of magnitude larger than that given by the diffusion model, indicating that models employing spatial cross-field diffusion cannot be used to describe early evolution of an SEP event. On the other hand, the diffusion of the particles from their initial field lines is negligible during the first 5 hr, which is consistent with the observations of SEP intensity dropouts. We conclude that modeling SEP events must take into account the particle propagation along meandering field lines for the first 20 hr of the event

Social responsibility of the hospitals in Isfahan city, Iran: Results from a cross-sectional survey.

Science.gov (United States)

Keyvanara, Mahmoud; Sajadi, Haniye Sadat

2015-02-12

Changes in modern societies develop the perception that the external environment is essential in organization's practices, especially in the way they deal with aspects such as human rights, community needs, market demands and environmental interests. These issues are usually under the umbrella of the concept of social responsibility. Given the importance of this concept in the context of health care delivery, suggesting a new paradigm in hospital governance, the aim of this study was to measure the social responsibility in hospitals. A cross-sectional survey was employed to collect data from a sample of 946 hospital staff of Isfahan city. Data was obtained by structured and valid self-administrated questionnaire and analyzed by descriptive and analytic statistics using SPSS. The mean score of hospitals' social responsibility was 3.0 compared with the justified range from 1.0 to 5.0. Results showed that there was a significant relationship between social responsibility score and hospitals' ownership (public or private). Also, there was no significant relationship between social responsibility and type of hospital specialty. It is recommended that hospital managers develop and apply appropriate policies and strategies to improve their hospitals' social responsibility level, especially through concentrating on their staff's working environment. © 2015 by Kerman University of Medical Sciences.

Characterization of veterinary hospital-associated isolates of Enterococcus species in Korea.

Science.gov (United States)

Chung, Yeon Soo; Kwon, Ka Hee; Shin, Sook; Kim, Jae Hong; Park, Yong Ho; Yoon, Jang Won

2014-03-28

Possible cross-transmission of hospital-associated enterococci between human patients, medical staff, and hospital environments has been extensively studied. However, limited information is available for veterinary hospital-associated Enterococcus isolates. This study investigated the possibility of cross-transmission of antibiotic-resistant enterococci between dog patients, their owners, veterinary staff, and hospital environments. Swab samples (n =46 5) were obtained from five veterinary hospitals in Seoul, Korea, during 2011. Forty-three Enterococcus strains were isolated, representing seven enterococcal species. E. faecalis and E. faecium were the most dominant species (16 isolates each, 37.2%). Although slight differences in the antibiotic resistance profiles were observed between the phenotypic and the genotypic data, our antibiogram analysis demonstrated high prevalence of the multiple drug-resistant (MDR) isolates of E. faecalis (10/16 isolates, 62.5%) and E. faecium (12/16 isolates, 75.0%). Pulsed-field gel electrophoretic comparison of the MDR isolates revealed three different clonal sets of E. faecalis and a single set of E. faecium, which were isolated from different sample groups or dog patients at the same or two separate veterinary hospitals. These results imply a strong possibility of cross-transmission of the antibiotic-resistant enterococcal species between animal patients, owners, veterinary staff, and hospital environments.

Measurements of Integral Cross Section Ratios in Two Dosimetry Benchmark Neutron Fields

International Nuclear Information System (INIS)

Fabry, A.; Czock, K.H.

1974-12-01

In the frame of a current interlaboratory effort devoted to the standardization of fuels and materials neutron dosimetry, the 103 Rh(n,n') 103m Rh and 58 Ni(n,p) 58 Co integral cross sections have been accurately measured relatively to the 115 In(n,n') 115m In cross section in the 235 U thermal dission neutron spectrum and in the MOLΣΣ Intermediate-Energy Standard Neutron field. In this last neutron field, the data are related also to the 235 U(n,f) cross section. The measurements are extensively documented and the results briefly compared to literature. Most noticeably, decisive support is provided for the selection of a specific 103 Rh(n,n') 103m Rh differential-energy cross section among the existing, conflicting data. (author)

Measurements of integral cross section ratios in two dosimetry benchmark neutron fields

International Nuclear Information System (INIS)

Fabry, A.; Czock, K.H.

1974-12-01

In the frame of a current interlaboratory effort devoted to the standardization of fuels and materials neutron dosimetry, the 103 Rh(n,n') 103m Rh and 58 Ni(n,p) 58 Co integral cross sections have been accurately measured relatively to the 115 In(n,n') 115m In cross section in the 235 U thermal fission neutron spectrum and in the MOL-ΣΣ intermediate-energy standard neutron field. In this last neutron field, the data are related also to the 235 U(n,f) cross section. The measurements are extensively documented and the results briefly compared to literature. Most noticeably, decisive support is provided for the selection of a specific 103 Rh(n,n') 103m Rh differential-energy cross section among the existing, conflicting data. (author)

Laser plasma heating in the presence of electrostatic-magnetostatic crosses fields

International Nuclear Information System (INIS)

Goya, A.; Fonseca, A.L.A.; Nunes, O.A.C.

1994-01-01

The mechanism of plasma heating by one or two lasers in the presence of electrostatic-magnetostatic crossed fields is studied. The results show that the increasing of heating ratio is bigger due to the increment of stationary electric field. 7 refs

Usage of unscheduled hospital care by homeless individuals in Dublin, Ireland: a cross-sectional study.

Science.gov (United States)

Ní Cheallaigh, Clíona; Cullivan, Sarah; Sears, Jess; Lawlee, Ann Marie; Browne, Joe; Kieran, Jennifer; Segurado, Ricardo; O'Carroll, Austin; O'Reilly, Fiona; Creagh, Donnacha; Bergin, Colm; Kenny, Rose Anne; Byrne, Declan

2017-12-01

Homeless people lack a secure, stable place to live and experience higher rates of serious illness than the housed population. Studies, mainly from the USA, have reported increased use of unscheduled healthcare by homeless individuals.We sought to compare the use of unscheduled emergency department (ED) and inpatient care between housed and homeless hospital patients in a high-income European setting in Dublin, Ireland. A large university teaching hospital serving the south inner city in Dublin, Ireland. Patient data are collected on an electronic patient record within the hospital. We carried out an observational cross-sectional study using data on all ED visits (n=47 174) and all unscheduled admissions under the general medical take (n=7031) in 2015. The address field of the hospital's electronic patient record was used to identify patients living in emergency accommodation or rough sleeping (hereafter referred to as homeless). Data on demographic details, length of stay and diagnoses were extracted. In comparison with housed individuals in the hospital catchment area, homeless individuals had higher rates of ED attendance (0.16 attendances per person/annum vs 3.0 attendances per person/annum, respectively) and inpatient bed days (0.3 vs 4.4 bed days/person/annum). The rate of leaving ED before assessment was higher in homeless individuals (40% of ED attendances vs 15% of ED attendances in housed individuals). The mean age of homeless medical inpatients was 44.19 years (95% CI 42.98 to 45.40), whereas that of housed patients was 61.20 years (95% CI 60.72 to 61.68). Homeless patients were more likely to terminate an inpatient admission against medical advice (15% of admissions vs 2% of admissions in homeless individuals). Homeless patients represent a significant proportion of ED attendees and medical inpatients. In contrast to housed patients, the bulk of usage of unscheduled care by homeless people occurs in individuals aged 25-65 years. © Article author

Analytical study of a reversed-field pinch with rectangular cross section

International Nuclear Information System (INIS)

Zhang Peng

1990-01-01

An analyic solution of the force-free equation for a toroidal configuration of rectangular cross section is presented. It is shown that the critical value of contraction ratio for the appearance of a reversed field as well as of the ohmic current increases as the elongation of the cross section increases

Measurements of integral cross section ratios in two dosimetry benchmark neutron fields

Energy Technology Data Exchange (ETDEWEB)

Fabry, A [CEN-SCK, Mol (Belgium); Czock, K H [International Atomic Energy Agency, Laboratory Seibersdorf, Vienna (Austria)

1974-12-01

In the frame of a current interlaboratory effort devoted to the standardization of fuels and materials neutron dosimetry, the {sup 103}Rh(n,n'){sup 103m}Rh and {sup 58}Ni(n,p){sup 58}Co integral cross sections have been accurately measured relatively to the {sup 115}In(n,n'){sup 115m} In cross section in the {sup 235}U thermal fission neutron spectrum and in the MOL-{sigma}{sigma} intermediate-energy standard neutron field. In this last neutron field, the data are related also to the {sup 235}U(n,f) cross section. The measurements are extensively documented and the results briefly compared to literature. Most noticeably, decisive support is provided for the selection of a specific {sup 103}Rh(n,n'){sup 103m}Rh differential-energy cross section among the existing, conflicting data. (author)

Measurements of Integral Cross Section Ratios in Two Dosimetry Benchmark Neutron Fields

Energy Technology Data Exchange (ETDEWEB)

Fabry, A. [CEN-SCK, Mol (Belgium); Czock, K. H. [International Atomic Energy Agency, Vienna (Austria)

1974-12-15

In the frame of a current interlaboratory effort devoted to the standardization of fuels and materials neutron dosimetry, the {sup 103}Rh(n,n'){sup 103m}Rh and {sup 58}Ni(n,p){sup 58}Co integral cross sections have been accurately measured relatively to the {sup 115}In(n,n'){sup 115m}In cross section in the {sup 235}U thermal dission neutron spectrum and in the MOL{Sigma}{Sigma} Intermediate-Energy Standard Neutron field. In this last neutron field, the data are related also to the {sup 235}U(n,f) cross section. The measurements are extensively documented and the results briefly compared to literature. Most noticeably, decisive support is provided for the selection of a specific {sup 103}Rh(n,n'){sup 103m}Rh differential-energy cross section among the existing, conflicting data. (author)

Method for confining the magnetic field of the cross-tail current inside the magnetopause

Science.gov (United States)

Sotirelis, T.; Tsyganenko, N. A.; Stern, D. P.

1994-01-01

A method is presented for analytically representing the magnetic field due to the cross-tail current and its closure on the magnetopause. It is an extension of a method used by Tsyganenko (1989b) to confine the dipole field inside an ellipsoidal magnetopause using a scalar potential. Given a model of the cross-tail current, the implied net magnetic field is obtained by adding to the cross-tail current field a potential field B = - del gamma, which makes all field lines divide into two disjoint groups, separated by the magnetopause (i.e., the combined field is made to have zero normal component with the magnetopause). The magnetopause is assumed to be an ellipsoid of revolution (a prolate spheroid) as an approximation to observations (Sibeck et al., 1991). This assumption permits the potential gamma to be expressed in spheroidal coordinates, expanded in spheroidal harmonics and its terms evaluated by performing inversion integrals. Finally, the field outside the magnetopause is replaced by zero, resulting in a consistent current closure along the magnetopause. This procedure can also be used to confine the modeled field of any other interior magnetic source, though the model current must always flow in closed circuits. The method is demonstrated on the T87 cross-tail current, examples illustrate the effect of changing the size and shape of the prescribed magnetopause and a comparison is made to an independent numerical scheme based on the Biot-Savart equation.

The origin of fluctuations and cross-field transport in idealized magnetic confinement systems

International Nuclear Information System (INIS)

Riviere, A.C.; Ashby, D.E.T.F.; Cordey, J.G.; Edlington, T.; Rusbridge, M.G.

1981-01-01

The study of plasma fluctuations and confinement in idealized systems such as octupoles and levitrons has contributed to the understanding of cross-field transport processes. The linear theory of plasma instabilities that cause fluctuations can predict growth rates and wavelengths around lines of force. However, the theoretical prediction of cross-field transport coefficient is restricted to quasilinear estimates which usually far exceed the measured values. A general view of the results from octupole and levitron experiments shows that under collisional conditions the diffusion coefficient scales in the same way as classical collisional diffusion. Agreement is closely approached in many cases, sometimes even in the presence of fluctuations. Under collisionless conditions, Bohm diffusion scaling is found in the few cases where the scaling law has been determined. There is also experimental and theoretical evidence that long-wavelength low-frequency electric fields (convection cells) can be generated nonlinearly from high-frequency fluctuations and can contribute to cross-field transport. (author)

Inpatient satisfaction at different public sector hospitals of a metropolitan city in Pakistan: a comparative cross-sectional study.

Science.gov (United States)

Hussain, Mehwish; Rehman, Rehana; Ikramuddin, Zia; Asad, Nava; Farooq, Ayesha

2018-04-01

To observe inpatient satisfaction at different public sector hospitals of Karachi, Pakistan. A cross sectional study was carried out during 2010-2012 in four major public sector hospitals of Karachi. A total of 710 patients completed the study. Responses were gathered in a self-structured questionnaire that comprised of four dimensions of satisfaction with doctor, staff, administration and treatment. Average Score of each dimension was taken and compared using one way analysis of variance. Satisfaction with doctors, staff and administration of provincial and federal hospitals were comparatively similar (P > 0.05). However, satisfaction with treatment significantly differed in all four hospitals (P public sector hospitals showed satisfaction with healthcare personnel and related administration. However, treatment dimension needs to be improved to get more satisfaction.

Hospitalized Patients' Awareness Of Their Rights-A Cross Sectional Survey In A Public And Private Tertiary Care Hospitals Of Punjab, Pakistan.

Science.gov (United States)

Tabassum, Tahirah; Ashraf, Mariam; Thaver, Inayat

2016-01-01

The awareness of patient's rights is negligible in developing countries where no legal framework is present to protect these rights and Pakistan is no exception. Not only is there an absence of legal structure for protection of patients' rights, but the enforcement and implementation for existing law is also questionable. Pakistan has an Islamic Charter of Medical and Health Ethics which includes the medical behaviour and physician's rights and duties towards the patients. Despite all these charters on patients' rights, there is little to no awareness regarding these rights and their practice remains low in healthcare system of Pakistan. This assessment of awareness among patients about their rights will guide in formulating recommendations to improve the existing system of healthcare delivery in the country. This descriptive cross-sectional comparative study was conducted in two hospitals in Lahore, each belonging to public and private sector. A structured questionnaire was used to collect data from patients. A total of 220 patients were selected to participate in the study, 110 belonging to each private and public hospital. The findings indicate that most of the patients (64%) were not aware of their rights. The awareness level was better in patients seeking care from private hospital than those from public hospital. Education, monthly income and type of hospital utilized were found to be positively associated with the level of awareness. Most of the patients were not satisfied with the practices of their rights, especially in public hospitals. The lack of awareness regarding the rights of a patient was more common in patients of public/government hospitals compared to private hospitals. A nation-wide healthcare education program is needed to increase awareness and practice of patients' rights in the country.

Using a verbal prompt to increase protein consumption in a hospital setting: a field study

NARCIS (Netherlands)

Zanden, van der L.D.T.; Essen, van H.; Kleef, van E.; Wijk, de R.A.; Trijp, van J.C.M.

2015-01-01

Background: Sufficient protein intake among hospitalized patients may contribute to faster recovery and a decrease in healthcare costs. Nevertheless, hospitalized patients are often found to consume too little protein. This field study explored the success of a small, inexpensive intervention

Psychological consequences of aggression in pre-hospital emergency care: cross sectional survey.

Science.gov (United States)

Bernaldo-De-Quirós, Mónica; Piccini, Ana T; Gómez, M Mar; Cerdeira, Jose C

2015-01-01

Pre-hospital emergency care is a particularly vulnerable setting for workplace violence. However, there is no literature available to date on the psychological consequences of violence in pre-hospital emergency care. To evaluate the psychological consequences of exposure to workplace violence from patients and those accompanying them in pre-hospital emergency care. A retrospective cross-sectional study. 70 pre-hospital emergency care services located in Madrid region. A randomized sample of 441 health care workers (135 physicians, 127 nurses and 179 emergency care assistants). Data were collected from February to May 2012. The survey was divided into four sections: demographic/professional information, level of burnout determined by Maslach Burnout Inventory (MBI), mental health status using General Health Questionnaire (GHQ-28) and frequency and type of violent behaviour experienced by staff members. The health care professionals who had been exposed to physical and verbal violence presented a significantly higher percentage of anxiety, emotional exhaustion, depersonalization and burnout syndrome compared with those who had not been subjected to any aggression. Frequency of verbal violence (more than five times) was related to emotional exhaustion and depersonalization. Type of violence (i.e. physical aggression) is especially related to high anxiety levels and frequency of verbal aggression is associated with burnout (emotional exhaustion and depersonalization). Psychological counselling should be made available to professional staff who have been subjected to physical aggression or frequent verbal violence. Copyright © 2014 Elsevier Ltd. All rights reserved.

Sound field separation with cross measurement surfaces.

Directory of Open Access Journals (Sweden)

Jin Mao

Full Text Available With conventional near-field acoustical holography, it is impossible to identify sound pressure when the coherent sound sources are located on the same side of the array. This paper proposes a solution, using cross measurement surfaces to separate the sources based on the equivalent source method. Each equivalent source surface is built in the center of the corresponding original source with a spherical surface. According to the different transfer matrices between equivalent sources and points on holographic surfaces, the weighting of each equivalent source from coherent sources can be obtained. Numerical and experimental studies have been performed to test the method. For the sound pressure including noise after separation in the experiment, the calculation accuracy can be improved by reconstructing the pressure with Tikhonov regularization and the L-curve method. On the whole, a single source can be effectively separated from coherent sources using cross measurement.

Increases in Intravenous Magnesium Use among Hospitalized Patients: An Institution Cross-Sectional Experience

Directory of Open Access Journals (Sweden)

Bryce A. Kiberd

2015-06-01

Full Text Available Background: Among hospitalized patients, indications for the measurement of magnesium levels and treatment of hypomagnesemia with intravenous magnesium are not well defined. Recently, there have been reports of worldwide shortages of intravenous magnesium sulphate. Objective: To examine secular trends in the administration of intravenous magnesium on hospital wards at a tertiary care institution. The secondary objective is to identify factors associated with magnesium use among admitted patients. Methods: Retrospective cross-section review of hospitalized patients at a single Canadian tertiary care center. Utilization of non-parental nutrition intravenous magnesium from 2003 to 2013 stratified by hospital ward was examined. In addition, patient level data from select wards (including medical and surgical services was examined at early and more recent time period (4/2006 versus 4/2013. Results: Among the 248,329 hospitalized patients, intravenous magnesium use increased by 2.86 fold from 2003 to 2013. Not all wards had an increase whereas some had nearly a 10 fold increase in use. In the sample ( n = 769, (adjusting for admission magnesium level, presence of an indication for intravenous magnesium, ward location, comorbidity and demographics intravenous magnesium administration was higher (25.8 % versus 5.5 % in 2013 versus 2006 (OR 13.91 (95 % CI, 6.21–31.17, p < 0.001. Despite this increase in intravenous magnesium administration, <3 % of patients were admitted on oral magnesium in 2006 and 2013. For patients receiving intravenous magnesium only a minority were discharged on oral therapy despite low levels. Conclusions: This center has witnessed a considerable increase in the use of in-hospital intravenous magnesium over the last 6 years that cannot be explained for by medical indications. The risks and benefits of this therapy deserve further study. If this change in practice is representative of other North American hospitals, it may be

Singularity Crossing, Transformation of Matter Properties and the Problem of Parametrization in Field Theories

Science.gov (United States)

Kamenshchik, A. Yu.

2018-03-01

We investigate particular cosmological models, based either on tachyon fields or on perfect fluids, for which soft future singularities arise in a natural way. Our main result is the description of a smooth crossing of the soft singularity in models with an anti-Chaplygin gas or with a particular tachyon field in the presence of dust. Such a crossing is made possible by certain transformations of matter properties. We discuss and compare also different approaches to the problem of crossing of the Big Bang-Big Crunch singularities.

Weather data around the world for design of field hospital HVAC

NARCIS (Netherlands)

Forejt, L.; Hensen, J.L.M.; Drkal, F.; Barankova, P.

2006-01-01

Field hospital (FH) is a military mobile complex to be deployed in almost any climate around the world. Heating, ventilation and air-conditioning (HVAC) system for the Czech Republic FH units is being redesigned. Computer simulation software will be used for the design of HVAC under variety of

Coping with the challenges of early disaster response: 24 years of field hospital experience after earthquakes.

Science.gov (United States)

Bar-On, Elhanan; Abargel, Avi; Peleg, Kobi; Kreiss, Yitshak

2013-10-01

To propose strategies and recommendations for future planning and deployment of field hospitals after earthquakes by comparing the experience of 4 field hospitals deployed by The Israel Defense Forces (IDF) Medical Corps in Armenia, Turkey, India and Haiti. Quantitative data regarding the earthquakes were collected from published sources; data regarding hospital activity were collected from IDF records; and qualitative information was obtained from structured interviews with key figures involved in the missions. The hospitals started operating between 89 and 262 hours after the earthquakes. Their sizes ranged from 25 to 72 beds, and their personnel numbered between 34 and 100. The number of patients treated varied from 1111 to 2400. The proportion of earthquake-related diagnoses ranged from 28% to 67% (P earthquakes, patient caseload and treatment requirements varied widely. The variables affecting the patient profile most significantly were time until deployment, total number of injured, availability of adjacent medical facilities, and possibility of evacuation from the disaster area. When deploying a field hospital in the early phase after an earthquake, a wide variability in patient caseload should be anticipated. Customization is difficult due to the paucity of information. Therefore, early deployment necessitates full logistic self-sufficiency and operational versatility. Also, collaboration with local and international medical teams can greatly enhance treatment capabilities.

Magnetic field from arbitrarily shaped flat coils with filamentary, ribbon, and rectangular cross sections

International Nuclear Information System (INIS)

Weissenburger, D.W.; Christensen, U.R.

1975-01-01

This report describes the derivation of three groups of equations: (1) Field components from an arbitrarily shaped filament lying in a plane. (2) Field components from an arbitrarily shaped ribbon of infinitesimal thickness with center line lying in a plane. (3) Field components from an arbitrarily shaped bar of rectangular cross section with its center line lying in a plane. In all three cases analytical expressions for the field components were found for an infinitesimal element of the cross section. These expressions are then integrated numerically along the arbitrarily shaped center line of the coil to obtain the three field components. As a check for accuracy the calculated field values of an elliptically shaped coil were compared to an existing analytic expression for a filamentary elliptical coil

Cross-covariance functions for multivariate random fields based on latent dimensions

KAUST Repository

Apanasovich, T. V.

2010-02-16

The problem of constructing valid parametric cross-covariance functions is challenging. We propose a simple methodology, based on latent dimensions and existing covariance models for univariate random fields, to develop flexible, interpretable and computationally feasible classes of cross-covariance functions in closed form. We focus on spatio-temporal cross-covariance functions that can be nonseparable, asymmetric and can have different covariance structures, for instance different smoothness parameters, in each component. We discuss estimation of these models and perform a small simulation study to demonstrate our approach. We illustrate our methodology on a trivariate spatio-temporal pollution dataset from California and demonstrate that our cross-covariance performs better than other competing models. © 2010 Biometrika Trust.

Hospital Nurses' and Physicians' Use of Information Sources during their Production of Discharge Summaries: A Cross-Sectional Study

OpenAIRE

Hellesø, Ragnhild; Sogstad, Maren Kristine Raknes

2014-01-01

Hospital nurses' and physicians' production and exchange of accurate information between levels of care are crucial for ensuring safe and seamless care for patients in transition. We report on a study in which we explored hospital providers' use of information sources when they prepared discharge information for colleges in the community health-care sector. In this cross-sectional study, 510 nurses and 236 physicians responded through a questionnaire. Our findings show that nurses and physici...

Workplace Violence against Health Care Workers in North Chinese Hospitals: A Cross-Sectional Survey

OpenAIRE

Peihang Sun; Xue Zhang; Yihua Sun; Hongkun Ma; Mingli Jiao; Kai Xing; Zheng Kang; Ning Ning; Yapeng Fu; Qunhong Wu; Mei Yin

2017-01-01

This research aimed to determine the prevalence of workplace violence (WPV) against healthcare workers, explore the frequency distribution of violence in different occupational groups, and determine which healthcare occupation suffers from WPV most frequently. Furthermore, the current study aimed to compare risk factors affecting different types of WPV in Chinese hospitals. A cross-sectional design was utilized. A total of 1899 healthcare workers from Heilongjiang, a province in Northeastern ...

Practice of use of diapers in hospitalized adults and elderly: cross-sectional study

Directory of Open Access Journals (Sweden)

Graziele Ribeiro Bitencourt

Full Text Available ABSTRACT Objective: analyze the practice of use of diapers in adults and elderly in hospital. Method: observational cross-sectional study, with a sample of 105 participants assigned according to the data collection period, from September 2013 to January 2014, in the surgical clinic wards in a University Hospital. Results: it was observed that 38% of the 105 participants of the study did not need the use of diapers. 18% used it because they were disabled and 16% had their cognitive system damaged. As they were hospitalized, it was identified that 51.4% of patients were there ranging from 02 to 10 days, and 60% used diapers for the same period. It is also identified that long term urinary catheter (24.8%, as technology associated to diapers in the urinary control and to pressure ulcers (12.4%, being the main complication. Conclusion: the use of diapers did not have specific criteria to be selected. For this, it was proposed an "Evaluation Scale of Diapers Use in Adults", as for indication as for its monitoring to help the study transposal for the nursing practice.

Nonlinear analysis of generalized cross-field current instability

International Nuclear Information System (INIS)

Yoon, P.H.; Lui, A.T.Y.

1993-01-01

Analysis of the generalized cross-field current instability is carried out in which cross-field drift of both the ions and electrons and their temperatures are permitted to vary in time. The unstable mode under consideration is the electromagnetic generalization of the classical modified-two-stream instability. The generalized instability is made of the modified-two-stream and ion-Weibel modes. The relative importance of the features associated with the ion-Weibel mode and those of the modified-two-stream mode is assessed. Specific applications are made to the Earth's neutral sheet prior to substorm onset and to the Earth's bow shock. The numerical solution indicates that the ion-Weibel mode dominates in the Earth's neutral sheet environment. In contrast, the situation for the bow shock is dominated by the modified-two-stream mode. Notable differences are found between the present calculation and previous results on ion-Weibel mode which restrict the analysis to only parallel propagating waves. However, in the case of Earth's bow shock for which the ion-Weibel mode plays no important role, the inclusion of the electromagnetic ion response is found to differ little from the previous results which treats ions responding only to the electrostatic component of the excited waves

Workplace violence against medical staff of Chinese children's hospitals: A cross-sectional study.

Science.gov (United States)

Li, Zhe; Yan, Chun-Mei; Shi, Lei; Mu, Hui-Tong; Li, Xin; Li, An-Qi; Zhao, Cheng-Song; Sun, Tao; Gao, Lei; Fan, Li-Hua; Mu, Yi

2017-01-01

In China, medical staff of children's hospitals are commonly exposed to violence. However, few studies on medical violence are conducted in the settings of children's hospitals. The aim of this study is to assess the incidence, magnitude, consequences, and potential risk factors of workplace violence (WPV) against medical staff of children's hospitals. A retrospective cross-sectional design was used. A self-administered questionnaire was utilized to collect data on 12 children's hospitals. The questionnaires were distributed to a stratified proportional random sample of 2,400 medical staff; 1,932 valid questionnaires were collected. A chi-square test and multiple logistic regression analysis were conducted. A total of 68.6% of respondents had experienced at least one WPV incident involving non-physical and/or physical violence in the past year. The perpetrators were mainly family members of patients (94.9%). Most of the WPV occurred during the day shift (70.7%) and in wards (41.8%). Males were 1.979 times (95% CI, 1.378 to 2.841) more likely than females to experience physical violence. Emergency departments were more exposed to physical violence than other departments. Oncology was 2.733 times (95% CI, 1.126 to 6.633) more exposed to non-physical violence than the emergency department. As a result of WPV, victims felt aggrieved and angry, work enthusiasm declined, and work efficiency was reduced. However, only 5.6% of the victims received psychological counseling. Medical staff are at high risk of violence in China's children's hospitals. Hospital administrators and related departments should pay attention to the consequences of these incidents. There is a need for preventive measures to protect medical staff and provide a safer workplace environment. Our results can provide reference information for intervention strategies and safety measures.

Anomalous cross-field current and fluctuating equilibrium of magnetized plasmas

DEFF Research Database (Denmark)

Rypdal, K.; Garcia, O.E.; Paulsen, J.V.

1997-01-01

It is shown by simple physical arguments and fluid simulations that electrostatic flute-mode fluctuations can sustain a substantial cross-field current in addition to mass and energy transport. The simulations show that this current determines essential features of the fluctuating plasma...

Social responsibility of the hospitals in Isfahan city, Iran: Results from a cross-sectional survey

Science.gov (United States)

Keyvanara, Mahmoud; Sajadi, Haniye Sadat

2015-01-01

Background: Changes in modern societies develop the perception that the external environment is essential in organization’s practices, especially in the way they deal with aspects such as human rights, community needs, market demands and environmental interests. These issues are usually under the umbrella of the concept of social responsibility. Given the importance of this concept in the context of health care delivery, suggesting a new paradigm in hospital governance, the aim of this study was to measure the social responsibility in hospitals. Methods: A cross-sectional survey was employed to collect data from a sample of 946 hospital staff of Isfahan city. Data was obtained by structured and valid self-administrated questionnaire and analyzed by descriptive and analytic statistics using SPSS. Results: The mean score of hospitals’ social responsibility was 3.0 compared with the justified range from 1.0 to 5.0. Results showed that there was a significant relationship between social responsibility score and hospitals’ ownership (public or private). Also, there was no significant relationship between social responsibility and type of hospital specialty. Conclusion: It is recommended that hospital managers develop and apply appropriate policies and strategies to improve their hospitals’ social responsibility level, especially through concentrating on their staff’s working environment. PMID:26340391

Workplace Violence against Health Care Workers in North Chinese Hospitals: A Cross-Sectional Survey.

Science.gov (United States)

Sun, Peihang; Zhang, Xue; Sun, Yihua; Ma, Hongkun; Jiao, Mingli; Xing, Kai; Kang, Zheng; Ning, Ning; Fu, Yapeng; Wu, Qunhong; Yin, Mei

2017-01-19

This research aimed to determine the prevalence of workplace violence (WPV) against healthcare workers, explore the frequency distribution of violence in different occupational groups, and determine which healthcare occupation suffers from WPV most frequently. Furthermore, the current study aimed to compare risk factors affecting different types of WPV in Chinese hospitals. A cross-sectional design was utilized. A total of 1899 healthcare workers from Heilongjiang, a province in Northeastern China, completed the questionnaire. Of the respondents, 83.3% reported exposure to workplace violence, and 68.9% reported non-physical violence. Gender, education, shift work, anxiety level, and occupation were significantly correlated with physical violence ( p gender, age, profession, anxiety, and shift work were predictive of workplace violence toward healthcare workers. Doctors appeared to experience non-physical workplace violence with particularly higher frequency when compared to nurses and other workers in hospitals. For healthcare workers, interventions aimed at WPV reduction should be enacted according to the types of violence, profession, and other factors underlying the various types of WPV in hospitals.

Cross-covariance functions for multivariate random fields based on latent dimensions

KAUST Repository

Apanasovich, T. V.; Genton, M. G.

2010-01-01

The problem of constructing valid parametric cross-covariance functions is challenging. We propose a simple methodology, based on latent dimensions and existing covariance models for univariate random fields, to develop flexible, interpretable

Testing of ENDF/B cross section data in the Californium-252 neutron benchmark field

International Nuclear Information System (INIS)

Mannhart, W.

1979-01-01

The fission neutron field of 252 Cf presently represents one of the most well-known neutron benchmark fields. For 13 neutron reactions which are of importance in reactor metrology, measurements of spectrum-averaged cross sections, [sigma], performed in this neutron field were compared with calculated average cross sections. This comparison allows one to draw conclusions as to the quality of different sigma(E) data taken from ENDF/B-IV, from ENDF/B-V, and from recent experiments and used in the calculation of average cross sections. The comparison includes an uncertainty analysis regarding the different uncertainty contributions of [sigma], of sigma(E), and of the spectral distribution of 252 Cf fission neutrons. Additionally, in a few examples, sensitivity studies were carried out. The sensitivity of the spectrum-averaged cross sections to individual characteristics of the sigma(E) data, such as normalization factors or shifts in the energy scale, was investigated. Similarly, the sensitivity of [sigma] to the spectral distribution of 252 Cf was determined. 4 figures, 2 tables

Field surveys for the humanization in hospital buildings: tools and case studies

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Elena Montacchini

2015-04-01

Full Text Available The international scientific literature supports the great interest to the evidence-based design, focused on the relationship between the spatial arrangement of hospital environment and the potential support to the healing process. According to this approach, the paper deals with field surveys in hospital departments of oncology; the research is aimed at evaluating the environmental perceived quality by the end users. The analysis carried out through questionnaires and interviews was useful to develop tools for the assessment of the relationship among environmental factors and psycho-emotional reactions and to validate the patients and staff’s needs.

Cultural competency of health-care providers in a Swiss University Hospital: self-assessed cross-cultural skillfulness in a cross-sectional study

Science.gov (United States)

2014-01-01

Background As the diversity of the European population evolves, measuring providers’ skillfulness in cross-cultural care and understanding what contextual factors may influence this is increasingly necessary. Given limited information about differences in cultural competency by provider role, we compared cross-cultural skillfulness between physicians and nurses working at a Swiss university hospital. Methods A survey on cross-cultural care was mailed in November 2010 to front-line providers in Lausanne, Switzerland. This questionnaire included some questions from the previously validated Cross-Cultural Care Survey. We compared physicians’ and nurses’ mean composite scores and proportion of “3-good/4-very good” responses, for nine perceived skillfulness items (4-point Likert-scale) using the validated tool. We used linear regression to examine how provider role (physician vs. nurse) was associated with composite skillfulness scores, adjusting for demographics (gender, non-French dominant language), workplace (time at institution, work-unit “sensitized” to cultural-care), reported cultural-competence training, and cross-cultural care problem-awareness. Results Of 885 questionnaires, 368 (41.2%) returned the survey: 124 (33.6%) physicians and 244 (66.4%) nurses, reflecting institutional distribution of providers. Physicians had better mean composite scores for perceived skillfulness than nurses (2.7 vs. 2.5, p cross-cultural training (β = 0.14, p = 0.01) and lack of practical experience caring for diverse populations (β = 0.11, p = 0.04). In stratified analyses among physicians alone, having French as a dominant language (β = −0.34, p cross-cultural skills training with an inter-professional focus on nurses, education that attunes provider awareness to the local issues in cross-cultural care, and increased diversity efforts in the work force, particularly among physicians. PMID:24479405

Cultural competency of health-care providers in a Swiss University Hospital: self-assessed cross-cultural skillfulness in a cross-sectional study.

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Casillas, Alejandra; Paroz, Sophie; Green, Alexander R; Wolff, Hans; Weber, Orest; Faucherre, Florence; Ninane, Françoise; Bodenmann, Patrick

2014-01-30

As the diversity of the European population evolves, measuring providers' skillfulness in cross-cultural care and understanding what contextual factors may influence this is increasingly necessary. Given limited information about differences in cultural competency by provider role, we compared cross-cultural skillfulness between physicians and nurses working at a Swiss university hospital. A survey on cross-cultural care was mailed in November 2010 to front-line providers in Lausanne, Switzerland. This questionnaire included some questions from the previously validated Cross-Cultural Care Survey. We compared physicians' and nurses' mean composite scores and proportion of "3-good/4-very good" responses, for nine perceived skillfulness items (4-point Likert-scale) using the validated tool. We used linear regression to examine how provider role (physician vs. nurse) was associated with composite skillfulness scores, adjusting for demographics (gender, non-French dominant language), workplace (time at institution, work-unit "sensitized" to cultural-care), reported cultural-competence training, and cross-cultural care problem-awareness. Of 885 questionnaires, 368 (41.2%) returned the survey: 124 (33.6%) physicians and 244 (66.4%) nurses, reflecting institutional distribution of providers. Physicians had better mean composite scores for perceived skillfulness than nurses (2.7 vs. 2.5, p cross-cultural training (β = 0.14, p = 0.01) and lack of practical experience caring for diverse populations (β = 0.11, p = 0.04). In stratified analyses among physicians alone, having French as a dominant language (β = -0.34, p cultural competency improvement among providers. These results support the need for cross-cultural skills training with an inter-professional focus on nurses, education that attunes provider awareness to the local issues in cross-cultural care, and increased diversity efforts in the work force, particularly among physicians.

Considerations on occupational therapy in a custody and psychiatric treatment hospital: The psychosocial field versus the forensic psychiatry field

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Ana Carolina Santos de Souza

2014-12-01

Full Text Available The Custody and Psychiatric Treatment Hospital (CPTH is ambivalent and ambiguous in its essence, because it gathers not only the characteristics of a mental institution, but also those of a prison – epitomized by the security system. By analyzing this context, one can perceive the importance of implementing some knowhow able to attend the real needs of the individuals hospitalized in this type of institution. This interpretation of their needs must be done in association with a work in mental health based on the principles of the Brazilian Psychiatric Reform and Psychosocial Field Practice. The objective of this study is to reflect on the real possibilities of implementing mental health work based on the Brazilian Psychiatric Reform, inserted in the Psychosocial Field, in institutions such as CPTHs. This reflection occurs from the conflicts arisen in the beginning of Occupational Therapy service in a CPTH located in the state of Sao Paulo, Brazil, as well as through the analysis of the reality in which this Custody Hospital is inserted. When studying the Psychiatric Reform Law, ordinance 28.195/1988, which deliberates on the functions of Occupational Therapy in the CPTHs of the state of Sao Paulo, and the Penal Execution Law, the reality was analyzed from its dimensions, to conclude that the institutional forces ruled the work process of occupational therapists. Therefore, the structural, particular, singular dimensions that rule the CPTH were understood and, after that, the “nodes” that hinder the implementation of mental health work in the Psychosocial Field in this type of institution were revealed.

Exploring Integrated Marketing Communications, Brand Awareness, and Brand Image in Hospitality Marketing: A Cross-Cultural Approach

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Maja Šerić

2016-12-01

Full Text Available Purpose – The purpose of this paper is to assess customer perceptions of integration of marketing communications, brand awareness, and brand image in hospitality. Moreover, cross-cultural differences are considered when evaluating all the concepts, since national culture can have a considerable impact on customer behavior. Design/Methodology/Approach – After a literature review of the examined concepts, the results of an empirical study are presented and discussed. The empirical investigation was carried out by approaching 475 guests of upscale Croatian hotels. The SPSS software was employed for data analysis. Findings and implications – The results indicate that hotel guests assessed integrated marketing communications fairly highly. Brand image also reached relatively high scores, while the level of awareness of the brand was more moderate. Significant differences in perceptions among three delimited groups according to their national culture were found. The findings suggest that hotel managers should increase brand awareness and consider cross-cultural differences when implementing their business strategies. Limitations – A greater number of hotel guests according to their national culture should be approached to obtain more representative subsamples. Originality – The contribution of this work lies in examining three key marketing variables from the consumer point of view and under a cross-cultural approach. In particular, there has been little empirical evidence on IMC perceptions from the consumer perspective and hardly any considering the cultural background of the respondents. The contribution is also made to the hotel environment, as the variables were examined from the cross-cultural perspective, an issue that was completely neglected in the literature on hospitality marketing to date.

A practical guide to manuscript writing with particular relevance to the field of pediatric hospital medicine.

Science.gov (United States)

Teufel, Ronald J; Andrews, Anne L; Williams, Derek J

2014-11-01

Publishing manuscripts in peer-reviewed journals, such as Hospital Pediatrics, is critical for both the academic development of practitioners in pediatric hospital medicine and the scientific advancement of our field. Understanding the purpose of scientific writing and developing a structured approach to the writing process is essential. Doing so will improve the clarity of your work and likely the ease at which your research is published and disseminated throughout the scientific community. The purposes of this article are to detail the structure of a scientific manuscript, to highlight specific writing strategies, and to provide writing tips that may help or hinder publication. Our ultimate goal is to advance the field of pediatric hospital medicine and its growing membership by promoting the dissemination of high-quality research. Copyright © 2014 by the American Academy of Pediatrics.

Density limit and cross-field edge transport scaling in Alcator C-Mod

International Nuclear Information System (INIS)

LaBombard, B.

2002-01-01

Experiments in Alcator C-Mod have uncovered a direct link between the character and scaling of edge transport and the empirical Greenwald density limit (n G ). In low to moderate density discharges, the scrape-off layer (SOL) exhibits a two-layer structure: a near SOL (∼5 mm zone) with steep density and temperature gradients and a far SOL with flatter profiles. In the far SOL, the transport fluxes exhibit large transport events ('bursts' which carry particles to main-chamber structures. In the near SOL, transport fluxes appear to be less 'bursty' particle diffusivities in this region is found to increase strongly with local plasma collisionality. As n/n G (or collisionality) is raised, cross-field heat convection begins to compete with parallel conduction to the divertor. At N/n G ∼0.5, T E at the separatrix is reduced. As n/n G approaches ∼1, regions inside the separatrix exhibit flatter profiles with 'bursty' transport behavior; cross-field heat convection to main-chamber structures becomes comparable to the radiated power. Thus as n/n G is increased, cross-field edge transport physics progressively changes, ultimately impacting the power balance of the discharge near N/n G ∼1. (author)

Psychological symptoms among hospital nurses in Taiwan: a cross sectional study.

Science.gov (United States)

Chen, Mei-Ju; Weng, Shiue-Shan

2017-11-07

A considerable number of studies have identified the risk factors attributable to job-related stress among nurses. However, studies investigating psychological symptoms among hospital nurses is still lacking, especially in Taiwan, where the average patient to nurse ratio is among the highest in the world. This study aimed to investigate the potential role of self-rated health status, self-reported diseases, and utilization of occupational health checks in psychological symptoms among Taiwanese nurses. A cross-sectional design was conducted from September through December 2013. Data were collected through online self-administered questionnaire among 697 registered nurses in seven regional hospitals governed by the Taipei City Government. Nurses with fair or poor self-rated health, lower education, psychological symptoms. A trend toward significance was also noticed for those aged 30-39. Importantly, low back pain was the most common disease among nurses in self-reported diseases and half of the nurses reported not utilizing the occupational health examination for the last 5 years. To alleviate or prevent the psychological symptoms, psychosocial support, and awareness program on prevention of occupational injuries should be offered to nurses younger than 39 years old and having lower educational levels. Moreover, underutilization of occupational health examination among nurses deserves more attention.

The Red Cross and the Liverpool Field Hospital, Hope and Despair during 1915.

Science.gov (United States)

Willis, Ian

2016-01-01

The outbreak of the First World War in August 1914 was met with much jingoistic enthusiasm by the Australian population. Men volunteered in their hundreds for service for God, King, and Country; to defend the Empire; for adventure; and to see the world. Women on the homefront formed up Red Cross branches across the country in small country towns and city suburbs to serve ‘their boys’. Unfortunately for the men who enlisted their desire to serve the Empire was not met with a similar level of organisational efficiency by authorities in Australia. The military were completely overwhelmed by the progress of the war, especially the level of casualties that resulted from the Gallipoli campaign.

High caseload of childhood tuberculosis in hospitals on Java Island, Indonesia: a cross sectional study.

Science.gov (United States)

Lestari, Trisasi; Probandari, Ari; Hurtig, Anna-Karin; Utarini, Adi

2011-10-11

Childhood tuberculosis (TB) has been neglected in the fight against TB. Despite implementation of Directly Observed Treatment Shortcourse (DOTS) program in public and private hospitals in Indonesia since 2000, the burden of childhood TB in hospitals was largely unknown. The goals of this study were to document the caseload and types of childhood TB in the 0-4 and 5-14 year age groups diagnosed in DOTS hospitals on Java Island, Indonesia. Cross-sectional study of TB cases recorded in inpatient and outpatient registers of 32 hospitals. Cases were analyzed by hospital characteristics, age groups, and types of TB. The number of cases reported in the outpatient unit was compared with that recorded in the TB register. Of 5,877 TB cases in the inpatient unit and 15,694 in the outpatient unit, 11% (648) and 27% (4,173) respectively were children. Most of the childhood TB cases were under five years old (56% and 53% in the inpatient and outpatient clinics respectively). The proportion of smear positive TB was twice as high in the inpatient compared to the outpatient units (15.6% vs 8.1%). Extra-pulmonary TB accounted for 15% and 6% of TB cases in inpatient and outpatient clinics respectively. Among children recorded in hospitals only 1.6% were reported to the National TB Program. In response to the high caseload and gross under-reporting of childhood TB cases, the National TB Program should give higher priority for childhood TB case management in designated DOTS hospitals. In addition, an international guidance on childhood TB recording and reporting and improved diagnostics and standardized classification is required.

High caseload of childhood tuberculosis in hospitals on Java Island, Indonesia: a cross sectional study

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Hurtig Anna-Karin

2011-10-01

Full Text Available Abstract Background Childhood tuberculosis (TB has been neglected in the fight against TB. Despite implementation of Directly Observed Treatment Shortcourse (DOTS program in public and private hospitals in Indonesia since 2000, the burden of childhood TB in hospitals was largely unknown. The goals of this study were to document the caseload and types of childhood TB in the 0-4 and 5-14 year age groups diagnosed in DOTS hospitals on Java Island, Indonesia. Methods Cross-sectional study of TB cases recorded in inpatient and outpatient registers of 32 hospitals. Cases were analyzed by hospital characteristics, age groups, and types of TB. The number of cases reported in the outpatient unit was compared with that recorded in the TB register. Results Of 5,877 TB cases in the inpatient unit and 15,694 in the outpatient unit, 11% (648 and 27% (4,173 respectively were children. Most of the childhood TB cases were under five years old (56% and 53% in the inpatient and outpatient clinics respectively. The proportion of smear positive TB was twice as high in the inpatient compared to the outpatient units (15.6% vs 8.1%. Extra-pulmonary TB accounted for 15% and 6% of TB cases in inpatient and outpatient clinics respectively. Among children recorded in hospitals only 1.6% were reported to the National TB Program. Conclusion In response to the high caseload and gross under-reporting of childhood TB cases, the National TB Program should give higher priority for childhood TB case management in designated DOTS hospitals. In addition, an international guidance on childhood TB recording and reporting and improved diagnostics and standardized classification is required

Barriers to healthy eating by National Health Service (NHS hospital doctors in the hospital setting: results of a cross-sectional survey

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Wilson Sue

2008-08-01

Full Text Available Abstract Background With high levels of obesity and related illness, improving the health of the nation is a major public health concern. This study aimed to identify factors that prevent healthy eating among doctors, and that are associated with satisfaction with catering services. Findings Methods: Cross-sectional survey of 328 NHS doctors working in two NHS Trusts with on-site hospital canteen. Questionnaire to establish perceived barriers to healthy eating, weekly use and satisfaction with the hospital canteen, lifestyle and dietary habits, gender, age, height, weight, job details, and affect. Results: 70% of doctors reported using their hospital canteen each week, with 2 visits per week on average. Canteen opening times, lack of selection and lack of breaks were the most commonly perceived barriers to healthy eating. Availability of healthy options caused the most dissatisfaction. Only 12% felt the NHS was supportive of healthy eating. 74% did not feel their canteen advocated healthy eating. Canteen use is associated with younger age (r = -0.254, p Conclusion Interventions to encourage regular meal breaks, eating breakfast and drinking more water each day need developing. Improved canteen accessibility and availability of healthy options at evenings and weekends may be beneficial.

Workplace Violence against Health Care Workers in North Chinese Hospitals: A Cross-Sectional Survey

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Peihang Sun

2017-01-01

Full Text Available This research aimed to determine the prevalence of workplace violence (WPV against healthcare workers, explore the frequency distribution of violence in different occupational groups, and determine which healthcare occupation suffers from WPV most frequently. Furthermore, the current study aimed to compare risk factors affecting different types of WPV in Chinese hospitals. A cross-sectional design was utilized. A total of 1899 healthcare workers from Heilongjiang, a province in Northeastern China, completed the questionnaire. Of the respondents, 83.3% reported exposure to workplace violence, and 68.9% reported non-physical violence. Gender, education, shift work, anxiety level, and occupation were significantly correlated with physical violence (p < 0.05 for all correlations. Additionally, age, professional title, and occupation were correlated with non-physical violence, which critically affected doctors. Thus, gender, age, profession, anxiety, and shift work were predictive of workplace violence toward healthcare workers. Doctors appeared to experience non-physical workplace violence with particularly higher frequency when compared to nurses and other workers in hospitals. For healthcare workers, interventions aimed at WPV reduction should be enacted according to the types of violence, profession, and other factors underlying the various types of WPV in hospitals.

Cross-Border Higher Education in China: How the Field of Research Has Developed

Science.gov (United States)

Qin, Yunyun; Te, Alice Y. C.

2016-01-01

The aim of the research was to investigate how the field of cross-border Chinese higher education has developed from 1990 to 2015. Ninety-five articles in international journals and 470 articles in national journals were collected and analyzed in terms of authorship pattern, thematic clusters, and research methods. Results show that cross-border…

Hospitality Language In Tourism Field: Facework

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Yohanes Kristianto

2017-01-01

Full Text Available This study aims to uncover, analyze, and interpret the reality of hospitality language in tourism from the perspective of the duality. The underlying assumption that language is an action  in social practices. This is shown by the practice of the English language in the service interaction. The structure of the English language is like  schemata of principles for service interaction and at the same time empowering service  provider to perform service interaction To uncover and interpret  hospitality language practice, the theory of structuration is applied. Theory of pragmatics is  used to analyze the linguistic phenomena. Based on the frame of structuration, this  research is identified in four issues, namely (1 the structure of hospitality language, (2 the system of  hospitality language, and (3 hospitality language as a representation facework. Problem (1 and (2 are analyzed by ethnography of communication. Problem (3 is analyzed using speech act theory and politeness theory. This study is a qualitative research, due to explore, pattern, interpreting the language practices, so it does not use statistical analysis to generalize the results. Population is not  in large quantities, but using purposive sample to determine the number of informants based on the criteria and representativeness in service encounter. In addition, language behavior in general is homogeneous. Data collected by the ethnography of communication methods, observation, and recording. The data selected are English due to English as the main foreign language in the service interaction. The findings of this study are: (1 the structure of the hospitality language, namely (a the structure of significance in the form of setting or scene of service encounter, (b the structure of domination, namely participants (tourism practitioners and tourists, (2 the system of  hospitality language in the form of (a the schemata interpretation of act sequences and keys, (b the schemata

Drift motion of a charged particle in the crossed axial magnetic and radial electric fields, and the electric field of a rotating potential wave

International Nuclear Information System (INIS)

Eliseev, Yu.N.; Stepanov, K.N.

1983-01-01

In the drift motion approximation solution of the problem is obtained on the motion of a nonrelativistic charged particle in the crossed axial magnetic and radial electric fields, and the electric field of a rotating potential wave under cherenkov and modified cyclotron resonances. The static radial electric field potential is supposed to be close to the parabolic one. The drift motion equations and their integrals are preseOted. The experimentally obtained effect of plasma ionic component division in the crossed fields under the excitation of ion cyclotron oscillations is explained with the help of the theory developed in the paper

Diffusive processes in the cross-field flow of intense plasma beams

International Nuclear Information System (INIS)

Newberger, B.; Rostoker, N.

1988-09-01

We consider magnetic field diffusion in the presence of strongly magnetized electrons (ω/sub ce//tau//sub co/ > 1) as a mechanism for the rapid field penetration observed in cross-field flows of high-β plasma beams. The diffusion has been investigated in several cases which are amenable to analytic solution. The flux penetration times are found to be insensitive to the particular configuration. Comparison with two experiments is made. Agreement within the limits of the experiments is found. Both require an anomalous collision rate which is consistent with observed fluctuations in one case but apparently not the other. 17 refs., 1 fig

[Anesthesiologic treatment of 3,665 patients in Red Cross hospitals in Thailand, Lebanon, Pakistan and Indonesia].

Science.gov (United States)

Lenz, G; Klöss, T; Bauer, J; Buschmann, J P; Dietrich, W; Hering, M; Schwandt-Boden, H; Stehle, R

1985-10-01

Between the end of 1979 and the beginning of 1984, the authors served as anaesthetists for Red Cross missions in surgical field hospitals on the Thai-Cambodian and the Afghan-Pakistan borders, in Lebanon, and in Indonesia. A total of 3665 civilian emergency patients were anaesthetised. 643 were operated on under local anaesthesia; 639, under regional anaesthesia, in most cases spinal anaesthesia. In spite of principal preference for local and regional anaesthetic techniques, 65% of the patients (2383 patients) were managed under general anaesthesia, which was maintained with halothane in 947 cases and ketamine in 1345 cases. 877 general anaesthesias with ketamine were performed with spontaneous breathing of ambient air; endotracheal anaesthesia was necessary in 1238 patients. In spite of the high risk for the patients and of the operative interventions and in the light of the simple and sometimes even primitive working conditions, no anaesthesia-related fatalities occurred. Postoperative lethality was 2%. In all cases, the duties of the anaesthesist involved more than performance of anaesthesia, which was sometimes assigned to paramedics. Other duties included preoperative examination, postoperative intensive care, consultation services in nonsurgical emergency cases, resuscitation, and training of local assistants.

Cross-talk free selective reconstruction of individual objects from multiplexed optical field data

Science.gov (United States)

Zea, Alejandro Velez; Barrera, John Fredy; Torroba, Roberto

2018-01-01

In this paper we present a data multiplexing method for simultaneous storage in a single package composed by several optical fields of tridimensional (3D) objects, and their individual cross-talk free retrieval. Optical field data are extracted from off axis Fourier holograms, and then sampled by multiplying them with random binary masks. The resulting sampled optical fields can be used to reconstruct the original objects. Sampling causes a loss of quality that can be controlled by the number of white pixels in the binary masks and by applying a padding procedure on the optical field data. This process can be performed using a different binary mask for each optical field, and then added to form a multiplexed package. With the adequate choice of sampling and padding, we can achieve a volume reduction in the multiplexed package over the addition of all individual optical fields. Moreover, the package can be multiplied by a binary mask to select a specific optical field, and after the reconstruction procedure, the corresponding 3D object is recovered without any cross-talk. We demonstrate the effectiveness of our proposal for data compression with a comparison with discrete cosine transform filtering. Experimental results confirm the validity of our proposal.

Study of Attitude staff in the Field of Total Quality Management by using Fuzzy Logic, Case Study in Teaching Hospitals in Yazd

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M ArabBanadaki

2016-03-01

Full Text Available Introduction: In Total Quality Management, Quality is not only an admirable phenomenon but also is a customer inalienable right and will be created through the involvement and participation of all employees, managers and customers of an organization. This study was designed to evaluate staff attitudes in teaching hospitals of Yazd in the field of Total Quality Management by using fuzzy logic. Methods: This was a descriptive, analytical, cross – sectional study. Research population, were all staff in teaching hospitals of Yazd that among them 235 people were randomly Stratified, selected and studied. Data for this study were collected through a questionnaire. Since the theory of fuzzy is more suitable approach for measuring linguistic variables, so this paper determines the attitude of staff in the field of Quality Management by the use of fuzzy logic. Results: Results showed that the dimensions of the “Identification and training of staff," "empowerment and teamwork of Employees" and "support and leadership of the top management organization" respectively ranked first, second and third importance In terms of staff. Conclusion: Criteria of identification and training of staff and teamwork and support and leadership of the top management organization are Important in motivating Total Quality Management. So in total quality management improve programs, these aspects should be prioritized according to the degree of importance and effort to improve the quality of service.

