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Sample records for cross field hospital

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

    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.

  2. Influence of gender, working field and psychosocial factors on the vulnerability for burnout in mental hospital staff: results of an Austrian cross-sectional study.

    Schadenhofer, Petra; Kundi, Michael; Abrahamian, Heidemarie; Stummer, Harald; Kautzky-Willer, Alexandra

    2018-03-01

    According to the European Agency for Safety and Health at Work (EU-OSHA), hospitals represent a work environment with high job strain. Prolonged perceived occupational stress may result in symptoms of burnout, such as emotional exhaustion (EE), depersonalisation (DP) and reduced personal accomplishment (PA). Understanding which factors may reduce vulnerability for burnout is an important requirement for well-targeted occupational stress prevention in mental hospital staff. To identify the influence of gender, age, working field, family structure, education, voluntarily occupational training during holidays and length of stay on job on occupational stress perception. In a cross-sectional design, 491 employees (311 female, 180 male) of an Austrian mental health centre participated in the study. The extent of perceived occupational stress was assessed by the Maslach Burnout Inventory (MBI) with the scales for emotional exhaustion, depersonalisation and personal accomplishment. Participants were divided according to their working field in those working with/without patients. Prevalence of emotional exhaustion was higher in women working with patients compared to men working with patients (25% vs. 18%, p = 0.003). Age above 45 years was significantly associated with decreased vulnerability for burnout in men (EE p = 0.040, DP p = 0.010, PA p = 0.007), but not in women. A lower level of education had a significant impact on depersonalisation in both sexes (p = 0.001 for men, p = 0.048 for women). Length of stay on job showed a significant influence on emotional exhaustion. No significant relationship was found between family structure and vulnerability for burnout. Gender had a differential effect on perceived occupational stress indicating a need for gender-tailored preventive strategies. Age, working field, education, voluntarily occupational training during holidays and length of stay on job affect vulnerability for burnout in mental hospital staff.

  3. Command in a field hospital.

    Bricknell, M C M

    2003-03-01

    This paper examines the challenges involved in commanding a field hospital. There are frequent, dynamic tensions between the military culture that is based on a task-focussed, hierarchical structure and the clinical culture that is based on flat, process-focussed, multidisciplinary teams. The paper outlines the cultural environment of the field hospital and then examines the deployment sequence whereby a functioning clinical facility may be created from a group of disparate individuals. There are a number of tools that may assist with this including the personality of the Commanding Officer, individual skills, the creation of an organizational identity and the choice of command structure.

  4. Numerical simulation of cross field amplifiers

    Eppley, K.

    1990-01-01

    Cross field amplifiers (CFA) have been used in many applications where high power, high frequency microwaves are needed. Although these tubes have been manufactured for decades, theoretical analysis of their properties is not as highly developed as for other microwave devices such as klystrons. One feature distinguishing cross field amplifiers is that the operating current is produced by secondary emission from a cold cathode. This removes the need for a heater and enables the device to act as a switch tube, drawing no power until the rf drive is applied. However, this method of generating the current does complicate the simulation. We are developing a simulation model of cross field amplifiers using the PIC code CONDOR. We simulate an interaction region, one traveling wavelength long, with periodic boundary conditions. An electric field with the appropriate phase velocity is imposed on the upper boundary of the problem. Evaluation of the integral of E·J gives the power interchanged between the wave and the beam. Given the impedance of the structure, we then calculate the change in the traveling wave field. Thus we simulate the growth of the wave through the device. The main advance of our model over previous CFA simulations is the realistic tracking of absorption and secondary emission. The code uses experimental curves to calculate secondary production as a function of absorbed energy, with a theoretical expression for the angular dependence. We have used this code to model the 100 MW X-band CFA under construction at SLAC, as designed by Joseph Feinstein and Terry Lee. We are examining several questions of practical interest, such as the power and spectrum of absorbed electrons, the minimum traveling wave field needed to initiate spoke formation, and the variation of output power with dc voltage, anode-cathode gap, and magnetic field. 5 refs., 8 figs

  5. Sound field separation with cross measurement surfaces.

    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.

  6. ion in crossed gradient electric and magnetic fields

    Photodetachment cross-section for variousexternal fields and the laser polarization are calculated and displayed. A comparison with the photodetachment cross-section in crossed uniform electric and magnetic fields or in a single gradient electric field has been made.The agreement of our results with the above two special ...

  7. Enhanced Dielectronic Recombination in Crossed Electric and Magnetic Fields

    Robicheaux, F.; Pindzola, M.S.

    1997-01-01

    The dependence of the dielectronic recombination cross section on crossed electric and magnetic fields is described. The enhancement of this cross section due to a static electric field is further increased when a magnetic field is added perpendicular to the electric field. Calculation of this field induced enhancement is presented for a realistic atomic model, and the mechanism for the enhancement is discussed. copyright 1997 The American Physical Society

  8. Hospitality Language In Tourism Field: Facework

    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

  9. Implementation of hospital governing boards: views from the field.

    McNatt, Zahirah; Thompson, Jennifer W; Mengistu, Abraham; Tatek, Dawit; Linnander, Erika; Ageze, Leulseged; Lawson, Ruth; Berhanu, Negalign; Bradley, Elizabeth H

    2014-04-17

    Decentralization through the establishment of hospital governing boards has been touted as an effective way to improve the quality and efficiency of hospitals in low-income countries. Although several studies have examined the process of decentralization, few have quantitatively assessed the implementation of hospital governing boards and their impact on hospital performance. Therefore, we sought to describe the functioning of governing boards and to determine the association between governing board functioning and hospital performance. We conducted a cross-sectional study with governing board chairpersons to assess board (1) structure, (2) roles and responsibilities and (3) training and orientation practices. Using bivariate analysis and multivariable regression, we examined the association between governing board functioning and hospital performance. Hospital performance indicators: 1) percent of hospital management standards met, measured with the Ethiopian Hospital Reform Implementation Guidelines and 2) patient experience, measured with the Inpatient and Outpatient Assessment of Healthcare surveys. A total of 92 boards responded to the survey (96% response rate). The average percentage of EHRIG standards met was 58.1% (standard deviation (SD) 21.7 percentage points), and the mean overall patient experience score was 7.2 (SD 2.2). Hospitals with greater hospital management standards met had governing boards that paid members, reviewed performance in several domains quarterly or more frequently, developed new revenue sources, determined services to be outsourced, reviewed patient complaints, and had members with knowledge in business and financial management (all P-values outsourced, and reviewed patient complaints (all P-values < 0.05). These cross-sectional data suggest that strengthening governing boards to perform essential responsibilities may result in improved hospital performance.

  10. Strategic Placing of Field Hospitals Using Spatial Analysis

    Rydén, Magnus

    2011-01-01

    Humanitarian help organisations today may benefit on improving their location analysis when placing field hospitals in countries hit by a disasters or catastrophe. The main objective of this thesis is to develop and evaluate a spatial decision support method for strategic placing of field hospitals for two time perspectives, long term (months) and short term (weeks). Specifically, the possibility of combining existing infrastructure and satellite data is examined to derive a suitability map f...

  11. Cross-field Mobility in a Pure Electron Plasma

    Fossum, E.C.; King, L.B.

    2006-01-01

    An electron trapping apparatus was constructed in order to study electron dynamics in the defining electric and magnetic field of a Hall-effect thruster. The approach presented here decouples the cross-field mobility from plasma effects by conducting measurements on a pure electron plasma in a highly controlled environment. Dielectric walls are removed completely eliminating all wall effect; thus, electrons are confined solely by a radial magnetic field and a crossed, independently-controlled, axial electric field that induces the closed-drift azimuthal Hall current. Electron trajectories and cross-field mobility were examined in response to electric and magnetic field strength and background neutral density

  12. Electromagnetic-gravitational conversion cross sections in external electromagnetic fields

    Hoang Ngoc Long; Dang Van Soa; Tuan Tran, A.

    1994-09-01

    The classical processes: the conversion of photons into gravitons in the static electromagnetic fields are considered by using Feynman perturbation techniques. The differential cross sections are presented for the conversion in the electric field of the flat condenser and the magnetic field of the solenoid. A numerical evaluation shows that the cross sections may have the observable value in the present technical scenario. (author). 11 refs

  13. Field dosimetry on sterilization area of medical-hospitable materials

    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)

  14. Cross border hospital use: analysis using data linkage across four Australian states.

    Spilsbury, Katrina; Rosman, Diana; Alan, Janine; Boyd, James H; Ferrante, Anna M; Semmens, James B

    2015-06-15

    To determine the quality and effectiveness of national data linkage capacity by performing a proof-of-concept project investigating cross-border hospital use and hospital-related deaths. Analysis of person-level linked hospital separation and death registration data of all public and private hospital patients in New South Wales, Queensland and Western Australia and of public hospital patients in South Australia, totalling 7.7 million hospital patients from 1 July 2004 to 30 June 2009. Counts and proportions of hospital stays and patient movement patterns. 223 262 patients (3.0%) travelled across a state border to attend hospitals, in particular, far northern and western NSW patients travelling to Queensland and SA hospitals, respectively. A further 48 575 patients (0.6%) moved their place of residence interstate between hospital visits, particularly to and from areas associated with major mining and tourism industries. Over 11 000 cross-border hospital transfers were also identified. Of patients who travelled across a state border to hospital, 2800 (1.3%) died in that hospital. An additional 496 deaths recorded in one jurisdiction occurred within 30 days of hospital separation from another jurisdiction. Access to person-level data linked across jurisdictions identified geographical hot spots of cross-border hospital use and hospital-related deaths in Australia. This has implications for planning of health service delivery and for longitudinal follow-up studies, particularly those involving mobile populations.

  15. [Red Cross hospital in Krapina, during the First world war from 1914 to 1918].

    Fures, Rajko; Habek, Dubravko; Kozina, Drago

    2016-08-01

    Red Cross Hospital in Krapina, during the First World War, was active from 1914 to 1918. Hospital led by Dr. Mirko Crkvenac, oriented humanist. The hospital is operated thanks to the help of municipalities and citizens. The hospital staff concern is for civilian and military victims of the First World War. Dr. Crkvenac, with the support of the City of Krapina and Mayor Vilibald Sluga, he succeeds to the organization and operation of the hospital to an enviable level. Across the Austro-Hungarian Empire and Croatian, Hospitals Red Cross, had a significant role in caring for the wounded, injured and sick soldiers and civilians. Red Cross Hospital in Krapina, is an example of a well-organized hospital in the toughest conditions. Such an organization was not simple in its implementation, and left the valuable lessons and experience.

  16. Evacuation of Hospitals during Disaster, Establishment of a Field Hospital, and Communication

    Tekin, Erdal; Bayramoglu, Atif; Uzkeser, Mustafa; Cakir, Zeynep

    2017-01-01

    The buildings, working personnel, and patients and their relatives may directly or indirectly be affected by the disasters. Here we will discuss evacuation, establishing a field hospital, communication, the role of the media in disasters, and defending against sabotage. The affected individuals should be evacuated and transferred to secure zones safely and rapidly. How the decision for evacuation should be made and how the evacuation triage should be performed are important issues. Field hosp...

  17. Internet Hospitals in China: Cross-Sectional Survey.

    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

  18. Telemedicine for a Children's Field Hospital in Chechnya.

    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.

  19. Phonon-assisted transitions in crossed electric and magnetic fields

    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)

  20. Photon - axion conversion cross sections in an electromagnetic field

    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)

  1. Oesophageal carcinoma in jordanian field hospital in afghanistan

    Ajlouni, Y.M.

    2007-01-01

    Mazzar-I-Shariff in Afghanistan, is a poor wartorn city with only one gastrointestinal endoscopist in the region. It was noticed by previous gastroenterologists working in Jordanian Field Hospital in Afghanistan that oesophageal carcinoma is seen more frequant than that in Jordan. The objectives of the study were to determine the spectrum of upper gastrointestinal diseases in patients who undergone upper endoscopy in the Jordanian Field Hospital in Afghanistan and to estimate the incidence,age of diagnosis, clinical presentations and the endoscopic appearance of the oesophageal carcinoma. Between 20 December 2003 and March 3, 2004, 289 gastroscopies were performed in Jordanian field Hospital/Afghanistan on patients aged 16 years or more. Biopsies were taken from any suspected lesion. Data for each patient were kept to correlate with the histopathological results. Thirty three (11.4%) endoscopies gave normal results. The most common major single findings in the other 256 were oseophageal carcinoma (22.5%) duodenal ulcers (13.5%), and oesophagitis (13%). About one third of the patients had more than one endoscopic finding. Oseophageal carcinoma was found in 22.5% of patients and it was more common in men than women. The most common presenting symptom for oseophageal carcinoma were dysphagia and weight loss. It was more frequent in age group of 60-72 years. The most common endoscopic findings were mass or ulcerative lesion. Oesophageal carcinoma is a common finding in patients who had upper endoscopy in the Jordanian Field Hospital in the north of Afghanistan.Mazzar-I-Sharif needs well equiped gastrointestinal unit and a multi disciplinary team (Gastroenterologist, Histopathologist,Surgeon and Dietitian) to deal with patients with oesophageal carcinoma and more research is needed to establish the possible etiology. (author)

  2. Nile Crossings: Hospitality and Revenge in Egyptian Rural Narratives

    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...

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

    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.

  4. Telecommunications in Israeli field hospitals deployed to three crisis zones.

    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.

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

    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.

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

    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.

  7. Magnetohydrodynamic free convection in a strong cross field

    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

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

    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).

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

    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.

  10. Cross Selling Implementation From Outpatient Unit to Radiology Unit in Semen Gresik Hospital

    Rochmah, Thinni Nurul; Faradisa, Mutiara Ayu

    2013-01-01

    Thelow visitingnumberinhospital€™sunitarecloselyrelatedtomarketingactivities,includinginternal marketing which consistsof cross sellingfromother units.Thisstudy aims toanalyze crossselling implementation from Outpatient Unit to Radiology Unit in Semen Gresik Hospital. This study was a cross sectional analytic design. Samplewastakenbysimple random samplingwithsamplesize25respondents.Independentvariableswere marketing policy,employee commitment,perception, motivation,andreadiness ofcross sellin...

  11. Electric field measurements at subcritical, oblique bow shock crossings

    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

  12. The deployment of information systems and information technology in field hospitals.

    Crowe, Ian R J; Naguib, Raouf N G

    2010-01-01

    Information systems and related technologies continue to develop and have become an integral part of healthcare provision and hospital care in particular. Field hospitals typically operate in the most austere and difficult of conditions and have yet to fully exploit related technologies. This paper addresses those aspects of healthcare informatics, healthcare knowledge management and lean healthcare that can be applied to field hospitals, with a view to improving patient care. The aim is to provide a vision for the deployment of information systems and information technology in field hospitals, using the British Army's field hospital as a representative model.

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

    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

  14. Notes from a field hospital south of Mosul.

    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.

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

    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

  16. 'Hospitality' Is an Inviting Field at Many Colleges.

    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)

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

    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

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

    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…

  19. Effect of radial electric field inhomogeneity on anomalous cross field plasma flux in Heliotron/Torsatron

    Yamagishi, Tomejiro; Sanuki, Heiji.

    1996-01-01

    Anomalous cross field plasma fluxes induced by the electric field fluctuations has been evaluated in a rotating plasma with shear flow in a helical system. The anomalous ion flux is evaluated by the contribution from ion curvature drift resonance continuum in the test particle model. The radial electric field induces the Doppler frequency shift which disappears in the frequency integrated anomalous flux. The inhomogeneity of the electric field (shear flow effect), however, induces a new force term in the flux. The curvature drift resonance also induces a new force term '/ which, however, did not make large influence in the ion flux in the CHS configuration. The shear flow term in the flux combined with the electric field in neoclassical flux reduces to a first order differential equation which governs the radial profile of the electric field. Numerical results indicate that the shear flow effect is important for the anomalous cross field flux and for determination of the radial electric field particularly in the peripheral region. (author)

  20. Average cross sections calculated in various neutron fields

    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)

  1. Nonlinear analysis of generalized cross-field current instability

    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

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

    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.

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

    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.

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

    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.

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

    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.

  6. Hospital Acquired Thrombosis (HAT) Prevention in an Acute Hospital; A Single Centre Cross-Sectional Study

    Khan, MI

    2017-04-01

    Evidence based guidelines are effective in reducing incidence of venous thromboembolism (VTE) which is associated with morbidly, mortality and economic burden. This study aimed to identify the proportion of inpatients who had a VTE risk assessment (RA) performed and who received thromboprophylaxis (TP), in Cork University Hospital. There was no structured RA tool at the time; information was obtained from medical and drug charts to ascertain if a RA was performed. Patients were then RA by researchers and stratified as per NICE guidelines and the proportion who received TP was calculated. One thousand and nineteen inpatients were screened. Risk was documented in 24% of cases. TP was prescribed in 43.2% of inpatients. Following application of a RA tool >80% were at high risk of VTE with low risk of bleeding with TP prescription in 46.3% of inpatients. A national collaborative effort should be encouraged to develop a standardized approach for safe RA of inpatients and prescription of TP for prevention of HAT

  7. Channeling of electrons in a crossed laser field

    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.

  8. Guidelines for the use of foreign field hospitals in the aftermath of sudden-impact disaster.

    2003-01-01

    Natural and complex disasters can cause a dramatic increase in the demand for emergency medical care. Local health services can be overwhelmed, and damage to clinics and hospitals can render them useless. Many countries maintain mobile field hospitals for defense or humanitarian purposes. Dispatching these facilities to disaster-affected countries would seem an ideal response to emergency medical needs. Unfortunately, experience has shown that in the case of natural disasters, field hospitals often have not met the expectations of recipients and donor institutions. In July 2003, the World Health Organization and Pan American Health Organization sponsored a workshop in El Salvador to discuss the pros and cons of using foreign field hospitals in the aftermath of natural disasters. These guidelines are the result of that workshop. The workshop participants identified different phases when foreign field hospitals and specialized medical personnel are most useful. They can provide advanced trauma care and life support if at the disaster site within 48 hours of the impact of an event; they would provide follow-up care for trauma victims and resumption of routine medical care in the two weeks following the event; during rehabilitation and reconstruction phases (from two months to two or more years), a field hospital might serve as a temporary replacement for damaged health facilities. These guidelines propose conditions that field hospitals and their staff should meet for each of these phases. The guidelines also outline issues that authorities in donor countries and disaster-affected countries should discuss before mobilizing a field hospital.

  9. Nosocomial tuberculosis prevention in Portuguese hospitals: a cross-sectional evaluation.

    Sousa, M; Gomes, M; Gaio, A R; Duarte, R

    2017-08-01

    Measures to control tuberculous infection are crucial to prevent nosocomial transmission and protect health care workers (HCWs). In Portugal, the extent of implementation of tuberculosis (TB) control measures in hospitals is not known. To determine the current implementation of preventive measures for tuberculous infection at administrative, environmental and personal levels in Portuguese hospitals. A cross-sectional evaluation was performed using two anonymous questionnaires: one sent to all the hospital infection control (IC) committees and the other sent to all pulmonologists and physicians specialising in infectious disease. Fourteen IC committees and 72 physicians responded. According to the IC committees, 92% of hospitals had a written TB control plan, but only 37% of the physicians said there was always/almost always a fast track for diagnosing suspected pulmonary TB cases. The majority of the hospitals had an isolation policy (85%) and these patients were always/almost always admitted in separate rooms, according to 70% of physicians. Both HCWs and TB patients used respiratory protection equipment (92%). These findings indicate that the most basic TB IC measures had been undertaken, but some TB IC measures were not fully implemented at all hospitals. An institutional effort should be made to solve this problem and strengthen TB prevention activities.

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

    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 ...

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

    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

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

    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

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

    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.

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

    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

  15. Ethical issues in purchasing: a field study of Midwest hospitals.

    Tomaszewski, K; Motwani, J

    1995-01-01

    A large sum of money is spent annually by salespeople on gifts and favors for purchasing executives. The provision of gifts and favors to buyers remains a common practice despite the fact that it often leads to ethical conflicts for purchasing executives, sales managers, and salespeople. This paper investigates the perceptions of 51 purchasing executives of midwest hospitals regarding their behavior towards certain buying practices, the favors offered by vendors, favors actually accepted, as well as purchasers' discomfort and repayment levels regarding indebtedness. Based on the data analysis, this paper provides conclusions and directions for future research.

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

    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.

  17. General renormalized statistical approach with finite cross-field correlations

    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)

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

    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.

  19. Plasma Flows in Crossed Magnetic and Electric Fields

    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

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

    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

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

    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.

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

    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.

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

    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.

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

    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.

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

    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.

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

    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.

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

    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

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

    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)

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

    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.

  10. [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].

    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.

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

    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...

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

    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

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

    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

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

    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

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

    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

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

    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

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

    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.

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

    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.

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

    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.

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

    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.

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

    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.

  2. Cross-Cultural Psychiatry in the Field: Collaborating with Anthropology

    Folmar, Steven; Palmes, Guy K.

    2009-01-01

    Psychiatric and anthropological collaborations have produced robust literatures on varied topics but there are challenges in the working relation between these two fields. A research into how cultures deal with attention-deficit hyperactivity disorders in Afghanistan is discussed to highlight the challenges in the working relations between…

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

    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.

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

    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.

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

    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

  6. Hospitals

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

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

    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.

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

    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.

  9. Weather data around the world for design of field hospital HVAC

    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

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

    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...

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

    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)

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

    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

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

    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

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

    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

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

    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…

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

    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.

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

    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

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

    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...

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

    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.

  20. Particle crossing versus field crossing; a corrective response to Duff's recent account of string theory

    Schroer, Bert; FU-Berlin

    2012-02-01

    Using recent results of advanced quantum field theory, we confute some of M. Duff's claims about string theory which he wrote as an invited paper to the project 'Forty Years Of String Theory: Reflecting on the Foundations' (author)

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

    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.

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

    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.

  3. Cross-field plasma injection into mirror geometry

    Uzun-Kaymak, I U; Clary, R; Ellis, R; Elton, R; Teodorescu, C; Young, W [Institute for Research in Electronics and Applied Physics, University of Maryland, College Park, MD 20742 (United States); Messer, S; Bomgardner, R; Case, A; Witherspoon, F D, E-mail: uzunkaymak@wisc.ed [HyperV Technologies Corp., Chantilly, VA 20151 (United States)

    2009-09-15

    The Maryland Centrifugal Experiment (MCX) and HyperV Technologies Corp. are collaborating on a series of experiments to test the use of a plasma gun to inject mass and momentum into a magnetic-confinement device. HyperV has designed, built and installed a prototype coaxial gun to drive rotation in MCX. The gun has been designed to avoid the blow-by instability via a combination of electrode shaping and a tailored plasma armature. Preliminary measurements at HyperV indicate the gun generates plasma jets with a mass of 160 {mu}g, velocities up to 90 km s{sup -1} and plasma density in the high 10{sup 14} cm{sup -3}. This paper emphasizes characteristics of the plasma gun and penetration of the plasma jet through the MCX magnetic field. Plans for future injection experiments are briefly discussed.

  4. Anomalous cross-field velocities in a CIV laboratory experiment

    Axnaes, I.

    1988-10-01

    The axial and radial ion velocities and the electron radial velocity are determined in coaxial plasma gun operated under critical velocity conditions. The particle celocities are determined from probe measurement together with He I 3889 AA absolute intensity measurements and the consideration of the total momentum balance of the current sheet. The ions are found move axially and the electrons radially much faster than predicted by the E/B drift in the macroscopic fields. These results agree with what can be expected from the instability processes, which has earlier been proposed to operate in these experiments. It is therefore a direct experimental demonstration that instability processes have to be invoked not only for the electron heating, but also to explain the macroscopic velocities and currents. (author)

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

    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.

  6. Statistical observation on autopsy cases of malignancy at the Japanese Red Cross, Nagasaki Atomic Bomb Hospital

    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.

  7. Statistical observation on autopsy cases of malignancy at the Japanese Red Cross, Nagasaki Atomic Bomb Hospital

    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.)

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

    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.

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

    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.

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

    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.

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

    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

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

    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.

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

    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

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

    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.

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

    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

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

    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.

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

    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\\'.

  18. A stochastic mathematical model to locate field hospitals under disruption uncertainty for large-scale disaster preparedness

    Nezir Aydin

    2016-03-01

    Full Text Available In this study, we consider field hospital location decisions for emergency treatment points in response to large scale disasters. Specifically, we developed a two-stage stochastic model that determines the number and locations of field hospitals and the allocation of injured victims to these field hospitals. Our model considers the locations as well as the failings of the existing public hospitals while deciding on the location of field hospitals that are anticipated to be opened. The model that we developed is a variant of the P-median location model and it integrates capacity restrictions both on field hospitals that are planned to be opened and the disruptions that occur in existing public hospitals. We conducted experiments to demonstrate how the proposed model can be utilized in practice in a real life problem case scenario. Results show the effects of the failings of existing hospitals, the level of failure probability and the capacity of projected field hospitals to deal with the assessment of any given emergency treatment system’s performance. Crucially, it also specifically provides an assessment on the average distance within which a victim needs to be transferred in order to be treated properly and then from this assessment, the proportion of total satisfied demand is then calculated.

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

    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

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

    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.