Prevalence of Depression and Anxiety amongst Cancer Patients in a Hospital Setting: A Cross-Sectional Study

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Anish Khalil

2016-01-01

Full Text Available Background. The biomedical care for cancer has not been complemented by psychosocial progressions in cancer care. Objectives. To find the prevalence of anxiety and depression amongst cancer patients in a hospital setting. Design and Setting. This cross-sectional study was conducted at the tertiary care hospitals Shifa International Hospital Islamabad and Nuclear Medicine, Oncology, and Radiotherapy Institute [NORI]. Patients and Methods. 300 patients were interviewed from both the outpatient and inpatient department using The Aga Khan University Anxiety and Depression Scale (AKUADS. Main Outcome Measures. Using a score of 20 and above on the AKUADS, 146 (48.7% patients were suffering from anxiety and depression. Results. When cross tabulation was done between different factors and the cancer patients with anxiety and depression, the following factors were found out to be significant with associated p value < 0.05: education of the patient, presence of cancer in the family, the severity of pain, and the patient’s awareness of his anxiety and depression. Out of 143 (47.7% uneducated patients, 85 (59.4% were depressed, hence making it the highest educational category suffering from depression and anxiety. Conclusion. The prevalence of anxiety and depression amongst cancer patients was high showing that importance should be given to screening and counseling cancer patients for anxiety and depression, to help them cope with cancer as a disease and its impact on their mental wellbeing. Limitations. The frequency of female patients in our research was higher than those of male patients.

FORMATION OF STUDENTS’ FOREIGN LANGUAGE COMPETENCE IN THE INFORMATIONAL FIELD OF CROSS CULTURAL INTERACTION

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Vitaly Vyacheslavovich Tomin

2015-09-01

Full Text Available Knowledge of foreign languages is becoming an integral feature of competitive persona-lity, ability to engage in cross-cultural communication and productive cross-cultural inte-raction, characterized by an adequate degree of tolerance and multi-ethnic competence, the ability for cross-cultural adaptation, critical thinking and creativity. However, the concept of foreign language competence has so far no clear, unambiguous definitions, thereby indicating the complexity and diversity of the phenomenon, which is an integrative, practice-oriented outcome of the wish and ability for intercultural communication. There have been mentioned a variety of requirements, conditions, principles, objectives, means and forms of foreign language competence forming, among which special attention is paid to non-traditional forms of practical training and information field in a cross-cultural interaction. There have been explained the feasibility of their application, which allows solving a complex of series of educational and teaching tasks more efficiently. There have been clarified the term «information field» in cross-cultural interaction, which is a cross-section of internally inherent in every individual «sections» of knowledge, skills, and experience, arising in certain given educational frameworks and forming a communication channel. The resultative indicators of the formation of foreign language competence and ways to improve its effectiveness are presented.

Can advanced paramedics in the field diagnose patients and predict hospital admission?

LENUS (Irish Health Repository)

Cummins, Niamh Maria

2013-02-13

BACKGROUND: Accurate patient diagnosis in the prehospital environment is essential to initiate suitable care pathways. The advanced paramedic (AP) is a relatively recent role in Ireland, and refers to a prehospital practitioner with advanced life-support skills and training. OBJECTIVES: The objectives of this study were to compare the diagnostic decisions of APs with emergency medicine (EM) physicians, and to investigate if APs, as currently trained, can predict the requirement for hospital admission. METHODS: A prospective study was initiated, whereby each emergency ambulance call received via the statutory 999 system was recorded by the attending AP. The AP was asked to provide a clinical diagnosis for each patient, and to predict if hospital admission was required. The data was then cross-referenced with the working diagnosis of the receiving emergency physician and the hospital admission records. RESULTS: A total of 17 APs participated in the study, and 1369 emergency calls were recorded over a 6-month period. Cases where a general practitioner attended the scene were excluded from the concordance analysis. Concordance with the receiving emergency physician represents 70% (525\\/748) for all cases of AP diagnosis, and is mirrored with 70% (604\\/859) correct hospital admission predictions. CONCLUSIONS: AP diagnosis and admission prediction for emergency calls is similar to other emergency medical services systems despite the relative recency of the AP programme in Ireland. Recognition of non-concordance case types may identify priorities for AP education, and drive future AP practice in areas such as \\'treat and refer\\'.

Theory of Thomson scattering in a strong magnetic field, 2. [Relativistic quantum theory, cross sections

Energy Technology Data Exchange (ETDEWEB)

Hamada, T [Ibaraki Univ., Mito (Japan). Dept. of Physics

1975-07-01

A relativistic quantum theory is formulated for the Compton scattering by electrons in a strong magnetic field. It is shown that the relativistic quantum (Klein-Nishina) cross section in the center of drift system reduces exactly to the classical Thomson cross section in the limit h..omega../2..pi..<field. There is one special case for which the Thomson cross section is valid irrespective of the magnitudes of ..omega.. and ..omega..sub(c); the forward scattering in the direction of the magnetic field by an electron in the ground state.

Effects of electric fields on the photodetachment cross section of the H- ion near threshold

International Nuclear Information System (INIS)

Stewart, J.E.

1987-12-01

The photodetachment cross section of the H - ion near the one electron threshold in electric fields ranging from approximately 5 x 10 -7 atomic units up to 2.4 x 10 -4 atomic units has been studied using an 800 MeV beam at the Los Alamos National Laboratory. The lowest field data, analyzed as though at zero field, are consistent with the Wigner prediction for p wave processes. At greater field values, photodetachment using σ polarized laser light displays the expected lowering of apparent threshold and evidence of tunneling. Using π polarized laser light the same features are seen with the addition of oscillations superimposed on the cross section. Three complementary explanations are presented for the oscillations. 42 refs., 35 figs., 8 tabs

Prevalence of Allergy to Natural Rubber Latex and Potential Cross Reacting Food in Operation Room Staff in Shiraz Hospitals -2006

OpenAIRE

H Nabavizade; R Amin

2007-01-01

Introduction & Objective: Allergic reactions to natural rubber latex have increased during past 10 years especially among health care workers and patients with high exposure to latex allergens. Allergic reaction to latex is related to many diseases like occupational asthma. This study was performed to determine the prevalence of allergy to natural rubber latex and potential cross reacting food in operation room staff in Shiraz hospitals. Materials & Methods: In this cross-sectional descr...

Average cross sections calculated in various neutron fields

International Nuclear Information System (INIS)

Shibata, Keiichi

2002-01-01

Average cross sections have been calculated for the reactions contained in the dosimetry files, JENDL/D-99, IRDF-90V2, and RRDF-98 in order to select the best data for the new library IRDF-2002. The neutron spectra used in the calculations are as follows: 1) 252 Cf spontaneous fission spectrum (NBS evaluation), 2) 235 U thermal fission spectrum (NBS evaluation), 3) Intermediate-energy Standard Neutron Field (ISNF), 4) Coupled Fast Reactivity Measurement Facility (CFRMF), 5) Coupled thermal/fast uranium and boron carbide spherical assembly (ΣΣ), 6) Fast neutron source reactor (YAYOI), 7) Experimental fast reactor (JOYO), 8) Japan Material Testing Reactor (JMTR), 9) d-Li neutron spectrum with a 2-MeV deuteron beam. The items 3)-7) represent fast neutron spectra, while JMTR is a light water reactor. The Q-value for the d-Li reaction mentioned above is 15.02 MeV. Therefore, neutrons with energies up to 17 MeV can be produced in the d-Li reaction. The calculated average cross sections were compared with the measurements. Figures 1-9 show the ratios of the calculations to the experimental data which are given. It is found from these figures that the 58 Fe(n, γ) cross section in JENDL/D-99 reproduces the measurements in the thermal and fast reactor spectra better than that in IRDF-90V2. (author)

Exploring Integrated Marketing Communications, Brand Awareness, and Brand Image in Hospitality Marketing: A Cross-Cultural Approach

OpenAIRE

Maja Šerić; Irene Gil Saura; Josip Mikulić

2016-01-01

Purpose – The purpose of this paper is to assess customer perceptions of integration of marketing communications, brand awareness, and brand image in hospitality. Moreover, cross-cultural differences are considered when evaluating all the concepts, since national culture can have a considerable impact on customer behavior. Design/Methodology/Approach – After a literature review of the examined concepts, the results of an empirical study are presented and discussed. The empirical investigat...

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

Science.gov (United States)

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

2017-12-01

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

The quality of hospital work environments and missed nursing care is linked to heart failure readmissions: a cross-sectional study of US hospitals

Science.gov (United States)

Carthon, J Margo Brooks; Lasater, Karen B; Sloane, Douglas M; Kutney-Lee, Ann

2015-01-01

Introduction Threats to quality and patient safety may exist when necessary nursing care is omitted. Empirical research is needed to determine how missed nursing care is associated with patient outcomes. Aim The aim of this study was to examine the relationship between missed nursing care and hospital readmissions. Methods Cross-sectional examination, using three linked data sources—(1) nurse survey, (2) patient discharge data from three states (California, New Jersey and Pennsylvania) and (3) administrative hospital data— from 2005 to 2006. We explored the incidence of 30-day readmission for 160 930 patients with heart failure in 419 acute care hospitals in the USA. Logistic regression was used to assess the effect of missed care on the odds of readmission, adjusting for patient and hospital characteristics. Results The most frequently missed nursing care activities across all hospitals in our sample included talking to and comforting patients (42.0%), developing and updating care plans (35.8%) and educating patients and families (31.5%). For 4 of the 10 studied care activities, each 10 percentage-point increase in the number of nurses reporting having missed the activity was associated with an increase in the odds of readmission by 2–8% after adjusting for patient and hospital characteristics. However, missed nursing care was no longer a significant predictor of readmission once adjusting for the nurse work environment, except in the case of the delivery of treatments and procedures (OR 1.08, 95% CI 1.02 to 1.14). Conclusions Missed care is an independent predictor of heart failure readmissions. However, once adjusting for the quality of the nurse work environment, this relationship is attenuated. Improvements in nurses’ working conditions may be one strategy to reduce care omissions and improve patient outcomes. PMID:25672342

Exploring the cross-level impact of market orientation on nursing innovation in hospitals.

Science.gov (United States)

Weng, Rhay-Hung; Huang, Ching-Yuan; Lin, Tzu-En

2013-01-01

Recently, many hospitals have been enthusiastically encouraging nurses to pursue nursing innovation to improve health care quality and increase nursing productivity by proposing innovative training methods, products, services, care skills, and care methods. This study tried to explore the cross-level impact of market orientation on nursing innovation. In our study, 3 to 7 nurses and 1 manager were selected from each nursing team to act as respondents. The questionnaire survey began after the managers of each nursing team and the nurses had been anonymously coded and paired up in Taiwan in 2009-2010. A total of 808 valid questionnaires were collected, including 172 valid teams. Hierarchical linear modeling was used for the analysis. Nursing innovation is the sum of knowledge creation, innovation behavior, and innovation diffusion displayed by the nurses during nursing care. The level of knowledge creation, as perceived by the nurses, was the highest, whereas the level of innovation diffusion was the lowest. Results of hierarchical linear modeling showed that only competitor orientation yielded a significant positive influence on knowledge creation, innovation behavior, or innovation diffusion. The r values were 0.53, 0.49, and 0.61, respectively. Customer orientation and interfunctional coordination did not have significant effects on nursing innovation. Hospital nurses exhibited better performance in knowledge creation than in innovation behavior and diffusion. Only competitor orientation had a significantly positive and cross-level influence on nursing innovation. However, competitor orientation was observed to be the lowest dimension of market orientation, which indicates that this factor should be the focus when improving nursing innovations in the future. Therefore, managers should continually understand the strategies, advantages, and methods of their competitors.

Interference generalized cross-section for the multiphoton detachment of H- in dichromatic fields

International Nuclear Information System (INIS)

Mercouris, Theodoros; Haritos, Costas; Nicolaides, Cleanthes A

2005-01-01

The paper reports results from the application of the many-electron, many-photon theory on the system 'H - 1s 2 1 S state plus two fields of weak strengths, F 1 and F 2 '. The two fields have commensurate frequencies (ω, 2ω) and (ω, 3ω), with ω ranging from 0.011 au to 0.028 au, field strengths from 5 x 10 -5 au to 1.7 x 10 -3 au and a phase difference ψ. It is possible to determine the regime where the dichromatic field is weak and to define and compute a corresponding 'interference generalized cross-section'. This cross-section is an intrinsic property of each state as a function of the pair (ω, mω), m = 2, 3,.... Its knowledge is directly relevant to deciding on the degree of effectiveness of coherent quantum control. The calculations show that, with respect to ψ, H - is more receptive to control if frequencies are low. The computed effects are large enough so as to be measurable

Quantum system driven by incoherent a.c fields: Multi-crossing Landau Zener dynamics

Energy Technology Data Exchange (ETDEWEB)

Jipdi, M.N., E-mail: jmichaelnicky@yahoo.fr; Fai, L.C.; Tchoffo, M.

2016-10-23

The paper investigates the multi-crossing dynamics of a Landau–Zener (LZ) system driven by two sinusoidal a.c fields applying the Dynamic Matrix approach (DMA). The system is shown to follow one-crossing and multi-crossing dynamics for low and high frequency regime respectively. It is shown that in low frequency regime, the resonance phenomenon occurs and leads to the decoupling of basis states; the effective gap vanishes and then the complete blockage of the system. For high frequency, the system achieves multi-crossing dynamics with two fictitious crossings; the system models a Landau–Zener–Stückelberg (LZS) interferometer with critical parameters that tailor probabilities. The system is then shown to depend only on the phase that permits the easiest control with possible application in implementing logic gates.

Predictors of hospitalized patients' intentions to prevent healthcare harm: a cross sectional survey.

Science.gov (United States)

Davis, R; Anderson, O; Vincent, C; Miles, K; Sevdalis, N

2012-04-01

Patients can play an important role in reducing healthcare harm but little is known about the factors that may affect patients' willingness to participate. In order to encourage the 'active' patient it is critical that we gain a deeper understanding of the antecedents of safety-relevant behaviours. Doing this will enable the implementation of effective interventions aimed at supporting patients to work with healthcare professionals in ensuring safe care. To examine predictors of patients' intentions to engage in two safety behaviours: (1) reminding healthcare staff to wash their hands and; (2) notifying healthcare staff if they are not wearing a hospital identification bracelet. Cross-sectional survey study. A purposive sampling method was employed to recruit 80 medical and surgical hospital inpatients aged 18-80 (mean 48) from one inner city London teaching hospital. A 42 item survey that measured the extent that patients' control beliefs, behavioural beliefs, normative beliefs and perceived susceptibility and severity towards a hospital-acquired infection or a misidentification error could predict their intentions to ask doctors/nurses about their hand washing compliance or notify doctors/nurses if they are not wearing a hospital identification bracelet. Data was analysed using multiple regression analysis. Control beliefs, normative beliefs and perceived severity were the strongest predictors of patients' intentions to participate in both behaviours. The regression models accounted for a smaller percentage of the variance in patients' intentions to ask doctors/nurses if they have washed their hands (42%/37%) than notifying staff if they were not wearing an identification bracelet (54%/56%). If patients understand why a behaviour is beneficial, they perceive it as acceptable to participate in and that they have control over the decision to engage in the behaviour, we hypothesise that more patients will intend to participate in that behaviour. When designing

Shape functions for separable solutions to cross-field diffusion problems

International Nuclear Information System (INIS)

Luning, C.D.; Perry, W.L.

1984-01-01

The shape function S(x), which arises in the study of nonlinear diffusion for cross-field diffusion in plasmas, satisfies the equation S''(x)+lambdaa(x)S/sup α/(x) = 0, 0 0. In the cases of physical interest a(x) possesses an integrable singularity at some point in (0,1) but is otherwise continuous. Existence of a positive solution to this problem is established

Patient satisfaction between primary care providers and hospitals: a cross-sectional survey in Jilin province, China.

Science.gov (United States)

Li, Jinghua; Wang, Pingping; Kong, Xuan; Liang, Hailun; Zhang, Xiumin; Shi, Leiyu

2016-06-01

To assess patient satisfaction with outpatient and inpatient care between primary care providers and secondary/tertiary hospitals, and to examine its association with socio-demographic characteristics and type of institution, based on self-reported survey data. Cross-sectional survey. Healthcare facilities within Jilin province, China. In total, 993 outpatients and 925 inpatients aged ≥15 years old were recruited. Patient satisfaction with the care experience. Patient satisfaction with outpatient and inpatient care was significantly associated with type of healthcare delivery setting in Jilin, China. Seeking outpatient care from community health centers (CHCs) was significantly associated with a higher ratio of patient satisfaction. Patients of county and tertiary hospitals complained about long-waiting times, bad attitudes of health workers, high expense of treatment, and their overall satisfaction towards outpatient care was lower. In the terms of inpatient care, patients were more satisfied with treatment expense in CHCs compared with county hospitals. CHCs and hospitals face different challenges regarding patient satisfaction. Further healthcare reform in China need to adopt more measures (e.g. increasing quality of primary care, setting up a referral medical system etc.) to improve patient satisfaction. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

Factors associated to inpatient mortality rates in type-2-diabetic patients: a cross-sectional analytical study in three Peruvian hospitals.

Science.gov (United States)

Atamari-Anahui, Noé; Martinez-Ninanqui, Franklin W; Paucar-Tito, Liz; Morales-Concha, Luz; Miranda-Chirau, Alejandra; Gamarra-Contreras, Marco Antonio; Zea-Nuñez, Carlos Antonio; Mejia, Christian R

2017-12-05

Diabetes mortality has increased in recent years. In Peru, there are few studies on in-hospital mortality due to type 2 diabetes in the provinces. To determine factors associated to hospital mortality in patients with diabetes mellitus type 2 in three hospitals from Cusco-Peru. An analytical cross-sectional study was performed. All patients with diabetes mellitus type 2 hospitalized in the city of Cusco during the 2016 were included. Socio-educational and clinical characteristics were evaluated, with "death" as the variable of interest. The crude (cPR) and adjusted (aPR) prevalence ratios were estimated using generalized linear models with Poisson family and log link function, with their respective 95% confidence intervals (95% CI). The values p diabetes mellitus type 2 patients died during the study period. Mortality was increased as age rises, patients admitted through emergency rooms, patients who were readmitted to the hospital, and patients who had metabolic or renal complications. Patients admitted for a urinary tract infection had a lower mortality rate.

High rate of burnout among anaesthesiologists in Belgrade teaching hospitals: Results of a cross-sectional survey.

Science.gov (United States)

Milenović, Miodrag; Matejić, Bojana; Vasić, Vladimir; Frost, Elizabeth; Petrović, Nataša; Simić, Dušica

2016-03-01

Decisions by anaesthesiologists directly impact the treatment, safety, recovery and quality of life of patients. Physical or mental collapse due to overwork or stress (burnout) in anaesthesiologists may, therefore, be expected to negatively affect patients, departments, healthcare facilities and families. To evaluate the prevalence of burnout among anaesthesiologists in Belgrade public teaching hospitals. A cross-sectional survey. Anaesthesiologists in 10 Belgrade teaching hospitals. Burnout was assessed using Maslach Burnout Inventory-Human Services Survey. The response rate was 76.2% (205/272) with the majority of respondents women (70.7%). The prevalence of total burnout among anaesthesiologists in Belgrade teaching hospitals was 6.34%. Measured level of burnout as assessed by high emotional exhaustion, high depersonalisation and low personal accomplishment was 52.7, 12.2 and 28.8%, respectively. More than a quarter of the studied population responded in each category with symptoms of moderate burnout. We detected that sex, additional academic education, marital status and working conditions were risk factors for emotional exhaustion and depersonalisation. Ageing increased the likelihood of burnout by 21.3% with each additional year. Shorter professional experience and increased educational accomplishment increased the risk of total burnout by 272%. Burnout rates in Belgrade teaching hospitals among anaesthesiologists are higher than in foreign hospitals. Emotional and/or physical breakdowns can have serious effects when these individuals care for patients in extremely stressed situations that may occur perioperatively. Causes for burnout should be examined more closely and means implemented to reverse this process.

Inconsistencies Between Two Cross-Cultural Adaptations of the Hospital Survey on Patient Safety Culture Into French.

Science.gov (United States)

Boussat, Bastien; François, Patrice; Gandon, Gérald; Giai, Joris; Seigneurin, Arnaud; Perneger, Thomas; Labarère, José

2017-11-15

Two cross-cultural adaptations of the 12-dimension Hospital Survey on Patient Safety Culture (HSOPSC) into French coexist: the Occelli and Vlayen versions. The objective of this study was to assess the psychometric properties of the Occelli version in comparison with those reported for the Vlayen and the original US versions of this instrument. Using the original data from a cross-sectional study of 5,064 employees at a single university hospital in France, we examined the acceptability, internal consistency, factorial structure, and construct validity of the Occelli version of the HSOPSC. The response rate was 76.8% (n = 3888). Our study yielded lower missing value rates (median, 0.4% [range, 0.0%-2.4%] versus 0.8% [range, 0.2%-11.4%]) and lower dimension scores (median, 3.19 [range, 2.67-3.54] versus 3.42 [range, 2.92-3.96]) than those reported for the Vlayen version. Cronbach alphas (median, 0.64; range, 0.56-0.84) compared unfavorably with those reported for the Vlayen (median, 0.73; range, 0.57-0.86) and original US (median, 0.78; range, 0.63-0.84) versions. The results of the confirmatory factor analysis were consistent between the Vlayen and Occelli versions, making it possible to conduct surveys from the 12-dimensional structure with both versions. The inconsistencies observed between the Occelli and Vlayen versions of the HSOPSC may reflect either differences between the translations or heterogeneity in the study population and context. Current evidence does not clearly support the use of one version over the other. The two cross-cultural adaptations of the HSOPSC can be used interchangeably in French-speaking countries.

Production of a rapidly rotating plasma by cross-field injection of gun-produced plasma

International Nuclear Information System (INIS)

Ohzu, Akira; Ikehata, Takashi; Tanabe, Toshio; Mase, Hiroshi

1984-01-01

Cross-field plasma injection with use of a JxB plasma gun is described as a method to produce rapidly rotating plasma in a crossed electric and magnetic field system. The rotational velocity of the plasma is seriously limited by neutrals surrounding the plasma through strong interactions at the boundary layer. The concentration of neutrals can be reduced by the injection of fully or partially ionized plasma into the discharge volume instead of filling the volume with an operating gas. With use of this method, it is observed that the rotational velocity increases by a factor of 2 to 3 when compared with the conventional method of stationary gas-filling. (author)

Managing a front-line field hospital in Libya: Description of case mix and lessons learned for future humanitarian emergencies

Directory of Open Access Journals (Sweden)

Adam C. Levine

2012-06-01

Full Text Available Between June and August 2011, International Medical Corps deployed a field hospital near the front-line of the fighting between government troops and opposition fighters in Western Libya. The field hospital cared for over 1300 combatants and non-combatants from both sides of the conflict during that time period, the vast majority of them presenting with war-related injuries. Over 60% of battle-related injuries were due to shrapnel wounds and blast injuries from exploding small mortars, with smaller percentages due to battle-related motor vehicle accidents, gun shot wounds, burns, and other causes. The most pertinent lessons learned from our experience were the importance of dedicating significant resources to logistics and supply chain management, the rewards garnered from building strong ties with the local community early in the deployment of the field hospital, and the need to pay careful attention to basic principles of humanitarian ethics.

Nurse-physician collaboration impacts job satisfaction and turnover among nurses: A hospital-based cross-sectional study in Beijing.

Science.gov (United States)

Zhang, Lin; Huang, Lei; Liu, Meng; Yan, Hong; Li, Xiue

2016-06-01

This study aims to explore the impact of physician-nurse collaboration on nurse job satisfaction and turnover in a dental hospital. Physician-nurse collaboration is important for the stability of the entire nursing team. Few studies have shown the impact on job satisfaction and turnover among nurses working in Chinese dental hospitals. This was a prospective, cross-sectional study and investigated nurses from a tertiary dental hospital in Beijing using convenience non-randomized sampling. A structured questionnaire was used to collect data, which included general information, the Index of Work Satisfaction, the Nurse-Physician Collaboration Scale and the Turnover Intention Scale. The scores of physician-nurse collaboration correlated positively with those for job satisfaction and negatively with the stated likelihood of turnover intention. Physician-nurse collaboration scores positively predicted job satisfaction and negatively predicted the likelihood of quitting the current job. In conclusion, improving the level of physician-nurse collaboration is helpful to enhance job satisfaction and reduce turnover among nurses in a dental hospital. © 2016 John Wiley & Sons Australia, Ltd.

Study on factors inducing workplace violence in Chinese hospitals based on the broken window theory: a cross-sectional study.

Science.gov (United States)

Zhou, Chenyu; Mou, Huitong; Xu, Wen; Li, Zhe; Liu, Xin; Shi, Lei; Peng, Boshi; Zhao, Yan; Gao, Lei; Fan, Lihua

2017-07-28

To explore the potential components of hospital workplace violence (HWPV) from the perspectives of hospital administrators and patients, and put forward corresponding strategies for its prevention and control. Using convenience sampling methods, 116 hospitals in 14 provinces of China were surveyed using a self-designed questionnaire. A cross-sectional study was used. Hospital administrators and patients from 116 hospitals in 14 provinces of China. First, hospital administrators point of workplace factors included six factors, with the following weighting coefficients: hospital administrator factors (29.40%), patient-related factors (20.08%), hospital environmental factors (19.45%), policy and institutional factors (11.92%), social psychological factors (10.26%), objective events factors (8.89%). Second, patients from the hospital workplace predisposing factors included three common factors. The weight coefficients of these were hospital-related factors (60.27%), social and governmental factors (23.64%) and patient-related factors (16.09%). A wide range of factors according to hospital administrators, patients and in the hospital environment play important roles in HWPV. From the perspectives of hospital administrators, communication skills and attitude to the service are important factors for inducing HWPV. From the perspective of patients, the characteristics of staff personalities and medical cognition are more important inducing factors. As far as social factors are concerned, economic compensation of medical malpractice is an important inducing factor for HWPV. In terms of environmental factors, management of Chinese medical hospitals, medical procedures and the layout of departments are all potential factors for the occurrence of violence. Corresponding defects were exposed in the health legal system and the supervision system for influencing public opinion. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017

Electron cyclotron instabilities of finite pressure inhomogeneous plasma in crossed fields

International Nuclear Information System (INIS)

Kirochkin, Yu.A.; Pokroev, A.G.; Stepanov, K.N.

1979-01-01

The stability of inhomogeneous plasma sheet with β<=1 in crossed electric and magnetic fields is investigated. The differential equation describing potential oscillations is obtained. Using the local approximation the sheet is shown to be unstable against the excitation of short wavelength electron cyclotron oscillations. The validity criterion of this method for a given type of waves is derived

Review of microscopic integral cross section data in fundamental reactor dosimetry benchmark neutron fields

International Nuclear Information System (INIS)

Fabry, A.; McElroy, W.N.; Kellogg, L.S.; Lippincott, E.P.; Grundl, J.A.; Gilliam, D.M.; Hansen, G.E.

1976-01-01

This paper is intended to review and critically discuss microscopic integral cross section measurement and calculation data for fundamental reactor dosimetry benchmark neutron fields. Specifically the review covers the following fundamental benchmarks: the spontaneous californium-252 fission neutron spectrum standard field; the thermal-neutron induced uranium-235 fission neutron spectrum standard field; the (secondary) intermediate-energy standard neutron field at the center of the Mol-ΣΣ, NISUS, and ITN-ΣΣ facilities; the reference neutron field at the center of the Coupled Fast Reactor Measurement Facility; the reference neutron field at the center of the 10% enriched uranium metal, cylindrical, fast critical; the (primary) Intermediate-Energy Standard Neutron Field

Photodetachment of H- by a short laser pulse in crossed static electric and magnetic fields

International Nuclear Information System (INIS)

Peng Liangyou; Wang Qiaoling; Starace, Anthony F.

2006-01-01

We present a detailed quantum mechanical treatment of the photodetachment of H - by a short laser pulse in the presence of crossed static electric and magnetic fields. An exact analytic formula is presented for the final state electron wave function (describing an electron in both static electric and magnetic fields and a short laser pulse of arbitrary intensity). In the limit of a weak laser pulse, final state electron wave packet motion is examined and related to the closed classical electron orbits in crossed static fields predicted by Peters and Delos [Phys. Rev. A 47, 3020 (1993)]. Owing to these closed orbit trajectories, we show that the detachment probability can be modulated, depending on the time delay between two laser pulses and their relative phase, thereby providing a means to partially control the photodetachment process. In the limit of a long, weak pulse (i.e., a monochromatic radiation field) our results reduce to those of others; however, for this case we analyze the photodetachment cross section numerically over a much larger range of electron kinetic energy (i.e., up to 500 cm -1 ) than in previous studies and relate the detailed structures both analytically and numerically to the above-mentioned, closed classical periodic orbits

Magnetic fluctuation driven cross-field particle transport in the reversed-field pinch

International Nuclear Information System (INIS)

Scheffel, J.; Liu, D.

1997-01-01

Electrostatic and electromagnetic fluctuations generally cause cross-field particle transport in confined plasmas. Thus core localized turbulence must be kept at low levels for sufficient energy confinement in magnetic fusion plasmas. Reversed-field pinch (RFP) equilibria can, theoretically, be completely stable to ideal and resistive (tearing) magnetohydrodynamic (MHD) modes at zero beta. Unstable resistive interchange modes are, however, always present at experimentally relevant values of the poloidal beta β θ . An analytical quasilinear, ambipolar diffusion model is here used to model associated particle transport. The results indicate that core density fluctuations should not exceed a level of about 1% for plasmas of fusion interest. Parameters of experimentally relevant stationary states of the RFP were adjusted to minimize growth rates, using a fully resistive linearized MHD stability code. Density gradient effects are included through employing a parabolic density profile. The scaling of particle diffusion [D(r)∝λ 2 n 0.5 T/aB, where λ is the mode width] is such that the effects of particle transport are milder in present day RFP experiments than in future reactor-relevant plasmas. copyright 1997 American Institute of Physics

Measuring cost efficiency in the Nordic hospitals--a cross-sectional comparison of public hospitals in 2002.

Science.gov (United States)

Linna, Miika; Häkkinen, Unto; Peltola, Mikko; Magnussen, Jon; Anthun, Kjartan S; Kittelsen, Sverre; Roed, Annette; Olsen, Kim; Medin, Emma; Rehnberg, Clas

2010-12-01

The aim of this study was to compare the performance of hospital care in four Nordic countries: Norway, Finland, Sweden and Denmark. Using national discharge registries and cost data from hospitals, cost efficiency in the production of somatic hospital care was calculated for public hospitals. Data were collected using harmonized definitions of inputs and outputs for 184 hospitals and data envelopment analysis was used to calculate Farrell efficiency estimates for the year 2002. Results suggest that there were marked differences in the average hospital efficiency between Nordic countries. In 2002, average efficiency was markedly higher in Finland compared to Norway and Sweden. This study found differences in cost efficiency that cannot be explained by input prices or differences in coding practices. More analysis is needed to reveal the causes of large efficiency disparities between Nordic hospitals.

Diagnosis and outcome of psychiatric referrals to the Field Mental Health Team, 202 Field Hospital, Op Telic I.

Science.gov (United States)

Scott, J N

2005-06-01

To assess referrals to a Field Hospital Mental Health Team (FMHT), assign a diagnosis, provide appropriate treatment, and decide whether suitable for safe return to unit in theatre (RTU), or evacuation home on psychiatric grounds (evac). All documented referrals to the FMHT of 202 Field Hospital during the Op Telic 1 study period of 17 March (day 1) to 23 July 2003 (day 129) were included. Data were collected on rank, gender, diagnosis, outcome (whether RTU or evac), and whether TA before mobilisation. Diagnosis was assigned by ICD-10 criteria. The FMHT documented 170 cases, 12 of whom were seen twice and one on three occasions, resulting in 184 referrals, all of whom were British. The commonest diagnosis was adjustment reaction (F43), accounting for 68% of all cases (n = 116). These were divided between chiefly theatre-related (n = 77) or chiefly home-related (n = 39) reactions. The majority (94%) of these cases were RTU. Referrals where the diagnosis was a Depressive disorder (F32, n = 23) or Intentional self-harm (by sharp object, X78, n = 7) were evacuated. Outcome was similar for Regular and TA personnel, with on average 72% of cases RTU. The majority of cases seen were ORs, reflecting their numbers in theatre. Only 14 NCOs and 14 officers were referred. Thirteen of the latter were TA before mobilisation. Gender was not associated with outcome, or TA status, but was associated with rank, in that significantly more female officers were referred. The FMHT role tasks emerged as (a) psychiatric triage and treatment, (b) psychological support of hospital staff, and (c) welfare and pastoral care liaison. The utility of the psychiatric management model employed, built upon previous military medical doctrines, was tested in a modern theatre of conflict, and seemed to prove its worth.

Factors influencing nurse-assessed quality nursing care: A cross-sectional study in hospitals.

Science.gov (United States)

Liu, Ying; Aungsuroch, Yupin

2018-04-01

To propose a hypothesized theoretical model and apply it to examine the structural relationships among work environment, patient-to-nurse ratio, job satisfaction, burnout, intention to leave and quality nursing care. Improving quality nursing care is a first consideration in nursing management globally. A better understanding of factors influencing quality nursing care can help hospital administrators implement effective programmes to improve quality of services. Although certain bivariate correlations have been found between selected factors and quality nursing care in different study models, no studies have examined the relationships among work environment, patient-to-nurse ratio, job satisfaction, burnout, intention to leave and quality nursing care in a more comprehensive theoretical model. A cross-sectional survey. The questionnaires were collected from 510 Chinese nurses in four Chinese tertiary hospitals in January 2015. The validity and internal consistency reliability of research instruments were evaluated. Structural equation modelling was used to test a theoretical model. The findings revealed that the data supported the theoretical model. Work environment had a large total effect size on quality nursing care. Burnout largely and directly influenced quality nursing care, which was followed by work environment and patient-to-nurse ratio. Job satisfaction indirectly affected quality nursing care through burnout. This study shows how work environment past burnout and job satisfaction influences quality nursing care. Apart from nurses' work conditions of work environment and patient-to-nurse ratio, hospital administrators should pay more attention to nurse outcomes of job satisfaction and burnout when designing intervention programmes to improve quality nursing care. © 2017 John Wiley & Sons Ltd.

Influence of crossed fields in structures combining large grain, bulk (RE)BCO superconductors and soft ferromagnetic discs

International Nuclear Information System (INIS)

Philippe, M P; Fagnard, J F; Wéra, L; Vanderheyden, B; Vanderbemden, P; Morita, M; Nariki, S; Teshima, H; Caps, H

2016-01-01

Bulk (RE)BCO superconductors are able to trap record magnetic fields and can be used as powerful permanent magnets in various engineering applications such as rotating machines and magnetic bearings. When such superconducting (SC) “trapped field magnets” are combined to a ferromagnetic (FM) disc, the total magnetic moment is increased with respect to that of the superconductor alone. In the present work, we study experimentally the magnetic behaviour of such hybrid FM/SC structures when they are subjected to cycles of applied field that are orthogonal to their permanent magnetization, i.e. a “crossed-field” configuration. Experimental results show that the usual “crossed-field demagnetization” caused by the cycles of transverse field is strongly reduced in the presence of the ferromagnet. (paper)

Oral health status among long-term hospitalized adults: a cross sectional study

Directory of Open Access Journals (Sweden)

Leon Bilder

2014-06-01

Full Text Available Background. Many Long-Term Care (LTC institutionalized patients are the most frail and functionally dependent among the geriatric population and have significant oral health disparities.They often suffer from dental neglect due to limited access to appropriate professional dental care. These patients have chronic health situations and are treated with medications, which increase their risk of oral diseases. Despite the growth in elderly population in Israel, there is insufficient data regarding their oral health status and treatment needs.Objective. To describe the oral health status of the LTC hospitalized adults in a geriatric and psychiatric hospital in Israel.Methods. Data was recorded from LTC hospitalized adults with a physical and/or mental disabilities in a cross-sectional research design, which included general health anamnesis and clinical oral examination. Variables included gender, medicines, oral hygiene (OH, using dentures, number of caries lesions and residual teeth. Univariate analyses included Pearson χ2 and t-test analyses. Multivariate analyses included logistic and linear regressions while the outcome variables were categorical OH index and number of carious cavitations, number of residual teeth and carious teeth percentage.Results. 153 participants were included in the study with a mean age of 65.03 ± 18.67 years. 31.3% of the patients were edentulous, and only 14% had partial or full dentures. Females had a significantly higher number of caries cavitation than males (P = 0.044. The number of caries cavitation was higher among patients with poor OH (P < 0.001 and when taking Clonazepam (P = 0.018. Number of residual teeth was higher in the fair OH group (P < 0.001. Carious teeth percentage was higher among the poor OH group (P < 0.001.

Natural ventilation for reducing airborne infection in hospitals

Energy Technology Data Exchange (ETDEWEB)

Qian, Hua [School of Energy and Environment, Southeast University, Nanjing (China); Department of Mechanical Engineering, The University of Hong Kong, Pokfulam, Hong Kong (China); Li, Yuguo; Ching, W.H.; Sun, H.Q. [Department of Mechanical Engineering, The University of Hong Kong, Pokfulam, Hong Kong (China); Seto, W.H.; Ching, Patricia [Department of Microbiology, Queen Mary Hospital, Hong Kong (China)

2010-03-15

High ventilation rate is shown to be effective for reducing cross-infection risk of airborne diseases in hospitals and isolation rooms. Natural ventilation can deliver much higher ventilation rate than mechanical ventilation in an energy-efficient manner. This paper reports a field measurement of naturally ventilated hospital wards in Hong Kong and presents a possibility of using natural ventilation for infection control in hospital wards. Our measurements showed that natural ventilation could achieve high ventilation rates especially when both the windows and the doors were open in a ward. The highest ventilation rate recorded in our study was 69.0 ACH. The airflow pattern and the airflow direction were found to be unstable in some measurements with large openings. Mechanical fans were installed in a ward window to create a negative pressure difference. Measurements showed that the negative pressure difference was negligible with large openings but the overall airflow was controlled in the expected direction. When all the openings were closed and the exhaust fans were turned on, a reasonable negative pressure was created although the air temperature was uncontrolled. The high ventilation rate provided by natural ventilation can reduce cross-infection of airborne diseases, and thus it is recommended for consideration of use in appropriate hospital wards for infection control. Our results also demonstrated a possibility of converting an existing ward using natural ventilation to a temporary isolation room through installing mechanical exhaust fans. (author)

Measurement and interpretation of current transmission in a crossed-field diode below cutoff

International Nuclear Information System (INIS)

Vanderberg, B.H.; Eninger, J.E.

1997-01-01

Measurements on the current-voltage-magnetic field characteristics of a space-charge-limited cylindrical cross-field diode below cutoff are presented. The measured current is found to be lower than predicted by simple cold-fluid theory. This reduction combined with observed oscillations in the current can be explained by secondary electron emission from the anode, leading to an increase of space charge in the diode. copyright 1997 American Institute of Physics

A cross-sectional study of the availability and pharmacist's knowledge of nano-pharmaceutical drugs in Palestinian hospitals.

Science.gov (United States)

Assali, Mohyeddin; Shakaa, Ali; Abu-Hejleh, Sabaa; Abu-Omar, Reham; Karajeh, Nareman; Ajory, Nawal; Zyoud, Saed; Sweileh, Waleed

2018-04-05

Nanomedicine is the medical application of nanomaterials that may have an infinite size with the range less than 100 nm. This science has provided solutions to many of the current limitations in the diagnosis and treatment of diseases. Therefore, the pharmacist's knowledge and awareness of nano-pharmaceutical drugs will increase their availability in the market, and will improve the patient's compliance to their drug therapy. This study aimed to determine the availability of nano-pharmaceutical drugs in Palestinian hospitals and evaluate the extent of pharmacist's knowledge about them. A cross-sectional study design questionnaire was used to determine the availability of nano-pharmaceutical drugs based on the database of the ministry of health in the Palestinian hospitals (governmental, private and non- governmental organizations). Moreover, the knowledge of these nano-pharmaceutical drugs among pharmacists working in Palestinian hospitals was assessed based on developed questionnaire from the literature of the pharmaceutical formulations and nano-formulations. The variables were analyzed using Statistical Package for Social Sciences (SPSS 22). Fifty six pharmacists from 27 hospitals in the West bank completed the survey. The results regarding the availability of nano-pharmaceutical drugs indicated only eight available in hospitals with a frequency range 0-39.3%. Moreover, pharmacist's knowledge in the pharmaceutical formulations was better than that in nano-formulations. The availability of nano-pharmaceutical drugs in Palestinian hospitals was not adequate due to the lack of various nano-pharmaceutical drugs. The knowledge among pharmacists regarding nano-pharmaceutical drugs should be improved by providing courses in nanomedicine during the undergraduate pharmacy programs.

Electric Field and Potential Distribution in a 420 kV Novel Unibody Composite Cross-Arm

DEFF Research Database (Denmark)

Jahangiri, Tohid; Bak, Claus Leth; Silva, Filipe Miguel Faria da

2015-01-01

the hollow core uni-body cross-arm through which ground cable passes to connect the shield wires. Two different shed profiles are considered on the cross-arm and evaluated based on the guidelines of IEC 60815-3. The 2D geometry of pylon is modeled in ANSYS Finite Element Analysis package. The electric field...

Cross-field flow and electric potential in a plasma slab

Directory of Open Access Journals (Sweden)

J. De Keyser

2013-08-01

Full Text Available We consider cross-field plasma flow inside a field-aligned plasma slab embedded in a uniform background in a 1-dimensional geometry. This situation may arise, for instance, when long-lasting reconnection pulses inject plasma into the inner magnetosphere. The present paper presents a detailed analysis of the structure of the interfaces that separate the slab from the background plasma on either side; a fully kinetic model is used to do so. Since the velocity shear across both interfaces has opposite signs, and given the typical gyroradius differences between injected and background ions and electrons, the structure of both interfaces can be very different. The behaviour of the slab and its interfaces depends critically on the flow of the plasma transverse to the magnetic field; in particular, it is shown that there are bounds to the flow speed that can be supported by the magnetised plasma. Further complicating the picture is the effect of the potential difference between the slab and its environment.

Review of microscopic integral cross section data in fundamental reactor dosimetry benchmark neutron fields

International Nuclear Information System (INIS)

Fabry, A.; McElroy, W.N.; Kellogg, L.S.; Lippincott, E.P.; Grundl, J.A.; Gilliam, D.M.; Hansen, G.E.

1976-10-01

The paper is intended to review and critically discuss microscopic integral cross section measurement and calculation data for fundamental reactor dosimetry benchmark neutron fields. Specifically the review covers the following fundamental benchmarks: (1) the spontaneous californium-252 fission neutron spectrum standard field; (2) the thermal-neutron induced uranium-235 fission neutron spectrum standard field; (3) the (secondary) intermediate-energy standard neutron field at the center of the Mol-ΣΣ, NISUS, and ITN--ΣΣ facilities; (4) the reference neutron field at the center of the Coupled Fast Reactor Measurement Facility (CFRMF); (5) the reference neutron field at the center of the 10 percent enriched uranium metal, cylindrical, fast critical; and (6) the (primary) Intermediate-Energy Standard Neutron Field

Channeling of electrons in a crossed laser field

Directory of Open Access Journals (Sweden)

S. B. Dabagov

2015-06-01

Full Text Available In this article a new analytical description of the effective interaction potential for a charged particle with the field of two interfering laser beams is presented. The potential dependence on the lasers intensities, orientation and parameters of the particle entering the considered system is analyzed. For the first time the phenomenon of effective potential inversion (or “relativistic reversal” is described for arbitrary lasers crossing angle. Threshold electron velocity values for the phenomenon are introduced and its extended illustration based on numerical simulations for two laser beams polarizations is presented. In addition the projectile radiation spectral distribution is given and general estimations on the expected beam radiation yield are outlined.

The prevalence, prevention and multilevel variance of pressure ulcers in Norwegian hospitals: a cross-sectional study.

Science.gov (United States)

Bredesen, Ida Marie; Bjøro, Karen; Gunningberg, Lena; Hofoss, Dag

2015-01-01

Pressure ulcers are preventable adverse events. Organizational differences may influence the quality of prevention across wards and hospitals. To investigate the prevalence of pressure ulcers, patient-related risk factors, the use of preventive measures and how much of the pressure ulcer variance is at patient, ward and hospital level. A cross-sectional study. Six of the 11 invited hospitals in South-Eastern Norway agreed to participate. Inpatients ≥18 years at 88 somatic hospital wards (N=1209). Patients in paediatric and maternity wards and day surgery patients were excluded. The methodology for pressure ulcer prevalence studies developed by the European Pressure Ulcer Advisory Panel was used, including demographic data, the Braden scale, skin assessment, the location and severity of pressure ulcers and preventive measures. Multilevel analysis was used to investigate variance across hierarchical levels. The prevalence was 18.2% for pressure ulcer category I-IV, 7.2% when category I was excluded. Among patients at risk of pressure ulcers, 44.3% had pressure redistributing support surfaces in bed and only 22.3% received planned repositioning in bed. Multilevel analysis showed that although the dominant part of the variance in the occurrence of pressure ulcers was at patient level there was also a significant amount of variance at ward level. There was, however, no significant variance at hospital level. Pressure ulcer prevalence in this Norwegian sample is similar to comparable European studies. At-risk patients were less likely to receive preventive measures than patients in earlier studies. There was significant variance in the occurrence of pressure ulcers at ward level but not at hospital level, indicating that although interventions for improvement are basically patient related, improvement of procedures and organization at ward level may also be important. Copyright © 2014 Elsevier Ltd. All rights reserved.

Drug utilization study from a government sponsored pharmacy in a tertiary care teaching hospital of rural West Bengal: A cross-sectional study

OpenAIRE

Tanmoy Gangopadhyay; Ananya Mandal; Sonai Mandal; Bishan Basu; Tamoghna Maiti; Abhijit Das; Soumitra Mandal; Sekhar Mandal

2016-01-01

Context: Newly started government sponsored pharmacies providing discounts have been available to the public at the medical college hospitals in West Bengal. Aims: The present study was undertaken to evaluate the drug prescribing trends from the prescriptions at such a pharmacy at a tertiary care hospital. Methods: The study was a prospective cross-sectional study that spanned for a period of 1-month from 1 to 31 August 2015. Prescriptions were reviewed and analyzed using the World Health Org...

Cross-field dust acoustic instability in a dusty negative ion plasma

International Nuclear Information System (INIS)

Rosenberg, M

2010-01-01

A cross-field dust acoustic instability in a dusty negative ion plasma in a magnetic field is studied using kinetic theory. The instability is driven by the ExB drifts of the ions. It is assumed that the negative ions are much heavier than the positive ions, and that the dust is negatively charged. The case where the positive ions and electrons are magnetized, the negative ions are marginally unmagnetized, and the dust is unmagnetized is considered. The focus is on a situation where Doppler resonances near harmonics of the positive ion gyrofrequency can affect the spectrum of unstable dust acoustic waves. Application to possible laboratory experimental parameters is discussed.

Nile Crossings: Hospitality and Revenge in Egyptian Rural Narratives

OpenAIRE

Granara, William E.

2010-01-01

This essay looks at acts of hospitality and revenge as constituent elements of a broad social code in rural Egyptian narratives. By looking at five stories in particular, I argue that hospitality and revenge work in complementarity, and that they often trespass and blur each other’s social and literary borders, creating ambiguity and complexity in the stories. The traditional rules that govern hospitality are at times challenged or inverted by hostile intentions, and revenge may be exacted fo...

Cross-field diffusion of energetic (100 keV to 2 MeV) protons in interplanetary space

Energy Technology Data Exchange (ETDEWEB)

Costa Jr, Edio da [Instituto Federal de Minas Gerais-IFMG, Ouro Preto, MG, 35400-000 (Brazil); Tsurutani, Bruce T. [Jet Propulsion Laboratory, California Institute of Technology, Pasadena, CA 91109 (United States); Alves, Maria Virgínia; Echer, Ezequiel [Instituto Nacional de Pesquisas Espaciais-INPE, São José dos Campos, SP, 12227-010 (Brazil); Lakhina, Gurbax S., E-mail: edio.junior@ifmg.edu.br, E-mail: costajr.e@gmail.com [Indian Institute for Geomagnetism, Navi Mumbai 410 218 (India)

2013-12-01

Magnetic field magnitude decreases (MDs) are observed in several regions of the interplanetary medium. In this paper, we characterize MDs observed by the Ulysses spacecraft instrumentation over the solar south pole by using magnetic field data to obtain the empirical size, magnetic field MD, and frequency of occurrence distribution functions. The interaction of energetic (100 keV to 2 MeV) protons with these MDs is investigated. Charged particle and MD interactions can be described by a geometrical model allowing the calculation of the guiding center shift after each interaction. Using the distribution functions for the MD characteristics, Monte Carlo simulations are used to obtain the cross-field diffusion coefficients as a function of particle kinetic energy. It is found that the protons under consideration cross-field diffuse at a rate of up to ≈11% of the Bohm rate. The same method used in this paper can be applied to other space regions where MDs are observed, once their local features are well known.

BIGRE: A LOW CROSS-TALK INTEGRAL FIELD UNIT TAILORED FOR EXTRASOLAR PLANETS IMAGING SPECTROSCOPY

International Nuclear Information System (INIS)

Antichi, Jacopo; Mouillet, David; Puget, Pascal; Beuzit, Jean-Luc; Dohlen, Kjetil; Gratton, Raffaele G.; Mesa, Dino; Claudi, Riccardo U.; Giro, Enrico; Boccaletti, Anthony

2009-01-01

Integral field spectroscopy represents a powerful technique for the detection and characterization of extrasolar planets through high-contrast imaging since it allows us to obtain simultaneously a large number of monochromatic images. These can be used to calibrate and then to reduce the impact of speckles, once their chromatic dependence is taken into account. The main concern in designing integral field spectrographs for high-contrast imaging is the impact of the diffraction effects and the noncommon path aberrations together with an efficient use of the detector pixels. We focus our attention on integral field spectrographs based on lenslet arrays, discussing the main features of these designs: the conditions of appropriate spatial and spectral sampling of the resulting spectrograph's slit functions and their related cross-talk terms when the system works at the diffraction limit. We present a new scheme for the integral field unit based on a dual-lenslet device (BIGRE), that solves some of the problems related to the classical Traitement Integral des Galaxies par l'Etude de leurs Rays (TIGER) design when used for such applications. We show that BIGRE provides much lower cross-talk signals than TIGER, allowing a more efficient use of the detector pixels and a considerable saving of the overall cost of a lenslet-based integral field spectrograph.

Spectrum integrated (n,He) cross section comparisons and least squares analyses for 6Li and 10B in benchmark fields

International Nuclear Information System (INIS)

Schenter, R.E.; Oliver, B.M.; Farrar, H. IV.

1986-06-01

Spectrum integrated cross sections for 6 Li and 10 B from five benchmark fast reactor neutron fields are compared with calculated values obtained using the ENDF/B-V Cross Section Files. The benchmark fields include the Coupled Fast Reactivity Measurements Facility (CFRMF) at the Idaho National Engineering Laboratory, the 10% Enriched U-235 Critical Assembly (BIG-10) at Los Alamos National Laboratory, the Sigma-Sigma and Fission Cavity fields of the BR-1 reactor at CEN/SCK, and the Intermediate Energy Standard Neutron Field (ISNF) at the National Bureau of Standards. Results from least square analyses using the FERRET computer code to obtain adjusted cross section values and their uncertainties are presented. Input to these calculations include the above five benchmark data sets. These analyses indicate a need for revision in the ENDF/B-V files for the 10 B and 6 Li cross sections for energies above 50 keV

Integral test on activation cross section of tag gas nuclides using fast neutron spectrum fields

Energy Technology Data Exchange (ETDEWEB)

Aoyama, Takafumi; Suzuki, Soju [Power Reactor and Nuclear Fuel Development Corp., Oarai, Ibaraki (Japan). Oarai Engineering Center

1997-03-01

Activation cross sections of tag gas nuclides, which will be used for the failed fuel detection and location in FBR plants, were evaluated by the irradiation tests in the fast neutron spectrum fields in JOYO and YAYOI. The comparison of their measured radioactivities and the calculated values using the JENDL-3.2 cross section set showed that the C/E values ranged from 0.8 to 2.8 for the calibration tests in YAYOI and that the present accuracies of these cross sections were confirmed. (author)

Cross-sectional survey of patients' need for information and support with medicines after discharge from hospital.

Science.gov (United States)

Mackridge, Adam J; Rodgers, Ruth; Lee, Dan; Morecroft, Charles W; Krska, Janet

2017-11-20

Most patients experience changes to prescribed medicines during a hospital stay. Ensuring they understand such changes is important for preventing adverse events post-discharge and optimising patient understanding. However, little work has explored the information that patients receive about medicines or their perceived needs for information and support after discharge. To determine information that hospital inpatients who experience medicine changes receive about their medicines during admission and their needs and preferences for, and use of, post-discharge support. Cross-sectional survey with adult medical inpatients experiencing medicine changes in six English hospitals, with telephone follow-up 2-3 weeks post-discharge. A total of 444 inpatients completed surveys, and 99 of these were followed up post-discharge. Of the 444, 44 (10%) were unaware of changes to medicines and 65 (16%) did not recall discussing them with a health professional, but 305 (77%) reported understanding the changes. Type of information provided and patients' perceived need for post-discharge support differed between hospitals. Information about changes was most frequently provided by consultant medical staff (157; 39%) with pharmacists providing information least often (71; 17%). One third of patients surveyed considered community pharmacists as potential sources of information about medicines and associated support post-discharge. Post-discharge, just 5% had spoken to a pharmacist, although 35% reported medicine-related problems. In north-west England, patient inclusion in treatment decisions could be improved, but provision of information prior to discharge is reasonable. There is scope to develop hospital and community pharmacists' role in medicine optimisation to maximise safety and effectiveness of care. © 2017 Royal Pharmaceutical Society.

Transport coefficients for electrons in argon in crossed electric and magnetic rf fields

International Nuclear Information System (INIS)

Raspopovic, Z M; Dujko, S; Makabe, T; Petrovic, Z Lj

2005-01-01

Monte Carlo simulations of electron transport have been performed in crossed electric and magnetic rf fields in argon. It was found that a magnetic field strongly affects electron transport, producing complex behaviour of the transport coefficients that cannot be predicted on the basis of dc field theory. In particular, it is important that a magnetic field, if it has sufficiently high amplitude, allows energy gain from the electric field only over a brief period of time, which leads to a pulse of directed motion and consequently to cyclotron oscillations being imprinted on the transport coefficients. Furthermore, this may lead to negative diffusion. The behaviour of drift velocities is also interesting, with a linear (sawtooth) dependence for the perpendicular drift velocity and bursts of drift for the longitudinal. Non-conservative effects are, on the other hand, reduced by the increasing magnetic field

Effects of the magnetic field variation on the spin wave interference in a magnetic cross junction

Science.gov (United States)

Balynskiy, M.; Chiang, H.; Kozhevnikov, A.; Dudko, G.; Filimonov, Y.; Balandin, A. A.; Khitun, A.

2018-05-01

This article reports results of the investigation of the effect of the external magnetic field variation on the spin wave interference in a magnetic cross junction. The experiments were performed using a micrometer scale Y3Fe5O12 cross structure with a set of micro-antennas fabricated on the edges of the cross arms. Two of the antennas were used for the spin wave excitation while a third antenna was used for detecting the inductive voltage produced by the interfering spin waves. It was found that a small variation of the bias magnetic field may result in a significant change of the output inductive voltage. The effect is most prominent under the destructive interference condition. The maximum response exceeds 30 dB per 0.1 Oe at room temperature. It takes a relatively small bias magnetic field variation of about 1 Oe to drive the system from the destructive to the constructive interference conditions. The switching is accompanied by a significant, up to 50 dB, change in the output voltage. The obtained results demonstrate a feasibility of the efficient spin wave interference control by an external magnetic field, which may be utilized for engineering novel type of magnetometers and magnonic logic devices.

Hazardous drinkers in Norwegian hospitals – a cross-sectional study of prevalence and drinking patterns among somatic patients

Directory of Open Access Journals (Sweden)

Kristian Oppedal

2011-12-01

Full Text Available Background: High alcohol intake has been associated with increased risk of hospital admission, increased complication rates, and prolonged hospital stay. Thus, hospital admission may present a relevant opportunity for alcohol intervention. To understand the potential of alcohol interventions we need knowledge about patients’ drinking patterns. The aim of this study was therefore to determine the drinking patterns in a Norwegian hospital population.Methods: A multicentre cross-sectional survey was carried out at three university hospitals. Patients were asked about alcohol intake one month prior to admission/outpatient treatment. The questionnaire included weekly alcohol intake calculated by frequency X quantity as well as episodes of binge drinking (drinking more than 5 AU during a single day. AUDIT-C was used to determine the frequency of patients having a hazardous drinking pattern during the 12 months prior to hospital treatment.Results: In total we assessed 2,932 patients for eligibility. A total of 2,350 patients fulfilled the inclusion criteria. We included 1,522 patients (65% in the analyses. Six percent of the women and 11% of the men reported drinking more than the weekly limits of nine alcohol units (AU for women and 14 AU for men. Fourteen percent of the women and 29% of the men reported binge drinking during the last month. The frequency of women scoring more or equal to 4 points on AUDIT-C was 20%. The frequency of men scoring more or equal to 5 points was 25%.Conclusion: Hazardous drinking among Norwegian hospital patients may be more prevalent than what has been reported for the Norwegian population in general. Binge drinking is the dominant drinking pattern.

Notes from a field hospital south of Mosul.

Science.gov (United States)

Quinn V, John M; Amouri, Omar F; Reed, Pete

2018-03-06

This short letter from the field is offered as a rapid communiqué of the emergency medical situation in Mosul and surrounding areas on the eve of the final onslaught to liberate the city. This letter is based on emergency medical work at two World Health Organization (WHO) and Ministry of Health (MoH) Iraq lead Role II+ Field Hospital facilities south of Mosul City from April to June 2017; these facilities are currently and temporarily managed and administered by private medical industry until full handover to MoH Iraq, with WHO support and expert facilitation. The prominence of non-state actors in the conflict, using hybrid warfare tactics that maximize casualties, makes health security a particular challenge for the global community. This challenge requires health leaders and other actors in the region to set clear strategic goals that support public health of the many millions displaced, maimed and affected by the war. Whether in clinical medicine, development, peace and stability operations, or global health diplomacy, the shared values and conviction to best serve vulnerable communities and mitigate morbidity must embrace the lessons of evidenced based practice derived from military medical experience. WHO is leading the charge in disaster response for the conflict in Iraq, and many challenges remain. This might also include developing a new process in emergency medical response that utilizes private contracting to improve efficiency in delivery and overall sustainability.

Hospital based patient coordination for ethnic minority patients - a health technology assessment

DEFF Research Database (Denmark)

Sodemann, Morten

A cross diciplinary, cross specialty, cross sectoral hospital based approach to cultural management of ethnic minority patients is effective in creating more approprite patient flows, better quality of care and increases functional level of patients. Surprisingly the aggregated effect saves...... especially on public medicine expenses and social services. Ethnic minority patients can achieve increased empowerment & Equity in type and quality of hospital care through cross dicplinary cross specialty cultural case management & support between hospital departments and primary sectors...

Cooling and focusing of a relativistic charged particle beam in crossed laser field

International Nuclear Information System (INIS)

Li Fuli

1987-01-01

A new method to focus a relativistic charged particle beam is suggested and studied. This idea is based on the use of the ponderomotive force which arises when a periodic electromagnetic field is created, as in the case of two crossed laser beams. (author)

Measuring cost efficiency in the Nordic hospitals--a cross-sectional comparison of public hospitals in 2002

DEFF Research Database (Denmark)

Linna, Miika; Häkkinen, Unto; Peltola, Mikko

2010-01-01

The aim of this study was to compare the performance of hospital care in four Nordic countries: Norway, Finland, Sweden and Denmark. Using national discharge registries and cost data from hospitals, cost efficiency in the production of somatic hospital care was calculated for public hospitals. Data......, average efficiency was markedly higher in Finland compared to Norway and Sweden. This study found differences in cost efficiency that cannot be explained by input prices or differences in coding practices. More analysis is needed to reveal the causes of large efficiency disparities between Nordic...

Cross-sectional study on factors hampering implementation of measles pre- and postexposure measures in Dutch hospitals during the 2013-2014 measles outbreak.

Science.gov (United States)

Fievez, L C R; Wong, A; Ruijs, W L M; Meerstadt-Rombach, F S; Timen, A

2017-07-01

This study examined adherence to national recommendations on measles pre- and postexposure measures, including immunization of health care workers (HCWs) in Dutch hospitals, during a national outbreak of measles in The Netherlands. This study also investigated which hospital characteristics and organizational issues hamper implementation. This was a cross-sectional survey among all general and academic hospitals in The Netherlands. An online structured questionnaire (48 questions) was administered. Analysis was performed using descriptive statistics and logistic regression. Of 88 hospitals, 70 (79.5%) were included. Of 68 hospitals, 48 (70.6%) assessed susceptibility to measles in HCWs. Of 70 hospitals, 61 (87.1%) offered vaccination to susceptible HCWs. Of 63 hospitals, 42 (66.7%) had postexposure policies consistent with national recommendations. Of 62 hospitals, 30 (48.4%) implemented all these measures, which is the minimum set of measures considered necessary to adequately prevent measles in HCWs. Logistic regression suggests that hospitals with several locations, hospitals with more employees, and hospitals where infectious disease experts designed infection prevention policies while occupational health experts implemented the policy less often implemented this minimum set of measures (P measles outbreak, most hospitals took measures to prevent measles in HCWs, but less than half implemented the minimum set of measures required. Implementation strategies in hospitals need to be improved, especially in large-sized hospitals and hospitals with several locations, and with respect to the assignment of responsibilities for infection prevention policies. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

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

Directory of Open Access Journals (Sweden)

Kai Xing

Full Text Available The purpose of this study is to identify risk factors of physical violence in Chinese township hospitals.A cross-sectional survey was used in a sample of 442 general practitioners and 398 general nurses from 90 township hospitals located in Heilongjiang province, China (response rate = 84.8%.A total of 106 of the 840 (12.6% respondents reported being physically attacked in their workplace in the previous 12 months. Most perpetrators were the patients' relatives (62.3%, followed by the patient (22.6%; 73.6% of perpetrators were aged between 20 and 40 years. Of the physical violence incidents, about 56.6% (n = 60 resulted in a physical injury, and 45.4% of respondents took two or three days of sick leave. Reporting workplace violence in hospitals to superiors or authorities was low (9.4%. Most respondents (62.8% did not receive training on how to avoid workplace violence. Logistic regression analyses indicated that general nurses, aged 35 years or younger, and with a higher-level professional title were more likely to experience physical violence. Healthcare workers with direct physical contact (washing, turning, lifting with patients had a higher risk of physical violence compared to other health care workers. Procedures for reporting workplace violence were a protective factor for physical violence; when in place, reporting after psychological violence (verbal abuse, bullying/mobbing, harassment, and threats was more protective than waiting until an instance of physical violence (beating, kicking, slapping, stabbing, etc..Physical violence in Chinese township hospitals is an occupational hazard of rural public health concern. Policies, procedures, and intervention strategies should be undertaken to manage this issue.

Low back pain among nurses in Slovenian hospitals: cross-sectional study.

Science.gov (United States)

Skela-Savič, B; Pesjak, K; Hvalič-Touzery, S

2017-12-01

The study investigated the prevalence and factors predicting low back pain among nurses in Slovenian hospitals. The risk factors for low back pain are physical and psychosocial. Implementation of interventions for reducing low back pain calls for management support, accessible equipment, education, knowledge and risk assessment. Low back pain prevalence and incidence among healthcare workers is very high compared to the general population and is a strong risk factor for long-term sickness absence. A cross-sectional study design was utilized. We used validated instruments: Nordic Musculoskeletal Disorder Questionnaire, Stanford Presenteeism Scale and Perceived Stress Scale. The sample included 1744 nursing employees from 16 Slovenian hospitals, ranging from practical nurses, registered nurses, nurses with a bachelor's degree and those with a master's degree. Results revealed a prevalence of low back pain among 85.9% of respondents. Relevant risk factors included female gender, age, length of employment, years in current position, shift work and the number of nurses per shift. In the regression model, factors predicting low back pain included presenteeism with a negative effect on work, presenteeism and maintaining work productivity, inability to control daily life, number of nurses per shift and respondents' age. Future activities should be oriented towards eliminating or reducing risks for low back pain incidents and towards different strategies, guidelines and actions which empower individuals and provide knowledge to manage and prevent low back pain. Slovenian healthcare system planning needs a national strategy to successfully promote LBP preventive and controlling strategies. Management can plan preventive and curative measures to reduce low back pain prevalence among nursing personnel. Management should also implement policies reflecting research findings. © 2017 International Council of Nurses.

Antecedents of hospital nurses' intention to leave the organization: A cross sectional survey.

Science.gov (United States)

Bobbio, Andrea; Manganelli, Anna Maria

2015-07-01

Leadership and perceived organizational support inspire trust in the leader and in the organization. Consequently, these aspects may contribute to a reduction in job burnout among nurses and, in the end, of the intention on their part to leave the hospital. It is crucial to develop models in order to simultaneously test the correlations between these relevant psychosocial variables, so that complexity of the nursing work environment may be better understood. We expected to give support to and to further corroborate results in the literature linking perceived leadership style – and particularly servant leadership – perceived organizational support, trust in the leader and in the organization, job burnout among nurses and their subsequent intention to leave the hospital. Cross-sectional study. Two Italian large size public hospitals. Two samples including both graduates and non-graduates members of the nursing staff. Overall mean age was equal to 42.06 years while the general mean for tenure was 12.99 years. Data were collected in 2012. A regression model with latent variables was tested via structural equation modeling using LISREL. The multi-sample procedure was also applied in order to test invariance of results between the two samples. Servant leadership was positively associated with trust in the leader and perceived organizational support was positively associated with trust in the organization. Trust in the leader and trust in the organization displayed a negative correlation with the emotional exhaustion and cynicism factors of job burnout, and a positive correlation with the professional efficacy factor. Furthermore, trust scores mediated the effects of servant leadership and perceived organizational support on job burnout factors. The cynicism factor was negatively associated with intention to leave the organization and it also mediated the effects of both trust in the leader and servant leadership on intention to leave. On the other hand, trust in the

Workplace violence against nurses--prevalence and association with hospital organizational characteristics and health-promotion efforts: Cross-sectional study.

Science.gov (United States)

Wei, Ching-Yao; Chiou, Shu-Ti; Chien, Li-Yin; Huang, Nicole

2016-04-01

To determine the prevalence of workplace violence and explore the role of hospital organizational characteristics and health promotion efforts in reducing hospital violence among nurses in Taiwan. Cross-sectional survey. One hundred hospitals across Taiwan. The final sample in our study comprised responses from 26,979 nurses. The data were obtained from a nationwide hospital survey, Physical and Mental Health and Safety Needs in Full-Time Health Care Staff, which was developed and conducted by the Bureau of Health Promotion, Taiwan, in 2011. The main dependent variable was whether nurses had experienced violence within the past year. Physical violence, threatened or intimidated personal safety, verbal violence or sexual harassment were all included. Of the 26,979 nurses, 13,392 nurses (49.6%) had experienced at least one episode of any type of violence in the past year; 5150 nurses (19.1%) had been exposed to physical violence, and 12,491 nurses (46.3%) had been exposed to non-physical violence. The prevalence of having experienced any violence varied widely and ranged from the highest (55.5%) in an emergency room or intensive care unit to the lowest (28.3%) among those aged 55-65 years. After adjusting for other characteristics, younger nurses were significantly more likely to be exposed to any violent threat. Nurses working in public hospitals had a significantly higher risk of workplace violence than those working in private hospitals. Significant variations were also observed among work units. Although nurses working in a certified health promoting hospital (HPH) did not have a lower risk of workplace violence, those working in an outstanding HPH had a significantly lower risk of workplace violence. A similar pattern was observed for non-physical violence. Workplace violence is a major challenge to workplace safety for nurses in hospitals. This large scale nurse survey identified individual, work and hospital characteristics associated with workplace violence

Hospital waste management in nonteaching hospitals of Lucknow City, India

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Manish Kumar Manar

2014-01-01

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

Preliminary study of cross-field plasma injection in 2XIIB

International Nuclear Information System (INIS)

Cheng, D.Y.; Hartman, C.W.; Simonen, T.C.

1978-01-01

Preliminary results are presented of a study of cross-field plasma injection in the 2XIIB mirror machine. Plasma accelerated by a coaxial deflagration gun was observed to pass 3.5M across the vacuum field, and some trapping was observed when the gun plasma intersected a plasma streaming along B at the center of the magnetic well. Parameters for the experiment are: gun plasma kinetic energy 50 to 200 eV, n/sub gun/ = 3 x 10 13 cm -3 , streaming plasma 25 to 50 eV and n/sub streaming/ = 6 x 10 11 cm -3 , duration of both 100 to 200 μsec. For the trapped plasma, n = 2.4 x 10 12 cm -3 , and the decay time is t/sub 1 / 2 / = 400 μsec consistent with Coulomb scattering loss at 100 eV mean ion energy

Research on the flow field of undershot cross-flow water turbines using experiments and numerical analysis

International Nuclear Information System (INIS)

Nishi, Y; Inagaki, T; Li, Y; Omiya, R; Hatano, K

2014-01-01

The purpose of this research is to develop a water turbine appropriate for low-head open channels in order to effectively utilize the unused hydropower energy of rivers and agricultural waterways. The application of the cross-flow runner to open channels as an undershot water turbine has come under consideration and, to this end, a significant simplification was attained by removing the casings. However, the flow field of undershot cross-flow water turbines possesses free surfaces. This means that with the variation in the rotational speed, the water depth around the runner will change and flow field itself is significantly altered. Thus it is necessary to clearly understand the flow fields with free surfaces in order to improve the performance of this turbine. In this research, the performance of this turbine and the flow field were studied through experiments and numerical analysis. The experimental results on the performance of this turbine and the flow field were consistent with the numerical analysis. In addition, the inlet and outlet regions at the first and second stages of this water turbine were clarified

Dream vs. reality: seven case-studies on the desirability and feasibility of cross-border hospital collaboration in Europe.

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Glinos, Irene A; Baeten, Rita

2014-09-01

Despite being a niche phenomenon, cross-border health care collaboration receives a lot of attention in the EU and figures visibly on the policy agenda, in particular since the policy process which eventually led to the adoption of Directive 2011/24/EU. One of the underlying assumptions is that cross-border collaboration is desirable, providing justification to both the European Commission and to border-region stakeholders for promoting it. The purpose of this paper is to question this assumption and to examine the role of actors in pushing (or not) for cross-border collaboration. The analysis takes place in two parts. First, the EU policies to promote cross-border collaboration and the tools employed are examined, namely (a) use of European funds to sponsor concrete border-region collaboration projects, (b) use of European funds to sponsor research which gives visibility to cross-border collaboration, and (c) use of the European Commission's newly acquired legal mandate to encourage "Member States to cooperate in cross-border health care provision in border-regions" (Art. 10) and support "Member States in the development of European reference networks between health care providers and centres of expertise" (Art. 12). Second, evidence gathered in 2011-2013 from seven European border-regions on hospital cross-border collaboration is systematically reviewed to assess the reality of cross-border collaboration - can it work and when, and why do actors engage in cross-border collaboration? The preliminary findings suggest that while the EU plays a prominent role in some border-region initiatives, cross-border collaboration needs such a specific set of circumstances to work that it is questionable whether it can effectively be promoted. Moreover, local actors make use of the EU (as a source of funding, legislation or legitimisation) to serve their needs. Copyright © 2014. Published by Elsevier Ltd.

Workplace violence against physicians and nurses in Palestinian public hospitals: a cross-sectional study

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2012-01-01

Background Violence against healthcare workers in Palestinian hospitals is common. However, this issue is under researched and little evidence exists. The aim of this study was to assess the incidence, magnitude, consequences and possible risk factors for workplace violence against nurses and physicians working in public Palestinian hospitals. Methods A cross-sectional approach was employed. A self-administered questionnaire was used to collect data on different aspects of workplace violence against physicians and nurses in five public hospitals between June and July 2011. The questionnaires were distributed to a stratified proportional random sample of 271 physicians and nurses, of which 240 (88.7%) were adequately completed. Pearson’s chi-square analysis was used to test the differences in exposure to physical and non-physical violence according to respondents’ characteristics. Odds ratios and 95% confidence intervals were used to assess potential associations between exposure to violence (yes/no) and the respondents’ characteristics using logistic regression model. Results The majority of respondents (80.4%) reported exposure to violence in the previous 12 months; 20.8% physical and 59.6% non-physical. No statistical difference in exposure to violence between physicians and nurses was observed. Males’ significantly experienced higher exposure to physical violence in comparison with females. Logistic regression analysis indicated that less experienced (OR: 8.03; 95% CI 3.91-16.47), and a lower level of education (OR: 3; 95% CI 1.29-6.67) among respondents meant they were more likely to be victims of workplace violence than their counterparts. The assailants were mostly the patients' relatives or visitors, followed by the patients themselves, and co-workers. Consequences of both physical and non-physical violence were considerable. Only half of victims received any type of treatment. Non-reporting of violence was a concern, main reasons were lack of

Characteristics of unit-level patient safety culture in hospitals in Japan: a cross-sectional study.

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Fujita, Shigeru; Seto, Kanako; Kitazawa, Takefumi; Matsumoto, Kunichika; Hasegawa, Tomonori

2014-10-22

Patient safety culture (PSC) has an important role in determining safety and quality in healthcare. Currently, little is known about the status of unit-level PSC in hospitals in Japan. To develop appropriate strategies, characteristics of unit-level PSC should be investigated. Work units may be classified according to the characteristics of PSC, and common problems and appropriate strategies may be identified for each work unit category. This study aimed to clarify the characteristics of unit-level PSC in hospitals in Japan. In 2012, a cross-sectional study was conducted at 18 hospitals in Japan. The Hospital Survey on Patient Safety Culture questionnaire, developed by the United States Agency for Healthcare Research and Quality, was distributed to all healthcare workers (n =12,076). Percent positive scores for 12 PSC sub-dimensions were calculated for each unit, and cluster analysis was used to categorise the units according to the percent positive scores. A generalised linear mixed model (GLMM) was used to analyse the results of the cluster analysis, and odds ratios (ORs) for categorisation as high-PSC units were calculated for each unit type. A total of 9,124 respondents (75.6%) completed the questionnaire, and valid data from 8,700 respondents (72.0%) were analysed. There were 440 units in the 18 hospitals. According to the percent positive scores for the 12 sub-dimensions, the 440 units were classified into 2 clusters: high-PSC units (n =184) and low-PSC units (n =256). Percent positive scores for all PSC sub-dimensions for high-PSC units were significantly higher than those for low-PSC units. The GLMM revealed that the combined unit type of 'Obstetrics and gynaecology ward, perinatal ward or neonatal intensive care unit' was significantly more likely to be categorised as high-PSC units (OR =9.7), and 'Long-term care ward' (OR =0.2), 'Rehabilitation unit' (OR =0.2) and 'Administration unit' (OR =0.3) were significantly less likely to be categorised as high

Health IT and inappropriate utilization of outpatient imaging: A cross-sectional study of U.S. hospitals.

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Appari, Ajit; Johnson, M Eric; Anthony, Denise L

2018-01-01

To determine whether the use of information technology (IT), measured by Meaningful Use capability, is associated with lower rates of inappropriate utilization of imaging services in hospital outpatient settings. A retrospective cross-sectional analysis of 3332 nonfederal U.S. hospitals using data from: Hospital Compare (2011 outpatient imaging efficiency measures), HIMSS Analytics (2009 health IT), and Health Indicator Warehouse (market characteristics). Hospitals were categorized for their health IT infrastructure including EHR Stage-1 capability, and three advanced imaging functionalities/systems including integrated picture archiving and communication system, Web-based image distribution, and clinical decision support (CDS) with physician pathways. Three imaging efficiency measures suggesting inappropriate utilization during 2011 included: percentage of "combined" (with and without contrast) computed tomography (CT) studies out of all CT studies for abdomen and chest respectively, and percentage of magnetic resonance imaging (MRI) studies of lumbar spine without antecedent conservative therapy within 60days. For each measure, three separate regression models (GLM with gamma-log link function, and denominator of imaging measure as exposure) were estimated adjusting for hospital characteristics, market characteristics, and state fixed effects. Additionally, Heckman's Inverse Mills Ratio and propensity for Stage-1 EHR capability were used to account for selection bias. We find support for association of each of the four health IT capabilities with inappropriate utilization rates of one or more imaging modality. Stage-1 EHR capability is associated with lower inappropriate utilization rates for chest CT (incidence rate ratio IRR=0.72, p-value value value value value value value use of Stage-1 Meaningful Use capable EHR systems along with advanced imaging related functionalities could have a beneficial impact on reducing some of the inappropriate utilization of

What's up doc? A national cross-sectional study of psychological wellbeing of hospital doctors in Ireland.

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Hayes, Blánaid; Prihodova, Lucia; Walsh, Gillian; Doyle, Frank; Doherty, Sally

2017-10-16

To measure levels of psychological distress, psychological wellbeing and self-stigma in hospital doctors in Ireland. National cross-sectional study of randomised sample of hospital doctors. Participants provided sociodemographic data (age, sex, marital status), work grade (consultant, higher/basic specialist trainee), specialty and work hours and completed well-being questionnaires (the Depression Anxiety Stress Scale, WHO Well-being Index, General Health Questionnaire) and single-item scales on self-rated health and self-stigma. Irish publicly funded hospitals and residential institutions. 1749 doctors (response rate of 55%). All hospital specialties were represented except radiology. Half of participants were men (50.5%). Mean hours worked per week were 57 hours. Over half (52%) rated their health as very good/excellent, while 50.5% reported positive subjective well-being (WHO-5). Over a third (35%) experienced psychological distress (General Health Questionnaire 12). Severe/extremely severe symptoms of depression, anxiety and stress were evident in 7.2%, 6.1% and 9.5% of participants (Depression, Anxiety, Stress Scale 21). Symptoms of distress, depression, anxiety and stress were significantly higher and levels of well-being were significantly lower in trainees compared with consultants, and this was not accounted for by differences in sociodemographic variables. Self-stigma was present in 68.4%. The work hours of doctors working in Irish hospitals were in excess of European Working Time Directive's requirements. Just over half of hospital doctors in Ireland had positive well-being. Compared with international evidence, they had higher levels of psychological distress but slightly lower symptoms of depression and anxiety. Two-thirds of respondents reported self-stigma, which is likely to be a barrier to accessing care. These findings have implications for the design of support services for doctors, for discussions on quality of patient care and for future

Exploring example models of cross-sector, sessional employment of pharmacists to improve medication management and pharmacy support in rural hospitals.

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Tan, Amy Cw; Emmerton, Lynne M; Hattingh, Laetitia; La Caze, Adam

2015-01-01

Many rural hospitals in Australia are not large enough to sustain employment of a full-time pharmacist, or are unable to recruit or retain a full-time pharmacist. The absence of a pharmacist may result in hospital nurses undertaking medication-related roles outside their scope of practice. A potential solution to address rural hospitals' medication management needs is contracted part-time ('sessional') employment of a local pharmacist external to the hospital ('cross-sector'). The aim of this study was to explore the roles and experiences of pharmacists in their provision of sessional services to rural hospitals with no on-site pharmacist and explore how these roles could potentially address shortfalls in medication management in rural hospitals. A qualitative study was conducted to explore models with pharmacists who had provided sessional services to a rural hospital. A semi-structured interview guide was informed by a literature review, preliminary research and stakeholder consultation. Participants were recruited via advertisement and personal contacts. Consenting pharmacists were interviewed between August 2012 and January 2013 via telephone or Skype for 40-55 minutes. Thirteen pharmacists with previous or ongoing hospital sessional contracts in rural communities across Australia and New Zealand participated. Most commonly, the pharmacists provided weekly services to rural hospitals. All believed the sessional model was a practical solution to increase hospital access to pharmacist-mediated support and to address medication management gaps. Roles perceived to promote quality use of medicines were inpatient consultation services, medicines information/education to hospital staff, assistance with accreditation matters and system reviews, and input into pharmaceutical distribution activities. This study is the first to explore the concept of sessional rural hospital employment undertaken by pharmacists in Australia and New Zealand. Insights from participants

Prevalence of Allergy to Natural Rubber Latex and Potential Cross Reacting Food in Operation Room Staff in Shiraz Hospitals -2006

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H Nabavizade

2007-07-01

Full Text Available Introduction & Objective: Allergic reactions to natural rubber latex have increased during past 10 years especially among health care workers and patients with high exposure to latex allergens. Allergic reaction to latex is related to many diseases like occupational asthma. This study was performed to determine the prevalence of allergy to natural rubber latex and potential cross reacting food in operation room staff in Shiraz hospitals. Materials & Methods: In this cross-sectional descriptive study five hundred eighty operation room staff of ten private and state hospitals in Shiraz completed latex allergy questionnaire. They were questioned about personal history and previous history of latex sensitivity, symptoms of latex reactivity and about other allergies particularly to foods that may cross react with latex. Informed consent was obtained and skin prick testing was performed with natural rubber latex. Skin prick tests were done with three potentially cross reacting food (banana, Kiwi, and potato. The obtained data were analyzed with SPSS software and Chi-square test. Results: Among the 580 operation room workers 104 (17.9 % of participants were positive to latex skin test. We found a significant association between positive skin test to latex in operation room staff and atopy, urticaria and food allergy. Positive skin test to latex related to positive kiwi skin test (p<0.05. The prevalence did not vary by sex, age, education, surgical and non surgical glove users, history of contact dermatitis or smoking status. Conclusion: Latex allergy has a high prevalence in personnel of operation room. Evaluation of present symptom and prediction of future disease necessitate screening test in individuals at risk.

'Hospitality' Is an Inviting Field at Many Colleges.

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Collison, Michele N-K

1988-01-01

Hospitality programs, which include courses in hotel, restaurant, and institutional management, are more popular than ever, due to a boom in the hotel and restaurant industries. Interest has also been spurred by increased demands from hospitals and retirement homes. (MLW)

A cross sectional study of maternal 'near-miss' cases in major public hospitals in Egypt, Lebanon, Palestine and Syria.

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Bashour, Hyam; Saad-Haddad, Ghada; DeJong, Jocelyn; Ramadan, Mohammed Cherine; Hassan, Sahar; Breebaart, Miral; Wick, Laura; Hassanein, Nevine; Kharouf, Mayada

2015-11-13

The maternal near-miss approach has been increasingly used as a tool to evaluate and improve the quality of care in maternal health. We report findings from the formative stage of a World Health Organization (WHO) funded implementation research study that was undertaken to collect primary data at the facility level on the prevalence, characteristics, and management of maternal near-miss cases in four major public referral hospitals - one each in Egypt, Lebanon, Palestine and Syria. We conducted a cross sectional study of maternal near-miss cases in the four contexts beginning in 2011, where we collected data on severe maternal morbidity in the four study hospitals, using the WHO form (Individual Form HRP A65661). In each hospital, a research team including trained hospital healthcare providers carried out the data collection. A total of 9,063 live birth deliveries were reported during the data collection period across the four settings, with a total of 77 cases of severe maternal outcomes (71 maternal near-miss cases and 6 maternal deaths). Higher indices for the maternal mortality index were found in both Al Galaa hospital, in Egypt (8.6%) and Dar Al Tawleed hospital in Syria (14.3%), being large referral hospitals, compared to Ramallah hospital in Palestine and Rafik Hariri University hospital in Lebanon. Compared to the WHO's Multicountry Survey using the same data collection tool, our study's mortality indices are higher than the index of 5.6% among countries with a moderate maternal mortality ratio in the WHO Survey. Overall, haemorrhage-related complications were the most frequent conditions among maternal near-miss cases across the four study hospitals. In all hospitals, coagulation dysfunctions (76.1%) were the most prevalent dysfunction among maternal near-miss cases, followed by cardiovascular dysfunctions. The coverage of key evidence-based interventions among women experiencing a near-miss was either universal or very high in the study hospitals

The distortion of the magnetotail equilibrium structure by a net cross-tail magnetic field

International Nuclear Information System (INIS)

Birn, J.

1990-01-01

Observations have shown that in addition to a y component associated with the flaring of the tail, a net y component of the magnetic field can persist in the geomagnetic tail, roughly proportional to the interplanetary B y . The author uses the tail equilibrium theory outlined by Birn (1987) to construct self-consistent three-dimensional models of the tail that include this effect. He finds that the net B yN field varies only weakly along field lines and across the tail. The presence of the net B yN in the neutral sheet implies that a part of the cross-tail current becomes field-aligned, flowing from the southern to the northern hemisphere for B yN > 0 and from north to south for B yN yN for small values. For a typical value of 2% of the lobe field strength the author finds a total current of 4.4 x 10 5 A flowing toward one hemisphere at x = -20 R E . This current, however is not expected to reach the Earth, because it decreases strongly along each field line away from the neutral sheet, due to a conversion into perpendicular current. The deformations of magnetic flux surfaces, implied by the models, are not consistent with an entirely closed magnetotail boundary. They suggest that in addition to traditional lobe field lines, interconnected with the solar wind field at large distances or high latitudes, there may be a class of field lines extending from the Earth into the magnetosheath region through the low latitude flanks of the tail. These field lines, which might even be associated with positive B z at a neutral sheet crossing, effectively reduce the region of closed flux. For typical values of B yN of 2% of the lobe field this effect is small, but for values above about 10%, not extremely unusual, it can be appreciable

Work stress, burnout, and perceived quality of care: a cross-sectional study among hospital pediatricians.

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Weigl, M; Schneider, A; Hoffmann, F; Angerer, P

2015-09-01

Poor hospital work environments affect physicians' work stress. With a focus on hospital pediatricians, we sought to investigate associations between work stress, burnout, and quality of care. A cross-sectional study was conducted in N = 96 pediatricians of a German academic children's hospital (response rate = 73.8 %). All variables were assessed with standardized questionnaires. Multivariate regression analyses were applied to investigate associations after adjusting for potential confounders. Critically high work stress (effort/reward ratio, ERR > 1.0) was reported by N = 25 (28.4 %) participants. Pediatricians in inpatient wards had significantly more work stress than their colleagues in intensive care units and outpatient wards; 10.2 % of surveyed pediatricians reported critically high burnout. Again, inpatient ward staff reported significantly increased emotional exhaustion. After controlling for several confounders, we found that pediatricians with high work stress and emotional exhaustion reported reduced quality of care. Mediation analyses revealed that especially pediatricians' emotional exhaustion partially mediated the effect of work stress on quality of care. Results demonstrate close relationships between increased work stress and burnout as well as diminished quality of care. High work stress environments in pediatric care influence mental health of pediatricians as well as quality of patient care. • The quality of pediatricians' work environment in the hospital is associated with their work stress and burnout. • The consequences of pediatricians' work life for the quality of care need to be addressed in order to inform interventions to improve work life and care quality. • Our study shows associations between increased work stress and burnout with mitigated quality of care. • Beyond indirect effects of work stress through emotional exhaustion on quality of care we also observed direct detrimental effects of pediatricians

Physicians reading and writing practices: a cross-sectional study from Civil Hospital, Karachi, Pakistan

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Khaliq Muhammad

2012-07-01

Full Text Available Abstract Background To determine the behavior of physicians regarding medical literature reading and participation in research activities at one of the largest teaching hospitals in Pakistan. Method This descriptive, cross-sectional study was conducted by interviewing the house officers, residents and fellows of six major specialties (Medicine, Surgery, Pediatrics, Psychology, Obstetrics & Gynecology and Anesthesia in Civil Hospital, Karachi between August and December, 2011. The questionnaire elicited responses regarding the reading habits of physicians, preferred sources of information, their participation in research activities (publication & supervision and views regarding journal club. SPSS 17.0 was used for data entry and analysis. Result A total of 259 completely filled questionnaires were returned with a response rate of 85.19%. Mean age of the participants was 29.67 ± 7.65 years. Books were selected by 71.4% doctors as their preferred source of information, regardless of their clinical specialties. (p  Conclusion Urgent intervention is required to promote healthcare literature reading and writing practice in our physicians. Easy access to workplace computers with internet and subscription of paid journals will facilitate physicians. Lack of supervisors and busy schedule were reported to be important contributors for not participating in research. Addressing these issues will encourage doctors to participate more in research activities.

Nursing skill mix in European hospitals: cross-sectional study of the association with mortality, patient ratings, and quality of care

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Aiken, Linda H; Rafferty, Anne Marie; Bruyneel, Luk; McHugh, Matthew; Maier, Claudia B; Moreno-Casbas, Teresa; Ball, Jane E; Ausserhofer, Dietmar; Sermeus, Walter

2017-01-01

Objectives To determine the association of hospital nursing skill mix with patient mortality, patient ratings of their care and indicators of quality of care. Design Cross-sectional patient discharge data, hospital characteristics and nurse and patient survey data were merged and analysed using generalised estimating equations (GEE) and logistic regression models. Setting Adult acute care hospitals in Belgium, England, Finland, Ireland, Spain and Switzerland. Participants Survey data were collected from 13 077 nurses in 243 hospitals, and 18 828 patients in 182 of the same hospitals in the six countries. Discharge data were obtained for 275 519 surgical patients in 188 of these hospitals. Main outcome measures Patient mortality, patient ratings of care, care quality, patient safety, adverse events and nurse burnout and job dissatisfaction. Results Richer nurse skill mix (eg, every 10-point increase in the percentage of professional nurses among all nursing personnel) was associated with lower odds of mortality (OR=0.89), lower odds of low hospital ratings from patients (OR=0.90) and lower odds of reports of poor quality (OR=0.89), poor safety grades (OR=0.85) and other poor outcomes (0.80nurses is associated with an 11% increase in the odds of death. In our hospital sample, there were an average of six caregivers for every 25 patients, four of whom were professional nurses. Substituting one nurse assistant for a professional nurse for every 25 patients is associated with a 21% increase in the odds of dying. Conclusions A bedside care workforce with a greater proportion of professional nurses is associated with better outcomes for patients and nurses. Reducing nursing skill mix by adding nursing associates and other categories of assistive nursing personnel without professional nurse qualifications may contribute to preventable deaths, erode quality and safety of hospital care and contribute to hospital nurse shortages. PMID:28626086

Restrictions on Oral and Parenteral Intake for Low-risk Labouring Women in Hospitals Across Canada: A Cross-Sectional Study.

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Chackowicz, Ariel; Spence, Andrea R; Abenhaim, Haim A

2016-11-01

The dietary intake allowed during the latent and active phases of labour varies between Canadian hospitals. Our objective was to document current restrictions on oral and parenteral intake for low-risk labouring women in hospitals across Canada. We carried out a cross-sectional study of 118 Canadian hospitals that have specialized birthing centres. Information on dietary protocols for low-risk women in labour was obtained from each hospital via a brief telephone interview with the head nurse of each birthing centre. Data were presented by stage of labour, both with and without epidural anaesthesia, and also by dextrose supplementation of intravenous fluids. If epidural anaesthesia was not used during the active phase of labour, oral intake was restricted to clear fluids and/or ice chips in 50.9% of surveyed hospitals and oral intake could include solid food in 38.1%. However, when epidural anaesthesia was used during the active phase of labour, oral intake was restricted to clear fluids and ice chips in 82.8% of surveyed hospitals, while oral intake could include solid food in 7.2%. Furthermore, in 77.5% of hospitals, not only was oral intake during active labour with epidural anaesthesia limited to clear fluids and/or ice chips, but in addition this restrictive diet was not supplemented with parenteral dextrose. The majority of low-risk pregnant women in Canadian hospitals are subjected to caloric restriction during the active phase of labour, especially when epidural anaesthesia is administered. Further studies on this subject are warranted because such pervasive practices may have important population effects on labouring women. Copyright © 2016 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.

Status of Waste Management in Selected Hospitals of Isfahan in 2014

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Elham Amiri

2017-01-01

Full Text Available Background: Hospital wastes are considered as a serious threat for public health. Hospital waste management may help to control disease transmission and have remarkable economic advantages. The purpose of this study was to assess  the hospitals' waste management in Isfahan, Iran in 2014. Methods: Data of this descriptive and cross-sectional study were collected through a check list for surveying hospital waste management. Validity of checklist was confirmed by analysis of face validity and field experts' opinions. Cronbach's alpha of 0.80 was calculated. Data were then analyzed using descriptive statistics in Excell software. Results: In the studied hospitals "Elimination" dimension was inappropriate while the "Human resources involved in waste management" dimension was estimated relatively appropriate. Other dimensions were estimated as appropriate. Infectious wastes consisted of about 10.89 % of the total wastes in hospitals and the average of waste generation for each bed was 3.67 kg per day. There was no environmental unit in the studied hospitals and only one of them did not have waste management unit. Conclusion: Despite the fact that waste management status in hospitals under study was relatively appropriate, but given the importance of the issue, it is essential to improve the current situation especially in some aspects of waste management. 

When children with profound multiple disabilities are hospitalized: A cross-sectional survey of parental burden of care, quality of life of parents and their hospitalized children, and satisfaction with family-centered care.

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Seliner, Brigitte; Latal, Bea; Spirig, Rebecca

2016-07-01

We aimed to assess parental burden of care, satisfaction with family-centered care, and quality of life (HRQoL) of parents and their hospitalized children with profound intellectual and multiple disabilities (PIMD), and determine the relationship among these factors. A cross-sectional study using printed questionnaires and qualitative questions was undertaken at a Swiss University Children's Hospital. The 117 parents (98 mothers, 19 fathers) studied indicated a substantial impact on burden of care and parental health-related quality of life. Significant correlations with the hospitalized children's well-being were rs = .408 for burden of care and rs -.368 for quality of life. Qualitative results showed parents struggling to safeguard their children and worrying most about the children's well-being. Health professionals need to be aware of parental burden and that the perception of the children's well-being and the parents' efforts determine their support needs. Easing parents' burden and fostering confidence in the hospitalized children's well-being requires coordination of care provided by advanced nurse specialists, with an institutional framework that clarifies parental collaboration. © 2016, Wiley Periodicals, Inc.

Children, care, career - a cross-sectional study on the risk of burnout among German hospital physicians at different career stages.

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Richter, Astrid; Kostova, Petya; Harth, Volker; Wegner, Ralf

2014-01-01

With the increasing number of female medical students physicians' need for work-life balanced hospital jobs rises at all career stages. The Working Time Act (Arbeitszeitgesetz, ArbZG), an implementation of the European Working Time Directive into German law in 2004, should have improved the general conditions for creating flexible work. Nevertheless, the vast majority of female physicians still report an incompatibility of work and family. So far, little is known about mothers working on leading positions in the medical field. The presented study focuses on gender differences in the level of emotional exhaustion between child-rearing junior and senior physicians and different predictors of burnout. Three years after the ArbZT-enactment, 994 physicians from the listed hospital physicians in the Medical Register of the city of Hamburg participated in the cross-sectional study and completed a 60-item questionnaire (return rate of 46,5%). The questionnaire included a 22-item version of the German translation of the Maslach Burnout Inventory whereat emotional exhaustion was interpreted as the crucial predictor of burnout. Results of an univariate covariance analysis and regression analyses are reported. In the level of emotional exhaustion no gender differences were found between junior and senior physicians with children in the overall analysis. Support by the superior was the only overall predictor of burnout. Female senior physicians having children presented the highest risk of burnout. Only in this group parenting contributed significantly to the risk of burnout. Support by the superior and the relationship to colleagues are generally important predictors of burnout among hospital physicians. Parenthood only gets a crucial influence on psychomental health for female senior physicians. Still conservative role models are common in this group, thus dealing with the triple burden of work, leadership responsibility and child rearing seems to be a special female

A cross-level investigation of informal field-based learning and performance improvements.

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Wolfson, Mikhail A; Tannenbaum, Scott I; Mathieu, John E; Maynard, M Travis

2018-01-01

Organizations often operate in complex and dynamic environments which place a premium on employees' ongoing learning and acquisition of new competencies. Additionally, the majority of learning in organizations does not take place in formal training settings, but we know relatively little about how informal field-based learning (IFBL) behaviors relate to changes in job performance. In this study, we first clarified the construct of IFBL as a subset of informal learning. Second, on the basis of this clarified construct definition, we developed a measure of IFBL behaviors and demonstrated its psychometric properties using (a) a sample of subject matter experts who made item content validity judgments and (b) both an Amazon Mechanical Turk sample (N = 400) and a sample of 1,707 healthcare employees. Third, we advanced a grounded theory of IFBL in healthcare, and related it to individuals' regulatory foci and contextual moderators of IFBL behaviors-job performance relationships using a cross-level design and lagged nonmethod bound measures. Specifically, using a sample of 407 healthcare workers from 49 hospital units, our results suggested that promotion-focused individuals, especially in well-staffed units, readily engage in IFBL behaviors. Additionally, we found that the IFBL-changes in job performance relationship was strengthened to the extent that individuals worked in units with relatively nonpunitive climates. Interestingly, staffing levels had a weakening moderating effect on the positive IFBL-performance improvements relationship. Detailed follow-up analyses revealed that the peculiar effect was attributable to differential relationships from IFBL subdimensions. Implications for future theory building, research, and practice are discussed. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Collective enhancement of inclusive cross sections at large transverse momentum in stochastic-field multiparticle theory

International Nuclear Information System (INIS)

Arnold, R.C.

1976-01-01

A stochastic-field calculus, previously discussed in connection with Regge intercepts and instability questions, is applied to inclusive cross sections, and is shown to predict a growth with energy of large-P/perpendicular/ to inclusives

Spectrum integrated (n,He) cross section comparison and least squares analysis for /sup 6/Li and /sup 10/B in benchmark fields

International Nuclear Information System (INIS)

Schenter, R.E.; Oliver, B.M.; Farrar, H. IV

1987-01-01

Spectrum integrated cross sections for /sup 6/Li and /sup 10/B from five benchmark fast reactor neutron fields are compared with calculated values obtained using the ENDF/B-V Cross Section Files. The benchmark fields include the Coupled Fast Reactivity Measurements Facility (CFRMF) at the Idaho National Engineering Laboratory, the 10% Enriched U-235 Critical Assembly (BIG-10) at Los Alamos National Laboratory, the Sigma Sigma and Fission Cavity fields of the BR-1 reactor at CEN/SCK, and the Intermediate-Energy Standard Neutron Field (ISNF) at the National Bureau of Standards. Results from least square analyses using the FERRET computer code to obtain adjusted cross section values and their uncertainties are presented. Input to these calculations include the above five benchmark data sets. These analyses indicate a need for revision in the ENDF/B-V files for the /sup 10/B cross section for energies above 50 keV

Positron cross-field transport due to quasibound states of antihydrogen

International Nuclear Information System (INIS)

Ahat, Y.; Correa, C.E.; Ordonez, C.A.

2007-01-01

Within the past few years, experiments have been reported in which antiprotons produced at the CERN Antiproton Decelerator facility were slowed, trapped in nested Penning traps and made to interact with a positron plasma such that antihydrogen was formed. Classical trajectory simulations of the interactions between the antiprotons and positrons have been reported to indicate that positive-energy, quasibound states of antihydrogen can form at a rate that exceeds the rate of formation of stable Rydberg states. The formation of quasibound states may affect the rate of diffusion of positrons across the magnetic field that confines them in the nested Penning trap. Simulations indicate that a binary interaction associated with the formation and disintegration of a quasibound state can cause a shift of the positron's guiding center that is much larger than the positron cyclotron radius before the interaction. A theory is presented that describes positron cross-magnetic-field diffusion due to quasibound states of antihydrogen

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

Science.gov (United States)

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

2009-09-01

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

Workplace violence against physicians and nurses in Palestinian public hospitals: a cross-sectional study

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Kitaneh Mohamad

2012-12-01

Full Text Available Abstract Background Violence against healthcare workers in Palestinian hospitals is common. However, this issue is under researched and little evidence exists. The aim of this study was to assess the incidence, magnitude, consequences and possible risk factors for workplace violence against nurses and physicians working in public Palestinian hospitals. Methods A cross-sectional approach was employed. A self-administered questionnaire was used to collect data on different aspects of workplace violence against physicians and nurses in five public hospitals between June and July 2011. The questionnaires were distributed to a stratified proportional random sample of 271 physicians and nurses, of which 240 (88.7% were adequately completed. Pearson’s chi-square analysis was used to test the differences in exposure to physical and non-physical violence according to respondents’ characteristics. Odds ratios and 95% confidence intervals were used to assess potential associations between exposure to violence (yes/no and the respondents’ characteristics using logistic regression model. Results The majority of respondents (80.4% reported exposure to violence in the previous 12 months; 20.8% physical and 59.6% non-physical. No statistical difference in exposure to violence between physicians and nurses was observed. Males’ significantly experienced higher exposure to physical violence in comparison with females. Logistic regression analysis indicated that less experienced (OR: 8.03; 95% CI 3.91-16.47, and a lower level of education (OR: 3; 95% CI 1.29-6.67 among respondents meant they were more likely to be victims of workplace violence than their counterparts. The assailants were mostly the patients' relatives or visitors, followed by the patients themselves, and co-workers. Consequences of both physical and non-physical violence were considerable. Only half of victims received any type of treatment. Non-reporting of violence was a concern, main

Patient satisfaction and non-UK educated nurses: a cross-sectional observational study of English National Health Service Hospitals.

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Germack, Hayley D; Griffiths, Peter; Sloane, Douglas M; Rafferty, Anne Marie; Ball, Jane E; Aiken, Linda H

2015-12-02

To examine whether patient satisfaction with nursing care in National Health Service (NHS) hospitals in England is associated with the proportion of non-UK educated nurses providing care. Cross-sectional analysis using data from the 2010 NHS Adult Inpatient Survey merged with data from nurse and hospital administrator surveys. Logistic regression models with corrections for clustering were used to determine whether the proportions of non-UK educated nurses were significantly related to patient satisfaction before and after taking account of other hospital, nursing and patient characteristics. 31 English NHS trusts. 12,506 patients 16 years of age and older with at least one overnight stay that completed a satisfaction survey; 2962 bedside care nurses who completed a nurse survey; and 31 NHS trusts. Patient satisfaction. The percentage of non-UK educated nurses providing bedside hospital care, which ranged from 1% to 52% of nurses, was significantly associated with patient satisfaction. After controlling for potential confounding factors, each 10-point increase in the percentage of non-UK educated nurses diminished the odds of patients reporting good or excellent care by 12% (OR=0.88), and decreased the odds of patients agreeing that they always had confidence and trust in nurses by 13% (OR=0.87). Other indicators of patient satisfaction also revealed lower satisfaction in hospitals with higher percentages of non-UK educated nurses. Use of non-UK educated nurses in English NHS hospitals is associated with lower patient satisfaction. Importing nurses from abroad to substitute for domestically educated nurses may negatively impact quality of care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Trends in admissions, morbidity and outcomes at Red Cross War Memorial Children’s Hospital, Cape Town, 2004 - 2013

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Y Isaacs-Long

2017-03-01

Full Text Available Background. Routinely collected patient information has the potential to yield valuable information about health systems and population health, but there have been few comprehensive analyses of paediatric admissions at South African (SA hospitals. Objectives. To investigate trends in hospitalisation and outcomes at Red Cross War Memorial Children’s Hospital (RCWMCH, a major referral hospital for children in the Western Cape and SA. Methods. Using routinely collected observational health data from the hospital informatics system, we investigated admissions between 2004 and 2013. Clinical classification software was used to group International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10 codes to rank causes during 2008 - 2013, when ICD-10 codes were widely available. Analyses examined trends in medical and surgical admissions over time. Results. There were 215 536 admissions over 10 years of 129 733 patients. Admissions increased by 9.3%, with increases in the general medical wards (5%, medical specialty wards (74%, the burns unit (73%, and the intensive care unit (16%. In contrast, admissions decreased in the trauma unit (21% and short-stay medical wards (1%. In-hospital mortality decreased by 54% (p-trend <0.001 over 10 years. Diarrhoea and lower-respiratory tract illness were the most common causes for medical admissions, although admissions and deaths due to these conditions decreased between 2008 and 2013, which coincided with the national introduction of related vaccines. Similarly, tuberculosis admissions and deaths decreased over this period. These trends could be owing to a concurrent decrease in HIV comorbidity (p-trend <0.001. Trauma was the most common reason for surgical admission. Conclusion. Paediatric in-hospital mortality decreased consistently over a decade, despite an overall increase in admissions. Pneumonia and diarrhoea admissions decreased markedly over a 6-year period, but

Study on performance and flow field of an undershot cross-flow water turbine comprising different number of blades

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Nishi, Yasuyuki; Hatano, Kentaro; Inagaki, Terumi

2017-10-01

Recently, small hydroelectric generators have gained attention as a further development in water turbine technology for ultra low head drops in open channels. The authors have evaluated the application of cross-flow water turbines in open channels as an undershot type after removing the casings and guide vanes to substantially simplify these water turbines. However, because undershot cross-flow water turbines are designed on the basis of cross-flow water turbine runners used in typical pipelines, it remains unclear whether the number of blades has an effect on the performance or flow fields. Thus, in this research, experiments and numerical analyses are employed to study the performance and flow fields of undershot cross-flow water turbines with varying number of blades. The findings show that the turbine output and torque are lower, the fluctuation is significantly higher, and the turbine efficiency is higher for runners with 8 blades as opposed to those with 24 blades.

Assessing process of paediatric care in a resource-limited setting: a cross-sectional audit of district hospitals in Rwanda.

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Hategeka, Celestin; Shoveller, Jeannie; Tuyisenge, Lisine; Lynd, Larry D

2018-05-01

Routine assessment of quality of care helps identify deficiencies which need to be improved. While gaps in the emergency care of children have been documented across sub-Saharan Africa, data from Rwanda are lacking. To assess the care of sick infants and children admitted to Rwandan district hospitals and the extent to which it follows currently recommended clinical practice guidelines in Rwanda. Data were gathered during a retrospective cross-sectional audit of eight district hospitals across Rwanda in 2012/2013. Medical records were randomly selected from each hospital and were reviewed to assess the process of care, focusing on the leading causes of under-5 mortality, including neonatal conditions, pneumonia, malaria and dehydration/diarrhoea. Altogether, 522 medical records were reviewed. Overall completion of a structured neonatal admission record was above 85% (range 78.6-90.0%) and its use was associated with better documentation of key neonatal signs (median score 6/8 and 2/8 when used and not used, respectively). Deficiencies in the processes of care were identified across hospitals and there were rural/urban disparities for some indicators. For example, neonates admitted to urban district hospitals were more likely to receive treatment consistent with currently recommended guidelines [e.g. gentamicin (OR 2.52, 95% CI 1.03-6.43) and fluids (OR 2.69, 95% CI 1.2-6.2)] than those in rural hospitals. Likewise, children with pneumonia admitted to urban hospitals were more likely to receive the correct dosage of gentamicin (OR 4.47, 95% CI 1.21-25.1) and to have their treatment monitored (OR 3.75, 95% CI 1.57-8.3) than in rural hospitals. Furthermore, children diagnosed with malaria and admitted to urban hospitals were more likely to have their treatment (OR 2.7, 95% CI 1.15-6.41) monitored than those in rural hospitals. Substantial gaps were identified in the process of neonatal and paediatric care across district hospitals in Rwanda. There is a need to (i

Medicare Payment Penalties and Safety Net Hospital Profitability: Minimal Impact on These Vulnerable Hospitals.

Science.gov (United States)

Bazzoli, Gloria J; Thompson, Michael P; Waters, Teresa M

2018-02-08

To examine relationships between penalties assessed by Medicare's Hospital Readmission Reduction Program and Value-Based Purchasing Program and hospital financial condition. Centers for Medicare and Medicaid Services, American Hospital Association, and Area Health Resource File data for 4,824 hospital-year observations. Bivariate and multivariate analysis of pooled cross-sectional data. Safety net hospitals have significantly higher HRRP/VBP penalties, but, unlike nonsafety net hospitals, increases in their penalty rate did not significantly affect their total margins. Safety net hospitals appear to rely on nonpatient care revenues to offset higher penalties for the years studied. While reassuring, these funding streams are volatile and may not be able to compensate for cumulative losses over time. © Health Research and Educational Trust.

Practices regarding hospital waste management at public and private sector hospitals of Lahore

International Nuclear Information System (INIS)

Mahmood, S.; Din, N.U.; Mohsin, J.

2011-01-01

Health care (Biomedical) waste is a term used for all waste arising from health care establishments. In most of health care centers of Pakistan, including Lahore, hospital wastes are simply mixed with the municipal waste in collecting bins at road-sides and disposed off similarly. Proper Management of biomedical waste, especially the hazardous one, being produced in hospital settings is important in terms of their ability to cause harm to the related per-sons and the environment as well. To Observe and compare the practices regarding Hospital Waste management of the public sector hospital with private sector hospital. Descriptive, Cross sectional. Methodology: Standardized checklist was used to assess the practices of nursing and sanitary staff. Practices regarding waste segregation were same at both hospitals. While practices regarding waste collection and transportation were better at The Children's Hospital. Public sector hospital has, paradoxically, better practices regarding hospital waste management in comparison to private sector hospital. (author)

A high power cross-field amplifier at X-Band

International Nuclear Information System (INIS)

Eppley, K.; Feinstein, J.; Ko, K.; Kroll, N.; Lee, T.; Nelson, E.

1991-05-01

A high power cross-field amplifier is under development at SLAC with the objective of providing sufficient peak power to feed a section of an X-Band (11.424 GHz) accelerator without the need for pulse compression. The CFA being designed employs a conventional distributed secondary emission cathode but a novel anode structure which consists of an array of vane resonators alternatively coupled to a rectangular waveguide. The waveguide impedance (width) is tapered linearly from input to output so as to provide a constant RF voltage at the vane tips, leading to uniform power generation along the structure. Nominal design for this tube calls for 300 MW output power, 20 dB gain, DC voltage 142 KV, magnetic field 5 KG, anode-cathode gap 3.6 mm and total interaction length of about 60 cm. These specifications have been supported by computer simulations of both the RF slow wave structure as well as the electron space charge wave interaction. We have used ARGUS to model the cold circuit properties and CONDOR to model the electronic power conversion. An efficiency of 60 percent can be expected. We will discuss the details of the design effort. 5 refs., 6 figs

Donor impurity-related photoionization cross section in GaAs cone-like quantum dots under applied electric field

Science.gov (United States)

Iqraoun, E.; Sali, A.; Rezzouk, A.; Feddi, E.; Dujardin, F.; Mora-Ramos, M. E.; Duque, C. A.

2017-06-01

The donor impurity-related electron states in GaAs cone-like quantum dots under the influence of an externally applied static electric field are theoretically investigated. Calculations are performed within the effective mass and parabolic band approximations, using the variational procedure to include the electron-impurity correlation effects. The uncorrelated Schrödinger-like electron states are obtained in quasi-analytical form and the entire electron-impurity correlated states are used to calculate the photoionisation cross section. Results for the electron state energies and the photoionisation cross section are reported as functions of the main geometrical parameters of the cone-like structures as well as of the electric field strength.