  1. Job satisfaction of nurses in a Saudi Arabian university teaching hospital: a cross-sectional study.

    Al-Dossary, R; Vail, J; Macfarlane, F

    2012-09-01

    Saudi Arabia is developing very fast in all disciplines, especially in nursing and health. Only about five studies between 1990 and 2010 have been undertaken in Saudi Arabia concerning factors influencing job satisfaction of nurses, although a body of knowledge exists globally. The purpose of this research was to measure nurses' job satisfaction in Saudi Arabia in a university teaching hospital and to determine the influencing factors. A quantitative, cross sectional method, self-administered questionnaire was used for this study. A systematic sample of N=189 nurses was used to collect data. The SPSS version 16.0. was used to analyze the data. An independent t-test and one-way analysis of variance were used to test hypotheses concerning different groups, and correlation tests (the Pearson's and Spearman's rank tests) were used to examine relationships between variables. Overall, nurses were neither satisfied nor dissatisfied with their jobs. However, nurses indicated satisfaction with supervision, co-workers and nature of work. The sources of dissatisfaction were with subscales such as pay, fringe benefits, contingent rewards and operating conditions. These findings indicate that there is a need to increase nurses' salaries and bonuses for extra duties. More training programmes and further education also should be encouraged for all nurses. Therefore, it is imperative that nursing managers and policy makers in Saudi Arabia consider these findings to improve nurses' job satisfaction. © 2012 The Authors. International Nursing Review © 2012 International Council of Nurses.

  2. Employing post-DEA cross-evaluation and cluster analysis in a sample of Greek NHS hospitals.

    Flokou, Angeliki; Kontodimopoulos, Nick; Niakas, Dimitris

    2011-10-01

    To increase Data Envelopment Analysis (DEA) discrimination of efficient Decision Making Units (DMUs), by complementing "self-evaluated" efficiencies with "peer-evaluated" cross-efficiencies and, based on these results, to classify the DMUs using cluster analysis. Healthcare, which is deprived of such studies, was chosen as the study area. The sample consisted of 27 small- to medium-sized (70-500 beds) NHS general hospitals distributed throughout Greece, in areas where they are the sole NHS representatives. DEA was performed on 2005 data collected from the Ministry of Health and the General Secretariat of the National Statistical Service. Three inputs -hospital beds, physicians and other health professionals- and three outputs -case-mix adjusted hospitalized cases, surgeries and outpatient visits- were included in input-oriented, constant-returns-to-scale (CRS) and variable-returns-to-scale (VRS) models. In a second stage (post-DEA), aggressive and benevolent cross-efficiency formulations and clustering were employed, to validate (or not) the initial DEA scores. The "maverick index" was used to sort the peer-appraised hospitals. All analyses were performed using custom-made software. Ten benchmark hospitals were identified by DEA, but using the aggressive and benevolent formulations showed that two and four of them respectively were at the lower end of the maverick index list. On the other hand, only one 100% efficient (self-appraised) hospital was at the higher end of the list, using either formulation. Cluster analysis produced a hierarchical "tree" structure which dichotomized the hospitals in accordance to the cross-evaluation results, and provided insight on the two-dimensional path to improving efficiency. This is, to our awareness, the first study in the healthcare domain to employ both of these post-DEA techniques (cross efficiency and clustering) at the hospital (i.e. micro) level. The potential benefit for decision-makers is the capability to examine high

  3. Inter-hospital Cross-validation of Irregular Discharge Patterns for Young vs. Old Psychiatric Patients

    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)

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

    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.

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

    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).

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

    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.

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

    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.

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

    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)

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

    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)

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

    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)

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

    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)

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

    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,

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

    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.

  14. The mental health of nurses in acute teaching hospital settings: a cross-sectional survey.

    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

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

    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

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

    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

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

    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.

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

    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.

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

    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)

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

    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

  1. Association Between Frailty and Cognitive Impairment: Cross-Sectional Data From Toulouse Frailty Day Hospital.

    Fougère, Bertrand; Daumas, Matthieu; Lilamand, Matthieu; Sourdet, Sandrine; Delrieu, Julien; Vellas, Bruno; Abellan van Kan, Gabor

    2017-11-01

    A consensus panel, based on epidemiologic evidence, argued that physical frailty is often associated with cognitive impairment, possibly because of common underlying pathophysiological mechanisms. The concepts of cognitive frailty and motoric cognitive risk were recently proposed in literature and may represent a prodromal stage for neurodegenerative diseases. The purpose of this study was to analyze the relationship between cognition and the components of the physical phenotype of frailty. Participants admitted to the Toulouse frailty day hospital aged 65 years or older were included in this cross-sectional study. Cognitive impairment was identified using the Mini-Mental State Examination (MMSE) and the Clinical Dementia Rating (CDR). Frailty was assessed using the physical phenotype as defined by Fried's criteria. We divided the participants into 2 groups: participants with normal cognition (CDR = 0) and participants who had cognitive impairment (CDR = 0.5). Participants with CDR >0.5 were excluded. Data from 1620 participants, mean age 82 years and 63% of women were analyzed. Cognitive impairment was identified in 52.5% of the participants. Frailty was identified in 44.7% of the sample. There were more frail subjects in the impaired group than the normal cognitive group (51% vs 38%, P impairment [adjusted odds ratio (OR) 1.66, 95% confidence interval (CI) 1.12-2.46]. Subsequent analysis showed that the association between cognitive impairment and frailty was only observed considering one of the 5 frailty criteria: gait speed (adjusted OR 1.89, 95% CI 1.55-2.32). Physical frailty and in particular slow gait speed were associated with cognitive impairment. Future research including longitudinal studies should exploit the association between cognitive impairment and frailty. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  2. A cross-sectional study of QOL of diabetic patients at tertiary care hospitals in Delhi

    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

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

    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

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

    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

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

    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

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

    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.

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

    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

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

    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

  9. Hospitals

    Mullins, Michael

    2013-01-01

    The challenge could be briefly seen in these terms: hospitals as places for treatment where there’s a technology focus and hospitals for healing where there’s a human focus. In the 60s - 70s wave of new hospital building, an emphasis on technology can be seen. It’s time to move from the technology...... focus. It is not enough to consider only the factors of function within architecture, hygiene, economy and logistics. We also need to look at aspects of aesthetics, bringing nature into the building, art, color, acoustics, volume and space as we perceive them. Contemporary methods and advances...... placed, accessible, provided with plenty of greenery, and maximize sensory impressions, providing sounds, smells, sight and the possibility to be touched. This is a very well documented area I can say. Hygiene, in terms of architecture can give attention to hand wash facilities and their positioning...

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

    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

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

    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

  12. No one can whistle a symphony: How hospitals design for daily cross-boundary collaboration

    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...

  13. Quality of paediatric blood transfusions in two district hospitals in Tanzania: a cross-sectional hospital based study

    Mosha, Dominic; Poulsen, Anja; Reyburn, Hugh

    2009-01-01

    respectively, prior to the BT decision. Pre-transfusion haemoglobin and body temperature were recorded in 2/3 of the patients, but respiratory rate and pulse rate were not routinely recorded. In 40% of BTs, the transfusion time exceeded the recommended 4 hours. The zonal blood bank (ZBB) and local donors......BACKGROUND: Blood transfusion (BT) can be lifesaving for children; however, monitoring the quality of BT is important. The current study describes the quality of paediatric BT delivered in two district hospitals in north-east Tanzania in order to identify areas for quality assurance and improvement...... in the administration of BT. METHODS: All 166 children admitted in the paediatric wards and receiving BT through April to June 2007 were prospectively observed. Medical records, request forms and registers in the laboratories were reviewed to identify blood source, blood screening and indications for BT. BT...

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

    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.

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

    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...

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

    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.

  17. Anomalous cross-field current and fluctuating equilibrium of magnetized plasmas

    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...

  18. Electron cyclotron instabilities of finite pressure inhomogeneous plasma in crossed fields

    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

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

    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)

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

    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

  1. ENERGETIC PARTICLE CROSS-FIELD PROPAGATION EARLY IN A SOLAR EVENT

    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.

  2. ENERGETIC PARTICLE CROSS-FIELD PROPAGATION EARLY IN A SOLAR EVENT

    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

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

    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

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

    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.

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

    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.

  6. The Border Crossed Us: Education, Hospitality Politics, and the Social Construction of the "Illegal Immigrant"

    Carlson, Dennis

    2009-01-01

    In this essay, Dennis Carlson explores some of the implications of Derrida's "hospitality politics" in helping articulate a progressive response to a rightist cultural politics in the United States of policing national, linguistic, and other borders. He applies the concept of hospitality politics to a critical analysis of the social construction…

  7. Appropriate use of medical imaging in two Spanish public hospitals: a cross-sectional analysis

    Vilar-Palop, Jorge; Hernandez-Aguado, Ildefonso; Pastor-Valero, María; Vilar, José; González-Alvarez, Isabel; Lumbreras, Blanca

    2018-01-01

    Objectives To determine the appropriateness of medical imaging examinations involving radiation and to estimate the effective radiation dose and costs associated. Design Cross-sectional retrospective study. Setting Two Spanish public tertiary hospitals. Participants 2022 medical imaging tests were extracted from the radiology information system in February and March of 2014. MRI and ultrasound examinations were excluded. Primary and secondary outcome measures Five outcomes were set independently by at least two researchers according to four guidelines: (1) appropriate; (2) inappropriate; (3) inappropriate due to repetition, if the timing to carry out next diagnostic tests was incorrect according to guidelines; (4) not adequately justified, if the referral form did not include enough clinical information to allow us to understand the patient’s clinical condition; and (5) not included in the guidelines, if the referral could not be matched to a clinical scenario described in the guidelines. We estimated the prevalence of the five categories according to relevant clinical and sociodemographic variables and the effective radiation dose and costs for each category. Results Approximately half of the imaging tests were deemed as appropriate (967, 47.8%) while one-third (634, 31.4%) were considered inappropriate. 19.6% of the effective dose and 25.2% of the cost were associated with inappropriate tests. Women were less likely than men to have an imaging test classified as appropriate (adjusted OR 0.70,95% CI 0.57 to 0.86). Imaging tests requested by general practitioners were less likely to be considered appropriate than those requested by central services (adjusted OR 0.60, 95% CI 0.38 to 0.93). Mammography and CT were more likely to be appropriate than conventional X-rays. Conclusion There was a significant frequency of inappropriateness, which resulted in a high percentage of associated effective radiation dose. Percentage of inappropriateness depends on

  8. Appropriate use of medical imaging in two Spanish public hospitals: a cross-sectional analysis.

    Vilar-Palop, Jorge; Hernandez-Aguado, Ildefonso; Pastor-Valero, María; Vilar, José; González-Alvarez, Isabel; Lumbreras, Blanca

    2018-03-16

    To determine the appropriateness of medical imaging examinations involving radiation and to estimate the effective radiation dose and costs associated. Cross-sectional retrospective study. Two Spanish public tertiary hospitals. 2022 medical imaging tests were extracted from the radiology information system in February and March of 2014. MRI and ultrasound examinations were excluded. Five outcomes were set independently by at least two researchers according to four guidelines: (1) appropriate; (2) inappropriate; (3) inappropriate due to repetition, if the timing to carry out next diagnostic tests was incorrect according to guidelines; (4) not adequately justified, if the referral form did not include enough clinical information to allow us to understand the patient's clinical condition; and (5) not included in the guidelines, if the referral could not be matched to a clinical scenario described in the guidelines. We estimated the prevalence of the five categories according to relevant clinical and sociodemographic variables and the effective radiation dose and costs for each category. Approximately half of the imaging tests were deemed as appropriate (967, 47.8%) while one-third (634, 31.4%) were considered inappropriate. 19.6% of the effective dose and 25.2% of the cost were associated with inappropriate tests. Women were less likely than men to have an imaging test classified as appropriate (adjusted OR 0.70,95% CI 0.57 to 0.86). Imaging tests requested by general practitioners were less likely to be considered appropriate than those requested by central services (adjusted OR 0.60, 95% CI 0.38 to 0.93). Mammography and CT were more likely to be appropriate than conventional X-rays. There was a significant frequency of inappropriateness, which resulted in a high percentage of associated effective radiation dose. Percentage of inappropriateness depends on sociodemographic and clinical characteristics such as sex, age, referral physician and medical imaging test

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

    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

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

    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

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

    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

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

    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.

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

    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

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

    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.

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

    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.

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

    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.

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

    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.

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

    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

  19. 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.

    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.

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

    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

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

    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.

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

    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

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

    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)

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

    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

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

    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.

  6. Does a referral from home to hospital affect satisfaction with childbirth? A cross-national comparison

    Gouwy Anneleen

    2007-07-01

    Full Text Available Abstract Background The Belgian and Dutch societies present many similarities but differ with regard to the organisation of maternity care. The Dutch way of giving birth is well known for its high percentage of home births and its low medical intervention rate. In contrast, home births in Belgium are uncommon and the medical model is taken for granted. Dutch and Belgian maternity care systems are compared with regard to the influence of being referred to specialist care during pregnancy or intrapartum while planning for a home birth. We expect that a referral will result in lower satisfaction with childbirth, especially in Belgium. Methods Two questionnaires were filled out by 605 women, one at 30 weeks of pregnancy and one within the first two weeks after childbirth, either at home or in a hospital. Of these, 563 questionnaires were usable for analysis. Women were invited to participate in the study by independent midwives and obstetricians during antenatal visits in 2004–2005. Satisfaction with childbirth was measured by the Mackey Satisfaction with Childbirth Rating Scale, which takes into account the multidimensional nature of the concept. Results Belgian women are more satisfied than Dutch women and home births are more satisfying than hospital births. Women who are referred to the hospital while planning for a home birth are less satisfied than women who planned to give birth in hospital and did. A referral has a greater negative impact on satisfaction for Dutch women. Conclusion There is no reason to believe Dutch women receive hospital care of lesser quality than Belgian women in case of a referral. Belgian and Dutch attach different meaning to being referred, resulting in a different evaluation of childbirth. In the Dutch maternity care system home births lead to higher satisfaction, but once a referral to the hospital is necessary satisfaction drops and ends up lower than satisfaction with hospital births that were planned in advance

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

    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/

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

    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.

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

    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.

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

    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

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

    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)

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

    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.

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

    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.

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

    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.

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

    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)

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

    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.

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

    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

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

    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.

  19. Shape functions for separable solutions to cross-field diffusion problems

    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

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

    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)

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

    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.

  2. [The construction process of managerial profile competencies for nurse coordinators in the hospital field].

    Manenti, Simone Alexandra; Ciampone, Maria Helena Trench; Mira, Vera Lucia; Minami, Lígia Fumiko; Soares, Jaqueline Maria Sousa

    2012-06-01

    The objective of this study was to construct a profile of managerial competencies, based on the consensus of nurse coordinators in the field. This study was developed in a philanthropic hospital in São Paulo, following the research-action model, and included 13 nurse coordinators as participants. The data collection was performed using the focal group technique. Data analysis was performed using the theoretical frameworks related to the working process and managerial competencies. The results identified the greater emphasis assigned to the competencies related to the mentor, coordinator and director roles. It was, therefore, possible to construct a professional development plan that is based on competencies in the technical, ethical-political, and communicative domains, as well as the development of citizenship. The analysis of the managerial working process and the study of the competencies within the managerial environment were shown to be important, because they highlighted the professionals' need to improve, thus fulfilling personal, professional, and organizational demands.

  3. Low field MR imaging of sellar and parasellar lesions: Experience in a developing country hospital

    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.

  4. Attitudes of hospitalized patients toward wearing patient clothing in Tianjin, China: A cross-sectional survey

    Lu Liu

    2016-12-01

    Conclusions: More than half of the hospitalized patients dislike wearing patient clothing because they were unaware of its functions and were skeptical about its hygiene, comfortability, fit, and appearance. Therefore, these patients must be provided with comfortable, well fitting, hygienic, and aesthetically pleasing clothing.

  5. Risk of Cross-Infection in a Hospital Ward with Downward Ventilation

    Nielsen, Peter V.; Li, Yuguo; Buus, Morten

    2010-01-01

    A two-bed hospital ward with one standing healthcare person and a ceiling-mounted lowimpulse semicircular inlet diffuser is simulated in a full-scale room. Tracer gas is used for simulating gaseous contaminants, and the concentration is measured at different air change rates and different posture...

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

    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.

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

    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.

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

    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

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

    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.

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

    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

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

    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

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

    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.

  13. Nurses’ knowledge on phlebotomy in tertiary hospitals in China: a cross-sectional multicentric survey

    Cai, Qian; Zhou, Yunxian; Yang, Dangan

    2017-01-01

    Introduction In China, phlebotomy practice is mostly executed by nurses instead of phlebotomists. Our hypothesis was that these nurses may lack of knowledge on phlebotomy, especially factors influencing quality of blood samples. This study aims to assess the overall nurses’ knowledge on phlebotomy to provide reference for improving blood sampling practice in China. Materials and methods A survey was conducted involving nurses from 4 regions and 13 hospitals in China. A phlebotomy knowledge qu...

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

    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.

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

    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.

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

    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.

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

    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.

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

    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

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

    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

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

    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.

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

    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.

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

    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

  3. Air Distribution Systems and Cross-Infection Risk in the Hospital Sector

    Nielsen, Peter V.

    2012-01-01

    . A large amount of air is supplied to the room to ensure dilution of airborne infection. The paper discusses both the macroenvironment and the microenvironment. The macroenvironment is the conditions created by the air distribution system, and the microenvironment is the conditions created by the local...... flow around persons in combination with the surrounding conditions. Analyses of the flow in the room (macroenvironment) show a number of parameters that play an important role in minimising of airborne cross-infection. The air flow rate to the room must be high, and the air distribution pattern can......We protect ourselves from airborne cross-infection in our indoor environment by supplying fresh air to the room by natural or mechanical ventilation. The air is distributed in the room according to different principles as e.g. mixing ventilation, downward ventilation, displacement ventilation, etc...

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

    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.

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

    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.

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

    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.

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

    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.

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

    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.

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

    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.

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

    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

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

    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)

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

    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.

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

    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

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

    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

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

    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

  16. 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.

    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.

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

    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

  18. Preliminary study of cross-field plasma injection in 2XIIB

    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

  19. Positron cross-field transport due to quasibound states of antihydrogen

    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

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

    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

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

    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.

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

    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

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

    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

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

    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.

  5. [Impact of headache among studied military population in Afghanistan deployed in the Kabul military field hospital].

    Guilloton, L; Bruneau, O; Trousselard, M; Zagnoli, F; Blanc, P A; De Greslan, T; Drouet, A

    2015-11-01

    Headaches are a common reason for consultation with a prevalence of 30%. Few data exist for military personnel, including in situations of war operations. The main objective of this work was to measure the evolution of the impact of headache in such a context. Two hundred and one personnel deployed in the Kaïa military field hospital in Afghanistan were recruited. A questionnaire designed to recognize headaches, supported by two quality of life scales (MIDAS and HIT-6) and a stress questionnaire were filled out before departure and upon return from missions. Sixty-three patients with headache were initially identified, of whom 52 remained symptomatic during the mission. The average total score of MIDAS before departure was 4 days and fell to 1.4 days upon return, with a mean measured change of 3.3 days. For HIT-6, the mean total score was 51.2 points initially and 51.9 points at the end of the mission with a mean change of-0.3 points. Nine patients without headache initially became symptomatic: MIDAS and HIT-6 were not affected. Thus, the impact of headache in the particular context of presence in a theater of operations was low: improved MIDAS score and the lack of influence on the HIT-6 score are underlined. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  6. Nurses’ knowledge on phlebotomy in tertiary hospitals in China: a cross-sectional multicentric survey

    Cai, Qian; Zhou, Yunxian; Yang, Dangan

    2017-01-01

    Introduction In China, phlebotomy practice is mostly executed by nurses instead of phlebotomists. Our hypothesis was that these nurses may lack of knowledge on phlebotomy, especially factors influencing quality of blood samples. This study aims to assess the overall nurses’ knowledge on phlebotomy to provide reference for improving blood sampling practice in China. Materials and methods A survey was conducted involving nurses from 4 regions and 13 hospitals in China. A phlebotomy knowledge questionnaire was designed based on the Clinical and Laboratory Standards Institute H3-A6 guidelines, combining with the situations in China. Descriptive analysis and binary logistic regression analysis were used to analyze the knowledge level and its influencing factors. Results A total of 3400 questionnaires were distributed and 3077 valid questionnaires were returned, with an effective return rate of 90.5%. The correct rates of patient identification, hand sanitization, patient assessment, tube mixing time, needle disposing location and tube labelling were greater than 90%. However, the correct rates of order of draw (15.5%), definition of an inversion (22.5%), time to release tourniquet (18.5%) and time to change tube (28.5%) were relatively low. Binary logistic regression analysis showed that the correct rates of the aforementioned four questions were mainly related to the regional distribution of the hospitals (P < 0.001). Conclusions The knowledge level on phlebotomy among Chinese nurses was found unsatisfactory in some areas. An education program on phlebotomy should be developed for Chinese nurses to improve the consistency among different regions and to enhance nurse’s knowledge level on phlebotomy. PMID:29187796

  7. Nurses' knowledge on phlebotomy in tertiary hospitals in China: a cross-sectional multicentric survey.

    Cai, Qian; Zhou, Yunxian; Yang, Dangan

    2018-02-15

    In China, phlebotomy practice is mostly executed by nurses instead of phlebotomists. Our hypothesis was that these nurses may lack of knowledge on phlebotomy, especially factors influencing quality of blood samples. This study aims to assess the overall nurses' knowledge on phlebotomy to provide reference for improving blood sampling practice in China. A survey was conducted involving nurses from 4 regions and 13 hospitals in China. A phlebotomy knowledge questionnaire was designed based on the Clinical and Laboratory Standards Institute H3-A6 guidelines, combining with the situations in China. Descriptive analysis and binary logistic regression analysis were used to analyze the knowledge level and its influencing factors. A total of 3400 questionnaires were distributed and 3077 valid questionnaires were returned, with an effective return rate of 90.5%. The correct rates of patient identification, hand sanitization, patient assessment, tube mixing time, needle disposing location and tube labelling were greater than 90%. However, the correct rates of order of draw (15.5%), definition of an inversion (22.5%), time to release tourniquet (18.5%) and time to change tube (28.5%) were relatively low. Binary logistic regression analysis showed that the correct rates of the aforementioned four questions were mainly related to the regional distribution of the hospitals (P < 0.001). The knowledge level on phlebotomy among Chinese nurses was found unsatisfactory in some areas. An education program on phlebotomy should be developed for Chinese nurses to improve the consistency among different regions and to enhance nurse's knowledge level on phlebotomy.

  8. Prevalence of metabolic syndrome in Chinese psoriasis patients: A hospital-based cross-sectional study.

    Gui, Xin-Yu; Yu, Xiao-Ling; Jin, Hong-Zhong; Zuo, Ya-Gang; Wu, Chao

    2018-01-01

    Psoriasis, a chronic autoimmune skin disorder, is believed to contribute to cardiovascular diseases and metabolic syndrome. Psoriasis's association with the components of metabolic syndrome has been reported previously. However, large-scale cross-sectional studies about psoriasis and metabolic syndrome are rare in China. We assessed the prevalence of metabolic syndrome in Chinese psoriasis patients and controls. A total of 859 psoriasis patients and 1,718 controls were recruited in an age- and sex-matched cross-sectional study. Metabolic syndrome occurred in 14.3% of the psoriasis patients as opposed to 10.0% of the control participants (P = 0.001). Psoriasis patients had a higher prevalence of overweight/obesity, hyperglycemia and dyslipidemia when compared with controls. Meanwhile, psoriasis patients with metabolic syndrome were older, and had an older age of onset and a longer disease duration when compared with those without metabolic syndrome. The prevalence of metabolic syndrome is higher in the Chinese psoriatic population, which can favor cardiovascular events. The present study strengthens the value of treating psoriasis patients not only dealing with the skin lesions, and we suggest appropriate screening and relevant health education be carried out in the treatment of psoriasis patients. © 2017 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

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

    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...

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

    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.

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

    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.

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

    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

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

    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

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

    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.

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

    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.

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

    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.

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

    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

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

    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.

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

    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.

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

    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.

  1. Work schedule flexibility is associated with emotional exhaustion among registered nurses in Swiss hospitals: A cross-sectional study.

    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.

  2. Prevalence of hepatitis B virus in patients with diabetes mellitus: a comparative cross sectional study at Woldiya General Hospital, Ethiopia.

    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.

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

    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.

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

    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.

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

    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.

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

    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

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

    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

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

    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

  9. Improving nutritional status of children with cystic fibrosis at Red Cross War Memorial Children's Hospital.

    van der Spuy, Dorothy A; Cader, Shihaam; van der Spuy, Gian D; Westwood, Anthony T

    2011-05-01

    To determine the nutritional status of children attending a cystic fibrosis clinic in a tertiary hospital in South Africa and compare it to previously reported 10-year rates. Weights and heights were measured of 69 (37 male and 32 female) children aged between 1 year and 18 years. Expected weight-for-age, expected height-for-age, expected weight-for-height and body mass index (BMI) were compared with international standards for underweight, stunting, wasting and BMI goal. The nutritional status of the patients has improved over the last 10 years, most significantly for wasting, which decreased from 58.3% in 1996 to 15.9% in 2006 (95% confidence interval (CI), 1.315-14.09, P nutritional status, although deficits remain. The normalisation of mean weight-for-age and weight-for-height with far fewer wasted patients is encouraging. Interventions are needed in some areas to ensure that all children show progress. © 2011 The Authors. Journal of Paediatrics and Child Health © 2011 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  10. Attitudes to and implementation of video interpretation in a Danish hospital: A cross-sectional study.