Anemia among adult HIV patients in Ethiopia: a hospital-based cross-sectional study

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Melese H

2017-02-01

Full Text Available Hermela Melese,1 Molla Mesele Wassie,2 Haile Woldie,2 Abilo Tadesse,3 Nebiyu Mesfin3 1HIV Follow-up Care Clinic, Debre-Tabor Hospital, Debre‑Tabor, 2Department of Human Nutrition, Institute of Public Health, 3Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia Background: Anemia is a major public health problem in HIV patients around the world. It has a negative effect on the quality of life of HIV patients and progression of the HIV disease. In the sub-Saharan African setting, including Ethiopia where both HIV infection and under-nutrition are expected to be high, there is a paucity of data on the matter. This study was aimed to reveal the magnitude and factors associated with anemia among adult HIV patients in Debre-Tabor Hospital, northwest Ethiopia. Methods: A hospital-based cross-sectional study was used among adult HIV patients in Debre-Tabor Hospital from April 1 to May 30, 2015. The diagnosis of anemia was made following the 2011 World Health Organization recommendation on hemoglobin cut-off points. Univariable and multivariable logistic regression was carried out to assess factors associated with anemia. Results: A total of 377 patients’ charts were reviewed. Most of the participants (n=237, 62.9% were taking antiretroviral treatment (ART. The overall prevalence of anemia was 23% (95% CI: 19.1, 27.6. Being ART-naïve (adjusted odds ratio [AOR]: 3.37; 95% CI: 1.59, 7.14, having treatment history with anti-tuberculosis (TB drug (AOR: 3.2; 95% CI: 1.19, 8.67, taking zidovudine (ZDV-containing ART regimen (AOR: 2.14; 95% CI: 1.03, 4.57, and having recent CD4+ T-lymphocytes count of <200 cells/µL (AOR: 2.13; 95% CI: 1.04, 4.36 were associated with occurrence of anemia among adult HIV patients. Conclusion and recommendation: Anemia continues to be a major co-morbidity among adult HIV patients in Ethiopia. Adult HIV patients who are taking ZDV-containing ART

A cross-sectional study of all clinicians' conflict of interest disclosures to NHS hospital employers in England 2015-2016.

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Feldman, Harriet Ruth; DeVito, Nicholas J; Mendel, Jonathan; Carroll, David E; Goldacre, Ben

2018-03-05

We set out to document how NHS trusts in the UK record and share disclosures of conflict of interest by their employees. Cross-sectional study of responses to a Freedom of Information Act request for Gifts and Hospitality Registers. NHS Trusts (secondary/tertiary care organisations) in England. 236 Trusts were contacted, of which 217 responded. We assessed all disclosures for completeness and openness, scoring them for achieving each of five measures of transparency. 185 Trusts (78%) provided a register. 71 Trusts did not respond within the 28 day time limit required by the FoIA. Most COI registers were incomplete by design, and did not contain the information necessary to assess conflicts of interest. 126/185 (68%) did not record the names of recipients. 47/185 (25%) did not record the cash value of the gift or hospitality. Only 31/185 registers (16%) contained the names of recipients, the names of donors, and the cash amounts received. 18/185 (10%) contained none of: recipient name, donor name, and cash amount. Only 15 Trusts had their disclosure register publicly available online (6%). We generated a transparency index assessing whether each Trust met the following criteria: responded on time; provided a register; had a register with fields identifying donor, recipient, and cash amount; provided a register in a format that allowed further analysis; and had their register publicly available online. Mean attainment was 1.9/5; no NHS trust met all five criteria. Overall, recording of employees' conflicts of interest by NHS trusts is poor. None of the NHS Trusts in England met all transparency criteria. 19 did not respond to our FoIA requests, 51 did not provide a Gifts and Hospitality Register and only 31 of the registers provided contained enough information to assess employees' conflicts of interest. Despite obligations on healthcare professionals to disclose conflicts of interest, and on organisations to record these, the current system for logging and

Nursing skill mix in European hospitals: cross-sectional study of the association with mortality, patient ratings, and quality of care.

Science.gov (United States)

Aiken, Linda H; Sloane, Douglas; Griffiths, Peter; Rafferty, Anne Marie; Bruyneel, Luk; McHugh, Matthew; Maier, Claudia B; Moreno-Casbas, Teresa; Ball, Jane E; Ausserhofer, Dietmar; Sermeus, Walter

2017-07-01

To determine the association of hospital nursing skill mix with patient mortality, patient ratings of their care and indicators of quality of care. Cross-sectional patient discharge data, hospital characteristics and nurse and patient survey data were merged and analysed using generalised estimating equations (GEE) and logistic regression models. Adult acute care hospitals in Belgium, England, Finland, Ireland, Spain and Switzerland. Survey data were collected from 13 077 nurses in 243 hospitals, and 18 828 patients in 182 of the same hospitals in the six countries. Discharge data were obtained for 275 519 surgical patients in 188 of these hospitals. Patient mortality, patient ratings of care, care quality, patient safety, adverse events and nurse burnout and job dissatisfaction. Richer nurse skill mix (eg, every 10-point increase in the percentage of professional nurses among all nursing personnel) was associated with lower odds of mortality (OR=0.89), lower odds of low hospital ratings from patients (OR=0.90) and lower odds of reports of poor quality (OR=0.89), poor safety grades (OR=0.85) and other poor outcomes (0.80nurses is associated with an 11% increase in the odds of death. In our hospital sample, there were an average of six caregivers for every 25 patients, four of whom were professional nurses. Substituting one nurse assistant for a professional nurse for every 25 patients is associated with a 21% increase in the odds of dying. A bedside care workforce with a greater proportion of professional nurses is associated with better outcomes for patients and nurses. Reducing nursing skill mix by adding nursing associates and other categories of assistive nursing personnel without professional nurse qualifications may contribute to preventable deaths, erode quality and safety of hospital care and contribute to hospital nurse shortages. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please

Incidence and risk factors of workplace violence against nurses in a Chinese top-level teaching hospital: A cross-sectional study.

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Chen, Xiaoming; Lv, Ming; Wang, Min; Wang, Xiufeng; Liu, Junyan; Zheng, Nan; Liu, Chunlan

2018-04-01

To investigate the incidence of workplace violence involving nurses and to identify related risk factors in a high-quality Chinese teaching hospital. A cross-sectional study design was used. The final sample comprised responses from 1831 registered nurses collected with a whole-hospital survey from June 1 to June 15, 2016. The demographic characteristics of the nurses who had experienced any form of violence were collected, and logistic regression analysis was applied to evaluate the risk factors for nurses related to workplace violence. Out of the total number of nurses surveyed, 904 (49.4%) nurses reported having experienced any type of violence in the past year. The frequencies of exposure to physical and non-physical violence were 6.3% (116) and 49.0% (897), respectively. All the incidence rates of violence were lower than those of other studies based on regional hospitals in China and were at the same level found in developed countries and districts. Binary logistic regression analysis revealed that nurses at levels 2 to 4 and female nurses in clinical departments were the most vulnerable to non-physical violence. For physical violence, the two independent risk factors were working in an emergency department and having 6-10 years of work experience. Workplace violence directly threatens nurses from high-quality Chinese teaching hospitals. However, the incidence of WPV against nurses in this teaching hospital was better than that in regional hospitals. This study also provides reference material to identify areas where nurses encounter relatively high levels of workplace violence in high-quality Chinese teaching hospitals. Copyright © 2018 Elsevier Inc. All rights reserved.

Prevalence and risk factors for VRE colonisation in a tertiary hospital in Melbourne, Australia: a cross sectional study

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Karki Surendra

2012-10-01

Full Text Available Abstract Background Vancomycin-resistant Enterococcus (VRE has been established as a significant health-care associated problem since its first isolation in Australia in 1994. In this study, we measured the point prevalence and identified risk factors associated with vanB VRE colonisation in a tertiary care hospital in Melbourne, Australia where VRE has been endemic for 15 years. Methods A hospital-wide point prevalence survey was conducted on October 13, 2008 with colonisation detected using rectal swab culture. Patient’s demographic and medical information was collected through a review of medical records. Factors associated with VRE colonisation in univariate analysis were included in multivariate logistic regression model to adjust for confounding. Results The prevalence of VRE colonisation on the day of screening was 17.5% (95% CI, 13.7 to 21.9. VRE was detected from patients in each ward with the prevalence ranging from 3% to 29%. Univariate analysis showed the use of any antibiotic, meropenem, ciprofloxacin, diarrhoea and longer length of hospital stay were associated with increased risk of VRE colonisation (p0.05. Multivariate analysis showed the exposure to meropenem (p=0.004, age (≥65 years (p=0.036 and length of stay ≥7 days (p Conclusion Our study suggests that exposure to antibiotics may have been more important than recent cross transmission for a high prevalence of vanB VRE colonisation at our hospital.

Investigation of the Effect of Training on Promoting Breast-feeding at Baby-Friendly Hospital Case Study; Tohid Hospital in Jam, Bushehr

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Azam Nickkhaha

2015-06-01

Full Text Available Background: The Baby-Friendly Hospital Initiative was launched in 1989 by World Health Organization and the United Nations Children's Fund for the promotion of breastfeeding. This program was implemented in many departments of gynecology and obstetrics and resulted in reduced malnutrition, infection, morbidity and mortality in children. This program has introduced 10 specific steps to support successful breastfeeding. For instance, in the fourth step, skin-to-skin contact and breastfeeding are promoted since the time of birth, and in the fifth step, mothers are instructed on how to breastfeed or persist in breastfeeding. In these ten steps, mothers are trained in various fields. Methods: In this cross-sectional study, a standardized questionnaire was used to collect data at baby-friendly hospitals. To assess the difference between multiple nominal variables, variance analysis was performed, using SPSS version 17. Results: Based on the analysis, mothers' awareness of the benefits of breast milk and breastfeeding was 83% in a baby-friendly hospital. Also, their awareness of proper breastfeeding was estimated at 78.5%. In addition, mothers' knowledge about the frequency of breastfeeding was 70%. Conclusion: Given the role of Baby-Friendly Hospital Initiative in training mothers on the importance of breastfeeding and its persistence in future, careful monitoring of these hospitals, breastfeeding support services and breastfeeding training by midwives at healthcare centers are of great importance.

Knowledge gap regarding dementia care among nurses in Taiwanese acute care hospitals: A cross-sectional study.

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Lin, Pei-Chao; Hsieh, Mei-Hui; Chen, Meng-Chin; Yang, Yung-Mei; Lin, Li-Chan

2018-02-01

The quality of dementia care in hospitals is typically substandard. Staff members are underprepared for providing care to older people with dementia. The objective of the present study was to examine dementia care knowledge, attitude and behavior regarding self-education about dementia care among nurses working in different wards. This was a descriptive cross-sectional study. The present study was carried out from July 2013 to December 2013. In total, 387 nurses working in different wards were recruited from two hospitals in Taiwan by using convenience sampling. The nurses completed a self-report questionnaire on demographic data, experience and learning behavior, and attitude towards dementia care, and a 16-item questionnaire on dementia care knowledge. Descriptive and inferential statistics were used to analyze the status and differences in dementia care knowledge among nurse in different wards. The average dementia care knowledge score was 10.46 (SD 2.13), with a 66.5% mean accuracy among all nurses. Dementia care knowledge was significantly associated with age, nursing experience, possession of a registered nurse license, holding a bachelor's degree, work unit, training courses and learning behavior towards dementia care. The dementia care knowledge of the emergency room nurses was significantly lower than that of the psychiatric and neurology ward nurses. A significantly lower percentage of emergency room nurses underwent dementia care training and actively searched for information on dementia care, compared with the psychiatric and neurology ward nurses. Hospital nurses show a knowledge gap regarding dementia care, especially emergency room nurses. Providing dementia care training to hospital nurses, particularly emergency room nurses, is crucial for improving the quality of care for patients with dementia. Geriatr Gerontol Int 2018; 18: 276-285. © 2017 Japan Geriatrics Society.

Probing of the isospin-dependent mean field and nucleon-nucleon cross section in a medium by nucleon emissions

International Nuclear Information System (INIS)

Liu Jianye; Xing Yongzhong; Guo Wenjun

2003-01-01

We study the isospin effects of the mean field and two-body collision on the nucleon emissions at the intermediate energy heavy-ion collisions by using an isospin-dependent transport theory. The calculated results show that the nucleon emission number N n depends sensitively on the isospin effect of nucleon-nucleon cross section and weakly on the isospin-dependent mean field for neutron-poor system in higher beam energy region. In particular, the correlation between the medium correction of two-body collision and the momentum-dependent interaction enhances the dependence of nucleon emission number N n on the isospin effect of nucleon-nucleon cross section. On the contrary, the ratio of the neutron-proton ratio of the gas phase to the neutron-proton ratio of the liquid phase, i.e., the degree of isospin fractionation [(N/Z) gas ] b /[(N/Z) liq ] b depends sensitively on the isospin-dependent mean field and weakly on the isospin effect of two-body collision for neutron-rich system in the lower beam energy region. In this case, N n and [(N/Z) gas ] b /[(N/Z) liq ] b are the probes for extracting the information about the isospin-dependent nucleon-nucleon cross section in the medium and the isospin-dependent mean field, respectively

Factors Associated with the Competencies of Public Health Workers in Township Hospitals: A Cross-Sectional Survey in Chongqing Municipality, China.

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He, Zhifei; Cheng, Zhaohui; Fu, Hang; Tang, Shangfeng; Fu, Qian; Fang, Haiqing; Xian, Yue; Ming, Hui; Feng, Zhanchun

2015-11-09

This study aimed to explore the competencies of public health workers (PHWs) of township hospitals in Chongqing Municipality (China), and determine the related impact factors of the competencies of PHWs; A cross-sectional research was conducted on 314 PHWs from 27 township hospitals in three districts in Chongqing Municipality (China), from June to August 2014. A self-assessment questionnaire was established on the basis of literature reviews and a competency dictionary. The differences in competencies among the three districts were determined by adopting the chi-square test, t-test, analysis of variance (ANOVA) method, and the impact factors of the competencies of PHWs were determined by adopting stepwise regression analysis. (1) RESULTS of the demographic characteristics of PHWs in three sample districts of Chongqing Municipality showed that a significant difference in age of PHWs (p = 0.021 competency results of PHWs in township hospitals, seven among the 11 aspects were found to have significant differences in the three districts by the ANOVA test; (3) By adopting the t-test and ANOVA method, results of the relationship between the characteristics of PHWs and their competency scores showed that significant differences were found in the economic level (p = 0.000 competencies of PHWs in township hospitals, including the economic level (p = 0.000 competencies of the township hospital staff in Chongqing Municipality (China), are generally insufficient, therefore, regulating the medical education and training skills of PHWs is crucial to improve the competencies of PHWs in the township hospitals of Chongqing Municipality. The results of this study can be mirrored in other areas of China.

Nurse managers' experience with ethical issues in six government hospitals in Malaysia: a cross-sectional study.

Science.gov (United States)

Musa, Maizura binti; Harun-Or-Rashid, M D; Sakamoto, Junichi

2011-11-16

Nurse managers have the burden of experiencing frequent ethical issues related to both their managerial and nursing care duties, according to previous international studies. However, no such study was published in Malaysia. The purpose of this study was to explore nurse managers' experience with ethical issues in six government hospitals in Malaysia including learning about the way they dealt with the issues. A cross-sectional study was conducted in August-September, 2010 involving 417 (69.2%) of total 603 nurse managers in the six Malaysian government hospitals. Data were collected using three-part self-administered questionnaire. Part I was regarding participants' demographics. Part II was about the frequency and areas of management where ethical issues were experienced, and scoring of the importance of 11 pre-identified ethical issues. Part III asked how they dealt with ethical issues in general; ways to deal with the 11 pre-identified ethical issues, and perceived stress level. Data were analyzed using descriptive statistics, cross-tabulations and Pearson's Chi-square. A total of 397 (95.2%) participants experienced ethical issues and 47.2% experienced them on weekly to daily basis. Experiencing ethical issues were not associated with areas of practice. Top area of management where ethical issues were encountered was "staff management", but "patient care" related ethical issues were rated as most important. Majority would "discuss with other nurses" in dealing generally with the issues. For pre-identified ethical issues regarding "patient care", "discuss with doctors" was preferred. Only 18.1% referred issues to "ethics committees" and 53.0% to the code of ethics. Nurse managers, regardless of their areas of practice, frequently experienced ethical issues. For dealing with these, team-approach needs to be emphasized. Proper understanding of the code of ethics is needed to provide basis for reasoning.

Calibration and field evaluation of polar organic chemical integrative sampler (POCIS) for monitoring pharmaceuticals in hospital wastewater

International Nuclear Information System (INIS)

Bailly, Emilie; Levi, Yves; Karolak, Sara

2013-01-01

The Polar Organic Chemical Integrative Sampler (POCIS) is a new tool for the sampling of organic pollutants in water. We tested this device for the monitoring of pharmaceuticals in hospital wastewater. After calibration, a field application was carried out in a French hospital for six pharmaceutical compounds (Atenolol, Prednisolone, Methylprednisolone, Sulfamethoxazole, Ofloxacin, Ketoprofen). POCIS were calibrated in tap water and wastewater in laboratory conditions close to relevant environmental conditions (temperature, flow velocity). Sampling rates (R s ) were determined and we observed a significant increase with flow velocity and temperature. Whatever the compound, the R s value was lower in wastewater and the linear phase of uptake was shorter. POCIS were deployed in a hospital sewage pipe during four days and the estimated water concentrations were close to those obtained with twenty-four hour composite samples. -- Highlights: ► Calibration of POCIS for the monitoring of pharmaceuticals in hospital wastewater. ► Uptake profile presents a shorter linear phase in wastewater than in tap water. ► Influence of R s values by temperature, flow velocity and bio-fouling. ► Correlation between concentrations estimated from POCIS or measured in TWA samples. ► Deployment period should be no longer than five days. -- After calibration in tap water and hospital wastewater, POCIS were used to monitor pharmaceuticals in hospital sewage and were compared to TWA sampling

Dependence of radar auroral scattering cross section on the ambient electron density and the destabilizing electric field

International Nuclear Information System (INIS)

Haldoupis, C.; Nielsen, E.; Schlegel, K.

1990-01-01

By using a data set that includes simultaneous STARE and EISCAT measurements made at a common magnetic flux tube E region in the ionosphere, we investigate the dependence of relative scattering cross section of 1-meter auroral irregularities on the destabilizing E x B electron drift, or alternatively the electric field, and the E region ambient electron density. The analysis showed that both, the E field and mean electron density are the decisive factors in determining the strength of radar auroral echoes at magnetic aspect angles near perpendicularity. We have found that at instability threshold, i.e., when the E field strength is in the 15 to 20 mV/m range, the backscatter power level is affected strongly by the mean electron density. Above threshold, the wave saturation amplitudes are determined mainly by the combined action of electron drift velocity magnitude, V d , and mean electron density, N e , in a way that the scattering cross section, or the electron density fluctuation level, increases with electric field magnitude but at a rate which is larger when the ambient electron density is lower. The analysis enabled us to infer an empirical functional relationship which is capable of predicting reasonably well the intensity of STARE echoes from EISCAT E field and electron density data. In this functional relationship, the received power at threshold depends on N e 2 whereas, from threshold to perhaps more than 50 mV/m, the power increases nonlinearly with drift velocity as V d n where the exponent n is approximately proportional to N e -1/2 . The results support the Farley-Bunemann instability as the primary instability mechanism, but the existing nonlinear treatment of the theory, which includes wave-induced cross field diffusion, cannot account for the observed role of electron density in the saturation of irregularity amplitudes

Hospitals, finance, and health system reform in Britain and the United States, c. 1910-1950: historical revisionism and cross-national comparison.

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Gorsky, Martin

2012-06-01

Comparative histories of health system development have been variously influenced by the theoretical approaches of historical institutionalism, political pluralism, and labor mobilization. Britain and the United States have figured significantly in this literature because of their very different trajectories. This article explores the implications of recent research on hospital history in the two countries for existing historiographies, particularly the coming of the National Health Service in Britain. It argues that the two hospital systems initially developed in broadly similar ways, despite the very different outcomes in the 1940s. Thus, applying the conceptual tools used to explain the U.S. trajectory can deepen appreciation of events in Britain. Attention focuses particularly on working-class hospital contributory schemes and their implications for finance, governance, and participation; these are then compared with Blue Cross and U.S. hospital prepayment. While acknowledging the importance of path dependence in shaping attitudes of British bureaucrats toward these schemes, analysis emphasizes their failure in pressure group politics, in contrast to the United States. In both countries labor was also crucial, in the United States sustaining employment-based prepayment and in Britain broadly supporting system reform.

Reprint of: Dream vs. reality: seven case-studies on the desirability and feasibility of cross-border hospital collaboration in Europe.

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Glinos, Irene A; Baeten, Rita

2015-01-01

Despite being a niche phenomenon, cross-border health care collaboration receives a lot of attention in the EU and figures visibly on the policy agenda, in particular since the policy process which eventually led to the adoption of Directive 2011/24/EU. One of the underlying assumptions is that cross-border collaboration is desirable, providing justification to both the European Commission and to border-region stakeholders for promoting it. The purpose of this paper is to question this assumption and to examine the role of actors in pushing (or not) for cross-border collaboration. The analysis takes place in two parts. First, the EU policies to promote cross-border collaboration and the tools employed are examined, namely (a) use of European funds to sponsor concrete border-region collaboration projects, (b) use of European funds to sponsor research which gives visibility to cross-border collaboration, and (c) use of the European Commission's newly acquired legal mandate to encourage "Member States to cooperate in cross-border health care provision in border-regions" (Art. 10) and support "Member States in the development of European reference networks between health care providers and centres of expertise" (Art. 12). Second, evidence gathered in 2011-2013 from seven European border-regions on hospital cross-border collaboration is systematically reviewed to assess the reality of cross-border collaboration - can it work and when, and why do actors engage in cross-border collaboration? The preliminary findings suggest that while the EU plays a prominent role in some border-region initiatives, cross-border collaboration needs such a specific set of circumstances to work that it is questionable whether it can effectively be promoted. Moreover, local actors make use of the EU (as a source of funding, legislation or legitimisation) to serve their needs. Copyright © 2014. Published by Elsevier Ltd.

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

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Botega, Neury José

2002-06-01

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

ELEMENTAL FORMS OF HOSPITALITY

OpenAIRE

Maximiliano Emanuel Korstanje

2010-01-01

Modern studies emphasized on the needs of researching the hospitality as relevant aspects of tourism and hospitality fields. Anyway, these approaches are inextricably intertwined to the industry of tourism and do not take seriously the anthropological and sociological roots of hospitality. In fact, the hotel seems to be a partial sphere of hospitality at all. Under this context, the present paper explores the issue of hospitality enrooted in the political and economic indo-European principle ...

A multilevel model of patient safety culture: cross-level relationship between organizational culture and patient safety behavior in Taiwan's hospitals.

Science.gov (United States)

Chen, I-Chi; Ng, Hui-Fuang; Li, Hung-Hui

2012-01-01

As health-care organizations endeavor to improve their quality of care, there is a growing recognition of the importance of establishing a culture of patient safety. The main objective of this study was to investigate the cross-level influences of organizational culture on patient safety behavior in Taiwan's hospitals. The authors measured organizational culture (bureaucratic, supportive and innovative culture), patient safety culture and behavior from 788 hospital workers among 42 hospitals in Taiwan. Multilevel analysis was applied to explore the relationship between organizational culture (group level) and patient safety behavior (individual level). Patient safety culture had positive impact on patient safety behavior in Taiwan's hospitals. The results also indicated that bureaucratic, innovative and supportive organizational cultures all had direct influence on patient safety behavior. However, only supportive culture demonstrated significant moderation effect on the relationship between patient safety culture and patient safety behavior. Furthermore, organizational culture strength was shown correlated negatively with patient safety culture variability. Overall, organizational culture plays an important role in patient safety activities. Safety behaviors of hospital staff are partly influenced by the prevailing cultural norms in their organizations and work groups. For management implications, constructed patient priority from management commitment to leadership is necessary. For academic implications, research on patient safety should consider leadership, group dynamics and organizational learning. These factors are important for understanding the barriers and the possibilities embedded in patient safety. Copyright © 2011 John Wiley & Sons, Ltd.

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

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

2018-01-01

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

Comparative Assessment of Patients’ Rights Observance in the Hospitalization Wards of Shahid Beheshti University of Medical Sciences’ Hospitals

Directory of Open Access Journals (Sweden)

M. Sharifi

2017-06-01

Full Text Available Background: Patients are one of the most vulnerable social groups. Respecting patients’ rights will lead in advantages like “decrease in hospitalization time” and “increase in patients’ satisfaction”. This study is performed to assess the patients' rights observance in the hospitalization wards of educational hospitals of Shahid Beheshti University of Medical Sciences. Methods: In this descriptive-cross sectional study 137 medical student (intern were selected by convenience sampling method. We used a questionnaire with 12 questions. Reliability of questionnaire was confirmed by experts of the field and validity was confirmed by Cronbach’s Alpha coefficient (81%. The obtained data were analyzed by SPSS (v21 using descriptive statistics, analysis of variance and Tukey test. Findings: In this study the observance rate of patients’ rights was at a good level in 41.6% of cases, at an average level in 55.5% of cases and at a low level in 2.9% of cases. There was a significant difference between several hospitalization wards in the observance rate of patients’ rights. (p = 0.001. The observance rate of patients’ rights in infectious disease ward and gynecology ward was at a lower level in comparison with other wards. Conclusion: The observance rate of patients’ rights was at an average to good level in most of hospitalization ward. However this observance rate is at a low level in some wards. More studies about the causes of these differences can help us in planning about improvement of patients’ rights observance.

Bistability induced by crossed electric and magnetic fields in a nematic film

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Barbero, G.; Miraldi, E.; Oldano, C.

1988-09-01

The static distortions in a homogeneously aligned nematic liquid-crystal film in crossed electric and magnetic fields are theoretically analyzed. Both fields are orthogonal to the undistorted molecular alignment and destabilizing. In the limit of small distortions, a first-order transition between two distorted configurations, with bistability and hysteresis, is obtained if the dielectric anisotropy parameter 1-ɛ∥/ɛ⊥ is lower than the elastic anisotropy parameter (k3-k2)2/(4k1k2), where k1, k2, and k3 are the Frank elastic constants. This condition is satisfied by many commonly used nematic materials. At higher distortions an inversion point is found, above which the transition becomes of the second order. At this point a phenomenon similar to the critical opalescence of fluids is expected.

Success or failure of hospital information systems of public hospitals affiliated with Zahedan University of Medical Sciences: A cross sectional study in the Southeast of Iran.

Science.gov (United States)

Alipour, Jahanpour; Karimi, Afsaneh; Ebrahimi, Saeid; Ansari, Fatemeh; Mehdipour, Yousef

2017-12-01

After implementation, evaluation of hospital information systems (HISs) is critical to ensure the fulfillment of the system goals. This study aimed to assess the success or failure of HISs in public hospitals affiliated with Zahedan University of Medical Sciences. A cross-sectional descriptive and analytic study was performed in 2016. The study population comprised IT and HIS authorities and hospital information system users. The sample consisted of 468 participants. The data were collected using two questionnaires and analyzed with the SPSS software using descriptive and analytical statistics. The mean score of functional, behavioral, ethical, organizational, cultural and educational factors from the users' perspective was 3.14±0.66, 2.97± 0.60, 3.39±0.70, 2.96±0.642, 3.09±0.63, and 2.95±0.74, respectively. The mean score of organizational, behavioral, cultural, technological, educational and legal factors from IT and HIS authorities' perspective was 3.51±0.54, 3.35±0.45, 2.75±0.61, 3.58±0.32, and 3.96±0.59, respectively. The evaluated hospital information systems were considered relatively successful in terms of functional, ethical, and cultural factors but were considered as a relative failure in terms of behavioral, organizational, and educational factors form the users' perspective. Only the legal factor showed success, while organizational, behavioral, technical and educational factors showed relative success and the cultural factor showed relative failure from HIS and IT authorities' perspective. Therefore, assessing the users' needs before implementing the system, involving them in various stages of implementation, training them, and improving their computer skills seem to be necessary to achieve a better level of system success. Copyright © 2017 Elsevier B.V. All rights reserved.

Prevalence of HTLV-1/2 infections in Spain: A cross-sectional hospital-based survey.

Science.gov (United States)

Treviño, Ana; García, Juan; de Mendoza, Carmen; Benito, Rafael; Aguilera, Antonio; Ortíz de Lejarazu, Raul; Ramos, José M; Trigo, Matilde; Eirós, Jose M; Rodríguez-Iglesias, Manuel; Torres, Alvaro; Calderón, Enrique; Hernandez, Araceli; Gomez, Cesar; Marcaida, Goizane; Soriano, Vincent

2010-08-01

The presence of antibodies to human T-lymphotropic virus (HTLV) types 1 and 2 was examined in 5742 sera belonging to consecutive adult outpatients attended during June 2008 at 13 different hospitals across Spain. Overall, 58.8% were female. Foreigners represented 8% of the study population. Seven individuals were seropositive for HTLV-2 (overall prevalence 0.12%). No cases of HTLV-1 infection were found. All HTLV-2(+) subjects were Spanish natives, of whom six were coinfected with HIV-1 and five with hepatitis C virus (HCV). Moreover, all but one of the HTLV-2(+) subjects had been intravenous drug users. In summary, this cross-sectional survey suggests that the rate of HTLV infection in Spain is low, and is mostly represented by HTLV-2. Infected individuals are generally Spanish natives with a prior history of intravenous drug use and are coinfected with HIV-1 and/or HCV.

Effect of electric field on the oscillator strength and cross-section for intersubband transition in a semiconductor quantum ring

International Nuclear Information System (INIS)

Bhattacharyya, S; Das, N R

2012-01-01

In this paper, we study the oscillator strength and cross-section for intersubband optical transition in an n-type semiconductor quantum ring of cylindrical symmetry in the presence of an electric field perpendicular to the plane of the ring. The analysis is done considering Kane-type band non-parabolicity of the semiconductor and assuming that the polarization of the incident radiation is along the axis of the ring. The results show that the oscillator strength decreases and the transition energy increases with the electric field. The assumption of a parabolic band leads to an overestimation of the oscillator strength. The effects of the electric field, band non-parabolicity and relaxation time on absorption cross-section for intersubband transition in a semiconductor quantum ring are also shown. (paper)

Factors Associated with the Competencies of Public Health Workers in Township Hospitals: A Cross-Sectional Survey in Chongqing Municipality, China

Science.gov (United States)

He, Zhifei; Cheng, Zhaohui; Fu, Hang; Tang, Shangfeng; Fu, Qian; Fang, Haiqing; Xian, Yue; Ming, Hui; Feng, Zhanchun

2015-01-01

Purpose: This study aimed to explore the competencies of public health workers (PHWs) of township hospitals in Chongqing Municipality (China), and determine the related impact factors of the competencies of PHWs; Methods: A cross-sectional research was conducted on 314 PHWs from 27 township hospitals in three districts in Chongqing Municipality (China), from June to August 2014. A self-assessment questionnaire was established on the basis of literature reviews and a competency dictionary. The differences in competencies among the three districts were determined by adopting the chi-square test, t-test, analysis of variance (ANOVA) method, and the impact factors of the competencies of PHWs were determined by adopting stepwise regression analysis. Results: (1) Results of the demographic characteristics of PHWs in three sample districts of Chongqing Municipality showed that a significant difference in age of PHWs (p = 0.021 competency results of PHWs in township hospitals, seven among the 11 aspects were found to have significant differences in the three districts by the ANOVA test; (3) By adopting the t-test and ANOVA method, results of the relationship between the characteristics of PHWs and their competency scores showed that significant differences were found in the economic level (p = 0.000 competencies of PHWs in township hospitals, including the economic level (p = 0.000 competencies of the township hospital staff in Chongqing Municipality (China), are generally insufficient, therefore, regulating the medical education and training skills of PHWs is crucial to improve the competencies of PHWs in the township hospitals of Chongqing Municipality. The results of this study can be mirrored in other areas of China. PMID:26569273

Integrated Patient Education on U.S. Hospital Web Sites.

Science.gov (United States)

Huang, Edgar; Wu, Kerong; Edwards, Kelsey

2016-01-01

Based on a census of the 2015 Most Wired Hospitals, this content analysis aimed to find out how patient education has been integrated on these best IT hospitals' Web sites to serve the purposes of marketing and meeting online visitors' needs. This study will help hospitals to understand where the weaknesses are in their interactive patient education implementation and come up with a smart integration strategy. The study found that 70% of these hospitals had adopted interactive patient education contents, 76.6% of such contents were from a third-party developer, and only 20% of the hospitals linked their patient education contents to one or more of the hospital's resources while 26% cross-references such contents. The authors concluded that more hospitals should take advantage of modern information communication technology to cross-reference their patient education contents and to integrate such contents into their overall online marketing strategy to benefit patients and themselves.

Nurse perceptions of safety climate in Australian acute hospitals: a cross-sectional survey.

Science.gov (United States)

Soh, Sze-Ee; Morello, Renata; Rifat, Sheral; Brand, Caroline; Barker, Anna

2017-03-16

Objectives The aim of the present study was to explore nurse perceptions of safety climate in acute Australian hospitals. Methods Participants included 420 nurses who have worked on 24 acute wards from six Australian hospitals. The Safety Attitudes Questionnaire (SAQ) Short Form was used to quantify nurse perceptions of safety climate and benchmarked against international data. Generalised linear mixed models were used to explore factors that may influence safety climate. Results On average, 53.5% of nurses held positive attitudes towards job satisfaction followed by teamwork climate (50.5%). There was variability in SAQ domain scores across hospitals. The safety climate and perceptions of hospital management domains also varied across wards within a hospital. Nurses who had worked longer at a hospital were more likely to have poorer perceptions of hospital management (β=-5.2; P=0.014). Overall, nurse perceptions of safety climate appeared higher than international data. Conclusions The perceptions of nurses working in acute Victorian and New South Wales hospitals varied between hospitals as well as across wards within each hospital. This highlights the importance of surveying all hospital wards and examining the results at the ward level when implementing strategies to improve patient safety and the culture of safety in organisations. What is known about the topic? Prior studies in American nursing samples have shown that hospitals with higher levels of safety climate have a lower relative incidence of preventable patient complications and adverse events. Developing a culture of safety in hospitals may be useful in targeting efforts to improve patient safety. What does this paper add? This paper has shown that the perceptions of safety climate among nurses working in acute Australian hospitals varied between hospitals and across wards within a hospital. Only half the nurses also reported positive attitudes towards job satisfaction and teamwork climate. What are

Energy levels of a quantum particle on a cylindrical surface with non-circular cross-section in electric and magnetic fields

International Nuclear Information System (INIS)

Cruz, Philip Christopher S.; Bernardo, Reginald Christian S.; Esguerra, Jose Perico H.

2017-01-01

We calculate the energy levels of a quantum particle on a cylindrical surface with non-circular cross-section in uniform electric and magnetic fields. Using separation of variables method and a change of independent variable, we show that the problem can be reduced to a one-dimensional Schrödinger equation for a periodic potential. The effects of varying the shape of the cross-section while keeping the same perimeter and the strengths of the electric and magnetic fields are investigated for elliptical, corrugated, and nearly-rectangular tubes with radial dimensions of the order of a nanometer. The geometric potential has minima at the angular positions where there is a significant amount of curvature. For the elliptical and corrugated tubes, it is shown that as the tube departs from the circular shape of cross-section the double-degeneracy between the energy levels is lifted. For the nearly-rectangular tube, it is shown that energy level crossings occur as the horizontal dimension of the tube is varied while keeping the same perimeter and radius of circular corners. The interplay between the curvature and the strength of the electric and magnetic fields determines the overall behavior of the energy levels. As the strength of the electric field increases, the overall potential gets skewed creating a potential well on the side corresponding to the more negative electric potential. The energy levels of the first few excited states approach more positive values while the ground state energy level approaches a more negative value. For large electric fields, all bound state energy levels tend to more negative values. The contribution of weak magnetic fields to the overall potential behaves in the same way as the electric field contribution but with its sign depending on the direction of the component of the momentum parallel to the cylindrical axis. Large magnetic fields lead to pairing of energy levels reminiscent of 2D Landau levels for the elliptical and nearly

Energy levels of a quantum particle on a cylindrical surface with non-circular cross-section in electric and magnetic fields

Energy Technology Data Exchange (ETDEWEB)

Cruz, Philip Christopher S., E-mail: pscruz1@up.edu.ph; Bernardo, Reginald Christian S., E-mail: rcbernardo@nip.upd.edu.ph; Esguerra, Jose Perico H., E-mail: jesguerra@nip.upd.edu.ph

2017-04-15

We calculate the energy levels of a quantum particle on a cylindrical surface with non-circular cross-section in uniform electric and magnetic fields. Using separation of variables method and a change of independent variable, we show that the problem can be reduced to a one-dimensional Schrödinger equation for a periodic potential. The effects of varying the shape of the cross-section while keeping the same perimeter and the strengths of the electric and magnetic fields are investigated for elliptical, corrugated, and nearly-rectangular tubes with radial dimensions of the order of a nanometer. The geometric potential has minima at the angular positions where there is a significant amount of curvature. For the elliptical and corrugated tubes, it is shown that as the tube departs from the circular shape of cross-section the double-degeneracy between the energy levels is lifted. For the nearly-rectangular tube, it is shown that energy level crossings occur as the horizontal dimension of the tube is varied while keeping the same perimeter and radius of circular corners. The interplay between the curvature and the strength of the electric and magnetic fields determines the overall behavior of the energy levels. As the strength of the electric field increases, the overall potential gets skewed creating a potential well on the side corresponding to the more negative electric potential. The energy levels of the first few excited states approach more positive values while the ground state energy level approaches a more negative value. For large electric fields, all bound state energy levels tend to more negative values. The contribution of weak magnetic fields to the overall potential behaves in the same way as the electric field contribution but with its sign depending on the direction of the component of the momentum parallel to the cylindrical axis. Large magnetic fields lead to pairing of energy levels reminiscent of 2D Landau levels for the elliptical and nearly

[Continuity of hospital identifiers in hospital discharge data - Analysis of the nationwide German DRG Statistics from 2005 to 2013].

Science.gov (United States)

Nimptsch, Ulrike; Wengler, Annelene; Mansky, Thomas

2016-11-01

In Germany, nationwide hospital discharge data (DRG statistics provided by the research data centers of the Federal Statistical Office and the Statistical Offices of the 'Länder') are increasingly used as data source for health services research. Within this data hospitals can be separated via their hospital identifier ([Institutionskennzeichen] IK). However, this hospital identifier primarily designates the invoicing unit and is not necessarily equivalent to one hospital location. Aiming to investigate direction and extent of possible bias in hospital-level analyses this study examines the continuity of the hospital identifier within a cross-sectional and longitudinal approach and compares the results to official hospital census statistics. Within the DRG statistics from 2005 to 2013 the annual number of hospitals as classified by hospital identifiers was counted for each year of observation. The annual number of hospitals derived from DRG statistics was compared to the number of hospitals in the official census statistics 'Grunddaten der Krankenhäuser'. Subsequently, the temporal continuity of hospital identifiers in the DRG statistics was analyzed within cohorts of hospitals. Until 2013, the annual number of hospital identifiers in the DRG statistics fell by 175 (from 1,725 to 1,550). This decline affected only providers with small or medium case volume. The number of hospitals identified in the DRG statistics was lower than the number given in the census statistics (e.g., in 2013 1,550 IK vs. 1,668 hospitals in the census statistics). The longitudinal analyses revealed that the majority of hospital identifiers persisted in the years of observation, while one fifth of hospital identifiers changed. In cross-sectional studies of German hospital discharge data the separation of hospitals via the hospital identifier might lead to underestimating the number of hospitals and consequential overestimation of caseload per hospital. Discontinuities of hospital

Prevalence and determinations of physical inactivity among public hospital employees in Shanghai, China: a cross-sectional study.

Science.gov (United States)

Li, Xinjian; Cheng, Minna; Zhang, Hao; Ke, Ting; Chen, Yisheng

2015-03-01

This study aims to explore the prevalence and determinations of physical inactivity among hospital employees in Shanghai, China. A cross-sectional study of 4612 employees aged 19 to 68 years was conducted through stratified cluster sampling from different classes of Shanghai hospitals in 2011. The total physical activity was evaluated using the metabolic equivalent according to the Global Physical Activity Questionnaire. Among the participants, 38.5%, 32.3%, and 64.6% of the employees are inactive at work, commuting, and taking leisure time, respectively. Up to 41.8% of the men and 37.8% of the women (P = 0.012) are physically inactive. When the age and educational level are adjusted, male doctors and medical technicians show a higher percentage of physical inactivity than male workers in logistics (P = 0.001). Among females, employees who are working in second- and third-class hospitals show a higher proportion of physical inactivity than those who are working in community health care centers. Logistic regression analyses show that the odds ratios (ORs) of leisure-time physical inactivity associated with the intensity of physical activity at work are 2.259, 2.897, and 4.266 for men (P physical inactivity in either sex (OR = 2.116 for men and 2.173 for women, P employees, particularly doctors and medical technicians, show a higher proportion of physical inactivity than other inhabitants in Shanghai. The time and intensity of activity at work and commuting are associated with leisure-time activities.

Anorectal pathology amongst HIV infected patients attending the Douala General Hospital: a cross-sectional study.

Science.gov (United States)

Luma, Henry Namme; Eloumou, Servais Albert Fiacre Bagnaka; Fualefeh-Morfaw, Ellis Atemlefeh; Malongue, Agnes; Temfack, Elvis; Lekpa, Fernando Kemta; Donfack-Sontsa, Olivier; Ndip, Lucy; Ditah, Ivo Che

2017-03-01

While gastrointestinal disease is common among HIV infected individuals, the prevalence and distribution of ano-rectal pathology has not been well studied in our setting. The objective of this study therefore was to determine the prevalence and determinants of ano-rectal pathology in HIV infected patients attending the Douala General Hospital HIV treatment centre. A hospital-based cross-sectional study was undertaken. We collected socio-demographic, clinical and laboratory data using a structured questionnaire and patients' files. Each study participant had a full physical and ano-rectal examination. We further studied factors associated with having at least one ano-rectal lesion by logistic regression reporting odds ratios (ORs) and their 95% confidence intervals (CI). We included 390 HIV infected patients. The mean age was 41 (SD: 8) years and 48% were men. Median duration since HIV diagnosis was 3 (interquartile range: 2-5) years and median CD4 cell count was 411 (interquartile range: 234-601) cells/mm 3 . Prevalence of ano-rectal pathology was 22.8% (95% CI: 18.7-27.3). Hemorrhoids and proctitis were most common lesions found; each in 10% of patients. From multivariate logistic regression, factors associated with ano-rectal pathology were CD4 HIV infected patients. Care givers should actively investigate and treat them as this will improve the quality of life of people living with HIV/AIDS.

[Screening for malnutrition among hospitalized patients in a Colombian University Hospital].

Science.gov (United States)

Cruz, Viviana; Bernal, Laura; Buitrago, Giancarlo; Ruiz, Álvaro J

2017-04-01

On admission, 30 to 50% of hospitalized patients have some degree of malnutrition, which is associated with longer length of stay, higher rates of complications, mortality and greater costs. To determine the frequency of screening for risk of malnutrition in medical records and assess the usefulness of the Malnutrition Screening Tool (MST). In a cross-sectional study, we searched for malnutrition screening in medical records, and we applied the MST tool to hospitalized patients at the Internal Medicine Wards of San Ignacio University Hospital. Of 295 patients included, none had been screened for malnutrition since hospital admission. Sixty one percent were at nutritional risk, with a higher prevalence among patients with HIV (85.7%), cancer (77.5%) and pneumonia. A positive MST result was associated with a 3.2 days increase in length of hospital stay (p = 0.024). The prevalence of malnutrition risk in hospitalized patients is high, but its screening is inadequate and it is underdiagnosed. The MST tool is simple, fast, low-cost, and has a good diagnostic performance.

Predicting nurse burnout from demands and resources in three acute care hospitals under different forms of ownership: a cross-sectional questionnaire survey.

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Hansen, Niklas; Sverke, Magnus; Näswall, Katharina

2009-01-01

Health care organizations have changed dramatically over the last decades, with hospitals undergoing restructurings and privatizations. The aim of this study is to enhance the understanding of the origin and prevalence of burnout in health care by investigating factors in the psychosocial work environment and comparing three Swedish emergency hospitals with different types of ownership. A cross-sectional design was used. We selected a total sample of 1800 registered nurses from three acute care hospitals, one private for-profit, one private non-profit and one publicly administered. A total of 1102 questionnaires were included in the analyses. The examined ownership types were a private for-profit, a private non-profit and a traditional publicly administered hospital. All were situated in the Stockholm region, Sweden. Data were collected by questionnaires using validated instruments, in accordance with the Job Demands-Resources Model and Maslach's Burnout Inventory. Descriptive statistics, correlation analyses, multivariate covariance analyses and multiple regression analyses were conducted. The results showed that the burnout levels were the highest at the private for-profit hospital and lowest at the publicly administered hospital. However, in contrast to expectations the demands were not higher overall at the for-profit organization or lowest at the public administration unit, and overall, resources were not better in the private for-profit or worse at the publicly administered hospital. Multiple regression analyses showed that several of the demands included were related to higher burnout levels. Job resources were linked to lower burnout levels, but not for all variables. Profit orientation in health care seems to result in higher burnout levels for registered nurses compared to a publicly administered hospital. In general, demands were more predictive of burnout than resources, and there were only marginal differences in the pattern of predictors across

Patient side cost and its predictors for cervical cancer in Ethiopia: a cross sectional hospital based study

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Hailu Alemayehu

2013-02-01

Full Text Available Abstract Background Cervical cancer is a leading cause of death from cancer among women in low-resource settings, affecting women at a time of life when they are critical to social and economic stability. In addition, the economic burden is important for policy formulation. The aim of this study is to estimate patient side cost and to determine predictors of its variation for the treatment of cervical cancer. Methods Analytic cross sectional study involving 227 cervical cancer cases at Tikur Anbessa Hospital, Ethiopia was conducted. Cost estimation was based on patients' perspective and using the prevalence-based model as a time frame. Productivity losses were estimated from lost working days. Results The mean outpatient cost per patient for cervical cancer was $407.2 (Median = $206.9. Direct outpatient cost (Mean = $334.2 takes the largest share compared with the indirect counterpart ($150. The outpatient cost for half of the respondent falls in a range between $93.7 and $478. The mean inpatient cost for hospitalized patients was $404.4. The average direct inpatient cost was $329 (74% medical costs and 26% non medical costs. The mean value for total inpatient cost for half of the respondents was in the range of $133.5 and $493.9. For every additional day of inpatient hospital stay, there is a daily incremental inpatient cost of $4.2. Conclusion As has been found in other studies, our findings revealed that cervical cancer creates an immense financial burden on patients. Primary prevention measures, vaccination against HPV and screening, should be initiated and expanded to reduce morbidity from cervical cancer and subsequent costs in both human lives and money resources. Control of co-morbidity and complication should be emphasized during management of cervical cancer patients. Capacitating regional hospitals and provision of low cost or fee exemption schemes should be arranged and strengthened.

Malnutrition in patients admitted to the medical wards of the Douala General Hospital: a cross-sectional study.

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Luma, Henry Namme; Eloumou, Servais Albert Fiacre Bagnaka; Mboligong, Franklin Ngu; Temfack, Elvis; Donfack, Olivier-Tresor; Doualla, Marie-Solange

2017-07-03

Malnutrition is common in acutely ill patients occurring in 30-50% of hospitalized patients. Awareness and screening for malnutrition is lacking in most health institutions in sub-Saharan Africa. This study aimed at screening for malnutrition using anthropometric and laboratory indices in patients admitted to the internal medicine wards. A cross-sectional study. We screened for malnutrition in 251 consecutive patients admitted from January to March 2013 in the internal medicine wards. Malnutrition defined as body mass index (BMI) less than 18.5 kg/m 2 and/or mid upper arm circumference (MUAC) less than 22 cm in women and 23 cm in men. Weight loss greater than 10% in the last 6 months prior to admission, relevant laboratory data, diagnosis at discharge and length of hospital stay (LOS) were also recorded. Mean age was 47 (SD 16) years. 52.6% were male. Mean BMI was 24.44 (SD 5.79) kg/m 2 and MUAC was 27.8 (SD 5.0) cm. Median LOS was 7 (IQR 5-12) days. 42.4% of patients reported weight loss greater than 10% in the 6 months before hospitalization. MUAC and BMI correlated significantly (r = 0.78; p malnutrition by the two methods showed moderate agreement (κ = 0.56; p malnutrition was 19.34% (35/251). Blood albumin and hemoglobin were significantly lower in malnourished patients. Malnourished patients had a significantly longer LOS (p = 0.019) when compared to those with no malnutrition. Malnutrition was most common amongst patients with malignancy. Malnutrition is common in patients admitted to the medical wards of the Douala General Hospital. Nutritional screening and assessment should be integrated in the care package of all admitted patients.

Surfaces and Air Bacteriology of Selected Wards at a Referral Hospital, Northwest Ethiopia: A Cross-Sectional Study.

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Getachew, Hailu; Derbie, Awoke; Mekonnen, Daniel

2018-01-01

The hospital environment is a source of medically important pathogens that are mostly multidrug resistant (MDR) and posing a major therapeutic challenge. The aim of this study was to assess the surface and air bacteriology of selected wards at Felege Hiwot Referral Hospital (FHRH), Northwest Ethiopia. A cross-sectional study was carried out from 15th February to 30th April 2017. A total of 356 surface and air samples were collected from selected wards using 5% sheep blood agar (Oxoid, UK) and processed at FHRH microbiology laboratory following the standard bacteriological procedures. Pure isolates were tested against the recommended antibiotics using Kirby-Bauer disc diffusion methods, and the susceptibility profile was determined based on Clinical Laboratory Standards Institute (CLSI). Data were entered and analyzed using SPSS version 23 for Windows. Of the total 356 samples processed, 274 were from surfaces and 82 were from air. Among these, 141 (39.6%) showed bacterial growth, yielding a total of 190 isolates. Gram-positive isolates were predominant at 81.6% ( n =155), while the gram negatives were at 18.4% ( n =35). The main isolates were coagulase negative staphylococci ( CoNs ), 44%, followed by S. aureus , 37.4%, and Klebsiella species at 11.6%. The bacterial load on surfaces and air was found beyond the standard limits. Besides, the antimicrobial susceptibility profile of the isolates showed that about 75% of the identified isolates were found resistant for two and more antimicrobial agents tested. This study showed high degree of bacterial load that is beyond the standard limits on both surfaces and air samples of the hospital. Furthermore, some 75% of the isolates were found multidrug resistant. Therefore, it is important to evaluate and strengthen the infection prevention practice of the hospital. Moreover, stakeholders should also reinforce actions to decrease the pressure of antimicrobial resistance in the studied area.

Momentum transfer theory of non-conservative charged particle transport in crossed electric and magnetic fields

International Nuclear Information System (INIS)

Vrhovac, S.B.; Petrovic, Z.Lj.

1995-01-01

Momentum - transfer approximation is applied to momentum and energy balance equations describing reacting particle swarms in gases in crossed electric and magnetic fields. Transport coefficients of charged particles undergoing both inelastic and reactive, non-particle-conserving collisions with a gas of neutral molecules are calculated. Momentum - transfer theory (MTT) has been developed mainly by Robson and collaborators. It has been applied to a single reactive gas and mixtures of reactive gases in electric field only. MTT has also been applied in crossed electric and magnetic fields recently and independently of our work but the reactive collisions were not considered. Consider a swarm of electrons of charge e and mass m moving with velocity rvec v through a neutral gas under the influence of an applied electric rvec E and magnetic rvec B field. The collision processes which we shall investigate are limited to elastic, inelastic and reactive collisions of electrons with gas molecules. Here we interpret reactive collisions as collisions which produce change in number of the swarm particles. Reactive collisions involve creation (ionization by electron impact) or loss (electron attachment) of swarm particles. We consider only single ionization in approximation of the mass ratio m/m 0 0 are masses of electrons and neutral particles, respectively. We assume that the stage of evolution of the swarm is the hydrodynamic limit (HDL). In HDL, the space - time dependence of all properties is carried by the number density n of swarm particles

NATO mission in Kosovo: historical backgrounds and informations of working as radiologist in the German field hospital

International Nuclear Information System (INIS)

Voelk, M.; Danz, B.

2005-01-01

The first part of this article describes how the NATO mission in Kosovo came into existence and focuses on the historical background and ethnical problems. The second part deals with the working conditions of a radiologist in the German field hospital in Prizren and focuses on the personnel and technical equipment in the radiological department. (orig.) [de

Retrieval of Droplet size Density Distribution from Multiple field of view Cross polarized Lidar Signals: Theory and Experimental Validation

Science.gov (United States)

2016-06-02

Retrieval of droplet-size density distribution from multiple-field-of-view cross-polarized lidar signals: theory and experimental validation...Gilles Roy, Luc Bissonnette, Christian Bastille, and Gilles Vallee Multiple-field-of-view (MFOV) secondary-polarization lidar signals are used to...use secondary polarization. A mathematical relation among the PSD, the lidar fields of view, the scattering angles, and the angular depolarization

Remagnetization of bulk high-temperature superconductors subjected to crossed and rotating magnetic fields

Energy Technology Data Exchange (ETDEWEB)

Vanderbemden, P [SUPRATECS and Department of Electrical Engineering and Computer Science B28, Sart-Tilman, B-4000 Liege (Belgium); Hong, Z [Centre for Advanced Photonics and Electronics, Engineering Department, University of Cambridge, 9 JJ Thomson Avenue, Cambridge CB3 0FA (United Kingdom); Coombs, T A [Centre for Advanced Photonics and Electronics, Engineering Department, University of Cambridge, 9 JJ Thomson Avenue, Cambridge CB3 0FA (United Kingdom); Ausloos, M [SUPRATECS and Department of Physics B5, Sart-Tilman, B-4000 Liege (Belgium); Babu, N Hari [IRC in Superconductivity, University of Cambridge, Madingley Road, Cambridge CB3 0HE (United Kingdom); Cardwell, D A [IRC in Superconductivity, University of Cambridge, Madingley Road, Cambridge CB3 0HE (United Kingdom); Campbell, A M [IRC in Superconductivity, University of Cambridge, Madingley Road, Cambridge CB3 0HE (United Kingdom)

2007-09-15

Bulk melt-processed Y-Ba-Cu-O (YBCO) has significant potential for a variety of high-field permanent-magnet-like applications, such as the rotor of a brushless motor. When used in rotating devices of this kind, however, the YBCO can be subjected to both transient and alternating magnetic fields that are not parallel to the direction of magnetization and which have a detrimental effect on the trapped field. These effects may lead to long-term decay of the magnetization of the bulk sample. In the present work, we analyze both experimentally and numerically the remagnetization process of a melt-processed YBCO single domain that has been partially demagnetized by a magnetic field applied orthogonal to the initial direction of trapped flux. Magnetic torque measurements are used as a tool to probe changes in the remanent magnetization during various sequences of applied field. The application of a small magnetic field between the transverse cycles parallel to the direction of original magnetization results in partial remagnetization of the sample. Rotating the applied field, however, is found to be much more efficient at remagnetizing the bulk material than applying a magnetizing field pulse of the same amplitude. The principal features of the experimental data can be reproduced qualitatively using a two-dimensional finite-element numerical model based on an E-J power law. Finally, the remagnetization process is shown to result from the complex modification of current distribution within the cross-section of the bulk sample.

Remagnetization of bulk high-temperature superconductors subjected to crossed and rotating magnetic fields

International Nuclear Information System (INIS)

Vanderbemden, P; Hong, Z; Coombs, T A; Ausloos, M; Babu, N Hari; Cardwell, D A; Campbell, A M

2007-01-01

Bulk melt-processed Y-Ba-Cu-O (YBCO) has significant potential for a variety of high-field permanent-magnet-like applications, such as the rotor of a brushless motor. When used in rotating devices of this kind, however, the YBCO can be subjected to both transient and alternating magnetic fields that are not parallel to the direction of magnetization and which have a detrimental effect on the trapped field. These effects may lead to long-term decay of the magnetization of the bulk sample. In the present work, we analyze both experimentally and numerically the remagnetization process of a melt-processed YBCO single domain that has been partially demagnetized by a magnetic field applied orthogonal to the initial direction of trapped flux. Magnetic torque measurements are used as a tool to probe changes in the remanent magnetization during various sequences of applied field. The application of a small magnetic field between the transverse cycles parallel to the direction of original magnetization results in partial remagnetization of the sample. Rotating the applied field, however, is found to be much more efficient at remagnetizing the bulk material than applying a magnetizing field pulse of the same amplitude. The principal features of the experimental data can be reproduced qualitatively using a two-dimensional finite-element numerical model based on an E-J power law. Finally, the remagnetization process is shown to result from the complex modification of current distribution within the cross-section of the bulk sample

Associations between teaching effectiveness scores and characteristics of presentations in hospital medicine continuing education.