    Mottelson, Ida Nygaard; Sodemann, Morten; Nielsen, Dorthe Susanne

    2018-03-01

    Immigrants, refugees, and their descendants comprise 12% of Denmark's population. Some of these people do not speak or understand Danish well enough to communicate with the staff in a healthcare setting and therefore need interpreter services. Interpretation through video conferencing equipment (video interpretation) is frequently used and creates a forum where the interpreter is not physically present in the medical consultation. The aim of this study was to investigate the attitudes to and experiences with video interpretation among charge nurses in a Danish university hospital. An electronic questionnaire was sent to 99 charge nurses. The questionnaire comprised both closed and open-ended questions. The answers were analysed using descriptive statistics and thematic text condensation. Of the 99 charge nurses, 78 (79%) completed the questionnaire. Most charge nurses, 21 (91%) of the daily/monthly users, and 21 (72%) of the monthly/yearly users, said that video interpretation increased the quality of their conversations with patients. A total of 19 (24%) departments had not used video interpretation within the last 12 months. The more the charge nurses used video interpretation, the more satisfied they were. Most of the charge nurses using video interpretation expressed satisfaction with the technology and found it easy to use. Some charge nurses are still content to allow family or friends to interpret. To reach its full potential, video interpretation technology has to be reliable and easily accessible for any consultation, including at the bedside.

  11. Contraceptive usage and awareness among postpartum mothers in urban field practice area of a tertiary hospital

    Tanvir Kaur Sidhu

    2015-03-01

    Full Text Available Background: To study contraceptive usage and awareness among postpartum mothers. Objective: To assess prevalence of postpartum contraception and factors affecting the usage of contraceptives in Urban area. Material and Methods: A cross-sectional descriptive study was carried out in the Urban Field practice area of Adesh Institute of Medical Sciences & Research, Bathinda. All females who delivered within last one year were included in the study. A pre-structured questionnaire was used to collect socio-demographic and other details. A total of 92 females were included. The appropriate statistical analysis was done to present the results. Results: 30.4% females had adopted one or the other postpartum contraceptive measure. Condom was the most common method used. Usage of postpartum contraception was significantly associated with women’s and husband’s education, type of delivery and availing of antenatal and postnatal visits. The main reason for not using postpartum contraception was lack of knowledge and access. 16.3% females had unmet need of postpartum contraception. Conclusions: Overall usage of postpartum contraception was low and mainly related to lack of awareness and knowledge.

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

    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...

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

    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

  14. Utilization of contraception among sexually active HIV positive women attending art clinic in University of Gondar Hospital: a hospital based cross-sectional study.

    Worke, Mulugeta Dile; Bezabih, Lealem Meseret; Woldetasdik, Mulat Adefris

    2016-10-21

    Contraception helps to prevent unplanned pregnancies among human immune virus positive women. The contraceptive utilization status and associated factors were not well addressed in the study area. Therefore, this study aimed to assess utilization of contraceptives and associated factors among human immune virus positive reproductive age group women appearing at anti-retroviral therapy clinic at the University of Gondar Hospital, North West Ethiopia. An institution based cross-sectional study was conducted among 397 systematically selected HIV positive reproductive age women who visited ART unit of the University of Gondar teaching referral hospital from January 8-20, 2014. The data were collected using pre tested and structured questionnaires through face-to-face interviews. The data were entered into Epi-Info version 3.5, and cleaned and analyzed using SPSS version 20. Descriptive summary of the data and logistic regression were used to identify possible predictors using odds ratio with 95 % confidence interval and P-value of 0.05. The study revealed that the overall utilization of any type of contraception was 50 %. Of them, 4.1 % got contraception from anti-retroviral therapy unit. Fear of side effects was the most common (42 %) reason for not using contraception. Women who attended secondary education, married and who had 4-6 children were more likely to use contraception than their counterparts were; (AOR: 5.63; 95 % CI: 1.74-18.21), (AOR: 8.07; 95 % CI: 3.10-20.99) and (AOR: 3.61; 95 % CI: 1.16-11.26) respectively. However, Women between 35-49 years, had no intention to have another child and discordant couples were 83 %, 76 % and 65 % less likely to use contraception respectively than their counterparts. The results of this study revealed that the utilization of contraception was low. Women between 35-49 years, those who had no intention to have another child and whose partner was HIV sero-negative and fear of side effect of the contraception

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

    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.

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

    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

  17. Prevalence of psychiatric morbidity among cancer patients – hospital-based, cross-sectional survey

    Mohan Roy Gopalan

    2016-01-01

    Full Text Available Aim: To study the prevalence of Psychiatric disorders in cancer patients and to find out the factors associated with Psychiatric disorders in Cancer Patients. Settings and Design: Department of Radiotherapy, Medical College, Thiruvananthapuram, cross sectional survey design was used. Methods and Material: Adult patients (18 years of age and above, having a diagnosis of carcinoma were selected by consecutive sampling method.A questionnaire which included back ground data, socio economic variables, treatment variables like type of malignancy, exposure to radiation & chemotherapy prior to the evaluation and current treatment, co occurring medical illness & treatment and past & family history of psychiatric illness was used to collect data. Delirium rating scale and MINI International neuropsychiatric interview were used to assess Psychiatric disorders and delirium. Statistical Analysis Used: Chi square and logistics regression tests were used for analysis. Results: Of the 384 assessed, 160(41.7% had psychiatric disorders. Adjustment disorders were seen in 22.6%. 10.9% of subjects had major depressive disorder. Thus a total of 33.5% of patients had a diagnosis of either anxiety or depressive disorder. Proportion of patients having delirium was 6.5%. Hypomania was seen in small (1.6% of patients. Multivariate analysis for various parameters for psychiatric disorders showed that age, past history of chemotherapy, past history of radiotherapy, & surgical treatment of carcinomas are significant predictors of psychiatric disorders. Conclusions: Psychiatric disorders are seen in a significant proportion of Psychiatric patients.

  18. Prevalence of psychiatric morbidity among cancer patients – hospital-based, cross-sectional survey

    Gopalan, Mohan Roy; Karunakaran, Vidhukumar; Prabhakaran, Anil; Jayakumar, Krishnannair Lalithamma

    2016-01-01

    Aim: To study the prevalence of Psychiatric disorders in cancer patients and to find out the factors associated with Psychiatric disorders in Cancer Patients. Settings and Design: Department of Radiotherapy, Medical College, Thiruvananthapuram, cross sectional survey design was used. Methods and Material: Adult patients (18 years of age and above), having a diagnosis of carcinoma were selected by consecutive sampling method.A questionnaire which included back ground data, socio economic variables, treatment variables like type of malignancy, exposure to radiation & chemotherapy prior to the evaluation and current treatment, co occurring medical illness & treatment and past & family history of psychiatric illness was used to collect data. Delirium rating scale and MINI International neuropsychiatric interview were used to assess Psychiatric disorders and delirium. Statistical Analysis Used: Chi square and logistics regression tests were used for analysis. Results: Of the 384 assessed, 160(41.7%) had psychiatric disorders. Adjustment disorders were seen in 22.6%. 10.9% of subjects had major depressive disorder. Thus a total of 33.5% of patients had a diagnosis of either anxiety or depressive disorder. Proportion of patients having delirium was 6.5%. Hypomania was seen in small (1.6%) of patients. Multivariate analysis for various parameters for psychiatric disorders showed that age, past history of chemotherapy, past history of radiotherapy, & surgical treatment of carcinomas are significant predictors of psychiatric disorders. Conclusions: Psychiatric disorders are seen in a significant proportion of Psychiatric patients. PMID:28066004

  19. Design of a high power cross field amplifier at X band with an internally coupled waveguide

    Eppley, K.; Ko, K.

    1991-01-01

    This paper reports that cross field amplifiers (CFA) have been used in many applications where high power, high frequency microwaves are needed. Although these tubes have been manufactured for decades, theoretical analysis of their properties is not as highly developed as for other microwave devices such as klystrons. The authors have developed a simulation model for CFAs using the PIC code CONDOR. The authors simulations indicate that there are limits to the maximum RF field strength that a CFA can sustain. When the fields become too high, efficiency becomes very poor, and the currents drawn may become so large that secondary emission cannot be maintained. It is therefore desirable to reduce the circuit impedance of a very high power tube. One method for doing this, proposed by Feinstein, involves periodically coupling a standard CFA circuit to an internal waveguide. Most of the power flows in the waveguide, so the overall impedance is much reduced. By adjusting the guide dimensions one can vary the impedance. Thus one can retain high impedance at the low power end but low impedance at the high power end. In principle one can maintain constant RF voltage throughout the tube

  20. Cross-field flow and electric potential in a plasma slab

    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.

  1. Deployment of field hospitals to disaster regions: Insights from ten medical relief operations spanning three decades.

    Naor, Michael; Heyman, Samuel N; Bader, Tarif; Merin, Ofer

    2017-01-01

    The Israeli Defense Force (IDF) Medical Corps developed a model of airborne field hospital. This model was structured to deal with disaster settings, requiring self-sufficiency, innovation and flexible operative mode in the setup of large margins of uncertainty regarding the disaster environment. The current study is aimed to critically analyze the experience, gathered in ten such missions worldwide. Interviews with physicians who actively participated in the missions from 1988 until 2015 as chief medical officers combined with literature review of principal medical and auxiliary publications in order to assess and integrate information about the assembly of these missions. A body of knowledge was accumulated over the years by the IDF Medical Corps from deploying numerous relief missions to both natural (earthquake, typhoon, and tsunami), and man-made disasters, occurring in nine countries (Armenia, Rwanda, Kosovo, Turkey, India, Haiti, Japan, Philippines, and Nepal). This study shows an evolutionary pattern with improvements implemented from one mission to the other, with special adaptations (creativity and improvisation) to accommodate logistics barriers. The principals and operative function for deploying medical relief system, proposed over 20 years ago, were challenged and validated in the subsequent missions of IDF outlined in the current study. These principals, with the advantage of the military infrastructure and the expertise of drafted civilian medical professionals enable the rapid assembly and allocation of highly competent medical facilities in disaster settings. This structure model is to large extent self-sufficient with a substantial operative flexibility that permits early deployment upon request while the disaster assessment and definition of needs are preliminary.

  2. Job related stress among nurses working in Jimma Zone public hospitals, South West Ethiopia: a cross sectional study.

    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

  3. Medication self-management skills and cognitive impairment in older adults hospitalized for heart failure: A cross-sectional study.

    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

  4. Medication self-management skills and cognitive impairment in older adults hospitalized for heart failure: A cross-sectional study

    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

  5. Smoking behaviour predicts tobacco control attitudes in a high smoking prevalence hospital: A cross-sectional study in a Portuguese teaching hospital prior to the national smoking ban

    Aguiar Pedro

    2011-09-01

    Full Text Available Abstract Background Several studies have investigated attitudes to and compliance with smoking bans, but few have been conducted in healthcare settings and none in such a setting in Portugal. Portugal is of particular interest because the current ban is not in line with World Health Organization recommendations for a "100% smoke-free" policy. In November 2007, a Portuguese teaching-hospital surveyed smoking behaviour and tobacco control (TC attitudes before the national ban came into force in January 2008. Methods Questionnaire-based cross-sectional study, including all eligible staff. Sample: 52.9% of the 1, 112 staff; mean age 38.3 ± 9.9 years; 65.9% females. Smoking behaviour and TC attitudes and beliefs were the main outcomes. Bivariable analyses were conducted using chi-squared and MacNemar tests to compare categorical variables and Mann-Whitney tests to compare medians. Multilogistic regression (MLR was performed to identify factors associated with smoking status and TC attitudes. Results Smoking prevalence was 40.5% (95% CI: 33.6-47.4 in males, 23.5% (95% CI: 19.2-27.8 in females (p Conclusions Smoking prevalence was high, especially among the lower socio-economic groups. The findings showed a very high level of support for smoking bans, despite the pro-smoking environment. Most staff reported passive behaviour, despite high SHS exposure. This and the high smoking prevalence may contribute to low compliance with the ban and low participation on smoking cessation activities. Smoking behaviour had greater influence in TC attitudes than health professionals' education. Our study is the first in Portugal to identify potential predictors of non-compliance with the partial smoking ban, further emphasising the need for a 100% smoke-free policy, effective enforcement and public health education to ensure compliance and promote social norm change.

  6. Supine Craniospinal Irradiation Using Intrafractional Junction Shifts and Field-in-Field Dose Shaping: Early Experience at Methodist Hospital

    South, Michael C.; Chiu, J. Kam; Teh, Bin S.; Bloch, Charles; Schroeder, Thomas M.; Paulino, Arnold C.

    2008-01-01

    Purpose: To describe our preliminary experience with supine craniospinal irradiation. The advantages of the supine position for craniospinal irradiation include patient comfort, easier access to maintain an airway for anesthesia, and reduced variability of the head tilt in the face mask. Methods and Materials: The cranial fields were treated with near lateral fields and a table angle to match their divergence to the superior edge of the spinal field. The collimator was rotated to match the divergence from the superior spinal field. The spinal fields were treated using a source to surface distance (SSD) technique with the couch top at 100 cm. When a second spinal field was required, the table and collimator were rotated 90 o to allow for the use of the multileaf collimator and so the gantry could be rotated to match the divergence of the superior spinal field. The multileaf collimator was used for daily dynamic featherings and field-in-field dose control. Results: With a median follow-up of 20.2 months, five documented failures and no cases of radiation myelitis occurred in 23 consecutive patients. No failures occurred in the junctions of the spine-spine or brain-spine fields. Two failures occurred in the primary site alone, two in the spinal axis alone, and one primary site failure plus distant metastasis. The median time to recurrence was 17 months. Conclusion: The results of our study have shown that supine approach for delivering craniospinal irradiation is not associated with increased relapses at the field junctions. To date, no cases of radiation myelitis have developed

  7. Electron Cross-field Transport in a Miniaturized Cylindrical Hall Thruster

    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)

  8. Design of a high power cross field amplifier at X band with an internally coupled waveguide

    Eppley, K.; Ko, Kwok.

    1991-01-01

    Cross field amplifiers (CFA) have been used in many applications where high power, high frequency microwaves are needed. Although these tubes have been manufactured for decades, theoretical analysis of their properties is not as highly developed as for other microwave devices such as klystrons. We have developed a simulation model for CFAs using the PIC code CONDOR. Our simulations indicate that there are limits to the maximum RF field strength that a CEA can sustain. When the fields become too high, efficiency becomes very poor, and the currents drawn may become so large that secondary emission cannot be maintained. It is therefore desirable to reduce the circuit impedance of a very high power tube. One method for doing this, proposed by Feinstein, involves periodically coupling a standard CFA circuit to an internal waveguide. Most of the power flows in the waveguide, so the overall impedance is much reduced. By adjusting the guide dimensions one can vary the impedance. Thus one can retain high impedance at the low power end but low impedance at the high power end. In principle one can maintain constant RF voltage throughout the tube. CONDOR simulations have identified a good operating point at X band, with power generation of over 5 MW per cm and total efficiency of over 60 percent. ARGUS simulations have modelled the cold test properties of the coupled structure. The nominal design specifications are 300 MW output, 17 db gain, frequency 11.4 GHz, dc voltage 142 kV, magnetic field 5 kG, anode cathode gap 3.6 mm, total interaction length about 60 cm. We will discuss the results of code simulations and report on the status of the experimental effort

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

    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

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

    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

  11. 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.

    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

  12. Temporal and spatial spectroscopy of the plasma formation in crossed electric and magnetic fields

    Miljevic, V.I.; Tosic, D.D.

    1980-01-01

    The formation of argon plasma in crossed electric and magnetic fields in a cylindrical diode with an incandescent cathode has been studied by means of the delay time of the anode current pulse and photon pulse (corresponding to the optical transitions) and the shape of the voltage collapse. The working conditions were: pressure p=10 -5 --10 -3 Torr, anode voltage U/sub a/=800 V, and maximum magnetic field B/sub max/=1200 Gs. Photoelectrical recording of spectral lines was performed with a monochromator in the wavelength range 3600--6000 A, and the total optical spectrum was recorded simultaneously on a photoplate in a separate spectrograph in the wavelength range 2000--10 000 A. The delay time of the anode current pulse and photon pulse are approximately the same and are in the millisecond range. The delay time of the photon pulse does not depend on the wavelength. Simultaneously the spectral lines of the working gas (A II), residual gas (O II), and tungsten (W I) appear. Tungsten atoms appear at the moment of breakdown as a result of ion bombardment of the cathode. Neutral atomic lines of the working gas (A I) have not been observed. Radial analysis shows that the delay time of the photon pulse does not depend on the radius. Spectroscopic results have been analyzed in terms of excitation and ionization processes during the formation time. The shape of the voltage collapse suggests the streamer breakdown mechanism

  13. A high power cross-field amplifier at X-Band

    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

  14. Pre-hospital care time intervals among victims of road traffic injuries in Iran. A cross-sectional study

    Bigdeli Maryam

    2010-07-01

    Full Text Available Abstract Background 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. Method 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. Results 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 Conclusion The response, 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.

  15. A cross-sectional study of shift work, sleep quality and cardiometabolic risk in female hospital employees

    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

  16. Mobile phone technology and hospitalized patients: a cross-sectional surveillance study of bacterial colonization, and patient opinions and behaviours.

    Brady, R R; Hunt, A C; Visvanathan, A; Rodrigues, M A; Graham, C; Rae, C; Kalima, P; Paterson, H M; Gibb, A P

    2011-06-01

    Healthcare workers' mobile phones provide a reservoir of bacteria known to cause nosocomial infections. UK National Health Service restrictions on the utilization of mobile phones within hospitals have been relaxed; however, utilization of these devices by inpatients and the risk of cross-contamination are currently unknown. Here, we examine demographics and characteristics of mobile phone utilization by inpatients and phone surface microbial contamination. One hundred and two out of 145 (70.3%) inpatients who completed a questionnaire detailing their opinions and utilization of mobile phones, also provided their mobile phones for bacteriological analysis and comparative bacteriological swabs from their nasal cavities; 92.4% of patients support utilization of mobile phones by inpatients; indeed, 24.5% of patients stated that mobile phones were vital to their inpatient stay. Patients in younger age categories were more likely to possess a mobile phone both inside and outside hospital (p mobile phone swabs were positive for microbial contamination. Twelve (11.8%) phones grew bacteria known to cause nosocomial infection. Seven (6.9%) phones and 32 (31.4%) nasal swabs demonstrated Staphylococcus aureus contamination. MSSA/MRSA contamination of phones was associated with concomitant nasal colonization. Patient utilization of mobile phones in the clinical setting is popular and common; however, we recommend that patients are educated by clear guidelines and advice on inpatient mobile phone etiquette, power charging safety, regular cleaning of phones and hand hygiene, and advised not to share phones or related equipment with other inpatients in order to prevent transmission of bacteria. 2011 The Authors. Clinical Microbiology and Infection; 2011 European Society of Clinical Microbiology and Infectious Diseases.

  17. Complementary alternative medicine use among patients with dengue fever in the hospital setting: a cross-sectional study in Malaysia.

    Ching, SiewMooi; Ramachandran, Vasudevan; Gew, Lai Teck; Lim, Sazlyna Mohd Sazlly; Sulaiman, Wan Aliaa Wan; Foo, Yoke Loong; Zakaria, Zainul Amiruddin; Samsudin, Nurul Huda; Lau, Paul Chih Ming Chih; Veettil, Sajesh K; Hoo, Fankee

    2016-01-29

    In Malaysia, the number of reported cases of dengue fever demonstrates an increasing trend. Since dengue fever has no vaccine or antiviral treatment available, it has become a burden. Complementary and alternative medicine (CAM) has become one of the good alternatives to treat the patients with dengue fever. There is limited study on the use of CAM among patients with dengue fever, particularly in hospital settings. This study aims to determine the prevalence, types, reasons, expenditure, and resource of information on CAM use among patients with dengue fever. This is a descriptive, cross-sectional study of 306 patients with dengue fever, which was carried out at the dengue clinic of three hospitals. Data were analysed using IBM SPSS Statistics version 21.0 and logistic regression analysis was used to determine the factors associated with CAM use. The prevalence of CAM use was 85.3% among patients with dengue fever. The most popular CAMs were isotonic drinks (85.8%), crab soup (46.7%) and papaya leaf extract (22.2%). The most common reason for CAM use was a good impression of CAM from other CAM users (33.3%). The main resource of information on CAM use among patients with dengue fever was family (54.8%). In multiple logistic regression analysis, dengue fever patients with a tertiary level are more likely to use CAM 5.8 (95% confidence interval (CI 1.62-20.45) and 3.8 (95% CI 1.12-12.93) times than secondary level and primary and below respectively. CAM was commonly used by patients with dengue fever. The predictor of CAM use was a higher level of education.

  18. Workplace violence in different settings and among various health professionals in an Italian general hospital: a cross-sectional study

    Ferri, Paola; Silvestri, Monica; Artoni, Cecilia; Di Lorenzo, Rosaria

    2016-01-01

    Background Workplace violence (WPV) against health professionals is a global problem with an increasing incidence. The aims of this study were as follows: 1) to examine the frequency and characteristics of WPV in different settings and professionals of a general hospital and 2) to identify the clinical and organizational factors related to this phenomenon. Methods The study was cross-sectional. In a 1-month period, we administered the “Violent Incident Form” to 745 professionals (physicians, head nurses, nurses, nursing assistants), who worked in 15 wards of a general hospital in northern Italy. Results With a response rate of 56%, 45% of professionals reported WPV. The most frequently assaulted were nurses (67%), followed by nursing assistants (18%) and physicians (12%). The first two categories were correlated, in a statistically significant way, with the risk of WPV (P=0.005, P=0.004, multiple logistic regression). The violent incidents more frequently occurred in psychiatry department (86%), emergency department (71%), and in geriatric wards (57%). The assailants more frequently were males whereas assaulted professionals more often were females. Men committed physical violence more frequently than women, in a statistically significant way (P=0.034, chi-squared test). Verbal violence (51%) was often committed by people in a lucid and normal state of consciousness; physical violence (49%) was most often perpetrated by assailants affected by dementia, mental retardation, drug and substance abuse, or other psychiatric disorders. The variables positively related to WPV were “calling for help during the attack” and “physical injuries suffered in violent attack” (P=0.02, P=0.03, multiple logistic regression). Conclusion This study suggests that violence is a significant phenomenon and that all health workers, especially nurses, are at risk of suffering aggressive assaults. WPV presented specific characteristics related to the health care settings, where

  19. Anaemia in pregnancy and associated factors: a cross sectional study of antenatal attendants at the Sunyani Municipal Hospital, Ghana.

    Anlaakuu, Peter; Anto, Francis

    2017-08-11

    Anaemia in pregnancy is an important health issue resulting in high maternal morbidity and mortality. The purpose of the current study was to identify factors associated with anaemia among pregnant women receiving antenatal care at the Sunyani Municipal Hospital in Ghana. A cross-sectional study involving pregnant women seeking antenatal care at the Sunyani Municipal Hospital was conducted between May and June, 2015. It involved the collection of data on socio demographic and obstetric variables, medical interventions and malaria infection, consumption of iron containing foods and supplements using a case record form and a structured questionnaire. Also, data on haemoglobin concentrations at first and current antenatal visit were collected. Bivariate and multivariate statistical analysis were done to determine factors associated with anaemia. Out of the 316 participants, 129 (40.8%) were found to be anaemic (Hb prevalence of anaemia was found to be similar to that of the first visit with 131 (41.5%) of them being anaemic [mean Hb: 11.24 g/dl, range 8.10-14.5 g/dl]. The haemoglobin levels however improved significantly during the most recent visit compared to the first with none of the women being severely anaemic (Hb prevalence of moderate anaemia reduced from 37.2% (CI 28.9-46.2) during the first visit to 19.1% (12.7-26.9) during the most recent visit, a reduction of 48.7%. Malaria infection, frequency at which one consumed fish/snails and gestational age at first ANC visit were the main factors found to be associated with anaemia among the pregnant women. Malaria infection, fish/snails intake and gestational age at first ANC visit were significantly associated with anaemia. Addressing these factors can reduce the incidence of anaemia in pregnancy.

  20. 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.

    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.

  1. Factors associated with occupancy of pharmacist positions in public sector hospitals in Uganda: a cross-sectional study.

    Obua, Thomas Ocwa; Adome, Richard Odoi; Kutyabami, Paul; Kitutu, Freddy Eric; Kamba, Pakoyo Fadhiru

    2017-01-05

    Pharmacists are invaluable resources in health care. Their expertise in pharmacotherapy and medicine management both ensures that medicines of appropriate quality are available in health facilities at the right cost and are used appropriately. Unfortunately, some countries like Uganda have shortage of pharmacists in public health facilities, the dominant providers of care. This study investigated the factors that affect the occupancy of pharmacist positions in Uganda's public hospitals, including hiring patterns and job attraction and retention. A cross-sectional survey of 91 registered pharmacists practicing in Uganda and desk review of records from the country's health care worker (HCW) recruiting agency was done in the months of May, June, and July, 2016. Pharmacist interviews were done using self-administered structured questionnaire and analyzed by descriptive statistics and chi-square test. Slight majority (53%) of the interviewed pharmacists work in two sectors. About 60% of the pharmacists had ever applied for public hospital jobs. Of those who received offers (N = 46), 30% had declined them. Among those who accepted the offers (N = 41), 41% had already quit. Meanwhile, the pace of hiring pharmacists into Uganda's public sector is too slow. Low socio-economic status of family in childhood (χ 2  = 2.77, p = 0.10), admission through matriculation and diploma scheme (χ 2  = 2.37, p = 0.12), internship in countryside hospitals (χ 2  = 2.24, p = 0.13), working experience before pharmacy school (χ 2  = 2.21, p = 0.14), salary expectation (χ 2  = 1.76, p = 0.18), and rural secondary education (χ 2  = 1.75, p = 0.19) favored attraction but in a statistically insignificant manner. Retention was most favored by zero postgraduate qualification (χ 2  = 4.39, p = 0.04), matriculation and diploma admission scheme (χ 2  = 2.57, p = 0.11), and working experience in private sector (χ 2  = 2

  2. Pre-hospital care time intervals among victims of road traffic injuries in Iran. A cross-sectional study.

    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.

  3. Workplace violence in different settings and among various health professionals in an Italian general hospital: a cross-sectional study

    Ferri P

    2016-09-01

    Full Text Available Paola Ferri,1 Monica Silvestri,1 Cecilia Artoni,2 Rosaria Di Lorenzo3 1Department of Diagnostic, Clinical and Public Health Medicine, School of Nursing, 2School of Psychiatry, University of Modena and Reggio, 3Department of Mental Health, Service of Psychiatric Diagnosis and Treatment, Modena, Italy Background: Workplace violence (WPV against health professionals is a global problem with an increasing incidence. The aims of this study were as follows: 1 to examine the frequency and characteristics of WPV in different settings and professionals of a general hospital and 2 to identify the clinical and organizational factors related to this phenomenon. Methods: The study was cross-sectional. In a 1-month period, we administered the “Violent Incident Form” to 745 professionals (physicians, head nurses, nurses, nursing assistants, who worked in 15 wards of a general hospital in northern Italy. Results: With a response rate of 56%, 45% of professionals reported WPV. The most frequently assaulted were nurses (67%, followed by nursing assistants (18% and physicians (12%. The first two categories were correlated, in a statistically significant way, with the risk of WPV (P=0.005, P=0.004, multiple logistic regression. The violent incidents more frequently occurred in psychiatry department (86%, emergency department (71%, and in geriatric wards (57%. The assailants more frequently were males whereas assaulted professionals more often were females. Men committed physical violence more frequently than women, in a statistically significant way (P=0.034, chi-squared test. Verbal violence (51% was often committed by people in a lucid and normal state of consciousness; physical violence (49% was most often perpetrated by assailants affected by dementia, mental retardation, drug and substance abuse, or other psychiatric disorders. The variables positively related to WPV were “calling for help during the attack” and “physical injuries suffered in violent

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

    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.

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

    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)

  6. Smoking behaviour predicts tobacco control attitudes in a high smoking prevalence hospital: a cross-sectional study in a Portuguese teaching hospital prior to the national smoking ban.

    Ravara, Sofia B; Calheiros, Jose M; Aguiar, Pedro; Barata, Luis Taborda

    2011-09-23

    Several studies have investigated attitudes to and compliance with smoking bans, but few have been conducted in healthcare settings and none in such a setting in Portugal. Portugal is of particular interest because the current ban is not in line with World Health Organization recommendations for a "100% smoke-free" policy. In November 2007, a Portuguese teaching-hospital surveyed smoking behaviour and tobacco control (TC) attitudes before the national ban came into force in January 2008. Questionnaire-based cross-sectional study, including all eligible staff. 52.9% of the 1, 112 staff; mean age 38.3 ± 9.9 years; 65.9% females. Smoking behaviour and TC attitudes and beliefs were the main outcomes. Bivariable analyses were conducted using chi-squared and MacNemar tests to compare categorical variables and Mann-Whitney tests to compare medians. Multilogistic regression (MLR) was performed to identify factors associated with smoking status and TC attitudes. Smoking prevalence was 40.5% (95% CI: 33.6-47.4) in males, 23.5% (95% CI: 19.2-27.8) in females (p smoking bans, even among smokers, despite the fact that 70.3% of the smokers smoked on the premises and 76% of staff reported being frequently exposed to second-hand smoke (SHS). In addition 42.8% reported that SHS was unpleasant and 28.3% admitted complaining. MLR showed that smoking behaviour was the most important predictor of TC attitudes. Smoking prevalence was high, especially among the lower socio-economic groups. The findings showed a very high level of support for smoking bans, despite the pro-smoking environment. Most staff reported passive behaviour, despite high SHS exposure. This and the high smoking prevalence may contribute to low compliance with the ban and low participation on smoking cessation activities. Smoking behaviour had greater influence in TC attitudes than health professionals' education. Our study is the first in Portugal to identify potential predictors of non-compliance with the partial

  7. A cross-platform solution for light field based 3D telemedicine.

    Wang, Gengkun; Xiang, Wei; Pickering, Mark

    2016-03-01

    Current telehealth services are dominated by conventional 2D video conferencing systems, which are limited in their capabilities in providing a satisfactory communication experience due to the lack of realism. The "immersiveness" provided by 3D technologies has the potential to promote telehealth services to a wider range of applications. However, conventional stereoscopic 3D technologies are deficient in many aspects, including low resolution and the requirement for complicated multi-camera setup and calibration, and special glasses. The advent of light field (LF) photography enables us to record light rays in a single shot and provide glasses-free 3D display with continuous motion parallax in a wide viewing zone, which is ideally suited for 3D telehealth applications. As far as our literature review suggests, there have been no reports of 3D telemedicine systems using LF technology. In this paper, we propose a cross-platform solution for a LF-based 3D telemedicine system. Firstly, a novel system architecture based on LF technology is established, which is able to capture the LF of a patient, and provide an immersive 3D display at the doctor site. For 3D modeling, we further propose an algorithm which is able to convert the captured LF to a 3D model with a high level of detail. For the software implementation on different platforms (i.e., desktop, web-based and mobile phone platforms), a cross-platform solution is proposed. Demo applications have been developed for 2D/3D video conferencing, 3D model display and edit, blood pressure and heart rate monitoring, and patient data viewing functions. The demo software can be extended to multi-discipline telehealth applications, such as tele-dentistry, tele-wound and tele-psychiatry. The proposed 3D telemedicine solution has the potential to revolutionize next-generation telemedicine technologies by providing a high quality immersive tele-consultation experience. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. Evaluation of serum anti-nuclear antibody among women with PCOS: a hospital based single center cross sectional study.

    Rashid, Aafia; Bhat, Javaid Ahmad; Ganie, Mohd Ashraf; Wani, Imtiyaz Ahmad; Bhat, Moomin Hussain; Shah, Zaffar Amin; Masoodi, Shariq R; Marwaha, R K

    2018-05-07

    Polycystic ovary syndrome (PCOS), a major endocrinopathy is associated with barrage of metabolic aberrations. Reports in literature on association of PCOS and autoimmunity are conflicting. We aim to evaluate serum levels of anti-nuclear antibody (ANA) among Indian women with PCOS. In this hospital-based single center cross-sectional study, women qualifying a diagnosis of PCOS by Rotterdam criteria 2003 were recruited. Eighty-nine eligible women who consented were enrolled. All these women along with 87 age-matched, healthy controls underwent, clinical (menstrual history, anthropometry, hirsutism scoring), biochemical, hormonal assessment and serum ANA estimation. OGTT after overnight (8-12 h) fast with 75 g oral glucose load was done for 1 h, 2 h glucose and insulin measurements. The mean age of cases and controls was comparable (22.67 ± 5.53 vs. 22.84 ± 3.64 years). The prevalence of ANA positivity was significantly higher among women with PCOS (18.4% vs. 2.29%; p PCOS, being a marker of autoimmunity, suggests a possible role of autoimmunity in causation of PCOS and needs further elucidation.

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

    Romano Del Nord

    2014-05-01

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

  10. Neonatal resuscitation: a knowledge gap amongst obstetrical trainees. A cross-sectional survey amongst medical graduates of Civil Hospital Karachi.

    Noor, Tooba; Raza, Natasha; Haq, Gulfishan

    2014-07-01

    To evaluate the neonatal resuscitation competence of obstetrical trainees to assess the gap in knowledge and to determine training needs. The cross-sectional study was conducted at the Department of Gynaecology and Obstetrics, Civil Hospital, Karachi, from January to March 2013 and comprised House Officers and Postgraduate trainees. A questionnaire was used to test the evaluation skills of different conditions and choice of appropriate action required during neonatal resuscitation. Data was collected and analysed through SPSS 17.0. Of the 102 obstetrical trainees, 44 (43.1%) were House Officers and 58 (56.9%) were Postgraduate trainees with an overall mean age 25.69 +/- 2.3 years. Only 19 (18.6%) subjects cleared the test; 8 (42.1%) of them were House Officers and 11 (57.9%) were Postgraduate trainees. The result did not show any significant difference between those who had previous training or those who had performed neonatal resuscitation and those who had no such exposure. Majority, 92 (90.2%) considered their knowledge inadequate and 99 (97%) favoured that updated neonatal resuscitation programmes should be periodically arranged. The study showed inadequate level of knowledge on neonatal resuscitation amongst obstetrical trainees. There is urgent need of formal training programmes which can make doctors skilful enough to face any adverse neonatal outcome professionally.

  11. Utilization of over the counter medication among pregnant women; a cross-sectional study conducted at Isra University Hospital, Hyderabad.

    Bohio, Rabail; Brohi, Zahida Perveen; Bohio, Farrukh

    2016-01-01

    To determine the frequency of use of over-the-counter medication among pregnant women, types of medicines, source of information and reason to opts for self-medication. The descriptive cross-sectional study was conducted at Isra University Hospital, Hyderabad, Pakistan, from April 14 to October 14, 2014, and comprised pregnant women who were interviewed face to face. Data was collected on a proforma comprising demographic data, practice of using over-the-counter medications before and during pregnancy, type of medicines, illnesses, knowledge about the medicines, source of recommendation and reason for practicing it. Data was analysed on SPSS 16. The mean age of 351 patients in the study was 26.19±4.82 years (range: 18-45 years).The mean gestational age was 26.28±10.42. Overall, 223(63.5%) patients were using over-the-counter drugs before pregnancy; 128(36.5%) had used them in previous pregnancy; and 133(37.9%) were using them during the current pregnancy. Most common medication used was acetaminophen 58(43.6%), headache was the most common illness 80(60.2%). A total of 103(77.4%) had no knowledge about the medicines. A significant number of pregnant women indulged in the practice of using over-the-counter medication.

  12. Emotional exhaustion is associated with work related stressors: a cross-sectional multicenter study in Malaysian public hospitals.

    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.

  13. Stigma towards mental illness: A hospital-based cross-sectional study among caregivers in West Bengal.

    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.

  14. Are nurses verbally abused? A cross-sectional study of nurses at a university hospital, Eastern Province, Saudi Arabia.

    Al-Shamlan, Nouf A; Jayaseeli, Nithya; Al-Shawi, Moneera M; Al-Joudi, Abdullah S

    2017-01-01

    Workplace violence against health-care workers is a significant problem worldwide. Nurses are at a higher risk of exposure to violence. Studies available in Saudi Arabia are few. The objective of the study was to estimate the prevalence of verbal abuse of nurses at King Fahd Hospital of the University (KFHU) in Khobar, Saudi Arabia, and to identify consequences and the demographic and work-related characteristics associated with it. This cross-sectional study of 391 nurses by total sample was conducted between November and December 2015, using a modified self-administered questionnaire developed by the World Health Organization. Data was entered, and analyzed using SPSS Version 16.0. The descriptive statistics were reported using frequency and percentages for all categorical variables. Chi-squared tests or Fisher's Exact test, as appropriate, were performed to test the associations of verbal abuse with the demographic and work-related characteristics of the participants. Variables with p violence in their workplace were more vulnerable to workplace verbal abuse. Workplace verbal abuse is a significant challenge in KFHU. For decision makers, it is rather disturbing that a lot of cases go unreported even though procedures for reporting exist. Implementation of an efficient transparent reporting system that provides follow-up investigations is mandatory. In addition, all victims should be helped with counseling and support.

  15. Frequency and Associated Factors for Anxiety and Depression in Pregnant Women: A Hospital-Based Cross-Sectional Study

    Niloufer S. Ali

    2012-01-01

    Full Text Available Antepartum anxiety and/or depression is a major public health problem globally. The aim of this study was to estimate the frequency of antepartum anxiety and/or depression among pregnant women. This was a cross-sectional study conducted in a tertiary care hospital among pregnant women. A total of 165 pregnant women were interviewed by a clinical psychologist using HADS for assessing anxiety and/or depression and also collected information regarding sociodemographic, obstetric, family relationships, and home environment. Out of the total of 165 pregnant women about 70 percent of them were either anxious and/or depressed. The increasing age of women (P-value=0.073, not having any live birth (P-value=0.036, adverse pregnancy outcome in past including death of a child, stillbirth or abortion (P-value=0.013, participant’s role in household decision making (P-value=0.013, and domestic violence (verbal or physical abuse towards mother or children by any family member (P-value=0.123. Our study highlights that anxiety and/or depression is quite common among pregnant women. Therefore, there is a need to incorporate screening for anxiety and depression in the existing antenatal programs and development of strategies to provide practical support to those identified.

  16. An Inter-, Trans-, Cross- and Multidisciplinary Approach to Higher Education in the Field of Business Studies

    Gheorghe Săvoiu

    2014-08-01

    Full Text Available Modern academic education in economics, and especially that in the field of business, frequently tries, and rather seldom manages to combine, interfere and unify, to varying degrees, distinct disciplines with practical interests usually similar or even seemingly adverse; its concrete action is an example of the successful attempt at prompt adaptation to the entrepreneurial reality, which is constantly changing, and also to the more and more dynamic economic environment, perhaps excessively so in the last two decades. This paper attempts to clarify the conceptual differences and the relatively common parts of inter-, trans-, cross- and multidisciplinarity in general, and in particular in education, focusing on business education. A brief introduction structures the inter-, trans-, cross- and multidisciplinary investigative approach within an educational context in business, and a review of the scientific literature section clarifies both the meaning of those major concepts, extending from simple paradigm of each concept to their multiple aggregative paradigm, and some modern educational trends in economics. A second section is devoted to the method of investigating opinions, based on the volume of a sample determined statistically and from a scientific methodology of observation and recording, by collecting individual data, validating the rigor of research on the diversity in business education approaches, by simply and consistently noting them by the students and graduates of faculties of economics. The study of the graduates’ opinions focused on an original questionnaire, presented in the a annexes of the paper, and the resulting databases were subjected to a descriptive statistical analysis, made with the software package Eviews, with emphasis on the homogeneity, symmetry, skewness and normality of distributions. The third section is a brief analysis of the research results, supplemented naturally by some clarifying discussions, which

  17. Prevalence and management status of urologic diseases in geriatric hospitals in South Korea: A field research

    Sang Heon Lee

    2017-01-01

    Full Text Available Purpose: We aimed to investigate the current management status of urologic diseases in geriatric hospitals in South Korea. Materials and Methods: Questionnaire surveys and in-depth person-to-person interviews were conducted at 13 hospitals within the Seoul and Incheon areas. Results: The study was carried out from July to December 2014; 75.6% of patients (1,858/2,458 and 77.5% (779/1,031 of medical personnel responded to our survey. All surveys and interviews were performed by urology specialists, fellows, residents, or nurses. The hospitals included in the study had an average of 215.2 beds (range, 110–367, 189.1 patients (range, 90–345, and 40.2 nurses (range, 10–83. The average number of physicians was 6.2 (range, 3–11, but none of these were certified urologists. Only 4 hospitals provided consultation services for urological disorders. In total, 64% of patients had urological disorders, although only 20.7% of patients were receiving medication. Most patients were being treated using urological interventions; diapers (49.7%, indwelling catheters (19.5%, clean intermittent catheters (12.2%, and external collection urinary drainage (7.9%. However, most interventions were inadequately implemented, and only 17% of the patients had been examined by a certified urologist. Urological complications were found in 20.2% of patients, and secondary complications occurred in 18.8%. Excluding redundant cases, the total prevalence of urological complications was 39.0%. Conclusions: Urologic diseases are poorly managed, and no certified urologists work in geriatric hospitals. Therefore, more designated urologists are needed in geriatric hospitals.

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

    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

  19. Productivity of Sumateran Composite dan Barbados Cross sheep breed in the field condition

    Bambang Setiadi

    2007-12-01

    Full Text Available Two years field study has been carried out in the Purwakarta district , West Java, to evaluate sheep productivity of Sumateran Composite (K and Barbados cross (BC breeds introduced to the farmers, compared with locally thin tail sheep breed (L that were maintained by the farmers. Genotype compositions of K sheep were Barbados Blackbelly 25%, St. Croix 25%, and Sumateran sheep 50%; and for BC were Barbados Blackbelly 50% and Sumateran sheep 50%. Sheep those were introduced was new breed from breeding improvement of Indonesian Research Institute for Animal Production. Litter size of K, BC, and L ewes was 1.3; 1.4; and 1.5 respectively. Pre-weaning mortality rate were 5.0; 5.0 and 8.0% respectively for K, BC, and L lambs. Ewe Reproduction Rate (LRI = number of lamb at weaning/ewe/year of L (2.14 was higher than BC (2.0 and K (1.85. The ewe productivity (PI = kg lambs/ewe/year is the average of weaning weight timed LRI. Because the weaning weight of L (7.0 kg were significantly lowest than BC (10.5 kg and K (9.25 kg will affect on PI. PI of L (14.98 ewe were significantly (P<00.5 lowest than BC (21 and K (17.11. Body weight of crossbred (K X L and BCxL under the same physiologic status were similarly with BC and K. According to the result of productivity evaluation of introduced sheep breed in the field condition, can be sumarize that productivity of K and BC sheep were significantly better than locally thin tail sheep.

  20. Fields of Tension in a Boundary-Crossing World: Towards a Democratic Organization of the Self.

    Hermans, Hubert J M; Konopka, Agnieszka; Oosterwegel, Annerieke; Zomer, Peter

    2017-12-01

    In their study of the relationship between self and society, scientists have proposed taking society as a metaphor for understanding the dynamics of the self, such as the analogy between the self and the functioning of a totalitarian state or the analogy between the self and the functioning of a bureaucratic organization. In addition to these models, the present article proposes a democratic society as a metaphor for understanding the workings of a dialogical self in a globalizing, boundary-crossing world. The article follows four steps. In the first step the self is depicted as extended to the social and societal environment and made up of fields of tension in which a multiplicity of self-positions are involved in processes of positioning and counter-positioning and in relationships of social power. In the second step, the fertility of the democratic metaphor is demonstrated by referring to theory and research from three identity perspectives: multicultural, multiracial, and transgender. In the fields of tension emerging between the multiplicity of self-positions, new, hybrid, and mixed identities have a chance to emerge as adaptive responses to the limitations of existing societal structures. In the third step, we place the democratic self in a broader societal context by linking three levels of inclusiveness, proposed by Self-Categorization Theory (personal, social, and human) to recent conceptions of a cosmopolitan democracy. In the fourth and final step, a model is presented which allows the formulation of a series of specific research questions for future studies of a democratically organized self.

  1. Systematic Approach to the Goalsetting of Higher Education in the Field of Tourism and Hospitality

    Romanova, Galina; Maznichenko, Marina; Neskoromnyh, Nataliya

    2016-01-01

    The article deals with key problems and contradictions of training of university graduates for the tourism and hospitality industry in Russia, primarily associated with the setting of educational goals. The article formulates the discussion points related to the updating of the existing educational standards for the enlarged "Service and…

  2. Analysis approach of turnout crossing performance by field measurements and finite element modeling

    Xin, L.; Markine, V.L.; Shevtsov, I.

    2015-01-01

    The procedure for analyzing turnout crossing performance is developed in this paper. The experimental and numerical analysis are both conducted to evaluate the dynamic behavior of the crossing and to further improve the crossing performance. Geometry and acceleration measurements are performed on

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

    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

  4. Photoabsorption spectra in the perturbative regime for atoms in crossed electric and magnetic fields

    Marxer, H.; Moser, I.; O'Mahony, P.F.; Mota-Furtado, F.

    1994-01-01

    We calculate photoabsorption spectra of atoms in crossed electric and magnetic fields using a truncated basis of Coulomb eigenfunctions. The method yields spectra in the regime where inter-n-mixing is not dominant and allows for the treatment of non-hydrogenic atoms via a simple recourse to quantum defects. We compare results for hydrogen to those obtained in second order perturbation theory where the residual degeneracy left in first order perturbation theory is completely lifted and we show that only a very small basis size is needed to achieve convergence to within the accuracy of second order perturbation theory. In the case of lithium the coupling of an incomplete hydrogen-like manifold to states with non-negligible quantum defects substantially modifies the spectra obtained in comparison to the purely hydrogenic spectra. In the inter-n-mixing regime we also compare our convoluted results directly with an experimental spectrum for hydrogen and find good agreement below the saddle point. (Author)

  5. Cross-Field Current Instabilities in Thin Ionization Layers and the Enhanced Aurora

    Johnson, Jay R.; Okuda, Hideo

    2008-01-01

    Nearly half of the time, auroral displays exhibit thin, bright layers known as 'enhanced aurora'. There is a substantial body of evidence that connects these displays with thin, dense, heavy ion layers in the E-region. Based on the spectral characteristics of the enhanced layers, it is believed that they result when wave-particle interaction heats ambient electrons to energies at or just above the 17 eV ionization energy of N2. While there are several possible instabilities that could produce suprathermal electrons in thin layers, there has been no clear theoretical investigation which examines in detail how wave instabilities in the thin ionization layers could develop and produce the suprathermal electrons. We examine instabilities which would occur in thin, dense, heavy ion layers using extensive analytical analysis combined with particle simulations. We analyze a cross field current instability that is found to be strongly unstable in the heavy ion layers. Electrostatic simulations show that substantial heating of the ambient electrons occurs with energization at or above the N2 ionization energy.

  6. Are Facebook user ratings associated with hospital cost, quality and patient satisfaction? A cross-sectional analysis of hospitals in New York State.

    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.

  7. Prevalence of hypertension and its risk factors in southwest Ethiopia: a hospital-based cross-sectional survey

    Gudina EK

    2013-07-01

    Full Text Available Esayas Kebede Gudina,1 Yadani Michael,1 Sahilu Assegid2 1Department of Internal Medicine, Jimma University, Jimma, Ethiopia; 2Department of Epidemiology, Jimma University, Jimma, Ethiopia Background: Hypertension is a common medical condition worldwide. It is an important public health challenge because of the associated morbidity, mortality, and the cost to the society. The objective of this study was to determine the prevalence of hypertension and its risk factors among attendants of adult outpatient departments at Jimma University Specialized Hospital in southwest Ethiopia. Materials and methods: A hospital-based cross-sectional study was conducted on 734 participants aged 15 years or older from May 2012 to June 2012. A pretested structured questionnaire consisting of characteristics related to sociodemographic profiles and risk factors for hypertension was used for data collection. Three separate measurements of blood pressure and relevant anthropometric evaluation were taken according to current recommended standards. Chi-square test and other statistical analyses were done to employ appropriate interpretations of the findings. P-values of <0.05 were considered statistically significant. Results: The mean age of the participants was 42.3 ± 13.2 years and 71.7% of them were 35 years and older; 58% of them were females. Overall prevalence of hypertension – defined by systolic blood pressure ≥140 and/or diastolic blood pressure ≥90 or reporting history of hypertension – was found to be 13.2%. Only 35.1% of them were aware of their hypertension and only 23.7% were on treatment. The overall control rate was 15.5%. Family history of hypertension, having diabetes mellitus, being overweight, and oral contraceptive use were associated with high blood pressure. Conclusion: Hypertension was found to be prevalent; morbidity, awareness, treatment, and control in those with hypertension were low. Hence, intervention measures should be undertaken

  8. Urinary trichloroacetic acid levels and semen quality: A hospital-based cross-sectional study in Wuhan, China

    Xie, Shao-Hua; Li, Yu-Feng; Tan, Yin-Feng; Zheng, Dan; Liu, Ai-Lin; Xie, Hong

    2011-01-01

    Toxicological studies indicate an association between exposure to disinfection by-products (DBPs) and impaired male reproductive health in animals. However, epidemiological evidence in humans is still limited. We conducted a hospital-based cross-sectional study to investigate the effect of exposure to DBPs on semen quality in humans. Between May 2008 and July 2008, we recruited 418 male partners in sub-fertile couples seeking infertility medical instruction or assisted reproduction services from the Tongji Hospital in Wuhan, China. Major semen parameters analyzed included sperm concentration, motility, and morphology. Exposure to DBPs was estimated by their urinary creatinine-adjusted trichloroacetic (TCAA) concentrations that were measured with the gas chromatography/electron capture detection method. We used linear regression to assess the relationship between exposure to DBPs and semen quality. According to the World Health Organization criteria (<20 million/mL for sperm concentration and <50% motile for sperm motility) and threshold value recommended by Guzick (<9% for sperm morphology), there were 265 men with all parameters at or above the reference values, 33 men below the reference sperm concentration, 151 men below the reference sperm motility, and 6 men below the reference sperm morphology. The mean (median) urinary creatinine-adjusted TCAA concentration was 9.2 (5.1) μg/g creatinine. Linear regression analyses indicated no significant association of sperm concentration, sperm count, and sperm morphology with urinary TCAA levels. Compared with those in the lowest quartile of creatinine-adjusted urinary TCAA concentrations, subjects in the second and third quartiles had a decrease of 5.1% (95% CI: 0.6%, 9.7%) and 4.7% (95% CI: 0.2%, 9.2%) in percent motility, respectively. However, these associations were not significant after adjustment for age, abstinence time, and smoking status. The present study provides suggestive but inconclusive evidence of the

  9. Urinary trichloroacetic acid levels and semen quality: A hospital-based cross-sectional study in Wuhan, China

    Xie, Shao-Hua [Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, 430030 Wuhan (China); The Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan (China); Li, Yu-Feng [Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan (China); Tan, Yin-Feng [Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, 430030 Wuhan (China); The Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan (China); Zheng, Dan [The Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan (China); Institute of Environmental Medicine, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan (China); Liu, Ai-Lin; Xie, Hong [Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No. 13 Hangkong Road, 430030 Wuhan (China); The Ministry of Education Key Laboratory of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan (China); and others

    2011-02-15

    Toxicological studies indicate an association between exposure to disinfection by-products (DBPs) and impaired male reproductive health in animals. However, epidemiological evidence in humans is still limited. We conducted a hospital-based cross-sectional study to investigate the effect of exposure to DBPs on semen quality in humans. Between May 2008 and July 2008, we recruited 418 male partners in sub-fertile couples seeking infertility medical instruction or assisted reproduction services from the Tongji Hospital in Wuhan, China. Major semen parameters analyzed included sperm concentration, motility, and morphology. Exposure to DBPs was estimated by their urinary creatinine-adjusted trichloroacetic (TCAA) concentrations that were measured with the gas chromatography/electron capture detection method. We used linear regression to assess the relationship between exposure to DBPs and semen quality. According to the World Health Organization criteria (<20 million/mL for sperm concentration and <50% motile for sperm motility) and threshold value recommended by Guzick (<9% for sperm morphology), there were 265 men with all parameters at or above the reference values, 33 men below the reference sperm concentration, 151 men below the reference sperm motility, and 6 men below the reference sperm morphology. The mean (median) urinary creatinine-adjusted TCAA concentration was 9.2 (5.1) {mu}g/g creatinine. Linear regression analyses indicated no significant association of sperm concentration, sperm count, and sperm morphology with urinary TCAA levels. Compared with those in the lowest quartile of creatinine-adjusted urinary TCAA concentrations, subjects in the second and third quartiles had a decrease of 5.1% (95% CI: 0.6%, 9.7%) and 4.7% (95% CI: 0.2%, 9.2%) in percent motility, respectively. However, these associations were not significant after adjustment for age, abstinence time, and smoking status. The present study provides suggestive but inconclusive evidence of the

  10. Investigating admitted patients' satisfaction with nursing care at Debre Berhan Referral Hospital in Ethiopia: a cross-sectional study.