Science.gov (United States)

Ratelle, John T; Wittich, Christopher M; Yu, Roger C; Newman, James S; Jenkins, Sarah M; Beckman, Thomas J

2015-09-01

There is little research regarding characteristics of effective continuing medical education (CME) presentations in hospital medicine (HM). Therefore, we sought to identify associations between validated CME teaching effectiveness scores and characteristics of CME presentations in the field of HM. This was a cross-sectional study of participants and didactic presentations from a national HM CME course in 2014. Participants provided CME teaching effectiveness (CMETE) ratings using an instrument with known validity evidence. Overall CMETE scores (5-point scale: 1 = strongly disagree; 5 = strongly agree) were averaged for each presentation, and associations between scores and presentation characteristics were determined using the Kruskal-Wallis test. The threshold for statistical significance was set at P teaching effectiveness scores and characteristics of effective CME presentations in HM. Our findings, which support previous research in other fields, indicate that CME presentations may be improved by increasing interactivity through the use of audience response systems and allowing longer presentations. © 2015 Society of Hospital Medicine.

Effects of a conducting E layer on classical F region cross-field plasma diffusion

International Nuclear Information System (INIS)

Vickrey, J.F.; Kelley, M.C.

1982-01-01

The rate of cross-field plasma diffusion in the F region ionosphere is significantly increased when the magnetic field lines thread a highly conducting E region below. This reduces the lifetime of small-scale F region electron density irregularities in the polar ionosphere where the presence of a highly conducting E region is comonplace. A simple mmodel is developed to describe the effects of a conducting E layer on classical F region plasma diffusion. In the absence of an E region, the difference in ion and electron diffusion rates leads to a charge separation and, hence, to an electrostatic field that retards ion diffusion. When the highly conducting magnetic field lines are tied to a conducting E region, however, electrons can flow along B to reduce the ambipolar diffusion electric field, and ions can proceed perpendicular to B at a rate approaching their own (higher) diffusion velocity. It is shown that the enhanced total diffusion rate that results depends strongly on the height of the F layer and on the ratio of the E to F region Pedersen conductivities

Relationship between low birth weight of babies and antenatal care of mothers: A cross sectional study at a tertiary care hospital of Kishanganj, Bihar

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Malvika Dubey

2015-01-01

Full Text Available Background Low birth weight (LBW is important risk factor for childhood morbidity and mortality thus an important public health concern. Aim To identify the maternal determinants associated with LBW of babies Setting M.G.M Medical college & L.S.K Hospital Kishanganj ,Bihar. Design Hospital based cross sectional study Study period January 2014 to March 2014 Methodology Institution based descriptive cross sectional study from February 2014 to April 2014. All postnatal women (190 with singleton apparently healthy babies during the study period were selected for study. Birth weight of babies was recorded, mothers were interviewed and antenatal cards were reviewed. Result 34% of newborns were found to be low birth weight in our study. Statistically significant association was found between Low birth weight of babies and mother’s age, religion, literacy of mother, consumption of IFA tablets and regular ANC checkup during pregnancy. Conclusion The study suggests various maternal factors influence the birth weight of newborn babies and by improving antenatal care services both in coverage and quality we can reduce infant mortality in country.

Decrease in use of manual vacuum aspiration in postabortion care in Malawi: a cross-sectional study from three public hospitals, 2008-2012.

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Maria L Odland

Full Text Available OBJECTIVES: To investigate the use of manual vacuum aspiration in postabortion care in Malawi between 2008-2012. METHODS: A retrospective cross-sectional study was done at the referral hospital Queen Elisabeth Central Hospital, and the two district hospitals of Chiradzulu and Mangochi. The data were collected simultaneously at the three sites from Feb-March 2013. All records available for women admitted to the gynaecological ward from 2008-2012 were reviewed. Women who had undergone surgical uterine evacuation after incomplete abortion were included and the use of manual vacuum aspiration versus sharp curettage was analysed. RESULTS: Altogether, 5121 women were included. One third (34.2% of first trimester abortions were treated with manual vacuum aspiration, while all others were treated with sharp curettage. There were significant differences between the hospitals and between years. Overall there was an increase in the use of manual vacuum aspiration from 2008 (19.7% to 2009 (31.0%, with a rapid decline after 2010 (28.5% ending at only 4.9% in 2012. Conversely there was an increase in use of sharp curettage in all hospitals from 2010 to 2012. CONCLUSION: Use of manual vacuum aspiration as part of the postabortion care in Malawi is rather low, and decreased from 2010 to 2012, while the use of sharp curettage became more frequent. This is in contrast with current international guidelines.

Factors related to burnout among Chinese female hospital nurses: cross-sectional survey in Liaoning Province of China.

Science.gov (United States)

Wu, Hui; Liu, Li; Sun, Wei; Zhao, Xue; Wang, Jiana; Wang, Lie

2014-07-01

To explore the factors associated with burnout among female hospital nurses in China. Burnout has been a major concern in the field of occupational health, and yet there has been little research exploring the factors related to burnout among Chinese nurses. Exploring the factors associated with burnout is important in improving nurses' health and the quality of health care services in China. The study population consisted of 1845 female hospital nurses in the Liaoning Province of China. Burnout was measured using the Chinese version of the Maslach Burnout Inventory-General Survey; occupational stress was measured using the Chinese versions of the Job Content Questionnaire and Effort-Reward Imbalance Questionnaire. A general linear regression model was applied to analyse the factors associated with burnout. Mean scores (±SD) were 11.74 (7.14) for emotional exhaustion, 7.12 (5.67) for cynicism and 23.34 (9.60) for self-efficacy. Strong extrinsic effort was the most powerful predictor of emotional exhaustion and cynicism; strong psychological job demands were the most robust predictor of low self-efficacy. The findings suggest that occupational stress was strongly related to burnout among female hospital nurses in China. Occupational stress was identified as the most robust predictor of burnout among Chinese female hospital nurses. Reducing burnout among nurses working in China may require health education, health promotion and occupational training programmes aimed at improving work situations and reducing occupational stress. © 2012 John Wiley & Sons Ltd.

What Impact Does Behavior of Doctors and Patients on Service Integration of Multi-institutional Readmission cross Township—county Hospitals in Rural China

OpenAIRE

Zhang, Yan; Tang, Wenxi; Zhang, Liang

2017-01-01

Background: With the change of rural residents’ disease spectrum and patients with chronic diseases boom, multi-institutional health service utilization of rural residents and the continuous service demands are growing sharply in rural China.Objective: Evaluate the service integration of multi-institutional readmission cross township—county hospitals (MRCTCH) in rural China, and figure out determines of service integration.Methods: This study featured 7 sample counties in rural China. Based o...

Moderating effects of coping on work stress and job performance for nurses in tertiary hospitals: a cross-sectional survey in China

OpenAIRE

Li, Li; Ai, Hua; Gao, Lei; Zhou, Hao; Liu, Xinyan; Zhang, Zhong; Sun, Tao; Fan, Lihua

2017-01-01

Background Work stress is a major problem for nurses and it can negatively influence job performance. Therefore, it is critical to explore variables that can reduce or buffer the negative effects of work stress. This study explores the moderating effects of coping strategies on the relationship between work stress and job performance for nurses in China. Methods A cross-sectional survey of 852 nurses from four tertiary hospitals in Heilongjiang Province, China, was conducted in 2013. Descript...

Pattern of Frequent But Nontargeted Pharmacologic Thromboprophylaxis for Hospitalized Patients With Cancer at Academic Medical Centers: A Prospective, Cross-Sectional, Multicenter Study

Science.gov (United States)

Zwicker, Jeffrey I.; Rojan, Adam; Campigotto, Federico; Rehman, Nadia; Funches, Renee; Connolly, Gregory; Webster, Jonathan; Aggarwal, Anita; Mobarek, Dalia; Faselis, Charles; Neuberg, Donna; Rickles, Frederick R.; Wun, Ted; Streiff, Michael B.; Khorana, Alok A.

2014-01-01

Purpose Hospitalized patients with cancer are considered to be at high risk for venous thromboembolism (VTE). Despite strong recommendations in numerous clinical practice guidelines, retrospective studies have shown that pharmacologic thromboprophylaxis is underutilized in hospitalized patients with cancer. Patients and Methods We conducted a prospective, cross-sectional study of hospitalized patients with cancer at five academic hospitals to determine prescription rates of thromboprophylaxis and factors influencing its use during hospitalization. Results A total of 775 patients with cancer were enrolled across five academic medical centers. Two hundred forty-seven patients (31.9%) had relative contraindications to pharmacologic prophylaxis. Accounting for contraindications to anticoagulation, the overall rate of pharmacologic thromboprophylaxis was 74.2% (95% CI, 70.4% to 78.0%; 392 of 528 patients). Among the patients with cancer without contraindications for anticoagulation, individuals hospitalized with nonhematologic malignancies were significantly more likely to receive pharmacologic thromboprophylaxis than those with hematologic malignancies (odds ratio [OR], 2.34; 95% CI, 1.43 to 3.82; P = .007). Patients with cancer admitted for cancer therapy were significantly less likely to receive pharmacologic thromboprophylaxis than those admitted for other reasons (OR, 0.37; 95% CI, 0.22 to 0.61; P < .001). Sixty-three percent of patients with cancer classified as low risk, as determined by the Padua Scoring System, received anticoagulant thromboprophylaxis. Among the 136 patients who did not receive anticoagulation, 58.8% were considered to be high risk by the Padua Scoring System. Conclusion We conclude that pharmacologic thromboprophylaxis is frequently administered to hospitalized patients with cancer but that nearly one third of patients are considered to have relative contraindications for prophylactic anticoagulation. Pharmacologic thromboprophylaxis in

Tattoo Practices in North-East India: A Hospital-based Cross-sectional Study.

Science.gov (United States)

Thakur, Binod Kumar; Verma, Shikha

2016-01-01

Tattooing has become increasingly popular, particularly among young people. However, little is known about the tattoo practices in North-East India. The primary objective of this study was to know the reasons and motivations of tattoo application and tattoo removal in individuals asking for tattoo removal. The secondary objective was to identify the demography, methods and safety of tattoo practices in these tattooed individuals. A hospital-based cross-sectional study was carried out in 212 consecutive individuals seeking tattoo removal. Chi-square and Fisher's exact tests were performed for intergroup comparisons. There were 178 (84%) males and 34 (16%) females. The mean ± standard deviation (SD) age of individuals seeking tattoo removal was 21.8 ± 4 years. The mean ± SD age of doing tattoo was 15.8 ± 3 years. Most individuals possessed an amateur tattoo (94.3%), 4.2% a professional one and 1.4% had a combination. Sewing needle was the most common instrument used for making tattoos in 51.4%. The individuals made their tattoos in an unsterile manner in 49.1%. The most common reason for doing tattoo was for fashion in 87.7%. The participants wanted tattoo removal to qualify for jobs, especially in armed forces in 49.5% and due to regret in 21.7%. Black was the most preferred colour in 37.3% followed by green in 28.3%. The fabric ink was the choice of ink in maximum number of individuals, i.e. 93.9%. It was a hospital-based study done only on individuals seeking tattoo removal. It needs caution to generalise the findings in population. In addition, there may be recall bias in the participants. The tattoo was done mostly below 18 years of age in a crude unsterile way. The individuals had poor risk perceptions about various infections and complications of tattooing. There is an urgent need to caution and educate the youngsters and school-going children about safe tattooing and consequences of tattooing.

Tattoo practices in north-east India: A hospital-based cross-sectional study

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Binod Kumar Thakur

2016-01-01

Full Text Available Background: Tattooing has become increasingly popular, particularly among young people. However, little is known about the tattoo practices in North-East India. Objectives: The primary objective of this study was to know the reasons and motivations of tattoo application and tattoo removal in individuals asking for tattoo removal. The secondary objective was to identify the demography, methods and safety of tattoo practices in these tattooed individuals. Materials and Methods: A hospital-based cross-sectional study was carried out in 212 consecutive individuals seeking tattoo removal. Chi-square and Fisher's exact tests were performed for intergroup comparisons. Results: There were 178 (84% males and 34 (16% females. The mean ± standard deviation (SD age of individuals seeking tattoo removal was 21.8 ± 4 years. The mean ± SD age of doing tattoo was 15.8 ± 3 years. Most individuals possessed an amateur tattoo (94.3%, 4.2% a professional one and 1.4% had a combination. Sewing needle was the most common instrument used for making tattoos in 51.4%. The individuals made their tattoos in an unsterile manner in 49.1%. The most common reason for doing tattoo was for fashion in 87.7%. The participants wanted tattoo removal to qualify for jobs, especially in armed forces in 49.5% and due to regret in 21.7%. Black was the most preferred colour in 37.3% followed by green in 28.3%. The fabric ink was the choice of ink in maximum number of individuals, i.e. 93.9%. Limitations: It was a hospital-based study done only on individuals seeking tattoo removal. It needs caution to generalise the findings in population. In addition, there may be recall bias in the participants. Conclusion: The tattoo was done mostly below 18 years of age in a crude unsterile way. The individuals had poor risk perceptions about various infections and complications of tattooing. There is an urgent need to caution and educate the youngsters and school-going children about safe

Tattoo Practices in North-East India: A Hospital-based Cross-sectional Study

Science.gov (United States)

Thakur, Binod Kumar; Verma, Shikha

2016-01-01

Background: Tattooing has become increasingly popular, particularly among young people. However, little is known about the tattoo practices in North-East India. Objectives: The primary objective of this study was to know the reasons and motivations of tattoo application and tattoo removal in individuals asking for tattoo removal. The secondary objective was to identify the demography, methods and safety of tattoo practices in these tattooed individuals. Materials and Methods: A hospital-based cross-sectional study was carried out in 212 consecutive individuals seeking tattoo removal. Chi-square and Fisher's exact tests were performed for intergroup comparisons. Results: There were 178 (84%) males and 34 (16%) females. The mean ± standard deviation (SD) age of individuals seeking tattoo removal was 21.8 ± 4 years. The mean ± SD age of doing tattoo was 15.8 ± 3 years. Most individuals possessed an amateur tattoo (94.3%), 4.2% a professional one and 1.4% had a combination. Sewing needle was the most common instrument used for making tattoos in 51.4%. The individuals made their tattoos in an unsterile manner in 49.1%. The most common reason for doing tattoo was for fashion in 87.7%. The participants wanted tattoo removal to qualify for jobs, especially in armed forces in 49.5% and due to regret in 21.7%. Black was the most preferred colour in 37.3% followed by green in 28.3%. The fabric ink was the choice of ink in maximum number of individuals, i.e. 93.9%. Limitations: It was a hospital-based study done only on individuals seeking tattoo removal. It needs caution to generalise the findings in population. In addition, there may be recall bias in the participants. Conclusion: The tattoo was done mostly below 18 years of age in a crude unsterile way. The individuals had poor risk perceptions about various infections and complications of tattooing. There is an urgent need to caution and educate the youngsters and school-going children about safe tattooing and

Imperfect implementation of an early warning scoring system in a Danish teaching hospital: a cross-sectional study.

Directory of Open Access Journals (Sweden)

Mark Niegsch

Full Text Available BACKGROUND: In 2007, the initiation of a patient safety campaign led to the introduction of Ward Observational Charts (WOC and Medical Early Warning Score (MEWS at Naestved Regional Hospital. This included systematic measuring of vital signs of all patients in order to prevent patient deterioration and assure timely and correct initiation of treatment. The aim of this study was to assess to what degree WOC guidelines being followed by ward staff. DESIGN AND SETTING: A 7-day prospective, observational, randomised, cross-sectional, point prevalence study of WOC guideline compliance in hospitalised patients on twelve wards at Naestved Hospital. RESULTS: The study included 132 patients. Of these, 58% had been observed and managed correctly according to WOC guidelines. 77% had all MEWS elements recorded by staff. One patient had no MEWS elements recorded. Only 38% of patients with abnormal MEWS were correctly escalated by nursing staff. Staff was aware of the abnormal MEWS observed by investigator in 60% of the patients. Each element of WOC was on average recorded by staff in 90% of the patients. CONCLUSION: At the time of our study, the long-term implementation of WOC guidelines has not been completed satisfactorily. The lacking component in the implementation of MEWS and WOC is the documentation of action taken upon finding an abnormal value. Unsuccessful implementation could result in incorrect results from evaluation of an early warning system. We suggest a redesign of the training programme to educate staff in recognising and caring for critically ill patients at Naestved Hospital.

A cross-sectional study of psychological distress, burnout, and the associated risk factors in hospital pharmacists in Japan

Directory of Open Access Journals (Sweden)

Yuji Higuchi

2016-07-01

Full Text Available Abstract Background Opportunities for face-to-face communication with patients is increasing in modern hospital pharmacist practice. This may impose new burdens on hospital pharmacists. We performed a cross-sectional study to examine the prevalence of psychological distress, burnout, and compassion fatigue among hospital pharmacists. We also investigated possible relevant factors, such as sex, years of experience, hospital size, interpersonal work hours, and personality traits related to communication. Methods We mailed self-administered questionnaires to all pharmacists (n = 823 belonging to the prefectural society of hospital pharmacists in Japan. The questionnaires were the General Health Questionnaire (GHQ-12, Burnout (BO and Compassion Fatigue and Secondary Traumatic Stress (CF/STS subscales of the Professional Quality of Life Scale, the Autism Spectrum Quotient (AQ, and the Adult ADHD (attention deficit hyperactivity disorder Self-Report Scale (ASRS. We examined associations between personality traits (AQ, ASRS and psychological burden (GHQ-12, BO, CF/STS using rank ANCOVA or multivariate logistic regression analyses. Results Complete responses were obtained from 380 pharmacists (46.2 % response rate. A substantial number of participants obtained scores that were higher than the cutoff points of the GHQ-12 (54.7 %, BO (49.2 %, and CF/STS (29.2 %. The GHQ-12 scores were negatively affected by years of experience (p < 0.001, and positively affected by AQ (p < 0.001 and ASRS (p < 0.001 scores. The BO scores was positively affected by AQ (p < 0.001 and ASRS (p = 0.001 scores, while the CF/STS (p = 0.023 score was negatively affected by years of experience, and positively affected by AQ (p < 0.001 and ASRS (p < 0.001 scores. Conclusions There is a high prevalence of psychological distress and work-related burnout/CF among hospital pharmacists. Additionally, two common personality traits, such as autistic-like traits and ADHD-like symptoms

ELEMENTAL FORMS OF HOSPITALITY

Directory of Open Access Journals (Sweden)

Maximiliano Emanuel Korstanje

2010-11-01

Full Text Available Modern studies emphasized on the needs of researching the hospitality as relevant aspects of tourism and hospitality fields. Anyway, these approaches are inextricably intertwined to the industry of tourism and do not take seriously the anthropological and sociological roots of hospitality. In fact, the hotel seems to be a partial sphere of hospitality at all. Under this context, the present paper explores the issue of hospitality enrooted in the political and economic indo-European principle of free-transit which is associated to a much broader origin.  Starting from the premise etymologically hostel and hospital share similar origins, we follow the contributions of J Derrida to determine the elements that formed the hospitality up to date.

Do hospital shift charge nurses from different cultures experience similar stress? An international cross sectional study.

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Admi, Hanna; Eilon-Moshe, Yael

2016-11-01

There is a need to improve understanding of role stress and how it affects nurses' wellbeing, burnout and health; and hence the quality and safety of patients' care, organizational outcomes and costs. The focus is on shift charge nurses in hospitals who are accountable during a specific shift for the patients' care and staff functioning in accordance with hospital and unit policy. To compare perceptions of stress and its intensity among hospital shift charge nurses amongst three countries: Israel, USA (state of Ohio) and Thailand. A cross-sectional study was performed across three countries, focusing on a convenience sample of 2616 hospital shift charge nurses recruited from 23 general hospitals. A validated shift Charge Nurse Stress Questionnaire was used to assess impacts of four factors: patient & family complaints, lack of resources, responsibility burden and professional conflict. Descriptive statistics were used to describe demographic and professional characteristics of the participants. Chi square and the Fisher Exact Test were performed to test for demographic differences amongst the three samples. Parametric and non-parametric tests were used to compare mean stress levels amongst the study samples. The mean stress level for the total sample was 2.84 (±0.71) on a Likert scale of 1-5, implying moderate stress levels. Significant differences in stress levels were found among countries, with Thai nurses scoring the highest and Israeli nurses the lowest. Similar perceptions of stress intensity were found for all countries, with the factors "responsibility burden" and "lack of resources" considered the most stressful. Israeli and American nurses perceived similar situations as stressful and different from those perceived by Thai nurses. The findings can be partially explained by demographic, professional and cultural differences. Similarities along with differences were found in the nature and levels of stress experienced across the studied countries. A

Correlation between Macular Thickness and Visual Field in Early Open Angle Glaucoma: A Cross-Sectional Study.

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Fallahi Motlagh, Behzad; Sadeghi, Ali

2017-01-01

The aim of this study was to correlate macular thickness and visual field parameters in early glaucoma. A total of 104 eyes affected with early glaucoma were examined in a cross-sectional, prospective study. Visual field testing using both standard automated perimetry (SAP) and shortwave automated perimetry (SWAP) was performed. Global visual field parameters, including mean deviation (MD) and pattern standard deviation (PSD), were recorded and correlated with spectral domain optical coherence tomography (SD-OCT)-measured macular thickness and asymmetry. Average macular thickness correlated significantly with all measures of visual field including MD-SWAP (r = 0.42), MD-SAP (r = 0.41), PSD-SWAP (r = -0.23), and PSD-SAP (r = -0.21), with P-values field parameters in early glaucoma. The results of this study should make macular thickness measurements even more meaningful to glaucoma specialists.

Antiproton cross-field diffusion in antihydrogen production experiments due to anisotropic binary interactions

International Nuclear Information System (INIS)

Ordonez, C.A.; Correa, J.R.

2007-01-01

Collisional processes in electrostatic ion storage rings and reflecting-beam-type electrostatic ion traps can be associated with anisotropic binary interactions, because shielding of the Coulomb interactions may not take place in one or more dimensions. Collisional scattering theory has recently been developed for describing the velocity-space scattering processes in such systems [J.R. Correa, Y. Chang, C.A. Ordonez, Phys. Plasmas 12 (2005) 084505]. The theory is extended to enable the effect of a magnetic field to be included. The theory is intended to be applicable, for example, to antiproton scattering within nested Penning traps that are used to produce antihydrogen [M. Amoretti et al., Nature 419 (2002) 456; G. Gabrielse et al., Phys. Rev. Lett. 89 (2002) 213401]. The theory is applied for considering the cross-magnetic-field diffusion of the antiprotons

Determining the Status Quo of Infection Prevention and Control Standards in the Hospitals of Iran: A Case Study in 23 Hospitals

OpenAIRE

Shojaee, Jalil; Moosazadeh, Mahmood

2014-01-01

Background: Applying Prevention and Control of Infection (PCI) standards in hospitals reduces probable risks to patients, staff and visitors; it also increases efficiency, and ultimately improves productivity of hospitals. Objective: The current study aimed to determine the status quo of international standards of PCI in hospitals located in the north of Iran. Materials and Methods: This cross-sectional study was conducted in 23 hospitals. Data collection tool was a questionnaire with confirm...

Modeling cross-field drifts and current with the B2 code for the CIT divertor

International Nuclear Information System (INIS)

Rognlien, T.D.; Milovich, J.L.; Rensink, M.E.

1990-01-01

We have modified the B2 edge-plasma code to include the effects of classical fluid drifts across the magnetic field lines and plasma currents. This report presents preliminary results of these effects for the CIT parameter regime. The basic plasma model described by Braams involves solving the continuity equation, the parallel momentum balance equation, and separate energy balance equations for the ions and the electrons. If multiple ion species are present, they are all assumed to have a common temperature, but their densities and parallel velocities are solved for using additional continuity and parallel momentum balance equations for each species. Momentum and heat transport parallel to the magnetic field, B, are given by the classical collisional theory. On the other hand, transport perpendicular to B is represented by anomalous diffusion coefficients which are adjusted to agree with experimental measurements. These transport coefficients are generally taken to be constant in radius and poloidal angle, although this is not necessary. The goal of our work has been to include both the classical cross-field drift terms and the effects of parallel currents in the equations used in the B2 code. The motivation for including the cross-field terms comes from simple model calculations which indicate that the classical flows can contribute an important asymmetry which may help explain the transition from L-mode to H-mode confinement. Radial electric fields which arise near the separatrix cause E x B poloidal rotation which may also be related to the L-to-H mode transition through its effect on edge turbulence. Including the parallel currents is done to provide a tool for understanding the biased divertor experiments on DIII-D at General Atomics. Such biasing may provide an effective means of controlling the asymmetry of the power flow to different divertor plates

Hospital 360°.

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Giraldo Valencia, Juan Carlos; Delgado, Liliana Claudia

2015-01-01

There are forces that are greater than the individual performance of each hospital institution and of the health system structural of each country. The world is changing and to face up to the future in the best possible way, we need to understand how contexts and emerging trends link up and how they affect the hospital sector. The Columbian Association of Hospitals and Clinics, ACHC, has thus come up with the Hospital 360° concept which uses hospitals capable of anticipating changing contexts by means of the transition between present and future and takes on board the experience of global, socio-economic, demographic, political, environmental and technological fields as its model. Hospital 360° is an invitation to reinvent processes and institution themselves allowing them to adapt and incorporate a high degree of functional flexibility. Hospital 360° purses goals of efficiency, effectiveness and relevance, but also of impact and sustainability, and is coherent with the internal needs of hospital institutions and society for long-term benefits.

The wake field acceleration using a cavity of elliptical cross section, part 1: WELL

International Nuclear Information System (INIS)

Chin, Yongho.

1983-11-01

A computer code WELL is developed for the calculation of the wake fields in a cavity of elliptical cross section. The method is basically an extention of that of BCI to the 3-dimensional computation, i.e., Maxwell's equations are solved in the time domain with boundary conditions. Open boundary conditions are used so as to simulate infinitely long beam pipes. Good agreements within a few percents are shown between the results of the computation by WELL and BCI in a cylindrically symmetrical structure. An example of computation in an elliptical structure gives a reasonable result and points out that the deflection of particles by the transverse wake field is severe. (author)

Unemployment and Causes of Hospital Admission Considering Different Analytical Approaches

DEFF Research Database (Denmark)

Berg-Beckhoff, Gabriele; Gulis, Gabriel; Kronborg Bak, Carsten

2016-01-01

and circulatory disease. Register-based data was analysed for the period of 2006 to 2009. In the cross-sectional analysis, a multiple logistic regression model was conducted based on the year 2006 and cohort information from the same year onward up to 2009 was available for a cox regression model. Social welfare...... compensated unemployment and both types of disease specific hospital admission was associated statistically significant in the cross-sectional analysis. With regard to circulatory disease, the cohort approach suggests that social welfare compensated unemployment might lead to hospital admission due...... to the disease. Given the significant results in the cross-sectional analysis for hospital admission due to cancer, the unfound cohort effect might indicate a reverse causation suggesting that the disease caused joblessness and finally, social welfare compensated unemployment and not vice versa. Comparing...

Giving Medicine Through Intravenous Towards Incident of Phlebitis to Hospitalized Patient in Hospital

OpenAIRE

Iradiyanti, Winda Pratama; Kurnia, Erlin

2013-01-01

Phlebitis incident is a reflection of the character of health care. The sign of phlebitis include an increase of skin temperature on the veins, pain, and some cases of redness in the site of insertion or along the vein line. The purpose of this research to study the phlebitis caused. The design used was cross sectional. Population of this research was all patients hospitalized at inpatient ward Kediri Baptist Hospital and all the nurses who provided medication through an intravenous tube a...

Cross-cultural comparison of workplace stressors, ways of coping and demographic characteristics as predictors of physical and mental health among hospital nurses in Japan, Thailand, South Korea and the USA (Hawaii).

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Lambert, Vickie A; Lambert, Clinton E; Itano, Joanne; Inouye, Jillian; Kim, Susie; Kuniviktikul, Wipada; Sitthimongkol, Yajai; Pongthavornkamol, Kanuangnit; Gasemgitvattana, Saipin; Ito, Misae

2004-08-01

In an attempt to cross-culturally compare factors that may contribute to the nursing shortage within countries that have produced a limited number of research findings on role stress in nurses, this research examined work stressors, ways of coping and demographic characteristics as predictors of physical and mental health among hospital nurses from Japan, South Korea, Thailand and the USA (Hawaii). Subjects (n = 1554 hospital-based nurses) were administered four self-report questionnaires: Demographic Questionnaire, "Nursing Stress Scale", "Ways of Coping Questionnaire" and "SF-36 Health Survey". Findings suggested that nurses indicated similar workplace stressors, ways of coping, and levels of physical and mental health. While subjects, across countries, demonstrated a variety of predictors of physical and mental health, several predictors were found to be the same. Cross-culturally the role of nurses may vary; however, certain factors are predictive of the status of hospital nurses' physical health and mental health. Copyright 2004 Elsevier Ltd.

A Cross-sectional Study on Evidence-Based Nursing Practice in the Contemporary Hospital Setting: Implications for Nurses in Professional Development.

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Rose Bovino, Leonie; Aquila, Anne M; Bartos, Susan; McCurry, Tina; Cunningham, C Elizabeth; Lane, Todd; Rogucki, Nicole; DosSantos, Jamie; Moody, Danielle; Mealia-Ospina, Karen; Pust-Marcone, Jancee; Quiles, Jonathan

Evidence indicates that nurses inconsistently engage in evidence-based practice (EBP). This cross-sectional study of 402 nurses at a medical-surgical hospital identifies strategies for augmenting EBP. Nurses' EBP beliefs scores were higher than their EBP implementation scores. Those with baccalaureate/postgraduate degrees had higher EBP beliefs and implementation scores than those with associate degrees or diplomas. Bedside or direct care nurses were less likely to have baccalaureate/higher degrees and had lower EBP beliefs and implementation scores than did those nurses not serving in direct care roles.

Mobile Display of Information about Aggregated Antibiotic Resistance in the Hospital Setting Supported by Near Field Communication.

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Meng, Philipp; Fehre, Karsten; Rappelsberger, Andrea; Adlassnig, Klaus-Peter

2014-01-01

Antibiotic resistance is a heterogeneous phenomenon. It does not only differ between countries or states, but also between wards of hospitals, where different resistance patterns have been found. To support clinicians in administering empiric antibiotic therapy, we developed software to present information about antibiotic resistance using a mobile concept. A pre-existing infrastructure was deployed as the server component. The systems analyze and aggregate data from laboratory information systems, generating statistical data on antibiotic resistance. The information is presented to the Android client using a Representational State Transfer (REST) interface. Geographical localization is performed using near field communication (NFC) tags. The prototype provides tabulated data concerning antibiotic resistance patterns in the wards of a hospital. Using Android, NFC, and data caching, the usability of the system is estimated to be high. We hypothesize that antibiotic stewardship in hospitals can be supported by this software, thus improving medical monitoring of antibiotic resistance. Future studies in a productive environment are needed to measure the impact of the system on the outcome of patient care.

Pair production in the gravitational field of a cosmic string

Science.gov (United States)

Harari, Diego D.; Skarzhinsky, Vladimir D.

1990-04-01

We show that many elementary particle physics processes, such as pair production by a high energy photon, that take place in Minkowski space only if a non-uniform external field provides for momentum non-conservation, do occur in the space-time around a straight cosmic string, even though the space is locally flat and there is no local gravitational potential. We exemplify this mechanism through the evaluation of the cross section per unit length of string for the decay of a massless scalar particle into a pair of massive particles. The cross sections for this kind of processes are typically small. Nevertheless, it is interesting to realize how these reactions occur due to topological properties of space, rather than to the action of a local field. V.S. is grateful to Mario Castagnino for hospitality at the Instituto de Astronomía y Física del Espacio during a visit while this work was done.

Problems in cross-cultural use of the hospital anxiety and depression scale: "no butterflies in the desert".

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Maters, Gemma A; Sanderman, Robbert; Kim, Aimee Y; Coyne, James C

2013-01-01

The Hospital Anxiety and Depression Scale (HADS) is widely used to screen for anxiety and depression. A large literature is citable in support of its validity, but difficulties are increasingly being identified, such as inexplicably discrepant optimal cutpoints and inconsistent factor-structures. This article examines whether these problems could be due to the construction of the HADS that poses difficulties for translation and cross-cultural use. Authors' awareness of difficulties translating the HADS were identified by examining 20% of studies using the HADS, obtained by a systematic literature search in Pubmed and PsycINFO in May 2012. Reports of use of translations and validation studies were recorded for papers from non-English speaking countries. Narrative and systematic reviews were examined for how authors dealt with different translations. Of 417 papers from non-English speaking countries, only 45% indicated whether a translation was used. Studies validating translations were cited in 54%. Seventeen reviews, incorporating data from diverse translated versions, were examined. Only seven mentioned issues of language and culture, and none indicated insurmountable problems in integrating results from different translations. Initial decisions concerning item content and response options likely leave the HADS difficult to translate, but we failed to find an acknowledgment of problems in articles involving its translation and cross-cultural use. Investigators' lack of awareness of these issues can lead to anomalous results and difficulties in interpretation and integration of these results. Reviews tend to overlook these issues and most reviews indiscriminately integrate results from studies performed in different countries. Cross-culturally valid, but literally translated versions of the HADS may not be attainable, and specific cutpoints may not be valid across cultures and language. Claims about rates of anxiety and depression based on integrating cross

ELECTRON TEMPERATURE FLUCTUATIONS AND CROSS-FIELD HEAT TRANSPORT IN THE EDGE OF DIII-D

International Nuclear Information System (INIS)

RUDAKOV, DL; BOEDO, JA; MOYER, RA; KRASENINNIKOV, S; MAHDAVI, MA; McKEE, GR; PORTER, GD; STANGEBY, PC; WATKINS, JG; WEST, WP; WHYTE, DG.

2003-01-01

OAK-B135 The fluctuating E x B velocity due to electrostatic turbulence is widely accepted as a major contributor to the anomalous cross-field transport of particles and heat in the tokamak edge and scrape-off layer (SOL) plasmas. This has been confirmed by direct measurements of the turbulent E x B transport in a number of experiments. Correlated fluctuations of the plasma radial velocity v r , density n, and temperature T e result in time-average fluxes of particles and heat given by (for electrons): Equation 1--Λ r ES = r > = 1/B varφ θ ; Equation 2--Q r ES = e (tilde v) r > ∼ 3/2 kT e Λ r ES + 3 n e /2 B varφ e (tilde E) θ > Q conv + Q cond . The first term in Equation 2 is referred to as convective and the second term as conductive heat flux. Experimental determination of fluxes given by Equations 1 and 2 requires simultaneous measurements of the density, temperature and poloidal electric field fluctuations with high spatial and temporal resolution. Langmuir probes provide most readily available (if not the only) tool for such measurements. However, fast measurements of electron temperature using probes are non-trivial and are not always performed. Thus, the contribution of the T e fluctuations to the turbulent fluxes is usually neglected. Here they report results of the studies of T e fluctuations and their effect on the cross-field transport in the SOL of DIII-D

Relationships between coping strategies, individual characteristics and job satisfaction in a sample of hospital nurses: cross-sectional questionnaire survey.

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Golbasi, Zehra; Kelleci, Meral; Dogan, Selma

2008-12-01

This study aims to describe and compare the job satisfaction, coping strategies, personal and organizational characteristics among nurses working in a hospital in Turkey. In this cross-sectional survey design study, 186 nurses from Cumhuriyet University Hospital completed Personal Data Form, Minnesota Satisfaction Questionnaire and Ways of Coping Inventory. Response rate was 74.4%. In this study, it was found that job satisfaction score of nurses showed moderate (mean: 3.46+/-0.56) was found. While nurses mostly used to employ self-confident and optimistic approaches that had already being considered as positive coping strategies with stress, yielding and helpless approaches were employed less than that. While a statistically significant positive relation (pjob satisfaction and dimensions of Ways of Coping Inventory "self-confident approach" and "optimistic approach", negative relation (pjob satisfaction and dimensions of the "helpless approach". Organizational and individual nurse characteristics were not found to be associated with job satisfaction. But, job satisfaction of the nurses who is bounded by a contract was found higher than that of permanent staff nurses (pjob satisfaction of Turkish hospital nurses was at a moderate and that of the nurses who succeeded to coping with the stress was heightened. Higher levels of job satisfaction were associated with positive coping strategies. This study contributes to a growing body of evidence demonstrating the importance of coping strategies to nurses' job satisfaction.

Research on Radar Cross Section Measurement Based on Near-field Imaging of Cylindrical Scanning

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Xing Shu-guang

2015-04-01

Full Text Available A new method of Radar Cross Section (RCS measurement based on near-field imaging of cylindrical scanning surface is proposed. The method is based on the core assumption that the target consists of ideal isotropic scattered centers. Three-dimensional radar scattered images are obtained by using the proposed method, and then to obtain the RCS of the target, the scattered far field is calculated by summing the fields generated by the equivalent scattered centers. Not only three dimensional radar reflectivity images but also the RCS of targets in certain three dimensional angle areas can be obtained. Compared with circular scanning that can only obtain twodimensional radar reflectivity images and RCS results in two-dimensional angle areas, cylindrical scanning can provide more information about the scattering properties of the targets. The method has strong practicability and its validity is verified by simulations.

Determinants of job satisfaction of healthcare professionals in public hospitals in Belgrade, Serbia--Cross-sectional analysis.

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Kuburović, Nina B; Dedić, Velimir; Djuricić, Slavisa; Kuburović, Vladimir

2016-01-01

The quality of health care significantly depends on the satisfaction of the employees. The objective of this study was to establish the level of professional satisfaction of healthcare professionals in state hospitals in Belgrade, Serbia, and to determine and to rank the factors which impact on their satisfaction or dissatisfaction. Professional satisfaction survey was designed and conducted as a cross-sectional study in 2008. Completed questionnaires were returned by 6,595 healthcare professionals from Belgrade's hospitals. Statistical analysis was performed using the Student's t-test, χ² test and ANOVA. Factor analysis was applied in order to define determinants of professional satisfaction, i.e. dissatisfaction. This study showed that the degree of professional satisfaction of Serbian healthcare professionals was low. The main causes of professionals'dissatisfaction were wages, equipment, the possibility of continuous medical education/training and the opportunities for professional development. Healthcare professionals with university education were more satisfied with all the individual aspects of job satisfaction than those with secondary school and college education. There were significantly more healthcare professionals satisfied with their job among males, older than 60 years, in the age group 50-59 years, with managerial function, and with 30 or more years of service. Development strategy of human resources in the Serbian health care system would significantly improve the professional satisfaction and quality of the provided health care.

Organizational culture in cardiovascular care in Chinese hospitals: a descriptive cross-sectional study.

Science.gov (United States)

Yin, Emily S; Downing, Nicholas S; Li, Xi; Singer, Sara J; Curry, Leslie A; Li, Jing; Krumholz, Harlan M; Jiang, Lixin

2015-12-21

Organizational learning, the process by which a group changes its behavior in response to newly acquired knowledge, is critical to outstanding organizational performance. In hospitals, strong organizational learning culture is linked with improved health outcomes for patients. This study characterizes the organizational learning culture of hospitals in China from the perspective of a cardiology service. Using a modified Abbreviated Learning Organization Survey (27 questions), we characterized organizational learning culture in a nationally representative sample of 162 Chinese hospitals, selecting 2 individuals involved with cardiovascular care at each hospital. Responses were analyzed at the hospital level by calculating the average of the two responses to each question. Responses were categorized as positive if they were 5+ on a 7-point scale or 4+ on a 5-point scale. Univariate and multiple regression analyses were used to assess the relationship between selected hospital characteristics and perceptions of organizational learning culture. Of the 324 participants invited to take the survey, 316 responded (98 % response rate). Perceptions of organizational learning culture varied among items, among domains, and both among and within hospitals. Overall, the median proportion of positive responses was 82 % (interquartile range = 59 % to 93 %). "Training," "Performance Monitoring," and "Leadership that Reinforces Learning" were characterized as the most favorable domains, while "Time for Reflection" was the least favorable. Multiple regression analyses showed that region was the only factor significantly correlated with overall positive response rate. This nationally representative survey demonstrated variation in hospital organizational learning culture among hospitals in China. The variation was not substantially explained by hospital characteristics. Organizational learning culture domains with lower positive response rates reveal important areas for

Effect of Secondary Electron Emission on Electron Cross-Field Current in E×B Discharges

Energy Technology Data Exchange (ETDEWEB)

Yevgeny Raitses, Igor D. Kaganovich, Alexander Khrabrov, Dmytro Sydorenko, Nathaniel J. Fisch and Andrei Smolyakov

2011-02-10

This paper reviews and discusses recent experimental, theoretical, and numerical studies of plasma-wall interaction in a weakly collisional magnetized plasma bounded with channel walls made from different materials. A lowpressure ExB plasma discharge of the Hall thruster was used to characterize the electron current across the magnetic field and its dependence on the applied voltage and electron-induced secondary electron emission (SEE) from the channel wall. The presence of a depleted, anisotropic electron energy distribution function with beams of secondary electrons was predicted to explain the enhancement of the electron cross-field current observed in experiments. Without the SEE, the electron crossfield transport can be reduced from anomalously high to nearly classical collisional level. The suppression of SEE was achieved using an engineered carbon velvet material for the channel walls. Both theoretically and experimentally, it is shown that the electron emission from the walls can limit the maximum achievable electric field in the magnetized plasma. With nonemitting walls, the maximum electric field in the thruster can approach a fundamental limit for a quasineutral plasma.

The Influence of Nurses' Demographics on Patient Participation in Hospitals: A Cross-Sectional Study.

Science.gov (United States)

Malfait, Simon; Eeckloo, Kristof; Van Hecke, Ann

2017-12-01

Patient participation is an important issue in contemporary healthcare as it improves quality of care and enhances positive health outcomes. The participation of patients is mainly initiated by the nurses' willingness to share their power and responsibility, but knowledge on nurses' demographic characteristics influencing this behavior is nonexistent. This knowledge is essential to understand and improve patient participation. To determine if nurses' demographic characteristics influence their willingness to engage in patient participation. A cross-sectional multicenter study in 22 general and three university hospitals with 997 nurses was performed. The Patient Participation Culture Tool for healthcare workers, which measures patient participation behavior, was used. Multilevel analysis, taking into account the difference in wards and hospitals, was used to identify the influence of demographic characteristics. A position as supervisor (range: p nurses seem to be more reluctant in accepting a collaborative patient role (p = .002) and coping with more active patient behavior (p nurses on geriatric wards (p = .013), who also showed less sharing of information with their patients (p nurses' willingness to share power and responsibility with their patients, perhaps indicating that patient participation behavior is an advanced nursing skill and multifaceted interventions, are needed for optimal implementation. Moreover, supervising nurses have different perceptions on patient participation and possibly regard patient participation as an easier task than their team members. This could lead to misunderstandings about the expectations toward patient participation in daily practice, leading to struggles with their nursing staff. Both findings implicate that implementing patient participation on a wide scale is more difficult than expected, which is conflicting with the widespread societal demand for more participation. © 2017 Sigma Theta Tau International.

Factors associated with job satisfaction among district hospital health workers in Northern Vietnam: a cross-sectional study.

Science.gov (United States)

Nguyen, Huy Van; Duong, Huong Thao; Vu, Toan Thinh

2017-04-01

In many developing countries, including Vietnam, little is known about job satisfaction among lower level-health staff. The purpose of this study was to assess job satisfaction and its determinants among district hospital health staff. In a cross-sectional quantitative study, 128 health staff from a rural district hospital in Northern Vietnam were approached for data collection. Regression techniques were adopted to assess factors associated with several types of job satisfaction. Overall job satisfaction was moderately high, ranging from 69% to 91%. Across all dimensions, health workers showed their highest satisfaction with co-worker relationships, while, in comparison, it was much lower for their supervisor's style and relationship. However, they claimed their lowest satisfaction with compensation and benefits. In final multivariate models, females and those satisfied with knowledge, skills and job performance were most likely to be satisfied with relationships with co-workers. Staff who were married, received a low pay, who were not satisfied with supervisor style and relationships and who were not satisfied with staff training, development opportunities were least likely to be satisfied with compensation and benefits. The study findings highlight an important need for designing an intervention program that considers organizational factors. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Management of necrotizing myositis in a field hospital: a case report

Directory of Open Access Journals (Sweden)

Bharathi Ramanathan

2009-04-01

Full Text Available Abstract Necrotizing myositis is a rare and fatal disease of skeletal muscles caused by group A beta hemolytic streptococci (GABHS. Its early detection by advanced imaging forms the basis of current management strategy. Paucity of advanced imaging in field/rural hospitals necessitates adoption of management strategy excluding imaging as its basis. Such a protocol, based on our experience and literature, constitutes: i. Prompt recognition of the clinical triad: disproportionate pain; precipitous course; and early loss of power- in a swollen limb with/without preceding trauma. ii. Support of clinical suspicion by 2 ubiquitous laboratory tests: gram staining- of exudates from bullae/muscles to indicate GABHS infection; and CPK estimation- to indicate myonecrosis. iii. Replacement of empirical antibiotics with high intravenous doses of sodium penicillin and clindamycin iv. Exploratory fasciotomy: to confirm myonecrosis without suppuration- its hallmark v. Emergent radical debridement vi. Primary closure with viable flaps – unconventional, if need be.

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.

Temperature fields induced by direct contact condensation of steam in a cross-flow in a channel

NARCIS (Netherlands)

Clerx, N.; van Deurzen, L.G.M.; Pecenko, A.; Liew, R.; van der Geld, C.W.M.; Kuerten, Johannes G.M.

2011-01-01

The temperature fields in the center plane of a channel with a square cross-section have been measured. Steam injected at relatively low mass fluxes through a small hole in one of the walls of the channel condensed intermittently in a small area close to the inlet. The upstream temperature of the

Using the Hospital Nutrition Environment Scan to Evaluate Health Initiative in Hospital Cafeterias.

Science.gov (United States)

Derrick, Jennifer Willahan; Bellini, Sarah Gunnell; Spelman, Julie

2015-11-01

Health-promoting environments advance health and prevent chronic disease. Hospitals have been charged to promote health and wellness to patients, communities, and 5.3 million adults employed in United States health care environments. In this cross-sectional observational study, the Hospital Nutrition Environment Scan (HNES) was used to measure the nutrition environment of hospital cafeterias and evaluate the influence of the LiVe Well Plate health initiative. Twenty-one hospitals in the Intermountain West region were surveyed between October 2013 and May 2014. Six hospitals participated in the LiVe Well Plate health initiative and were compared with 15 hospitals not participating. The LiVe Well Plate health initiative identified and promoted a healthy meal defined as health initiative branding were also posted at point of purchase. Hospital cafeterias were scored on four subcategories: facilitators and barriers, grab-and-go items, menu offerings, and selection options at point of purchase. Overall, hospitals scored 35.3±13.7 (range=7 to 63) points of 86 total possible points. Cafeterias in health initiative hospitals had significantly higher mean nutrition composite scores compared with non-health initiative hospitals (49.2 vs 29.7; Penvironment of hospital cafeterias. Additional research is needed to quantify and strategize ways to improve nutrition environments within hospital cafeterias and assess the influence on healthy lifestyle behaviors. Copyright © 2015 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

Medication details documented on hospital discharge: cross-sectional observational study of factors associated with medication non-reconciliation.

LENUS (Irish Health Repository)

Grimes, Tamasine C

2012-02-01

AIMS: Movement into or out of hospital is a vulnerable period for medication safety. Reconciling the medication a patient is using before admission with the medication prescribed on discharge, and documenting any changes (medication reconciliation) is recommended to improve safety. The aims of the study were to investigate the factors contributing to medication reconciliation on discharge, and identify the prevalence of non-reconciliation. METHODS: The study was a cross-sectional, observational survey using consecutive discharges from purposively selected services in two acute public hospitals in Ireland. Medication reconciliation, potential for harm and unplanned re-admission were investigated. RESULTS: Medication non-reconciliation was identified in 50% of 1245 inpatient episodes, involving 16% of 9569 medications. The majority of non-reconciled episodes had potential to result in moderate (63%) or severe (2%) harm. Handwritten rather than computerized discharges (adjusted odds ratio (adjusted OR) 1.60, 95% CI 1.11, 2.99), increasing number of medications (adjusted OR 1.26, 95% CI 1.21, 1.31) or chronic illness (adjusted OR 2.08, 95% CI 1.33, 3.24) were associated with non-reconciliation. Omission of endocrine, central nervous system and nutrition and blood drugs was more likely on discharge, whilst omission on admission and throughout inpatient care, without documentation, was more likely for obstetric, gynaecology and urinary tract (OGU) or respiratory drugs. Documentation in the discharge communication that medication was intentionally stopped during inpatient care was less likely for cardiovascular, musculoskeletal and OGU drugs. Errors involving the dose were most likely for respiratory drugs. CONCLUSIONS: The findings inform strategies to facilitate medication reconciliation on discharge from acute hospital care.

New perspectives on the dynamics of AC and DC plasma arcs exposed to cross-fields

International Nuclear Information System (INIS)

Abdo, Youssef; Rohani, Vandad; Cauneau, François; Fulcheri, Laurent

2017-01-01

Interactions between an arc and external fields are crucially important for the design and the optimization of modern plasma torches. Multiple studies have been conducted to help better understand the behavior of DC and AC current arcs exposed to external and ‘ self-induced ’ magnetic fields, but the theoretical foundations remain very poorly explored. An analytical investigation has therefore been carried out in order to study the general behavior of DC and AC arcs under the effect of random cross-fields. A simple differential equation describing the general behavior of a planar DC or AC arc has been obtained. Several dimensionless numbers that depend primarily on arc and field parameters and the main arc characteristics (temperature, electric field strength) have also been determined. Their magnitude indicates the general tendency pattern of the arc evolution. The analytical results for many case studies have been validated using an MHD numerical model. The main purpose of this investigation was deriving a practical analytical model for the electric arc, rendering possible its stabilization and control, and the enhancement of the plasma torch power. (paper)

New perspectives on the dynamics of AC and DC plasma arcs exposed to cross-fields

Science.gov (United States)

Abdo, Youssef; Rohani, Vandad; Cauneau, François; Fulcheri, Laurent

2017-02-01

Interactions between an arc and external fields are crucially important for the design and the optimization of modern plasma torches. Multiple studies have been conducted to help better understand the behavior of DC and AC current arcs exposed to external and ‘self-induced’ magnetic fields, but the theoretical foundations remain very poorly explored. An analytical investigation has therefore been carried out in order to study the general behavior of DC and AC arcs under the effect of random cross-fields. A simple differential equation describing the general behavior of a planar DC or AC arc has been obtained. Several dimensionless numbers that depend primarily on arc and field parameters and the main arc characteristics (temperature, electric field strength) have also been determined. Their magnitude indicates the general tendency pattern of the arc evolution. The analytical results for many case studies have been validated using an MHD numerical model. The main purpose of this investigation was deriving a practical analytical model for the electric arc, rendering possible its stabilization and control, and the enhancement of the plasma torch power.

Hip osteoarthritis in Douala General Hospital: Clinical, radiological ...

African Journals Online (AJOL)

Objectives: To describe the epidemiological, clinical and radiological profile of hip OA, and also treatment options offered to patients presenting with this condition at the Douala General Hospital, Cameroon. Methods: After prior ethical clearance, a hospital-based cross sectional descriptive study was carried out, including ...

Four decades of conjoined twins at Red Cross Children's Hospital ...

African Journals Online (AJOL)

anatomy and discordant anomalies, especially in the right- ... and functional description of normal and fused anatomy. ... Over a period of 42 years (1964- 2006), Red Cross Children's .... transfused ranged from 10% to 450% of the estimated blood ... Owing to cross-circulation, pharmacokinetics ... size of the right ventricle.

Role of centrifugal and charge effects of the mass separation in a plasma centrifuge with crossed fields

International Nuclear Information System (INIS)

Zhdanov, V.M.; Karchevskii, A.I.; Lukovnikov, A.I.; Potanin, E.P.

1982-01-01

The coefficients of mass separation have been calculated for gas mixtures in crossed electric and magnetic fields. The initial kinetic equations have been derived, and the contribution of centrifugal and charge separation mechanisms to mass separation in a weakly ionized plasma has been assessed

Occupational exposure to second hand smoke and respiratory and sensory symptoms: A cross-sectional survey of hospital workers in Egypt

Directory of Open Access Journals (Sweden)

Ghada Radwan

2014-02-01

Full Text Available Objective: Exposure to Second Hand Smoke (SHS has been associated with an increased risk of respiratory symptoms, upper and lower respiratory tract diseases and an increased risk of asthma and chronic obstructive pulmonary disease. The majority of cases of mortality and morbidity is attributable to exposure of adults to SHS and is related to cardiovascular diseases and lung cancer. In Egypt, comprehensive smoke-free laws exist, however, in many workplaces they are poorly enforced consequently exposing workers to the detrimental health hazards of SHS. We aimed at determination of workplace exposure to Second Hand Smoke (SHS and its association with respiratory and sensory irritation symptoms in hospital workers in Port-said governorate in Egypt. Material and methods: A cross-sectional face to face survey was conducted by the use of a standardised questionnaire among 415 adult hospital workers; representing 50% of all employees (81% response rate; recruited from 4 randomly selected general hospitals in Port-said governorate in Egypt. Results: All hospitals employees reported exposure to SHS - on average 1.5 (SD = 2.5 hours of exposure per day. After controlling for potential confounders, exposure to SHS at work was significantly associated with an increased risk of wheezes (OR = 1.14, p < 0.01, shortness of breath (OR = 1.17, p < 0.01, phlegm (OR = 1.23, p < 0.01, running and irritated nose (OR = 1.14, p < 0.01 as well as a sore, scratchy throat (OR = 1.23. Conclusions: These findings point out that workplace exposure to SHS is evident in hospitals in Port-said governorate and that workers are adversely affected by exposure to it at work. This underlines the importance of rigorous enforcement of smoke-free policies to protect the workers' health in Egypt.

Developing cross-sectoral quality assurance for cataract surgery in the statutory quality assurance program of the German health care system: Experiences and lessons learned.

Science.gov (United States)

Bramesfeld, Anke; Pauletzki, Jürgen; Behrenz, Lars; Szecsenyi, Joachim; Willms, Gerald; Broge, Björn

2015-08-01

Since 2001, statutory external quality assurance (QA) for hospital care has been in place in the German health system. In 2009, the decision was taken to expand it to cross-sectoral procedures. This novel and unprecedented form of national QA aims at (1) making the quality procedures comparable that are provided both in inpatient and outpatient care, (2) following-up outcomes of hospital care after patients' discharge and (3) measuring the quality of complex treatment chains across interfaces. As a pioneer procedure a QA procedure in cataract surgery QA was developed. Using this as an example, challenges of cross-sectoral QA are highlighted. These challenges relate, in particular, to three technical problems: triggering cases for documentation, following-up patients' after hospital discharge, and the burden of documentation in outpatient care. These problems resulted finally in the haltering of the development of the QA procedure. However, the experiences gained with this first development of cross-sectoral QA inspired the reorientation and further development of the field in Germany. Future cross-sectoral QA will rigorously aim at keeping burden of documentation small. It will draw data for QA mainly at three sources: routine data, patient surveys and peer reviews using indicators. Policy implications of this reorientation are discussed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Quasi-TEM electromagnetic modes of a plasma waveguide with a nonsimply connected cross section in an external magnetic field

International Nuclear Information System (INIS)

Kartashov, I. N.; Kuzelev, M. V.