    Sharew, Nigussie Tadesse; Bizuneh, Hailegiorgis Teklegiorgis; Assefa, Hilina Ketema; Habtewold, Tesfa Dejenie

    2018-05-17

    The aims of the study were (1) to assess the level of patient satisfaction with nursing care and (2) to identify factors influencing patient satisfaction. A hospital-based, cross-sectional study was conducted with 252 admitted patients in the medical, surgical and paediatric wards. Debre Berhan Referral Hospital, Debre Berhan, Ethiopia, with a catchment population of 2.8 million. All patients admitted at least for 2 days and capable of independent communication were included. However, patients were excluded on any one of the following conditions: admitted for less than 2 days, cannot understand Amharic language, with critical illness or cognitive impairment that affects judgement, or inability to provide written informed consent. The mean age of the patients was 37.9 (SD=12.9) years, and half (50.4%) of them were male. Patient satisfaction with nursing care, measured by the Newcastle Satisfaction with Nursing Scale, was the outcome variable. Using a mean split approach, patient satisfaction scores were dichotomised into 'satisfied' and 'unsatisfied'. 49.2% of patients were satisfied with nursing care. Educational status and history of admission were significant factors influencing patient satisfaction with nursing care. Patients who had high educational status were 80% less satisfied compared with those who had no formal education (p=0.01, OR=0.2, 95% CI 0.1 to 0.7). Patients who had a history of admission were 2.2 times more satisfied compared with those who had no history of admission (p=0.02, OR=2.2, 95% CI 1.2 to 4.2). About half the admitted patients were satisfied with the nursing care. Satisfaction differed significantly by patients' educational attainment and history of admission. This study provided evidence on patient satisfaction with nursing care in Ethiopia. This information may be useful in comparative studies of patient satisfaction and in identifying characteristics that may explain or predict patient satisfaction. © Article author(s) (or

  11. Prevalence and Factors Associated with Low Birth Weight among Teenage Mothers in New Mulago Hospital: A Cross Sectional Study.

    Louis, Bayo; Steven, Buyungo; Margret, Nakiwala; Ronald, Nabimba; Emmanuel, Luyinda; Tadeo, Nsubuga; Namagembe, Imelda; Kasangaki, Arabat; Cecily, Banura

    2016-01-01

    The World Health Organization defines low birth weight (LBW) as a new born having a weight of less than 2,500 g at birth. Low birth weight is one of the major determinants of perinatal survival, infant morbidity and mortality as well as the risk of developmental disabilities and illnesses in future lives. WHO estimates that about 30 million low birth weight babies are born annually (23.4% of all births) and they often face short and long term health consequences. Whereas the global prevalence of LBW has slightly declined, the rate in many developing countries is still quite high. In Uganda, low birth weight among teenage mothers is a problem. Our study aimed to estimate the prevalence of and identify the factors associated with low birth weight among teenage mothers in New Mulago hospital. We conducted an analytical cross sectional study among teenage mothers who delivered from new Mulago Hospital Complex labour suite from August 2013 to August 2014. Trained interviewers, administered pre-tested questionnaires to consecutive mothers to obtain information on their socio-demographic characteristics, obstetric history and child factors. Odds ratios and P -values were calculated to determine the relationship between independent and dependent variables. We also used descriptive statistics for the quantitative data. A total of 357 teenage mothers were enrolled on the study. Their mean age was 18 years (Range 13-19), majority, 98.4% aged 15-19 years. The prevalence of LBW was 25.5%. Pre-term delivery (OR = 3.3032 P = 0.0001) and multiple pregnancies (OR = 0.165 P = 0.039) were associated with LBW. Malaria, young maternal age and ANC attendance were not associated with LBW. Child factors such as birth order, congenital anomalies and sex of the baby were also not associated with LBW. The prevalence of LBW is high among teenage mothers, pre-term delivery and multiple pregnancies were associated factors with LBW. Health professional's need to address teenage maternal health

  12. Breast cancer risk factor knowledge among nurses in teaching hospitals of Karachi, Pakistan: a cross-sectional study

    Hatcher Juanita

    2006-09-01

    Full Text Available Abstract Background Breast cancer is the most common cancer among women in both the developed and the developing world. The incidence of breast cancer in Karachi, Pakistan is 69.1 per 100,000 with breast cancer presentation in stages III and IV being common (≥ 50%. The most pragmatic solution to early detection lies in breast cancer education of women. Nurses constitute a special group having characteristics most suited for disseminating breast cancer information to the women. We assessed the level of knowledge of breast cancer risk factors among registered female nurses in teaching hospitals of Karachi. We also identified whether selected factors among nurses were associated with their knowledge of breast cancer risk factors, so that relevant measures to improve knowledge of nurses could be implemented. Methods A cross-sectional survey was conducted in seven teaching hospitals of Karachi using stratified random sampling with proportional allocation. A total of 609 registered female nurses were interviewed using a structured questionnaire adapted from the Stager's Comprehensive Breast Cancer Knowledge Test. Knowledge of breast cancer risk factors was categorized into good, fair and poor categories. Ordinal regression was used to identify factors associated with risk knowledge among nurses. Results Thirty five percent of nurses had good knowledge of risk factors. Graduates from private nursing schools (aOR = 4.23, 95% CI: 2.93, 6.10, nurses who had cared for breast cancer patients (aOR = 1.41, 95% CI: 1.00, 1.99, those having received a breast examination themselves (aOR = 1.56, 95% CI: 1.08, 2.26 or those who ever examined a patient's breast (aOR = 1.87, 95% CI: 1.34, 2.61 were more likely to have good knowledge. Conclusion A relatively small proportion of the nursing population had good level of knowledge of the breast cancer risk factors. This knowledge is associated with nursing school status, professional breast cancer exposure and self

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

    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

  14. An empirical analysis of the public's attitudes toward advertising hospital services: a comparative cross-sectional study.

    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.

  15. 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)

    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.

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

    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

  17. Computation of the Arnol close-quote d web for the hydrogen atom in crossed electric and magnetic fields

    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

  18. Maxima of the scattering cross section, the wave vector being quasi orthogonal to the confining magnetic field

    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

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

    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

  20. Congenital Heart Disease in Children's hospital medical center A Cross-Sectional study 2000 - 2001

    Zeinaloo. A. A Tadbir. M

    2002-07-01

    Full Text Available The most common congenital diseases in children is congenital heart disease. Factors such as environment, genetic, old maternal age during pregnancy, maternal disease and using medicine in pregnancy, prematuritiy, and specific seasons are significant in the prevalence of disease."nMaterials and Methods: A cross sectional study was conducted to investigate the status of children with congenital heart diseases, among 665 child that refereed to Children's hospital medical center, Tehran University of Medical Sciences and Health Services, during 1 year (2000 tO 2001. The researchers due to the lack of existing appropriate tools developed the instrument for the study. The questionnaire was 15 items, nominal, ordinal and interval scale. All items were verified using major authoritative pediatric cardiologists references and were subjected to face and content validation by three experts. Convenient sampling was utilized for collecting data. All subjects were examined in cardiology department and echocardiography was done for them."nResults: From a total of 665 children with congenital heart defects, 56.2 percent were male and 43.8 percent were female. 32.6 percent were born in autumn. Septal defects were predominant lesions, which account for 36.1 percent of lesions. 89.8 percent of children have never extracardiac defects. Children of mothers age 20-35 years had a percentage of 86.2 percent of developing congenital heart disease, Percentage of children who their birth weight less than 2500 gram was quite small, at 24.1 per cent overall. There was no significant relationship between selected variables and congenital heart diseases."nConclusion: With regard to the prevalence of disease and preventing therapeutic costs, parents and teachers education have an important role in preventing congenital heart disease. Therefore, the formation of a learning curriculum model for a life free of congenital heart disease and congenital heart diseases

  1. Awareness and perceptions of electroconvulsive therapy among psychiatric patients: a cross-sectional survey from teaching hospitals in Karachi, Pakistan

    Choudhary Maria

    2007-06-01

    Full Text Available Abstract Background Electroconvulsive therapy (ECT is shown to be effective in many psychiatric illnesses, but its distorted projection by the Pakistani media and its unregulated use by many physicians across the country have adversely affected its acceptability. Given this situation we aimed to assess the awareness and perceptions regarding ECT as a treatment modality among the psychiatric patients. Methods This was a questionnaire based cross-sectional study carried out at 2 tertiary care hospitals in Karachi, Pakistan. Results We interviewed 190 patients of which 140 were aware of ECT. The study showed that the level of education had a significant impact on the awareness of ECT (p = 0.009. The most common source of awareness was electronic and print media (38%, followed by relatives (24% and doctors (23%. Physical injuries (42% and neurological (12% and cognitive disturbances (11% were the commonly feared side effects. The most popular belief about ECT was that it was a treatment of last resort (56%. Thirty-nine percent thought that ECT could lead to severe mental and physical illness and 37% considered it inhumane. Patients' willingness to receive ECT was dependant on whether or not they were convinced of its safety (p = 0.001 and efficacy (p = 0.0001. Conclusion We identified a serious lack of dissemination of information regarding ECT by the psychiatrists and the mental health care providers. This may be the result of an inadequate postgraduate training in Pakistan or just a lack of concern about the mentally ill patients. The media seemed to be the major source of information for our patients. We also saw the prevalence of a variety of myths regarding ECT in our society, which we feel may be responsible for the patients' adverse attitudes. Given the widespread applicability of ECT there is a dire need to dispel these misconceptions and improve its acceptability.

  2. Can sleep quality and burnout affect the job performance of shift-work nurses? A hospital cross-sectional study.

    Giorgi, Fabio; Mattei, Antonella; Notarnicola, Ippolito; Petrucci, Cristina; Lancia, Loreto

    2018-03-01

    The aim of this study was to investigate any possible relationship between sleep disorders, burnout and job performance in a shift-work population of nurses. Sleep disorders and burnout can affect the job performance of nurses in terms of efficiency, productivity, task execution speed and supervision, which can be compromised when work shifts are organized on a 24-hour schedule and when the shift itself is irregular. A cross-sectional observational study was conducted from August 2014 - January 2015 on a sample of 315 shift-work nurses across 39 wards in seven central Italian hospitals. The Pittsburgh Sleep Quality Index was used to detect the presence of sleep disorders, the Copenhagen Burnout Inventory was used to detect the presence of any possible type of burnout and the Job Performance Scale was used to measure job performance. Data analysis was mainly based on a multivariate logistic regression to identify variables significantly associated with investigated outcomes. On shift-work nurses' sleep quality and burnout correlated positively. The female gender and personal burnout were significantly associated with impaired sleep quality, while working in the psychiatric setting, working a long cycle shift pattern and experiencing daytime dysfunction were significantly associated with burnout. A significant negative association between patient-related burnout and job performance was observed. Specific characteristics of shift-work nurses can directly affect sleep quality and burnout and indirectly job performance. This evidence offers healthcare administrators opportunities to intervene with measures to promote nurse's health, well-being and safety. © 2017 John Wiley & Sons Ltd.

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

    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

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

    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

  5. Cross-Cultural Field Experiences in Earth and Social Sciences for Chilean and American Graduate Students

    Duffin, J.; Russell, M.; Fuentes, B.; Riffo, A.; Link, T. E.; Caamaño, D.; King, R.; Barra, R.

    2017-12-01

    The University of Idaho (UI) was awarded a 5-year grant titled "Adaptation to change in water resources: science to inform decision-making across disciplines, cultures and scales", from the National Science Foundation's Integrative Graduate Education and Research Traineeship (IGERT) Program. The program supports over 20 doctoral students working in interdisciplinary teams, with participation across several departments and other universities including collaboration between the UI, Universidad Católica de la Santísima Concepción, and Universidad de Concepción in Chile. Each cohort of IGERT trainees visits Chile in their first year for a 2-week course focused on interdisciplinary water resource issues in the Bío Bío River Basin. Multiple field excursions are organized by faculty of the three institutions where students see first-hand the complexities, and the environmental and social consequences of rapid modernization. They then work in cross-cultural teams to identify research needs and potential solutions. One such project is entitled "Comparing USA and Chile hydropower system vulnerability to volcanic lahars". Comparisons are made between the geologic hazards, the associated hazard mitigation, and the emergency response plans at a Cascadian volcano and a pair of Andean volcanos. Geologic variables, dam specifications, government policies and regulations, scientific institutional capacity, and corporate influence are all considered in assessing the likelihood and consequences of a lahar interacting with, or causing failure of a dam. These consequences include loss of life, infrastructure destruction, degradation of water supply and quality, harm to sensitive plant and animals, and depressed local and regional economies. Given the locations of the case studies, special attention is paid to indigenous peoples and the cultural uses of the local environments. Recommendations accounting for both physical and social factors are made to strengthen deficiencies in

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

    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)

  7. Association between payer mix and costs, revenues and profitability: a cross-sectional study of Lebanese hospitals.

    Saleh, S; Ammar, W; Natafgi, N; Mourad, Y; Dimassi, H; Harb, H

    2015-09-08

    This study aimed to examine the association between the payer mix and the financial performance of public and private hospitals in Lebanon. The sample comprised 24 hospitals, representing the variety of hospital characteristics in Lebanon. The distribution of the payer mix revealed that the main sources of revenue were public sources (61.1%), out-of-pocket (18.4%) and private insurance (18.2%). Increases in the percentage of revenue from public sources were associated with lower total costs and revenues, but not profit margins. An inverse association was noted between increased revenue from private insurance and profitability, attributed to increased costs. Increased percentage of out of- pocket payments was associated with lower costs and higher profitability. The study provides evidence that payer mix is associated with hospital costs, revenues and profitability. This should initiate/inform discussions between public and private payers and hospitals about the level of payment and its association with hospital sector financial viability.

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

    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

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

    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.

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

    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...

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

    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...

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

    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...

  13. A field study on thermal comfort in an Italian hospital considering differences in gender and age.

    Del Ferraro, S; Iavicoli, S; Russo, S; Molinaro, V

    2015-09-01

    The hospital is a thermal environment where comfort must be calibrated by taking into account two different groups of people, that is, patients and medical staff. The study involves 30 patients and 19 medical staff with a view to verifying if Predicted Mean Vote (PMV) index can accurately predict thermal sensations of both groups also taking into account any potential effects of age and gender. The methodology adopted is based on the comparison between PMV values (calculated according to ISO 7730 after having collected environmental data and estimated personal parameters) and perceptual judgments (Actual Mean Vote, AMV), expressed by the subjects interviewed. Different statistical analyses show that PMV model finds his best correlation with AMV values in a sample of male medical staff under 65 years of age. It has been observed that gender and age are factors that must be taken into account in the assessment of thermal comfort in the hospital due to very weak correlation between AMV and PMV values. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  14. JUNK FOOD CONSUMPTION PATTERN AND OBESITY AMONG SCHOOL GOING CHILDREN IN AN URBAN FIELD PRACTICE AREA: A CROSS SECTIONAL STUDY

    Vidya

    2015-03-01

    Full Text Available BACKGROUND: Junk food simply means an empty calorie food; it lacks in micronutrients such as vitamins, minerals, or amino acids, and fibre but has high energy (calories. During school - age years, children begin to establish habits for eating and exercise that stick w ith them for their entire lives. If children establish healthy habits, their risk for developing many chronic diseases will be greatly decreased. The family, friends, schools, and community resources in a child’s environment reinforce lifestyle habits rega rding diet and activity. OBJECTIVES: To study the fast food consumptions pattern and fast food preferences among the school going children (9 - 13yrs and some of the determinants related to fast food consumption . STUDY SETTING: Department of Community Medic ine in an Urban field practice area of Rajarajeswari Medical College & Hospital, Bangalore. STUDY DESIGN: Cross - sectional study. STUDY DURATION: Three months duration ( Oct – Dec 2014. STUDY POPULATION: school students studying in V th standard to X th standar d. SAMPLE SIZE : The selected school had a strength of 200 students. Hence complete enumeration of the students was considered for this study. DATA COLLECTION : by using pre - structured questionnaire by interview method. The variables included were socio - demographic profile, measurement of height, weight and questions related to junk food consumption and its patterns. DATA ANALYSIS: using statistics software SPSS 20. Mean and standard deviation was calculated for anthropometric measurements. Test of significance for proportions was done by Chi - square test. RESULTS: Among 200 study subjects, 107 were male (53.5% and 93 females (46.5%. Majority of the students wer e in the age group of 12 - 15 years ( 66% and 9 - 11 years ( 34%. Snacks (41%, Fast food (25.50%, soft drinks (17.50% and candies (16% were the favourite junk foods among the study subjects. Taste and time factors, watching television while consuming

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

    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.

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

    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.

  17. 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.

    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.

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

    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

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

    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.

  20. Attitude of Nurses toward the Patient Safety Culture: A Cross-Sectional Study of the Hospitals in Tehran, Iran

    Maryam Saberi

    2017-07-01

    Conclusion: According to the results, attitude of the nurses in the selected hospitals was poor toward the dimensions of the patient safety culture. Therefore, it is strongly recommended that specific training interventions be performed to enhance the work conditions and safety climate in these hospitals

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

    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.

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

    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

  3. Risky sexual practices and related factors among ART attendees in Addis Ababa Public Hospitals, Ethiopia: a cross-sectional study.

    Dessie, Yadeta; Gerbaba, Mulusew; Bedru, Abdo; Davey, Gail

    2011-06-01

    Many HIV-positive persons avoid risky sexual practices after testing HIV sero-positive. However, a substantial number continue to engage in risky sexual practices that may further transmit the virus, put them at risk of contracting secondary sexually transmitted infections and lead to problems with drug resistance. Thus, this study was intended to assess risky sexual practices and related factors among HIV- positive ART attendees in public hospitals of Addis Ababa. A cross-sectional study was conducted among ART attendees from February to March, 2009. Questionnaire-based face-to-face interviews were used to gather data. SPSS software was used to perform descriptive and logistic regression analyses. Six hundred and one ART attendees who fulfilled the inclusion criteria was included in the study and interviewed. More than one-third (36.9%) had a history of risky sexual practices in the three months prior to the study. The major reasons given for not using condoms were: partner's dislike of them, both partners being positive for HIV and the desire to have a child. Factors associated with risky sexual practices included: lack of discussion about condom use (Adjusted Odds Ratio (AOR = 7.23, 95% CI: 4.14, 12.63); lack of self-efficacy in using condoms (AOR = 3.29, 95% CI: 2.07, 5.23); lack of sexual pleasure when using a condom (AOR = 2.39, 95% CI: 1.52, 3.76); and multiple sexual partners (AOR = 2.67, 95% CI: 1.09, 6.57). Being with a negative sero-status partner (AOR = 0.33, 95% CI: 0.14, 0.80), or partners of unknown sero-status (AOR = 0.19, 95% CI: 0.09, 0.39) were associated with less risky practice. A considerable proportion (36.9%) of respondents engaged in unprotected sexual intercourse, potentially resulting in re-infection by a new virus strain, other sexually transmitted infections and onward transmission of the HIV virus. Health education and counseling which focuses on the identified factors has to be provided. The health education and counseling can be

  4. A cross-sectional evaluation of computer literacy among medical students at a tertiary care teaching hospital in Mumbai (Bombay

    T S Panchabhai

    2011-01-01

    Full Text Available Background: Computer usage capabilities of medical students for introduction of computer-aided learning have not been adequately assessed. Aim: Cross-sectional study to evaluate computer literacy among medical students. Settings and Design: Tertiary care teaching hospital in Mumbai, India. Materials and Methods: Participants were administered a 52-question questionnaire, designed to study their background, computer resources, computer usage, activities enhancing computer skills, and attitudes toward computer-aided learning (CAL. The data was classified on the basis of sex, native place, and year of medical school, and the computer resources were compared. The computer usage and attitudes toward computer-based learning were assessed on a five-point Likert scale, to calculate Computer usage score (CUS - maximum 55, minimum 11 and Attitude score (AS - maximum 60, minimum 12. The quartile distribution among the groups with respect to the CUS and AS was compared by chi-squared tests. The correlation between CUS and AS was then tested. Results: Eight hundred and seventy-five students agreed to participate in the study and 832 completed the questionnaire. One hundred and twenty eight questionnaires were excluded and 704 were analyzed. Outstation students had significantly lesser computer resources as compared to local students (P<0.0001. The mean CUS for local students (27.0±9.2, Mean±SD was significantly higher than outstation students (23.2±9.05. No such difference was observed for the AS. The means of CUS and AS did not differ between males and females. The CUS and AS had positive, but weak correlations for all subgroups. Conclusion: The weak correlation between AS and CUS for all students could be explained by the lack of computer resources or inadequate training to use computers for learning. Providing additional resources would benefit the subset of outstation students with lesser computer resources. This weak correlation between the attitudes

  5. Risky sexual practices and related factors among ART attendees in Addis Ababa Public Hospitals, Ethiopia: A cross-sectional study

    Bedru Abdo

    2011-06-01

    Full Text Available Abstract Background Many HIV-positive persons avoid risky sexual practices after testing HIV sero-positive. However, a substantial number continue to engage in risky sexual practices that may further transmit the virus, put them at risk of contracting secondary sexually transmitted infections and lead to problems with drug resistance. Thus, this study was intended to assess risky sexual practices and related factors among HIV- positive ART attendees in public hospitals of Addis Ababa. Methods A cross-sectional study was conducted among ART attendees from February to March, 2009. Questionnaire-based face-to-face interviews were used to gather data. SPSS software was used to perform descriptive and logistic regression analyses. Results Six hundred and one ART attendees who fulfilled the inclusion criteria was included in the study and interviewed. More than one-third (36.9% had a history of risky sexual practices in the three months prior to the study. The major reasons given for not using condoms were: partner's dislike of them, both partners being positive for HIV and the desire to have a child. Factors associated with risky sexual practices included: lack of discussion about condom use (Adjusted Odds Ratio (AOR = 7.23, 95% CI: 4.14, 12.63; lack of self-efficacy in using condoms (AOR = 3.29, 95% CI: 2.07, 5.23; lack of sexual pleasure when using a condom (AOR = 2.39, 95% CI: 1.52, 3.76; and multiple sexual partners (AOR = 2.67, 95% CI: 1.09, 6.57. Being with a negative sero-status partner (AOR = 0.33, 95% CI: 0.14, 0.80, or partners of unknown sero-status (AOR = 0.19, 95% CI: 0.09, 0.39 were associated with less risky practice. Conclusions A considerable proportion (36.9% of respondents engaged in unprotected sexual intercourse, potentially resulting in re-infection by a new virus strain, other sexually transmitted infections and onward transmission of the HIV virus. Health education and counseling which focuses on the identified factors has to

  6. Thyroid disorders in polycystic ovarian syndrome subjects: A tertiary hospital based cross-sectional study from Eastern India

    Uma Sinha

    2013-01-01

    Full Text Available Context: Polycystic ovarian syndrome (PCOS, the most common endocrinopathy of women in the reproductive age group seems to be adversely affected by associated thyroid dysfunction. Both pose independent risks of ovarian failure and pregnancy related complications. Aims: The present study from Eastern India is, therefore, aimed to investigate the prevalence and etiology of different thyroid disorders in PCOS subjects. Settings and Design: Cross-sectional hospital based survey-single centre observational case-control study. Materials and Methods: This prospective single-center study recruited 106 female patients with hypertrichosis and menstrual abnormality among which 80 patients were defined as having PCOS according to the revised 2003 Rotterdam criteria and comprised the study population. Another 80 age-matched female subjects were studied as the control population. Thyroid function and morphology were evaluated by measurement of serum thyroid stimulating hormone (TSH, free thyroxine levels (free T3 and free T4, anti-thyroperoxidase antibody (anti-TPO Ab, clinical examination and ultrasound (USG of thyroid gland. Statistical Analysis Used: It was done by Student′s t-test and Chi-square test using appropriate software (SPSS version 19. Results: This case-control study revealed statistically significant higher prevalence of autoimmune thyroiditis, detected in 18 patients (22.5% vs. 1.25% of control as evidenced by raised anti-TPO antibody levels (means 28.037 ± 9.138 and 25.72 ± 8.27 respectively; P = 0.035. PCOS patients were found to have higher mean TSH level than that of the control group (4.547 ± 2.66 and 2.67 ± 3.11 respectively; P value < 0.05. There was high prevalence of goiter among PCOS patients (27.5% vs. 7.5% of control, P value < 0.001. On thyroid USG a significantly higher percentage of PCOS patients (12.5%; controls 2.5% had hypoechoic USG pattern also compatible with the diagnosis of autoimmune thyroiditis. Conclusions: High

  7. Intraband absorption in GaAs-(Ga,Al)As variably spaced semiconductor superlattices under crossed electric and magnetic fields

    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.