2014-01-01

Electromagnetic modes of a plasma waveguide with a nonsimply connected cross section in an external magnetic field are investigated. The existence of quasi-TEM modes in a finite-strength magnetic field is demonstrated. It is shown that, in the limits of infinitely strong and zero magnetic fields, this mode transforms into a true TEM mode. The possibility of excitation of such modes by an electron beam in the regime of the anomalous Doppler effect is analyzed

Thermal comfort study of hospital workers in Malaysia.

Science.gov (United States)

Yau, Y H; Chew, B T

2009-12-01

This article presents findings of the thermal comfort study in hospitals. A field survey was conducted to investigate the temperature range for thermal comfort in hospitals in the tropics. Thermal acceptability assessment was conducted to examine whether the hospitals in the tropics met the ASHRAE Standard-55 80% acceptability criteria. A total of 114 occupants in four hospitals were involved in the study. The results of the field study revealed that only 44% of the examined locations met the comfort criteria specified in ASHRAE Standard 55. The survey also examined the predicted percentage of dissatisfied in the hospitals. The results showed that 49% of the occupants were satisfied with the thermal environments in the hospitals. The field survey analysis revealed that the neutral temperature for Malaysian hospitals was 26.4 degrees C. The comfort temperature range that satisfied 90% of the occupants in the space was in the range of 25.3-28.2 degrees C. The results from the field study suggested that a higher comfort temperature was required for Malaysians in hospital environments compared with the temperature criteria specified in ASHRAE Standard (2003). In addition, the significant deviation between actual mean vote and predicted mean vote (PMV) strongly implied that PMV could not be applied without errors in hospitals in the tropics. The new findings on thermal comfort temperature range in hospitals in the tropics could be used as an important guide for building services engineers and researchers who are intending to minimize energy usage in heating, ventilating and air conditioning systems in hospitals operating in the tropics with acceptable thermal comfort level and to improve the performance and well-being of its workers.

Exertional and CrossFit-Induced Rhabdomyolysis.

Science.gov (United States)

Meyer, Michelle; Sundaram, Sneha; Schafhalter-Zoppoth, Ingeborg

2017-07-14

Few publications of exercise-induced rhabomyolysis currently exist in the medical literature besides case reports. However, this condition can be severe, resulting in hospitalization and IV fluid administration to prevent serious sequelae. This report describes a case of exercise-induced rhabdomyolysis caused by a CrossFit workout. A 31-year-old female presented with 2 days of bilateral upper extremity pain and soreness, which began 2 days after she completed a CrossFit workout. Workup revealed an elevated creatine phosphokinase (CPK) of 18 441 U/L, consistent with exercise-induced rhabdomyolysis, and elevated liver function tests and elevated D-dimer, although her renal function was normal. She was hospitalized for 2 days and treated with IV fluids. This case report demonstrates that CrossFit exercises can lead to rhabdomyolysis, highlighting a condition that may be underdiagnosed and underreported.

Pulsed-field gel electrophoresis of multidrug-resistant and -sensitive strains of Pseudomonas aeruginosa from a Malaysian hospital.

Science.gov (United States)

Thong, Kwai Lin; Lai, Kin Seng; Ganeswrie, R; Puthucheary, S D

2004-10-01

Over a period of 6 months from January to June 2002, an unusual increase in the isolation of highly resistant Pseudomonas aeruginosa strains was observed in the various wards and intensive care units of a large general hospital in Johor Bahru, Malaysia. An equal number of multidrug resistant (MDR) and drug-susceptible strains were collected randomly from swabs, respiratory specimens, urine, blood, cerebral spinal fluid, and central venous catheters to determine the clonality and genetic variation of the strains. Macrorestriction analysis by pulsed-field gel electrophoresis showed that the 19 MDR strains were genetically very homogenous; the majority showed the dominant profile S1 (n = 10), the rest very closely related profiles S1a (n = 1), S2 (n = 4), and S2a (n = 3), indicating the endemicity of these strains. In contrast, the 19 drug-sensitive strains isolated during the same time period were genetically more diverse, showing 17 pulsed-field profiles (F = 0.50-1.00), and probably derived from the patients themselves. The presence of the MDR clone poses serious therapeutic problems as it may become endemic in the hospital and give rise to future clonal outbreaks. There is also the potential for wider geographical spread.

Two-epoch cross-sectional case record review protocol comparing quality of care of hospital emergency admissions at weekends versus weekdays.

Science.gov (United States)

Bion, Julian; Aldridge, Cassie P; Girling, Alan; Rudge, Gavin; Beet, Chris; Evans, Tim; Temple, R Mark; Roseveare, Chris; Clancy, Mike; Boyal, Amunpreet; Tarrant, Carolyn; Sutton, Elizabeth; Sun, Jianxia; Rees, Peter; Mannion, Russell; Chen, Yen-Fu; Watson, Samuel Ian; Lilford, Richard

2017-12-22

The mortality associated with weekend admission to hospital (the 'weekend effect') has for many years been attributed to deficiencies in quality of hospital care, often assumed to be due to suboptimal senior medical staffing at weekends. This protocol describes a case note review to determine whether there are differences in care quality for emergency admissions (EAs) to hospital at weekends compared with weekdays, and whether the difference has reduced over time as health policies have changed to promote 7-day services. Cross-sectional two-epoch case record review of 20 acute hospital Trusts in England. Anonymised case records of 4000 EAs to hospital, 2000 at weekends and 2000 on weekdays, covering two epochs (financial years 2012-2013 and 2016-2017). Admissions will be randomly selected across the whole of each epoch from Trust electronic patient records. Following training, structured implicit case reviews will be conducted by consultants or senior registrars (senior residents) in acute medical specialities (60 case records per reviewer), and limited to the first 7 days following hospital admission. The co-primary outcomes are the weekend:weekday admission ratio of errors per case record, and a global assessment of care quality on a Likert scale. Error rates will be analysed using mixed effects logistic regression models, and care quality using ordinal regression methods. Secondary outcomes include error typology, error-related adverse events and any correlation between error rates and staffing. The data will also be used to inform a parallel health economics analysis. The project has received ethics approval from the South West Wales Research Ethics Committee (REC): reference 13/WA/0372. Informed consent is not required for accessing anonymised patient case records from which patient identifiers had been removed. The findings will be disseminated through peer-reviewed publications in high-quality journals and through local High-intensity Specialist-Led Acute

Workplace violence against nurses in the emergency departments of three hospitals in Riyadh, Saudi Arabia: A cross-sectional survey

Directory of Open Access Journals (Sweden)

Asmaa Alyaemni

Full Text Available Background: Emergency department nurses are continuously exposed to violence on the job. Objectives: This study sought to identify the prevalence and pattern of workplace violence and the consequences of violence on nurses working in emergency departments in Riyadh. Design: Cross-sectional survey conducted from April to May 2015. Setting: Emergency departments of three hospitals in Riyadh. Participants: Nurses participated voluntarily and anonymously. Methods: Nurses were recruited by advertisement. A self-administered questionnaire with 23 items was given to participants by a head nurse. Violent acts were classified as physical or nonphysical. Descriptive statistics are presented and statistical comparisons were made to evaluate differences by gender, nationality, age, experience and other demographic variables. Results: Of 150 questionnaires distributed, 121 were returned (80.6%. One hundred were females (82.6% and 71 (58.7% had worked in nursing for less than or equal to 5 years. Most participants (n=108, 89.3% had experienced a violent incident in the past 12 months. Eighty (80/108, 74.1% of those who had experienced violence had experienced verbal abuse and 20 (20/108, 18.5% had faced verbal and physical violence during the past year. The type of violence was associated with gender and educational level. Patients (89/108, 82.4% and their relatives (70/108, 64.8% were the most common instigators of violence. Most nurses (78/108, 72.3% expressed dissatisfaction with the manner in which incidents were handled. Conclusion: Workplace violence was pervasive in the emergency departments of these three hospitals in Riyadh. The data are consistent with other reports of workplace violence in emergency departments in Saudi Arabia and in other countries. Recommendations: Suitable strategies to deal with the issue include establishing workplace violence management teams and creating appropriate rules and regulations that can improve workplace safety

Perceptions of Hospital Pharmacist's Role in Pakistan's Healthcare ...

African Journals Online (AJOL)

Purpose: To investigate hospital pharmacists' perception of their current clinical role in Pakistan's healthcare system. Methods: This was a cross-sectional study in a population that consisted of hospital pharmacists in Islamabad, Faisalabad and Lahore which are three cities in Punjab State, Pakistan. A sample of 116 ...

Use of alternative and complementary therapies in labor and delivery care: a cross-sectional study of midwives' training in Catalan hospitals accredited as centers for normal birth.

Science.gov (United States)

Muñoz-Sellés, Ester; Vallès-Segalés, Antoni; Goberna-Tricas, Josefina

2013-11-15

The use of complementary and alternative medicine (CAM) and complementary and alternative therapies (CAT) during pregnancy is increasing. Scientific evidence for CAM and CAT in the field of obstetrics mainly covers pain relief in labor. Midwives are responsible for labor and delivery care: hence, their knowledge of CAM and CAT is important. The aims of this study are to describe the professional profile of midwives who provide care for natural childbirth in Catalan hospitals accredited as centers for normal birth, to assess midwives' level of training in CAT and their use of these therapies, and to identify specific resources for CAT in labor wards. A descriptive, cross-sectional, quantitative method was used to assess the level of training and use of CAT by midwives working at 28 hospitals in Catalonia, Spain, accredited as public normal birth centers. Just under a third of midwives (30.4%) trained in CAT after completion of basic training. They trained in an average of 5.97 therapies (SD 3.56). The number of CAT in which the midwives were trained correlated negatively with age (r = - 0.284; p trained in CAT considered that the following therapies were useful or very useful for pain relief during labor and delivery: relaxation techniques (64.3%), hydrotherapy (84.8%) and the application of compresses to the perineum (75.9%). The availability of resources for providing CAT during normal birth care varied widely from center to center. Age may influence attitudes towards training. It is important to increase the number of midwives trained in CAM for pain relief during childbirth, in order to promote the use of CAT and ensure efficiency and safety. CAT resources at accredited hospitals providing normal childbirth care should also be standardized.

Editorial: The developing field | Lashley | Research in Hospitality ...

African Journals Online (AJOL)

Research in Hospitality Management. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 1 (2015) >. Log in or Register to get access to full text downloads.

The management of hospital waste products in hospitals of Bushehr Province

Directory of Open Access Journals (Sweden)

kamran Mirzaie

2008-02-01

Full Text Available Background: Hospital waste contains a large quantity of dangerous pathogenic agents, which are hazardous to the health of man, animal, plant and the environment. In Iran, like many other developing countries, not enough attention is paid to this matter and available information regarding the generation and disposal of medical wastes are low. The existing information about production and disposal of wastes in our hospitals is little and incomplete. In this study, a survey on hospital waste management system in Bushehr province hospitals was conducted. Methods: In this cross-sectional study, 8 hospitals in Bushehr province were investigated during a period of 6 months using a questionnaire, interviews and direct observations. The questionnaire had 93 questions (open and closed about general information on the hospitals and about various systems of managing hospital waste according to the World Health Organization suggested survey questionnaire for hospital waste management in developing countries. Results: In hospitals of bushehr province, waste generation rate was 2615 kg/day, including domestic waste (51.7%, infectious waste (20.8%, sharps (15.2% and chemical and drugs wastes (12.3%. In almost all hospitals, segregation of infectious waste from domestic waste at the place of origin and putting them in special containers had been done but this segregation wasn’t complete and sometimes some hazardous waste were disposed of in domestic waste containers. All hospitals used a color coding system for waste containers, 75 % of hospitals had incinerators. In others, waste was carried out by municipal service daily. In all hospitals, all workers were trained about hospital waste management. In none of the surveyed hospitals, there was an obvious policy and plan for purchasing equipment and necessary facilities in order to dispose hospital waste correctly and also no clear budget was allocated for hospital waste management. In none of these hospitals

Resident cats in small animal veterinary hospitals carry multi-drug resistant enterococci and are likely involved in cross-contamination of the hospital environment

Directory of Open Access Journals (Sweden)

Anuradha eGhosh

2012-02-01

Full Text Available In the U.S., small animal veterinary hospitals (SAVHs commonly keep resident cats living permanently as pets within their facilities. Previously, multi-drug resistant (MDR enterococci were found as a contaminant of multiple surfaces within such veterinary hospitals, and nosocomial infections are a concern. The objectives of this study were to determine whether resident cats carry MDR enterococci and if they potentially play a role in the contamination of the hospital environment. Enterococcal strains (n=180 were isolated from the feces of six healthy resident cats from different SAVHs. The concentration of enterococci ranged from 1.1 x 105 to 6.0 x 108 CFU g-1 of feces, and the population comprised E. hirae (38.3±18.6%, E. faecium (35.0±14.3%, E. faecalis (23.9±11.0%, and E. avium (2.8±2.2%. Testing of phenotypic resistance to 14 antimicrobial agents revealed multi-drug resistance (≥3 antimicrobials in 48.9% of all enterococcal isolates with most frequent resistance to tetracycline (72.8%, erythromycin (47.8%, and rifampicin (35.6%. Vancomycin resistant E. faecalis (3.9% with vanB not horizontally transferable in in vitro conjugation assays were detected from one cat. Genotyping (pulsed-field gel electrophoresis demonstrated a host-specific clonal population of MDR E. faecalis and E. faecium. Importantly, several feline isolates were genotypically identical or closely related to isolates from surfaces of cage door, thermometer, and stethoscope of the corresponding SAVHs. These data demonstrate that healthy resident cats at SAVHs carry MDR enterococci and likely contribute to contamination of the SAVH environment. Proper disposal and handling of fecal material and restricted movement of resident cats within the ward is recommended.

Out for blood. The newly overhauled American Red Cross is thirsty for a bigger share of the $2 billion business of supplying blood to hospitals.

Science.gov (United States)

Hensley, S

1998-06-22

The newly overhauled American Red Cross, led by President Elizabeth Dole (left), has launched an ambitious campaign to increase its piece of the more than $2 billion business of supplying blood to hospitals. Its quest for market share has sparked what some call a "blood war" with its main competitors: independent, community-governed blood banks affiliated with America's Blood Centers.

Electron Cross-field Transport in a Miniaturized Cylindrical Hall Thruster

International Nuclear Information System (INIS)

Smirnov Artem; Raitses Yevgeny; Fisch Nathaniel J

2005-01-01

Conventional annular Hall thrusters become inefficient when scaled to low power. Cylindrical Hall thrusters, which have lower surface-to-volume ratio, are more promising for scaling down. They presently exhibit performance comparable with conventional annular Hall thrusters. The present paper gives a review of the experimental and numerical investigations of electron crossfield transport in the 2.6 cm miniaturized cylindrical Hall thruster (100 W power level). We show that, in order to explain the discharge current observed for the typical operating conditions, the electron anomalous collision frequency ν b has to be on the order of the Bohm value, ν B ∼ ω c /16. The contribution of electron-wall collisions to cross-field transport is found to be insignificant. The optimal regimes of thruster operation at low background pressure (below 10 -5 Torr) in the vacuum tank appear to be different from those at higher pressure (∼ 10 -4 Torr)

Original Research Factors associated with hospital arrival time after ...

African Journals Online (AJOL)

Original Research. Factors associated with hospital arrival time after the onset of stroke symptoms: A cross-sectional study at two teaching hospitals in Harare, Zimbabwe .... hypertension causing small vessel disease which outweigh the causes of ..... Stroke Mechanism in Atherosclerotic Middle Cerebral Artery Disease:.

The Effects of Magnetic-Field Geometry on Longitudinal Oscillations of Solar Prominences: Cross-Sectional Area Variation for Thin Tubes

Science.gov (United States)

Luna, M.; Diaz, A. J.; Oliver, R.; Terradas, J.; Karpen, J.

2016-01-01

Solar prominences are subject to both field-aligned (longitudinal) and transverse oscillatory motions, as evidenced by an increasing number of observations. Large-amplitude longitudinal motions provide valuable information on the geometry of the filament channel magnetic structure that supports the cool prominence plasma against gravity. Our pendulum model, in which the restoring force is the gravity projected along the dipped field lines of the magnetic structure, best explains these oscillations. However, several factors can influence the longitudinal oscillations, potentially invalidating the pendulum model. Aims. The aim of this work is to study the influence of large-scale variations in the magnetic field strength along the field lines, i.e., variations of the cross-sectional area along the flux tubes supporting prominence threads. Methods. We studied the normal modes of several flux tube configurations, using linear perturbation analysis, to assess the influence of different geometrical parameters on the oscillation properties. Results. We found that the influence of the symmetric and asymmetric expansion factors on longitudinal oscillations is small.Conclusions. We conclude that the longitudinal oscillations are not significantly influenced by variations of the cross-section of the flux tubes, validating the pendulum model in this context.

Pain prevalence in hospitalized children

DEFF Research Database (Denmark)

Walther-Larsen, S; Pedersen, M T; Friis, S M

2017-01-01

admitted the same day. The single most common painful procedure named by the children was needle procedures, such as blood draw and intravenous cannulation. CONCLUSION: This study reveals high pain prevalence in children across all age groups admitted to four Danish university hospitals. The majority......BACKGROUND: Pain management in hospitalized children is often inadequate. The prevalence and main sources of pain in Danish university hospitals is unknown. METHODS: This prospective mixed-method cross-sectional survey took place at four university hospitals in Denmark. We enrolled 570 pediatric...... patients who we asked to report their pain experience and its management during the previous 24 hours. For patients identified as having moderate to severe pain, patient characteristics and analgesia regimes were reviewed. RESULTS: Two hundred and thirteen children (37%) responded that they had experienced...

Organizational culture in Qazvin hospitals (2013

Directory of Open Access Journals (Sweden)

AM. Mosadeghrad

2017-12-01

Full Text Available Background: Organizational culture influences employees’ job satisfaction, commitment and performance. A strong corporate culture enhances organizational performance. Objective: The aim of this study was to determine the type of organizational culture in Qazvin hospitals. Methods: A descriptive and cross-sectional study was conducted by a survey questionnaire in Qazvin (2013 that was distributed among 800 hospital employees and managers based on stratified random sampling. Findings: The mean of hospitals’ organizational culture was 2.95 out of 5 score. Hospitals' organizational cultures were evaluated as strong in attention to details and stability dimensions and moderate in creativity, risk taking, team working and power distance dimensions. Attention to details in public hospitals was higher than private and social security hospitals. Conclusion: Organizational culture of Qazvin hospitals was evaluated as moderate. Managers for improving hospitals' performance and enhancing employees' and patients' satisfaction should create a culture of higher creativity, innovation, team working and risk taking and lower power distance.

Density and field effect on electron-ion collision cross-sections in hot dense plasma

International Nuclear Information System (INIS)

Gaufridy de Dortan, F. de

2003-03-01

Collisional excitation cross-sections are essential for the modeling of the properties of non equilibrium plasmas. There has been a lot of work on electron impact excitation of isolated ions, but in dense plasmas, neighboring particles are expected to widely disturb these electron transitions in atoms. Plasma modeling through a radially perturbed potential has already been done but is not satisfactory as it does not account for levels degeneracy breaking and its consequences. Introduction of a quasistatic electric micro-field of neighboring ions allows us to break spherical symmetry. Our original theoretical study has given birth to a numerical code that accurately computes collisional strengths and rates (in the Distorted Waves approach) in atoms submitted to a realistic micro-field. Hydrogen- and helium-like aluminium is studied. Stark mixing widely increases rates of transitions from high l levels and forbidden transitions are field-enhanced by many orders of magnitude until they reach allowed ones. Eventually, we conduct an elementary stationary collisional radiative study to investigate field-enhancement effects on corresponding line shapes. In cases we study (aluminium, hydrogen- and helium-like) we find a relatively weak increase of K-shell line broadening

Determinants of job satisfaction of healthcare professionals in public hospitals in Belgrade, Serbia - cross-sectional analysis

Directory of Open Access Journals (Sweden)

Kuburović Nina B.

2016-01-01

Full Text Available Introduction. The quality of health care significantly depends on the satisfaction of the employees. Objective. The objective of this study was to establish the level of professional satisfaction of healthcare professionals in state hospitals in Belgrade, Serbia, and to determine and to rank the factors which impact on their satisfaction or dissatisfaction. Method. Professional satisfaction survey was designed and conducted as a cross-sectional study in 2008. Completed questionnaires were returned by 6,595 healthcare professionals from Belgrade’s hospitals. Statistical analysis was performed using the Student’s t-test, χ2 test and ANOVA. Factor analysis was applied in order to define determinants of professional satisfaction, i.e. dissatisfaction. Results. This study showed that the degree of professional satisfaction of Serbian healthcare professionals was low. The main causes of professionals’ dissatisfaction were wages, equipment, the possibility of continuous medical education/training and the opportunities for professional development. Healthcare professionals with university education were more satisfied with all the individual aspects of job satisfaction than those with secondary school and college education. Conclusion. There were significantly more healthcare professionals satisfied with their job among males, older than 60 years, in the age group 50-59 years, with managerial function, and with 30 or more years of service. Development strategy of human resources in the Serbian health care system would significantly improve the professional satisfaction and quality of the provided health care.

Occupational Accidents among Clinical Staff of Tabriz University Hospitals

OpenAIRE

Leila Sahebi; Rana Gholamzadeh nikjoo; Majid Khalili

2015-01-01

​Background and Objectives : Occupational health and safety is one of the most important issues in the workplace. The purpose of this study was to explore the one –year prevalence of occupational accidents in Tabriz University hospitals. Materials and Methods : A cross-sectional study was conducted on 400 patients of seven university hospitals using researcher made questionnaire. The hospitals were selected based on their specialty of the service. Then, one hospital was selected from each s...

A cross-national comparison of incident reporting systems implemented in German and Swiss hospitals.

Science.gov (United States)

Manser, Tanja; Imhof, Michael; Lessing, Constanze; Briner, Matthias

2017-06-01

This study aimed to empirically compare incident reporting systems (IRS) in two European countries and to explore the relationship of IRS characteristics with context factors such as hospital characteristics and characteristics of clinical risk management (CRM). We performed exploratory, secondary analyses of data on characteristics of IRS from nationwide surveys of CRM practices. The survey was originally sent to 2136 hospitals in Germany and Switzerland. Persons responsible for CRM in 622 hospitals completed the survey (response rate 29%). None. Differences between IRS in German and Swiss hospitals were assessed using Chi2, Fisher's Exact and Freeman-Halton-Tests, as appropriate. To explore interrelations between IRS characteristics and context factors (i.e. hospital and CRM characteristics) we computed Cramer's V. Comparing participating hospitals across countries, Swiss hospitals had implemented IRS earlier, more frequently and more often provided introductory IRS training systematically. German hospitals had more frequently systematically implemented standardized procedures for event analyses. IRS characteristics were significantly associated with hospital characteristics such as hospital type as well as with CRM characteristics such as existence of strategic CRM objectives and of a dedicated position for central CRM coordination. This study contributes to an improved understanding of differences in the way IRS are set up in two European countries and explores related context factors. This opens up new possibilities for empirically informed, strategic interventions to further improve dissemination of IRS and thus support hospitals in their efforts to move patient safety forward. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Do Robotic Surgical Systems Improve Profit Margins? A Cross-Sectional Analysis of California Hospitals.

Science.gov (United States)

Shih, Ya-Chen Tina; Shen, Chan; Hu, Jim C

2017-09-01

The aim of this study was to examine the association between ownership of robotic surgical systems and hospital profit margins. This study used hospital annual utilization data, annual financial data, and discharge data for year 2011 from the California Office of Statewide Health Planning and Development. We first performed bivariate analysis to compare mean profit margin by hospital and market characteristics and to examine whether these characteristics differed between hospitals that had one or more robotic surgical systems in 2011 and those that did not. We applied the t test and the F test to compare mean profit margin between two groups and among three or more groups, respectively. We then conducted multilevel logistic regression to determine the association between ownership of robotic surgical systems and having a positive profit margin after controlling for other hospital and market characteristics and accounting for possible correlation among hospitals located within the same market. The study sample included 167 California hospitals with valid financial information. Hospitals with robotic surgical systems tended to report more favorable profit margins. However, multilevel logistic regression showed that this relationship (an association, not causality) became only marginally significant (odds ratio [OR] = 6.2; P = 0.053) after controlling for other hospital characteristics, such as ownership type, teaching status, bed size, and surgical volumes, and market characteristics, such as total number of robotic surgical systems owned by other hospitals in the same market area. As robotic surgical systems become widely disseminated, hospital decision makers should carefully evaluate the financial and clinical implications before making a capital investment in this technology. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Problems in Cross-Cultural Use of the Hospital Anxiety and Depression Scale: “No Butterflies in the Desert”

Science.gov (United States)

Maters, Gemma A.; Sanderman, Robbert; Kim, Aimee Y.; Coyne, James C.

2013-01-01

Objective The Hospital Anxiety and Depression Scale (HADS) is widely used to screen for anxiety and depression. A large literature is citable in support of its validity, but difficulties are increasingly being identified, such as inexplicably discrepant optimal cutpoints and inconsistent factor-structures. This article examines whether these problems could be due to the construction of the HADS that poses difficulties for translation and cross-cultural use. Methods Authors’ awareness of difficulties translating the HADS were identified by examining 20% of studies using the HADS, obtained by a systematic literature search in Pubmed and PsycINFO in May 2012. Reports of use of translations and validation studies were recorded for papers from non-English speaking countries. Narrative and systematic reviews were examined for how authors dealt with different translations. Results Of 417 papers from non-English speaking countries, only 45% indicated whether a translation was used. Studies validating translations were cited in 54%. Seventeen reviews, incorporating data from diverse translated versions, were examined. Only seven mentioned issues of language and culture, and none indicated insurmountable problems in integrating results from different translations. Conclusion Initial decisions concerning item content and response options likely leave the HADS difficult to translate, but we failed to find an acknowledgment of problems in articles involving its translation and cross-cultural use. Investigators’ lack of awareness of these issues can lead to anomalous results and difficulties in interpretation and integration of these results. Reviews tend to overlook these issues and most reviews indiscriminately integrate results from studies performed in different countries. Cross-culturally valid, but literally translated versions of the HADS may not be attainable, and specific cutpoints may not be valid across cultures and language. Claims about rates of anxiety and

Multimorbidity in a large district hospital: A descriptive cross ...

African Journals Online (AJOL)

Mitchell's Plain District Hospital, Western Cape Department of Health, Cape Town, South Africa. Corresponding author: E de .... group as a whole, 6.3% of patients had mental illness. .... be investigated, research can also be focused specifically on reducing .... strongly affected by social stigma, particularly in the case of illicit.

Knowledge and attitudes of nurses on pressure ulcer prevention: a cross-sectional multicenter study in Belgian hospitals.

Science.gov (United States)

Beeckman, Dimitri; Defloor, Tom; Schoonhoven, Lisette; Vanderwee, Katrien

2011-09-01

Evidence-based guidelines for pressure ulcer prevention have been developed and promoted by authoritative organizations. However, nonadherence to these guidelines is frequently reported. Negative attitudes and lack of knowledge may act as barriers to using guidelines in clinical practice. To study the knowledge and attitudes of nurses about pressure ulcer prevention in Belgian hospitals and to explore the correlation between knowledge, attitudes, and the application of adequate prevention. A cross-sectional multicenter study was performed in a random sample of 14 Belgian hospitals, representing 207 wards. Out of that group, 94 wards were randomly selected (2105 patients). Clinical observations were performed to assess the adequacy of pressure ulcer prevention and pressure ulcer prevalence. From each participating ward, a random selection of at least five nurses completed an extensively validated knowledge and attitude instrument. In total, 553 nurses participated. A logistic regression analysis was performed to evaluate the correlation between knowledge, attitudes, and the application of adequate prevention. Pressure ulcer prevalence (Category I-IV) was 13.5% (284/2105). Approximately 30% (625/2105) of the patients were at risk (Bradenscore pressure ulcer). Only 13.9% (87/625) of these patients received fully adequate prevention whilst in bed and when seated. The mean knowledge and attitude scores were 49.7% and 71.3%, respectively. The application of adequate prevention on a nursing ward was significantly correlated with the attitudes of the nurses (OR = 3.07, p = .05). No independent correlation was found between knowledge and the application of adequate prevention (OR = 0.75, p = .71). Knowledge of nurses in Belgian hospitals about the prevention of pressure ulcers is inadequate. The attitudes of nurses toward pressure ulcers are significantly correlated with the application of adequate prevention. No correlation was found between knowledge and the

A cross-sectional observational study to assess inhaler technique in Saudi hospitalized patients with asthma and chronic obstructive pulmonary disease

Science.gov (United States)

Ammari, Maha Al; Sultana, Khizra; Yunus, Faisal; Ghobain, Mohammed Al; Halwan, Shatha M. Al

2016-01-01

Objectives: To assess the proportion of critical errors committed while demonstrating the inhaler technique in hospitalized patients diagnosed with asthma and chronic obstructive pulmonary disease (COPD). Methods: This cross-sectional observational study was conducted in 47 asthmatic and COPD patients using inhaler devices. The study took place at King Abdulaziz Medical City, Riyadh, Saudi Arabia between September and December 2013. Two pharmacists independently assessed inhaler technique with a validated checklist. Results: Seventy percent of patients made at least one critical error while demonstrating their inhaler technique, and the mean number of critical errors per patient was 1.6. Most patients used metered dose inhaler (MDI), and 73% of MDI users and 92% of dry powder inhaler users committed at least one critical error. Conclusion: Inhaler technique in hospitalized Saudi patients was inadequate. Health care professionals should understand the importance of reassessing and educating patients on a regular basis for inhaler technique, recommend the use of a spacer when needed, and regularly assess and update their own inhaler technique skills. PMID:27146622

Factors Associated with Potential Food-Drug Interaction in Hospitalized Patients: A Cross-Sectional Study in Northeast Iran

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Mostafa Abdollahi

2018-04-01

Full Text Available Background: The minimization of adverse food-drug interactions will improve patient care by optimizing the therapeutic effects and maintaining proper nutritional status. Aim: The aim of the present study was to find the main factors that may place the hospitalized patients at risk of potential food-drug interactions. Method: This cross-sectional, descriptive study was conducted on 400 inpatients admitted to the Department of Internal Medicine of a teaching hospital in Mashhad, Northeast Iran, within 20 March 2013 to 20 April 2013. The potential food-drug interactions were evaluated for 19 commonly prescribed medications. The main factors (e.g., age, gender, education level, number of medications, and duration of the disease that may place the patients at risk of potential food-drug interactions were analyzed for each patient. Results: Out of the 19 commonly prescribed medications, 17 drugs (89% were not properly used with respect to meal. Furthermore, 14 commonly prescribed drugs were found to have a high frequency (≥50% of potential food-drug interactions. Most of the patients (n=359, 89.8% consumed their medicines at inappropriate time with respect to meals. The results of a multiple logistic regression after adjustment for confounders revealed that the age [β=0.005, CI: 0.0-0.01; P=033], number of medications [β=0.1, CI: 0.083-0.117; P

Field tests of photovoltaic power generation at the Fukuroi Mitsukawa Hospital in Fukuroi City, Shizuoka Prefecture; Fukuroishi Mitsukawa byoin taiyoko hatsuden field test jigyo (Shizuokaken Fukuroishi)

Energy Technology Data Exchange (ETDEWEB)

Namikawa, K

1996-05-30

A 30 kW-scale photovoltaic power generation system has been installed on the roof of an existing hospital. Various data have been collected to prove the applicability and stability of the system. The system was designed so as to be suitable for installing on the roof with high-wind. Structures of the frame and base were decided by considering the load and high-wind. The selection of design and materials for this system on the roof with high-wind due to the topography is expected to be technically proven. This field test is the first for private hospitals. The power can be supplied to medical equipment during outage at disasters. The introduction of a system having the self-function is also the first case. Brochure illustrating the outline of this system and the mechanism of photovoltaic power generation system was made and distributed to the public offices, hospitals, and visitors inside and outside the prefecture. Effectiveness of the photovoltaic power generation system has been positively diffused. A display board showing various conditions is placed in the entrance lounge, to diffuse and promote the system. 12 figs., 1 tab.

Hospital waste management in Lebanon

International Nuclear Information System (INIS)

Chaker, Alissar

1999-01-01

Hospital wastes comprises approximately 80% domestic waste components, also known as non-risk waste and 20% hazardous or risk waste. The 20% of the hospital waste stream or the risk waste (also known as infectious, medical, clinical wastes) comprises components which could be potentially contaminated with infections, chemical or radioactive agents. Therefore, it should be handled and disposed of in such a manner as to minimize potential human exposure and cross-contamination. Hospital risk waste and be subdivided into seven general categories as follows: infections, anatomical/pathological, chemical, pharmaceutical, radioactive waste, sharps and pressurised containers. These waste categories are generated by many types of health care establishments, including hospitals, clinics, infirmaries.... The document presents also tables of number of hospitals and estimated bed number in different regions in Lebanon; estimated hospital risk and non-risk waste generation per tonnes per day for the years 1998 until 2010 and finally sensitivity analysis of estimated generation of hospital risk waste in Lebanon per tonnes per day for the years 1998 until 2010. The management, treatment and disposal of hospital risk waste constitute important environmental and public safety issues. It is recognised that there is alack of infrastructure for the safe and environmentally acceptable disposal of hospital waste in Lebanon

Enhancing field GP engagement in hospital-based studies. Rationale, design, main results and participation in the diagest 3-GP motivation study

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Berkhout Christophe

2012-06-01

Full Text Available Abstract Background Diagest 3 was a study aimed at lowering the risk of developing type 2 diabetes within 3 years after childbirth. Women with gestational diabetes were enrolled in the study. After childbirth, the subjects showed little interest in the structured education programme and did not attend workshops. Their general practitioners (GPs were approached to help motivate the subjects to participate in Diagest 3, but the GPs were reluctant. The present study aimed to understand field GPs’ attitudes towards hospital-based studies, and to develop strategies to enhance their involvement and reduce subject drop-out rates. Methods We used a three-step process: step one used a phenomenological approach exploring the beliefs, attitudes, motivations and environmental factors contributing to the GPs’ level of interest in the study. Data were collected in face-to-face interviews and coded by hand and with hermeneutic software to develop distinct GP profiles. Step two was a cross-sectional survey by questionnaire to determine the distribution of the profiles in the GP study population and whether completion of an attached case report form (CRF was associated with a particular GP profile. In step three, we assessed the impact of the motivation study on participation rates in the main study. Results Fifteen interviews were conducted to achieve data saturation. Theorisation led to the definition of 4 distinct GP profiles. The response rate to the questionnaire was 73%, but dropped to 52% when a CRF was attached. The link between GP profiles and the rate of CRF completion remains to be verified. The GPs provided data on the CRF that was of comparable quality to those collected in the main trial. Our analysis showed that the motivation study increased overall participation in the main study by 23%, accounting for 16% (24/152 of all final visits for 536 patients who were initially enrolled in the Diagest 3 study. Conclusions When a hospital-led study

Enhancing field GP engagement in hospital-based studies. Rationale, design, main results and participation in the Diagest 3-GP motivation study.

Science.gov (United States)

Berkhout, Christophe; Vandaele-Bétancourt, Marie; Robert, Stéphane; Lespinasse, Solène; Mitha, Gamil; Bradier, Quentin; Vambergue, Anne; Fontaine, Pierre

2012-06-21

Diagest 3 was a study aimed at lowering the risk of developing type 2 diabetes within 3 years after childbirth. Women with gestational diabetes were enrolled in the study. After childbirth, the subjects showed little interest in the structured education programme and did not attend workshops. Their general practitioners (GPs) were approached to help motivate the subjects to participate in Diagest 3, but the GPs were reluctant. The present study aimed to understand field GPs' attitudes towards hospital-based studies, and to develop strategies to enhance their involvement and reduce subject drop-out rates. We used a three-step process: step one used a phenomenological approach exploring the beliefs, attitudes, motivations and environmental factors contributing to the GPs' level of interest in the study. Data were collected in face-to-face interviews and coded by hand and with hermeneutic software to develop distinct GP profiles. Step two was a cross-sectional survey by questionnaire to determine the distribution of the profiles in the GP study population and whether completion of an attached case report form (CRF) was associated with a particular GP profile. In step three, we assessed the impact of the motivation study on participation rates in the main study. Fifteen interviews were conducted to achieve data saturation. Theorisation led to the definition of 4 distinct GP profiles. The response rate to the questionnaire was 73%, but dropped to 52% when a CRF was attached. The link between GP profiles and the rate of CRF completion remains to be verified. The GPs provided data on the CRF that was of comparable quality to those collected in the main trial. Our analysis showed that the motivation study increased overall participation in the main study by 23%, accounting for 16% (24/152) of all final visits for 536 patients who were initially enrolled in the Diagest 3 study. When a hospital-led study explores issues in primary care, its design must anticipate GP

Nutritional Assessment in Elderly Hospitalized Patients in Qazvin Teaching Hospitals in 2011

Directory of Open Access Journals (Sweden)

Azam Ghorbani

2013-04-01

Full Text Available Objectives: Nutritional status in the elderly is an important issue in developing countries has been little attention to it. It results from complex interaction between personal and environmental factors that have a considerable effect on mortality, morbidity and quality of life of elderly people especially the hospitalized ones. The aim of this study was to investigate nutritional status in elderly hospitalized patients in Qazvin Teaching Hospitals and know Influential factors to plan appropriate programs for improving their health. Methods & Materials: In this cross-sectional study 233 elderly (151 women and 171 men aging more than 60 years, hospitalized in two hospitals in Qazvin city were studied. Nutritional status were evaluated using Mini Nutritional Assessment, The nutritional status was classified into: malnourished, risk of malnutrition and without malnutrition (adequate. Results: Among the assessed elderly 29.8% were well nourish, 13.4% malnourished and 42.95 at risk of malnutrition. There was more malnutrition in females compared to males (25.8% vs 7.2 P=23(62.5% vs. 12.6% P<0.001, Statistical analysis of the studied variables showed that nutritional status were significantly associated with Age, BMI, WC and WHR Conclusion: This study confirms a high prevalence of malnutrition risk in hospitalized elderly patients. The assessment of nutritional status with MNA that can facilitate evaluation of the nutritional status of elderly individuals in hospitals

Biological risk among hospital housekeepers.

Science.gov (United States)

Ream, Priscilla Santos Ferreira; Tipple, Anaclara Ferreira Veiga; Barros, Dayane Xavier; Souza, Adenícia Custódia Silva; Pereira, Milca Severino

2016-01-01

Although not directly responsible for patient care, hospital housekeepers are still susceptible to accidents with biological material. The objectives of this study were to establish profile and frequency of accidents among hospital housekeepers, describe behaviors pre- and postaccident, and risk factors. This was a cross-sectional study with hospital housekeepers in Goiania, Brazil. Data were obtained from interviews and vaccination records. The observations were as follows: (1) participating workers: 94.3%; (2) incomplete hepatitis B vaccination: 1 in 3; and (3) accident rate: 26.5%, mostly percutaneous with hypodermic needles, and involved blood from an unknown source; roughly half occurred during waste management. Upon review, length of service less than 5 years, completed hepatitis B vaccination, and had been tested for anti-HBs (hepatitis B surface antigen) influenced frequency of accidents. These findings suggest that improper disposal of waste appears to enhance the risk to hospital housekeepers. All hospital workers should receive continued training with regard to waste management.

Effect of Secondary Electron Emission on Electron Cross-Field Current in E x B Discharges

International Nuclear Information System (INIS)

Raitses, Yevgeny; Kaganovich, Igor D.; Khrabrov, Alexander; Sydorenko, Dmytro; Fisch, Nathaniel J.; Smolyakov, Andrei

2011-01-01

This paper reviews and discusses recent experimental, theoretical, and numerical studies of plasma-wall interaction in a weakly collisional magnetized plasma bounded with channel walls made from different materials. A lowpressure ExB plasma discharge of the Hall thruster was used to characterize the electron current across the magnetic field and its dependence on the applied voltage and electron-induced secondary electron emission (SEE) from the channel wall. The presence of a depleted, anisotropic electron energy distribution function with beams of secondary electrons was predicted to explain the enhancement of the electron cross-field current observed in experiments. Without the SEE, the electron crossfield transport can be reduced from anomalously high to nearly classical collisional level. The suppression of SEE was achieved using an engineered carbon velvet material for the channel walls. Both theoretically and experimentally, it is shown that the electron emission from the walls can limit the maximum achievable electric field in the magnetized plasma. With nonemitting walls, the maximum electric field in the thruster can approach a fundamental limit for a quasineutral plasma.

Drug Prescribing Pattern in Two Hospitals in Mwanza, Northwest ...

African Journals Online (AJOL)

Prof. Kongola

A retrospective cross-sectional study to evaluate compliance with Tanzanian guidelines,. World Health Organization (WHO) guidelines, and various other aspects of drug prescription at Sekou Toure Regional Hospital and Magu Hospital both in Mwanza. Region of Tanzania was carried out. In particular, the study was ...

Adherence to iron supplements among women receiving antenatal care at Mulago National Referral Hospital, Uganda-cross-sectional study.

Science.gov (United States)

Kiwanuka, Tusuubira S; Ononge, Sam; Kiondo, Paul; Namusoke, Fatuma

2017-10-25

Antenatal iron supplementation is a cost effective way of reducing iron deficiency anaemia among pregnant women in resource limited countries like Uganda. Poor adherence to iron supplements has limited its effectiveness in reducing maternal anaemia as evidenced by the high burden of iron deficiency anemia in Sub-saharan Africa. The aim of this study was to determine the level of and factors associated with adherence to iron supplementation among women attending antenatal clinic at Mulago National Referral Hospital, Kampala, Uganda. Three hundred and seventy pregnant women were recruited in a cross sectional survey in Mulago National Referral Hospital antenatal clinic after informed consent between February and April 2014. Levels of adherence to iron supplements were assessed using visual analogue scale and factors associated collected using an interviewer administered questionnaire. About 12% (11.6%) of the mothers attending the antenatal clinic adhered to iron supplements over 30 day period. Mothers who had had four or more antenatal visits prior to the survey [odds ratio (OR) = 1.49, 95% confidence interval (CI) 1.12-1.97], had more than 2 week supply of iron supplements in the previous visit (OR 2.81, 95% CI 1.02-1.09), prior health education (OR 1.56, 95% CI 1.07-2.29) were more likely to adhere to iron supplements. Inadequate drug supplies and fear for side effects were the main reasons why participants missed the iron supplements. There was low adherence to iron supplements among mothers attending antenatal clinic at Mulago National Referral  Hospital. We recommend a national evaluation of adherence to iron supplements and look at ways of increasing adherence.

A Valid Matérn Class of Cross-Covariance Functions for Multivariate Random Fields With Any Number of Components

KAUST Repository

Apanasovich, Tatiyana V.; Genton, Marc G.; Sun, Ying

2012-01-01

We introduce a valid parametric family of cross-covariance functions for multivariate spatial random fields where each component has a covariance function from a well-celebrated Matérn class. Unlike previous attempts, our model indeed allows

Determining Disturbing Factors of Sleep Quality among Hospitalized Elderly Patients in Kashan Hospitals, Iran 2009

Directory of Open Access Journals (Sweden)

M Kafaei

2013-03-01

Full Text Available Introduction: Sleep is an effective factor in the recovery processes. Many variables affect on the sleep quality of hospitalized elderly people. This study was conducted to determine the factors disturbing sleep quality among hospitalized older adult patients in Kashan hospitals. Methods: A cross-sectional study was carried out on a sample of 390 elderly hospitalized patients in Kashan hospitals. The study data was gathered via Pittsburgh Sleep Quality Index (PSQI Questionnaire. A global total score of 5 or greater indicated a “poor" quality of sleep. The data were analyzed using Chi square, t- test and binary logistic regression at multivariate model. Results: The total quality of sleep was poor in hospitalized elderly patients (7/2±4/8. Sex, marital status, level of education, type of ward, previous hospitalization experience, use of hypnotics at home and hospital, and previous sleep disorders were statistically associated with quality of sleep; however, there was not significant relationship between quality of sleep and age, length of hospitalization, and daytime napping. In the final regression model, marital status (OR=4.6, level of education (OR=1.9, length of hospitalization (OR=1.1, Previous hospitalization experience (OR=0.4, use of hypnotics in hospital (OR=0.27 and previous sleep disorder (OR=0.01 were the most important determinants of sleep quality. Conclusion: Quality of sleep was poor in hospitalized elderly due to a wide range of sleep disturbing factors. The most important factors involved marital status, level of education, previous hospitalization experience, previous sleep disorder and use of hypnotics in hospital.

Administrative management of dental departments in hospitals in Taiwan: A field survey

Directory of Open Access Journals (Sweden)

Tsang-Lie Cher

2012-12-01

Conclusion: For the overall administrative management of dental departments, medical centers were superior to regional hospitals, which were better than district hospitals. In order to elevate the quality, we suggest that dental department should be included in teaching hospital accreditation, and the criteria we used can be taken for reference for the dental department accreditation in the future.

Knowledge, opinions and compliance related to the 100% smoke-free law in hospitality venues in Kampala, Uganda: cross-sectional results from the KOMPLY Project

OpenAIRE

Gravely, Shannon; Nyamurungi, Kellen Namusisi; Kabwama, Steven Ndugwa; Okello, Gabriel; Robertson, Lindsay; Heng, Kelvin Khow Chuan; Ndikum, Achiri Elvis; Oginni, Adeniyi Samuel; Rusatira, Jean Christophe; Kakoulides, Socrates; Huffman, Mark D; Yusuf, Salim; Bianco, Eduardo

2018-01-01

Objective This study evaluated knowledge, opinions and compliance related to Uganda’s comprehensive smoke-free law among hospitality venues in Kampala Uganda. Design This multi-method study presents cross-sectional findings of the extent of compliance in the early phase of Uganda’s comprehensive smoke-free law (2 months postimplementation; pre-enforcement). Setting Bars, pubs and restaurants in Kampala Uganda. Procedure and participants A two-stage stratified cluster sampling procedure was us...

Some of the results of the protection measures in the field of ionizing radiation at FRY border crossings

International Nuclear Information System (INIS)

Benderac, R.; Kokotovic, J.; Kolundzija, V.

2002-01-01

Full text: SUMMARY: The paper describes some of the results of the protection measures in the field of ionizing radiation at FRY border crossings where there were placed stationary monitors of gamma-radiation. The Institute of Security as licensed institution for ionizing radiation detection, designed and placed stationary devices MZ - 100 at border crossings check points named Kelebija, Horgos, Vatin, Gradina, Presevo, Djeneral Jankovic, Batrovci and the ship lock 'Djerdap-I'. CONCLUSION: Over the several years ago IAEA and its member states as well as other international organizations have become increasingly aware of the consequences which might result from illegal activities involving these materials. Therefore initiatives to strengthen physical protection regime are strongly supported and steps towards improving security of nuclear and other radioactive material have already been taken. Yugoslavia as IAEA member state wishes to contribute to the all together efforts in reducing the possibility of illegal activities such as theft, sabotage and trafficking, involving nuclear materials and other radioactive materials, and on the associated proliferation threat and radiation risks. Therefore relevant national bodies prepare project proposal titled 'PREVENTION OF ILLICIT TRAFFICKING IN NUCLEAR AND RADIOACTIVE MATERIALS IN THE FEDERAL REPUBLIC OF YUGOSLAVIA'. Significant work is ahead in this field, since harmonization of radiological control at our border crossings must be achieved. (author)

Cross polarization with phase and amplitude modulation of radio frequency fields in NMR-experiments with sample rotation at magic angle

International Nuclear Information System (INIS)

Dvinskij, S.V.; Chizhik, V.I.

2006-01-01

One analyzes cross polarization of nuclei within a rotating system of coordinates as applied to the NMR-experiments with a specimen rotation under the magic angle. One worded a concept of simultaneous phase and amplitude modulation according to which the Hamiltonian form of the restored dipole interaction persisted if inversion of difference of radiofrequency field amplitudes occurred simultaneously with phase inversion. One presents a theoretical substantiation in terms of the average Hamiltonian theory. The concept is demonstrated both experimentally and by means of numerical analysis for a number of special cases. Phase periodic inversion in cross polarized experiments is shown to result into practically important advantage of suppression of interactions of chemical shift and influence of effects of coarse adjustment of radiofrequency field parameters [ru

Knowledge and attitudes of doctors towards e-health use in healthcare delivery in government and private hospitals in Northern Uganda: a cross-sectional study.

Science.gov (United States)

Olok, Geoffrey Tabo; Yagos, Walter Onen; Ovuga, Emilio

2015-11-04

E-health is an essential information sharing tool in healthcare management and delivery worldwide. However, utilization of e-health may only be possible if healthcare professionals have positive attitudes towards e-health. This study aimed to determine the relationships between healthcare professionals' attitudes towards e-health, level of ICT skills and e-Health use in healthcare delivery in government and private hospitals in northern Uganda. Cross-sectional survey design was used. Sixty-eight medical doctors in three government hospitals and four private hospitals in Northern Uganda participated in the study. A pretested self-administered questionnaire was used to collect the required data. Data was analysed using SPSS software Version 19. Out of the 68 respondents, 39 (57.4 %) reported access to computer and 29 (48.5 %) accessed Internet in the workplace. Majority of healthcare professionals had positive attitudes towards e-health attributes (mean 3.5). The level of skills was moderate (mean 3.66), and was the most important and significant predictor of ICT use among healthcare professionals (r = .522, p < .001); however, attitudes towards e-health attributes did not contribute significantly in predicting e-health use. The findings suggest need for hospitals managements to strengthen e-health services in healthcare delivery in Northern Uganda.

Availability of treatment resources for the management of acute toxic exposures and poisonings in emergency departments among various types of hospitals in Palestine: a cross-sectional study.

Science.gov (United States)

Zyoud, Sa'ed H; Al-Jabi, Samah W; Bali, Yara I; Al-Sayed, Afnan M; Sweileh, Waleed M; Awang, Rahmat

2014-02-21

Poisoning exposures continue to be a significant cause of morbidity and mortality worldwide. The lack of facilities, treatment resources, and antidotes in hospitals may affect the treatments provided and outcomes. This study aimed to determine the availability of gastrointestinal (GI) decontamination, stabilisation, elimination enhancement resources, and antidotes for the management of acute toxic exposures and poisonings in emergency departments (EDs) among various types of governmental and private hospitals in Palestine. A cross-sectional study using semi-structured questionnaire was performed. Data were collected based on hospital resources; GI decontamination, stabilisation, elimination enhancement resources and antidotes from Palestinian hospitals. Eighteen hospitals (94.7%) have responded. Among them, paracetamol poisoning was the most frequently reported cases by EDs (mean frequency score = 7.6 ± 2.1), followed by bee stings (mean = 6.9 ± 2.7) and organophosphate poisoning (mean = 6.7 ± 2.7). The availabilities of most resources related to GI decontamination items varied substantially with hospital type, but these differences were not statistical significant. The availability of stabilisation resources was not significantly different between hospitals types. For the availability of techniques used to enhance the elimination of toxic substances, there were variations between the hospitals types. However, these differences were not statistical significant, except for haemodialysis (p = 0.003) which was more available in governmental hospitals. For the availability of antidotes, none of the hospitals had sufficient stock of all antidotes listed. In relation to hospital type, there was variability in the availability of antidotes, but this did not reach statistical significance, except for deferoxamine (p management of acute toxic exposure and poisoning. The implementation of a minimum list of antidotes and treatment resources would be useful to increase the

A Cross-Cultural Perspective on Challenges Facing Comparative Cancer Survivorship Research

International Nuclear Information System (INIS)

Syse, A.; Syse, A.; Geller, B.

2011-01-01

Cancer survivorship research includes the study of physical, psychosocial, and economic consequences of cancer diagnosis and treatment among pediatric and adult cancer survivors. Historically, the majority of cancer survivorship studies were from the United States, but survivorship issues are increasingly being addressed in other developed countries. Cross-cultural studies remain, however, scarce. The degree to which knowledge attained may or may not be transferred across cultures, countries, or regions is not known. Some important challenges for comparative research are therefore discussed in a cross-cultural perspective. Several substantive and methodological challenges that complicate the execution of cross-cultural cancer survivorship research are presented with examples and discussed to facilitate comparative research efforts in the establishment of new survivorship cohorts and in the planning and implementation of survivorship studies. Comparative research is one key to understanding the nature of cancer survivorship, distinguishing modifiable from non modifiable factors at individual, hospital, societal, and system levels and may thus guide appropriate interventions. Lastly, suggested future courses of action within the field of comparative cancer survivorship research are provided.

Effects of perceptions of care, medical advice, and hospital quality on patient satisfaction after primary total knee replacement: A cross-sectional study.

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Tom Schaal

Full Text Available The increase in the number of patients presenting with osteoarthritis in the past decade has led to a 32% increase in knee replacement surgeries designed to reduce restrictions on patient movement and improve their quality of life. Patient satisfaction is becoming an increasingly important indicator of quality of care. This study was designed to identify predictors of various service components in the treatment process and hospital key performance indicators significantly associated with patient satisfaction.A multicenter cross-sectional study was conducted with 856 patients having their primary total knee replacements at 41 hospitals. Patient satisfaction was queried via a validated, multidimensional questionnaire mainly using a six-point scale. In addition to bivariate calculations, patient satisfaction was the dependent variable in a binary logistic regression model.The bivariate analysis showed a strong association between satisfaction and sex (male or female, the patients' health before admission, and the length of stay. The number of cases treated at each hospital did not reveal any impact on satisfaction. The multivariate analysis identified three predictors associated with overall satisfaction. The strongest factor was the treatment outcome and the weakest was the quality of food. It became apparent that the statutory procedure minimums were not being met.The relevant factors influencing patient satisfaction were partially the same as previous study results and allowed more detailed conclusions. The results provide suggestions across hospitals that could help health care providers better meet needs of patients after knee arthroplasties.

Effects of perceptions of care, medical advice, and hospital quality on patient satisfaction after primary total knee replacement: A cross-sectional study.

Science.gov (United States)

Schaal, Tom; Schoenfelder, Tonio; Klewer, Joerg; Kugler, Joachim

2017-01-01

The increase in the number of patients presenting with osteoarthritis in the past decade has led to a 32% increase in knee replacement surgeries designed to reduce restrictions on patient movement and improve their quality of life. Patient satisfaction is becoming an increasingly important indicator of quality of care. This study was designed to identify predictors of various service components in the treatment process and hospital key performance indicators significantly associated with patient satisfaction. A multicenter cross-sectional study was conducted with 856 patients having their primary total knee replacements at 41 hospitals. Patient satisfaction was queried via a validated, multidimensional questionnaire mainly using a six-point scale. In addition to bivariate calculations, patient satisfaction was the dependent variable in a binary logistic regression model. The bivariate analysis showed a strong association between satisfaction and sex (male or female), the patients' health before admission, and the length of stay. The number of cases treated at each hospital did not reveal any impact on satisfaction. The multivariate analysis identified three predictors associated with overall satisfaction. The strongest factor was the treatment outcome and the weakest was the quality of food. It became apparent that the statutory procedure minimums were not being met. The relevant factors influencing patient satisfaction were partially the same as previous study results and allowed more detailed conclusions. The results provide suggestions across hospitals that could help health care providers better meet needs of patients after knee arthroplasties.