  8. Cross-Field Comparison of Ethics Education: Golden Rules and Particulars.

    Mulhearn, Tyler J; Watts, Logan L; Torrence, Brett S; Todd, E Michelle; Turner, Megan R; Connelly, Shane; Mumford, Michael D

    2017-01-01

    Research misconduct negatively impacts the scientific community and society in general. Providing training in the responsible conduct of research (RCR) to researchers is one viable approach to minimizing research misconduct. Although recent evidence suggests ethics training can indeed be effective, little empirical work has examined the similarities and differences across fields. In the present study, we analyzed 62 empirical studies in engineering, biomedical science, social science, and mixed fields. The findings suggest certain instructional principles, or "golden rules," apply generally to all fields. These golden rules include maintaining a field-specific or field-general approach and emphasizing processes in training. The findings also suggest that content areas contributing to instructional effectiveness vary as a function of field. Generally, it appears that all fields may benefit from taking a multi-pronged approach to ethics education wherein the salient field issues are covered. Implications for RCR education are discussed.

  9. Hospital-associated methicillin-resistant Staphylococcus aureus: A cross-sectional analysis of risk factors in South African tertiary public hospitals.

    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.

  10. Hospital-associated methicillin-resistant Staphylococcus aureus: A cross-sectional analysis of risk factors in South African tertiary public hospitals

    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

  11. Stealth metamaterial objects characterized in the far field by Radar Cross Section measurements

    Iwaszczuk, Krzysztof; Fan, K.; Strikwerda, A. C.

    Reflection spectra and radar cross sections (RCS) at terahertz frequencies are measured on structures incorporating absorbing metamaterials. Reduction of the RCS by the factor of 375 at the resonant frequencies is observed.......Reflection spectra and radar cross sections (RCS) at terahertz frequencies are measured on structures incorporating absorbing metamaterials. Reduction of the RCS by the factor of 375 at the resonant frequencies is observed....

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

    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.

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

    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.

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

    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.

  15. Effect of nurses' work environment on patient satisfaction: A cross-sectional study of four hospitals in Japan.

    Tei-Tominaga, Maki; Sato, Fusako

    2016-01-01

    The Magnet Recognition Program is a system in the USA that recognizes a hospital as a magnet hospital for having a high retention rate of nurses and providing high quality patient care. The purpose of this study was to examine the effect of nurses' work environment with characteristics that are similar to those of magnet hospitals on patient satisfaction in Japan. The authors distributed anonymous self-administered questionnaires in August 2011 to all nurses via the directors of the nursing departments of four private hospitals. The response rates were 91% (n = 425) for nurses and 51% (n = 379) for patients. In the questionnaire for nurses, the items addressed basic attributes and a scale of work environment characteristics of a magnet hospital (the Japanese version of the Practice Environment Scale of the Nursing Work Index [PES-NWI]). The questionnaire for patients addressed basic attributes, information about their hospitalization, and items to assess patient satisfaction. To examine the effects of the PES-NWI subscales on patient satisfaction, the authors conducted multivariate logistic regression analysis for groups, which were dichotomized by 75 percentile of the scores of patient satisfaction. The result of model 1 in the multivariate logistic regression analysis demonstrated that collegial nurse-physician relations showed significant relationships with low patient satisfaction (odds ratio = 0.144, P patient satisfaction in hospitals in Japan. © 2015 Japan Academy of Nursing Science.

  16. Patient-centeredness and e-health among Italian hospitals: results of a cross-sectional web-based survey.

    De Feo, Emma; de Belvis, Antonio Giulio; Silenzi, Andrea; Specchia, Maria Lucia; Gallì, Paoloa; Ricciardi, Walter

    2012-12-01

    Given the growing recognition of patient-centeredness as a healthcare quality indicator and its limited implementation in practice, our study evaluated how the Italian hospitals (ItHs), including research hospitals (IRCCSs), research teaching hospitals (THs), and independent public hospital trusts (AOs), address the dimension of online data access through their institutional Web sites to promote a patient-centered care. To address patient-centeredness and e-health, eight specific indicators adapted from the Euro Health Consumer Index were evaluated from 169 ItHs: online booking of healthcare services; access to medical records; register of legitimate doctors; waiting times for most commonly delivered healthcare services; transport information; centralized booking; public relations office; and pain management hospital committee. Univariate and bivariate statistics and a logistic regression analysis have been performed. The majority of the ItHs were under public ownership, and half of them are located in Northern Italy. From the logistic regression analysis, AOs appeared to be more likely to develop a patient-centered healthcare approach (odds ratio [OR]=3.69; 95% confidence interval [CI] 1.14-11.89) compared with IRCCSs or THs. In addition, when grouped together, all public hospitals show more than threefold higher implementation of patient-centeredness strategies (OR=3.60; 95% CI 1.49-8.72) with respect to private ones. Northern hospitals are more likely to ensure wider implementation of a patient-centered approach to healthcare (OR=3.37; 95% CI 1.49-7.62). According to our results, most of the ItHs are under public ownership, and half of them are located in the northern regions of Italy. The higher implementation of patient-centeredness strategies observed for Northern hospitals highlights interregional disparity in healthcare that needs a coordinated effort at both the hospital and policymaker levels to ensure a widespread implementation of patient-centered care

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

    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.

  18. 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.

    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/.

  19. 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

    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

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

    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

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

    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.

  2. Assessment and management of pain in newborns hospitalized in a Neonatal Intensive Care Unit: a cross-sectional study.

    Sposito, Natália Pinheiro Braga; Rossato, Lisabelle Mariano; Bueno, Mariana; Kimura, Amélia Fumiko; Costa, Taine; Guedes, Danila Maria Batista

    2017-09-12

    to determine the frequency of pain, to verify the measures adopted for pain relief during the first seven days of hospitalization in the Neonatal Intensive Care Unit and to identify the type and frequency of invasive procedures to which newborns are submitted. cross-sectional retrospective study. Out of the 188 hospitalizations occurred during the 12-month period, 171 were included in the study. The data were collected from the charts and the presence of pain was analyzed based on the Neonatal Infant Pain Scale and on nursing notes suggestions of pain. For statistical analysis, the Statistical Package for the Social Sciences was used, and the significance level was set at 5%. there was at least one record of pain in 50.3% of the hospitalizations, according to the pain scale adopted or nursing note. The newborns underwent a mean of 6.6 invasive procedures per day. Only 32.5% of the pain records resulted in the adoption of pharmacological or non-pharmacological intervention for pain relief. newborns are frequently exposed to pain and the low frequency of pharmacological or non-pharmacological interventions reinforces the undertreatment of this condition. determinar a frequência de dor e verificar as medidas realizadas para seu alívio durante os sete primeiros dias de internação na Unidade de Terapia Intensiva Neonatal, bem como identificar o tipo e frequência de procedimentos invasivos aos quais os recém-nascidos foram submetidos. estudo retrospectivo transversal. Das 188 internações ocorridas no período estipulado de 12 meses, 171 foram incluídas na pesquisa. Os dados foram coletados a partir dos prontuários e a presença de dor foi analisada tanto com base na escala de dor Neonatal Infant Pain Scale quanto mediante anotação de enfermagem sugestiva de dor. Para análise estatística, utilizou-se o programa Statistical Package for the Social Sciences, adotando-se nível de significância de 5%. em 50,3% das internações houve ao menos um registro de dor

  3. Manual cross check of computed dose times for motorised wedged fields

    Porte, J.

    2001-01-01

    If a mass of tissue equivalent material is exposed in turn to wedged and open radiation fields of the same size, for equal times, it is incorrect to assume that the resultant isodose pattern will be effectively that of a wedge having half the angle of the wedged field. Computer programs have been written to address the problem of creating an intermediate wedge field, commonly known as a motorized wedge. The total exposure time is apportioned between the open and wedged fields, to produce a beam modification equivalent to that of a wedged field of a given wedge angle. (author)

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

    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.

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

    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

  6. Dose field research of analysis room for in-hospital neutron irradiator

    Zhang Zizhu; Song Mingzhe; Li Wei; Chen Jun; Yang Yong; Li Yiguo

    2012-01-01

    Neutron equivalent dose rate and y ray dose rate inside the analysis room of the in-hospital neutron irradiator (IHNI) and outdoor were measured. The results show that γ ray dose rate inside the analysis room exceeds calculation value many times and γ/ ray dose rate outdoor is higher than supervision region dose limit of 7.5 μSv/h. According to the measurement results and the Monte Carlo simulation, the following shielding plan was adopted. Lead shielding with thickness of 16 cm was installed on the wall, which faces the neutron beam, to shield γ ray, and lithium polyethylene plate with thickness of l cm was installed on all the wall (not including ceiling and floor) to shield scattering neutron. After shielding transformation, the highest γ ray dose rate point inside the analysis room decreased 277 times, the neutron equivalent dose rate decreased 5.8 times, and the outdoor γ/ray dose rate decreased nearly 90 times. (authors)

  7. Performance studies of varian VPM-154D.6D VPM-154A/1.6L static crossed field photomultipliers

    Lo, C.C.; Leskovar, B.

    1977-01-01

    Characteristics have been measured for the Varian VPM-154D.6D and VPM-154A/1.6L Static Crossed Field Photomultipliers. Some typical photomultiplier characteristics such as: gain, dark current, quantum efficiency, and rise-time--are compared with data provided by the manufacturer. Photomultiplier characteristics generally not available from the manufacturer, such as: transit time, FWHM of the output pulse, peak output current measurement and multiphotoelectron time resolution were measured and are discussed

  8. 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.

    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

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

    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

  10. 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.

    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.

  11. Effort-reward imbalance and quality of life of healthcare workers in military hospitals: a cross-sectional study

    Tzeng Dong-Sheng

    2012-09-01

    Full Text Available Abstract Background Taiwan’s National Defense Bureau has been merging its hospitals and adjusting hospital accreditation levels since the beginning of 2006. These changes have introduced many stressors to the healthcare workers in these hospitals. This study investigates the association between job stress, psychological morbidity and quality of life in healthcare workers in three military hospitals. Methods We posted surveys to 1269 healthcare workers in three military hospitals located in southern Taiwan. The surveys included the General Health Questionnaire (GHQ, the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF, and the Effort-Reward Imbalance (ERI Questionnaire. High effort-reward (ER ratio and overcommitment were defined when scores fell into the upper tertile of the total distribution. Results The survey was completed by 791 healthcare workers. On average, women reported a higher ERI than men. High ERI was associated with younger age, higher psychological morbidity, and poor physical and psychological QOL domains in this population. High ER ratio and high overcommitment were associated with psychological morbidity and poor QOL in both sexes. However, high ER ratio was not significantly associated with the social QOL domain in either sexes or the physical QOL domain in males. Conclusions There was a clear association between ERI and QOL in the healthcare workers in the military hospitals under reorganization and accreditation in this study. We found ER ratio and overcommitment to be suitable indicators of job stress.

  12. Different elution modes and field programming in gravitational field-flow fractionation IV. Field programming achieved with channels of non-constant cross-sections

    Plocková, Jana; Matulík, František; Chmelík, Josef

    2002-01-01

    Roč. 955, č. 1 (2002), s. 95-103 ISSN 0021-9673 R&D Projects: GA AV ČR IAA4031805 Institutional research plan: CEZ:AV0Z4031919 Keywords : gravitational field-flow fractionation * field programming * hydrodynamic lift forces Subject RIV: CB - Analytical Chemistry, Separation Impact factor: 3.098, year: 2002

  13. Prospects for the Cross-Border Cooperation between Russia and Poland in the Field of Tourism

    Zaitseva, Natalia A.; Korneevets, Valentin S.; Semenova, Lyudmila V.

    2016-01-01

    The relevance of the research topic is driven by the increasing role of cross-border cooperation for economic development of regions of the neighbouring countries located in the immediate vicinity to the border, as well as for the tourism development. The purpose of scientific research, the results of which are presented in the article, was the…

  14. Unsteady thermal field in bars of doubly connected cross section with heat generation

    Ercoli, L.; Laura, P.A.A.; Grossi, R.O.; Sanchez Sarmiento, G.

    1985-01-01

    The title problem is approximately solved by means of a variational formulation. It is shown that in the case of complicated boundary shapes of the cross section, the technique of conformal mapping is, sometimes, quite advantageous. The analytical predictions are compared with the results obtained by means of the finite element method and, in general, good engineering agreement is shown to exist. (orig.)

  15. Nurse Level of Education, Quality of Care and Patient Safety in the Medical and Surgical Wards in Malaysian Private Hospitals: A Cross-sectional Study.

    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.

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

    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

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

    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.

  18. Identifying research fields within business and management: a journal cross-citation analysis

    Mingers, J.; Leydesdorff, L.

    2015-01-01

    A discipline such as business and management (B&M) is very broad and has many fields within it, ranging from fairly scientific ones such as management science or economics to softer ones such as information systems. There are at least three reasons why it is important to identify these sub-fields

  19. Psycho-Physiological Associates of Dyspnea in Hospitalized Patients with Interstitial Lung Diseases: A Cross-Sectional Study.

    Zhou, Yan Hua; Mak, Yim Wah

    2017-10-24

    Dyspnea has been found to be an independent predictor of mortality among patients with respiratory diseases and is often regarded as a difficult symptom to control in patients with interstitial lung diseases (ILDs). Previous studies have found an association of psychological and physiological factors with dyspnea among patients with chronic obstructive airway diseases. However, symptom management of hospitalized patients with ILDs has been hampered by difficulty in priority, since they are often admitted with multiple psycho-physiological needs. This study examined the prevalence of dyspnea and the psycho-physiological factors associated with it among hospitalized Chinese patients with ILDs. We studied 165 hospitalized patients with ILDs recruited consecutively over three months in a public hospital in Guangzhou, China. Dyspnea and common psycho-physiological factors, including cough symptoms, activity capacity, lung function, physical and mental health status, and anxiety and depression symptoms, were measured. By ordered logistic regression, level of dyspnea statistically significantly affected performance in a six-minute walk test and physical functioning in work or other regular daily activities in hospitalized patients with ILDs. Respiratory rehabilitation with an appropriate intensity of exercise training or other strategies for enhancing the physical functioning of this population with moderate and severe levels of dyspnea should be prioritized.

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

    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.

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

    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.

  2. 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.

    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.

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

    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.

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

    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.

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

    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.

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

    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.

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

    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

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

    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

  9. Can the large-scale magnetic field lines cross the spiral arms in our Milky Way galaxy?

    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

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

    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.

  11. Nudging Healthier Choices in a Hospital Cafeteria: Results From a Field Study.

    Mazza, Mary Carol; Dynan, Linda; Siegel, Robert M; Tucker, Anita L

    2017-11-01

    More than two thirds of adults and one third of children are overweight or obese in the United States. These trends have led to initiatives to provide information that supports informed choices. Traffic light labeling has been shown to increase consumer awareness and encourage healthy selections. This article contributes to the literature on healthy choices by comparing the additional contribution of a number of interventions used in combination with traffic light labeling. We conducted a 21-month field study in a workplace cafeteria. We analyzed cash register receipts, focusing on sales of beverages and chips. We found that the traffic light system was effective. The addition of caloric information to traffic light labeling had a positive effect on the purchase of healthy chips. However, other interventions appeared to produce more harm than good, essentially wiping out the benefits from traffic light labeling. These findings suggest that although it is possible to improve on traffic light labeling with selective interventions, caution is in order as some interventions may trigger compensatory behavior that results in the purchase of unhealthy items.

  12. Integral equation and simulation studies of a planar nematogenic liquid in crossed external fields

    Lado, F; Lomba, E; MartIn, C; Almarza, N G

    2005-01-01

    We study a fluid of nematogenic molecules with centres of mass constrained to lie in a plane but with axes free to rotate in any direction. An external disorienting field perpendicular to the plane along with a second orienting field in the plane induce an in-plane order-disorder transition. We analyse the behaviour of this simple biaxial model using a well-established generalization of molecular integral equation methods built upon specially tailored basis functions that maintain orthogonality in the presence of anisotropy. Computer simulation and integral equation calculations predict an isotropic-nematic transition at low temperatures in zero field and an in-plane transition at somewhat higher temperatures in the presence of the disorienting field. The oriented states obtained in the presence of both fields can subsequently be used as input to uncover in detail first the transition in the absence of the in-plane orienting field and finally the spontaneous transition in the absence of any field. According to the simulation, the transition apparently belongs to the Berezinskii-Kosterlitz-Thouless defect-mediated type, whereas the theory reproduces a weak first-order transition

  13. Development of a patient safety climate survey for Chinese hospitals: cross-national adaptation and psychometric evaluation.

    Zhu, Junya; Li, Liping; Zhao, Hailei; Han, Guangshu; Wu, Albert W; Weingart, Saul N

    2014-10-01

    Existing patient safety climate instruments, most of which have been developed in the USA, may not accurately reflect the conditions in the healthcare systems of other countries. To develop and evaluate a patient safety climate instrument for healthcare workers in Chinese hospitals. Based on a review of existing instruments, expert panel review, focus groups and cognitive interviews, we developed items relevant to patient safety climate in Chinese hospitals. The draft instrument was distributed to 1700 hospital workers from 54 units in six hospitals in five Chinese cities between July and October 2011, and 1464 completed surveys were received. We performed exploratory and confirmatory factor analyses and estimated internal consistency reliability, within-unit agreement, between-unit variation, unit-mean reliability, correlation between multi-item composites, and association between the composites and two single items of perceived safety. The final instrument included 34 items organised into nine composites: institutional commitment to safety, unit management support for safety, organisational learning, safety system, adequacy of safety arrangements, error reporting, communication and peer support, teamwork and staffing. All composites had acceptable unit-mean reliabilities (≥0.74) and within-unit agreement (Rwg ≥0.71), and exhibited significant between-unit variation with intraclass correlation coefficients ranging from 9% to 21%. Internal consistency reliabilities ranged from 0.59 to 0.88 and were ≥0.70 for eight of the nine composites. Correlations between composites ranged from 0.27 to 0.73. All composites were positively and significantly associated with the two perceived safety items. The Chinese Hospital Survey on Patient Safety Climate demonstrates adequate dimensionality, reliability and validity. The integration of qualitative and quantitative methods is essential to produce an instrument that is culturally appropriate for Chinese hospitals

  14. The trend of pressure ulcer prevalence rates in German hospitals: results of seven cross-sectional studies.

    Kottner, Jan; Wilborn, Doris; Dassen, Theo; Lahmann, Nils

    2009-05-01

    Pressure ulcer prevalence rates provide useful information about the magnitude of this health problem. Only limited information on pressure ulcers in Germany was available before 2001. The purpose of this study was to compare results of seven pressure ulcer prevalence surveys which were conducted annually between 2001 and 2007 and to explore whether pressure ulcer prevalence rates decreased. The second aim was to evaluate if the measured prevalence rates of our sample could be generalised for all German hospitals. Results of seven point pressure ulcer prevalence studies conducted in 225 German hospitals were analysed. Chi-square tests, chi-square trend tests and one-way ANOVA to assess differences and trends across the years were applied. The sample was stratified according to pressure ulcer risk and speciality. Finally, study samples were compared with the potential population. In total data of 40,247 hospital patients were analysed. The overall pressure ulcer prevalence rate in German hospitals was 10.2%. Patient samples of each year were comparable regarding gender, age and pressure ulcer risk. Pressure ulcer prevalence rates decreased from 13.9% (year 2001) to 7.3% (year 2007) (pcare units remained stable. With some limitations our study results are representative for all hospitals within Germany. It is highly probable that the decrease of prevalence rates was due to an increased awareness of the pressure ulcer problem in Germany and subsequent efforts to improve pressure ulcer prevention and treatment. The quality of clinical practice regarding pressure ulcer prevention and treatment has improved. However, pressure ulcers are still relevant and require attention. In 2007, one out of 10 hospital patients who were at pressure ulcer risk had at least one pressure related skin damage.

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

    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)

  16. 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

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

    2013-01-01

    Background: 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 accre...

  17. Suicide Risk, Meaning in Life, and Need for Life Respect in Adults and Elderly Among Public Hospital Outpatients in South Korea: A Cross-Sectional Survey.

    Kang, Kyung-Ah; Kim, Shin-Jeong; Kim Ellis, Hyon

    2017-01-01

    The purpose of this study was to identify the differences in suicide risk, meaning in life, and need for life respect among three age groups (young adults, the middle aged, and the elderly) of 540 public hospital outpatients in South Korea. This was a cross-sectional study. Among these 3 age groups, we observed significant differences in suicide risk, meaning in life, and need for life respect according to education level, marital status, living arrangements, type of disease, gender, and monthly income. These findings might contribute to the prevention of suicide in the future and the implementation of better community-based nursing care.

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

    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.

  19. Field performance of timber bridges. 4, Graves Crossing stress-laminated deck bridge

    J. P. Wacker; M. A. Ritter

    The Graves Crossing bridge was constructed October 1991 in Antrim County, Michigan, as part of the demonstration timber bridge program sponsored by the USDA Forest Service. The bridge is a two-span continuous, stress-laminated deck superstructure and it is 36-ft long and 26-ft wide. The bridge is one of the first stress-laminated deck bridges to be built of sawn lumber...

  20. A cross-case analysis of three Native Science Field Centers

    Augare, Helen J.; Davíd-Chavez, Dominique M.; Groenke, Frederick I.; Little Plume-Weatherwax, Melissa; Lone Fight, Lisa; Meier, Gene; Quiver-Gaddie, Helene; Returns From Scout, Elvin; Sachatello-Sawyer, Bonnie; St. Pierre, Nate; Valdez, Shelly; Wippert, Rachel

    2017-06-01

    Native Science Field Centers (NSFCs) were created to engage youth and adults in environmental science activities through the integration of traditional Native ways of knowing (understanding about the natural world based on centuries of observation including philosophy, worldview, cosmology, and belief systems of Indigenous peoples), Native languages, and Western science concepts. This paper focuses on the Blackfeet Native Science Field Center, the Lakota Native Science Field Center, and the Wind River Native Science Field Center. One of the long-term, overarching goals of these NSFCs was to stimulate the interest of Native American students in ways that encouraged them to pursue academic and career paths in science, technology, engineering, and mathematics (STEM) fields. A great deal can be learned from the experiences of the NSFCs in terms of effective educational strategies, as well as advantages and challenges in blending Native ways of knowing and Western scientific knowledge in an informal science education setting. Hopa Mountain—a Bozeman, Montana-based nonprofit—partnered with the Blackfeet Community College on the Blackfeet Reservation, Fremont County School District #21 on the Wind River Reservation, and Oglala Lakota College on the Pine Ridge Reservation to cooperatively establish the Native Science Field Centers. This paper presents a profile of each NSFC and highlights their program components and accomplishments.

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

    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

  2. Overweight, obesity and related conditions: a cross-sectional study of adult inpatients at a Norwegian Hospital

    2014-01-01

    Background Overweight, obesity and associated conditions are major public health concerns in Norway. The prevalence of overweight and obesity in the general population in Norway is increasing, but there are limited data on how the situation is in hospitals. This study aimed to find the prevalence of overweight and obesity, and explore the associations of overweight, obesity and its related medical conditions in an adult in-patient sample at specified somatic and psychiatric departments at St. Olavs Hospital, Trondheim. Results A total of 497 patients participated. The mean BMI for the total sample at screening was 25.4 kg/m2. The prevalence of overweight and obesity was 45.1%. There was a higher association of overweight and obesity among patients aged 40–59 years (OR: 1.7) compared to those being younger. There was no significant difference between the somatic and the psychiatric samples. In the somatic sample overweight and obesity was associated with obesity-related conditions for both genders (OR: 2.0 and 2.1, respectively), when adjusted for age. Conclusion The substantial prevalence of overweight and obese patients may pose a threat to future hospital services. To further address the burden of overweight and obesity in hospitals, we need more knowledge about consequences of length of stay, use of resources and overall cost. PMID:24571809

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

    Grimes, Tamasine C

    2011-03-01

    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.

  4. Cross Infection in Hospital Wards with Downward Ventilation - Different Locations of Return Openings without and with Partitions between Beds

    Nielsen, Peter V.; Li, Yuguo; Buus, Morten

    2009-01-01

    A two-bed hospital ward with one standing healthcare assistant and a ceiling-mounted low-impulse semicircular inlet diffuser is simulated in a full-scale room. Tracer gas is used for simulating gaseous contaminants, and the concentration is measured at different air change rates and different pos...

  5. Children in hospital in Ireland - what do they eat and what do they weigh: a cross-sectional study

    Flinn Aisling

    2012-09-01

    Full Text Available Abstract Background Overweight and obesity is a growing problem in Ireland. Many parents are unaware when their child is overweight or obese. Our objectives were to examine parents’ perceptions of a healthy diet and their children’s BMI; and to evaluate the food offered to children in our paediatric in-patient unit. Findings A retrospective questionnaire was distributed to 95 patients and their families admitted over one month. Seventy-eight had BMI values calculated (42 males, 36 females. Twenty-one children (26.9% were overweight/obese: 14/21 parents (66.7% thought their child had a normal weight. Sixty percent of children served dinner in the hospital were given fried potatoes. Four had fruit/vegetables. Forty-six parents brought food into hospital, of these 14 brought purchased food. Conclusions This study highlights the problem of child obesity in Ireland and parental underestimation of this problem. The nutritional value of food served to children in hospital needs to be improved and hospital admissions used as opportunities to promote healthy eating habits.

  6. Barriers to Research Utilization among Registered Nurses in Traditional Chinese Medicine Hospitals: A Cross-Sectional Survey in China

    Fen Zhou

    2015-01-01

    Full Text Available Background. As there might be relevant differences with regard to research utilization in the general hospitals, we aimed to study research utilization among registered nurses working in traditional Chinese medicine hospitals. Methods. A total of 648 registered nurses from 4 tertiary-level hospitals in China were recruited for participation. A modified BARRIERS Scale and self-designed questionnaires were used for data collection. Data were analyzed with descriptive statistics, t-tests, and one-way ANOVAs and Spearman correlation analysis. Results. Overall, items which belong to the subscale “Research” were identified as the most important barriers. Among the individual items, the lack of time on the job was ranked as the top barrier, followed by the lack of knowledgeable colleagues and by overwhelming research publications. Clinical experience, working pressure, job satisfaction, and research experience could be identified as associated factors for barriers to research utilization. Conclusions. Registered nurses in traditional Chinese medicine hospitals felt high barriers to research utilization. Reducing registered nurses’ working pressure, promoting their positive attitude to nursing, and improving research training might be helpful for increasing research utilization. Close cooperation between clinical and nursing schools or academic research centres might facilitate the necessary change in nursing education and routine.

  7. Children in hospital in Ireland - what do they eat and what do they weigh: a cross-sectional study

    Flinn, Aisling

    2012-09-06

    AbstractBackgroundOverweight and obesity is a growing problem in Ireland. Many parents are unaware when their child is overweight or obese. Our objectives were to examine parents’ perceptions of a healthy diet and their children’s BMI; and to evaluate the food offered to children in our paediatric in-patient unit.FindingsA retrospective questionnaire was distributed to 95 patients and their families admitted over one month. Seventy-eight had BMI values calculated (42 males, 36 females). Twenty-one children (26.9%) were overweight\\/obese: 14\\/21 parents (66.7%) thought their child had a normal weight. Sixty percent of children served dinner in the hospital were given fried potatoes. Four had fruit\\/vegetables. Forty-six parents brought food into hospital, of these 14 brought purchased food.ConclusionsThis study highlights the problem of child obesity in Ireland and parental underestimation of this problem. The nutritional value of food served to children in hospital needs to be improved and hospital admissions used as opportunities to promote healthy eating habits.

  8. The intrinsic crossing point of the magnetization vs. temperature curves in superconducting cuprates in the high-magnetic-field limit

    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.)

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

    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.

  10. Measuring the electric field of few-cycle laser pulses by attosecond cross correlation

    Bandrauk, Andre D.; Chelkowski, Szczepan; Shon, Nguyen Hong

    2002-01-01

    A new technique for directly measuring the electric field of linearly polarized few-cycle laser pulses is proposed. Based on the solution of the time-dependent Schroedinger equation (TDSE) for an H atom in the combined field of infrared (IR) femtosecond (fs) and ultraviolet (UV) attosecond (as) laser pulses we show that, as a function of the time delay between two pulses, the difference (or equivalently, asymmetry) of photoelectron signals in opposite directions (along the polarization vector of laser pulses) reproduces very well the profile of the electric field (or vector potential) in the IR pulse. Such ionization asymmetry can be used for directly measuring the carrier-envelope phase difference (i.e., the relative phase of the carrier frequency with respect to the pulse envelope) of the IR fs laser pulse

  11. Chain of Dirac spectrum loops of nodes in crossed magnetic and electric fields

    Gavrilenko, V. I.; Perov, A. A.; Protogenov, A. P.; Turkevich, R. V.; Chulkov, E. V.

    2018-03-01

    New semimetal systems along with Dirac and Weyl semimetals contain compounds, in which the energy of electron excitations vanishes not at nodes but on lines. A higher dimension of the degeneracy space changes many physical properties. We consider a chain of loops consisting of Dirac spectrum nodes in nonsymmorphic crystalline compounds placed in external mutually perpendicular magnetic and electric fields. An exact solution for the spectrum is obtained under the assumption of particle-hole symmetry. An analysis of this spectrum shows the existence of a line of critical values of the magnetic and electric fields, at which a quantum phase transition to a gapless state occurs. The use of the obtained spectrum allows also predicting a number of new oscillation and resonance effects in the field of magneto-optical phenomena.

  12. Probabilistic Cross-identification in Crowded Fields as an Assignment Problem

    Budavári, Tamás; Basu, Amitabh

    2016-10-01

    One of the outstanding challenges of cross-identification is multiplicity: detections in crowded regions of the sky are often linked to more than one candidate associations of similar likelihoods. We map the resulting maximum likelihood partitioning to the fundamental assignment problem of discrete mathematics and efficiently solve the two-way catalog-level matching in the realm of combinatorial optimization using the so-called Hungarian algorithm. We introduce the method, demonstrate its performance in a mock universe where the true associations are known, and discuss the applicability of the new procedure to large surveys.

  13. PROBABILISTIC CROSS-IDENTIFICATION IN CROWDED FIELDS AS AN ASSIGNMENT PROBLEM

    Budavári, Tamás; Basu, Amitabh, E-mail: budavari@jhu.edu, E-mail: basu.amitabh@jhu.edu [Dept. of Applied Mathematics and Statistics, Johns Hopkins University, 3400 N. Charles St., MD 21218 (United States)

    2016-10-01

    One of the outstanding challenges of cross-identification is multiplicity: detections in crowded regions of the sky are often linked to more than one candidate associations of similar likelihoods. We map the resulting maximum likelihood partitioning to the fundamental assignment problem of discrete mathematics and efficiently solve the two-way catalog-level matching in the realm of combinatorial optimization using the so-called Hungarian algorithm. We introduce the method, demonstrate its performance in a mock universe where the true associations are known, and discuss the applicability of the new procedure to large surveys.

  14. PROBABILISTIC CROSS-IDENTIFICATION IN CROWDED FIELDS AS AN ASSIGNMENT PROBLEM

    Budavári, Tamás; Basu, Amitabh

    2016-01-01

    One of the outstanding challenges of cross-identification is multiplicity: detections in crowded regions of the sky are often linked to more than one candidate associations of similar likelihoods. We map the resulting maximum likelihood partitioning to the fundamental assignment problem of discrete mathematics and efficiently solve the two-way catalog-level matching in the realm of combinatorial optimization using the so-called Hungarian algorithm. We introduce the method, demonstrate its performance in a mock universe where the true associations are known, and discuss the applicability of the new procedure to large surveys.

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

    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)

  16. The Use of Mobile Health Applications to Improve Patient Experience: Cross-Sectional Study in Chinese Public Hospitals.

    Lu, Chuntao; Hu, Yinhuan; Xie, Jinzhu; Fu, Qiang; Leigh, Isabella; Governor, Samuel; Wang, Guanping

    2018-05-23

    The proliferation of mobile health apps has greatly changed the way society accesses the health care industry. However, despite the widespread use of mobile health apps by patients in China, there has been little research that evaluates the effect of mobile health apps on patient experience during hospital visits. The purpose of our study was to examine whether the use of mobile health apps improves patient experience and to find out the difference in patient experience between users and nonusers and the characteristics associated with the users of these apps. We used the Chinese Outpatient Experience Questionnaire to survey patient experience. A sample of 300 outpatients was randomly selected from 3 comprehensive public hospitals (3 tertiary hospitals) in Hubei province, China. Each hospital randomly selected 50 respondents from mobile health app users and 50 from nonusers. A chi-square test was employed to compare the different categorical characteristics between mobile health app users and nonusers. A t test was used to test the significance in continuous variables between user scores and nonuser scores. Multiple linear regression was conducted to determine whether the use of mobile health apps during hospital visits was associated with patient experience. The users and nonusers differed in age (χ 2 2 =12.2, P=.002), education (χ 2 3 =9.3, P=.03), living place (χ 2 1 =7.7, P=.006), and the need for specialists (χ 2 4 =11.0, P=.03). Compared with nonusers, mobile health app users in China were younger, better educated, living in urban areas, and had higher demands for specialists. In addition, mobile health app users gave significantly higher scores than nonusers in total patient experience scores (t 298 =3.919, Pmobile health apps during hospital visits influenced patient experience (t 289 =3.143, P=.002). After controlling for other factors, it was shown that the use of mobile health apps increased the outpatient experience scores by 17.7%. Additional

  17. Magnetic flux density distribution in superconducting cylinders of arbitrary cross section subjected to an axial magnetic field

    Fournet, G.

    1982-07-01

    We show here how the application of the critical state model allows one to determine the magnetic flux density B⃗ in each point of a superconducting cylinder with an arbitrary cross section subjected to axial magnetic fields Hz; the B = 0 boundaries of the regions occupied by the vortices are so defined. We successively consider the cases where the critical current density Jc is either isotropic (constant or an arbitrary function of B) or tensorial, which means, for our problem, the use of two components Jcx and Jcy (either constant or depending on B but Jcx/Jcy remaining constant).

  18. Effect of δ meson and ρ-ω cross couplings in effective field theory motivated Lagrangian approach

    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

  19. Let’s have a meeting: How hospitals use scheduled meetings to support cross-boundary collaboration

    Prætorius, Thim; Hasle, Peter; Nielsen, Anders Paarup

    2018-01-01

    of meetings, we add to previous research studying when meetings are used (e.g., task and input uncertainty). In particular, we focus on meetings’ role for achieving collaboration across occupational and departmental boundaries and for developing the collaboration skills component of organizational social...... and help those involved to solve concrete care tasks. Meetings are often inter-disciplinary, thereby having the potential to develop relations, common goals and trust (organizational social capital components) across occupational and departmental boundaries. For hospital managers, our findings...... are important because they can use meetings to respond to the pressing need for more and better intra-organizational health care collaboration. Using meetings sensibly also allows hospitals to benefit from the positive outcomes of collaboration and social capital (e.g., knowledge sharing, performance...

  20. Psychogenic Stress in Hospitalized Dogs: Cross Species Comparisons, Implications for Health Care, and the Challenges of Evaluation

    Jessica P. Hekman

    2014-06-01

    Full Text Available Evidence to support the existence of health consequences of psychogenic stress has been documented across a range of domestic species. A general understanding of methods of recognition and means of mitigation of psychogenic stress in hospitalized animals is arguably an important feature of the continuing efforts of clinicians to improve the well-being and health of dogs and other veterinary patients. The intent of this review is to describe, in a variety of species: the physiology of the stress syndrome, with particular attention to the hypothalamic-pituitary-adrenal axis; causes and characteristics of psychogenic stress; mechanisms and sequelae of stress-induced immune dysfunction; and other adverse effects of stress on health outcomes. Following that, we describe general aspects of the measurement of stress and the role of physiological measures and behavioral signals that may predict stress in hospitalized animals, specifically focusing on dogs.

  1. Cross-cultural adaptation into Punjabi of the English version of the Hospital Anxiety and Depression Scale

    Taylor Rod S

    2007-01-01

    Full Text Available Abstract Background We wanted to use a Punjabi version of the Hospital Anxiety and Depression Scale (HADS to enable non-English speaking patients to participate in a clinical trial. The aim of the study was to translate and validate the Hospital Anxiety and Depression Scale into Punjabi. Methods The HADS was translated into Punjabi by a multidisciplinary team, verified against the original version, and administered to 73 bilingual patients attending an outpatient clinic. Results One sample t-tests and the Bland-Altman plots demonstrated acceptable linguistic agreement between the two versions of the HADS. Spearman's rank-order correlation coefficients (p Conclusion The Punjabi HADS is an acceptable, reliable and valid measure of anxiety and depression among physically ill Punjabi speaking people in the United Kingdom.

  2. Extension of HPM Pulse Duration by Cesium Iodide Cathodes in Crossed Field Devices

    Benford, James

    1998-01-01

    .... The introduction of cathodes made from Cesium Iodide-coated (CsI) carbon fiber has shown plasma speeds reduced by factors of a few from uncoated carbon fiber, but previous work was at low diode fields of a few 10's of kV/cm...

  3. Comparison of two self-reported measures of physical work demands in hospital personnel: A cross-sectional study

    Jensen Jette N

    2008-04-01

    Full Text Available Abstract Background Low back pain (LBP is a frequent health complaint among health care personnel. Several work tasks and working postures are associated with an increased risk of LBP. The aim of this study was to compare two self-reported measures of physical demands and their association with LBP (the daily number of patient handling tasks and Hollmann's physical load index. Methods A questionnaire was distributed to 535 hospital employees in a psychiatric and an orthopedic ward in a Danish hospital. Of these 411 (77% filled in and returned the questionnaire. Only the 373 respondents who had non-missing values on both measures of physical demands were included in the analyses. The distribution of physical demands in different job groups and wards are presented, variance analysis models are employed, and logistic regression analysis is used to analyze the association between measures of physical demands and LBP. Results In combination, hospital ward and job category explained 56.6% and 23.3% of the variance in the self-reported physical demands measured as the daily number of patient handling tasks and as the score on the physical load index, respectively. When comparing the 6% with the highest exposure the prevalence odds ratio (POR for LBP was 5.38 (95% CI 2.03–14.29 in the group performing more than 10 patient handling tasks per day and 2.29 (95% CI 0.93–5.66 in the group with the highest score on the physical load index. Conclusion In specialized hospital wards the daily number of patient handling tasks seems to be a more feasible measure of exposure when assessing the risk of LBP compared to more advanced measures of physical load on the lower lumbar spine.

  4. Epidemiology of Clostridium difficile infection in two tertiary-care hospitals in Perth, Western Australia: a cross-sectional study

    N.F. Foster

    2014-05-01

    Full Text Available The epidemiology of Clostridium difficile infection (CDI has changed over time and between countries. It is therefore essential to monitor the characteristics of patients at risk of infection and the circulating strains to recognize local and global trends, and improve patient management. From December 2011 to May 2012 we conducted a prospective, observational epidemiological study of patients with laboratory-confirmed CDI at two tertiary teaching hospitals in Perth, Western Australia to determine CDI incidence and risk factors in an Australian setting. The incidence of CDI varied from 5.2 to 8.1 cases/10 000 occupied bed days (OBDs at one hospital and from 3.9 to 16.3/10 000 OBDs at the second hospital. In total, 80 patients with laboratory-confirmed CDI met eligibility criteria and consented to be in the study. More than half (53.8% had hospital-onset disease, 28.8% had community-onset and healthcare facility-associated disease and 7.5% were community-associated infections according to the definitions used. Severe CDI was observed in 40.0% of these cases but the 30-day mortality rate for all cases was only 2.5%. Besides a shorter length of stay among cases of community-onset CDI, no characteristics were identified that were significantly associated with community-onset or severe CDI. From 70 isolates, 34 different ribotypes were identified. The predominant ribotypes were 014 (24.3%, 020 (5.7%, 056 (5.7% and 070 (5.7%. Whereas this study suggests that the characteristics of CDI cases in Australia are not markedly different from those in other developed countries, the increase in CDI rate observed emphasizes the importance of surveillance.

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

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

    2015-08-28

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

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

    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.

  7. Clinical characteristics of synthetic cannabinoid-induced psychosis in relation to schizophrenia: a single-center cross-sectional analysis of concurrently hospitalized patients

    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

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

    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

  9. Concern about Workplace Violence and Its Risk Factors in Chinese Township Hospitals: A Cross-Sectional Study

    Kai Xing

    2016-08-01

    Full Text Available Workplace violence in Chinese township hospitals is a major public health problem. We identified the risk factors of healthcare workers’ worry about experiencing workplace violence in 90 Chinese township hospitals and determined specific measures for differing stages of violence (based on crisis management theory. Participants were 440 general practitioners and 398 general nurses from Heilongjiang Province, China (response rate 84.6%. One hundred and six (12.6% respondents reported being physically attacked in their workplace in the previous 12 months. Regarding psychological violence, the most common type reported was verbal abuse (46.0%. While most (85.2% respondents had some degree of worry about suffering violence, 22.1% were worried or very worried. Ordinal regression analysis revealed that being ≤35 years of age, having a lower educational level, having less work experience, and working night shifts were all associated with worry about workplace violence. Furthermore, those without experience of such violence were more likely to worry about it. Respondents’ suggested measures for controlling violence included “widening channels on medical dispute solutions,” “improving doctor-patient communication,” and “advocating for respect for medical workers via the media.” Results suggest the target factors for reducing healthcare workers’ worry by according to the type of education and training and possible measures for limiting workplace violence in township hospitals.

  10. Comparison of two self-reported measures of physical work demands in hospital personnel: a cross-sectional study

    Nabe-Nielsen, Kirsten; Fallentin, Nils; Christensen, Karl B

    2008-01-01

    daily number of patient handling tasks and Hollmann's physical load index). METHODS: A questionnaire was distributed to 535 hospital employees in a psychiatric and an orthopedic ward in a Danish hospital. Of these 411 (77%) filled in and returned the questionnaire. Only the 373 respondents who had non...... the prevalence odds ratio (POR) for LBP was 5.38 (95% CI 2.03-14.29) in the group performing more than 10 patient handling tasks per day and 2.29 (95% CI 0.93-5.66) in the group with the highest score on the physical load index. CONCLUSION: In specialized hospital wards the daily number of patient handling tasks......BACKGROUND: Low back pain (LBP) is a frequent health complaint among health care personnel. Several work tasks and working postures are associated with an increased risk of LBP. The aim of this study was to compare two self-reported measures of physical demands and their association with LBP (the...

  11. Concern about Workplace Violence and Its Risk Factors in Chinese Township Hospitals: A Cross-Sectional Study

    Xing, Kai; Zhang, Xue; Jiao, Mingli; Cui, Yu; Lu, Yan; Liu, Jinghua; Zhang, Jingjing; Zhao, Yuchong; Zhao, Yanming; Li, Ye; Liang, Libo; Kang, Zheng; Wu, Qunhong; Yin, Mei

    2016-01-01

    Workplace violence in Chinese township hospitals is a major public health problem. We identified the risk factors of healthcare workers’ worry about experiencing workplace violence in 90 Chinese township hospitals and determined specific measures for differing stages of violence (based on crisis management theory). Participants were 440 general practitioners and 398 general nurses from Heilongjiang Province, China (response rate 84.6%). One hundred and six (12.6%) respondents reported being physically attacked in their workplace in the previous 12 months. Regarding psychological violence, the most common type reported was verbal abuse (46.0%). While most (85.2%) respondents had some degree of worry about suffering violence, 22.1% were worried or very worried. Ordinal regression analysis revealed that being ≤35 years of age, having a lower educational level, having less work experience, and working night shifts were all associated with worry about workplace violence. Furthermore, those without experience of such violence were more likely to worry about it. Respondents’ suggested measures for controlling violence included “widening channels on medical dispute solutions,” “improving doctor-patient communication,” and “advocating for respect for medical workers via the media.” Results suggest the target factors for reducing healthcare workers’ worry by according to the type of education and training and possible measures for limiting workplace violence in township hospitals. PMID:27517949

  12. Predictors of job satisfaction among nurses working in Ethiopian public hospitals, 2014: institution-based cross-sectional study.

    Semachew, Ayele; Belachew, Tefera; Tesfaye, Temamen; Adinew, Yohannes Mehretie

    2017-04-24

    Nurses play a pivotal role in determining the efficiency, effectiveness, and sustainability of health care systems. Nurses' job satisfaction plays an important role in the delivery of quality health care. There is paucity of studies addressing job satisfaction among nurses in the public hospital setting in Ethiopia. Thus, this study aimed to assess job satisfaction and factors influencing it among nurses in Jimma zone public hospitals, southwestern Ethiopia. An institution-based census was conducted among 316 nurses working in Jimma zone public hospitals from March to April, 2014. A structured self-administered questionnaire based on a modified version of the McCloskey/Mueller Satisfaction Scale was used. Data were entered using Epi Info version 3.5.3 statistical software and analyzed using SPSS version 20 statistical package. Mean satisfaction scores were compared by independent variables using an independent sample t test and ANOVA. Bivariate and multivariable linear regressions were done. A total of 316 nurses were included, yielding a response rate of 92.67%. The overall mean job satisfaction was (67.43 ± 13.85). One third (33.5%) of the study participants had a low level of job satisfaction. Mutual understandings at work and professional commitment showed significant and positive relationship with overall job satisfaction, while working at an inpatient unit and work load were negatively associated. One third of nurses had a low level of job satisfaction. Professional commitment, workload, working unit, and mutual understanding at work predicted the outcome variable.

  13. Concern about Workplace Violence and Its Risk Factors in Chinese Township Hospitals: A Cross-Sectional Study.

    Xing, Kai; Zhang, Xue; Jiao, Mingli; Cui, Yu; Lu, Yan; Liu, Jinghua; Zhang, Jingjing; Zhao, Yuchong; Zhao, Yanming; Li, Ye; Liang, Libo; Kang, Zheng; Wu, Qunhong; Yin, Mei

    2016-08-10

    Workplace violence in Chinese township hospitals is a major public health problem. We identified the risk factors of healthcare workers' worry about experiencing workplace violence in 90 Chinese township hospitals and determined specific measures for differing stages of violence (based on crisis management theory). Participants were 440 general practitioners and 398 general nurses from Heilongjiang Province, China (response rate 84.6%). One hundred and six (12.6%) respondents reported being physically attacked in their workplace in the previous 12 months. Regarding psychological violence, the most common type reported was verbal abuse (46.0%). While most (85.2%) respondents had some degree of worry about suffering violence, 22.1% were worried or very worried. Ordinal regression analysis revealed that being ≤35 years of age, having a lower educational level, having less work experience, and working night shifts were all associated with worry about workplace violence. Furthermore, those without experience of such violence were more likely to worry about it. Respondents' suggested measures for controlling violence included "widening channels on medical dispute solutions," "improving doctor-patient communication," and "advocating for respect for medical workers via the media." Results suggest the target factors for reducing healthcare workers' worry by according to the type of education and training and possible measures for limiting workplace violence in township hospitals.

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

    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

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

    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

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

    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

  17. High-field EPR on membrane proteins - crossing the gap to NMR.

    Möbius, Klaus; Lubitz, Wolfgang; Savitsky, Anton

    2013-11-01

    In this review on advanced EPR spectroscopy, which addresses both the EPR and NMR communities, considerable emphasis is put on delineating the complementarity of NMR and EPR concerning the measurement of molecular interactions in large biomolecules. From these interactions, detailed information can be revealed on structure and dynamics of macromolecules embedded in solution- or solid-state environments. New developments in pulsed microwave and sweepable cryomagnet technology as well as ultrafast electronics for signal data handling and processing have pushed to new horizons the limits of EPR spectroscopy and its multifrequency extensions concerning the sensitivity of detection, the selectivity with respect to interactions, and the resolution in frequency and time domains. One of the most important advances has been the extension of EPR to high magnetic fields and microwave frequencies, very much in analogy to what happens in NMR. This is exemplified by referring to ongoing efforts for signal enhancement in both NMR and EPR double-resonance techniques by exploiting dynamic nuclear or electron spin polarization via unpaired electron spins and their electron-nuclear or electron-electron interactions. Signal and resolution enhancements are particularly spectacular for double-resonance techniques such as ENDOR and PELDOR at high magnetic fields. They provide greatly improved orientational selection for disordered samples that approaches single-crystal resolution at canonical g-tensor orientations - even for molecules with small g-anisotropies. Exchange of experience between the EPR and NMR communities allows for handling polarization and resolution improvement strategies in an optimal manner. Consequently, a dramatic improvement of EPR detection sensitivity could be achieved, even for short-lived paramagnetic reaction intermediates. Unique structural and dynamic information is thus revealed that can hardly be obtained by any other analytical techniques. Micromolar

  18. National audit of pressure ulcers and incontinence-associated dermatitis in hospitals across Wales: a cross-sectional study.