Factors Associated with the Competencies of Public Health Workers in Township Hospitals: A Cross-Sectional Survey in Chongqing Municipality, China

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Zhifei He

2015-11-01

Full Text Available Purpose: This study aimed to explore the competencies of public health workers (PHWs of township hospitals in Chongqing Municipality (China, and determine the related impact factors of the competencies of PHWs; Methods: A cross-sectional research was conducted on 314 PHWs from 27 township hospitals in three districts in Chongqing Municipality (China, from June to August 2014. A self-assessment questionnaire was established on the basis of literature reviews and a competency dictionary. The differences in competencies among the three districts were determined by adopting the chi-square test, t-test, analysis of variance (ANOVA method, and the impact factors of the competencies of PHWs were determined by adopting stepwise regression analysis. Results: (1 Results of the demographic characteristics of PHWs in three sample districts of Chongqing Municipality showed that a significant difference in age of PHWs (p = 0.021 < 0.05 and the majors of PHWs (p = 0.045 < 0.05; (2 In terms of the self-evaluation competency results of PHWs in township hospitals, seven among the 11 aspects were found to have significant differences in the three districts by the ANOVA test; (3 By adopting the t-test and ANOVA method, results of the relationship between the characteristics of PHWs and their competency scores showed that significant differences were found in the economic level (p = 0.000 < 0.05, age (p = 0.000 < 0.05, years of working (p = 0.000 < 0.05 and title of PHWs (p = 0.000 < 0.05; (4 Stepwise regression analysis was used to determine the impact factors of the competencies of PHWs in township hospitals, including the economic level (p = 0.000 < 0.001, years of working (p = 0.000 < 0.001, title (p = 0.001 < 0.005, and public health major (p = 0.007 < 0.01. Conclusions: The competencies of the township hospital staff in Chongqing Municipality (China, are generally insufficient, therefore, regulating the medical education and training skills of PHWs is crucial

[IBEAS design: adverse events prevalence in Latin American hospitals].

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Aranaz-Andrés, J M; Aibar-Remón, C; Limón-Ramírez, R; Amarilla, A; Restrepo, F R; Urroz, O; Sarabia, O; Inga, R; Santivañez, A; Gonseth-García, J; Larizgoitia-Jauregui, I; Agra-Varela, Y; Terol-García, E

2011-01-01

To describe the methodological characteristics of the IBEAS study: adverse events prevalence in Latin American hospitals, with the aim of analysing the magnitude, significance and impact of adverse events (AE); to identify the main problems associated with patient safety AE; to increase the capacity of professionals involved in patient safety; and the setting up of patient safety agendas in the participating countries. A patient safety study launched in 35 Latin American hospitals through the analysis of AE in 5 countries: Argentina, Colombia, Costa Rica, Mexico and Peru, using a cross-sectional study using a review of clinical records as the main method. The implications of using a cross-sectional design when studying AE are described, in terms of resources required, internal validity and usefulness related to risk management. The cross-sectional design seems an efficient methodology in terms of time and resources spent, as well as being easy to carry out. Although the cross-sectional design does not review the all hospital episodes, it is able to provide a reliable estimate of prevalence and to support a surveillance system. Because of a possible survival bias, it is likely that the AE which led to hospital admissions will be overestimated, as well as the health related infections or those adverse events which are difficult to identify if the patient is not examined (e.g. contusions). Communication with the ward staff (if the patient is still hospitalised) help in finding the causality and their prevention. Copyright © 2010 SECA. Published by Elsevier Espana. All rights reserved.

Hospital care for persons with AIDS in European-Union countries; a cross-country comparison

NARCIS (Netherlands)

Postma, Maarten; Kornarou, H; Paparizos, V; Leidl, R M; Tolley, K; Kyriopoulos, J; Jager, Johannes C

This paper compares AIDS hospital care in several European-Union countries. For this purpose hospital-care utilisation studies on inpatient days and outpatient contacts were analysed in a generic approach controlling for severity stages of AIDS. Lifetime hospital-care needs for AIDS are derived,

HIV, appendectomy and postoperative complications at a reference hospital in Northwest Tanzania: cross-sectional study

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Heukelbach Jorg

2010-12-01

Full Text Available Abstract Background Appendicitis is a frequent surgical emergency worldwide. The present study was conducted to determine the prevalence of HIV, and the association of infection with clinical, intraoperative and histological findings and outcome, among patients with appendicitis. Methods We performed a cross sectional study at Weill-Bugando Medical Centre in northwest Tanzania. In total, 199 patients undergoing appendectomy were included. Demographic characteristics of patients, clinical features, laboratory, intraoperative and histopathological findings, and HIV serostatus were recorded. Results In total, 26/199 (13.1% were HIV-seropositive. The HIV-positive population was significantly older (mean age: 38.4 years than the HIV-negative population (25.3 years; p Conclusion HIV infections are common among patients with appendicitis in Tanzania, and are associated with severe morbidity, postoperative complications and longer hospital stays. Early diagnosis of appendicitis and prompt appendectomy are crucial in areas with high prevalence of HIV infection. Routine pre-test counseling and HIV screening for appendicitis patients is recommended to detect early cases who may benefit from HAART.

Weekend specialist intensity and admission mortality in acute hospital trusts in England: a cross-sectional study.

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Aldridge, Cassie; Bion, Julian; Boyal, Amunpreet; Chen, Yen-Fu; Clancy, Mike; Evans, Tim; Girling, Alan; Lord, Joanne; Mannion, Russell; Rees, Peter; Roseveare, Chris; Rudge, Gavin; Sun, Jianxia; Tarrant, Carolyn; Temple, Mark; Watson, Sam; Lilford, Richard

2016-07-09

admitted at weekends was higher than among those admitted on weekdays (adjusted odds ratio 1·10, 95% CI 1·08-1·11; pspecialist intensity ratios and weekend to weekday mortality ratios (r -0·042; p=0·654). This cross-sectional analysis did not detect a correlation between weekend staffing of hospital specialists and mortality risk for emergency admissions. Further investigation is needed to evaluate whole-system secular change during the implementation of 7 day services. Policy makers should exercise caution before attributing the weekend effect mainly to differences in specialist staffing. National Institute for Health Research Health Services and Delivery Research Programme. Copyright © 2016 Aldridge et al. Open Access article distributed under the terms of CC BY. Published by Elsevier Ltd.. All rights reserved.

Influence of initial velocity on trajectories of a charged particle in uniform crossed electric and magnetic fields

International Nuclear Information System (INIS)

Khotimah, Siti Nurul; Viridi, Sparisoma; Widayani

2017-01-01

Magnetic and electric fields can cause a charged particle to form interesting trajectories. In general, each trajectory is discussed separately in university physics textbooks for undergraduate students. In this work, a solution of a charged particle moving in a uniform electric field at right angles to a uniform magnetic field (uniform crossed electric and magnetic fields) is reported; it is limited to particle motion in a plane. Specific solutions and their trajectories are obtained only by varying the initial particle velocity. The result shows five basic trajectory patterns, i.e., straight line, sinusoid-like, cycloid, cycloid-like with oscillation, and circle-like. The region of each trajectory is also mapped in the initial velocity space of the particle. This paper is intended for undergraduate students and describes further the trajectories of a charged particle through the regions of electric and magnetic fields influenced by initial condition of the particle, where electromagnetic radiation of an accelerated particle is not considered. (paper)

Patient safety, satisfaction, and quality of hospital care: cross sectional surveys of nurses and patients in 12 countries in Europe and the United States.

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Aiken, Linda H; Sermeus, Walter; Van den Heede, Koen; Sloane, Douglas M; Busse, Reinhard; McKee, Martin; Bruyneel, Luk; Rafferty, Anne Marie; Griffiths, Peter; Moreno-Casbas, Maria Teresa; Tishelman, Carol; Scott, Anne; Brzostek, Tomasz; Kinnunen, Juha; Schwendimann, Rene; Heinen, Maud; Zikos, Dimitris; Sjetne, Ingeborg Strømseng; Smith, Herbert L; Kutney-Lee, Ann

2012-03-20

To determine whether hospitals with a good organisation of care (such as improved nurse staffing and work environments) can affect patient care and nurse workforce stability in European countries. Cross sectional surveys of patients and nurses. Nurses were surveyed in general acute care hospitals (488 in 12 European countries; 617 in the United States); patients were surveyed in 210 European hospitals and 430 US hospitals. 33 659 nurses and 11 318 patients in Europe; 27 509 nurses and more than 120 000 patients in the US. Nurse outcomes (hospital staffing, work environments, burnout, dissatisfaction, intention to leave job in the next year, patient safety, quality of care), patient outcomes (satisfaction overall and with nursing care, willingness to recommend hospitals). The percentage of nurses reporting poor or fair quality of patient care varied substantially by country (from 11% (Ireland) to 47% (Greece)), as did rates for nurses who gave their hospital a poor or failing safety grade (4% (Switzerland) to 18% (Poland)). We found high rates of nurse burnout (10% (Netherlands) to 78% (Greece)), job dissatisfaction (11% (Netherlands) to 56% (Greece)), and intention to leave (14% (US) to 49% (Finland, Greece)). Patients' high ratings of their hospitals also varied considerably (35% (Spain) to 61% (Finland, Ireland)), as did rates of patients willing to recommend their hospital (53% (Greece) to 78% (Switzerland)). Improved work environments and reduced ratios of patients to nurses were associated with increased care quality and patient satisfaction. In European hospitals, after adjusting for hospital and nurse characteristics, nurses with better work environments were half as likely to report poor or fair care quality (adjusted odds ratio 0.56, 95% confidence interval 0.51 to 0.61) and give their hospitals poor or failing grades on patient safety (0.50, 0.44 to 0.56). Each additional patient per nurse increased the odds of nurses reporting poor or fair

Prediction of Emergency Department Hospital Admission Based on Natural Language Processing and Neural Networks.

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Zhang, Xingyu; Kim, Joyce; Patzer, Rachel E; Pitts, Stephen R; Patzer, Aaron; Schrager, Justin D

2017-10-26

To describe and compare logistic regression and neural network modeling strategies to predict hospital admission or transfer following initial presentation to Emergency Department (ED) triage with and without the addition of natural language processing elements. Using data from the National Hospital Ambulatory Medical Care Survey (NHAMCS), a cross-sectional probability sample of United States EDs from 2012 and 2013 survey years, we developed several predictive models with the outcome being admission to the hospital or transfer vs. discharge home. We included patient characteristics immediately available after the patient has presented to the ED and undergone a triage process. We used this information to construct logistic regression (LR) and multilayer neural network models (MLNN) which included natural language processing (NLP) and principal component analysis from the patient's reason for visit. Ten-fold cross validation was used to test the predictive capacity of each model and receiver operating curves (AUC) were then calculated for each model. Of the 47,200 ED visits from 642 hospitals, 6,335 (13.42%) resulted in hospital admission (or transfer). A total of 48 principal components were extracted by NLP from the reason for visit fields, which explained 75% of the overall variance for hospitalization. In the model including only structured variables, the AUC was 0.824 (95% CI 0.818-0.830) for logistic regression and 0.823 (95% CI 0.817-0.829) for MLNN. Models including only free-text information generated AUC of 0.742 (95% CI 0.731- 0.753) for logistic regression and 0.753 (95% CI 0.742-0.764) for MLNN. When both structured variables and free text variables were included, the AUC reached 0.846 (95% CI 0.839-0.853) for logistic regression and 0.844 (95% CI 0.836-0.852) for MLNN. The predictive accuracy of hospital admission or transfer for patients who presented to ED triage overall was good, and was improved with the inclusion of free text data from a patient

Hospital marketing: characterization of marketing actions in private hospitals in the city of São Paulo - Brazil.

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Leiderman, Eduardo Blay; Padovan, Jorge Luis; Zucchi, Paola

2010-01-01

Characterize the marketing actions in private hospitals in the city of São Paulo, the organizational structure of the marketing area, the target public of marketing actions and the media used. Exploratory cross-sectional study, carried out by a survey made with hospital administrators. The hospitals studied were clearly divided in two groups whose differentials are statistically significant: 1. good infrastructure and equipment, with a well-defined investment policy in marketing; 2. worse infrastructure and less equipment, with lower proportional investment in marketing. 1. The actions most used are the evaluation of patients/caregivers satisfaction, web site and dissemination of the hospital services. 2. The hospital administrators attribute a level of significant importance to the application of hospital marketing concepts. 3. There is a marketing structure in most of the hospitals studied. 4. The hospitals consider as extremely or very important publics: patients and relatives, doctors, collaborators, health plans and community. 5. The media most used are the most simple and of lower cost. 6. There is a statistically significant correlation between the higher investment in marketing and the best infrastructure. 7. The studied hospitals apply the concept of marketing in a restricted way.

Asymptomatic bacteriuria and antimicrobial susceptibility pattern of the isolates among pregnant women attending Dessie referral hospital, Northeast Ethiopia: A hospital-based cross-sectional study.

Science.gov (United States)

Ali, Ismail Ebrie; Gebrecherkos, Teklay; Gizachew, Mucheye; Menberu, Martha Alemayehu

2018-05-01

The aim of the current study was to find out the prevalence of asymptomatic bacteriuria, antimicrobial susceptibility pattern of the isolates and related risk factors among pregnant women. A hospital-based cross-sectional study was carried out from February 2017 to May 2017 among asymptomatic pregnant mothers attending Dessie Referral Hospital, Northeast Ethiopia. About 10-15 mL of freshly voided midstream urine samples were collected from each study participants, and analyzed at Dessie regional research microbiology laboratory with conventional antibiotic susceptibility, and biochemical tests. Isolates were tested against commonly used antimicrobials using Kirby Bauer disc diffusion method. Data were analyzed by SPSS version 20 software and in all cases, p-values below 0.05 was considered as statistically significant. Overall, 358 pregnant women were included in the study with a mean age of 26.5±4.6 years (range, 19-43 yrs). The overall prevalence of asymptomatic bacteriuria was 56% (15.6%). Isolated microorganisms were mainly Escherichia coli and Staphylococcus aureus (for each, n=18; 31%). Escherichia coli and Staphylococcus aureus were resistant to ampicillin (66.7%), and penicillin (94.44%). The prevalence of multidrug- resistant isolates was 72.4%. History of catheterization [AOR=2.28, 95% CI=(1.03-5.06)] and anemia [AOR=4.98, 95% CI=(2.395-10.34) were statistically significant regarding the prevalence of asymptomatic bacteriuria. The overall prevalence of asymptomatic bacteriuria among pregnant women in the study area was high. The presence of asymptomatic bacteriuria and their antibiotic susceptibility test results should be taken into consideration during the management of pregnant women who are visiting antenatal care clinic.

Drugs use during pregnancy at Medani Maternity Hospital, Sudan ...

African Journals Online (AJOL)

Background: There is a limited knowledge on use of drugs during pregnancy including beneficial and possible adverse effects of drugs on both the mother and the fetus. Objective: To investigate epidemiology of use of drugs during pregnancy. Methods: A cross sectional hospital based study at Medani Hospital during the ...

Characterisation of drug resistance of nosocomial ESBL-producing E. coli isolates obtained from a Turkish university hospital between 2009 and 2012 by pulsed field gel electrophoresis and antibiotic resistance tests.

Science.gov (United States)

Karagöz, Alper; Sunnetcioglu, Mahmut; Ceylan, Mehmet Resat; Bayram, Yasemin; Yalcin, Gozde; Kocak, Nadir; Suvak, Burak; Andac, Cenk A

2016-01-01

In this study, drug resistance of 28 ESBL-producing Escherichia coli isolates obtained from 144 patients hospitalized at the Yüzüncüyil University Hospital at Van (YUH), Turkey, between 2009 and 2012 were characterized by pulsed field gel electrophoresis and antibiotic susceptibility tests. Antibiotic resistance profile was determined by Phoenix automated system (BD, USA). The ratio of ESBL-producing E. coli strains was determined to be 19.4% (28 out of 144 E. coli isolates). It was determined that the anaesthesiology, paediatrics and thoracic medicine intensive care units in YUH were cross-contaminated between 2009 and 2012 by ESBL-producing E. coli strains, which is a sign of nosocomial infection in YUH. Analysis of PFGE results gave rise to two main PFGE profiles, profile-A with four subprofiles and profile-B with three subprofiles, where profile-A predominates over profile-B (14%). Comparison of the antibiotic resistance profile with the PFGE profile yielded similarities while some differences also exist due to either identical restriction enzyme cutting sites with slightly different genetic sequences in between the cutting sites or newly formed restriction enzyme cutting sites that do not affect antibiotic resistance genes. Enterobacteriaceae, particularly E. coli, have developed resistance in YUH by producing ESBLs against oxyimino and non-oxyimino cephalosporins, and penicillin-type antibiotics. Therefore, more effective antibiotics such as cefoxitin or cefoperazone-sulbactam should be used for the treatment of future nosocomial infections in YUH while hospital staff should take care with hygiene, such as hand washing.

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

Science.gov (United States)

Anbäcken, O

1994-01-01

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

The orthopaedic error index: development and application of a novel national indicator for assessing the relative safety of hospital care using a cross-sectional approach.

Science.gov (United States)

Panesar, Sukhmeet S; Netuveli, Gopalakrishnan; Carson-Stevens, Andrew; Javad, Sundas; Patel, Bhavesh; Parry, Gareth; Donaldson, Liam J; Sheikh, Aziz

2013-11-21

The Orthopaedic Error Index for hospitals aims to provide the first national assessment of the relative safety of provision of orthopaedic surgery. Cross-sectional study (retrospective analysis of records in a database). The National Reporting and Learning System is the largest national repository of patient-safety incidents in the world with over eight million error reports. It offers a unique opportunity to develop novel approaches to enhancing patient safety, including investigating the relative safety of different healthcare providers and specialties. We extracted all orthopaedic error reports from the system over 1 year (2009-2010). The Orthopaedic Error Index was calculated as a sum of the error propensity and severity. All relevant hospitals offering orthopaedic surgery in England were then ranked by this metric to identify possible outliers that warrant further attention. 155 hospitals reported 48 971 orthopaedic-related patient-safety incidents. The mean Orthopaedic Error Index was 7.09/year (SD 2.72); five hospitals were identified as outliers. Three of these units were specialist tertiary hospitals carrying out complex surgery; the remaining two outlier hospitals had unusually high Orthopaedic Error Indexes: mean 14.46 (SD 0.29) and 15.29 (SD 0.51), respectively. The Orthopaedic Error Index has enabled identification of hospitals that may be putting patients at disproportionate risk of orthopaedic-related iatrogenic harm and which therefore warrant further investigation. It provides the prototype of a summary index of harm to enable surveillance of unsafe care over time across institutions. Further validation and scrutiny of the method will be required to assess its potential to be extended to other hospital specialties in the UK and also internationally to other health systems that have comparable national databases of patient-safety incidents.

Near field of an oscillating electric dipole and cross-polarization of a collimated beam of light: Two sides of the same coin

Science.gov (United States)

Aiello, Andrea; Ornigotti, Marco

2014-09-01

We address the question of whether there exists a hidden relationship between the near-field distribution generated by an oscillating electric dipole and the so-called cross-polarization of a collimated beam of light. We find that the answer is affirmative by showing that the complex field distributions occurring in both cases have a common physical origin: the requirement that the electromagnetic fields must be transverse.

Risk of maltreatment-related injury: a cross-sectional study of children under five years old admitted to hospital with a head or neck injury or fracture.

Directory of Open Access Journals (Sweden)

Joseph Jonathan Lee

Full Text Available To determine the predictive value and sensitivity of demographic features and injuries (indicators for maltreatment-related codes in hospital discharge records of children admitted with a head or neck injury or fracture.Population-based, cross sectional study.NHS hospitals in England.Children under five years old admitted acutely to hospital with head or neck injury or fracture.Hospital Episodes Statistics, 1997 to 2009.Maltreatment-related injury admissions, defined by ICD10 codes, were used to calculate for each indicator (demographic feature and/or type of injury: i the predictive value (proportion of injury admissions that were maltreatment-related; ii sensitivity (proportion of all maltreatment-related injury admissions with the indicator.Of 260,294 childhood admissions for fracture or head or neck injury, 3.2% (8,337 were maltreatment-related. With increasing age of the child, the predictive value for maltreatment-related injury declined but sensitivity increased. Half of the maltreatment-related admissions occurred in children older than one year, and 63% occurred in children with head injuries without fractures or intracranial injury.Highly predictive injuries accounted for very few maltreatment-related admissions. Protocols that focus on high-risk injuries may miss the majority of maltreated children.

Patterns of referral to Red Cross War Memorial Children's Hospital ...

African Journals Online (AJOL)

Memorial Children's Hospital, K1ipfontein Road, Rondebosch, 7700 RSA,. Accepted 10 Apt 1990, ... of every patient referred in the study period, or recorded the folder number of ..... Council for providing a short-term grant; Mariah Jacobs of the.

[Scientific production from public hospitals of the City of Buenos Aires, 2017].

Science.gov (United States)

Ibarra, Mariano; Torrents, Milagros; Ossorio, María Fabiana; Ferrero, Fernando

2018-01-01

The number of publications in the scientific literature coming from an institution is an indicator of its scientific production. The scientific production of the hospitals of the Government of the City of Buenos Aires (GCBA) has been evaluated previously, but without discriminating how much of that production corresponded to other academic institutions settled there (University of Buenos Aires, UBA, National Council of Scientific Research and Techniques, CONICET). Our objective was to evaluate the publications included in PubMed that correspond to hospitals of the GCBA, describe their main characteristics, and discriminate the contribution of other academic institutions (UBA and CONICET). It is a cross-sectional study based on a PubMed search, using the name of each of the 34 GCBA hospitals, CONICET and UBA in the "affiliation" field. In total, 2727 publications from GCBA hospitals were identified (4.6% of Argentine publications); 73.9% in English, 78.9% in relation to humans, 37.2% in the last 5 years; 6.4% with high level of evidence (clinical trials and meta-analysis), and 28.4% including children. Compared to the national total, the GCBA publications include fewer works in English, more research in humans, more clinical trials and more research in children. Of the publications corresponding to hospitals of the GCBA, 90.4% did not share the affiliation with CONICET or with UBA. In conclusion, the GCBA hospitals generated 4.6% of the total Argentine publications in PubMed; and 90% of these was not shared with UBA or CONICET. Publications from GCBA institutions include more clinical trials and research in children.

Sexual Dysfunction among Females Receiving Psychotropic Medication: A Hospital-based Cross-sectional Study

Science.gov (United States)

Shetageri, Veda N.; Bhogale, Govind S.; Patil, N. M.; Nayak, R. B.; Chate, S. S.

2016-01-01

Background: Sexual dysfunction (SD) is a known adverse effect of psychotropic medications. Even though sexual difficulties are common among women; very few studies have been carried out in India. Objective: To study the prevalence and nature of SD among females receiving psychotropic medications and to compare the SD among female patients receiving antipsychotics and antidepressants. Materials and Methods: Female investigator conducted a hospital-based cross-sectional study on female patients visiting the psychiatry outpatient department. Patients meeting inclusion criteria were assessed for SD disorder as per Diagnostic and Statistical Manual of Mental Disorders 4th Edition Text Revision. SD severity was measured using Female Sexual Function Index (FSFI) scale. Results: The prevalence of SD in this study was 68.32%. There was more than one SD in 48 (47.52%). FSFI score was significantly low in patients with SD as compared to patients not having SD (P = 0.001). SD was more common in patients who were on combination of antidepressants and benzodiazepines than antidepressant alone or antipsychotic alone. Conclusion: SD was prevalent in more than 50% of female patients on psychotropic drugs. Number of patients on individual psychotropic drugs was so small that a definite conclusion could not be drawn. Study emphasizes the need to carry out similar study on larger number of patients to get better insight into this problem. PMID:27833229

Perceived barriers to communication between hospital and nursing home at time of patient transfer.

Science.gov (United States)

Shah, Faraaz; Burack, Orah; Boockvar, Kenneth S

2010-05-01

To identify perceived barriers to communication between hospital and nursing home at the time of patient transfer and examine associations between perceived barriers and hospital and nursing home characteristics. Mailed survey. Medicare- or Medicaid-certified nursing homes in New York State. Nursing home administrators, with input from other nursing home staff. Respondents rated the importance as a barrier to hospital-nursing home communication of (1) hospital providers' attitude, time, effort, training, payment, and familiarity with nursing home patients; (2) unplanned and off-hours transfers; (3) HIPAA privacy regulations; and (4) lost or failed information transmission. Associations were determined between barriers and the following organizational characteristics: (1) hospital-nursing home affiliations, pharmacy or laboratory agreements, cross-site staff visits, and cross-site physician care; (2) hospital size, teaching status, and frequency of geriatrics specialty care; (3) nursing home size, location, type, staffing, and Medicare quality indicators; and (4) hospital-to-nursing home communication, consistency of hospital care with health care goals, and communication quality improvement efforts. Of 647 questionnaires sent, 229 were returned (35.4%). The most frequently reported perceived barriers to communication were sudden or unplanned transfers (44.4%), transfers that occur at night or on the weekend (41.4%), and hospital providers' lack of effort (51.0%), lack of familiarity with patients (45.0%), and lack of time (43.5%). Increased hospital size, teaching hospitals, and urban nursing home location were associated with greater perceived importance of these barriers, and cross-site staff visits and hospital provision of laboratory and pharmacy services to the nursing home were associated with lower perceived importance of these barriers. Hospital and nursing home characteristics and interorganizational relationships were associated with nursing home

Liver transplantation at Red Cross War Memorial Children's Hospital ...

African Journals Online (AJOL)

The liver transplant programme for infants and children at Red Cross War Memorial ... Four combined liver/kidney transplants have been performed. ... was complicated by chronic rejection (1) and TB-drug-induced subfulminant liver failure (1).

Prevalence of hepatitis B virus in patients with diabetes mellitus: a comparative cross sectional study at Woldiya General Hospital, Ethiopia.

Science.gov (United States)

Mekonnen, Daniel; Gebre-Selassie, Solomon; Fantaw, Surafel; Hunegnaw, Andualem; Mihret, Adane

2014-01-01

The overall prevalence of HBV in Ethiopia varies from 4.7-16.8% for Hepatitis B surface antigen (HBsAg) and 70-76.38% for at least one marker positive. Patients suffering from type I Diabetes Mellitus (DM) incur high risk of infection with hepatotropic viruses because of frequent hospitalization and blood tests. A comparative cross sectional study was conducted at Woldiya General Hospital using 108 consented study populations from Diabetes and 108 non diabetes control groups during the period November 2010 - January 2011. VISITECT HBsAg rapid test kit and Humastat 80 chemistry analyzer were used. Multivariate logistic regression was used to see the association of HBV with clinical history of participants and Sociodemographic variables. All tests were two-sided with α-level of 0.05 and 80% power. Prevalence of HBsAg was equal between diabetic and non diabetic individuals, 3.7% indicating that there was no difference between the two groups. Only history of invasive procedures and chronic liver disease showed association with HBsAg seropositivity. In this study a positive relation was not indicated between HBV and Diabetes and the prevalence of HBsAg was equal between diabetic and non diabetic individuals.

Maxima of the scattering cross section, the wave vector being quasi orthogonal to the confining magnetic field

International Nuclear Information System (INIS)

Meyer, R.-L.

1975-01-01

The evolution of the scattering cross section maximas of an electromagnetic wave by a magnetoplasma, the angle between the wave vector and the confining magnetic field approaching π/2 were computed. It is shown that the maximas are shifted toward the roots of the electrostatic dispersion relation in perpendicular propagation. These roots are not exactly the electron cyclotron harmonics [fr

Are Facebook user ratings associated with hospital cost, quality and patient satisfaction? A cross-sectional analysis of hospitals in New York State.

Science.gov (United States)

Campbell, Lauren; Li, Yue

2018-02-01

Hospital care costs are high while quality varies across hospitals. Patient satisfaction may be associated with better clinical quality, and social media ratings may offer another opportunity to measure patient satisfaction with care. To test if Facebook user ratings of hospitals are associated with existing measures of patient satisfaction, cost and quality. Data were obtained from Centers for Medicare and Medicaid Services Hospital Compare, the Hospital Inpatient Prospective Payment System impact files and the Area Health Resource File for 2015. Information from hospitals' Facebook pages was collected in July 2016. Multivariate linear regression was used to test if there is an association between Facebook user ratings (star rating and adjusted number of 'likes') and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction measures, the 30-day all-cause readmission rate, and the Medicare spending per beneficiary (MSPB) ratio. One hundred and thirty-six acute care hospitals in New York State in 2015. An increase in the Facebook star rating is associated with significant increases in 21/23 HCAHPS measures (p≤0.003). An increase in the adjusted number of 'likes' is associated with very small increases in 3/23 HCAHPS measures (pFacebook user ratings are not associated with the 30-day all-cause readmission rate or the Medicare spending per beneficiary ratio. Results demonstrate an association between HCAHPS patient satisfaction measures and Facebook star ratings. Adjusted number of 'likes' may not be a useful measure of patient satisfaction. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Maturity of hospital information systems: Most important influencing factors.

Science.gov (United States)

Vidal Carvalho, João; Rocha, Álvaro; Abreu, António

2017-07-01

Maturity models facilitate organizational management, including information systems management, with hospital organizations no exception. This article puts forth a study carried out with a group of experts in the field of hospital information systems management with a view to identifying the main influencing factors to be included in an encompassing maturity model for hospital information systems management. This study is based on the results of a literature review, which identified maturity models in the health field and relevant influencing factors. The development of this model is justified to the extent that the available maturity models for the hospital information systems management field reveal multiple limitations, including lack of detail, absence of tools to determine their maturity and lack of characterization for stages of maturity structured by different influencing factors.

Low field MR imaging of sellar and parasellar lesions: Experience in a developing country hospital

International Nuclear Information System (INIS)

Ogbole, G.I.; Adeyinka, O.A.; Okolo, C.A.; Ogun, A.O.; Atalabi, O.M.

2012-01-01

Background: Magnetic resonance imaging (MRI), an advancement which followed computed tomography (CT) is expensive and inaccessible in most developing countries. However it is the procedure of choice in evaluating sellar and parasellar lesions. Its major advantages are its superior soft tissue contrast differentiation, its capacity for multiplanar imaging and nonexistence of ionising radiation. Its use is relatively new in Nigeria, a developing economy in Africa. Since its introduction in 2005, it has been utilised extensively for neuroimaging at the University College Hospital (UCH), Ibadan; a large hospital in south-western Nigeria. Objective: To review the role and pattern of low field MR Imaging in sellar and parasellar lesions presenting to a tertiary care centre in Nigeria. Methods: All 62 patients with clinically suspected sellar and parasellar masses, referred to the Department of Radiology, UCH Ibadan for MRI between December 2006 and January 2010 were retrospectively analysed. The examinations were performed using an open 0.2 T permanent magnet MR unit. T1W, T2W, T2/FLAIR, TOF and T1W post gadolinium DTPA sequences of the sellar region were obtained. Results: Of the 62 patients, there were 27 males and 35 females. The modal age group was 40–49 years with a mean age of 39.94 years (±16.65 years). Twenty-four cases (38.7%) had histological diagnosis, of which 20 (83.3%) were consistent with initial MRI diagnosis. Pituitary adenomas were the commonest (58.06%) lesions of the sellar and parasellar regions. Others include parasellar meningiomas, cranipharyngiomas, and giant aneurysms. Headache and visual impairment were the major presenting features and showed no significant correlation with tumour size. Conclusion: The use of low field MRI in the diagnostic evaluation of patients with suspected sellar or parasellar lesions in developing countries of low economic resource is commendable as it provides beneficial outcomes in management.

Investigation of high-current low pressure quasistationary volume discharge in cross-field ExH

International Nuclear Information System (INIS)

Bashutin, O.A.; Vovchenko, E.D.; Kirnev, G.S.

1995-01-01

Different types of high current discharge permitted to create large volume of high density homogeneous plasma are widely used in modern technique. Such discharges are applied as plasma emitters of charged particles and also in various technologies for sputtering, implantation and etching of materials. The results of a plasma electron density dynamics investigation of low pressure quasistationary volume discharge in cross-field E x H is described in this paper. The discharge was created in a quadrupole magnetic system with special form electrodes and has following characteristics current up to 1,8 kA, voltage on the interval 80-120 V, existence time up to 1,5 ms. The discharge conserves diffusive character of plasma and cathode layer on all current range. On a first research stage plasma parameters of discharge were determined by means of Langmuir probe, that could been used in central discharge region only, where magnetic field was equal to zero. An obtained plasma density was reached 1,5*10 15 cm -3 with electron temperature T e =10 eV. The research of discharge plasma in regions with magnetic field had required to use interferometric measurement technique

General renormalized statistical approach with finite cross-field correlations

International Nuclear Information System (INIS)

Vakulenko, M.O.

1992-01-01

The renormalized statistical approach is proposed, accounting for finite correlations of potential and magnetic fluctuations. It may be used for analysis of a wide class of nonlinear model equations describing the cross-correlated plasma states. The influence of a cross spectrum on stationary potential and magnetic ones is investigated. 10 refs. (author)

Intraband absorption in GaAs-(Ga,Al)As variably spaced semiconductor superlattices under crossed electric and magnetic fields

Science.gov (United States)

Reyes-Gómez, E.; Raigoza, N.; Oliveira, L. E.

2013-11-01

A theoretical study of the intraband absorption properties of GaAs-Ga1-xAlxAs variably spaced semiconductor superlattices under crossed magnetic and electric fields is presented. Calculations are performed for the applied electric field along the growth-axis direction, whereas the magnetic field is considered parallel to the heterostructure layers. By defining a critical electric field so that the heterostructure energy levels are aligned in the absence of the applied magnetic fields, one finds that, in the weak magnetic-field regime, an abrupt red shift of the absorption coefficient maxima is obtained at fields equal to or larger than the critical electric field, a fact which may be explained from the localization properties of the electron wave functions. Results in the strong magnetic-field regime reveal a rich structure on the intraband absorption coefficient which may be explained from the strong dispersion exhibited by both the energy levels and transition strengths as functions of the generalized orbit-center position. Moreover, the possibility of occurrence of absorption in a wide frequency range is also demonstrated. Present calculated results may be of interest for future design and improvement of multilayered-based photovoltaic and solar-cell devices.

Increase in hospital admissions for acute childhood asthma in Cape ...

African Journals Online (AJOL)

To determine whether hospital admissions for acute childhood asthma were rising in Cape Town in line with the experience of other countries, Red Cross War Memorial Children's Hospital's records for the period 1978 - 1990 were analysed. These were compared with total admissions for non-surgical causes and lower ...

[Ryazan hospital--80 years].

Science.gov (United States)

Klimov, A S; Gromov, M F

2012-02-01

In December 2011 marked 80 years of the founding of the Ryazan garrison hospital, originally housed in two buildings: "Redut housed"--a monument of architecture of the XVIII century and the former almshouses room "for the maimed in the war", was built in 1884 now Ryazan garrison hospital (from 2010--Branch No 6 FSI "in 1586 the district military hospital in the Western Military District", the Defense Ministry of Russia)--a multi-field medical preventive institution on the basis of which soldiers, military retirees, family members and military retirees from Ryazan, Moscow, Tambov regions are treated. Every year more than 7 thousand patients get treatment here. During the counterterrorism operations in Chechnya over 800 wounded were brought to the hospital from the battle area.

The Relationship between Place of Residence and Hospitalization Rate in the Biggest Referral Hospital of the Northwest according to Hospitalization Wards

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Amin Talebpour

2016-06-01

Full Text Available ​ Background and objectives: In accordance with the global pattern, the urban population in Iran is higher than the rural population. But, are the statistics of using hospitalization services in public hospitals in these two categories similar to this pattern? This study seeks to determine the effect of place of residence on hospitalization rate by examining annual hospitalization statistics of the country’s biggest referral hospital in the northwest. Material and Methods: The method used in this study is cross-sectional and all cases of hospitalization in Imam Reza Hospital as the northwest’s biggest referral hospital were picked by available sampling method. The cases of 30260 hospitalized patients were examined through direct observation and items extracted from their files were recorded in the checklist. In order to determine the relations between the variables, K2 test was applied and the P-value was considered less than 0.05 The obtained data were analyzed by SPSS.16 software. Results: Results indicated that the frequency distribution of patients in terms of their urban or rural residence did not yield any significant difference (P>0/05. Results also showed that the highest hospitalization rate for urban patients was 16.1% (3305 individuals in surgery ward while it was 14.2% (1384 individuals for rural patients in orthopedic ward. The least significant statistical difference between urban and rural hospitalization rates was observed in renal ward with 72.9% (1162 individual urban patients and 27.1% (432 individuals rural patients of total patients hospitalized in this ward. The most significant statistical difference between urban and rural hospitalization rates was observed in ICU with 44.9% (297 individuals urban patients and 55.1% (365 individuals rural patients of the total patients hospitalized in this ward. Conclusion: A relative comparison among illnesses in urban and rural populations, aside from illnesses caused by trauma

Pre-hospital care time intervals among victims of road traffic injuries in Iran. A cross-sectional study.

Science.gov (United States)

Bigdeli, Maryam; Khorasani-Zavareh, Davoud; Mohammadi, Reza

2010-07-09

Road traffic injuries (RTIs) are a major public health problem, requiring concerted efforts both for their prevention and a reduction of their consequences. Timely arrival of the Emergency Medical Service (EMS) at the crash scene followed by speedy victim transportation by trained personnel may reduce the RTIs' consequences. The first 60 minutes after injury occurrence--referred to as the "golden hour"--are vital for the saving of lives. The present study was designed to estimate the average of various time intervals occurring during the pre-hospital care process and to examine the differences between these time intervals as regards RTIs on urban and interurban roads. A retrospective cross-sectional study was designed and various time intervals in relation to pre-hospital care of RTIs identified in the ambulance dispatch centre in Urmia, Iran from 20 March 2005 to 20 March 2007. All cases which resulted in ambulance dispatches were reviewed and those that had complete data on time intervals were analyzed. In total, the cases of 2027 RTI victims were analysed. Of these, 61.5% of the subjects were injured in city areas. The mean response time for city locations was 5.0 minutes, compared with 10.6 minutes for interurban road locations. The mean on-scene time on the interurban roads was longer than on city roads (9.2 vs. 6.1 minutes, p transport times from the scene to the hospital were also significantly longer for interurban incidents (17.1 vs. 6.3 minutes, p transport and total time intervals among EMS responding to RTI incidents were longer for interurban roads, compared to the city areas. More research should take place on needs-to and access-for EMS on city and interurban roads. The notification interval seems to be a hidden part of the post-crash events and indirectly affects the "golden hour" for victim management and it needs to be measured through the establishment of the surveillance systems.

Medication self-management skills and cognitive impairment in older adults hospitalized for heart failure: A cross-sectional study.

Science.gov (United States)

Howell, Erik H; Senapati, Alpana; Hsich, Eileen; Gorodeski, Eiran Z

2017-01-01

Cognitive impairment is highly prevalent among older adults (aged ≥65 years) hospitalized for heart failure and has been associated with poor outcomes. Poor medication self-management skills have been associated with poor outcomes in this population as well. The presence and extent of an association between cognitive impairment and poor medication self-management skills in this population has not been clearly defined. We assessed the cognition of consecutive older adults hospitalized for heart failure, in relation to their medication self-management skills. We conducted a cross-sectional study of older adults (aged ≥65 years) who were hospitalized for heart failure and were being discharged home. Prior to discharge, we assessed cognition using the Mini-Cog. We also tested patients' ability to read a pill bottle label, open a pill bottle safety cap, and allocate mock pills to a pill box. Pill allocation performance was assessed quantitatively (counts of errors of omission and commission) and qualitatively (patterns suggestive of knowledge-based mistakes, rule-based mistakes, or skill-based slips). Of 55 participants, 22% were found to have cognitive impairment. Patients with cognitive impairment tended to be older as compared to those without cognitive impairment (mean age = 81 vs 76 years, p = NS). Patients with cognitive impairment had a higher prevalence of inability to read pill bottle label (prevalence ratio = 5.8, 95% confidence interval = 3.2-10.5, p = 0.001) and inability to open pill bottle safety cap (prevalence ratio = 3.3, 95% confidence interval = 1.3-8.4, p = 0.03). While most patients (65%) had pill-allocation errors regardless of cognition, those patients with cognitive impairment tended to have more errors of omission (mean number of errors = 48 vs 23, p = 0.006), as well as more knowledge-based mistakes (75% vs 40%, p = 0.03). There is an association between cognitive impairment and poor

Job related stress among nurses working in Jimma Zone public hospitals, South West Ethiopia: a cross sectional study.

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Dagget, Tadesse; Molla, Ashagre; Belachew, Tefera

2016-01-01

Occupational stress exists in every profession, nevertheless, the nursing profession appears to experience more stress at work compared to other health care workers. Unmanaged stress leads to high levels of employee dissatisfaction, illness, absenteeism, high turnover, and decreased productivity that compromise provision of quality service to clients. However, there is a scarcity of information about nurses' job stress in Jimma zone public hospital nurses. The aim of the present study was to assess job related stress and its predictors among nurses working in Jimma Zone public hospitals, South-West Ethiopia in 2014. An institution based cross sectional study was conducted from March 10 to April 10, 2014 through a census of nurses who are working in Jimma Zone public hospitals using a structured self-administered questionnaire. SPSS Statistics Version 20 used. For the outcome variable: overall job related stress, the participant's responses on each item score summed: a stress score ranging from a minimum of 26 and maximum score of 116. The higher the sum the more the stressed the nurse. The level of stress calculated through tertial the lower to low stress, the middle to moderate & the higher to high stress. Moreover, bivariate and multivariable linear regressions done to see the association between the predictor (sex, age, mutual understanding at work, Job satisfaction and working unit/department) and the outcome variable (Job related stress). A total of 341 nurses working in Jimma Zone public hospitals were given the questionnaire, and the response rate was 92.3 % (315). This study indicated an average overall job related stress level of 58.46 ± 12.62. The highest level of job related stress was on the sub scale of dealing with death & dying mean score of 62.94 % followed by uncertainty regarding patient treatment 57.72 % and workload 57.6 %. While job related stress from sexual harassment had the lowest mean score of 46.19 %. Overall job related stress varies

Medication self-management skills and cognitive impairment in older adults hospitalized for heart failure: A cross-sectional study

Directory of Open Access Journals (Sweden)

Erik H Howell

2017-03-01

Full Text Available Background: Cognitive impairment is highly prevalent among older adults (aged ≥65 years hospitalized for heart failure and has been associated with poor outcomes. Poor medication self-management skills have been associated with poor outcomes in this population as well. The presence and extent of an association between cognitive impairment and poor medication self-management skills in this population has not been clearly defined. Objective: We assessed the cognition of consecutive older adults hospitalized for heart failure, in relation to their medication self-management skills. Methods: We conducted a cross-sectional study of older adults (aged ≥65 years who were hospitalized for heart failure and were being discharged home. Prior to discharge, we assessed cognition using the Mini-Cog. We also tested patients’ ability to read a pill bottle label, open a pill bottle safety cap, and allocate mock pills to a pill box. Pill allocation performance was assessed quantitatively (counts of errors of omission and commission and qualitatively (patterns suggestive of knowledge-based mistakes, rule-based mistakes, or skill-based slips. Results: Of 55 participants, 22% were found to have cognitive impairment. Patients with cognitive impairment tended to be older as compared to those without cognitive impairment (mean age = 81 vs 76 years, p = NS. Patients with cognitive impairment had a higher prevalence of inability to read pill bottle label (prevalence ratio = 5.8, 95% confidence interval = 3.2–10.5, p = 0.001 and inability to open pill bottle safety cap (prevalence ratio = 3.3, 95% confidence interval = 1.3–8.4, p = 0.03. While most patients (65% had pill-allocation errors regardless of cognition, those patients with cognitive impairment tended to have more errors of omission (mean number of errors = 48 vs 23, p = 0.006, as well as more knowledge-based mistakes (75% vs 40%, p = 0.03. Conclusion

German cross-cultural psychology

OpenAIRE

Trommsdorff, Gisela

1986-01-01

The present study deals with German-language cross-cultural research in different fields of psychology which attempts to achieve one Or more goals of cross-cultural psychology. First, methodological problems are discussed, followed by a selective presentation of cross-cultural research in personality, clinical, ethological, developmental, and social psychology. The theoretical and methodological advancement of these studies is investigated with respect to four approaches - universals in cross...

Examination of psychosocial predictors of Chinese hospital pharmacists' intention to provide clinical pharmacy services using the theory of planned behaviour: a cross-sectional questionnaire study.

Science.gov (United States)

He, Yuan; Yang, Fan; Mu, Dongqin; Xing, Yuan; Li, Xin

2016-10-05

Main study aim was as follows: (1) to explore the usefulness of the theory of planned behaviour (TPB) model in predicting Chinese hospital pharmacists' intention to provide clinical pharmacy services (CPSs), including auxiliary CPSs and core CPSs; (2) to identify the main factors affecting the Chinese hospital pharmacists' intention to provide core CPSs based on TPB quantitatively. Cross-sectional questionnaire study. The study was conducted in 22 general hospitals in seven cities located in the eastern and western part of China. 416 hospital pharmacists (292 (70.2%) female) entered and completed the study. Quantitative responses with hospital pharmacists' intention, attitude, subjective norms (SNs) and perceived behavioural control (PBC) over provision of CPSs and their past behaviour (PB)-related CPSs. The structural equation model analysis found that attitude (p=0.0079, β=0.12), SN (p=0.038, β=0.10) and the pharmacists' intention to provide auxiliary CPSs (p=0.0001, β=0.63) significantly predicted of their intention to provide core CPSs, accounting for 54.0% of its variance. Attitude (p=0.0001, β=0.35), PBC (p=0.0182, β=0.12) and PB (p=0.0009, β=0.15) are significant predictors of pharmacists' intention, accounting for 21% of the variance in pharmacists' intention to provide auxiliary CPSs. The TPB with the addition of PB is a useful framework for predicting pharmacists' intention to provide CPSs in Chinese hospital care context. Strategies to improve hospital pharmacists' intention to provide CPSs should focus on helping the individuals related medical care see the value of CPSs, altering their perception of social pressure towards core CPSs and the removal of obstacles that impede the translation of intentions into behaviour. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Examination of psychosocial predictors of Chinese hospital pharmacists' intention to provide clinical pharmacy services using the theory of planned behaviour: a cross-sectional questionnaire study

Science.gov (United States)

He, Yuan; Yang, Fan; Mu, Dongqin; Xing, Yuan; Li, Xin

2016-01-01

Objectives Main study aim was as follows: (1) to explore the usefulness of the theory of planned behaviour (TPB) model in predicting Chinese hospital pharmacists' intention to provide clinical pharmacy services (CPSs), including auxiliary CPSs and core CPSs; (2) to identify the main factors affecting the Chinese hospital pharmacists' intention to provide core CPSs based on TPB quantitatively. Design Cross-sectional questionnaire study. Setting The study was conducted in 22 general hospitals in seven cities located in the eastern and western part of China. Participants 416 hospital pharmacists (292 (70.2%) female) entered and completed the study. Primary and secondary outcome measures Quantitative responses with hospital pharmacists' intention, attitude, subjective norms (SNs) and perceived behavioural control (PBC) over provision of CPSs and their past behaviour (PB)-related CPSs. Results The structural equation model analysis found that attitude (p=0.0079, β=0.12), SN (p=0.038, β=0.10) and the pharmacists' intention to provide auxiliary CPSs (p=0.0001, β=0.63) significantly predicted of their intention to provide core CPSs, accounting for 54.0% of its variance. Attitude (p=0.0001, β=0.35), PBC (p=0.0182, β=0.12) and PB (p=0.0009, β=0.15) are significant predictors of pharmacists' intention, accounting for 21% of the variance in pharmacists' intention to provide auxiliary CPSs. Conclusions The TPB with the addition of PB is a useful framework for predicting pharmacists' intention to provide CPSs in Chinese hospital care context. Strategies to improve hospital pharmacists' intention to provide CPSs should focus on helping the individuals related medical care see the value of CPSs, altering their perception of social pressure towards core CPSs and the removal of obstacles that impede the translation of intentions into behaviour. PMID:27707835

Statistical observation on autopsy cases of malignancy at the Japanese Red Cross, Nagasaki Atomic Bomb Hospital

Energy Technology Data Exchange (ETDEWEB)

Takahara, O; Toyoda, S; Tsuno, S; Mukai, H; Uemura, S [Nagasaki Atomic Bomb Hospital (Japan)

1976-09-01

Statistical observation was made as to autopsy cases of atomic-bomb survivors in Nagasaki. The total of autopsy cases at the Japanese Red Cross, Nagasaki Atomic Bomb Hospital from the opening of the hospital, 1968, to December in 1975 was 1,486 cases (autopsy rate, 65.1%) in which 880 cases of atomic bomb survivors (autopsy rate, 68.0%) were contained. Cases of malignancy totaled 829 and 528 cases of those were atomic bomb survivors. Cases of malignancy were divided into three groups, that is, group exposured to atomic bomb at place within 2 km from the explosion place, group exposured at place from more than 2 km or entering after explosion into the city, and not-exposured group. Relationship between main malignancies and exposure was discussed, and the following results were obtained. 1) Obvious relationship was found to exist between exposure and acute and chronic medullary leukemia. 2) Malignant lymphoma was scarcely correlated with exposure, but its occurrence rate was higher than the mean rate in Japan in reflection the region where this disease occurs much geographically. 3) Relationship between exposure and stomach cancer, lung cancer, cancer of the large intestine, and double cancer was not found obviously, but occurrence rate of hepatic cancer was higher than the mean rate in Japan in three groups. The reason was supposed to be geographical factor. 4) Cases of thyroid gland cancer were a small number in female of the group exposured within 2 km, and cases of prostate cancer were a small number in the group within 2 km, but their occurrence rate was high specifically.

Statistical observation on autopsy cases of malignancy at the Japanese Red Cross, Nagasaki Atomic Bomb Hospital

International Nuclear Information System (INIS)

Takahara, Osamu; Toyoda, Shigeki; Tsuno, Sumio; Mukai, Hideaki; Uemura, Seiji

1976-01-01

Statistical observation was made as to autopsy cases of atomic-bomb survivors in Nagasaki. The total of autopsy cases at the Japanese Red Cross, Nagasaki Atomic Bomb Hospital from the opening of the hospital, 1968, to December in 1975 was 1,486 cases (autopsy rate, 65.1%) in which 880 cases of atomic bomb survivors (autopsy rate, 68.0%) were contained. Cases of malignancy totaled 829 and 528 cases of those were atomic bomb survivors. Cases of malignancy were divided into three groups, that is, group exposured to atomic bomb at place within 2 km from the explosion place, group exposured at place from more than 2 km or entering after explosion into the city, and not-exposured group. Relationship between main malignancies and exposure was discussed, and the following results were obtained. 1) Obvious relationship was found to exist between exposure and acute and chronic medullary leukemia. 2) Malignant lymphoma was scarecely correlated with exposure, but its occurrence rate was higher than the mean rate in Japan in reflection the region where this disease occurs much geographically. 3) Relationship between exposure and stomach cancer, lung cancer, cancer of the large intestine, and double cancer was not found obviously, but occurrence rate of hepatic cancer was higher than the mean rate in Japan in three groups. The reason was supposed to be geographical factor. 4) Cases of thyroid gland cancer were a small number in female of the group exposured within 2 km, and cases of prostate cancer were a small number in the group within 2 km, but their occurrence rate was high specifically. (Tsunoda, M.)

Nurse Level of Education, Quality of Care and Patient Safety in the Medical and Surgical Wards in Malaysian Private Hospitals: A Cross-sectional Study.

Science.gov (United States)

Abdul Rahman, Hamzah; Jarrar, Mu'taman; Don, Mohammad Sobri

2015-04-23

Nursing knowledge and skills are required to sustain quality of care and patient safety. The numbers of nurses with Bachelor degrees in Malaysia are very limited. This study aims to predict the impact of nurse level of education on quality of care and patient safety in the medical and surgical wards in Malaysian private hospitals. A cross-sectional survey by questionnaire was conducted. A total 652 nurses working in the medical and surgical wards in 12 private hospitals were participated in the study. Multistage stratified simple random sampling performed to invite nurses working in small size (less than 100 beds), medium size (100-199 beds) and large size (over than 200) hospitals to participate in the study. This allowed nurses from all shifts to participate in this study. Nurses with higher education were not significantly associated with both quality of care and patient safety. However, a total 355 (60.9%) of respondents participated in this study were working in teaching hospitals. Teaching hospitals offer training for all newly appointed staff. They also provide general orientation programs and training to outline the policies, procedures of the nurses' roles and responsibilities. This made the variances between the Bachelor and Diploma nurses not significantly associated with the outcomes of care. Nursing educational level was not associated with the outcomes of care in Malaysian private hospitals. However, training programs and the general nursing orientation programs for nurses in Malaysia can help to upgrade the Diploma-level nurses. Training programs can increase their self confidence, knowledge, critical thinking ability and improve their interpersonal skills. So, it can be concluded that better education and training for a medical and surgical wards' nurses is required for satisfying client expectations and sustaining the outcomes of patient care.

An Evaluation of the Management Information System and Technology in Hospitals (GESITI/Hospitals

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Antonio José Balloni

2017-02-01

Full Text Available The research project "Management of System and Information Technology in Hospitals" (GESITI/Hospitals has the purpose of mapping out the management of Information Systems (IS and Information Technology (IT in hospitals. By applying a multifocal prospective questionnaire in hospitals, the research aims to identify the hospitals need and demand, prospecting for unfolding, and generate a public integrated research report for supporting public and/or private decisions-makings. The ultimate result from this GESITI/Health research project should be a significant improvement on the hospital management and on the decisions-makings, which must reflect on peoples more satisfied regarding a better health care. Therefore, this paper aims to publish the main ideas of the GESITI/Health project i.e., its "Methodology & original Prospective Questionnaire (PQ". The methodology used is the Interpretative (or Introspective. About the PQ, we do not known, up to this date, who have developed a multifocal broad field tool -the PQ-, aiming wide hospitals management-. From 2010-16 the "methodology and PQ" have been implemented by about forty -40- universities -and increasing-, from Brazil and Abroad and, forty local research reports were generated. A book, published by the Brazilian Minister of Health [1], presents the results of a pilot project carried out by nineteen -19- out of these forty -40- universities, to know: sixteen Brazilian, one Mexican, one Argentina, one from Slovakia and one from Portugal. The chapter 25 of this book [1.A] presents an integrated research from all nineteen chapters -an integrated research report-. Finally, in the oral presentation, we will briefly present the "Methodology and the PQ" presented in this paper and, also, we will present an integrated comparative analyzes -main results got with the field application of the PQ- regarding the case studies accomplished by the universities from Brazil and Abroad.

The relationship between bed size and profitability in South Carolina hospitals.

Science.gov (United States)

Kim, Yang K; Glover, Saundra H; Stoskopf, Carleen H; Boyd, Suzan D

2002-01-01

The purpose of the study is to identify factors affecting hospital profitability and to find the optimal hospital bed size that assures maximum profit. This is a cross-sectional study using survey data obtained from acute care hospitals in South Carolina in 1997. The relationship of hospital profitability and hospital bed size revealed that when bed size increases, hospital profitability increases, decreases, and then increases again. For the patient profit proportion, the turning points in bed size are 238.22 and 560.08. For the total profit proportion, the turning points in bed size are 223.31 and 503.86. The results on the relationship between bed size and hospital profitability indicate that medium-size hospitals have less profitability.

Can the large-scale magnetic field lines cross the spiral arms in our Milky Way galaxy?

International Nuclear Information System (INIS)

Vallee, J.P.

1988-01-01

For the Sgr, Ori, and Per spiral arms, the pitch angle (i.e., deviation from a tangent parallel to a circular orbit around the center of the Galaxy) of the magnetic-field lines differs from the pitch angle of the spiral arms. For the spiral arms, the pitch angle of the magnetic-field lines can be measured independently from both quasars and galaxies as well as from pulsars, yielding a small (-6 deg) pitch angle, as predicted in the roughly circular oval gas streamline model of the density-wave theory. Meanwhile, the pitch angle of the spiral arms can be measured independently from both the O type stars and from the H II regions, yielding a large (-18 deg) pitch angle, also as predicted in the density-wave theory. Thus for these arms, the magnetic-field lines cross the spiral arms, to leave them outwardly at a sizable mean angle (+12 deg). 19 references

Computation of the Arnol close-quote d web for the hydrogen atom in crossed electric and magnetic fields

International Nuclear Information System (INIS)

von Milczewski, J.; Diercksen, G.H.; Uzer, T.