    Clark, Michael; Semple, Martin J; Ivins, Nicola; Mahoney, Kirsten; Harding, Keith

    2017-08-21

    The Chief Nurse National Health Service Wales initiated a national survey of acute and community hospital patients in Wales to identify the prevalence of pressure ulcers and incontinence-associated dermatitis. Teams of two nurses working independently assessed the skin of each inpatient who consented to having their skin observed. Over 28 September 2015 to 2nd October 2015, 8365 patients were assessed across 66 hospitals with 748 (8.9%) found to have pressure ulcers. Not all patients had their skin inspected with all mental health patients exempt from this part of the audit along with others who did not consent or were too ill. Of the patients with pressure ulcers, 593 (79.3%) had their skin inspected with 158 new pressure ulcers encountered that were not known to ward staff, while 152 pressure ulcers were incorrectly categorised by the ward teams. Incontinence-associated dermatitis was encountered in 360 patients (4.3%), while medical device-related pressure ulcers were rare (n=33). The support surfaces used while patients were in bed were also recorded to provide a baseline against which future changes in equipment procurement could be assessed. The presence of other wounds was also recorded with 2537 (30.3%) of all hospital patients having one or more skin wounds. This survey has demonstrated that although complex, it is feasible to undertake national surveys of pressure ulcers, incontinence-associated dermatitis and other wounds providing comprehensive and accurate data to help plan improvements in wound care across Wales. © 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.

  19. Contributing factors of elective surgical case cancellation: a retrospective cross-sectional study at a single-site hospital.

    Yu, Kaiye; Xie, Xiaolei; Luo, Li; Gong, Renrong

    2017-09-11

    Case cancellation (CC) has significant impact on the efficiency of operating room (OR) management, which can be mitigated by taking preventive measures. In this study, using the data of the West China Hospital (WCH), we identified the effect of contributing factors and recommended hospital interventions to facilitate CC prevention. We conducted a retrospective review of 11,331 elective surgical cases from January 1 to December 31, 2014. CC reasons were grouped into six categories. The methods of descriptive statistics and hypothesis test were used to identify the effect of factors. CC reasons (746) were divided into six broad categories: workup related (preoperative diagnostic assessment issues or sudden medical condition changes) (25.8%), non-specified reasons (25.8%), coordination issues (15.1%), patient related (13.0%), support system issues (11.8%), and doctor related (8.5%). The types of the most frequently performed operations are identified, as well as their CRs. The cancellation rate (CR) of males was lower than that of females (16.7% to 18.3%). A large difference in the CRs existed among doctors. The CR on Monday was significantly higher than the other four weekdays. Workup related issues, the types of procedures, the menstrual cycle of females, highly imbalanced CRs among doctors, and tendency of cancellation on Monday are the major identified factors, which account for a significant amount of preventable cancellations. It is suggested that corresponding hospital interventions can reduce CR and improve OR efficiency, including maintaining effective coordination, good communication and well-designed preoperative assessment processes, focusing on the type of procedures which are more time-consuming and complex, paying special attention to the physiology of females during surgery planning, taking measures to reduce CR of top eight doctors, and improving surgery scheduling on Monday.

  20. Danish and Norwegian hospital social workers’ cross-institutional work amidst inter-sectoral restructuring of health and social welfare

    Søbjerg Nielsen, Ulla; Harsløf, Ivan; Feiring, Marte

    2017-01-01

    , they report increasing difficulties in ‘making their way through’ the state-municipal bureaucracy. However, by drawing on the formal health knowledge derived from medical settings and the symbolic capital it bestows on them, they often manage to negotiate the work-and-welfare services, thereby transforming......-makers have instituted economic incentives to both individuals and the health and welfare organisations who handle them. Through an institutional logics approach, this paper explores how hospital social workers in these countries are experiencing these changes. The ‘social’ part of post-treatment care...

  1. Functional visual fields: a cross-sectional UK study to determine which visual field paradigms best reflect difficulty with mobility function.

    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.

  2. The relationship between work engagement and psychological distress of hospital nurses and the perceived communication behaviors of their nurse managers: A cross-sectional survey.

    Kunie, Keiko; Kawakami, Norito; Shimazu, Akihito; Yonekura, Yuki; Miyamoto, Yuki

    2017-06-01

    Communication between nurse managers and nurses is important for mental health of hospital nurses. The aim of the present study was to investigate the relationship between managers' communication behaviors toward nurses, and work engagement and psychological distress among hospital nurses using a multilevel model. The present study was a cross-sectional questionnaire survey. The participants were nurses working at three hospitals in Japan. A total of 906 nurses from 38 units participated in the present study. The units with small staff sizes and participants with missing entries in the questionnaire were excluded. The data for 789 nurses from 36 questionnaire survey units were analyzed. A survey using a self-administered questionnaire was conducted. The questionnaire asked staff nurses about communication behaviors of their immediate manager and their own levels of work engagement, psychological distress, and other covariates. Three types of manager communication behaviors (i.e., direction-giving, empathetic, and meaning-making language) were assessed using the Motivating Language scale; and the scores of the respondents were averaged for each unit to calculate unit-level scores. Work engagement and psychological distress were measured using the Utrecht Work Engagement Scale and the K6 scale, respectively. The association of communication behaviors by unit-level managers with work engagement and psychological distress among nurses was analyzed using two-level hierarchical linear modeling. The unit-level scores for all three of the manager communication behaviors were significantly and positively associated with work engagement among nurses (pwork environment. The individual levels of all three of the manager communication behaviors were also significantly and positively associated with work engagement (p0.05). Motivating language by unit-level managers might be positively associated with work engagement among hospital nurses, which is mediated through the better

  3. Work related stress and its anticipated solutions among post-graduate medical resident doctors: a cross-sectional survey conducted at a tertiary municipal hospital in Mumbai, India.

    Rajan, Pavithra; Bellare, Bharati

    2011-03-01

    It is now known that resident doctors registered for postgraduate studies are prone to work related stress and eventual burnout. Though stress can happen in any profession, reduced performance of resident doctors due to vocational stress could cause an increase in medical errors and thus affect the quality of life of the patients. Resident doctors at a Municipal hospital in India form a unique population as number of stresses they undergo are many and varied. To study the prevalence of work-related stress and its anticipated solutions among the resident doctors registered for postgraduate studies in clinical subjects at a tertiary Municipal hospital. A stratified sampling cross-sectional survey was conducted at the Inpatient, Outpatient, and Intensive Care Units at a tertiary Municipal hospital in Mumbai, India. Data collection was done using a validated 20-point questionnaire to assess the factors causing stress and their anticipated solutions. Simple percentage analysis of stress questionnaire. 71 resident doctors completed the survey. The major stressors in this cohort were inadequate hostel/quarter facilities (92.1%), and the need to perform extra duties (80.0%). Also, non-conducive environment for clinical training and studies (81.7%), inadequate study (78.9%) and break (81.2%), threat from deadly infections (74.6%), and overburdening with work (69.0%) were the other major stress causing factors. The perceived stress busters were good music (40.8%) and family and friends (40.8%). Eighty-seven percent of the respondents perceived regular physical exercise to be an effective mode of stress management and 83.8% expressed their need to have a simple therapeutic gymnasium established within the campus with a qualified trainer. There is a high level of work related stress among the resident doctors registered for postgraduate clinical studies at a tertiary Municipal hospital in Mumbai. One of the perceived stress busters is regular physical exercise that is

  4. Empirical electron cross-field mobility in a Hall effect thruster

    Garrigues, L.; Perez-Luna, J.; Lo, J.; Hagelaar, G. J. M.; Boeuf, J. P.; Mazouffre, S.

    2009-01-01

    Electron transport across the magnetic field in Hall effect thrusters is still an open question. Models have so far assumed 1/B 2 or 1/B scaling laws for the 'anomalous' electron mobility, adjusted to reproduce the integrated performance parameters of the thruster. We show that models based on such mobility laws predict very different ion velocity distribution functions (IVDF) than measured by laser induced fluorescence (LIF). A fixed spatial mobility profile, obtained by analysis of improved LIF measurements, leads to much better model predictions of thruster performance and IVDF than 1/B 2 or 1/B mobility laws for discharge voltages in the 500-700 V range.

  5. Some analytical results for toroidal magnetic field coils with elongated minor cross-sections

    Raeder, J.

    1976-09-01

    The problem of determining the shape of a flexible current filament forming part of an ideal toroidal magnetic field coil is solved in a virtually analytical form. Analytical formulae for characteristic coil dimensions, stored magnetic energies, inductances and forces are derived for the so-called D-coils. The analytically calculated inductances of ideal D-coils are compared with numerically calculated ones for the case of finite numbers of D-shaped current filaments. Finally, the magnetic energies stored in ideal rectangular, elliptic and D-coils are compared. (orig.) [de

  6. Klystrons, traveling wave tubes, magnetrons, crossed-field amplifiers, and gyrotrons

    Gilmour, A S

    2011-01-01

    Microwave tubes are vacuum electron devices used for the generation and amplification of radio frequencies in the microwave range. An established technology area, the use of tubes remains essential in the field today for high-power applications. The culmination of the author's 50 years of industry experience, this authoritative resource offers you a thorough understanding of the operations and major classes of microwave tubes.Minimizing the use of advanced mathematics, the book places emphasis on clear qualitative explanations of phenomena. This practical reference serves as an excellent intro

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

    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

  8. Cross-cultural adaptation into Punjabi of the English version of the Hospital Anxiety and Depression Scale.

    Lane, Deirdre A; Jajoo, Jagdish; Taylor, Rod S; Lip, Gregory Yh; Jolly, Kate

    2007-01-26

    We wanted to use a Punjabi version of the Hospital Anxiety and Depression Scale (HADS) to enable non-English speaking patients to participate in a clinical trial. The aim of the study was to translate and validate the Hospital Anxiety and Depression Scale into Punjabi. The HADS was translated into Punjabi by a multidisciplinary team, verified against the original version, and administered to 73 bilingual patients attending an outpatient clinic. One sample t-tests and the Bland-Altman plots demonstrated acceptable linguistic agreement between the two versions of the HADS. Spearman's rank-order correlation coefficients (p Punjabi HADS adequately identified borderline cases of anxiety (80.8%), definite cases of anxiety (91.8%) and depression (91.8%), but was less reliable in identifying borderline cases of depression (65.8%). Cronbach alpha coefficients revealed high levels of internal consistency for both the Punjabi and English versions (0.81 and 0.86 for anxiety and 0.71 and 0.85 for depression, respectively). The Punjabi HADS is an acceptable, reliable and valid measure of anxiety and depression among physically ill Punjabi speaking people in the United Kingdom.

  9. Charging and the cross-field discharge during electron accelerator operation on a rocket

    Kellogg, P.J.; Monson, S.J.

    1988-01-01

    We present some limited results obtained from the flight of SCEX II, from Poker Flat, Alaska, on January 31, 1987. Some of the experiments were aimed at understanding neutralization processes around an electron beam emitting rocket. It was expected that electrons drifting in the strong electric fields around the charged rocket would acquire sufficient energy to ionize neutrals, and that the resulting ions would be hurled outward at energies up to the rocket potential. Three hemispherical retarding potential analyzers were ejected from the main payload to measure these ions. This experiment was successful, in spite of arcs which developed around the batteries for the electron guns, which degraded the emitted electron beam to unusable levels except for about 8 sec of the flight. Ions were observed at energies up to 175 eV, the limit of the analyzers. The main payload carried, in addition to the electron accelerator, two arms with conducting elements to act as Langmuir probes, and to measure floating potentials. These measurements show that fields sufficient to accelerate electrons to ionizing energies were present around the rocket. (author)

  10. Analytical solutions and particle simulations of cross-field plasma sheaths

    Gerver, M.J.; Parker, S.E.; Theilhaber, K.

    1989-01-01

    Particles simulations have been made of an infinite plasma slab, bounded by absorbing conducting walls, with a magnetic field parallel to the walls. The simulations have been either 1-D, or 2-D, with the magnetic field normal to the simulation plane. Initially, the plasma has a uniform density between the walls, and there is a uniform source of ions and electrons to replace particles lost to the walls. In the 1-D case, there is no diffusion of the particle guiding centers, and the plasma remains uniform in density and potential over most of the slab, with sheaths about a Debye length wide where the potential rises to the wall potential. In the 2-D case, the density profile becomes parabolic, going almost to zero at the walls, and there is a quasineutral presheath in the bulk of the plasma, in addition to sheaths near the walls. Analytic expressions are found for the density and potential profiles in both cases, including, in the 2-D case, the magnetic presheath due to finite ion Larmor radius, and the effects of the guiding center diffusion rate being either much less than or much grater than the energy diffusion rate. These analytic expressions are shown to agree with the simulations. A 1-D simulation with Monte Carlo guiding center diffusion included gives results that are good agreement with the much more expensive 2-D simulation. 17 refs., 10 figs

  11. Cross-field blob transport in tokamak scrape-off-layer plasmas

    D'Ippolito, D.A.; Myra, J.R.; Krasheninnikov, S.I.

    2002-01-01

    Recent measurements show that nondiffusive, intermittent transport of particles can play a major role in the scrape-off-layer (SOL) of fusion experiments. A possible mechanism for fast convective plasma transport is related to the plasma filaments or 'blobs' observed in the SOL with fast cameras and probes. In this paper, physical arguments suggesting the importance of blob transport [S. I. Krasheninnikov, Phys. Lett. A 283, 368 (2001)] have been extended by calculations using a three-field fluid model, treating the blobs as coherent propagating structures. The properties of density, temperature and vorticity blobs, and methods of averaging over ensembles of blobs to get the average SOL profiles, are illustrated. The role of ionization of background neutrals in sustaining the density blob transport is also discussed. Many qualitative features of the experiments, such as relatively flat density profiles and transport coefficients increasing toward the wall, are shown to emerge naturally from the blob transport paradigm

  12. Peculiarities of field penetration in the presence of cross-flux interaction

    Berseth, V.; Buzdin, A. I.; Indenbom, M. V.; Benoit, W.

    1996-02-01

    The attractive core interaction between two orthogonal vortex lattices in alayered superconductor is calculated. When one of these lattices is moving, this interaction gives rise to a drag force acting on the other one. Considering a moving in-plane flux lattice, the effect of the drag force on the perpendicular flux is modelled through a modification of the bulk critical current for this field component. The new critical current depends on the direction of motion of both parallel and perpendicular vortices. The results are derived within the critical-state model for the infinite slab and for the thin strip. For this latter geometry, computations are made with the help of a new numerical method simulating flux penetration in the critical state. The new predicted qualitative phenomena (like the formation of a vortex-free region between two zones of opposite flux in the flat geometry) can be directly verified by the magneto-optic technique.

  13. Selection of Amino Acid Chirality via Neutrino Interactions with 14N in Crossed Electric and Magnetic Fields

    Boyd, Richard N.; Kajino, Toshitaka; Onaka, Takashi

    2018-01-01

    Abstract Previous work has suggested that the chirality of the amino acids could be established in the magnetic field of a nascent neutron star from a core-collapse supernova or massive collapsar. The magnetic field would orient the 14N nuclei, and the alignment of its nuclear spin with respect to those of the electron antineutrinos emitted from the collapsing star would determine the probability of destruction of the 14N nuclei by interactions with the antineutrinos. Subsequent work estimated the bulk polarization of the 14N nuclei in large rotating meteoroids in such an environment. The present work adds a crucial piece of this model by describing the details by which the selective 14N nuclear destruction would produce molecular chiral selectivity. The effects of the neutrino-induced interactions on the 14N nuclei bound in amino acids polarized in strong magnetic fields are studied. It is shown that electric fields in the reference frame of the nuclei modify the magnetic field at the nucleus, creating nuclear magnetizations that are asymmetric in chirality. The antineutrino cross sections depend on this magnetization, creating a selective destructive effect. The environmental conditions and sites in which such a selection mechanism could occur are discussed. Selective destruction of D-enantiomers results in enantiomeric excesses which may be sufficient to drive subsequent autocatalysis necessary to produce the few-percent enantiomeric excesses found in meteorites and subsequent homochirality. Molecular quantum chemical calculations were performed for alanine, and the chirality-dependent effects studied were included. A preference for left-handed molecules was found, and enantiomeric excesses as high as 0.02% were estimated for molecules in the electromagnetic conditions expected from a core-collapse supernova. Key Words: Amino acids—Supernovae—Antineutrinos—Enantiomeric excess—Chirality. Astrobiology 18, 190–206. PMID:29160728

  14. Measurement of the temperature and flow fields of the magnetically stabilized cross-flow N2 arc

    Sebald, N.

    1980-01-01

    A straight, steady-state cross-flow arc is burning in an N 2 wind tunnel. The arc is held in position by the balance of the Lorentz forces produced by an external magnetic field perpendicular to the arc axis and by the viscous forces of the gas flow acting on the arc column. The temperature field in the discharge is determined spectroscopically using the radiation of N I lines. For known local temperature the mass flow field inside the arc may be evaluated from the convective term of the energy equation and the continuity equation. This is done by expanding the terms of these two equations around the point of the temperature maximum into Fourier-Taylor series and determining coefficients of the same order and power. The solution of the resulting set of algebraic equations yields the unknown coefficients of the mass flow. The flow field obtained by these calculations shows a relatively strong counter-flow through the arc core. In the region for which the series expansions holds a partial structure pertaining to a closed double vortex can be recognized. The terms of the momentum equation are calculated on the basis of these results. In order to obtain a better understanding of the importance attributed to the individual local forces acting on the plasma, a simple model was devised which separates the momentum equation into gradient and curl terms. It is shown that viscosity as a damping mechanism is necessary for the existence of stationary flow fields as investigated in this work. (orig./CDS) 891 CDS/orig.- 892 ARA

  15. Anaemia in pregnancy: a cross-sectional study of pregnant women in a Sahelian tertiary hospital in Northeastern Nigeria.

    Kagu, M B; Kawuwa, M B; Gadzama, G B

    2007-10-01

    This prospective study was carried out between June 2005 and June 2006, to determine the prevalence and determinants of anaemia among pregnant women attending a tertiary Sahelian Hospital in Northeastern Nigeria. A total of 1,040 pregnant women enrolled at their first antenatal visit were monitored through pregnancy for anaemia. The overall prevalence of anaemia, malaria parasitaemia and schistosomiasis was 72.0%, 22.1% and 3.8%, respectively. Mild, moderate and severe anaemia constituted 31.8%, 39.4% and 0.9%, respectively. Anaemia was most common among the multipara and women presenting in late stages of pregnancy. More multipara and primigravidae had malaria parasitaemia than grandmultipara. Schistosomiasis, malaria infestation and a short birth interval as well as illiteracy are additional risk factors for anaemia in pregnancy. This study confirms the high prevalence of anaemia in pregnancy in this area. Appropriate intervention strategies are necessary to reduce the prevalence of anaemia.

  16. A point prevalence cross-sectional study of healthcare-associated urinary tract infections in six Australian hospitals

    Gardner, Anne; Mitchell, Brett; Beckingham, Wendy; Fasugba, Oyebola

    2014-01-01

    Objectives Urinary tract infections (UTIs) account for over 30% of healthcare-associated infections. The aim of this study was to determine healthcare-associated UTI (HAUTI) and catheter-associated UTI (CAUTI) point prevalence in six Australian hospitals to inform a national point prevalence process and compare two internationally accepted HAUTI definitions. We also described the level and comprehensiveness of clinical record documentation, microbiology laboratory and coding data at identifying HAUTIs and CAUTIs. Setting Data were collected from three public and three private Australian hospitals over the first 6 months of 2013. Participants A total of 1109 patients were surveyed. Records of patients of all ages, hospitalised on the day of the point prevalence at the study sites, were eligible for inclusion. Outpatients, patients in adult mental health units, patients categorised as maintenance care type (ie, patients waiting to be transferred to a long-term care facility) and those in the emergency department during the duration of the survey were excluded. Outcome measures The primary outcome measures were the HAUTI and CAUTI point prevalence. Results Overall HAUTI and CAUTI prevalence was 1.4% (15/1109) and 0.9% (10/1109), respectively. Staphylococcus aureus and Candida species were the most common pathogens. One-quarter (26.3%) of patients had a urinary catheter and fewer than half had appropriate documentation. Eight of the 15 patients ascertained to have a HAUTI based on clinical records (6 being CAUTI) were coded by the medical records department with an International Classification of Diseases (ICD)-10 code for UTI diagnosis. The Health Protection Agency Surveillance definition had a positive predictive value of 91.67% (CI 64.61 to 98.51) compared against the Centers for Disease Control and Prevention definition. Conclusions These study results provide a foundation for a national Australian point prevalence study and inform the development and

  17. Investigation of high-current low pressure quasistationary volume discharge in cross-field ExH

    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

  18. Cross-comparison and evaluation of air pollution field estimation methods

    Yu, Haofei; Russell, Armistead; Mulholland, James; Odman, Talat; Hu, Yongtao; Chang, Howard H.; Kumar, Naresh

    2018-04-01

    Accurate estimates of human exposure is critical for air pollution health studies and a variety of methods are currently being used to assign pollutant concentrations to populations. Results from these methods may differ substantially, which can affect the outcomes of health impact assessments. Here, we applied 14 methods for developing spatiotemporal air pollutant concentration fields of eight pollutants to the Atlanta, Georgia region. These methods include eight methods relying mostly on air quality observations (CM: central monitor; SA: spatial average; IDW: inverse distance weighting; KRIG: kriging; TESS-D: discontinuous tessellation; TESS-NN: natural neighbor tessellation with interpolation; LUR: land use regression; AOD: downscaled satellite-derived aerosol optical depth), one using the RLINE dispersion model, and five methods using a chemical transport model (CMAQ), with and without using observational data to constrain results. The derived fields were evaluated and compared. Overall, all methods generally perform better at urban than rural area, and for secondary than primary pollutants. We found the CM and SA methods may be appropriate only for small domains, and for secondary pollutants, though the SA method lead to large negative spatial correlations when using data withholding for PM2.5 (spatial correlation coefficient R = -0.81). The TESS-D method was found to have major limitations. Results of the IDW, KRIG and TESS-NN methods are similar. They are found to be better suited for secondary pollutants because of their satisfactory temporal performance (e.g. average temporal R2 > 0.85 for PM2.5 but less than 0.35 for primary pollutant NO2). In addition, they are suitable for areas with relatively dense monitoring networks due to their inability to capture spatial concentration variabilities, as indicated by the negative spatial R (lower than -0.2 for PM2.5 when assessed using data withholding). The performance of LUR and AOD methods were similar to

  19. Information Risk Management: Qualitative or Quantitative? Cross industry lessons from medical and financial fields

    Upasna Saluja

    2012-06-01

    Full Text Available Enterprises across the world are taking a hard look at their risk management practices. A number of qualitative and quantitative models and approaches are employed by risk practitioners to keep risk under check. As a norm most organizations end up choosing the more flexible, easier to deploy and customize qualitative models of risk assessment. In practice one sees that such models often call upon the practitioners to make qualitative judgments on a relative rating scale which brings in considerable room for errors, biases and subjectivity. On the other hand under the quantitative risk analysis approach, estimation of risk is connected with application of numerical measures of some kind. Medical risk management models lend themselves as ideal candidates for deriving lessons for Information Security Risk Management. We can use this considerably developed understanding of risk management from the medical field especially Survival Analysis towards handling risks that information infrastructures face. Similarly, financial risk management discipline prides itself on perhaps the most quantifiable of models in risk management. Market Risk and Credit Risk Information Security Risk Management can make risk measurement more objective and quantitative by referring to the approach of Credit Risk. During the recent financial crisis many investors and financial institutions lost money or went bankrupt respectively, because they did not apply the basic principles of risk management. Learning from the financial crisis provides some valuable lessons for information risk management.

  20. Cross-field dynamics of the homogenization of the pellet deposited material in Tore Supra

    Sakamoto, R.; Pégourié, B.; Clairet, F.; Géraud, A.; Gil, C.; Hacquin, S.; Köchl, F.

    2013-01-01

    For investigating the damping effect of low-order rational surfaces on the drift of pellet deposited plasmoids, a safety factor (q) profile scan experiment was performed in Tore Supra, on a series of discharges with identical temperature and density profiles. Fast time-resolved density measurements show that the position of the deposition peak does not move smoothly during the ablation/homogenization phase but changes step by step, each step being located close to an integer or half-integer q value. This behaviour is well reproduced by time-dependent simulations with the pellet ablation/deposition code HPI2, which takes into account the braking of the plasmoid drift by external currents flowing along field lines in the background plasma. The key feature of this damping mechanism is a modulation as a function of the local safety factor, the braking being more effective in the vicinity of simple rational q values. The overall agreement between measurements and code predictions for a significant range of edge safety factors is fully consistent with the fact that the limitation of the plasmoid polarization by parallel currents is the dominant damping process of the ∇B-induced drift in tokamaks. (paper)

  1. Diabetic peripheral neuropathy in ambulatory patients with type 2 diabetes in a general hospital in a middle income country: a cross-sectional study.

    Lazo, María de Los Angeles; Bernabé-Ortiz, Antonio; Pinto, Miguel E; Ticse, Ray; Malaga, German; Sacksteder, Katherine; Miranda, J Jaime; Gilman, Robert H