1996-01-01

A Rydberg atom placed in crossed static electric and magnetic fields is presented as a new testbed for phenomena not possible in two degrees of freedom. We compute the Arnol close-quote d web for this system and explore the time scale and the physical consequences of diffusion along this web. copyright 1996 The American Physical Society

Nurses' perception of how an e-message system influences cross-sectoral communication

DEFF Research Database (Denmark)

Petersen, Helle V; Foged, Signe; Madsen, Annette L

2018-01-01

AIM: To investigate hospital and home care nurses' experiences on how an e-message system influences cross-sectoral communication 2 years after introduction. BACKGROUND: Cross-sectoral communication is identified as the main barrier for high quality in transitional care. An e-message system......-message system was used in both sectors but did not promote cross-sectoral dialogue. The home care nurses expressed distrust in the information from the hospital. The hospital nurses' intention was to provide relevant and accurate information but their main focus was to fulfil the standards within the system...... rather than the quality of the information exchanged. CONCLUSIONS: The e-message system supports a one-way information flow, rather than the intended loop of information exchange and dialogue. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers should recognise that although an e-message system is being...

Hospital-associated methicillin-resistant Staphylococcus aureus: A cross-sectional analysis of risk factors in South African tertiary public hospitals.

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Liliwe L Shuping

Full Text Available Hospital-associated methicillin-resistant S. aureus (HA-MRSA remains a significant cause of morbidity and mortality worldwide. We conducted a study to determine risk factors for HA-MRSA in order to inform control strategies in South Africa.We used surveillance data collected from five tertiary hospitals in Gauteng and Western Cape provinces during 2014 for analysis. A case of HA-MRSA was defined as isolation of MRSA from a blood culture 48 hours after admission and/or if the patient was hospitalised in the six months prior to the current culture. Multivariable logistic regression modelling was used to determine risk factors for HA-MRSA.Of the 9971 patients with positive blood cultures, 7.7% (772 had S. aureus bacteraemia (SAB. The overall prevalence of MRSA among those with SAB was 30.9% (231/747; 95% confidence interval [CI] 27.6%- 34.3%. HA-MRSA infections accounted for 28.3% of patients with SAB (207/731; 95% CI 25.1%- 31.7%. Burns (adjusted odds ratio [aOR] 12.7; 95% CI 4.7-34.4, age ≤1 month (aOR 8.7; 95% CI 3.0-24.6, residency at a long-term care facility (aOR 5.2; 95% CI, 1.5-17.4, antibiotic use within two months of the current SAB episode (aOR 5.1; 95% CI 2.8-9.1, hospital stay of 13 days or more (aOR 2.8; 95% CI 1.3-5.6 and mechanical ventilation (aOR 2.2; 95% CI 1.07-4.6, were independent risk factors for HA-MRSA infection.The prevalence of MRSA remains high in South African tertiary public hospitals. Several identified risk factors of HA-MRSA infections should be considered when instituting infection and prevention strategies in public-sector hospitals, including intensifying the implementation of antimicrobial stewardship programmes. There is an urgent need to strengthen infection prevention and control in burn wards, neonatal wards, and intensive care units which house mechanically ventilated patients.

No one can whistle a symphony: How hospitals design for daily cross-boundary collaboration

DEFF Research Database (Denmark)

Prætorius, Thim; Hasle, Peter; Nielsen, Anders Paarup

2018-01-01

departments across four hospitals facing fast to slow response task requirements was carried out using interviews and observations. The selected cases were revealing as the departments had designed and formalized their daily hospital operations differently to solve collaboration and performance issues...... and hospital managers can consider designing bundles of organizational design features to proactively develop and ensure collaboration capable of solving collective tasks and bridging departmental and occupational silos to improve health care delivery. Originality/value: This research article addresses...

Scientific production from public hospitals of the City of Buenos Aires, 2017

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Mariano Ibarra

2018-01-01

Full Text Available The number of publications in the scientific literature coming from an institution is an indicator of its scientific production. The scientific production of the hospitals of the Government of the City of Buenos Aires (GCBA has been evaluated previously, but without discriminating how much of that production corresponded to other academic institutions settled there (University of Buenos Aires, UBA, National Council of Scientific Research and Techniques, CONICET. Our objective was to evaluate the publications included in PubMed that correspond to hospitals of the GCBA, describe their main characteristics, and discriminate the contribution of other academic institutions (UBA and CONICET. It is a cross-sectional study based on a PubMed search, using the name of each of the 34 GCBA hospitals, CONICET and UBA in the "affiliation" field. In total, 2727 publications from GCBA hospitals were identified (4.6% of Argentine publications; 73.9% in English, 78.9% in relation to humans, 37.2% in the last 5 years; 6.4% with high level of evidence (clinical trials and meta-analysis, and 28.4% including children. Compared to the national total, the GCBA publications include fewer works in English, more research in humans, more clinical trials and more research in children. Of the publications corresponding to hospitals of the GCBA, 90.4% did not share the affiliation with CONICET or with UBA. In conclusion, the GCBA hospitals generated 4.6% of the total Argentine publications in PubMed; and 90% of these was not shared with UBA or CONICET. Publications from GCBA institutions include more clinical trials and research in children.

[Competition between hospitals--from a legal perspective].

Science.gov (United States)

Bohle, Thomas

2009-01-01

Competition between hospitals exists in many different fields. In legal terms this competition is shaped by disputes over the status of "hospitals forming part of the Hospital Plan" (Plankrankenhaus). The German Federal Constitutional Court's ruling of January 14, 2004 granted hospital authorities the right of action for unfair competition. According to the Federal Administrative Court's ruling of September 25, 2008, however, third-party protection is limited to cases where the hospital filing the suit has itself unsuccessfully applied for inclusion in the state-level hospitals plan for the market segment served by the accepted hospital. In contrast, action that merely challenges an unfair preference of a competitor will remain inadmissible. Third-party protection between hospitals is also under way in the field of "Integrated Healthcare" (Integrierte Versorgung) (Sect. 140a et seqq. Book V of the German Social Security Code-SGB V): in the case of ECJ C-300/07 on December 16, 2008 (Oymanns/AOK Rheinland & Hamburg) the Advocate General in his final submissions not only expressed the opinion that the statutory health insurance funds are contract-placing authorities, but also argued that integration contracts are public orders. If the European Court of Justice (ECJ) takes the Advocate General's view, future integration contracts will become subject to the regulations governing public orders and thus also subject to the relevant verification procedure.

Estudo comparativo das indicações de cesariana entre um hospital público-universitário e um hospital privado Comparative study of cesarean section indications between a public university hospital and a private hospital

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Renato Humberto Fabri

2002-04-01

Full Text Available OBJETIVOS: analisar a incidência e as indicações de cesariana realizadas no Hospital Escola da Falculdade de Medicina do Triângulo Mineiro e um hospital privado, ambos localizados em Uberaba, Minas Gerais, Brasil. MÉTODOS: trata-se de estudo transversal desenvolvido a partir da coleta nos prontuários dos hospitais, consistindo da idade, procedência, situação conjugal, escolaridade, paridade e indicações de cesariana. RESULTADOS: a incidência de cesariana foi de 24,3% no Hospital Escola contra 89,2% no hospital privado. As indicações mais freqüentes de cesariana no Hospital Escola foram a cesárea iterativa (26,7%, distócia (22,4% e o sofrimento fetal agudo (18,2%, e no hospital privado foram cesárea iterativa (36% e distócia (36%. As pacientes do hospital privado tinham maior escolaridade. CONCLUSÕES: os dados sugerem que o aumento de cesarianas no hospital privado foi decorrente de iteratividade, distócia e a escolaridade mais elevada das pacientes.OBJECTIVES: to analyse the incidence and the indications of cesarean section performed in the University Hospital of the "Triângulo Mineiro Faculty of Medicine " and a private hospital in Uberaba, Minas Gerais, Brazil. METHODS: a cross sectional study was carried out by using the data source of the medical files from both hospitals consisting of patient age, place of origin, marital status, education level, parity and cesarean sections indications. RESULTS: the cesarean sections rate was 24,3 % (325 of 1.441 births at the university hospital against 89,2% (100 of 112 births of the private hospital. The most frequent indications in the University Hospital were previous cesarean sections (26,7%, dystocia (22,4% and acute fetal distress (18,2%. In the private hospital, indications were previous cesarean section (36% and dystocia (36%. The private hospital's patients had higher education levels. CONCLUSIONS: the higher rate of cesarean sections observed in the private hospital

Work schedule flexibility is associated with emotional exhaustion among registered nurses in Swiss hospitals: A cross-sectional study.

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Dhaini, Suzanne R; Denhaerynck, Kris; Bachnick, Stefanie; Schwendimann, René; Schubert, Maria; De Geest, Sabina; Simon, Michael

2018-06-01

Emotional exhaustion among healthcare workers is a widely investigated, well-recognized problem, the incidence of which has recently been linked to work environment factors, particularly work/family conflict. However, another environmental feature that may be equally influential, but that is more amenable to nurse manager action, remains less recognized: shift schedule flexibility. This study's main purposes were to assess variations in work schedule flexibility between Swiss acute care hospital units, and to investigate associations between psychosocial work environment (e.g. work schedule flexibility) and self-reported emotional exhaustion among registered nurses. This is a secondary analysis of data collected for the multi-center observational cross-sectional Match RN study, which included a national sample of 23 hospitals and 1833 registered nurses across Switzerland. Overall, self-reported work schedule flexibility among registered nurses was limited: 32% of participants reported little or no influence in planning their own shifts. Work schedule flexibility (β -0.11; CI -0.16; -0.06) and perceived nurse manager ability (β -0.30; CI -0.49; -0.10) were negatively related to self-reported emotional exhaustion. Work-family conflict (β 0.39; CI 0.33; 0.45) was positively correlated to emotional exhaustion. The study results indicate that managerial efforts to improve working environments, including special efforts to improve work schedule flexibility, might play an important role in promoting nurses' emotional health. Copyright © 2018 Elsevier Ltd. All rights reserved.

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

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Firoozeh Bairami

2016-01-01

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

Red Cross Emblem and the medical profession--the Indian scenario.

Science.gov (United States)

Menon, Anand; Kuruvilla, Ajee

2005-02-01

The Red Cross Emblem has come to symbolize the medical profession in our country. Many medical practitioners use the emblem to designate our profession. Others including hospitals (Government and private), chemists, pharmaceutical firms and sometimes public transport vehicle use the Red Cross Emblem.

Predictors of Hospitalization in Patients with Syncope Assisted in Specialized Cardiology Hospital

Energy Technology Data Exchange (ETDEWEB)

Fischer, Leonardo Marques; Dutra, João Pedro Passos [Instituto de Cardiologia, Fundação Universitária de Cardiologia do Rio Grande do Sul, Porto Alegre, RS (Brazil); Mantovani, Augusto [UFCSPA - Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS (Brazil); Lima, Gustavo Glotz de [Instituto de Cardiologia, Fundação Universitária de Cardiologia do Rio Grande do Sul, Porto Alegre, RS (Brazil); UFCSPA - Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS (Brazil); Leiria, Tiago Luiz Luz, E-mail: drleiria@cardiol.br [Instituto de Cardiologia, Fundação Universitária de Cardiologia do Rio Grande do Sul, Porto Alegre, RS (Brazil)

2013-12-15

Risk stratification of a syncopal episode is necessary to better differentiate patients needing hospitalization of those who can be safely sent home from the emergency department. Currently there are no strict guidelines from our Brazilian medical societies to guide the cardiologist that evaluate patients in an emergency setting. To analyze the criteria adopted for defining the need for hospitalization and compare them with the predictors of high risk for adverse outcome defined by the OESIL score that is already validated in the medical literature for assessing syncope. A cross-sectional study of patients diagnosed with syncope during emergency department evaluation at our institution in the year 2011. Of the 46,476 emergency visits made in that year, 216 were due to syncope. Of the 216 patients analyzed, 39% were hospitalized. The variables associated with the need of hospital admission were - having health care insurance, previous known cardiovascular disease, no history of prior stroke, previous syncope and abnormal electrocardiograms during the presentation. Patients classified in OESIL scores of 0-1 had a greater chance of emergency discharge; 2-3 scores showed greater association with the need of hospitalization. A score ≥ 2 OESIL provided an odds ratio 7.8 times higher for hospitalization compared to score 0 (p <0.001, 95% CI:4,03-15,11). In approximately 39% no etiological cause for syncope was found and in 18% cardiac cause was identified. Factors such as cardiovascular disease, prior history of syncope, health insurance, no previous stroke and abnormal electrocardiograms, were the criteria used by doctors to indicate hospital admission. There was a good correlation between the clinical judgment and the OESIL criteria for high risk described in literature.

Predictors of Hospitalization in Patients with Syncope Assisted in Specialized Cardiology Hospital

International Nuclear Information System (INIS)

Fischer, Leonardo Marques; Dutra, João Pedro Passos; Mantovani, Augusto; Lima, Gustavo Glotz de; Leiria, Tiago Luiz Luz

2013-01-01

Risk stratification of a syncopal episode is necessary to better differentiate patients needing hospitalization of those who can be safely sent home from the emergency department. Currently there are no strict guidelines from our Brazilian medical societies to guide the cardiologist that evaluate patients in an emergency setting. To analyze the criteria adopted for defining the need for hospitalization and compare them with the predictors of high risk for adverse outcome defined by the OESIL score that is already validated in the medical literature for assessing syncope. A cross-sectional study of patients diagnosed with syncope during emergency department evaluation at our institution in the year 2011. Of the 46,476 emergency visits made in that year, 216 were due to syncope. Of the 216 patients analyzed, 39% were hospitalized. The variables associated with the need of hospital admission were - having health care insurance, previous known cardiovascular disease, no history of prior stroke, previous syncope and abnormal electrocardiograms during the presentation. Patients classified in OESIL scores of 0-1 had a greater chance of emergency discharge; 2-3 scores showed greater association with the need of hospitalization. A score ≥ 2 OESIL provided an odds ratio 7.8 times higher for hospitalization compared to score 0 (p <0.001, 95% CI:4,03-15,11). In approximately 39% no etiological cause for syncope was found and in 18% cardiac cause was identified. Factors such as cardiovascular disease, prior history of syncope, health insurance, no previous stroke and abnormal electrocardiograms, were the criteria used by doctors to indicate hospital admission. There was a good correlation between the clinical judgment and the OESIL criteria for high risk described in literature

Knowledge, opinions and compliance related to the 100% smoke-free law in hospitality venues in Kampala, Uganda: cross-sectional results from the KOMPLY Project.

Science.gov (United States)

Gravely, Shannon; Nyamurungi, Kellen Namusisi; Kabwama, Steven Ndugwa; Okello, Gabriel; Robertson, Lindsay; Heng, Kelvin Khow Chuan; Ndikum, Achiri Elvis; Oginni, Adeniyi Samuel; Rusatira, Jean Christophe; Kakoulides, Socrates; Huffman, Mark D; Yusuf, Salim; Bianco, Eduardo

2018-01-05

This study evaluated knowledge, opinions and compliance related to Uganda's comprehensive smoke-free law among hospitality venues in Kampala Uganda. This multi-method study presents cross-sectional findings of the extent of compliance in the early phase of Uganda's comprehensive smoke-free law (2 months postimplementation; pre-enforcement). Bars, pubs and restaurants in Kampala Uganda. A two-stage stratified cluster sampling procedure was used to select hospitality sites stratified by all five divisions in Kampala. A total of 222 establishments were selected for the study. One hospitality representative from each of the visited sites agreed to take part in a face-to-face administered questionnaire. A subsample of hospitality venues were randomly selected for tobacco air quality testing (n=108). Data were collected between June and August 2016. Knowledge and opinions of the smoke-free law among hospitality venue staff and owners. The level of compliance with the smoke-free law in hospitality venues through: (1) systematic objective observations (eg, active smoking, the presence of designated smoking areas, 'no smoking' signage) and (2) air quality by measuring the levels of tobacco particulate matter (PM 2.5 ) in both indoor and outdoor venues. Active smoking was observed in 18% of venues, 31% had visible 'no smoking' signage and 47% had visible cigarette remains. Among interviewed respondents, 57% agreed that they had not been adequately informed about the smoke-free law; however, 90% were supportive of the ban. Nearly all respondents (97%) agreed that the law will protect workers' health, but 32% believed that the law would cause financial losses at their establishment. Indoor PM 2.5 levels were hazardous (267.6 µg/m 3 ) in venues that allowed smoking and moderate (29.6 µg/m 3 ) in smoke-free establishments. In the early phase of Uganda's smoke-free law, the level of compliance in hospitality venues settings in Kampala was suboptimal. Civil society and the

Maternal near miss and mortality in a tertiary care hospital in Rwanda

NARCIS (Netherlands)

Rulisa, S.; Umuziranenge, I.; Small, M; van Roosmalen, J.

2015-01-01

Background: To determine the prevalence and factors associated with severe ('near miss') maternal morbidity and mortality in the University Teaching Hospital of Kigali - Rwanda. Methods: We performed a cross sectional study of all women admitted to the tertiary care University Hospital in Kigali

Constructing Episodes of Inpatient Care: How to Define Hospital Transfer in Hospital Administrative Health Data?

Science.gov (United States)

Peng, Mingkai; Li, Bing; Southern, Danielle A; Eastwood, Cathy A; Quan, Hude

2017-01-01

Hospital administrative health data create separate records for each hospital stay of patients. Treating a hospital transfer as a readmission could lead to biased results in health service research. This is a cross-sectional study. We used the hospital discharge abstract database in 2013 from Alberta, Canada. Transfer cases were defined by transfer institution code and were used as the reference standard. Four time gaps between 2 hospitalizations (6, 9, 12, and 24 h) and 2 day gaps between hospitalizations [same day (up to 24 h), ≤1 d (up to 48 h)] were used to identify transfer cases. We compared the sensitivity and positive predictive value (PPV) of 6 definitions across different categories of sex, age, and location of residence. Readmission rates within 30 days were compared after episodes of care were defined at the different time gaps. Among the 6 definitions, sensitivity ranged from 93.3% to 98.7% and PPV ranged from 86.4% to 96%. The time gap of 9 hours had the optimal balance of sensitivity and PPV. The time gaps of same day (up to 24 h) and 9 hours had comparable 30-day readmission rates as the transfer indicator after defining episode of care. We recommend the use of a time gap of 9 hours between 2 hospitalizations to define hospital transfer in inpatient databases. When admission or discharge time is not available in the database, a time gap of same day (up to 24 h) can be used to define hospital transfer.

Inter-hospital Cross-validation of Irregular Discharge Patterns for Young vs. Old Psychiatric Patients

Science.gov (United States)

Mozdzierz, Gerald J.; Davis, William E.

1975-01-01

Type of discharge (irregular vs. regular) and length of time hospitalized were used as unobtrusive measures of psychiatric patient acceptance of hospital treatment regime among two groups (18-27 years and 45 years and above) of patients. (Author)

A cross-sectional study of shift work, sleep quality and cardiometabolic risk in female hospital employees

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Aronson, K J; Day, A; Tranmer, J

2015-01-01

Objectives Investigating the potential pathways linking shift work and cardiovascular diseases (CVD), this study aimed to identify whether sleep disturbances mediate the relationship between shift work and the metabolic syndrome, a cluster of CVD risk factors. Design Cross-sectional study. Setting A tertiary-level, acute care teaching hospital in Southeastern Ontario, Canada. Participants Female hospital employees working a shift schedule of two 12 h days, two 12 h nights, followed by 5 days off (n=121) were compared with female day-only workers (n=150). Primary and secondary outcome measures Each of the seven components of the Pittsburgh Sleep Quality Index (PSQI) was measured. Of these, PSQI global score, sleep latency and sleep efficiency were examined as potential mediators in the relationship between shift work and the metabolic syndrome. Results Shift work status was associated with poor (>5) PSQI global score (OR=2.10, 95% CI 1.20 to 3.65), poor (≥2) sleep latency (OR=2.18, 95% CI 1.23 to 3.87) and poor (≥2) sleep efficiency (OR=2.11, 95% CI 1.16 to 3.84). Although shift work was associated with the metabolic syndrome (OR=2.29, 95% CI 1.12 to 4.70), the measured components of sleep quality did not mediate the relationship between shift work and the metabolic syndrome. Conclusions Women working in a rapid forward rotating shift pattern have poorer sleep quality according to self-reported indicators of the validated PSQI and they have a higher prevalence of the metabolic syndrome compared with women who work during the day only. However, sleep quality did not mediate the relationship between shift work and the metabolic syndrome, suggesting that there are other psychophysiological pathways linking shift work to increased risk for CVD. PMID:25757950

An empirical analysis of the public's attitudes toward advertising hospital services: a comparative cross-sectional study.

Science.gov (United States)

Moser, H Ronald; Freeman, Gordon L

2014-01-01

This study investigates current opinions about hospital advertising and compares them to the attitudes expressed 25 years ago. It replicates a survey done in 1985, using the same questionnaire and population to compare responses longitudinally. The study indicates some changes in the public's opinions of hospital advertising. Although the image of hospitals remains positive, most of the 2010 respondents' opinions were rather mixed regarding whether it is proper for hospitals to advertise. The study also confirmed that the quality of service and reputation of hospitals remain more important to the public than price.

Clinical characteristics of synthetic cannabinoid-induced psychosis in relation to schizophrenia: a single-center cross-sectional analysis of concurrently hospitalized patients

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Altintas M

2016-08-01

Full Text Available Merih Altintas,1 Leman Inanc,2 Gamze Akcay Oruc,1 Selim Arpacioglu,1 Huseyin Gulec1 1Department of Psychiatry, Erenköy Mental and Neurological Diseases Training and Research Hospital, Istanbul, 2Department of Psychiatry, Dr Cevdet Aykan Mental Health and Diseases Hospital, Tokat, Turkey Background: This study aimed to evaluate synthetic cannabinoid (SC-induced psychosis in terms of patient profile and clinical characteristics with reference to concurrently hospitalized schizophrenic patients. Methods: A total of 81 male patients diagnosed with psychotic disorder induced by the use of SCs (n=50; mean (standard deviation [SD] age: 25.9 (5.5 years or with schizophrenia (n=31, mean (SD age: 42.9 (11.6 years based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, diagnosis criteria who were concurrently hospitalized at Erenköy Mental and Neurological Diseases Training and Research Hospital were included in this cross-sectional study. Data on sociodemographic characteristics, Brief Psychiatric Rating Scale (BPRS, Positive and Negative Syndrome Scale (PANSS, Frontal Assessment Battery (FAB, Hamilton Rating Scale for Depression (HRSD, and Hamilton Anxiety Rating Scale (HAM-A were recorded in all the patients. Results: Mean (SD age at disease onset in SC-induced psychosis patients was 22.3 (5.6 years; 26.0% had suicidal ideation and 58.4% were hospitalized involuntarily. Marijuana was the most common first used substance (72.0%, and solitary use of SC was noted in 38.0% of patients. SC-induced psychosis patients had similar PANSS positive, BPRS, HRSD, and FAB scores and significantly lower PANSS negative scores (18.0 [6.5] vs 22.3 [6.0], P=0.004 than patients with schizophrenia, while they had similar HAM-A scores (17.8 [10.3] vs 21.6 [5.5], P=0.085 as young schizophrenics. Age at onset for SC (r=0.364, P=0.05 or substance (r=0.395, P=0.01 use was correlated positively with total FAB scores.Conclusion: In conclusion, our

Collection performance: an empirical analysis of not-for-profit community hospitals.

Science.gov (United States)

Prince, T R; Ramanan, R

1992-01-01

Many not-for-profit community hospitals had major shifts in their annual collection performance between 1986 and 1988. The collection performance is measured by excess collection time; this is computed as the difference between the actual average collection time for a hospital and the median for one of the six panels to which the hospital is assigned based on ownership, control code, and financial reporting practices. The sample for this study has 1,246 not-for-profit hospitals comprising over 50 percent of total revenue and expenses of all community hospitals (about 5,500). More than 16 percent of these hospitals had annual changes of ten-plus days in each of the years. Excess collection time within the six panels was examined by state, payer mix (Medicare, Medicaid, and Blue Cross), membership in the Council of Teaching Hospitals, medical school affiliation, case-mix index for Medicare, contractual allowance rate, debt-service coverage, return on assets, new investments, age of property, and urban location. Major findings were that collection patterns are different among some states. The proportions of Medicare, Medicaid, and Blue Cross are negatively associated with excess collection time in three of the panels. Contractual allowance is positively related, and return on assets is negatively associated with excess collection time in two of the panels. The other factors had virtually no effect on the collection performance.

'Family-centred care' in American hospitals in late-Qing China.

Science.gov (United States)

Renshaw, Michelle

2009-01-01

Today, patients' families in the West are regaining the access to hospitals that they lost when hospitals emerged as the primary site for medical treatment, research and training at the beginning of the twentieth century. In China, however, families were never excluded from American mission-run hospitals, in fact, they were indispensable. Families were in the waiting rooms, consulting rooms,wards and operating theatres. They provided more than reassurance and comfort: they fed and nursed their sick relatives, acted as advocates and middlemen and may even have lowered the incidence of cross-infection, the scourge of the contemporary hospital in the West.

A cross-sectional study of peripartum blood transfusion in the ...

African Journals Online (AJOL)

A cross-sectional study of peripartum blood transfusion in the Eastern Cape, South Africa. ... To assess the incidence of peripartum transfusion in a sample of Eastern Cape, SA hospitals to evaluate generalisability of preceding study findings. Methods. Hospital chart reviews were conducted of all deliveries at three large ...

An adapted triage tool (ETAT) at Red Cross War Memorial ...

African Journals Online (AJOL)

Objective. To evaluate the efficacy of an adapted Emergency Triage Assessment and Treatment (ETAT) tool at a children's hospital. Design. A two-armed descriptive study. Setting. Red Cross War Memorial Children's Hospital, Cape Town, South Africa. Methods. Triage data on 1 309 children from October 2007 and July ...

Functional textiles in hospital interiors

DEFF Research Database (Denmark)

Mogensen, Jeppe

This PhD thesis explores the possibilities and design qualities of using functional textiles in the interior of hospital environments, and is the result of a three years collaboration between Aalborg University, Department of Civil Engineering, and VIA University College, VIA Design. The project...... that the physical environments affect the patients’ level of stress and influence their process of recovery and healing. However, although research in this field of hospital design has increased substantially in recent years, knowledge on the use of new materials and textiles in hospital interiors is still rather...... limited. Concerned with the design potentials of using textiles in hospital interiors, the purpose of the PhD project has been to explore the possibilities and design qualities of using these materials in hospital design. Relating to both technical and aesthetic aspects of using functional textiles...

Plasma Flows in Crossed Magnetic and Electric Fields

International Nuclear Information System (INIS)

Belikov, A.G.

2005-01-01

The effect of the magnitude and direction of an external electric field on the plasma flowing through a magnetic barrier is studied by numerically solving two-fluid MHD equations. The drift velocity of the plasma flow and the distribution of the flow electrons over transverse velocities are found to depend on the magnitude and direction of the electric field. It is shown that the direction of the induced longitudinal electric field is determined by the direction of the external field and that the electric current generated by the plasma flow significantly disturbs the barrier field

Neutral sheet crossings in the distant magnetotail

International Nuclear Information System (INIS)

Heikkila, W.J.; Slavin, J.A.; Smith, E.J.; Baker, D.N.; Zwickl, R.D.

1985-01-01

We have analyzed the magnetic field data from ISEE-3 in the distant magnetotail for 18 crossings of the cross-tail current sheet (or so-called natural sheet) to determine the direction of the normal component B/sub z/. The crossings occurred near the middle of the aberrated magnetotail (0 0.4 nT), consistent with closed field lines connected to the earth. In 3 cases B/sub z/ was very close to zero; in several instances there was structure in B/sub y/, suggesting localized currents with x or z directions. One may have been a magnetopause crossing. The strong preponderance of northward B/sub z/ favors a model of the magnetotail which is dominated by boundary layer plasma, flowing tailward on closed magnetic field lines, which requires the existence of an electric field in the sense from dusk to dawn. 37 refs., 15 figs., 1 tab

Hospital-associated methicillin-resistant Staphylococcus aureus: A cross-sectional analysis of risk factors in South African tertiary public hospitals

Science.gov (United States)

Kuonza, Lazarus; Musekiwa, Alfred; Iyaloo, Samantha; Perovic, Olga

2017-01-01

Introduction Hospital-associated methicillin-resistant S. aureus (HA-MRSA) remains a significant cause of morbidity and mortality worldwide. We conducted a study to determine risk factors for HA-MRSA in order to inform control strategies in South Africa. Methods We used surveillance data collected from five tertiary hospitals in Gauteng and Western Cape provinces during 2014 for analysis. A case of HA-MRSA was defined as isolation of MRSA from a blood culture 48 hours after admission and/or if the patient was hospitalised in the six months prior to the current culture. Multivariable logistic regression modelling was used to determine risk factors for HA-MRSA. Results Of the 9971 patients with positive blood cultures, 7.7% (772) had S. aureus bacteraemia (SAB). The overall prevalence of MRSA among those with SAB was 30.9% (231/747; 95% confidence interval [CI] 27.6%– 34.3%). HA-MRSA infections accounted for 28.3% of patients with SAB (207/731; 95% CI 25.1%– 31.7%). Burns (adjusted odds ratio [aOR] 12.7; 95% CI 4.7–34.4), age ≤1 month (aOR 8.7; 95% CI 3.0–24.6), residency at a long-term care facility (aOR 5.2; 95% CI, 1.5–17.4), antibiotic use within two months of the current SAB episode (aOR 5.1; 95% CI 2.8–9.1), hospital stay of 13 days or more (aOR 2.8; 95% CI 1.3–5.6) and mechanical ventilation (aOR 2.2; 95% CI 1.07–4.6), were independent risk factors for HA-MRSA infection. Conclusion The prevalence of MRSA remains high in South African tertiary public hospitals. Several identified risk factors of HA-MRSA infections should be considered when instituting infection and prevention strategies in public-sector hospitals, including intensifying the implementation of antimicrobial stewardship programmes. There is an urgent need to strengthen infection prevention and control in burn wards, neonatal wards, and intensive care units which house mechanically ventilated patients. PMID:29145465

Rifampicin resistance in mycobacterium tuberculosis patients using GeneXpert at Livingstone Central Hospital for the year 2015: a cross sectional explorative study.

Science.gov (United States)

Masenga, Sepiso K; Mubila, Harrison; Hamooya, Benson M

2017-09-22

Since the recent introduction of GeneXepert for the detection of Tuberculosis (TB) drug resistance mutations in both primary resistance and acquired resistance in Zambia, little has been documented in literature on the issue of rifampicin resistance especially in the face of a high National TB burden. The study aimed to determine the prevalence of rifampicin resistance in tuberculosis patients at Livingstone Central Hospital for the year 2015. This was a cross sectional study conducted at Livingstone Central Hospital where we reviewed 152 records (from January 1, 2015 to 31st December, 2015) involving patients who presented with clinically suspected TB or documented TB, whose samples were sent to the laboratory for GeneXpert Mycobacterium tuberculosis/rifampicin testing. Statistical evaluations used a one-sample test of proportion and Fisher's exact test. The age of participants ranged from 8 months to 73 years old (median = 34). Of the participants with complete data on gender, 99 (66%) and 52 (34%) were males and females respectively. The TB co-infection with HIV prevalence was 98.3% (p < 0.001). Prevalence of rifampicin resistance was 5.9% and there was no statistical significant difference between being male or female (p = 0.721). We were able to show from our study, evidence of rifampicin resistance at Livingstone Central Hospital. Hence, there was need for further in-depth research and appropriate interventions (i.e close follow-up and patient care for drug resistance positive patients).

The mental health of nurses in acute teaching hospital settings: a cross-sectional survey.

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Perry, Lin; Lamont, Scott; Brunero, Scott; Gallagher, Robyn; Duffield, Christine

2015-01-01

Nursing is an emotionally demanding profession and deficiencies in nurses' mental wellbeing, characterised by low vitality and common mental disorders, have been linked to low productivity, absenteeism and presenteeism. Part of a larger study of nurses' health, the aim of this paper was to describe the mental health status and related characteristics of nurses working in two acute metropolitan teaching hospitals. A cross sectional survey design was used. The Registered and Enrolled Nurse workforce, employed on any form of contract, at two teaching hospitals in Sydney Australia were invited to participate. The survey tool was compiled of validated tools and questions. Family and medical history and health risk-related characteristics, current psycho-active medications, smoking status, alcohol intake, eating disorders, self-perceived general health, mental health and vitality, demographic, social and occupational details were collected. A total of 1215 surveys were distributed with a usable response rate of 382 (31.4%). Altogether 53 nurses (14%) reported a history of mental health disorders, of which n = 49 (13%) listed diagnoses of anxiety and/or depression; 22 (6%) were currently taking psychoactive medication. Symptoms that could potentially indicate a mental health issue were more common, with 248 (65.1%) reporting they had experienced symptoms sometimes or often in the last 12 month. Nurses had better mental health if they had better general health, lived with a spouse/ partner rather than alone, had fewer symptoms, sleep problems or disordered eating behaviours, were not an informal carer and did not work nights. Nurses had greater vitality if they were male, had better general health, fewer sleep problems or symptoms generally and lived with a spouse/ partner rather than alone; less vitality if they were an informal carer or had disordered eating. Nurses and their managers should strive to create workplaces where working practices promote nurses' health

A cross-sectional study of QOL of diabetic patients at tertiary care hospitals in Delhi

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Gautam Yogesh

2009-01-01

Full Text Available Background: According to WHO estimates India will be the global capital of diabetes by 2025, accounting for 57.2 million diabetics. Worsening the situation is the fact that diabetes affects the economically productive age-group (45-65 years in developing countries. Objective : To measure quality of life (QOL and study the clinical profiles and associated sociodemographic factors affecting diabetic patients aged 20 years and above. Materials and Methods: We conducted a hospital-based cross-sectional study using a generic instrument, Short-Form 36 (SF-36 of the Medical Outcome Study Group to measure QOL of diabetic subjects aged ≥20 years. Two hundred and sixty diabetics, including 91 males and 169 females, were selected from the clinics of SSK Hospital and Dr RML Hospital of New Delhi. Data was analysed using SPSS for Windows, version 12. Results: The mean age of the respondents was 49.7 years, with 80% of respondents being in the age-group of 40-69 years. The majority (52.1% of female respondents were illiterate and 91.1% were economically dependent. Of the male respondents, 65.9% were skilled workers. Substance abuse was present among 41.8% male subjects. Type 2 diabetes was the commonest, with 94.6% of the subjects having this form. The mean duration of diabetes was 6.96 ± 6.08 years. Oral hypoglycemic agents were being taken by 70.77% of the respondents. Among the diabetics the most common comorbidity was hypertension (30.8% and the commonest complication was neuropathy (26.2%. We calculated the body mass index (BMI of all subjects and found that, 46.2% of the male and 59.8% of the female respondents were either overweight or obese. As predicted by the waist/hip ratio (WHR, 53.8% of the male and 66.9% of the female respondents had high risk for CHD. Regular physical activity was undertaken by less than half of the subjects (46.5%. Out of eight domains of QOL in the SF-36, the two most affected were ′General Health′ and �

Culture of Safety among Nurses in a Tertiary Teaching Hospital in ...

African Journals Online (AJOL)

Purpose: To assess the culture of safety among nurses in a tertiary teaching hospital in Saudi Arabia. Methods: A cross-sectional survey was conducted in King Khaled University Hospital in Riyadh, Saudi Arabia. A random sample of 492 nurses was included in the survey using a pre-validated instrument, Safety Attitudes ...

Evaluation of rational drug use based on World Health Organization core drug use indicators in selected public hospitals of eastern Ethiopia: a cross sectional study.

Science.gov (United States)

Sisay, Mekonnen; Mengistu, Getnet; Molla, Bereket; Amare, Firehiwot; Gabriel, Tesfaye

2017-02-23

Despite the complexity of drug use, a number of indicators have been developed, standardized and evaluated by the World Health Organization (WHO). These indicators are grouped in to three categories namely: prescribing indicators, patient care indicators and facility indicators. The study was aimed to evaluate rational drug use based on WHO-core drug use indicators in Dilchora referral hospital, Dire Dawa; Hiwot Fana specialized university hospital, Harar and Karamara general hospital, Jigjiga, eastern Ethiopia. Hospital based quantitative cross sectional study design was employed to evaluate rational drug use based on WHO core drug use indicators in selected hospitals. Systematic random sampling for prescribing indicators and convenient sampling for patient care indicators was employed. Taking WHO recommendations in to account, a total of 1,500 prescription papers (500 from each hospitals) were investigated. In each hospital, 200 outpatient attendants and 30 key essential drugs were also selected using the WHO recommendation. Data were collected using retrospective and prospective structured observational check list. Data were entered to EPI Data Version 3.1, exported and analyzed using SPSS version 16.0. Besides, the data were evaluated as per the WHO guidelines. Statistical significance was determined by one way analysis of variance (ANOVA) for some variables. P-value of less than 0.05 was considered statistically significant. Finally, tabular presentation was used to present the data. Mean, 2.34 (±1.08) drugs were prescribed in the selected hospitals. Prescriptions containing antibiotics and that of injectables were 57.87 and 10.9% respectively. The average consultation and dispensing time were 276.5 s and 61.12 s respectively. Besides, 75.77% of the prescribed drugs were actually dispensed. Only 3.3% of prescriptions were adequately labeled and 75.7% patients know about the dosage of the prescription. Not more than, 20(66.7%) key drugs were available in

Functional visual fields: a cross-sectional UK study to determine which visual field paradigms best reflect difficulty with mobility function.

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Subhi, Hikmat; Latham, Keziah; Myint, Joy; Crossland, Michael

2017-11-20

To develop an appropriate method of assessing visual field (VF) loss which reflects its functional consequences, this study aims to determine which method(s) of assessing VF best reflect mobility difficulty. This cross-sectional observational study took place within a single primary care setting. Participants attended a single session at a University Eye Clinic, Cambridge, UK, with data collected by a single researcher (HS), a qualified optometrist. 50 adult participants with peripheral field impairment were recruited for this study. Individuals with conditions not primarily affecting peripheral visual function, such as macular degeneration, were excluded from the study. Participants undertook three custom and one standard binocular VF tests assessing VF to 60°, and also integrated monocular threshold 24-2 visual fields (IVF). Primary VF outcomes were average mean threshold, percentage of stimuli seen and VF area. VF outcomes were compared with self-reported mobility function assessed with the Independent Mobility Questionnaire, and time taken and patient acceptability were also considered. Receiver operating characteristic (ROC) curves determined which tests best predicted difficulty with mobility tasks. Greater VF loss was associated with greater self-reported mobility difficulty with all field paradigms (R 2 0.38-0.48, all Pmobility tasks in ROC analysis. Mean duration of the tests ranged from 1 min 26 s (±9 s) for kinetic assessment to 9 min 23 s (±24 s) for IVF. The binocular VF tests extending to 60° eccentricity all relate similarly to self-reported mobility function, and slightly better than integrated monocular VFs. A kinetic assessment of VF area is quicker than and as effective at predicting mobility function as static threshold assessment. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Stigma towards mental illness: A hospital-based cross-sectional study among caregivers in West Bengal.

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Mukherjee, Shrabani; Mukhopadhyay, Dipta Kanti

2018-01-01

Stigma among caregivers of people with mental illness has a serious impact on the disease outcome and lives of people with mental illness as well as other family members. The objectives of this study were (i) To determine the level of self-perceived stigma toward mental illness, (ii) To measure perception to it among caregivers of people with mental illness, and (iii) To identify the factors associated with self-perceived stigma of caregivers. In this cross-sectional study, a structured interview was conducted among 200 caregivers of people with mental illness in the psychiatry outpatient department of a tertiary care hospital in West Bengal, India. Stigma and perception regarding mental illness were assessed with a validated 12-item Explanatory Model Interview Catalogue and 20-item perception scale, respectively. Information on their sociodemographic characteristics was also collected. Average stigma score (53.3 ± 13.2) was higher than 50% of maximum attainable score. Caregivers of higher age, female gender, low income, higher education, manual job, rural residence, and those who are single or widowed scored higher in stigma scale. Caregivers with female gender (P = 0.007) and rural residence (P = 0.01) were more likely to have stigma while the perception score was negatively associated (P illness and improve family life.

Quality of sleep for hospitalized patients in Rasoul-Akram hospital.

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Ghanbari Jolfaei, Atefeh; Makvandi, Alena; Pazouki, Abdolreza

2014-01-01

Sleep disturbances have negative effects on medical conditions, mental health and cognitive performance. It was shown that about 60% of inpatients suffer from sleep problems. The aim of this study was to assess the correlation between sleep quality and other factors in the inpatients of Rasoul-e-Akram hospital. In this cross-sectional study, all the hospitalized patients in twelve wards of Rasoul-e-Akram hospital during September 2012, were examined. Sleeping habits of 209 inpatients of different wards were assessed through the Persian version of Pittsburgh Sleep Questionnaire (PSQI). A self-designed 18- question questionnaire was conducted for all patients in order to assess their attitude to interior and atmosphere of wards. Content validity and test retest reliability were evaluated. The pain level was also measured by the visual analog scale (VAS) and scores analyzed by the statistical methods of frequency, percentage, chi-square and logistic regression. The mean of the total scores in PSQI was 8.8±4.8 and 70.8% of the patients were 'poor sleepers' (global PSQI> 5). Age and gender had no effect on the PSQI total score, but the number of roommates, type of the ward, hospitalization period, presence and severity of pain, taking sleep medication and attitude toward the overall atmosphere and interior of wards have caused deviation in scores. Sleep problems are quite frequent in medical inpatients. Pain management and modification of the ward interior and atmosphere can impact inpatients sleep quality.

Work-related stress and associated factors among nurses working in public hospitals of Addis Ababa, Ethiopia: a cross-sectional study.

Science.gov (United States)

Salilih, Selamawit Zewdu; Abajobir, Amanuel Alemu

2014-08-01

Work-related stress is a pattern of reactions to work demands unmatched to nurses' knowledge, skills, or abilities; these challenges exceed their ability to cope, resulting in burnout, turnover, and low quality patient care. An institution-based cross-sectional study of 343 nurses was conducted in public hospitals of Addis Ababa in 2012. Data were collected by pretested and self-administered questionnaires using a nursing stress scale. One hundred twenty-one (37.8%) (95% confidence interval: 34.3 to 39.1) nurses reported experiencing occupational stress. Significant associations were found between nurses' stress and gender, work shift, illness, marital status, and worksite or unit. Prevalence of work-related stress was higher than expected and opportunities exist for stake holders to design stress reduction and management programs for nurses. Copyright 2014, SLACK Incorporated.

Malnutrition in Acutely Unwell Hospitalized Elderly - "The Skeletons Are Still Rattling in the Hospital Closet".

Science.gov (United States)

Sharma, Y; Thompson, C; Shari, R; Hakendorf, P; Miller, M

2017-01-01

Malnutrition is common in hospitalized patients with prevalence rates of up to 30% in Australian hospitals with adverse consequences for both the patients and health care services. Despite formulation of nutritional screening protocols, not all hospitalized patients get nutritional screening. Real life screening rates of hospitalized elderly patients are unknown. The present study explored nutrition screening rate in acutely unwell elderly patients admitted in a large tertiary hospital and how these patients fared depending upon their nutrition status. A prospective cross-sectional study involving 205 general medical patients ≥60years recruited between November 2014 and November 2015. The number of patients who missed nutrition screening were noted and all patients underwent nutritional assessment by a qualified dietitian using PG-SGA and quality of life was measured using EQ-5D 5L. A survival curve was plotted and multivariate cox proportional hazard model was used to adjust for confounders. Only 99 (49.7%) patients underwent nutritional screening. One hundred and six (53.5%) patients were confirmed as malnourished by PG-SGA. Malnourished patients had significantly longer length of hospital stay and had worse quality of life. Mortality was significantly higher in malnourished patients at one year (23 (21.7%) vs 4 (4.3%); pmalnutrition significantly affects survival even after adjustment for confounders like age, sex, Charlson index and polypharmacy. This study confirms that nutrition screening is still suboptimal in elderly hospitalized patients with adverse consequences and suggests need for review of policies to improve screening practices.

Defining specific problems in the thai government hospital buildings. A study of architectural planning and space management of maharaj hospital, Chiang Mai Thailand

DEFF Research Database (Denmark)

Prugsiganont, Supuck; Jensen, Per Anker

The purpose of this paper is to present and analyse the preliminary results of field work observation in one of the biggest government hospitals in Thailand – the Maharaj Hospital, Chiang Mai, Thailand. Hospitals in Thailand are the result of the imported concept from the European and American...

Applying a Network-Lens to Hospitality Business Research: A New Research Agenda

Directory of Open Access Journals (Sweden)

Florian AUBKE

2014-06-01

Full Text Available Hospitality businesses are first and foremost places of social interaction. This paper argues for an inclusion of network methodology into the tool kit of hospitality researchers. This methodology focuses on the interaction of people rather than applying an actor-focused view, which currently seems dominant in hospitality research. Outside the field, a solid research basis has been formed, upon which hospitality researchers can build. The paper introduces the foundations of network theory and its applicability to the study of organizations. A brief methodological introduction is provided and potential applications and research topics relevant to the hospitality field are suggested.

Prevalence and risk factors affecting low birth weight in a district hospital at Perambalur, Tamilnadu

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Rahul Hanumant Dandekar

2014-03-01

Full Text Available The low birth weight is an index of our status of public health in general and of maternal health and nutrition in particular. The major challenge in the field of public health is to identify the factors influencing low birth weight and to institute remedial measures. This hospital based cross-sectional study was conducted to know the prevalence and to identify risk factors affecting low birth weight in a District Hospital at Perambalur, Tamilnadu during six months period. All pregnant mothers who delivered babies in District Hospital were included in this study. Sample size 300 was calculated by taking 25% as the minimum prevalence of low birth weight with 20% permissible error. The statistical analysis was done by Epi Info™ 7 (7.1.2 software packages. The prevalence of LBW was found as 11.67% in 300 mothers while it was 21.5% in NFHS-3. Significant association was found between Low birth weight and weight gain in pregnancy. Though the prevalence of LBW is lower than national level, it is the need of the hour to strengthen the existing maternal services at the basic level of community.

Emotional exhaustion is associated with work related stressors: a cross-sectional multicenter study in Malaysian public hospitals.

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Khoo, Erwin J; Aldubai, Sami; Ganasegeran, Kurubaran; Lee, Bernice Xe; Zakaria, Nurul A; Tan, Kah K

2017-06-01

Emotional exhaustion is an important component of burnout. Burnout is common among doctors. It affects the physical and mental health of doctors, their performance and the quality of care they provide. This study aimed to investigate the level and factors associated with emotional exhaustion among doctors in pediatric practice in Malaysia. A self-administered questionnaire was used in this multicenter cross-sectional study. It included questions on the socio-demographics, work characteristics, Emotional Exhaustion, Perceived Stress Scale and sources of job stress. Descriptive, univariate and multivariate analysis were conducted using the SPSS software. A total of 197 doctors working in the Pediatric department in eight hospitals returned complete questionnaire. High and moderate emotional exhaustion was reported by 25.4% and 24.4% doctors, respectively. In bivariate analysis, 29 out of the 38 items of sources of stress showed significant association with emotional exhaustion (p appreciation from supervisors, lack of incentives and promotions, time pressures and deadlines to meet, and setting unrealistic goals of having them imposed on oneself (p workplace but not with socio-demographic factors.

Impact of CrossFit-Related Spinal Injuries.

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Hopkins, Benjamin S; Cloney, Michael B; Kesavabhotla, Kartik; Yamaguchi, Jonathon; Smith, Zachary A; Koski, Tyler R; Hsu, Wellington K; Dahdaleh, Nader S

2017-11-16

Exercise-related injuries (ERIs) are a common cause of nonfatal emergency department and hospital visits. CrossFit is a high-intensity workout regimen whose popularity has grown rapidly. However, ERIs due to CrossFit remained under investigated. All patients who presented to the main hospital at a major academic center complaining of an injury sustained performing CrossFit between June 2010 and June 2016 were identified. Injuries were classified by anatomical location (eg, knee, spine). For patients with spinal injuries, data were collected including age, sex, body mass index (BMI), CrossFit experience level, symptom duration, type of symptoms, type of clinic presentation, cause of injury, objective neurological examination findings, imaging type, number of clinic visits, and treatments prescribed. Four hundred ninety-eight patients with 523 CrossFit-related injuries were identified. Spine injuries were the most common injuries identified, accounting for 20.9%. Among spine injuries, the most common location of injury was the lumbar spine (83.1%). Average symptom duration was 6.4 months ± 15.1, and radicular complaints were the most common symptom (53%). A total of 30 (32%) patients had positive findings on neurologic examination. Six patients (6.7%) required surgical intervention for treatment after failing an average of 9.66 months of conservative treatment. There was no difference in age, sex, BMI, or duration of symptoms of patients requiring surgery with those who did not. CrossFit is a popular, high-intensity style workout with the potential to injure its participants. Spine injuries were the most common type of injury observed and frequently required surgical intervention.

Framework for near-field-communication-based geo-localization and personalization for Android-based smartphones--application in hospital environments.

Science.gov (United States)

Meng, Philipp; Fehre, Karsten; Rappelsberger, Andrea; Adlassnig, Klaus-Peter

2014-01-01

Various applications using near field communication (NFC) have been developed for the medical sector. As a method of short-range wireless contact-driven data transfer, NFC is a useful tool in medicine. It can be used to transfer data such as blood pressure, control adherence to medication, or transmit in vivo data. The first proposed general framework uses NFC as a mechanism for indoor geo-localization in hospitals. NFC geo-localization is economical compared to classical concepts using indoor GPS or WLAN triangulation, and the granularity of location retrieval can be defined at a tag level. Using this framework, we facilitate the development of medical applications that require exact indoor geo-localization. Multi-user Android systems are addressed in the second framework. Using private NFC tags, users are able to carry on their personal settings for enabled applications. This eliminates the need for multiple user accounts on common Android devices, improves usability, and eases technical administration. Based on the prototypes presented here, we show a novel concept of using NFC-enabled Android devices in hospital environments.

The profile of meningitis in a tertiary paediatric hospital in South Africa

African Journals Online (AJOL)

Background. Meningitis in children is a major health problem worldwide, leading to high rates of mortality and morbidity. Objectives. To describe the profile of patients treated for meningitis at a leading tertiary paediatric hospital (Red Cross War Memorial Children's Hospital) in South Africa. Methods. This study describes all ...

Hospital burden of road traffic injury: major concern in primary and secondary level hospitals in Bangladesh.

Science.gov (United States)

Mashreky, S R; Rahman, A; Khan, T F; Faruque, M; Svanström, L; Rahman, F

2010-04-01

To assess the burden of road traffic injury (RTI) in primary and secondary level hospitals in Bangladesh, and its economic impact on affected families. Cross-sectional study. The study was carried out in February and March 2001. To estimate the burden of RTI patients and the length of stay in hospital, the discharge records of primary and secondary level hospitals were used as data sources. Records from 16 district hospitals and 45 Upazila health complexes (subdistrict level hospitals), selected at random, were included in this study. A direct interview method was adopted to estimate the patient costs of RTI; this involved interviewing patients or their attendants. In this study, patient costs included money spent by the patient for medicine, transport, food and lodging (including attendants). Approximately 33% of the beds in primary and secondary level hospitals in Bangladesh were occupied by injury-related patients, and more than 19% of the injury patients had been injured in a road traffic accident. People aged 18-45 years were the major victims of RTI, and constituted 70% of the total RTI-related admissions in primary and secondary level hospitals. More than two-thirds of RTI patients were male. The average duration of hospital stay was 5.7 days, and the average patient cost for each RTI patient was US$86 (5834 BDT). RTI is a major cause of hospital admission in Bangladesh, and represents an economic and social burden for the family and the nation. A national strategy and road safety programme need to be developed to reduce the hospital burden and minimize the economic and social impact. 2010 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Effect of δ meson and ρ-ω cross couplings in effective field theory motivated Lagrangian approach

International Nuclear Information System (INIS)

Jagota, R.K.; Dhiman, S.K.; Sharma, B.K.; Arumugam, P.; Patra, S.K.

2005-01-01

It is shown that the self and cross couplings of ω meson plays an important role to make the nuclear equation of state (EOS) softer. The parameter set G2, obtained from the effective field theory motivated Lagrangian (E-RMF) approach, is very successful to reproduce the nuclear matter properties including the structure of neutron star as well as of finite nuclei. The motivation of the present report is to see the effects of these terms in the E-RMF Lagrangian on infinite nuclear matter as well as finite nuclei

Creating Cross-disciplinary Courses.

Science.gov (United States)

Reynolds, Elaine R

2012-01-01

Because of its focus on the biological underpinnings of action and behavior, neuroscience intersects with many fields of human endeavor. Some of these cross-disciplinary intersections have been long standing, while others, such as neurotheology or neuroeconomics, are more recently formed fields. Many undergraduate institutions have sought to include cross-disciplinary courses in their curriculum because this style of pedagogy is often seen as applicable to real world problems. However, it can be difficult for faculty with specialized training within their discipline to expand beyond their own fields to offer cross-disciplinary courses. I have been creating a series of multi- or cross-disciplinary courses and have found some strategies that have helped me successfully teach these classes. I will discuss general strategies and tools in developing these types of courses including: 1) creating mixed experience classrooms of students and contributing faculty 2) finding the right tools that will allow you to teach to a mixed population without prerequisites 3) examining the topic using multiple disciplinary perspectives 4) feeding off student experience and interest 5) assessing the impact of these courses on student outcomes and your neuroscience program. This last tool in particular is important in establishing the validity of this type of teaching for neuroscience students and the general student population.

Analysis of hospital interior air quality audits

Directory of Open Access Journals (Sweden)

Lin Lee-Kuo

2017-01-01

Full Text Available In general, people spent more than 80∼90% of living time in the indoor every day, human health and indoor environmental quality are closely related. The hospital has a complex and unique environmental characteristics, medical personnel and patients are prolonged exposed to risk factors in a variety of environments. Therefore, the merits of indoor air quality in the hospital, not only has a threat to the health of medical personnel and patients, but also will directly affect the quality and efficiency of health care work. A regular monitoring can, improve and maintain a well of indoor air quality, thus ensuring the safety maintenance of medical personnel and patients in hospital, it has become an important issue for hospital. This study has literatures review to collate and analyse that are related issues with indoor air quality. Then measures the indoor air quality test with direct-reading instruments. In selected hospital of this study were field-tested, then use the measured data in the field, discussion and analysis of the causes of air pollutants and the establishment of the sensing area of pollutants Concentration empirical mode.

The intrinsic crossing point of the magnetization vs. temperature curves in superconducting cuprates in the high-magnetic-field limit

International Nuclear Information System (INIS)

Mosqueira, J.; Torron, C.; Veira, J.A.; Vidal, F.

1998-01-01

The crossing point of the magnetization vs. temperature curves that appears below T c in highly anisotropic superconducting cuprates was measured in different compounds, with a different number, N, of superconducting CuO 2 layers per periodicity length, s, and also with different values of s. By correcting the measurements from different extrinsic inhomogeneity effects through the Meissner fraction, it is demonstrated experimentally for the first time that in the high-magnetic-field limit the intrinsic crossing point may be explained at a quantitative level in terms of the Tesanovic and coworkers approach based on thermal fluctuations of quasi-2D vortices (pancakes), with an effective periodicity length equal to s, independently of N. (orig.)

Mobile phone base stations and adverse health effects: phase 2 of a cross-sectional study with measured radio frequency electromagnetic fields

DEFF Research Database (Denmark)

Berg-Beckhoff, Gabriele; Blettner, M; Kowall, B

2009-01-01

OBJECTIVE: The aim of the cross-sectional study was to test the hypothesis that exposure to continuous low-level radio frequency electromagnetic fields (RF-EMFs) emitted from mobile phone base stations was related to various health disturbances. METHODS: For the investigation people living mainly...